title: A school-based physical activity program to improve health and fitness in children aged 6-13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785].
abstract: BACKGROUND
  Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA). However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT) aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children.
  
  
  METHODS
  15 schools were randomized to the intervention (n = 9) or the control (n = 6) group, stratified by geographic region (urban vs. rural) and by age (1st and 5th grade). Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2-5 min each) during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health questionnaire in the intervention group compared to the control group. Secondary outcomes were overall fitness, differences in body composition including body fat distribution, cardiovascular risk factors, psychosocial health, bone mineral content and density of femur, lumbar spine and total body and food intake.
  
  
  CONCLUSIONS
  Our preliminary data suggest that the children were representative of Swiss children with respect to sex, socio-demographic status, and body mass index. Short-term results can be expected by the beginning of 2007. We hypothesized that our intervention will lead to an increase in PA, fitness and overall health. Based on our data, we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children.
authors.affiliation: Institute of Exercise and Health Sciences, University of Basel, Brüglingen 33, 4052 Basel, Switzerland. lukas.zahner@unibas.ch
authors.forename: Lukas
authors.initials: L
authors.lastname: Zahner
authors.forename: Jardena J
authors.initials: JJ
authors.lastname: Puder
authors.forename: Ralf
authors.initials: R
authors.lastname: Roth
authors.forename: Marco
authors.initials: M
authors.lastname: Schmid
authors.forename: Regula
authors.initials: R
authors.lastname: Guldimann
authors.forename: Uwe
authors.initials: U
authors.lastname: Pühse
authors.forename: Martin
authors.initials: M
authors.lastname: Knöpfli
authors.forename: Charlotte
authors.initials: C
authors.lastname: Braun-Fahrländer
authors.forename: Bernard
authors.initials: B
authors.lastname: Marti
authors.forename: Susi
authors.initials: S
authors.lastname: Kriemler
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D015444:Exercise / Q000502:physiology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010806:Physical Education and Training; D010809:Physical Fitness / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D012424:Rural Population; D012572:School Health Services / Q000458:organization & administration*; D013557:Switzerland; D014505:Urban Population