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Morales-Cahuancama B, Verdezoto N, Gonzales-Achuy E, Quispe-Gala C, Bautista-Olortegui W, Hinojosa-Mamani P, Aparco JP. Exploring Children's Knowledge of Healthy Eating, Digital Media Use, and Caregivers' Perspectives to Inform Design and Contextual Considerations for Game-Based Interventions in Schools for Low-Income Families in Lima, Peru: Survey Study. JMIR Form Res 2024; 8:e49168. [PMID: 38743472 PMCID: PMC11134240 DOI: 10.2196/49168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.
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Affiliation(s)
- Bladimir Morales-Cahuancama
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Programa Académico de Nutrición y Dietética, Facultad de ciencias de la salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Nervo Verdezoto
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Elena Gonzales-Achuy
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Cinthia Quispe-Gala
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | | | - Paul Hinojosa-Mamani
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Juan Pablo Aparco
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Escuela Profesional de Nutrición, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Figueira M, Santos AC, Gregório MJ, Araújo J. Changes in screen time from 4 to 7 years of age, dietary patterns and obesity: Findings from the Generation XXI birth cohort. Nutr Metab Cardiovasc Dis 2023; 33:2508-2516. [PMID: 37580233 DOI: 10.1016/j.numecd.2023.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND AIMS Increased screen exposure is associated with unhealthy eating behaviours and obesity. Screen time (ST) changes from pre-school to school age, and associations with dietary patterns (DP) and obesity remain unknown. We, therefore, analysed ST changes from 4 to 7 years of age, associated factors, and the relation with DP and obesity. METHODS AND RESULTS We included 4531 children evaluated at 4 and 7 years, as part of the Generation XXI birth cohort (Porto, Portugal). ST was assessed for weekdays and weekend, and average daily time was estimated. Associations between covariates and ST changes, and between ST changes and 3 DP previously identified (Energy-dense foods, Snacking, and Healthier) were estimated by odds ratios (OR) and 95% confidence interval (95%CI), using adjusted multinomial regression models. From 4 to 7 years, 31.5% of the children decreased their ST, 21.8% increased, 16.5% maintained low (≤60 min), and 30.2% maintained high (61-120 min or >120 min) ST. After adjustment, lower maternal education (OR = 2.33, 95%CI:1.82-2.99) and lower family income (OR = 1.72, 95%CI:1.35-2.21) were associated with higher odds of increasing ST, while being a girl was associated with 35% decreased odds of increasing ST. Children that increased and those that maintained high ST showed greater odds of presenting a Snacking DP at 7 years (OR = 2.34, 95%CI:1.64-3.35) and (OR = 2.65, 95%CI:1.89-3.72), respectively. No statistically significant differences were found regarding changes in ST and the child's BMI. CONCLUSION Children increasing screen exposure during this period were more frequently from lower socioeconomic strata and presented unhealthier DP.
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Affiliation(s)
- Marta Figueira
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica -Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Maria João Gregório
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Direção-Geral da Saúde, Lisboa, Portugal
| | - Joana Araújo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica -Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
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Pizarro A, Oliveira-Santos JM, Santos R, Ribeiro JC, Santos MP, Coelho-e-Silva M, Raimundo AM, Sardinha LB, Mota J. Results from Portugal's 2022 report card on physical activity for children and youth. J Exerc Sci Fit 2023; 21:280-285. [PMID: 37304392 PMCID: PMC10251122 DOI: 10.1016/j.jesf.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/30/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
Background The purpose of this study is to update results of Portuguese's Report Card on Physical activity (PA) for Children and Adolescents. Methods The grades were assigned by results derived from the PA and Fitness in Portugal 2021 Portuguese Report Card and corresponds to the third report for the Portuguese children and adolescents. It includes indicators of PA and sedentary behavior (SB) that are common to the GLOBAL matrix 4.0: Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviors, Family and Peers, School, Community and the Environment, Government and Physical Fitness. The search focused on published national evidence/data sources (academia, NGO, governmental) from end 2018 onwards excluding data obtained during the covid-19 pandemic. Results The grades were assigned as follows: Overall PA (D-), Organized Sport Participation (C-), Active Play (D+), Active Transportation (D-), Sedentary behaviors (C+), Physical Fitness (C), Family and Peers (B), School (A), Community and Environment (B), and Government (B). Conclusion In line with previous Portuguese Report Cards, a large proportion of Portuguese children and adolescents are not sufficiently active nor fit enough setting urgency for effective strategies. Particular attention should be given to Active play, Active transport and Organized Sports Participation has their grades have decreased. Some actions in selected indicators as Governmental and policy seems promising however results weren't seen yet. Despite the strong support of schools with mandatory curricula in PE no correspondent change is observed in fitness or PA, so more research is needed to find why.
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Affiliation(s)
- Andreia Pizarro
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600, Porto, Portugal
| | - José Miguel Oliveira-Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Rute Santos
- Research Centre in Child Studies, University of Minho, Portugal
- Institute of Education, University of Minho, Portugal
| | - José Carlos Ribeiro
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600, Porto, Portugal
| | - Maria Paula Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600, Porto, Portugal
| | | | - Armando M. Raimundo
- Universidade de Évora, Escola de Saúde e Desenvolvimento Humano – Departamento de Desporto e Saúde, Comprehensive Health Research Centre (CHRC), Portugal
| | - Luís B. Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600, Porto, Portugal
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Machado-Rodrigues AM, Rodrigues D, Gama A, Nogueira H, Silva MRG, Mascarenhas LP, Padez C. Tri-axial accelerometer-assessed physical activity and its association with weight status in a sample of elementary-school children. Obes Res Clin Pract 2023:S1871-403X(23)00027-3. [PMID: 37087316 DOI: 10.1016/j.orcp.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/26/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND AND AIMS Objective assessment of physical activity (PA) using accelerometers and pedometers has become more accurate and common practice in the study of childhood overweight. The study aimed: i) to compare PA levels and body shape of boys and girls, and assess compliance of active children with the PA recommendation; ii) to analyse associations between the risk of overweight and the moderate-to-vigorous physical activity (MVPA) in children. METHODS The sample comprised 395 children (198 girls) aged 6-10 years. Height and weight were measured, and BMI was calculated subsequently. A tri-axial accelerometer was used to obtain seven consecutive days of MVPA, as well as the weekly time being sedentary. Logistic regression analysis was used to examine the afore-mentioned relationship among the risk of obesity and MVPA, controlling for confounders. RESULTS After controlling for wearing time, boys spent significantly more minutes in the moderate-to-vigorous portion of PA than their female counterparts. About 47% of boys were active on week days by achieve the mean value of 60 min/day of MVPA; corresponding percentage for the weekend was just 32%. Among girls, only 22% were active on week days and 29% at the weekend. MVPA was not significantly associated with the risk of being overweight nor in female neither in male children. The final regression model revealed that girls of mothers with high educational level were less likely to be classified as overweight girls. CONCLUSIONS Findings revealed no significantly relation between MVPA and obesity risk among Portuguese children. Future research should extend similar design to other lifestyle features of children to clarify potential predictors of being overweight at early ages.
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Affiliation(s)
- Aristides M Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal; Faculty of Sport Sciences and Physical Education, University of Coimbra, Portugal.
| | - Daniela Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - Augusta Gama
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - Maria-Raquel G Silva
- Research Centre for Anthropology and Health, University of Coimbra, Portugal; Department of Nutrition, Fernando Pessoa University, Porto, Portugal; Comprehensive Health Research Centre-Group of Sleep, University of Lisbon, Portugal
| | - Luís P Mascarenhas
- UniCentro, Department of Physical Education, Midwestern Paraná State University, Brazil
| | - Cristina Padez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
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MACHADO-RODRIGUES AM, RODRIGUES D, GAMA A, NOGUEIRA H, SILVA MR, MASCARENHAS LP, PADEZ C. Pediatric lifestyle and risk of obesity: the role of sedentary behaviour, daily physical activity, and eating patterns in 7-9 years-old children. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2023. [DOI: 10.23736/s0393-3660.22.04821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Rodrigues D, Machado-Rodrigues A, Gama A, Nogueira H, Silva MRG, Padez C. The Portuguese economic crisis is associated with socioeconomic and sex disparities on children's health-related behaviors and obesity: A cross-sectional study. Am J Hum Biol 2022; 34:e23796. [PMID: 36070351 DOI: 10.1002/ajhb.23796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Our objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status. METHOD This is a cross-sectional study, including data collected in 2016/2017 among 5134 children aged 6-11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep- and screen-time, participation in organized sports, and specific dietary habits were reported parental-reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact. RESULTS First, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high-fat food, screen-time, sleep-time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health-related behaviors and the impact of the economic crisis was stronger for girls compared to boys. CONCLUSION Our findings give us an indication of how economic crises may drive changes in health outcomes.
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Affiliation(s)
- Daniela Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Aristides Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Polytechnic Institute of Viseu, High School of Education, Viseu, Portugal
| | - Augusta Gama
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Animal Biology, University of Lisbon, Lisbon, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Maria-Raquel G Silva
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Cristina Padez
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Coimbra, Coimbra, Portugal
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Effect of screen time intervention on obesity among children and adolescent: A meta-analysis of randomized controlled studies. Prev Med 2022; 157:107014. [PMID: 35248682 DOI: 10.1016/j.ypmed.2022.107014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Abstract
Several studies have investigated the effect of screen time interventions on obesity in children and adolescents, but the existing results were controversial. This study aimed to analyze the effect of screen time intervention on obesity in children and adolescents. PubMed, Cochrane, Web of Science, Embase databases were searched through December 2020 to identify publications meeting a priori inclusion criteria and references in the published articles were also reviewed. Finally, 14 randomized controlled trials and 1894 subjects were included in this meta-analysis. The results showed that interventions targeting screen time are effective in reducing total screen time (MD: -6.90 h/week, 95% CI: [-9.19 to -4.60], p < 0.001) and television time (MD: -6.17 h/week, 95% CI: [-10.70 to -1.65], p < 0.001) in children and adolescents. However, there was no significant difference between the intervention and control groups in body mass index and body mass index-z score. In conclusion, there is no evidence that screen time interventions alone can decrease obesity risk in children and adolescents, though they can effectively reduce screen time.
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The Association of Family, Friends, and Teacher Support With Girls' Sport and Physical Activity on the Island of Ireland. J Phys Act Health 2021; 18:929-936. [PMID: 34098528 DOI: 10.1123/jpah.2020-0386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 03/24/2021] [Accepted: 04/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The current study was the largest physical activity (PA) surveillance assessment of youth undertaken in Ireland in recent years. The purpose of this research was to assess the impact of social support, while controlling for age and screen time, on PA and sport participation, across a representative sample of Irish female youth. METHODS A total of 3503 children (mean age: 13.54 [2.05] y) across the island of Ireland participated. Participants completed a previously validated electronic questionnaire while supervised in a classroom setting, which investigated their (1) levels of PA; (2) screen time; (3) community sport participation; and (4) social support (friend, family, and teacher) to be physically active/partake in sport. RESULTS There were significant differences, with medium and large effect sizes, for social support from friends and family across types of sports participation. Specifically, girls who participated in the most popular team sports, when compared with the most popular individual sports, reported higher social support scores for friends and family structures. CONCLUSIONS Findings from this study confirm the contributing influence of friends and family as sport and PA support networks for girls. Interventions should consider the importance of culturally relevant team sports for PA engagement in female youth.
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