Faculty of Teacher Education and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.
Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA.
Scand J Med Sci Sports. 2023 Jul;33(7):1177-1189. doi: 10.1111/sms.14350. Epub 2023 Mar 31.
While there have been several school-based physical activity (PA) interventions targeting improvement in cardiovascular disease (CVD) risk factors, few have assessed long-term effects. The aim of this paper was therefore to determine intervention effects on CVD risk factors 5 years after cessation.
Two schools were assigned to intervention (n = 125) or control (n = 134). The intervention school offered 210 min/week more PA than the control school over two consecutive years (fourth and fifth grades). Follow-up assessment was conducted 5-year post-intervention (10th grade) where 180-210 (73%-85%) children provided valid data. Outcomes were CVD risk factors: triglyceride, total-to-high-density-lipoprotein-cholesterol ratio (TC:HDL ratio), insulin resistance, blood pressure (BP), waist circumference, and cardiorespiratory fitness (VO ). Variables were analyzed individually and as a composite score through linear mixed models, including random intercepts for children.
Analyses revealed significant sustained 5-year intervention effects for HDL (effect sizes [ES] = 0.22), diastolic BP (ES = 0.48), VO (ES = 0.29), and composite risk score (ES = 0.38). These effects were similar to the immediate results following the intervention. In contrast, while TC:HDL ratio initially decreased post-intervention (ES = 0.27), this decrease was not maintained at 5-year follow-up (ES = 0.09), whereas WC was initially unchanged post-intervention (ES = 0.02), but decreased at 5-year follow-up (ES = 0.44).
The significant effects of a 2-year school-based PA intervention remained for CVD risk factors 5 years after cessation of the intervention. As cardiometabolic health can be maintained long-term after school-based PA, this paper demonstrates the sustainability and potential of schools in the primary prevention of future CVD risk in children.
虽然已经有几项针对改善心血管疾病 (CVD) 风险因素的基于学校的身体活动 (PA) 干预措施，但很少有研究评估其长期效果。因此，本文的目的是确定干预措施停止 5 年后对 CVD 风险因素的影响。
两所学校被分配到干预组（n=125）或对照组（n=134）。干预学校在连续两年（四年级和五年级）内提供比对照组多 210 分钟/周的 PA。在干预结束 5 年后（十年级）进行了随访评估，其中 180-210（73%-85%）名儿童提供了有效数据。结果是 CVD 风险因素：甘油三酯、总胆固醇与高密度脂蛋白胆固醇比值 (TC:HDL 比值)、胰岛素抵抗、血压 (BP)、腰围和心肺适能 (VO )。通过线性混合模型对个体和综合评分进行分析，包括儿童的随机截距。
分析显示，高密度脂蛋白 (HDL)（效应大小 [ES] = 0.22）、舒张压 (BP)（ES = 0.48）、VO （ES = 0.29）和综合风险评分（ES = 0.38）的 5 年干预效果持续显著。这些效果与干预后的即时结果相似。相比之下，虽然 TC:HDL 比值在干预后最初下降（ES = 0.27），但在 5 年随访时并未保持（ES = 0.09），而腰围在干预后最初不变（ES = 0.02），但在 5 年随访时下降（ES = 0.44）。
为期两年的基于学校的 PA 干预措施的显著效果在干预停止 5 年后仍然存在于 CVD 风险因素中。由于在学校进行 PA 可以长期维持心血管代谢健康，因此本文证明了学校在儿童未来 CVD 风险的初级预防中的可持续性和潜力。
