{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T05:02:04Z","timestamp":1773810124208,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Curbing the rise in overweight and obesity in childhood is of top priority in the public health agenda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the effectiveness of a 2\u2010year school\u2010based intervention on children's body mass index (BMI) <jats:italic>z<\/jats:italic>\u2010score, considering children's baseline weight status, as well as to identify socio\u2010demographic factors that could predict a positive weight outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from 9255 children 5\u201312\u2009years, from six European countries, participating in the Feel4Diabetes study. The intervention group received a lifestyle intervention, aiming to promote a healthy and active lifestyle. Children's anthropometrics were measured at baseline and 2\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children with overweight, but not with obesity, at baseline randomized in the intervention group had a higher reduction in BMI <jats:italic>z<\/jats:italic>\u2010scores compared to the control group. In logistic regression models, older age, female sex, overweight or obesity increased the likelihood of any decrease in BMI <jats:italic>z<\/jats:italic>\u2010score in the intervention group. Mother's obesity and a lower family income were associated with a decreased probability of a positive weight outcome from the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Feel4Diabetes school\u2010based intervention demonstrated that it could effectively improve the BMI <jats:italic>z<\/jats:italic>\u2010score among children with overweight, but not with obesity. Family's characteristics (mother's weight and family income) may affect the effectiveness of such interventions and should be considered in relevant public health efforts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijpo.70025","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T22:44:39Z","timestamp":1748299479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A school\u2010based intervention for obesity prevention and management: Effectiveness and determinants of its success. The <scp>Feel4Diabetes<\/scp> study"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-3065","authenticated-orcid":false,"given":"Matzourana","family":"Argyropoulou","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education Harokopio University  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3536-3034","authenticated-orcid":false,"given":"Costas A.","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education Harokopio University  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1169-7141","authenticated-orcid":false,"given":"Maria","family":"Papamichael","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education Harokopio University  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greet","family":"Cardon","sequence":"additional","affiliation":[{"name":"Department of Movement and Sports Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros","family":"Liatis","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaana","family":"Lindstrom","sequence":"additional","affiliation":[{"name":"Department of Public Health Solutions Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-653X","authenticated-orcid":false,"given":"Luis A.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Arag\u00f3n (IA2), Instituto de Investigaci\u00f3n Sanitaria Arag\u00f3n (IIS Arag\u00f3n) Universidad de Zaragoza  Zaragoza Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violeta","family":"Iotova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Medical University  Varna Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuliya","family":"Bazdarska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Medical University  Varna Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsvetalina","family":"Tankova","sequence":"additional","affiliation":[{"name":"Department of Diabetology, Clinical Center of Endocrinology Medical University of Sofia  Sofia Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imre","family":"Rurik","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Semmelweis University  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Toprzsa","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Semmelweis University  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Public Health Solutions Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Makrilakis","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannis","family":"Manios","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education Harokopio University  Athens Greece"},{"name":"Institute of Agri\u2010food and Life Sciences Hellenic Mediterranean University Research Centre  Heraklion Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42255\u2010020\u20100183\u2010z"},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization.Obesity and overweight fact sheet. 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