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For all of the above&#44; school-based programmes have been developed that aim at reducing childhood obesity and other cardiovascular risk factors&#44; usually by attempting to improve diet and physical activity&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The early literature reviews on school-based interventions for the prevention of childhood obesity have shown inconsistent results&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">8&#8211;14</span></a> However&#44; studies on this subject published in recent years and new literature reviews and meta-analyses have found strong evidence that integral school-based interventions can be effective in reducing body mass index &#40;BMI&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">15&#8211;17</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of our study was to assess the effect of an integral school-based intervention on BMI&#44; 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The control group included the students enrolled in the same years at the El Quirinal public school&#44; located in another Avil&#233;s neighbourhood of similar socioeconomic characteristics&#46; The two schools are 3&#46;5<span class="elsevierStyleHsp" style=""></span>km apart&#44; separated by a national highway&#46; The school principals and the parent associations were given detailed information about the study and agreed to participate&#46; The study was approved by the Comit&#233; de &#201;tica de la Investigaci&#243;n &#40;Committee on Research Ethics&#41; of the Principality of Asturias&#44; and we obtained the written informed consent of the parents or legal guardians of participating students&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Intervention</span><p id="par0035" class="elsevierStylePara elsevierViewall">The intervention project&#44; called &#8220;<span class="elsevierStyleItalic">T&#250; decides tu salud&#46; &#161;Ponte a vivir&#33;</span>&#8221; &#40;Your health is up to you&#46; Start living&#33;&#41; was implemented for 2 consecutive academic years &#40;September through June&#41; The activities of the programme were designed by the teaching staff of the school under the guidance of the paediatricians of the research team&#44; and were carried out in the school&#46; The programme was supported by the Asociaci&#243;n de Madres y Padres de Alumnos &#40;Association of Students&#8217; Mothers and Fathers&#41;&#44; with whom we held several meetings prior to the study to explain the project and receive suggestions&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The activities carried out consisted of&#58; &#40;1&#41; workshops on healthy nutrition for the students&#44; offered every term &#40;trimester&#41; of the academic year&#46; Once each term&#44; a workshop for all the students of approximately 60<span class="elsevierStyleHsp" style=""></span>min of duration was conducted by two paediatricians from the research team&#44; and supplemented with activities on the same subject led by teachers in the classrooms every two weeks or every month&#46; The first term emphasised the importance of having breakfast to achieve an optimal diet&#59; in the second term&#44; the focus was on the need of having a varied diet&#59; and in the third term there was a discussion of which foods are more or less healthy&#46; In the second year of the intervention&#44; the workshops focused on healthy snacks and the importance of eating fish&#44; fruits and vegetables&#59; &#40;2&#41; educational talks for the parents&#44; 60<span class="elsevierStyleHsp" style=""></span>min long&#44; offered once each term&#44; on the same subjects covered in the workshops attended by the children&#44; and given by a paediatrician from the research team&#59; they took place in the evening hours to facilitate family attendance&#59; &#40;3&#41; a joint 2-h long workshop on healthy cooking and nutrition&#44; carried out collectively by paediatricians&#44; teachers and students&#8217; parents&#44; offered once each academic year&#59; &#40;4&#41; monthly meetings with teachers to study healthy lifestyle habits and nutrition and to resolve any doubts about these subjects&#59; &#40;5&#41; printed informational materials for the parents developed by the school&#39;s teaching staff on recommendations and limits pertaining to physical and sedentary activities&#44; and how to follow a healthy diet&#44; and &#40;6&#41; promotion of physical activity in recesses&#44; for example&#44; by recovering traditional outdoor children&#39;s games&#46; In agreement with the Asociaci&#243;n de Madres y Padres de Alumnos&#44; the use of handheld game consoles and mobile phones was banned during school hours&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">During the period of the study&#44; no such interventions were scheduled to be performed in the control school&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Outcome variables</span><p id="par0050" class="elsevierStylePara elsevierViewall">The primary outcome measure was the BMI <span class="elsevierStyleItalic">z</span>-score &#40;BMIz&#41;&#46; The secondary outcome measures were the prevalence of obesity and overweight&#44; waist circumference &#40;WC&#41;&#44; dietary habits and physical activity&#46; The measurements were taken consecutively in both schools at the beginning of the intervention in October 2006 and at the end in June 2008&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Weight was measured with the students barefoot and in light clothing&#44; and was rounded to an accuracy of 0&#46;1<span class="elsevierStyleHsp" style=""></span>kg with a calibrated scale &#40;Seca GmbH &#38; Co&#46; KG&#44; Hamburg&#44; Germany&#41;&#46; Height was measured with the students barefoot and rounded to the nearest millimetre using a rigid stadiometer &#40;A&#241;o Sayol SL&#44; Barcelona&#44; Spain&#41;&#46; Obesity and overweight were defined based on BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41; applying the cut-off points of the International Obesity Task Force&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> The World Health Organization &#40;WHO&#41; 2007 growth reference charts were used to calculate BMIz&#46; We measured WCs with a measuring tape at the level of the waist&#44; between the last rib and the iliac crest&#44; at the end of a normal expiration&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The quality of the diet was assessed by the KIDMED Mediterranean Diet Quality Index&#46; It is a questionnaire comprising 16 questions concerning the Mediterranean diet&#44; the final score of which gives the KIDMED index&#44; used to categorise the diet into 3 levels&#58; &#8805;8&#44; optimal diet&#59; 4&#8211;7&#44; dietary habits requiring improvement for better adherence to the Mediterranean pattern&#44; and &#8804;3&#44; very low quality diet&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Physical activity habits were assessed by means of the Physical Activity Scale&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> a self-administered questionnaire that has been previously used in children<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a> with questions covering time spent at school&#44; spare time and sports activities&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">The data were analysed with the SPSS 17&#46;0 software &#40;SPSS Inc&#46;&#44; Chicago&#44; USA&#41;&#46; We assessed the normality of the distributions by means of the Kolmogorov&#8211;Smirnov test&#46; We used Student&#39;s <span class="elsevierStyleItalic">t</span> test for independent or paired samples and the Mann&#8211;Whitney&#8211;Wilcoxon test as applicable&#46; We compared proportions by means of the chi square test&#46; We used McNemar&#39;s test to compare proportions before and after the intervention&#46; The level of statistical significance was set at <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; We have expressed discrete variables as percentages and continuous variables as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#40;interquartile range&#41; depending on whether or not they followed a normal distribution&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">The study included 382 of a total of 526 students enrolled in the first to fifth years of elementary education in the two schools &#40;177 girls&#44; 205 boys&#41;&#44; with an initial mean age of 8&#46;4 years &#40;range&#44; 5&#46;8&#8211;11&#46;8 years&#41;&#46; One hundred and forty four students declined to participate&#46; We obtained the full anthropometric data for 340 of the 382 participants &#40;162 girls&#44; 178 boys&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows a flow chart of the study participants&#59; losses to follow-up were due to students being absent at the time of the second measurement or changing schools&#46; The Physical Activity Scale questionnaire was completed by 213 children&#44; 150 from the control group and 63 from the intervention group&#46; The initial characteristics of both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; When the study started&#44; the participants in the intervention and control groups did not differ in age&#44; sex distribution&#44; BMIz&#44; WC or KIDMED index&#46; The students in the intervention school spent less time on sedentary activities and more time on physical activities&#46; We detected overweight or obesity in a total of 141 students from both groups &#40;41&#46;5&#37;&#41;&#46; In both groups&#44; the prevalence of overweight or obesity was greater in boys than in girls &#40;42&#46;0 vs 38&#46;9&#37; in the control school and 48&#47;5 vs 37&#46;0&#37; in the intervention school&#41;&#44; although this difference was not statistically significant&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the observed changes in BMIz in the intervention and control groups&#46; The BMIz decreased significantly in the intervention group &#40;initial&#44; 1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&#59; final&#44; 1&#46;02<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41;&#44; while no significant changes were observed in the control group &#40;initial&#44; 0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&#59; final&#44; 0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;09&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;150&#41;&#46; When we analysed the results stratifying by sex&#44; we observed that in the intervention school the BMIz only decreased significantly in girls&#44; while in the control school it increased significantly in boys&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">There was a decrease in the prevalence of obesity in both groups that was not statistically significant&#44; of 3&#46;3&#37; &#40;95&#37; confidence interval &#91;CI&#93;&#44; &#8722;9&#46;6&#37; to 2&#46;7&#37;&#41; in the intervention group and 1&#46;8&#37; &#40;95&#37; CI&#44; &#8722;5&#46;2&#37; to 1&#46;3&#37;&#41; in the control group&#46; When we considered the combined prevalence of overweight and obesity&#44; the differences were more pronounced in both groups&#44; although they still did not reach statistical significance&#58; in the intervention group&#44; it decreased by 3&#46;3&#37; &#40;95&#37; CI&#44; &#8722;10&#46;7&#37; to 4&#46;1&#37;&#41;&#44; while in the control group it increased by 2&#46;3&#37; &#40;95&#37; CI&#44; &#8722;2&#46;9&#37; to 7&#46;4&#37;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As for the impact of the programme on eating habits&#44; the KIDMED index of the intervention group improved&#44; changing from 7&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;61 to 7&#46;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;77 points &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#44; while we found no statistically significant differences in the control group&#44; the index of which changed from 7&#46;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;76 to 7&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;66 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;603&#41;&#46; The number of students that followed an optimal diet also increased in the intervention group &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; from 42&#46;6&#37; to 52&#46;3&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#44; while no significant differences were observed in the control group &#40;from 54&#46;1&#37; to 55&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;742&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The effects on physical activity habits are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; We did not find statistically significant differences in the intervention group between the beginning and the end of the intervention&#46; In the control school&#44; we only found a small increase in the time spent on helping with house chores and using computers and videogames&#44; along with a decrease in the duration of sleep and rest&#46; When we compared both schools at the end of the programme&#44; we found no statistically significant differences in the time spent on physical activities&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The proportion of individuals with a WC above the 95th percentile did not change in a statistically significant manner compared to the beginning of the study&#58; from 55&#46;0&#37; to 57&#46;5&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;664&#41; in the intervention group and from 54&#46;8&#37; to 56&#46;1&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;719&#41; in the control group&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The main finding of our study was a significant decrease in BMI in students in the intervention school compared to students in the control school&#46; This decrease was only found in girls&#44; but boys also benefitted&#44; as the intervention prevented the increase in BMI observed in the control school&#46; The intervention was also associated to changes in lifestyle&#44; with an improvement in the quality of the diet&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The results of this study are consistent with the most recent literature reviews&#44; which show strong evidence that school-based interventions may be moderately effective in helping reduce BMI in the paediatric population&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">16&#44;17</span></a> However&#44; these small changes achieved through population-based strategies &#8211; in this case&#44; focused on the population of schoolchildren and their families &#8211; may have a more considerable influence on overall cardiovascular risk and a greater probability of having a long-lasting effect than results achieved with interventions that focus solely on high-risk individuals&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;23</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Few studies have evaluated this type of intervention in Spain&#46; The Avall study&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> an intervention over the course of 2 academic years on the dietary and physical activity habits of first-year elementary school students in Granollers&#44; found that BMI and the combined prevalence of overweight and obesity increased less in the intervention group&#46; The Movi programme&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> a two-year long project of physical activity during leisure time conducted in Cuenca with schoolchildren 9&#8211;10 years of age did not find differences in BMI between the intervention and the control groups&#46; The best results were obtained in the EdAl study&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> a programme implemented over 3 academic years in school children 7&#8211;8 years of age in Reus that achieved significant reductions both in BMI and the prevalence of obesity in the intervention group&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Despite the reduction in BMI&#44; this study did not show a decrease in the prevalence of overweight or obesity&#46; This circumstance has been described in other studies with similar methodologies&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">27&#44;28</span></a> While it was not statistically significant&#44; we did observe a decreasing trend in the combined prevalence of overweight and obesity in the intervention group&#44; compared to an increase in the control group&#46; Something that stood out in our study was the high prevalence of overweight and obesity observed&#44; higher than the prevalences found in other interventions or reported in prevalence studies conducted in the same autonomous community under similar circumstances&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> It may be that children with overweight and obesity are less susceptible to community-based strategies&#44; but it is also possible that the effects on weight category are harder to prove in a small study than overall changes in BMI&#46; At present&#44; there is evidence that school-based interventions&#44; especially those of long duration&#44; are effective in reducing the prevalence of childhood obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Systematic reviews show that nutrition education&#44; the promotion of physical activity and the fight against sedentary behaviours are key elements in the long-term prevention of childhood obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;12&#44;13&#44;17</span></a> This is consistent with the findings in the intervention group of a higher KIDMED index and a greater proportion of children following an optimal Mediterranean diet at the end of the study&#46; We found no differences in physical activity between the two groups&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">There are limitations to this study&#46; The sample size was small&#44; and with only 2 schools participating&#44; it was not possible to perform a cluster randomisation&#46; We were careful to choose two public schools in neighbourhoods of similar socioeconomic characteristics&#44; but far enough from each other so as to avoid group contamination to the extent possible&#46; The intervention school was selected for the interest expressed in the past by its teaching staff in implementing a programme to fight obesity&#46; The collaboration of educators is indispensable to carry out an intervention programme of this nature&#44; so the results may not be generalisable to every school&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Another possible limitation of the study is that when it started&#44; the students in the intervention school spent less time engaged in sedentary activities and more time engaged in physical activities than the students in the control school&#46; This may be due to a previous greater involvement in health education on the part of the intervention school&#44; but nevertheless the intervention improved its past results&#44; as it obtained a higher KIDMED index of adherence to the Mediterranean diet&#46; Thus&#44; it is plausible that the observed reduction in BMI was due to the intervention&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Another limitation was the use of the Physical Activity Scale&#44; a self-administered questionnaire to measure physical activity validated in the adult population but rarely used in children&#46; Self-administered instruments provide information on the type and context of physical activity&#44; but pedometers or accelerometers are more objective measurement tools&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This kind of school-based programme may be a feasible way to improve children&#39;s health without a large investment of human and material resources&#46; In 1995&#44; the WHO launched the Global School Health Initiative&#44; an integral strategy that pursues teaching health information and skills in the classrooms&#44; changing the school environments&#44; and developing bonds with the community&#46; According to the Health Evidence Network of the WHO&#44; school-based programmes that promote good dietary and physical activity habits are among the most effective interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">In conclusion&#44; this school-based programme achieved improvements in BMI and dietary habits&#46; More studies are needed to establish the real effectiveness of these interventions and learn whether the improvements achieved last through adulthood&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Funding</span><p id="par0155" class="elsevierStylePara elsevierViewall">This project has been funded with a clinical and epidemiological research grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Fundaci&#243;n Ernesto S&#225;nchez Villares</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">2006&#47;02</span>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Intervention for childhood obesity is a public health priority&#46; The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avil&#233;s &#40;Spain&#41;&#46; The intervention lasted for 2 school years comprising healthy diet workshops&#44; educational chats&#44; educational meetings&#44; informative written material&#44; and promotion of physical activities&#46; Primary outcome measure was body mass index <span class="elsevierStyleItalic">z</span>-score&#46; Secondary outcomes included obesity and overweight prevalence&#44; waist circumference&#44; dietary habits&#44; and physical activity&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 382 &#40;177 girls&#44; 205 boys&#41; out of 526 pupils of both schools were included in the study&#46; Complete anthropometric data were obtained in 340 of the 382 individuals&#46; Compared to children in the control group&#44; those in the intervention group decreased body mass index <span class="elsevierStyleItalic">z</span>-score from 1&#46;14 to 1&#46;02 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41;&#44; and improved KIDMED score from 7&#46;33 to 7&#46;71 points &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#46; The percentage of students who carried on an optimal diet increased from 42&#46;6&#37; to 52&#46;3&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; There were no statistical differences in the prevalence of obesity and overweight&#44; or in waist circumference between the intervention and control groups&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This school-based programme resulted in modest beneficial changes in body mass index and diet quality&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las intervenciones sobre la obesidad infantil son una prioridad para la salud p&#250;blica&#46; El objetivo de este estudio fue evaluar la efectividad de un programa de intervenci&#243;n contra la obesidad en un colegio de Educaci&#243;n Primaria&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de intervenci&#243;n controlado no aleatorizado en alumnos de primero a quinto cursos de Educaci&#243;n Primaria en 2 colegios p&#250;blicos de Avil&#233;s &#40;Espa&#241;a&#41;&#46; La intervenci&#243;n se desarroll&#243; durante 2 cursos escolares&#44; incluyendo talleres sobre alimentaci&#243;n saludable&#44; charlas educativas&#44; material informativo escrito y promoci&#243;n de la actividad f&#237;sica&#46; La variable de resultado principal fue la puntuaci&#243;n z del &#237;ndice de masa corporal &#40;IMC&#41;&#46; Como variables de resultado secundarias se consideraron&#58; prevalencia de obesidad y sobrepeso&#44; per&#237;metro abdominal&#44; h&#225;bitos de dieta y actividad f&#237;sica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fueron incluidos en el estudio 382 &#40;177 ni&#241;as&#44; 205 ni&#241;os&#41; de 526 alumnos de ambos colegios&#46; En 340 individuos se obtuvieron datos antropom&#233;tricos completos&#46; A diferencia del grupo control&#44; los pertenecientes al grupo de intervenci&#243;n disminuyeron la puntuaci&#243;n z del IMC desde 1&#44;14 a 1&#44;02 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; mejoraron el &#237;ndice KIDMED de adhesi&#243;n a la dieta mediterr&#225;nea de 7&#44;33 a 7&#44;71 puntos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41; y aumentaron la proporci&#243;n de estudiantes con una dieta &#243;ptima del 42&#44;6&#37; al 52&#44;3&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#46; No se encontraron diferencias estad&#237;sticamente significativas en la prevalencia de obesidad y sobrepeso&#44; ni en el per&#237;metro abdominal&#44; entre los grupos de intervenci&#243;n y control&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Este programa escolar consigui&#243; peque&#241;as mejoras en el IMC y la calidad de la dieta&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; P&#233;rez Sol&#237;s D&#44; D&#237;az Mart&#237;n JJ&#44; &#193;lvarez Caro F&#44; Su&#225;rez Tom&#225;s I&#44; Su&#225;rez Men&#233;ndez E&#44; Ria&#241;o Gal&#225;n I&#46; Efectividad de una intervenci&#243;n escolar contra la obesidad&#46; An Pediatr &#40;Barc&#41;&#46; 2015&#59;83&#58;19&#8211;25&#46;</p>"
      ]
    ]
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        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart of participants throughout the study&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evolution of the KIDMED index of compliance with the Mediterranean diet in the intervention and control schools&#46;</p>"
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        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or as percentages&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BMIz&#44; body mass index <span class="elsevierStyleItalic">z</span>-score&#59; WC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th &#37;ile&#44; waist circumference<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th percentile&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">220&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Female&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age &#40;in years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">BMIz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">WC&#44; cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;625&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">KIDMED index&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sedentary activities&#44; h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Physical activities&#44; h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesity&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Overweight&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;534&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesity or overweight&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">WC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th &#37;ile&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Participant characteristics at the beginning of the study&#46;</p>"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Girls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;73<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;680&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Boys&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evolution of the body mass index <span class="elsevierStyleItalic">z</span>-score &#40;BMIz&#41; in the intervention and control schools&#44; overall and by sex&#46;</p>"
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        "etiqueta" => "Table 3"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as median &#40;interquartile range&#41; in hours a day &#40;h&#47;day&#41; or minutes a day &#40;min&#47;day&#41;&#46; The difference corresponds to the final value minus the initial value&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Activity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>150</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference &#40;min&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference &#40;min&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sleeping&#44; resting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;10&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;45 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;599&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sitting&#44; in class&#44; TV&#44; or reading&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;0 &#40;6&#46;0&#8211;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;0 &#40;6&#46;0&#8211;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;5&#46;0&#8211;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;5&#46;0&#8211;7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;71 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Computer&#44; videogames&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;732&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Organising&#44; cleaning up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;15 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;3 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Playing outdoors&#44; running errands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;38 &#40;1&#46;0&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9 &#40;1&#46;0&#8211;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;737&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;0 &#40;1&#46;0&#8211;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9 &#40;1&#46;0&#8211;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;37 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;610&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Helping with house chores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;0&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;0&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Walking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;33 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;848&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Exercising&#44; riding bicycle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;56&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;56&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sports&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;75&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;&#8722;15 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;75&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;19 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sedentary activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;0 &#40;16&#46;8&#8211;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;5 &#40;17&#46;3&#8211;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;3 &#40;15&#46;5&#8211;19&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5 &#40;16&#46;5&#8211;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;134 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;342&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Physical activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;0 &#40;3&#46;6&#8211;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;0 &#40;4&#46;0&#8211;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;&#8722;60 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;5 &#40;4&#46;0&#8211;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;4&#46;25&#8211;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;&#8722;97 to 120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;966&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Distribution of physical and sedentary activities at the beginning and the end of the intervention&#46;</p>"
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      "titulo" => "References"
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Original Article
Effectiveness of a school-based programme to prevent obesity
Efectividad de una intervención escolar contra la obesidad
D. Pérez Solísa,
Corresponding author
david@perezsolis.es

Corresponding author.
, J.J. Díaz Martínb, F. Álvarez Caroc, I. Suárez Tomása, E. Suárez Menéndeza, I. Riaño Galána
a Servicio de Pediatría, Hospital San Agustín, Avilés, Asturias, Spain
b Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
c Servicio de Pediatría, Hospital de Cabueñes, Gijón, Asturias, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The prevalence of childhood overweight and obesity has increased considerably worldwide since the 1990s&#44;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">1&#44;2</span></a> although recent studies show that it is stabilising in some developed countries&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> The high prevalence of overweight and obesity in the young population has been attributed partly to a decrease in physical activity and an increase in sedentary behaviours&#46; There is also a clear trend for individuals to have a combination of several cardiovascular risk factors that is more marked in obese children and adolescents&#46; Nearly half of the children with severe obesity meet the criteria for metabolic syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a> The cardiovascular and metabolic consequences of obesity&#44; such as hypertension&#44; insulin resistance and dyslipidaemia&#44; which may already be present in childhood&#44; are particularly worrisome&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Childhood overweight and obesity carry an increased risk of becoming an overweight or obese adult&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a> It is also known that treating obesity with lifestyle changes is extremely difficult in adults&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> Thus&#44; interventions should focus on treatment and prevention in the paediatric population&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Public health strategies have been advocated to improve cardiovascular health in children&#44; as research shows that they are more effective and easier to implement than other&#44; more selective strategies based on risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a> The school setting offers ample opportunity for intervention programmes&#46; For all of the above&#44; school-based programmes have been developed that aim at reducing childhood obesity and other cardiovascular risk factors&#44; usually by attempting to improve diet and physical activity&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The early literature reviews on school-based interventions for the prevention of childhood obesity have shown inconsistent results&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">8&#8211;14</span></a> However&#44; studies on this subject published in recent years and new literature reviews and meta-analyses have found strong evidence that integral school-based interventions can be effective in reducing body mass index &#40;BMI&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">15&#8211;17</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of our study was to assess the effect of an integral school-based intervention on BMI&#44; as well as on the prevalence of overweight and obesity and lifestyle habits such as diet and physical activity&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Type of study</span><p id="par0030" class="elsevierStylePara elsevierViewall">We carried out a school-based programme for preventing obesity designed as a non-randomised controlled trial&#46; We selected two public elementary schools in the town of Avil&#233;s &#40;Asturias&#44; Spain&#41;&#46; The intervention group consisted of the first- to fifth-year students of the Villalegre public school&#46; This school was chosen for the intervention because the previous year its teaching staff had expressed an interest in implementing a programme to fight obesity in collaboration with the Hospital San Agust&#237;n of Avil&#233;s&#46; The control group included the students enrolled in the same years at the El Quirinal public school&#44; located in another Avil&#233;s neighbourhood of similar socioeconomic characteristics&#46; The two schools are 3&#46;5<span class="elsevierStyleHsp" style=""></span>km apart&#44; separated by a national highway&#46; The school principals and the parent associations were given detailed information about the study and agreed to participate&#46; The study was approved by the Comit&#233; de &#201;tica de la Investigaci&#243;n &#40;Committee on Research Ethics&#41; of the Principality of Asturias&#44; and we obtained the written informed consent of the parents or legal guardians of participating students&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Intervention</span><p id="par0035" class="elsevierStylePara elsevierViewall">The intervention project&#44; called &#8220;<span class="elsevierStyleItalic">T&#250; decides tu salud&#46; &#161;Ponte a vivir&#33;</span>&#8221; &#40;Your health is up to you&#46; Start living&#33;&#41; was implemented for 2 consecutive academic years &#40;September through June&#41; The activities of the programme were designed by the teaching staff of the school under the guidance of the paediatricians of the research team&#44; and were carried out in the school&#46; The programme was supported by the Asociaci&#243;n de Madres y Padres de Alumnos &#40;Association of Students&#8217; Mothers and Fathers&#41;&#44; with whom we held several meetings prior to the study to explain the project and receive suggestions&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The activities carried out consisted of&#58; &#40;1&#41; workshops on healthy nutrition for the students&#44; offered every term &#40;trimester&#41; of the academic year&#46; Once each term&#44; a workshop for all the students of approximately 60<span class="elsevierStyleHsp" style=""></span>min of duration was conducted by two paediatricians from the research team&#44; and supplemented with activities on the same subject led by teachers in the classrooms every two weeks or every month&#46; The first term emphasised the importance of having breakfast to achieve an optimal diet&#59; in the second term&#44; the focus was on the need of having a varied diet&#59; and in the third term there was a discussion of which foods are more or less healthy&#46; In the second year of the intervention&#44; the workshops focused on healthy snacks and the importance of eating fish&#44; fruits and vegetables&#59; &#40;2&#41; educational talks for the parents&#44; 60<span class="elsevierStyleHsp" style=""></span>min long&#44; offered once each term&#44; on the same subjects covered in the workshops attended by the children&#44; and given by a paediatrician from the research team&#59; they took place in the evening hours to facilitate family attendance&#59; &#40;3&#41; a joint 2-h long workshop on healthy cooking and nutrition&#44; carried out collectively by paediatricians&#44; teachers and students&#8217; parents&#44; offered once each academic year&#59; &#40;4&#41; monthly meetings with teachers to study healthy lifestyle habits and nutrition and to resolve any doubts about these subjects&#59; &#40;5&#41; printed informational materials for the parents developed by the school&#39;s teaching staff on recommendations and limits pertaining to physical and sedentary activities&#44; and how to follow a healthy diet&#44; and &#40;6&#41; promotion of physical activity in recesses&#44; for example&#44; by recovering traditional outdoor children&#39;s games&#46; In agreement with the Asociaci&#243;n de Madres y Padres de Alumnos&#44; the use of handheld game consoles and mobile phones was banned during school hours&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">During the period of the study&#44; no such interventions were scheduled to be performed in the control school&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Outcome variables</span><p id="par0050" class="elsevierStylePara elsevierViewall">The primary outcome measure was the BMI <span class="elsevierStyleItalic">z</span>-score &#40;BMIz&#41;&#46; The secondary outcome measures were the prevalence of obesity and overweight&#44; waist circumference &#40;WC&#41;&#44; dietary habits and physical activity&#46; The measurements were taken consecutively in both schools at the beginning of the intervention in October 2006 and at the end in June 2008&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Weight was measured with the students barefoot and in light clothing&#44; and was rounded to an accuracy of 0&#46;1<span class="elsevierStyleHsp" style=""></span>kg with a calibrated scale &#40;Seca GmbH &#38; Co&#46; KG&#44; Hamburg&#44; Germany&#41;&#46; Height was measured with the students barefoot and rounded to the nearest millimetre using a rigid stadiometer &#40;A&#241;o Sayol SL&#44; Barcelona&#44; Spain&#41;&#46; Obesity and overweight were defined based on BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41; applying the cut-off points of the International Obesity Task Force&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> The World Health Organization &#40;WHO&#41; 2007 growth reference charts were used to calculate BMIz&#46; We measured WCs with a measuring tape at the level of the waist&#44; between the last rib and the iliac crest&#44; at the end of a normal expiration&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The quality of the diet was assessed by the KIDMED Mediterranean Diet Quality Index&#46; It is a questionnaire comprising 16 questions concerning the Mediterranean diet&#44; the final score of which gives the KIDMED index&#44; used to categorise the diet into 3 levels&#58; &#8805;8&#44; optimal diet&#59; 4&#8211;7&#44; dietary habits requiring improvement for better adherence to the Mediterranean pattern&#44; and &#8804;3&#44; very low quality diet&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Physical activity habits were assessed by means of the Physical Activity Scale&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> a self-administered questionnaire that has been previously used in children<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a> with questions covering time spent at school&#44; spare time and sports activities&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">The data were analysed with the SPSS 17&#46;0 software &#40;SPSS Inc&#46;&#44; Chicago&#44; USA&#41;&#46; We assessed the normality of the distributions by means of the Kolmogorov&#8211;Smirnov test&#46; We used Student&#39;s <span class="elsevierStyleItalic">t</span> test for independent or paired samples and the Mann&#8211;Whitney&#8211;Wilcoxon test as applicable&#46; We compared proportions by means of the chi square test&#46; We used McNemar&#39;s test to compare proportions before and after the intervention&#46; The level of statistical significance was set at <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; We have expressed discrete variables as percentages and continuous variables as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#40;interquartile range&#41; depending on whether or not they followed a normal distribution&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">The study included 382 of a total of 526 students enrolled in the first to fifth years of elementary education in the two schools &#40;177 girls&#44; 205 boys&#41;&#44; with an initial mean age of 8&#46;4 years &#40;range&#44; 5&#46;8&#8211;11&#46;8 years&#41;&#46; One hundred and forty four students declined to participate&#46; We obtained the full anthropometric data for 340 of the 382 participants &#40;162 girls&#44; 178 boys&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows a flow chart of the study participants&#59; losses to follow-up were due to students being absent at the time of the second measurement or changing schools&#46; The Physical Activity Scale questionnaire was completed by 213 children&#44; 150 from the control group and 63 from the intervention group&#46; The initial characteristics of both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; When the study started&#44; the participants in the intervention and control groups did not differ in age&#44; sex distribution&#44; BMIz&#44; WC or KIDMED index&#46; The students in the intervention school spent less time on sedentary activities and more time on physical activities&#46; We detected overweight or obesity in a total of 141 students from both groups &#40;41&#46;5&#37;&#41;&#46; In both groups&#44; the prevalence of overweight or obesity was greater in boys than in girls &#40;42&#46;0 vs 38&#46;9&#37; in the control school and 48&#47;5 vs 37&#46;0&#37; in the intervention school&#41;&#44; although this difference was not statistically significant&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the observed changes in BMIz in the intervention and control groups&#46; The BMIz decreased significantly in the intervention group &#40;initial&#44; 1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&#59; final&#44; 1&#46;02<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41;&#44; while no significant changes were observed in the control group &#40;initial&#44; 0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&#59; final&#44; 0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;09&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;150&#41;&#46; When we analysed the results stratifying by sex&#44; we observed that in the intervention school the BMIz only decreased significantly in girls&#44; while in the control school it increased significantly in boys&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">There was a decrease in the prevalence of obesity in both groups that was not statistically significant&#44; of 3&#46;3&#37; &#40;95&#37; confidence interval &#91;CI&#93;&#44; &#8722;9&#46;6&#37; to 2&#46;7&#37;&#41; in the intervention group and 1&#46;8&#37; &#40;95&#37; CI&#44; &#8722;5&#46;2&#37; to 1&#46;3&#37;&#41; in the control group&#46; When we considered the combined prevalence of overweight and obesity&#44; the differences were more pronounced in both groups&#44; although they still did not reach statistical significance&#58; in the intervention group&#44; it decreased by 3&#46;3&#37; &#40;95&#37; CI&#44; &#8722;10&#46;7&#37; to 4&#46;1&#37;&#41;&#44; while in the control group it increased by 2&#46;3&#37; &#40;95&#37; CI&#44; &#8722;2&#46;9&#37; to 7&#46;4&#37;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As for the impact of the programme on eating habits&#44; the KIDMED index of the intervention group improved&#44; changing from 7&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;61 to 7&#46;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;77 points &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#44; while we found no statistically significant differences in the control group&#44; the index of which changed from 7&#46;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;76 to 7&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;66 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;603&#41;&#46; The number of students that followed an optimal diet also increased in the intervention group &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; from 42&#46;6&#37; to 52&#46;3&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#44; while no significant differences were observed in the control group &#40;from 54&#46;1&#37; to 55&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;742&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The effects on physical activity habits are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; We did not find statistically significant differences in the intervention group between the beginning and the end of the intervention&#46; In the control school&#44; we only found a small increase in the time spent on helping with house chores and using computers and videogames&#44; along with a decrease in the duration of sleep and rest&#46; When we compared both schools at the end of the programme&#44; we found no statistically significant differences in the time spent on physical activities&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The proportion of individuals with a WC above the 95th percentile did not change in a statistically significant manner compared to the beginning of the study&#58; from 55&#46;0&#37; to 57&#46;5&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;664&#41; in the intervention group and from 54&#46;8&#37; to 56&#46;1&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;719&#41; in the control group&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The main finding of our study was a significant decrease in BMI in students in the intervention school compared to students in the control school&#46; This decrease was only found in girls&#44; but boys also benefitted&#44; as the intervention prevented the increase in BMI observed in the control school&#46; The intervention was also associated to changes in lifestyle&#44; with an improvement in the quality of the diet&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The results of this study are consistent with the most recent literature reviews&#44; which show strong evidence that school-based interventions may be moderately effective in helping reduce BMI in the paediatric population&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">16&#44;17</span></a> However&#44; these small changes achieved through population-based strategies &#8211; in this case&#44; focused on the population of schoolchildren and their families &#8211; may have a more considerable influence on overall cardiovascular risk and a greater probability of having a long-lasting effect than results achieved with interventions that focus solely on high-risk individuals&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;23</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Few studies have evaluated this type of intervention in Spain&#46; The Avall study&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> an intervention over the course of 2 academic years on the dietary and physical activity habits of first-year elementary school students in Granollers&#44; found that BMI and the combined prevalence of overweight and obesity increased less in the intervention group&#46; The Movi programme&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> a two-year long project of physical activity during leisure time conducted in Cuenca with schoolchildren 9&#8211;10 years of age did not find differences in BMI between the intervention and the control groups&#46; The best results were obtained in the EdAl study&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> a programme implemented over 3 academic years in school children 7&#8211;8 years of age in Reus that achieved significant reductions both in BMI and the prevalence of obesity in the intervention group&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Despite the reduction in BMI&#44; this study did not show a decrease in the prevalence of overweight or obesity&#46; This circumstance has been described in other studies with similar methodologies&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">27&#44;28</span></a> While it was not statistically significant&#44; we did observe a decreasing trend in the combined prevalence of overweight and obesity in the intervention group&#44; compared to an increase in the control group&#46; Something that stood out in our study was the high prevalence of overweight and obesity observed&#44; higher than the prevalences found in other interventions or reported in prevalence studies conducted in the same autonomous community under similar circumstances&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> It may be that children with overweight and obesity are less susceptible to community-based strategies&#44; but it is also possible that the effects on weight category are harder to prove in a small study than overall changes in BMI&#46; At present&#44; there is evidence that school-based interventions&#44; especially those of long duration&#44; are effective in reducing the prevalence of childhood obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Systematic reviews show that nutrition education&#44; the promotion of physical activity and the fight against sedentary behaviours are key elements in the long-term prevention of childhood obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">9&#44;12&#44;13&#44;17</span></a> This is consistent with the findings in the intervention group of a higher KIDMED index and a greater proportion of children following an optimal Mediterranean diet at the end of the study&#46; We found no differences in physical activity between the two groups&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">There are limitations to this study&#46; The sample size was small&#44; and with only 2 schools participating&#44; it was not possible to perform a cluster randomisation&#46; We were careful to choose two public schools in neighbourhoods of similar socioeconomic characteristics&#44; but far enough from each other so as to avoid group contamination to the extent possible&#46; The intervention school was selected for the interest expressed in the past by its teaching staff in implementing a programme to fight obesity&#46; The collaboration of educators is indispensable to carry out an intervention programme of this nature&#44; so the results may not be generalisable to every school&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Another possible limitation of the study is that when it started&#44; the students in the intervention school spent less time engaged in sedentary activities and more time engaged in physical activities than the students in the control school&#46; This may be due to a previous greater involvement in health education on the part of the intervention school&#44; but nevertheless the intervention improved its past results&#44; as it obtained a higher KIDMED index of adherence to the Mediterranean diet&#46; Thus&#44; it is plausible that the observed reduction in BMI was due to the intervention&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Another limitation was the use of the Physical Activity Scale&#44; a self-administered questionnaire to measure physical activity validated in the adult population but rarely used in children&#46; Self-administered instruments provide information on the type and context of physical activity&#44; but pedometers or accelerometers are more objective measurement tools&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This kind of school-based programme may be a feasible way to improve children&#39;s health without a large investment of human and material resources&#46; In 1995&#44; the WHO launched the Global School Health Initiative&#44; an integral strategy that pursues teaching health information and skills in the classrooms&#44; changing the school environments&#44; and developing bonds with the community&#46; According to the Health Evidence Network of the WHO&#44; school-based programmes that promote good dietary and physical activity habits are among the most effective interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">In conclusion&#44; this school-based programme achieved improvements in BMI and dietary habits&#46; More studies are needed to establish the real effectiveness of these interventions and learn whether the improvements achieved last through adulthood&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Funding</span><p id="par0155" class="elsevierStylePara elsevierViewall">This project has been funded with a clinical and epidemiological research grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Fundaci&#243;n Ernesto S&#225;nchez Villares</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">2006&#47;02</span>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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            1 => "Obesity"
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            0 => "&#205;ndice de masa corporal"
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            2 => "Sobrepeso"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Intervention for childhood obesity is a public health priority&#46; The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avil&#233;s &#40;Spain&#41;&#46; The intervention lasted for 2 school years comprising healthy diet workshops&#44; educational chats&#44; educational meetings&#44; informative written material&#44; and promotion of physical activities&#46; Primary outcome measure was body mass index <span class="elsevierStyleItalic">z</span>-score&#46; Secondary outcomes included obesity and overweight prevalence&#44; waist circumference&#44; dietary habits&#44; and physical activity&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 382 &#40;177 girls&#44; 205 boys&#41; out of 526 pupils of both schools were included in the study&#46; Complete anthropometric data were obtained in 340 of the 382 individuals&#46; Compared to children in the control group&#44; those in the intervention group decreased body mass index <span class="elsevierStyleItalic">z</span>-score from 1&#46;14 to 1&#46;02 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41;&#44; and improved KIDMED score from 7&#46;33 to 7&#46;71 points &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#46; The percentage of students who carried on an optimal diet increased from 42&#46;6&#37; to 52&#46;3&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; There were no statistical differences in the prevalence of obesity and overweight&#44; or in waist circumference between the intervention and control groups&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This school-based programme resulted in modest beneficial changes in body mass index and diet quality&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las intervenciones sobre la obesidad infantil son una prioridad para la salud p&#250;blica&#46; El objetivo de este estudio fue evaluar la efectividad de un programa de intervenci&#243;n contra la obesidad en un colegio de Educaci&#243;n Primaria&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de intervenci&#243;n controlado no aleatorizado en alumnos de primero a quinto cursos de Educaci&#243;n Primaria en 2 colegios p&#250;blicos de Avil&#233;s &#40;Espa&#241;a&#41;&#46; La intervenci&#243;n se desarroll&#243; durante 2 cursos escolares&#44; incluyendo talleres sobre alimentaci&#243;n saludable&#44; charlas educativas&#44; material informativo escrito y promoci&#243;n de la actividad f&#237;sica&#46; La variable de resultado principal fue la puntuaci&#243;n z del &#237;ndice de masa corporal &#40;IMC&#41;&#46; Como variables de resultado secundarias se consideraron&#58; prevalencia de obesidad y sobrepeso&#44; per&#237;metro abdominal&#44; h&#225;bitos de dieta y actividad f&#237;sica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fueron incluidos en el estudio 382 &#40;177 ni&#241;as&#44; 205 ni&#241;os&#41; de 526 alumnos de ambos colegios&#46; En 340 individuos se obtuvieron datos antropom&#233;tricos completos&#46; A diferencia del grupo control&#44; los pertenecientes al grupo de intervenci&#243;n disminuyeron la puntuaci&#243;n z del IMC desde 1&#44;14 a 1&#44;02 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; mejoraron el &#237;ndice KIDMED de adhesi&#243;n a la dieta mediterr&#225;nea de 7&#44;33 a 7&#44;71 puntos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41; y aumentaron la proporci&#243;n de estudiantes con una dieta &#243;ptima del 42&#44;6&#37; al 52&#44;3&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#46; No se encontraron diferencias estad&#237;sticamente significativas en la prevalencia de obesidad y sobrepeso&#44; ni en el per&#237;metro abdominal&#44; entre los grupos de intervenci&#243;n y control&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Este programa escolar consigui&#243; peque&#241;as mejoras en el IMC y la calidad de la dieta&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; P&#233;rez Sol&#237;s D&#44; D&#237;az Mart&#237;n JJ&#44; &#193;lvarez Caro F&#44; Su&#225;rez Tom&#225;s I&#44; Su&#225;rez Men&#233;ndez E&#44; Ria&#241;o Gal&#225;n I&#46; Efectividad de una intervenci&#243;n escolar contra la obesidad&#46; An Pediatr &#40;Barc&#41;&#46; 2015&#59;83&#58;19&#8211;25&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart of participants throughout the study&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evolution of the KIDMED index of compliance with the Mediterranean diet in the intervention and control schools&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or as percentages&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BMIz&#44; body mass index <span class="elsevierStyleItalic">z</span>-score&#59; WC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th &#37;ile&#44; waist circumference<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th percentile&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">220&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Female&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age &#40;in years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">BMIz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">WC&#44; cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;625&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">KIDMED index&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sedentary activities&#44; h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Physical activities&#44; h&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesity&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Overweight&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;534&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Obesity or overweight&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">WC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95th &#37;ile&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Participant characteristics at the beginning of the study&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Girls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;73<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;680&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Boys&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evolution of the body mass index <span class="elsevierStyleItalic">z</span>-score &#40;BMIz&#41; in the intervention and control schools&#44; overall and by sex&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as median &#40;interquartile range&#41; in hours a day &#40;h&#47;day&#41; or minutes a day &#40;min&#47;day&#41;&#46; The difference corresponds to the final value minus the initial value&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Activity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>150</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference &#40;min&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final &#40;h&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference &#40;min&#47;day&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sleeping&#44; resting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;10&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0 &#40;9&#46;0&#8211;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;45 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;599&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sitting&#44; in class&#44; TV&#44; or reading&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;0 &#40;6&#46;0&#8211;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;0 &#40;6&#46;0&#8211;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;5&#46;0&#8211;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;5&#46;0&#8211;7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;71 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Computer&#44; videogames&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;732&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Organising&#44; cleaning up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;15 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;3 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Playing outdoors&#44; running errands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;38 &#40;1&#46;0&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9 &#40;1&#46;0&#8211;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;737&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;0 &#40;1&#46;0&#8211;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9 &#40;1&#46;0&#8211;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;37 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;610&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Helping with house chores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;0&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;0 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25 &#40;0&#46;0&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;0&#46;25&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Walking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;33 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;848&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Exercising&#44; riding bicycle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;56&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;56&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;30 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sports&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;75&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;&#8722;15 to 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;5&#8211;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;75&#8211;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;19 to 60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sedentary activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;0 &#40;16&#46;8&#8211;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;5 &#40;17&#46;3&#8211;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;60 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;3 &#40;15&#46;5&#8211;19&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5 &#40;16&#46;5&#8211;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;&#8722;134 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;342&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Physical activities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;0 &#40;3&#46;6&#8211;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;0 &#40;4&#46;0&#8211;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;&#8722;60 to 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;5 &#40;4&#46;0&#8211;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;4&#46;25&#8211;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;&#8722;97 to 120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;966&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Distribution of physical and sedentary activities at the beginning and the end of the intervention&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in childhood and adolescent obesity prevalence in Oviedo &#40;Asturias&#44; Spain&#41; 1992&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; D&#237;az Mart&#237;n"
                            1 => "L&#46; Somalo Hern&#225;ndez"
                            2 => "M&#46; Garc&#237;a Gonzalez"
                            3 => "C&#46; Perill&#225;n Mendez"
                            4 => "C&#46; Rey Gal&#225;n"
                            5 => "S&#46; M&#225;laga Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2008.00828.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2008"
                        "volumen" => "97"
                        "paginaInicial" => "955"
                        "paginaFinal" => "958"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18462466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global prevalence and trends of overweight and obesity among preschool children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; De Onis"
                            1 => "M&#46; Bl&#246;ssner"
                            2 => "E&#46; Borghi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3945/ajcn.2010.29786"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr"
                        "fecha" => "2010"
                        "volumen" => "92"
                        "paginaInicial" => "1257"
                        "paginaFinal" => "1264"
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        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0165" class="elsevierStylePara elsevierViewall">We want to thank all the teachers&#44; students and families that participated in the project&#46; We thank Isabel Aguilera&#44; a teacher at the Villalegre public school&#44; for her outstanding work and leadership in launching the school-based programme&#46;</p>"
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ISSN: 23412879
Original language: English
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