Childhood Obesity Clinical Trial
Official title:
The YMCA After School Program of Physical Activity and Nutrition
There is an epidemic rise in the number of overweight and obese children. Overweight and obesity in children tracks into adulthood and carries elevated risk of chronic diseases such as seen with the metabolic syndrome (i.e., elevated glucose, hypertension, etc.). Low levels of PA and poor nutrition seem to be tightly linked to the increase in overweight and obesity. A minimal intervention that targets simple strategies for both sides of the energy balance equation may diminish overweight and obesity. Increasing moderate to vigorous physical activity and improving nutrition through snacks is a feasible, low cost strategy and can be disseminated nationally through the YMCA, if successful. Specifically, we expect that children receiving YMCA PAN will show smaller changes in BMI after 3 years of the intervention when compared to children not receiving YMCA PAN (i.e. standard, existing YMCA After School Program or "YMCA standard care").
Our primary outcome measurement is body mass index (BMI) as this is now recommended by major
health organizations as the preferred measure for the determination of obesity. All children
at YMCA After School Programs will receive either YMCA-PAN or YMCA standard care; however,
we will only follow children in grades kindergarten through second grade (K-2). For children
in grades K-2, we will determine if 3 years of increased physical activity and snacks lower
in energy and fat and higher in nutrient density will diminish gains in BMI. We have
specifically targeted an increase of moderate to vigorous physical activity (MVPA) by 225
minutes per week that is delivered in YMCA-PAN as this is a compromise between the
recommendations suggested by Healthy People 2010 and the Institute of Medicine (IOM) and is
administratively feasible within the existing YMCA After School Programs. YMCA-PAN would
exceed the Healthy People 2010 guidelines and would provide the majority of PA for the IOM
guidelines. Children would satisfy the IOM guidelines with just 15 additional minutes of
MVPA accrued throughout the day in physical education class or free play. Finally, YMCA PAN
would provide opportunity for PA at the very time the guidelines call "most critical:" the
hours between 3 and 6pm when children have finished the school day and frequently are
sedentary. For the nutritional component, we are targeting snacks, as snacks are part of the
YMCA after school programs, snacks contribute significantly to 24 hour energy intake,
children are increasingly in control of the snacks they consume, and we have previously
diminished 24 hour energy intake and fat intake using snacks in elementary school children.
We will provide this intervention using regular YMCA staff and use the regular time periods
for PA that exist in the YMCA after school programs. We will also use the regular YMCA staff
to provide snacks. Specifically, we expect that children receiving YMCA-PAN will show
smaller changes in BMI after 3 years of the intervention when compared to children not
receiving YMCA-PAN (i.e. standard, existing YMCA after school program or "YMCA standard
care").
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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