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Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study
  1. Sheila Bhave1,
  2. Anand Pandit1,
  3. Rajiv Yeravdekar2,
  4. Vaishali Madkaikar1,
  5. Trushna Chinchwade1,
  6. Nasreen Shaikh3,
  7. Tasneem Shaikh4,
  8. Shraddha Naik5,
  9. Ella Marley-Zagar6,
  10. Caroline H D Fall6
  1. 1Department of Paediatrics, KEM Hospital, Pune, Maharashtra, India
  2. 2Faculty of Health and Biomedical Sciences, Symbiosis International University, Pune, Maharashtra, India
  3. 3Department of Statistics, ZVMU Medical College, Pune, Maharashtra, India
  4. 4Excellentstat, Pune, Maharashtra, India
  5. 5Chandrashekhar Agashe College of Physical Education, Pune, Maharashtra, India
  6. 6MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  1. Correspondence to Dr Sheila Bhave, Department of Paediatrics, KEM Hospital, Pune 411011, Maharashtra, India; sheilabhave{at}, kemhrc{at}


Design Non-randomised non-blinded school-based intervention study.

Setting Two schools in the cities of Pune and Nasik, India.

Participants The intervention group comprised children attending a Pune school from 7–10 years until 12–15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12–15 years at the start of the study.

Intervention A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a ‘scoring’ subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families.

Main outcome measures Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing).

Results After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004).

Conclusions It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity.

  • Obesity
  • School Health
  • Outcomes research

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