Evidence-based development of school-based and family-involved prevention of overweight across Europe: The ENERGY-project's design and conceptual framework

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Abstract

Background

There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY)-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment.

Methods

Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1) systematic reviews of the literature, 2) secondary analyses of existing data, 3) focus group research, and 4) a cross European school-based survey.

Results and discussion

The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population.

Conclusions

The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children.

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Most cited references 10

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Worldwide trends in childhood overweight and obesity.

Youfa Wang, Tim Lobstein (2005)

Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.

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Obesity prevention: the case for action.

S. Kumanyika, R Jeffery, A. Morabia … (2002)

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Dietary risk factors for development of childhood obesity.

Rosa L Moreno, Gerardo Rodriguez-Araujo (2007)

Controversial information exists on the contribution of several dietary factors for overweight development in childhood, but there is no doubt that obesity prevalence is increasing. We review the most up-to-date information in order to clarify the evidence-based dietary aspects influencing obesity development in children and adolescents. Longitudinal studies are the preferred method for analysing the relationship between dietary factors and obesity development. With the exception of infants, there are no conclusive associations between energy intake or diet composition and later overweight development in children. Among formula or mixed-fed infants, the increase in energy intake has been associated with an increased risk of being overweight during childhood. Breastfeeding seems to be a protective factor for later obesity development. In terms of food intake, longitudinal studies have only found a clear and positive association between obesity development and sugar-sweetened beverage consumption; this is not the case with snacking, fast food or food portion sizes. Cross-sectional studies have found correlations between being overweight in childhood and buying lunch at school, eating supper while watching television or without family supervision, consuming less energy at breakfast or more at dinner, and missing breakfast. Results from longitudinal studies must be taken into account in order to design preventive strategies to counteract the increased prevalence of obesity and its consequences in children. Lack of breastfeeding, high early energy intake and high intake of sugar-sweetened beverages seem to be the main dietary factors contributing to obesity development.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2010

Publication date (Electronic): 25 May 2010

Volume: 10

Page: 276

Affiliations

[1 ]Department of Epidemiology & Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands

[2 ]Department of Public & Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands

[3 ]Faculty of Health and Sport, Agder University, Kristiansand, Norway

[4 ]Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium

[5 ]Obesity related behaviours research group, Durham University, Durham, UK

[6 ]Department of Public Health, Ghent University, Ghent, Belgium

[7 ]Institute of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark

[8 ]Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

[9 ]Department of Nutrition, University of Oslo, Oslo, Norway

[10 ]International Association for the Study of Obesity, London, UK

[11 ]Rescon, Amsterdam, the Netherlands

[12 ]Center for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia

Article

Publisher ID: 1471-2458-10-276

DOI: 10.1186/1471-2458-10-276

PMC ID: 2885336

PubMed ID: 20500859

SO-VID: 3f2e3da3-f3c5-4722-b7a5-b554e08ebb03

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Evidence-based development of school-based and family-involved prevention of overweight across Europe: The ENERGY-project's design and conceptual framework

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Abstract

Background

Methods

Results and discussion

Conclusions

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Chinese Journal of School Health

Most cited references 10

Worldwide trends in childhood overweight and obesity.

Obesity prevention: the case for action.

Dietary risk factors for development of childhood obesity.

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