G-20: Free Communication/Poster – Children and Adolescents: SATURDAY, JUNE 4, 2005 9:00AM – 12:00PM: ROOM: Ryman C1
The health problem affecting the greatest number of Wisconsin youth is obesity and poor physical fitness. This can lead to insulin resistance, type 2 diabetes mellitus, blood lipid abnormalities, and hypertension in their future. Diverse causes of childhood obesity arise from a pervasive “toxic” environment that collectively facilitates increased caloric intake and reduced physical activity. An effective strategy for prevention and treatment of childhood obesity, therefore, must be similarly pervasive, collaborative, and emblematic of a strong public health system. An attractive starting point for collaborative effort is the school setting, where both active and passive decisions regarding physical activity, food choices, and attendance can be reasonably controlled and programmatically altered.
To determine whether a school-based lifestyle focused fitness program can improve body composition, fitness level, and insulin sensitivity in overweight children.
50 overweight middle school children with a body mass index above the 95th percentile for age were randomized to either 1) lifestyle focused fitness oriented gym classes (treatment group), or 2) standard gym classes (controls) for 9 months. Children underwent fasting evaluation of insulin and glucose, body composition by dual x-ray absorptiometry (DXA), and maximal VO2 treadmill testing at baseline (prior to the school-year) and again at end of the school year (after 9 months).
At baseline there were no differences between groups prior to randomization (mean ± SD; age = 12±0.5 yrs, BMI = 31.0±3.7, percent body fat = 36.5±4.6%, lean body mass = 41.4±8.6kg, VO2 = 31.5 ± 5.1 ml/kg/min). The treatment subjects, when compared to controls (regular gym class), demonstrated a significantly greater loss of body fat (−4.1±3.40vs. −1.9±2.3%, p=0.04), greater increase in cardiovascular fitness (VO2 max) (+2.7±2.6 vs. 0.4±3.3 ml/kg/min, p<0.001), and greater improvement in fasting insulin (−5.1±5.2 vs. +3.0±14.3 μIU/ml, p=0.02).
Our results demonstrated a significantly greater loss of body fat, greater increase in cardiovascular fitness and greater improvement in fasting insulin in the treatment group versus controls. The modification to the school physical education curriculum demonstrates that even a small and relatively easy to achieve change in the amount of physical activity has beneficial effects on body composition, fitness and insulin levels in children. These data also suggest that partnering with school districts may help address important public health goals and improve the health of overweight children.