Additional physical activity in school can yield cost-effective weight benefits for children
The Daily Mile, a school-based physical activity program in addition to physical education, may be considered a favorable and cost-effective approach to childhood obesity prevention when compared to the usual health and wellbeing activities in schools, according to findings from a recent study.
“Worldwide around one in five children ages 5 to 19 years are either overweight or living with obesity,” Emma Frew, PhD, MSc, professor in health economics at the University of Birmingham in the U.K., and colleagues wrote. “Obesity also has a significant economic burden leading to costs equivalent to 2.8% of global gross domestic product. The causes of the energy imbalance responsible for excess weight gain are the result of several interacting factors including genetics, poor diet and [lack of] physical activity.”
In this cluster randomized control trial set to evaluate the clinical and cost-effectiveness of The Daily Mile, 40 United Kingdom schools were chosen to measure baseline data from 850 children aged 7 to 10 years. Using a 1:1 allocation ratio based on school size, baseline BMI z score and number of students in the free lunch program, schools were split and assigned to either control or intervention groups.
Over a 12-month period the intervention group was instructed to implement 15 minutes of exercise a day on top of usual school mandated physical activity; frequency and duration were left to the teacher’s discretion. The control group carried on with regularly implemented physical education without any additional activity. At the trial’s conclusion, fitness, body fat percentage, quality of life, well-being, overall academic attainment and the cost quality-adjusted life-years were recorded and compared with baseline.
Results yielded similar increases in mean BMI z score among both groups. Among girls, small differences favoring the intervention group were observed for BMI z score and body fat percentage, but these were not clinically significant, according to the researchers.
Economic analyses of quality-adjusted life-years were conducted separately for boys and girls where The Daily Mile was found to be highly cost-effective for girls with a 97% probability of cost-effectiveness at the United Kingdom threshold compared with a 12% effectiveness in boys. There was an 76% chance of cost-effectiveness overall, according to the researchers.
“Whilst interventions such as The Daily Mile are not going to reduce childhood obesity alone, they should be considered as part of a whole system approach to childhood obesity prevention.”—by Kate Burba
Disclosures: The study was funded by the Birmingham City Council. Frew reports she received research funding from the National Institute for Health Research in England. Please see the full study for all other authors’ relevant financial disclosures.