Background: The foundation for lifelong good health is laid in childhood. Schools can play a pivotal role in preventing obesity/type 2 diabetes with effective interventions.

Methods: We devised a novel school-based program using a sticker based food diary (FD) and colorful 12-page story book to motivate young school children to adopt a healthier diet/lifestyle. This study to conducted among 1500 grade 1 and 2 students from 4 schools between March 2018- April 2019, to evaluate its effectiveness. During the first week(W1), each child self-monitored his/her food intake daily at home for a week, using the FD, and received a Smiley Face based Score (SFS) based on the healthiness of each meal. In the second week, class teachers read the story book (illustrating the physical and psychosocial effects of obesity and benefits of healthy lifestyle in a child friendly manner). In the third week(W3) children completed the FD again. Effectiveness of the program to improve healthy eating/lifestyle was assessed by comparing mean SFS between W1 and W3, and by anonymized graded-response and open response questionnaires completed by parents and class teachers.

Results: Completed FDs were returned by 1029 students. Overall there was an improvement in healthy eating, with mean SFS increasing by 11.7% from W1 to W3 (51.3 ± 22.9 vs. 63.1 ± 24.2, p< 0.001). SFS improved >10% in all BMI categories. SFS improvement was more in boys (13.0 vs. 9.7, p=0.02), and in 2nd graders compared to 1st graders (13.1 vs. 10.3, p=0.045). Majority of responding parents (> 90%) and teachers (95%) strongly agreed/agreed that this program motivated children towards a healthier lifestyle and led to an observable improvement in food habits.

Conclusion: This novel program led to a demonstrable improvement in healthy lifestyle among 5-7 year olds and was received favorably by parents and teachers. Based on these results and positive (ongoing) longer-term follow up data, wider implementation involving 750,000 children is planned for mid 2020.


S.N. Seneviratne: None. S. Sachchithananthan: None. P.S. Angulugaha Gamage: None. S. Ramamoorthy: None. R. Peiris: None. V.P. Wickramasinghe: None. N. Somasundaram: None.


World Diabetes Foundation (WDF15-1291)

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