Perceptions of childcare staff for preventing overweight in Mexican preschool children: A SWOT analysis

Objective. To identify strengths, weaknesses, opportunities, and threats (SWOT) perceived by childcare staff for prevent­ing childhood overweight. Materials and methods. Qualitative study using an interpretative phenomenological approach; 18 in-depth, semi-structured interviews and 12 focus groups with 89 key informants working in six Mexican public childcare centers (CCC) were conducted. Through content and SWOT analyses, experts further ranked fifty-nine recurrent perceptions regarding healthy feeding and physical activity (PA), using the Delphi method. Results. Strengths: Acknowledgement of the CCC’s responsibility in fostering healthy feeding, availability of organizational regulations, and access to PA infrastructure/indoor activities. Weaknesses: Disregard of preschool overweight as a health problem, nu­tritional misperceptions, and perceived risk of child injuries while conducting PA. Opportunities: Willingness to reduce children’s access to junk foods, and parental active play with children during weekends. Threats: Limited family nutritional education, and restricted parental time/economic constraints/ access to safe public spaces for PA. Conclusion. The identi­fied SWOT must be considered when developing obesity-prevention interventions targeted at CCC

Feasibility and impact of Creciendo Sanos, a clinic-based pilot intervention to prevent obesity among preschool children in Mexico City

Background: Mexico has the highest adult overweight and obesity prevalence in the Americas; 23.8% of children <5 years old are at risk for overweight and 9.7% are already overweight or obese. Creciendo Sanos was a pilot intervention to prevent obesity among preschoolers in Instituto Mexicano del Seguro Social (IMSS) clinics. Methods: We randomized 4 IMSS primary care clinics to either 6 weekly educational sessions promoting healthful nutrition and physical activity or usual care. We recruited 306 parent-child pairs: 168 intervention, 138 usual care. Children were 2-5 years old with WHO body mass index (BMI) z-score 0-3. We measured children’s height and weight and parents reported children’s diet and physical activity at baseline and 3 and 6-month follow-up. We analyzed behavioral and BMI outcomes with generalized mixed models incorporating multiple imputation for missing values. Results: 93 (55%) intervention and 96 (70%) usual care families completed 3 and 6-month follow-up. At 3 months, intervention v. usual care children increased vegetables by 6.3 servings/week (95% CI, 1.8, 10.8). In stratified analyses, intervention participants with high program adherence (5-6 sessions) decreased snacks and screen time and increased vegetables v. usual care. No further effects on behavioral outcomes or BMI were observed. Transportation time and expenses were barriers to adherence. 90% of parents who completed the post-intervention survey were satisfied with the program. Conclusions: Although satisfaction was high among participants, barriers to participation and retention included transportation cost and time. In intention to treat analyses, we found intervention effects on vegetable intake, but not other behaviors or BMI. Trial registration ClinicalTrials.gov NCT01539070. Comisión Nacional de Investigación Científica del IMSS: 2009-785-120

Preferencias alimentarias y estado de nutrición en niños escolares de la Ciudad de México

Introducción: Durante la niñez es fundamental el desarrollo de prácticas saludables que definan buenos hábitos que perdurarán a lo largo de la vida. El objetivo de este estudio fue identificar las preferencias alimentarias y su variación de acuerdo con el estado nutricional de niños escolares en la Ciudad de México. Métodos: Se realizó un estudio transversal que incluyó a 1,456 niños escolares de ocho escuelas públicas en la Ciudad de México. Los niños respondieron un cuestionario autoadministrado sobre sus preferencias de 70 alimentos seleccionados, y se les realizó antropometría; los padres proporcionaron información sociodemográfica de la familia. Se evaluaron las preferencias de cada alimento con escala tipo Likert y se calcularon las frecuencias para el total de niños y por nivel nutricional. Resultados: La mediana de edad de los niños fue de 9 años. El 48.6% tuvo sobrepeso u obesidad. Los alimentos con mayor preferencia fueron frutas, pizzas, leche con sabor y papas a la francesa (fritas). Los alimentos menos preferidos fueron verduras, cereales integrales, pescado, carnes y queso panela. El agua (72%) y las bebidas azucaradas (71%) tuvieron alta preferencia. No se encontraron variaciones en las preferencias con respecto al estado nutricional. Conclusiones: El patrón de preferencias alimentarias de los niños escolares representa un riesgo para el consumo inadecuado de alimentos y para el aumento en la prevalencia de obesidad en esta población. Se requiere de intervenciones oportunas para promover un entorno alimentario saludable y que las preferencias nutricionales sean adecuadas desde edades tempranas

Diseño de una aplicación electrónica para la evaluación del ambiente nutricional y sanitario en escuelas, basado en las mejores pruebas disponibles

VIII Congreso Iberoamericano de Nutrición. ¿Nutrición basada en la videncia o en la evidencia