Effects of a recreational physical activity and healthy habits orientation program, using an illustrated diary, on the cardiovascular risk profile of overweight and obese schoolchildren: a pilot study in a public school in Brasilia, Federal District, Brazil

Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity

Childhood obesity is one of the most important problems of public health. Searching was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from January 2022 to June 2022, for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Five main topics were defined in a consensus join statement of the Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes and Polish Association for the Study on Obesity: (1) definition, causes, consequences of obesity; (2) treatment of obesity; (3) obesity prevention; (4) the role of primary care in the prevention of obesity; (5) Recommendations for general practitioners, parents, teachers, and regional authorities. The statement outlines the role of diet, physical activity in the prevention and treatment of overweight and obesity, and gives appropriate recommendations for interventions by schools, parents, and primary health care. A multisite approach to weight control in children is recommended, taking into account the age, the severity of obesity, and the presence of obesity-related diseases. Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education are effective in improving metabolic and anthropometric indices. More actions are needed to strengthen the role of primary care in the effective prevention and treatment of obesity because a comprehensive, multi-component intervention appears to yield the best results.

Physiotherapy and related management for childhood obesity: A systematic scoping review

INTRODUCTION

Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity.

METHOD

A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy.

RESULTS

From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively.

CONCLUSION

When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.

[Assistance programs for physical activity in Brazilian schools: a review based on the RE-AIM model]

The analysis of physical activity (PA) assistance programs is of major importance to ensure progress in the area. The Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) tool has been broadly disseminated in the literature. This study set out to identify PA assistance programs among Brazilian students and analyze them using the RE-AIM tool. The search was conducted in the Lilacs, SportDiscus, SciELO, Scopus, Web of Science, EBSCOhot, PsycINFO and PubMed databases. After thoroughly researching titles, abstracts and studies, 15 articles (seven PA assistance programs) were included. The programs were conducted in the past decade at public schools in the South and Southeast of Brazil. Multicomponent (education and teacher training) strategies were used with positive results in the practice of PA. With respect to the results of the RE-AIM tool, it was found that the most reported dimensions were "reach" (74%), followed by "efficacy" (48%), "adoption" (43%), "implementation" (35%) and "maintenance" (5%). The indicators most frequently mentioned were those related to the internal validity of the program: demographic and behavioral information of the target population, method of identification of the target population, sample size, participation rate and number of organizational units involved.

A brief survey of health habits among childhood cancer survivors

Using a survey, we assessed four health habits in 468 pediatric cancer survivors. Approximately 75% were at goal for ≥1 behavior-44% were active ≥1 hr per day, 40% engaged in ≤1 hr of screen time a day, 34% consumed sweetened beverages not often, and 4% ate >4 servings of fruits and vegetables per day. Survivors' age was associated with being active (P < 0.001) and limited screen time (P = 0.001). Males were more likely to be active (P = 0.003). The most common combination of goal behaviors was activity and screen time. Encouraging healthy behaviors may decrease the burden of late effects in survivors.

Implementation of public health policies for healthy lifestyles promotion: what Brazil should tell us?

The objective of this work was to update Brazilian experiences on implementation research (IR)regarding promotion of healthy lifestyles to decrease the risk of chronic non-communicable diseases (CNCD). Some Brazilian governmental activities for promotion of healthy lifestyles have been adopted around the world such as the case of the "World Physical Activity Day" and the"Walking for health program". Following the example of many other developing and developed countries, Brazilian government has been sponsored leisure-time physical activity and healthy eating programs which still were not capable of promoting massive participation, especially from workers, elderly and people from the less privileged socioeconomic classes. Although successful exercise promotion strategies have been done in Brazil, the implementation science on promotion of healthy lifestyles is still rising and more research is necessary to identify the settings, circumstances, and processes for effective and sustainable adoption of healthy dietary and exercise practices. Understanding problems, concerns and barriers for implementation of health promotion (HP) policies in Brazil could be useful for many other developing nations.

[Interdisciplinarity as a strategy for the prevention of systemic arterial hypertension in children: a systematic review]

Researches that developed interdisciplinary actions in schools seeking to modify the arteial pressure levels or salt and/or sodium consumption by children were analyzed. Studies available on the PubMed, ScienceDirect and Lilacs databases, associating the keywords: intervention study, nutrition intervention, schoolchildren, school health, blood pressure, sodium and salt were included. The research included articles from the last 15 years, in Portuguese, English and Spanish, which had preschool or school children as participants. With respect to the change of the blood pressure levels, 7 studies with positive and significant results and 6 without variation were identified. In terms of modification of the ingestion of food with high salt and/or sodium content, 4 studies revealed positive and significant results, and only one was unsuccessful. The conclusions drawn are that the interventions that use nutritional education combined with physical activities prevail in the literature. However, these actions proved to be more effective when implemented over a long period of time.

[Metabolic effects of exercise on childhood obesity: a current view]

OBJECTIVE

To review the current literature concerning the effects of physical exercise on several metabolic variables related to childhood obesity.

DATA SOURCES

A search was performed in Pubmed/Medline and Web of Science databases. The keywords used were as follows: Obesity, Children Obesity, Childhood Obesity, Exercise and Physical Activity. The online search was based on studies published in English, from April 2010 to December 2013.

DATA SYNTHESIS

Search queries returned 88,393 studies based on the aforementioned keywords; 4,561 studies were selected by crossing chosen keywords. After applying inclusion criteria, four studies were selected from 182 eligible titles. Most studies have found that aerobic and resistance training improves body composition, lipid profile and metabolic and inflammatory status of obese children and adolescents; however, the magnitude of the effects is associated with the type, intensity and duration of practice.

CONCLUSIONS

Regardless of type, physical exercise promotes positive adaptations to childhood obesity, mainly acting to restore cellular and cardiovascular homeostasis, to improve body composition, and to activate metabolism; therefore, physical exercise acts as a co-factor in combating obesity.