Team sports for overweight children: The Stanford Sports to Prevent Obesity Randomized Trial (SPORT)

Division of General Pediatrics and Stanford Prevention Research Center, Stanford University School of Medicine, 211 Quarry Rd, Hoover Pavilion, Room N032, Stanford, CA 94305-5705, USA.
JAMA Pediatrics (Impact Factor: 5.73). 04/2008; 162(3):232-7. DOI: 10.1001/archpediatrics.2007.43
Source: PubMed


To evaluate the feasibility, acceptability, and efficacy of an after-school team sports program for reducing weight gain in low-income overweight children.
Six-month, 2-arm, parallel-group, pilot randomized controlled trial.
Low-income, racial/ethnic minority community.
Twenty-one children in grades 4 and 5 with a body mass index at or above the 85th percentile.
The treatment intervention consisted of an after-school soccer program. The "active placebo" control intervention consisted of an after-school health education program.
Implementation, acceptability, body mass index, physical activity measured using accelerometers, reported television and other screen time, self-esteem, depressive symptoms, and weight concerns.
All 21 children completed the study. Compared with children receiving health education, children in the soccer group had significant decreases in body mass index z scores at 3 and 6 months and significant increases in total daily, moderate, and vigorous physical activity at 3 months.
An after-school team soccer program for overweight children can be a feasible, acceptable, and efficacious intervention for weight control.

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    • "Briefly, studies were included if they were randomized controlled trials examining the effects of exercise (aerobic, strength training, or both) on BMI í µí± §-score in overweight and obese children and adolescents [9]. A total of 10 studies representing 835 overweight and obese children and adolescents (456 exercise, 379 control) were included [21] [22] [23] [24] [25] [26] [27] [28] [29] [30]. BMI í µí± §-score was chosen as the primary outcome based on previous research suggesting its greater validity over other types of BMI-related measures [31]. "
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    ABSTRACT: Background. Given the cardiovascular disease (CVD) related importance of understanding the true effects of exercise on adiposity in overweight and obese children and adolescents, this study examined whether there is evidential value to rule out excessive and inappropriate reporting of statistically significant results, a major problem in the published literature, with respect to exercise-induced improvements in BMI z -score among overweight and obese children and adolescents. Methods. Using data from a previous meta-analysis of 10 published studies that included 835 overweight and obese children and adolescents, a novel, recently developed approach (p -curve) was used to test for evidential value and rule out selective reporting of findings. Chi-squared tests (χ 2) were used to test for statistical significance with alpha (p) values <0.05 considered statistically significant. Results. Six of 10 findings (60%) were statistically significant. Statistically significant right-skew to rule out selective reporting was found (χ 2 = 38.8, p = 0.0001). Conversely, studies neither lacked evidential value (χ 2 = 6.8, p = 0.87) nor lacked evidential value and were intensely p -hacked (χ 2 = 4.3, p = 0.98). Conclusion. Evidential value results confirm that exercise reduces BMI z -score in overweight and obese children and adolescents, an important therapeutic strategy for treating and preventing CVD.
    Full-text · Article · Oct 2015
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    • "Little information exists about the cardiovascular effects of football training in untrained children and adolescents , although recent cross-sectional and longitudinal studies have described positive effects of football participation on aerobic capacity and other measures of fitness (Krustrup et al., 2010a, b; Seabra et al., 2012; Bendiksen et al., 2014). Moreover, studies of untrained overweight children have reported considerable cardiovascular adaptations to short-term football interventions (Weintraub et al., 2008; Faude et al., 2010; Hansen et al., 2013). Specifically, in terms of cardiac adaptations to football training, we recently found that 3 months with four 60–90-min football sessions per week added to the normal physical education curriculum (2 × 45 min per week) were associated with significant structural and functional effects on the heart in overweight preadolescent children, with increased left ventricular (LV) posterior wall diameter (LVPWD), improved right ventricular (RV) systolic function determined by tricuspid annular plane systolic excursion (TAPSE) and increased global isovolumetric relaxation time (IVRT) (Hansen et al., 2013). "
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    ABSTRACT: The present study investigated the cardiac effects of a 10-week football training intervention for school children aged 9-10 years using comprehensive transthoracic echocardiography as a part of a larger ongoing study. A total of 97 pupils from four school classes were cluster-randomized into a control group that maintained their usual activities (CON; two classes, n = 51, 21 boys and 30 girls) and a football training group that performed an additional 3 × 40 min of small-sided football training per week (FT; two classes, n = 46, 23 boys and 23 girls). No baseline differences were observed in age, body composition, or echocardiographic variables between FT and CON. After the 10-week intervention, left ventricular posterior wall diameter was increased in FT compared with CON [0.4 ± 0.7 vs -0.1 ± 0.6 (± SD) mm; P < 0.01] as was the interventricular septum thickness (0.2 ± 0.7 vs -0.2 ± 0.8 mm; P < 0.001). Global isovolumetric relaxation time increased more in FT than in CON (3.8 ± 10.4 vs -0.9 ± 6.6 ms, P < 0.05) while the change in ventricular systolic ejection fraction tended to be higher (1.4 ± 8.0 vs -1.1 ± 5.5%; P = 0.08). No changes were observed in resting heart rate or blood pressure. In conclusion, a short-term, school-based intervention comprising small-sided football sessions resulted in significant structural and functional cardiac adaptations in pre-adolescent children.
    Full-text · Article · Aug 2014 · Scandinavian Journal of Medicine and Science in Sports
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    • "For example, in a recent review of after-school PA interventions, Pate and O’Neill reported that three of the five randomized controlled trials that had been conducted had reported positive increases in objectively measured PA [10]. Of particular interest is the Stanford Sports to prevent Obesity Trial (SPORT) which reported a ten minute increase in moderate intensity PA after provision of an extracurricular soccer program [25]. Thus, a ten minute per weekday increase in MVPA would represent a marked increase in PA levels and is consistent with successful PA interventions. "
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    ABSTRACT: Many adolescent girls do not engage in sufficient physical activity (PA). This study examined the feasibility of conducting a cluster randomized controlled trial (RCT) to evaluate an after-school dance program to increase PA among 11-12 year old girls in Bristol, UK. Three-arm, cluster RCT. Three secondary schools were assigned to intervention arm. Intervention participants received a 9-week dance program with 2, 90-minute dance classes per week. Participants at 2 control schools received incentives for data collection. Participants at 2 additional control schools received incentives and a delayed dance workshop. Accelerometer data were collected at baseline (time 0), during the last week of the dance program (time 1) and 20 weeks after the start of the study (time 2). Weekly attendance, enjoyment and perceived exertion were assessed in intervention participants. Post-study qualitative work was conducted with intervention participants and personnel. 40.1% of girls provided consent to be in the study. The mean number of girls attending at least one dance session per week ranged from 15.4 to 25.9. There was greater number of participants for whom accelerometer data were collected in control arms. The mean attendance was 13.3 sessions (maximum=18). Perceived exertion ratings indicated that the girls did not find the sessions challenging. The dance teachers reported that the program content would benefit from revisions including less creative task time, a broader range of dance genres and improved behavioral management policies. At time 2, the 95% confidence intervals suggest between 5 and 12 minutes more weekday MVPA in the intervention group compared with the control incentives only group, and between 6 minutes fewer and 1 minute more compared with the control incentives plus workshop group. Between 14 and 24 schools would be required to detect a difference of 10 minutes in mean weekday MVPA between intervention and control groups. It is possible to recruit 11-12 year old girls to participate in an after-school dance study. An after-school dance intervention has potential to positively affect the PA levels of 11-12 year old girls but an adequately powered RCT is required to test this intervention approach.
    Full-text · Article · Jul 2012 · International Journal of Behavioral Nutrition and Physical Activity
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