Community health-promotion interventions with physical activity: does this approach prevent obesity?

Abstract

Background: Prevention of weight gain is a primary strategy in tackling the obesity epidemic. Objective: This review summarizes results of community interventions for prevention of cardiovascular diseases, with dietary changes and increased physical activity as target behaviours, and change in obesity as one outcome variable. Design: A Medline search was used to identify studies. The focus behaviour was physical activity, but all of the five selected interventions also had dietary changes as an essential component. Results: The interventions were aimed at prevention of cardiovascular diseases, and all had dietary changes, increased physical activity and decreased prevalence of obesity as means to achieve the main objective. The duration of intervention was 4–7 years. Out of the four projects with physical activity assessments, two did not observe any significant intervention effects on physical activity. The residents of the intervention communities of the Minne sota Heart Health Study were somewhat more physically active at the end of the follow-up. In the Stanford Five-City Project, the intervention had a positive effect on physical activity in independent, cross-sectional samples. Most projects did not find any intervention impact on body mass index (BMI). In the Stanford Five-City Project, BMI increased less in treatment than in control communities, but this effect was observed only by using the cross-sectional, independent surveys. Conclusion: It seems that the increase in energy expenditure due to physical activity was not large enough. To enable improvements, future interventions may need a stronger emphasis on changes in the local physical and social environment. Keywords: Cardiovascular diseases, eating, environment, exercise, overweight.