Control Childhood Obesity Research Articles

THE ROLE OF NURSING IN THE PREVENTION AND CONTROL OF CHILDHOOD OBESITY

Research on nursing interventions in the prevention and control of childhood obesity has addressed three main determinants: sedentary lifestyles, poor diet, and psychosocial and environmental factors. Through an integrative literature review, negative points associated with each determinant were identified, such as increased risk of obesity, nutritional deficiencies, social stigma, and lack of emotional support. However, several nursing interventions have been highlighted as effective in addressing these problems, including nutritional education, promotion of physical activity, psychosocial support, and advocacy for healthy environments. Authors such as Jardim (2017), Borfe et al. (2017), Serra et al. (2018), among others, have contributed significantly to the development of these strategies. The research highlights the role of nurses in promoting child health, highlighting the importance of a multidimensional and collaborative approach to prevent and control childhood obesity. In summary, the results obtained provide valuable insights to improve nursing practices, promoting healthy lifestyle habits, and combating the childhood obesity epidemic.

Impact of the COVID-19 pandemic on lifestyle’s behaviours of school-aged children in Portugal

Abstract Background COVID-19 pandemic impacted children’s daily routines. Based on this, WHO Collaborating Centre for Nutrition and Childhood Obesity in collaboration with WHO Regional Office for Europe coordinated the study about the impact of COVID-19 on lifestyle’s behaviours of school-age children in Europe, where 17 Member States participated, including Portugal. Methods Cross-sectional study was conducted within the sixth round of COSI Portugal, following a WHO common methodological protocol, during 2021-2022 school year. A national representative sample of families with children 6-8 years old were included and asked to report on variables comparing two periods: pre and during the COVID-19 pandemic. Results 5139 families participated. 11.4% reported a worsening of their perceived wealth and the percentage of fathers and mothers working full- or part-time decreased (74.6% to 68.7% and 70.6% to 59.6%, respectively) during pandemic. Children’s consumption of sweets (19.4%), savoury snacks (13.8%), fruit (11.9%) and vegetables (7.1%) increased, and sugary soft drinks (13.8%) decreased during pandemic. Family behaviours with the highest increases during pandemic were “eating together as a family” (35.4%), “cooking meals together with your child” (33.6%), “buying food in large quantities” (33.6%) and “eating home-cooked meals” (29.1%). Approximately, one in four parents reported children’s physical activity decreased and almost one in two reported an increase in recreational screen time. Parents who perceived their child as overweight during pandemic doubled (f7.9% to 14.6%). Children’s well-being behaviours that worsened more during pandemic were “having fun with friends” (44.3%), “got on well at school” (27.9%), “feel full of energy” (23.8%) and “feel fit and well” (22.2%). Conclusions These observations underscore the need to “build back better” post-pandemic with a focus on preventing and controlling childhood obesity and its determinants. Key messages • Portuguese children experienced negative impacts of the pandemic in their lifestyle behaviours, particularly on their physical health and well-being, with a report of a poorer socioeconomic situation. • This study and its findings give us a first-of-its-kind view into the physical and mental outcomes of the pandemic on school-aged children with a focus on the long-term, high-risk disease of obesity

Preventing Childhood Obesity in Diabetes: A Critical Imperative

: Diabetes mellitus (DM) encompasses a range of chronic metabolic conditions characterized by hyperglycemia, stemming from either insulin deficiency due to pancreatic β-cell damage (T1DM) or peripheral tissue insulin resistance (T2DM). Given the importance of DM and obesity, this narrative review aimed to address the optimal screening and control of childhood obesity as the main strategies for dealing with the comorbidities of T2DM. This review underscores the critical importance of optimal screening and management of childhood obesity as primary strategies for addressing comorbidities associated with T2DM. In many cases, T2DM may remain asymptomatic for several years, leaving patients unaware of their condition or experiencing few symptoms despite having poorly controlled prediabetes or DM. Hence, it is imperative to recognize that screening for prediabetes and childhood obesity presents a crucial opportunity for intervention to avert the future development of DM and its lifelong health repercussions. Moreover, lifestyle modifications stand out as the most effective approach for preventing or delaying the onset of T2DM comorbidities and complications. It is noteworthy that reductions in mortality among people with DM, associated with current antidiabetic medications, will increase the lifetime accumulation of T2DM complications and morbidities worldwide.

Lifestyle intervention in children with obesity and nonalcoholic fatty liver disease (NAFLD): study protocol for a randomized controlled trial in Ningbo city (the SCIENT study)

BackgroundThe increasing prevalence of childhood obesity has become an urgent public health problem, evidence showed that intervention for childhood obesity bring enormous health benefits. However, an effective individualized intervention strategy remains to be developed, and the accompanying remission of related complications, such as nonalcoholic fatty liver disease (NAFLD), needs to be assessed. This study aimed to develop an m-Health-assisted lifestyle intervention program targeting overweight/obese children and assess its effectiveness on indicators of adiposity and NAFLD.MethodsThis is a cluster-randomized controlled trial that conducted in children with overweight/obesity in Ningbo city, Zhejiang Province, China. Students in Grade 3 (8–10 years old) were recruited from six primary schools, with three be randomized to intervention group and three to usual practice group. The intervention program will last for one academic year and consists of health education, dietary guidance, and physical activity reinforcement. This program is characterized by encouraging four stakeholders, including School, Clinic, famIly, and studENT (SCIENT), to participate in controlling childhood obesity, assisted by m-Health technology. Assessments will be conducted at baseline and 3 months, 9 months, 24 months, and 36 months after baseline. The primary outcome will be the differences between the two groups in students’ body mass index and fatty liver index at the end of the intervention (9 months after baseline). During the implementation process, quality control methods will be adopted.DiscussionThe program will test the effectiveness of the m-Health-assisted lifestyle intervention on children with obesity and NAFLD. The results of this study will provide evidence for establishing effective lifestyle intervention strategy aimed at childhood obesity and NAFLD and may help develop guidelines for the treatment of obesity and NAFLD in Chinese children.Trial registrationClinicaltrials.gov NCT05482191. Registered on July 2022.

Progress in research of etiology of childhood obesity based on interaction between genes and environment

Childhood obesity is a global public health problem, which can not only endangers children's health, but also might be an important cause of chronic diseases in adulthood. In recent years, with the in-depth development of precision medicine research, more and more research evidences have shown that there are interactions between environmental factors, such as early intrauterine environment, children's diet, physical activity and children's gene factor on the incidence of childhood obesity, which can result in or inhibit the incidence and development of childhood obesity. This paper summarizes the progress in research in this field to reveal the effects and potential mechanisms of genetic factors and environmental factors on the incidence of childhood obesity in order to provide reference for the precise prevention and control of childhood obesity under different genetic backgrounds.

Interventions to reduce and prevent childhood obesity in low-income and middle-income countries: a systematic review and meta-analysis

Background70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity. MethodsWe conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. FindingsThe search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01–3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I2>75%). InterpretationPreventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity. FundingNone.

Have States Reduced Obesity by Legislating More Physical Activity in Elementary School?

To control childhood obesity, leading medical organizations have recommended increasing the time that children spend in physical education (PE) and other school-based physical activity (PA). Yet, it is unknown how many states have passed laws that codify these recommendations, and it is unknown what effect changing state laws has had on obesity or the time that children actually spent in PE and PA. We joined state laws to national samples of 13,920 children from two different cohorts of elementary students. One cohort attended kindergarten in 1998; the other attended kindergarten in 2010; both cohorts were followed from kindergarten through fifth grade. We estimated the effects of changes to state laws in a regression with state and year fixed effects. Twenty-four states and the District of Columbia increased the time that children were recommended or required to spend in PE or PA. These changes in state policies did not increase actual time spent in PE or recess, did not affect average body mass index (BMI) or BMI Z score, and did not affect the prevalence of overweight or obesity. Increasing the PE or PA time required or recommended by state laws has not slowed the obesity epidemic. Many schools have failed to comply with state laws. A back-of-the-envelope calculation suggests that, even with better compliance, the legislated changes in PE laws might not have changed energy balance enough to reduce obesity prevalence.

Setting and prioritizing evidence-informed policies to control childhood obesity in Iran: a mixed Delphi and policy dialogue approach

BackgroundThe prevalence of childhood obesity (CO) and related complications is high and alarmingly increasing in Iran. This study applied a mixed Delphi & Policy Dialogue approach to exploring and prioritizing policy options to control childhood obesity in Iran.MethodsThis study is organized in three Delphi phases followed by a policy dialogue session. This study applied the advocacy collation framework and evidence-informed policy-making approach to enhance the chance of a feasible and acceptable policy package. The first step consisted of interviews with 30 experts and primary stakeholders. Based on their answers and a comprehensive literature review, a list of presumed effective policy options to combat CO in Iran was made. Then, panelists were asked to score each policy option using a five-point Likert scale in seven constructs. To maximize the spread of opinions, panelists were chosen to represent three perspectives: policy-makers at different levels, presidents of various organizations who would implement potential policy options, and academics. Twenty-one stakeholders were invited to discuss the policy options in a policy dialogue section.ResultsWe introduced 27 policy options and asked stakeholders to rank them using seven criteria on a five-level Likert scale. Totally, 41 experts participated in round 2 (66.2% response rate), and 33 experts took part in round 3 (72% response rate). Participants believed that healthy schools, creating healthy environments in kindergartens and other child care centers, subsidizing healthy foods, educating healthy lifestyles in mass media, and increasing access to physical activity facilities are the most effective and feasible policies in controlling CO. After the policy dialogue, the healthy school remained the most prioritized policy. a policy package to combat CO in Iran was designed with the participation of all stakeholders.ConclusionThe advocacy collation framework and the evidence-informed policy-making approach were used to draft a policy package to combat CO, increasing the acceptability and feasibility of the developed policy package.Graphical

Influence of Parental and Offspring Dietary Behaviors on the Association of Overweight and Obesity between Two Generations: Results from a Cross-Sectional Analysis of Parent-Offspring Trios in China.

Limited evidence exists on the influence of dietary behaviors on the association of overweight/obesity between parents and offspring. This study aimed to investigate the influence of dietary behaviors on the association of overweight/obesity between two generations, and puts forward strategies for preventing childhood obesity. Data were obtained from a cross-sectional survey conducted in China; a total of 40,197 parent-offspring pairs were included. Overweight/obesity was defined based on the body mass index and waist circumstance; the association of overweight/obesity between two generations was evaluated by multivariate and binary logistic regression and stratified analyses. Compared with the offspring who were free of parental overweight/obesity, the ORs of offspring with both parental overweight/obesity reached 2.66, 1.72 and 4.04 for general, simple abdominal and compound obesity. The offset effect of dietary behaviors was observed on the association between parental obesity and the offspring's general or simple abdominal obesity, with non-significant ORs when parents or/and offspring had healthy dietary behaviors. It was difficult for a healthy diet alone to offset the high heritability and intergenerational transmission of childhood obesity caused by parental obesity. Multifaceted improvement of lifestyle behaviors, and a combination of individual and family engagement, could be targeted measures to control childhood obesity.

ODP389 Lipid Peroxidation System Reactivity in Adolescents During Constitutional Obesity Non-drug Therapy

Abstract Background In recent years, there has been a worldwide trend toward preventing and controlling childhood obesity by non-drug therapy. The success of this trend largely depends on better understanding the various metabolic and regulatory systems functions. Lipid peroxidation (LPO) - antioxidant defense (AOD) nonspecific system reactivity should be of special attention. The aim of the study was to reveal the lipid peroxidation and antioxidant defense parameters changes in different sex's adolescents during constitutional obesity non-drug therapy. Materials and methods Adolescents of 12-17 years old with constitutional obesity (CO) (22 boys and 24 girls) before and after constitutional obesity non-drug therapy were examined. The therapy included routine recommendations for food consumption modification, motivational education in the School of Rational Eating, a steady diet, a low-calorie diet, aerobic physical exercises (running track), impulse physiotherapy on the rectus abdominis. Healthy teenager's data (20 boys and 16 girls) were used as a control. We analyzed the content of LPO products - diene conjugates (DC), ketodienes and conjugated trienes (KD and CT), TBA-active products and AOD factors activity: total antioxidant activity (TAA), α-tocopherol, retinol, reduced (GSH) and oxidized (GSSG) glutathione, superoxide dismutase activity (SOD). Spectrophotometric and fluorometric methods were used. Results The boys with CO had decreased values of primary LPO products – DC (by 1.35 times lower, p=0. 001) and AOD factors: TAA (by 1.16 times lower, p=0. 036) and SOD activity (by 1.49 times lower, p&amp;lt;0. 0001), against the increased background values of secondary products - KD and CT (by 1.42 times higher, p=0. 046) in comparison with control results. Boys with CO therapy did not lead to normalization of the studied parameters. The girls with CO had decreased values of TAA values (by 1.4 times lower, p=0. 0001), SOD (by 1.42 times lower, p&amp;lt;0. 0001) and α-tocopherol (by 1.33 times lower, p=0. 012) compared to the control group. After the course of therapy, there was an increase in GSSG levels (by 1.14 times higher, p=0. 029). Conclusions This study showed the presence of negative changes in the pro- and antioxidant status in adolescents with CO, which did not normalize after a course of non-drug therapy. Additional pharmacological correction by prescription of antioxidant drugs becomes relevant in addition to the course of non-drug therapy. Presentation: No date and time listed

Relationship between energy balance-related behaviors and personal and family factors in overweight/obese primary school students aged 10–12 years in China: a cross-sectional study

BackgroundIncreasing rates of childhood obesity worldwide are a serious threat to the health of school-aged children. Unhealthy behavioral habits are modifiable factors in the control of childhood obesity, and personal and family factors are key influencing factors of behavioral habits in school-aged children. This study assessed the relationship between overweight/obesity, energy balance-related behaviors (EBRB), and their influencing factors in school-aged children.MethodsThis cross-sectional survey included 4412 primary school-aged (10–12 years) students who underwent body tests and were selected through stratified sampling in the Northeast, North, Northwest, and Southwest regions of China from March to July 2021. Independent sample t test was used to compare differences between behaviors and influencing factors of energy balance among overweight/obesity and normal weight students. Logistic regression analysis was used to assess the influence of EBRB on body shape. Multiple linear regression was used to assess the influence of personal and family factors on EBRB effects.ResultsCompared with normal-weight students, number of breakfasts consumed per week by overweight/obese students was significantly lower (p < 0.01), and weekly screen-viewing time was significantly longer (p < 0.01). Overweight/obese students’ health beliefs, parental subjective norms, parental modelling, parental practices, and home availability scores increased significantly in terms of beverage consumption behavior (p < 0.01 or p < 0.05). Attitude, health beliefs, self-efficacy, parental subjective norms, and parental support scores decreased significantly in terms of breakfast consumption (p < 0.01 or p < 0.05). Health belief scores on physical activity increased significantly (p < 0.01), while preference and autonomy scores decreased significantly (p < 0.01). Health beliefs, parental subjective norms, and parental practices scores of screen-viewing activities increased significantly (p < 0.01 or p < 0.05). Breakfast consumption (odds ratio [OR]: 0.911; 95% confidence interval [CI]: 0.870–0.954) and screen-viewing activities (OR:1.055; 95% CI: 1.030–1.080) correlated negatively and positively with overweight/obesity, respectively. The main influencing factors of breakfast behavior in overweight/obese students were self-efficacy (0.14), preference (0.11), attitude (0.07), home availability (0.18), and parent modelling (0.09); those for screen-viewing behavior were preference (0.19), self-efficacy (− 0.15), parental practices (0.13), and parental subjective norm (0.12).ConclusionsIrregular breakfast consumption and excessive screen-viewing time are key EBRB associated with overweight/obesity among these Chinese participants. Their unhealthy breakfast consumption and screen-viewing activities result from a combination of personal and family factors.

İstanbul'da 6-15 Yaş Arası Çocuklarda Obezite Prevalansı

Aim: This research aims to evaluate the prevalence of obesity and nutritional habits in children aged 6-15 in a district of Istanbul.Method: This is a cross-sectional study conducted with 2452 students aged 6-15 in 19 primary schools in Avcılar district of Istanbul. A face-to-face questionnaire was applied about the children's nutrition habits and food consumption frequencies. Children's height, weight, waist and hip circumference measurements were taken. Children were categorized according to Z-scores. Statistics were made using the SPSS 21 program. Results: A total of 47.8% of students were boys, 52.2% were girls. The mean age of the students was 9.47±2.21 years, average BMI was 18.7±3.73 kg/m2. Overweight and obesity prevalence was 20.3% and 13.2%, respectively. The obesity prevalence of 9-y-old was at the highest level, and males were more obese than females (p&amp;lt;0.001). A significant difference was found between obese and non-obese students in terms of snacking while studying and watching TV, and the frequency of some food consumption (p&amp;lt;0.05). Conclusion: It was found that one out of every three children was overweight. In addition to national and international policies, regional and local follow-ups and taking necessary precautions may be beneficial in controlling childhood obesity.

Evaluation of the intervention “Bom Dia”, in Recife- Pernambuco-Brazil in the control of childhood obesity

Childhood obesity has been increased sharply in Brazil and worldwide, becoming a major public health problem. This study aims to evaluate the “Bom Dia” program (a multidisciplinary program to care of obese children) in Recife, Pernambuco, Brazil, according to the reach, effectiveness, adoption, implementation, and maintenance using the RE-AIM model. In this study, mixed methods were used to collect data, with triangulation of methods, documentation research, directed observation, field journal, questionnaire, and semi-structured interviews, conducted from February to December 2020. This program had a 0.95% reach at community level. Some barriers such as: inflexibility of the program schedule, poor economic conditions, access difficulties, and weak integration in Health Care Network, made in difficult to reach the target population. The program presented "adoption" by all members of the multi professional team. The intervention was successfully implemented, although some adjustments to of the logic model were required over time. “Bom Dia” has been maintained at the organizational level over the years, due to the performance of the intervention team and the support from the health organizations. Finally, despite the "reach" to the target audience had not achieved expressive results, this study is unpublished, and the intervention can promote improvements in the quality of life of obese children and adolescents. Therefore, the results of this study are important for practice and could support the implementation of similar intervention programs to control obesity in children.

Nutritional Quality of Kids' Fast-Food Meals

Despite the increasing consumption of fast foods, the nutrient quality of such meals has not been systematically evaluated I Turkey. Our study aimed to investigate and compare the nutritional value of the kids' menus of 4 popular fast-food chains and traditional Turkish menus created by specialist dietitians. The nutritional values of the kids' menus were assessed using the recommended daily allowance, dietary guidelines for Turkey, and national food-based dietary recommendations of the Turkish Ministry of Health. All meals were compared in terms of energy, macro food items, and sodium content. The kids' menus from the following 4 most preferred fast-food companies in Turkey were included in the study: McDonald's, Burger King, Popeyes, and Arby's. The menus with the highest energy and fat content were offered by Burger King, those with the highest protein content were offered by Popeyes, and those with the highest sodium content were offered by Arby's. The contribution of fat to the energy content was found to be low in traditional Turkish menus (P &lt; .05), whereas the contribution of protein to the energy content was significantly higher in the Popeyes menus (P &lt; .05). Improving the nutritional quality of kids' fast-food menus may be effective in controlling childhood obesity.

Relationship Between Body Composition Components and Functional State of the Autonomic Nervous System in Primary School Children with Overweight

Objective: Obesity and overweight in children is a socio-economic and medical problem around the world. [1] Target organs for the influence of excess fat are the heart, blood vessels, kidneys, liver and others. Therefore, more and more scientists and health professionals try to detect, prevent and control childhood obesity. [2] Methods: 72 children aged 10-11 years were examined by body composition parameters using the bioimpedance method on Tanita BC-601 analyzer scales. Heart rate variability and autonomic nervous system status were assessed using a “CardioLab” electrocardiograph. Results: Both BMI and total body fat, visceral fat and fat free mass were statistically significantly correlated with the activity of the sympathetic and parasympathetic systems. As the total fat content of the body increased, the total power of the regulatory systems decreased. Visceral fat content was statistically significantly affected by both ANS systems, but there was a stronger association between visceral fat and the sympathetic nervous system. Conclusion: The data obtained can serve as an impetus for the identification of children with autonomic dysfunction and overweight to develop corrective and preventive programs for the prevention of CVD by normalizing the body composition. Keywords: fat content, heart rate variability, obesity, BMI.

Collaborative Efforts of Families, Schools, Health Care Providers, and the Government to Control Childhood Obesity in China

Collaborative Efforts of Families, Schools, Health Care Providers, and the Government to Control Childhood Obesity in China

Sugar-Sweetened Beverage Consumption Status and Its Association with Childhood Obesity among Chinese Children Aged 6-17 Years.

Objective: There is a remarkable growth in sugar-sweetened (SSB) production and obesity prevalence among school-aged children in China. This paper describes SSB consumption and its association with obesity among Chinese children aged 6–17 years in 2012. Methods: in total, 25,553 children aged 6~17 years enrolled in the China Nutrition and Health Surveillance 2010–2013 were included in this study. Data of SSB consumption frequency and quantity were obtained from a food frequency questionnaire, and the children’s nutritional status was assessed. Multivariate logistic regression was used to evaluate the association between SSB consumption and obesity status. Results: SSB intake was estimated as 181.0 g/day, occurring 2.2 times/week. Older children, males, children from urban areas, and children with higher socioeconomic status were more likely to consume SSBs. Children who consumed SSBs 1~<5 times/week (11.7%) and >5 times/week (12.9%) were more likely to be overweight/obesity than those who consumed SSBs less than once/week. Conclusion: SSB consumption was common among Chinese school-aged children, especially among males, older children, and children from urban areas. High consumption of SSBs was associated with a higher prevalence of overweight/obesity. Actions and plans are required to reduce SSB consumption and control childhood obesity in China.

Chinese Preschool Children Growth Reference Standard and Related Curve: Based on GAMLSS Approach.

Background:The current national growth and development standard of preschool children in China was formulated in 2003, which has many deficiencies. It is necessary to construct more scientific percentile curve and growth reference standards in order to evaluate more effectively the growth, development and health status of Chinese children.Methods:Based on the physical and health data of 31 provinces in China measured in 2010 and 2014, the GAMLSS model was used to construct the growth reference standard and correlation curve.Results:We obtained growth reference standards for percentile curve and Z-score curve of height-for-age, sitting height-for-age, Weight-for-age, Chest circumference-for-age of Chinese preschool children. The C50 percentile of all indicators showed an obvious increasing trend with aged 3.0 to 6.5. Such as, the height of boys and girls increased by 21.1cm and 20.3cm respectively, the sitting height boys and girls increased by 10.3cm and 10.1cm respectively, the weight of boys and girls increased by 7.1 kg and 6.3 kg respectively, the Chest circumference of boys and girls increased by 6cm and 5.2 cm respectively.Conclusion:The children’s growth and development charts provided in this study provide effective monitoring and personalized evaluation tools for the growth and development assessment of preschool children, as well as for the reduction of malnutrition, prevention and control of childhood obesity. It is recommended to be used in some areas such as child health, medical treatment and public health.

The social environment and childhood obesity: Implications for research and practice in the United States and countries in Latin America.

SummaryThe environments of children influence their risk for childhood obesity through, among other factors, a child's weight‐related behaviors (i.e., diet and physical activity). In this article, we present evidence on social environmental factors associated with a child's diet and physical activity, and more generally, the prevention and control of childhood obesity among Hispanic/Latinx children in the United States and children from countries in Latin America. Using a socio‐ecologic lens, we present evidence from cross‐sectional and longitudinal studies conducted in the United States involving Hispanic/Latinx children, and evidence from studies involving children in Latin America. Studies examining parenting factors in the home environment (e.g., parenting strategies) are especially emphasized, with more limited evidence on social environmental factors in other lived contexts (e.g., school). The influence of acculturation on social relationships cuts across levels of the socio‐ecological framework. Intervention research identified strategies and research gaps for intervening on social factors to promote healthy behaviors and reduce risk for childhood obesity. Community health workers and others forms of peer support were identified as relevant approaches at multiple levels of the socio‐ecological framework. This article concludes with directions for future research to further understand the environment using newer information and communication technologies.

Experiência de Implantação de um Programa de Educação Alimentar e Nutricional para Pré-escolares

Food and Nutrition Education (FNE) promotes healthy eating habits starting from the first years of life, which is a fundamental part in programs for the prevention and control of childhood obesity. In this context, in addition to the family, the school is an ideal environment, as it is a conducive place for learning, and where children spend most of their time, as well as eat their meals. The objective of this study was to implement the “Grow Healthy at School” Program through problematization methodologies using the Charles Maguerez Arch (CMA), for preschoolers in a school for early childhood education (SP/SP). The study design is longitudinal in nature, qualitative, and quantitative. The sample consisted of 151 children, 4-6 years old, after parental consent, during 2018-2019. The steps of the CMA comprise observation of reality, identification of key points, theorization, formulation of hypotheses, and application in reality. Therefore, 39 FNE activities were applied, and a portion of fruit was offered weekly while educational messages were sent to parents about healthy eating, biweekly. As a result, the children participated with great enthusiasm and interest, and accepted the fruits very well. Although, there is a limitation in measuring the results related to food consumption, as they are perceived in the long term, the children were very interested and willing to replicate the knowledge learned, demonstrating that this Program has practical applicability and can be repeated in other schools. Thus, permanent resources and continuous methodologies are needed that address the awareness of the school community, as well as the planning and the regular consumption of healthy foods by students.