published_or_final_version / abstract / toc / Paediatrics and Adolescent Medicine / Doctoral / Doctor of Philosophy

The dietary outcomes of a school-based heart health promotion program in a low-income, multiethnic, inner-city neighbourhood of Montreal, Canada, were investigated. Eight intervention schools and sixteen control schools participated in the project from 1993 to 1997. Twenty-four hour recall data, as well as data on anthropometric and sociodemographic characteristics, were collected from a subsample of all students in grades 4--6 (aged 9--12 years) at baseline (n = 498), after two years (n = 491), and after four years (n = 347). There were no significant differ in nutrient intakes between 1995 and 1997, so these data were combined for analyses. Compared to students in control schools, students exposed to the program had a significantly increased mean intake of vitamin C per 1000 kcal (4184 kJ) (p = 0.0013). Compared to students in designated intervention schools at baseline, mean make of vitamin C per 1000 kcal was significantly increased (p = 0.002) and mean folate intake was significantly domed (p = 0.0058) in exposed to the program. When the intervention group was restricted to only those students who had received 16 hours or more of program exposure (n = 113), there were no significant differences in any nutrient intakes when compared to control students or students in intervention schools at baseline. This program was unsuccessful in changing nutrient intakes of school-aged children, contributing further evidence that conscious dietary change is difficult to achieve by means of a school-based program with a reasonable number of curriculum hours.

M.A. / This research has been undertaken against the background of Coronary Heart Disease (CHD) as being one of the major causes of death in South Africa. An indepth literature study made it evident that, despite intervention programs that have been successful in reducing the CHD rate, it still remains a number one killer. This could possibly be attributed to CHD prevention programs that historically have focused on biologically related lifestyle factors, and neglected a very important adjuvant risk factor for CHD, namely Type A behaviour. The aim of this dissertation was to study the viability of changing Type A behaviour in childhood through group sport participation in view of the fact that the Type A behaviour pattern (TABP) already present in childhood, has to date not been addressed as a primary preventative possibility. Group sport was chosen as an intervention by nature of it being co-operative, socially supportive and successful in the improvement of a number of relevant factors. Sport has also been demonstrated to be an appropriate outlet for aggressive impulses apparent in Type A behaviour. Twenty subjects participated in the intervention program that took place over a period of eight weeks. A second group of ten Type A subjects served as a no-treatment control group. The intervention was carried out at a primary school in Johannesburg. The results of the study revealed that Type A behaviour (TAB) was not reduced, save for the impatience component, by participation in group sport. Aggressive potential and anxiety in the Type A child, were also not reduced. It is concluded that the intervention of group sport in the reduction of TAB was not successful, and that future studies should investigate an intervention that is successful for the reduction of the TABP in childhood.

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