Under 5 Energize: Tracking Progress of a Preschool Nutrition and Physical Activity Programme with Regional Measures of Body Size and Dental Health at Age of Four Years.

Elaine Rush,Madeleine Kirk,Leanne Young,Vladimir Obolonkin,Marilyn Tseng

doi:10.3390/nu9050456

Abstract

To reduce weight gain and encourage healthy eating including reduced sugar intake, Under 5 Energize (U5E) was introduced to 121 early-childhood-centres in the Waikato region of New Zealand in July 2013. Using anonymized data collected from January 2013 to September 2016 through free physical assessments of all 4-year-olds provided by the NZ Ministry of Health, the prevalence of obesity and dental decay children measured in the Waikato region was examined. Data were divided into four periods representing pre-implementation and 3 years of gradual implementation. Obesity was defined according to International Obesity Task Force criteria. Of 18,774 Waikato children included in the analysis, 32% were indigenous Māori, and 32% attended an U5E centre. Pre-implementation prevalences of obesity (4%) and visible dental decay (11%) of children attending and not-attending U5E centres were not different. While obesity prevalence did not change significantly over time, prevalence of dental decay decreased among children at U5E (trend p = 0.003) but not non-U5E (trend p = 0.14) centres, such that prevalences were significantly different between children at U5E vs. non-U5E centres at Year 3 (p = 0.02). The U5E intervention is a small but arguably effective part of the wider system approach that is required to improve children’s future health.

Highlights

Promoting healthy eating in children establishes a foundation for healthy behaviors and good health later in life
Of 18,046 Waikato children included in the analysis, 32% attended an Under 5 Energize (U5E) centre, 64% attended a non U5E centre and 4% did not attend any ECE
A primary finding from this study was a significant decrease in prevalence of dental decay in Waikato children attending U5E centres, compared with children attending non-U5E centres, as indicated by routinely collected administrative data among preschoolers, a significant decrease in prevalence of obesity was not detected

Summary

Introduction

Promoting healthy eating in children establishes a foundation for healthy behaviors and good health later in life. Interventions in childcare settings have demonstrated a positive impact on nutrition [1] and weight status [2,3,4,5]. They might be expected to have beneficial effects for dental caries because sugar intake is a shared risk factor [6,7,8], and reducing added sugar intake is a common message in such interventions. In New Zealand (NZ), early childcare education centres (ECECs) provide a convenient and targeted setting [9] to provide a healthy environment and to support staff and parents in contributing to the optimal health and development of young children [10]. For New Zealand children aged 2 to 14 years, Nutrients 2017, 9, 456; doi:10.3390/nu9050456 www.mdpi.com/journal/nutrients

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Conclusion