Community Based Interventions to Fight Obesity

May 03, 2010

The American Journal of Clinical Nutrition (AJCN)

Community-wide interventions can help reduce childhood obesity, according to a recent report conducted by the WHO Collaborating Centre for Obesity Prevention in Victoria, Australia and published in the April 2010 issue of The American Journal of Clinical Nutrition(AJCN). The study examined the effectiveness of the Romp & Chomp initiative; a Victoria-based program focused on increasing healthy eating and active play patterns in early-childhood and education settings.

Some of the main goals of Romp & Chomp, which looked at 12,000 children aged five and under, were to decrease consumption of high sugar drinks, decrease consumption of energy-dense snacks and boost that of fruit and vegetables, significantly increase active play both at home and in childcare and education settings, and limit television viewing time. 

Researchers found that, at the conclusion of the program, there was a lower intake of packaged snacks, as well as a significantly higher intake of vegetables per day. Television and DVD viewing time was down significantly as well. Water and plain milk started to take the place of fruit juice in many instances. At follow up, children were drinking approximately one-half cup less fruit juice and eating one extra piece of fruit and one-half serving more vegetables daily.

“We believe that one of the key factors for success was the consistency of message across the entire community over a sustained period of time. A large number of children’s settings and services were involved in the intervention and parents of young children received the program messages from a range of places. In addition, the intervention strategies were developed with a high level of engagement of early childhood workers and service delivery personnel which increase relevance and ownership of the program for those involved in implementation,” says study author Dr. Andrea de Silva-Sanigorski.

Ultimately, the study found that the reduction in the prevalence of overweight and obesity was three and five times greater (in two year olds and five year olds, respectively) than those not exposed to community-directed health promotion activities. Children's diets in the intervention community improved overall.

However, even with the efforts of varying community groups and family members, physical activity occasions did not increase. Since more sensitive measures of physical activity were not collected, researchers were not able to make conclusions about the effect of Romp & Chomp on physical activity levels – a limitation of the study.

“The challenges with carrying through with a program of this nature include bringing together a range of community, government and children’s organizations to implement a long term, large scale program on limited funding. Though even with challenges, the community capacity building and partnership approach taken in Romp & Chomp is transferable to other communities,” says de Silva-Sanigorski.

Early intervention has been identified as a key component in the fight against obesity, which is why children have become the target group for intervention programs such as Romp & Chomp. But reaching children in an effective manner is no small task. Since there are multiple influences on a child’s eating and physical activity behaviors, ranging from those a child faces at home, in school, at childcare, and in the media, community-based intervention programs could be vital to breaking the unhealthy cycle of obesity. And retailers have a role to play too.

“The role of retailers is vital in that they can support parents’ ability to provide healthy foods and drinks for their children and families. This includes promoting healthy foods and drinks and not heavily discounting unhealthy items, having confectionary-free aisles, and not encouraging children to pester their parents to buy unhealthy products through the use of marketing, toys and incentives. We also need healthy food to be affordable for the whole community,” says de Silva-Sanigorski.