National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension

Introduction: This study aimed to examine the effectiveness of the national school-based intervention on both obesity and high blood pressure in Chinese children and adolescents aged 6–18 years.Methods: The national school-based cluster non-randomized controlled trial was done in seven provinces fro...

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Main Authors: Yanhui Dong, Zhiyong Zou, Haijun Wang, Bin Dong, Peijin Hu, Yinghua Ma, Yi Song, Jun Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-05-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2021.615283/full
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author Yanhui Dong
Zhiyong Zou
Haijun Wang
Bin Dong
Peijin Hu
Yinghua Ma
Yi Song
Jun Ma
author_facet Yanhui Dong
Zhiyong Zou
Haijun Wang
Bin Dong
Peijin Hu
Yinghua Ma
Yi Song
Jun Ma
author_sort Yanhui Dong
collection DOAJ
description Introduction: This study aimed to examine the effectiveness of the national school-based intervention on both obesity and high blood pressure in Chinese children and adolescents aged 6–18 years.Methods: The national school-based cluster non-randomized controlled trial was done in seven provinces from September 2013 to February 2014. A total of 23,175 children and adolescents in the control group and 25,702 in the intervention group were included in this trial with a mean follow-up of 6.7 ± 0.9 months. Mixed-effects regression models were used to evaluate the effect of the interventions on body weight and blood pressure (BP).Results: A significant upward in the body mass index (BMI) levels but downward in systolic BP (SBP), diastolic BP (DBP), BMI Z-scores, SBP Z-scores, and DBP Z-scores were witnessed in the intervention group compared to those in the control group (<0.001). Subgroup analyses presented significant intervention effects in children aged 6–12 years for BMI, SBP, DBP, and their standardized values Z-scores, but no effective results were found in adolescents aged 13–18 years. Stratification analyses based on the dynamic weight changes presented non-differential HBP, SHBP, and DHBP prevalence gaps between the control and intervention groups. Children aged 6–12 years with higher BMI percentiles at baseline presented obvious declines in SBP and DBP standardized values Z-scores.Conclusion: A mean 6-month multi-centered school-based comprehensive obesity intervention in China yields a small to null effect on obesity and hypertension with increasing age; the early age before 12 years may be the key period for interventions, and the younger, the better. Precise and high-intensity interventions targeting the population at different stages of childhood and adolescence are urgently needed to be developed.Clinical Trial Registration:https://www.clinicaltrials.gov/, identifier: NCT02343588
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spelling doaj.art-998e03a5eda2410c9f58c76d73e28c432022-12-21T19:51:00ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-05-01910.3389/fped.2021.615283615283National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and HypertensionYanhui Dong0Zhiyong Zou1Haijun Wang2Bin Dong3Peijin Hu4Yinghua Ma5Yi Song6Jun Ma7School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaDepartment of Maternal and Child Health, School of Public Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaSchool of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, ChinaIntroduction: This study aimed to examine the effectiveness of the national school-based intervention on both obesity and high blood pressure in Chinese children and adolescents aged 6–18 years.Methods: The national school-based cluster non-randomized controlled trial was done in seven provinces from September 2013 to February 2014. A total of 23,175 children and adolescents in the control group and 25,702 in the intervention group were included in this trial with a mean follow-up of 6.7 ± 0.9 months. Mixed-effects regression models were used to evaluate the effect of the interventions on body weight and blood pressure (BP).Results: A significant upward in the body mass index (BMI) levels but downward in systolic BP (SBP), diastolic BP (DBP), BMI Z-scores, SBP Z-scores, and DBP Z-scores were witnessed in the intervention group compared to those in the control group (<0.001). Subgroup analyses presented significant intervention effects in children aged 6–12 years for BMI, SBP, DBP, and their standardized values Z-scores, but no effective results were found in adolescents aged 13–18 years. Stratification analyses based on the dynamic weight changes presented non-differential HBP, SHBP, and DHBP prevalence gaps between the control and intervention groups. Children aged 6–12 years with higher BMI percentiles at baseline presented obvious declines in SBP and DBP standardized values Z-scores.Conclusion: A mean 6-month multi-centered school-based comprehensive obesity intervention in China yields a small to null effect on obesity and hypertension with increasing age; the early age before 12 years may be the key period for interventions, and the younger, the better. Precise and high-intensity interventions targeting the population at different stages of childhood and adolescence are urgently needed to be developed.Clinical Trial Registration:https://www.clinicaltrials.gov/, identifier: NCT02343588https://www.frontiersin.org/articles/10.3389/fped.2021.615283/fullobesityblood pressureinterventionnon-randomized controlled trialschildren and adolescents
spellingShingle Yanhui Dong
Zhiyong Zou
Haijun Wang
Bin Dong
Peijin Hu
Yinghua Ma
Yi Song
Jun Ma
National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
Frontiers in Pediatrics
obesity
blood pressure
intervention
non-randomized controlled trials
children and adolescents
title National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
title_full National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
title_fullStr National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
title_full_unstemmed National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
title_short National School-Based Health Lifestyles Intervention in Chinese Children and Adolescents on Obesity and Hypertension
title_sort national school based health lifestyles intervention in chinese children and adolescents on obesity and hypertension
topic obesity
blood pressure
intervention
non-randomized controlled trials
children and adolescents
url https://www.frontiersin.org/articles/10.3389/fped.2021.615283/full
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