Taylor Rachael W, Mcauley Kirsten A, Williams Sheila M, Barbezat Wyn, Nielsen Glen, Mann Jim I
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Int J Pediatr Obes. 2006;1(3):146-52. doi: 10.1080/17477160600881247.
Community-based lifestyle intervention may offer the best means of reducing the global epidemic of childhood obesity and its consequences, yet few successful interventions have been reported. The objective was to determine whether increasing extra-curricular levels of activity could reduce weight gain in children.
A controlled intervention study was conducted using standardised methods to assess outcomes. Two comparable relatively rural communities in Otago, New Zealand formed intervention and control settings. Height, weight, waist circumference and participation in physical activity (by accelerometry) were measured at baseline and at 1 year in 384 children aged 5 to 12 years representing the majority of children in this age group in intervention and control communities. Community Activity Co-ordinators were employed at each school in the intervention area. Their brief was to widen exposure to activity and engage children not interested in traditional sporting activities by encouraging lifestyle-based activities (e.g. walking) and non-traditional sports (e.g. golf and taekwondo) during extra-curricular time at school, after school and during vacations. Simple dietary advice was offered and the wider community was encouraged to participate.
Average accelerometry counts at 1 year were 28% (95% CI: 11 to 47%) higher in intervention compared with control children after adjusting for age, sex, baseline values and school. Intervention children spent less time in sedentary activity (ratio 0.91, p = 0.007) and more time in moderate (1.07, p = 0.001) and moderate/vigorous (1.10, p = 0.01) activity. Adjusted mean BMI Z-score was lower in intervention relative to control children by -0.12 units (95% CI: -0.22 to -0.02).
. An intervention designed to maximise opportunities for physical activity during extra-curricular time at school and during leisure time through the provision of community-based Activity Co-ordinators significantly increased participation in physical activity and slowed unhealthy weight gain in primary school-aged children.
基于社区的生活方式干预可能是减少全球儿童肥胖流行及其后果的最佳方式，但鲜有成功干预的报道。本研究目的是确定增加课外活动水平是否能减少儿童体重增加。
采用标准化方法进行对照干预研究以评估结果。新西兰奥塔哥地区两个类似的相对农村社区分别作为干预组和对照组。对干预组和对照组社区中5至12岁的384名儿童（该年龄组大多数儿童）在基线时和1年后测量身高、体重、腰围以及身体活动参与情况（通过加速度计测量）。在干预地区的每所学校雇佣社区活动协调员。他们的任务是通过鼓励在学校课外时间、放学后和假期开展基于生活方式的活动（如步行）和非传统运动（如高尔夫和跆拳道），扩大儿童接触活动的范围，并让对传统体育活动不感兴趣的儿童参与进来。提供简单的饮食建议，并鼓励更广泛的社区参与。
在调整年龄、性别、基线值和学校因素后，干预组儿童1年后的平均加速度计计数比对照组儿童高28%（95%置信区间：11%至47%）。干预组儿童久坐活动时间更少（比值为0.91，p = 0.007），中度活动（1.07，p = 0.001）和中度/剧烈活动（1.10，p = 0.01）时间更多。干预组儿童调整后的平均BMI Z评分相对于对照组儿童低 -0.12个单位（95%置信区间：-0.22至-0.02）。
一项旨在通过提供社区活动协调员，在学校课外时间和休闲时间最大限度增加身体活动机会的干预措施，显著增加了小学适龄儿童的身体活动参与度，并减缓了不健康的体重增加。
