Waist Circumference and Healthy Lifestyle Preferences/Knowledge Monitoring in a Preschool Obesity Prevention Program
Abstract
:1. Introduction
2. Materials and Methods
2.1. Baseline and Follow-Up Investigations
2.2. Classroom Activities
2.3. Statistical Analysis
3. Results
3.1. Anthropometric Changes
3.2. Behavioral Changes
3.3. Anthropometric/Behavioral Relations
4. Discussion
4.1. Methodological Observations
4.2. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Ahrens, W.; Pigeot, I.; Pohlabeln, H.; De Henauw, S.; Lissner, L.; Molnár, D.; Moreno, L.A.; Tornaritis, M.; Veidebaum, T.; Siani, A. Prevalence of overweight and obesity in European children below the age of 10. Int. J. Obes. 2014, 2 (Suppl. 38), S99–S107. [Google Scholar] [CrossRef]
- Geserick, M.; Vogel, M.; Gausche, R.; Lipek, T.; Spielau, U.; Keller, E.; Pfäffle, R.; Kiess, W.; Körner, A. Acceleration of BMI in Early Childhood and Risk of Sustained Obesity. N. Engl. J. Med. 2018, 379, 1303–1312. [Google Scholar] [CrossRef]
- Pelone, F.; Specchia, M.L.; Veneziano, M.A.; Capizzi, S.; Bucci, S.; Mancuso, A.; Ricciardi, W.; de Belvis, A.G. Economic impact of childhood obesity on health systems: A systematic review. Obes. Rev. 2012, 13, 431–440. [Google Scholar] [CrossRef]
- Pandita, A.; Sharma, D.; Pandita, D.; Pawar, S.; Tariq, M.; Kaul, A. Childhood obesity: Prevention is better than cure. Diabetes Metab. Syndr. Obes. 2016, 9, 83–89. [Google Scholar] [CrossRef]
- Morano, M.; Rutigliano, I.; Rago, A.; Pettoello-Mantovani, M.; Campanozzi, A. A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children. Nutrition 2016, 32, 1075–1080. [Google Scholar] [CrossRef]
- Peirson, L.; Fitzpatrick-Lewis, D.; Morrison, K.; Ciliska, D.; Kenny, M.; Usman Ali, M.; Raina, P. Prevention of overweight and obesity in children and youth: A systematic review and meta-analysis. CMAJ Open 2015, 3, E23–E33. [Google Scholar] [CrossRef]
- Hu, Y.; He, J.R.; Liu, F.H.; Li, W.D.; Lu, J.H.; Xing, Y.F.; Lin, S.F.; Liu, X.; Bartington, S.; Feng, Q.; et al. Effectiveness of a Kindergarten-Based Intervention for Preventing Childhood. Pediatrics 2017, 140, e20171221. [Google Scholar] [CrossRef]
- Lanigan, J. Prevention of overweight and obesity in early life. In Proceedings of the Nutrition Society Summer Meeting, Kings College, London, UK, 10–12 July 2017; pp. 1–10. [Google Scholar]
- Pan, L.; Freedman, D.S.; Park, S.; Galuska, D.A.; Potter, A.; Blanck, H.M. Changes in Obesity among US Children Aged 2 through 4 Years Enrolled in WIC during 2010–2016. JAMA 2019, 321, 2364–2366. [Google Scholar] [CrossRef]
- Dalla Valle, M.; Laatikainen, T.; Lehikoinen, M.; Nykänen, P.; Jääskeläinen, J. Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans. Acta Paediatr. 2017, 106, 1842–1850. [Google Scholar] [CrossRef]
- Freemark, M. Determinants of Risk for Childhood Obesity. N. Engl. J. Med. 2018, 379, 1371–1372. [Google Scholar] [CrossRef]
- Kato, N.; Isojima, T.; Yokoya, S.; Tanaka, T.; Ono, A.; Yokomichi, H.; Yamagata, Z.; Tanaka, S.; Matsubara, H.; Ishikuro, M.; et al. Earlier BMI rebound and lower pre-rebound BMI as risk of obesity among Japanese preschool children. Int. J. Obes. 2018, 42, 52–58. [Google Scholar] [CrossRef]
- Hughes, A.R.; Sherriff, A.; Ness, A.R.; Reilly, J.J. Timing of adiposity rebound and adiposity in adolescence. Pediatrics 2014, 134, e1354–e1361. [Google Scholar] [CrossRef]
- Ward, D.S.; Welker, E.; Choate, A.; Henderson, K.E.; Lott, M.; Tovar, A.; Wilson, A.; Sallis, J.F. Strength of obesity prevention interventions in early care & education settings: A systematic review. Prev. Med. 2016, 95, S37–S52. [Google Scholar]
- Sisson, S.B.; Krampe, M.; Anundson, K.; Castle, S. Obesity prevention and obesogenic behavior interventions in child care: A systematic review. Prev. Med. 2016, 87, 57–69. [Google Scholar] [CrossRef]
- Stanhope, K.K.; Kay, C.; Stevenson, B.; Gazmararian, J.A. Measurement of obesity prevention in childcare settings: A systematic review of current instruments. Obes. Res. Clin. Pract. 2017, 11 (Suppl. 1), 52–89. [Google Scholar] [CrossRef]
- World Health Organization. Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development; World Health Organization: Geneva, Switzerland, 2006. [Google Scholar]
- Fernández, J.R.; Redden, D.T.; Pietrobelli, A.; Allison, D.B. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J. Pediatr. 2004, 145, 439–444. [Google Scholar] [CrossRef]
- Calfas, K.J.; Sallis, J.F.; Nader, P.R. The development of scales to measure knowledge and preference for diet and physical activity behavior in 4- to 8-year-old children. J. Dev. Behav. Pediatr. 1991, 12, 185–190. [Google Scholar] [CrossRef]
- Händel, M.N.; Larsen, S.C.; Rohde, J.F.; Stougaard, M.; Olsen, N.J.; Heitmann, B.L. Effects of the healthy start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity. PLoS ONE 2017, 12, e0185266. [Google Scholar] [CrossRef]
- Serra-Majem, L.; Ribas, L.; Ngo, J.; Ortega, R.M.; García, A.; Pérez-Rodrigo, C.; Aranceta, J. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 2004, 7, 931–935. [Google Scholar] [CrossRef]
- Fletcher, E.N.; Whitaker, R.C.; Marino, A.J.; Anderson, S.E. Screen time at home and school among low-income children attending Head Start. Child. Indic. Res. 2014, 7, 421–436. [Google Scholar] [CrossRef]
- Sim, L.A.; Lebow, J.; Wang, Z.; Koball, A.; Murad, M.H. Brief Primary Care Obesity Interventions: A Meta-analysis. Pediatrics 2016, 138, e20160149. [Google Scholar] [CrossRef] [Green Version]
- Adab, P.; Pallan, M.J.; Lancashire, E.R.; Hemming, K.; Frew, E.; Barrett, T.; Bhopal, R.; Cade, J.E.; Canaway, A.; Clarke, J.L.; et al. Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: Cluster randomised controlled trial (WAVES study). BMJ 2018, 360, k211. [Google Scholar] [CrossRef]
- Sharma, S.V.; Vandewater, E.; Chuang, R.J.; Byrd-Williams, C.; Kelder, S.; Butte, N.; Hoelscher, D.M. Impact of the Coordinated Approach to Child Health Early Childhood Program for Obesity Prevention among Preschool Children: The Texas Childhood Obesity Research Demonstration Study. Child. Obes. 2019, 15, 1–13. [Google Scholar] [CrossRef]
- Kim, J.; Kim, G.; Park, J.; Wang, Y.; Lim, H. Effectiveness of Teacher-Led Nutritional Lessons in Altering Dietary Habits and Nutritional Status in Preschool Children: Adoption of a NASA Mission X-Based Program. Nutrients 2019, 11, 1590. [Google Scholar] [CrossRef]
- Armstrong, S.C.; Skinner, A.C. Defining “Success” in Childhood Obesity Interventions in Primary Care. Pediatrics 2016, 138, e20162497. [Google Scholar] [CrossRef]
- Munday, K.; Wilson, M. Implementing a Health and Wellbeing Programme for Children in Early Childhood: A Preliminary Study. Nutrients 2017, 9, 1031. [Google Scholar] [CrossRef]
- Weihrauch-Blüher, S.; Kromeyer-Hauschild, K.; Graf, C.; Widhalm, K.; Korsten-Reck, U.; Jödicke, B.; Markert, J.; Müller, M.J.; Moss, A.; Wabitsch, M.; et al. Systematic Review. Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obes. Facts 2018, 11, 263–276. [Google Scholar] [CrossRef]
- Fisher, J.O.; Serrano, E.L.; Foster, G.D.; Hart, C.N.; Davey, A.; Bruton, Y.P.; Kilby, L.; Harnack, L.; Ruth, K.J.; Kachurak, A.; et al. Efficacy of a food parenting intervention for mothers with low income to reduce preschooler’s solid fat and added sugar intakes: A randomized controlled trial. Int. J. Behav. Nutr. Phys. Act. 2019, 16, 6. [Google Scholar] [CrossRef]
- Morshed, A.B.; Tabak, R.G.; Schwarz, C.D.; Haire-Joshu, D. The Impact of a Healthy Weight Intervention Embedded in a Home-Visiting Program on Children’s Weight and Mothers’ Feeding Practices. J. Nutr. Educ. Behav. 2019, 51, 237–244. [Google Scholar] [CrossRef]
- Mirotta, J.A.; Darlington, G.A.; Buchholz, A.C.; Haines, J.; Ma, D.W.L.; Duncan, A.M. Guelph Family Health Study. Guelph Family Health Study’s Home-Based Obesity Prevention Intervention Increases Fibre and Fruit Intake in Preschool-Aged Children. Can. J. Diet. Pract. Res. 2018, 79, 86–90. [Google Scholar] [CrossRef]
- Kain, J.; Leyton, B.; Baur, L.; Lira, M.; Corvalán, C. Demographic, Social and Health-Related Variables that Predict Normal-Weight Preschool Children Having Overweight or Obesity When Entering Primary Education in Chile. Nutrients 2019, 11, 1277. [Google Scholar] [CrossRef] [PubMed]
- Schmutz, E.A.; Haile, S.R.; Leeger-Aschmann, C.S.; Kakebeeke, T.H.; Zysset, A.E.; Messerli-Bürgy, N.; Stülb, K.; Arhab, A.; Meyer, A.H.; Munsch, S.; et al. Physical activity and sedentary behavior in preschoolers: A longitudinal assessment of trajectories and determinants. Int. J. Behav. Nutr. Phys. Act. 2018, 15, 35. [Google Scholar] [CrossRef] [PubMed]
- Wiseman, N.; Harris, N. A Systematic Review of Data Collection Techniques Used to Measure Preschool Children’s Knowledge of Food and Nutrition. J. Nutr. Educ. Behav. 2015, 47, 345–353. [Google Scholar] [CrossRef] [PubMed]
- Whiteley, C.; Matwiejczyk, L. Preschool Program Improves Young Children’s Food Literacy and Attitudes to Vegetables. J. Nutr. Educ. Behav. 2015, 47, 397–398. [Google Scholar] [CrossRef] [PubMed]
- Masis, N.; McCaffrey, J.; Johnson, S.L.; Chapman-Novakofski, K. Design and Evaluation of a Training Protocol for a Photographic Method of Visual Estimation of Fruit and Vegetable Intake among Kindergarten through Second-Grade Students. J. Nutr. Educ. Behav. 2017, 49, 346–351. [Google Scholar] [CrossRef] [PubMed]
- Byrne, R.; Bell, L.; Taylor, R.W.; Mauch, C.; Mihrshahi, S.; Zarnowiecki, D.; Hesketh, K.D.; Wen, L.M.; Trost, S.G.; Golley, R. Brief tools to measure obesity-related behaviours in children under 5 years of age: A systematic review. Obes. Rev. 2019, 20, 432–447. [Google Scholar] [CrossRef]
- Wiseman, N.; Harris, N.; Downes, M. Validation of an iPad activity to measure preschool children’s food and physicalactivity knowledge and preferences. Int. J. Behav. Nutr. Phys. Act. 2017, 14, 11. [Google Scholar] [CrossRef]
- Byrd-Bredbenner, C.; Martin-Biggers, J.; Povis, G.A.; Worobey, J.; Hongu, N.; Quick, V. Promoting healthy home environments and lifestyles in families with preschool children: HomeStyles, a randomized controlled trial. Contemp. Clin. Trials 2018, 64, 139–151. [Google Scholar] [CrossRef]
- Ordway, M.R.; Sadler, L.S.; Holland, M.L.; Slade, A.; Close, N.; Mayes, L.C. A Home Visiting Parenting Program and Child Obesity: A Randomized Trial. Pediatrics 2018, 141, e20171076. [Google Scholar] [CrossRef] [Green Version]
- Martin, A.; Booth, J.N.; Laird, Y.; Sproule, J.; Reilly, J.J.; Saunders, D.H. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database Syst. Rev. 2018, 3, CD009728. [Google Scholar]
Healthy Choices | Unhealthy Choices |
---|---|
Foods | |
1. Rice | French fries |
2. Fruits | Chocolate snacks |
3. Boiled fish | Sausages |
4. Ice lolly | Ice cream |
5. Orange juice | Cola |
6. Peanuts | Popcorn with butter and salt |
7. Whole grain biscuits | Potato chips |
8. White yogurt | Spread chocolate cream |
Activities | |
1. Dancing | Coloring |
2. Swimming | Watching TV |
3. Sliding | Swinging |
4. Bicycling | Sitting and rolling toy train |
5. Kicking ball | Playing videogames |
6. Climbing on jungle gym | Playing with Legos |
7. Running | Walking |
Intervention Group (n = 23) | Control Group (n = 22) | |||||
---|---|---|---|---|---|---|
NW n (%) | OW n (%) | OB n (%) | NW n (%) | OW n (%) | OB n (%) | |
Baseline (T0) | 16 (69.5%) (5 (21.7%))• | 3 (13%) | 4 (17, 5%) | 18 (82%) (7 (31.8%))• | 2 (9%) | 2 (9%) |
Follow-up (T4) | 19 (82.6%) (0 (0%))• | 2 (8, 7%) | 2 (8, 7%) | 18 (82%) (7 (31.8%))• | 2 (9%) | 2 (9%) |
EFT p-value | ns (0.0486)• | ns | ns | ns (ns)• | ns | ns |
Intervention Group | Control Group | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
T0 | T1 | T2 | T3 | T4 | p | T0 | T1 | T2 | T3 | T4 | p | |
Age (years) | 3.4 ± 0.4 | 4.0 ± 0.4 | 4.6 ± 0.4 | 5.4 ± 0.4 | 6.5 ± 0.6 | 3.4 ± 0.4 | 4.0 ± 0.4 | 4.6 ± 0.4 | 5.4 ± 0.4 | 6.5 ± 0.6 | ||
BMI (Z-score) | 0.05 ± 1.19 | 0.08 ± 1.26 | 0.36 ± 1.35 | 0.53 ± 0.95 | 0.42 ± 0.98 | 0.5382(a) 0.0830(b) | 0.22 ± 1.12 | 0.23 ± 0.91 | 0.34 ± 0.98 | 0.12 ± 1.08 | 0.23 ± 1.17 | 0.9883(a) 0.9561(b) |
WC (percentile) | 78.9 ± 16.5 | 68.4 ± 22.3 | 62.4 ± 20.9 | 59.3 ± 20.4 | 58.6 ± 21.0 | 0.0049(a) <0.0001(b) | 70 ± 23.5 | 56.0 ± 21.4 | 46.5 ± 23.8 | 45.4 ± 23.9 | 51.7 ± 28.1 | 0.9950(a) 0.5041(b) |
Food knowledge | 3.8 ± 1.6 | 4.8 ± 1.6 | 5.2 ± 1.9 | 6.1 ± 2.0 | 6.5 ± 1.1 | 0.0001(a) <0.0001(b) | 4.1 ± 2.3 | 5.6 ± 2.0 | 6.6 ± 1.6 | 6.6 ± 1.6 | 6.4 ± 1.2 | 0.6349(a) 0.4806(b) |
Food preferences | 3.2 ± 1.6 | 4.6 ± 1.6 | 3.7 ± 1.7 | 4.8 ± 2.0 | 5.4 ± 1.6 | <0.0001(a) 0.0007(b) | 2.9 ± 2.0 | 4.8 ± 2.3 | 4.8 ± 2.2 | 4.6 ± 2.4 | 4.3 ± 1.8 | 0.5205(a) 0.2282(b) |
PA knowledge | 3.7 ± 1.6 | 3.8 ± 1.5 | 4.4 ± 1.5 | 4.9 ± 1.6 | 5.4 ± 1.2 | 0.002(a) <0.0001(b) | 3.4 ± 1.9 | 4.1 ± 2.0 | 4.4 ± 1.0 | 4.6 ± 1.3 | 4.3 ± 0.9 | 0.8380(a) 0.5191(b) |
PA preferences | 3.0 ± 1.5 | 4.3 ± 1.6 | 4.2 ± 1.3 | 4.7 ± 1.4 | 5.3 ± 1.2 | <0.0001(a) <0.0001(b) | 3.1 ± 1.7 | 3.8 ± 1.7 | 4.1 ± 1.2 | 4.0 ± 1.3 | 4.6 ± 1.2 | 0.4398(a) 0.3012(b) |
KidMed score | 6.2 ± 2.1 | 6.3 ± 2.3 | 7.0 ± 1.9 | 6.7 ± 2.1 | 6.9 ± 2.1 | 0.4580(a) 0.1503(b) | 4.9 ± 1.4 | 5.4 ± 1.3 | 6.0 ± 1.8 | 5.4 ± 2.8 | 6.0 ± 2.0 | 0.9819(a) 0.9999(b) |
Sweet beverage (mL/week) | 97.0 ± 105.0 | 103.0 ± 108.0 | 47.0 ± 77.0 | 70.0 ± 101.0 | 49.0 ± 50.0 | 0.4394(a) 0.1358(b) | 45.0 ± 60.0 | 28.0 ± 36.0 | 30.0 ± 42.0 | 40.0 ± 38.0 | 52.5 ± 60.0 | 0.9599(a) 0.6793(b) |
Screen time (min/week) | 163.5 ± 46.6 | 147.8 ± 46.2 | 133.6 ± 37.1 | 139.6 ± 52.9 | 136.3 ± 50.8 | 0.2051(a) 0.0098(b) | 151.0 ± 37.0 | 130.0 ± 32.9 | 113.3 ± 29.0 | 147.1 ± 31.6 | 156.8 ± 48.52 | 0.9713(a) 0.2142(b) |
PA (min/week) | 84.6 ± 36.7 | 89.1 ± 37.7 | 94.7 ± 38.1 | 98.4 ± 41.8 | 105.2 ± 40.6 | 0.4621(a) 0.0106(b) | 84.1 ± 27.8 | 83.4 ± 34.9 | 89.8 ± 29.0 | 86.5 ± 34.3 | 91.0 ± 40.4 | 0.9651(a) 0.2206(b) |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Poeta, M.; Lamberti, R.; Di Salvio, D.; Massa, G.; Torsiello, N.; Pierri, L.; Delli Bovi, A.P.; Di Michele, L.; Guercio Nuzio, S.; Vajro, P. Waist Circumference and Healthy Lifestyle Preferences/Knowledge Monitoring in a Preschool Obesity Prevention Program. Nutrients 2019, 11, 2139. https://doi.org/10.3390/nu11092139
Poeta M, Lamberti R, Di Salvio D, Massa G, Torsiello N, Pierri L, Delli Bovi AP, Di Michele L, Guercio Nuzio S, Vajro P. Waist Circumference and Healthy Lifestyle Preferences/Knowledge Monitoring in a Preschool Obesity Prevention Program. Nutrients. 2019; 11(9):2139. https://doi.org/10.3390/nu11092139
Chicago/Turabian StylePoeta, Marco, Rossella Lamberti, Dario Di Salvio, Grazia Massa, Nives Torsiello, Luca Pierri, Anna Pia Delli Bovi, Laura Di Michele, Salvatore Guercio Nuzio, and Pietro Vajro. 2019. "Waist Circumference and Healthy Lifestyle Preferences/Knowledge Monitoring in a Preschool Obesity Prevention Program" Nutrients 11, no. 9: 2139. https://doi.org/10.3390/nu11092139