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With evidence that impaired glucose metabolism arises progressively during childhood, we sought to determine whether elementary school physical education (PE) could improve insulin resistance (IR).
In this 4-year cluster-randomized intervention study, we enrolled 229 boys and 239 girls (age 8.1, SD 0.35) years from 29 elementary schools in suburbs of similar socioeconomic status. In the schools that were allocated to the PE intervention, 100 min/week of PE and sport, usually conducted under the supervision of general classroom teachers, was replaced by two classes of an established intervention program provided by visiting PE teachers. The remaining schools formed the control. Measurements in grades 2, 4 and 6 included fasting blood glucose and insulin for calculation of the homeostatic model of insulin resistance (HOMA-IR), percent body fat (dual-emission X-ray absorptiometry), physical activity (7-day pedometers and accelerometers), fitness (multistage run), and pubertal development (Tanner stage self-assessment).
On average, the intervention PE included more specific fitness work than the control, mainly involving muscular endurance and strength (7 min v 1 min, p<0.001) and more moderate physical activity (17min v 10 min, p<0.001). With no significant differences in IR at baseline, by grade 6 (age 12) the intervention had lowered IR by 14% (95% CI 1-31%) in the boys and by 9% (5-26%) in the girls. Accordingly, the percentage of children with IR greater than 3, a published cut-off point for metabolic risk, was lower in the intervention group (boys 12%, girls 32%, combined 22%) than in the control group (boys 21%, girls 40%, combined 31%).
A sustainable program of PE improved IR in community-based children, thereby offering a primordial preventative strategy that could be coordinated widely though a school-based approach.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Opportunities for Improvement
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1274M-8
- 2013 American College of Cardiology Foundation