School-Based Physical Activity Interventions Can Curb Childhood Obesity Rates


A study from Slovenia suggests a physical activity intervention that would require physical activity every day while at school was effective for reducing BMI and reversing obesity in young children.

Maroje Sorić, MD, PhD

Maroje Sorić, MD, PhD
Courtesy: University of Zagreb

New research from investigators in Europe indicated a population-scaled, school-based physical activity intervention could help stave of childhood obesity.

With rates of obesity in younger patients increasing across the globe, results of the study, which found BMI was lower in the intervention group, irrespective of participation duration or baseline weight status, offer a potential framework and improve understanding of the impact of such an intervention in school-based settings.

“Our results show the importance of sustainable, long-lasting, physical activity programs set in schools for children’s health at both the individual and the population level. While this study analyzed only the effectiveness of such program for obesity prevention, physical activity programs are likely to benefit growth and development, improve fitness, enhance mental health and boost cognitive performance of the children, and should be a cornerstone of educational and health policies,” said senior investigator Maroje Sorić, MD, PhD, University of Zagreb in Croatia.2

Given the present ate rain the obesity epidemic has placed on health care systems within the US and abroad, the field of pediatric obesity has witnessed an explosion in research. In the current study Sorić and a team of colleagues from the University of Ljubljana sought to explore whether a population-scaled, school-based physical activity intervention that provides children with 2-3 additional physical activity lessons per week might influence the weight gain and prevalence of obesity among this cohort.1

Named Healthy Lifestyle, the nationwide intervention was introduced in Slovenia in 2011 and conducted through 2018. The intervention called for 2 additional PE lessons in grades 1-6 and 3 in grades 7-9, which correlated to 1 physical activity session per day for those aged 6-14 years. Implemented in more than 200 schools in Slovenia, the study included more than 34,000 participants.1

For the purpose of analysis, generalized estimating equations were used to estimate the effects of differing levels of exposure to the interview on BMI in children with normal weight, overweight, or obesity at baseline. Of note, the duration of exposure to the intervention within the study ranged from 1-5 years.1

Upon analysis, results indicated those in the intervention group had a lower BMI, regardless of participant duration or baseline weight status. Investigators pointed out differences in BMI increased with program duration, with the maximal effects observed after 3-4 years of participation. Investigators also pointed out the differences in BMI achieved during the study were significantly larger for children with obesity, investigators noting peak differences of 1.4 kg/m2 (95% CI, 1.0-1.9) for girls with obesity and 0.9 kg/m2 (95% CI, 0.6-1.3) for boys with obesity. Further analysis indicated the program started to become effective at reversing obesity after 3 years and the lowest numbers needed to treat (17 for girls, 12 for boys) were observed after 5 years.1

“This study demonstrates that small changes to physical activity programming in schools can, given enough time, make a significant difference in health outcomes, including obesity,” said Travis Masterson, PhD, Broadhurst Career Development Professor for the Study of Health Promotion and Disease Prevention at the Pennsylvania State University, who was not involved in the study.2 “This study speaks to two well-known facets of successful health-related programs. The first is that structural components of an individual’s environment, such as additional physical activity classes, can significantly influence health outcomes. The second is that long-term consistency plays a key role in weight-related outcomes.”


  1. Jurić, P, Jurak, G, Morrison, SA, Starc, G, Sorić, M. Effectiveness of a population-scaled, school-based physical activity intervention for the prevention of childhood obesityObesity (Silver Spring). 2023; 31( 3): 811- 822. doi:10.1002/oby.23695
  2. Obesity Society. Population-scaled, school-based physical activity intervention can help prevent childhood obesity. EurekAlert! Published February 22, 2023. Accessed February 22, 2023.

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