School-based child obesity prevention programs that combine nutrition and exercise over an extended period of time have the most success in changing students’ daily behaviors, according to a new study.
Since 1990, obesity rates among American children—particularly in rural and underserved areas—have skyrocketed due to a variety of factors, including more sedentary human behavior and an increase in communities with both limited access to fresh fruits and vegetables as well as excessive access to fast food.
For the study, published in the journal JBI Evidence Synthesis, researchers reviewed 72 obesity prevention programs that were implemented in rural elementary, middle, and high schools from 1990 to 2020 across the United States, England, and Australia to identify the strategies that worked best to help young people live healthier lifestyles.
The findings can help provide inspiration for rural school districts in underserved areas who are interested in implementing similar programs, as well as help identify the roles teachers, parents, and community members can play in combating the issue of childhood obesity.
“There seemed to be different variations in how the programs were implemented, as some programs focused solely on the nutrition aspect and others focused solely on the exercise aspect,” says lead authorn Crystal Lim, an associate professor in the University of Missouri School of Health Professions. “Some interventions were a one-time event while others lasted the entire school year.”
Lim also found that most of the successfully implemented programs included evidence-based strategies to create effective, long-lasting behavior changes, including goal setting, problem solving, and self-regulation techniques.
“My biggest recommendation going forward is we should make these interventions more fun and engaging for kids so that the healthy behaviors become activities they look forward to as opposed to dread,” Lim says.
“An example can be playing dodgeball or capture the flag during PE class rather than running miles or doing pushups. Goal setting can help lead to gradual and practical changes, such as drinking three glasses of water per day instead of two, and then tracking the results over time.”
While reviewing the past research literature, Lim found that teachers were most often the ones implementing the interventions, but a multi-pronged approach is more successful.
“Teachers can implement nutrition and exercise concepts into their classrooms. Rather than math problems about the speed of an airplane, for example, what about math problems regarding the speed of a marathon runner or the number of calories consumed in a day,” Lim says.
“Another strategy is taking short breaks to allow kids to stretch and be active, as it is not realistic for them to sit still for most of the school day.”
School districts and administrators can play an integral role as well in creating a healthy school environment.
“Whether it is reassessing what foods we offer in vending machines, in the school cafeteria or at school celebrations, we need to set up the school environment so that the healthy choice becomes the ‘easy’ choice and the ‘cool’ choice,” Lim says. “When kids see their peers and role models eating healthy, hydrating, and exercising, they are more likely to engage in those behaviors themselves.”
Finally, parents and community members can help students continue healthy behaviors outside the classroom.
“To make a simple activity like going for a walk more fun and engaging, consider listening to music, bringing a soccer ball, or turning it into a scavenger hunt,” Lim says. “Community organizations, such as churches and YMCAs can be leveraged as well to continue the conversation outside the classroom.”
The National Institutes of Health funded the work.
Source: University of Missouri
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