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/DesignA 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. ResultsPositive 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. ConclusionBaseline 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.

摘要 研究目的：肥胖儿童的心血管疾病危险因素检出率更高。PANK项目（Project PANK）是一项为期6个月的多学科校园干预项目，旨在改善儿童的BMI z评分（BMI z-score）、腰围（waist circumference, WC）、腰围身高比（waist-to-height ratio, WHtR）、血压（blood pressure, BP）、营养状况、体力活动（physical activity, PA）、久坐行为（sedentary behaviour, SB）、心肺适能（cardiorespiratory fitness, CRF）、血糖（glucose）、胆固醇（cholesterol）及甘油三酯（triglycerides, TG）水平。方法与设计：本研究从一所城市学校招募77名7~10岁儿童。研究方案涵盖面向儿童及家长的体力活动与久坐行为一对一咨询、增加校园体育活动时长、面向儿童的体力活动与久坐行为专题课程，以及设定在校及课后的每日目标步数。营养干预部分包含3次儿童与家长的一对一咨询，以及6次儿童专项课程。研究结果：分析显示，BMI z评分、腰围及腰围身高比均与甘油三酯呈正相关；BMI z评分与腰围身高比均与血糖呈正相关；轻度体力活动时长与高密度脂蛋白胆固醇（HDL-C）呈正相关；高强度及中高强度体力活动与心肺适能呈正相关；热量摄入与血脂水平分别与低密度脂蛋白胆固醇（LDL-C）、BMI z评分、腰围及腰围身高比呈正相关；心肺适能与甘油三酯呈负相关。研究结论：本研究的基线结果凸显了多学科校园干预的重要性。我们假设，通过调整饮食摄入、提升体力活动与心肺适能水平、减少久坐行为，PANK项目可改善受试者的血液学指标、人体测量学指标及血压水平。