ESPE Abstracts

Introduction: Childhood obesity is an international pandemic which affects 13% of Canadian youth, and is the leading cause of cardiovascular disease (CVD) in children. While the optimal approach to treat pediatric obesity remains elusive, comprehensive and intensive behavioral interventions which leverage the child’s living environment in order to promote improvements in healthy lifestyles appear promising. The CIRCUIT program (Centre Pédiatrique d’Intervention en Prévention et en Réadaptation Cardiovasculaires, Sainte-Justine Hospital University Center, Montreal, Canada) is an innovative lifestyle intervention program for youth aged 4–18 y at risk of CVD. The program consists of a personalized plan created by a clinical kinesiologist to increase physical activity and reduce sedentary behaviors by considering the specific needs and opportunities of each child within their living environment.

Objective: To assess changes in cardiometabolic health outcomes among 107 participants who completed the 2-year CIRCUIT intervention.

Methods: Children with at least one CVD risk factor were referred to the program by their health care professional. At baseline, 1-year and 2-year follow-up, we measured body mass index z-scores (zBMI), blood pressure z-scores (zBP), adiposity (%body fat and %trunk fat by Tanita), fasting blood glucose and lipid profile (TC, LDL, HDL, triglycerides), aerobic fitness (VO₂max) anaerobic fitness (5 m shuttle run test) and physical capacity (flexibility, push-ups, sit-ups, hand grip strength, leg power, balance and hand-eye coordination). Outcomes were analyzed using paired t-tests (for age and sex standardized zBMI and zBP) or multivariable mixed effect models, adjusted for age and sex, for other outcomes.

Results: Among the 107 participants (54 males), mean age was 10.9 years (S.D.=3.3). Both zBMI and diastolic zBP improved at years 1 and 2 compared to baseline: zBMI decreased by 0.21SD and 0.29SD, respectively (P<0.001); similarly, diastolic zBP decreased by 0.35SD and 0.42SD, respectively (P<0.001). No change in systolic zBP was observed. At year 1, participants significantly decreased %trunk fat (β=1.42%, 95%CI: 0.19–2.65) and improved aerobic fitness (β=2.20 ml/min.kg, 95%CI: 0.99–3.41), anaerobic fitness (β=0.68 s, 95%CI: 0.34–1.02), and physical capacity (push-ups, sit-ups, hand grip strength, leg power). Further improvements, albeit attenuated, were noted at year 2 for these indicators except %trunk fat and sit-ups. Lipid profile and fasting glucose (on average within normal range at baseline) did not significantly change during the intervention period.

Conclusion: CIRCUIT is a promising intervention for children at risk of CVD and is associated with many favorable effects on cardiometabolic health outcomes.