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1.
Cochrane Database Syst Rev ; 9: CD012415, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32914461

RESUMO

BACKGROUND: Overweight and obesity are increasing worldwide and are considered to be a major public health issue of the 21st century. Introducing taxation of the fat content in foods is considered a potentially powerful policy tool to reduce consumption of foods high in fat or saturated fat, or both. OBJECTIVES: To assess the effects of taxation of the fat content in food on consumption of total fat and saturated fat, energy intake, overweight, obesity, and other adverse health outcomes in the general population. SEARCH METHODS: We searched CENTRAL, Cochrane Database of Systematic Reviews, MEDLINE, Embase, and 15 other databases and trial registers on 12 September 2019. We handsearched the reference lists of all records of included studies, searched websites of international organizations and institutions (14 October 2019), and contacted review advisory group members to identify planned, ongoing, or unpublished studies (26 February 2020). SELECTION CRITERIA: In line with Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria, we included the following study types: randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs), non-randomized controlled trials (nRCTs), controlled before-after (CBA) studies, and interrupted time series studies. We included studies that evaluated the effects of taxes on the fat content in foods. Such a tax could be expressed as sales, excise, or special value added tax (VAT) on the final product or an intermediary product. Eligible interventions were taxation at any level, with no restriction on the duration or the implementation level (i.e. local, regional, national, or multinational). Eligible study populations were children (zero to 17 years) and adults (18 years or older) from any country and setting. We excluded studies that focused on specific subgroups only (e.g. people receiving pharmaceutical intervention; people undergoing a surgical intervention; ill people who are overweight or obese as a side effect, such as those with thyroiditis and depression; and people with chronic illness). Primary outcomes were total fat consumption, consumption of saturated fat, energy intake through fat, energy intake through saturated fat, total energy intake, and incidence/prevalence of overweight or obesity. We did not exclude studies based on country, setting, comparison, or population. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods for all phases of the review. Risk of bias of the included studies was assessed using the criteria of Cochrane's 'Risk of bias' tool and the EPOC Group's guidance. Results of the review are summarized narratively and the certainty of the evidence was assessed using the GRADE approach. These steps were done by two review authors, independently. MAIN RESULTS: We identified 23,281 records from searching electronic databases and 1173 records from other sources, leading to a total of 24,454 records. Two studies met the criteria for inclusion in the review. Both included studies investigated the effect the Danish tax on saturated fat contained in selected food items between 2011 and 2012. Both studies used an interrupted time series design. Neither included study had a parallel control group from another geographic area. The included studies investigated an unbalanced panel of approximately 2000 households in Denmark and the sales data from a specific Danish supermarket chain (1293 stores). Therefore, the included studies did not address individual participants, and no restriction regarding age, sex, and socioeconomic characteristics were defined. We judged the overall risk of bias of the two included studies as unclear. For the outcome total consumption of fat, a reduction of 41.8 grams per week per person in a household (P < 0.001) was estimated. For the consumption of saturated fat, one study reported a reduction of 4.2% from minced beef sales, a reduction of 5.8% from cream sales, and an increase of 0.5% to sour cream sales (no measures of statistical precision were reported for these estimates). These estimates are based on a restricted number of food types and derived from sales data; they do not measure individual intake. Moreover, these estimates do not account for other relevant sources of fat intake (e.g. packaged or processed food) or other food outlets (e.g. restaurants or cafeterias); hence, we judged the evidence on the effect of taxation on total fat consumption or saturated fat consumption to be very uncertain. We did not identify evidence on the effect of the intervention on energy intake or the incidence or prevalence of overweight or obesity. AUTHORS' CONCLUSIONS: Given the very low quality of the evidence currently available, we are unable to reliably establish whether a tax on total fat or saturated fat is effective or ineffective in reducing consumption of total fat or saturated fat. There is currently no evidence on the effect of a tax on total fat or saturated fat on total energy intake or energy intake through saturated fat or total fat, or preventing the incidence or reducing the prevalence of overweight or obesity.


Assuntos
Gorduras na Dieta/administração & dosagem , Obesidade/prevenção & controle , Impostos , Adolescente , Adulto , Criança , Comércio/estatística & dados numéricos , Dinamarca , Humanos , Análise de Séries Temporais Interrompida , Sobrepeso/prevenção & controle
2.
PLoS One ; 15(8): e0237564, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810194

RESUMO

BACKGROUND: Prevention of overweight during early childhood seems promising. OBJECTIVE: To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). METHODS: A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI. RESULTS: No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses. CONCLUSION: The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight.


Assuntos
Índice de Massa Corporal , Educação não Profissionalizante/métodos , Comportamentos Relacionados com a Saúde/fisiologia , Sobrepeso/prevenção & controle , Poder Familiar , Adulto , Desenvolvimento Infantil/fisiologia , Serviços de Saúde da Criança , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Lactente , Recém-Nascido , Estilo de Vida , Masculino , Países Baixos , Visita a Consultório Médico , Relações Pais-Filho , Obesidade Pediátrica/prevenção & controle , Prevenção Primária/métodos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
3.
PLoS One ; 15(8): e0237720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32834011

RESUMO

BACKGROUND: Underweight, overweight, and obesity are major public health challenges among reproductive-age women of lower- and middle-income countries (including Tanzania). In those settings, obesogenic factors (attributes that promote excessive body weight gain) are increasing in the context of an existing high burden of undernutrition. The present study investigated factors associated with underweight, overweight, and obesity among reproductive age women in Tanzania. METHODS: This study used 2015-16 Tanzania Demographic and Health Survey data (n = 11735). To account for the hierarchical nature of the data (i.e., reproductive age women nested within clusters), multilevel multinomial logistic regression models were used to investigate the association between individual-level (socioeconomic, demographic and behavioural) and community-level factors with underweight, overweight, and obesity. RESULTS: Reproductive age women who were informally employed (relative risk ratio [RRR] = 0.79; 95% confidence interval [CI]: 0.64, 0.96), those who were currently married (RRR = 0.59; 95% CI: 0.43, 0.82) and those who used contraceptives (RRR = 0.70; 95% CI: 0.54, 0.90) were less likely to be underweight. Reproductive age women who attained secondary or higher education (RRR = 1.48; 95% CI: 1.11, 1.96), those who resided in wealthier households (RRR = 2.31; 95% CI: 1.78, 3.03) and those who watched the television (RRR = 1.26; 95% CI: 1.06, 1.50) were more likely to be overweight. The risk of experiencing obesity was higher among reproductive age women who attained secondary or higher education (RRR = 1.79; 95% CI: 1.23, 2.61), those who were formally employed (RRR = 1.50; 95% CI: 1.14, 1.98), those who resided in wealthier households (RRR = 4.77; 95% CI: 3.03, 7.50), those who used alcohol (RRR = 1.43; 95% CI: 1.12, 1.82) and/or watched the television (RRR = 1.70; 95% CI: 1.35, 2.13). CONCLUSION: Our study suggests that relevant government jurisdictions need to identify, promote, and implement evidence-based interventions that can simultaneously address underweight and overweight/obesity among reproductive age women in Tanzania.


Assuntos
Necessidades e Demandas de Serviços de Saúde/organização & administração , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Saúde Reprodutiva/estatística & dados numéricos , Magreza/epidemiologia , Adolescente , Adulto , Estudos Transversais , Medicina Baseada em Evidências/organização & administração , Medicina Baseada em Evidências/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Sobrepeso/fisiopatologia , Sobrepeso/prevenção & controle , Prevalência , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/estatística & dados numéricos , Reprodução/fisiologia , Fatores de Risco , Fatores Socioeconômicos , Tanzânia/epidemiologia , Magreza/fisiopatologia , Magreza/prevenção & controle , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-32708459

RESUMO

BACKGROUND: Healthcare monitoring of child growth reduces with age, which may increase parental influences on children's weight development. This study aimed to examine the association between maternal underestimation of child's weight at age 5/6 and weight development between 5 and 12 years. METHODS: We performed univariate and multivariate linear regression analyses with data on maternal perception of child's weight and weight development (∆SDS body-mass index; BMI) derived from the Amsterdam Born Children and their Development (ABCD) birth-cohort study. Underestimation was defined by comparing maternal perception of child's weight with the actual weight status of her child. Associations were studied in two groups: children with overweight (n = 207) and children with normal weight (n = 1982) at baseline (children with underweight were excluded). RESULTS: Underestimation was 5.5% in children with normal weight and 79.7% in children with overweight. Univariate analyses in children with normal weight and overweight showed higher weight development for children with underestimated vs. accurately estimated weights (respectively: ß = 0.19, p < 0.01; ß = 0.22, p < 0.05). After adjusting for child sex and baseline SDS BMI, the effect size became smaller for children with a normal weight (ß = 0.15, p < 0.05) and overweight (ß = 0.18, p > 0.05). Paternal and maternal BMI, ethnicity, and educational level explained the association further (remaining ß = -0.11, p > 0.05 in children with normal weight; ß = 0.06, p > 0.05 in children with overweight). CONCLUSIONS: The relationship between maternal underestimation of child's weight and higher weight development indicates a need for promoting a realistic perception of child's weight, this is also the case if the child has a normal weight.


Assuntos
Peso Corporal , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Sobrepeso/prevenção & controle , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia
5.
PLoS One ; 15(4): e0232624, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353069

RESUMO

BACKGROUND: A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. METHODS: A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. RESULTS: A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. CONCLUSION: The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan.


Assuntos
Obesidade Abdominal/epidemiologia , Sobrepeso/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/prevenção & controle , Sobrepeso/diagnóstico , Sobrepeso/prevenção & controle , Prevalência , Fatores de Risco , Fatores Sexuais , Sudão/epidemiologia , Circunferência da Cintura
6.
Br J Sports Med ; 54(22): 1321-1331, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32471813

RESUMO

China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation's youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China's more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6-17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.


Assuntos
Exercício Físico , Programas Gente Saudável , Obesidade Pediátrica/prevenção & controle , Sucesso Acadêmico , Adolescente , Criança , China/epidemiologia , Cognição/fisiologia , Meio Ambiente , Exercício Físico/psicologia , Política de Saúde , Estilo de Vida Saudável , Programas Gente Saudável/métodos , Humanos , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Obesidade Pediátrica/epidemiologia , Aptidão Física , Classe Social
7.
Cochrane Database Syst Rev ; 4: CD012333, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32270494

RESUMO

BACKGROUND: Global prevalence of overweight and obesity are alarming. For tackling this public health problem, preventive public health and policy actions are urgently needed. Some countries implemented food taxes in the past and some were subsequently abolished. Some countries, such as Norway, Hungary, Denmark, Bermuda, Dominica, St. Vincent and the Grenadines, and the Navajo Nation (USA), specifically implemented taxes on unprocessed sugar and sugar-added foods. These taxes on unprocessed sugar and sugar-added foods are fiscal policy interventions, implemented to decrease their consumption and in turn reduce adverse health-related, economic and social effects associated with these food products. OBJECTIVES: To assess the effects of taxation of unprocessed sugar or sugar-added foods in the general population on the consumption of unprocessed sugar or sugar-added foods, the prevalence and incidence of overweight and obesity, and the prevalence and incidence of other diet-related health outcomes. SEARCH METHODS: We searched CENTRAL, Cochrane Database of Systematic Reviews, MEDLINE, Embase and 15 other databases and trials registers on 12 September 2019. We handsearched the reference list of all records of included studies, searched websites of international organisations and institutions, and contacted review advisory group members to identify planned, ongoing or unpublished studies. SELECTION CRITERIA: We included studies with the following populations: children (0 to 17 years) and adults (18 years or older) from any country and setting. Exclusion applied to studies with specific subgroups, such as people with any disease who were overweight or obese as a side-effect of the disease. The review included studies with taxes on or artificial increases of selling prices for unprocessed sugar or food products that contain added sugar (e.g. sweets, ice cream, confectionery, and bakery products), or both, as intervention, regardless of the taxation level or price increase. In line with Cochrane Effective Practice and Organisation of Care (EPOC) criteria, we included randomised controlled trials (RCTs), cluster-randomised controlled trials (cRCTs), non-randomised controlled trials (nRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included controlled studies with more than one intervention or control site and ITS studies with a clearly defined intervention time and at least three data points before and three after the intervention. Our primary outcomes were consumption of unprocessed sugar or sugar-added foods, energy intake, overweight, and obesity. Our secondary outcomes were substitution and diet, expenditure, demand, and other health outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all eligible records for inclusion, assessed the risk of bias, and performed data extraction.Two review authors independently assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We retrieved a total of 24,454 records. After deduplicating records, 18,767 records remained for title and abstract screening. Of 11 potentially relevant studies, we included one ITS study with 40,210 household-level observations from the Hungarian Household Budget and Living Conditions Survey. The baseline ranged from January 2008 to August 2011, the intervention was implemented on September 2011, and follow-up was until December 2012 (16 months). The intervention was a tax - the so-called 'Hungarian public health product tax' - on sugar-added foods, including selected foods exceeding a specific sugar threshold value. The intervention includes co-interventions: the taxation of sugar-sweetened beverages (SSBs) and of foods high in salt or caffeine. The study provides evidence on the effect of taxing foods exceeding a specific sugar threshold value on the consumption of sugar-added foods. After implementation of the Hungarian public health product tax, the mean consumption of taxed sugar-added foods (measured in units of kg) decreased by 4.0% (standardised mean difference (SMD) -0.040, 95% confidence interval (CI) -0.07 to -0.01; very low-certainty evidence). The study was at low risk of bias in terms of performance bias, detection bias and reporting bias, with the shape of effect pre-specified and the intervention unlikely to have any effect on data collection. The study was at unclear risk of attrition bias and at high risk in terms of other bias and the independence of the intervention. We rated the certainty of the evidence as very low for the primary and secondary outcomes. The Hungarian public health product tax included a tax on sugar-added foods but did not include a tax on unprocessed sugar. We did not find eligible studies reporting on the taxation of unprocessed sugar. No studies reported on the primary outcomes of consumption of unprocessed sugar, energy intake, overweight, and obesity. No studies reported on the secondary outcomes of substitution and diet, demand, and other health outcomes. No studies reported on differential effects across population subgroups. We could not perform meta-analyses or pool study results. AUTHORS' CONCLUSIONS: There was very limited evidence and the certainty of the evidence was very low. Despite the reported reduction in consumption of taxed sugar-added foods, we are uncertain whether taxing unprocessed sugar or sugar-added foods has an effect on reducing their consumption and preventing obesity or other adverse health outcomes. Further robustly conducted studies are required to draw concrete conclusions on the effectiveness of taxing unprocessed sugar or sugar-added foods for reducing their consumption and preventing obesity or other adverse health outcomes.


Assuntos
Açúcares da Dieta/economia , Obesidade/prevenção & controle , Impostos , Açúcares da Dieta/efeitos adversos , Açúcares da Dieta/provisão & distribução , Alimentos/economia , Manipulação de Alimentos , Humanos , Hungria , Análise de Séries Temporais Interrompida , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Prevalência
8.
BMC Public Health ; 20(1): 482, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32293391

RESUMO

BACKGROUND: The first 1000 days after conception are a critical period to encourage lifestyle changes to reduce the risk of childhood obesity and early programming of chronic diseases. A healthy lifestyle during pregnancy is also crucial to avoid high post-partum weight retention. Currently, lifestyle changes are not consistently discussed during routine health services in Germany. The objective of this study is to evaluate a novel computer-assisted lifestyle intervention embedded in prenatal visits and infant check-ups. The intervention seeks to reduce lifestyle-related risk factors for overweight and obesity among expecting mothers and their infants. METHODS: The study is designed as a hybrid effectiveness-implementation trial to simultaneously collect data on the effectiveness and implementation of the lifestyle intervention. The trial will take place in eight regions of the German state Baden-Wuerttemberg. Region were matched using propensity score matching. Expecting mothers (n = 1860) will be recruited before 12 weeks of gestation through gynecological practices and followed for 18 months. During 11 routine prenatal visits and infant check-ups gynecologists, midwives and pediatricians provide lifestyle counseling using Motivational Interviewing techniques. The primary outcome measure is the proportion of expecting mothers with gestational weight gain within the recommended range. To understand the process of implementation (focus group) interviews will be conducted with providers and participants of the lifestyle intervention. Additionally, an analysis of administrative data and documents will be carried out. An economic analysis will provide insights into cost and consequences compared to routine health services. DISCUSSION: Findings of this study will add to the evidence on lifestyle interventions to reduce risk for overweight and obesity commenced during pregnancy. Insights gained will contribute to the prevention of early programming of chronic disease. Study results regarding implementation fidelity, adoption, reach and cost-effectiveness of the lifestyle intervention will inform decisions about scale up and public funding. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00013173). Registered 3rd of January 2019, https://www.drks.de.


Assuntos
Estudos de Avaliação como Assunto , Promoção da Saúde/métodos , Estilo de Vida Saudável , Cuidado do Lactente , Obesidade/prevenção & controle , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal , Adolescente , Adulto , Aconselhamento , Feminino , Alemanha , Pessoal de Saúde , Humanos , Lactente , Masculino , Mães , Entrevista Motivacional , Sobrepeso/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Gravidez , Projetos de Pesquisa , Fatores de Risco , Ganho de Peso
9.
Artigo em Inglês | MEDLINE | ID: mdl-32225027

RESUMO

(1) Background: Obesity is a global health problem, and its prevention must be a priority goal of public health, especially considering the seriousness of the problem among children. It is known that fetal and early postnatal environments may favor the appearance of obesity in later life. In recent years, the impact of the programs to prevent obesity in childhood has been scarce. The aim of this research is to evaluate the effectiveness of an intervention based on the concept of early programming. (2) Methods: Non-randomized controlled trial design. Inclusion criteria are: two-year-old infants whose gestational period begins in the 14 months following the start of the intervention, and whose mothers have made the complete follow-up of their pregnancy in the same clinical unit of the study. The intervention will be developed over all the known factors that affect early programming, during pregnancy up to 2 years of life. Data will be collected through a data collection sheet by the paediatricians. A unibivariate and multivariate analysis of the data will be carried out. (3) Ethics and dissemination: The trial does not involve any risk to participants and their offspring. Signed informed consent is obtained from all participants. Ethical approval has been obtained. (4) Results: It is expected that this study will provide evidence on the importance of the prevention of obesity from the critical period of the first 1000 days of life, being able to establish this as a standard intervention in primary care.


Assuntos
Promoção da Saúde/métodos , Sobrepeso/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Atenção Primária à Saúde , Ensaios Clínicos Controlados como Assunto , Feminino , Humanos , Lactente , Mães , Gravidez
10.
Nutr. hosp ; 37(2): 251-259, mar.-abr. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190588

RESUMO

BACKGROUND AND OBJECTIVE: impulsiveness might affect the ability of an individual to plan meals, eat regularly, and resist impulses to enjoy foods that are high in fat and sugars in a particular way. The objective of the present study was to evaluate the effectiveness of a fading strategy regarding a reinforcer dimension to promote the development of self-control and decrease impulsive choice among 14 overweight and obese children. MATERIAL AND METHODS: to meet this objective, an experimental procedure of choice behavior was used to evaluate the impulsivity and self-control choices influenced by four reinforcer dimensions on a computer: reinforcement rate, reinforcer quality, immediacy of the reinforcement, and response effort. RESULTS: the results indicate that the children's decisions were influenced primarily by the immediacy of the reinforcement and the reinforcement rate; therefore, the children's behavior can be classified as impulsive. Based on these results, a fading procedure was implemented for self-control training in which the immediacy values of the reinforcement and other influential dimensions that devalued the reinforcer were progressively increased. CONCLUSIONS: after this fading strategy, a change in preference was observed among the children with regard to the proportion of alternative responses that produced high rates of reinforcement or were of higher quality compared with the allocation of choices associated with immediate reinforcement, which required less effort and were of lower quality. It is possible to design strategies regarding the development of self-control based on the contrasting qualities of these dimensions and the gradual training of tolerance of restrictions on access to the reinforcer


INTRODUCCIÓN Y OBJETIVO: la impulsividad puede afectar a la capacidad de la persona para planificar su alimentación, comer con regularidad y resistir los impulsos para disfrutar de alimentos con alto contenido de grasas y azúcares en particular. El objetivo del presente estudio fue evaluar la efectividad de una estrategia de desvanecimiento con respecto a una dimensión del reforzador para promover el desarrollo del autocontrol y disminuir la elección impulsiva entre 14 niños con sobrepeso y obesos. MATERIAL Y MÉTODOS: para cumplir con este objetivo se utilizó un procedimiento experimental sobre la conducta de elección para evaluar los comportamientos impulsivos y autocontrolados influenciados por cuatro dimensiones del reforzador (tasa de reforzamiento, calidad del reforzador, inmediatez del refuerzo y esfuerzo de la respuesta) en una tarea computarizada. RESULTADOS: los resultados indican que las decisiones de los niños fueron influenciadas principalmente por la inmediatez del refuerzo y la tasa de refuerzo; por lo tanto, el comportamiento de los niños puede clasificarse como impulsivo. Sobre la base de estos resultados se implementó un procedimiento de desvanecimiento para el entrenamiento del autocontrol en el que los valores de inmediatez del refuerzo y otras dimensiones influyentes que devaluaron el reforzador aumentaron progresivamente. CONCLUSIONES: después de esta estrategia de desvanecimiento se observó un cambio en la preferencia de los niños con respecto a la proporción de respuestas alternativas que produjeron altas tasas de refuerzo o fueron de mayor calidad en comparación con la asignación de opciones asociadas con el refuerzo inmediato, que requirieron menos esfuerzo y fueron de menor calidad. Fue posible diseñar estrategias con respecto al desarrollo del autocontrol basado en el contraste de las cualidades de estas dimensiones y el entrenamiento gradual de la tolerancia a las restricciones de acceso al reforzador


Assuntos
Humanos , Masculino , Feminino , Criança , Promoção da Saúde/métodos , Sobrepeso/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Autocontrole , Obesidade/epidemiologia , Comportamento Alimentar , Peso Corporal , Estatura , Sobrepeso/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-32326133

RESUMO

Metabolically unhealthy obesity (MUO) is a regular state in people with primary hypertension (HTN), obesity, and who are physically inactive. To achieve and maintain a metabolically healthy overweight/obese (MHO) state should be a main treatment goal. The aims of the study were (1) to determine differences in metabolic profiles of overweight/obese, physically inactive individuals with HTN following a 16-week (POST) supervised aerobic exercise training (SupExT) intervention with an attentional control (AC) group, and (2) to determine whether the changes observed were maintained following six months (6 M) of unsupervised time. Participants (n = 219) were randomly assigned into AC or SupExT groups. All participants underwent a hypocaloric diet. At POST, all participants received diet and physical activity advice for the following 6 M, with no supervision. All measurements were assessed pre-intervention (PRE), POST, and after 6 M. From PRE to POST, MUO participants became MHO with improved (p < 0.05) total cholesterol (TC, ∆ = -12.1 mg/dL), alanine aminotransferase (∆ = -8.3 U/L), glucose (∆ = -5.5 mg/dL), C-reactive protein (∆ = -1.4 mg/dL), systolic blood pressure (SBP), and cardiorespiratory fitness (CRF) compared to unhealthy optimal cut-off values. However, after 6 M, TC, glucose, and SBP returned to unhealthy values (p < 0.05). In a non-physically active population with obesity and HTN, a 16-week SupExT and diet intervention significantly improves cardiometabolic profile from MUO to MHO. However, after 6 M of no supervision, participants returned to MUO. The findings of this study highlight the need for regular, systematic, and supervised diet and exercise programs to avoid subsequent declines in cardiometabolic health.


Assuntos
Dieta Redutora , Terapia por Exercício , Obesidade/terapia , Sobrepeso/terapia , Adulto , Humanos , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Avaliação da Tecnologia Biomédica
12.
Rev. andal. med. deporte ; 13(1): 21-24, mar. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193412

RESUMO

OBJECTIVE: To correlate the 2-minute step test (2MST) with anthropometric variables and habitual physical activity. METHODS: This is a cross-sectional study. Sixty young adult participants of both sexes were classified into three groups with 20 participants each according to their body mass index (BMI): eutrophic, with a BMI between 18.5 and 24.9 kg/m2; overweight, with a BMI between 25 and 29.9 kg/m2; and obese type I, with a BMI between 30 and 34.9 kg/m2. In addition to personal and clinical data, we collected height, weight, BMI, waist and neck circumference measurements. The Baecke Questionnaire (BQ) and 2-minute step test (2MST) were used to measure habitual physical activity and functional capacity, respectively. RESULTS: There was no difference between groups (p > 0.05) for the 2MST and BQ. There was no significant correlation between 2MST, anthropometric variables and habitual physical activity (p > 0.05, r = 0.005 to 0.248). Regarding the accuracy of 2MST in differentiating non-obese from obese subjects, there was insufficient accuracy, with an area under the curve of 0.54. CONCLUSION: 2MST does not relate to body mass index, abdominal and neck circumference, or habitual physical activity


OBJETIVO: Correlacionar el 2-minute step test (2MST) con variables antropométricas y actividad física habitual. MÉTODOS: Este es un estudio transversal. Sesenta adultos jóvenes de ambos sexos, se clasificaron en tres grupos con 20 participantes cada uno según su índice de masa corporal (IMC): eutrófico, con IMC entre 18.5 y 24.9 kg/m2; sobrepeso, con IMC entre 25 y 29.9 kg/m2; y obesos tipo I, con IMC entre 30 y 34.9 kg/m2. Además de los datos personales y clínicos, recopilamos las medidas de altura, peso, IMC, circunferencia de cintura y cuello. El cuestionario Baecke (CB) y la prueba 2MST se utilizaron para medir la actividad física habitual y la capacidad funcional, respectivamente. RESULTADOS: No hubo diferencia entre los grupos (p > 0.05) para 2MST y CB. No hubo correlación significativa entre 2MST, variables antropométricas y actividad física habitual (p > 0.05, r = 0.005 a 0.248). En cuanto a la precisión de 2MST en la diferenciación entre los sujetos no obesos y los obesos, no hubo precisión suficiente, con un área por debajo de la curva de 0.54. CONCLUSIÓN: 2MST no se relaciona con el índice de masa corporal, la circunferencia abdominal y del cuello, o la actividad física habitual


OBJETIVO: Correlacionar o 2-minute step test (2MST) com variáveis antropométricas e atividade física habitual. MÉTODOS: Este é um estudo transversal. Sessenta jovens adultos de ambos os sexos foram classificados em três grupos com 20 participantes em cada de acordo com o índice de massa corporal (IMC): eutróficos, com IMC entre 18.5 e 24.9 kg/m2; sobrepeso, com IMC entre 25 e 29.9 kg/m2; e obeso tipo I, com IMC entre 30 e 34.9 kg/m2. Além dos dados pessoais e clínicos, foram coletadas altura, peso, IMC, circunferência da cintura e do pescoço. O questionário Baecke (BQ) e o 2MST foram usados para medir a atividade física habitual e a capacidade funcional, respectivamente. RESULTADOS: Não houve diferença entre os grupos (p > 0.05) para o 2MST e BQ. Não houve correlação significativa entre o 2MST, variáveis antropométricas e atividade física habitual (p > 0.05, r = 0.005 a 0.248). Em relação à acurácia do 2MST na diferenciação entre obesos e não obesos, houve acurácia insuficiente, com área sob a curva de 0.54. CONCLUSÃO: 2MST não se relaciona com índice de massa corporal, circunferência abdominal e do pescoço, ou atividade física habitual


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Teste de Esforço/métodos , Índice de Massa Corporal , Estudos Transversais , Brasil , Antropometria , Comportamento Sedentário
13.
Int J Qual Stud Health Well-being ; 15(1): 1735093, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32148191

RESUMO

Purpose: Lifestyle interventions can be effective in the management of overweight and obesity in children. However, ineffective guidance towards interventions and high attrition rates affect health impacts and cost effectiveness. The aim of this study was to gain insight into the factors influencing participation, in particular guidance towards, adherence to and completion of an intervention.Methods: A narrative literature review was performed to identify factors related to participation, leading to the development of the "Stages towards Completion Model". Semi-structured interviews (n = 33) and three focus group discussions (n = 25) were performed with children and parents who completed two different group lifestyle interventions, as well as with their coaches.Results: The main barrier to participating in a lifestyle intervention was the complex daily reality of the participants. The main facilitator to overcome these barriers was a personal approach by all professionals involved.Conclusions: Participation in a lifestyle intervention is not influenced by one specific factor, but by the interplay of facilitators and barriers. A promising way to stimulate participation and thereby increase the effectiveness of interventions would be an understanding of and respect for the complex circumstances of participants and to personalize guidance towards and execution of interventions.


Assuntos
Estilo de Vida , Menores de Idade/psicologia , Sobrepeso/prevenção & controle , Pais/psicologia , Cooperação do Paciente , Obesidade Pediátrica/prevenção & controle , Adolescente , Adulto , Criança , Feminino , Grupos Focais , Humanos , Masculino , Tutoria , Países Baixos/epidemiologia , Pesquisa Qualitativa
14.
Int J Behav Nutr Phys Act ; 17(1): 20, 2020 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050975

RESUMO

BACKGROUND: Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating- and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5. METHODS: At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models. RESULTS: At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years. CONCLUSIONS: Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.


Assuntos
Dieta/estatística & dados numéricos , Exercício Físico/fisiologia , Sobrepeso , Sono/fisiologia , Televisão/estatística & dados numéricos , Adiposidade , Pré-Escolar , Comportamento Alimentar/fisiologia , Feminino , Humanos , Masculino , Mães , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle
15.
J Sports Sci ; 38(6): 682-691, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32050850

RESUMO

This study aimed to verify the effect of a multicomponent intervention on cardiometabolic risk factors (CMRF), and to determine the prevalence of responders on CMRF among children and adolescents with overweight/obesity. This is a quasi-experimental study, developed with 35 children and adolescents with overweight/obesity (control group (CG) = 18; intervention group (IG) = 17), aged between 7 and 13 years. Participants in IG underwent a multicomponent intervention for 12 weeks. The following variables were evaluated: anthropometric measures, maturational stages and CMRF (body fatness, HOMA-IR, triglycerides, high-density and low-density lipoprotein) (HDL-C, LDL-C), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. There was a significant time x group interaction on body fatness (p < 0.001), HOMA-IR (p = 0.01), HDL-C (p < 0.001), LDL-C (p = 0.009) and TC (p < 0.001). The prevalence of responders for CMRF in IG and CG was respectively: body fatness (47%; 0%; p = 0.04), HOMA-IR (58.8%; 16.6%; p = 0.04); triglycerides (17.6%; 5.5%; p = 0.31); HDL-C (76.4%; 5.5%; p = 0.01), LDL-C (35.3%; 5%; p = 0.08), TC (64.7%; 5%; p = 0.01), AST (5.8%; 0%; p = 0.87), ALT (29.4%; 11.1%; p = 0.24) and AST/ALT ratio (24.4%; 22.2%; p = 0.67). Multicomponent intervention induced positive changes on CMRF along with a higher prevalence of positive adaptations in IG than the CG in some of the cardiometabolic outcomes assessed.


Assuntos
Dieta Saudável , Exercício Físico , Sobrepeso/prevenção & controle , Pais/psicologia , Obesidade Pediátrica/prevenção & controle , Apoio Social , Adolescente , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Distribuição da Gordura Corporal , Criança , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Homeostase , Humanos , Resistência à Insulina/fisiologia , Masculino , Fatores de Risco , Triglicerídeos/sangue
16.
BMC Public Health ; 20(1): 249, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32093707

RESUMO

BACKGROUND: Engagement of men with commercial and UK National Health Service (NHS) weight loss services is low, and few studies report on why this may be. However, evidence shows that men who do participate in weight loss programmes tend to lose as much, or more weight than women. The present study aimed to explore men's experiences and expectations of mainstream weight loss services in the UK, following referral from a medical professional, particular in relation to barriers and motivators. METHODS: Semi-structured interviews were conducted with 18 men with a BMI over 25 kg/m2 including those who had, and had not, attended group-based or one-to-one weight loss services. Interviews were analysed using thematic analysis. RESULTS: Two themes were identified; 'Fear as a motivation for change' (1) and 'Attitudes towards existing weight loss services' (2). Within theme two, two subthemes were identified; 'Female dominated services' and 'Incompatibility of existing services for men'. The findings suggest that fear, as a result of a medical diagnosis or referral is a mechanism for motivating men to engage with weight loss services. This was often augmented by awareness of other people's experiences of poor health due to their weight. The gender imbalance and attitudes towards existing weight loss services deterred men from engaging with or continuously attending sessions. This imbalance resulted in feelings of self-consciousness, shame and a perceived stigma for men using weight loss services. These experiences highlighted the importance of providing services which align with men's preferences to promote engagement. CONCLUSIONS: A medical diagnosis or referral serves as a strong motivator for men to engage with weight loss services by invoking fear of negative consequences of not losing weight. Men perceived weight loss services to be feminised spaces, in which they felt self-conscious and out of place. As a result, men were deterred from engaging and considered their options were limited. Implications for service design and commissioning are discussed. Involving men in research, service design and evaluation is key to improving their engagement and weight loss.


Assuntos
Homens/psicologia , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Programas de Redução de Peso/estatística & dados numéricos , Adulto , Idoso , Atitude Frente a Saúde , Medo , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pesquisa Qualitativa , Medicina Estatal , Reino Unido/epidemiologia
17.
BMC Public Health ; 20(1): 199, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32033544

RESUMO

BACKGROUND: The impacts of interventions designed to change health behaviours are potentially affected by the complex social systems in which they are embedded. This study uses Scottish data to explore how men receive and utilise partner support when attempting to change dietary practices and physical activity within the context of Football Fans in Training (FFIT), a gender-sensitised weight management and healthy living programme for men who are overweight/obese. METHODS: Separate semi-structured face-to-face interviews were conducted with 20 men and their cohabiting female partners (total n = 40), 3-12 months after the men had completed FFIT. Data were thematically analysed and individual interviews were combined for dyadic analysis. RESULTS: Men's and women's accounts suggested variations in men's need for, and utilisation of, partner support in order to make changes to dietary practices and physical activity. There were also differences in descriptions of women's involvement in men's behaviour changes. Typologies were developed categorising men as 'resolute', 'reliant'/'receptive' and 'non-responsive' and women as 'very involved', 'partially involved' and 'not involved'. Men were more reliant, and women more involved, in changes to dietary practices compared to physical activity. The role of partner involvement in promoting men's behaviour change seemed contingent on men's resoluteness, or their reliance on the partner support. CONCLUSIONS: These results highlight how interactions between men's resoluteness/reliance on cohabiting female partners and the partners' involvement impact the extent to which female partners influence men's changes to dietary practices and physical activity following a weight loss intervention. Understanding this interaction could increase the impact of health interventions aimed at one individual's behaviour by considering other family members' roles in facilitating those changes. The typologies developed for this study might contribute towards the development of behaviour change theories within the cohabiting couple context.


Assuntos
Dieta/psicologia , Exercício Físico/psicologia , Homens/psicologia , Sobrepeso/prevenção & controle , Parceiros Sexuais/psicologia , Apoio Social , Programas de Redução de Peso , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Sobrepeso/epidemiologia , Pesquisa Qualitativa , Escócia/epidemiologia , Futebol
18.
BMC Health Serv Res ; 20(1): 88, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024505

RESUMO

BACKGROUND: In light of the high prevalence of overweight and obesity among adults and the subsequent stigmatization and health consequences, there is a need to develop effective interventions to support lifestyle change. The literature supports the key role of healthcare professionals (HPs) in facilitating self-management through lifestyle interventions for those with chronic conditions. However, there is a lack of knowledge about how HPs practice self-management support (SMS) and user involvement for persons afflicted by overweight or obesity in lifestyle interventions in primary care Healthy Life Centres (HLC). The aim of this study was to explore how HPs provide SMS and what user involvement implies for HPs in HLCs. METHODS: An interpretative exploratory design, using qualitative thematic analysis of data from two focus group interviews with ten HPs from eight different HLCs, was conducted. RESULTS: The analysis resulted in one overall theme; A partnership based on ethical awareness, non-judgemental attitude, dialogue and shared responsibility, comprising four interrelated themes: 1) Supporting self-efficacy, self-worth and dignity through an attitude of respect, acknowledgement and generosity, 2) Promoting self-belief and self-perceived health, 3) Collaborating and sharing responsibility, and 4) Being flexible, adjusting and sharing time. CONCLUSION: HPs in HLCs see service users as equal partners in a collaboration based on shared responsibility, acknowledgement and generosity. In order to help, their practice involves a heightened level of ethical awareness, including a non-judgemental attitude and dialogue. HPs in HLCs have something to teach us about ethical acting and helping persons who are struggling with overweight or obesity to change their lifestyle and regain dignity. They seem to see the service users' existential needs and have learned the art of meeting the other in her/his most vulnerable situation i.e., seeking help for a "wrong lifestyle". It may be time to highlight the need for SMS and user involvement to focus on shared responsibility in partnership rather than personal responsibility. More research is required to explore the conditions for such practice.


Assuntos
Pessoal de Saúde/psicologia , Estilo de Vida , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Relações Médico-Paciente , Autogestão/psicologia , Apoio Social , Adulto , Feminino , Grupos Focais , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Atenção Primária à Saúde , Pesquisa Qualitativa
19.
BMC Womens Health ; 20(1): 14, 2020 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-31973716

RESUMO

BACKGROUND: Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. METHODS: Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15-44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes. RESULTS: Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). CONCLUSIONS: This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.


Assuntos
Terapia Comportamental/tendências , Obesidade/prevenção & controle , Obesidade/terapia , Sobrepeso/prevenção & controle , Sobrepeso/terapia , Programas de Redução de Peso/tendências , Adolescente , Adulto , Feminino , Humanos , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31947884

RESUMO

BACKGROUND: Overweight and obesity are the result of a complex interaction between genetic and environmental factors, which begins prenatally. AIM: To analyse an intervention based on play as a means of improving the body composition of children who are overweight or obese. METHODS: The Kids-Play study is a randomized clinical trial (RCT) consisting of 49 children aged 8-12 years on a nine-month intervention programme based on physical activity, play and nutritional advice. Controls had another 49 children, who received only nutritional advice. RESULTS: The play-based intervention achieved a moderate-vigorous level of physical activity in the study group of 81.18 min per day, while the corresponding level for the control group was only 37.34 min. At the start of the intervention, the children in the study group had an average body fat content of 41.66%, a level that decreased to 38.85% by the end of the programme. Among the control group, body fat increased from 38.83% to 41.4% during the same period. CONCLUSIONS: The intervention programme considered, based on both play and nutritional recommendations, produced a decrease in body fat among children aged 8-12 years. However, the control group, which received only nutritional recommendations, experienced an increase in body weight.


Assuntos
Terapia Comportamental/métodos , Exercício Físico/fisiologia , Exercício Físico/psicologia , Sobrepeso/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Ludoterapia/métodos , Criança , Feminino , Humanos , Masculino , Estudantes/psicologia , Estudantes/estatística & dados numéricos
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