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School-based diet and activity interventions show modest adiposity gains in African youthSchool Based Programs May Help Manage Childhood Obesity in Africa

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Key Takeaway
Interpret school-based diet and activity interventions as modestly beneficial for adiposity, but not for BMI, in African youth.

This meta-analysis synthesized evidence from school-based diet and physical activity interventions targeting obesity in children and adolescents in Africa. The primary outcome was BMI-for-age, with secondary outcomes including elevated adiposity and maintenance of normal weight status. The analysis included nine comparisons, though the total sample size was not reported.

The pooled effect on BMI-for-age was non-significant, with a mean difference of 0.03 (95% CI: -0.24 to 0.29; p = 0.813). However, the authors report modest improvements in elevated adiposity and observed maintenance of normal weight status among participants. These findings suggest that school-based interventions may have limited impact on BMI but could still offer benefits in terms of adiposity and weight maintenance.

The authors note limitations, including the need for more geographically diverse and methodologically robust evidence. The certainty of the evidence was not explicitly graded, and the follow-up duration was not reported. Adverse events were not reported.

In practice, these results should be interpreted cautiously. While school-based diet and physical activity interventions show potential to improve adiposity and maintain healthy weight status among African children and adolescents, particularly when combined, the non-significant effect on BMI-for-age underscores the need for further research to identify effective components and implementation strategies.

How this fits prior evidence

This meta-analysis extends prior coverage on obesity interventions by focusing on school-based settings in African youth. It confirms the modest benefits of lifestyle interventions on adiposity, consistent with prior findings that high-intensity interval training reduces body weight and fat mass, though the effect on BMI was non-significant. It also addresses a gap by examining weight maintenance, which aligns with prior coverage on dietary interventions influencing obesity through metabolic pathways. However, the non-significant BMI result contrasts with the stronger effects seen in some adult interventions, highlighting the need for more robust pediatric evidence.

Researchers looked at how school-based programs involving diet and physical activity affect children and adolescents in Africa. The study looked at several factors, including body mass index (BMI) for age, body fat levels, and the ability to maintain a healthy weight.

The results showed that these school-based programs did not have a significant effect on BMI-for-age. However, the programs did show modest improvements in body fat levels and helped children maintain a normal weight status. These findings suggest that combining diet and exercise in a school setting can be helpful for these specific goals.

Because the evidence is limited by a lack of geographical diversity and some methodological gaps, these results should be viewed with caution. The findings are specific to the population studied. You should talk with a healthcare provider to determine the best approach for a child's specific health needs.

What this means for you:
School-based diet and exercise programs may help manage body fat and maintain weight in African children.

Common questions

Do school-based programs help with weight in children?

School-based programs that combine diet and physical activity showed modest improvements in body fat and helped maintain a normal weight status. However, these programs did not show a significant effect on BMI-for-age in the studies reviewed. You should consult a doctor to discuss specific weight management plans for children.

What were the results for body fat in the study?

The analysis of school-based diet and physical activity interventions showed modest improvements in elevated adiposity. This suggests that these programs may be effective at addressing body fat levels in children and adolescents in the African region.

Is this a proven way to treat obesity?

The evidence is currently limited by a need for more geographically diverse and methodologically robust data. While the results show potential for improving body fat, they are not yet enough to provide a definitive recommendation for all children.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
INTRODUCTION: The increasing prevalence of Obesity and associated health risks in LMICs underscores the urgent need to adopt an integrated approach to Obesity prevention and management. This systematic review aims to assess the impact of school-based diet and physical activity interventions on weight-related outcomes among children and adolescents in Africa. METHODS: This systematic review was registered with PROSPERO (CRD42023450307) and reported according to the PRISMA statement. A comprehensive literature search was conducted across three databases, PubMed, Google Scholar and African Journals Online from January 2000 to December 2025. RESULT: Our search identified a total of 11 eligible studies, with modest to low risk of bias, of which majority of the studies were published within the last decade (63.6%), and conducted in South Africa (72.7%). These studies were predominantly quasi-experimental (70%) or cluster randomized control trail (18.2%) in design. The majority (73%) interventions were delivered in primary school settings and participants were mainly engaged in group activities. The bulk of the interventions were multi-component, comprising physical activity, alongside nutrition, and other health/behavioural interventions. Overall, the studies reported modest improvements in elevated adiposity and maintenance of normal weight status in the intervention groups. However, this translated into a non-significant effect in the meta-analysis of nine intervention comparisons on BMI-for-age (MD = 0.03, 95% CI: -0.24 to 0.29; p = 0.813; I² = 69.0%), although combined nutrition and physical activity interventions showed reductions in a few comparisons. CONCLUSION: School-based diet and physical activity interventions show potential to improve adiposity and maintain healthy weight status among African children and adolescents, particularly when combined. However, the overall effect on BMI-for-age was not significant, highlighting the need for more geographically diverse and methodologically robust evidence across Africa.
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