YMCA-Physical Activity and Nutrition
Condition: Childhood Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      There is an epidemic rise in the number of overweight and obese children. Overweight and
      obesity in children tracks into adulthood and carries elevated risk of chronic diseases such
      as seen with the metabolic syndrome (i.e., elevated glucose, hypertension, etc.). Low levels
      of PA and poor nutrition seem to be tightly linked to the increase in overweight and obesity.
      A minimal intervention that targets simple strategies for both sides of the energy balance
      equation may diminish overweight and obesity. Increasing moderate to vigorous physical
      activity and improving nutrition through snacks is a feasible, low cost strategy and can be
      disseminated nationally through the YMCA, if successful. Specifically, we expect that
      children receiving YMCA PAN will show smaller changes in BMI after 3 years of the
      intervention when compared to children not receiving YMCA PAN (i.e. standard, existing YMCA
      After School Program or "YMCA standard care").
    

Detailed description: 
      Our primary outcome measurement is body mass index (BMI) as this is now recommended by major
      health organizations as the preferred measure for the determination of obesity. All children
      at YMCA After School Programs will receive either YMCA-PAN or YMCA standard care; however, we
      will only follow children in grades kindergarten through second grade (K-2). For children in
      grades K-2, we will determine if 3 years of increased physical activity and snacks lower in
      energy and fat and higher in nutrient density will diminish gains in BMI. We have
      specifically targeted an increase of moderate to vigorous physical activity (MVPA) by 225
      minutes per week that is delivered in YMCA-PAN as this is a compromise between the
      recommendations suggested by Healthy People 2010 and the Institute of Medicine (IOM) and is
      administratively feasible within the existing YMCA After School Programs. YMCA-PAN would
      exceed the Healthy People 2010 guidelines and would provide the majority of PA for the IOM
      guidelines. Children would satisfy the IOM guidelines with just 15 additional minutes of MVPA
      accrued throughout the day in physical education class or free play. Finally, YMCA PAN would
      provide opportunity for PA at the very time the guidelines call "most critical:" the hours
      between 3 and 6pm when children have finished the school day and frequently are sedentary.
      For the nutritional component, we are targeting snacks, as snacks are part of the YMCA after
      school programs, snacks contribute significantly to 24 hour energy intake, children are
      increasingly in control of the snacks they consume, and we have previously diminished 24 hour
      energy intake and fat intake using snacks in elementary school children.

      We will provide this intervention using regular YMCA staff and use the regular time periods
      for PA that exist in the YMCA after school programs. We will also use the regular YMCA staff
      to provide snacks. Specifically, we expect that children receiving YMCA-PAN will show smaller
      changes in BMI after 3 years of the intervention when compared to children not receiving
      YMCA-PAN (i.e. standard, existing YMCA after school program or "YMCA standard care").
    

Intervention name(s): Healthy Snacks and Organized Physical Activity
Intervention type(s): Other
Intervention description(s): Children in the intervention group will receive healthy snacks, smaller portion sizes and participate in organized physical activity on a daily bais
Other intervention name(s): YMCA PAN; YMCA Standard Care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: YMCA; Preventative child obesity