Effects of a lifestyle intervention on adiposity and fitness in overweight or low fit preschoolers (Ballabeina) |
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| Authors: | I Niederer F Bürgi V Ebenegger P Marques‐Vidal C Schindler A Nydegger S Kriemler J J Puder |
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| Institution: | 1. Institute of Exercise and Health Sciences, University of Basel, 4052 Basel, Switzerland;2. Institute of Sport Sciences, University of Lausanne, Batiments administratifs de Vidy, Route de Chavannes 33, 1015 Lausanne, Switzerland;3. Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois, University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland;4. Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland;5. Department of Paediatric Gastroenterology and Nutrition, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland;6. Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland |
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| Abstract: | Objective: Overweight (OW) and low fit children represent cardiovascular high‐risk groups. A multidimensional school‐based lifestyle intervention performed in 652 preschoolers reduced skinfold thickness and waist circumference, and improved fitness, but did not affect BMI. The objective of this study is to examine whether the intervention was equally effective in OW (≥90th national percentile) and/or low fit (lowest sex‐ and age‐adjusted quartile of aerobic fitness) children compared to their normal weight and normal fit counterparts. Design and Methods: Cluster randomized controlled single blinded trial, conducted in 2008/09 in 40 randomly selected preschool classes in Switzerland. The intervention included a playful physical activity program and lessons on nutrition, media use and sleeps. Primary outcomes were BMI and aerobic fitness; secondary outcomes included sum of four skinfolds, waist circumference and motor agility. Modification of intervention effects by BMI‐group and fitness‐group was tested by interaction terms. Results: Compared to their counterparts, OW children (n = 130) had more beneficial effects on waist circumference (p for interaction = 0.001) and low fit children (n = 154) more beneficial effects on all adiposity outcomes (p for interaction ≤0.03). The intervention effects on both fitness outcomes were not modified by BMI‐ or fitness‐group (all p for interaction ≥0.2). Average intervention effect sizes for BMI were ?0.12, ?0.05, ?0.26 and ?0.02 kg/m2 and for aerobic fitness were 0.40, 0.30, 0.12 and 0.36 stages for OW, normal weight, low fit and normal fit children, respectively. Conclusions: This multidimensional intervention was equally and for some adiposity measures even more effective in high‐risk preschoolers and represents a promising option for these children. |
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