HEALTHY LIFESTYLES -EDUCATION AND HEALTH PROMOTION. EDUCACIÓ EN ALIMENTACIÓ (EDAL) COHORT

L’Obesitat (OB) és un dels principals determinants de mortalitat evitable. L’objectiu és avaluar els efectes del programa escolar EdAl que promou estils saludables de vida, inclouen recomanacions dietètiques i d’activitat física (AF) en la prevalença d’OB, en nens de 7-8 anys, durant 28 mesos i dos anys després de la seva finalització. La intervenció del programa es basa en 8 objectius d’estil de vida desenvolupats en 4 activitats/any durant 3 anys (12 activitats; 1h/activitat) realitzat per estudiants universitaris en qualitat d’Agent Promotor de la Salut (APS). Les dades recollides inclouen nom, gènere, any i lloc de naixement, pes, alçada, Índex de Massa Corporal (IMC) i perímetre de cintura, cada any de seguiment i un qüestionari sobre hàbits d’alimentació i d’Activitat Física (AF) contestat pels pares/tutors. Després de 28 mesos d’intervenció, la prevalença d’OB en els nens intervenció va disminuir 4,39% (p5h/setmana d’AF extraescolar al final de la intervenció comparat amb el grup control (p=0,02). Després de 2 anys de finalitzar el programa, el grup intervenció va canviar el seu IMC z-score amb una efectiva reducció dels dos gèneres. Un 16% més dels escolars practiquen ≥4h/setmana AF extraescolar en el grup intervenció (p5h/semana de AF extraescolar al final de la intervención comparado con el control (p=0,02). Después de 2 años de finalizar el programa, el grupo intervención cambió su IMC z-score con una efectiva reducción de los dos géneros. Un 16 % más de los escolares practican ≥4h/semana AF extraescolar en el grupo intervención (p5 hours/week than control pupils (p=0.02). Two-year follow-up, OB prevalence of intervention group was reduced (-5.5%; p<0.01) and BMI z-score (-0.25; p<0.01) in both genders; 16% higher scholars practice ≥4 after-school PA h/week in intervention group (51.7% vs. 34.9%; p<0.01). The design of EdAl program provided 12 activities developed by HPA and are designed to be entertaining but as well informative, and are focused on healthy lifestyle concepts that can be achieved by improving diet and PA practice. A regular, systematic, educational intervention that promotes healthy lifestyle, including dietary and PA recommendations is an easy tool implemented by HPA as part of their university curriculum to reduce the prevalence of OB and increase after-school PA practice in children and these benefits achieved are sustained at 2-year post-cessation intervention

Effectiveness of social marketing strategies to reduce youth obesity in European school-based interventions : a systematic review and meta-analysis

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A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project) : A Protocol for Pilot Cluster Randomized Controlled Trial (Spain)

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Impact of a youth-led social marketing intervention run by adolescents to encourage healthy lifestyles among younger school peers (EYTO-Kids project) : a parallel-cluster randomised controlled pilot study

Acknowledgements: This Spanish research project was supported by the Central Market of Reus, Spain (Mercat Central de Reus), which provided fresh food for the intervention. We thank the professors, parents and students of the Reus primary and high schools for their enthusiastic participation in this study. Funding: This research project was funded by Obra Social La Caixa, Convocatòria acció social 2015. Reference: AS15-00350//17.980 euros.Peer reviewedPublisher PD

Cost-Effectiveness of the EdAl (Educacio en Alimentacio) Program: A Primary School-Based Study to Prevent Childhood Obesity

Background: The cost-effectiveness of childhood obesity prevention interventions is critical for their sustained implementation. This study evaluated the cost-effectiveness of the Educacio en Alimentacio (EdAl) program, a school-based intervention for reducing obesity. Methods: Total EdAl program implementation costs and per-child costs were estimated. Cost-effectiveness, defined using the incremental cost-effectiveness ratio (ICER), was estimated as the difference between the intervention and control group costs divided by the obesity-related outcome effects for boys (avoided cases of obesity', obesity prevalence, body mass index [BMI], and BMI z-score units) for each group. As a significant difference (4.39%) in the reduction of obesity prevalence between the intervention and control groups was observed for boys in the EdAl program, the data were calculated only for boys. Results: The intervention cost was 24,246.53 (sic) for 1,550 children (15.64 (sic)/child/3 years) or 5.21 f/child/year. The ICERs/ boy were 968.66 (sic) to avoid one case of obesity, 3.6 (sic) to reduce the obesity prevalence by 1%, 44.68 (sic) to decrease BMI by one unit, and 65.16 (sic) to reduce the BMI z-score by one unit. Conclusions: The cost of reducing the obesity prevalence in boys by 4.39% was 5.21 (sic)/child/year, half the cost proposed by the Spanish Health Ministry, indicating that the EdAl program is cost-effective

Impact of a youth-led social marketing intervention run by adolescents to encourage healthy lifestyles among younger school peers (EYTO-Kids project): a parallel-cluster randomised controlled pilot study

Background: Encouraging healthy lifestyles in children is a challenge. This project aimed to improve lifestyles of younger peers by engaging adolescent creators (ACs) to design and implement peer-led and social marketing (SM) health-promoting activities. Methods: A 10-month parallel-cluster randomised controlled school-based pilot study was performed in disadvantaged neighbourhoods in Reus (Spain) spanning two academic years (2015-2016/2016-2017). Eight primary schools (n=375 children) and four high schools (n=94ACs) were randomly placed in the intervention group. The 94 ACs (12-14 years) designed and implemented four SM activities for their younger peers (9-11 years). Eight primary schools (n=327 children) and three high schools (n=98 adolescents) served as the control group and received no intervention. Primary (physical activity and fruit consumption) and secondary outcomes (screen time, vegetables, soft drinks, sweets and fast food consumptions) were assessed with validated questionnaires at baseline and at the end of the study. Results: After 10 months, fruit consumption and physical activity were maintained in the children who consumed ≥1 fruit/day and spent ≥6 hours/week physical activity. However, compared with the controls, the intervention significantly increased the physical activity of girls to 15.6 min/week, whereas the percentage of girls who consumed sweets, soft drinks and fast food decreased significantly by 8.4%, 14.5% and 5.9%, respectively. Additionally, the percentage of ≥2 hour/weekday of screen time by boys decreased significantly by 8.2%. Conclusion: The European Youth Tackling Obesity-Kids, SM and peer-led intervention, effectively increased physical activity hours/week in girls, but was not effective in improving the percentage of children who consumed the recommended fruit. Moreover, the percentages of girls who consumed sweets, soft drinks and fast food and boys screen time decreased

Cost-Effectiveness of the EdAl (Educació en Alimentació) Program: : A Primary School-Based Study to Prevent Childhood Obesity

We sincerely thank all the participants in this study, their families, and the schools. # MC and ELL contributed equally to this manuscript. This work was supported by a fellowship granted to MC from the “Santander CRUE CEPYME Prácticas en Empresa”. D.M. was partially supported by grants from the Instituto de Salud Carlos III-ISCIII (Spanish Government) cofunded by FEDER funds=European Regional Development Fund (ERDF) - a way to build Europe (References: RD12=0036=0056, PI11=02090 and PI16=01254) and from the Agència de Gestió d’Ajuts Universitaris i de Recerca (2014SGR756) and RecerCaixa 2015 (2015ACUP00129). Conflicts of interest: None declared. Supplementary data related to this article can be found at https:== doi.org=10.2188=jea.JE20170111.Peer reviewedPublisher PD

A primary-school-based study to reduce the prevalence of childhood obesity - the EdAl (Educació en Alimentació) study : A randomized controlled trial

Background: Obesity is one of the main determinants of avoidable disease burden. To implement a program by university students acting as " health promoting agents" (HPAs) and to evaluate the effects on obesity prevalence of the primary-school-based program that promotes healthy lifestyle, including dietary and physical activity recommendations over 28 months. Methods: Two school clusters were randomly assigned to intervention (24 schools, 1,222 pupils) or control (14 schools, 717 pupils); 78% of pupils were Western European. Mean age (±SD) was 8.4 ± 0.6 years (49.9% females) at baseline. Generalized linear mixed models were used to analyze differences in primary outcome between both groups. Data collected included body mass index (BMI) every year. Dietary habits and lifestyle questionnaires were filled in by the parents at baseline and at the end of the study. The interventions focused on eight lifestyle topics covered in 12 activities (1 hour/activity/session) implemented by HPAs over 3 school academic years. Results: At 28 months, obesity prevalence in boys was decreased -2.36% in the intervention group (from 9.59% to 7.23%) and increased 2.03% (from 7.40% to 9.43%) in the control group; the difference was 4.39% (95% CI 3.48 to 5.30; P = 0.01). The boys in the intervention group had an effective reduction of -0.24 units in the change of BMI z-score (from 0.01 to -0.04), compared to control (from -0.10 to 0.09); 5.1% more intervention pupils undertook physical activity >5 hours/week than control pupils (P = 0.02).Fish consumption was a protector (odds ratio 0.39; 95% CI 0.23 to 0.67) while " fast-food" consumption was a risk factor for childhood obesity (odds ratio: 2.27; 95% CI 1.08 to 4.77). Conclusions: Our school-based program, conducted by HPA students, successfully reduced childhood obesity prevalence in boys. Trial registration: International Standard Randomized Controlled Trial Number: ISRCTN29247645

Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review

A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applications to increase fruit and vegetable intake. PubMed and Web of Science were used to conduct this systematized review, and the inclusion criteria were: randomized controlled trials evaluating mobile phone applications focused on increasing fruit and/or vegetable intake as a primary or secondary outcome performed from 2008 to 2018. Eight studies were included in the final assessment. The interventions described in six of these studies were effective in increasing fruit and/or vegetable intake. Targeting stratified populations and using long-lasting interventions were identified as key aspects that could influence the effectiveness of these interventions. In conclusion, evidence shows the effectiveness of mHealth application interventions to increase fruit and vegetable consumption. Further research is needed to design effective interventions and to determine their efficacy over the long term