Multi-Year Examination of School-Based Programs in Preventing Childhood Obesity: A Case of a State Policy in the U.S.

This study examined the association between the obesogenic factors and the risk of suffering from weight excess in school-based state programs regarding physical activity, physical education, nutrition standards, and nutrition education in preventing childhood obesity. Data were drawn from the 1999–2011 Youth Risk Behavior Survey in the State of Mississippi (N = 8862; grades 9–12). Logistic regression with year-fixed effects was performed to capture the influence of the legislation on teenage obesity, controlling for demographics and nutrition- and physical activity-related behaviors. The age-, sex-, and ethnicity-adjusted mean of the body mass index had reduced since 2007 (year 1999: 23.52; year 2001: 23.53; year 2003: 23.76; year 2007: 24.26; year 2009: 24.29; and year 2011: 23.91). The legislation was significantly associated with a decreased likelihood of being overweight (year 2007, odds ratio (OR) = 0.686; year 2009, OR = 0.739; and year 2011, OR = 0.760; all p < 0.01). Children who were more sedentary, more frequently fasted to lose weight, and were less physically active and likelier to be overweight (OR = 1.05, 1.37, and 0.97, respectively; all p < 0.05), as were African-American children (OR = 0.64; p < 0.05) and female students (OR = 1.59; p < 0.05). In conclusion, schools are among the most easily modifiable settings for preventing childhood obesity and reducing its prevalence, with the implementation of physical activity and nutritional policies.