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School-based nutrition, exercise intervention program may not maintain BMI decreases through 10 months in overweight students, data indicate

Monday, October 13 2008 | Comments
Evidence Grade 7 What's This?
By Patrice LaVigne

A school-based intervention to promote healthy nutrition and physical activity may decrease body mass index (BMI) in overweight, inner-city students through 3 months of follow-up, but not through 10 months, researchers conclude.

Sr Melinda Lando, a nurse practitioner from the Bronx Lebanon Hospital Center in New York, conducted a pilot randomized controlled trial to assess the impact of an exercise program at Pura Belpre School, an urban-based public school for a low-income, widely ethnic population in the South Bronx. The study subjects included 28 second- and third-grade students who were overweight (BMI =>85th percentile). Most of the students were of Hispanic ethnicity. All of the students received nutrition education regarding subjects such as recognizing the different food groups and realizing the importance of drinking water. The intervention group (n=14) also received 40 minutes of physical activity conducted by Sister Melinda during school hours 3 times per week for 3 months from December 2006 through March 2007. Follow-up was conducted in October 2007.

At 3 months, the students' mean BMI (kg/m2) decreased from 20.9 to 20.3 in the intervention group, representing a mean decrease from baseline of 0.6. In contrast, the mean BMI increased from 20.5 to 22.2 in the control group, representing a mean increase of 1.7. This between-group difference was significant (P<.05).

However, the between-group difference was not significant by 10 months (P=.07). BMI averaged 22.7 for the intervention group and 22.4 for the control group.

Sister Melinda said the research team also tested the students' knowledge of nutrition and exercise and administered the Piers-Harris Children's Self-Concept scale at baseline and follow-up to both groups. The between-group difference in knowledge regarding regular healthy eating and exercise was not statistically significant at baseline or follow-up. The students did, however, exhibit a more positive self-image perception of physical appearance following the intervention program as compared with the control group (P=.02).

Because obesity prevention is a public health priority, Sister Melinda stressed that "increasing physical activity in the school setting seems ideal." She added that diet remains a challenge, but at least the school-based intervention programs are "instilling the seeds of activity and healthy eating" in children.

"A full-scale, longer-term study is recommended to replicate these early findings and to develop a strategy for achieving a safe reduction in BMI," she concluded. (Abstract 235.)

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