Systematic review and meta-analysis of school-based interventions to reduce body mass index

作者：Lavelle H V; Mackay D F; Pell J P^*

来源：JOURNAL OF PUBLIC HEALTH, 2012, 34(3): 360-369.

DOI：10.1093/pubmed/fdr116

• children
• health promotion
• obesity

Background Childhood obesity predisposes to adult obesity and increases the risk of many diseases. Schools provide a vehicle to deliver public health interventions to all children. %26lt;br%26gt;Methods Medline and Embase were used to undertake a systematic review of published studies of school-based interventions aimed at reducing the body mass index (BMI) of children %26lt;= 18 years. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed, and eligible studies subjected to a random effects meta-analysis. %26lt;br%26gt;Results Between 1991 and 2010, 43 published studies provided 60 measurements of effect. The pooled effect was a 0.17 (95% Cl: 0.08, 0.26, P %26lt; 0.001) reduction in BMI. Heterogeneity was high (I-2 = 93.4%) but there was no significant small study bias (Egger%26apos;s test, P = 0.422) nor significant variation by length of follow-up. The intervention comprised physical activity only in 11(26%) studies, education only in three (7%), and combinations of these and improved nutrition in the remaining 29 (67%). On stratified analysis, physical activity used in isolation (-0.13, 95% CI: -0.22, -0.04, P = 0.001) or combined with improved nutrition (-0.17, 95% Cl: -0.29, -0.06, P %26lt; 0.001) was associated with significant improvements in BMI. Interventions targeted at overweight/obese children reduced their BMI by 0.35 (95% Cl: 0.12, 0.58, P = 0.003). Those delivered to all children reduced it by 0.16(95% Cl: 0.06, 0.25, P = 0.002). %26lt;br%26gt;Conclusions There is growing evidence that school-based interventions that contain a physical activity component may be effective in helping, to reduce BMI in children.

• 出版日期2012-8