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Updated: Jan 22, 2026

Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Intervention effects of a kindergarten-based health promotion programme on obesity related behavioural outcomes and
Susanne Kobel1, Olivia Wartha1, Christine Lämmle1
1Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, D-89075 Ulm, Germany.
Insights
Childhood overweight is a growing concern. A kindergarten program improved children's BMI percentile, increased physical activity (PA), and boosted endurance, demonstrating effective early health promotion.
Area of Science:
- Public Health
- Pediatrics
- Sports Science
Background:
- Childhood overweight is a global public health issue.
- Insufficient physical activity (PA) in children is linked to motor skill deficits.
- Early health promotion in kindergartens is crucial for addressing these concerns.
Purpose of the Study:
- To evaluate the effectiveness of the
- Join the Healthy Boat
- kindergarten-based health promotion programme.
- To assess the programme's impact on children's BMI percentile (BMIPCT), PA levels, and endurance capacity.
Main Methods:
- A randomized controlled trial was conducted with 973 kindergarten children.
- Intervention and control groups were assessed at baseline and follow-up (558 children).
- Data collected included anthropometrics, 3-minute-run endurance, parental-reported PA, and socio-economic variables. Linear regression models were used for analysis.
Main Results:
- The intervention group showed a significant positive effect on children's BMIPCT (p ≤ 0.04).
- Children in the intervention group engaged in significantly more days of sufficient PA (3.1 vs. 2.5 days; p ≤ 0.005).
- The intervention group demonstrated significantly better performance in the 3-minute endurance run (305.8m vs. 286.9m; p ≤ 0.001).
Conclusions:
- The teacher-centered, low-dose, bottom-up health promotion program achieved significant positive outcomes.
- The program effectively reduced BMIPCT and increased endurance capacity and daily PA in young children.
- This intervention is well-suited for intensive integration into children's daily lives to promote health.
Abstract:
In recent decades, prevalence of childhood overweight has increased worldwide and became a public health concern. One reason is children's insufficient engagement in physical activity (PA) which may lead to deficient motor skills, which are interdependent. Therefore, early health promotion such as the kindergarten-based health promotion programme "Join the Healthy Boat" is necessary. In order to evaluate the programme's effectiveness on children's BMI percentiles (BMIPCT), PA and endurance capacity, a randomised controlled trial including intervention (IG) and control group (CG) was conducted. 973 kindergarten children (3.6 ± 0.6 years; 47.1% male) in 57 kindergartens were assessed at baseline and 558 of them at follow-up. Anthropometrics and endurance capability (3-minute-run) were assessed on site. PA behaviour and socio-economic data were assessed using parental report. Linear regression models were used to determine intervention effects for all health outcomes, adjusting for baseline values, age, gender, BMIPCT and socio-economic variables. After one year, a significant positive intervention effect on children's BMIPCT was found (p ≤ 0.04). Children in the IG spent significantly more days in sufficient PA than children in the CG (3.1 ± 2.1 days vs. 2.5 ± 1.9 days; p ≤ 0.005). Children in the IG performed significantly better in the three minute endurance run than their counterparts in the CG (305.8 ± 46.2 m vs. 286.9 ± 43.2 m; p ≤ 0.001). This teacher-centred health promotion using a low-dose bottom-up approach with action alternatives achieved significant positive effects in the reduction of BMIPCT and significant increases in endurance capacity and daily PA. The programme is therefore ideal for integrating health promotion more intensively into the everyday life of children.
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