Effects of controlled school-based multi-component model of nutrition and lifestyle interventions on behavior modification, anthropometry and metabolic risk profile of urban Asian Indian adolescents in North India

Abstract

Background/Objectives: To study the effectiveness of a multi-component intervention model of nutrition and lifestyle education on behavior modification, anthropometry and metabolic risk profile of urban Asian-Indian adolescents in North India. Subjects/Methods: Two schools matched for student strength and middle socioeconomic strata were randomly allocated to intervention and control group. Changes in nutrition-related knowledge, attitude, lifestyle practices, food frequency and body image of eleventh-grade students (15-17 years) in both schools were tested using a validated questionnaire. Anthropometric and biochemical measurements were made using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. Results: At 6 months follow-up, significant improvement in several domains of knowledge was observed in intervention children (n ¼ 99; males ¼ 60; females ¼ 39) as compared with control school children (n ¼ 102; males ¼ 61; females ¼ 41). In the intervention group, significantly lower proportion of children consumed aerated drinks (15.1%; Po0.001) and energy-dense unhealthy foods (8.9%; P ¼ 0.03), whereas significantly higher proportion brought tiffin (packed lunch) to school (14.9%; P ¼ 0.004) and brought a fruit in their tiffin (30.7%; Po0.001) as compared with the control group. Significant decrease in mean waist circumference (P ¼ 0.02, 95% confidence interval (CI) ¼ À2.43,À0.17), sagittal abdominal diameter (Po0.001, 95% CI ¼ À0.82,À0.09), waist-to-hip ratio (P ¼ 0.02, 95% CI ¼ À0.03,À0.004) and fasting blood glucose (P ¼ 0.05, 95% CI ¼ À0.09, 5.00) was seen in intervention as compared with control school children. Conclusions: Multi-component model of nutrition and lifestyle education was successful in improving the nutrition-related knowledge, eating habits and lifestyle practices, and resulted in beneficial changes in anthropometric and biochemical profiles of the Asian Indian adolescents. This model should be applied on countrywide basis to prevent obesity and diabetes.

Kost i skole og barnehage og betydningen for helse og læring

“…Ser på effekten av automater i forhold til spisevaner Pelsser et al 2009 Behandling av barn med ADHD Ser på forskjeller i selvvurdert helse blant ungdommer Robinson-O'Brien et al 2010 Ingen relevante utfall (laering eller helse), sammenheng mellom å spise det ene og det andre... Rogers et al 2010 Ser på sammenheng mellom kosthold i barndom og sykdom/ikke skolemat, ikke skolesetting Ruottinen et al 2010 Ser på naeringsinnhold og effekten av det Tiltak: Bevisstgjøring og opplaering Singhal et al 2010 Tiltak er bevisstgjøring, ikke mattilbud St-Onge et al 2009 Ser på helseutfall i forhold til omlegging av diett hos barn. Story et al 2006 Vurdering av politikkutforming Suarez-Balcazar et al 2007 Systemendringer i skolen Ser ikke på relevante utfall Wojcicki and Heyman 2006 Vurderer utfall av politikk Omhandler Kina.…”

Pilot project of the Nutrition-Friendly School Initiative (NFSI) in Ouagadougou, Burkina Faso and Cotonou, Benin, in West Africa

“…It was suggested that multi-component interventions (promoting healthy eating, less sedentary behavior and more physical activity), particularly when they target whole communities and environments rather than merely schoolchildren and education, may be more effective in developed countries (17), as well as in developing countries such as in the Pacific (18). In a metropolitan area in North India, a case-control study among school adolescents shows for the first time that a low-cost nutrition and lifestyle educational intervention was effective in improving participants' diet, reducing abdominal adiposity and reducing fasting blood glucose levels, after only a few months (19). Thus, improving the nutritional status of school-age children in developing countries appears feasible, whether undernutrition or overnutrition is the main problem (18,19).…”

“…In a metropolitan area in North India, a case-control study among school adolescents shows for the first time that a low-cost nutrition and lifestyle educational intervention was effective in improving participants' diet, reducing abdominal adiposity and reducing fasting blood glucose levels, after only a few months (19). Thus, improving the nutritional status of school-age children in developing countries appears feasible, whether undernutrition or overnutrition is the main problem (18,19). Furthermore, healthpromoting school approaches, including NFSI, engages parents and other community members and leaders in actively preventing child malnutrition in all its forms, as is claimed for Africa (20).…”

Effectiveness of preventive school-based obesity interventions in low- and middle-income countries: a systematic review

“…Overall, 13 interventions involved school staff, communities, parents, children, and/or families and are referred to as multicomponent interventions in the remainder of this review. Four of the 25 interventions provided an individual counseling component (44)(45)(46)(47).…”