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Al-Jawaldeh A, Matbouli D, Diab S, Taktouk M, Hojeij L, Naalbandian S, Nasreddine L. School-Based Nutrition Programs in the Eastern Mediterranean Region: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7047. [PMID: 37998278 PMCID: PMC10671197 DOI: 10.3390/ijerph20227047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/27/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
This systematic review aims at documenting government-led school nutrition programs/interventions in countries of the Eastern Mediterranean Region (EMR). A systematic review of the available literature on this topic was conducted between 25 October 2022 and 15 November 2022 using 15 electronic databases as well as grey literature. The search was limited to materials published post 2000 in English, Arabic, or French. Articles/Reports were included in the review if they provided information on school-based nutrition programs/interventions developed, adopted or implemented by a governmental entity in the EMR countries, irrespective of study design. In total, 158 documents were retained until 16 May 2023. School-based programs/interventions were categorized into 13 types. In total, 298 school-based nutrition programs/interventions were identified. The most common were school meals and school feeding programs (all EMR countries) followed by nutrition education within the curriculum (77% of countries), extracurricular nutrition education (64%), standards for school canteens or foods/beverages available in schools (64%), and training of school staff (59%). Approximately half reported the inclusion of fruit and vegetable schemes (54%) or the establishment of hygienic cooking facilities (50%), while less than half reported standards for the marketing of food/beverages (45%), bans/standards for vending machines, milk feeding schemes, or micronutrient supplementation programs (41%). The least common interventions were school gardens (32%) and take-home rations (14%). Countries with the lowest gross domestic product and lowest government effectiveness score had the lowest number of programs/interventions. Many of the programs have tackled both school-aged children as well as preschoolers. We were able to identify monitoring and process evaluation for 21 programs in 14 countries. Few programs have undergone impact assessment.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 11371, Egypt;
| | - Dana Matbouli
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon; (D.M.); (S.D.); (M.T.); (L.H.)
| | - Sarah Diab
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon; (D.M.); (S.D.); (M.T.); (L.H.)
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon; (D.M.); (S.D.); (M.T.); (L.H.)
| | - Leila Hojeij
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon; (D.M.); (S.D.); (M.T.); (L.H.)
| | - Sally Naalbandian
- Science and Agriculture Library, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon; (D.M.); (S.D.); (M.T.); (L.H.)
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Miller M, Barwood D, Devine A, Boston J, Smith S, Masek M. Rethinking Adolescent School Nutrition Education Through a Food Systems Lens. THE JOURNAL OF SCHOOL HEALTH 2023; 93:891-899. [PMID: 37254564 DOI: 10.1111/josh.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/24/2023] [Accepted: 05/21/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food production, costing, handling, processing, and accessing local produce. Experiential activities were preferred pedagogical approaches. CONCLUSIONS Cross-curricular pedagogy which embraces human and planetary health through a food systems lens, can engage adolescents in nutrition education. Transformational computer games are effective to engage, educate and stimulate inquiry in food systems education.
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Affiliation(s)
- Margaret Miller
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Donna Barwood
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Amanda Devine
- Public Health and Occupational Health & Safety, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Julie Boston
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Sandra Smith
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Martin Masek
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
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Tanous DR, Ruedl G, Kirschner W, Drenowatz C, Craddock J, Rosemann T, Wirnitzer K. School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School. PLoS One 2022; 17:e0275012. [PMID: 36201567 PMCID: PMC9536596 DOI: 10.1371/journal.pone.0275012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.
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Affiliation(s)
- Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- * E-mail:
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Joel Craddock
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Health and Lifestyle Science Cluster Tirol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Verbund West, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
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Wirnitzer KC, Tanous DR, Motevalli M, Göbel G, Wirnitzer G, Drenowatz C, Ruedl G, Cocca A, Kirschner W. Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools. Front Sports Act Living 2022; 4:967915. [PMID: 36249320 PMCID: PMC9554638 DOI: 10.3389/fspor.2022.967915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Georg Göbel
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
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Raufi А, Konstantinova MK. Prevalence of Overweight and Obesity in Children: Variation in Different Ethnicities, Age, and Sex in North Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2022; 43:23-31. [PMID: 35843913 DOI: 10.2478/prilozi-2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Childhood obesity is assuredly one of the most important health challenges of the 21st century, particularly regarding long-term metabolic complications. In the last four decades, there has been a tenfold increase in childhood and adolescence obesity. This cross-sectional study aimed to show the prevalence of overweight and obesity compared by age, sex, and ethnicity in n=1034 healthy male and female children, aged 6-13 years in North Macedonia. Out of the total 1034 children included in the study, 589 (57.0%) were observed with normal weight, 202 (19.5%) children were obese, 140 (13.5%) children were overweight and, 103 (10.0%) children underweight. The study presents an insight that 33% of primary school children are at >85th percentile overweight; or at ≥95th percentile with increased weight due to obesity. The data show that boys have a higher prevalence of obesity and overweight with 37.1%, compared to girls with 29.1%. Also, all age groups demonstrate an exponential increase of the prevalence of overweight: in 6-7 years (5.8%); 8-9 years (12%); 10-11 years (15%); and, 12-13 years old with 19.5%. A jump of prevalence of overweight and obesity between the age groups of 6-7 years, and 8-9 years was observed (17.9% to 25.4% obese and 5.8% to 12.0% overweight). The onset of puberty may be the possible cause. According to the Global Atlas of Childhood Obesity, North Macedonia is graded with a risk index of 7/11; i.e. it is expected that in the next decade until 2030 the obesity rate will rise to 52.5% for children aged 5-19 years old. It is with utmost importance to emphasize that continuous monitoring of children's nutritional status and their risk of obesity is essential, as to further prevent obesity and overweight in the pediatric population.
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Affiliation(s)
- Аrjeta Raufi
- Children's Department, Clinical Hospital in Tetovo, RN Macedonia
| | - Marina Krstevska Konstantinova
- Department of Endocrinology and Genetics, University Children's Hospital, Faculty of Medicine, St's. Cyril and Methodius University in Skopje, RN Macedonia
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Nicholson LM, McLeod Loren D, Reifenberg A, Beets MW, Bohnert AM. School as a Protective Setting for Excess Weight Gain and Child Obesity: A Meta-Analysis. THE JOURNAL OF SCHOOL HEALTH 2021; 91:19-28. [PMID: 33152808 DOI: 10.1111/josh.12972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/30/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The structure provided by school settings even with no specific obesity-intervention may prevent weight gain. This meta-analytic study considered this premise by examining weight outcomes from control groups in published randomized controlled trials of school-year obesity-related interventions conducted in-school and out-of-school. METHODS A systematic review and random-effects meta-analysis were conducted in accordance with Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were systematically searched and resulted in 1976 unique citations, with 14 retained for analysis. Analyses examined the change in weight outcomes among control group participants. RESULTS For studies (N = 6) reporting body mass index (BMI) (kg/m2 ) the overall standardized mean difference (SMD) from pre- to post-intervention was 0.085 (raw units 0.278 kg/m2 ); for studies (N = 9) reporting zBMI, the SMD was 0.022 (0.020 z-scores), for studies (N = 2) reporting waist circumference (cm), the SMD was 0.149 (1.609 cm); for studies (N = 2) reporting BMI percentile, the SMD was 0.064 (0.985 percentiles); and for studies (N = 1) reporting percent body fat, the SMD was 0.031 (0.30 percentage). CONCLUSIONS Children assigned to control conditions (as part of school-based obesity-related interventions) experience, on average, minimal changes in weight outcomes during the school year. Therefore, routine practices of schools may protect against unhealthy weight gains.
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Affiliation(s)
| | | | | | - Michael W Beets
- University of South Carolina, 921 Assembly St, Columbia, SC 29208
| | - Amy M Bohnert
- Loyola University Chicago, 1032 W. Sheridan Rd, Chicago, IL 60660
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Carotenoid Intake and Serum Concentration in Young Finnish Children and Their Relation with Fruit and Vegetable Consumption. Nutrients 2018; 10:nu10101533. [PMID: 30336644 PMCID: PMC6213073 DOI: 10.3390/nu10101533] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/11/2018] [Accepted: 10/13/2018] [Indexed: 01/27/2023] Open
Abstract
Fruit and vegetable intake has been associated with a reduced risk of many chronic diseases. These foods are the main dietary source of carotenoids. The aim of the present study was to evaluate the associations between dietary intake and serum concentrations of α- and β-carotene in a sample of young Finnish children from the population-based birth cohort of the Type 1 Diabetes Prediction and Prevention (DIPP) Study. The current analysis comprised 3-day food records and serum samples from 207 children aged 1, 2 and 3 years. Spearman and partial correlations, as well as a cross-classification analyses, were used to assess the relationship between dietary intake and the corresponding biomarkers. Serum concentrations of α- and β-carotene were significantly higher among the 1-year-old compared to the 3-year-old children. Dietary intakes of α- and β-carotene correlated significantly with their respective serum concentrations in all age groups, the association being highest at the age of 1 year (α-carotene r = 0.48; p < 0.001 and β-carotene r = 0.47; p < 0.001), and lowest at the age of 3 years (α-carotene r = 0.44; p < 0.001 and β-carotene r = 0.30; p < 0.001). A cross-classification showed that 72⁻81% of the participants were correctly classified to the same or adjacent quartile, when comparing the reported dietary intakes and the concentrations of the corresponding carotenoid in serum. The 3-day food record seems to be reasonably valid in the assessment of root vegetable consumption among young Finnish children. Root vegetables were the main dietary source of both carotenoids in all age groups. The high consumption of commercial baby foods among the 1-year-old children was reflected in the relatively high dietary intake and serum concentration of both carotenoids.
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Jeet G, Thakur JS, Prinja S, Singh M, Paika R, Kunjan K, Dhadwal P. Effectiveness of targeting the health promotion settings for non-communicable disease control in low/middle-income countries: systematic review protocol. BMJ Open 2018; 8:e014559. [PMID: 29950455 PMCID: PMC6020988 DOI: 10.1136/bmjopen-2016-014559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Settings-based approaches to health promotion, involving holistic and multidisciplinary methods, which integrate action across risk factors are important. Major advantage of focusing on these settings is the continuous and intensive contact with the participant. Despite the apparent advantages of addressing non-communicable diseases (NCDs) using targeted interventions for several developed country settings, a relative lack of evidence of effectiveness of such interventions in low/middle-income countries has led to poor allocation of resources towards these interventions. The focus is therefore on the settings rather than any one condition, and we therefore expect the findings to generalise to NCD prevention and control efforts. We intend to estimate the effectiveness of targeted interventions in low/middle-income countries. METHODS AND ANALYSIS We will search PubMed, Excerpta Medica Database, OVID, WHO Library and The Cochrane Library from the year 2000 to March 2018 without language restrictions. Study designs to be included will be randomised controlled trials. The primary outcome of effectiveness will be the percentage change in population having different behavioural risk factors. Subgroup analyses will be performed, and sensitivity analyses will be conducted to assess the robustness of the findings. ETHICS AND DISSEMINATION No ethical issues are foreseen. The Institute Ethics Committee of the Post Graduate Institute of Medical Education and Research approved the doctoral research protocol under which this review is being done. Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant conferences and meetings. STUDY DESIGN Systematic review. PROSPERO REGISTRATION NUMBER CRD42016042647; Pre-results.
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Affiliation(s)
- Gursimer Jeet
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jarnail Singh Thakur
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shankar Prinja
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ronika Paika
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kunjan Kunjan
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Priya Dhadwal
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Hobin E, Erickson T, Comte M, Zuo F, Pasha S, Murnaghan D, Manske S, Casey C, Griffith J, McGavock J. Examining the impact of a province-wide physical education policy on secondary students' physical activity as a natural experiment. Int J Behav Nutr Phys Act 2017; 14:98. [PMID: 28724390 PMCID: PMC5518116 DOI: 10.1186/s12966-017-0550-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 07/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students’ moderate to vigorous physical activity (MVPA). Methods Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.g., ≥30 min/day of MVPA on ≥5 days a week) during a 5-month semester to achieve the course credit. Study Designs: A natural experimental study was designed using two sub-studies: 1) quasi-experimental controlled pre-post analysis of self-reported MVPA data obtained from census data in intervention and comparison [Prince Edward Island (PEI)] provinces in 2008 (n = 33,619 in Manitoba and n = 2258 in PEI) and 2012 (n = 41,169 in Manitoba and n = 4942 in PEI); and, 2) annual objectively measured MVPA in cohorts of secondary students in intervention (n = 447) and comparison (Alberta; n = 224) provinces over 4 years (2008 to 2012). Analysis: In Study 1, two logistic regressions were conducted to model the odds that students accumulated: i) ≥30 min/day of MVPA, and ii) met Canada's national recommendation of ≥60 min/day of MVPA, in Manitoba versus PEI after adjusting for grade, sex, and BMI. In Study 2, a mixed effects model was used to assess students’ minutes of MVPA per day per semester in Manitoba and Alberta, adjusting for age, sex, BMI, school location and school SES. Results In Study 1, no significant differences were observed in students achieving ≥30 (OR:1.13, 95% CI:0.92, 1.39) or ≥60 min/day of MVPA (OR:0.92, 95% CI: 0.78, 1.07) from baseline to follow-up between Manitoba and PEI. In Study 2, no significant policy effect on students’ MVPA trajectories from baseline to last follow-up were observed between Manitoba and Alberta overall (−1.52, 95% CI:-3.47, 0.42), or by covariates. Conclusions The Manitoba policy mandating PE in grades 11 and 12 had no effect on student MVPA overall or by key student or school characteristics. However, the effect of the PE policy may be underestimated due to the use of a nonrandomized research design and lack of data assessing the extent of policy implementation across schools. Nevertheless, findings can provide evidence about policy features that may improve the PE policy in Manitoba and inform future PE policies in other jurisdictions.
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Affiliation(s)
- Erin Hobin
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5R 1V2, Canada. .,University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A2, Canada.
| | - Tannis Erickson
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada
| | - Melisa Comte
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada.,University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
| | - Fei Zuo
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5R 1V2, Canada
| | - Saamir Pasha
- Peel Public Health Unit, 150 Central Park Dr, Brampton, ON, L6T 2T9, Canada
| | - Donna Murnaghan
- Thompson Rivers University, 900 McGill Rd, Kamloops, BC, V2C 0C8, Canada
| | - Steve Manske
- University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.,Propel Centre for Population Health Impact, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Catherine Casey
- University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
| | - Jane Griffith
- Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, MB, R3E 0V9, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, 513-715 McDermot Ave, Winnipeg, MB, R3E 3P4, Canada.,University of Manitoba, 66 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada
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Zhang M, Shen F, Petryk A, Tang J, Chen X, Sergi C. "English Disease": Historical Notes on Rickets, the Bone-Lung Link and Child Neglect Issues. Nutrients 2016; 8:E722. [PMID: 27854286 PMCID: PMC5133108 DOI: 10.3390/nu8110722] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 12/14/2022] Open
Abstract
Nutritional or classical rickets (here labeled as "rickets") is a worldwide disease involving mostly infants and young children having inadequate sunlight exposure, often associated with a low dietary intake of Vitamin D. Rickets targets all layers of society independently of economic status with historical information spanning more than two millennia. Vitamin D is critical for the absorption of calcium and prevention of rickets in children as well as osteomalacia in adults. The initial and misleading paradigm of the 19th and 20th centuries that rickets may have been the consequence of infection has been, indeed, reversed following the identification of the Vitamin D molecule's important role in the function of the immune system. Although traditionally considered limited to osteopathology, Vitamin D deficiency is now known to be linked to infection, inflammation, and carcinogenesis. In this review, we consider the key historical (Whistler, pre-Whistler and post-Whistler descriptors) and social facts around rickets; highlight the osteo-pathological features of rickets and the pathology of the upper and lower respiratory tract, stressing the fact that lungs remain the main secondary organ affected by Vitamin D deficiency; and emphasize the public health role in identifying the cases of child neglect or abuse based on the evaluation of the costochondral region.
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Affiliation(s)
- Mingyong Zhang
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan 430064, China.
| | - Fan Shen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada.
| | - Anna Petryk
- Comprehensive Pediatric Bone Health Program, Div. Pediatric Endocrinology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jingfeng Tang
- Membrane Protein Disease and Cancer Research Centre, Provincial Innovation Center, Hubei University of Technology, Wuhan 430068, China.
| | - Xingzhen Chen
- Membrane Protein Disease and Cancer Research Centre, Provincial Innovation Center, Hubei University of Technology, Wuhan 430068, China.
- Department of Physiology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | - Consolato Sergi
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan 430064, China.
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada.
- Stollery Children's Hospital, University of Alberta Hospital, Edmonton, AB T6G 2B7, Canada.
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Machín L, Giménez A, Curutchet MR, Martínez J, Ares G. Motives Underlying Food Choice for Children and Perception of Nutritional Information Among Low-Income Mothers in a Latin American Country. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:478-485.e1. [PMID: 27373862 DOI: 10.1016/j.jneb.2016.04.396] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/06/2016] [Accepted: 04/24/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of the present study was to investigate the influence of nutritional information on how low-income mothers select food for their children. DESIGN Five focus groups, each consisting of 5-10 participants, were conducted. PARTICIPANTS Women, older than 18 years, mothers of young children who were beneficiaries of one of the national food stamps programs in Uruguay. PHENOMENON OF INTEREST Focus group discussions were held around motives underlying food choices for children and perception of labeling systems. ANALYSIS Transcripts of the focus group discussions were analyzed using inductive coding. RESULTS Forty-two women, aged between 18 and 40 years, participated in 5 focus groups. Results showed that low-income mothers do not consider nutritional information when selecting food their children. Traditional nutritional labeling was perceived as complex, difficult to find, and difficult to understand. Participants stressed that they relied on the nutrition claims included on labels for assessing the healthfulness of food products. Semi-directive and directive front-of-pack labels were positively evaluated in terms of ease of interpretation. Participants preferred the traffic light system over other alternatives. CONCLUSIONS AND IMPLICATIONS Results suggest the need to implement simplified nutritional labeling and to regulate the use of nutrition claims on products targeted at children.
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Affiliation(s)
- Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Ana Giménez
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay; Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Canelones, Uruguay
| | | | | | - Gastón Ares
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay; Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Canelones, Uruguay.
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