Research Article| Volume 51, ISSUE 4, P440-455, April 2019

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Food, Health, & Choices: Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders

Published:February 14, 2019DOI:



      To evaluate Food, Health, & Choices, two 10-month interventions.


      Cluster-randomized, controlled study with 4 groups: curriculum, wellness, curriculum plus wellness, and control.


      Twenty elementary schools (5/group) in New York City.


      Fifth-grade students (n = 1,159). At baseline, 44.6% were at the ≥85th body mass index (BMI) percentile for age and 86% qualified for free or reduced-price lunch.


      Curriculum was 23 science lessons based on social cognitive and self-determination theories, replacing 2 mandated units. Wellness was classroom food policy and physical activity bouts of Dance Breaks.

      Main Outcome Measures

      For obesity, age- and sex-specific BMI percentiles were used (anthropometric measures). The researchers also employed 6 energy balance-related behaviors and 8 theory-based determinants of behavior change (by questionnaire).


      Pairwise adjusted odds in hierarchical logistic regression models were determined for >85th BMI percentile. Behaviors and theory-based determinants were examined in a 2-level hierarchical linear model with a 2 × 2 design for intervention effects and interactions.


      Obesity showed no change. For behaviors, there was a negative curriculum intervention change in physical activity (P = .04). The wellness intervention resulted in positive changes for sweetened beverages frequency (P = .05) and size (P = .006); processed packaged snacks size (P = .01); candy frequency (P = .04); baked good frequency (P = .05); and fast food frequency (P = .003), size (P = .01), and combo meals (P = .002). Theory-based determinants demonstrated no change.

      Conclusions and Implications

      The findings of the lack of a decrease in obesity, behavior changes only for the wellness intervention, and no changes in theory-based determinants warrant further research.

      Key Words

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      Linked Article

      • Corrigendum
        Journal of Nutrition Education and BehaviorVol. 52Issue 6
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          The April 2019 issue of the Journal of Nutrition Education and Behavior carried a Research Article titled “Food, Health, & Choices: Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders” (J Nutr Educ Behav. 2019;51(4):440-455; ). There were 2 errors regarding the body mass index percentile. The second sentence of the Study Design section on page 441 should read, “The primary outcome was reduced prevalence of body mass index (BMI) ≥85th percentile for gender and age.” The first sentence of the evaluation section on page 448 should read, “Primary outcomes were a decrease in the percentage of students who had an age- and gender-specific ≥85th percentile BMI.” The percentile was incorrectly described as “>85th” and “<85th,” respectively.
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