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SCHOOL-BASED INTERVENTION INSTILLS HEALTHY HABITS THAT LAST YEARS
Students from ethnically diverse backgrounds in four states, including 1,379 San Diego students, are demonstrating that the diet and exercise principles they learned years before in an elementary school-based intervention program are still having positive effects, according to a study led by UCSD Department of Pediatrics researchers.
These findings, published in the July 1999 issue of Archives of Pediatric and Adolescent Medicine, are a follow up to the CATCH (Child and Adolescent Trial for Cardiovascular Health) Study, conducted in California, Louisiana, Minnesota and Texas. The initial CATCH study demonstrated that healthful school lunches, well-designed physical education programs and a supporting educational program that includes the family can ultimately improve children's dietary and physical activity patterns, not only in school but after school as well.
CATCH was completed in 1996 and the results were published in the Journal of the American Medical Association. Of the 5,106 elementary school children (grades 3 through 5 in 1991 to 1994) from California, Louisiana, Minnesota and Texas who participated in CATCH, 3,714 (73 percent; while in grades 6 through 8 in 1995 to 1998), participated in a follow-up assessment of their diet, physical activity and related health indicators done through self-reporting by the students.
The follow-up study indicates that health behaviors instilled during the elementary school years through the CATCH intervention have persisted into early adolescence, according to Philip R. Nader, M.D., a UCSD School of Medicine professor of pediatrics and the study's lead author.
"We found that the group which participated in the CATCH exercise and nutrition program maintained a lower fat diet and continued their vigorous activity in the three years following the end of the CATCH study, even thought they received no coaching, compared to the control group which followed their normal diet and exercise patterns during the CATCH trials," he said.
When just a third grader at Lemon Avenue Elementary School in San Diego County, as part of the CATCH program, Krissy Meckel-Parker was learning the important roles diet and exercise played in her life. The now 15-year-old junior at neighboring Helix High School said these lessons have carried over well beyond elementary school, particularly the exercise aspect. "A big thing for me during my elementary school physical education classes was learning and knowing that exercise is important to my health," said Krissy, who is a member of her high school's water polo, volleyball and swim teams.
This active teen says she also is well aware of how her food choices effect her health. "I learned at an early age what foods were good for me and what were bad," Krissy said. "I always try to eat balanced meals and healthy snacks."
While this follow-up assessment shows that health intervention at an early age is important, Nader says that consistent reinforcement of healthful diet and behaviors is just as important through junior high and high school.
"Although the effects of the behavioral interventions that occurred in grades 3 to 5 persisted over a long period of time, we found that the effects are beginning to fade in grades 5 through 8," said Nader, who pointed out slightly higher fat intake of the intervention group since the end of the CATCH study.
"These studies suggest that schools can be an important place to help youth establish habits that may help prevent the early onset of cardiovascular and other adult chronic diseases," Nader said. "We hope that the results from this follow-up study justify the need for intervention not just in elementary school but also in middle and high school years."
The study, which was funded by the National Heart, Lung, and Blood Institute, also included researchers from University of Texas, Houston and Austin; Tulane University in New Orleans, and the University of Minneapolis. The study data center was at New England Research Institute in Boston.
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