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Prevention of overweight in preschool children: results of kindergarten-based interventions

International Journal of Obesity volume 33, pages 1075–1083 (2009)Cite this article

Abstract

Objective:

Given the increasing prevalence of pediatric obesity, we evaluated two kindergarten-based strategies for reducing overweight in preschool children in the Haute-Garonne Department in France.

Methods:

Kindergartens (n=79) were randomly assigned to one of the two strategies and followed for 2 years. In the first group (Epidémiologie et prévention de l’obésité infantile, EPIPOI-1), parents and teachers received basic information on overweight and health, and children underwent screening to identify those with overweight (body mass index (BMI) ⩾90th percentile) or at risk for overweight (BMI between 75 and 90th percentile), who were then followed up by their physicians. EPIPOI-2 children, in addition, received kindergarten-based education to promote healthy practices related to nutrition, physical activity and sedentary behaviors. Data on control children from non-intervention kindergartens (n=40) were retrieved from medical records at the Division of School Health.

Results:

At baseline, groups differed significantly on age and school area (underprivileged/ not). Owing to a significant interaction between school area and group, analyses were stratified by school area. At baseline, groups did not differ on overweight prevalence and BMI z-scores for any school area. After intervention, prevalence of overweight, BMI z-score and change in BMI z-score were significantly lower in intervention groups compared with controls in underprivileged areas. Using multilevel analysis adjusted for potential confounders, a significant effect on overweight prevalence at the end of the study was noted for EPIPOI-1 in underprivileged areas only (odds ratio and 95% confidence interval: 0.18 (0.07–0.51). In non-underprivileged areas, the gain in BMI z-score was lower in EPIPOI-2 group compared with control and EPIPOI-1.

Conclusion:

Our results suggest that simple measures involving increasing awareness on overweight and health, and periodic monitoring of weight and height with follow-up care when indicated, could be useful to reduce overweight in young children from underprivileged areas. A reinforced strategy with an education component, in addition, may be indicated in children in non-underprivileged areas.

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Acknowledgements

We are indebted to Pierre Machicot and Richard Cosaert, Caisse Primaire d’Assurance Maladie (social security) of Haute-Garonne region for their assistance with subject recruitment. We are thankful to Drs Francoise Collet, Danielle Augier, Danielle Leautier and Claudine Guitard, the Protection Maternelle et Infantile (Division of School Health), and Drs Marie-Françoise Delors, Fanny Delon et Dorothée Querleu (Ministry of Education), Haute-Garonne region, for their assistance in obtaining the information from children's medical records. We are grateful to Dr Nadia Lounis, Johanne Galino and Corinne Fleury for their assistance in data collection. We thank Professor Didier Concordet, Institut National de la Recherche Agronomique (National Institute for Research in Agronomy), for his guidance with multilevel regression analyses. The authors’ contributions were as follows—BJ: overseeing study and writing of the paper; NA: supervision of data analysis, and writing of the paper; MD: contributed to data analysis under the supervision of HG and NA and to the paper development; CC: contributed to data analysis under the supervision of HG and NA and to the paper development; LNP: study coordination and comments on the paper; HG: design of the study, supervision of data analysis and contributing to the paper development; MT: design of study, funding for the study, overseeing study and contributing to the paper development. This work is supported by grants from the French Social Security System.

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Authors and Affiliations

  1. Department of Pediatrics, Children's Hospital, CHU-Toulouse, Toulouse, France

    B Jouret, M Dupuy & M Tauber

  2. Department of Epidemiology and Public Health, INSERM U558, University Paul Sabatier, Toulouse, France

    B Jouret, N Ahluwalia, M Dupuy, C Cristini & H Grandjean

  3. LN Pharma, Toulouse, France

    L Nègre-Pages

  4. Department of Clinical Pharmacology, CHU-Toulouse, Toulouse, France

    L Nègre-Pages

Authors
  1. B Jouret
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  2. N Ahluwalia
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  3. M Dupuy
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  4. C Cristini
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  6. H Grandjean
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Correspondence to B Jouret.

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Jouret, B., Ahluwalia, N., Dupuy, M. et al. Prevention of overweight in preschool children: results of kindergarten-based interventions. Int J Obes 33, 1075–1083 (2009). https://doi.org/10.1038/ijo.2009.166

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