Health and nutrition education program in primary schools of Crete: changes in blood pressure over 10 years

Eur J Clin Nutr. 2007 Jul;61(7):837-45. doi: 10.1038/sj.ejcn.1602584. Epub 2007 Jan 10.


Objective: To examine the long-term effects of the 'Cretan Health and Nutrition Education Program' on blood pressure.

Subjects: A representative population of 176 pupils (85 from the intervention schools and 91 from the control schools).

Design: Blood pressure, dietary, anthropometrical and physical activity data were obtained at baseline (academic year 1992-1993) and at follow-up examination (academic year 2001-2002).

Results: The findings of the current study revealed that the increase over the 10-year period in systolic (SBP) and diastolic blood pressure (DBP) was higher in the control group (CG) than in the intervention group (IG) (P=0.003 and P<0.001 respectively). Regarding dietary indices, the IG were found to have a significantly higher intake of potassium (P=0.018) and magnesium (P=0.011) compared to the CG. Furthermore, the decrease in body mass index (BMI) z-score observed in the IG was found to differentiate significantly from the increase observed in the CG (P=0.042). On the contrary, the increase in leisure time, moderate to vigorous physical activities (MVPA) observed in the IG, was found to differentiate significantly from the decrease observed in the CG (P=0.032). Intervention's effect on SBP was mediated by changes in MVPA (beta=-0.20, P=0.030) and BMI (beta=0.19, P=0.048). Similarly, intervention's effect on DBP was mediated by changes in MVPA (beta=-0.18, P=0.048), BMI (beta=0.26, P=0.007) and magnesium intake (beta=-0.20, P=0.048).

Conclusion: The findings of the current study are encouraging, indicating favorable changes in blood pressure, micronutrients intake, BMI and physical activity over the 10 years of follow-up and 4 years after program's cessation, thus providing some support for the effectiveness of school-based health education programs in successfully tackling certain chronic disease risk factors early in life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior* / psychology
  • Blood Pressure / physiology*
  • Body Mass Index
  • Child
  • Child Behavior* / psychology
  • Diet
  • Exercise / physiology
  • Exercise / psychology
  • Female
  • Follow-Up Studies
  • Greece
  • Health Education / methods*
  • Health Promotion / methods*
  • Humans
  • Leisure Activities
  • Male
  • Nutritional Sciences / education*
  • School Health Services