BACKGROUND School programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers’ knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. METHODS Using a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities) or to usual curriculum (7 preschool facilities). A total of 1216 children aged 3–5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. RESULTS Children in the intervention group showed a 10.9% increase in weighted score, compared with 5.3% in controls. The absolute adjusted difference was 3.90 units (95% confidence interval [CI], 1.64–6.16; P <.001). Among parents, the equivalent statistics were 8.9% and 3.1%, respectively (absolute difference 4.08 units; 95% CI, 2.03 to 6.12; P <.001), and among teachers, 9.4% and 2.5%, respectively (absolute difference 5.36 units; 95% CI, −0.29–11.01; P = .06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P <.001). CONCLUSIONS A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.

The constructed reference growth curves are a start for following secular trends in Colombia and are also in the presented layout an optimal clinical tool for health care.

BACKGROUND Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low- and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months. METHODS Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children’s knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children’s nutritional status and the mean change in parent’s knowledge, attitudes, and habits. RESULTS We included 1216 children, 3–5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001). CONCLUSIONS After 36 months, the educational intervention maintained a beneficial trend toward a healthy lifestyle in children and their parents.

Introducción. Los factores de riesgo cardiovascular pueden presentarse desde la infancia y predecir la enfermedad cardiovascular del adulto. Objetivo. Determinar la prevalencia de los factores de riesgo cardiovascular de un grupo de niños, hijos de enfermeras de una institución de salud de Bogotá, Colombia. Materiales y métodos. Se hizo un estudio de corte transversal en niños entre 3 y 17 años de edad, evaluados entre junio de 2011 y julio de 2012. Resultados. Participaron 118 niños, con una edad promedio de 7,4 años (desviación estándar=3,86), la mayoría de ellos eutróficos (72,0 %). Los niños presentaban los siguientes factores de riesgo para enfermedad cardiovascular: malos hábitos alimenticios (89,0 %), sedentarismo (78,8 %), exposición al tabaco (19,5 %), historia familiar de riesgo cardiovascular (16,1 %), sobrepeso (15,3 %) y obesidad (12,7 %). No se encontraron diferencias estadísticamente significativas entre los factores de riesgo según sexo. El sedentarismo en niños con sobrepeso u obesidad fue de 90,9 % y en niños eutróficos, de 36,5 %, p<0,001. En 84,8 % de los niños con sobrepeso u obesidad y en 42,4 % de los eutróficos, se presentaron malos hábitos alimentarios (p<0,001). El 97,5 % de los niños presentó, al menos, un factor de riesgo, y el 42,4 %, tres o más. La presencia de tres o más factores fue más frecuente en los obesos que en aquellos con sobrepeso (p<0,001) y en los eutróficos (p<0,001). Conclusiones. Los resultados indican que los niños de 3 a 17 años incluidos en el estudio, presentaban varios factores de riesgo de enfermedad cardiovascular, en especial, aquellos con sobrepeso y obesidad.Palabras clave: obesidad, sobrepeso, hipertensión, estilo de vida sedentario, hábitos alimentarios, enfermedades cardiovasculares. doi: http://dx.doi.org/10.7705/biomedica.v35i2.2314 High prevalence of cardiovascular disease risk factors in a pediatric populationIntroduction: Cardiovascular disease risk factors begin in childhood. Their presence may predict cardiovascular disease in adulthood. Objective: To determine the prevalence of cardiovascular disease risk factors in a group of nurses´ children at a health facility in Bogotá, Colombia. Materials and methods: A cross-sectional, population-based observational study among 3-17 year-old individuals evaluated between June, 2011, and July, 2012. Results: A total number of 118 children were included. The mean age was 7.4 years, with a standard deviation of 3.86; 72.0% of the children had a normal weight. Prevalence of cardiovascular risk factors was distributed as follows: inadequate food habits, 89.0%; sedentary lifestyle, 78.8%; family history of cardiovascular disease, 16.1%; overweight, 15.3%, and obesity, 12.7%. There were no significant differences in risk factors between boys and girls. Among overweight and obese children, sedentary lifestyle was present in 90.9%, and among normal-weight children, in 36.5% (p<0.001). Inadequate food habits were present in 84.8% of the overweight and obese children, and in 42.4% of those with normal weight (p<0.001...

Introducción. Los factores de riesgo cardiovascular (FRCV) tienen su origen en la infancia. Existen estudios que muestran diferencias en la prevalencia de los FRCV en el área rural y urbana posiblemente asociadas a los estilos de vida.Objetivos. El presente estudio describe los FRCV identificados en niños de una población rural y una población urbana en Colombia.Materiales y métodos. Estudio de corte transversal realizado entre marzo y junio de 2013 en escolares de un área urbana y otra rural en Colombia. Se realizaron mediciones de peso, ta-lla, presión arterial, triglicéridos, glicemia y colesterol total en ayunas, y se aplicó una encues-ta alimentaria sobre actividad física y tabaquismo pasivo. Se evaluaron prevalencias de los FRCV con un IC95%.Resultados. 1055 escolares, 833 (urbanos), 222 (rurales), promedio de edad de 6.71 años. La prevalencia de FRCV en la población de estudio rural/urbano fue para sedentarismo 68.69%/90.16%, dieta no saludable 97.18%/95.44%, tabaquismo pasivo 11.16%/14.52%, obe-sidad 0%/5.64%, hipertensión arterial 6.31%/11.28%, diabetes 0%/0%, hipercolesterolemia 18.28/16.31%. El 99.15% de la población de estudio presentó al menos un FRCV, promedio área urbana de 3.14 (DE: 1.12), y rural 2.76 (DE: 1.1). Los niños con exceso de peso presen-taron mayor prevalencia de hipertensión arterial, 15,21%, y de sedentarismo, 90.69%, comparado con aquellos sin exceso de peso, 8,98 %, y 84,32% respectivamente.Conclusiones. Nuestros resultados evidencian una alta prevalencia de FRCV en niños, siendo mayor en el área urbana. Es necesario la implementación de estrategias en salud pú-blica adaptadas a la población rural y urbana.