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A 4-year, cluster-randomized, controlled childhood obesity prevention study: STOPP

International Journal of Obesity volume 33, pages 408–417 (2009)Cite this article

Abstract

Objective:

To assess the efficacy of a school-based intervention programme to reduce the prevalence of overweight in 6 to 10-year-old children.

Design:

Cluster-randomized, controlled study.

Subjects:

A total of 3135 boys and girls in grades 1–4 were included in the study.

Methods:

Ten schools were selected in Stockholm county area and randomized to intervention (n=5) and control (n=5) schools. Low-fat dairy products and whole-grain bread were promoted and all sweets and sweetened drinks were eliminated in intervention schools. Physical activity (PA) was aimed to increase by 30 min day−1 during school time and sedentary behaviour restricted during after school care time. PA was measured by accelerometry. Eating habits at home were assessed by parental report. Eating disorders were evaluated by self-report.

Results:

The prevalence of overweight and obesity decreased by 3.2% (from 20.3 to 17.1) in intervention schools compared with an increase of 2.8% (from 16.1 to 18.9) in control schools (P<0.05). The results showed no difference between intervention and controls, after cluster adjustment, in the longitudinal analysis of BMIsds changes. However, a larger proportion of the children who were initially overweight reached normal weight in the intervention group (14%) compared with the control group (7.5%), P=0.017. PA did not differ between intervention and control schools after cluster adjustment. Eating habits at home were found to be healthier among families with children in intervention schools at the end of the intervention. There was no difference between children in intervention and control schools in self-reported eating disorders.

Conclusions:

A school-based intervention can reduce the prevalence of overweight and obesity in 6 to 10-year-old children and may affect eating habits at home. The effect of the intervention was possibly due to its effect on healthy eating habits at school and at home rather than on increased levels of PA.

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Acknowledgements

We thank all participating schools for their efforts. The study was supported by grants from Stockholm County Council, Swedish Council for working life and social research, Swedish Research Council, Freemason's in Stockholm Foundation for Children's Welfare and Signhild Engkvist Foundation.

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Authors and Affiliations

  1. Division of Pediatrics, Department of Clinical Science, Karolinska Institutet, Intervention and Technology, National Childhood Obesity Centre, Stockholm, Sweden

    C Marcus, G Nyberg, A Nordenfelt, M Karpmyr & J Kowalski

  2. MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

    U Ekelund

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  1. C Marcus
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Correspondence to C Marcus.

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Marcus, C., Nyberg, G., Nordenfelt, A. et al. A 4-year, cluster-randomized, controlled childhood obesity prevention study: STOPP. Int J Obes 33, 408–417 (2009). https://doi.org/10.1038/ijo.2009.38

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