Participatory intervention to improve nutrition and physical activity of school-age children in Mexico.

Obesity is one of the major public health problems of the 21st century, affecting every country in the world. In Mexico, the prevalence of overweight and obesity in children (5 to 11 years) was 35.5%. Childhood obesity is a chronic disease itself; and is associated with other chronic conditions. To assess the effect and feasibility of a participatory intervention to improve nutrition and physical activity within the school environment in children in public elementary schools in Mexico. The present study is a cluster trial. The intervention focused on; changes in food offered, training the schools' food service staff, promoting water consumption and physical activity at the community level, implementing healthy spaces inside the school, improving the quality of physical education within schools, among others. The main outcomes will focus on rate of weight gain, time devoted to physical activity, sedentary behaviors, diet quality and response feeding behaviors. We also will assess the time and personnel involved in the intervention development, maintenance, and dissemination. Findings from this trial will generate new translational knowledge in Mexico; if the results are positive, this participatory intervention could serve as a basis for designing multidimensional interventions that could be scaled up at the national level.

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Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.