Three-year maintenance of improved diet and physical activity - The CATCH cohort

Objective: To assess differences through grade 8 in diet, physical activity , and related health indicators of students who participated in the Child a nd Adolescent Trial for Cardiovascular Health (CATCH) school and family int ervention from grades 3 through 5. Design: Follow-up of the 4-center, randomized, controlled field trial with 56 intervention and 40 control elementary schools. Participants: We studied 3714 (73%) of the initial CATCH cohort of 5106 stu dents from ethnically diverse backgrounds in California, Louisiana, Minneso ta, and Texas at grades 6, 7, and 8. Results: St lf-reported daily energy intake from fat at baseline was virtua lly identical in the control (32.7%) and intervention (32.6%) groups. At gr ade 5, the intake for controls remained at 32.2%, while the intake for the intervention group declined to 30.3% (P<.001). At grade 8, the between grou p differential was maintained (31.6% vs 30.6%, P = .01). Intervention stude nts maintained significantly higher self-reported daily vigorous activity t han control students (P = .001), although the difference declined from 13.6 minutes in grade 5 to 11.2, 10.8, and 8.8 minutes in grades 6, 7, and 8, r espectively. Significant differences in favor of the intervention students also persisted at grade 8 for dietary knowledge and dietary intentions, but not for social support for physical activity. No impact on smoking behavio r or stages of contemplating smoking was detected at grade 8. No significan t differences were noted among physiologic indicators of body mass index, b lood pressure, or serum lipid and cholesterol levels. Conclusion: The original CATCH results demonstrated that school-level inter ventions could modify school lunch and school physical education programs a s well as influence student behaviors. This 3-year follow-up without furthe r intervention suggests that the behavioral changes initiated during the el ementary school years persisted to early adolescence for self-reported diet ary and physical activity behaviors.