ABC | Volume 112, Nº6, June 2019

Original Article The Olympic Experimental Gymnasium Program and its Association with the Prevalence of Cardiovascular Risk Factors in Adolescents: A Cross-Sectional Study Carlos Scherr, 1 Lucas Helal, 2,4, 5 Filipe Ferrari, 2,4, 6 Luciano Juaçaba Belém, 3 Leonardo Correa Castro Fabiano, 1 Ludmila Talita Pinheiro, 1 Ricardo Stein 2,4,6,7, 8 Fundação Pró-Coração, 1 Rio de Janeiro, RJ – Brazil Universidade Federal do Rio Grande do Sul, 2 Porto Alegre, RS – Brazil Instituto Nacional do Coração, 3 Rio de Janeiro, RJ – Brazil Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares - Faculdade de Medicina - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, 4 Porto Alegre, RS – Brazil Laboratório de Fisiopatologia do Exercício (LaFiEx) do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, 5 Porto Alegre, RS – Brazil Grupo de Pesquisa em Cardiologia do Exercício (CardioEx) - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, 6 Porto Alegre, RS – Brazil Divisão de Medicina Interna - Hospital de Clínicas de Porto Alegre, 7 Porto Alegre, RS – Brazil Vitta Centro de Bem-Estar Físico, 8 Porto Alegre, RS – Brazil Mailing Address: Ricardo Stein • Rua João Caetano 20, apt 402. Postal Code 90470-260, Porto Alegre, RS – Brazil E-mail: rstein@cardiol.br Manuscript received August 23, 2018, revised manuscript October 03, 2018, accepted October 10, 2018 DOI: 10.5935/abc.20190067 Abstract Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Physical activity (PA) and appropriate diet, if adopted in childhood and adolescence, may reduce the CVD burden in later life. The Olympic Experimental Gymnasium (OEG) project was implemented to increase the PA levels of students by means of regular physical exercise and healthy eating habits. Objectives: To estimate and compare the prevalence of CVD risk factors in OEG schools versus regular schools (RSch) and to examine associations between the school environment and CVD risk factors. Methods: In this cross-sectional study with a comparator group, adolescents aged 12-13 years attending three OEG schools (n = 719) and three RSch (n = 394) were evaluated after one year of the ongoing program to estimate the prevalence of overweight, pre-hypertension/hypertension, altered glycemia, and lipid profile. An α level of 0.05 was set for statistical analysis. Results: RSch students had higher odds to have high blood pressure (OR 1.86, 1.36–2.54) and to be overweight (OR 1.49, 1.13–1.98) than OEG students. Glucose levels were not altered in most cases regardless of school type, and no differences were found in lipid profile. In the sensitivity analysis stratified by gender, girls from RSch were more likely to have high body mass index than boys. Conclusions: Exposure of adolescents to the OEG policies was positively associated with an important reduction in CVD risk factors, including high blood pressure and overweight. (Arq Bras Cardiol. 2019; 112(6):775-781) Keywords: Cardiovascular Diseases/mortality; Hypertension; Overweight; Dyslipidemias; Exercise; Life Style; Child; Adolescent; Diet. Introduction The attributable fraction of deaths due to physical inactivity can reach values around five million persons in the world. 1 Among adolescents, the prevalence of a sedentary lifestyle is also high. The Study of Cardiovascular Risks in Adolescents (ERICA) found a frequency of 54% of physical inactivity, which was more prevalent in girls. 2 The same study, when considering approximately 37,000 subjects, found that higher physical activity (PA) levels were independently associated with cardiovascular risk and with sedentary time. Interestingly, PA levels do not appear to change the association between body mass index (BMI) and cardiovascular risk. 3 Lifestyle patterns related to eating habits and PA practices established in the school environment can have potential consequences in adulthood. There is evidence that atherosclerosis begins in early life, progressing slowly into elderliness. 4 Scherr et al. 5 stated that it is important to consider the presence of cardiovascular risk factors in school children and that they may be related to lifestyle behaviors. Given that young people spend most of their time in school, the role of school programs cannot be underestimated. 6 In this respect, the most common ways to increase PA through the school system have been based on engagement in physical education classes and extracurricular physical activities. However, those are often underused. 7 School-based interventions to increase PA seem to be feasible as a strategy to reduce risk factors. Knox et al. 8 reported a decrease in cardiovascular risk factors among 115 participants aged 12 years-old after an 18-week intervention in a secondary school. Similarly, the ACORDA project found a reduction of obesity in adolescents after increasing PA levels with and without dietary advice after an 8-month interdisciplinary approach. 9 775