Nutr Res Pract.  2021 Aug;15(4):479-491. 10.4162/nrp.2021.15.4.479.

Effect of nutrition education and traditional game-based physical activity interventions, on lipid profile improvement in overweight and obese children in West Java Indonesia

• Yulia C
• Khomsan A
• Sukandar D
• Riyadi H

• KMID: 2518759
• DOI: http://doi.org/10.4162/nrp.2021.15.4.479

Abstract

BACKGROUND/OBJECTIVES
One ongoing effort to curtail dyslipidemia in school children is through lifestyle intervention. This study analyzes outcomes of the intervention of nutrition education and Javanese traditional game-based physical activity, on lipid profiles of overweight and obese children.
SUBJECTS/METHODS
The experimental study consisted of three steps: data collection (October to December 2016), intervention processes (January to March 2017), and final report preparation (April to May 2017). This was a split-plot block study, enrolling a total of 72 subjects. Traditional game intervention (12 meetings) and nutrition education (9 meetings) was carried out within 3 months with material related to obesity.
RESULTS
Our results showed no decrease in the levels of total cholesterol in the group receiving nutrition education (rise by 1.56 mg/dL), but when compared to subjects without intervention, total cholesterol levels experienced was increased. The group which did not receive physical activity showed increase in the total cholesterol, whereas the traditional game intervention group showed a decrease of 0.05 mg/dL total cholesterol at the end of the intervention. Nutrition education and physical activity interventions did not influence any reduction in the low-density lipoprotein cholesterol (LDL-C) levels, but rather showed a tendency to increase at the end of the intervention. However, the increase in LDL-c levels in the traditional game group was lower than in other intervention groups. Duncan's test indicated that the effect of nutrition education and physical activity interventions did not differ from the cut-off values of LDL-C and high-density lipoprotein cholesterol.
CONCLUSIONS
Total cholesterol and triglyceride levels in the traditional game group tended to decrease at the end of the intervention, but the results did not differ much from other intervention groups. We deduce that nutrition education and traditional game-based physical activity interventions are not capable of improving blood lipid profiles in overweight and obese children within 3 months. It is necessary to increase the time of physical activity intervention to maintain the lipid profile in another study.

Keyword

Health education; HDL-LDL; physical activity; primary school

Figure

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  Fig. 1 Galasin (A), sapintrong/luncat tinggi (B) and ucing kup (C) games.

Reference

1. PB Perkeni. Panduan Pengelolaan Dislipidemia di Indonesia - 2015. Jakarta: PB Perkeni;2015.

2. Kemenkes. Riset Kesehatan Dasar 2013. Jakarta: Kemenkes;2013.

3. Ribas SA, Santana da Silva LC. Anthropometric indices: predictors of dyslipidemia in children and adolescents from north of Brazil. Nutr Hosp. 2012; 27:1228–1235. PMID: 23165566.

4. Meral G, Uslu A, Yozgatli AU, Akçay F. Association of body mass index and lipid profiles in children. Open J Pediatr. 2015; 5:141–146.

5. Yulia C, Khomsan A, Riyadi H, Sukandar D. Nutritional status, lipid profile and blood pressure among primary schoolchildren in Urban West Java, Indonesia. Pak J Nutr. 2017; 16:770–775.

6. Fodor JG, Frohlich JJ, Genest JJ. McPherson PR. Recommendations for the management and treatment of dyslipidemia. Report of the Working Group on Hypercholesterolemia and Other Dyslipidemias. CMAJ. 2000; 162:1441–1447. PMID: 10834048.

7. Chiu S, Williams PT, Krauss RM. Effects of a very high saturated fat diet on LDL particles in adults with atherogenic dyslipidemia: a randomized controlled trial. PLoS One. 2017; 12:e0170664. PMID: 28166253.

8. Antunes Bde M, Monteiro PA, Silveira LS, Brunholi Cde C, Lira FS, Freitas Júnior IF. Macronutrient intake is correlated with dyslipidemia and low-grade inflammation in childhood obesity but mostly in male obese. Nutr Hosp. 2015; 32:997–1003. PMID: 26319811.

9. Yulia C. Intervensi pendidikan gizi dan aktivitas fisik permainan tradisional untuk mengatasi masalah overweight dan obesitas pada anak sekolah dasar [dissertation]. Bogor: Institut Pertanian Bogor;2017.

10. Yulia C, Khomsan A, Riyadi H, Sukandar D. Nutritional status, physical activity, and sedentary activity of school children in urban area, West Java, Indonesia. J Gizi Pangan. 2018; 13:123–130.

11. Brugnara L, Murillo S, Novials A, Rojo-Martínez G, Soriguer F, Goday A, Calle-Pascual A, Castaño L, Gaztambide S, Valdés S, et al. Low physical activity and its association with diabetes and other cardiovascular risk factors: a nationwide, population-based study. PLoS One. 2016; 11:e0160959. PMID: 27532610.

12. Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia. Pedoman Tata Laksana Dislipidemia. Jakarta: Centra Communications;2013.

13. Abdallah AM, Zainad B, Shahat MA. Nutrition Education intervention in dyslipidemic children and adolescent with insulin-dependent diabetes mellitus (IDDM). Egypt J Hosp Med. 2008; 33:639–649.

14. American College of Sports Medicine. Guideline for Exercise Testing and Prescription. Philadelphia (PA): Lippincott William & Wilkins;2014.

15. Zlatohlávek L, Hubáček JA, Vrablík M, Pejšová H, Lánská V, Češka R. The impact of physical activity and dietary measures on the biochemical and anthropometric parameters in obese children. Is there any genetic predisposition? Cent Eur J Public Health. 2015; 23(Suppl):S62–S66. PMID: 26849546.

16. Li XH, Lin S, Guo H, Huang Y, Wu L, Zhang Z, Ma J, Wang HJ. Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC Public Health. 2014; 14:1282. PMID: 25510313.

17. Mattjik AA, Sumertajaya M. Perancangan Percobaan Dengan Aplikasi SAS Dan MINITAB Jilid 1. Bogor: IPB Press;2002.

18. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization;2010.

19. World Cancer Research Fund. American Institute for Cancer Research. Continuous update project report. Food, nutrition, physical activity, and the prevention of ovarian cancer [Internet]. London: World Cancer Research Fund;2014. cited 2018 December 10. Available from: http://www.dietandcancerreport.org/cup/cup_resources.php.

20. Yoon JM. Dyslipidemia in children and adolescents: when and how to diagnose and treat? Pediatr Gastroenterol Hepatol Nutr. 2014; 17:85–92. PMID: 25061583.

21. National Heart Foundation of Australia. Guideline for the Diagnosis and Management of Hypertension in Adults. Melbourne: National Heart Foundation of Australia;2016.

22. Hengkengbala G, Polii H, Wungwouw HIS. Pengaruh latihan fisik aerobik terhadap kolesterol high density lipoprotein (HDL) pria dengan berat badan lebih (overweight). eBM. 2013; 1:284–290.

23. Paes ST, Marins JC, Andreazzi AE. Metabolic effects of exercise on childhood obesity: a current view. Rev Paul Pediatr. 2015; 33:122–129. PMID: 25662015.

24. Hardy OT, Wiechab J, Kimb A, Salasc C, Bricenoc R, Moodyc K, Beckerd J. Effects of a Multicomponent Wellness Intervention on Dyslipidemia in an Overweight Adolescent Population. Boston (MA): University of Massachusetts Medical School;2011.