Childhood overweight and obesity are serious, large-scale, global, public health concerns and the number of children affected is still increasing every year. As the treatment of overweight and obesity is rarely effective, its prevention has priority today.
According to recent evidence school-based intervention programmes provide the best results for reducing prevalence of childhood overweight and obesity if they are performed with involvement of stakeholders and political support. In this context physical activity education in schools, reducing television viewing and nutritional education are examples of interventions that have been successful.
Reducing the consumption of sugar-added drinks has significant beneficial effects on weight development.
Introduction of school-based prevention programmes is justified for a number of reasons: First, a large number of children can be monitored because most children attend school and much of their eating and exercise takes place in school. Second, we are able to influence children’s behaviour towards the desired aim of healthy living. Third, with intervention in school the peer group itself can be supportive and enhance motivation. Moreover the teachers can function as a role model and guide children’s behaviour.
The child itself should become part of intervention and motivate family and friends to take part. According to present evidence, all school-based interventions show some effects on either reducing the BMI, the thickness of skin folds or in changing behaviour.
Ulm Research on Metabolism, Exercise and Lifestyle in children (URMEL-ICE) is a one-year school-based programme for the prevention of obesity and cardiovascular risk factors in primary schools. The programme has been established by an interdisciplinary working group at the Ulm University also involving school teachers. The programme focuses on a reduction of TV-time, intensive motivation of physical activity and reduction of energy rich drinks as an integral part of daily education over a period of one school year. The programme has been most effectively applied and shows beneficial effects on the reduction of body fat mass. Children in the intervention group showed a mean relative reduction of body fat mass by 260 g after the one year programme.
With a further improvement in content of school-based programmes via parallel interventions on various levels we hope to reduce the escalation of childhood obesity.
Assoc. Professor Wabitsch recently presented this material at the ESC Congress 2008 organized by the European Society of Cardiology.
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