Under 5 Energize: Tracking Progress of a Preschool Nutrition and Physical Activity Programme with Regional Measures of Body Size and Dental Health at Age of Four Years

Rush, Elaine; Obolonkin, Victor; Young, Leanne; Kirk, Madeleine; Tseng, Marilyn

doi:10.3390/nu9050456

Cited by 8 publications

(15 citation statements)

References 21 publications

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“…Many of the studies reviewed reported improvements in nutrition-related outcomes, although methodological quality varied. Three interventions with a focus on reducing sugar-sweetened beverages in children’s settings demonstrated statistically significant improvements in health outcomes for Indigenous children, including dental health 25 31 and insulin sensitivity, 43 suggesting a pro-equity effect. Although most school-based interventions did not change BMI, those studies that evaluated BMI as an outcome were of relatively short duration.…”

Section: Discussionmentioning

confidence: 99%

Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review

et al. 2020

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IntroductionIndigenous Peoples worldwide endure unacceptable health disparities with undernutrition and food insecurity often coexisting with obesity and chronic diseases. Policy-level actions are required to eliminate malnutrition in all its forms. However, there has been no systematic synthesis of the evidence of effectiveness of food and nutrition policies for Indigenous Peoples around the world. This review fills that gap.MethodsEight databases were searched for peer-reviewed literature, published between 2000 and 2019. Relevant websites were searched for grey literature. Articles were included if they were original studies, published in English and included data from Indigenous Peoples from Western colonised countries, evaluated a food or nutrition policy (or intervention), and provided quantitative impact/outcome data. Study screening, data extraction and quality assessment were undertaken independently by two authors, at least one of whom was Indigenous. A narrative synthesis was undertaken with studies grouped according to the NOURISHING food policy framework.ResultsWe identified 78 studies from Canada, Australia, Aotearoa/New Zealand and the USA. Most studies evaluated targeted interventions, focused on rural or remote Indigenous communities. The most effective interventions combined educational strategies with policies targeting food price, composition and/or availability, particularly in retail and school environments. Interventions to reduce exposure to unhealthy food advertising was the only area of the NOURISHING framework not represented in the literature. Few studies examined the impact of universal food policies on Indigenous Peoples’ diets, health or well-being.ConclusionBoth targeted and universal policy action can be effective for Indigenous Peoples. Actions that modify the structures and systems governing food supply through improved availability, access and affordability of healthy foods should be prioritised. More high-quality evidence on the impact of universal food and nutrition policy actions for Indigenous Peoples is required, particularly in urban areas and in the area of food marketing.

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Section: Discussionmentioning

confidence: 99%

Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review

et al. 2020

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“…In the B4SC data set, deprivation (based on the location of the child's home) is reported on an integral scale of 1 to 5, with 1 being the least deprived and 5 the most deprived. Details of measurement protocols have been reported previously 12 and are mandated by the Ministry of Health. 13 From the initial set of 281,680 records, we removed any that were incomplete and/or the WHO z-score for height, weight, or implausible BMI z-scores that were <− 3 or >+ 4.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously analysed regional data from the national and free New Zealand Before School Check (B4SC) and reported that between January 2013 and September 2016, there was no observable change in obesity prevalence. 12 However, for the children attending the U5Ee centres the prevalence of visible dental decay decreased, with the decrease particularly marked for the indigenous Māori children, in whom the prevalence declined from 19 to 16% (P for trend 0.02). It is important to document the time trend of the impact of U5E on overweight/obesity and dental decay particularly from 2015 onwards when the U5E intervention was fully implemented in all selected preschools (n = 121).…”

Section: Introductionmentioning

confidence: 94%

Secular trends 2013–2017 in overweight and visible dental decay in New Zealand preschool children: influence of ethnicity, deprivation and the Under-5-Energize nutrition and physical activity programme

Rush

Kirk

Parmar

et al. 2018

J Dev Orig Health Dis

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Early-life intervention to reduce obesity and poor dental health through early-life nutrition will improve health outcomes in later life. This study examined the prevalence of overweight and obesity and visual dental decay in 4-year old children in New Zealand between 2013 and 2017, and the impact of a nutrition and physical activity intervention programme, Under-5-Energize (U5E), on prevalence of these conditions within ethnic groups and by deprivation. The data set included 277,963 4-year-old children, including 25,140 from the Waikato region children of whom 8067 attended one of the 121 early childhood centres (ECC) receiving the U5E programme from 2014. Purposively the U5E-ECC selected were attended by higher proportions of indigenous Māori children and children living in higher deprivation areas than non-U5E-ECC. From 2013 to 2017, the overall prevalence of obesity, as defined by World Health Organisation criteria, declined slightly but rates of dental decay did not change. In the Waikato region, the prevalence of obesity declined in non-Māori children from 2015 to 2017 and children attending U5E-ECC had lower rates of dental decay than non-U5E children. Binary logistic regression showed that between 2015 and 2017 visible dental decay was more likely in children who were Māori (3.06×3.17), living in high deprivation (1.54×1.66) and male (1.10) but less likely if attending an U5E-ECC (0.83×0.79). Early-life intervention had efficacy at reducing dental decay, and demonstrated that the origins of disparities in health such as ethnicity and deprivation need to be addressed further to break the intergenerational cycles of poor health.

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“…There is also limited inclusion of nutrition in teacher training across the ECE sector in New Zealand and nutrition education opportunities for ECE staff are sparse ( 49 ) . A possible way to achieve more professional development in nutrition for ECE staff would be to incorporate aspects of the Heart Foundation’s HHA into widespread teacher training and professional practice, and/or the expansion of health-promotion programmes such as the HHA or Under 5 Energize ( 50 ) , which promote knowledge transfer to staff. The HHA is currently voluntary and targeted to early education services in areas of high deprivation ( 51 ) .…”

Section: Discussionmentioning

confidence: 99%

Pre-school nutrition-related behaviours at home and early childhood education services: findings from the Growing Up in New Zealand longitudinal study

Gerritsen¹,

Anderson²,

Morton³

et al. 2018

Public Health Nutr.

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Children, across all socio-economic positions, may not experience RNB at home. ECE settings provide an opportunity to improve or support behaviours learned at home. Targeting of health-promotion programmes in high-deprivation areas has resulted in higher adherence to RNB at these ECE services. The lack of congruence between home and ECE behaviours suggests health-promotion messages may not be effectively communicated to parents/family. Greater support is required across the ECE sector to adhere to RNB and promote wider change that can reach into homes.

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Under 5 Energize: Tracking Progress of a Preschool Nutrition and Physical Activity Programme with Regional Measures of Body Size and Dental Health at Age of Four Years

Cited by 8 publications

References 21 publications

Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review

Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review

Secular trends 2013–2017 in overweight and visible dental decay in New Zealand preschool children: influence of ethnicity, deprivation and the Under-5-Energize nutrition and physical activity programme

Pre-school nutrition-related behaviours at home and early childhood education services: findings from the Growing Up in New Zealand longitudinal study

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