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I can hardly believe it, but just having drinking fountains in schools (and no sugary drinks) seems to be enough to reduce the risk of obesity in kids by 31%. This astonishing result is reported in the latest issue of Pediatrics. Investigators arranged to have drinking fountains installed in about half of 32 elementary schools in "socially deprived" areas of Germany. They also prepared lesson plans encouraging water consumption. Kids in the intervention schools drank more water and reported consuming less juice.
Could we try this here? The barriers are formidable. First, the water fountain problem. Water fountains must (a) be present, (b) be usable, (c) be clean and sanitary, and (d) produce water that is free of harmful chemicals and bacteria. All of these are problematic. I once tried to find out whether the water in school drinking fountains in New York City had been tested and was known to be safe to drink. I had to file a FOIA (freedom of information act) request to get testing data. This came from only a few schools and from water going into the fountains, not coming out of them.
And then there is the soda problem. Schools in Germany do not have vending machines all over the place and kids do not have access to sodas, juice drinks, and other such things all day long. Ours do.
But doesn't this study suggest that if we got rid of vending machines and junk foods in schools--and made sure water fountains worked, were clean, and distributed clean water--that we could make a little progress on preventing childhood obesity? Worth a try, no?
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Actually, there was no significant difference in juice consumption after they adjusted for baseline consumption:
"Changes in juice consumption from baseline to the follow-up assessment differed significantly between the treatment groups (IG – CG) by –0.2 glasses per day (95% CI: –0.4 to 0.0 glasses per day; P = .039), with adjustment for migrational background; after adjustment for baseline juice consumption, however, the estimated difference of –0.1 glasses per day (95% CI: –0.2 to 0.1 glasses per day) was no longer significant (P = .500). No intervention effect on soft drink consumption was observed (P = .406)."
It's an interesting idea, and one that might warrant further attention if you can get similar effects with less intensive use of classtime (four separate 45 minute classtime sessions on water would probably be met with pushback or noncompliance from teachers already pressed to fit in all their state-mandated subject content).
This also seems to good to be true to me. On closer examination, over 280 days the percent overweight went from 23.4 to 23.5 (+1 overweight kid) in the experimental group, and from 25.9 to 27.8 (+25 kids) in the control group. The odds ratio they report, which is the ratio of the likelihood of being overweight if you're in the control group to the likelihood if you're in the experimental group, is barely statistically significant, and at the upper end of the 95% confidence interval is 0.98--and an odds ratio of 1 means the events are equally likely in the two cases. Moreover, the impact on BMI standard deviation score was negligible and not statistically significant. The result, then, is driven by not quite 2% of kids moving from barely under an arbitrary "overweight" threshold to barely over it in the control group, while the experimental group doesn't change at all. So at the very least we should get a bigger study with more precision to understand this more fully. Right now it looks like you have to pick your measurement of "reducing the risk of obesity" very carefully for this to matter much, although you can't deny that there were fewer overweight kids in the treated group at the end of the day.
It would also be good to know whether the important difference was the lessons or the shiny new water dispensers offering sparkling water.
There is also the challenge of schools receiving funding from juice/soda companies to host vending machines. Given the state of funding for school systems, many would find it hard to give up that source of revenue, even for such a good cause as improving childhood obesity.
1. Don't believe it. This intervention did not work. In the authors' own words: "BMI SDS changes from baseline to the follow-up assessment were 0.005 ± 0.289 in the IG and 0.007 ± 0.295 in the CG. The estimated group difference (IG – CG) in BMI SDS changes of –0.004 (95% CI: –0.045 to 0.036) was not significant (P = .829), with adjustment for BMI SDS at baseline."
And again: "The present trial resulted in a reduction in the risk for overweight but did not find an intervention effect on the mean changes in BMI SDS, similar to the results of another prevention trial,(27) which indicates that there was no general weight-reducing effect."
2. "16% of all children provided no written consent" - How would you feel if your child was unwillingly roped into an experiment?
3. "The participants in this randomized, controlled cluster trial were second- and third-graders from 32 elementary schools in socially deprived areas of 2 German cities."
Ok, we'll just run this experiment on the poor kids.
I can't believe this got past an ethics review panel!!
sushil,
You're joking, right?
Your objection is to an experiment wherein children were convinced to drink more water? I actually created an account on this site JUST to ask if you were serious.
Ethics review panel?
Should someone REVIEW whether it's ETHICAL for kids to be coerced into drinking water?
You know, objecting to something simply for the sake of objecting to something is an obstinate, unproductive position to take. It also reeks of paranoia, or at least fear mongering. I suggest you prioritize for yourself what matters to society before posting and attempting to influence people with your unconsidered comments.
By drinking water instead of soda and juices (which are all sugar) you can cut your daily caloric intake by 20-50% Ask any nutritionist and this is the fist step to be taken in any weight loss program. Its not "fat" which makes you fat, it is sugars and carbohydrates which are stored as fat. This is what is to be eliminated. Also by drinking not just water but alkaline ionized water you can further increase weight loss by removing chemicals from the body. This water has also been shown to prevent and cure many common diseases from skin diseases to type 1 diabetes.