Project PANK: Rationale, Design and Baseline Results of a Multidisciplinary School-Based Intervention in Children with Cardiovascular and Metabolic Risk Factors. A Randomized Controlled Trial.

Introduction: Atherosclerosis begins in youth and is related to the presence of cardiovascular and metabolic risk factors (CMRF): age, gender, nutrition, physical inactivity, cardiorespiratory fitness (CF), blood pressure (BP), lipids and overweight/obesity. There is strong evidence showing that schools should include nutrition and physical activity (PA) in the curriculum. However, few school-based studies measured physical and clinical outcomes, some of them reporting no changes. Project PANK (PA and Nutrition for Kids) is a multidisciplinary school-based intervention to improve many variables associated with CMRF: BMI, waist circumference (WC), waist-height ratio (WHR), BP, PA, CF, nutrition, sedentary behavior (SB) and blood variables (glucose, total cholesterol (TC), HDL-C, LDL-C), and triglycerides (TG)) among Portuguese children. This study reports the PANK baseline data.

Methods: The main variables were objectively measured. The CF through the 20m shuttle run test; SB and PA by accelerometers (GT3X) for 7 consecutive days and blood variables after an overnight fast. The other variables were assessed using standardized procedures. Participants (N=77, aged 7-10 years) were recruited after a cross-sectional study and allocated by intervention or control group. The inclusion criteria were the presence of, at least, one variable associated with the development of CMRF. Overweight and obesity condition were the main inclusion criteria.

Results: The Spearman`s rho revealed a statistically significant inverse relationship between CF and levels of TG (rho=-.53, p<.001), as well as, CF and TC (rho=-.25,p=.036). The length of time spent in sedentary behaviors was inversely correlated with moderate (rho=-.38,p=.001) and vigorous PA (rho=-.32,p=.005). The length of time spent in moderate (rho=.27,p=.018) and vigorous PA (rho=.33,p=.004) were positively correlated with CF. Obese children had higher values of fasting glucose (t=-2.05,p=.044), WC (t=-7.17,p<.001), and WHR (t=-.6457,p<.001), when compared to overweight children.

Discussion: These results justify the importance of school-based interventions to promote the reversion of overweight/obesity conditions and to decrease abdominal fat. Additionally, it seems to be equally important the increase of moderate/vigorous PA to improve CF in order to control blood variables. Project PANK focus on these factors in a comprehensive, multi-component and significant curriculum in nutrition and PA programs, taught by trained expert, and a parental component.

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