Nutrition Guidance for Healthy Children

PWM: School-based Programs and Interventions (2006-2011)

Child Nutrition and School-Based Programs

For additional information on the EAL^® about Pediatric Overweight, click here.

• Assessment
  In school-based programs, what is the effectiveness of nutrition education as a part of an intervention program to address childhood overweight?

  • Conclusion

    There is insufficient evidence to draw conclusions about the effectiveness of school-based nutrition education interventions alone to address adiposity in children.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: School-Based Nutrition Education Programs and Childhood Adiposity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: An update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev. 2009 Jan; 10(1): 110-141. Epub: 2008 Jul 30. Review.
      • Connelly JB, Duaso MJ, Butler G. A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: A realistic synthesis of the evidence. Public Health. 2007; 121: 510-517.
      • Kropski JA, Keckley PH, Jensen GL. School-based obesity prevention programs: An evidence-based review. Obesity 2008; 16: 1,009-1,018
  • Search Plan and Results: Update to School-Based Intervention Programs: Nutrition Education Interventions 2009
     
  In school-based programs, what is the effectiveness of combined nutrition education and physical activity interventions to address childhood overweight?

  • Conclusion

    School-based programs that combined both a physical activity and a nutrition education component were diverse, combining different types of interventions for different lengths of time.

    Multi-component school-based programs that include at least physical activity and nutrition education interventions may be effective in improving adiposity measures, though results appear to be heavily dependent on a wide range of program design factors, population and context.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: School-Based Programs Combining Physical Activity and Nutrition Education Components and Childhood Adiposity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: An update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev. 2009 Jan; 10(1): 110-141. Epub: 2008 Jul 30. Review.
      • Connelly JB, Duaso MJ, Butler G. A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: A realistic synthesis of the evidence. Public Health. 2007; 121: 510-517.
      • Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: A meta-analysis. CMAJ. 2009 Mar 31;180(7): 719-726. 
      • Kropski JA, Keckley PH, Jensen GL. School-based obesity prevention programs: An evidence-based review. Obesity 2008; 16: 1,009-1,018
  • Search Plan and Results: POW: Update to School-Based Intervention Programs: Combined Physical Activity and Nurition Education Interventions
     
• Intervention
  In school-based programs, what is the effectiveness of parental modeling as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Using parental modeling as part of a school-based intervention may be associated with changes in weight status/adiposity

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of parental modeling as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Angelico F, Del Ben M, Fabiani L, Lentini P, Pannozzo F, Urbinati GC, Ricci G. Management of childhood obesity through a school-based programme of general health and nutrition education. Public Health 1991; 105:393-8.
      • Arbeit ML, Johnson CC, Mott DS, Harsha DW, Nicklas TA, Webber LS, Berenson GS. The Heart Smart cardiovascular school health promotion: behavior correlates of risk factor change. Prev Med 1992;21:18-32.
      • Brownell KD, Kaye FS. A school-based behavior modification, nutrition education, and physical activity program for obese children. Am J Clin Nutr 1982; 35: 277-283.
      • Davis S, Gomez Y, Lambert L, Skipper B. Primary prevention of obesity in American Indian children. Ann NY Acad Sci. 1993; 699: 167-180.
      • Lansky D, Vance MA. School-based intervention for adolescent obesity: analysis of treatment, randomly selected control, and self-selected control subjects. J Consult Clin Psychol 1983;51: 147-8.
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Manios Y, Kafatos A, Mamalakis G. The effects of a health education intervention initiated at first grade over a 3 year period: physical activity and fitness indices. Health Education Research 1998; 13:593-606.
      • Manios Y, Moschandreas J, Hatzis C, Kafatos A. Evaluation of a health and nutrition education program in primary school children in Crete over a three-year period. Prev Med 1999; 28: 149-59.
      • Muller MJ, Asbeck I, Mast M, Langnase K, Grund A. Prevention of obesity – more than an intention. Concept and first results of the Kiel Obesity Prevention study (KOPS). Int J Obes 2001; 25: S66-S74.
      • Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV. Three-year maintenance of improved diet and physical activity. Arch Pediatr Adolesc Med 1999; 153: 695-704.
      • Puska P, Vartiainen E, Pallonen U, Salonen JT, Poyhia P, Koskela K, McAlister A. The North Karelia youth project: evaluation of two years of intervention on health behavior and CVD risk factors among 13- to 15-year old children. Prev Med 1982; 11: 550-570.
      • Robinson TN. Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA 1999; 282: 1561-7.
      • Simonetti D, Arca A, Tarsitani G, Cairella M, et al. Prevention of obesity in elementary and nursery school children. Public Health 1986;100:166-75.
      • Skybo TA, Ryan-Wenger N. A school-based intervention to teach third grade children about the prevention of heart disease. Pediatric Nursing 2002; 28: 223-231.
      • Teufel NI, Ritenbaugh CK. Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr 1998;37:131-42.
      • Trevino RP, Pugh JA, Hernandez AE, Menchaca VD, Ramirez RR, Mendoza M. Bienestar: a diabetes risk-factor prevention program.  J School Health 1998;68:62-8.
      • Walter HJ, Hofman A, Vaughan RD, Wynder EL. Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. New England Journal of Medicine, 1988; 318 (17): 1,093-1,100. 
      • Webber LS, Osganian SK, Feldman HA, Wu M, McKenzie TL, Nichaman M, Lytle LA, Edmundson E, Cutler J, Nader PR, Luepker RV. Cardiovascular risk factors among children after a 2 1/2 –year intervention – The CATCH study. Prev Med 1996; 25: 432-41.
      • Wong ML, Koh D, Lee MH, Fong YT. Two-year follow-up of a behavioural weight control programme for adolescents in Singapore: Predictors of long-term weight loss. Ann Acad Med Singapore. 1997; 26: 147-153.
  In school-based programs, what is the effectiveness of peer modeling as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Using peer modeling as part of a school-based intervention may be associated with changes in weight status/adiposity

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of peer modeling as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV. Three-year maintenance of improved diet and physical activity. Arch Pediatr Adolesc Med 1999; 153: 695-704.
      • Webber LS, Osganian SK, Feldman HA, Wu M, McKenzie TL, Nichaman M, Lytle LA, Edmundson E, Cutler J, Nader PR, Luepker RV. Cardiovascular risk factors among children after a 2 1/2 –year intervention – The CATCH study. Prev Med 1996; 25: 432-41.
  In school-based programs, what is the effectiveness of limiting media influences as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Limiting media influences as part of a school-based intervention may be associated with changes in weight status/adiposity

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of limiting media influences as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Simonetti D, Arca A, Tarsitani G, Cairella M, et al. Prevention of obesity in elementary and nursery school children. Public Health 1986;100:166-75.
  In school-based programs, what is the effectiveness of nutrition education as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Using nutrition education to change food eaten, food preferences, or eating patterns as part of a school-based intervention may be associated with changes in weight status/adiposity.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of nutrition education as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Alexandrov A, Isakova G, Maslennikova G, Shugaeva E, Prokhorov A, Olferiev A, Kulikov S. Prevention of atherosclerosis among 11-year-old schoolchildren in two Moscow administrative districts. Health Psychol 1988; 7(s):247-52.
      • Angelico F, Del Ben M, Fabiani L, Lentini P, Pannozzo F, Urbinati GC, Ricci G. Management of childhood obesity through a school-based programme of general health and nutrition education. Public Health 1991; 105:393-8.
      • Donnelly JE, Jacobsen DJ, Whatley JE, Hill JO, Swift LL, Cherrington A, Polk B, Tran ZV, Reed G. Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children. Obes Res 1996; 4: 229-243.
      • Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, Laird N. Reducing obesity via a school-based interdisciplinary intervention among youth. Arch Pediatr Adolesc Med 1999; 153: 409-418.
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Manios Y, Kafatos A, Mamalakis G. The effects of a health education intervention initiated at first grade over a 3 year period: physical activity and fitness indices. Health Education Research 1998; 13:593-606.
      • Manios Y, Moschandreas J, Hatzis C, Kafatos A. Evaluation of a health and nutrition education program in primary school children in Crete over a three-year period. Prev Med 1999; 28: 149-59.
      • Muller MJ, Asbeck I, Mast M, Langnase K, Grund A. Prevention of obesity – more than an intention. Concept and first results of the Kiel Obesity Prevention study (KOPS). Int J Obes 2001; 25: S66-S74.
      • Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV. Three-year maintenance of improved diet and physical activity. Arch Pediatr Adolesc Med 1999; 153: 695-704.
      • Resnicow K, Cohn L, Reinhardt J, Cross D, Futterman R, Kirschner E, Wynder EL, Allegrante JP. A three-year evaluation of the Know Your Body program in inner-city schoolchildren. Health Education Quarterly 1992; 19: 463-480.
      • Sahota P, Rudolf MCJ, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001; 323: 1-5.
      • Sallis JF, McKenzie TL, Conway TL, Elder JP, Prochaska JJ, Brown M, Zive MM, Marshall SJ, Alcaraz JE. Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools.  Am J Prev Med 2003;24:209-17.
      • Skybo TA, Ryan-Wenger N. A school-based intervention to teach third grade children about the prevention of heart disease. Pediatric Nursing 2002; 28: 223-231.
      • Vandongen R, Jenner DA, Thompson C, Taggart AC, Spickett EE, Burke V, Beilin LJ, Millgan RA, Dunbar DL. A controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children. Prevention Medicine 1995; 24: 9-22.
      • Walter HJ, Hofman A, Vaughan RD, Wynder EL. Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. New England Journal of Medicine, 1988; 318 (17): 1,093-1,100. 
      • Webber LS, Osganian SK, Feldman HA, Wu M, McKenzie TL, Nichaman M, Lytle LA, Edmundson E, Cutler J, Nader PR, Luepker RV. Cardiovascular risk factors among children after a 2 1/2 –year intervention – The CATCH study. Prev Med 1996; 25: 432-41.
    • Related Topics
  In school-based programs, what is the effectiveness of altering school meals and available school foods as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Altering school meals and available school foods as part of a school-based intervention may be associated with changes in weight status/adiposity

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of altering school meals and available school foods as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Arbeit ML, Johnson CC, Mott DS, Harsha DW, Nicklas TA, Webber LS, Berenson GS. The Heart Smart cardiovascular school health promotion: behavior correlates of risk factor change. Prev Med 1992;21:18-32.
      • Brownell KD, Kaye FS. A school-based behavior modification, nutrition education, and physical activity program for obese children. Am J Clin Nutr 1982; 35: 277-283.
      • Donnelly JE, Jacobsen DJ, Whatley JE, Hill JO, Swift LL, Cherrington A, Polk B, Tran ZV, Reed G. Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children. Obes Res 1996; 4: 229-243.
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV. Three-year maintenance of improved diet and physical activity. Arch Pediatr Adolesc Med 1999; 153: 695-704.
      • Puska P, Vartiainen E, Pallonen U, Salonen JT, Poyhia P, Koskela K, McAlister A. The North Karelia youth project: evaluation of two years of intervention on health behavior and CVD risk factors among 13- to 15-year old children. Prev Med 1982; 11: 550-570.
      • Resnicow K, Cohn L, Reinhardt J, Cross D, Futterman R, Kirschner E, Wynder EL, Allegrante JP. A three-year evaluation of the Know Your Body program in inner-city schoolchildren. Health Education Quarterly 1992; 19: 463-480.
      • Ritenbaugh C, Teufel-Shone NI, Aickin MG, Joe JR, Poirier S, Dillingham DC, Johnson D, Henning S, Cole SM, Cockerham D. A lifestyle intervention improves plasma insulin levels among Native American high school youth.  Prev Med 2003;36:309-19. 
      • Sahota P, Rudolf MCJ, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001; 323: 1-5.
      • Sallis JF, McKenzie TL, Conway TL, Elder JP, Prochaska JJ, Brown M, Zive MM, Marshall SJ, Alcaraz JE. Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools.  Am J Prev Med 2003;24:209-17.
      • Teufel NI, Ritenbaugh CK. Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr 1998;37:131-42.
      • Trevino RP, Pugh JA, Hernandez AE, Menchaca VD, Ramirez RR, Mendoza M. Bienestar: a diabetes risk-factor prevention program.  J School Health 1998;68:62-8.
      • Webber LS, Osganian SK, Feldman HA, Wu M, McKenzie TL, Nichaman M, Lytle LA, Edmundson E, Cutler J, Nader PR, Luepker RV. Cardiovascular risk factors among children after a 2 1/2 –year intervention – The CATCH study. Prev Med 1996; 25: 432-41.
    • Related Topics
  In school-based programs, what is the effectiveness of altering physical activity patterns as a part of an intervention program to treat childhood overweight?

  • Conclusion

    Altering physical activity patterns as part of a school-based intervention may be associated with changes in weight status/adiposity.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In school-based programs, what is the effectiveness of altering physical activity patterns as a part of an intervention program to treat childhood overweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Alexandrov A, Isakova G, Maslennikova G, Shugaeva E, Prokhorov A, Olferiev A, Kulikov S. Prevention of atherosclerosis among 11-year-old schoolchildren in two Moscow administrative districts. Health Psychol 1988; 7(s):247-52.
      • Angelico F, Del Ben M, Fabiani L, Lentini P, Pannozzo F, Urbinati GC, Ricci G. Management of childhood obesity through a school-based programme of general health and nutrition education. Public Health 1991; 105:393-8.
      • Arbeit ML, Johnson CC, Mott DS, Harsha DW, Nicklas TA, Webber LS, Berenson GS. The Heart Smart cardiovascular school health promotion: behavior correlates of risk factor change. Prev Med 1992;21:18-32.
      • Brownell KD, Kaye FS. A school-based behavior modification, nutrition education, and physical activity program for obese children. Am J Clin Nutr 1982; 35: 277-283.
      • Davis S, Gomez Y, Lambert L, Skipper B. Primary prevention of obesity in American Indian children. Ann NY Acad Sci. 1993; 699: 167-180.
      • Donnelly JE, Jacobsen DJ, Whatley JE, Hill JO, Swift LL, Cherrington A, Polk B, Tran ZV, Reed G. Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children. Obes Res 1996; 4: 229-243.
      • Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, Laird N. Reducing obesity via a school-based interdisciplinary intervention among youth. Arch Pediatr Adolesc Med 1999; 153: 409-418.
      • Hayashi T, Fujino M, Shindo M, Hiroki T, Arakawa K. Echocardiographic and electrocardiographic measures in obese children after an exercise program. International Journal of Obesity 1987; 11:465-72.
      • Ignico AA, Mahon AD. The effects of a physical fitness program on low fit children. Research Quarterly for Exercise and Sport 1995; 66: 85-90.
      • Killen JD, Robinson TN, Telch MJ, et al. The Stanford Adolescent Heart Health Program. Health Educ Q 1989; 16: 263-283.
      • Lansky D, Vance MA. School-based intervention for adolescent obesity: analysis of treatment, randomly selected control, and self-selected control subjects. J Consult Clin Psychol 1983;51: 147-8.
      • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Fledman HA, Johnson CC, Kelder SH, Wu M. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996; 75:768-77.
      • Manios Y, Kafatos A, Mamalakis G. The effects of a health education intervention initiated at first grade over a 3 year period: physical activity and fitness indices. Health Education Research 1998; 13:593-606.
      • Manios Y, Moschandreas J, Hatzis C, Kafatos A. Evaluation of a health and nutrition education program in primary school children in Crete over a three-year period. Prev Med 1999; 28: 149-59.
      • Muller MJ, Asbeck I, Mast M, Langnase K, Grund A. Prevention of obesity – more than an intention. Concept and first results of the Kiel Obesity Prevention study (KOPS). Int J Obes 2001; 25: S66-S74.
      • Nader PR, Stone EJ, Lytle LA, Perry CL, Osganian SK, Kelder S, Webber LS, Elder JP, Montgomery D, Feldman HA, Wu M, Johnson C, Parcel GS, Luepker RV. Three-year maintenance of improved diet and physical activity. Arch Pediatr Adolesc Med 1999; 153: 695-704.
      • Puska P, Vartiainen E, Pallonen U, Salonen JT, Poyhia P, Koskela K, McAlister A. The North Karelia youth project: evaluation of two years of intervention on health behavior and CVD risk factors among 13- to 15-year old children. Prev Med 1982; 11: 550-570.
      • Resnicow K, Cohn L, Reinhardt J, Cross D, Futterman R, Kirschner E, Wynder EL, Allegrante JP. A three-year evaluation of the Know Your Body program in inner-city schoolchildren. Health Education Quarterly 1992; 19: 463-480.
      • Ritenbaugh C, Teufel-Shone NI, Aickin MG, Joe JR, Poirier S, Dillingham DC, Johnson D, Henning S, Cole SM, Cockerham D. A lifestyle intervention improves plasma insulin levels among Native American high school youth.  Prev Med 2003;36:309-19. 
      • Sahota P, Rudolf MCJ, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001; 323: 1-5.
      • Sallis JF, McKenzie TL, Alcaraz JE, Kolody B, Hovell MF, Nader PR. Project SPARK. Effects of physical education on adiposity in children. Ann N Y Acad Sci 1993 Oct;699:127-36.
      • Sallis JF, McKenzie TL, Conway TL, Elder JP, Prochaska JJ, Brown M, Zive MM, Marshall SJ, Alcaraz JE. Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools.  Am J Prev Med 2003;24:209-17.
      • Sallis JF, McKenzie TL, Alcaraz JE, Kolody B, Faucette N, Hovell MF. The effects of a 2-year physical education program (SPARK) on physical activity and fitness in elementary school students.  Am J Public Health 1997;87:1328-34.
      • Sasaki J, Shindo M, Tanaka H, Ando M, Arakawa K. A long-term aerobic exercise program decreases the obesity index and increases the high density lipoprotein cholesterol concentration in obese children. Int J Obesity 1987;11(4):339-45.
      • Skybo TA, Ryan-Wenger N. A school-based intervention to teach third grade children about the prevention of heart disease. Pediatric Nursing 2002; 28: 223-231.
      • Tamir D, Feurstein A, Brunner S, Halfon ST, Reshef A, Palti H. Primary prevention of cardiovascular diseases in childhood: changes in serum total cholesterol, high density lipoprotein, and body mass index after 2 years of intervention in Jerusalem schoolchildren age 7-9 years.  Prev Med 1990;19:22-30.
      • Teufel NI, Ritenbaugh CK. Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr 1998;37:131-42.
      • Trevino RP, Pugh JA, Hernandez AE, Menchaca VD, Ramirez RR, Mendoza M. Bienestar: a diabetes risk-factor prevention program.  J School Health 1998;68:62-8.
      • Vandongen R, Jenner DA, Thompson C, Taggart AC, Spickett EE, Burke V, Beilin LJ, Millgan RA, Dunbar DL. A controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children. Prevention Medicine 1995; 24: 9-22.
      • Walter HJ, Hofman A, Vaughan RD, Wynder EL. Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. New England Journal of Medicine, 1988; 318 (17): 1,093-1,100. 
      • Webber LS, Osganian SK, Feldman HA, Wu M, McKenzie TL, Nichaman M, Lytle LA, Edmundson E, Cutler J, Nader PR, Luepker RV. Cardiovascular risk factors among children after a 2 1/2 –year intervention – The CATCH study. Prev Med 1996; 25: 432-41.
      • Wong ML, Koh D, Lee MH, Fong YT. Two-year follow-up of a behavioural weight control programme for adolescents in Singapore: Predictors of long-term weight loss. Ann Acad Med Singapore. 1997; 26: 147-153.
    • Related Topics