A CONTROLLED TRIAL OF HEALTH PROMOTION PROGRAMS IN 11-YEAR-OLDS USINGPHYSICAL-ACTIVITY ENRICHMENT FOR HIGHER RISK CHILDREN

Objective: To evaluate the short and long term benefits of a school an d home based physical activity ''enrichment'' program for children at higher risk of cardiovascular disease as identified by cluster analysi s. Study design: During two 10-week school terms, 800 Ii-year-olds too k part in a randomized controlled trial with the standard physical act ivity and nutrition program in six schools, the standard program in a further seven schools but with the addition of physical activity enric hment for higher risk children in those schools, and no program in fiv e control schools. Cluster analysis identifying the 29% or so highest risk children used systolic blood pressure, percent body fat, physical fitness, and blood cholesterol. Results: Fitness improved significant ly in program schools, particularly with enrichment in higher risk boy s. Substantial improvements persisted 6 months later in girls from pro gram schools. At ''Enrichment'' schools, cholesterol showed significan t benefits in higher risk girls and, 6 months later, in both boys and higher risk girls. Sodium intake and, in girls, subscapular skinfolds were lower in ''Enrichment'' schools when the program ended, but not 6 months later. Conclusion: Two-semester health programs with physical activity enrichment for higher risk children can produce benefits sust ained for at least 6 months. Improvements extend to lower risk childre n exposed indirectly to the enrichment. Attenuation of effects on diet and body composition in the longer-term suggest the need for on-going programs.