Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial.

Karin Louise Lenz Dunker,Ruth Bartelli Grigolon,Marle Dos Santos Alvarenga,Paula Costa Teixeira

doi:10.1590/1516-3180.2020.0420.r2.04022021

Karin Louise Lenz Dunker, Ruth Bartelli Grigolon + Show 2 more

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https://doi.org/10.1590/1516-3180.2020.0420.r2.04022021

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Abstract

Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs.

Highlights

Pediatric obesity is a worldwide health concern, and the majority of overweight or obese children live in low-to-middle income countries.[1,2,3] Studies on low-income individuals[4] and schoolbased interventions in low-to-middle income countries[5,6] have demonstrated improvements in eating behavior (EB), physical activity (PA) and body weight
We aimed to evaluate the effectiveness of an intervention and the predictors of better outcomes relating to eating behaviors and PA levels
Out of the overall sample (n = 270), 65.2% of all the subjects did not participate in any sessions, 15.2% participated in 1 to 9 sessions and 19.6% participated in 10 to 17 sessions

Summary

Introduction

Pediatric obesity is a worldwide health concern, and the majority of overweight or obese children live in low-to-middle income countries.[1,2,3] Studies on low-income individuals[4] and schoolbased interventions in low-to-middle income countries[5,6] have demonstrated improvements in eating behavior (EB), physical activity (PA) and body weight. Traditional preventive measures against obesity that focus on weight seem to be ineffective and harmful to the participants These programs contribute to eating and weight concerns, body image dissatisfaction, low selfesteem and unhealthy weight control practices. Obesity and ED result from cultural contexts that motivate an unhealthy relationship with food, EB and PA In addition to these factors, this cultural context discourages respect for the diversity of body size.[9] Obesity and ED share psychosocial and behavioral risk factors, which suggests that integrated interventions would lead to better outcomes.[9] These integrated interventions can include overlapping of problems and involvement of similar risk factors (diet and weight). BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-6ddpb[3]

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