Long-term Effect of an Excess-Weight-Reduction Intervention among Iranian School Children: A ۱۳-month Follow-up of a Cluster Randomized Controlled Trial

Background: Childhood obesity and overweight have become major public health problems worldwide. To combat this problem, effective, sustainable, and consistent strategies are needed. In this study, the long-term effect of a school-based intervention for weight reduction was evaluated in primary school students in Tehran, Iran. Methods: This was a cluster randomized controlled trial (RCT) conducted in ۱۲ primary schools in a low- to middle-class district in Tehran, Iran. The participants were ۳۳۴ overweight or obese primary school students (girls =۱۶۴) based on World Health Organization standards, equally distributed in the intervention (n=۱۶۷) and comparison (n=۱۶۷) groups. It was a multi-component intervention and included nutrition education and increased physical activity (PA), a lifestyle modification program for parents, and changing the food items sold in canteens of the schools. Body mass index Z-score [BMI-Z] was determined as the primary outcome and measured at baseline, three months after baseline, at post-test (after ۱۸ weeks), and follow-up (۱۳-month). In total, ۲۰۵ students (۵۹.۵%) completed the follow-up. Analyses were carried out based on the intention-to-treat principle using linear mixed models. Results: After ۱۳ months, the BMI Z-score decreased in both intervention and comparison groups. However, the change was more significantly observed in the intervention group (adjusted change: ۰.۰۹۸, ۹۵% CI: (۰.۰۳-۰.۱۶) compared with comparison group (P=۰.۰۰۳(. The intervention had a more significant effect on BMI Z-score among girls (adjusted change: ۰.۳۶, ۹۵% CI: (۰.۲۷-۰.۴۵) compared with the comparison group (P<۰.۰۰۱)( than among boys (adjusted change: -۰.۱۴, ۹۵% CI: (-۰.۲۳- -۰.۰۵) compared with the comparison group (P=۰.۰۰۲). Conclusion: The intervention was an effective way to reduce BMI in the girls and the effect lasted for a relatively long time.

کلیدواژه ها:

Schools ، Obesity ، Child ، Education ، Physical activity