Promotion of physical activity and healthy food choices was hampered by competitiveness, lack of quality food, easy access to non-nutritious food, and time constraints

摘要

Prevention of childhood obesity and associated diseases (eg, type 2 diabetes and cardiovascular disease) is important worldwide. Limited evidence exists, however, on which to base a programme of interventions.Schools have a potentially important role in promoting a healthy diet and exercise.The study by Bauer et al raises issues that should be considered in developing interventions in schools.Bauer ef al highlight the importance of understanding culture through their use of an ecological model to examine factors that facilitate or compete with programmes and policies developed to improve physical activity and nutrition in schools. The authors explain why children and adolescents might not make use of available resources to maintain a healthy lifestyle, including physical education, sports teams, morning open gym, and healthy food in the cafeteria. It is also noteworthy that Bauer et al involved children and school staff members to obtain a comprehensive view of what occurs within the school environment. Schools could be an important setting for interventions to prevent childhood obesity. However, families also play an important role, and as the authors suggest, a limitation of this study is that parents' perspectives were not solicited.The study identifies barriers such as athletic competitiveness, teasing and bullying, time constraints, safety, weight concerns, unpalatable healthy food, and availability of non-nutritious snacks that should be addressed when developing interventions.