1. Hangzhou Center for Disease Control and Prevention (Hangzhou Institute of Public Health Supervision), Hangzhou, Zhejiang 310021, China; 2. Linping District Center for Disease Control and Prevention (Linping District Institute of Public Health Supervision), Hangzhou, Zhejiang 311100, China; 3. Gongshu District Center for Disease Control and Prevention (Gongshu District Institute of Public Health Supervision), Hangzhou, Zhejiang 310022, China
Abstract:Objective To evaluate the effect of weight monitoring feedback intervention among primary school students, so as to provide the evidence for strengthening children's weight management. Methods In October 2023, students from grades four to six in a primary school in Hangzhou City were selected and randomly assigned to a control group and an intervention group on a class-by-class basis. The included primary school students had their height and weight measured at a fixed time each week, and the results were fed back to their parents in the form of cards. The cards for the control group contained knowledge about healthy lifestyles, while those for the intervention group additionally included information on body mass index (BMI), BMI grouping, and BMI ranking. Overweight and obesity were determined according to the age- and gender-specific criteria in the Screening for Overweight and Obesity among School-aged Children and Adolescents. After a 9-month intervention period, the prevalence rates of overweight and obesity and lifestyle behavior data between the two groups before and after the intervention were compared by a generalized linear mixed model, in order to assess the effectiveness of the weight monitoring information feedback intervention. Results The intervention group consisted of 368 students, including 208 boys (56.52%) and 160 girls (43.48%). The majority of students were 11 years, with 153 students accounting for 41.58%. The prevalence rate of overweight and obesity was 24.18%. The control group had 324 students, with 180 boys (55.56%) and 144 girls (44.44%). The predominant age was also 11 years, with 128 students accounting for 39.51%. The prevalence rate of overweight and obesity was 25.31%. Before the intervention, there were no statistically significant differences between the two groups in terms of gender, age, prevalence rate of overweight and obesity, eating habits, exercise situation, and sleep patterns (all P>0.05). After the intervention, there were significant interactions between group and time for the prevalence rate of overweight and obesity, the frequency of moderate-intensity exercise per week, and adequate sleep in the two groups (all P<0.05). The prevalence rate of overweight and obesity in the intervention group (OR=0.461, 95%CI: 0.252-0.845) was lower than that in the control group. The proportions of students in the intervention group who engaged in moderate-intensity exercise ≥4 times per week (OR=1.315, 95%CI: 1.033-1.675) and had adequate sleep (OR=1.402, 95%CI: 1.049-1.875) were higher than those in the control group. Conclusion Weight monitoring feedback can reduce the incidence of overweight and obesity among primary school students and has a certain improving effect on lifestyle behaviors such as exercise and sleep.
[1] World Health Organization.Obesity and overweight[EB/OL].[2025-05-13].https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [2] 董彦会,陈力,刘婕妤,等.1985—2019年中国7-18岁儿童青少年超重与肥胖的流行趋势及预测研究[J].中华预防医学杂志,2023,57(4):461-469. DONG Y H,CHEN L,LIU J Y,et al.Epidemiology and prediction of overweight and obesity among children and adolescents aged 7-18 years in China from 1985 to 2019[J].Chin J Prev Med,2023,57(4):461-469.(in Chinese) [3] 陈海苗,马岩,刘明奇,等.儿童期肥胖与2型糖尿病、冠心病的孟德尔随机化研究[J].预防医学,2025,37(3):307-311. CHEN H M,MA Y,LIU M Q,et al.Association among childhood obesity,type 2 diabetes mellitus and coronary artery heart disease:a Mendelian randomization study[J].China Prev Med J,2025,37(3):307-311.(in Chinese) [4] 刘琳,叶纪伟,金文波,等.儿童青少年代谢综合征心率减速力变化与糖脂代谢异常关系的研究[J].中国糖尿病杂志,2021,29(3):189-194. LIU L,YE J W,JIN W B,et al.Relationship between deceleration capacity of heart rate and glucose and lipid metabolism disorders in children and adolescents with metabolic syndrome[J].Chin J Diabetes,2021,29(3):189-194.(in Chinese) [5] KEPPER M M,WALSH-BAILEY C,BROWNSON R C,et al.Development of a health information technology tool for behavior change to address obesity and prevent chronic disease among adolescents:designing for dissemination and sustainment using the ORBIT model[J/OL].Front Digit Health,2021,3[2025-05-13].https://doi.org/10.3389/fdgth.2021.648777. [6] 江南,唐晓敏,孙文韬.膳食模式与中小学生超重肥胖的关联研究[J].预防医学,2025,37(3):228-232. JIANG N,TANG X M,SUN W T.Association between dietary patterns and overweight and obesity among primary and middle school students[J].China Prev Med J,2025,37(3):228-232.(in Chinese) [7] 国家卫生和计划生育委员会.学龄儿童青少年超重与肥胖筛查:WS/T 586—2018[S].北京:中国标准出版社,2018. National Health and Family Planning Commission of the People's Republic of China.Screening for overweight and obesity among school-age children and adolescents:WS/T 586—2018[S].Beijing:China Standards Press,2018.(in Chinese) [8] 张云婷,马生霞,陈畅,等.中国儿童青少年身体活动指南[J].中国循证儿科杂志,2017,12(6):401-409. ZHANG Y T,MA S X,CHEN C,et al.Guidelines for physical activity in children and adolescents in China[J].Chin J Evid Based Pediatr,2017,12(6):401-409.(in Chinese) [9] 中华人民共和国卫生部,中国国家标准化管理委员会.中小学生一日学习时间卫生要求:GB/T 17223—2012[S].2012. Ministry of Health of the People's Republic of China,National Standardization Administration.Health requirements of daily learning time for secondary and elementary school students:GB/T 17223—2012[S].2012.(in Chinese) [10] 梁茵茵,袁瑞,朱幸,等.湖州市中小学生超重肥胖状况调查[J].预防医学,2024,36(10):847-850. LIANG Y Y, YUAN R,ZHU X,et al.Overweight and obesity among primary and middle school students in Huzhou City[J].China Prev Med J,2024,36(10):847-850.(in Chinese) [11] 程巧云,郑文峰,吴宏,等.学校健康促进干预对中学生超重肥胖的影响[J].中国学校卫生,2021,42(3):381-384,388. CHENG Q Y,ZHENG W F,WU H,et al.Effect of school health promotion intervention on overweight and obesity of middle school students[J].Chin J Sch Health,2021,42(3):381-384,388.(in Chinese) [12] 邢淑芬,俞国良.社会比较:对比效应还是同化效应?[J].心理科学进展,2006,14(6):944-949. XING S F,YU G L.Social comparison:contrast effect or assimilation effect?[J].Adv Psychol Sci,2006,14(6):944-949.(in Chinese) [13] CHAUDHRY U A R,WAHLICH C,FORTESCUE R,et al.The effects of step-count monitoring interventions on physical activity:systematic review and meta-analysis of community-based randomised controlled trials in adults[J].Int J Behav Nutr Phys Act,2020,17(1):129-144. [14] WAHLICH C,CHAUDHRY U A R,FORTESCUE R,et al.Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up:a systematic review and meta-analysis[J/OL].BMJ Open,2020,10(5)[2025-05-13].https://doi.org/10.1136/bmjopen-2019-034541. [15] CHEN S A,ZHANG X Y,DU W,et al.Association of insufficient sleep and skipping breakfast with overweight/obesity in children and adolescents:findings from a cross-sectional provincial surveillance project in Jiangsu[J/OL].Pediatr Obes,2022,17(11)[2025-05-13].https://doi.org/10.1111/ijpo.12950. [16] YUAN R F,JIANG M Q,LI J,et al.Problem-solving model guided by stimulus-organism-response theory:state of mind and coping styles of depressed mothers after cesarean delivery[J].World J Psychiatry,2024,14(6):945-953. [17] 傅华. 健康教育学[M].北京:人民卫生出版社,2020. FU H.Health Education[M].Beijing:People's Medical Publishing House,2020.(in Chinese)