Open Access Highly Accessed Study protocol

The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): design and methods

Peter T Katzmarzyk1*, Tiago V Barreira1, Stephanie T Broyles1, Catherine M Champagne1, Jean-Philippe Chaput2, Mikael Fogelholm3, Gang Hu1, William D Johnson1, Rebecca Kuriyan4, Anura Kurpad4, Estelle V Lambert5, Carol Maher6, José Maia7, Victor Matsudo8, Tim Olds6, Vincent Onywera9, Olga L Sarmiento10, Martyn Standage11, Mark S Tremblay2, Catrine Tudor-Locke1, Pei Zhao12 and Timothy S Church1

Author Affiliations

1 Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808-4124, USA

2 Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada

3 University of Helsinki, Helsinki, Finland

4 St. Johns Research Institute, Bangalore, India

5 UCT/MRC Research Unit for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

6 School of Health Sciences / Sansom Institute, University of South Australia, Adelaide, Australia

7 CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal

8 Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), Sao Paulo, Brazil

9 Kenyatta University, Nairobi, Kenya

10 Universidad de los Andes, Bogota, Colombia

11 University of Bath, Bath, UK

12 Tianjin Women’s and Children’s Health Center, Tianjin, China

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BMC Public Health 2013, 13:900  doi:10.1186/1471-2458-13-900

Published: 30 September 2013



The primary aim of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was to determine the relationships between lifestyle behaviours and obesity in a multi-national study of children, and to investigate the influence of higher-order characteristics such as behavioural settings, and the physical, social and policy environments, on the observed relationships within and between countries.


The targeted sample included 6000 10-year old children from 12 countries in five major geographic regions of the world (Europe, Africa, the Americas, South-East Asia, and the Western Pacific). The protocol included procedures to collect data at the individual level (lifestyle, diet and physical activity questionnaires, accelerometry), family and neighborhood level (parental questionnaires), and the school environment (school administrator questionnaire and school audit tool). A standard study protocol was developed for implementation in all regions of the world. A rigorous system of training and certification of study personnel was developed and implemented, including web-based training modules and regional in-person training meetings.


The results of this study will provide a robust examination of the correlates of adiposity and obesity in children, focusing on both sides of the energy balance equation. The results will also provide important new information that will inform the development of lifestyle, environmental, and policy interventions to address and prevent childhood obesity that may be culturally adapted for implementation around the world. ISCOLE represents a multi-national collaboration among all world regions, and represents a global effort to increase research understanding, capacity and infrastructure in childhood obesity.

Adiposity; Behaviour; Pediatric obesity; Energy balance; Physical activity; Nutrition