| Abstract |
Coronary Heart disease is the leading cause of death in the Western World today including Greece. However, while death for Coronary heart disease can occur instantly the disease has its roots set in childhood and from this age and onwords it seems to develop slowly and silendly. Certain socio-economic and genetic factors derermine the onset and rapid development of atherosclerosis, but the prescence of certain daily habits such as smoking, physical activity and diet seem to be the principal determinant. Therefore, the prevention of coronary disease involves developing appropriate habits, in order to significantly minimize the chances of developing the disease. According to several recent studies, pupils and schools in general seem to serve as an ideal enviroment for intervention aiming programmes. In which these programmes aim to develop appropriate daily habits that will minimize the risk for coronary heart disease in adulthood. The aim of the present study is to implewent and evaluate a "Health and Nutrition Education" programme on primary school children. The intervention group consisted of the total number of pupils registered in first grade in the county of Heraklion and Rethimno, a long with their parents, while the control group consisted of pupils and parents from the country of Chania respectively. On the total population of the Intervention group the "Health and Nutrition Education" programme was applied for three years, while no intervention was applied on the control group. For the needs of the present study the health profile component of the "Know Your Body" school health promotion programme of the American Health Foundation, was adapted, modified and supplemented to suit our population. During school time, the organisation and responsibility of the programme was performed by the teachers and Physical Education instructors, who prior had attended the annual seminars that had been organised the research team. Parental intervention was performed directly by the research team at the annual meetings that were organized in schools during afternoon hours. The intervention that was applied to both the pupils and parents focused principally on issues such as, diet, physical activity and fitness. In order to evaluate the effectiveness of the intervention programme a randomly selected representative subsanple of 558 1st grade pupils from the intervention group (301 from urban areas and 257 from rural areas) and 419 from the control group (258 from urban and 161 from rural areas) along with their parents participated in a series of examinations during the period September 1992 - January 1993 before the commencement of the intervention programme. From the total number of examined students and parents of 1992, 290 of these students were randomly selected for the intervention group (144 from urban areas and 146 from rural areas), and 186 for the control group, (117 from urban areas and 69 from rural areas), while the parents were re-examined during the period September 1995 - January 1996, after the completion of the first 3 year of the intervention programme. At this stage the students were currently enrolled in fourth grade. The tests that the students underwent were: biochemical blood tests, anthropometric measures, measuring physical activity, a record of dietary habits with the use of a weelky questionnaire that reported the intake of food and weighted food for 3 days, a record of the level of physical activity and health knowledge in topics involving diet and physical activity. Parents were asked to complete a questionnaire that involved their daily habits, sush as diet, levels of physical activity, smoking, and health knowledge in respect to diet, physical activity, smoking, arterial pressure and oral hygeine. The effectiveness of the programme was evaluated on the basis of the changes that were found between the initial measures and the re-examined measures taken from the total parametres used, mentioned above. The data obtained from the students and parents who took part in both tests were used in the statistical analysis. The initial changes between the students of the two groups were balanced by applying dispersion analysis with covariants for the initial incluces, the sex, the education level of the parents and the re-examined body maps indicies. The measures of the statistical analysis indicated that the degree of improvement was significantly higher in the intervention group for the levels of total plasma cholestero, LDL-cholested, and factions of total plasma cholesterol towards HDL-cholesterol. According to the anthropometric measures, the degree of improvement was significantly higher in the intervention as opposed to the control group in height. However, the data obtained for the body maps measures and the suprailiar skin told for the intervention group indicated smaller increases in relation to the control group. In regards to dietary habits, the weelky questionnaire ........ showed no significant differences between the two groups. However the 3-day-weighted food method indicated that the intervention group consumed much less saturated fats, thus resulting in significant smaller increases. There was again a significantly higher rate of improvement in the intervention group for physical excercise, and for most of the physical fitness indicess, including cardiorespinatory fitness. Finally, both the children of the intervention group and their parents showed significant increases opposed to the control group regarding health knowledge scores. However, it must be noted that during statistical evaluation of the results, for most of the parameters used, it was found that among the students of the intervention group that showed to benefit the most were children whose parents had higher education levels. In conclusion, the positive results that were observed, over the 3-uear period of the intervention programme, are encouraging and underline the importance of implementingsuch programmes that could influence.
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