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Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk : subgroups analysis from a cluster-randomized trial

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Abstract
Background: Adolescents with overweight and poor physical fitness have an increased likelihood of developing cardiovascular diseases during adulthood. In Ecuador, a health promotion program improved the muscular strength and speed-agility, and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months. We performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents. Methods: We performed a cluster-randomized pair matched trial in schools located in Cuenca–Ecuador. In total 20 schools (clusters) were pair matched, and 1440 adolescents of grade 8 and 9 (mean age of 12.3 and 13.3 years respectively) participated in the trial. For the purposes of the subgroup analysis, the adolescents were classified into groups according to their weight status (body mass index) and aerobic capacity (scores in the 20 m shuttle run and FITNESSGRAM standards) at baseline. Primary outcomes included physical fitness (vertical jump, speed shuttle run) and physical activity (proportion of students achieving over 60 min of moderate–to-vigorous physical activity/day). For these primary outcomes, we stratified analysis by weight (underweight, normal BMI and overweight/ obese) and fitness (fit and low fitness) groups. Mixed linear regression models were used to assess the intervention effect. Results: The prevalence of overweight/obesity, underweight and poor physical fitness was 20.3 %, 5.8 % and 84.8 % respectively. A higher intervention effect was observed for speed shuttle run in overweight (β = −1.85 s, P = 0.04) adolescents compared to underweight (β = −1.66 s, P = 0.5) or normal weight (β = −0.35 s, P = 0.6) peers. The intervention effect on vertical jump was higher in adolescents with poor physical fitness (β = 3.71 cm, P = 0.005) compared to their fit peers (β = 1.28 cm, P = 0.4). The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/ day was not significantly different according to weight or fitness status. Conclusion: Comprehensive school-based interventions that aim to improve diet and physical activity could improve speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents.
Keywords
Physical activity, Fitness, Adolescents, Randomized control trial, Subgroup analysis, Body mass index, BODY-MASS INDEX, AEROBIC FITNESS, OBESE CHILDREN, OVERWEIGHT, LIFE, METAANALYSIS, ASSOCIATION, ADIPOSITY, CHILDHOOD, BENEFITS

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Chicago
Andrade Tenesaca, Dolores Susana, Carl Lachat, Greet Cardon, Angélica María Ochoa Avilés, Roosmarijn Verstraeten, John Van Camp, Silvia Johana Ortiz Ulloa, Patricia Ramirez, Silvana Donoso, and Patrick Kolsteren. 2016. “Two Years of School-based Intervention Program Could Improve the Physical Fitness Among Ecuadorian Adolescents at Health Risk : Subgroups Analysis from a Cluster-randomized Trial.” Bmc Pediatrics 16.
APA
Andrade Tenesaca, D. S., Lachat, C., Cardon, G., Ochoa Avilés, A. M., Verstraeten, R., Van Camp, J., Ortiz Ulloa, S. J., et al. (2016). Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk : subgroups analysis from a cluster-randomized trial. BMC PEDIATRICS, 16.
Vancouver
1.
Andrade Tenesaca DS, Lachat C, Cardon G, Ochoa Avilés AM, Verstraeten R, Van Camp J, et al. Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk : subgroups analysis from a cluster-randomized trial. BMC PEDIATRICS. 2016;16.
MLA
Andrade Tenesaca, Dolores Susana, Carl Lachat, Greet Cardon, et al. “Two Years of School-based Intervention Program Could Improve the Physical Fitness Among Ecuadorian Adolescents at Health Risk : Subgroups Analysis from a Cluster-randomized Trial.” BMC PEDIATRICS 16 (2016): n. pag. Print.
@article{7209107,
  abstract     = {Background: Adolescents with overweight and poor physical fitness have an increased likelihood of developing
cardiovascular diseases during adulthood. In Ecuador, a health promotion program improved the muscular strength and
speed-agility, and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months. We
performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents.
Methods: We performed a cluster-randomized pair matched trial in schools located in Cuenca--Ecuador. In total
20 schools (clusters) were pair matched, and 1440 adolescents of grade 8 and 9 (mean age of 12.3 and 13.3 years
respectively) participated in the trial. For the purposes of the subgroup analysis, the adolescents were classified
into groups according to their weight status (body mass index) and aerobic capacity (scores in the 20 m shuttle
run and FITNESSGRAM standards) at baseline. Primary outcomes included physical fitness (vertical jump, speed
shuttle run) and physical activity (proportion of students achieving over 60 min of moderate--to-vigorous physical
activity/day). For these primary outcomes, we stratified analysis by weight (underweight, normal BMI and overweight/
obese) and fitness (fit and low fitness) groups. Mixed linear regression models were used to assess the intervention effect.
Results: The prevalence of overweight/obesity, underweight and poor physical fitness was 20.3 \%, 5.8 \% and
84.8 \% respectively. A higher intervention effect was observed for speed shuttle run in overweight (\ensuremath{\beta} = \ensuremath{-}1.85 s, P = 0.04)
adolescents compared to underweight (\ensuremath{\beta} = \ensuremath{-}1.66 s, P = 0.5) or normal weight (\ensuremath{\beta} = \ensuremath{-}0.35 s, P = 0.6) peers. The intervention
effect on vertical jump was higher in adolescents with poor physical fitness (\ensuremath{\beta} = 3.71 cm, P = 0.005) compared to their fit
peers (\ensuremath{\beta} = 1.28 cm, P = 0.4). The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/
day was not significantly different according to weight or fitness status.
Conclusion: Comprehensive school-based interventions that aim to improve diet and physical activity could improve
speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents.},
  articleno    = {51},
  author       = {Andrade Tenesaca, Dolores Susana and Lachat, Carl and Cardon, Greet and Ochoa Avil{\'e}s, Ang{\'e}lica Mar{\'i}a and Verstraeten, Roosmarijn and Van Camp, John and Ortiz Ulloa, Silvia Johana and Ramirez, Patricia and Donoso, Silvana and Kolsteren, Patrick},
  issn         = {1471-2431},
  journal      = {BMC PEDIATRICS},
  keyword      = {Physical activity,Fitness,Adolescents,Randomized control trial,Subgroup analysis,Body mass index,BODY-MASS INDEX,AEROBIC FITNESS,OBESE CHILDREN,OVERWEIGHT,LIFE,METAANALYSIS,ASSOCIATION,ADIPOSITY,CHILDHOOD,BENEFITS},
  language     = {eng},
  pages        = {15},
  title        = {Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk : subgroups analysis from a cluster-randomized trial},
  url          = {http://dx.doi.org/10.1186/s12887-016-0588-8},
  volume       = {16},
  year         = {2016},
}

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