Atencion primaria · 2026
[Effectiveness of interventions in schools for the prevention and reduction of childhood obesity and overweight: A systematic review and meta-analysis].
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Méndez-López Fátima, Aguilar-Latorre Alejandra, Vicente-García Carmen, Gastón-Faci Ana, Magallón-Botaya Rosa
Аннотация
OBJECTIVE: To synthesize evidence on the effectiveness of school-based program strategies aimed at reducing the prevalence of childhood obesity and overweight.
DESIGN: Systematic review and meta-analysis following the PRISMA guidelines.
DATA SOURCES: PubMed, SciELO, Embase, Cuiden, ScienceDirect, Dialnet, IBECS and Web of Science STUDY SELECTION: Empirical studies published between January 1, 2010, and June 1, 2025, conducted in school-aged children in Spain, were included if they evaluated interventions implemented in the school setting and provided complete data on obesity and/or overweight before and after the intervention. Studies conducted outside Spain, non-school-based interventions, and documents without sufficient data for analysis were excluded.
DATA EXTRACTION: Screening was performed in two phases: title/abstract and full text. Data were extracted on study characteristics, sample size, participants' age, type of intervention, assessment instruments, prevalence of obesity and/or overweight before and after the intervention, intervention duration, and follow-up. Methodological quality was assessed using CASPe and CONSORT criteria.
RESULTS: Seven studies were included in the meta-analysis, with a total sample of 6,716 schoolchildren. The interventions mainly combined nutrition education, promotion of physical activity, practical activities, and, in some cases, family involvement. The estimated prevalence of childhood obesity was 10.3%. After the school-based interventions, a mean reduction in obesity prevalence of 4.00 percentage points was observed (95% CI: -6.44 to -1.55). Heterogeneity among studies was relevant. Exploratory meta-regression analyses suggested an association with participants' age and intervention follow-up.
CONCLUSIONS: School-based interventions focused on health education, physical activity promotion, and healthy eating habits may contribute to reducing the prevalence of childhood obesity. However, the magnitude of the effect should be interpreted with caution due to the small number of included studies, the heterogeneity observed, and methodological differences between interventions. Further studies with higher methodological quality, longer follow-up, and more homogeneous designs are needed to identify which components of these interventions are most effective.
DESIGN: Systematic review and meta-analysis following the PRISMA guidelines.
DATA SOURCES: PubMed, SciELO, Embase, Cuiden, ScienceDirect, Dialnet, IBECS and Web of Science STUDY SELECTION: Empirical studies published between January 1, 2010, and June 1, 2025, conducted in school-aged children in Spain, were included if they evaluated interventions implemented in the school setting and provided complete data on obesity and/or overweight before and after the intervention. Studies conducted outside Spain, non-school-based interventions, and documents without sufficient data for analysis were excluded.
DATA EXTRACTION: Screening was performed in two phases: title/abstract and full text. Data were extracted on study characteristics, sample size, participants' age, type of intervention, assessment instruments, prevalence of obesity and/or overweight before and after the intervention, intervention duration, and follow-up. Methodological quality was assessed using CASPe and CONSORT criteria.
RESULTS: Seven studies were included in the meta-analysis, with a total sample of 6,716 schoolchildren. The interventions mainly combined nutrition education, promotion of physical activity, practical activities, and, in some cases, family involvement. The estimated prevalence of childhood obesity was 10.3%. After the school-based interventions, a mean reduction in obesity prevalence of 4.00 percentage points was observed (95% CI: -6.44 to -1.55). Heterogeneity among studies was relevant. Exploratory meta-regression analyses suggested an association with participants' age and intervention follow-up.
CONCLUSIONS: School-based interventions focused on health education, physical activity promotion, and healthy eating habits may contribute to reducing the prevalence of childhood obesity. However, the magnitude of the effect should be interpreted with caution due to the small number of included studies, the heterogeneity observed, and methodological differences between interventions. Further studies with higher methodological quality, longer follow-up, and more homogeneous designs are needed to identify which components of these interventions are most effective.