Cardiovascular disease risk factors, weight, and the strategies to tackle future risk in school aged children

Background: Cardiovascular disease (CVD) can have its beginnings in childhood, especially if the child is overweight. Without intervention, increased risk factors in childhood track in adulthood, putting the individual at increased risk for early cardiovascular morbidity and mortality. As a result, childhood health outcomes are an increasingly popular area for health research. However, little progress has been made on the most effective way to enable children to lead healthy lives. Methods: This thesis incorporated five studies. Firstly, a systematic review and meta-analysis of 63 papers involving nearly 50,000 school children examined the relationship between body mass index (BMI) categories and CVD risk factors. Secondly, a focus group study with 46 students to discuss their knowledge and attitudes towards health, health behaviours and health education. Thirdly, a focus group study with six mothers to discuss screening weight in childhood, and their perceptions of childhood health and health education. Fourthly, a component analysis to establish the characteristics of nine successful educational interventions on children’s health. Finally, a pilot intervention and feasibility study involving 314 students. Results: Overweight and obese BMI categories were associated with substantial increases in CVD risk factors measured and that the association with obesity was greater than that with being overweight. The focus group studies found that the depth of knowledge and the perceived depth of knowledge that participants had about CVD risk factors affected their attitudes and behaviours, although not in the same way. The pilot intervention was deemed feasible. A significant change was brought about in the students’ knowledge of cardiovascular disease and raised their self-efficacy towards ensuring the health of their hearts. Conclusion: The effect of obesity on cardiovascular risk factors is greater than that of being overweight. Additionally, studies in this area are hindered by inconsistent measurements and definitions of the BMI categories. Secondly, both parents and children need to be equipped with deep knowledge and understanding to facilitate attitude and behaviour change towards healthy living. Finally, the pilot intervention should be trialled in a randomised, controlled trial.