School-based programmes aimed at preventing obesity in children are unlikely to have much impact on the childhood obesity epidemic, suggest latest UK trial results.
While school is an important setting for supporting healthy lifestyles, researchers said wider influences like family, local community and the food industry may ultimately have a greater effect.
“Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support”
The study authors noted that, in the UK, around a quarter of children were overweight when they started school at age four or five. In addition, the proportion of very overweight children then doubled during the subsequent six years, from around 9% to 19%, they said in the British Medical Journal.
They noted that previous reviews had suggested school-based interventions may be effective in reducing the proportion of overweight children, but study weaknesses prevented firm recommendations.
As a result, the researchers, led by Professor Peymane Adab from Birmingham University, assessed the effectiveness of a lifestyle and healthy eating programme – the West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) – compared with usual practice.
WAVES is a 12-month school delivered intervention focusing on healthy eating and physical activity among primary school children.
The results were based on data from around 1,400 six- and seven-year-olds at 54 state run primary schools in the West Midlands, who were monitored over a period of two and a half years.
At the start of the trial, height and weight was recorded for each child, along with other measurements relating to body fat, diet and physical activity levels.
The programme included daily additional physical activity opportunities in schools, a physical activity and healthy eating programme in conjunction with local sporting heroes, regular information to parents about local activity opportunities, and workshops on healthy cooking for families at schools.
The researchers found no significant difference in weight status and no meaningful effect on body fat measurements, diet or physical activity levels at 15 and 30 months in children taking part in the programme, compared with those not taking part.
The researchers suggested that “nudge” interventions – for example using financial incentives to prompt healthier behaviour – were worth further investigation.
“It is time to step back, take stock and generate new, solution-focused approaches”
But they concluded that school based motivational, educational approaches were “unlikely to halt the childhood obesity epidemic”.
“Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments,” they added.
In a linked editorial in the same journal, Australian paediatrician Professor Melissa Wake said the findings “could perhaps help break the cycle of policymakers continuing with ineffective educational preventive approaches”.
She said that “effective, scalable, and affordable strategies are needed that reduce childhood obesity, can be implemented locally and do not widen health inequities”.
She added: “It is time to step back, take stock, carefully examine longitudinal data from contemporary children, and generate new, solution-focused approaches.”