Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial

Institute of Exercise and Health Sciences, University of Basel, 4052 Basel, Switzerland.
BMJ (online) (Impact Factor: 16.38). 02/2010; 340:c785. DOI: 10.1136/bmj.c785
Source: PubMed

ABSTRACT To assess the effectiveness of a school based physical activity programme during one school year on physical and psychological health in young schoolchildren.
Cluster randomised controlled trial.
28 classes from 15 elementary schools in Switzerland randomly selected and assigned in a 4:3 ratio to an intervention (n=16) or control arm (n=12) after stratification for grade (first and fifth grade), from August 2005 to June 2006.
540 children, of whom 502 consented and presented at baseline.
Children in the intervention arm (n=297) received a multi-component physical activity programme that included structuring the three existing physical education lessons each week and adding two additional lessons a week, daily short activity breaks, and physical activity homework. Children (n=205) and parents in the control group were not informed of an intervention group. For most outcome measures, the assessors were blinded.
Primary outcome measures included body fat (sum of four skinfolds), aerobic fitness (shuttle run test), physical activity (accelerometry), and quality of life (questionnaires). Secondary outcome measures included body mass index and cardiovascular risk score (average z score of waist circumference, mean blood pressure, blood glucose, inverted high density lipoprotein cholesterol, and triglycerides).
498 children completed the baseline and follow-up assessments (mean age 6.9 (SD 0.3) years for first grade, 11.1 (0.5) years for fifth grade). After adjustment for grade, sex, baseline values, and clustering within classes, children in the intervention arm compared with controls showed more negative changes in the z score of the sum of four skinfolds (-0.12, 95 % confidence interval -0.21 to -0.03; P=0.009). Likewise, their z scores for aerobic fitness increased more favourably (0.17, 0.01 to 0.32; P=0.04), as did those for moderate-vigorous physical activity in school (1.19, 0.78 to 1.60; P<0.001), all day moderate-vigorous physical activity (0.44, 0.05 to 0.82; P=0.03), and total physical activity in school (0.92, 0.35 to 1.50; P=0.003). Z scores for overall daily physical activity (0.21, -0.21 to 0.63) and physical quality of life (0.42, -1.23 to 2.06) as well as psychological quality of life (0.59, -0.85 to 2.03) did not change significantly.
A school based multi-component physical activity intervention including compulsory elements improved physical activity and fitness and reduced adiposity in children. Trial registration Current Controlled Trials ISRCTN15360785.

Download full-text


Available from: Lukas Zahner, Jun 21, 2015
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6-18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40-0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin.
    Journal of Diabetes Research 01/2015; 2015:539835. DOI:10.1155/2015/539835 · 3.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Children aged 10-11 years are in going through a dynamic developmental period marked by rapid changes in body size, shape, and composition, all of which are sexually dimorphic. The purpose of this study was to analyze the effects of gender on a school-based intervention in the pre-pubertal growth spurt. One hundred twenty-five healthy children (58 boys, 67 girls) in fifth- and sixth-grade classrooms from an urban public elementary school in Portugal (10.8 ± 0.4 years), were randomly assigned into two experimental groups to train twice a week for 8 weeks: strength training group (19 boys, 22 girls), endurance training group (21 boys, 24 girls), and a control group (18 boys, 21 girls; no training program). Compared with the values at the beginning of the protocol, both strength and endurance training programs produced significant improvements (p< 0.05) in vertical and horizontal jumps, 1 kg and 3 kg medicine ball throw, time-at-20 m and VO2max, for both boys and girls. No significant interactions were observed relative to gender on training-induced strength (p> 0.05, ƞ_p^2= 0.16, Power= 0.29) and aerobic (p> 0.05, ƞ_p^2= 0.05, Power= 0.28) adaptations. This should be taken into consideration to optimize strength training school-based programs.
    Journal of Human Kinetics 11/2014; 43(1):159-167. DOI:10.2478/hukin-2014-0101 · 0.70 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Schools are a key setting for promoting physical activity in children. There is little evidence on the potential of widely implemented programs to improve the quality of physical education (PE). The aim was to assess the effects of a short training course for classroom teachers on the quality of PE, assessed as activity time during PE. A quasi-experimental study was conducted with 6 intervention (N = 86) and 13 control classes (N = 151). Schools were selected in a random procedure (26.9% participation). Participation in children was 86.2% (mean age 7.8 years, 48.9% girls). Physical activity was assessed objectively using accelerometers. Effect on time spent in sedentary, moderate, vigorous and moderate-to-vigorous (MVPA) activities, steps and counts/minute during PE were analysed using t-tests and mixed linear models. Physical activity time increased significantly in the intervention but not in the control group between baseline and follow-up (relative increase in moderate-to-vigorous physical activity of 12% in intervention group). Increases were strongest in girls and in children inactive at baseline. In the mixed linear models adjusted for clustering, the effects were significant in girls for vigorous activities, sedentary time and counts/minute, in inactive children for steps. Results indicate that a short training course for classroom teachers can have subtle positive effects on physical activity time during PE. Girls and the most inactive children at baseline profited most from the intervention.
    Open Journal of Preventive Medicine 05/2014; 4(05):317-326. DOI:10.4236/ojpm.2014.45039