Effectiveness of a kindergarten-based intervention for preventing childhood obesity

Background and Objectives: Interventions to prevent childhood obesity targeting school age children have mostly reported limited effectiveness, suggesting such prevention programs may need to start at an earlier age, but evidence has been scarce. We reported a pilot study aiming to demonstrate the feasibility of a multifaceted intervention for preschool children and to provide a preliminary assessment of the effectiveness.Methods: This non-randomized controlled trial recruited children aged 3-6 years from six kindergartens in Guangzhou, China. Based on the preference of the School and Parents Committees, four kindergartens (648 children) received a three-component intervention (training of kindergarten staff, instigating a curriculum promoting healthy diet and lifestyle, and close collaboration between families and kindergartens) over 12 months, while the other two kindergartens (336 children), serving as controls, received routine health care provision.Outcome measures were the changes in body mass index (BMI) z-score between baseline and the end of 12 months, and the prevalence of post-intervention overweight/obese children.Results: By 12 months, children within the intervention group had a smaller BMI z-score increase (0.24) compared to the control (0.41), with a difference of -0.31 (95% CI -0.47 to -0.15) (p<0.0001). The prevalence of overweight/obesity was also lower among the intervention group at the end of the study (OR: 0.43, 95% CI 0.19 to 0.96), adjusted for baseline overweight/obesity status.Conclusions: Our results indicated a multi-component health behavior intervention might be effective in reducing the prevalence of obesity, but the longer term effects will need confirmation from randomized controlled trials.