期刊论文详细信息
BMC Pediatrics
A policy-driven multifaceted approach for early childhood physical fitness promotion: impacts on body composition and physical fitness in young Chinese children
Kaizhen Wang1  Lihong Wang2  Zenong Yin5  Hong Ren4  Zhixiong Zhou3 
[1] School of Recreation and Community Sports, Capital University of Physical Education and Sports, Beijing, China;Department of Physical Education Physical Education College of Zhengzhou University, Zhengzhou, China;Graduate School of Being Sport University, Beijing, China;School of Sport Sciences, Beijing Sport University, Beijing, China;Department of Health and Kinesiology, University of Texas at San Antonio, San Antonio, Texas, USA
关键词: Obesity;    Body composition;    Growth;    Physical fitness;    Physical activity;    Preschool children;    Multifaceted intervention;   
Others  :  1138866
DOI  :  10.1186/1471-2431-14-118
 received in 2014-01-12, accepted in 2014-05-01,  发布年份 2014
PDF
【 摘 要 】

Background

The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. This study tested the effectiveness of a multifaceted intervention that integrated childcare center, families, and community to promote healthy growth and physical fitness in preschool Chinese children.

Methods

This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group. The participants were 357 children (mean age = 4.5 year) enrolled in three grade levels in two childcare centers in Beijing, China. The intervention included: 1) childcare center intervention (physical activity policy changes, teacher training, physical education curriculum and food services training), 2) family intervention (parent education, internet website for support, and family events), and 3) community intervention (playground renovation and community health promotion events). The study outcome measures included body composition (percent body fat, fat mass, and muscle mass), Body Mass Index (BMI) and BMI z-score and physical fitness scores in 20-meter agility run (20M-AR), broad jump for distance (BJ), timed 10-jumps, tennis ball throwing (TBT), sit and reach (SR), balance beam walk (BBW), 20-meter crawl (20M-C)), 30-meter sprint (30M-S)) from a norm referenced test. Measures of process evaluation included monitoring of children’s physical activity (activity time and intensity) and food preparation records, and fidelity of intervention protocol implementation.

Results

Children in the intervention center significantly lowered their body fat percent (−1.2%, p < 0.0001), fat mass (−0.55 kg, p <0.0001), and body weight (0.36 kg, p <0.02) and increased muscle mass (0.48 kg, p <0.0001), compared to children in the control center. They also improved all measures of physical fitness except timed 10-jumps (20M-AR: −0.74 seconds, p < 0.0001; BJ: 8.09 cm, p < 0.0001; TBT: 0.52 meters, p < 0.006; SR: 0.88 cm, p < 0.03; BBW: −2.02 seconds, p <0.0001; 30M-S: −0.45 seconds, p < 0.02; 20M-C: −3.36 seconds, p < 0.0001). Process evaluation data showed that the intervention protocol was implemented with high fidelity.

Conclusions

The study demonstrated that a policy-driven multi-faceted intervention can improve preschool children’s body composition and physical fitness. Program efficacy should be tested in a randomized trial.

Trial registration

ChiCTR-ONRC-14004143.

【 授权许可】

   
2014 Zhou et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150320134230375.pdf 1170KB PDF download
Figure 1. 105KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]de Onis M, Blössner M, Borghi E: Global prevalence and trends of overweight and obesity among preschool children. The Am J of Clin nutrition 2010, 92(5):1257-1264.
  • [2]Gupta N, Goel K, Shah P, Misra A: Childhood Obesity in Developing Countries: Epidemiology, Determinants, and Prevention. Endocr Rev 2012, 33(1):48-70.
  • [3]Zong X-N, Li H: Secular Trends in Prevalence and Risk Factors of Obesity in Infants and Preschool Children in 9 Chinese Cities, 1986–2006. PLoS One 2012, 7(10):e46942.
  • [4]Song Y, Wang H-J, Ma J, Wang Z: Secular Trends of Obesity Prevalence in Urban Chinese Children from 1985 to 2010: Gender Disparity. PLoS One 2013, 8(1):e53069.
  • [5]Qiu D, Guo X, Duan J, Yang L, Sakamoto N: Body mass index for children aged 6–18 years in Beijing. Ann Hum Biol: China; 2013.
  • [6]The State General Administration of Sports: Chinese National Measurement Standards on People's Physical Fitness (in Chinese). Beijing, China: People's Sports Publishing House; 2003.
  • [7]Pediatric CSGoNcotpGaDoCCIo: A national survey on growth of children under 7 years of age in nine cities of China,2005. Chin J Pedia 2007, 45(8):6.
  • [8]Health NCfWsaCs: National epidemiological survey on childhood obesity , 2006. Chin J Pediatr 2008, 46(3):6.
  • [9]The State General Administration of Sports: Bulletin on the 2010 Chinese National Survey on People’s Health (in Chinese). Beijing, China: People's Sports Publishing House; 2011.
  • [10]Malina RM: Physical activity and fitness: Pathways from childhood to adulthood. Am J Hum Biol 2001, 13(2):162-172.
  • [11]Strong WB, Malina RM, Blimkie CJR, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence Based Physical Activity for School-age Youth. J Pediatr 2005, 146(6):732-737.
  • [12]Pate RR, O'Neill JR, Liese AD, Janz KF, Granberg EM, Colabianchi N, Harsha DW, Condrasky MM, O'Neil PM, Lau EY, Taverno Ross SE: Factors associated with development of excessive fatness in children and adolescents: a review of prospective studies. Obes Rev 2013, 14(8):645-658.
  • [13]Shang X, Liu A, Li Y, Hu X, Du L, Ma J, Xu G, Li Y, Guo H, Ma G: The Association of Weight Status with Physical Fitness among Chinese Children. Int J Pediatr 2010, 2010:515414.
  • [14]Reilly JJ, Jackson DM, Montgomery C, Kelly LA, Slater C, Grant S, Paton JY: Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet 2004, 363(9404):211-212.
  • [15]Vale S, Silva P, Santos R, Soares-Miranda L, Mota J: Compliance with physical activity guidelines in preschool children. J Sports Sci 2010, 28(6):603-608.
  • [16]Bornstein DB, Beets MW, Byun W, McIver K: Accelerometer-derived physical activity levels of preschoolers: A meta-analysis. J of Sci and Med in sport / Sports Med Australia 2011, 14(6):504-511.
  • [17]Trost SG, Sirard JR, Dowda M, Pfeiffer KA, Pate RR: Physical activity in overweight and nonoverweight preschool children. Int J Obes Relat Metab Disord 2003, 27(7):834-839.
  • [18]Janz KF, Burns TL, Levy SM: Tracking of Activity and Sedentary Behaviors in Childhood: The Iowa Bone Development Study. Am J Prev Med 2005, 29(3):171-178.
  • [19]Morano M, Colella D, Caroli M: Gross motor skill performance in a sample of overweight and non-overweight preschool children. Int J Pediatr Obes 2011, 6(S2):42-46.
  • [20]Castetbon K, Andreyeva T: Obesity and motor skills among 4 to 6-year-old children in the united states: nationally-representative surveys. BMC Pediatr 2012, 12(1):28. BioMed Central Full Text
  • [21]Cliff DP, Okely AD, Morgan PJ, Jones RA, Steele JR, Baur LA: Proficiency deficiency: mastery of fundamental movement skills and skill components in overweight and obese children. Obesity 2012, 20(5):1024-1033.
  • [22]Summerbell CD, Moore HJ, Vögele C, Kreichauf S, Wildgruber A, Manios Y, Douthwaite W, Nixon CA, Gibson EL, ToyBox-study g: Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children. Obes Rev 2012, 13:129-132.
  • [23]Tucker P: The physical activity levels of preschool-aged children: A systematic review. Early Childhood Res Quarterly 2008, 23(4):547-558.
  • [24]Hardy LL, King L, Farrell L, Macniven R, Howlett S: Fundamental movement skills among Australian preschool children. J of Sci and Med in sport / Sports Med Australia 2010, 13(5):503-508.
  • [25]The Ministry of Education of People's Republic of China and The State General Administration of Sports: 关于开展全国亿万学生阳光体育运动的通知(in Chinese). Beijing, China: ; 2006.
  • [26]Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD: Interventions for preventing obesity in children. Cochrane Database Syst Rev 2011, 12:CD001871.
  • [27]Story M, Kaphingst K, French S: The role of child care settings in obesity prevention. The Future of children / Center for the Future of Children, the David and Lucile Packard Foundation 2006, 16(1):143-168.
  • [28]Wang J-H, Wu M-C, Chang H-H: Urban–rural disparity in physical fitness of elementary schoolchildren in Taiwan. Pediatr Int 2013, 55(3):346-354.
  • [29]Lau XC, Chong KH, Poh BK, Ismail MN: Chapter Two - Physical Activity, Fitness and the Energy Cost of Activities: Implications for Obesity in Children and Adolescents in the Tropics. Adv Food Nutr Res 2013, 70:49-101.
  • [30]Flynn MAT, McNeil DA, Maloff B, Mutasingwa D, Wu M, Ford C, Tough SC: Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with ‘best practice’ recommendations. Obes Rev 2006, 7:7-66.
  • [31]Gutin B: Diet vs exercise for the prevention of pediatric obesity: the role of exercise. Int J Obes (Lond) 2011, 35(1):29-32.
  • [32]Institute of Medicine: Early Childhood Obesity Prevention Policies. Washington, DC: National Academy Press; 2011.
  • [33]Ward DS, Vaughn A, Story M: Expert and Stakeholder Consensus on Priorities for Obesity Prevention Research in Early Care and Education Settings. Child Obes 2013, 9(2):116-124.
  • [34]Yin Z, Parra-Medina D, Cordova A, He M, Trummer V, Sosa E, Gallion KJ, Sintes-Yallen A, Huang Y, Wu X, Acosta D, Kibbe D, Ramirez A: Miranos! Look at us, we are healthy! An environmental approach to early childhood obesity prevention. Child Obes 2012, 8(5):429-439.
  • [35]Fitzgibbon ML, Stolley MR, Dyer AR, VanHorn L, KauferChristoffel K: A Community-Based Obesity Prevention Program for Minority Children: Rationale and Study Design for Hip-Hop to Health Jr. Prev Med 2002, 34(2):289-297.
  • [36]Fitzgibbon ML, Stolley MR, Schiffer LA, Braunschweig CL, Gomez SL, Van Horn L, Dyer AR: Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: Postintervention Results Obesity 2011, 19(5):994-1003.
  • [37]Gortmaker SL, Swinburn BA, Levy D, Carter R, Mabry PL, Finegood DT, Huang T, Marsh T, Moodie ML: Changing the future of obesity: science, policy, and action. Lancet 2011, 378(9793):838-847.
  • [38]Ward DS, Vaughn A, McWilliams C, Hales D: Interventions for Increasing Physical Activity at Child Care. Med Sci Sports Exerc 2010, 42(3):526-534.
  • [39]Hu FB: Globalization of Diabetes: The role of diet, lifestyle, and genes. Diabetes Care 2011, 34(6):1249-1257.
  • [40]Jiang J, Rosenqvist U, Wang H, Greiner T, Ma Y, Toschke AM: Risk factors for overweight in 2- to 6-year-old children in Beijing. China Int J Pediatr Obes 2006, 1(2):103-108.
  • [41]Xiao-Yi Shan BX, Hong C, Dong-Qing H, Youfa W, Jie M: Prevalence and behavioral risk factors of overweight and obesity among children aged 2–18 in Beijing, China. Int J Pediatr Obes 2010, 5(5):383-389.
  • [42]LI Xiaohui DZ, Hong WEN: Risk factors of obesity for children 3–6 years old in 11 cities in China. China J Clinicians(Electronic Edition) 2011, 15(1):6.
  • [43]Meng L, Xu H, Liu A, van Raaij J, Bemelmans W, Hu X, Zhang Q, Du S, Fang H, Ma J, Xu G, Li Y, Guo H, Du L, Ma G: The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in china. PLoS One 2013, 8(10):e77971.
  • [44]Chen CM: Overview of obesity in Mainland China. Obes Rev 2008, 9:14-21.
  • [45]City of Beijing Ministry of Education: 关于印发进一步做好托幼园所分级分类验收和年度考核工作意见的通知 (in Chinese). Beijing, China; 2001.
  • [46]Standage M, Duda JL, Ntoumanis N: A test of self-determination theory in school physical education. Br J Educ Psychol 2005, 75(3):411-433.
  • [47]Verbestel V, Henauw SD, Maes L, Haerens L, Marild S, Eiben G, Lissner L, Moreno L, Frauca N, Barba G, Kovács E, Konstabel K, Tornaritis M, Gallois K, Hassel H, De Bourdeaudhuij I: Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention. Int J Behav Nutr Phys Act 2011, 8(1):82. BioMed Central Full Text
  • [48]Larson N, Ward DS, Neelon SB, Story M: What Role Can Child-Care Settings Play in Obesity Prevention? A Review of the Evidence and Call for Research Efforts. J Am Diet Assoc 2011, 111(9):1343-1362.
  • [49]Xin Tao SJ, Lin C: Revised norm of teaeher’s teaehing effieacy scale. J of psychological development and education(in Chinese) 1995, 4:5. doi:5
  • [50]Larson N, Ward D, Neelon Benjamin S, Story M: Preventing Obesity Among Preschool Children: How Can Child-care Settings Promote Healthy Eating and Physical Activity? In Princeton, NJ. The Robert Wood Johnson Foundation; 2011.
  • [51]Bower JK: The childcare environment and children's physical activity. Am J Prev Med 2008, 34(1):23-29.
  • [52]Dowda M, Brown WH, McIver KL, Pfeiffer KA, O'Neill JR, Addy CL, Pate RR: Policies and Characteristics of the Preschool Environment and Physical Activity of Young Children. Pediatrics 2009, 123(2):e261-e266.
  • [53]The Beijing Childcare Administration: 北京市幼儿园管理规范-儿童伙食管理常规 (in Chinese). In. Beijing, China: Beijing Medical University Press; 2002.
  • [54]Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Jeong JS, Cheon GJ: Cross-calibration of multi-frequency bioelectrical impedance analysis with eight-point tactile electrodes and dual-energy X-ray absorptiometry for assessment of body composition in healthy children aged 6–18 years. Pediatr Int 2009, 51(2):263-268.
  • [55]Ren R: Body fat ranges and body fat proportion measurement methods comoarison studies in children at different developments level. Beijing, China: Beijing Sport University; 2011.
  • [56]Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, Rocca HPB-L, Mechelen W, Puder JJ: Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ 2010, 340:c785.
  • [57]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320(7244):1240.
  • [58]Yoon DY, Scott K, Hill MN, Levitt NS, Lambert EV: Review of three tests of motor proficiency in children. Percept Mot Skills 2006, 102(2):543-551.
  • [59]Pařízková J: Nutrition, Physical Activity, and Health in Early Life. Second edition. Boca Raton, FL: CRC Press; 2010.
  • [60]Presidential Youth Fitness Program: Presidential Youth Fitness Program Physical Educator Resource Guide (Internet Resource). National Foundation on Fitness, Sports and Nutrition: Silver Spring, MD; 2013.
  • [61]Cliff DP, Reilly JJ, Okely AD: Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0–5 years. J Sci Med Sport 2009, 12(5):557-567.
  • [62]Guangya W: Chinese food composition tables (2nd Edition) (in Chinese). Beijing, China: Peking University Medical Press; 2009.
  • [63]Gutin B, Yin Z, Johnson M, Barbeau P: Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: The Medical College of Georgia Fitkid Project. Int J Pediatr Obes 2008, 3(s1):3-9.
  • [64]Yin Z, Gutin B, Johnson MH, Hanes J Jr, Moore JB, Cavnar M, Thornburg J, Moore D, Barbeau P: An environmental approach to obesity prevention in children: Medical College of Georgia FitKid Project year 1 results. Obes Res 2005, 13(12):2153-2161.
  • [65]Moore LL, Nguyen U-SDT, Rothman KJ, Cupples LA, Ellison RC: Preschool Physical Activity Level and Change in Body Fatness in Young Children: The Framingham Children's Study. Am J Epidemiol 1995, 142(9):982-988.
  • [66]de Silva-Sanigorski AM, Bell AC, Kremer P, Nichols M, Crellin M, Smith M, Sharp S, de Groot F, Carpenter L, Boak R, Robertson N, Swinburn BA: Reducing obesity in early childhood: results from Romp & Chomp, an Australian community-wide intervention program. Am J Clin Nutr 2010, 91(4):831-840.
  • [67]Reilly JJ, McDowell ZC: Physical activity interventions in the prevention and treatment of paediatric obesity: systematic review and critical appraisal. Proc Nutr Soc 2003, 62(03):611-619.
  • [68]Reilly JJ, Kelly L, Montgomery C, Williamson A, Fisher A, McColl JH, Conte RL, Paton JY, Grant S: Physical activity to prevent obesity in young children: cluster randomised controlled trial. BMJ 2006, 333(7577):1041.
  • [69]Cliff DP, Okely AD, Smith LM, McKeen K: Relationships between fundamental movement skills and objectively measured physical activity in preschool children. Pediatr Exerc Sci 2009, 21(4):436-449.
  • [70]Logan SW, Robinson LE, Wilson AE, Lucas WA: Getting the fundamentals of movement: a meta-analysis of the effectiveness of motor skill interventions in children. Child Care Health Dev 2012, 38(3):305-315.
  • [71]Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD: Fundamental Movement Skills in Children and Adolescents: Review of Associated Health Benefits. Sports Med 2010, 40(12):1019-1035.
  • [72]Morgan PJ, Barnett LM, Cliff DP, Okely AD, Scott HA, Cohen KE, Lubans DR: Fundamental Movement Skill Interventions in Youth: A Systematic Review and Meta-analysis. Pediatrics 2013, 132(5):e1361-e1383.
  • [73]Trost SG, Messner L, Fitzgerald K, Roths B: A Nutrition and Physical Activity Intervention for Family Child Care Homes. Am J Prev Med 2011, 41(4):392-398.
  • [74]Finch M, Wolfenden L, Falkiner M, Edenden D, Pond N, Hardy L, Milat A, Wiggers J: Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study. Int J Behav Nutr Phys Act 2012, 9(1):101. BioMed Central Full Text
  • [75]Jones RA, Riethmuller A, Hesketh K, Trezise J, Batterham M, Okely AD: Promoting fundamental movement skill development and physical activity in early childhood settings: a cluster randomized controlled trial. Pediatr Exerc Sci 2011, 23(4):600-615.
  • [76]Cleland V, Timperio A, Salmon J, Hume C, Baur LA, Crawford D: Predictors of time spent outdoors among children: 5-year longitudinal findings. J Epidemiol Community Health 2010, 64(5):400-406.
  • [77]Skouteris H, McCabe M, Swinburn B, Hill B: Healthy eating and obesity prevention for preschoolers: a randomised controlled trial. BMC Public Health 2010, 10(1):220. BioMed Central Full Text
  • [78]Dev DA, McBride BA, Fiese BH, Jones BL, Cho On Behalf Of The Strong Kids Research Team H: Risk Factors for Overweight/Obesity in Preschool Children: An Ecological Approach. Child Obes 2013, 9(5):399-408.
  • [79]Weber DR, Leonard MB, Zemel BS: Body composition analysis in the pediatric population. Pediatr Endocrinol Rev 2012, 10(1):130-139.
  • [80]Thompson FE, Subar AF: Chapter 1 - Dietary Assessment Methodology. In Nutrition in the Prevention and Treatment of Disease. Third edition. San Diego: Academic Press; 2013:5-46.
  文献评价指标  
  下载次数:24次 浏览次数:26次