School-based Interventions Improve Heart Health in Children With Multiple Cardiovascular Disease Risk Factors

OBJECTIVE: To determine the immediate effects of two types of elementary school-based interventions on children with multiple cardiovascular disease (CVD) risk factors. DESIGN: Randomized, controlled field trial. SETTING: Conducted in 18 randomly selected elementary schools across North Carolina. STUDY PARTICIPANTS: Four hundred twenty-two children age 9 +/- 0.8 years with at least two risk factors at baseline: low aerobic power and either high serum cholesterol or obesity. INTERVENTION: Both 8-week interventions consisted of a knowledge and attitude program and an adaptation of physical education. The classroom-based intervention was given by regular teachers to all children in the 3rd and 4th grades. The risk-based intervention was given in small groups only to children with identified risk factors. Children in the control group received usual teaching and physical education. OUTCOME MEASURES: The primary outcome measure was cholesterol; additional measures were blood pressure, body mass index, body fat, eating and activity habits, and health knowledge. RESULTS: Both interventions produced large reductions in cholesterol (-10.1 mg/dL and -11.7 mg/dL) compared with a small drop (-2.3 mg/dL) in the controls. There was a trend for systolic blood pressure to increase less in both intervention groups than in the controls. Both intervention groups had a small reduction in body fat and higher health knowledge than the control group. CONCLUSIONS: Both brief interventions can improve the CVD risk profile of children with multiple risk factors. The classroom-based approach was easier to implement and used fewer resources. This population approach should be considered as one means of early primary prevention of CVD.