Nutrition and Physical Activity Program to Attenuate Obesity and Promote Physical and Metabolic Fitness in Elementary School Children

Abstract

Obesity and low levels of physical and metabolic fitness are risk factors for cardiovascular disease and diabetes. The purpose of this investigation was to attenuate obesity and improve physical and metabolic fitness in elementary school children. Schools have the opportunity, mechanisms, and personnel in place to deliver nutrition education, fitness activities, and a school food service that is nutritious and healthy. Cohorts from grades 3 to 5 in two school districts in rural Nebraska (Intervention/Control) participated in a 2-year study of physical activity and modified school lunch program. Data collection for aerobic capacity, body composition, blood chemistry, nutrition knowledge, energy intake, and physical activity was at the beginning and end of each year. Int received enhanced physical activity, grade specific nutrition education, and a lower fat and sodium school lunch program. Con continued with a regular school lunch and team sports activity program. At year 2, Int lunches had significantly less energy (9%), fat (25%), sodium (21%), and more fiber (17%). However, measures of 24-hour energy intake for Int and Con showed significant differences for sodium only. Physical activity in the classroom was 6% greater for Int compared to Con (p < 0.05) but physical activity outside of school was approximately 16% less for Int compared to Con (p < 0.05). Body weight and body fat were not different between schools for normal weight or obese children. No differences were found for cholesterol, insulin, and glucose; however, HDL cholesterol was significantly greater and cholesterol/HDL was significantly less for Int compared to Con (p < 0.05). It appears that compensation in both energy intake and physical activity outside of school may be responsible for the lack of differences between Int and Con.

A comprehensive physical activity promotion programme at elementary school: the effects on physical activity, physical fitness and psychosocial correlates of physical activity

“…Because improvements in physical fitness are associated with participation in both moderate-and vigorous-intensity PA 3 , the lack of increased vigorous-intensity activity in the intervention condition could also explain this finding. Other intervention studies in elementary schools also reported no effects on children's physical fitness 14,15,28 . The anthropometric parameters showed a slightly more favourable evolution in the intervention schools compared with the control schools.…”

A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work.

“…In support of this speculation, Donnelly et al, (1996) found that an intervention that mandated increased physical activity during school resulted in increased activity during school, but a significant decrease in activity outside of school. If participants compensate for such mandated health behavior changes by making alterations outside of the program to keep them at a particular energy intake or energy expenditure level, these mandated changes may not produce differential effects relative to interventions without mandated behavioral change.…”

“…Relation of the average age of participants to the weight gain intervention effect sizes. Donnelly, et al, (1996) 100 girls and boys.…”

“…Another benefit is that this coding scheme captures environmental manipulations of the food environment, which is useful because theorists have suggested that the food environment plays a key role in obesity promotion (Wadden, Brownell, & Foster, 2002). The most common example was interventions that directly changed the nutritional content of school lunches (e.g., Donnelly, et al, 1996;Luepker, et al, 1996). We hypothesized that interventions that involved a direct improvement to dietary intake should produce stronger intervention effects than those that did not.…”

Obesogenic environments – aspects on measurement and indicators

“…Both methods rely heavily on assumptions and are inherently uncertain. Third, dynamic interactions within and between individual and societal levels complicate the (72) Share of schools with a ban on the sale of soft drinks and candy von Haartman (2006) (63) Presence of nutrition guidelines for school meals (free or subsidised) and share of schools complying with guidelines Donnelly et al (1996) (69) ; Luepker et al (1996) (70) Work (86) ; French (2003) (88) ; Horgen and Brownell (2002) (89) interpretation of results (15) . Multilevel studies are beginning to be performed, addressing both individual-level determinants and area characteristics.…”