EFFECTIVENESS OF OBESITY INTERVENTION PROGRAMS BASED ON GUIDELINES FOR ADOLESCENT STUDENTS: SYSTEMATIC REVIEW

An introduction to MyBFF@school, a school-based childhood obesity intervention program: a cluster randomized controlled trial

Obesity trend among Malaysian children is on the rise. Noting that the tendency for them to grow into obese adults and the relationship of obesity to many non-communicable diseases, the My Body is Fit and Fabulous at School (MyBFF@school program) was designed to combat obesity among the schoolchildren. The program was piloted in 2014 in Putrajaya, Malaysia. There were several challenges during the pilot study which included strain in manpower, limited variation of physical activity, nutrition, and psychology modules, time-constraint after school hours, co-curriculum marks, contamination effect, and school selection. The main MyBFF@school in 2016 addressed the challenges and improvised the design which were elaborated in subsequent articles in this supplement. This cluster randomized controlled trial was conducted in three states; Federal Territory of Kuala Lumpur, Selangor and Negeri Sembilan in 23 primary and 15 secondary schools were selected through proportionate random sampling. The MyBFF@school intervention package consisted of physical activity, nutrition and psychology components were carried out for six months. Data were collected at baseline, mid (month-3) and end (month-6) of the study period. The effects of the program on body composition, clinical, physical fitness, nutrition, and psychology were assessed in primary schoolchildren aged 9 to 11 years old (children age group) and secondary schoolchildren (adolescent) aged 13 to 16 years old. The prevalence of overweight and obesity at screening (N=22,816) were 29.4% in primary and 26.8% in secondary schoolchildren. Outcomes of the trial is presented in this supplement. In summary, the MyBFF@school program is a school-based intervention for overweight and obese children and adolescent. It is a combination of physical activity, nutrition and psychology components. We present in this supplement, the rationale, methodology and the outcomes of this randomized control trial of the MyBFF@school program.

Prevention and Interventional Strategies of Adolescent Obesity / Overweight

Purpose: It’s a known factor that obesity and overweight among adolescentsare major emerging global health problems associated with morbidityand mortality throughout their life in developed and developing countries. There is evidence that reducing overweight and obesity by increasing awareness, self-efficacy, and contemplation to adopt a health-promoting lifestyle.The aim of this review how the theory and model used to reduce this burden through vicarious interventional activities among adolescence (10-19 years)in a school setting. Methods: A literature search was performed in four databases to identify published studies between January 2009 and December 2019. Randomized control trial exploring the multiple interventional effects on obesity and overweight by utilization of with or without theoretical constructs and outcome on body mass index. Results: Originally references searched were 2112 abstracts and full-text articles. The total population was 34,846 adolescents. Most of the multiple interventionshad little positive effect onphysical activity, dietary intake, and sedentary behavior changes directly on BMI. Only three studies show changes in behavior through theory. Minimal studies reported the involvement and motivation of parents, friends, and teachers for themselves and adolescents. Conclusion: The contemporary review to visualizemultiple interventions, and how models and theory focused on various pragmatic activities in the delivery and outcome in school settings among adolescents.

Effects of the application of a prolonged combined intervention on body composition in adolescents with obesity

BACKGROUND

The aim of this study is to describe the effects of a prolonged dietary-behavioral-physical activity intervention (24 months) on body composition in a group of adolescents with obesity.

METHODS

Longitudinal study in 196 individuals with obesity (86 boys and 110 girls) aged 10.1-14.9 years that completed a prolonged combined intervention (24 months). Values for weight, height, skinfold thickness, waist circumference, BMI, body fat, fat mass index (FMI) and fat-free mass index (FFMI) were registered or calculated. A good response to treatment was reported when a BMI z-score reduction of greater than or equal to 0.5 units of the initial value occurred after 24 month of follow up.

RESULTS

A good response after 24 months of follow-up reached 58.2% (n = 114). In boys with obesity and BMI status improvement, weight z-score, BMI z-score, body fat, and FMI significantly decreased (p < 0.05). In girls with obesity and BMI status improvement, weight z-score, BMI z-score, waist circumference, waist z-score, body fat and FMI significantly decreased (p < 0.05). In both sexes the height and FFMI increased significantly (p < 0.05). The multiple logistic regression analysis showed that girls and younger age were associated with BMI status improvement; concurrently, the place of residence (urban or rural) and degree of obesity were not associated with BMI status improvement.

CONCLUSION

The application of long-term combined strategies in the treatment of childhood obesity seems to be effective. As BMI decreases, a reduction in fat mass is also detected, with evident sexual dimorphism, in the absence of changes in fat-free mass and, consequently, in longitudinal growing.