Abdulrahman Mohammad Ibrahem, Bushra Muhammed Ali, Shahow Abdulrehman Ezzaddin


Background: The prevalence of obesity and overweight among children and adolescents has increased globally. Research in Iraq reported an increase in the rate of obesity and overweight among the Iraqi population. In a study of 620 students in basic school, the prevalence of overweight and obese students in Baghdad rose to 30.3%. This study aimed to evaluate the effectiveness of parental education interventions through specific education programs to reduce obesity and overweight in basic school students.

Materials & Methods: A randomized controlled trial was conducted in the Sulaimani governorate of the Kurdistan region/Iraq among 15 basic schools. A total of 300 students aged 6 through 15 years, 150 in the intervention group and 150 in the comparison group, who were obese or overweight, were enrolled in this study. Participants were selected by applying stratified multistage cluster sampling from a total of 647 schools, and students were selected according to a probability proportional to the size. The intervention process included two parental education sessions focused on improving eating habits and physical activity of students. Data collection included anthropometric measurements, dietary habits, daily time spent on digital devices, and physical activity at the beginning and end of the school year.

Results: A significant change in body mass index (BMI) was observed between the groups at the end of the intervention; 1.16 kg/m2 was reduced in the intervention group and 0.58 kg/m2 in the comparison group, P ≤0.001. There was a significant change in the mean waist circumference (WC) between the groups: (-3.49) centimeters (cm) in the intervention group and (-2.52) cm in the comparison group (P = 0.05). After the follow-up, the baseline intervention group’s total mean physical activity score was 27.66 ±9.58 and significantly increased to 30.78 ±7.80 at the end of the year. While in the comparison groups, it increased from 27.58 ±8.51 to 28.00 ±7.32.

Conclusion: Parental participation in education programs positively affected body mass index, dietary habits, and physical activity of obese and overweight students in basic school and lead to reducing body weight of students.


Childhood Obesity; Dietary Habits; Exercise; Intervention; Overweight.

Full Text:



Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. The lancet 2002;360(9331):473-82.

De Onis M, Onyango AW, Borghi E, Garza C, Yang H, Group WMGRS. Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr 2006;9(7):942-7.

Alredainy R, Al Lami F. Overweight and obesity in a sample of primary school children in Baghdad. The Iraqi Postgrad Med J 2016;15(4):452.

Mendonça MRT, Silva MAMd, Rivera IR, Moura AÁ. Prevalence of overweight and obesity in children and adolescents from the city of Maceió (AL). Revista Da Associacao Medica Brasileira 2010;56(2):192-6.

Adami F, Vasconcelos FdAGd. Obesity and sexual maturation early in schoolchildren Florianópolis - SC. Revista Brasileira de Epidemiologia 2008;11(4):549-60.

Lafta RK, Kadhim MJ. Childhood obesity in Iraq: prevalence and possible risk factors. Ann. Saudi Med 2005;25(5):389-93.

Dudley DA, Cotton WG, Peralta LR. Teaching approaches and strategies that promote healthy eating in primary school children: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2015;12(1):28.

Blondin S, Anzman-Frasca S, Djang H, Economos C. Breakfast consumption and adiposity among children and adolescents: an updated review of the literature. Pediatr obes 2016;11(5):333-48.

Francis M, Nichols SS, Dalrymple N. The effects of a school-based intervention programme on dietary intakes and physical activity among primary-school children in Trinidad and Tobago. Public health nutr 2010;13(5):738-47.

Flynn M, McNeil D, Maloff B, Mutasingwa D, Wu M, Ford C, et al. Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with 'best practice'recommendations. Obes Rev 2006;7:7-66.

Xu F, Ware RS, Leslie E, Tse LA, Wang Z, Li J, et al. Effectiveness of a randomized controlled lifestyle intervention to prevent obesity among Chinese primary school students: CLICK-obesity study. PloS one 2015;10(10):e0141421.

Aperman-Itzhak T, Yom-Tov A, Vered Z, Waysberg R, Livne I, Eilat-Adar S. School-Based intervention to promote a healthy lifestyle and obesity prevention among fifth-and sixth-grade children. Am J Health Educ 2018;49(5):289-95.

Sharma M. Designing effective health education interventions for preventing obesity in South Asian Americans. Californian Journal of Health Promotion 2006;4(1):119-28.

Nemet D, Barkan S, Epstein Y, Friedland O, Kowen G, Eliakim A. Short- and long-term beneficial effects of a combined dietary-behavioral-physical activity intervention for the treatment of childhood obesity. Pediatrics 2005;115(4):e443-9.

Jiang J, Xia X, Greiner T, Wu G, Lian G, Rosenqvist U. The effects of a 3-year obesity intervention in schoolchildren in Beijing. Child: care, health and development 2007;33(5):641-6.

Mazloomy-Mahmoodabad SS, Navabi ZS, Ahmadi A, Askarishahi M. The effect of educational intervention on weight loss in adolescents with overweight and obesity: Application of the theory of planned behavior. ARYA atherosclerosis 2017;13(4):176.

Pasdar Y, Moridi S, Najafi F, Niazi P, Heidary M. The effect of nutritional intervention and physical activities on weight reduction. J Kermanshah Univ Med Sci 2012;15(6):e78894.

Llargues E, Franco R, Recasens A, Nadal A, Vila M, Pérez MJ, et al. Assessment of a school-based intervention in eating habits and physical activity in school children: the AVall study. J Epidemiol Community Health. 2011;65(10):896-901.

Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, et al. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. Bmj 2010;340.

Van Cauwenberghe E, Maes L, Spittaels H, Van Lenthe FJ, Brug J, Oppert J-M, et al. Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and 'grey'literature. Br J Nutr 2010;103(6):781-97.

Waters E, de Silva-Sanigorski A, Burford BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane database of systematic reviews 2011;12: CD001871.

Jansen W, Borsboom G, Meima A, Zwanenburg vJ-V, Mackenbach JP, Raat H, et al. Effectiveness of a primary school-based intervention to reduce overweight. International Journal of Pediatric Obesity 2011;6(sup3):e70-7.

Ritchie LD, Rosen NJ, Fenton K, Au LE, Goldstein LH, Shimada T. School breakfast policy is associated with dietary intake of fourth-and fifth-grade students. Journal of the Academy of Nutrition and Dietetics 2016;116(3):449-57.

Whitaker RC, Dearth-Wesley T, Herman AN, Oakes JM, Owens JA. A quasi-experimental study of the impact of school start time changes on adolescents' mood, self-regulation, safety, and health. Sleep Health 2019;5(5):466-9.

Elseifi OS, Abdelrahman DM, Mortada EM. Effect of a nutritional education intervention on breakfast consumption among preparatory school students in Egypt. Int J Public Health 2020;65(6):893-903.

Warren J, Henry C, Lightowler H, Bradshaw S, Perwaiz S. Evaluation of a pilot school programme aimed at the prevention of obesity in children. Health promotion international 2003;18(4):287-96.

Bauer KW, Foster GD, Weeks HM, Polonsky HM, Davey A, Sherman S, et al. Breakfast in the classroom initiative and students' breakfast consumption behaviors: A group randomized trial. Am j public health 2020;110(4):540-6.

Kobel S, Wirt T, Schreiber A, Kesztyüs D, Kettner S, Erkelenz N, et al. Intervention effects of a school-based health promotion programme on obesity related behavioural outcomes. J Obes 2014;2014.

Fairclough SJ, Hackett AF, Davies IG, Gobbi R, Mackintosh KA, Warburton GL, et al. Promoting healthy weight in primary school children through physical activity and nutrition education: a pragmatic evaluation of the CHANGE! randomised intervention study. BMC public health 2013;13(1):1-14.

Ma X, Chen Q, Pu Y, Guo M, Jiang Z, Huang W, et al. Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obes Res Clin Pract 2020;14(1):1-8.

Tarro L, Llauradó E, Albaladejo R, Moriña D, Arija V, Solà R, et al. A primary-school-based study to reduce the prevalence of childhood obesity-the (Food education)study: a randomized controlled trial. Trials 2014;15(1):1-13.

Eather N, Morgan PJ, Lubans DR. Improving the fitness and physical activity levels of primary school children: Results of the Fit-4-Fun group randomized controlled trial. Preventive medicine 2013;56(1):12-9.

Li X-H, Lin S, Guo H, Huang Y, Wu L, Zhang Z, et al. Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC public health 2014;14(1):1-12.

Spiegel SA, Foulk D. Reducing overweight through a multidisciplinary school-based intervention. Obesity 2006;14(1):88-96.

Anderson A, Porteous L, Foster E, Higgins C, Stead M, Hetherington M, et al. The impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables. Public health nutr 2005;8(6):650-6.

Lynch BA, Gentile N, Maxson J, Quigg S, Swenson L, Kaufman T. Elementary school-based obesity intervention using an educational curriculum. Journal of Primary Care & Community Health 2016;7(4):265-71.

Hollis JL, Sutherland R, Campbell L, Morgan P, Lubans D, Nathan N, et al. Effects of a 'school-based'physical activity intervention on adiposity in adolescents from economically disadvantaged communities: secondary outcomes of the 'Physical Activity 4 Everyone'RCT. Int J Obes 2016;40(10):1486-93.

Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obesity reviews 2009;10(1):110-41.



  • There are currently no refbacks.

Copyright (c) 2023. Abdulrahman Mohammad Ibrahem, Bushra Muhammed Ali, Shahow Abdelrahman Ezzaddin

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan

ISSN: 1819-7973, e-ISSN: 1997-2067


Phone: +92-966-747373

Scimago Journal & Country Rank