Graf Christine, Rost Sylvia V, Koch Benjamin, Heinen Sandy, Falkowski Gisa, Dordel Sigrid, Bjarnason-Wehrens Birna, Sreeram Narayanswami, Brockmeier Konrad, Christ Hildegard, Predel Hans-Georg
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany.
Cardiol Young. 2005 Jun;15(3):291-8. doi: 10.1017/S1047951105000594.
Obesity in childhood, which is associated with cardiovascular risk factors such as hypertension, is on the increase. Countermeasures are necessary. In this paper, we present the baseline and final data from the StEP TWO programme, a prospective study to prevent overweight and obesity in primary schools.
We recorded and calculated, from 1689 children, anthropometric data, including analyses of bioelectric impedance, waist and hip circumferences, body mass index and its standard deviation, and the ratio of waist to hip. Blood pressure was measured after 5 minutes at rest. From the three schools involved in a programme of intervention, 121 children were invited to take part, and 40 (33.1 per cent) completed the programme. The effect was compared with 155 overweight and obese children identified at the 4 control schools.
830 (49.5 per cent) boys and 848 girls (50.5 per cent) took part. Their mean age was 8.2 plus or minus 1.3 years, their height was 1.31 plus or minus 0.09 metres, they weighed 30.0 plus or minus 8.2 kilograms, and their mean index of body mass was 17.1 plus or minus 2.9 kilograms per metre squared. Of the children, 7.3 per cent were obese, 10.4 per cent were overweight, 75.7 per cent had normal weights, and 6.6 per cent were underweight. Resting hypertension was observed in 2.3 per cent of the children. Increased blood pressure was associated with a higher body weight, body mass index, standard deviation score for body mass index, and waist and hip circumferences (each p < 0.001), but not with the ratio of waist to hip. Hypertension at rest was also found in 11.0 per cent of obese children, 4.4 per cent of those who were overweight, 1.2 per cent of those with normal weight, and 1.0 per cent of underweight children (p < 0.001). After the intervention, the increase of the body mass index tended to be lower in those in whom we had intervened (p = 0.069), and in these the decrease of the standard deviation score for body mass index was significantly higher (p = 0.028). Systolic blood pressure was reduced by about 10 millimetres of mercury in those in whom we had intervened (p = 0.002), while there were no changes in the control group. Diastolic blood pressure was lowered by 3 millimetres of mercury, but this was not significant.
Obese children had the highest values for systolic and diastolic blood pressure. Increased levels of blood pressure are associated with other parameters of obesity, such as the circumference of the waist and hip. Early preventive measurements in childhood are necessary, and appropriate intervention appears to be effective.
儿童肥胖现象正在增加，且与高血压等心血管危险因素相关。有必要采取应对措施。在本文中，我们展示了“StEP TWO”项目的基线数据和最终数据，该项目是一项预防小学儿童超重和肥胖的前瞻性研究。
我们记录并计算了1689名儿童的人体测量数据，包括生物电阻抗分析、腰围和臀围、体重指数及其标准差以及腰臀比。休息5分钟后测量血压。在参与干预项目的三所学校中，邀请了121名儿童参与，40名（33.1%）完成了该项目。将效果与4所对照学校中识别出的155名超重和肥胖儿童进行了比较。
830名（49.5%）男孩和848名女孩（50.5%）参与了研究。他们的平均年龄为8.2±1.3岁，身高为1.31±0.09米，体重为30.0±8.2千克，平均体重指数为17.1±2.9千克/平方米。这些儿童中，7.3%为肥胖，10.4%为超重，75.7%体重正常，6.6%体重过轻。2.3%的儿童存在静息高血压。血压升高与较高的体重、体重指数、体重指数标准差评分以及腰围和臀围相关（均p<0.001），但与腰臀比无关。在肥胖儿童中，11.0%存在静息高血压，超重儿童中为4.4%，体重正常儿童中为1.2%，体重过轻儿童中为1.0%（p<0.001）。干预后，干预组儿童的体重指数增加趋势较低（p = 0.069），且干预组儿童体重指数标准差评分的下降幅度显著更高（p = 0.028）。干预组儿童的收缩压降低了约10毫米汞柱（p = 0.002），而对照组无变化。舒张压降低了3毫米汞柱，但不显著。
肥胖儿童的收缩压和舒张压值最高。血压升高与肥胖的其他参数相关，如腰围和臀围。儿童早期预防性测量是必要的，适当的干预似乎是有效的。
