Systematic review and meta-analysis of school-based obesity interventions in mainland China.

BACKGROUND: Numerous school-based interventions for childhood obesity have been emerging in mainland China in recent decades, but little is known about the effectiveness of such interventions. This study aims to assess the effectiveness of school-based interventions for childhood obesity conducted in mainland China. METHODS: A systematic search was undertaken in eight databases to identify both randomized and non-randomized controlled trials from January 1990 to December 2015 examining the effectiveness of school-based obesity interventions. A random effects meta-analysis was conducted assessing the impact of included interventions on (body mass index) BMI. The quality of each included studies were assessed using Effective Public Health Practice Project Quality Assessment Tool. A P value <0.05 (two-sided) was considered statistically significant. RESULT: Of the seventy-six included studies, we found physical activity and health education were the two most common components of interventions. More treatment studies were effective compared with prevention studies (85.0% vs. 58.3%). Comprehensive interventions involving physical activity and health education appeared more effective than the physical activity only interventions in both obesity treatment and prevention studies. The meta-analyses showed comprehensive interventions involving physical activity and health education had larger effect on the change of BMI than physical activity only interventions (treatment studies: -1.80 kg/m2 (95% CI: -2.15,-1.44) vs. -0.91 kg/m2 (95% CI: -1.15,-0.67); prevention studies: -0.19 kg/m2 (95% CI: -0.27, -0.11) vs. +0.05 kg/m2 (95% CI: -0.04, +0.15)). CONCLUSIONS: Comprehensive school-based interventions may assist in tackling the rising prevalence of childhood obesity in mainland China.

Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial.

BACKGROUND: Childhood obesity has been a serious public health problem. An effective school-based physical activity (PA) intervention is still lacking in China. This study aimed to assess the effectiveness of a school-based physical activity intervention during 12 weeks on obesity and related health outcomes in school children. METHODS: It was a non-randomized controlled trial. Altogether 921 children aged 7 to 15 years were recruited at baseline survey. Children in the intervention group (n = 388) participated in a multi-component physical activity intervention during 12 weeks that included improvement of physical education, extracurricular physical activities for overweight/obese students, physical activities at home, and health education lectures for students and parents. Children (n = 533) in the control group participated in usual practice. RESULTS: Participants had mean age of 10.4 years, mean body mass index (BMI) of 19.59 kg/m2, and 36.8 % of them were overweight or obese at baseline survey. The change in BMI in intervention group (-0.02 ± 0.06 kg/m2) was significantly different from that in control group (0.41 ± 0.08 kg/m2). The adjusted mean difference was -0.43 kg/m2 (95% CI: -0.63 to -0.23 kg/m2, P < 0.001). The effects on triceps, subscapular, abdominal skinfold thickness and fasting glucose were also significant in intervention group compared with control group (all P < 0.05). The change in duration of moderate to vigorous physical activity (MVPA) in intervention group (8.9 ± 4.3 min/day) was significantly different from that in control group (-13.8 ± 3.3 min/day). The adjusted mean difference was 22.7 min/day (95% CI: 12.2 to 33.2 min/day, P < 0.001). CONCLUSIONS: The school-based, multi-component physical activity intervention was effective to decreasing levels of BMI, skinfold thickness, fasting glucose and increasing duration of MVPA. These findings provided evidence for the development of effective and feasible school-based obesity interventions. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT02074332 (2014-02-26).

A text messaging-assisted randomized lifestyle weight loss clinical trial among overweight adults in Beijing.

OBJECTIVE: The impact of a text messaging-assisted lifestyle weight loss intervention on weight change among overweight adults in Beijing was examined. METHODS: It was a 6-month randomized two arm clinical trial. The control group received a brief advice session after randomization. The intervention group received three group sessions, five coaching calls, and a daily text message prompting participants to follow predetermined lifestyle goals. RESULTS: A total of 123 participants were randomized. At 6 months, controls gained 0.24 ± 0.28 kg (0.21% ± 0.38%) (NS) while intervention participants lost 1.6 ± 0.28 kg (2.31% ± 0.38%) (p < 0.0001). Intervention participants decreased waist circumference (WC) (-2.69 ± 0.43 cm, p < 0.0001), percent body fat (%BF) (-0.66% ± 0.19%, p = 0.0007), and systolic/diastolic blood pressure (SBP/DBP) significantly (-1.71 ± 1.12/-3.24 ± 0.87 mmHg), while the controls had no change in WC and %BF and increased SBP/DBP by 2.43 ± 1.14/1.20 ± 0.88 mmHg (between groups: p = 0.01/p = 0.0004). CONCLUSIONS: This text message-assisted lifestyle intervention was effective in reducing weight, WC, %BF, and improving BP. Coupled with the scalable feature of the intervention, this finding is intriguing in light of the potential reach of the intervention for countries like China where mobile phone penetration is high and the obesity rate continues to rise.

[Physical activities and dietary intervention on metabolic syndrome in children].

OBJECTIVE: To study the effect of physical activities and dietary intervention on metabolic syndrome (MS) in primary school students. METHODS: Either one-year physical activities (PA) or dietary intervention was conducted in Grade 1-5 children from eight primary schools in Haidian district, Beijing. A 'happy 10 minutes' program was held in the PA group, while the dietary group receiving nutrition lectures. Baseline and post-intervention data on height, weight, waist circumference, serum lipids, glucose, and blood pressure were collected. RESULTS: The prevalence of MS at baseline was 9.0%. After intervention programs were carried out, improvements on triglyceride, high density lipoprotein, fasting blood glucose, diastolic blood pressure and waist circumference in the dietary group or PA group were seen, with the dietary group showed better effects than the PA group. The prevalence of MS decreased from 10.4% to 4.6% in the dietary group with statistically significant difference, while it increased in both the PA group and the control group. Girls showed better effects in the dietary group. Older students showed better effects than the younger students in the PA group. In non-overweight and overweight students of the dietary intervention group, the MS related components were significantly improved. CONCLUSION: The prevalence of metabolic syndrome was relatively high in the primary school students in Beijing. Education on nutrition could reduce the prevalence and improve the related components, which seemed to be more effective than in the PA intervention. Sex, age and nutritional status were the confounding factors for intervention programs.