Clinical Nutrition and Obesity Research Center, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, NL, Mexico.
J Hum Nutr Diet. 2013 Jul;26 Suppl 1:82-9. doi: 10.1111/jhn.12070. Epub 2013 Apr 19.
Currently, there is limited evidence about effective strategies to manage childhood obesity and the metabolic syndrome in school settings. The present study aims to analyse changes in the prevalence of being overweight/obese and having the metabolic syndrome in relation to a 10-month lifestyle intervention based on individualised face-to-face sessions and parental education in school settings.
The study sample comprised a cross-sectional sample of 96 overweight/obese Mexican children aged 6-12 years from eight schools. Clinical, anthropometric measurements and 24-h recalls were obtained during each of 13 visits. Laboratory measurements were determined at the beginning and end. The energy-reduced diet was based on dietary recommended intakes. Individualised structured daily meals and a physical activity plan, tailored-made for each child, were provided every 3 weeks at the schools. Parental attendance was required. Student's t-test, McNemar and Shapiro-Wilk tests and simple linear regression were used for the statistical analysis.
The prevalence of metabolic syndrome fell significantly from 44% to 16% (P < 0.01), high blood pressure fell from 19% to 0%, hypertrigliceridaemia fell from 64% to 35%, high-density lipoprotein-cholesterol ≤ 40 fell from 60% to 41%, hyperglycaemia fell from 1% to 0%, and waist circumference ≥90th percentile fell from 72% to 57%. There was a 2.84 [95% confidence interval (CI) = -4.10 to -1.58; P < 0.01] significant decrease in body mass index percentile and in body-fat percentage (95% CI = -3.31 to -1.55; P < 0.01). Of the overweight children, 32% achieved normal-weight, whereas 24% of the obese ones converted to overweight and 1% reached normal-weight. Physical activity increased 16 min/day(-1) (P = 0.02) and 2 days/week(-1) .
A school-setting lifestyle intervention led to a decreased prevalence of being overweight/obese and to a striking reduction in the prevalence of the metabolic syndrome in a sample of Mexican children.
目前，关于在学校环境中管理儿童肥胖和代谢综合征的有效策略的证据有限。本研究旨在分析与基于个性化面对面会议和学校家长教育的为期 10 个月的生活方式干预相关的超重/肥胖和代谢综合征患病率的变化。
研究样本包括来自 8 所学校的 96 名超重/肥胖墨西哥 6-12 岁儿童的横断面样本。在 13 次就诊期间的每次就诊中，均进行临床、人体测量测量和 24 小时回忆。实验室测量在开始和结束时确定。减少能量的饮食基于饮食推荐摄入量。每周 3 次在学校为每个孩子提供个性化结构化的日常膳食和身体活动计划。需要家长出席。使用学生 t 检验、McNemar 和 Shapiro-Wilk 检验和简单线性回归进行统计分析。
代谢综合征的患病率从 44%显著下降至 16%（P < 0.01），高血压从 19%降至 0%，高甘油三酯血症从 64%降至 35%，高密度脂蛋白胆固醇≤40%从 60%降至 41%，高血糖从 1%降至 0%，腰围≥90 百分位从 72%降至 57%。体重指数百分位和体脂肪百分比分别显著下降 2.84（95%置信区间[CI] = -4.10 至-1.58；P < 0.01）。超重儿童中，32%达到正常体重，而肥胖儿童中 24%转为超重，1%达到正常体重。每天增加 16 分钟的体力活动（P = 0.02），每周增加 2 天（P = 0.02）。
学校环境中的生活方式干预导致超重/肥胖的患病率下降，并使墨西哥儿童中代谢综合征的患病率显著降低。
