The Prevention Education Program (PEP) Nuremberg: design and baseline dataof a family oriented intervention study

OBJECTIVE: We describe the design and baseline data of the Prevention Educa tion Program (PEP), a home-based and family oriented intervention program, aimed to assess and improve cardiovascular risk factors in school children and their families during an intervention period of 10y. DESIGN AND METHODS: At study entry all participants were randomized either to an intervention group (screening and intervention program) or to a contr ol group (risk screening, general advice). Cardiovascular risk factors (hyp ertension, elevated lipids, smoking, obesity) as well as dietary behaviour are evaluated yearly using structured interview physical examination, labor atory analysis, and seven-day dietary protocol. RESULTS: During the years 1993 - 1998, 3547 adults (age 36.2 +/- 7y) and 34 95 children (age 6.5 +/- 2 y) were recruited. Adults show a high prevalence of risk factors: hypertension 21%; active smoking 39%, elevated LDL-choles terol 19%; and obesity 42%. Children exhibit these risk factors in comparab le frequency: hypertension 20%; passive smoking 44%; elevated LDL-cholester ol 17%; and obesity 19%. The analysis of the dietary protocols (1926 adults , 1569 children) shows that both generations adhere to a diet exceeding the recommended fat intake (adults 38% of total energy, children 38%), while c arbohydrate intake (adults 43% of total energy intake, children 50%) is red uced compared to NCEP-(step I)-guidelines. CONCLUSION: The finding, that children show a prevalence of risk factors wh ich is comparable to that found in adults, supports the need for an early b eginning of intervention. Since both generations adhere to an unhealthy die t which contributes to cardiovascular risk, dietary intervention may be a p romising method in primary prevention of cardiovascular risk.