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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Study protocol

The nutrition-based comprehensive intervention study on childhood obesity in China (NISCOC): a randomised cluster controlled trial

Authors: Yanping Li, Xiaoqi Hu, Qian Zhang, Ailing Liu, Hongyun Fang, Linan Hao, Yifan Duan, Haiquan Xu, Xianwen Shang, Jun Ma, Guifa Xu, Lin Du, Ying Li, Hongwei Guo, Tingyu Li, Guansheng Ma

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Childhood obesity and its related metabolic and psychological abnormalities are becoming serious health problems in China. Effective, feasible and practical interventions should be developed in order to prevent the childhood obesity and its related early onset of clinical cardiovascular diseases. The objective of this paper is to describe the design of a multi-centred random controlled school-based clinical intervention for childhood obesity in China. The secondary objective is to compare the cost-effectiveness of the comprehensive intervention strategy with two other interventions, one only focuses on nutrition education, the other only focuses on physical activity.

Methods/Design

The study is designed as a multi-centred randomised controlled trial, which included 6 centres located in Beijing, Shanghai, Chongqing, Shandong province, Heilongjiang province and Guangdong province. Both nutrition education (special developed carton style nutrition education handbook) and physical activity intervention (Happy 10 program) will be applied in all intervention schools of 5 cities except Beijing. In Beijing, nutrition education intervention will be applied in 3 schools and physical activity intervention among another 3 schools. A total of 9750 primary students (grade 1 to grade 5, aged 7-13 years) will participate in baseline and intervention measurements, including weight, height, waist circumference, body composition (bioelectrical impendence device), physical fitness, 3 days dietary record, physical activity questionnaire, blood pressure, plasma glucose and plasma lipid profiles. Data concerning investments will be collected in our study, including costs in staff training, intervention materials, teachers and school input and supervising related expenditure.

Discussion

Present study is the first and biggest multi-center comprehensive childhood obesity intervention study in China. Should the study produce comprehensive results, the intervention strategies would justify a national school-based program to prevent childhood obesity in China.

Trial Registration

Chinese clinical trial registry (Primary registry in the WHO registry network) Identifier: ChiCTR-TRC-00000402
Appendix
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Literature
1.
go back to reference Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ, Luan DC, Hu YH, Yang XG: The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Zhonghua Yu Fang Yi Xue Za Zhi (in Chinese). 2005, 39: 311-315. Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ, Luan DC, Hu YH, Yang XG: The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Zhonghua Yu Fang Yi Xue Za Zhi (in Chinese). 2005, 39: 311-315.
2.
go back to reference Wang H, Du S, Zhai F, Popkin BM: Trends in the distribution of body mass index among Chinese adults, aged 20-45 years (1989-2000). Int J Obes (Lond). 2007, 31: 272-278. 10.1038/sj.ijo.0803416.CrossRef Wang H, Du S, Zhai F, Popkin BM: Trends in the distribution of body mass index among Chinese adults, aged 20-45 years (1989-2000). Int J Obes (Lond). 2007, 31: 272-278. 10.1038/sj.ijo.0803416.CrossRef
3.
go back to reference Li Y, Schouten EG, Hu X, Cui Z, Luan D, Ma G: Obesity prevalence and time trend among youngsters in China, 1982-2002. Asia Pac J Clin Nutr. 2008, 17 (1): 131-137.PubMed Li Y, Schouten EG, Hu X, Cui Z, Luan D, Ma G: Obesity prevalence and time trend among youngsters in China, 1982-2002. Asia Pac J Clin Nutr. 2008, 17 (1): 131-137.PubMed
4.
go back to reference Wang Y, Mi J, Shan XY, Wang QJ, Ge KY: Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond). 2007, 31: 177-188. 10.1038/sj.ijo.0803354.CrossRef Wang Y, Mi J, Shan XY, Wang QJ, Ge KY: Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond). 2007, 31: 177-188. 10.1038/sj.ijo.0803354.CrossRef
5.
go back to reference Popkin BM: Will China's nutrition transition overwhelm its health care system and slow economic growth?. Health Aff (Millwood). 2008, 27: 1064-1076. 10.1377/hlthaff.27.4.1064.CrossRef Popkin BM: Will China's nutrition transition overwhelm its health care system and slow economic growth?. Health Aff (Millwood). 2008, 27: 1064-1076. 10.1377/hlthaff.27.4.1064.CrossRef
6.
go back to reference de Onis M, Onyango WA, Borghi E, Siyam A, Nishida C, Siekmann J: Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization. 2007, 85: 660-667. 10.2471/BLT.07.043497.CrossRefPubMedPubMedCentral de Onis M, Onyango WA, Borghi E, Siyam A, Nishida C, Siekmann J: Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization. 2007, 85: 660-667. 10.2471/BLT.07.043497.CrossRefPubMedPubMedCentral
7.
go back to reference Li Y, Hu X, Zhao J, Yang X, Ma G: Application of the WHO Growth Reference (2007) to Assess the Nutritional Status of Children in China. Biomed Environ Sci. 2009, 22: 130-135. 10.1016/S0895-3988(09)60035-0.CrossRefPubMed Li Y, Hu X, Zhao J, Yang X, Ma G: Application of the WHO Growth Reference (2007) to Assess the Nutritional Status of Children in China. Biomed Environ Sci. 2009, 22: 130-135. 10.1016/S0895-3988(09)60035-0.CrossRefPubMed
8.
go back to reference Zhou BF: Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases - report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002, 15: 245-252.PubMed Zhou BF: Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases - report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002, 15: 245-252.PubMed
9.
go back to reference Razak F, Anand SS, Shannon H, Vuksan V, Davis B, Jacobs R, Teo KK, McQueen M, Yusuf S: Defining obesity cut points in a multiethnic population. Circulation. 2007, 115: 2111-2118. 10.1161/CIRCULATIONAHA.106.635011.CrossRefPubMed Razak F, Anand SS, Shannon H, Vuksan V, Davis B, Jacobs R, Teo KK, McQueen M, Yusuf S: Defining obesity cut points in a multiethnic population. Circulation. 2007, 115: 2111-2118. 10.1161/CIRCULATIONAHA.106.635011.CrossRefPubMed
10.
go back to reference Li Y, Yang X, Zhai F, Kok FJ, Zhao W, Piao J, Zhang J, Cui Z, Ma G: Prevalence of the metabolic syndrome in Chinese adolescents. Br J Nutr. 2008, 99: 565-570. 10.1017/S0007114507797064.CrossRefPubMed Li Y, Yang X, Zhai F, Kok FJ, Zhao W, Piao J, Zhang J, Cui Z, Ma G: Prevalence of the metabolic syndrome in Chinese adolescents. Br J Nutr. 2008, 99: 565-570. 10.1017/S0007114507797064.CrossRefPubMed
11.
go back to reference Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004, 350: 2362-2374. 10.1056/NEJMoa031049.CrossRefPubMed Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004, 350: 2362-2374. 10.1056/NEJMoa031049.CrossRefPubMed
12.
go back to reference Csabi G, Torok K, Jeges S, Molnar D: Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr. 2000, 159: 91-94. 10.1007/PL00013812.CrossRefPubMed Csabi G, Torok K, Jeges S, Molnar D: Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr. 2000, 159: 91-94. 10.1007/PL00013812.CrossRefPubMed
13.
go back to reference Hou L, Ji BT, Blair A, Dai Q, Gao YT, Potter JD: Body mass index and colon cancer risk in Chinese people: menopause as an effect modifier. Eur J Cancer. 2006, 42: 84-90. 10.1016/j.ejca.2005.09.014.CrossRefPubMedPubMedCentral Hou L, Ji BT, Blair A, Dai Q, Gao YT, Potter JD: Body mass index and colon cancer risk in Chinese people: menopause as an effect modifier. Eur J Cancer. 2006, 42: 84-90. 10.1016/j.ejca.2005.09.014.CrossRefPubMedPubMedCentral
14.
go back to reference Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, Huang G, Chen CS, Whelton PK: Body weight and mortality among men and women in China. JAMA. 2006, 295: 776-783. 10.1001/jama.295.7.776.CrossRefPubMed Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, Huang G, Chen CS, Whelton PK: Body weight and mortality among men and women in China. JAMA. 2006, 295: 776-783. 10.1001/jama.295.7.776.CrossRefPubMed
15.
go back to reference Popkin BM, Kim S, Rusev ER, Du S, Zizza C: Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. Obes Rev. 2006, 7: 271-293. 10.1111/j.1467-789X.2006.00230.x.CrossRefPubMed Popkin BM, Kim S, Rusev ER, Du S, Zizza C: Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. Obes Rev. 2006, 7: 271-293. 10.1111/j.1467-789X.2006.00230.x.CrossRefPubMed
16.
go back to reference Doak CM, Visscher TL, Renders CM, Seidell JC: The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev. 2006, 7: 111-136. 10.1111/j.1467-789X.2006.00234.x.CrossRefPubMed Doak CM, Visscher TL, Renders CM, Seidell JC: The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev. 2006, 7: 111-136. 10.1111/j.1467-789X.2006.00234.x.CrossRefPubMed
17.
go back to reference Lazaar N, Aucouturier J, Ratel S, Rance M, Meyer M, Duché P: Effect of physical activity intervention on body composition in young children: influence of body mass index status and gender. Acta Paediatr. 2007, 96: 1315-1320. 10.1111/j.1651-2227.2007.00426.x.CrossRefPubMedPubMedCentral Lazaar N, Aucouturier J, Ratel S, Rance M, Meyer M, Duché P: Effect of physical activity intervention on body composition in young children: influence of body mass index status and gender. Acta Paediatr. 2007, 96: 1315-1320. 10.1111/j.1651-2227.2007.00426.x.CrossRefPubMedPubMedCentral
18.
go back to reference Dao HH, Frelut ML, Oberlin F, Peres G, Bourgeois P, Navarro J: Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents. Int J Obes Relat Metab Disord. 2004, 28: 290-299. 10.1038/sj.ijo.0802542.CrossRefPubMed Dao HH, Frelut ML, Oberlin F, Peres G, Bourgeois P, Navarro J: Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents. Int J Obes Relat Metab Disord. 2004, 28: 290-299. 10.1038/sj.ijo.0802542.CrossRefPubMed
19.
go back to reference Yan S: Review of childhood obesity intervention studies. Zhong Guo Fu You Bao Jian. 2006, 21: 2463-2466. (in Chinese) Yan S: Review of childhood obesity intervention studies. Zhong Guo Fu You Bao Jian. 2006, 21: 2463-2466. (in Chinese)
20.
go back to reference Ma G, Hu X: Healthy School. 2009, Beijing: China Population Publisher Ma G, Hu X: Healthy School. 2009, Beijing: China Population Publisher
21.
go back to reference Liu A, Hu X, Ma G, Cui Z, Pan Y, Chang S, Zhao W, Chen C: Evaluation of a classroom-based physical activity promoting programme. Obes Rev. 2008, 9 (Suppl 1): 130-134. 10.1111/j.1467-789X.2007.00454.x.CrossRefPubMed Liu A, Hu X, Ma G, Cui Z, Pan Y, Chang S, Zhao W, Chen C: Evaluation of a classroom-based physical activity promoting programme. Obes Rev. 2008, 9 (Suppl 1): 130-134. 10.1111/j.1467-789X.2007.00454.x.CrossRefPubMed
22.
go back to reference Deurenberg P, Kooy van der K, Leenen R, Weststrate JA, Seidell JC: Sex and age specific prediction formulas for estimating body composition from bio-electrical impedance: a cross validation study. Int J Obes. 1991, 15 (1): 17-25.PubMed Deurenberg P, Kooy van der K, Leenen R, Weststrate JA, Seidell JC: Sex and age specific prediction formulas for estimating body composition from bio-electrical impedance: a cross validation study. Int J Obes. 1991, 15 (1): 17-25.PubMed
23.
go back to reference Liu AL, Ma GS, Zhang Q, Ma WJ: Reliability and validity of a 7-day physical activity questionnaire for elementary students. Chin J Epidemiol. 2003, 24: 901-904. Liu AL, Ma GS, Zhang Q, Ma WJ: Reliability and validity of a 7-day physical activity questionnaire for elementary students. Chin J Epidemiol. 2003, 24: 901-904.
24.
go back to reference McCrindle BW: Will childhood obesity lead to an epidemic of premature cardiovascular disease?. Evid Based Cardiovasc Med. 2006, 10: 71-74. 10.1016/j.ebcm.2006.04.015.CrossRefPubMed McCrindle BW: Will childhood obesity lead to an epidemic of premature cardiovascular disease?. Evid Based Cardiovasc Med. 2006, 10: 71-74. 10.1016/j.ebcm.2006.04.015.CrossRefPubMed
25.
go back to reference Livingstone MBE, McCaffrey TA, Rennie KL: Childhood obesity prevention studies: lessons learned and to be learned. Public Health Nutrition. 2006, 9 (8A): 1121-1129. 10.1017/S1368980007668505.CrossRefPubMed Livingstone MBE, McCaffrey TA, Rennie KL: Childhood obesity prevention studies: lessons learned and to be learned. Public Health Nutrition. 2006, 9 (8A): 1121-1129. 10.1017/S1368980007668505.CrossRefPubMed
Metadata
Title
The nutrition-based comprehensive intervention study on childhood obesity in China (NISCOC): a randomised cluster controlled trial
Authors
Yanping Li
Xiaoqi Hu
Qian Zhang
Ailing Liu
Hongyun Fang
Linan Hao
Yifan Duan
Haiquan Xu
Xianwen Shang
Jun Ma
Guifa Xu
Lin Du
Ying Li
Hongwei Guo
Tingyu Li
Guansheng Ma
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-229

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