Abstract
Background and ObjectivesElevated blood lipids during childhood are predictive of dyslipidemia in adults. Although obese and inactive children have elevated values, any potentially protective role of elementary school physical education is unknown. Our objective was to determine the effect of a modern elementary school physical education (PE) program on the blood lipid concentrations in community-based children.MethodsIn this cluster-randomized controlled trial, 708 healthy children (8.1±0.3 years, 367 boys) in 29 schools were allocated to either a 4-year intervention program of specialist-taught PE (13 schools) or to a control group of the currently practiced PE conducted by generalist classroom teachers. Fasting blood lipids were measured at ages 8, 10, and 12 years and intervention and control class activities were recorded.ResultsIntervention classes included more fitness work and more moderate and vigorous physical activity than control classes (both p<0.001). With no group differences at baseline, the percentage of 12 year-old boys and girls with elevated low density lipoprotein cholesterol (LDL-C, >3.36mmol.L−1,130 mg/dL) was lower in the intervention than control group (14% vs. 23%, p = 0.02). There was also an intervention effect on mean LDL-C across all boys (reduction of 9.6% for intervention v 2.8% control, p = 0.02), but not girls (p = 0.2). The intervention effect on total cholesterol mirrored LDL-C, but there were no detectable 4-year intervention effects on high-density lipoprotein cholesterol or triglycerides.ConclusionsThe PE program delivered by specialist teachers over four years in elementary school reduced the incidence of elevated LDL-C in boys and girls, and provides a means by which early preventative practices can be offered to all children.Trial RegistrationAustralia New Zealand Clinical Trial Registry ANZRN12612000027819 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347799.
Highlights
There is compelling evidence that elevated lipid concentrations during childhood are predictive of dyslipidemia in adults [1,2] and are associated with an increased risk of cardiovascular disease in later life [3,4,5]
Statistical Methods Statistical modeling was used to determine whether the specialist-taught physical education (PE) had any effect on lipid levels in comparison with the usual PE program delivered by classroom teachers
A comparison of the baseline data from children who remained in the study with those who left revealed no evidence of any difference in the means of blood lipids, body weight, percent body fat or physical activity
Summary
There is compelling evidence that elevated lipid concentrations during childhood are predictive of dyslipidemia in adults [1,2] and are associated with an increased risk of cardiovascular disease in later life [3,4,5]. Given that overweight [6] and insufficiently active children [7] are more likely to possess elevated lipid levels, the challenge is to identify and implement strategies capable of reducing obesity and increasing physical activity across the general community. Elevated blood lipids during childhood are predictive of dyslipidemia in adults. Our objective was to determine the effect of a modern elementary school physical education (PE) program on the blood lipid concentrations in community-based children
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