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Effect of deworming on physical fitness of school-aged children in Yunnan, China: a double-blind, randomized, placebo-controlled trial.

ABSTRACT: There is considerable debate on the health impacts of soil-transmitted helminth infections. We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan, People's Republic of China, where soil-transmitted helminthiasis is highly endemic.The double-blind, randomized, placebo-controlled trial was conducted between October 2011 and May 2012. Children, aged 9-12 years, were treated with either triple-dose albendazole or placebo, and monitored for 6 months post-treatment. The Kato-Katz and Baermann techniques were used for the diagnosis of soil-transmitted helminth infections. Physical fitness was assessed with a 20-m shuttle run test, where the maximum aerobic capacity within 1 min of exhaustive exercise (VO2 max estimate) and the number of 20-m laps completed were recorded. Physical strength was determined with grip strength and standing broad jump tests. Body height and weight, the sum of skinfolds, and hemoglobin levels were recorded as secondary outcomes.Children receiving triple-dose albendazole scored slightly higher in the primary and secondary outcomes than placebo recipients, but the difference lacked statistical significance. Trichuris trichiura-infected children had 1.6 ml kg(-1) min(-1) (P = 0.02) less increase in their VO2 max estimate and completed 4.6 (P = 0.04) fewer 20-m laps than at baseline compared to non-infected peers. Similar trends were detected in the VO2 max estimate and grip strength of children infected with hookworm and Ascaris lumbricoides, respectively. In addition, the increase in the VO2 max estimate from baseline was consistently higher in children with low-intensity T. trichiura and hookworm infections than in their peers with high-intensity infections of all soil-transmitted helminths (range: 1.9-2.1 ml kg(-1) min(-1); all P<0.05).We found no strong evidence for significant improvements in physical fitness and anthropometric indicators due to deworming over a 6-month follow-up period. However, the negative effect of T. trichiura infections on physical fitness warrants further investigation.

SUBMITTER: Yap P

PROVIDER: S-EPMC4091871 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Effect of deworming on physical fitness of school-aged children in Yunnan, China: a double-blind, randomized, placebo-controlled trial.

Yap Peiling P Wu Fang-Wei FW Du Zun-Wei ZW Hattendorf Jan J Chen Ran R Jiang Jin-Yong JY Kriemler Susi S Krauth Stefanie J SJ Zhou Xiao-Nong XN Utzinger Jürg J Steinmann Peter P

PLoS neglected tropical diseases 20140710 7

<h4>Background</h4>There is considerable debate on the health impacts of soil-transmitted helminth infections. We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan, People's Republic of China, where soil-transmitted helminthiasis is highly endemic.<h4>Methodology</h4>The double-blind, randomized, placebo-controlled trial was conducted between October 2011 and May 2012. Children, aged 9-12 years, were treated with either triple-dose albendazole or pla ...[more]

PMID: 25010608

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Project description:PurposeThis study was to present the 2016 prevalence estimates of Chinese school-aged children meeting physical fitness standards and to examine differences by sex and residence locales in children who did not meet fitness standards.MethodsWe conducted cross-sectional analyses of 171,991 children and adolescents (boy: 50.0%, Grades 1-12) who participated in the 2016 Physical Activity and Fitness in China-The Youth Study. The main outcomes were fitness measures, assessed by the 2014 revised Chinese National Student Physical Fitness Standard (CNSPFS), covering areas of aerobic capacity, upper body strength, flexibility, body mass index, abdominal strength, and trunk strength. Children's overall physical fitness performance was categorized, per CNSPFS standards, as excellent, good, pass, or no pass. Data on the prevalence of physical fitness categories and not meeting fitness standards (i.e., among children who received a "no pass" mark) were analyzed, through logistic regression, by sex (boy, girl) and residence locales (urban, rural) across 3 school grades (primary, junior middle, and junior high).ResultsIn 2016, 5.95% of Chinese children and adolescents achieved an "excellent" mark, 25.80% received a "good" rating, 59.90% received a "pass", and 8.35% received a "no pass". Overall, boys were more likely to not pass the fitness standards compared with girls (adjusted odds ratio (aOR)?=?1.710; 95% confidence interval (CI): 1.708-1.712) and children living in urban areas were more likely to not pass the standards than those living in rural areas (aOR?=?1.298; 95%CI: 1.296-1.299). Consistent patterns of not meeting fitness standards were also found by sex and residence locales across all 3 school grades.ConclusionIn the Chinese school-aged population, about 3 in 10 children achieved an "excellent" or "good" fitness standard in 2016, and about 8% of this population did not meet CNSPFS standards. Children living in urban areas were more likely to not meet minimum fitness performance levels, and boys in school were more likely to not meet minimum fitness performance levels than girls.

Project description:BackgroundMalaria and helminth infections are thought to negatively affect children's nutritional status and to impair their physical and cognitive development. Yet, the current evidence-base is weak. The purpose of this study was to determine the effect of deworming against soil-transmitted helminthiasis and schistosomiasis on children's physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic setting of Côte d'Ivoire.MethodsWe designed an intervention study with a 5-month follow-up among schoolchildren aged 5-14 years from Niablé, eastern Côte d'Ivoire. In late 2012, a baseline cross-sectional survey was conducted. Finger-prick blood, stool and urine samples were subjected to standardised, quality-controlled techniques for the diagnosis of Plasmodium spp., Schistosoma spp., soil-transmitted helminths and intestinal protozoa infections. Haemoglobin level was determined and anthropometric measurements were taken for appraisal of anaemia and nutritional status. Children underwent memory (digit span) and attention (code transmission) cognitive testing, and their physical fitness and strength were determined (20 m shuttle run, standing broad jump and grip strength test). All children were treated with albendazole (against soil-transmitted helminthiasis) and praziquantel (against schistosomiasis) after the baseline cross-sectional survey and again 2 months later. Five months after the initial deworming, the same battery of clinical, cognitive and physical fitness tests was performed on the same children.ResultsLower scores in strength tests were significantly associated with children with harbouring nutritional deficiencies. Surprisingly, boys infected with Schistosoma mansoni achieved longer jumping distances than their non-infected counterparts. Light-intensity infection with S. mansoni was associated with slightly better aerobic capacity. Deworming showed no effect on haemoglobin levels and anaemia, but children with moderate- to heavy-intensity Schistosoma infection at baseline gained weight more pronouncedly than non-infected children. Interestingly, children with soil-transmitted helminth or Schistosoma infection at baseline performed significantly better in the sustained attention test than their non-infected counterparts at the 5-month follow-up.ConclusionsThis study revealed conflicting results regarding clinical parameters and cognitive behaviour of children after two rounds of deworming. We speculate that potential beneficial effects of deworming are likely to be undermined in areas where malaria is co-endemic and nutritional deficiencies are widespread.

Project description:BACKGROUND:Prenatal alcohol exposure results in a broad range of cognitive and behavioral impairments. Because of the long-lasting problems that are associated with fetal alcohol spectrum disorders (FASDs), the development of effective treatment programs is critical. Preclinical animal studies have shown that choline, which is an essential nutrient, can attenuate the severity of alcohol-related cognitive impairments. OBJECTIVE:We aimed to translate preclinical findings to a clinical population to investigate whether choline supplementation can ameliorate the severity of memory, executive function, and attention deficits in children with FASDs. DESIGN:In the current study, which was a randomized, double-blind, placebo-controlled clinical trial, we explored the effectiveness of a choline intervention for children with FASDs who were aged 5-10 y. Fifty-five children with confirmed histories of heavy prenatal alcohol exposure were randomly assigned to either the choline (n = 29) or placebo (n = 26) treatment arms. Participants in the choline group received 625 mg choline/d for 6 wk, whereas subjects in the placebo group received an equivalent dose of an inactive placebo treatment. Primary outcomes, including the performance on neuropsychological measures of memory, executive function, and attention and hyperactivity, were assessed at baseline and postintervention. RESULTS:Compared with the placebo group, participants in the choline group did not differentially improve in cognitive performance in any domain. Treatment compliance and mean dietary choline intake were not predictive of treatment outcomes. CONCLUSIONS:Findings of the current study do not support that choline, administered at a dose of 625 mg/d for 6 wk, is an effective intervention for school-aged (5-10 y old) children with FASDs. This research provides important information about choline's therapeutic window. Combined with other studies of choline and nutritional interventions in this population, this study emphasizes a further need for the continued study of the role of nutritional status and supplementation in children with FASDs and the contributions of nutrition to neurocognition. This trial was registered at clinicaltrials.gov as NCT01911299.

Project description:Background:Good nutrition and physical activity of school-aged children are important for ensuring optimum growth and reducing obesity. This present study assessed associations between breakfast consumption, BMI-for-Age (BMI) and physical fitness in a cross-section of school-aged children attending government-owned primary schools in Kumasi, Ghana. Method:The sample consisted of 438 pupils (boys?=?213; girls?=?225; mean age 11.1?±?1.1), attending 10 randomly selected schools. Weight (kg), height (cm) and Mid Upper Arm Circumference (MUAC) were measured for each participant, and BMI-for-age z-scores determined using the World Health Organisation (WHO) anthroplus software. Participants were stratified into thinness, normal weight, overweight/obese using WHO cut offs. Physical fitness was assessed using forward jump, left and right handgrips, flexibility, sit-ups and 50?metre run following standard procedures and converted to scores of 1 to 10 following Japanese standards, based on which percentiles were derived. Total fitness score for each pupil was computed by adding all scores. A questionnaire was used to assess meal intake patterns. Results:The mean BMI-for-age z-score for participants was -?0.24?±?0.99. Thinness, normal weight and overweight/obesity were 2.7, 86.5, and 10.5% respectively among the pupils. Overweight was higher in girls (14.2%) compared to boys (4.2%), p?=?0.003. Similarly, mean MUAC was significantly (p?=?0.021) higher in the girls (22.0 ± 3.2?cm) than the boys (20.7 ± 7.3?cm). For physical fitness, the girls scored higher in forward jump (p?<?0.0001), 50-m run (p?=?0.002) and overall fitness score than the boys (21.0?±?6.2 versus 19.2?±?8.3, p?=?0.012). However, a larger proportion of boys performed excellently and poorly than girls (p?=?0.019). A positive correlation was observed between BMI z-score and hand grip (r =?0.21, p?<?0.001), while sit up (r =?-?0.11, p?=?0.018) showed a negative correlation with BMI z-score. No other fitness test varied by BMI. Overweight children performed best in handgrip. Majority of children said they engaged in exercise (89.9%) and consumed breakfast (78.9%). Breakfast consumption was not associated with BMI z-score (x2 0.0359, p?=?0.549) but non-breakfast consumers performed better in 50?m run compared to consumers (7.0 seconds?±?2.3 vrs 6.3 seconds?±?2.5, p?=?0.022). Children who reported to exercise were physically fitter than those who did not. Conclusion:Underweight levels were low while overweight was over 10% in these children. Girls were more than 3 times affected by overweight than boys, and were also physically fitter than boys. Breakfast consumption was not related to weight or fitness.

Project description:BackgroundThe purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings.MethodsThe systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered.ResultsPhysical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required.ConclusionThe following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].

Project description:BACKGROUND:One of the most serious secondary manifestations of Cardiovascular Disease (CVD) is coronary atherosclerosis. This study aimed to evaluate whether aged garlic extract (AGE) can influence coronary artery calcification (CAC) and to predict the individual effect of AGE using a standard process for data mining (CRISP-DM). METHOD:This was a single-center parallel randomized controlled study in a university hospital in Europe. Patients were randomized, in a double-blind manner, through a computer-generated randomization chart. Patients with a Framingham risk score???10 after CT scan (n?=?104) were randomized to an intake of placebo or AGE (2400?mg daily) for 1?year. Main outcome measures were changes in CAC score and secondary outcome measures changes in blood pressure, fasting blood glucose, blood lipids and inflammatory biomarkers. RESULT:104 patients were randomized and 46 in the active group and 47 in the placebo group were analyzed. There was a significant (p?<?0.05) change in CAC progression (OR: 2.95 [1.05-8.27]), blood glucose (OR: 3.1 [1.09-8.85]) and IL-6 (OR 2.56 [1.00-6.53]) in favor of the active group. There was also a significant (p?=?0.027) decrease in systolic blood pressure in the AGE group, from a mean of 148 (SD: 19) mmHg at 0?months, to 140 (SD: 15) mmHg after 12?months. The AGE Algorithm, at a selected probability cut-off value of 0.5, the accuracy score for CAC progression was 80%, precision score of 79% and recall score 83%. The score for blood pressure was 74% (accuracy, precision and recall). There were no side-effects in either group. CONCLUSIONS:AGE inhibits CAC progression, lowers IL-6, glucose levels and blood pressure in patients at increased risk of cardiovascular events in a European cohort. An algorithm was made and was used to predict with 80% precision which patient will have a significantly reduced CAC progression using AGE. The algorithm could also predict with a 74% precision which patient will have a significant blood pressure lowering effect pressure using AGE. TRIAL REGISTRATION:Clinical trials NCT03860350, retrospectively registered (1/32019).

Project description:Introduction: Few studies have examined the association between the individual-, family-, and school-level ecological correlates and physical fitness among Chinese children and adolescents, which is the purpose of the present study. Methods: A total of 157,168 children and adolescents, 10-18 years of age, with physical fitness data in 2014, participated in the study. Physical fitness was assessed, using six tests: forced vital capacity, standing long jump, sit and reach, body muscle strength, 50-m dash, and endurance running. Scores were aggregated to form a summary physical fitness indicator (PFI), which was then classified into five levels: low, low-middle, middle, middle-high, and high. Each option of individual-, family-, and school-level measures were constructed into a positive or negative correlate of physical fitness and then accumulated as a composite ecological score. Results: Among the 20 individual-, family-, and school-level correlates, 18 were found to be significantly associated with PFI, with high PFI levels being correlated with the positive group of correlates and low PFI levels correlated with the negative group of correlates (p < 0.05). High scores of ecological correlates were associated with a high level of PFI [adjusted odds ratio (OR) = 1.06, 95% CI: 1.06, 1.07)] whereas low scores were associated with a low level of PFI (OR = 0.95, 95% CI:0.95, 0.95). The ecological correlates at the individual, school- and family-levels were shown to be significantly related to high PFI among Chinese children and adolescents aged 10-18 years with different ORs of 5.97 (95% CI: 5.51, 6.47), 3.94 (3.66, 4.24), and 1.25 (1.19, 1.31). The PAR% of 20 cumulative factors effects due to the negative and positive responses for low PFI levels were 35.9 and 16.1%, and, for high PFI levels, were 15.3 and 24.1%, among Chinese children and adolescents, respectively. Compared with the correlates at family and school levels, the correlates at individual levels had the largest PAR%. Conclusion: Individual-, family-, and school-multilevel factors had a significant cumulative association with either improving or worsening aspects of physical fitness. Individual level factors remain at the core of physical fitness improvement. Comprehensive policies and measures are urgently needed to enhance the physical fitness of Chinese children and adolescents through involving further individual and environmental factors.

Dataset Information

Effect of deworming on physical fitness of school-aged children in Yunnan, China: a double-blind, randomized, placebo-controlled trial.

Publications

Effect of deworming on physical fitness of school-aged children in Yunnan, China: a double-blind, randomized, placebo-controlled trial.

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