Municipality-Based Lifestyle Intervention of Childhood Overweight and Obesity: 4-Years Follow-Up on BMI Trajectories

Area of Science:

• Public Health
• Pediatrics
• Obesity Research

Background:

• Childhood overweight and obesity are significant public health concerns requiring effective interventions.
• Municipality-based early treatment interventions and school-based surveillance are common approaches to manage pediatric weight.
• Understanding the comparative long-term effectiveness of these strategies is crucial for public health policy.

Purpose of the Study:

• To evaluate 4-year changes in Body Mass Index z-score (BMIz) among children and adolescents with overweight or obesity.
• To compare the effectiveness of municipality-based interventions against school-based surveillance.
• To determine if intervention effects varied by age, sex, or baseline weight category.

Main Methods:

• A matched cohort study involving 1274 children and adolescents aged 5-15 years.
• Intervention group received municipality-based early treatment; control group received school-based surveillance with anthropometric assessments.
• BMIz trajectories analyzed using mixed-effects models with linear splines, adjusting for socioeconomic factors.

Main Results:

• No significant differences in BMIz trajectories were observed between intervention and control groups over 4 years.
• Both groups exhibited an initial short-term decrease in BMIz, followed by an increase and subsequent plateau.
• Baseline overweight prevalence was high (56.9%-58.0%) in both groups.

Conclusions:

• Municipality-based interventions did not demonstrate superior long-term BMIz reductions compared to matched school-based surveillance.
• Modest short-term improvements in both groups suggest potential benefits from both intervention types and surveillance.
• Findings indicate system-level equivalence within the Danish school health system, highlighting the need to understand mechanisms for sustained weight management.