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[对一项肥胖预防干预措施的评估,该措施包括在智利圣地亚哥的公立学校开展营养教育和体育活动]

[Evaluation of an obesity prevention intervention which included nutrition education and physical activity applied in public schools of Santiago, Chile].

作者信息

Kain Juliana, Leyton Bárbara, Concha Fernando, Weisstaub Gerardo, Lobos Luz, Bustos Nelly, Vio Fernando

机构信息

Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago de Chile.

出版信息

Arch Latinoam Nutr. 2012 Mar;62(1):60-7.

Abstract

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.

摘要

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。

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