Improving Nutrition Habits and Reducing Sedentary Time Among Preschool-Aged Children in Cuenca, Ecuador: A Trial of a School-Based Intervention

Abstract

IntroductionIn Ecuador, the prevalence of overweight and obesity among school-age children is more than triple that of preschool-age children; however, preschoolers have not been the target of interventions.MethodsWe developed an educational and behavioral intervention that included games, singing, and storytelling. Children were recruited from municipal preschools in Cuenca and were enrolled in the pilot intervention (PI) (N=155) for the 2015–2016 school year, which consisted of a 3-month in-school program. For the 2016–2017 school year, a separate group of children was enrolled in the enhanced intervention (EI) (N=152), which consisted of a 7-month program at both school and home.ResultsParents in both groups reported a post-intervention reduction in their child’s daily at-home consumption of sugar-sweetened beverages (PI: −23.2%, P < .001; EI: −16.8%, P < .001). Additional beneficial effects of the EI not observed with the PI were an increase in drinking water daily at home (+8.3%, P = .04) and eating fruits and vegetables daily for snacks at home (+21.8%, P < .001), a reduction in excessive weekend screen time (−7.6%, P = .03), and a reduction of 0.11 in mean BMI-for-age z score (P = .003). When comparing the PI and EI, the EI was associated with a greater difference in mean BMI-for-age z score (−0.25; P < .001) and fruit and vegetable consumption (+15.9%; P = .01).ConclusionOur preschool-based intervention appeared to be successful in promoting healthy lifestyle habits, especially when combined with a household component. Further research is needed to determine if the intervention had long-term effects, as well as to adapt it for different settings.

Interventions to increase the consumption of water among children: A systematic review and meta‐analysis

“…After all rounds of screening, 39 articles were identified and included. Eight additional studies were identified by hand searching references of included articles and other relevant articles, resulting in 47 articles that met the inclusion criteria and were included in the systematic review . Of these 47 studies, 24 studies could be included in the meta‐analysis because they had a controlled design and measured water consumption in an amount or frequency …”

“…Of the 47 studies, the majority were based in the United States (24/47) or in Europe (14/47) . All studies were published after 2000, and most (40/47) were published in or after 2010. Most studies were RCTs (24/47); other designs were non‐RCTs (9/47), repeated cross‐sectional controlled (1/47), or noncontrolled quasi‐experimental study designs (13/47) …”

“…Sixteen interventions targeted preschool‐aged children, and the other interventions (31/47) targeted school‐aged children. The majority of interventions were based in a school and/or preschool setting (28/47); other settings were the community (7/47) and home (4/47), and some interventions were based in multiple settings (8/47) .…”

“…Sixteen interventions targeted preschool‐aged children, and the other interventions (31/47) targeted school‐aged children. The majority of interventions were based in a school and/or preschool setting (28/47); other settings were the community (7/47) and home (4/47), and some interventions were based in multiple settings (8/47) . Around half of the interventions focused on changing children's diet and other lifestyle factors (23/47), while some interventions focused specifically on children's diet (11/47) or consumption of beverages (13/47) .…”

“…The majority of interventions were based in a school and/or preschool setting (28/47); other settings were the community (7/47) and home (4/47), and some interventions were based in multiple settings (8/47) . Around half of the interventions focused on changing children's diet and other lifestyle factors (23/47), while some interventions focused specifically on children's diet (11/47) or consumption of beverages (13/47) . Most studies (40/47) reported the use of theories for intervention development; only seven studies did not report any theory.…”