Hostname: page-component-6766d58669-fx4k7 Total loading time: 0 Render date: 2026-05-17T17:03:22.699Z Has data issue: false hasContentIssue false
  • English
  • Français

Health and nutrition education in primary schools in Crete: 10 years' follow-up of serum lipids, physical activity and macronutrient intake

Published online by Cambridge University Press:  08 March 2007

Yannis Manios  and
Anthony Kafatos
Yannis Manios
Affiliation:
Harokopio University of AthensDepartment of Nutrition & DieteticsGreece
Anthony Kafatos*
Affiliation:
University of CretePreventive Medicine and Nutrition Clinic, School of MedicineGreece
*
*Corresponding author: fax +30 81 394 604, kafatos@med.uoc.gr
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

The current study is a 4-year follow-up after the 6-year-long health and nutrition intervention programme applied in the primary schools of Crete. The aim of the current work was to identify whether the benefits obtained in certain health indices at the end of the intervention period were also present 4 years later. From a representative population of 441 pupils (250 from the intervention schools and 191 from the control schools), biochemical, dietary and physical activity data were obtained at baseline, at the end of the intervention period and after intervention (academic years 1992–1993, 1997–1998 and 2001–2002, respectively). The findings of the current study revealed that the favourable changes in serum lipids observed at the end of the intervention period were maintained from baseline to after intervention for total cholesterol (−24·3 (SE 1·65) V. −9·70 (SE 2·03) mg/dl; P=0·001), LDL-cholesterol (−18·6 (SE 1·41) V. −2·49 (SE 1·75) mg/dl; P<0·001), HDL-cholesterol (−8·34 (SE 0·75) V. −9·60 (SE 1·10) mg/dl; P=0·014) and total cholesterol:HDL-cholestrol ratio (0·31 (SE 0·06) V. 0·04 (SE 0·05); P=0·001). Similar favourable changes for the intervention group were observed in leisure-time physical activities (38·3 (SE 11·7) V. −13·2 (SE 10·9) min/week; P=0·038) and BMI (6·05 (SE 0·18) V. 6·67 (SE 0·21) kg/m2; P=0·014), whereas no changes were observed in the fitness and dietary indices examined. The findings of the current study are encouraging, indicating maintenance of the favourable changes observed in serum lipids, BMI and physical activity 4 years after the programme had ended

Keywords

Nutrition educationChildrenDiet and physical activitySerum lipidsObesity

Information

Type
Research Article
Information
British Journal of Nutrition , Volume 95 , Issue 3 , March 2006 , pp. 568 - 575
Copyright
Copyright © The Nutrition Society 2006

References

Boreham, C, Robson, PJ, Gallagher, AM, Cran, GW, Savage, JM & Murray, LJ 2004 Tracking of physical activity, fitness, body composition and diet from adolescence to young adulthood: the Young Hearts Project, Northern Ireland. Int J Behav Nutr Phys Act 1 14CrossRefGoogle Scholar
Bouziotas, C, Koutedakis, Y, Nevill, A, Ageli, E, Tsigilis, N, Nikolaou, A & Nakou, A 2004 Greek adolescents, fitness, fatness, fat intake, activity and coronary heart disease risk. Arch Dis Child 89 41–44.Google Scholar
Caspersen, CJ, Pereira, MA & Curran, KM 2000 Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc 32 1601–1609.Google Scholar
Cohen, MS 2004 Fetal and childhood onset of adult cardiovascular diseases. Pediatr Clin N Am 51 1697–1719.CrossRefGoogle ScholarPubMed
Committee of Experts on Sports Research EUROFIT. Rome: Edigraf Editoriale Grafica 1988Google Scholar
Copeland, E & Hess, R 1995 Differences in young adolescents' coping strategies based on gender and ethnicity. J Early Adolesc 15 203–219.CrossRefGoogle Scholar
Durstine, JL, Grandjean, PW, Davis, PG, Ferguson, MA, Alderson, NL & DuBose, KD 2001 Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 31 1033–1062.CrossRefGoogle ScholarPubMed
Friedewald, WT, Levy, RI & Fredrickson, DS 1972 Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18 499–502.Google Scholar
Hardman, AE 1999 Physical activity intervention studies with healthrelated outcomes: some issues. J Sports Sci 17 685–687.Google ScholarPubMed
Harrell, JS, Gansky, SA, McMurray, RG, Bangdiwala, SI, Frauman, AC & Bradley, CB 1998 School-based interventions improve heart health in children with multiple cardiovascular disease risk factors. Pediatrics 102 371–380.CrossRefGoogle ScholarPubMed
Hayman, LL, Williams, CL, Daniels, SR, Steinberger, J, Paridon, S, Dennison, BA & McCrindle, BW 2004 Cardiovascular health promotion in the schools: a statement for health and education professionals and child health advocates from the Committee on Atherosclerosis, Hypertension, and Obesity in Youth (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110 2266–2275.Google Scholar
Janz, KF, Dawson, JD & Mahoney, LT 2000 Tracking physical fitness and physical activity from childhood to adolescence: the muscatine study. Med Sci Sports Exerc 32 1250–1257.CrossRefGoogle ScholarPubMed
Kafatos, A, Manios, Y, Markatji, I, Giachetti, I, Vaz de Almeida, MD & Engstrom, LM 1999 Regional, demographic and national influences on attitudes and beliefs with regard to physical activity, body weight and health in a nationally representative sample in the European Union. Public Health Nutr 2 87–95.CrossRefGoogle Scholar
Kafatos, A & Papoutsakis, G 1998 Mortality rates in Greece and their relationship to the Mediterranean diet and to health and nutrition education. Iatriki 73 287–301.Google Scholar
Kelder, SH, Mitchell, PD, McKenzie, TL, Derby, C, Strikmiller, PK, Luepker, RV & Stone, EJ 2003 Long-term implementation of the CATCH physical education program. Health Educ Behav 30 463–475.CrossRefGoogle ScholarPubMed
Kelder, SH, Perry, CL & Klepp, KI 1993 Community-wide youth exercise promotion: long-term outcomes of the Minnesota Heart Health Program and the Class of 1989 Study. J Sch Health 63 218–223.Google Scholar
Kimm, SY, Glynn, NW, Kriska, AM, Fitzgerald, SL, Aaron, DJ, Similo, SL, McMahon, RP & Barton, BA 2000 Longitudinal changes in physical activity in a biracial cohort during adolescence. Med Sci Sports Exerc 32 1445–1454.CrossRefGoogle Scholar
Klepp, KL, Oygard, L, Tell, GS & Vellar, OD 1994 Twelve year follow-up study of a school-based health education program. Eur J Public Health 4 195–200.CrossRefGoogle Scholar
Law, M 2000 Dietary fat and adult diseases and the implications for childhood nutrition: an epidemiologic approach. Am J Clin Nutr 72 1291S–1296S.Google Scholar
Lee, IM, Sesso, HD & Paffenbarger, RS Jr 2000 Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk?. Circulation 102 981–986.Google Scholar
Li, S, Chen, W, Srinivasan, SR, Bond, MG, Tang, R, Urbina, EM & Berenson, GS 2003 Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. J Am Med Assoc 290 2271–2276.CrossRefGoogle ScholarPubMed
Luepker, RV, Perry, CL, McKinlay, SM et al. Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. J Am Med Assoc 1996 275 768–776.CrossRefGoogle ScholarPubMed
Lytle, LA, Jacobs, DR, Jr Perry, CL, Klepp, KI 2002 Achieving physiological change in school-based intervention trials: what makes a preventive intervention successful?. Br J Nutr 88 219–221.CrossRefGoogle ScholarPubMed
Manios, Y & Kafatos, A 1999 Health and nutrition education in elementary schools: changes in health knowledge, nutrient intakes and physical activity over a six year period. Public Health Nutr 2 445–448.CrossRefGoogle Scholar
Manios, Y, Kafatos, A & Mamalakis, G 1998a The effects of a health education intervention initiated at first grade over a 3 year period: physical activity and fitness indices. Health Educ Res 13 593–606.CrossRefGoogle Scholar
Manios, Y, Kafatos, A & Markakis, G 1998b Physical activity in 6-year-old children: validation of two proxy reports. Pediatr Exerc Sci 10 176–188.Google Scholar
Manios, Y, Moschandreas, JHatzis, C & Kafatos, A 1999 Evaluation of a health and nutrition education program in primary school children of Crete over a three-year period. Prev Med 28 149–159.CrossRefGoogle Scholar
Manios, Y, Moschandreas, JHatzis, C & Kafatos, A 2002 Health and nutrition education in primary schools of Crete: changes in chronic disease risk factors following a 6-year intervention programme. Br J Nutr 88 315–324.Google Scholar
McKenzie, TL, Li, D, Derby, CA, Webber, LS, Luepker, RV & Cribb, P 2003 Maintenance of effects of the CATCH physical education program: results from the CATCH-ON study. Health Educ Behav 30 447–462.CrossRefGoogle ScholarPubMed
McMurray, RG, Harrell, JS, Bangdiwala, SI & Hu, J 2003 Tracking of physical activity and aerobic power from childhood through adolescence. Med Sci Sports Exerc 35 1914–1922.CrossRefGoogle ScholarPubMed
Mikkila, V, Rasanen, L, Raitakari, OT, Pietinen, P & Viikari, JLongitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: the Cardiovascular Risk in Young Finns Study. Eur J Clin Nutr 2004 58 1038–1045.CrossRefGoogle ScholarPubMed
Nader, PR, Stone, EJ, Lytle, LA et al. Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health. Arch Pediatr Adolesc Med 1999 153 695–704.Google Scholar
Osganian, SK, Hoelscher, DM, Zive, M, Mitchell, PD, Snyder, P & Webber, LS 2003 Maintenance of effects of the eat smart school food service program:results from the CATCH-ON study. Health Educ Behav 30 418–433.Google Scholar
Pitsavos, C, Panagiotakos, DB, Chrysohoou, C, Skoumas, J, Papaioannou, I, Stefanadis, C & Toutouzas, PK 2002 The effect of Mediterranean diet on the risk of the development of acute coronary syndromes in hypercholesterolemic people: a case-control study (CARDIO2000). Coron Artery Dis 13 295–300.CrossRefGoogle ScholarPubMed
Pitsavos, C, Panagiotakos, DB, Chrysohoou, C & Stefanadis, C 2003 Epidemiology of cardiovascular risk factors in Greece: aims, design and baseline characteristics of the ATTICA study. BMC Public Health 3 32CrossRefGoogle ScholarPubMed
Raitakari, OT, Juonala, M, Kahonen, M et al. 2003 Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. J Am Med Assoc 290 2277–2283.CrossRefGoogle ScholarPubMed
Sesso, HD, Paffenbarger, RS Jr & Lee, IM 2000 Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. Circulation 102 975–980.CrossRefGoogle ScholarPubMed
Superko, HR 1991 Exercise training, serum lipids, and lipoprotein particles: is there a change threshold?. Med Sci Sports Exerc 23 677–685.Google Scholar
van Beurden, E, Barnett, LM, Zask, A, Dietrich, UC, Brooks, LO & Beard, J 2003 Can we skill and activate children through primary school physical education lessons? “Move it Groove it” – a collaborative health promotion intervention. Prev Med 36 493–501.CrossRefGoogle ScholarPubMed
Vilhjalmsson, R & Kristjansdottir, G 2003 Gender differences in physical activity in older children and adolescents: the central role of organized sport. Soc Sci Med 56 363–374.Google Scholar
Walter, HJ & Wynder, EL 1989 The development, implementation, evaluation, and future directions of a chronic disease prevention program for children: the “now Your Body” studies. Prev Med 18 59–71.CrossRefGoogle Scholar
Wei, M, Kampert, JB, Barlow, CE, Nichaman, MZ, Gibbons, LW, Paffenbarger, RS Jr & Blair, SN 1999 Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. J Am Med Assoc 282 1547–1553.Google Scholar
Williams, CL, Arnold, CB & Wynder, ELPrimary prevention of chronic disease beginning in childhood. The “know your body” program:design of study. Prev Med 1977 6 344–357.Google Scholar
Williams, CL, Hayman, LL, Daniels, SR, Robinson, TN, Steinberger, J, Paridon, S & Bazzarre, T 2002 Cardiovascular health in childhood: a statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 106 143–160.Google Scholar