CHIRPY DRAGON intervention prevents obesity in urban Chinese children

November 26, 2019

A school- and family-based intervention, called the CHIRPY DRAGON program, may be an effective intervention for preventing obesity in children in urban China, according to a study published November 26 in the open-access journal PLOS Medicine by Bai Li of the University of Bristol, Peymane Adab of the University of Birmingham , and Wei Jia Liu of the Guangzhou Centre of Disease Control and Prevention, and colleagues.

In low- and middle-income countries where childhood obesity is increasing rapidly, there is a lack of rigorous development and evaluation of prevention interventions. Previous childhood obesity prevention trials conducted in China have not provided robust, high-quality evidence of effective interventions. Without effective prevention programs, China is estimated to have 50 million overweight/obese children by 2030. In the new study, the researchers developed CHIRPY DRAGON (CHInese pRimary school children PhYsical activity and DietaRy behAviour chanGes InterventiON), with the goal of preventing obesity in urban, primary school-aged children in China. Participants in the randomized controlled trial included 1,461 six-year-old children from 40 primary schools in Guangzhou, China.

One group of schools received a package of activities designed to increase healthy eating and physical activity (i.e., the CHIRPY DRAGON program) over 12 months and the other group of schools continued with their usual activities. Children, particularly girls and those who were overweight or obese at baseline, in the group of schools receiving the program had a lower body-mass index at the end of the 12-month period, compared with children in the schools not receiving the program. In the intervention group, significant beneficial effects were also observed for the consumption of fruits and vegetables, sugar-sweetened beverages and unhealthy snacks, in addition to sedentary behavior and physical activity. The program was also good value for money (£1,760 per quality-adjusted life-years). It is not yet determined whether this intervention program can be successfully transferred to other contexts, but it may be effective in other locations that share similar characteristics to urban China.
Research Article


This study was funded through a philanthropic donation from Zhejiang Yong Ning Pharmaceutical Ltd Co. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: PA holds grants from NIHR related to research on childhood obesity prevention. She is chair of the NIHR Public Health Research Funding Committee. She was a trustee of the Association for the Study of Obesity (2014-2017). She provided written expert evidence for the Health and Social Care Committee, Childhood obesity inquiry, 2018.


Li B, Pallan M, Liu WJ, Hemming K, Frew E, Lin R, et al. (2019) The CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school--aged children: A cluster-randomised controlled trial. PLoS Med 16(11): e1002971.

Image Credit: MabelAmber, Pixabay

Author Affiliations:

Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol, United Kingdom
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
School Health Unit, Guangzhou Centre of Disease Control and Prevention, Guangzhou, P.R.China

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