The Impact of a 3-Year After-School Obesity Prevention Program in Elementary School Children

Abstract

Background: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. the objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%bF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children.Methods: A cluster randomization design was employed. A total of 574 3 rd grade children from 18 elementary schools in the southeastern United states participated. the intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. the main outcomes of interest were %bF measured by dual-energy X-ray absorptiometry; CRF measured by heart rate in response to a submaximal step test; nonfasting total and high-density lipoprotein cholesterol (HDL-C); and resting blood pressure (bP).Results: intent-to-treat analyses showed significant treatment by time interactions for %bF (p = 0.009) and CRF (p = 0.0003). the change pattern of the means suggested that %bF and CRF in intervention children improved relative to control children during the school months, rebounding to the levels of control children over the summers following years 1 and 2. year-by-year analyses of what occurred during the months when the program was offered revealed dose-response relations for %bF and CRF, such that the clearest beneficial effects were seen for those youth who attended at least 60% of the after-school sessions. No significant intervention effects were seen for cholesterol or bP.Conclusions: An after-school PA program was effective in reducing adiposity and improving CRF, especially in the children who attended the sessions at least 3 days/week. However, the favorable effects on %bF and CRF were lost over the summer. thus, it is critical to incorporate strategies that attract and retain the children to receive an adequate dose of PA year-round.

The Viennese EDDY Study as a Role Model for Obesity: Prevention by Means of Nutritional and Lifestyle Interventions

“…The main influencing factors were identified as combined nutritional and movement interventions, which improve the health behavior of children and adolescents and reduce the risk of developing overweight and its consequences by improving their nutritional knowledge and physical activity [10,11,12,13,14,15]. Most programs focus on behavioral prevention and school-based interventions, which were most effective in direct communication with the adolescents [16].…”

Die Wiener Präventionsstudie EDDY – Erste Ergebnisse

“…Als Haupteinflussfaktoren wurden dabei Ernährungs-und Bewegungsinterventionen identifiziert, welche durch eine Verbesserung des Gesundheitswissens das Gesundheitsverhalten von Kindern und Jugendlichen nachhaltig positiv beeinflussen und somit das Risiko für die Entwicklung von Übergewicht und dessen Folgeerkrankungen reduzieren [7][8][9].…”

“…Also, the involvement of school doctors in the prevention project was hardly ever possible. [6,8,9].…”

Physical Fitness and Obesity in Children: The Role of Vigorous Physical ActivityMoncton

“…By following the principles of physical training and child development, we and others have shown that children on wide spectrum of age and obesity can complete long-term programs of VPA (age-adjusted relative intensity: 70-80% of maximum heart rate) [24,29,30]. Risk for injury in intervention studies using VPA is no different from what is reported in children participating in recreational sport play [24,29,30]. However, it is unrealistic to expect all children starting the program with all activities being vigorous.…”

“…We have successfully demonstrated that children's body composition is responsive to physical fitness oriented PA intervention that targets multiple attributes of physical fitness (i.e., more than CRF) and applies the physiological principles of physical training [23][24][25]. Metabolically significant changes were observed in body fat percent, fat-free mass, and bone density in addition to measures of physical fitness.…”