Kain Juliana, Leyton Bárbara, Concha Fernando, Weisstaub Gerardo, Lobos Luz, Bustos Nelly, Vio Fernando
Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago de Chile.
Arch Latinoam Nutr. 2012 Mar;62(1):60-7.
The main objective of this study was to assess the effectiveness of an obesity prevention intervention which included nutrition education and physical activity applied to low income Chilean children in a longitudinal three-year follow-up study. Participants included all 4-7 year old children from 7 public schools located in a low socioeconomic district of Santiago. The main aspects of the intervention were: training of teachers so they could apply an educational program on healthy eating, increase in physical education classes from 3 to 4 per week, and improvement of their quality. Weight, height, waist circumference (WC) and the 6-minute walk distance (6MWD) were assessed yearly in 597 children. We calculated BMI, BMI Z, % normal (N), overweight (OW) and obesity (OB), WC > 90th percentile (NHANES III) and fitness (6MWD/height). Annual changes in BMI Z, WC, 6MWD and fitness were assessed, using repeated measures ANOVA and the test of proportions. Knowledge in healthy eating was assessed during 2 of the 3 years. Results showed that % OB remained unchanged for 2 years (17%) but increased to 19.3% at follow-up. BMI Z increased from 0.3 to 0.38 (p = 0.052) in the N, remained unchanged in the OW, while decreasing significantly in the OB (2.73 to 2.41 p < 0.0001). % WC > 90 th percentile decreased in the OW and OB; 6 MWD was higher in the OW, but the increase in distance overtime was greater among the N. Overall fitness improved, however it was only significant among the N (p = 0.0002). There was a significant increase in food knowledge. We conclude that in spite of a decrease in BMI Z of the OB, an improvement in fitness in the N and food knowledge in all the children, obesity increased at follow-up. This study shows that in school-based obesity programs it is necessary to apply more intense interventions with another type of methodology; otherwise this condition will continue to rise.
本研究的主要目的是在一项为期三年的纵向随访研究中，评估一项肥胖预防干预措施的效果，该干预措施包括对智利低收入儿童进行营养教育和体育活动。参与者包括来自圣地亚哥一个社会经济地位较低地区的7所公立学校的所有4至7岁儿童。干预的主要方面包括：培训教师，使其能够实施一项关于健康饮食的教育计划；将体育课每周从3节增加到4节，并提高其质量。每年对597名儿童进行体重、身高、腰围（WC）和6分钟步行距离（6MWD）评估。我们计算了体重指数（BMI）、BMI Z值、正常百分比（N）、超重（OW）和肥胖（OB）、WC>第90百分位数（NHANES III）以及健康状况（6MWD/身高）。使用重复测量方差分析和比例检验评估BMI Z值、WC、6MWD和健康状况的年度变化。在三年中的两年对健康饮食知识进行评估。结果显示，肥胖百分比（%OB）在两年内保持不变（17%），但在随访时增至19.3%。正常组（N）的BMI Z值从0.3增至0.38（p = 0.052），超重组（OW）保持不变，而肥胖组（OB）显著下降（从2.73降至2.41，p < 0.0001）。超重组和肥胖组中WC>第90百分位数的百分比下降；超重组的6MWD更高，但随着时间推移距离的增加在正常组中更大。总体健康状况有所改善，但仅在正常组中显著（p = 0.0002）。食物知识有显著增加。我们得出结论，尽管肥胖组的BMI Z值有所下降，正常组的健康状况有所改善且所有儿童的食物知识有所增加，但随访时肥胖率仍有所上升。本研究表明，在基于学校的肥胖项目中，有必要采用另一种方法实施更强化的干预措施；否则这种情况将继续上升。
