The Combined Effect of Teaching a Healthy Diet and Physical Activity on the Management of Obesity and Overweight Students: A Clinical Trial

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Nutritional Sciences, School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 PhD in Nutritional Sciences, Professor, Department of Nutritional Sciences, School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Faculty Member of Research Institute of Exceptional Children-RIEC/Research Institute of Education-RIE (Organization for Educational Research and Planning-OERP), Tehran, Iran

4 Assistant Professor Eductional Psychology, Faculty Member of Research Institute of Education-RIE (Organization for Educational Research and Planning-OERP), Tehran, Iran

Abstract

Background: The prevalence of obesity and overweight in children and adolescents has increased greatly, and it is considered one of the most important health issues in society. This study was conducted to determine the effect of a combined intervention program with the approach of nutrition education and physical activities for the prevention and treatment of obesity and overweight in students of Kermanshah, Iran.
Methods: In this randomized clinical trial study, 1000 students from schools in Kermanshah city were randomly divided into two intervention and control groups. The intervention group received nutritional education based on consuming low-calorie foods and increasing physical activities in schools for one academic year. The control group received the standard recommendations to make lifestyle modifications. The data before and after the intervention in two groups were analyzed with paired t-tests and ANCOVA.
Findings: After the intervention, energy intake, carbohydrates, and fat significantly decreased in the intervention group. After the intervention, the weight and waist size of the students in the intervention group were significantly reduced compared to the control group. In the intervention group, physical activity, nutritional awareness, and nutritional attitude increased significantly after the intervention. In the control group, there was no significant change in weight, energy, physical activity, and nutritional awareness at the end of the study.
Conclusion: The combined intervention program with the approach of nutrition education and physical activity can be used as an effective approach in the prevention and treatment of obesity and overweight in students.

Highlights

Jalal Moludi: Google Scholar, PubMed

Mostafa Nachvak: Google Scholar, PubMed

Amir Saber: Google Scholar

Keywords

Main Subjects

References

  1. Moore VL. Effects of Obesity in Elementary School Children after No Child Left Behind (NCLB) [Thesis]. Seaside, CA: California State University, Monterey Bay; 2016.
  2. Lifshitz F. Obesity in children. J Clin Res Pediatr Endocrinol 2008; 1(2): 53-60.
  3. McCrindle BW. Cardiovascular consequences of childhood obesity. Can J Cardiol 2015; 31(2): 124-30.
  4. Brown T, Moore TH, Hooper L, Gao Y, Zayegh A, Sharea Ijaz S, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2019; 7(7): CD001871.
  5. Aceves-Martins, M., et al., Interventions to prevent obesity in Mexican children and adolescents: systematic review. Prev Sci 2022; 23(4): 563-86.
  6. Lee JAC, Cheah WL, Anchang GNJ, Noor Hafizah Y, Abim M, Ruzita AT, et al. Teachers’ and parents’ perspectives on the feasibility of a preschool-based behavioral intervention to prevent obesity: An embedded qualitative study within ToyBox study Malaysia. Early Child Educ J 2023; 51(1): 149-64.
  7. Liu Z, Gao P, Gao AY, Lin Y, Feng XX, Zhang F, et al. Effectiveness of a multifaceted intervention for prevention of obesity in primary school children in China: a cluster randomized clinical trial. JAMA Pediatr 2022; 176(1): e214375.
  8. Flynn AC, Suleiman F, Windsor-Aubrey H, Wolfe I, O'Keeffe M, Poston L, et al. Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting. Matern Child Nutr 2022; 18(3): e13354.
  9. Bonvicini L, Pingani I, Venturelli F, Patrignani N, Chiara Bassi M, Broccoli S, et al. Effectiveness of mobile health interventions targeting parents to prevent and treat childhood Obesity: Systematic review. Prev Med Rep 2022; 29: 101940.
  10. Niknam M, Omidvar N, Eini-Zinab H, Kalantari N, Olazadeh K, Amiri P. Improving community readiness among Iranian local communities to prevent childhood obesity. BMC Public Health 2023; 23(1): 1-12.
  11. Ahmadpour M, Omidvar N, Shakibazadeh E, Doustmohammadian A, Rahimiforoushani A. Development and evaluation of an intervention to improve food and nutrition literacy among Iranian Kurdish primary school children: An application of intervention mapping approach. Front Public Health 2023; 10: 1059677.
  12. Robertson W, Fleming J, Kamal A, Hamborg T, Khan KA, Griffiths F, et al. Randomised controlled trial and economic evaluation of the ‘Families for Health’programme to reduce obesity in children. Arch Dis Child 2017; 102(5): 416-426.
  13. Mirsolimany H, Mokhtari N, Mirhadiyan L, Kazemnejad Leili E. Survey predictors of overweight and obesity in children beginning [in Persian]. Journal of Holistic Nursing and Midwifery 2015; 25(3): 55-62.
  14. Choobineh MA, Hesari SN, Hossain D, Haghighizadeh MH. Study of nutritional knowledge of Ahwaz high school girls and the education effect [in Persian]. J Birjand Univ Med Sci 2009; 16(1): 23-30.
  15. Safavi SM, Omidvar N, Djazayery A, Minaie M, Hooshiarrad A, Sheikoleslam R. Development of food-based dietary guidelines for Iran: A preliminary report. Annals of Nutrition and Metabolism 2007; 51(Suppl 2): 32-5.
  16. Kirk S, Brehm B, Saelens BE, Woo JG, Kissel E, D'Alessio D , et al. Role of carbohydrate modification in weight management among obese children: a randomized clinical trial. J Pediatr 2012; 161(2):
    320-327. e1.
  17. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID‐19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity (Silver Spring) 2020; 28(8): 1382-5.
  18. Baranowski T, Cullen KW, Nicklas T, Thompson D,
    Baranowski J. Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res 2003; 11(S10): 23S-43S.
  19. Kuchenbecker J, Reinbott A, Mtimuni B, Krawinkel MB, Jordan I. Nutrition education improves dietary diversity of children 6-23 months at community-level: Results from a cluster randomized controlled trial in Malawi. PLoS One 2017; 12(4): e0175216.
  20. Verjans-Janssen SRB, van de Kolk I, van Kann DHH, Kremers SPJ, Gerards SMPL. Effectiveness of school-based physical activity and nutrition interventions with direct parental involvement on children’s BMI and energy balance-related behaviors–A systematic review. PLoS One 2018; 13(9): e0204560.
  21. Yuksel YHS, Neşe Şahin F, Maksimovic N, Drid P, Bianco A. School-based intervention programs for preventing obesity and promoting physical activity and fitness: A systematic review. Int J Environ Res Public Health 2020; 17(1): 347.
  22. Peña S, Carranza M, Cuadrado C, Parra DC, Dintrans PV, et al., Effectiveness of a gamification strategy to prevent childhood obesity in schools: a cluster controlled trial. Obesity (Silver Spring) 2021; 29(11): 1825-34.
  23. Timpel P, Yue Cesena FH, da Silva Costa C, Soldatelli MD, Gois Jr E, Castrillon E, et al. Efficacy of gamification-based smartphone application for weight loss in overweight and obese adolescents: study protocol for a phase II randomized controlled trial. Ther Adv Endocrinol Metab 2018; 9(6): 167-76.
  24. Fang Y, Ma Y, Mo D, Zhang S, Xiang M, Zhang Z. Methodology of an exercise intervention program using social incentives and gamification for obese children. BMC Public Health 2019; 19(1): 686.
  25. Pomerleau J, Lock K, Knai C, McKee M. Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. J Nutr 2005; 135(10): 2486-95.
Journal of Isfahan Medical School
Volume 41, Issue 735
3rd Week, November
November and December 2023
Pages 791-801

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History

  • Receive Date: 04 July 2023
  • Revise Date: 30 October 2023
  • Accept Date: 31 October 2023

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