P François1, A Guyomard2, D Baudet3, D Dubois-Fabing3, S Boussuges4, F Perrin5, A Seigneurin6. 1. Unité d'évaluation médicale, pôle santé publique, pavillon Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble, France; Laboratoire TIMC-IMAG CNRS, université Grenoble 1, pavillon Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble, France. Electronic address: pfrancois@chu-grenoble.fr. 2. Unité d'évaluation médicale, pôle santé publique, pavillon Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble, France. 3. Association de gestion des centres de santé AGECSA, 162, Galerie-de-l'Arlequin, 38100 Grenoble, France. 4. Service municipal de santé scolaire, 33, rue Joseph-Chanrion, 38000, Grenoble, France. 5. Direction santé publique environnementale de la ville de Grenoble, 33, rue Joseph-Chanrion, 38000 Grenoble, France. 6. Unité d'évaluation médicale, pôle santé publique, pavillon Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble, France; Laboratoire TIMC-IMAG CNRS, université Grenoble 1, pavillon Taillefer, CHU de Grenoble, BP 217, 38043 Grenoble, France.
Abstract
OBJECTIVE: Increasing prevalence of obesity particularly affects underprivileged families and children. This study aimed to estimate the efficiency of an obesity prevention program for school-aged children in deprived urban areas. METHODS: This was an intervention trial with a before-and-after comparison of a cohort of school-aged children in preschool and primary school in three deprived urban areas in Grenoble, France. All school-aged children in the first and third year of preschool and the third year of primary school during the 2008-2009 and 2009-2010 school years, whose parents agreed to participate in the study, were included. Children were seen again 2 years later. The staff of the school health service measured and weighed the children during a medical check-up, thus determining their body mass index (BMI) and Z score. A school doctor suggested specific care to the parents of overweight children. A lifestyle questionnaire was completed. The primary outcome was changes in BMI and the Z score over 2 years. The secondary outcome was changes in lifestyle and eating habits. RESULTS: A total of 2434 children were included in the screening campaign. Of the 2434 children included in screening, 1824 children were reviewed and evaluated at 2 years. At inclusion, overweight prevalence increased with age, from 6.4% in the first year of preschool to 21.9% in the third year of primary school. More than 60% of overweight children had a high social vulnerability score. Prevalence of overweight increased from 13.8% to 21.5% in 2 years in the entire cohort (P<0.001). In the 252 overweight children, the mean BMI increased from 20 kg/m(2) to 21.8 kg/m(2) (P<0.001), as did the mean Z score, which increased from 2.72 to 2.9 (P<0.001). There was no significant interaction depending on whether the family physician was in private practice or employed by a health center. According to their eating habits, fewer of the overweight children had a snack in the morning and more had a school lunch. More than half of the children thought they had improved their eating habits. They played more sports (30% versus 49.5%). CONCLUSION: This study failed to demonstrate that incentive for medical management of excess weight had an effect on the short-term (2 years) evolution of the children's corpulence.
OBJECTIVE: Increasing prevalence of obesity particularly affects underprivileged families and children. This study aimed to estimate the efficiency of an obesity prevention program for school-aged children in deprived urban areas. METHODS: This was an intervention trial with a before-and-after comparison of a cohort of school-aged children in preschool and primary school in three deprived urban areas in Grenoble, France. All school-aged children in the first and third year of preschool and the third year of primary school during the 2008-2009 and 2009-2010 school years, whose parents agreed to participate in the study, were included. Children were seen again 2 years later. The staff of the school health service measured and weighed the children during a medical check-up, thus determining their body mass index (BMI) and Z score. A school doctor suggested specific care to the parents of overweight children. A lifestyle questionnaire was completed. The primary outcome was changes in BMI and the Z score over 2 years. The secondary outcome was changes in lifestyle and eating habits. RESULTS: A total of 2434 children were included in the screening campaign. Of the 2434 children included in screening, 1824 children were reviewed and evaluated at 2 years. At inclusion, overweight prevalence increased with age, from 6.4% in the first year of preschool to 21.9% in the third year of primary school. More than 60% of overweight children had a high social vulnerability score. Prevalence of overweight increased from 13.8% to 21.5% in 2 years in the entire cohort (P<0.001). In the 252 overweight children, the mean BMI increased from 20 kg/m(2) to 21.8 kg/m(2) (P<0.001), as did the mean Z score, which increased from 2.72 to 2.9 (P<0.001). There was no significant interaction depending on whether the family physician was in private practice or employed by a health center. According to their eating habits, fewer of the overweight children had a snack in the morning and more had a school lunch. More than half of the children thought they had improved their eating habits. They played more sports (30% versus 49.5%). CONCLUSION: This study failed to demonstrate that incentive for medical management of excess weight had an effect on the short-term (2 years) evolution of the children's corpulence.