Many schools are on their half-term break this week and children will, no doubt, be enjoying their extra sleep and relaxation time. If the weather is good there will be ample opportunity for outdoor pursuits but I wonder how many children will be running around outside and how many will opt for the TV or video games? The childhood obesity problem in the UK is serious and ever increasing. Today I would like to share some recent evidence which shows that schools can play a major role in the prevention of overweight and obesity in children.
The first paper I would like to discuss comes from a group of researchers at Ulm University in Germany (1). They have put together a school-based programme for the prevention of cardiovascular (heart) risk factors and obesity in primary school children. The programme “Ulm Research on Metabolism, Exercise and Lifestyle in children (URMEL-ICE)” is a one-year course which fully involves the whole school including the teachers. The daily educational course aims to:
-Encourage a reduction of TV viewing time
-Encourage a reduction of energy rich, sugar-added, drinks
-Provide nutritional education
-Encourage physical activity during the school day
The programme has provided consistently beneficial results, with children showing an average reduction of fat mass of 260g after a year. The findings were presented at the ESC (European Society of Cardiology) Congress 2008 which took place in Munich.
The group responsible for developing the intervention programme wrote a press release (1) to accompany the presentation given at the congress. In it they detailed how overweight and obesity are increasingly prevalent among our children, representing a very serious public health concern. To date treatment programmes have not been very effective. The key lies in PREVENTION which really must take priority. Obesity is not just a matter of aesthetics, it represents serious risks for health complications such as diabetes, heart disease and cancers as well as psychological problems. One key to preventing obesity across all ages is physical activity. In children an increase in physical activity has been linked with improvements in bone health, reduced risk of heart disease, reduced fat mass, increased self esteem and mental health. However, around 30% of boys and 40% of girls in the UK do not meet the current physical activity guideline of 60minutes of moderate activity daily (2).
School based interventions could be really useful in helping to stop and hopefully reverse the trend in obesity and inactivity among children in the UK.
The German researchers (1) go on to say that school-based intervention programmes have been shown to provide the most success in large-scale reduction in the prevalence of childhood overweight and obesity, especially if they are performed with involvement of stakeholders and political support. The reasons that a school-based course seems to be particularly effective include the following:
-A large number of children can be monitored and hence influenced in a school based setting.
- Children are at school for a large proportion of the week and much of their eating and exercise therefore takes place in school time.
-Regular time spent on health education can influence children’s behaviour towards the desired aim of healthy living.
-Intervention in school a school setting means that children have their friends around them and this can be encouraging and supportive and may enhance motivation.
-Teachers can function as a role models and guide children’s behaviour.
-Children themselves may take their new healthy knowledge into the ‘outside world’ to motivate their family and friends in healthy lifestyle changes, further strengthening the support and motivation.
The teaching of healthy eating and nutritional principles and encouraging fun physical activity is so important in early life as it tends to set up life-long healthy patterns of behaviour. Slowly schools in the UK are introducing really great measures to promote healthy eating and healthy living and I hope this continues and develops over the coming years. Until now much of the work on primary school-based intervention studies has been conducted abroad in the USA and other parts of Europe, these studies are useful but cultural differences mean that they are not as applicable here in the UK. However, a UK study (3) published last month, in January 2009, has found that primary schools represent a suitable setting for the promotion of healthy lifestyles to children aged 7-11.
The UK study (3) was set up in order to evaluate the effect of a school-based healthy lifestyles intervention on physical activity, fruit and vegetable consumption, body composition, health knowledge, and psychological variables. The study lasted for 10 months and involved 8 primary schools including 589 7-11 year old children, 4 were given a programme to follow and 4 acted as a control (no lifestyle programme was conducted). The 4 schools following the programme were given CD-rom learning and teaching resource for teachers; an interactive website for pupils, teachers and parents; two highlight physical activity events (1 mile school runs/walks); a local media campaign; and a summer activity wall planner and record. Children in the schools following the intervention programme significantly increased their daily total time in moderate-to-vigorous physical activity compared to the children in the control schools. Older school children participating in the programmed showed a significant slowing in the rate of increase in estimated percent body fat, body mass index (BMI) and waist circumference. The authors conclude that the intervention produced positive changes in physical activity levels and body composition and that schools represent suitable settings for the promotion of healthy lifestyles. However the authors of the study also highlight the need for more work, particularly focussed on dietary change, in a variety of schools and social settings.
The study found that the so called ‘highlight events’ such as one mile walks or runs appeared to be crucial in the programme, they provided focus goals and motivation for the children. The intervention programme also seemed to be so useful because everyone in the school, from the pupils to the teachers and parents, became actively involved, children also received summer activity suggestions aimed at encouraging them to continue the physical and dietary recommendations when not in school. Parents felt that wearing pedometers helped their children to become more active and that their children were more aware of why they should be more active, how much activity they were undertaking and why they should consume more fruit and vegetables (3).
For information on school-based help in the UK I would suggest that you visit the Health Education Trust website. The Health Education Trust is a charity that promotes the development of health education for young people in the UK. They have many resources including information for schools, children, parents and teachers.
(1)The European Society of Cardiology Press Office: Press release, 1st September 2008
(2) Department of Health. At least five a week: Evidence of the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. London: HM Government Stationary Office; 2004.
(3)Gorley T et al. 2009. Effect of a school-based intervention to promote healthy lifestyles in 7-11 year old children. Int J Behav Nutr Phys Act. 6:5
Written by Ani Kowal
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