Project PANK: Rationale, study protocol and baseline results of a multidisciplinary school based intervention in children with cardiovascular and metabolic risk factors

Abstract

-Aims: Cardiovascular disease risk factors occur more frequently in children with obesity. Project PANK is a multidisciplinary school-based intervention lasting 6 months to improve BMI z-score, waist circumference (WC), waist-to-height ratio (WHtR), blood pressure (BP), nutrition, physical activity (PA), sedentary behaviour (SB), cardiorespiratory fitness (CRF), glucose, cholesterol, and triglycerides (TG). Methods/Design: A total of 77 children (7-10 years) were recruited from an urban school. The protocol includes PA and SB individual meetings for children/ parents; increasing school exercise; PA and SB lessons for children; A goal in the number of steps/day to accomplish in and after school. In nutrition, the protocol includes three individual meetings for children/parents and six lessons for children. Results: Positive associations were found between the BMI Z-score, WC, and WHtR with TG; the BMI Z-score and WHtR with glucose; the light PA time and HDL-C; the vigorous and moderate-to-vigorous PA with CRF; the caloric intake and lipids with LDL-C, BMI z-score, WC, and WHtR. A negative association was found between CRF and TG. Conclusion: Baseline results stress the importance of multidisciplinary school-based interventions. We hypothesized that PANK will improve blood variables, anthropometric measures, and BP, by changing food intake, enhancing PA and CRF, and decreasing SB.

Sedentary Behavior and Cardiovascular Risk in Children: A Systematic Review

“…There was no relationship between total sedentary time and levels of insulin, 35,36,40,43,52,53,56 glucose, 25,31,35,36,40,43,50,52,53,56,58 , and insulin resistance 36,54,57,58 in the analyzed studies (Table 2). Only three studies showed a positive association between total sedentary time and each individual parameter (insulin, 58 glucose, 18 and insulin resistance 12 ).…”

“…The data on lipid profile presented in Table 2 show that the majority of studies did not demonstrate an association between total sedentary time and levels of total cholesterol (TC), 18,43,50,56 high-density lipoprotein cholesterol (HDL-C), 18,25,31,35,36,43,50,52,56,58 low-density lipoprotein cholesterol (LDL-C), 18,43,50,52,56,58 very low-density lipoprotein cholesterol (VLDL-C), 43 non-HDL cholesterol, 22,32 TC/HDL-C ratio, 54,57 and triglycerides (TG). 25,31,35,36,40,50,[52][53][54][56][57][58] However, some studies indicated that children and adolescents with more sedentary time during the day had higher levels of TG 18,43 and LDL-C 53 and lower levels of HDL-C. 40,53 The analysis focusing on patterns of sedentary time showed that in most studies there was no relationship between bouts 22,32,…”

“…16,23 However, the majority of studies did not indicate an association between screen time and levels of insulin, glucose, and insulin resistance. 25,27,31,43,46,48,50,52…”

“…Only two studies demonstrated an association between total sedentary time and systolic blood pressure (SBP), in which adolescents with longer total sedentary time had higher levels of SBP, 18,53 a finding that contrasts most studies reporting a lack of association. 15,22,31,32,40,43,50,52,54,[56][57][58] Prolonged bouts of sedentary time 22,32,40,50 and breaks 32 were not associated with BP. However, there were associations with specific indicators of sedentary behavior.…”

“…58 Regarding the impact that sedentary behavior may have on health, in addition to total sedentary time and other related activities, the patterns of sedentary time accumulation were also investigated. 22,32,35,40,50,59,60 Some authors analyzed bouts of sedentary time over a continuous period of sedentary time, as well as breaks in prolonged sedentary time. Prolonged bouts of sedentary time have been associated with overweight 32 and lower levels of HDL-C. 40 On the contrary, short bouts of sedentary time mitigated CV.…”