Pediatric Cardiology

, Volume 29, Issue 5, pp 940–945 | Cite as

A School-Based Health Education Program Can Improve Cholesterol Values for Middle School Students

  • T. B. Cotts
  • C. S. Goldberg
  • L. M. Palma Davis
  • J. E. DuRussel-Weston
  • S. M. Aaronson
  • K. Lin
  • K. A. Eagle
Original Article



This prospective study aimed to measure the impact of a school-based multidisciplinary education program on risk factors for atherosclerosis in sixth-grade students.


A prospective study was performed in which patients served as their own controls. Healthy sixth-grade students from three middle schools in a city of approximately 100,000 were exposed to an educational program promoting healthful habits through behavioral and environmental change. Risk factors including body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), cholesterol panel, and random blood glucose were measured before program initiation, then 5 months afterward.


Of 711 sixth-graders at three middle schools, 287 (47% boys; mean age, 11.5 ± 0.37 years) consented to participate in the study. The mean total cholesterol value decreased from 169 ± 26 to 154 ± 26 mg/dl (p < 0.0001). The low-density lipoprotein (LDL) cholesterol value decreased from 86 ± 25 to 84 ± 23 mg/dl (p = 0.01), and the high-density lipoprotein (HDL) cholesterol value decreased from 56 ± 13 to 50 ± 13 mg/dl (p < 0.0001). The random glucose value decreased from 96 ± 13 to 93 ± 15 mm/dl (p = 0.01). The mean SBP did not change, showing 109 ± 12.5 mmHg before the program and 108 ± 11.5 mmHg afterward. The DBP decreased from 63.6 ± 8.6 to 62.3 ± 7.8 mmHg (p = 0.01).


The Project Healthy Schools program is feasible and appears to be effective. The results showed significant improvement in risk factors for early atherosclerosis among sixth-grade students including total cholesterol, LDL cholesterol, random glucose levels, and diastolic blood pressure. Further study with a larger group and a longer follow-up period would be valuable.


Therosclerosis Cholesterol Low-density lipoprotein High-density lipoprotein Random glucose levels 



The authors thank the Ann Arbor School Board for their cooperation and participation in this research. The authors also acknowledge the support of the Ann Arbor Community Foundation, the Southeast Michigan Community Foundation, and the Borders Group for their support. Finally, the authors acknowledge Theresa Han-Markey, MS, RD, and Anita Sandretto, PhD, for their role in the development of Project Healthy Schools, as well as Bruce Rogers for database support.


  1. 1.
    Anderson RN, Smith BL (2005) Deaths: leading causes for 2002. National Vital Statistics Reports, vol 53 no. 17. National Center for Health Statistics, Hyattsville, Maryland, p 7Google Scholar
  2. 2.
    Baranowski T, Cullen KW, Nicklas T et al (2002) School-based obesity prevention: a blueprint for taming the epidemic. Am J Health Behav 26:486–493PubMedGoogle Scholar
  3. 3.
    Bautista-Castano I, Doreste J, Serra-Majem L (2004) Effectiveness of interventions in the prevention of childhood obesity. Eur J Epidemiol 19:617–622PubMedCrossRefGoogle Scholar
  4. 4.
    Berenson GS, Srinivasan SR, Bao W et al (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med 338:1650–1656PubMedCrossRefGoogle Scholar
  5. 5.
    Flores R (1995) Dance for health: improving fitness in African American and Hispanic adolescents. Public Health Rep 110:189–193PubMedGoogle Scholar
  6. 6.
    Ford ES, Ajani UA, Croft JB et al (2007) Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med 356:2388–2398PubMedCrossRefGoogle Scholar
  7. 7.
    Gortmaker SL, Peterson K, Wiecha J et al (1999) Reducing obesity via a school-based interdisciplinary intervention among youth. Arch Pedatr Adolesc Med 154:409–418Google Scholar
  8. 8.
    Hoelscher DM, Day RS, Kelder SH, Ward JL (2003) Reproducibility and validity of the secondary-level school-based nutrition monitoring student questionnaire. J Am Diet Assoc 103:186–194PubMedCrossRefGoogle Scholar
  9. 9.
    James J, Thomas P, Cavan D, Kerr D (2004) Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomized controlled trial. BMJ 328:1237PubMedCrossRefGoogle Scholar
  10. 10.
    Joliffe D (2004) Extent of overweight among U.S. children and adolescents from 1971 to 2000. Int J Obes Relat Metab Disord 28:4–9CrossRefGoogle Scholar
  11. 11.
    Joliffe CJ, Janssen I (2006) Distribution of lipoproteins by age and gender in adolescents. Circulation 114:1056–1062CrossRefGoogle Scholar
  12. 12.
    Lauer RM, Clark WR (1988) Childhood risk factors for high adult pressure: the Muscatine study. Pediatrics 82:309–318PubMedGoogle Scholar
  13. 13.
    Lauer RM, Lee J, Clarke WR (1988) Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. Pediatrics 82:309–318PubMedGoogle Scholar
  14. 14.
    Luepker RV, Perry CL, McKinlay SM et al (1996) Outcomes of a field trial to improve children’s dietary patterns and physical activity. the child and adolescent trial for cardiovascular health. CATCH collaborative group. JAMA 275:768–776PubMedCrossRefGoogle Scholar
  15. 15.
    Mo-suwan L, Pongrapai S, Junjuna C, Puetpaiboon A (1998) Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children. Am J Clin Nutr 68:1006–1011PubMedGoogle Scholar
  16. 16.
    Mueller MJ, Asbeck I, Mast M et al 2001 Prevention of obesity—more than an intention: concept and first results of the Kiel Obesity Preventions Study (KOPS). Int J Obes Relat Metab Disord 25(Suppl 1):S66–S74CrossRefGoogle Scholar
  17. 17.
    National Center for Health Statistics (2005) Health, United States, Hyattsville, Maryland, p 299Google Scholar
  18. 18.
    National Heart, Lung, Blood Institute (2007) Morbidity and mortality: chart book on cardiovascular and lung diseases. National Institutes of Health, Bethesda, MD, p 7Google Scholar
  19. 19.
    Neumark-Sztainer D, Story M, Hannan PJ, Rex J (2003) New moves: a school-based obesity prevention program for adolescent girls. Prev Med 37:41–51PubMedCrossRefGoogle Scholar
  20. 20.
    Potkka KV, Viikari JS, Taimela S et al (1994) Tracking and predictiveness of serum lipid and lipoprotein measurements in childhood: a 12-year follow-up: the cardiovascular risk in young finns study. Am J Epidemiol 140:1096–1110Google Scholar
  21. 21.
    Robinson TN (1999) Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA 282:1561–1567PubMedCrossRefGoogle Scholar
  22. 22.
    Rosamond W, Flegal K, Friday G et al (2007) Heart disease and stroke statistics—2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation1 15:e69–e171CrossRefGoogle Scholar
  23. 23.
    Rosenbloom AL, Joe JR, Young RS, Winter WE (1999) Emerging epidemic of type 2 diabetes in youth. Diabetes Care 22:345–354PubMedCrossRefGoogle Scholar
  24. 24.
    Sallis JF, McKenzie TL, Conway TL et al (2003) Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. Am J Prev Med 24:209–217PubMedCrossRefGoogle Scholar
  25. 25.
    Wang Y, Tussing L, Odoms-Young A et al (2006) Obesity prevention in low socioeconomic status urban African American Adolescents: study design and preliminary findings of the HEALTH-KIDS Study. Eur J Clin Nutr 60:92–103PubMedCrossRefGoogle Scholar
  26. 26.
    Webber LS, Srinivasan SR, Wattigney WA, Berenson GS (1991) Tracking of serum lipids and lipoproteins from childhood to adulthood: the Bogalusa Heart Study. Am J Epidemiol 133:884–889PubMedGoogle Scholar
  27. 27.
    Whitaker RC, Wright JA, Pepe MS et al (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337:869–875PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • T. B. Cotts
    • 1
  • C. S. Goldberg
    • 1
  • L. M. Palma Davis
    • 1
  • J. E. DuRussel-Weston
    • 1
  • S. M. Aaronson
    • 1
  • K. Lin
    • 1
  • K. A. Eagle
    • 1
  1. 1.University of Michigan Health SystemAnn ArborUSA

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