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Does Encouraging Drinking Water in Schools Help Overweight Prevention?

August 7, 2023

Editor’s Note: Elizabeth Zeichner is a former high school teacher and fourth-year medical student at Emory University School of Medicine. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics

There have been a few studies exploring the effect of school-based interventions to increase water intake on overweight prevention in school-aged children. Water First in northern California is one such intervention that promotes drinking water in schools through classroom lessons, water stations, and school-wide water promotion. To expand on existing evidence surrounding the impact on drinking water interventions, Dr. Anisha I. Patel and colleagues at Stanford University and the University of California, San Francisco designed an intervention to evaluate the impact on Water First on overweight prevalence. This week, Pediatrics is early releasing “Effectiveness of a School Drinking Water Promotion and Access Program for Overweight Prevention,” along with a video abstract, that describes their results (10.1542/peds.2022-060021).

In this cluster-randomized trial, which took place from 2016 to 2019, 18 elementary schools in the California Bay area, in communities that are under-resourced and ethnically diverse, were randomized to control or intervention. In intervention schools, lead-free tap water stations were installed in playgrounds, high traffic areas, and cafeterias. Over the course of a single school year, students in intervention schools were exposed to a kickoff assembly, water-promoting signage, modest prizes for drinking water at lunch, and in-class lessons and home activities about the benefits of drinking water.

A total of 1,249 4th grade students participated in the study. Heights and weights were measured at baseline, 7 months, and 15 months. Students also completed surveys about dietary intake, physical activity, and screen time.

Compared to the control group, students participating in the intervention drank water at an increased frequency, and this was sustained at 15 months. Despite some challenges due to COVID-19 school closures that prevented 8 additional schools from completing the study, the study found a 3.2% decrease in prevalence in overweight prevalence in students in the intervention (0.5%) compared to the control (3.7%) schools.

When I was a high school teacher in Los Angeles, my students seldom drank from the water fountains as they were old, dirty, and had not been sufficiently tested and cleared for the presence of lead. As shown in this article, a program that promotes the benefits of drinking water through installing safe and appealing water sources located conveniently throughout schools has promising effects on health and overweight in school-aged children.

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