Obesity Clinical Trial
In the first study, to identify children at high and low risk for cardiovascular disease and study their nutritional and physical activity behaviors as they relate to cardiovascular disease. In the second study, to make yearly assessments over a four year period of diet and physical activity among children and their parents. The initial effort redefined and retested methods to collect data on dietary intake and activity levels of young children.
BACKGROUND:
In the past several decades, relationships between various lifestyle behaviors and the
development of cardiovascular risk factors have been identified. Nutritional status/eating
behaviors and physical activity patterns both directly and indirectly are related to the
development of coronary heart disease. For example, obesity, which may be a result of both
eating and physical activity behaviors, greatly increases the risk of hypertension,
hyperlipidemia, and diabetes mellitus, placing the individuals at greater risk for coronary
heart disease. Dietary factors such as composition in fatty acids and cholesterol,
composition in vegetable protein and complex carbohydrates, caloric excess and a high intake
of salt also are related to the development of risk of coronary heart disease.
Physical activity in adults has also been correlated with coronary heart disease.
Epidemiological research has demonstrated that increased physical activity is associated
with reduced risk of myocardial infarctions. Regular physical exercise has been shown to
have beneficial effects on relative weight and obesity and may act indirectly to
beneficially affect hypertension, hypertriglyceridemia and glucose intolerance and raise HDL
cholesterol levels. However, in 1985 when SCAN was initiated, little information was
available concerning the development of nutritional status/eating behaviors and routine
physical activity patterns in children.
Various psychosocial factors have been associated with increased risk of coronary heart
disease. Among these factors are behavioral characteristics such as type A behaviors and
coping styles to stressors. However, relatively little was known in 1985 concerning the
development of such characteristics in children and when these characteristics became
associated with risk of cardiovascular disease.
SCAN initiated on the recommendations of the Preventive Cardiology Branch Task Force Group
in the Five Year Forward Plan 1982-1987, the Conference on School Health Education Research
in the Heart, Lung, and Blood Areas, and the Clinical Applications and Prevention Advisory
Committee of the National Heart, Lung, and Blood Institute. A Request for Applications was
released in October 1984. In 1985, six grants were awarded as part of the Study of
Children's Activity and Nutrition (SCAN).
DESIGN NARRATIVE:
There were six projects supported by the SCAN program. They did not follow a common protocol
but were basically similar.
Medical College of Georgia: Five hundred and one Black and white children were followed over
a four year period for food intake behavior, physical activity and fitness, anthropometric
measurements, blood lipids and lipoproteins, heart rate and blood pressure, and psychologic
characteristics associated with coronary heart disease.
West Virginia University: Two hundred and eight predominantly white children of adults
followed since adolescence in the Bourbon County Study were members of this cohort. Children
participated in cardiovascular fitness tests, and underwent blood pressure measurements, and
serum lipid determinations. The effects of television-viewing, child-rearing patterns,
exercise, and nutrition-related knowledge and attitudes were assessed over a four year
period.
Columbia University: Seven hundred and ninety-four primarily Hispanic children and their
parents were followed for four years to determine the extent to which diet and physical
activity predict coronary heart disease risk. Cross sectional and longitudinal analyses were
performed.
Georgetown University: Five hundred and seventy Black children were followed for the
influence of the risk status of an older sibling and day care versus home care on nutrient
intake and physical activity. Eating events were videotaped, activity levels were recorded,
and measurements were obtained on height, weight, cholesterol, blood pressure, and skinfold
thickness. Dietary recalls and nutrition knowledge surveys were obtained.
University of Massachusetts: In the Framingham Children's Study, one hundred children who
were direct descendents of Framingham Heart Study participants were followed for four years.
Measurements included height, weight, skinfold thickness, lipid profiles, heart rate and
activity monitoring, and assessment of dietary intake four times per year.
Memphis State University: Six hundred and sixty-three children and their parents were
assessed for food intake, physical activity, and parent-child interactions related to food
intake and exercise. Anthropometric and cardiovascular data were also collected every four
months for four years.
Two of the studies were renewed in FY 1992 and again in FY 1996. See the Framingham
Children's Study and the Children's Activity and Nutrition III.
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