title: The beneficial effects of preschool attendance on adult cardiovascular disease risk.
abstract: OBJECTIVE
  To assess the effect of South Australian Kindergarten Union participation on adult cardiovascular behavioural risk factors.
  
  
  METHODS
  Using a retrospective cohort design, this study examined the effect of attendance at a Kindergarten Union preschool from 1940 to 1972 on behavioural risk factors for cardiovascular disease in adults 34-67 years. Dichotomous outcomes were analysed using a generalised linear model (Poisson distribution) with robust variance estimates. Outcomes with more than two categories were analysed with a multinomial logistic model.
  
  
  RESULTS
  There was a beneficial effect of preschool on high physical activity relative to sedentary and on ever smoking, but a negative effect on fruit consumption. Preschool attendance was not associated with alcohol risk or vegetable consumption under traditional criteria, however the point estimate for vegetable consumption was in the beneficial direction. The point estimates from the multinomial model suggested a step-wise decreasing risk for preschool attendees to have less risk of experiencing multiple behavioural risk factors (e.g. risk of five risk factors for preschool participants compared with non-participants).
  
  
  CONCLUSIONS
  Attendance at a Kindergarten Union preschool was associated with a reduced risk of two and an indication of benefit in a third behavioural risk factor in adulthood. This study provides some evidence for the potential health benefit of interventions outside of the health sector to prevent cardiovascular diseases, which are strongly associated with lifelong social disadvantage.
authors.affiliation: Sansom Institute for Health Research, University of South Australia, Australia. katina.d’onise@postgrads.unisa.edu.au
authors.forename: Katina
authors.initials: K
authors.lastname: D'Onise
authors.forename: John W
authors.initials: JW
authors.lastname: Lynch
authors.forename: Robyn A
authors.initials: RA
authors.lastname: McDermott
authors.forename: Adrian
authors.initials: A
authors.lastname: Esterman
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002657:Child Development; D002675:Child, Preschool; D018479:Early Intervention, Educational; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012578:Schools, Nursery; D012959:Socioeconomic Factors; D013021:South Australia