Study Protocol of MINI SALTEN: a technology-based multi-component intervention in the school environment targeting healthy habits of first grade children and their parents.

BACKGROUND: MINI SALTEN is a program developed to increase moderate to vigorous physical activity (PA) and improve eating habits at home and school in first grade children. It aims to assess the effects of a technology family-based and PA school-based intervention. The purpose of this manuscript is to describe the protocol design and the MINISALTEN intervention. METHODS: This is cluster-randomized controlled trial designed to run from July 2015 to November 2016 in 12 public schools of the city of Buenos Aires, matched for socio-demographic characteristics. The intervention is based on two main components: (a) "active breaks" (AB): implemented during school breaks by a PA instructor; (b) "virtual" (V): web-based contents delivered to the families via a multiplatform application. Using a computer generated random sequence participants are allocated to one of four intervention conditions: (AB), (V), (AB + V), and control (C). Outcomes are measured at baseline and 12 months post intervention, and will include data collected from the child and her/his mother/father or guardian. Primary outcome measures are: PA and sedentary behaviour (measured with accelerometers). Secondary outcome measures related are: percentage of kilocalories (kcal) from added sugars, and from total and saturated fats; grams of fruits and vegetables; and number of snacks and kcal coming from their added sugars and total and saturated fats. Family socio-economic level, home environment, and school environment will also be assessed. Statistical analysis is on an intention-to-treat principle. Baseline characteristics are described using summary measures and mixed models (with school as random effect). The effect of the two interventions will be estimated using a generalized mixed linear model with link and distribution selected according to the type of outcome. Included random effects are: child (or mother/father or guardian) accounting for repeated measures; school accounting for cluster induced by school. The most parsimonious model for each outcome will be reported. The False Discovery Rate criterion will be used to correct for multiple testing in non-planned analyses. DISCUSSION: It is a pioneer assessment of the impact of a technology-based virtual intervention and a school-based PA program, designed to prevent obesity, and involving the parents at public schools of Buenos Aires. TRIAL REGISTRATION: Current Controlled Trials ISRCTN58093412 . Registered March 14th, 2016 (retrospectively registered).

Gender differences and a school-based obesity prevention program in Argentina: a randomized trial.

OBJECTIVE: To evaluate the impact of a school-based obesity prevention program that seeks to change food intake among students at schools in Rosario, Argentina. METHODS: This was a prospective study involving 405 children 9-11 years of age at six schools in the poor areas of Rosario, Argentina, in May-October 2008. After matching for socioeconomic status, schools were selected by simple randomization; participants were assessed at baseline (T1) and again 6 months later, after completion of the intervention (T2). The program focused on increasing the children's knowledge of healthy nutrition and exercise through four workshops; educating the parents/caregivers; and offering healthy options at the school snack bar. The main outcome measures were the children's intake of healthy and unhealthy foods (assessed with a weekly food frequency questionnaire) and their body mass index (BMI). RESULTS: Of the 387 children assessed at T1, 369 were reassessed at T2 (205 intervention; 164 control). Girls at the schools where the intervention occurred increased their intake of three of the five healthy food items promoted by the program (fruits, vegetables, low-sugar cereals). Statistical significance was reached for skim milk (P = 0.03) and for pure orange juice (P = 0.05). Boys of both the intervention and control groups failed to improve their intake of healthy foods, but those of the intervention arm significantly reduced their intake of hamburgers and hot dogs (P = 0.001). CONCLUSIONS: Girls were more amenable to improving their dietary intake. Overall, the program was more likely to increase consumption of healthy food than to decrease intake of unhealthy foods. Gender differences should be taken into account when designing preventive interventions.

Food intake and anthropometric evaluation in school-aged children of Buenos Aires.

INTRODUCTION: The main objectives of this study were to analyze food intake and to determine the prevalence of overweight and obesity in school-aged children. POPULATION AND METHODS: Fifth-grade children from 80 randomly-selected public schools from the Buenos Aires metropolitan area were included. Data on food intake were collected using a 24-hour recall period and frequency of weekly consumption. Data on weight and height were also collected. RESULTS: The sample was made up of 1673 children (854 girls and 819 boys), with an average age of 10.9 years old. The average calorie intake was 2316 kcal/day (±888) with an adequacy ratio of 115.8% in relation to the dietary reference intake. Of the total assessed children, 21.3% was overweight and 14.3% was obese. Mean intake of dietary fiber was 9 g/day (dietary reference intake: 28 g/day, 32.1% of adequacy). Only 2% of children complied with the recommended intake of vegetables and 17%, with the recommended intake of fruit. The most frequently consumed high calorie density foods were: soft drinks/juices, candies, sweet cookies and high fat seasonings and dressings. CONCLUSIONS: The high calorie intake, together with the prevalence of overweight and obesity in the studied population, justifies the need to implement nutrition education programs targeted at encouraging a healthier diet.

Gender differences and a school-based obesity prevention program in Argentina: a randomized trial / Diferencias entre los sexos en un programa de prevención de la obesidad en medio escolar en la Argentina: un ensayo aleatorizado

OBJECTIVE: To evaluate the impact of a school-based obesity prevention program that seeks to change food intake among students at schools in Rosario, Argentina. METHODS: This was a prospective study involving 405 children 9-11 years of age at six schools in the poor areas of Rosario, Argentina, in May-October 2008. After matching for socioeconomic status, schools were selected by simple randomization; participants were assessed at baseline (T1) and again 6 months later, after completion of the intervention (T2). The program focused on increasing the children's knowledge of healthy nutrition and exercise through four workshops; educating the parents/caregivers; and offering healthy options at the school snack bar. The main outcome measures were the children's intake of healthy and unhealthy foods (assessed with a weekly food frequency questionnaire) and their body mass index (BMI). RESULTS: Of the 387 children assessed at T1, 369 were reassessed at T2 (205 intervention; 164 control). Girls at the schools where the intervention occurred increased their intake of three of the five healthy food items promoted by the program (fruits, vegetables, low-sugar cereals). Statistical significance was reached for skim milk (P = 0.03) and for pure orange juice (P = 0.05). Boys of both the intervention and control groups failed to improve their intake of healthy foods, but those of the intervention arm significantly reduced their intake of hamburgers and hot dogs (P = 0.001). CONCLUSIONS: Girls were more amenable to improving their dietary intake. Overall, the program was more likely to increase consumption of healthy food than to decrease intake of unhealthy foods. Gender differences should be taken into account when designing preventive interventions.

OBJETIVO: Evaluar la repercusión de un programa de prevención de la obesidad en medio escolar, que busca modificar la ingesta de los alumnos de las escuelas de Rosario, Argentina. MÉTODOS: Estudio prospectivo en el cual participaron 405 niños de 9 a 11 años de edad, realizado en seis escuelas de las zonas pobres de Rosario, Argentina, de mayo a octubre del 2008. Tras emparejamiento en función de la situación socioeconómica, se escogieron las escuelas mediante una aleatorización sencilla; se evaluaron los participantes al inicio del estudio (T1) y 6 meses más tarde, después de haber completado la intervención (T2). El programa consistió en cuatro talleres encaminados a mejorar los conocimientos de los niños sobre la nutrición y el ejercicio saludables; educar a los padres y los cuidadores; y ofrecer opciones sanas en la cafetería escolar. Los principales criterios de valoración fueron la ingestión de alimentos sanos o malsanos por parte de los niños (evaluada mediante un cuestionario sobre la frecuencia semanal de consumo de alimentos) y el índice de masa corporal de los niños. RESULTADOS: Se evaluaron 387 niños en T1 y de ellos 369 contaron con una nueva evaluación en T2 (205 del grupo de intervención y 164 del grupo testigo). Las niñas de las escuelas donde tuvo lugar la intervención aumentaron la ingesta de tres de los cinco alimentos sanos propuestos por el programa (las frutas, las verduras y los cereales con bajo contenido de azúcar). Se alcanzó una significación estadística con la leche desnatada (P = 0,03) y el jugo de naranja puro (P = 0,05). Los niños de los grupos de intervención y de los grupos de referencia no lograron mejorar su ingesta de alimentos sanos, pero los que pertenecían al grupo de intervención disminuyeron significativamente el consumo de hamburguesas y perros calientes (P = 0,001). CONCLUSIONES: Las niñas estaban más dispuestas a mejorar su alimentación. En términos generales, con el programa, la probabilidad de aumentar el consumo de alimentos saludables fue mayor que la probabilidad de disminuir el consumo de alimentos malsanos. Es necesario tener en cuenta las diferencias entre los sexos cuando se diseñan intervenciones preventivas.

Food intake and anthropometric evaluation in school-aged children of Buenos Aires / Ingesta alimentaria y evaluación antropométrica en niños escolares de Buenos Aires

Introduction. The main objectives of this study were to analyze food intake and to determine the prevalence of overweight and obesity in school-aged children. Population and Methods. Fifth-grade children from 80 randomly-selected public schools from the Buenos Aires metropolitan area were included. Data on food intake were collected using a 24-hour recall period and frequency of weekly consumption. Data on weight and height were also collected. Results. The sample was made up of 1673 children (854 girls and 819 boys), with an average age of 10.9 years old. The average calorie intake was 2316 kcal/day (±888) with an adequacy ratio of 115.8% in relation to the dietary reference intake. Of the total assessed children, 21.3% was overweight and 14.3% was obese. Mean intake of dietary fiber was 9 g/day (dietary reference intake: 28 g/day, 32.1% of adequacy). Only 2% of children complied with the recommended intake of vegetables and 17%, with the recommended intake of fruit. The most frequently consumed high calorie density foods were: soft drinks/juices, candies, sweet cookies and high fat seasonings and dressings. Conclusions. The high calorie intake, together with the prevalence of overweight and obesity in the studied population, justifies the need to implement nutrition education programs targeted at encouraging a healthier diet.

Introducción. Los principales objetivos de este estudio fueron analizar la ingesta alimentaria y determinar la prevalencia de sobrepeso y obesidad en niños escolares. Población y métodos. Se incluyeron niños de 5º grado provenientes de 80 escuelas públicas, aleatoriamente seleccionadas, del área metropolitana de Buenos Aires. Los datos de ingesta fueron recolectados a través del recordatorio de 24 h y de la frecuencia de consumo semanal. También se recabaron datos de peso y talla. Resultados. La muestra quedó constituida por 1673 niños (854 mujeres y 819 varones), con una edad promedio de 10,9 años. La ingesta calórica promedio fue de 2316 kcal/día (± 888) con un porcentaje de adecuación respecto de la ingesta dietética de referencia de 115,8%. El 21,3% de los niños evaluados presentó sobrepeso y el 14,3% obesidad. La ingesta media de fibra fue de 9 g/día (ingesta dietética de referencia: 28 g/día, 32,1% adecuación). Solo el 2% de los niños cumplió con la recomendación de ingesta de verduras y el 17% con la de frutas. Los alimentos de alta densidad calórica más frecuentemente consumidos fueron: gaseosas/jugos, golosinas, galletitas dulces y aderezos de alto contenido graso. Conclusiones. La elevada ingesta calórica hallada, sumada a la prevalencia de sobrepeso y obesidad en la población estudiada, justifican la necesidad de implementar programas de educación nutricional para estimular una alimentación más saludable.