PREVENTIVE MEDICINE 25, 432–441 (1996) ARTICLE NO. 0075 Cardiovascular Risk Factors among Children after a 2 1 - 2 -Year Intervention—The CATCH Study LARRY S. WEBBER, 1 STAVROULA K. OSGANIAN, 2 HENRY A. FELDMAN, 2 MARGARET WU, 3 THOMAS L. MCKENZIE, 4 MILTON NICHAMAN, 5 LESLIE A. LYTLE, 6 ELIZABETH EDMUNDSON, 7 JEFFREY CUTLER, 3 PHILIP R. NADER, 8 AND RUSSEL V. LUEPKER 6 1 Department of Biostatistics and Epidemiology, School of Public Health & Tropical Medicine, Tulane University, New Orleans, Louisiana 70112; 2 New England Research Institutes, Inc., Watertown, Massachusetts 02172; 3 Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892; 4 Department of Exercise and Nutritional Studies, San Diego State University, San Diego, California 92182; 5 Center for Health Promotion Research and Development, University of Texas Health Science Center, School of Public Health, Houston, Texas 77225; 6 Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota 55454; 7 Department of Kinesiology and Health Education, The University of Texas, Austin, Texas 78712; and 8 Department of Pediatrics, Community Pediatrics Division, University of California, San Diego, La Jolla, California 92093 INTRODUCTION Background. Cardiovascular risk factors and related behaviors begin during youth. Prevention efforts have become a national priority, Methods. As part of the Child and Adolescent Trial and logically, the promotion of healthful behaviors for Cardiovascular Health, 4,019 children from four must begin in childhood 1–3 since it has been established states and representing multiple ethnic groups were that atherosclerosis begins during youth. 4,5 Studies measured for selected risk factors both at baseline and have shown that anatomic changes in the aorta, coro- after 2 1 2 years of intervention. Common protocols were nary arteries, and kidneys of youth and young adults, used for both examinations at the four sites. are related to risk factor levels during childhood. 6–9 Results. Overall, changes in obesity, blood pres- Evidence also exists that levels of blood pressure, obe- sure, and serum lipids in the intervention group, sity, and serum lipids and lipoproteins track from child- compared with the control group, were not statisti- hood to young adulthood. 10–15 Promoting healthy life- cally significant. Total cholesterol, the primary phys- styles during childhood, therefore, has become the fo- iologic outcome measure, decreased by 1.3 mg/dl over time in the intervention group and by 0.9 mg/dl cus of community studies as one approach for (P ú 0.05) in the control group. Different risk factor preventing the onset of cardiovascular disease. 16–18 patterns for boys and girls and among three ethnic The Child and Adolescent Trial for Cardiovascular groups were noted. Health (CATCH) was a National Heart, Lung, and Conclusions. Although the school-based program Blood Institute-sponsored multicenter, school-based effected significant institutional changes in food ser- intervention study promoting healthy eating, physical vice and physical education class and although the activity, and tobacco non-use by elementary school chil- children made significant changes in eating and dren. Both behavioral and risk factor goals were identi- physical activity behaviors, these did not translate fied. The primary physiologic goal was to reduce serum to significant changes in risk factors at these ages. total cholesterol levels. Behavioral goals included re- These behavioral changes, however, if sustained into duction of dietary fat (total, saturated) and sodium in- adulthood, have the potential to influence cardiovas- take, increased physical activity, and prevention of the cular risk reduction.  1996 Academic Press, Inc. onset of smoking. The study began in 1991 with all Key words: risk factors; youth; school health promo- intervention activities completed by Spring 1994. The tion; ethnic groups; lipids; blood pressure; obesity. study cohort will be followed until 1997. The objectives, rationale, and main results for the study have been presented elsewhere. 19–24 The baseline (preintervention) and follow-up (postin- This research was supported by funds from the National Heart, Lung, and Blood Institute of the U.S. Public Health Service: U01- tervention) examinations conducted at the school sites HL-39880, U01-HL-39906, U01-HL-39852, U01-HL-39927, and U01- included measurement of risk factors. 21 This article HL-39870. Address correspondence and reprint requests to Larry S. presents results for selected cardiovascular risk factors Webber, Ph.D., Tulane School of Public Health & Tropical Medicine, and other physiologic measures: anthropometry, blood 1501 Canal Street, Room 1007, New Orleans, LA 70112-2824. Fax: (504) 585-7194. pressure and heart rate, and serum lipid, lipoprotein, 432 0091-7435/96 $18.00 Copyright  1996 by Academic Press, Inc. All rights of reproduction in any form reserved.