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Cited by 1,023Obesity, Physical Activity, DietSchool Health and Nursing EducationPhysical Activity and Health

Outcomes of a Field Trial to Improve Children's Dietary Patterns and Physical Activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH)

Luepker, Russell V.·1996·JAMA
DOI 10.1001/jama.1996.03530340032026
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Abstract

OBJECTIVE: To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease. DESIGN: A randomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994). PARTICIPANTS: A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas. INTERVENTION: Twenty-eight schools participated in a third-grade through fifth-grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education. MAIN OUTCOME MEASURES: At the school level, two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychological factors, recall measures of eating and physical activity patterns, and other physiologic measures. RESULTS: In intervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%)(P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed. CONCLUSION: The CATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years.

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Authors
Luepker, R. V.
Affiliations
University of Minnesota (US)
Corresponding author
Luepker, Russell V.
ORCID
Luepker, Russell V.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1996-03-13
Volume
275
Issue
10
Pages
768
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1996.03530340032026
OpenAlex
W2107667479
Cited by
1,023
References
53
Citations by year
2026: 3 · 2025: 2 · 2024: 8 · 2023: 7 · 2022: 15 · 2021: 18 · 2020: 18 · 2019: 22 · 2018: 22 · 2017: 24 · 2016: 28 · 2015: 34 · 2014: 44 · 2013: 46 · 2012: 51
FWCI
54.11
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (7u01hl039880-03, 5u01hl039906-12, 5u01hl039852-11)
  • National Heart, Lung, and Blood Institute (U-01 HL 39906, U01HL39880, U01HL39852)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
cardiovascular disease prevention, physical education, physical activity, family education, serum cholesterol, dietary fat intake, primary prevention, elementary school students
MeSH terms
Analysis of Variance, Energy Intake, Cardiovascular Diseases, Child, Cholesterol, Curriculum, Diet, Dietary Fats, Female, Food Services, Health Education, Humans, Male, Outcome and Process Assessment, Health Care, Physical Education and Training, Physical Fitness, Primary Prevention, Schools, Skinfold Thickness, United States, Health Behavior

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