Elsevier

American Heart Journal

Volume 163, Issue 2, February 2012, Pages 302-312
American Heart Journal

Obesity and physical fitness in California school children

https://doi.org/10.1016/j.ahj.2011.10.020Get rights and content

Background

Obesity rates have reached epidemic proportions in the United States and California. Thus, the California Department of Education began a series of steps to address the increase in obesity and decline in fitness in the 6.3 million public school children in California. We evaluated serial changes in obesity and fitness in California school children following implementation of prevention steps in all California public schools.

Methods

The California Department of Education implemented changes in school nutrition and exercise programs aimed at reducing obesity and improving fitness. Outcome results were monitored by performing Physical Fitness Testing on 8.4 million students (5th, 7th, and 9th grade) for body composition, aerobic capacity, flexibility, and upper body, abdominal, and truncal strength using the Cochran-Armitage trend test and multivariable logistic regression models.

Results

Overall fitness improved from 2003 to 2008. Serial changes in body composition, aerobic capacity, flexibility, and upper body, abdominal, and truncal strength improved or remained stable within school as students progressed from 5th to 7th to 9th grade. However, students entering 5th grade were more obese every year, and this early obesity was not reversible within the school programs.

Conclusions

Following prevention measures within California public schools, obesity and fitness levels have stabilized. However, continued increases in early entrance (5th grade) obesity will require additional efforts directed at preschool and elementary students to completely stop and reverse this obesity epidemic.

Section snippets

Methods

In 1996, the CDE designated a Physical Fitness Test (PFT) called the “Fitnessgram” as the required physical performance test to be administered to all 5th, 7th, and 9th graders in California on an annual basis to assess the prevalence and development of overweight, obesity, and overall physical fitness in school children. The Fitnessgram was developed by the Cooper Institute for Aerobics Research in Dallas, Texas, and endorsed by the American Alliance for Health, Physical Education, Recreation,

Results

The Fitnessgram was performed in 8.4 million students over 6 years (approximately 1.4 million each year in grades 5, 7, and 9) in the State of California, and complete test results were available in 75% (Table I). Between 2003 and 2008, approximately half of the tested students were male (51.13%) and the overall mean age was 12.4 years (mean age 5th grade 10.5 years, 7th grade 12.5 years, 9th grade 14.5 years). Hispanic/Latino (46.8%) was the largest ethnic group followed by whites (30.6%),

Obesity rate slowing

Our results show that obesity continued to increase from 2003 to 2008 in all tested grades. However, this annual increase in childhood obesity may have slowed down when compared to prior decades in other national studies. In prior decades, childhood obesity prevalence increased 0.8% to 1.7% per year. However, in this study of California school children, the obesity prevalence increased only 0.33% per year (2003-2008). This suggests a slowing of obesity rate increases in California school

Conclusions

Despite the fact that progress has been made, much more is needed. Although the rise in obesity rates seems to have slowed down, our current efforts have not yet reduced obesity in children. Long-term follow-up is needed to determine if obesity in children will continue to rise in the long run. The best way to stop and eventually reduce childhood obesity has yet to be discovered.

Because obesity is a multifactorial problem, biomedical researchers need to continue to study metabolic, genetic,

Disclosures

Dr Bommer was a member of the California Department of Education multidisciplinary Task Force for Childhood Obesity, Type 2 Diabetes, and Cardiovascular Disease.

Funding source: California Department of Education.

Acknowledgements

The authors thank the California Department of Education (Jack O'Connell, Superintendent 2003-2011, and Thomas Torlakson, Superintendent 2011-present) and the Task Force for Childhood Obesity, Type 2 Diabetes, and Cardiovascular Disease (Barry Coughlin, MD, Chair), for implementing these prevention programs and gathering these data. Geeta Mahendra is acknowledged for statistical programming and graphic presentations.

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