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Editor’s Choice : The Children in Action Pilot Study
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Abstract: Interventions that can successfully alter the trajectory toward obesity among high-risk children are critical if we are to effectively address this public health crisis. The goal of this pilot study was to implement and evaluate an innovative physical activity program with Hispanic-American (HA) preschool children attending Head Start. The Children in Action (CIA) program was a five month physical activity intervention. This intervention was a pilot study with 3- to 5-year-olds enrolled in four HA Head Start centers. After baseline assessment, centers were matched by enrollment and randomly assigned to either the intervention or the control condition. A total of 295 preschool children were randomly selected across the four centers. The primary endpointsof this study were favorable changes in physical activity levels and gross motor skills. Using mixed effect time-series regression models, changes in weight was a secondary endpoint. We did not observe a statistical difference between intervention and control groups in physical activity levels during the awake time, gross motor skills,or weight status. Process evaluation data showed that there was adherence to protocols and the intervention was delivered 92% of the time, four times per week, during the five month intervention. We demonstrated that it is feasible to conduct the SPARK-Early Childhood (EC) curriculum among preschool children attending Head Start centers but that an increased dose and/or longer intervention duration will be required to impact gross motor skills, physical activity levels and weight status during this critical early childhood development stage. Keywords: Physical activity, children, Head Start, SPARK-EC.Download Full Article |
Editor’s Choice : Do Childhood Cancer Survivors Meet the Diet and Physical Activity Guidelines?
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Abstract: Despite advances in cancer treatment, childhood cancer survivors are at higher risk of developing chronic health conditions than peers who have not had cancer. Being overweight or obese adds to the already elevated risk of cardiovascular diseases and metabolic abnormalities. Diet and physical activity are modifiable behaviors that reduce obesity risk and have been shown to improve cancer survival in adult cancer survivors. Specific guidelines have been developed for cancer survivors that provide advice on nutrition, physical activity and weight management following cancer diagnosis and treatment. In this review, we report on existing nutrition and physical activity guidelines for cancer survivors, supplemented by available literature on diet and physical activity status of childhood cancer survivors and their associations with health-related outcomes. The 2012 American Cancer Society (ACS) and the 2008 Children’s Oncology Group (COG) guidelines provide similar advice on diet but the ACS guidelines also offer specific advice on physical activity and weight management. Thirty-one observational studies and 18 intervention trials published prior to June 2012 that met the inclusion criteria were reviewed. Results suggest that a high proportion of childhood cancer survivors had poor adherence to dietary and physical activity guidelines. Although findings from existing intervention trials are preliminary due to small sample size, available evidence suggests that exercise intervention is safe and feasible for patients and survivors of childhood cancer. Childhood cancer survivors should be encouraged to engage in physical activity, adopt a healthy diet, and maintain a healthy weight throughout cancer survivorship. Keywords: Childhood cancer survivors, diet, physical activity, guidelines, review.Download Full Article |
Editor’s Choice : Maternal and Neonatal Factors Influencing Preterm Birth and Low Birth Weight in Oman: A Hospital Based Study
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Abstract: Background: Preterm births (PTB) and low birth weight (LBW) - the two distinct adverse pregnancy outcomes - are the major determinants of perinatal survival and development. The purpose of this study was to determine the incidence of LBW and PTB and identify the maternal and neonatal risk factors influencing them. Methods: Data for the study come from a cross-sectional retrospective study conducted at the maternity ward of Sultan Qaboos University Hospital (SQUH) in Oman during the period between November 2011 and February 2012. Data on 534 singleton live births that occurred during the study period were extracted from hospital record. Descriptive statistics, bivariate analysis and multivariate logistic regression model were used for data analysis. Results: The incidence of PTB and LBW were observed to be 9.7% and 13.7% respectively. Half (51.8%) of the LBW babies were PTB and 48.2% of the LBW babies were of term births. Differences and similarities were noted for the risk profile for PTB and LBW. Risk factors specific to PTB were maternal age, previous pregnancy loss, and infant’s length, while birth interval, maternal weight and BMI during pregnancy, and gestational age were the risk factors unique to LBW. ANC visit, infant’s gender, Apgar score, and head circumference of infants were the common significant risk factors influencing both LBW and PTB. Conclusions: The incidence of PTB and LBW are moderately high in Oman. They are associated with different risk factors. A greater understanding and modification of identified risk factors would help reduce the incidence of PTB and LBW in Oman. Keywords: Birth weight, Low birth weight, Preterm birth, Incidence, Risk factor, Consanguinity, Oman.Download Full Article |
Editor’s Choice : Relationship between Snacking Patterns, Diet Quality and Risk of Overweight and Abdominal Obesity in Children
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Abstract: Snacking is very common among Americans; the impact of variety of snacking patterns on nutrient intake and weight status is unclear. This study examined the associations of snacking patterns on nutrient intake and weight in U.S. children 2-18 years (n=14,220) participating in the 2001-2008 National Health and Nutrition Examination Survey. Cluster analysis generated 12 distinct snacking patterns, explaining 57% of variance in total calories consumed. Only 8% of the children did not consume snacks on the day of the 24-hour recall. Cakes, cookies and pastries was the most common snacking pattern (16%) followed by miscellaneous snacks (e.g. whole milk, orange juice and meat/fish/poultry; 13%), and crackers and salty snacks (10%). Most snacking patterns resulted in higher total energy intake than the no snack pattern. After controlling for energy intake, most snacking patterns resulted in higher intakes of fiber; vitamins A, C, B12, and K; riboflavin; folate; potassium; calcium; zinc; and magnesium than the no snack pattern. However, most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Several of the snacking patterns (i.e. cakes/cookies/pastries, crackers/salty snacks, sweets, and other grains) were associated with a reduced risk of overweight and abdominal obesity. Overall, several snacking patterns compared with non-snackers had better diet quality and were less likely to be overweight or obese and less likely to have abdominal obesity. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet. Keywords: Children, Snacking Patterns, Overweight, Abdominal Obesity, Diet Quality.Download Full Article |
Editor’s Choice : Prevalence and Determinants of Chronic Malnutrition Among Under-5 Children in Ethiopia
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Abstract: In Bangladesh, the prevalence of diarrhoea is the highest among children aged 6-23 months and the outbreaks are common among slum-dwellers of Dhaka city, Bangladesh. A qualitative explorative research was undertaken among slum-dwellers to explore the feeding practices and care-seeking behaviours of mothers with children with diarrhoeal diseases aged less than two years. Data were collected through in-depth interviews, focus-group discussions and observation checklist with mothers and elder family members. Breastmilk was blamed for causing diarrhoea among predominantly or exclusively breastfed children. The blameworthiness leads to withholding of breastfeeding during diarrhoeal episodes especially with recurrent and persistent diarrhoea. Teething, eating protein diet by children and eating leafy vegetables by mothers were believed to be responsible for diarrhoea among the older children. Hand-washing before preparing foods and before feeding children was virtually not practised. Usual complementary foods were not offered to the children with diarrhoea. Almost all of the children were offered oral rehydration salt solution and other fluids at home. A common healthcare-seeking behaviour of the mothers was to give medicines from local drug stores. Some mothers performed some rituals for the purification of their breastmilk. As the mother’s diet was believed to be responsible for the child’s diarrhoea, some foods, especially leafy-vegetables, some types of fish, and meat, were restricted to the mothers. The study concludes that perceptions of mothers regarding the causes of children’s diarrhoea direct to inappropriate feeding practices and care-seeking behaviours of under-two children with diarrhoeal diseases. Keywords: Nutritional status, Chronic malnutrition, Prevalence, Stunting, Ethiopia.Download Full Article |