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Obesity (Silver Spring). 2016 Mar;24(3):687-95. doi: 10.1002/oby.21365. Epub 2016 Feb 1.

Association between a school-based intervention and adiposity outcomes in adolescents: The Italian "EAT" project.

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Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
Operative Unit Service of Laboratory Medicine-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, University of Milan, Milan, Italy.



To evaluate whether a school-based multicomponent educational program could improve adiposity measures in middle-school adolescents.


A non-randomized controlled pilot study was conducted in six state middle schools (487 adolescents, 11-15 years) in townships in an urban area around Milan, three schools (n = 262 adolescents) being assigned to the intervention group and three schools (n = 225 adolescents) to the control group. The two-school-year intervention included changes in the school environment (alternative healthy vending machines, educational posters) and individual reinforcement tools (school lessons, textbook, text messages, pedometers, re-usable water bottles). The main outcome measure was change in BMI z-score. The secondary outcomes were changes in waist-to-height ratio (WHtR) and behavioral habits.


The intervention was associated with a significant difference in BMI z-score (-0.18 ± 0.03, P<0.01) and in WHtR (-0.04 ± 0.002, P < 0.001), after controlling for baseline covariates. Subgroup analysis showed the maximum association between the intervention and the difference in BMI z-score for girls with overweight/obesity. Physical activity increased and consumption of sugar-sweetened beverages and high-energy snacks decreased in adolescents after the intervention.


A school-based multicomponent intervention conducted at both environmental and individual levels may be effective for reducing adiposity measures mainly in adolescents with overweight/obesity.

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