苹果项目：一项针对小学适龄儿童的社区肥胖预防计划的两年研究结果

APPLE Project: 2-y findings of a community-based obesity prevention program in primary school age children.

作者信息

Taylor Rachael W, McAuley Kirsten A, Barbezat Wyn, Strong Amber, Williams Sheila M, Mann Jim I

机构信息

Department of Human Nutrition, University of Otago, Dunedin, New Zealand.

出版信息

Am J Clin Nutr. 2007 Sep;86(3):735-42. doi: 10.1093/ajcn/86.3.735.

DOI:10.1093/ajcn/86.3.735

PMID:17823440

Abstract

BACKGROUND

Developing effective strategies for obesity prevention in children is urgently required.

OBJECTIVE

We determined the effectiveness of a 2-y controlled community-based intervention to prevent excessive weight gain in 5-12-y-old children by enhancing opportunities for healthy eating and noncurricular physical activity.

DESIGN

Children (n = 730) from 4 intervention and 3 control schools underwent measurements of height, weight, waist circumference, blood pressure, diet, and physical activity at baseline and at 1 and 2 y. Intervention components included nutrition education that targeted reductions in sweetened drinks and increased fruit and vegetable intake and activity coordinators who managed an activity program that focused on noncurricular lifestyle-based activities (eg, community walks).

RESULTS

Body mass index (BMI; in kg/m2) z score was significantly lower in intervention children than in control children by a mean of 0.09 (95% CI: 0.01, 0.18) after 1 y and 0.26 (95% CI: 0.21, 0.32) at 2 y, but the prevalence of overweight did not differ. Waist circumference was significantly lower at 2 y (-1 cm), and systolic blood pressure was reduced at 1 y (-2.9 mm Hg). An interaction existed between intervention group and overweight status (P = 0.029), such that mean BMI z score was reduced in normal-weight (-0.29; 95% CI: -0.38, -0.21) but not overweight (-0.02; 95% CI: -0.16, 0.12) intervention children relative to controls. Intervention children consumed fewer carbonated beverages (67% of control intake; P = 0.04) and fruit juice or drinks (70%; P = 0.03) and more fruit (0.8 servings/3 d; P < 0.01).

CONCLUSION

A relatively simple approach, providing activity coordinators and basic nutrition education in schools, significantly reduces the rate of excessive weight gain in children, although this may be limited to those not initially overweight. This trial was registered at Australian Clinical Trials Registry as #12605000578606.

摘要

背景

迫切需要制定有效的儿童肥胖预防策略。

目的

我们确定了一项为期2年的基于社区的对照干预措施的有效性，该措施通过增加健康饮食和非课程体育活动的机会，来预防5至12岁儿童体重过度增加。

设计

来自4所干预学校和3所对照学校的730名儿童在基线、1年和2年时接受了身高、体重、腰围、血压、饮食和体育活动的测量。干预措施包括旨在减少含糖饮料摄入和增加水果和蔬菜摄入量的营养教育，以及管理一项侧重于非课程生活方式活动（如社区散步）的活动计划的活动协调员。

结果

干预组儿童的体重指数（BMI；单位：kg/m²）z评分在1年后比对照组儿童显著低0.09（95%CI：0.01，0.18），在2年后低0.26（95%CI：0.21，0.32），但超重患病率没有差异。2年后腰围显著降低（-1厘米），1年后收缩压降低（-2.9毫米汞柱）。干预组与超重状态之间存在交互作用（P = 0.029），相对于对照组，正常体重干预组儿童的平均BMI z评分降低（-0.29；95%CI：-0.38，-0.21），但超重干预组儿童没有降低（-0.02；95%CI：-0.16，0.12）。干预组儿童饮用的碳酸饮料（占对照组摄入量的67%；P = 0.04）和果汁或饮料（70%；P = 0.03）较少，食用的水果较多（0.8份/3天；P < 0.01）。