School and family-based lifestyle intervention in obese Chinese children: A follow-up control study

Background: The rising trends of childhood obesity and related risk of chronic diseases is a challenge in Shanghai (24.6% of school children are overweight/obese, 2011), China. It is important to address the lifestyle intervention among school students. Purpose: To evaluate the efficacy of a lifestyle intervention in obese children with or without chronic diseases. The primary end point of the present study was changes in body mass index (BMI). Secondary end points were changes in hypertension and fatty liver disease (defined by ultrasounds). Methodology: This study was performed in two elementary schools in Shanghai with a total of 590 obese students included during 2010-2011. Two schools were randomized to intervention (n=245) or control group (n=345) and followed for 9 months. A school- and family-based lifestyle intervention consisting of strengthening nutrition information and education to teachers, students and parents, a diet tailored to the students' suitable calorie needs and increased physical activity. Results: The rate that obesity decreased at 9 months was significantly different in the intervention and control groups (14.2% versus 3.8%, P<0.01). A significant decrease also occurred in BMI in the intervention group (-0.75 versus 0.05, P<0.01). The decrease in blood pressure and improvement in liver ultrasounds performance were observed in the intervention group as well. Conclusion: The school- and family-based lifestyle intervention implemented is effective in reducing obesity in children and therefore is associated with reduction in the risk of pediatric chronic diseases.