Eight-year follow-up of school-based intervention on childhood overweight--the Kiel Obesity Prevention Study.

OBJECTIVE: The aim of this study was to evaluate the 8-year outcome of school-based intervention on weight status, lifestyle and blood pressure (BP) as part of the Kiel Obesity Prevention Study (KOPS). METHODS: Within a quasi-randomized controlled trial, 240 intervention (I) and 952 non-intervention (NI) students at age 6 and 14 years were assessed in schools. Six nutrition units followed by 20-min running games were performed within the first year at school. Primary outcome was the 8-year change in body mass index standard deviation score (BMI-SDS) according to German references. Effective intervention was tested using multilevel linear regression analysis. RESULTS: Eight-year changes in BMISDS were +0.18 and +0.22 with increases in prevalence of overweight from 8.3 to 10.4% and 7.0 to 11.2% in I and NI students, respectively. Cumulative 8-year incidence of overweight was 5.9% and 7.1% in I and NI students, respectively. There was no overall effect of intervention, but a significant interaction was shown between the intervention and the socio-economic status (SES), which demonstrated that in high SES, the 8-year change in BMI-SDS was in favour of I (-0.17 in I and +0.17 in NI; p < 0.01). Intervention had no measurable effects on lifestyle and BP. CONCLUSIONS: School-based health promotion has some favourable and sustained effects on 8-year changes in BMI-SDS, which are most pronounced in students of high SES families. The data argue in favour of further preventive measures.

Clustering of lifestyle factors and association with overweight in adolescents of the Kiel Obesity Prevention Study.

OBJECTIVE: To identify lifestyle clusters in adolescents and to characterize their association with overweight and obesity. DESIGN: Cross-sectional and longitudinal data of the Kiel Obesity Prevention Study. SETTING: Schools in Kiel, Germany. SUBJECTS AND METHODS: Cross-sectional data of 1894 adolescents aged 14 years and 4-year longitudinal data of a subsample of 389 children aged 10 and 14 years. Self-reported data of physical activity, modes of commuting to school, media time, nutrition, alcohol consumption and smoking were used to identify lifestyle clusters with two-step cluster analysis. Obesity indices (height, weight, waist circumference and fat mass (FM)) were measured. RESULTS: Three lifestyle clusters were identified: a 'low activity and low-risk behaviour' cluster (cluster 1: n 740, 39·1 %); a 'high media time and high-risk behaviour' cluster (cluster 2: n 498, 26·3 %); and a 'high activity and medium-risk behaviour' cluster (cluster 3: n 656, 34·6 %). Strictly speaking, none of these clusters was considered to be markedly healthy. The prevalence of overweight and obesity tended to be lower in cluster 3 (15·9 %) than in clusters 1 (20·4 %) and 2 (20·5 %; P = 0·053). Longitudinally, 4-year changes in FM were found to be lowest in cluster 2, but the 4-year incidence rate of obesity was lowest in cluster 3. CONCLUSIONS: Explicit healthy lifestyles do not exist, but an active lifestyle reduces the incidence of obesity. In adolescents, health promotion should take into account the diversity of lifestyles and address specific lifestyle clusters.

Quercetin reduces systolic blood pressure and plasma oxidised low-density lipoprotein concentrations in overweight subjects with a high-cardiovascular disease risk phenotype: a double-blinded, placebo-controlled cross-over study.

Regular consumption of flavonoids may reduce the risk for CVD. However, the effects of individual flavonoids, for example, quercetin, remain unclear. The present study was undertaken to examine the effects of quercetin supplementation on blood pressure, lipid metabolism, markers of oxidative stress, inflammation, and body composition in an at-risk population of ninety-three overweight or obese subjects aged 25-65 years with metabolic syndrome traits. Subjects were randomised to receive 150 mg quercetin/d in a double-blinded, placebo-controlled cross-over trial with 6-week treatment periods separated by a 5-week washout period. Mean fasting plasma quercetin concentrations increased from 71 to 269 nmol/l (P < 0.001) during quercetin treatment. In contrast to placebo, quercetin decreased systolic blood pressure (SBP) by 2.6 mmHg (P < 0.01) in the entire study group, by 2.9 mmHg (P < 0.01) in the subgroup of hypertensive subjects and by 3.7 mmHg (P < 0.001) in the subgroup of younger adults aged 25-50 years. Quercetin decreased serum HDL-cholesterol concentrations (P < 0.001), while total cholesterol, TAG and the LDL:HDL-cholesterol and TAG:HDL-cholesterol ratios were unaltered. Quercetin significantly decreased plasma concentrations of atherogenic oxidised LDL, but did not affect TNF-alpha and C-reactive protein when compared with placebo. Quercetin supplementation had no effects on nutritional status. Blood parameters of liver and kidney function, haematology and serum electrolytes did not reveal any adverse effects of quercetin. In conclusion, quercetin reduced SBP and plasma oxidised LDL concentrations in overweight subjects with a high-CVD risk phenotype. Our findings provide further evidence that quercetin may provide protection against CVD.