Advertisement

Promotion of Cardiovascular Health in Preschool Children: 36-Month Cohort Follow-up

      Abstract

      Background

      Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low- and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months.

      Methods

      Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children's knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children's nutritional status and the mean change in parent's knowledge, attitudes, and habits.

      Results

      We included 1216 children, 3-5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001).

      Conclusions

      After 36 months, the educational intervention maintained a beneficial trend toward a healthy lifestyle in children and their parents.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wang H.
        • Dwyer-Lindgren L.
        • Lofgren K.T.
        • et al.
        Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010.
        Lancet. 2012; 380: 2071-2094
        • World Health Organization
        Informe sobre la situación mundial de las enfermedades no transmisibles 2010.
        ([Spanish]) Organizacion Mundial de la Salud, Geneva, Switzerland2010
        • Deshmukh-Taskar P.
        • Nicklas T.A.
        • Morales M.
        • Yang S.J.
        • Zakeri I.
        • Berenson G.S.
        Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study.
        Eur J Clin Nutr. 2006; 60: 48-57
        • Freedman D.S.
        • Khan L.K.
        • Dietz W.H.
        • Srinivasan S.R.
        • Berenson G.S.
        Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study.
        Pediatrics. 2001; 108: 712-718
        • Virdis A.
        • Ghiadoni L.
        • Masi S.
        • et al.
        Obesity in the childhood: a link to adult hypertension.
        Curr Pharm Des. 2009; 15: 1063-1071
        • Centers for Disease Control and Prevention
        Physical Activity and Good Nutrition: Essential Elements to Prevent Chronic Diseases and Obesity 2008.
        Center for Disease Control and Prevention, Atlanta, GA2008
        • Summerbell C.D.
        • Waters E.
        • Edmunds L.D.
        • Kelly S.
        • Brown T.
        • Campbell K.J.
        Interventions for preventing obesity in children.
        Cochrane Database Syst Rev. 2005; 3: CD001871
        • Centers for Disease Control
        Increasing physical activity. A report on recommendations of the Task Force on Community Preventive Services.
        MMWR Recomm Rep. 2001; 50: 1-14
        • Ekelund U.
        • Luan J.
        • Sherar L.B.
        • Esliger D.W.
        • Griew P.
        • Cooper A.
        Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents.
        JAMA. 2012; 307: 704-712
        • US Department of Health and Human Services
        Physical Activity Evaluation Handbook.
        US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA2002
        • Cespedes J.
        • Briceno G.
        • Farkouh M.E.
        • et al.
        Targeting preschool children to promote cardiovascular health: cluster randomized trial.
        Am J Med. 2013; 126: 27-35.e23
        • Shamah-Levy T.
        • Villalpando-Hernandez S.
        • Rivera-Dommarco J.
        Manual de procedimientos para proyectos de nutricion.
        ([Spanish]) Instituto de Salud Publica, Cuernavaca, Morelos, Mexico2006
        • Kuczmarski R.J.
        • Ogden C.L.
        • Guo S.S.
        • et al.
        2000 CDC growth charts for the United States: methods and development.
        Vital Health Stat 11. 2002; : 1-190
      1. El Departamento Administrativo Nacional de Estadistica (DANE). DANE Web site. Available at: http://www.dane.gov.co/#twoj_fragment1-4. Accessed November 10, 2010.

        • Verstraeten R.
        • Roberfroid D.
        • Lachat C.
        • et al.
        Effectiveness of preventive school-based obesity interventions in low- and middle-income countries: a systematic review.
        Am J Clin Nutr. 2012; 96: 415-438
        • Nixon C.A.
        • Moore H.J.
        • Douthwaite W.
        • et al.
        Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4-6-year-olds: a systematic review.
        Obes Rev. 2012; 13: 106-117
        • Colin-Ramierz E.
        • Castillo-Martinez L.
        • Orea-Tejada A.
        • Vergara A.
        • Villa A.
        Impact of a school-based intervention to cardiovascular risk factors prevention (RESCATE) on physican activity and diet in Mexican children aged 9-10 years.
        Revista Espanola de Nutricion Comunitaria. 2009; 15: 71-80
        • Goldfield G.S.
        • Harvey A.
        • Grattan K.
        • Adamo K.B.
        Physical activity promotion in the preschool years: a critical period to intervene.
        Int J Environ Res Public Health. 2012; 9: 1326-1342
        • Kreichauf S.
        • Wildgruber A.
        • Krombholz H.
        • et al.
        Critical narrative review to identify educational strategies promoting physical activity in preschool.
        Obes Rev. 2012; 13: 96-105
        • Manios Y.
        • Grammatikaki E.
        • Androutsos O.
        • et al.
        A systematic approach for the development of a kindergarten-based intervention for the prevention of obesity in preschool age children: the ToyBox-study.
        Obes Rev. 2012; 13: 3-12
        • Instituto Colombiano de Bienestar Familiar (ICBF)
        Encuesta Nacional de la Situacion Nutricional en Colombia 2010 (ENSIN).
        Instituto Colombiano de Bienestar Familiar, Bogota, Colombia2010
        • Kain J.
        • Leyton B.
        • Concha F.
        • Salazar G.
        • Lobos L.
        • Vio F.
        Effect of counselling school teachers on healthy lifestyle on the impact of a program to reduce childhood obesity.
        Rev Med Chil. 2010; 138 ([Spanish]): 181-187
        • Jiang J.
        • Xia X.
        • Greiner T.
        • Wu G.
        • Lian G.
        • Rosenqvist U.
        The effects of a 3-year obesity intervention in schoolchildren in Beijing.
        Child Care Health Dev. 2007; 33: 641-646
        • Kain J.
        • Leyton B.
        • Cerda R.
        • Vio F.
        • Uauy R.
        Two-year controlled effectiveness trial of a school-based intervention to prevent obesity in Chilean children.
        Public Health Nutr. 2009; 12: 1451-1461
        • Kain J.
        • Uauy R.
        • Leyton B.
        • Cerda R.
        • Olivares S.
        • Vio F.
        Effectiveness of a dietary and physical activity intervention to prevent obesity in school age children.
        Rev Med Chil. 2008; 136 ([Spanish]): 22-30
        • Alcaldia Mayor de Bogota
        Promoción de la Alimentación Saludable y la Actividad Física.
        ([Spanish]) Alcaldia Mayor de Bogotá, Bogotá, Colombia2012