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. 2025 Aug 27;17(17):2778.
doi: 10.3390/nu17172778.

Lights and Shadows of a Primary School-Based Nutrition Education Program in Italy: Insights from the LIVELY Project

Sara Basilico  1 , Maria Vittoria Conti  1 , Ilaria Ardoino  2 , Chiara Breda  1 , Federica Loperfido  1 , Francesca Orsini  2 , Maria Luisa Ojeda Fernandez  3 , Laura Pierini  2 , Stefano Conca Bonizzoni  4 , Elisabetta Modena  4 , Federica Villa  4 , Hellas Cena  1   5   6 , Marta Baviera  3 , Carlotta Franchi  2   6
Affiliations

Lights and Shadows of a Primary School-Based Nutrition Education Program in Italy: Insights from the LIVELY Project

Sara Basilico et al. Nutrients. .

Abstract

Background/Objectives: Childhood obesity represents a pressing global health challenge, demanding coordinated, long-term strategies. Schools and families are pivotal environments for shaping children's lifestyle behaviors. The LIVELY project aimed to assess overweight/obesity prevalence and associated factors in primary school children, and to implement a multidimensional educational intervention promoting healthy, sustainable lifestyles. Methods: This single-arm study was conducted from October 2023 to October 2024 in a primary school in Milan. The intervention included age and culturally tailored lessons, games, and activities. Anthropometric measures, dietary adherence, and lifestyle habits were assessed before and after the intervention. Satisfaction surveys were administered to children, families, and teachers. Results: The project involved 227 children across 14 classes (mean age 8.9, SD 1.2 years). The prevalence of overweight/obesity was 23.4%. Adherence to the Mediterranean Diet was moderate, limited by low intake of vegetables, nuts, and dairy. Physical activity was low, screen time excessive, and sleep insufficient. No statistically significant improvements in anthropometrics or diet adherence were observed post-intervention, but positive trends emerged for physical activity, sleep, and hydration. Over half of the children passed the nutritional knowledge test. Despite these challenges, high satisfaction levels have been shared by children, parents, and teachers. Conclusions: The limited duration of the intervention and challenges engaging families in a low socio-economic context may have constrained the impact of the program, and caution is advised in generalizing the findings. The LIVELY project highlights the complexity of tackling childhood obesity in multicultural settings and emphasizes the need for longer, continuous, and culturally tailored programs that actively involve families to promote sustainable healthy behaviors.

Keywords: childhood obesity; healthy lifestyle; mediterranean diet; nutritional education; primary prevention.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Timeline of the LIVELY project.
Figure 2
Figure 2
Example of a character realized during the multimedia workshop and animated using augmented reality techniques. (a) Description of the main features of the depicted fantasy character; (b) Humanized carrot drawn by a fourth-grade class; (c) Animation through a tablet.
Figure 3
Figure 3
Flowchart of the sample.
See this image and copyright information in PMC

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