Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study

Background We evaluated the effects of a national school‐based lifestyle intervention program against childhood obesity on improving cardiovascular health (CVH), assessed using the recently introduced Life's Essential 8 metric framework. Methods and Results Our post hoc analysis of the national...

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Main Authors: Pengfei Guo, Yueqin Zhou, Zhiyong Zou, Yajun Chen, Jin Jing, Yinghua Ma, Yi Song, Wenhua Ling, Jun Ma, Yanna Zhu
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.037371
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author Pengfei Guo
Yueqin Zhou
Zhiyong Zou
Yajun Chen
Jin Jing
Yinghua Ma
Yi Song
Wenhua Ling
Jun Ma
Yanna Zhu
author_facet Pengfei Guo
Yueqin Zhou
Zhiyong Zou
Yajun Chen
Jin Jing
Yinghua Ma
Yi Song
Wenhua Ling
Jun Ma
Yanna Zhu
author_sort Pengfei Guo
collection DOAJ
description Background We evaluated the effects of a national school‐based lifestyle intervention program against childhood obesity on improving cardiovascular health (CVH), assessed using the recently introduced Life's Essential 8 metric framework. Methods and Results Our post hoc analysis of the national school‐based lifestyle intervention targeting diet and physical activity included 94 schools with eligible students aged 7 to 17 years (intervention group n=30 629; control group n=26 581). We assessed CVH metrics by individual scores for 4 health behaviors (diet, physical activity, nicotine exposure, and body mass index) and 3 health factors (blood lipids, glucose, and pressure). These scores were subsequently combined to calculate the CVH score, health behavior score, and health factor score. The primary outcomes were these 3 composite scores and high CVH (CVH score≥80). All analyses applied a likelihood‐based random‐effects regression modeling following the intention‐to‐treat. The school‐based lifestyle intervention was associated with a 0.89‐point increase in the CVH score (95% CI, 0.03–1.74), 14% greater odds of having high CVH (odds ratio, 1.14 [95% CI, 1.01–1.29]), and a 1.35‐point improvement in the health behavior score (95% CI, 0.32–2.38). According to our subgroup analyses, this intervention had stronger favorable effects on CVH and health behavior scores in primary (grades 1–6) and junior (grades 7–9) schools than in senior high (grades 10–12) schools (P<0.001). Conclusions This school‐based lifestyle intervention improved CVH behaviors in Chinese children and adolescents. The differences in the intervention effect according to school grade imply critical windows for forming healthy lifestyles at younger ages. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02343588.
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spelling doaj-art-46e5d2a320384e28888315d21d4c561a2025-08-20T02:34:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-01-0114110.1161/JAHA.124.037371Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter StudyPengfei Guo0Yueqin Zhou1Zhiyong Zou2Yajun Chen3Jin Jing4Yinghua Ma5Yi Song6Wenhua Ling7Jun Ma8Yanna Zhu9Department of Maternal and Child Health School of Public Health, Sun Yat‐sen University Guangzhou ChinaDepartment of Maternal and Child Health School of Public Health, Sun Yat‐sen University Guangzhou ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University Beijing ChinaDepartment of Maternal and Child Health School of Public Health, Sun Yat‐sen University Guangzhou ChinaDepartment of Maternal and Child Health School of Public Health, Sun Yat‐sen University Guangzhou ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University Beijing ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University Beijing ChinaDepartment of Nutrition School of Public Health, Sun Yat‐sen University Guangzhou ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University Beijing ChinaDepartment of Maternal and Child Health School of Public Health, Sun Yat‐sen University Guangzhou ChinaBackground We evaluated the effects of a national school‐based lifestyle intervention program against childhood obesity on improving cardiovascular health (CVH), assessed using the recently introduced Life's Essential 8 metric framework. Methods and Results Our post hoc analysis of the national school‐based lifestyle intervention targeting diet and physical activity included 94 schools with eligible students aged 7 to 17 years (intervention group n=30 629; control group n=26 581). We assessed CVH metrics by individual scores for 4 health behaviors (diet, physical activity, nicotine exposure, and body mass index) and 3 health factors (blood lipids, glucose, and pressure). These scores were subsequently combined to calculate the CVH score, health behavior score, and health factor score. The primary outcomes were these 3 composite scores and high CVH (CVH score≥80). All analyses applied a likelihood‐based random‐effects regression modeling following the intention‐to‐treat. The school‐based lifestyle intervention was associated with a 0.89‐point increase in the CVH score (95% CI, 0.03–1.74), 14% greater odds of having high CVH (odds ratio, 1.14 [95% CI, 1.01–1.29]), and a 1.35‐point improvement in the health behavior score (95% CI, 0.32–2.38). According to our subgroup analyses, this intervention had stronger favorable effects on CVH and health behavior scores in primary (grades 1–6) and junior (grades 7–9) schools than in senior high (grades 10–12) schools (P<0.001). Conclusions This school‐based lifestyle intervention improved CVH behaviors in Chinese children and adolescents. The differences in the intervention effect according to school grade imply critical windows for forming healthy lifestyles at younger ages. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02343588.https://www.ahajournals.org/doi/10.1161/JAHA.124.037371cardiovascular healthchildexercisehealthy dietlifestyle intervention
spellingShingle Pengfei Guo
Yueqin Zhou
Zhiyong Zou
Yajun Chen
Jin Jing
Yinghua Ma
Yi Song
Wenhua Ling
Jun Ma
Yanna Zhu
Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular health
child
exercise
healthy diet
lifestyle intervention
title Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
title_full Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
title_fullStr Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
title_full_unstemmed Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
title_short Effects of School‐Based Lifestyle Interventions on Cardiovascular Health in Chinese Children and Adolescents: A Post Hoc Analysis of a National Multicenter Study
title_sort effects of school based lifestyle interventions on cardiovascular health in chinese children and adolescents a post hoc analysis of a national multicenter study
topic cardiovascular health
child
exercise
healthy diet
lifestyle intervention
url https://www.ahajournals.org/doi/10.1161/JAHA.124.037371
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