Effects of Before-School Physical Activity on Obesity Prevention and Wellness

  • Rachel C. Whooten
    Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
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  • Meghan E. Perkins
    Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
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  • Monica W. Gerber
    Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
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  • Elsie M. Taveras
    Address correspondence to: Elsie M. Taveras, MD, MPH, Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston MA 02114
    Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts

    Kraft Center for Community Health, Massachusetts General Hospital, Boston, Massachusetts

    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Published:February 12, 2018DOI:


      The effects of Build Our Kids Success—a 12-week, 1-hour before-school physical activity program—on BMI and social–emotional wellness among kindergarten to eighth grade students was examined.

      Study Design

      This was a nonrandomized trial.


      Participants were from 24 schools in Massachusetts; there were 707 children from kindergarten to eighth grade.


      Children registered for Build Our Kids Success in 2015–2016 participated in a 2 days/week or 3 days/week program. Nonparticipating children served as controls.

      Main outcome measures

      At baseline and 12 weeks, study staff measured children’s heights/weights; children aged ≥8 years completed surveys. Main outcomes were 12-week change in BMI z-score, odds of a lower BMI category at follow-up, and child report of social−emotional wellness. Analyses were completed in March−June 2017.


      Follow-up BMI was obtained from 67% of children and self-reported surveys from 72% of age-eligible children. Children in the 3 days/week group had improvements in BMI z-score (−0.22, 95% CI= −0.31, −0.14) and this mean change was significantly different than the comparison group (−0.17 difference, 95% CI= −0.27, −0.07). Children in the 3 days/week group also had higher odds of being in a lower BMI category at follow-up (OR=1.35, 95% CI=1.12, 1.62); significantly different than the comparison group (p<0.01). Children in the 2 days/week program had no significant changes in BMI outcomes. Children in the 3 days/week group demonstrated improvement in their student engagement scores (0.79 units, p=0.05) and had nonsignificant improvements in reported peer relationships, affect, and life satisfaction versus comparison. The 2 days/week group had significant improvements in positive affect and vitality/energy versus comparison.


      A 3 days/week before-school physical activity program resulted in improved BMI and prevented increases in child obesity. Both Build Our Kids Success groups had improved social−emotional wellness versus controls.

      Trial registration

      This study is registered at NCT03190135.
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