OBJECTIVE:To assess the impact of a 6 months nutrition education and physical activity intervention on primary school children through changes in adiposity and physical fitness. DESIGN: Longitudinal school-based controlled evaluation study. SUBJECTS: Children from 1st to 8th grade, 2141 in intervention and 945 in control schools. INTERVENTION: Nutrition education for children and parents, 'healthier' kiosks, 90 min of additional physical activity (PA) weekly, behavioral PA program and active recess. MEASUREMENTS: Adiposity indices (BMI, BMI Z-score, triceps skinfold thickness (TSF), waist circumference and physical fitness (20 m shuttle run test and lower back flexibility). RESULTS: Positive effect on adiposity indices (except TSF) was observed in boys (Po0.001 for BMI Z), while both physical fitness parameters increased significantly in both boys (Po0.001 for each test) and girls (Po0.0001 for each test). A differential effect in BMI Z was observed according to baseline nutritional status. CONCLUSIONS: This intervention showed a robust effect on physical fitness in both genders and decreased adiposity only in boys.
Objectives: The purpose of this study was to analyse the determinants and consequences of the nutrition transition in Chile and describe the related health promotion policies. Design and setting: This is a descriptive, population-based study including data on demographic, diet, nutrition and biomedical related variables. Data came from the Food and Agriculture Organization (FAO), the National Institute of Statistics (INE), the Ministries of Planning, Health and Education surveillance systems, and national surveys. Results: As malnutrition decreased during the 1980s, obesity increased rapidly in all age groups. In adults, currently about 25% of women are obese (body mass index .30 kg m 22); particularly those from low socio-economic levels. Among preschoolers, obesity is now 10% while in 6-year-old children it is 17.5% (weight/height greater than two standard deviations (.2SD) of the World Health Organization reference). Nutritional risk factors are prevalent, diet is changing to a 'Western diet' with an increasing fat consumption, and sedentarianism is constant in all groups. High blood pressure (.140/90) is greater than 10% in adults. Diabetes is increasing in urban areas, including in the indigenous population, and more than 40% of adults have a cholesterol level of more than 200 mg ml 21. Conclusions: Promotion of healthy lifestyles is the main strategy to cope with this situation, particularly changing behaviour in food habits, physical activity and psychosocial factors. Changes in lifestyles will not only allow the prolonged life expectancy to be of better quality, but also will favour a decrease in the morbidity and mortality from chronic diseases, mainly cardiovascular diseases.
Objective: To analyse the nutritional status component of the nutrition transition in Chile in relation to the evolution of obesity rates in all age groups until 2005, comparing these with the goals established by the Ministry of Health for the period 2000-2010. Design and setting: A descriptive study which includes data on the nutritional status of the Chilean population categorised by age. The data originate from: (1) institutions which administer nutritional programmes -the National Board for Day-Care Centres (JUNJI) and the National Board for School Assistance and Scholarships (JUNAEB); (2) the Ministry of Health and the National Institute of Statistics; and (3) epidemiological studies which include adolescents and the elderly.Results: The prevalence of obesity in pre-school children attending JUNJI was 10.6% in 2005; by age group, it was 6% in 2-year-olds, 11% in 3-year-olds and 14% in 4-year-olds. Among schoolchildren in first grade, obesity prevalence was 18.5%. In pregnant women, obesity has increased from 12% in 1987 to 33% in 2004. For adults, the 2003 National Health Survey showed that the prevalence of obesity (body mass index (BMI) $ 30 kg m 22 ) was 22% and of morbid obesity (BMI $ 40 kg m 22 ), 1.3%. Obesity varied according to gender and educational level, being higher among women (25% vs. 19% in men) and adults from low socio-economic levels. In the elderly there was a high prevalence of obesity in the 60-64 years age group for both men (35.6%) and women (44.1%), decreasing to 18% and 26%, respectively, in those aged 75 years and older. Conclusions: The goals for the decade (2000-2010) consider a reduction of obesity rates from 10% to 7% in pre-school children attending JUNJI, and from 16% to 12% in schoolchildren attending first grade. For pregnant women, the goal is to reduce the prevalence from 32% to 28%. Despite the implementation of initiatives in nutrition and physical activity, these have been insufficient to shift the rising trend in obesity. The explanation could be that after a rapid rise in obesity in children and pregnant women between 1987 and 2000, a stabilisation period or a 'plateau' is observed. In that situation, very effective interventions are required to reduce obesity, because it is extremely difficult to reverse the trend. Some positive experiences are being implemented in Chile, but government priorities are not focused in health promotion. A comprehensive State Policy in health promotion, that includes the public and private sectors related with obesity, is needed to reverse this trend.
Objective: To assess the nutritional status, food consumption and physical activity (PA) habits of Chilean school children, as a baseline for developing an educational intervention. Design: Cross-sectional study. Subjects: A total of 1701 children from 3rd to 7th grade in nine schools located in three geographical regions. Methods: We determined body mass index, food consumption (quantified FFQ which we categorised into five groups), PA in terms of TV viewing and frequency of after school PA. The data were analysed according to age, nutritional status and gender. A logistic regression analysis was performed using obesity as outcome. Results: Obesity was higher among boys; younger children presented higher prevalence in both genders. Daily intake of dairy products varied between 240 and 308 g, fruits/vegetables, between 197 and 271 g, energy-dense foods between 343 and 460 g. In all, 22.3 and 47% of the children watched over 3 h of TV during the week and weekend, respectively. Older children watched significantly more TV during the week, while on weekends all children increased this time significantly. Boys were more active than girls after school. The logistic regression analysis showed a significant association between obesity and low intake of dairy products. Conclusions: Prevalence of obesity among Chilean children is high. Although TV time, intake of energy dense foods and fruits/ vegetables appeared as risk factors for obesity, only dairy consumption was significantly associated with obesity. Sponsorship: FAO
Obesity rates have increased markedly in Latin America, especially during the last 10-15 years, becoming a public health problem in most countries. Prevalence of obesity among preschool children remains low, while among schoolchildren it has increased considerably. Prevalence is high in the adult population, especially among women with less schooling. In developed populations, obesity occurs more frequently among the poor; the opposite occurs in less developed societies, where in households undergoing nutritional transition, underweight can coexist with obesity. The most important determinant factors involved in the increasing obesity prevalence are fetal and infant nutritional conditions (stunting), education and socioeconomic conditions, dietary changes (especially increased total energy intake), and physical inactivity. Because chronic diseases are the main causes of death in the Region and obesity is one of the main risk factors for these diseases, policies to improve economic and educational levels with the implementation of health promotion and prevention should be a priority in every country.
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