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Rush E.,Auckland University of Technology | McLennan S.,Sport Waikato | Obolonkin V.,Auckland University of Technology | Vandal A.C.,Auckland University of Technology | And 4 more authors.
British Journal of Nutrition | Year: 2014

Project Energize, a region-wide whole-school nutrition and physical activity programme, commenced as a randomised controlled trial (RCT) in the period 2004-6 in 124 schools in Waikato, New Zealand. In 2007, sixty-two control schools were engaged in the programme, and by 2011, all but two of the 235 schools in the region were engaged. Energizers (trained nutrition and physical activity specialists) work with eight to twelve schools each to achieve the goals of the programme, which are based on healthier eating and enhanced physical activity. In 2011, indices of obesity and physical fitness of 2474 younger (7·58 (sd 0·57) years) and 2330 older (10·30 (sd 0·51) years) children attending 193 of the 235 primary schools were compared with historical measurements. After adjusting for age, sex, ethnicity, socio-economic status (SES) and school cluster effects, the combined prevalence of obesity and overweight among younger and older children in 2011 was lower by 31 and 15%, respectively, than that among 'unEnergized' children in the 2004 to 2006 RCT. Similarly, BMI was lower by 3·0% (95% CI-5·8,- 1·3) and 2·4% (95% CI-4·3,-0·5). Physical fitness (time taken to complete a 550m run) was significantly higher in the Energized children (13·7 and 11·3%, respectively) than in a group of similarly aged children from another region. These effects were observed for boys and girls, both indigenous Māori and non-Māori children, and across SES. The long-term regional commitment to the Energize programme in schools may potentially lead to a secular reduction in the prevalence of overweight and obesity and gains in physical fitness, which may reduce the risk of developing obesity and type 2 diabetes. Copyright © The Authors 2013.


Rush E.,University of Auckland | Coppinger T.,University of Auckland | Obolonkin V.,University of Auckland | Hinckson E.,University of Auckland | And 3 more authors.
Journal of Science and Medicine in Sport | Year: 2012

Objectives: To examine in the context of a school day whether a pedometer, compared to an accelerometer, was an effective tool to identify children with low physical activity levels. Additionally, to characterise within the school day, patterns of variation in level and timing of activity of the most active and least active children. Design: Observational study to compare two methods (accelerometer and pedometer) of identifying less active children and intensity of activity. Method: During school hours, for three consecutive days, children (n= 47, aged 8-11 years) in two classes wore an accelerometer and sealed pedometer. Accelerometers were programmed to record at 15s epochs and the number of pedometer steps taken were recorded at the end of each school day. Patterns of activity by total accelerometer counts, and with cutoffs applied, were examined against time and the number of steps taken. Results: Based on the accelerometer (>1500. counts/min), the majority (68%) of children spent more than 60. min in moderate to vigorous physical activity (MVPA) during the school day. Overall, time spent in MVPA was three times greater during break times compared to classroom time, with no apparent differences by class/age or gender. Total accelerometer counts and pedometer steps were correlated (r= 0.60). One minute of MVPA was equivalent to 45 (95% CI 20 to 70) pedometer steps. Conclusion: The pedometer, a practical, relatively inexpensive tool, is suitable for the identification of less active children and has some utility to assess the relative intensity of activities in the context of a school day. © 2011 Sports Medicine Australia.


Rush E.,Auckland University of Technology | Reed P.W.,University of Auckland | McLennan S.,Sport Waikato | Coppinger T.,Auckland University of Technology | And 2 more authors.
European Journal of Clinical Nutrition | Year: 2012

Background/Objectives:In 2002, the prevalence of overweight and obesity, defined by body mass index (BMI), was higher in New Zealand Mori (40%) and Pacific (60%) than in European (24%) children; however, this does not take into account interethnic differences in body composition. This study compared trajectories of anthropometric indices from 2004 to 2006 among 5-and 10-year-old Mori and European children.Subjects/Methods:In 2004 and then in 2006, 1244 children (639 boys and 605 girls) aged 5 and 10 years had height, weight and fat-free mass (FFM) by bioimpedance measured to derive measures of fat mass (FM), percentage body fat (%BF), FM index (FMI, FM/height 2), FFM index (FFMI, FFM/height 2), and s.d. scores for BMI and %BF and BMI categories by International Obesity Task Force criteria.Results:Body composition and growth in Mori children is different from European children. Over 2 years, the BMI and %BF s.d. scores in both 5-and 10-year-old cohorts increased more in Mori children than in European children. The prevalence of overweight and obesity also increased within ethnicity and age group. The relative change of FMI and FFMI differed by age group, gender and ethnicity. In Mori girls, the magnitude of the changes between 10 and 12 years of age was most markedthe major contribution was from an increase in FMI. At 12 years, the mean %BF of Mori girls was 31.7% (95% confidence interval (CI): 30.1 and 33.3) compared with that of European girls (28.0%; 95% CI: 27.0 and 29.0).Conclusions:FM and FFM measures provide a more appropriate understanding of growth and body composition change in children than BMI, and vary with gender and ethnicity. Thus, FMI and FFMI should be tracked and compared among populations. © 2012 Macmillan Publishers Limited. All rights reserved.


Rush E.,Auckland University of Technology | Reed P.W.,University of Auckland | Simmons D.,University of Cambridge | Coppinger T.,Auckland University of Technology | And 2 more authors.
Journal of Paediatrics and Child Health | Year: 2013

Aim School-based interventions to tackle the rise in childhood overweight and obesity remain inconclusive and are often limited in their application to diverse populations. To inform and measure the effect of the implementation of a primary school-based longitudinal randomised controlled nutrition and activity intervention, Project Energize, baseline measures of body size and blood pressure were required. Methods This cross-sectional study stratified by age, sex, ethnicity, rurality and school socio-economic-status (school-SES) measured body mass index (BMI), percentage body fat (%BF), waist and resting blood pressure from 2752 5- and 10-year-old children (62% European, 31% Māori) representative of the Waikato region of New Zealand. Result Waikato children have a high prevalence of overweight and obesity that is linked with hypertension. Cardiovascular risk factors including raised blood pressure and hypertension, waist and arm circumference and percentage body fat (%BF) were more prevalent in 10-year-olds, lower school-SES and to some extent, urban living. In European children, BMI and waist circumference were similarly predictive of %BF, but for Māori children, waist circumference predicted %BF better than BMI. Conclusions A variety of stratified, baseline measurements is important when designing school-based interventions. In particular, waist circumference measures may be a more accurate predictor of %BF than BMI when determining measurement protocols that consider different ethnic groups and environments among children. The effect of targeted improvements of the school physical activity and nutrition environment on the rate of increase of weight, fatness and blood pressure in children should be examined. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).


Rush E.,Auckland University of Technology | Obolonkin V.,Auckland University of Technology | McLennan S.,Sport Waikato | Graham D.,Child Health | And 4 more authors.
Obesity Research and Clinical Practice | Year: 2014

Project Energize, a multicomponent through-school physical activity and nutrition programme, is delivered to all primary school children in the Waikato region the programme aim is to improve the overall health and reduce the rate of weight gain of all Waikato primary school children. An existing economic model was used to extrapolate the programme effects, initial costs, lifetime health treatment cost structures, quality-adjusted-life-years gained and increased life expectancy to the general and Māori child population of New Zealand. In March 2011, a sample of 2474 younger (7.58 ± 0.57 years, mean ± SD) and 2330 older (10.30 ± 0.51 years) children (36% Māori) attending Energize schools had body mass index measured and compared using mixed effect modelling with unEnergized comparison children from 2004 and 2006 from the same region. In 2011 the median body mass index reduction compared with the comparison younger children was -0.504 (90% CI -0.435 to -0.663) kg/m 2 and in the older children -0.551 (-0.456 to -0.789) kg/m 2. In 2010 there were 42,067 children attending Energize schools and in the same year NZ$1,891,175 was spent to deliver the programme; a cost of $44.96/child/year. Compared to the comparison children the increment in cost/quality-adjusted-life-year gained was $30,438 for the younger and $24,690 for the older children, and lower for Māori (younger $28,241, older $22,151) and for the middle socioeconomic status schools ($23,211, $17,891). Project Energize would improve quality and length of life and when compared with other obesity prevention programmes previously assessed with this model, it would be relatively cost-effective from the health treatment payer's perspective. © 2013 Asian Oceanian Association for the Study of Obesity.

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