A systematised review of primary school whole class child obesity interventions: effectiveness, characteristics and strategies

Background. A systematised review was conducted to examine the effectiveness of school-based interventions that focus on changing dietary intake and physical activity levels to reduce childhood obesity. Methods. Multiple databases were searched for randomised and non-randomised interventions from 2007 – 2016 in full-time elementary schools, delivered to the whole class, included dietary and physical activity components, involved both sexes, written in English, and used body mass index (BMI) as an outcome. Results. The database search produced 8,866 titles from which 78 were deemed relevant and assessed for inclusion resulting in 15 studies meeting all inclusion criteria. From these 15 studies, 9 yielded a reduction or stabilisation in BMI or BMI z-score in the entire intervention group and/or sub-groups. Programmes lasting between 6-12 months that involve multiple environmental, educational, and physical strategies appear to be most likely to result in BMI or BMI z-score improvement. Moderators most likely influencing an improvement in BMI included increased physical activity, decreased sugar sweetened beverages intake, and increased fruit intake. Conclusions. School-based interventions may be an effective means for child obesity prevention. The identification of consistent elements used in school-based interventions that have demonstrated effectiveness may aid in preventing child obesity.