Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 10
Obesity p revention in p rimary s chool s ettings:
e vidence from i ntervention s tudies
Juliana Kain, 1 Yang Gao, 2 Colleen Doak 3 and Simon Murphy 4
1 Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
2 School of Public Health, The Chinese University of Hong Kong, Hong Kong SAR, China
3 Department of Health Sciences, Faculty of Earth and Life Sciences, VU University,
Amsterdam, The Netherlands
4 Cardiff Institute of Society and Health, School of Social Sciences, Cardiff University,
Cardiff, UK
Summary and r ecommendations
for p ractice
• Interventions should be complex and ecological in
nature, addressing the multiple and interactive
influences on obesity, of which the primary school
is one part.
• Interventions within schools should be multi -
faceted covering curriculum, policy and social and
physical environments.
• School interventions should be developed and
implemented with community involvement.
• Interventions within schools should address
multiple rather than single risk behaviors.
• Interventions should be implemented within a rigorous
evaluation framework to develop an adequate
evidence base and to assess their impact on health
inequalities.
Method
References were searched and retrieved from international
databases, including MEDLINE, EMBASE,
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
PsycINFO, and Cochrane databases from 1991 to
February 2008. Effective interventions were recommended
mainly based on findings in systematic
reviews.
Rationale/ i mportance of
p rimary s etting
Childhood obesity has increased rapidly over the past
two decades, both in developing and industrialized
countries. 1 Interventions targeted at primary school -
aged children are considered critical to prevent and
control this disease since food and physical activity
related behaviors are established early in life and
persist into adulthood. 2 The life-course approach to
public health suggests that interventions in early life
may define lifelong behaviors and protect children
from developing unhealthy dietary habits. Children
aged 5 – 11 have been identified as the optimal group
to target for interventions on physical activity and
healthy food preferences. 3 School settings are the
prime focus for preventive actions since they cover
most children in a country. Most children attend
school approximately 180 days/year for six or more
hours per day. 4 Children can easily be reached
to assess their health needs, receive tailored interventions
such as health education and physical activity
promotion, be provided with healthy school
meals, and be affected by environmental factors that
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