Prevention of childhood obesity: Preliminary data of the “Not just diet” project

ABSTRACT

Introduction: In Italy, the latest survey data show that 21.3% of 48,900 children have overweight status (OV), while 9.3% have obesity (OB). Therefore, 1 in 3 Italian children have OV or OB status, placing Italy in 2nd place in Europe for male childhood OB and 4th for female childhood OB. The epidemiological picture of the ASL TO 3, provided by the IT platform updated by pediatricians during health assessments, shows a prevalence of children with OV of 6% at 2-3 years, 15% at 5 years, 15% at 8 years and 19% at 12 years;the data on OB show a prevalence of 3% of children with OB at 2-3 years, 8% at 5 years, 12% at 8 years and 7% at 12 years. The aim of the project is to identify, on the occasion of pediatric health assessments, cases of children with excess weight but without complications. They can then be placed on a targeted path of re-education to healthy lifestyles and correction of incorrect patient and family behavior through play activities and group workshops mainly oriented at improving breakfast food an increasing the consumption of fruit and vegetables (F&V). This approach achieves more promising results in terms of improving nutrition and consequently weight loss. Methods: On the occasion of health assessments carried out at 5-6, 8 and 10-11 years of age (before pubertal development), pediatricians select patients to be sent to the nutritional re-education program “Not just diet” organized in several steps: 1st, reception weight and height measurement, BIA, food history, assessment of structured physical activity and identification of prevalent dietary errors;2nd, definition of health objectives and communication of the strategies to be followed;3rd, group activity of simulated shopping at the hypermarket to educate about the correct choice of foods to be consumed at breakfast and during snacks;4th, workshop on the five colors of the F&V group to teach how to prepare, taste and portion correctly;5th, verification of the learning and possible redefinition of objectives;6th, conclusion of the path. Results: The outcomes are shown in the tables and refer to a sample of 24 children/young people in the period February-October 2020 (suspension of 5 months due to the Covid-19 pandemic). Conclusion: The food consumption of our sample reflects the literature data, i.e. a poor introduction of protective foods such as F&V and the habit of insufficient breakfast. Of note is the excessive consumption of sugars and fats (S&F) and the use of large portions unsuitable for the age group. In addition, there is a tendency to reduce the introduction of main courses, an event that must be kept under control in order to avoid a low intake of especially noble proteins. In fact, proteins are useful for growth and for obtaining a correct sense of satiety in subjects who tend to have a spontaneous high-calorie diet, in some cases resorting to “munching” throughout the day. The data, relating only to the program's first step, derive from a small sample but they seem to indicate a dual necessity the treatment of OB in childhood and adolescence as a path in itself, and training in motor activity understood as a style of active life throughout the day.