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      Nutritional status of pre-school children from low income families

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          Abstract

          Background

          We evaluated growth and nutritional status of preschool children between 2 and 6 years old from low income families from 14 daycare centers.

          Methods

          Cross-sectional study with 1544 children from daycare centers of Santo Andre, Brazil. Body weight (W), height (H) and body mass index (BMI) were classified according to the 2000 National Center for Health Statistics (CDC/NCHS). Cutoff points for nutritional disorders: -2 z scores and 2.5 and 10 percentiles for malnutrition risk, 85 to 95 percentile for overweight and above BMI 95 percentile for obesity. Stepwise Forward Regression method was used including age, gender, birth weight, breastfeeding duration, age of mother at birth and period of time they attended the daycare center.

          Results

          Children presented mean z scores of H, W and BMI above the median of the CDC/NCHS reference. Girls were taller and heavier than boys, while we observed similar BMI between both genders. The z scores tended to rise with age. A Pearson Coefficient of Correlation of 0.89 for W, 0.93 for H and 0.95 for BMI was documented indicating positive association of age with weight, height and BMI. The frequency of children below -2 z scores was lower than expected: 1.5% for W, 1.75% for H and 0% for BMI, which suggests that there were no malnourished children. The other extremity of the distribution evidenced prevalence of overweight and obesity of 16.8% and 10.8%, respectively.

          Conclusion

          Low income preschool children are in an advanced stage of nutritional transition with a high prevalence of overweight.

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          Most cited references24

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          Childhood obesity, prevalence and prevention

          Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.
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            Television viewing and childhood obesity.

            Children spend a substantial portion of their lives watching television. Investigators have hypothesized that television viewing causes obesity by one or more of three mechanisms: (1) displacement of physical activity, (2) increased calorie consumption while watching or caused by the effects of advertising, and (3) reduced resting metabolism. The relationship between television viewing and obesity has been examined in a relatively large number of cross-sectional epidemiologic studies but few longitudinal studies. Many of these studies have found relatively weak, positive associations, but others have found no associations or mixed results; however, the weak and variable associations found in these studies may be the result of limitations in measurement. Several experimental studies of reducing television viewing recently have been completed. Most of these studies have not tested directly the effects of reducing television viewing behaviors alone, but their results support the suggestion that reducing television viewing may help to reduce the risk for obesity or help promote weight loss in obese children. Finally, one school-based, experimental study was designed specifically to test directly the causal relationship between television viewing behaviors and body fatness. The results of this randomized, controlled trial provide evidence that television viewing is a cause of increased body fatness and that reducing television viewing is a promising strategy for preventing childhood obesity.
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              The increasing prevalence of snacking among US children from 1977 to 1996.

              To determine snacking trends and changes in nutrient contribution of snacking over time. Nationally representative data from the 1977-78 Nationwide Food Consumption Survey (NFCS77), 1989-91 Continuing Survey of Food Intake by Individuals (CSFII89), and 1994-96 (CSFII96) were used. The sample consisted of 21,236 individuals aged 2 to 18 years. For each survey year, mean numbers of snacks consumed, mean grams consumed per snack, and mean energy intake from snacks were computed, as was contribution of snacking to total energy intake and fat intake. Snacking was self-defined, and a snacking occasion consisted of all snack foods consumed during a 15-minute period. Differences in means between age groups and across survey years were compared. The prevalence of snacking increased in all age groups. The average size of snacks and energy per snack remained relatively constant; however, the number of snacking occasions increased significantly, therefore increasing the average daily energy from snacks. Compared with non-snack eating occasions, the nutrient contribution of snacks decreased in calcium density and increased in energy density and proportion of energy from fat. Snacking is extremely prevalent in our society. Healthy snack food choices should be emphasized over high-energy density convenience snacks for children.
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                Author and article information

                Journal
                Nutr J
                Nutrition Journal
                BioMed Central
                1475-2891
                2011
                8 May 2011
                : 10
                : 43
                Affiliations
                [1 ]Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
                [2 ]Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
                [3 ]Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
                [4 ]Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
                Article
                1475-2891-10-43
                10.1186/1475-2891-10-43
                3112402
                21549003
                5500977a-b062-4852-a5ff-29910b93c26a
                Copyright ©2011 Shoerps et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 September 2010
                : 8 May 2011
                Categories
                Research

                Nutrition & Dietetics
                Nutrition & Dietetics

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