Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
Am J Prev Med. 2024 Jun;66(6):1078-1088. doi: 10.1016/j.amepre.2024.01.017. Epub 2024 Feb 1.
Physical activity (PA) promotion combined with multimicronutrient supplementation (MMNS) among school-age children may reduce fat mass accrual and increase muscle mass through different mechanisms and so benefit child health. This study determined the efficacy of combined interventions on body composition among South African schoolchildren and determined if micronutrients mediate these effects.
Longitudinal cluster randomized controlled trial of children followed from 2019 to 2021. Statistical analyses carried from 2022 to 2023.
SETTING/PARTICIPANTS: A total of 1,304 children 6-12 years of age recruited from public schools in Gqeberha, South Africa.
Children were randomized by classes to either: (a) a physical activity group (PA); (b) a MMNS group; (c) a physical activity + multimicronutrient supplementation group (PA + MMNS); and (d) a placebo control group.
Trajectories of overall and truncal fat free mass (FFM) and fat mass (FM) estimates in modeled at 9 and 21 months using latent growth curve models (LGCM). Changes in micronutrient concentrations at 9 months from baseline.
An increased FFM trajectory was found among children in the MMNS arm at 9 months (Beta 0.16, 95% CI = 0.12, 0.31). The PA and MMNS arms both had positive indirect effects on this trajectory at 9 months (Beta 0.66, 95% CI = 0.44, 0.88 and Beta 0.32 95% CI = 0.1 0.5, respectively) and similarly at 21 months when mediated by zinc concentration changes. A reduced FM trajectory was found among children in the PA promotion arm at 9 months when using this collection point as the referent intercept. This arm was inversely associated with the FM trajectory at 9 months when mediated by zinc changes.
PA and MMNS promotion in school-based interventions directly contributed to reductions in FM and increased FFM among South African children and indirectly through changes in micronutrient status.
ISRCTN, ISRCTN29534081. Registered on August 9, 2018 Institutional review board: Ethikkommission Nordwest- und Zentralschweiz" (EKNZ, project number: Req-2018-00608). Date of approval: 2018.
在学龄儿童中，将身体活动（PA）促进与多种微量营养素补充（MMNS）相结合，可能通过不同的机制减少脂肪量的积累并增加肌肉量，从而有益于儿童健康。本研究旨在确定南非学童中联合干预措施对身体成分的功效，并确定微量营养素是否介导这些影响。
对 2019 年至 2021 年期间随访的儿童进行纵向聚类随机对照试验。统计分析于 2022 年至 2023 年进行。
地点/参与者：总共招募了 1304 名 6-12 岁的儿童，他们来自南非格贝哈的公立学校。
儿童按班级随机分为以下四组：（a）身体活动组（PA）；（b）多种微量营养素补充组（MMNS）；（c）身体活动+多种微量营养素补充组（PA+MMNS）；和（d）安慰剂对照组。
使用潜在增长曲线模型（LGCM）在 9 个月和 21 个月时对整体和躯干脂肪游离质量（FFM）和脂肪质量（FM）的轨迹进行建模。从基线开始，在 9 个月时测量微量营养素浓度的变化。
在 MMNS 组的儿童中，9 个月时发现 FFM 轨迹增加（Beta 0.16，95%CI=0.12，0.31）。PA 和 MMNS 组在 9 个月时都对该轨迹具有积极的间接影响（Beta 0.66，95%CI=0.44，0.88 和 Beta 0.32 95%CI=0.1 0.5），在 21 个月时，当通过锌浓度变化介导时也是如此。在 9 个月时，在促进身体活动的手臂中发现 FM 轨迹减少，此时使用此采集点作为参考截距。该手臂与 9 个月时的 FM 轨迹呈负相关，当通过锌变化介导时也是如此。
在基于学校的干预措施中促进身体活动和多种微量营养素补充直接有助于减少南非儿童的 FM 和增加 FFM，并通过微量营养素状况的变化间接有助于减少 FM 和增加 FFM。
ISRCTN，ISRCTN29534081。于 2018 年 8 月 9 日注册。伦理审查委员会：“Ethikkommission Nordwest- und Zentralschweiz"（EKNZ，项目编号：Req-2018-00608）。批准日期：2018 年。
