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Successful overweight prevention in adolescents by increasing physical activity: a 4-year randomized controlled intervention

International Journal of Obesity volume 32, pages 1489–1498 (2008)Cite this article

A Corrigendum to this article was published on 13 October 2008

Abstract

Background:

Population-based studies directed at promoting physical activity in youth have shown limited success in obesity prevention.

Objective:

To assess whether an intervention integrating environmental changes to induce sustained changes in physical activity, prevents overweight in adolescents.

Design:

Four-year randomized trial started in 2002 in eight middle schools of Eastern France. The intervention, randomized at school level, was designed to promote physical activity by changing attitudes through debates and attractive activities, and by providing social support and environmental changes encouraging physical activity.

Subjects:

Nine hundred and fifty four 12-year-old six-graders.

Measurements:

Body mass index (BMI), body composition, physical activity by questionnaire, plasma lipids and glucose, insulin resistance.

Results:

Intervention students had a lower increase in BMI (P=0.01) and age- and gender-adjusted BMI (P<0.02) over time than controls. The differences across groups of the age- and gender-adjusted BMI changes (95% confidence interval (CI)) were −0.29 (−0.51; −0.07) kg/m2 at 3 years, −0.25 (−0.51; 0.01) kg/m2 at 4 years. An interaction with baseline weight status was noted. The intervention had a significant effect throughout the study in initially non-overweight adolescents (−0.36 (−0.60;−0.11) kg/m2 for adjusted BMI at 4 years), corresponding to a lower increase in fat mass index (P<0.001). In initially overweight adolescents, the differences observed across groups at 2 years (–0.40 (−0.94; 0.13) kg/m2 for adjusted BMI) did not persist over time. At 4 years, 4.2% of the initially non-overweight adolescents were overweight in the intervention schools, 9.8% in the controls (odds ratio=0.41 (0.22; 0.75); P<0.01). Independent of initial weight status, compared with controls, intervention adolescents had an increase in supervised physical activity (P<0.0001), a decrease of TV/video viewing (P<0.01) and an increase of high-density cholesterol concentrations (P<0.0001).

Conclusion:

Enhancing physical activity with a multilevel program prevents excessive weight gain in non-overweight adolescents. Our study provides evidence that prevention of obesity in youth is feasible.

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Acknowledgements

This study was supported by grants from The Regional Health Insurance of Alsace-Moselle; National Program of Research in Human Nutrition (INSERM and INRA); French Public Authorities within the National Nutritional Health Program and through the Youth and Sports Department; Conseil General du Bas-Rhin; Municipalities of Drusenheim, Illkirch-Graffenstaden, Obernai and Schiltigheim and The International Longevity Centre. We thank T Klumpp, MD, for biological analyses, the physical educators who were in charge of the ICAPS intervention program, the schools' administrative, educational and medical staffs, the parents' organizations and the sports clubs for their active participation, F Ghazlane for her technical assistance and members of the ICAPS Scientific Advisory Board for their advised suggestions. The funding sponsors had no role in the design and protocol development of the study, in data collection, analysis and interpretation or in manuscript preparation. C Simon initiated the ICAPS study, supervised its conduct and data analysis and had primary responsibility for writing this paper. C Simon and M Oujaa did statistical analyses. C Platat coordinated the study and, along with B Schweitzer, was responsible for the data acquisition. A Wagner and D Arveiler were involved in the design of the study. S Blanc assisted in interpretation and writing the manuscript. All authors commented on drafts and approved the manuscript.

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Authors and Affiliations

  1. Louis Pasteur University of Strasbourg, Strasbourg, France

    C Simon, M Oujaa, A Wagner, D Arveiler, N Copin & C Platat

  2. Department of Students' Health Promotion, School Academy of Bas-Rhin, Strasbourg, France

    B Schweitzer

  3. Department of Educational and Communication Sciences, Louis Pasteur University of Strasbourg, Strasbourg, France

    E Triby

  4. Département d' Ecologie Physiologie et Ethologie, CNRS UMR 7178, Louis Pasteur University of Strasbourg, Institut Pluridisciplinaire Hubert Curien, Strasbourg, France

    S Blanc

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Correspondence to C Simon.

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Simon, C., Schweitzer, B., Oujaa, M. et al. Successful overweight prevention in adolescents by increasing physical activity: a 4-year randomized controlled intervention. Int J Obes 32, 1489–1498 (2008). https://doi.org/10.1038/ijo.2008.99

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