Background: Population level child measurement is an established international practice. However, there is limited clarity around the protocol and roles of school-based child measurement programmes (CMPs). Furthermore, questions remain about the positive and adverse outcomes associated with CMPs, as well as their longer-term sustainability. This research contributes new information by addressing these key unanswered questions. Methods: This thesis describes a three-part, mixed methods research project incorporating: a systematic literature review of existing CMPs; an in-depth case study of England’s National Child Measurement Programme; and the development, pilot implementation and evaluation of a CMP in Guernsey. This research was conducted sequentially; individual components informed and guided subsequent work. Results: Routine child measurement is a popular, complex and adaptive practice and offers significant epidemiological value. The principal roles of CMPs are delivery of local prevalence data and assessment of longitudinal trends. However, CMPs are often tasked with additional, diverse and changing roles that do not translate to acknowledged outcomes. Specifically, feedback of individual results represents an unproven programme element. Programme roles can evolve according to political, logistical, or other influences, without consideration of available evidence or wider-reaching implications. There is no evidence of short-term harm from CMPs. Evaluation of the pilot CMP in Guernsey demonstrated that these programmes are perceived to be feasible, acceptable and sustainable. Conclusions: To maximise the broader utility of CMPs, there should be clarity and consistency around their aims, roles and outcomes. Overall, surveillance reflects the preferred programme type. All CMPs should incorporate a standardised, rigorously applied protocol and routine evaluation. These features are essential to ensure the accuracy and comparability of resultant data, as well as programme credibility. Population level CMPs should not function in isolation; instead, they should be integrated into comprehensive strategies for obesity management. This research has important implications for CMP stakeholders and the wider public health arena.

The aim of this study was to determine the relationship between HRQOL and adherence to an adolescent weight management program and identify variables predictive of increased adherence which are critical to motivating engagement in weight management. This study was a non-experimental, retrospective secondary analysis from aggregate data collected as part of the REWARD Teens program, a weight management program for overweight and obese adolescents. Data from 37 subjects were included in this study. Subject adherence to the program was the primary outcome variable. There was no significant relationship between baseline adolescent or parent-proxy sub-scale or total HRQOL scores with program adherence. A significant positive relationship for improved adherence was found only when change in BMI (p=.023), change of parent-proxy total PedsQL (p=.014), and change in child total PedsQL (p=.007) were present in the regression model. Body mass index and changes in both parent-proxy and child total HRQOL significantly affected attendance. Our findings suggest that baseline HRQOL does not affect program adherence. However, we identified a potentially novel interplay between variables predictive of program adherence. Future studies should focus on elucidating the mechanism by which these factors gained significance in the relationship with adherence when combined, perhaps as mediators or moderators, in order to identify interactions which may function as barriers or facilitators to adherence.

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for obesity prevention programs, and the desired route to developing a plan for action. Prior to this assessment, no clear picture of the complexity of Virginia’s childhood obesity problem existed outside of the facts: Virginia ranks 25th in the country for percentage of overweight or obese children; one-third of new obesity diagnoses in Virginia each year occur in children; Virginia’s African American population (19%) is significantly higher than the national average (12%); and research shows that African American children and adolescents have a higher rate and risk of overweight or obesity and a need for exposure to obesity-prevention programs. Research from respected and peer-reviewed sources on childhood overweight and obesity was conducted and the data compiled. This information was utilized to develop a new website for VFHY, provide education to the staff, and to develop a survey for the Board of Directors to guide strategic plan development. An assessment of the state of Virginia’s problem with childhood overweight and obesity was conducted from this research and a closer look was taken at the needs of Virginia’s public schools. Education on the benefits of implementing childhood obesity prevention and reduction programs was conducted via presentations at Board meetings and obesity workgroup meetings, as well as one-on-one to the VFHY staff. Finally, materials were developed to promote VYOP and its mission to consumers. The assessment of Virginia’s childhood overweight and obesity problem resulted in: increased VFHY staff competence regarding the issue and confidence in combating it; location of potential funding streams; a centralization of childhood overweight and obesity reduction and prevention efforts for Virginia; and the utilization of supplemental programs and street marketing to implement change in Virginia’s children and youth regarding factors surrounding overweight and obesity. VYOP is examining marketing approaches that would be successful for obesity reduction and prevention and is actively determining partners for their efforts who can impact economic development initiatives that will positively change behaviors. The combination of the ecological perspective and the social marketing theory to develop communication strategies and a strategic plan will help Virginia to decrease childhood overweight and obesity due to the multi-factorial nature of the problem. The strategies will take time to implement, and will be constantly evaluated and revised to best fit the needs of Virginia’s children and youth, but with patience and perseverance, VFHY will be as successful with its obesity prevention and reduction efforts as it has been with those targeting youth tobacco use.

Introdução: A influência de variantes genéticas dos genes da visfatina e dos recep- tores ?2-adrenérgicos em resposta ao treinamento físico é ainda inconclusiva. Obje- tivos: Verificar os efeitos do treinamento com danças afro-brasileiras por 13 sema- nas sobre parâmetros de saúde de crianças com sobrepeso ou obesidade e a in- fluência das variantes genéticas acima descritas na magnitude de resposta a este treinamento. Materiais e métodos: 30 crianças (9 ± 1,1 anos) realizaram um trei- namento que consistia em 5 minutos de aquecimento a 60% da FCmáx, quatro mo- mentos dez minutos de 70% a 80% da FCmáx intercalados com cinco momentos de dois minutos de recuperação ativa a 60% da FCmáx, 3x/sem, 60 min por sessão. Antes e após o treinamento realizou-se avaliação da composição corporal, índice de massa corporal (IMC), z- score do IMC, circunferência da cintura (CC), relação cintu- ra/estatura (RCE), pressão arterial sistólica (PAS) e diastólica (PAD), capacidade aeróbia e analise da variabilidade da frequência cardíaca (VFC). Análises sanguí- neas foram realizadas para genotipagem, avaliação do perfil lipídico, glicemia, insu- lina e HOMA-IR. A análise estatística foi realizada utilizando modelo de regressão de efeitos mistos. Resultados: Após o treinamento com dança afro-brasileira houve redução significativa (p<0,05) no z-score do IMC (-6,6%), na relação cintura/estatura (-4,8%) e consumo calórico (-15,3%). Considerando os genótipos dos polimorfismos estudados houve uma diminuição significativa no valor do z-score do IMC (-10%) para o genótipo AG do gene do receptor ?2-adrenérgico Arg16Gly, mas nenhuma alteração significativa para os genótipos relacionados aos genes da visfatina e Gln27Glu do receptor ?2-adrenérgico. Conclusão: O treinamento com dança afro- brasileira foi uma estratégia com efeito positivo sobre o score-z do IMC e relação cintura/estatura em crianças com sobrepeso e obesidade. E o genótipo AG do poli- morfismo do receptor ?2-adrenérgico Arg16Gly apresentou melhor resposta ao trei- namento no z-score do IMC, o que pode indicar uma influência genética à resposta ao treinamento. / Introduction: The influences of NAMPT and ?2-adrenergic receptors polymorphisms in response to dance training remain unclear. Objectives: To verify the effects of dance training on health parameters of overweight or obese children and to verify the influence of the genetic variants previously mentioned in response to 13 weeks of training with African-Brazilian dance. Methods: Thirty children (9 ± 1.1 years) per- formed a training that consisted of 10 minutes at 60% of HRmax, four moments from 70% to 80 % of HRmax interspersed with five minutes of active recovery at 60% of HRmax, in total of 60 minutes of training session. Before and after the training body composition, body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (DBP), physical fitness and heart rate variability (HRV) were evaluat- ed. Blood analyzes were performed for genotyping and evaluation of the lipid profile, glucose, insulin and HOMA-IR. Statistical analysis was performed using a general linear mixed effects model. Results: The African-Brazilian dance training resulted in a significant reduction (p<0.05) in BMI z-score (-6.6%), waist-to-height ratio (-4.8%) and caloric intake (-15.3%). In the analysis of each polymorphism, it was possible to observe a significant decrease in the z-score BMI (-10%) for the AG genotype of the Arg16Gly polymorphism in the ?2-adrenergic receptor gene, but there is no signifi- cant difference for the visfatin and Gln27Glu of the ?2-adrenergic receptor polymor- phisms. Conclusion: Afro-Brazilian dance training was a strategy with a positive ef- fect on BMI-z score and waist-to-height ratio in overweight and obese children. In addition, the AG genotype of the ?2-adrenergic receptor Arg16Gly polymorphism presented a better response to training on the BMI z-score, which can suggest a ge- netic influence on the training response.

Thesis advisor: Maureen E. Kenny / Childhood obesity is one of the most significant threats to the health development of children in the United States. A relationship has been found between mental health conditions, such as depression, and obesity development. Obesity prevention initiatives frequently target children's health behaviors due to their important role in the development of childhood obesity. Yet despite their importance, relatively little is known about the association between mental health factors and children's health behaviors. In addition, self-efficacy and self-regulation, cognitive factors which have been found to have a prominent role in behavior change, may also be correlated with children's health behaviors. These cognitive factors may also interact with mental health factors to predict children's health behaviors. The current study sought to investigate whether or not internalizing behaviors, self-efficacy, and self-regulation significantly predicted healthy eating behavior, unhealthy eating behavior, and physical activity behavior in preadolescent children. The study was a secondary data analysis of the Study of Early Child Care and Youth Development (SECCYD) Phase II-III data. Internalizing behaviors were found to have a significant relationship with unhealthy eating behaviors for both boys and girls, however, the relationship was positive for girls and negative for boys. Among the cognitive factors, sports self-efficacy and self-regulation, sports self-efficacy was found to be a significant predictor of physical activity behavior for both boys and girls. In addition, the moderating relationship between internalizing behaviors and self-regulation as a predictor of physical activity behavior was supported for boys. Findings from the study indicate individual psychological factors, such as mental health and self-efficacy may have a significant influence on children's health behaviors. Results also suggest factors at the psychological level may be interacting with one another, along with factors at the biological and social levels of development, to influence health behaviors. The current study highlights that investigating the psychological factors influencing health behaviors may yield an important contribution towards understanding obesity development. These findings have implications both for identifying children at risk for developing obesity, as well as, the design and implementation of obesity prevention initiatives. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

The interplay between child characteristics and parenting is increasingly implicated as crucial to child health outcomes. This study assessed the joint effects of children’s temperamental characteristics and maternal sensitivity on children’s weight status. Data from the National Institute of Child Health and Human Development’s Study of Early Child Care and Youth Development were utilized. Infant temperament, assessed at child’s age of 6 months by maternal report, was categorized into three types: easy, average, and difficult. Maternal sensitivity, assessed at child’s age of 6 months by observing maternal behaviors during mother-child semi-structured interaction, was categorized into two groups: sensitive and insensitive. Children’s height and weight were measured longitudinally from age 2 years to Grade 6, and body mass index (BMI) was calculated. BMI percentile was obtained based on the Centers for Disease Control and Prevention’s BMI charts. Children, who had a BMI ≥ the 85th percentile, were defined as overweight-or-obese. Generalized estimating equations were used to analyze the data. The proportions of children overweight-or-obese increased with age, 15.58% at 2 years old to 34.34% by Grade 6. The joint effects of children’s temperament and maternal sensitivity on a child’s body mass status depended on the child’s age. For instance, children with difficult temperament and insensitive mothers had significantly higher risks for being overweight-or-obese during the school age phase but not during early childhood. Specific combinations of child temperament and maternal sensitivity were associated with the development of obesity during childhood. Findings may hold implications for childhood obesity prevention/intervention programs targeting parents.

Considerada um dos principais problemas de Saúde Pública em todo o mundo, a obesidade vem crescendo de forma significativa entre a população infantil devido às mudanças no estilo de vida e aos hábitos alimentares. Sabe-se que a obesidade na infância tende a continuar na fase adulta, levando a diminuição da expectativa de vida e maior risco de doenças. O conhecimento epidemiológico que aponte grupos com maior chance de desenvolver sobre peso e obesidade traz importantes contribuições na abordagem clínica da doença. Dessa forma, o objetivo deste trabalho foi estimar a prevalência de excesso de peso em préescolares de 2 a 5 anos assistidos pelo Programa de Saúde da Família na cidade de Ribeirão Preto - SP; descrever características socioeconômicas e demográficas das famílias; descrever aspectos alimentares e antropométricos das crianças e investigar possíveis associações entre as variáveis. Trata-se de um estudo transversal, no qual foram coletados dados antropométricos (peso, altura, pregas cutâneas e circunferências) e aplicado um questionário sobre dados socioeconô micos, demográficos e de consumo alimentar. Para diagnóstico de excesso de peso foi usado o escore-Z de peso/altura >= +1. Foram estudados 155 pré-escolares com média de idade de 4,3±1,0 anos, sendo 80 (51,6%) meninas e 75 (48,4%) meninos. As prevalências encontradas foram: 16,8% de subnutrição; 62,6% de eutrofia; 20,6% de excesso de peso, sem diferença entre os sexos (p=0,92). As famílias eram, em sua maioria, (63%) nucleares, tinham em média 4,8±1,8 membros e 25% das crianças viviam sem o pai biológico. A escolaridade das mães e dos chefes da família e a classificação de estimativa de renda não mostraram associação com os estado nutricional das crianças. O peso e o IMC da mãe foram maiores no grupo de crianças com excesso de peso (p<0,01). Todas as medidas de circunferências (CB, CC, CA e CQ) foram significativamente maiores no grupo de excesso de peso (p<0,01). Dentre as medidas de pregas cutâneas (PCB, PCT, PCSI e PCSE) destacam-se os valores da PCT (7,8±1,8;9,0±1,6; 13,6±4,4) e da porcentagem de gordura corporal (10,1±2,5; 15,3±2,7;22,3±6,1) que, respectivamente para os grupos subnutrição, eutrofia e excesso de peso, apresentaram diferenças significativas (p< 0,01). A base da alimentação das crianças, para todos os grupos, era arroz, leite, feijão, pão e carnes e alimentos com alta densidade calórica como bolachas, doces, refrigerantes e salgadinhos que apresentaram consumo freqüente. Foi encontrada prevalência de excesso de peso condizente com a situação de transição nutricional do país e as medidas de composição corporal das crianças indicam excesso de gordura corporal. Ações voltadas para Educa ção Alimentar e Nutricional para as crianças e suas famílias são fundamentais para se evitar o agravamento do problema num futuro próximo. / Considered one of the main problems of Public Health all over the world, the obesity is growing in a significant way among the infantile population due to changes in the lifestyle and to the food habits. It is known that the childhood obesity tends to continue in the adult phase, taking the decrease of the life expectative and larger risk of diseases. The epidemic knowledge that points to groups with larger chance of developing overweight and obesity brings important contributions in the clinical approach of the disease. So, the aim of this study was to assess the prevalence of overweight in preschool children from 2 to 5 years attended by the Program of Health of the Family in the city of Ribeirão Preto - SP; to describe socioeconomic and demographic characteristics of the families; to describe infant food and anthropome trics aspects and to investigate possible associations among the variables. It is a cross-sectional study, in which anthro pometrics was collected (weight, height, skinfolds thickness and circumferences) and the collection of socioeconomics, demographic and alimentary datas. Overweight was defines as weight to height Z score >= +1. Were assessed 155 preschool with average age 4,3±1,0 years, 80 (51,6%) girls and 75 (48,4%) boys. The prevalence found were 16,8% of malnutrition and 20,6% of overweight, without difference among the sexes (p=0,92). The families were, in majority (63%) nuclear, they had 4,8±1,8 members on average and 25% of the children lived without the biological father. The mothers and the family\'s bosses education level and classifica tion of estimate of income didn\'t show association with statement nutritional of the children. The weight and the mother\'s IMC were larger in the children\'s group with overweight (p <0,01). All the measures of circum ferences they were significantly larger in the group of overweight (p <0,01). The measures of tricipital skinfold (7,8±1,8; 9,0±1,6; 13,6±4,4) and the percentage of corporal fat (10,1±2,5; 15,3±2,7; 22,3±6,1) that, respectively for the groups malnutrition, normal and overweight, they presented p <0,01. The base of the children\'s feeding, for all of the groups, was rice, milk, bean, bread and meats and foods with high caloric density as cookies, candies, soft drinks and chips presented frequent consumption. Found prevalence of overweight is suitable with transition nutrition in Brazil and the body composition children\'s measures they indicate fat body excess. Before the presented data it is ended that are necessary educational and preventive measures for the infantile obesity in that population. Actions turned to alimentary and nutritional education for the children and their families are fundamental to avoid the aggravation of the problem in a close future.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-06-20T14:41:56Z No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-06-20T14:42:15Z (GMT) No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) / Made available in DSpace on 2018-06-20T14:42:15Z (GMT). No. of bitstreams: 1 HeronFloresNogueiraTeseParcial2017.pdf: 1090458 bytes, checksum: 7fb58690cffa20a016340355c25897be (MD5) Previous issue date: 2017-07-26 / Childhood obesity has reached levels never seen in our history. The family environment is one of the factors that can contribute to the emergence and maintenance of obesity, on the other hand, the participation of families is also considered as fundamental in prevention and treatment. In the literature there is notably a shortage of studies that focus on this issue. The present research has as general objective to perform a psychosocial intervention with families of obese children and to investigate their experiences and perceptions about possible changes in family dynamics, eating habits and lifestyle. This is a qualitative research through action research from the perspective of the Systemic Approach to the Family. Three families with children diagnosed with obesity participated in this study, living in different administrative regions of the Federal District and having an average family income of two minimum wages. The instruments used for the collection were: family life cycle interview script, genogram, scripts for the Multifamily Group (MG), follow-up interview script, HAT-Helpful Aspects of Therapy and the CCI-Client Change Interview. After the signing of the Informed Consent Term, the families were interviewed separately and the genogram was built, with an average duration of two hours, at the UCB Applied Psychology Training Center (CEFPA). After a few weeks, in the same place, the families participated in the GM, which happened in five meetings, with biweekly intervals, each with an average duration of three hours. For these steps the researcher counted on scholarship students of Scientific Initiation of the course of Psychology. After two years, the families were interviewed by the researcher in their homes (follow-up) and each interview lasted an average of two hours. All stages of the research were recorded in audios, whose contents were later transcribed in full. The analysis of the information was made in the light of the Qualitative Epistemology in which the researcher realizes a constructive-interpretative production, and discussed based on the contribution of the systemic theory. The main aspects observed and discussed were organized in three stages: 1) the interview of the family life cycle: knowing the family and its history - the information collected showed the gestation of the babies without planning; Interaction pattern with conflicts, absence of parental authority and diffuse internal borders; Inadequate food pattern and difficulties in adhering to treatments. 2) The GM: interaction, learning and growth - transgenerational influences on the current food pattern and extensive family interferences; Difficulties in exercising the parental role and promoting adequate nutrition; Meanings of feeding and expression of intrafamilial affections; Attempts to make changes, and 3) the follow-up interview: revisiting families - jobs and activities remembered with ease; The changes made possible after the interventions; Current family dynamics with the presence of limits, authority and health care; Family contributions to the intervention model and expectations for the future. The present study, therefore, analyzed the families' experience in the psychosocial intervention, providing an in-depth and complex reading of the different factors related to childhood obesity and the family. This study can contribute to preventive actions and treatment of obesity, as well as help in the promotion of new research on the disease. / A obesidade infantil atingiu índices nunca vistos na nossa história. O ambiente familiar é um dos fatores que podem contribuir para o surgimento e manutenção da obesidade, por outro lado, a participação das famílias é apontada também como fundamental na prevenção e no tratamento. Na literatura há notadamente uma escassez de estudos que enfoquem essa questão. A presente pesquisa tem como objetivo geral realizar uma intervenção psicossocial com famílias de crianças obesas e investigar suas vivências e percepções sobre possíveis mudanças na dinâmica familiar, nos hábitos alimentares e no estilo de vida. Trata-se de uma pesquisa qualitativa por meio de pesquisa-ação numa perspectiva da Abordagem Sistêmica da Família. Participaram deste estudo três famílias com crianças diagnosticadas com obesidade, moradoras de diferentes regiões administrativas do Distrito Federal e possuem renda familiar média de dois salários mínimos. Os instrumentos utilizados para a coleta foram: roteiro de entrevista do ciclo de vida familiar, genograma, roteiros para o Grupo Multifamiliar (GM), roteiro de entrevista de follow-up, HAT-Helpful Aspects of Therapy e o CCI-Client Change Interview. Após a assinatura do Termo de Consentimento Livre e Esclarecido, as famílias foram entrevistadas separadamente e foi construído o genograma, com duração média de duas horas, no Centro de Formação em Psicologia Aplicada (CEFPA) da UCB. Após algumas semanas, no mesmo local, as famílias participaram do GM, que aconteceu em cinco encontros, com intervalos quinzenais, cada um com duração média de três horas. Para essas etapas o pesquisador contou com alunos bolsistas de Iniciação Científica do curso de Psicologia. Após dois anos, as famílias foram entrevistadas pelo pesquisador em suas residências (follow-up) e cada entrevista teve duração média de duas horas. Todas as etapas da pesquisa foram registradas em áudios, cujo conteúdo foi posteriormente transcrito na íntegra. A análise das informações foi feita à luz da Epistemologia Qualitativa em que o pesquisador realiza uma produção construtivo-interpretativa, e discutidas com base no aporte da teoria sistêmica. Os principais aspectos observados e discutidos foram organizados em três etapas: 1) a entrevista do ciclo de vida familiar: conhecendo a família e sua história – as informações levantadas mostraram a gestação dos bebês sem planejamento; padrão interacional com conflitos, ausência de autoridade parental e fronteiras internas difusas; padrão alimentar inadequado e dificuldades em aderir aos tratamentos. 2) O GM: interação, aprendizado e crescimento – influências transgeracionais no padrão alimentar atual e interferências das famílias extensas; dificuldades de exercer o papel parental e promover alimentação adequada; significados da alimentação e expressão dos afetos intrafamiliares; tentativas de realizar mudanças e 3) a entrevista de follow-up: revisitando as famílias - os trabalhos e as atividades lembrados com facilidade; as mudanças possibilitadas após as intervenções; dinâmicas familiares atuais com presença de limites, autoridade e cuidados com a saúde; contribuições das famílias para o modelo de intervenção e expectativas para o futuro. O presente trabalho, portanto, analisou a vivência das famílias na intervenção psicossocial proporcionando uma leitura aprofundada e complexa dos diferentes fatores relacionados à obesidade infantil e à família. Este estudo pode contribuir para ações preventivas e de tratamento da obesidade, assim como auxiliar no fomento de novas investigações sobre a doença.

Considerada um dos principais problemas de Saúde Pública em todo o mundo, a obesidade vem crescendo de forma significativa entre a população infantil devido às mudanças no estilo de vida e aos hábitos alimentares. Sabe-se que a obesidade na infância tende a continuar na fase adulta, levando a diminuição da expectativa de vida e maior risco de doenças. O conhecimento epidemiológico que aponte grupos com maior chance de desenvolver sobre peso e obesidade traz importantes contribuições na abordagem clínica da doença. Dessa forma, o objetivo deste trabalho foi estimar a prevalência de excesso de peso em préescolares de 2 a 5 anos assistidos pelo Programa de Saúde da Família na cidade de Ribeirão Preto - SP; descrever características socioeconômicas e demográficas das famílias; descrever aspectos alimentares e antropométricos das crianças e investigar possíveis associações entre as variáveis. Trata-se de um estudo transversal, no qual foram coletados dados antropométricos (peso, altura, pregas cutâneas e circunferências) e aplicado um questionário sobre dados socioeconô micos, demográficos e de consumo alimentar. Para diagnóstico de excesso de peso foi usado o escore-Z de peso/altura >= +1. Foram estudados 155 pré-escolares com média de idade de 4,3±1,0 anos, sendo 80 (51,6%) meninas e 75 (48,4%) meninos. As prevalências encontradas foram: 16,8% de subnutrição; 62,6% de eutrofia; 20,6% de excesso de peso, sem diferença entre os sexos (p=0,92). As famílias eram, em sua maioria, (63%) nucleares, tinham em média 4,8±1,8 membros e 25% das crianças viviam sem o pai biológico. A escolaridade das mães e dos chefes da família e a classificação de estimativa de renda não mostraram associação com os estado nutricional das crianças. O peso e o IMC da mãe foram maiores no grupo de crianças com excesso de peso (p<0,01). Todas as medidas de circunferências (CB, CC, CA e CQ) foram significativamente maiores no grupo de excesso de peso (p<0,01). Dentre as medidas de pregas cutâneas (PCB, PCT, PCSI e PCSE) destacam-se os valores da PCT (7,8±1,8;9,0±1,6; 13,6±4,4) e da porcentagem de gordura corporal (10,1±2,5; 15,3±2,7;22,3±6,1) que, respectivamente para os grupos subnutrição, eutrofia e excesso de peso, apresentaram diferenças significativas (p< 0,01). A base da alimentação das crianças, para todos os grupos, era arroz, leite, feijão, pão e carnes e alimentos com alta densidade calórica como bolachas, doces, refrigerantes e salgadinhos que apresentaram consumo freqüente. Foi encontrada prevalência de excesso de peso condizente com a situação de transição nutricional do país e as medidas de composição corporal das crianças indicam excesso de gordura corporal. Ações voltadas para Educa ção Alimentar e Nutricional para as crianças e suas famílias são fundamentais para se evitar o agravamento do problema num futuro próximo. / Considered one of the main problems of Public Health all over the world, the obesity is growing in a significant way among the infantile population due to changes in the lifestyle and to the food habits. It is known that the childhood obesity tends to continue in the adult phase, taking the decrease of the life expectative and larger risk of diseases. The epidemic knowledge that points to groups with larger chance of developing overweight and obesity brings important contributions in the clinical approach of the disease. So, the aim of this study was to assess the prevalence of overweight in preschool children from 2 to 5 years attended by the Program of Health of the Family in the city of Ribeirão Preto - SP; to describe socioeconomic and demographic characteristics of the families; to describe infant food and anthropome trics aspects and to investigate possible associations among the variables. It is a cross-sectional study, in which anthro pometrics was collected (weight, height, skinfolds thickness and circumferences) and the collection of socioeconomics, demographic and alimentary datas. Overweight was defines as weight to height Z score >= +1. Were assessed 155 preschool with average age 4,3±1,0 years, 80 (51,6%) girls and 75 (48,4%) boys. The prevalence found were 16,8% of malnutrition and 20,6% of overweight, without difference among the sexes (p=0,92). The families were, in majority (63%) nuclear, they had 4,8±1,8 members on average and 25% of the children lived without the biological father. The mothers and the family\'s bosses education level and classifica tion of estimate of income didn\'t show association with statement nutritional of the children. The weight and the mother\'s IMC were larger in the children\'s group with overweight (p <0,01). All the measures of circum ferences they were significantly larger in the group of overweight (p <0,01). The measures of tricipital skinfold (7,8±1,8; 9,0±1,6; 13,6±4,4) and the percentage of corporal fat (10,1±2,5; 15,3±2,7; 22,3±6,1) that, respectively for the groups malnutrition, normal and overweight, they presented p <0,01. The base of the children\'s feeding, for all of the groups, was rice, milk, bean, bread and meats and foods with high caloric density as cookies, candies, soft drinks and chips presented frequent consumption. Found prevalence of overweight is suitable with transition nutrition in Brazil and the body composition children\'s measures they indicate fat body excess. Before the presented data it is ended that are necessary educational and preventive measures for the infantile obesity in that population. Actions turned to alimentary and nutritional education for the children and their families are fundamental to avoid the aggravation of the problem in a close future.

The purpose of this study was to increase the nutrition knowledge of elementary school students by implementing nutrition education lessons. The subjects included 49 kindergarten through third grade students in Johnson County, Tennessee during the fall of 2004. Knowledge increase was measured by pretest and posttest scores. The tests were analyzed by paired t-tests. While all students showed an increase in mean score, kindergarten and first grade students did not show a significant increase in posttest scores. However, second and third grade students showed a significant increase in posttest scores, indicating an increase in nutrition knowledge.