Roberta Roggia Friedrich

Efeito de intervenções sobre o índice de massa corporal em escolares

OBJECTIVE To evaluate the effect of intervention programs using nutritional education, physical activity or both on the reduction of body mass index in school-age students. METHODS The systematic review with meta-analysis included randomized controlled studies available from the following electronic databases for the years 1998 to 2010: PubMed, Lilacs, Embase, Scopus, Web of Science and Cochrane Library. The descriptors were: randomized controlled trial, overweight, obesity, body mass index, child, adolescent, physical activity, nutrition education and Schools. A weighted average was based on the standardized means difference and used a 95% confidence interval. The inconsistency test was utilized to evaluate the heterogeneity of studies. RESULTS Initially, 995 studies were identified, of which 23 were included, and 3 meta-analyses were performed. Isolated physical activity interventions did not present a significant reduction in BMI, with a standardized mean difference of -0.02 (95%CI: -0.08; 0.04). A similar result (n= 3,524) was observed in the isolated interventions of nutritional education, with a standardized mean difference of -0.03 (95%CI: -0.10; 0.04).When the interventions with physical activity and nutritional education were combined, the result of the meta-analysis (n= 9,997) presented a statistically significant effect in the reduction of body mass index in school-age students, with a standardized mean difference: -0.37 (95%CI: -0.63; -0.12). CONCLUSIONS The interventions that combined physical activity and nutritional education had more positive effects in the reduction of body mass index among school-age students than when they were applied individually.OBJETIVO: Avaliar o efeito dos programas de intervencoes com a atividade fisica e/ou a educacao nutricional na reducao do indice de massa corporal em escolares. METODOS: Revisao sistematica com metanalise de estudos controlados randomizados disponiveis nas seguintes bases de dados eletronicas entre o ano de 1998 a 2010: PubMed, Lilacs, Embase, Scopus, Web of Science e Cochrane Library, com os descritores: estudo controlado randomizado, sobrepeso, obesidade, indice de massa corporal, crianca, adolescente, atividade fisica, educacao nutricional e escolas. Medida de sumario baseada na diferenca das medias padronizadas foi usada com intervalo de 95% de confianca. O teste de inconsistencia foi utilizado para avaliar a heterogeneidade dos estudos. RESULTADOS: Foram identificados 995 estudos, dos quais 23 foram incluidos e realizadas tres metanalises. Intervencoes isoladas com atividade fisica nao apresentaram efeito significativo na reducao do indice de massa corporal, com diferenca das medias padronizadas: -0,02 (IC95% -0,08;0,04). Resultado semelhante (n = 3.524) foi observado nas intervencoes isoladas com educacao nutricional, com diferenca das medias padronizadas: -0,03 (IC95% -0,10;0,04). Quando combinadas as intervencoes com atividade fisica e educacao nutricional, o resultado da metanalise (n = 9.997) apresentou efeito estatisticamente significativo na reducao do indice de massa corporal em escolares, com diferenca das medias padronizadas: - 0,37 (IC95% -0,63;-0,12). CONCLUSOES: As intervencoes combinadas de atividade fisica e educacao nutricional tiveram mais efeitos positivos na reducao do indice de massa corporal em escolares do que quando aplicadas isoladamente.

Effect of interventions on the body mass index of school-age students

OBJECTIVE To evaluate the effect of intervention programs using nutritional education, physical activity or both on the reduction of body mass index in school-age students. METHODS The systematic review with meta-analysis included randomized controlled studies available from the following electronic databases for the years 1998 to 2010: PubMed, Lilacs, Embase, Scopus, Web of Science and Cochrane Library. The descriptors were: randomized controlled trial, overweight, obesity, body mass index, child, adolescent, physical activity, nutrition education and Schools. A weighted average was based on the standardized means difference and used a 95% confidence interval. The inconsistency test was utilized to evaluate the heterogeneity of studies. RESULTS Initially, 995 studies were identified, of which 23 were included, and 3 meta-analyses were performed. Isolated physical activity interventions did not present a significant reduction in BMI, with a standardized mean difference of -0.02 (95%CI: -0.08; 0.04). A similar result (n= 3,524) was observed in the isolated interventions of nutritional education, with a standardized mean difference of -0.03 (95%CI: -0.10; 0.04).When the interventions with physical activity and nutritional education were combined, the result of the meta-analysis (n= 9,997) presented a statistically significant effect in the reduction of body mass index in school-age students, with a standardized mean difference: -0.37 (95%CI: -0.63; -0.12). CONCLUSIONS The interventions that combined physical activity and nutritional education had more positive effects in the reduction of body mass index among school-age students than when they were applied individually.OBJETIVO: Avaliar o efeito dos programas de intervencoes com a atividade fisica e/ou a educacao nutricional na reducao do indice de massa corporal em escolares. METODOS: Revisao sistematica com metanalise de estudos controlados randomizados disponiveis nas seguintes bases de dados eletronicas entre o ano de 1998 a 2010: PubMed, Lilacs, Embase, Scopus, Web of Science e Cochrane Library, com os descritores: estudo controlado randomizado, sobrepeso, obesidade, indice de massa corporal, crianca, adolescente, atividade fisica, educacao nutricional e escolas. Medida de sumario baseada na diferenca das medias padronizadas foi usada com intervalo de 95% de confianca. O teste de inconsistencia foi utilizado para avaliar a heterogeneidade dos estudos. RESULTADOS: Foram identificados 995 estudos, dos quais 23 foram incluidos e realizadas tres metanalises. Intervencoes isoladas com atividade fisica nao apresentaram efeito significativo na reducao do indice de massa corporal, com diferenca das medias padronizadas: -0,02 (IC95% -0,08;0,04). Resultado semelhante (n = 3.524) foi observado nas intervencoes isoladas com educacao nutricional, com diferenca das medias padronizadas: -0,03 (IC95% -0,10;0,04). Quando combinadas as intervencoes com atividade fisica e educacao nutricional, o resultado da metanalise (n = 9.997) apresentou efeito estatisticamente significativo na reducao do indice de massa corporal em escolares, com diferenca das medias padronizadas: - 0,37 (IC95% -0,63;-0,12). CONCLUSOES: As intervencoes combinadas de atividade fisica e educacao nutricional tiveram mais efeitos positivos na reducao do indice de massa corporal em escolares do que quando aplicadas isoladamente.

Effect of intervention programs in schools to reduce screen time: a meta-analysis

OBJECTIVE to evaluate the effects of intervention program strategies on the time spent on activities such as watching television, playing videogames, and using the computer among schoolchildren. SOURCES a search for randomized controlled trials available in the literature was performed in the following electronic databases: PubMed, Lilacs, Embase, Scopus, Web of Science, and Cochrane Library using the following Keywords randomized controlled trial, intervention studies, sedentary lifestyle, screen time, and school. A summary measure based on the standardized mean difference was used with a 95% confidence interval. DATA SYNTHESIS a total of 1,552 studies were identified, of which 16 were included in the meta-analysis. The interventions in the randomized controlled trials (n=8,785) showed a significant effect in reducing screen time, with a standardized mean difference (random effect) of: -0.25 (-0.37, -0.13), p<0.01. CONCLUSION interventions have demonstrated the positive effects of the decrease of screen time among schoolchildren.

Ultra-processed food consumption in children from a Basic Health Unit

OBJECTIVES To evaluate the contribution of ultra-processed food (UPF) on the dietary consumption of children treated at a Basic Health Unit and the associated factors. METHODOLOGY Cross-sectional study carried out with a convenience sample of 204 children, aged 2-10 years old, in Southern Brazil. Childrens food intake was assessed using a 24-h recall questionnaire. Food items were classified as minimally processed, processed for culinary use, and ultra-processed. A semi-structured questionnaire was applied to collect socio-demographic and anthropometric variables. Overweight in children was classified using a Z score >2 for children younger than 5 and Z score >+1 for those aged between 5 and 10 years, using the body mass index for age. RESULTS Overweight frequency was 34% (95% CI: 28-41%). Mean energy consumption was 1672.3 kcal/day, with 47% (95% CI: 45-49%) coming from ultra-processed food. In the multiple linear regression model, maternal education (r=0.23; p=0.001) and child age (r=0.40; p<0.001) were factors associated with a greater percentage of UPF in the diet (r=0.42; p<0.001). Additionally, a statistically significant trend for higher UPF consumption was observed when data were stratified by child age and maternal educational level (p<0.001). CONCLUSIONS The contribution of UPF is significant in childrens diets and age appears to be an important factor for the consumption of such products.

Design, randomization and methodology of the TriAtiva Program to reduce obesity in school children in Southern Brazil

BackgroundThe prevalence of child obesity in Brazil has increased rapidly in recent decades. There is, therefore, an urgent need to develop effective strategies to prevent and control child obesity. In light of these considerations, an intervention program with a focus on nutrition education and physical activity was developed for to prevent and control obesity in schools. The intervention was called the TriAtiva Program: Education, Nutrition and Physical Activity. This article describes the design, randomization and method used to evaluate the TriAtiva program.Methods/designThis randomized controlled cluster trial was performed in 12 municipal schools in the city of Porto Alegre/RS (six schools in the intervention group and six control schools) which offered first- through fourth grade, during one school year. The TriAtiva Program was implemented through educational activities related to healthy eating and physical activity, creating an environment which promoted student health while involving the school community and student families. The primary outcome of the present study was body mass, while its secondary outcomes were waist circumference, percent body fat, blood pressure and behavioural variables such as eating habits and physical activity levels, as well as the prevalence, incidence and remission rates of obesity.DiscussionThe intervention was developed based on a comprehensive review of controlled trials of similar design. The TriAtiva Program: Education, Nutrition and Physical Activity was the first study in Southern Brazil to use a randomized controlled design to evaluate an intervention involving both nutrition education and physical activity in schools. Our results will contribute to the development of future interventions aimed at preventing and controlling child obesity in schools, especially in Brazil. Brazilian Clinical Trials Registry (REBEC) number RBR2xx2z4.

Efecto de las intervenciones con actividad física y educación nutricional sobre el índice de masa corporal en escolares

OBJECTIVE To evaluate the effect of intervention programs using nutritional education, physical activity or both on the reduction of body mass index in school-age students. METHODS The systematic review with meta-analysis included randomized controlled studies available from the following electronic databases for the years 1998 to 2010: PubMed, Lilacs, Embase, Scopus, Web of Science and Cochrane Library. The descriptors were: randomized controlled trial, overweight, obesity, body mass index, child, adolescent, physical activity, nutrition education and Schools. A weighted average was based on the standardized means difference and used a 95% confidence interval. The inconsistency test was utilized to evaluate the heterogeneity of studies. RESULTS Initially, 995 studies were identified, of which 23 were included, and 3 meta-analyses were performed. Isolated physical activity interventions did not present a significant reduction in BMI, with a standardized mean difference of -0.02 (95%CI: -0.08; 0.04). A similar result (n= 3,524) was observed in the isolated interventions of nutritional education, with a standardized mean difference of -0.03 (95%CI: -0.10; 0.04).When the interventions with physical activity and nutritional education were combined, the result of the meta-analysis (n= 9,997) presented a statistically significant effect in the reduction of body mass index in school-age students, with a standardized mean difference: -0.37 (95%CI: -0.63; -0.12). CONCLUSIONS The interventions that combined physical activity and nutritional education had more positive effects in the reduction of body mass index among school-age students than when they were applied individually.OBJETIVO: Avaliar o efeito dos programas de intervencoes com a atividade fisica e/ou a educacao nutricional na reducao do indice de massa corporal em escolares. METODOS: Revisao sistematica com metanalise de estudos controlados randomizados disponiveis nas seguintes bases de dados eletronicas entre o ano de 1998 a 2010: PubMed, Lilacs, Embase, Scopus, Web of Science e Cochrane Library, com os descritores: estudo controlado randomizado, sobrepeso, obesidade, indice de massa corporal, crianca, adolescente, atividade fisica, educacao nutricional e escolas. Medida de sumario baseada na diferenca das medias padronizadas foi usada com intervalo de 95% de confianca. O teste de inconsistencia foi utilizado para avaliar a heterogeneidade dos estudos. RESULTADOS: Foram identificados 995 estudos, dos quais 23 foram incluidos e realizadas tres metanalises. Intervencoes isoladas com atividade fisica nao apresentaram efeito significativo na reducao do indice de massa corporal, com diferenca das medias padronizadas: -0,02 (IC95% -0,08;0,04). Resultado semelhante (n = 3.524) foi observado nas intervencoes isoladas com educacao nutricional, com diferenca das medias padronizadas: -0,03 (IC95% -0,10;0,04). Quando combinadas as intervencoes com atividade fisica e educacao nutricional, o resultado da metanalise (n = 9.997) apresentou efeito estatisticamente significativo na reducao do indice de massa corporal em escolares, com diferenca das medias padronizadas: - 0,37 (IC95% -0,63;-0,12). CONCLUSOES: As intervencoes combinadas de atividade fisica e educacao nutricional tiveram mais efeitos positivos na reducao do indice de massa corporal em escolares do que quando aplicadas isoladamente.