***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Population -based studies directed at promoting physical activity in youth have shown limited success in obesity prevention . Objective : To assess whether an intervention integrating environmental changes to induce sustained changes in physical activity , prevents overweight in adolescents . Design : Four-year r and omized trial started in 2002 in eight middle schools of Eastern France . The intervention , r and omized at school level , was design ed to promote physical activity by changing attitudes through debates and attractive activities , and by providing social support and environmental changes encouraging physical activity . Subjects : Nine hundred and fifty four 12-year-old six- grade rs . Measurements : Body mass index ( BMI ) , body composition , physical activity by question naire , plasma lipids and glucose , insulin resistance . Results : Intervention students had a lower increase in BMI ( P=0.01 ) and age- and gender-adjusted BMI ( P<0.02 ) over time than controls . The differences across groups of the age- and gender-adjusted BMI changes ( 95 % confidence interval ( CI ) ) were −0.29 ( −0.51 ; −0.07 ) kg/m2 at 3 years , −0.25 ( −0.51 ; 0.01 ) kg/m2 at 4 years . An interaction with baseline weight status was noted . The intervention had a significant effect throughout the study in initially non-overweight adolescents ( −0.36 ( −0.60;−0.11 ) kg/m2 for adjusted BMI at 4 years ) , corresponding to a lower increase in fat mass index ( P<0.001 ) . In initially overweight adolescents , the differences observed across groups at 2 years ( –0.40 ( −0.94 ; 0.13 ) kg/m2 for adjusted BMI ) did not persist over time . At 4 years , 4.2 % of the initially non-overweight adolescents were overweight in the intervention schools , 9.8 % in the controls ( odds ratio=0.41 ( 0.22 ; 0.75 ) ; P<0.01 ) . Independent of initial weight status , compared with controls , intervention adolescents had an increase in supervised physical activity ( P<0.0001 ) , a decrease of TV/video viewing ( P<0.01 ) and an increase of high-density cholesterol concentrations ( P<0.0001 ) . Conclusion : Enhancing physical activity with a multilevel program prevents excessive weight gain in non-overweight adolescents . Our study provides evidence that prevention of obesity in youth is feasible This study aims to evaluate the cost-effectiveness of a long-term workplace health promotion programme on physical activity ( PA ) and nutrition . In total , 924 participants enrolled in a 2-year cluster r and omized controlled trial , with departments ( n = 74 ) within companies ( n = 6 ) as the unit of r and omization . The intervention was compared with a st and ard programme consisting of a physical health check with face-to-face advice and personal feedback on a website . The intervention consisted of several additional website functionalities : action-oriented feedback , self-monitoring , possibility to ask questions and monthly e-mail messages . Primary outcomes were meeting the guidelines for PA and fruit and vegetable intake . Secondary outcomes were self-perceived health , obesity , elevated blood pressure , elevated cholesterol level and maximum oxygen uptake . Direct and indirect costs were calculated from a societal perspective , and a process evaluation was performed . Of the 924 participants , 72 % participated in the first and 60 % in the second follow-up . No statistically significant differences were found on primary and secondary outcomes , nor on costs . Average direct costs per participant over the 2-year period were € 376 , and average indirect costs were € 9476 . In conclusion , no additional benefits were found in effects or cost savings . Therefore , the programme in its current form can not be recommended for implementation Background There is growing evidence of the impact of overweight and obesity on short- and long-term functioning , health and well-being . Internationally , childhood obesity rates continue to rise in some countries ( for example , Mexico , India , China and Canada ) , although there is emerging evidence of a slowing of this increase or a plateauing in some age groups . In most European countries , the United States and Australia , however , socioeconomic inequalities in relation to obesity and risk factors for obesity are widening . Addressing inequalities in obesity , therefore , has a very high profile on the public health and health services agendas . However , there is a lack of accessible policy-ready evidence on what works in terms of interventions to reduce inequalities in obesity . Methods and design This article describes the protocol for a National Health Service Trust ( NHS ) National Institute for Health Research -funded systematic review of public health interventions at the individual , community and societal levels which might reduce socioeconomic inequalities in relation to obesity amongst children ages 0 to 18 years . The studies will be selected only if ( 1 ) they included a primary outcome that is a proxy for body fatness and ( 2 ) examined differential effects with regard to socioeconomic status ( education , income , occupation , social class , deprivation and poverty ) or the intervention was targeted specifically at disadvantaged groups ( for example , children of the unemployed , lone parents , low income and so on ) or at people who live in deprived areas . A rigorous and inclusive international literature search will be conducted for r and omised and nonr and omised controlled trials , prospect i ve and retrospective cohort studies ( with and /or without control groups ) and prospect i ve repeat cross-sectional studies ( with and /or without control groups ) . The following electronic data bases will be search ed : MEDLINE , Embase , CINAHL , PsycINFO , Social Science Citation Index , ASSIA , IBSS , Sociological Abstract s and the NHS Economic Evaluation Data base . Data base search es will be supplemented with website and grey literature search es . No studies will be excluded on the basis of language , country of origin or publication date . Study inclusion , data extraction and quality appraisal will be conducted by two review ers . Meta- analysis and narrative synthesis will be conducted . The main analysis will examine the effects of ( 1 ) individual , ( 2 ) community and ( 3 ) societal level public health interventions on socioeconomic inequalities in childhood obesity . Interventions will be characterised by their level of action and their approach to tackling inequalities . Context ual information on how such public health interventions are organised , implemented and delivered will also be examined . Discussion In this review , we consider public health strategies which reduce and prevent inequalities in the prevalence of childhood obesity , highlight any gaps in the evidence base and seek to establish how such public health interventions are organised , implemented and delivered . PROSPERO registration number : OBJECTIVE Over the past several decades , the prevalence of childhood obesity has increased worldwide . In France , the National Nutrition and Health Program ( PNNS ) , implemented in 2001 , was aim ed at stopping this increase . The purpose of our study was to monitor changes in prevalence of overweight and obesity in 7 - 9-year-old children in France since the PNNS was set up . METHODS A cross-sectional study was conducted in 2007 in France based on a comparable protocol used in 2000 . Primary schools were r and omly selected in 11 out of 26 administrative school districts . In each of these schools , two classes were r and omly selected . All children from these classes were included .  Weight and height were measured by nurses or physicians belonging to the French educational system . A lifestyle self-administered question naire was completed by the parents . International Obesity Task Force cut-offs were used to define body mass status . Direct st and ardization was used to enable a comparison between 2000 and 2007 . RESULTS In 2007 , the prevalence of overweight was 15.8 % , including 2.8 % obesity , compared with 18.1 % and 3.8 % , respectively , in 2000 . Differences between 2000 and 2007 did not reach statistical significance . In both years , the risk of being overweight or obese was significantly lower for children whose parents ' occupation was that of manager or white collar rather than the other , less-privileged occupational categories . CONCLUSION Our study demonstrates stabilization of the prevalence of overweight and obesity  in 7 - 9-year-old children in France between 2000 and 2007 . It is possible that the PNNS may be partly responsible for this stabilization OBJECTIVE : To describe the design , methods , and first year results of the Pound of Prevention ( POP ) study , a r and omized trial examining whether weight gain with age can be prevented using low intensity intervention . DESIGN : Participants were r and omized to either ( 1 ) no-contact control , ( 2 ) education through monthly newsletters and semiannual classes on nutrition and exercise , and ( 3 ) education plus a lottery incentive for participation . SUBJECTS : Two hundred and twenty-eight men , 594 high-income women , and 404 low-income women . Entry requirements were age 20–45 y , healthy , and willing to participate for three years . MEASUREMENTS : At baseline and one year later , participants were weighed and completed question naires about behaviors and attitudes related to weight and weight control . RESULTS : Mean body mass indices at baseline were 28.1 , 26.1 , and 28.2 for men , high-income women and low-income women , respectively . After one year , participants in the intervention conditions reported significantly increased frequency of weight monitoring , but no change in other targeted behaviors . One year weight changes in the control , education , and education plus lottery groups were 1.94 lb , 0.72 lb , and 0.21 lb in men ; 1.38 lb , 1.03 lb , and 0.51 lb in high-income women ; and 1.30 lb , 2.11 lb , and 3.23 lb in low-income women . CONCLUSIONS : These one-year results suggest that the intervention may be having a greater impact on high than low-income participants OBJECTIVE To assess the effects of reducing television viewing and computer use on children 's  body mass index ( BMI ) as a risk factor for the development of overweight in young children . DESIGN R and omized controlled clinical trial . SETTING University children 's hospital . PARTICIPANTS Seventy children aged 4 to 7 years whose BMI was at or above the 75th BMI percentile for age and sex . INTERVENTIONS Children were r and omized to an intervention to reduce their television viewing and computer use by 50 % vs a monitoring control group that did not reduce television viewing or computer use . MAIN OUTCOME MEASURES Age- and sex-st and ardized BMI ( z BMI ) , television viewing , energy intake , and physical activity were monitored every 6 months during 2 years . RESULTS Children r and omized to the intervention group showed greater reductions in targeted sedentary behavior ( P < .001 ) , z BMI ( P < .05 ) , and energy intake ( P < .05 ) compared with the monitoring control group . Socioeconomic status moderated z BMI change ( P = .01 ) , with the experimental intervention working better among families of low socioeconomic status . Changes in targeted sedentary behavior mediated changes in z BMI ( P < .05 ) . The change in television viewing was related to the change in energy intake ( P < .001 ) but not to the change in physical activity ( P = .37 ) . CONCLUSIONS Reducing television viewing and computer use may have an important role in preventing obesity and in lowering  BMI in young children , and these changes may be related more to changes in energy intake than to changes in physical activity Background : Be Active Eat Well ( BAEW ) was a multifaceted community capacity-building program promoting healthy eating and physical activity for children ( aged 4–12 years ) in the Australian town of Colac . Objective : To evaluate the effects of BAEW on reducing  children 's unhealthy weight gain . Methods : BAEW had a quasi-experimental , longitudinal design with anthropometric and demographic data collected on Colac children in four preschools and six primary schools at baseline ( 2003 , n=1001 , response rate : 58 % ) and follow-up ( 2006 , n=839 , follow-up rate : 84 % ) . The comparison sample was a stratified r and om selection of preschools ( n=4 ) and primary schools ( n=12 ) from the rest of the Barwon South Western region of Victoria , with baseline assessment in 2003–2004 ( n=1183 , response rate : 44 % ) and follow-up in 2006 ( n=979 , follow-up rate : 83 % ) . Results : Colac children had significantly lower increases in body weight ( mean : −0.92 kg , 95 % CI : −1.74 to −0.11 ) , waist ( −3.14 cm , −5.07 to −1.22 ) , waist/height ( −0.02 , −0.03 to −0.004 ) , and body mass index z-score ( −0.11 , −0.21 to −0.01 ) than comparison children , adjusted for baseline variable , age , height , gender , duration between measurements and clustering by school . In Colac , the anthropometric changes were not related to four indicators of socioeconomic status ( SES ) , whereas in the comparison group 19/20 such analyses showed significantly greater gains in anthropometry in children from lower SES families . Changes in underweight and attempted weight loss were no different between the groups . Conclusions : Building community capacity to promote healthy eating and physical activity appears to be a safe and effective way to reduce unhealthy weight gain in children without increasing health inequalities Objective : The aim of this study was to evaluate the 8-year outcome of school 
    Output:
    
Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change .