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Aaron L. Carrel, MD; R. Randall Clark, MS; Susan Peterson, MS; Jens Eickhoff, PhD; David B. Allen, MD

Arch Pediatr Adolesc Med. 2007;161(6):561-564.

Objective  To determine the changes in percentage of body fat, cardiovascular fitness, and insulin levels during the 3-month summer break in overweight children enrolled in a school-based fitness program.

Study Design  Overweight middle-school children were randomized to a lifestyle-focused physical education class (treatment) or standard physical education class (control) for 1 school year (9 months; previously reported). This analysis reports changes during the 3-month summer break in children who participated in the fitness intervention group and who remained at this school the following year and repeated a fitness class. At the beginning and end of the school year, children underwent evaluation of (1) fasting levels of insulin and glucose, (2) body composition by means of dual x-ray absorptiometry, and (3) maximum oxygen consumption as determined by treadmill use.

Setting  Rural middle school and an academic children's hospital.

Participants  Overweight middle-school children.

Intervention  School-based fitness curriculum, followed by summer break, and an additional year of school-based fitness intervention.

Main Outcome Measures  Cardiovascular fitness test results (maximum oxygen consumption), body composition, and fasting insulin levels.

Results  Improvements seen during the 9-month school-year intervention in cardiovascular fitness, fasting insulin levels, and body composition were lost during the 3-month summer break. During this summer break, mean ± SD fitness level decreased (maximum oxygen consumption, –3.2 ± 1.9 mL/kg per minute; P = .007), fasting insulin level increased (+44 ± 69 pmol/L [+6.1 ± 9.7 mIU/mL]; P = .056), and percentage of body fat increased (+1.3% ± 1.3%; P = .02) to levels that were similar to those seen before the school intervention.

Conclusion  In obese middle-school children, school-based fitness interventions are an important vehicle for health promotion, but without sustained intervention, these benefits may be lost during the extended summer break.

Author Affiliations: Departments of Pediatrics (Drs Carrel, Eickhoff, and Allen) and Sports Medicine (Mr Clark and Ms Peterson), University of Wisconsin Children's Hospital, Madison.

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