title: Health and nutrition education program in primary schools of Crete: changes in blood pressure over 10 years.
abstract: OBJECTIVE
  To examine the long-term effects of the 'Cretan Health and Nutrition Education Program' on blood pressure.
  
  
  METHODS
  A representative population of 176 pupils (85 from the intervention schools and 91 from the control schools).
  
  
  METHODS
  Blood pressure, dietary, anthropometrical and physical activity data were obtained at baseline (academic year 1992-1993) and at follow-up examination (academic year 2001-2002).
  
  
  RESULTS
  The findings of the current study revealed that the increase over the 10-year period in systolic (SBP) and diastolic blood pressure (DBP) was higher in the control group (CG) than in the intervention group (IG) (P=0.003 and P<0.001 respectively). Regarding dietary indices, the IG were found to have a significantly higher intake of potassium (P=0.018) and magnesium (P=0.011) compared to the CG. Furthermore, the decrease in body mass index (BMI) z-score observed in the IG was found to differentiate significantly from the increase observed in the CG (P=0.042). On the contrary, the increase in leisure time, moderate to vigorous physical activities (MVPA) observed in the IG, was found to differentiate significantly from the decrease observed in the CG (P=0.032). Intervention's effect on SBP was mediated by changes in MVPA (beta=-0.20, P=0.030) and BMI (beta=0.19, P=0.048). Similarly, intervention's effect on DBP was mediated by changes in MVPA (beta=-0.18, P=0.048), BMI (beta=0.26, P=0.007) and magnesium intake (beta=-0.20, P=0.048).
  
  
  CONCLUSIONS
  The findings of the current study are encouraging, indicating favorable changes in blood pressure, micronutrients intake, BMI and physical activity over the 10 years of follow-up and 4 years after program's cessation, thus providing some support for the effectiveness of school-based health education programs in successfully tackling certain chronic disease risk factors early in life.
authors.affiliation: Department of Nutrition & Dietetics, Harokopio University of Athens, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Kafatos
authors.forename: Y
authors.initials: Y
authors.lastname: Manios
authors.forename: J
authors.initials: J
authors.lastname: Moschandreas
authors.forename: A
authors.initials: A
authors.lastname: Kafatos
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000523:psychology; D004032:Diet; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007899:Leisure Activities; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D012572:School Health Services