Children, Vol. 12, Pages 1352: A Combined Physical Activity and Multi-Micronutrient Supplementation Intervention in South African Primary Schools: Effects on Physical Activity, Fitness, and Cardiovascular Disease Risk Factors

Children doi: 10.3390/children12101352

Authors:
Siphesihle Nqweniso
Cheryl Walter
Rosa du Randt
Larissa Adams
Johanna Beckmann
Danielle Dolley
Nandi Joubert
Kurt Z. Long
Ivan Müller
Uwe Pühse
Harald Seelig
Peter Steinmann
Jürg Utzinger
Christin Lang
Markus Gerber

Background/Objectives: Declining physical activity (PA) and cardiorespiratory fitness (CRF) in children are global public health concerns, particularly in populations experiencing urbanization and economic transition. This study investigated the effects of a school-based intervention on PA, CRF, and cardiovascular disease (CVD) risk factors in children aged 6–12 years from marginalized communities in Gqeberha, South Africa. Methods: A cluster randomized controlled trial was conducted in four schools, with participants randomly assigned to one of the following four arms: (i) PA and multi-micronutrient supplementation (MMNS); (ii) PA and placebo; (iii) MMNS; or (iv) placebo (control). A total of 1151 children were assessed at baseline (T1), 1003 at post-intervention (T2), and 549 at follow-up (T3). PA was measured using accelerometers. Secondary outcomes included CRF (20 m shuttle-run) and CVD risk factors (i.e., anthropometry, blood pressure, glycated hemoglobin [HbA1c], and lipid profile). Mixed linear models adjusted for baseline characteristics were used. Results: None of the interventions significantly improved daily PA. From T1 to T2, the MMNS arm significantly increased CRF, while PA + MMNS reduced HbA1c. However, MMNS alone increased triglycerides, and PA + placebo increased low-density lipoprotein (LDL). From post-intervention (T2) to follow-up (T3), the MMNS arms significantly reduced blood pressure. Yet, the PA + MMNS arm increased body fat percentage and decreased high-density lipoprotein (HDL). Conclusions: While MMNS showed promise for improving fitness and blood pressure and PA + MMNS reduced HbA1c, adverse metabolic changes emerged. The results should be interpreted with caution due to the short intervention span and COVID-19 disruptions during the second year of the intervention.

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Siphesihle Nqweniso www.mdpi.com