The Prevention Education Program (PEP) Nuremberg: design and baseline data of a family oriented intervention study

We describe the design and baseline data of the Prevention Education Program (PEP), a home-based and family oriented intervention program, aimed to assess and improve cardiovascular risk factors in school children and their families during an intervention period of 10 y.

At study entry all participants were randomized either to an intervention group (screening and intervention program) or to a control group (risk screening, general advice). Cardiovascular risk factors (hypertension, elevated lipids, smoking, obesity) as well as dietary behaviour are evaluated yearly using structured interview, physical examination, laboratory analysis, and seven-day dietary protocol.

During the years 1993-1998, 3547 adults (age 36.2+/-7 y) and 3495 children (age 6.5+/-2 y) were recruited. Adults show a high prevalence of risk factors: hypertension 21%; active smoking 39%, elevated LDL-cholesterol 19%; and obesity 42%. Children exhibit these risk factors in comparable frequency: hypertension 20%; passive smoking 44%; elevated LDL-cholesterol 17%; and obesity 19%. The analysis of the dietary protocols (1926 adults, 1569 children) shows that both generations adhere to a diet exceeding the recommended fat intake (adults 38% of total energy, children 38%), while carbohydrate intake (adults 43% of total energy intake, children 50%) is reduced compared to NCEP-(step I)-guidelines.

The finding, that children show a prevalence of risk factors which is comparable to that found in adults, supports the need for an early beginning of intervention. Since both generations adhere to an unhealthy diet which contributes to cardiovascular risk, dietary intervention may be a promising method in primary prevention of cardiovascular risk.