RESUMO
OBJECTIVE: The aim of this study was to report outcomes of the UK service level delivery of MEND (Mind,Exercise,Nutrition...Do it!) 5-7, a multicomponent, community-based, healthy lifestyle intervention designed for overweight and obese children aged 5-7 years and their families. DESIGN: Repeated measures. SETTING: Community venues at 37 locations across the UK. PARTICIPANTS: 440 overweight or obese children (42% boys; mean age 6.1 years; body mass index (BMI) z-score 2.86) and their parents/carers participated in the intervention. INTERVENTION: MEND 5-7 is a 10-week, family-based, child weight-management intervention consisting of weekly group sessions. It includes positive parenting, active play, nutrition education and behaviour change strategies. The intervention is designed to be scalable and delivered by a range of health and social care professionals. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was BMI z-score. Secondary outcome measures included BMI, waist circumference, waist circumference z-score, children's psychological symptoms, parenting self-efficacy, physical activity and sedentary behaviours and the proportion of parents and children eating five or more portions of fruit and vegetables. RESULTS: 274 (62%) children were measured preintervention and post-intervention (baseline; 10-weeks). Post-intervention, mean BMI and waist circumference decreased by 0.5 kg/m(2) and 0.9 cm, while z-scores decreased by 0.20 and 0.20, respectively (p<0.0001). Improvements were found in children's psychological symptoms (-1.6 units, p<0.0001), parent self-efficacy (p<0.0001), physical activity (+2.9 h/week, p<0.01), sedentary activities (-4.1 h/week, p<0.0001) and the proportion of parents and children eating five or more portions of fruit and vegetables per day (both p<0.0001). Attendance at the 10 sessions was 73% with a 70% retention rate. CONCLUSIONS: Participation in the MEND 5-7 programme was associated with beneficial changes in physical, behavioural and psychological outcomes for children with complete sets of measurement data, when implemented in UK community settings under service level conditions. Further investigation is warranted to establish if these findings are replicable under controlled conditions.
RESUMO
INTRODUCTION: The aim of this study was to record the prevalence of iron deficiency (serum ferritin concentration <15 microg L(-1)) among schoolchildren and identify possible factors related to the development of this medical condition. MATERIALS AND METHODS: The study population consisted of 504 schoolchildren attending three primary schools, located in two districts of Istanbul with higher and lower socio-economic level (SEL) respectively. Certain biochemical and haematological indices of iron status were measured. Dietary intake was estimated using the 24-h recall technique and a food frequency questionnaire. RESULTS: The prevalence of iron deficiency in the lower SEL school district was twice that of the higher SEL school district (42% and 21.2% respectively). Furthermore, the levels of serum ferritin, mean corpuscular volume, mean corpuscular haemoglobin (all P < 0.001) and mean corpuscular haemoglobin concentration (P = 0.016) were higher for students in the higher than in the lower SEL school district. Consumption of tea, cola beverages and dairy products was more frequent by children living in the lower than in the higher SEL school district. Furthermore, consumption of red meat and citrus fruits was less frequent by boys in the lower than in the higher SEL school district. CONCLUSIONS: Iron deficiency was more prevalent among children from the lower SEL school district. Different patterns in the consumption of foods and beverages that inhibit or enhance intestinal iron absorption between children in the two school districts could provide some explanation for the observed differences in the prevalence of iron deficiency.
