Abstract: Dissemination of obesity prevention programs in different settings is needed. Moreover, new outreach tools to teach parents healthy eating and exercise lessons provided in these programs are important to develop. The pilot studies presented in this paper examined the implementation of the Children’s Healthy Eating and Exercise Program in two different after school programs in 2015 and 2016. Participants were elementary school-age children and their parents. Eight lessons were presented at each school. Child perceptions of healthy eating and exercise goals were examined as well as child knowledge retention and perceptions of behavior change. Parent perceptions of the program were analyzed. Results indicated that children reported improved knowledge and behaviors. Parents reported satisfaction with the program, but remained hard to reach. Children recalled key components of the healthy eating lessons at long-term follow-up assessments. In the second pilot study, children served as health coaches for teaching parents about family goals. Children believed they were successful at coaching parents, but they requested help in developing family eating and exercise goals. Improving outreach to parents and involving siblings remains a goal for future studies as does beginning to examine changes in eating and physical activity using food diaries and accelerometry.

Keywords:  Prevention, children, obesity, after-school program, motivational interviewing.

Abstract: This study examined the benefits of a 10-week childhood obesity intervention program on various measures of health. The program involved parents and children who met once weekly for two hours. Each session of the intervention program consisted of a structured dynamic warm-up an aerobic exercise component in a game play setting and a motor-skill specific instruction period. Subjects were recruited from pediatrician recommendation and a total of 99 subjects (n=48 boys, n=51 girls) completed both pretest and posttest intervention measures. The mean age was 9.86 (SD=0.02 years). Each of the following were assessed on pediatric assessment prior to and following the intervention program: height, weight, body mass index (BMI), waist circumference, resting heart rate, resting blood pressure, habitual physical activity, percent body fat, and quality of life. Assessment of the participant’s cardiovascular fitness and the state of home environment in regards to nutrition and physical activity were completed as part of the first and tenth (final) intervention program sessions. Results indicated that the changes observed that were statistically significant included the categories of systolic blood pressure, height, weight, quality of life, habitual physical activity, FNPA score, and PACER scores. Improvements in outcomes measured were modest but this result was expected due to the short intervention program of only ten-weeks duration. Recommendations include increasing the length of the intervention and conducting follow-up assessment to determine long-term impact.

Keywords:  Obesity, Overweight, Pediatric, Physical Activity, Physical and Health Education, Nutrition, Quality of Life, Self-Efficacy, BMI, Cardio-respiratory fitness, PACER.

Abstract: Objectives: To examine the association of maternal GDM with 1) child BMI z-score at preschool; 2) breastfeeding initiation and duration, while adjusting for child birthweight in addition to potential confounders.

Method: Sample included 53 children (3 - 5 years old) recruited from two preschools in Jeddah, Saudi Arabia. Mothers completed a self-administered questionnaire. Child anthropometry was completed using standardized procedures. BMI z-scores were calculated using the WHO standards/reference data. Linear regression models were tested to examine the association between maternal GDM and child BMI z-score, as well as breastfeeding duration. Logistic regression models were tested to examine the association between maternal GDM and breastfeeding initiation. Models were adjusted for child birthweight, maternal BMI, and maternal age at pregnancy.

Results: Mean child BMI z-score was 1.10 (SD= 1.22). About one quarter (24.5%) of mothers reported being diagnosed with GDM. Mean birthweight of children whose mothers were diagnosed with GDM was 3.10 kg (SD= 0.74). Adjusting for covariates, we found that maternal GDM was associated with increased child BMI z-score (B= 1.04, 95% CI= 0.14 - 1.94, P-value= 0.02), and lower odds of breastfeeding initiation (OR= 0.10, 95% CI= 0.02 – 0.49, P-value= 0.005). Maternal GDM was not associated with breastfeeding duration (B= -4.75, 95% CI: -11.79 – 2.29, P-value= 0.18).

Conclusion: Findings suggest that maternal GDM is associated with higher child BMI z-score at preschool and lower likelihood of breastfeeding initiation. Studies are needed in order to identify the underlying mechanisms of associations. Obesity prevention programs may target children whose mothers were diagnosed with GDM; prenatal breastfeeding counseling may be offered.

Keywords:  Gestational diabetes, Breastfeeding, BMI z-score, Preschool.

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Abstract: Background: Good nutritional status is of paramount importance for a child’s physical, mental and social development after inter-uterine life.

Objective: Dietary pattern, anthropometric indices and developmental milestone of children aged 6-60 months in peri-urban communities were investigated.

Design: The children (236) were randomly selected from health centers and nursery schools in three selected communities. Data were collected with structured questionnaire and anthropometry. The questionnaire administered to the mothers of the children elicited information on their socioeconomic characteristics, dietary pattern and developmental milestones of the children. Anthropometric parameters of the children were measured using standard instruments and procedures. The mean length/height and weight of the children in relation to their ages were compared with WHO child growth standard. Data collected were statistically analyzed using SPSS version 16.

Results: Less than 6% of the mothers introduced complementary food at 6 months, 31.4% introduced before 6 months and 63.2% after 7 months. Majority (97.5%) of the mothers enriched complementary foods with fish (73.7%), infant formular (72.9%), soybean powder (66.5%) and egg (64.0%). A total of 10.6% and 1.7% of the children were moderately and severely stunted, respectively while 4.7% of them had moderate wasting. Underweight was observed more among children within 6 – 24 months. The mean ages for sitting, crawling, standing with support and standing without support reported in this study were 6, 7, 8 and 10 months, respectively.

Conclusion: Scaling up actions on optimal complementary feeding of children would go a long way in improving their nutritional status and physical development.

Keywords:  Nutritional status, milestone, food consumption pattern, children, peri-urban Nigeria.

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Abstract: Background:Severe acute malnutrition is an excessive loss of weight due to the acute shortage of food or illness. It is one of the major public health problems in developing countries including Nepal. According to multiple indicator cluster survey (MICS) 2014, 2.6% severely malnourished in Nepal and 4.4% are severely malnourished in Kavre district. However, there are limited studies about predictors of severe acute malnutrition in Nepal. Thus, this study was aimed to identify the predictors of severe acute malnutrition in Kavre district of Nepal.

Methods: Health facility based matched case control study was conducted among 210 (70 cases and 140 controls) children aged 6-59 months from November 2015 to April 2016. Data was collected through face to face interview with mother of eligible children using structured questionnaires. Multivariate analysis was applied to estimate adjusted odds ratio along with 95% confidence interval.

Results:Children with severe acute malnutrition were 11.32 times more likely than control to have recurrent diarrhea in past six months (95% CI=4.64-28.21). Similarly, severe acute malnutrition was associated with female sex (AOR=2.44, 95% CI=1.88-6.78), fathers occupation daily labor (AOR=4.69, 95% CI=1.17-13.76) and agriculture (AOR=6.850, 95%CI=3.81-12.93), improper exclusive breast feeding (AOR=6.646, 95%CI=2.11-20.90), not feeding colostrum (AOR=3.89, 95% CI=2.88-11.21), severe food insecurity access (AOR=3.55, 95% CI=1.85-9.77) and monthly income less than average level (AOR=8.214, 95% CI=1.43-22.16).

Conclusion: Severe acute malnutrition was independently associated with sex of child, occupation of father, monthly household income, not feeding colostrum, improper exclusive breast feeding, severe household food insecurity access and recurrent diarrhea.

Keywords:  Acute Malnutrition, Food security, Breast feeding, Therapeutic center, Diarrheal disease.

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