一项为期 3 年的针对小学生的课外肥胖预防计划的影响。
The impact of a 3-year after-school obesity prevention program in elementary school children.
机构信息
Department of Health and Kinesiology, University of Texas at San Antonio, 6900 North Loop 1604 West, San Antonio, TX 78249, USA.
出版信息
Child Obes. 2012 Feb;8(1):60-70. doi: 10.1089/chi.2011.0085.
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 3rd 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.
背景
儿童在课后往往久坐不动，这对他们的健康有不良影响。本研究的目的是确定一项为期 3 年的课后体育活动（PA）计划对儿童体脂肪百分比（%BF）、心肺健康（CRF）和心血管代谢标志物的影响，该计划不限制膳食能量摄入。
方法
采用整群随机设计。共有来自美国东南部 18 所小学的 574 名 3 年级儿童参与。干预措施包括每天在学校进行 80 分钟适合年龄的中高强度 PA。主要观察指标为双能 X 射线吸收法测量的%BF；通过亚最大踏步试验测量的 HR 得出的 CRF；非禁食总胆固醇和高密度脂蛋白胆固醇（HDL-C）；以及静息血压（BP）。
结果
意向治疗分析显示，%BF（p = 0.009）和 CRF（p = 0.0003）的处理与时间存在显著交互作用。均值变化模式表明，干预组儿童的%BF 和 CRF 在上学期间相对对照组儿童有所改善，在第 1 年和第 2 年的暑假期间恢复到对照组儿童的水平。对在提供项目期间的月份发生的情况进行逐年分析，显示%BF 和 CRF 存在剂量-反应关系，即参加课后课程至少 60%的青少年受益最明显。胆固醇或 BP 没有观察到显著的干预效果。
结论
课后 PA 计划可有效减少肥胖，提高 CRF，尤其是在每周至少参加 3 天课程的儿童中。然而，%BF 和 CRF 的有利影响在暑假期间消失。因此，必须采取吸引和留住儿童的策略，以确保他们全年接受足够剂量的 PA。
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