Effects of family nutrition and physical activity screening for obesity risk in school‐age children

Abstract

Purpose An obesogenic home environment is a major contributor to overeating and sedentariness in school‐aged children, as children have less autonomy during this phase of development and are influenced by family environmental cues. The purpose of this study was to implement a screening tool at a low socioeconomic elementary school clinic to identify children at risk of developing obesity and provide standardization for practitioners on educating parents regarding child obesity risk factors. Design and Methods An evidence‐based practice design utilizing the Family Nutrition and Physical Activity (FNPA) tool was completed at all visits of patients ages 4 to 11. Parents completed the 20‐item screening tool related to 10 factors (family meal patterns, family eating habits, food choices, beverage choices, restriction/reward, screen time behavior and monitoring, healthy environment, family activity involvement, child activity involvement, family routine). The nurse practitioner (NP) provided parents with education regarding healthy home practices based on American Academy of Pediatrics (AAP) recommendations. Level of obesity risk (low, moderate, and high) was determined based on the FNPA score and body mass index (BMI) of the patient. Patients identified as at‐risk were scheduled for a 2‐month follow‐up and rescreened to determine if lifestyle modifications were made. Results Twenty‐seven children were screened using the FNPA tool, with an initial mean FNPA score of 64. Ninety‐three percent were classified as a moderate or high risk for obesity (BMI percentile 85th or greater and/or moderate‐high risk FNPA scores). Seven percent had a healthy BMI and low‐risk FNPA scores and did not require follow‐up intervention. Sixty‐seven percent of patients scores improved at follow‐up, with an average FNPA score of 70. Effect size stratified by risk category was low‐risk score 0.07 and moderate‐risk score 1.49 with a standard deviation of 5.36. Practice Implications Implementation of the FNPA tool at a school‐based clinic is a feasible opportunity to identify children at risk for obesity and allows for anticipatory guidance by the NP to increase awareness of parental influence as role models for healthy lifestyle behaviors.

Comparative Analysis of the Effects of Daily Eating Habits and Physical Activity on Anthropometric Parameters in Elementary School Children in Latvia: Pach Study

“…To maintain healthy weight and avoid unhealthy weight gain, it is important to balance energy intake through healthy foods and beverages and energy expenditure with basal metabolic rate (BMR) and PA. Previous studies reported that children with higher BMI had unhealthier EH and more sedentary lifestyle habits [ 10 ]. For example, it has been shown that obese and overweight pupils more often skipped breakfast [ 11 ], consumed more ultra-processed calorie dense foods [ 12 ] and had lower MVPA levels [ 13 , 14 ].…”

Gestational weight gain and childhood body mass index across three generations: Results from the 1993 Pelotas (Brazil) Birth Cohort

“…One possible explanation for these associations is that children who have experienced maternal excessive GWG are at increased risk of obesity due to developmental programming in utero as well as exposure to the same obesogenic environment and lifestyle from the mother, such as high‐caloric food intake and low physical activity 15 . Children over 2 years of age have already incorporated familiar habits and behaviours that may influence their nutritional status 30 …”

Biopsychosocial Factors Associated with Active or Sedentary Lifestyles of Children and Adolescents in Costa Rica

“…In fact, if these two conditions were present among children and adolescents, a sedentary lifestyle could be avoided in 56.5% and 48.2% of exposed cases, respectively. An obesogenic home environment is known to be an important factor in overeating and promoting a sedentary life- Hence the need for this contemporary society to become aware of the influence of parents and family members as role models for children and adolescents to adopt healthy lifestyles behaviors (Herbenick et al, 2018). A Canadian study confirms the positive influence that physical activity modeling and parental support have on the child's physical activity level, whether both conditions are fulfilled or only one of the two (Garriguet, Colley, & Bushnik, 2017).…”