ABSTRACT
BACKGROUND: The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE: This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS: A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS: We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS: The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.
ABSTRACT
OBJECTIVE.: To describe the iron status profile and to propose hemoglobin adjustment factors for altitude for children aged 6 to 8 months in Lima, Arequipa, Cusco and Puno. MATERIALS AND METHODS.: Cross-sectional study in children aged 6 to 8 months from four cities. We measured hemoglobin and other iron biomarkers, C-reactive protein (CRP), among others. To estimate the adjustment equation, we applied an exponential regression. We excluded children with iron deficiency (ID) and/or inflammation. RESULTS.: The proportions of ID were higher in Puno and Arequipa, while inflammation did not exceed 19% in any of the cities. Hemoglobin showed an exponential increase at higher altitude. The adjustment equation was: 10.34249 x (1.00007 ^ Alt). CONCLUSIONS.: Children residing in Arequipa and Puno showed higher rates of ID and lower iron reserves; furthermore, the increase in hemoglobin by altitude was exponential, showing the need to adjust hemoglobin at altitude.
OBJETIVOS.: Caracterizar el estado del hierro y proponer factores de ajuste de hemoglobina por altitud, en niños de 6 a 8 meses de Lima, Arequipa, Cusco y Puno. MATERIALES Y MÉTODOS.: Estudio transversal en niños de 6 a 8 meses de edad en cuatro ciudades, se midió hemoglobina y otros biomarcadores de hierro, Proteína C reactiva (PCR), entre otros. Para estimar la ecuación de ajuste, se aplicó una regresión exponencial y excluimos a los niños con deficiencia de hierro (DH) y/o inflamación. RESULTADOS.: Las proporciones de DH fueron mayores en Puno y Arequipa, mientras que la inflamación no superó el 19% en ninguna de las ciudades. La hemoglobina mostró un incremento exponencial a mayor altitud. La ecuación de ajuste fue: 10,34249 x (1,00007
Subject(s)
Anemia, Iron-Deficiency , Anemia , Iron Deficiencies , Child , Humans , Iron , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/epidemiology , Altitude , Cross-Sectional Studies , Hemoglobins/analysis , Inflammation , PrevalenceABSTRACT
OBJECTIVES.: To evaluate and compare the macronutrient distribution of the food baskets delivered by Peruvian municipalities during the COVID-19 pandemic according to the geographic domain and assigned budget level. MATERIALS AND METHODS.: Secondary analysis of the database "Consultation of Acquisition and distribution of basic necessities of the basic family basket" of the General Comptroller of the Republic. Stratified probability sampling was carried out. The caloric intake distribution was calculated according to macronutrients and compared with the Acceptable Intervals of Macronutrient Distribution (IADM) of the Nutrition Institute of Central America and Panama (INCAP) and the National Institute of Civil Defense (INDECI). RESULTS.: At the national level, the median caloric intake of proteins was 7.7%; for carbohydrates it was 62.5%; and for fats it was 28.1%. The proportion of municipalities with protein deficit was 84%; Municipalities with excess carbohydrates ranged from 16.5% (according to INCAP) to 35.9% (according to INDECI), and with excess fat, it was between 61.6% (according to INCAP) and 20.2% (according to INDECI). According to INDECI, nationally only 9.2% of municipalities delivered baskets with an adequate distribution of macronutrients; Metropolitan Lima stands out with the highest proportions of adequate baskets, while in the Jungle region this percentage was less than 5%. CONCLUSIONS.: Most of the baskets delivered did not have adequate macronutrient distribution. Especially the baskets of municipalities outside of Metropolitan Lima or those that had smaller budget. Carbohydrates and fats were the nutrients that were included in excess, while proteins were deficient.
OBJETIVOS.: Evaluar y comparar la distribución de macronutrientes de las canastas alimentarias entregadas por las municipalidades peruanas durante la pandemia de COVID-19 según dominio geográfico y nivel de presupuesto asignado. MATERIALES Y MÉTODOS.: Análisis secundario de la base de datos «Consulta de adquisición y distribución de bienes de primera necesidad de la canasta básica familiar¼ de la Contraloría General de la República. Se realizó un muestreo probabilístico estratificado. Se calculó la distribución del aporte calórico según macronutrientes y se comparó con los intervalos aceptables de distribución de macronutrientes (IADM) del Instituto de Nutrición de Centro América y Panamá (INCAP) y del Instituto Nacional de Defensa Civil (INDECI). RESULTADOS.: A nivel nacional la mediana del aporte calórico de las proteínas fue 7,7%; carbohidratos 62,5%, y grasas 28,1%. La proporción de municipalidades con canastas con déficit de proteínas fue de 84%. Las municipalidades con canastas con exceso de carbohidratos variaron de 16,5% (según INCAP) a 35,9% (según INDECI) y con exceso de grasas fue 61,6 % (según INCAP) y 20,2% (según INDECI). Según INDECI, a nivel nacional solo el 9,2% de municipalidades entregaron canastas con distribución adecuada de macronutrientes, aquí destaca Lima Metropolitana con las proporciones más altas; mientras que en la selva este porcentaje fue menor del 5%. CONCLUSIONES.: La mayoría de las canastas entregadas no tuvieron distribución adecuada de macronutrientes, en especial las canastas de municipalidades fuera de Lima Metropolitana o las que contaban con menor presupuesto. Los carbohidratos y las grasas fueron los nutrientes que se incluyeron en exceso, mientras que las proteínas tuvieron déficit.
Subject(s)
COVID-19 , COVID-19/epidemiology , Carbohydrates , Cities , Diet , Dietary Fats , Humans , Nutrients/analysis , Pandemics , Peru/epidemiologyABSTRACT
OBJECTIVES: To evaluate the predictive capacity of gestational weight gain recommendations regarding low birth weight (LBW) and neonatal macrosomia, proposed by the Institute of Medicine (IOM) and the Latin American Center of Perinatology (CLAP). MATE RIALS AND METHODS: The bibliographic search was performed in PubMed, Embase (via Ovid), Cochrane Library, EBSCOhost, Sco pus, LILACS and SciELO. Methodological quality was evaluated using QUADAS 2. RESULTS: A total of 1,192 articles were identified, only 5 articles met the inclusion criteria, no study evluated the CLAP recomendations. Sensitivity and specificity to predict LBW and macrosomia varied widely depending on which country the study took place. In the Latin American cohorts, the sensitivity for predicting LBW ranged from 62.8% to 74% and the specificity from 61.7% to 68%, while the sensitivity for predicting macrosomia was 28.8% and the specificity 43.8%. In most studies the positive predictive value was less than 25%, and the negative predictive va lue was more than 90%. Most studies had high risk of bias and applicability problems in patient selection. CONCLUSIONS: The limited methodological quality and representativeness of the studied cohorts, probable unadjusted confounding factors and modest values of sensitivity and specificity suggest the need to develop studies aimed at providing recommendations that fit the epidemiological characteristics of the Peruvian population.
OBJETIVOS: Evaluar la capacidad predictiva de las recomendaciones de ganancia de peso gestacional respecto del bajo peso al nacer (BPN) y la macrosomía neonatal, propuestas por el Institute of Medicine (IOM) y el Centro Latinoamericano de Perinatología (CLAP). MATERIALES Y MÉTODOS: La búsqueda bibliográfica se realizó en PubMed, Embase (vía Ovid), Cochrane Library, EBSCO host, Scopus, LILACS y SciELO. La calidad metodológica se evaluó utilizando QUADAS 2. RESULTADOS: Se obtuvieron 1192 artícu los, cinco cumplieron los criterios de inclusión, ningún estudio evaluó las recomendaciones CLAP. La sensibilidad y especificidad para predecir el BPN y la macrosomía variaron largamente según el país de realización del estudio. En las cohortes de América Latina, la sensibilidad para predecir el BPN varió entre 62,8% y 74%, y la especificidad, entre 61,7% y 68%, mientras que la sensi bilidad para predecir macrosomía fue 28,8%, y la especificidad, 43,8%. En la mayoría de estudios el valor predictivo positivo fue inferior al 25%, y el valor predictivo negativo, superior al 90%. La mayoría de los estudios tuvo alto riesgo de sesgo y problemas de aplicabilidad en la selección de pacientes. CONCLUSIONES: La limitada calidad metodológica y representatividad de las cohortes estudiadas, probables factores de confusión no ajustados y modestos valores de sensibilidad y especificidad sugieren la necesidad de desarrollar estudios para establecer recomendaciones que se ajusten a las características epidemiológicas de la población peruana.
Subject(s)
Fetal Macrosomia , Gestational Weight Gain , Infant, Low Birth Weight , Female , Fetal Macrosomia/epidemiology , Humans , Infant, Newborn , PregnancyABSTRACT
RESUMEN Objetivos. Caracterizar el estado del hierro y proponer factores de ajuste de hemoglobina por altitud, en niños de 6 a 8 meses de Lima, Arequipa, Cusco y Puno. Materiales y métodos. Estudio transversal en niños de 6 a 8 meses de edad en cuatro ciudades, se midió hemoglobina y otros biomarcadores de hierro, Proteína C reactiva (PCR), entre otros. Para estimar la ecuación de ajuste, se aplicó una regresión exponencial y excluimos a los niños con deficiencia de hierro (DH) y/o inflamación. Resultados. Las proporciones de DH fueron mayores en Puno y Arequipa, mientras que la inflamación no superó el 19% en ninguna de las ciudades. La hemoglobina mostró un incremento exponencial a mayor altitud. La ecuación de ajuste fue: 10,34249 x (1,00007 ^ Alt). Conclusiones. Los niños residentes en Arequipa y Puno mostraron mayores proporciones de DH y menores reservas de hierro; además el aumento de la hemoglobina por altitud fue exponencial evidenciando la necesidad de ajustar la hemoglobina en altura.
ABSTRACT Objective. To describe the iron status profile and to propose hemoglobin adjustment factors for altitude for children aged 6 to 8 months in Lima, Arequipa, Cusco and Puno. Materials and methods. Cross-sectional study in children aged 6 to 8 months from four cities. We measured hemoglobin and other iron biomarkers, C-reactive protein (CRP), among others. To estimate the adjustment equation, we applied an exponential regression. We excluded children with iron deficiency (ID) and/or inflammation. Results. The proportions of ID were higher in Puno and Arequipa, while inflammation did not exceed 19% in any of the cities. Hemoglobin showed an exponential increase at higher altitude. The adjustment equation was: 10.34249 x (1.00007 ^ Alt). Conclusions. Children residing in Arequipa and Puno showed higher rates of ID and lower iron reserves; furthermore, the increase in hemoglobin by altitude was exponential, showing the need to adjust hemoglobin at altitude.
ABSTRACT
OBJECTIVE: To determine the impact of the educational-motivational intervention "Como jugando" on the body mass index (BMI), knowledge on nutrition, physical activity levels, and eating patterns in students from the first to fourth grades of four educational institutions (EIs) of Cercado de Lima after the first year of the intervention. MATERIALS AND METHODS: This was a quasi-experimental, controlled study. BMI, knowledge on nutrition, frequency of food consumption, and level of physical activity were evaluated. The "Como jugando" program included playful and experiential activities for school children and involved both teachers and parents. The impact was estimated by applying the McNemar test for related samples and regression models for the analysis of differences in adjusted variables related to children and their mothers. RESULTS: The study included 696 school children from two experimental EIs and two control EIs. The Z-score for BMI and the prevalence of obesity did not vary during the study period. The intervention improved the knowledge of nutrition [odds ratio (OR): 1.46; 95% confidence interval (CI): 1.17-1.81], reduced the likelihood of poor levels of physical activity (OR: 0.63; 95% CI: 0.46-0.87), and improved the consumption patterns for all food categories except vegetables in the intervention group. CONCLUSIONS: The "Como jugando" intervention, in the first year of implementation, did not reduce the Z-score for BMI but improved the knowledge of nutrition, reduced the probability of poor levels of physical activity, and maintained or increased the consumption of fruits, sugar-free water, packaged juices, and sweet and savory cookies. Therefore, the "Como jugando" intervention should be better studied in order to estimate its impact on biological indicators.
OBJETIVO: Determinar el impacto, al primer año, de la intervención educativa-motivacional "Como Jugando" sobre el índice de masa corporal (IMC), conocimientos en alimentación, niveles de actividad física y patrones de consumo alimentario en escolares del 1.° al 4.° grado de primaria, de cuatro instituciones educativas (IE) del Cercado de Lima. MATERIALES Y MÉTODOS: Estudio cuasiexperimental, controlado. Se evaluó el IMC, conocimientos en nutrición, frecuencia de consumo de alimentos y nivel de actividad física. "Como Jugando" incluyó actividades lúdicas y vivenciales para escolares e involucró a docentes y padres. El impacto se estimó aplicando la prueba de McNemar para muestras relacionadas y modelos de regresión de diferencias en diferencias ajustados por variables relativas al escolar y la madre. RESULTADOS: El estudio incluyó a 696 escolares de 2 IE de intervención y 2 IE de control, el puntaje Z de IMC y las prevalencias de obesidad no variaron durante el periodo de estudio. La intervención mostró impacto en mejorar los conocimientos en nutrición (OR: 1,46; IC95%: 1,17-1,81) redujo el riesgo de tener un nivel malo de actividad física (OR: 0,63; IC95%: 0,46-0,87) y mejoró los patrones de consumo de todos los alimentos, salvo verduras (grupo intervención). CONCLUSIONES: La intervención "Como Jugando", al primer año de implementación, no redujo el Puntaje Z del IMC, sin embargo, tuvo impacto sobre los conocimientos en nutrición, redujo la probabilidad de tener un nivel malo de actividad física y mantuvo o aumentó la frecuencia adecuada del consumo de frutas, agua sin azúcar, jugos envasados y galletas dulces y saladas. Es necesario continuar evaluando la intervención "Como Jugando" para estimar el impacto sobre indicadores biológicos.
Subject(s)
Exercise , Health Education , Motivation , Pediatric Obesity/prevention & control , Play and Playthings , Body Mass Index , Child , Feeding Behavior , Health Impact Assessment , Health Knowledge, Attitudes, Practice , Humans , Schools , Time FactorsABSTRACT
RESUMEN Objetivos. Evaluar y comparar la distribución de macronutrientes de las canastas alimentarias entregadas por las municipalidades peruanas durante la pandemia de COVID-19 según dominio geográfico y nivel de presupuesto asignado. Materiales y métodos. Análisis secundario de la base de datos «Consulta de adquisición y distribución de bienes de primera necesidad de la canasta básica familiar¼ de la Contraloría General de la República. Se realizó un muestreo probabilístico estratificado. Se calculó la distribución del aporte calórico según macronutrientes y se comparó con los intervalos aceptables de distribución de macronutrientes (IADM) del Instituto de Nutrición de Centro América y Panamá (INCAP) y del Instituto Nacional de Defensa Civil (INDECI). Resultados. A nivel nacional la mediana del aporte calórico de las proteínas fue 7,7%; carbohidratos 62,5%, y grasas 28,1%. La proporción de municipalidades con canastas con déficit de proteínas fue de 84%. Las municipalidades con canastas con exceso de carbohidratos variaron de 16,5% (según INCAP) a 35,9% (según INDECI) y con exceso de grasas fue 61,6 % (según INCAP) y 20,2% (según INDECI). Según INDECI, a nivel nacional solo el 9,2% de municipalidades entregaron canastas con distribución adecuada de macronutrientes, aquí destaca Lima Metropolitana con las proporciones más altas; mientras que en la selva este porcentaje fue menor del 5%. Conclusiones. La mayoría de las canastas entregadas no tuvieron distribución adecuada de macronutrientes, en especial las canastas de municipalidades fuera de Lima Metropolitana o las que contaban con menor presupuesto. Los carbohidratos y las grasas fueron los nutrientes que se incluyeron en exceso, mientras que las proteínas tuvieron déficit.
ABSTRACT Objectives. To evaluate and compare the macronutrient distribution of the food baskets delivered by Peruvian municipalities during the COVID-19 pandemic according to the geographic domain and assigned budget level. Materials and methods. Secondary analysis of the database "Consultation of Acquisition and distribution of basic necessities of the basic family basket" of the General Comptroller of the Republic. Stratified probability sampling was carried out. The caloric intake distribution was calculated according to macronutrients and compared with the Acceptable Intervals of Macronutrient Distribution (IADM) of the Nutrition Institute of Central America and Panama (INCAP) and the National Institute of Civil Defense (INDECI). Results. At the national level, the median caloric intake of proteins was 7.7%; for carbohydrates it was 62.5%; and for fats it was 28.1%. The proportion of municipalities with protein deficit was 84%; Municipalities with excess carbohydrates ranged from 16.5% (according to INCAP) to 35.9% (according to INDECI), and with excess fat, it was between 61.6% (according to INCAP) and 20.2% (according to INDECI). According to INDECI, nationally only 9.2% of municipalities delivered baskets with an adequate distribution of macronutrients; Metropolitan Lima stands out with the highest proportions of adequate baskets, while in the Jungle region this percentage was less than 5%. Conclusions. Most of the baskets delivered did not have adequate macronutrient distribution. Especially the baskets of municipalities outside of Metropolitan Lima or those that had smaller budget. Carbohydrates and fats were the nutrients that were included in excess, while proteins were deficient.
Subject(s)
Nutrients , Cities , Food Supply , COVID-19 , Emergency Feeding , Disaster Vulnerability , FoodABSTRACT
OBJECTIVES: To assess the nutritional status, physical activity, and eating habits of schoolchildren in Cercado de Lima (Lima district). MATERIALS AND METHODS: Cross-sectional descriptive study. The sample included schoolchildren from first to fourth grade in four public elementary schools located in Cercado de Lima. The study variables were nutritional status, hemoglobin dose, physical activity, and eating habits. The percentages of the qualitative variables and central tendency measures for quantitative ones were calculated. The t-test and chi-squared test were applied to analyze differences between both genders. RESULTS: Of 824 schoolchildren included in the study, 24% were obese, 22% were overweight, 5% had short stature, and 11.9% had anemia; in all instances, there were no substantial gender differences. More than 40% of schoolchildren would eat crackers and drink packaged juice and/or soda two or more times a week. In addition, 28% of schoolchildren were inactive; there were significant differences in both genders (P<0.05). CONCLUSIONS: Obesity is an ongoing problem with higher rates than overweight and, together, the aforementioned problems affect almost 50% of schoolchildren surveyed. Similarly, the study revealed patterns associated with a sedentary lifestyle and frequent consumption of foods with high levels of sugar, salt, and/or fats.
Subject(s)
Feeding Behavior , Nutritional Status , Obesity , Overweight , Body Mass Index , Child , Cross-Sectional Studies , Exercise , Female , Humans , MaleABSTRACT
RESUMEN Objetivos: Evaluar la capacidad predictiva de las recomendaciones de ganancia de peso gestacional respecto del bajo peso al nacer (BPN) y la macrosomía neonatal, propuestas por el Institute of Medicine (IOM) y el Centro Latinoamericano de Perinatología (CLAP). Materiales y métodos: La búsqueda bibliográfica se realizó en PubMed, Embase (vía Ovid), Cochrane Library, EBSCO host, Scopus, LILACS y SciELO. La calidad metodológica se evaluó utilizando QUADAS 2. Resultados: Se obtuvieron 1192 artícu los, cinco cumplieron los criterios de inclusión, ningún estudio evaluó las recomendaciones CLAP. La sensibilidad y especificidad para predecir el BPN y la macrosomía variaron largamente según el país de realización del estudio. En las cohortes de América Latina, la sensibilidad para predecir el BPN varió entre 62,8% y 74%, y la especificidad, entre 61,7% y 68%, mientras que la sensi bilidad para predecir macrosomía fue 28,8%, y la especificidad, 43,8%. En la mayoría de estudios el valor predictivo positivo fue inferior al 25%, y el valor predictivo negativo, superior al 90%. La mayoría de los estudios tuvo alto riesgo de sesgo y problemas de aplicabilidad en la selección de pacientes. Conclusiones: La limitada calidad metodológica y representatividad de las cohortes estudiadas, probables factores de confusión no ajustados y modestos valores de sensibilidad y especificidad sugieren la necesidad de desarrollar estudios para establecer recomendaciones que se ajusten a las características epidemiológicas de la población peruana.
ABSTRACT Objectives: To evaluate the predictive capacity of gestational weight gain recommendations regarding low birth weight (LBW) and neonatal macrosomia, proposed by the Institute of Medicine (IOM) and the Latin American Center of Perinatology (CLAP). Mate rials and methods: The bibliographic search was performed in PubMed, Embase (via Ovid), Cochrane Library, EBSCOhost, Sco pus, LILACS and SciELO. Methodological quality was evaluated using QUADAS 2. Results: A total of 1,192 articles were identified, only 5 articles met the inclusion criteria, no study evluated the CLAP recomendations. Sensitivity and specificity to predict LBW and macrosomia varied widely depending on which country the study took place. In the Latin American cohorts, the sensitivity for predicting LBW ranged from 62.8% to 74% and the specificity from 61.7% to 68%, while the sensitivity for predicting macrosomia was 28.8% and the specificity 43.8%. In most studies the positive predictive value was less than 25%, and the negative predictive va lue was more than 90%. Most studies had high risk of bias and applicability problems in patient selection. Conclusions: The limited methodological quality and representativeness of the studied cohorts, probable unadjusted confounding factors and modest values of sensitivity and specificity suggest the need to develop studies aimed at providing recommendations that fit the epidemiological characteristics of the Peruvian population.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Fetal Macrosomia , Infant, Low Birth Weight , Gestational Weight Gain , Fetal Macrosomia/epidemiology , LiteratureABSTRACT
RESUMEN Objetivo. Determinar el impacto, al primer año, de la intervención educativa-motivacional "Como Jugando" sobre el índice de masa corporal (IMC), conocimientos en alimentación, niveles de actividad física y patrones de consumo alimentario en escolares del 1.° al 4.° grado de primaria, de cuatro instituciones educativas (IE) del Cercado de Lima. Materiales y métodos. Estudio cuasiexperimental, controlado. Se evaluó el IMC, conocimientos en nutrición, frecuencia de consumo de alimentos y nivel de actividad física. "Como Jugando" incluyó actividades lúdicas y vivenciales para escolares e involucró a docentes y padres. El impacto se estimó aplicando la prueba de McNemar para muestras relacionadas y modelos de regresión de diferencias en diferencias ajustados por variables relativas al escolar y la madre. Resultados. El estudio incluyó a 696 escolares de 2 IE de intervención y 2 IE de control, el puntaje Z de IMC y las prevalencias de obesidad no variaron durante el periodo de estudio. La intervención mostró impacto en mejorar los conocimientos en nutrición (OR: 1,46; IC95%: 1,17-1,81) redujo el riesgo de tener un nivel malo de actividad física (OR: 0,63; IC95%: 0,46-0,87) y mejoró los patrones de consumo de todos los alimentos, salvo verduras (grupo intervención). Conclusiones. La intervención "Como Jugando", al primer año de implementación, no redujo el Puntaje Z del IMC, sin embargo, tuvo impacto sobre los conocimientos en nutrición, redujo la probabilidad de tener un nivel malo de actividad física y mantuvo o aumentó la frecuencia adecuada del consumo de frutas, agua sin azúcar, jugos envasados y galletas dulces y saladas. Es necesario continuar evaluando la intervención "Como Jugando" para estimar el impacto sobre indicadores biológicos.
ABSTRACT Objective. To determine the impact of the educational-motivational intervention "Como jugando" on the body mass index (BMI), knowledge on nutrition, physical activity levels, and eating patterns in students from the first to fourth grades of four educational institutions (EIs) of Cercado de Lima after the first year of the intervention. Materials and methods. This was a quasi-experimental, controlled study. BMI, knowledge on nutrition, frequency of food consumption, and level of physical activity were evaluated. The "Como jugando" program included playful and experiential activities for school children and involved both teachers and parents. The impact was estimated by applying the McNemar test for related samples and regression models for the analysis of differences in adjusted variables related to children and their mothers. Results. The study included 696 school children from two experimental EIs and two control EIs. The Z-score for BMI and the prevalence of obesity did not vary during the study period. The intervention improved the knowledge of nutrition [odds ratio (OR): 1.46; 95% confidence interval (CI): 1.17-1.81], reduced the likelihood of poor levels of physical activity (OR: 0.63; 95% CI: 0.46-0.87), and improved the consumption patterns for all food categories except vegetables in the intervention group. Conclusions. The "Como jugando" intervention, in the first year of implementation, did not reduce the Z-score for BMI but improved the knowledge of nutrition, reduced the probability of poor levels of physical activity, and maintained or increased the consumption of fruits, sugar-free water, packaged juices, and sweet and savory cookies. Therefore, the "Como jugando" intervention should be better studied in order to estimate its impact on biological indicators.
Subject(s)
Child , Humans , Play and Playthings , Exercise , Health Education , Pediatric Obesity/prevention & control , Motivation , Schools , Time Factors , Body Mass Index , Health Knowledge, Attitudes, Practice , Feeding Behavior , Health Impact AssessmentABSTRACT
RESUMEN Objetivos Evaluar el estado nutricional, los patrones alimentarios y de actividad física en escolares del Cercado de Lima. Materiales y métodos Estudio descriptivo transversal. La muestra incluyó escolares del 1.° a 4.° grado de primaria de cuatro instituciones educativas públicas ubicadas en el Cercado de Lima. Las variables de estudio fueron el estado nutricional, nivel de hemoglobina, los patrones de consumo de alimentos y de actividad física. Se calcularon los porcentajes de las variables cualitativas y medidas de tendencia central para las cuantitativas, en el análisis bivariado se aplicó la prueba t y la prueba de chi cuadrado para analizar las diferencias según sexo. Resultados De 824 escolares incluidos en el estudio, se encontró un 24% con obesidad, mientras que el sobrepeso afectó al 22%, la proporción de talla baja fue de 5% y la de anemia fue 11,9%, en todos los casos no hubo diferencias significativas según sexo. Más del 40% de escolares consumían 2 o más veces a la semana galletas saladas, jugos envasados y/o gaseosas. Además, el 28% de escolares eran sedentarios, encontrándose diferencias significativas según sexo (p<0,05). Conclusiones La obesidad es un problema vigente, con mayor frecuencia que el sobrepeso y que juntos afectan a casi el 50% de los escolares del estudio. Asimismo, se evidencia que existen patrones de sedentarismo y consumo frecuente de alimentos con alto contenido de azúcar, sal y/o grasas.
ABSTRACT Objectives To assess the nutritional status, physical activity, and eating habits of schoolchildren in Cercado de Lima (Lima district). Materials and methods Cross-sectional descriptive study. The sample included schoolchildren from first to fourth grade in four public elementary schools located in Cercado de Lima. The study variables were nutritional status, hemoglobin dose, physical activity, and eating habits. The percentages of the qualitative variables and central tendency measures for quantitative ones were calculated. The t-test and chi-squared test were applied to analyze differences between both genders. Results Of 824 schoolchildren included in the study, 24% were obese, 22% were overweight, 5% had short stature, and 11.9% had anemia; in all instances, there were no substantial gender differences. More than 40% of schoolchildren would eat crackers and drink packaged juice and/or soda two or more times a week. In addition, 28% of schoolchildren were inactive; there were significant differences in both genders (P<0.05). Conclusions Obesity is an ongoing problem with higher rates than overweight and, together, the aforementioned problems affect almost 50% of schoolchildren surveyed. Similarly, the study revealed patterns associated with a sedentary lifestyle and frequent consumption of foods with high levels of sugar, salt, and/or fats.