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Health and nutrition education in primary schools of Crete: follow-up changes in body mass index and overweight status

Abstract

The current study examines the long-term effects of a school-based ‘Health and Nutrition Education programme’ on body mass index (BMI) changes and the prevalence of overweight. The intervention group consisted of all pupils registered in the first grade of two counties of the island of Crete in 1992, while all pupils registered in a third county formed the control group. For evaluation purposes, a representative sample was examined at baseline (1992) following the 6-y intervention (1998) and 4 y after the programme's cessation (2002). The data presented here are based on pupils with full anthropometrical data in all three examination periods (284 intervention group pupils and 257 control group pupils). Former intervention group pupils had lower average BMI (by 0.7 kg/m2, s.e. 0.28, P=0.019) at the 10-y follow-up compared to the control group subjects, while no differences were detected in the prevalence of obesity between the two groups. The findings of the current study indicate that the beneficial effects of the programme on pupils’ BMI continue, to an extent, 4 years after its cessation. However, the lack of significant differences in the prevalence of overweight between the two groups indicates that the effects of the intervention may not be equally distributed in the population, with greater effects in certain subgroups and less or none in others.

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References

  • Campbell K, Waters E, O’Meara S & Summerbell C (2001): Interventions for preventing obesity in childhood. A systematic review. Obes. Rev. 2, 149–157.

    Article  CAS  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM & Dietz WH (2000): Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240–1243.

    Article  CAS  Google Scholar 

  • Eriksson J, Forsen T, Osmond C & Barker D (2003): Obesity from cradle to grave. Int. J. Obes. Relat. Metab. Disord. 27, 722–727.

    Article  CAS  Google Scholar 

  • Lobstein T, Baur L & Uauy R (2004): Obesity in children and young people: a crisis in public health. Obes. Rev. 5, 4–104.

    Article  Google Scholar 

  • Lobstein T & Frelut ML (2003): Prevalence of overweight among children in Europe. Obes. Rev. 4, 195–200.

    Article  CAS  Google Scholar 

  • Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, Webber LS, Elder JP, Feldman HA & Johnson CC (1996): Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. JAMA 275, 768–776.

    Article  CAS  Google Scholar 

  • Lytle LA, Jacobs Jr DR, Perry CL & Klepp KI (2002): Achieving physiological change in school-based intervention trials: what makes a preventive intervention successful? Br. J. Nutr. 88, 219–221.

    Article  CAS  Google Scholar 

  • Manios Y, Kafatos A & Mamalakis G (1998): The effects of a health education intervention initiated at first grade over a 3-year period: physical activity and fitness indices. Health Educ. Res. 13, 593–606.

    Article  CAS  Google Scholar 

  • Manios Y, Moschandreas J, Hatzis C & Kafatos A (1999): Evaluation of a health and nutrition education program in primary school children of Crete over a three-year period. Prev. Med. 28, 149–159.

    Article  CAS  Google Scholar 

  • Manios Y, Moschandreas J, Hatzis C & Kafatos A (2002a): Health and nutrition education in primary schools of Crete: changes in chronic disease risk factors following a 6-year intervention programme. Br. J. Nutr. 88, 315–324.

    Article  CAS  Google Scholar 

  • Manios Y, Yannakouris N, Papoutsakis C, Magkos F, Christou D, Felliou G, Sialvera T, Skenderi K, Anastasiadou A & Zampelas A (2002b): Prevalence of overweight and obesity in a cohort of primary school children: the role of diet and physical activity. In nd Congress of the European Chapter of the American College of Nutrition. Athens.

  • McKenzie TL, Li D, Derby CA, Webber LS, Luepker RV & Cribb P (2003): Maintenance of effects of the CATCH physical education program: results from the CATCH-ON study. Health Educ. Behav. 30, 447–462.

    Article  Google Scholar 

  • Muller MJ, Asbeck I, Mast M, Langnase K & Grund A (2001): Prevention of obesity—more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int. J. Obes. Relat. Metab. Disord. 25, S66–S74.

    Article  Google Scholar 

  • Neumark-Sztainer D, Story M, Hannan PJ & Rex J (2003): New Moves: a school-based obesity prevention program for adolescent girls. Prev. Med. 37, 41–51.

    Article  Google Scholar 

  • Osganian SK, Hoelscher DM, Zive M, Mitchell PD, Snyder P & Webber LS (2003): Maintenance of effects of the EAT smart school food service program: results from the CATCH-ON study. Health Educ. Behav. 30, 418–433.

    Article  Google Scholar 

  • Puska P, Vartiainen E, Pallonen U, Salonen JT, Poyhia P, Koskela K & McAlister A (1982): 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. 11, 550–570.

    Article  CAS  Google Scholar 

  • Resnicow K, Cohn L, Reinhardt J, Cross D, Futterman R, Kirschner E, Wynder EL & Allegrante JP (1992): A three-year evaluation of the know your body program in inner-city schoolchildren. Health Educ. Q. 19, 463–480.

    Article  CAS  Google Scholar 

  • Story M (1999): School-based approaches for preventing and treating obesity. Int. J. Obes. Relat Metab. Disord. 23, S43–S51.

    Article  Google Scholar 

  • Tell GVO (1987): Noncommunical disease risk factor intervention in Norwegian adolescents: the Oslo youth study. In: Cardiovascular Risk Factors in Childhood: Epidemiology and Prevention, ed. BHAG Berenson, pp 203–217. Amsterdam: Elsevier.

    Google Scholar 

  • Walter HJ, Hofman A, Vaughan RD & Wynder EL (1988): Modification of risk factors for coronary heart disease. Five-year results of a school-based intervention trial. N. Engl. J. Med. 318, 1093–1100.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by a research Grant from Kellogg Europe, the Greek Ministry of Sports and the Greek Ministry of Education. We would also like to acknowledge the help of Irene Kafatos.

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Correspondence to A Kafatos.

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Guarantor: A Kafatos.

Contributors: AK and YM interpreted the data and wrote the manuscript. JM contributed to the statistical analysis and the writing of the manuscript.

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Kafatos, A., Manios, Y., Moschandreas, J. et al. Health and nutrition education in primary schools of Crete: follow-up changes in body mass index and overweight status. Eur J Clin Nutr 59, 1090–1092 (2005). https://doi.org/10.1038/sj.ejcn.1602216

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