Hostname: page-component-5d59c44645-k78ct Total loading time: 0 Render date: 2024-02-22T16:56:25.079Z Has data issue: false hasContentIssue false

School- and family-based interventions to prevent overweight in children

Published online by Cambridge University Press:  07 March 2007

Manfred J. Müller*
Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düstern-brooker Weg 17, D-24105, Kiel, Germany
Sandra Danielzik
Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düstern-brooker Weg 17, D-24105, Kiel, Germany
Svenja Pust
Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düstern-brooker Weg 17, D-24105, Kiel, Germany
*Corresponding author: Professor Dr Manfred James Müller, fax +49 431 8805679, email
Rights & Permissions [Opens in a new window]


Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

There have been only a few controlled studies on the prevention of overweight and obesity in children and adolescents. These studies differ in relation to strategy, setting, duration, focus, variables of outcome and statistical power, and therefore do not allow general conclusions to be made about the value of preventive measures. All school-based interventions aimed at the prevention of overweight and obesity show some improvement of health knowledge and health-related behaviours. Short-term effects on nutritional state seem to be more pronounced in girls than in boys. School-based interventions can reduce the incidence of overweight. There is evidence that families of intermediate and high socio-economic status as well as intact families benefit more from treatment than families sharing other characteristics. Selected prevention in obese children is most successful when children are treated together with their parents. However, there are social barriers limiting the success of family-based interventions. Although some positive effects have been reported, simple interventions in a single area (e.g. a school health education programme) are unlikely to work on their own. The development of effective preventive interventions probably requires strategies that affect multiple settings simultaneously. At present there is no concerted action, rather many strategies in health promotion that are followed in isolation. Faced with the epidemic of overweight there is a need for national campaigns and action plans on childhood overweight and obesity. It is tempting to speculate that this strategy will also increase the value of isolated approaches (e.g. in schools and families).

Symposium on ‘Prevention of obesity’
Copyright © The Nutrition Society 2005


Barker, DJP, Blundell, JE, Dietz, WH, Epstein, LH, Jeffry, RW, Remschmidt, H, Rolls, BJ, Rössner, S & Saris, WHM (1996) Group report: What are the bio-behavioral determinants of body weight regulation? In Regulation of Body Weight 159 – 177. Dahlem Workshop Reports, Life Sciences Research Report no.57, pp. 159177 [Bouchasel, C and Bray, GA editors]. Chichester, West Sussex: Wiley Johnsons.Google Scholar
Birch, LL & Krahnstoever-Davison, K (2001) Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatrics Clinics of North America 48, 893907.Google Scholar
Campbell, K, Waters, E, O'Meara, S, Kelly, S & Summerbell, C (2002) Interventions for preventing obesity in children. Cochrane Database Systems Review 2:CD001871, Oxford: Update Software; available at Scholar
Danielzik, S, Czwerwinski-Mast, M, Langnäse, K, Dilba, B & Müller, MJ (2004) Parental overweight, socioeconomic status and high birth weight are major determinants of overweight and obesity in 5–7 year old children. Baseline data of the Kiel Obesity Prevention Study (KOPS). International Journal of Obesity 28, 14941502.Google Scholar
Danielzik, S, Langnäse, K, Mast, M, Spethmann, C & Müller, MJ (2002) Impact of parental BMI manifestation of overweight in 5–7 year old children. European Journal of Nutrition 41, 132138.Google Scholar
Davison, KK & Birch, LL (2001) Childhood overweight: a contextual model and recommendations for future research. Obesity Reviews 2, 159171.Google Scholar
Dietz, WH (1998) Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 101, 518525.Google Scholar
Dietz, WH & Gortmaker, SL (2001) Preventing obesity in children and adolescents. Annual Review of Public Health 22, 337353.Google Scholar
Ebbeling, CB, Pawlak, DB & Ludwig, DS (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360, 473482.Google Scholar
Egger, G & Swinburn, B (1997) An ‘ecological’ approach to the obesity pandemic. British Medical Journal 315, 477480.Google Scholar
Egger, G, Swinburn, B & Rossner, S (2003) Dusting off the epidemiological triad: could it work with obesity? Obesity Reviews 4, 115119.Google Scholar
Epstein, L, Valoski, A, Wing, RR & McCurley, J (1990) Ten-year follow-up of behavioral family-based treatment of obese children. Journal of the American Medical Association 264, 25192523.Google Scholar
Epstein, LH, Valoski, A, Wing, RR & McCurley, I (1994) Ten year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology 13, 373383.Google Scholar
Flodmark, CE, Ohlsson, T, Ryden, O & Sveger, T (1993) Prevention of progression to severe obesity in a group of obese schoolchildren treated with family therapy. Pediatrics 91, 880884.Google Scholar
Gortmaker, SL, Peterson, K, Wiecha, J, Sobol, AM, Dixit, S, Fox, MK & Laird, N (1999) Reducing obesity via school-based interdisciplinary intervention among youth. Planet Health. Archives of Pediatrics and Adolescent Medicine 153, 409418.Google Scholar
Hill, IO & Peters, IC (1998) Environmental contribution to the obesity epidemic. Science 280, 13711374.Google Scholar
International Association for the Study of Obesity (2004) Obesity in children and young people. A crisis in public health. Obesity Reviews 5, Suppl. 1, 1104.Google Scholar
James, WPT & Gill, TP (2004) Prevention of obesity. In Handbook of Obesity. Clinical Applications, 7596 [Bray, GA, Bouchard, C, editors]. New York: Marcel Decker.Google Scholar
Kumanyika, S, Jeffery, RW, Morabia, A, Ritenbaugh, C & Antipatis, VJ (2002) Obesity prevention: the case for action. International Journal of Obesity 26, 425436.Google Scholar
Langnäse, K, Asbeck, I, Mast, M & Müller, MJ (2004) Influence of socioeconomic status on long-term effect of family-based obesity treatment intervention in prepubertal overweight children. Health Education 104, 336343.Google Scholar
Langnäse, K, Mast, M, Danielzik, S, Spethmann, C & Müller, MJ (2003) Socioeconomic gradient in body weight of German children reverse direction between ages 2 and 6 years. Journal of Nutrition 133, 789796.Google Scholar
Langnäse, K, Mast, M & Müller, MJ (2002) Social class differences in overweight of prepubertal children in northwest Germany. International Journal of Obesity 26, 566572.Google Scholar
Müller, MJ, Asbeck, I, Mast, M, Langnäse, K & Grund, A (2001) Prevention of obesity-more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). International Journal of Obesity 25 Suppl. 1, S66S74.Google Scholar
Müller, MJ, Danielzik, S & Spethmann, C (2004) Prevention of overweight and obesity. In Obesity in Childhood and Adolescence, pp. 243263 [Kiess, W, Marcus, C and Wabitsch, M, editors]. Basel, Switzerland: Karger.Google Scholar
Müller, MJ, Langnäse, K, Danielzik, S, Spethmann, C & Mast, M (2002) Childhood obesity: the genetic-environmental interface. In Study on Obesity and Functional Foods in Europe, 193204 [Palou, A, Bonet, ML, editors]. Serra F Brussels: European Commission.Google Scholar
Must, A, Dallal, GE & Dietz, WH (1991) Reference data for obesity. 85th and 95th percentile of body mass index (wt/ht 2 ) and triceps skinfold thickness. American Journal of Clinical Nutrition 53, 839846.Google Scholar
Reinken, L, Stolley, H, Droese, W & van Ost, G (1980) Longitudinale Körperentwicklung gesunder Kinder. II. Grösse, Gewicht, Hautfalten von Kindern im Alter von 1.5–16. Jahren (Longitudinal data of physical growth of healthy children. II. Height, weight, skinfold thickness of children aged 1.5–16 years). Klinische Pädiatrie 192, 2533.Google Scholar
Sherry, B & Dietz, WH (2004) Pediatric overweight: an overview. In Handbook of Obesity Clinical Applications, 117133 [Bray, GA, Bouchard, C, editors]. New York: Clinical Applications Marcel Decker.Google Scholar
Summerbell, C, Ashton, V, Campbell, K, Edmunds, L, Kelly, S & Waters, E (2003) Interventions for treating obesity in children. Cochrane Database System Review. 3: CD001872. Oxford: Update Software; available at Scholar
Vogler, GP, Sörensen, TIA, Stunkard, AJ, Srinivasan, MR & Rao, DC (1995) Influences of genes and shared family environment on adult body mass index assessed in an adoption study by a comprehensive path model. International Journal of Obesity 19, 4045.Google Scholar
Wang, LV, Yang, Q, Lowry, R & Wechsler, H (2003) Economic analysis of a school-based obesity prevention program. Obesity Research 11, 13131324.Google Scholar
Whitaker, RC, Wright, JA, Pepe, MS, Seidel, KD & Dietz, WH (1997) Predicting obesity in young adulthood from childhood and parenteral obesity. New England Journal of Medicine 337, 869873.Google Scholar
Willett, WC (2002) Balancing life-style and genomics research for disease prevention. Science 296, 695698.Google Scholar
World Health OrganizationWorld Health Organization (2000) Obesity: Preventing and Managing a Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series no.Geneva:WHO.Google Scholar