Highlights:
- Health education-based interventions reduced the progression of obesity markers in children.
- The benefits were most pronounced among children who participated in the program in the first grade.
Researchers reported that early initiation of a school-based health education intervention reduced the progression of obesity markers among Spanish primary school children.
The main results of the SI! program in Spain are: Journal of the American College of Cardiology.
“School-based health promotion efforts are increasingly being emphasized to enhance the health, well-being and development of children and adolescents through comprehensive programs that promote healthy school environments, health and nutrition literacy, physical activity and mental health.” Gloria Santos –StupidPhD, The Foundation for Science, Health and Education (Fundación SHE) and the National Center for Cardiovascular Research (Centro Nacional de Investigaciones Cardiovasculares), Barcelona, Spain [CNIC]), they and their colleagues write, “However, the results of most of these efforts have been inconclusive, particularly with regard to the effect of timing on intervention efficacy.”
This analysis of the SI! program assessed the effects of time-varying exposure to a school-based health intervention on obesity markers.
The SI! program is a multicomponent intervention aimed at instilling healthy habits starting from an early age and is being implemented in schools in Spain, Colombia and the United States.
Interventions include education on diet, physical activity and managing the body, mind and emotions, according to the study.
In the current analysis, 48 schools in Madrid were randomly assigned to either the SI! program or the standard curriculum.
Twelve primary schools in grades 1-6 (459 children), 12 primary schools in grades 1-3 (513 children), and 12 primary schools in grades 4-6 (419 children) were assigned to the SI! program, while 12 control primary schools implemented the standard curriculum (379 children).
The primary outcomes were 3- and 6-year differences in obesity markers and overall knowledge, attitudes, and habits scores between the intervention and control groups.
Effects of SI! on obesity markers in children
Elementary school students who received the SI! program intervention at age 3: figure BMI score (0.09; 95% CI, 0.16–0.03; P = .003) and waist-to-height ratio and waist circumference (0.19; 95% CI, 0.28 to 0.1; P The percent increase from baseline compared with the control group was < .001.
Observed profit trends figure The group who started the SI! program intervention earliest maintained their waist-to-height ratio and waist circumference scores over six years.
- Waist circumference figure scores comparing the control group with those in grades 1-6 (0.19; P = .02);
- Waist circumference figure Comparison of scores between the control group and first through third graders (0.22; P = .009);
- Waist to height ratio figure scores comparing the control group with those in grades 1-6 (0.24; P = .009); and
- Waist to height ratio figure Comparison of scores between the control group and first through third graders (0.29; P = .001).
The researchers reported that there were no significant differences in change in overall knowledge, attitudes, and habits scores between the intervention and control groups.
“this is [the] “This is the largest and longest-follow-up randomized trial of a school-based health promotion intervention reported to date,” the researchers wrote. “In this randomized trial, significant positive changes were observed in two of the three intervention groups (E1-3 and E1-6). figure Waist circumference score and figure “Waist-to-height ratio scores were compared with controls. These obesity markers are strongly associated with cardiovascular health in children and adults. … The impact of school-based interventions on children’s health is likely to be more sustained if they begin as early as possible and include re-interventions that reinforce key messages to families until children become more independent.”
In the words of Valentin Fuster
Carl J. Lovie Jr.
In a related editorial, Carl J. Lavie, Jr., MD, FACC, FACP, FCCPThe medical director of cardiac rehabilitation and prevention and director of the exercise laboratory at the John Ochsner Heart and Vascular Institute, Ochsner Clinical School of Medicine at the University of Queensland in New Orleans, and colleagues discussed the prevalence of overweight and obesity in young children and the importance of early health education.
“Even earlier in life (preschool age 3–5 years), the prevalence of overweight and obesity is already very high, at 35% in Spain,” the authors write. “This finding suggests that we as a society are already doing something wrong in the first 2 years of life, and a question for future research is what policy strategies and interventions can address this problem very early in life.”
“I was the editor-in-chief for many years. Jack and lead author of the study Dr. Valentin Fuster“As CVD physicians and researchers, we believe that educating children (and their parents and families) is where we can have the greatest impact in reducing the global incidence of CVD,” they wrote in a recent editorial. “The results of this intervention study in school-age children to prevent the progression of obesity and cardiometabolic problems that can lead to CVD are a great start and a real paradigm shift in preventing CVD early.”
reference:
Sources/Disclosures
Collapse
Disclosure: Mr. Santos-Beneit and the editorial authors have no relevant financial disclosures. Please see the study for relevant financial disclosures of all other authors.
