ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
This article is part of the Research TopicMonitoring Nutritional Status and Physical Activity in Youths GloballyView all 7 articles
The Need for Tailoring School-Based Physical Activity Interventions: Preliminary Insights into Body Weight and Cross-Country Differences from the DELICIOUS Project
Provisionally accepted
Achraf Ammar1*
Mohamed Aly2*
Khaled Trabelsi3
TANIA MARIA ABRIL MERA4
Liwa Masmoudi3
Noha El-Gyar5
Amira M Shalaby5
Haitham Jahrami6
Waqar Husain7
Piotr Zmijewski8Evelyn Frias-Toral9
Giuseppe Grosso10
Wolfgang Immanuel Schöllhorn11
Osama Abdelkarim5- 1Johannes Gutenberg University Mainz, Mainz, Germany
- 2Faculty of Sport Sciences, Assiut University, Assiut 71515, Egypt, Assiut, Egypt
- 3Universite de Sfax Institut Superieur du Sport et de l'Education Physique de Sfax, Sfax, Tunisia
- 4Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
- 5Assiut University Faculty of Medicine, Asyut, Egypt
- 6Arabian Gulf University, Manama, Bahrain
- 7COMSATS University Islamabad, Islamabad, Pakistan
- 8Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
- 9Universidad de Especialidades Espiritu Santo, Samborondon, Ecuador
- 10Universita degli Studi di Catania, Catania, Italy
- 11Johannes Gutenberg Universitat Mainz, Mainz, Germany
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Background: Although school-based physical activity (PA) programs are recognized for enhancing children's health-related fitness (HRF), limited evidence exists on how responsiveness varies by country and body weight status. Within the framework of the DELICIOUS project, this study analyzed cross-country variations in anthropometric and health-related fitness (HRF) changes among children with normal weight, overweight, and obesity who participated in a standardized school-based PA intervention.This study, conducted within the framework of the DELICIOUS project, investigated the differential impact of a standardized school-based PA intervention on anthropometric and HRF outcomes among normal-weight, overweight, and obese children across five Mediterranean countries. Methods: Over 900 children aged 8–14 years from Egypt, Lebanon, Italy, Portugal, and Spain participated in a standardized six-month PA-program. Anthropometric measures (weight, height, and BMI) and physical fitness components (sprint, jump, strength, endurance, and coordination) were assessed before and after the intervention. Intervention effects were analyzed using repeated measures and factorial ANOVA models to examine interactions between time, country, and body weight category. Results: The intervention showed the greatest anthropometric effectiveness in Egypt and Spain, where children with overweight and obese children obesity experienced weight stabilization and BMI reductions, significant among obese groups with obesity (-4% in Egypt; -2% in Spain). In contrast, Lebanon and Italy exhibited slight but significant increases in BMI among participants with normal and overweight participants. Regarding physical performance, the intervention led to significant improvements across countries, particularly in coordination
Keywords: Physical Fitness, Exercise Intervention, Mediterranean Region, cross-cultural study, youth health promotion, early adolescents, Children, anthropometrics
Received: 29 Jul 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Ammar, Aly, Trabelsi, ABRIL MERA, Masmoudi, El-Gyar, Shalaby, Jahrami, Husain, Zmijewski, Frias-Toral, Grosso, Schöllhorn and Abdelkarim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Achraf Ammar
Mohamed Aly
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