Margarita Andrade

Characteristics of the diet and patterns of physical activity in obese Chilean preschoolers

Abstract The prevalence of obesity among chilean children has increased progressively during the last decade. A study was carried out with the objective of identifying the two most important environmental factors involved in this condition, characteristics of the diet and patterns of physical activity. It was a case-control study which included 237 obese, weight/height (WH)>2 S.D. WHO) and 449 non-obese (WH between -1 and 1 S. D.), four year old low income children who regularly assisted to 8 health centers in Santiago during 1995/96. Two questionnaires were applied to the mother: a food frequency plus a physical activity recall. The first one registered her childs usual daily food intake, the second one, the childs usual daily activities, defining 5 categories, according to their energy cost. In terms of the diet, there was no difference in the estimated intake of total energy, energy dense foods or macronutrients between obese and non-obese. For boys, for example, the estimated energy intake was 1823±442 versus 1778±373 Kcal respectively. With respect to physical activity, the results showed that in obese boys, the average time spent on the different categories was: sleep, 11.2 ± 1 hr; TV, 3.2 ±1.8 hr; sedentary (includes TV), 7.8 ±2 hr; moderate, 3.2± 2 hr and intense, 1.9 ± 1.8 hr. No significant differences with these figures were observed for non-obese boys as for both obese as non-obese girls, with the exception of the moderate and intense categories, in which the first one was significantly greater and the second significantly smaller in girls. The calculated physical activity level (PAL) was low and very similar for both obese as non-obese, 1.46±0.14 and 1.47 ±0.12, respectively. Although no differences were found in either the estimated energy consumption or in the PAL values between obese and non-obese, probably due to the weaknesses of the methodologies, to the variability of the diet, and to the difficulty in identifying the persistent small dietary imbalances which lead to obesity, we have shown nevertheless, that these children have significantly higher estimated intakes of energy than recommended and lead very sedentary lives.

Nutrition Education in Chilean Primary Schools

The purpose of this study was to incorporate nutrition education in Chilean primary schools. The baseline information included nutritional status, food consumption and physical activity of 1,701 children from 3rd to 7th grade in ten urban and rural schools. Main results showed a high prevalence of obesity (15.4%) and overweight (19.6%), low consumption of vegetables, fruits, and dairy products, high intake of snacks and a low level of physical activity, especially in girls. Because the Ministry of Education does not allow the incorporation of new programs into the curriculum, the educational strategy was based on the development of a text book, a teachers guide, five practical guides for students from third to eighth grade and a CD-Rom. These materials were validated by 36 teachers in six schools through an educational intervention. Teachers and students considered the educational materials useful, motivational and easy to understand. This program is being implemented in 57 schools.

Pilot nutrition and physical activity intervention for preschool children attending daycare centres (JUNJI); primary and secondary outcomes

INTRODUCTION A pilot intervention was conducted to promote physical activity and nutrition in public preschool education (near half a million children in Chile), in order to prevent obesity. OBJECTIVE To assess the primary (body fat) and secondary outcomes (physical activity and energy intake) of a nutrition and physical activity pilot intervention for preschool children, attending day care centres. METHODS A pilot intervention in six day care centres selected at random (n = 530), in 4-5 years old preschool children, Santiago, Chile intending to: provide nutritional and physical activity education to educators and health promotion activities for the family, which in turn, will affect the primary (body fat), and secondary outcomes (physical activity pattern and energy food intake) were measured in a representative subsample of 120 intervened and 145 controls children. RESULTS In relation to secondary outcomes monitoring, moderate-vigorous activity was duplicated in the intervention group (+5.4% and +4.7%, respectively), in both obese and eutrophic children. Energy intake decreased in 11.7% in obese and 7.5% in eutrophic children. Dietary fat intake was reduced (-11 g in obese and -8.4 g in eutrophic children). Intervened obese children reduced body fat in 1.5%, meanwhile in control obese children, body fat increased 1.3% (p < 0.01). CONCLUSIONS The pilot intervention demonstrated the feasibility to influence dietary risk factors and physical activity at the day care centres and families. Therefore, the implementation of the validated intervention program will be tested in different weather conditions, to prevent unhealthy habits in preschool children and their families.