Effect of an Educational Intervention on Healthy Lifestyle in Iranian Children and Adolescents: The Iran-ending Childhood Obesity (IRAN-ECHO) Program

Author(s):  
Zahra Abdollahi ◽  
Ali-Akbar Sayyari ◽  
Beheshteh Olang ◽  
Hassan Ziaodini ◽  
Hossein Fallah ◽  
...  

Background: This study aimed at examining the effect of an educational program on children’s and adolescents’ knowledge of, attitude toward, and practice of healthy lifestyle habits. Methods: This was a quasi-experimental nationwide intervention carried out as part of the Iran-Ending Childhood Obesity (IRAN-ECHO) program. Participants were selected from six cities of Iran. The sample size was calculated to be 1264 for each city. Knowledge of, attitude toward, and practice of healthy nutritional habits were measured at baseline and following the intervention. A physician and a dietitian provided recommendations on healthy diet, screen time, physical activity, and sleep time. Behavioral therapy was given when necessary. Results: The prevalence of overweight or obesity was 7.6%. The frequency of students with desirable knowledge was significantly greater after the intervention compared with baseline (32.5% vs 24.8%, p = 0.02). The mean score for attitude toward obesity complications significantly increased from 73.09 to 74.78 (p = 0.03). There was also a significant increase in the mean score for the practice of low consumption of unhealthy snacks after the intervention (difference = 1.63, p = 0.03). The mean score for participation in mild physical activity increased from 50.67 to 65 after the intervention (p < 0.001). However, there were no significant changes in the number of students with desirable attitude and practice following the intervention (p> 0.05). Conclusion: The study shows that an educational intervention based on WHO-ECHO recommendations can be useful for improving the knowledge of a healthy lifestyle in children and adolescents. Over time, it might lead to a positive attitude and behavior toward a healthier lifestyle. Continued professional education and implementation of guidelines for the prevention and management of early childhood overweight and obesity are suggested.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 936.2-937
Author(s):  
F. Milatz ◽  
J. Klotsche ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
D. Windschall ◽  
...  

Background:In patients with JIA, growth impairment and variance in body composition are well-known long-term complications that may be associated with prolonged drug therapy (e.g. glucocorticoids) as well as impaired physical and psychosocial well-being. An increased accumulation of body fat represents a significant risk factor for metabolic abnormalities and a modifiable variable for a number of comorbidities. Recently, evidence has emerged in favour of the potential negative influence of overweight on the course of the disease and treatment response [1].Objectives:The study aimed a) to estimate the prevalence of underweight, overweight and obesity in children and adolescents with JIA compared to the general population, and b) to investigate correlates of patients’ weight status.Methods:A cross-sectional analysis of physicians’ recorded body weights and heights of patients with JIA enrolled in the NPRD in the year 2019 was performed. Underweight (BMI <10th), overweight (BMI >90th) and obesity (BMI >97th) were defined according to age- and sex-specific percentiles used in the German reference system. For comparison with data from the general population [2], sex- and age-matched pairs of 3-17-year-old patients and controls were generated. A multinomial logistic regression analysis was performed to examine the association between weight status and patients’ clinical and self-reported outcomes.Results:In total, data from 6.515 children and adolescents with JIA (age 11.2 ± 4.1 years, disease duration 4.9 ± 3.8 years, 67% girls, 40% persistent oligoarthritis) were included. Of these, 3.334 (age 5.9 ± 2.1 years, 52.5% girls) could be considered for matched-pair analysis. Compared with the general population, patients underweight, overweight and obesity rates were 10.6% (vs. 8.1%), 8.8% (vs. 8.5%) and 6.1% (vs. 5.7%), respectively. No significant sex differences were found in either group. Largest difference in prevalence was registered for underweight, specifically in the age group 3-6 years (12.9% patients vs. 5.9% controls). Similar to the general population, higher rates of overweight were observed in adolescent patients than in affected children (19.1% age group 11-13 vs. 8.4% age group 3-6). While the highest underweight prevalence was registered in patients with RF+ polyarthritis (16%), patients with Enthesitis-related arthritis (22%), psoriatic arthritis (21%) and systemic JIA (20%) showed the highest overweight rates (including obesity). Younger age (OR = 0.51, 95% CI = 0.31-0.83), more frequent physical activity (OR = 0.92, 95% CI = 0.85-0.99) and high parental vocational education (OR = 0.39, 95% CI = 0.18-0.80) were independently associated with a lower likelihood of being overweight/obese.Conclusion:The overall prevalence of underweight, overweight and obesity in children and adolescents with JIA is comparable to that found in the general population. Behavioural health promotion, including regular physical activity, as part of the treatment strategy in JIA should preventively already begin at preschool age and necessarily be made accessible to patients of all educational levels.References:[1]Giani T et al. The influence of overweight and obesity on treatment response in juvenile idiopathic arthritis. Front Pharmacol 2019;10:637.[2]Schienkiewitz A et al. BMI among children and adolescents: prevalences and distribution considering underweight and extreme obesity. Bundesgesundheitsbl 2019;62:1225–1234.Acknowledgements:The National Paediatric Rheumatological Database has been funded by AbbVie, Chugai, Novartis and GSK.Disclosure of Interests:Florian Milatz: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Daniel Windschall: None declared, Frank Weller-Heinemann Speakers bureau: Pfizer, AbbVie, SOBI, Roche and Novartis., Frank Dressler: None declared, Rainer Berendes: None declared, Johannes-Peter Haas: None declared, Gerd Horneff: None declared, Kirsten Minden Speakers bureau: Pfizer, AbbVie, Consultant of: Novartis


2021 ◽  
pp. 1-28
Author(s):  
Tarcisus Ho ◽  
Ling Jie Cheng ◽  
Ying Lau

Abstract Objective Schools offer an ideal setting for childhood obesity interventions due to their access to children and adolescents. This review aimed to systematically review the impact of school-based intervention for the treatment of childhood obesity. Design Eight databases were searched from inception till May 30, 2020. A revised Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to evaluate the risk of bias and overall evidence. Meta-analysis and meta-regression were performed on Stata software using the random-effects model. Overall effect was evaluated using Hedges’ g, and heterogeneity was assessed using Cochran’s Q and I2. Setting Cluster randomised trials (cluster-RCTs) delivered in school. Participants Children and adolescents (6-18 years of age) with overweight and obesity. Results Twelve cluster-RCTs from seven countries with 1,755 participants were included in the meta-analysis. School-based interventions for the treatment of childhood obesity reduced body mass index (BMI) and BMI z-scores with a medium effect (g=0·52). Subgroup analyses showed the greater effectiveness of brief school-based interventions and the interventions conducted in lower-middle to upper-middle economies. Meta-regression assessed the heterogeneity and the final model, with covariates of the type of economies and trial duration, accounted for 41.2% of the variability. The overall quality of evidence was rated low because of the high risk of bias and inconsistency. Conclusions School-based interventions is a possible approach to provide universal healthcare for the treatment of childhood obesity, and further well-designed cluster-RCTs with longer follow-up are needed. This study is registered with PROSPERO (CRD42020160735).


2021 ◽  
Vol 14 (01) ◽  
pp. 006-010
Author(s):  
Valeria Moro ◽  
Luiz Antonio Del Ciampo

Abstract Introduction The global obesity epidemic has mobilized health services to offer care at all levels, with reference outpatient clinics playing a prominent role in cases of greater complexity. Objectives The present study aimed to identify soft drinks consumption and physical activity habits among children and adolescents diagnosed with overweight and obesity during the first visit at a secondary level nutrology outpatient clinic, and to verify attendance at follow-up visits in a 2-year period from the first visit. Materials and Methods This is a retrospective, descriptive study based on data collection from medical records of overweighted or obese patients receiving first care at the Nutrology Clinic of the Municipal Health Secretariat from Ribeirão Preto, São Paulo, Brazil. The study population included children and adolescents aged between 2 and 18 years old cared for from January 2, 2013 to December 30, 2017. Age, weight, height, soft drinks consumption, physical activity, and attendance in scheduled follow-up visits during a 2-year period were analyzed. Results During the study period, 316 patients were registered, including 302 (95.5%) diagnosed with obesity. Of these, 112 (35.4%) were children and 204 (64.6%) were adolescents. Only 2.0% of the children and adolescents did not consume soft drinks, while 23.5 and 26.2% of the children and adolescents, respectively, consumed them daily. Physical inactivity was reported by 31.8% of the children and by 35.8% of the adolescents. Among those who practiced some type of physical activity, 81.3% of the children and 78.2% of the adolescents did not meet the recommendation of moderate to vigorous activity for 60 minutes per day. Dropout rates within the 1st year were of 41.9% for children and of 34.3% for adolescents, increasing to 76.9% and 73.8%, respectively, within the 2nd year. Conclusion There was a high consumption of soft drinks and low adherence to physical activity among patients who started outpatient follow-up. A small adherence to the follow-up program was also identified, with high dropout rates within the 2-year period following the first visit.


Author(s):  
Silva Hovsepian ◽  
Mostafa Qorbani ◽  
Mohammad Esmaeil Motlagh ◽  
Aryan Madady ◽  
Morteza Mansourian ◽  
...  

AbstractBackground:Considering the role of different ethnical, cultural and geographical factors in health related quality of life (HRQOL) as well as the perception of different populations regarding various weight disorders, we aimed to evaluate the association between body mass index (BMI) and HRQOL in Iranian children and adolescents.Methods:This cross-sectional study was part of the Weight Disorders Survey of the CASPIAN-IV study. During this study, students aged 6–18 years from urban and rural areas of 30 provinces of Iran were selected. HRQOL of the students was evaluated by using the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0™ 4.0) Generic Core Scales. The mean of total HRQOL and its subscales were compared in underweight, normal weight, overweight and obese students.Results:The mean of total HRQOL, physical functioning and psychological functioning scores in the total population were 83.31, 84.25 and 82.79, respectively. The mean of the total HRQOL score and the psychosocial score were significantly lower in underweight students aged 6–12 years than in other groups (p<0.05). The mean of the total HRQOL score and psychosocial score were significantly lower in obese students aged 13–18 years than in other groups (p<0.05). Overweight and obesity was negatively associated with total HRQOL, psychosocial and school functioning subscales (p<0.05). There was a significant negative association between emotional functioning and obesity (p<0.05).Conclusions:The findings or this study support the importance of personal perception and cultural norm roles in HRQOL. Given the association between weight disorders and psychosocial health, it is suggested that social and cultural factors have a more crucial role in the HRQOL of children and adolescents.


2021 ◽  
pp. 1-5
Author(s):  
Asma Saghir Khan

Childhood, overweight and obesity are increasingly significant problems, and ones that are likely to endure and to have long term adverse influences on the health of individuals and populations unless action is taken to reverse the trend. A number of factors have been suggested as contributing to the development of childhood obesity. These include genetic factors, decreasing levels of physical activity, increased time spent in sedentary behavior and changes in diet. In addition, lifestyle factors, including family influences, changes in society and media advertising, have been associated with the increasing incidence of obesity and overweight in childhood. To address the problem, health care professionals should incorporate appropriate screening in their child practice. Comprehensive assessment of children who are, or who are at risk of becoming, obese is also necessary


Author(s):  
Andreia Pelegrini ◽  
Mateus Augusto Bim ◽  
Fernanda Ulsula de Souza ◽  
Karoline Sisnandes da Silva Kilim ◽  
André de Araújo Pinto

abstract It is important to know about overweight and obesity situation of Brazilian children and adolescents. The present study aims to update scientific production, through a systematic review, on the prevalence and factors associated with overweight and obesity in Brazilian children and adolescents. Nine databases were verified, and 1,316 references were examined from 2018 to 2019. The electronic search was conducted by three independent researchers. All review steps followed a strategy based on PRISMA. 40 studies were included in this systematic review. Most studies use the World Health Organization classification criteria. The prevalence of overweight in Brazilian children and adolescents varies from 8.8% to 22.2% (boys: 6.2% to 21%; girls: 6.9% to 27.6%). The prevalence of obesity varied from 3.8% to 24% (boys: 2.4% to 28.9%; girls: 1.6% to 19.4%). It was observed that the socioeconomic factors (sex, skin color, economic level, region, mother's educational level, living in a rented house and without access to the internet), hereditary/genetic (family history of dyslipidemia and overweight and rs9939609 genotype) and behavioral (physical activity, screen time, eating habits, perceived body weight, health vulnerability, presence of a result close to home, alcoholic beverages, cigarette consumption) were associated with the outcome. It is concluded that the prevalence of overweight and obesity among Brazilian children and adolescents are worrisome and most of the factors associated with the outcomes are subject to change from the adoption of a healthy lifestyle.


10.2196/16930 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e16930
Author(s):  
Ching Lam ◽  
Madison Milne-Ives ◽  
Michelle Helena Van Velthoven ◽  
Edward Meinert

Background Childhood obesity is a serious global issue, leading to increased medical spending on obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for health care services that link health behavior to risk factors, such as diet and physical activity, and that provide better advice and feedback to users, which Internet of Things–enabled technologies could facilitate. Objective The objective of the systematic review will be to identify available Internet of Things–enabled technologies for weight management of children and adolescents (users younger than 18 years). It will also aim to understand the use, effectiveness, and feasibility of these technologies. Methods We will search the Medline, PubMed, Web of Science, Scopus, ProQuest Central, and IEEE Xplore Digital Library databases for studies published after 2010, using a combination of keywords and subject headings related to health activity tracking, youth, and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications, and health outcomes related to weight management. Results A preliminary search on Medline returned 484 results. The publication of the final systematic review is expected in mid-2020. Conclusions The effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed, but there are currently no published reviews that look into these technologies in the wider Internet of Things context. This review aims to address this gap by examining Internet of Things–enabled technologies that are designed for youth weight management and thus inform further research and clinical studies to reduce childhood obesity. International Registered Report Identifier (IRRID) PRR1-10.2196/16930


Author(s):  
Jaclyn B. Gaylis ◽  
Susan S. Levy ◽  
Shiloah Kviatkovsky ◽  
Rebecca DeHamer ◽  
Mee Young Hong

Abstract Given the increased prevalence of pediatric obesity and risk of developing chronic disease, there has been great interest in preventing these conditions during childhood by focusing on healthy lifestyle habits, including nutritious eating and physical activity (PA). The purpose of this study was to determine the relationship between PA, body mass index (BMI) and food choices in adolescent males and females. This cross-sectional study, using a survey questionnaire, evaluated 1212 Southern Californian adolescents’ self-reported PA, BMI and food frequency. Results revealed that even though males are more active than females, they have higher BMI percentile values (p < 0.05). Females consumed salad, vegetables and fruit more frequently than males (p < 0.05), where males consumed hamburgers, pizza, red meat, processed meat, eggs, fish, fruit juice, soda and whole milk more frequently than females (p < 0.05). Overweight/obese teens consumed red meat, processed meat and cheese more frequently than healthy weight teens (p < 0.05), yet there was no difference in PA between healthy and overweight/obese teens. These results demonstrate that higher levels of PA may not counteract an unhealthy diet. Even though PA provides numerous metabolic and health benefits, this study suggests that healthy food choices may have a protective effect against overweight and obesity. Healthy food choices, along with PA, should be advocated to improve adolescent health by encouraging maintenance of a healthy weight into adulthood.


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