Progress 07/15/05 to 07/14/06
Outputs
The goal of this original project was to implement a nutrition and exercise intervention program in two middle school districts in Pennsylvania for children who were overweight or at risk of becoming overweight. A nonrandomized control group pretest-posttest design was used in which 36 subjects were assigned to either the control or treatment groups. The mean percentile on the National Center for Health Statistics (NCHS) Body Mass Index (BMI)-for-age- growth charts for boys and girls during pre and post testing for the control and treatment groups was 95%. Both groups slightly decreased in the percentile, but results were not significant. The data from both the nutrient and food group analyses indicate that the number of servings and calories in the dairy group and the intake of vitamin D with supplements were significantly higher in the treatment group than the control group in the posttest with the pretest as the covariate. Calcium with and without supplements showed
a similar trend. The number of dairy servings consumed in the posttest for the treatment group was closer to the recommended servings for this age group. The calories and servings from the fruit group also increased from pre to post testing for the treatment group. The nutrition knowledge scores for the treatment group were significantly higher than those for the control group. This indicates that the treatment group increased their nutrition knowledge after the intervention. The major cardiovascular/health efficiency factors that were analyzed included energy expenditure index, resting heart rate and working heart rate for both the 12-minute walk and 3-minute step tests, distance walked in 12 minutes, and number of steps completed in 3 minutes. Energy expenditure index is measure of change in heart rate divided by the speed of movement. The energy expenditure index for the 12-minute walk significantly decreased between the pre and post testing for the treatment group. No significant
change occurred in the control group. This indicates that students in the treatment group demonstrated improved cardiac efficiency during the 12-minute walk exercise. No significant changes between pre and post testing were seen in the treatment group for self-esteem in the areas of physical appearance and attributes, popularity, happiness and satisfaction as measured by the Piers-Harris Children's Self Concept. With regards to the stage of change behavior for diet, the control and treatment groups were both between the Preparation/Action stages in the pretest. At the end of the study, the control group significantly decreased to the Contemplation/Preparation stages, but the treatment group stayed at the Preparation/Action Stages. This is important in that the treatment group remained motivated to continue the change in behavior. Self rated current body image by the students in the treatment group decreased when compared to the control group who made no change. This improvement in
self-perceived body image suggests an improvement in the treatment group's self rated physical image. This change is a positive reflection of the intervention program.
Impacts
Childhood obesity is an alarming problem. The National Health and Nutrition Examination Survey found that 15.3 percent of children between 6-11 years, and 15.5 percent of adolescents between 12-19 years are overweight in the United States (www.cdc.gov/nchs/nhanes.htm, 2004). An objective related to obesity in Healthy People 2010 (www.healthypeople.gov/) is to reduce the proportion of children who are overweight or at risk of being overweight to 5 percent from a baseline of 11 percent in 1988-94. By conducting this research/ intervention project which promoted a healthy lifestyle through nutrition, exercise, and family education for a group of children who were overweight or at risk of obesity (percentile on the NCHS BMI- for-age-growth chart equal or greater than 85 percent), the investigators sought important insights into the problem of childhood obesity and to decrease the problem. This project supported the USDA Strategic Plan FY2002-2007 and Healthy People 2010,
which had goals to reduce the proportion of children who are overweight or at risk of becoming of overweight. In addition, this project had very positive feedback and impact on children and staff in both school districts.
Publications
- A.R. Kolesar, RD, LDN1; K. Murphy, RD, CNSD1; M.E. Borja, EdD, RD, LDN1; M. Grant-Buettler, PT, PhD2; B. Wagner, PT, DPT2; L.M. Powell, PhD3 1-Marywood University, Scranton, PA; 2-University of Scranton, Scranton, PA; 3- Bloomsburg University, Bloomsburg, PA. Development of the Nutrition Knowledge Questionnaire and Utilization in the Nutrition and Exercise Intervention Project for at Risk of or Overweight Middle School Children. Abstract in Journal of American Dietetic Association, 106(8)l, A49. Poster Session FNCE Annual Meeting, Honolulu, September 2006.
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