Development of an educational intervention to promote healthy eating and physical activity in Mexican school-age children

Nutritional counseling in childhood and adolescence: a systematic review

Healthy eating habits are the basis for good health status, especially for children and adolescents, when growth and development are still ongoing. Nutrition educational programs are essential to prevent and treat chronic diseases. Nutritional counseling (NC), as a collaborative process between the counselor and the client process, could help to achieve better outcomes. This review aims to collect information about the utilization of NC during childhood and adolescence and to highlight its possible impact on adherence/compliance rates, nutrition knowledge, status and dietary intake. The methods applied in this systematic review followed the instruction of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search in PubMed/Medline, Scopus, Web of Science, LILACS, and Science Direct included observational or randomized studies. RoB 2.0 and Robins-I tools was used for the risk of bias assessment in randomized and non-randomized studies, respectively. The quality of evidence was checked by the Mixed Methods Appraisal Tool system. A total of 21 articles were selected, computing 4,345 individuals. 11 achieved at least 4 stars quality level. The highest risk of bias for randomized studies was related to the randomization process. 42.9% of non-randomized studies had some concerns of bias, mainly because of a lack of control of all confounding factors. Different strategies of NC were used in children and adolescents with positive results for health or diseases. NC strategies can be effectively used in children and adolescents. In general, NC showed benefits in pediatrics age for anthropometric or body composition parameters, dietary intake, nutrition knowledge and physical activity improvement. Performing NC in pediatrics is challenging due to the counseling strategies that must be adapted in their contents to the cognitive ability of each age. More structured research must be done focused on this population. Investments in healthy eating behaviors in pediatrics can lead to better health outcomes in the future population with substantial benefits to society.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42022374177].

Healthy living behaviors in youth: a comparative study in Brazil, Colombia and Mexico

The physical, mental and social well being, refers to a new concept of health, far from a conceptualisations of absence of disease Additional challenges emerge as individuals face deep social inequities depending on their ethnicity, rural residence or low educational level, as these translate to poor access to health services and more difficulties to adhere to healthy living behaviors. The objective of this study was to assess the perception that adolescents and young adults in Latinamerica have of the importance of healthy living behaviors (HLB) in the physical, emotional and lifestyle spheres. The approach is considered quantitative and descriptive with a cross sectional design. The sampling consisted of 192 young adults in Brazil, Colombia and Mexico. The results show that participants prioritize higher emotional wellbeing. They state that the health crisis changed the perception, as now the value more the emotional side of health, and understand the status of a combination of the different aspects of wellness. The Latinamerican context poses a challenge in designing strategies with a holistic health perspective, with complexities in the economic and sociocultural domains.

Determine the BMI levels, self-concept and healthy life behaviours of children during a school based obesity training programme

Sedentary lifestyles and unhealthy nutrition, in particular, cause childhood obesity. The purpose of this semi-experimental research is to determine the changes in body mass index, self-concept, and healthy lifestyle behaviours of children during a training programme to prevent obesity. Children 9 and 15 years old were included from two public secondary schools. A total of 1609 students completed the study in the intervention and control groups (1022 vs 587, respectively). The training programme for the intervention group at the schools had three sessions in 12 weeks and was about obesity, body mass index (BMI) calculation, a healthy lifestyle and coping with stress. Data was collected through a sociodemographic data form, healthy lifestyle behaviours data form, Piers-Harris Children's Self-Concept Scale and weight-height measurements during the first and last weeks of the programme (except for the sociodemographic form). Before training, BMI's of children in the intervention group were higher than in the control group (19.61 ± 3.8 vs 19.00 ± 3.5, respectively). The gap between BMI scores of the groups was narrowed after the training (p > 0.05). The mean score on the Self-Concept Scale increased in the intervention group after the training (63.21 ± 9.5) as compared to before the training (61.16 ± 10.4); whereas in the control group, there were no differences found (p = 0.908). In the intervention group, the number of children who had breakfast after the training (81.1%) increased compared to before the training (74.1%) (p = 0.001). The trainings were provided to students to increase healthy nutrition, physical activity and to decrease sedentary lifestyles.

Systematic Review: Frameworks Used in School-Based Interventions, the Impact on Hispanic Children's Obesity-Related Outcomes

BACKGROUND

Childhood obesity among Hispanic children is a public health concern in the United States and Mexico. Although experiences from school-based intervention programs aimed at influencing obesity-related behaviors have been positive, the understanding of those framework elements that are associated with successful outcomes is limited. The purpose of this study was to examine the frameworks used within school-based intervention programs in the United States and Mexico that showed improvements in obesity-related outcomes among Hispanic children.

METHODS

A systematic review of the literature was conducted using 4 electronic databases. Inclusion criteria included: incorporating a framework or aspects of frameworks within an intervention, more than 50% of Hispanic children used in the study and obesity-related outcomes (eg, dietary behaviors and anthropometric measurements). Data extraction and evaluation were completed using the Academy of Nutrition and Dietetics Evidence Analysis Manual.

RESULTS

Ten articles (United States = 4; Mexico = 6) meeting inclusion criteria were evaluated. Eight studies that included a community-based framework, intensive nutrition education, and continuous communication among stakeholders resulted in improvements in dietary behaviors and anthropometric measurements among children compared to control groups.

CONCLUSIONS

Incorporating community-based frameworks may increase the efficacy of school-based intervention programs to reduce obesity-related outcomes among Hispanic children.

Elementary School-Based Obesity Intervention Using an Educational Curriculum

BACKGROUND

Pediatric obesity is a significant public health problem with a prevalence of 16.9% among US children. School-based obesity interventions show promise for reducing adiposity in elementary age children. This pilot study evaluated the impact of the Let's Go! 5-2-1-0 pediatric obesity intervention program in an elementary school setting.

METHODS

This was a cluster randomized controlled field trial comprising 8 classrooms of second- and third-grade children. The impact of implementation of a standardized 5-2-1-0 curriculum was evaluated in the classrooms by looking at health behavior (self-reported fruit and vegetable and sugar-containing beverage intake, and screen time), physical activity (steps measured by pedometer), and body mass index (BMI). Half of the classrooms were given 5-2-1-0 teaching over a 4-month period.

RESULTS

There was no statistical difference in improvement of healthy habits, BMI, or physical activity in the intervention group compared with the control group.

CONCLUSIONS

The 5-2-1-0 intervention used in this study was feasible. There was no significant change in healthy habits, likely due to the small number of participants in the study. The intervention and control sites were in different classrooms and there could be factors such as teacher enthusiasm, socioeconomic factors, and individual traits affecting habits. Future studies could use pre- and post-intervention quizzes to assess healthy habits knowledge retention, involving the environments the child participates in outside of school, using research-grade pedometers or accelerometers for measuring activity data collection, and recruiting larger samples to ensure adequate statistical power.