A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children

• All health outcome measures improved after the school-initiated obesity program.
• Childhood obesity programs should target psychosocial correlates of physical activity.
• Healthy lifestyle interventions in obese children require a multidimensional approach.

ObjectivesIn the context of a 6-mo obesity program, incorporating school- and family-based components, nutritional education, fun-type skill-learning physical activities, and exercise training, this study examined relationships among changes in nutritional status, physical fitness, and some psychosocial and behavioral treatment-related outcomes, using a before and after comparison.MethodsEighteen obese and overweight children ages 10 to 12 y were assessed with respect to body weight, height, circumferences, skinfold thickness, and fat mass. Health-related fitness tests, and self-reported physical activity enjoyment and perceived physical ability also were administered. Health-related quality of life (HRQoL) was evaluated using the Pediatric Quality of Life Inventory; dietary habits were collected using a 7-d food diary. The WinFood software was used for the estimation of nutrient and caloric intake.ResultsAfter treatment, children showed decreases in body mass index z-score (P = 0.001), body fat percentage (P < 0.001), arm (P = 0.003) and waist circumferences (P = 0.004), and skinfold thickness (P < 0.008). Actual (P < 0.001) and perceived (P < 0.03) physical abilities, physical activity enjoyment (P = 0.03), and psychosocial HRQoL (P < 0.05) also improved from pre- to postintervention. Participants reported reductions in total and commercial food caloric intakes (P < 0.001), with higher protein and lower fat consumptions (P < 0.001) after the program.ConclusionsThe findings from the present study highlight the importance of combined dietary–behavioral–physical activity interventions in overweight children, and place emphasis on directing such interventions toward improving perceived physical competence that could lead to increased exercise adherence and promotion of the health benefits associated with it.