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Randomized Controlled Trial
. 2018 Sep 25;15(1):92.
doi: 10.1186/s12966-018-0727-8.

Strength exercises during physical education classes in secondary schools improve body composition: a cluster randomized controlled trial

G A Ten Hoor  1   2 , G M Rutten  3 , G J P Van Breukelen  4 , G Kok  5 , R A C Ruiter  5 , K Meijer  6 , S P J Kremers  3 , F J M Feron  7 , R Crutzen  8 , A M J W Schols  9 , G Plasqui  6
Affiliations
Randomized Controlled Trial

Strength exercises during physical education classes in secondary schools improve body composition: a cluster randomized controlled trial

G A Ten Hoor et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Metabolic health in people with obesity is determined by body composition. In this study, we examined the influence of a combined strength exercise and motivational programme -embedded in the school curriculum- on adolescents body composition and daily physical activity.

Methods: A total of 695 adolescents (11-15y) from nine Dutch secondary schools participated in a one year cluster randomised controlled trial (RCT). In the intervention schools, physical education teachers were instructed to spend 15-30 min of all physical education lessons (2× per week) on strength exercises. Monthly motivational lessons were given to stimulate students to be more physically active. Control schools followed their usual curriculum. The primary outcome measure was body composition assessed by the deuterium dilution technique. Daily physical activity and sedentary behaviour measured by accelerometry served as a secondary outcome.

Results: After 1 year, a 1.6% fat mass difference was found in favour of the intervention group (p = .007). This reflected a 0.9 kg difference in fat free mass (intervention>control; p = .041) and 0.7 kg difference in fat mass (intervention<control; p = .054). Daily physical activity decreased from baseline to posttest in both groups, but less so in the intervention group (p = .049). After 1 year, a difference of 0.4% was found for moderate to vigorous physical activities in favour of the intervention group (p = .046). No differences in sedentary behaviour, or light physical activity were found between groups.

Conclusion: In 11-15 year olds, the combination of strength exercises plus motivational lessons contributed to an improvement in body composition and a smaller decrease in physical activity level. TRIAL REGISTRATION ID: ( NTR5676 - retrospectively registered 8 February 2016; enrolment of first participant: 2 March 2015).

Keywords: Body composition; Cluster randomised controlled trial; Motivation; Overweight and obesity; Physical activity; School-based; Strength exercises.

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Conflict of interest statement

Ethics approval and consent to participate

Following consent from the schools, parents and their children were informed about the intervention and related outcome measurements, and told they could refuse participation at any time. The study methods and consent procedure were approved by the Ethical Review Committee of the Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands [ERCPN-05-09-2012A1].

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection
Fig. 2
Fig. 2
Effect of the intervention on body composition. Body composition scores as measured by the deuterium dilution technique: Observed data, possibly biased by missingness (left panel), and predicted means based on the mixed regression (right panel). Note that observed means and SDs can be biased by ignoring both the clustering and dropout/missingness. The predicted means based on mixed regression are the best estimates of the time courses of all outcomes
Fig. 3
Fig. 3
Effect of the intervention on physical activity. Physical activity measured by accelerometers: Observed data, possibly biased by missingness (left panel), and predicted means based on the mixed regression (right panel). Note that observed means and SDs can be biased by ignoring both the clustering and dropout/missingness. The predicted means based on mixed regression are the best estimates of the time courses of all outcomes
See this image and copyright information in PMC

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