Effect on Physical Activity of a Randomized Afterschool Intervention for Inner City Children in 3rd to 5th Grade

Background Less than 45% of U.S. children meet the 60 min.d(-1) physical activity (PA) guideline. Structured after-school PA programing is one approach to help increase activity levels. This study aimed to evaluate the feasibility and short-term impact of a supervised after-school PA and nutrition education program on activity levels. Methods Forty-two 3rd-5th graders from an inner-city school in Boston, MA were randomly assigned to a 10-wk after-school program of either: 1) weekly nutrition education, or 2) weekly nutrition education plus supervised PA 3 d.wk(-1) at a community-based center. At baseline and follow-up, PA was measured using accelerometry and fitness (VO2max) was estimated using the PACER 15-m shuttle run. Additional measures obtained were non-fasting finger stick total cholesterol (TC) and glucose levels, waist circumference (WC), body mass index (BMI), percent body fat (% BF), and blood pressure (BP). Values are presented as mean +/- SE, unless noted otherwise. Results Thirty-six participants completed the study (mean +/- SD; age 9.7 +/- 0.9 years). Participants attended >80% of the sessions. After adjusting for accelerometer wear time and other design factors, light and moderate-to-vigorous PA (MVPA) increased in the nutrition+PA group (+21.5 +/- 14.5 and +8.6 +/- 8.0 min.d(-1), respectively) and decreased in the nutrition only group (-35.2 +/- 16.3 and -16.0 +/- 9.0 min.d(-1), respectively); mean difference between groups of 56.8 +/- 21.7 min.d(-1) (light PA, p = 0.01) and 24.5 +/- 12.0 min.d-1 (MVPA, p = 0.04). Time spent in sedentary behaviors declined in the nutrition+PA group (-14.8 +/- 20.7 min.d(-1)) and increased in the nutrition only group (+55.4 +/- 23.2 min.d(-1)); mean difference between groups of -70.2 +/- 30.9 min.d(-1) (p = 0.02). Neither group showed changes in TC, BP, WC, %BF, BMI percentile, or fitness (p>0.05). Conclusions The supervised afterschool community-based nutrition and PA program was well accepted and had high attendance. The changes in light PA and MVPA has potential to promote weight maintenance in inner-city elementary school children, however longer term studies with larger samples are needed.