目的 探讨基于学校环境的学生超重肥胖综合干预效果,为预防和控制中小学生超重肥胖提供依据。方法 采用多阶段分层整群抽样方法抽取重庆市主城区12所中小学9 933名学生,随机分为6所干预校和6所对照校,对干预校采取学校环境政策干预、健康教育、体育活动指导结合的综合干预,干预前后进行体格检查和问卷调查。结果 干预后干预校超重率在原有基础上(12.9%)上升了0.2%,肥胖率(7.4%)未变化;对照校超重率、肥胖率分别在原有基础上(11.5%、7.7%)上升了0.5%、0.1%。干预前两组学校正常体重的学生在干预后BMI、腰围、臀围均升高(P<0.05),干预校超重肥胖的学生在干预后BMI、腰围均下降(P<0.05),对照校超重肥胖的学生在干预后臀围升高、腰围降低(P<0.05);干预校学生在干预后肥胖相关饮食问题正确率上升,不健康饮食行为报告率下降(P<0.05)。结论 基于学校环境的学生超重肥胖综合干预能控制肥胖相关指标的增长速度,改善中小学生的饮食行为。

Objective To evaluate consequence of a school-based overweight and obesity intervention,and to provide evidence to prevent and control obesity in primary and middle school students. Methods Multi-stage stratified cluster sampling was used to select 9 933 students from six primary schools and six secondary schools in Chongqing which were randomly divided into intervention schools and control schools.Intervention schools were given to school environment policy intervention,health education and physical activity guidance.Before and after intervention,anthropometric examination and questionnaire survey were accomplished. Results After the intervention,the increased rate of overweight of intervention school (0.2%) was lower than the control schoo l(0.5%),the increased rate of obesity of intervention school (0.0%) was similar to the control school (0.1%),normal weight students of two groups in BMI,waist circumference,hip circumference were increased (P<0.05),overweight and obesity students of intervention school in BMI,waist circumference were decreased (P<0.05),overweight and obesity students of control school in hip circumference was increased and waist circumference was decreased (P<0.05),students of intervention school in obesity related diet accuracy was increased and unhealthy eating behavior reported rate were decreased (P<0.05). Conclusion A school-based overweight and obesity comprehensive intervention could control related indicators of obesity,and improve knowledge and behavior of dietary among primary and middle school students.