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Implementing School-Based Policies to Prevent Obesity: Cluster Randomized Trial.

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  • 1Yale School of Public Health, New Haven, Connecticut; Yale-NUS College, Singapore.

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Implementing school nutrition policies effectively limited BMI increases in middle school students over three years. Physical activity policies did not show a significant impact on student BMI trajectories.

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Area of Science:

  • Public Health
  • Pediatric Health
  • Nutrition Science

Background:

  • School wellness policies are mandated for schools in federal child nutrition programs.
  • Meaningful enhancements in student health can result from healthier school environments.
  • Student Body Mass Index (BMI) trajectories are a key indicator of long-term health.

Purpose of the Study:

  • To assess the effectiveness of implementing school-based nutrition and physical activity policies on student BMI trajectories.
  • To evaluate the impact of supported policy implementation on student weight status.
  • To identify which types of school wellness policies are most effective in managing student BMI.

Main Methods:

  • A cluster randomized trial with a 2x2 factorial design was employed.
  • Twelve urban schools participated, following 595 students from fifth to eighth grade over three years.
  • Interventions involved providing support for nutrition and/or physical activity policy implementation.

Main Results:

  • Schools receiving support for nutrition policy implementation showed healthier BMI trajectories (p=0.02).
  • BMI percentile increases were significantly lower (<1%) in the nutrition intervention group compared to others (3-4%).
  • No significant differences in student BMI were observed between schools with or without physical activity policy implementation.

Conclusions:

  • Support for implementing school-based nutrition policies is effective in limiting BMI increases among middle school students.
  • Physical activity policies, as implemented in this study, did not demonstrate a significant effect on BMI trajectories.
  • Findings can inform future school-based interventions aimed at improving student weight management and health outcomes.