Evidence map›Paper›PMID 40204310›Full record

ArticleBMJ open2025

Long-term effects of a primary school-based overweight preventive intervention on physical fitness and physical activity: a propensity score-matched retrospective cohort study within the Generation R Study.

Michel Sebastiaan Smit, Famke Mölenberg, Rosalie Mensink-Bout, Daan Nieboer, Trudy Voortman, Liesbeth Duijts, Hein Raat, Wilma Jansen

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Michel Sebastiaan SmitPublic Health, Erasmus MC, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0003-4231-3972
Famke MölenbergPublic Health, Erasmus MC, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-5305-9730
Rosalie Mensink-BoutErasmus MC, Rotterdam, The Netherlands.
Daan NieboerPublic Health, Erasmus MC, Rotterdam, The Netherlands.
Trudy VoortmanErasmus MC, Rotterdam, The Netherlands.
Liesbeth DuijtsPediatrics-Division of Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands.
Hein RaatPublic Health, Erasmus MC, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-6000-7445
Wilma JansenPublic Health, Erasmus MC, Rotterdam, The Netherlands w.jansen.1@erasmusmc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn this study, we evaluate the long-term effects (±1.5 years postintervention) of 6-year exposure to the Lekker Fit! intervention on physical fitness and physical activity (PA).

designThe retrospective intervention evaluation is embedded within the Generation R Study in Rotterdam, the Netherlands, a population-based prospective birth cohort study.

settingMeasurements took place in the research centre of the Generation R cohort study.

participants5489 adolescents from the Generation R Study were eligible for inclusion within this study. Successful linking to school career data was possible for 4129 adolescents who were then retrospectively subdivided into a Lekker Fit! group, mixed group and regular school group based on their primary school career.

interventionsThe Lekker Fit! intervention is a multicomponent primary school-based intervention for the prevention of overweight. It focuses on a healthy diet and healthy lifestyle rather than focusing directly on the reduction of overweight. The intervention targets individual behaviour of children as well as their obesogenic environment and parental engagement in shaping their children's behaviour. PRIMARY AND SECONDARY OUTCOME MEASURES: Aged 13/14 years old, physical fitness was measured with an incremental ergometer test. The actual highest achieved work rate was divided by the expected highest achieved work rate (age- and sex-related Dutch population-based reference data), and converted into z-scores. PA was determined by the number of days with at least 1 hour of PA, obtained by a self-reported questionnaire. Propensity score matching was performed to correct for non-random selection bias. Linear regression analyses were performed to estimate intervention effects.

resultsChildren from the Lekker Fit! group had significantly lower fitness z-scores (-0.18 (95% CI -0.29 to -0.06), n=1826) compared with children from the matched regular school group. No Lekker Fit! intervention effect was found on PA (-0.12 (95% CI -0.36 to 0.12), n=1258).

conclusionsNo evidence was found for long-term favourable effects of a school-based multicomponent intervention on physical fitness and PA. Recommendations for policy and future research are discussed.

Indexed as

ExerciseHealth PromotionOverweightPediatric ObesityPhysical FitnessSchool Health ServicesAdolescentChildFemaleHumansMaleNetherlandsPropensity ScoreRetrospective StudiesSchoolsAdolescentOverweightPUBLIC HEALTH

Identifiers

PMID40204310
PMCPMC11979498

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.