Physical Education Can Improve Insulin Resistance: The LOOK Randomized Cluster Trial

• Published in: Medicine and science in sports and exercise 2013-10, Vol.45 (10), p.1956-1964
• Main Authors: TELFORD, RICHARD DAVID, CUNNINGHAM, ROSS B., TELFORD, ROHAN M., DALY, ROBIN M., OLIVE, LISA S., ABHAYARATNA, WALTER P.
• Format: Article
• Language: English
• Subjects: Adiposity; Australia; Biological and medical sciences; Blood Glucose - metabolism; Child; Exercise - physiology; Female; Fundamental and applied biological sciences. Psychology; Homeostasis; Human physiology applied to population studies and life conditions. Human ecophysiology; Humans; Insulin - blood; Insulin Resistance; Male; Medical sciences; Physical Education and Training - methods; Space life sciences; Suburban Population; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
• ISSN: 0195-9131; 1530-0315
• DOI: 10.1249/MSS.0b013e318293b1ee

PURPOSEAs impaired glucose metabolism may arise progressively during childhood, we sought to determine whether the introduction of specialist-taught school physical education (PE) based on sound educational principles could improve insulin resistance (IR) in elementary school children. METHODSIn this 4-yr cluster-randomized intervention study, participants were 367 boys and 341 girls (mean age = 8.1 yr, SD = 0.35) initially in grade 2 in 29 elementary schools situated in suburbs of similar socioeconomic status. In 13 schools, 100 min·wk of PE, usually conducted by general classroom teachers, was replaced with two classes per week taught by visiting specialist PE teachers; the remaining schools formed the control group. Teacher and pupil behavior were recorded, and measurements in grades 2, 4, and 6 included fasting blood glucose and insulin to calculate the homeostatic model of IR, percent body fat, physical activity, fitness, and pubertal development. RESULTSOn average, the intervention PE classes included more fitness work than the control PE classes (7 vs 1 min, P < 0.001) and more moderate physical activity (17 vs 10 min, P < 0.001). With no differences at baseline, by grade 6, the intervention had lowered IR by 14% (95% confidence interval = 1%–31%) in the boys and by 9% (95% confidence interval = 5%–26%) in the girls, and the percentage of children with IR greater than 3, a cutoff point for metabolic risk, was lower in the intervention than the control group (combined, 22% vs 31%, P = 0.03; boys, 12% vs 21%, P = 0.06; girls, 32% vs 40%, P = 0.05). CONCLUSIONSSpecialist-taught primary school PE improved IR in community-based children, thereby offering a primordial preventative strategy that could be coordinated widely although a school-based approach.