In 2009 alarming rates of childhood obesity resulted in the Government of Ontario launching a province-wide initiative through the Ministry of Health Promotion & Sport. This study focused on Eastview Boys and Girls Club (Eastview unit) in Oshawa, Ontario and examined immediate impacts of an after-school snack program involving close to 100-children daily. Data collection included key informant interviews (n=7); one focus group interview with parents (n=8); three interactive children‟s sessions, and document review. Findings identified changes in children‟s eating behaviours (e.g., willingness to try new foods) and shifts in staff attitudes (e.g., role-modelling). Facilitators included staff commitment, strong partnerships, and previous program accreditation. Organizational barriers included gaps in nutrition-related knowledge/skills of staff and insufficient program-specific training and resources. Recommendations call for building capacities at individual-, organizational- and community-levels to strengthen the nutritional component of the after-school initiative. Future research should evaluate long-term outcomes of the snack program. / UOIT

Background: Obesity’s rapid growth and its serious consequences for public health, is assessed as one of the most serious public health challenges. In Sweden, the number of children with child obesity has duplicated in 15 years. Statistics reveals that approximately 4 to 5% of all children in Sweden suffer of obesity. As families and individuals themselves choose their diet, they need knowledge to make healthy choices for themselves and for their children. Parents are the primary source for communicating health information to their children and adolescents. Hence, there is a demand to improve the targeted information to parents. The risk of a child becoming overweight reduces the sooner parents embrace healthy habits. Purpose: The aim was to examine the experts' experiences and perceptions of how parents get and receive information about children's health with a focus on child obesity. Method: The study design was explorative with a qualitative approach. Ten interviews were conducted and used for qualitative content analysis, and basis for the presented results. Results: The analysis resulted in ten subcategories and four categories presented below. 1. To study the environment around the entire family, 2. That there is a interest by all to promote children’s health, 3. To personalize information, 4. What the information should discuss. The main result of this study reveals that expert´s perceived parents today are getting good information through actors like child health center (BVC) and the school, hence the parents interpreted as positive to information regarding their children's health. However, it stated that the experts' experienced barriers in the treatment of child obesity and lack of information about child obesity. These barriers highlighted to depend on both genetics and environment while lack emphasized to base on ignorance and prejudices from parents and other stakeholders. Conclusion: The experts perceived that parents were positive towards information about children's health, but sometimes less positive towards information regarding child obesity. In contrary, the experts conveyed that there were gaps in the information of child obesity from BVC, due to a lack of knowledge and prejudice of the BVC: s staff. The biggest barrier to treatment and prevention against child obesity mediated as the environment. Society needs to make changes by suggestion to remove extra prices on candy, and instead both offer and send out information about healthier options. Suggested strategies was to organize group meetings to help parents manage information about child obesity. Stakeholders like BVC and school could take healthlitteracy into count when providing information. / Bakgrund: Fetmans snabba ökning och dess allvarliga konsekvenser för folkhälsan, bedöms som en av de allvarligaste folkhälsoutmaningarna. I Sverige har antalet barn med barnobesitas fördubblats på 15 år. Statistik visar att ungefär 4 till 5 % av barn i Sverige lider av obesitas. Eftersom familjer och individer själva väljer sin kost behöver de kunskap att göra hälsosamma val till sig själva och sina barn. Föräldrar är den primära källan för att vidarebefordra hälsorelaterad information till sina barn. Med hänsyn till detta behöver den riktade informationen till föräldrar utvecklas. Risken att ett barn blir överviktig minskar ju tidigare föräldrar anammar hälsosamma vanor. Syfte: Att undersöka experters erfarenheter och upplevelser av hur föräldrar får och tar emot information om barns hälsa med fokus på barnobesitas. Metod: Studiens design var explorativ med en kvalitativ ansats. Tio intervjuer genomfördes och med en kvalitativ innehållsanalys som grund, kunde resultat presenteras. Resultat: Analysen resulterade i tio subkategorier och fyra kategorier som presenteras nedan. 1. Att se över miljön runt hela familjen, 2. Att det finns ett intresse hos alla att främja barns hälsa, 3. Att individanpassa informationen, 4. Vad informationen ska avhandla. Huvudresultatet av föreliggande studie var att experterna uppfattade att föräldrar idag får bra information via aktörer som barnavårdscentralen (BVC) och skolan, samt att föräldrarna upplevdes som positiva till information gällande deras barns hälsa. Dock framkom att experterna upplevde barriärer vid behandling av barnobesitas och brister vid information som handlade om barnobesitas. Dessa barriärer ansågs bero på både arv och miljö. Dessutom ansågs bristerna grundas i okunskap och fördomar hos föräldrar och andra aktörer. Slutsats: Experterna upplevde att föräldrarna var positiva till information gällande barns hälsa, men ibland mindre positiva till information om barnobesitas. Intervjuade parter förmedlade att det fanns brister i informationen om barnobesitas från BVC, beroende på brist på kunskap samt fördomar hos BVC:s personal. Den största barriären för behandling och förebyggande insatser mot barnobesitas ansågs vara miljön. Samhället behöver göra förändringar genom att förslagsvis ta bort extrapriser på godis, och istället både erbjuda och sända ut information om hälsosammare alternativ. Förslag på strategier var att anordna gruppträffar för att hjälpa föräldrar att hantera information om barnobesitas. Aktörer som BVC och skolan behöver ta hänsyn till hälsolitteracitet när de ger information.

A Obesidade é uma doença multifatorial que tem aumentado em incidência nos últimos anos. Considerar a família no contexto da Obesidade é fundamental para a compreensão de sua etiologia e manutenção. Diante disso, este estudo objetivou compreender a maneira como os pais de crianças obesas experienciam sua parentalidade e associar essas vivências ao desenvolvimento do Self do filho. Esta é uma pesquisa clínico-qualitativa que utiliza as Narrativas Transferenciais como estratégia metodológica e a psicanálise winnicottiana como referencial teórico. Os participantes são 5 famílias compostas de pai, mãe e filho(a) diagnosticado(a) com Obesidade. Foram realizados um encontro com os pais, no início do processo, para a apresentação da pesquisa e coleta de dados demográficos; outro com pai e mãe, separadamente, em que alguns cartões selecionados do Teste de Apercepção Temática Infantil - forma animal (CAT-A) foram apresentados para que, a partir da visualização das figuras, eles falassem sobre a experiência de ser pai/mãe de seu filho(a). Com as crianças, os mesmos cartões do CAT-A usados com os pais foram apresentados, solicitando que contassem uma história sobre cada um deles. Os dados foram qualitativamente analisados pelo método de livre inspeção do material, apresentados na forma de Narrativas Transferenciais e interpretados seguindo o referencial da Psicanálise winnicottiana. Todos os aspectos éticos foram contemplados e os nomes e sobrenome apresentados são fictícios. A análise das narrativas revelou que as crianças representam, por meio do engordar, a internalização dos conflitos familiares e a dificuldade na aquisição da autonomia. Pais e filhos demonstraram dificuldades para integrar os afetos no Self, principalmente os hostis projetando estes últimos no ambiente externo, por considerá-los ameaçadores para si mesmos e para o grupo familiar. As vivências parentais impactam diretamente no Self das crianças, pois os pais não conseguem auxiliar seus filhos no desenvolvimento da criatividade ao não se sentirem em condições de oferecer uma contenção firme e amorosa dos impulsos infantis, o que faria com que a espontaneidade pudesse existir sem ser sentida como um risco à harmonia familiar. Diante da necessidade de proteger o ambiente familiar, as diferenças entre os membros não são aceitas, pois seriam fontes eventuais de conflitos e colocariam em risco a manutenção do grupo. Sem possibilidades de diferenciação dos genitores, as crianças permanecem em uma relação de dependência com os pais e sentem-se pouco capazes de viverem no mundo externo, pois não podem contar com a criatividade para auxiliá-las nas dificuldades que surgirem. A capacidade simbólica não se desenvolve, pois o hipercontrole da agressividade não permite a separação da díade mãe e filho e a diferenciação entre eles. Cresce o receio nas crianças de que, ao romperem com a relação de dependência com seus pais, precisarão ser autônomas sem sentirem-se em condições para tal. As figuras parentais não podem ser introjetadas simbolicamente, mas apenas de uma maneira concreta: por meio da comida, a representação materna. A Obesidade infantil aparece como um sintoma para protegê-las do sentimento de que não podem existir verdadeiramente no mundo. / With many causes, the incidence of obesity has increased in recent years. Considering families in the context of Obesity, understanding its etiology and maintenance is fundamental. This study aims to comprehend the way parents of obese children experience their parenthood and the way they associate these experiences to the development of their children\"s Self. This is a clinical and qualitative research that employs the Transfer Narratives as the methodological strategy and Winnicott\"s psychoanalysis as the theoretical framework. Five families participated in this study. Each of them consisted of a father, a mother and a child diagnosed with Obesity. One meeting was held with each group of parents, so as to present the research and to collect demographic data. Afterwards, a meeting with each father and mother, separately, were held in order to introduce some cards from the Children\'s Thematic Apperception Test - animal form (CAT-A), whose aim was to encourage them to talk about the experience of being a mother/father. The same cards were presented to the children, who were asked to tell a story about each of them. The data, which were analyzed according to the method of free material inspection, were presented in the form of Transfer Narratives and interpreted by means of Winnicott\"s Psychoanalysis. All ethical aspects were considered, and the names presented are fictitious. The analysis of the narratives indicated that children represent, by means of putting on weight, the internalization of the family conflict and of the difficulty in achieving autonomy. Both parents and children had difficulties in integrating their affection into the Self, especially the hostile ones, projecting the latter in the external environment, for considering them threatening to themselves and to their families. The parental experiences directly influence the children\"s Self, because patents do not manage to assist their children in developing their creativity, for these adults do not feel prepared to impose a firm and loving restraint of infantile impulses, which, otherwise, could provide room for spontaneity without it been felt as a threat to the family. Due to the imperative for protecting family environment, the differences among family members are not accepted, for they could be sources of conflict that put in danger the group\"s existence. Without the possibility to differentiate themselves from their parents, children remain dependent upon them, felling unable to live in an external world, because they cannot rely on creativity to help them in times of trouble. In such context, children do not develop their symbolic capacity, for the tight control of their aggressiveness does not lead to the end to the dyadic relationship between mother and child and their differentiation. Children are increasingly afraid that, when their dependent relationship with their parents is over, they will need to be autonomous, without feeling prepared to be so. Parental figures cannot be symbolically introjected, but only in a correct manner: by means of food, the maternal representation. Child obesity is a symptom to protect them from the feeling that they cannot truly exist in the world.

Introdução - A obesidade vem aumentando de forma expressiva, inclusive em crianças e adolescentes, e traz consigo comorbidades graves. O aleitamento materno tem sido relacionado como fator preventivo de muitas doenças e, nos últimos anos, tem sido verificado o papel de proteção do aleitamento contra a obesidade na infância. Objetivo - Verificar a prevalência de excesso de peso e sua relação com a duração do aleitamento materno em crianças de 48 a 60 meses. Métodos - Estudo transversal, no qual foram coletados dados antropométricos (peso e estatura) de crianças de 48 a 60 meses, de escolas públicas do município de Capitólio, MG, para cálculo de índice de massa corpórea (IMC) e sua classificação nutricional. Foram coletados, também, por meio de questionário respondido pela mãe da criança, dados sobre a duração do aleitamento materno, introdução de chá, de outros leites e alimentação atual da criança, além de variáveis demográficas e socioeconômicas. Excesso de peso foi considerado variável desfecho. A variável explanatória principal foi o aleitamento materno e as variáveis de controle foram a alimentação atual e as variáveis demográficas e socioeconômicas. A relação entre o desfecho e as variáveis explanatórias foi verificada por meio de regressão logística. Resultados A prevalência de crianças com excesso de peso foi de 9,59 por cento . O aleitamento materno exclusivo (AME) até os 6 meses ou mais foi oferecido a 32,11 por cento das crianças, sendo que 18,81 por cento das população pesquisada nunca recebeu AME. O presente estudo sugere uma relação positiva entre a presença de AME e a prevenção do excesso de peso em crianças de 48 a 60 meses para a categoria de AME por 6 meses ou mais (OR=0,15; IC95 por cento 0,03-0,77; p=0,023). Relação semelhante não foi encontrada para o aleitamento materno total. Considerações Finais: O AME, além dos benefícios já comprovados em literatura, apresentou no presente estudo efeito protetor contra a obesidade infantil, mesmo após análise logística multivariável que incluía variáveis controle. O investimento em políticas de promoção, proteção e incentivo ao aleitamento materno tornam-se cada vez mais relevantes / Introduction - Obesity is increasing significantly, including in children and adolescents, and brings with it severe comorbidities. Breastfeeding has been linked as a prevention of many diseases and, in recent years, it has been observed the protective role of breastfeeding against childhood obesity. Objective - To investigate the prevalence of overweight and its relationship with duration of breastfeeding in children 48 to 60 months. Methods - Cross-sectional study in which anthropometric data (weight and height) of children 48-60 months of public schools of CapitólioMG, for calculation of body mass index (BMI) and their nutritional classification. Were also collected, through a questionnaire answered by the child\'s mother, data of breastfeeding duration, introduction of tea, other kind of milk and current feeding, as well as demographic and socioeconomic variables. Overweight was considered the outcome variable. The main explanatory variable was breastfeeding and the control variables were current feeding and demographic and socioeconomic variables. The relationship between the outcome and explanatory variables was assessed through logistic regression. Results - The prevalence of overweight children was 9.59 per cent . Exclusive breastfeeding (EBF) until 6 months or more was offered to 32.11 per cent of children, with 18.81 per cent of the surveyed population never received EBF. This study suggests a positive relationship between the presence of EBF and prevention of overweight in children 48 to 60 months for the category of EBF for 6 months or more ( OR = 0.15, 95 per cent CI 0.03 to 0.77, p = 0.023). Similar relationship was not found for total breastfeeding. Final Thoughts: The EBF, and its benefits have been proven in the literature, the present study showed a protective effect against childhood obesity, even after multivariable logistic analysis that included control variables. The investment in promotion, protection and encouragement of breastfeeding policies become increasingly relevant

Childhood obesity puts children at risk for chronic metabolic diseases. Identification of weight-related risk factors in childhood is important to prevent adult cardiovascular disease (CVD). This dissertation evaluates risk factors for adolescent obesity and dyslipidemia. Multivariable regression analyses of data from black and white girls in the National Growth and Health Study (n=2,379) were used to identify predictors of these cardiometabolic risks (CMR). The first aim was to compare the impact of different measures of early adolescent adiposity (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, WHR; percent body fat from bioelectrical impedance, %BF) as predictors of later adolescent lipid levels. Black girls had significantly lower pre-adolescent %BF (23.6% vs. 26.4%) than whites, but gained fat more rapidly (34.7% vs. 14.0% increases), exceeding whites in %BF by late adolescence. WC was a stronger predictor of subsequent low-density lipoprotein (LDL) levels than other measures of body composition (LDL difference between WC of highest and lowest quintiles: 29.5 mg/dL, whites; 17.9 mg/dL, blacks). Regardless of race, BMI was associated with lower levels of high-density lipoprotein (HDL), and higher levels of LDL, TG, and TG/HDL (triglyceride to HDL ratio). The second aim compared pre- and post-menarche measures of early adolescent body fat as determinants of later LDL, HDL, TG, and TG/HDL. BMI measures post-menarche were generally better predictors of later lipids in white girls compared with pre-menarche measures, while pre- and post-menarche BMI measures were equally good as predictors of later lipid levels in black girls. The third aim examined the role of maternal depressive symptoms as a risk factor for increased BMI among daughters. Daughters of mothers with higher depression scores had greater BMI increases throughout adolescence (p<0.0001), and a late adolescent BMI that was 0.88 kg/m2 higher than those of mothers with lower depression scores. These findings underline the importance of monitoring early physical and psychosocial CMR factors during adolescence to prevent CVD risk.

No description available.

Bakgrund: Prevalensen av övervikt och fetma hos barn har ökat över hela världen de senaste årtionden. Primroseprojektet är ett forskningsprojekt som studerar möjligheten att förebygga barnfetma genom föräldrasamtal på barnavårdscentralen (BVC). Sjuksköterskans compliance till den interventionsmanual som används förväntas vara viktigt för resultatet. Syfte: Att inom ramen för Primroseprojektet bedöma hur föräldrar och BVC sjuksköterskor, i samband med att barnet genomgår hälsoundersökning vid tolv månaders ålder på barnavårdscentralen, följt Primrosemanualens instruktioner. Metod : Matdagbok och målformuleringsblad granskades utifrån om de var ifyllda enligt manualens instruktioner . Målformuleringsbladet poängsattes också utifrån den detaljnivå målen var formulerade. Resultat: Nästan 75 procent av de inkomna matdagböckerna var ifyllda på ett korrekt sätt. Resultatet av poängbedömningen av målformuleringsbladen visade att sjuksköterskan tillsammans med föräldern inte hade formulerat detaljerade mål i den omfattning som var önskvärd. Slutsats: Instruktionerna för hur matdagböckerna skulle fyllas i var tydliga. Den låga graden av detaljerade mål tror författarna beror på en bristande överensstämmelse mellan hur instruktionerna till sjuksköterskan var formulerade och de kriterier som skulle vara uppfyllda för att få poäng. / Background: The prevalence of childhood overweight and obesity has increased worldwide during the last few decades. The Primrose project studies the potential to prevent child obesity by parental consultation at a child health centre. It is critical that the health visitor complies with the instruction manual for any intervention. Aim : Within the framework of the Primrose project, evaluate to what extent health visitors and parents have followed the instructions in the Primrose manual, during a health control at the age of twelve months. Method: The food diary and the goal formulation sheet were studied in order to evaluate whether they had been completed according to the manual. The latter was graded using a recommended point system related to the level of detail the goals were formulated. Result: Nearly 75% of the food diaries were completed in a correct manner. The evaluation of the points derived from the goal formulation sheets indicates that the health visitor, together with the parents, had not been able to formulate the goals in sufficient detail. Conclusion: The instructions for the completion of the food diaries are clear. The authors consider that the unsatisfactory result with the level of detail the goals were formulated is caused by the lack of agreement between the way the instructions were presented and the demands of the criteria that steer the point system.

Source: Masters Abstracts International, Volume: 47-06, page: 3557. Adviser: Arnold J. Schecter. Includes bibliographical references.

Introdução - A obesidade vem aumentando de forma expressiva, inclusive em crianças e adolescentes, e traz consigo comorbidades graves. O aleitamento materno tem sido relacionado como fator preventivo de muitas doenças e, nos últimos anos, tem sido verificado o papel de proteção do aleitamento contra a obesidade na infância. Objetivo - Verificar a prevalência de excesso de peso e sua relação com a duração do aleitamento materno em crianças de 48 a 60 meses. Métodos - Estudo transversal, no qual foram coletados dados antropométricos (peso e estatura) de crianças de 48 a 60 meses, de escolas públicas do município de Capitólio, MG, para cálculo de índice de massa corpórea (IMC) e sua classificação nutricional. Foram coletados, também, por meio de questionário respondido pela mãe da criança, dados sobre a duração do aleitamento materno, introdução de chá, de outros leites e alimentação atual da criança, além de variáveis demográficas e socioeconômicas. Excesso de peso foi considerado variável desfecho. A variável explanatória principal foi o aleitamento materno e as variáveis de controle foram a alimentação atual e as variáveis demográficas e socioeconômicas. A relação entre o desfecho e as variáveis explanatórias foi verificada por meio de regressão logística. Resultados A prevalência de crianças com excesso de peso foi de 9,59 por cento . O aleitamento materno exclusivo (AME) até os 6 meses ou mais foi oferecido a 32,11 por cento das crianças, sendo que 18,81 por cento das população pesquisada nunca recebeu AME. O presente estudo sugere uma relação positiva entre a presença de AME e a prevenção do excesso de peso em crianças de 48 a 60 meses para a categoria de AME por 6 meses ou mais (OR=0,15; IC95 por cento 0,03-0,77; p=0,023). Relação semelhante não foi encontrada para o aleitamento materno total. Considerações Finais: O AME, além dos benefícios já comprovados em literatura, apresentou no presente estudo efeito protetor contra a obesidade infantil, mesmo após análise logística multivariável que incluía variáveis controle. O investimento em políticas de promoção, proteção e incentivo ao aleitamento materno tornam-se cada vez mais relevantes / Introduction - Obesity is increasing significantly, including in children and adolescents, and brings with it severe comorbidities. Breastfeeding has been linked as a prevention of many diseases and, in recent years, it has been observed the protective role of breastfeeding against childhood obesity. Objective - To investigate the prevalence of overweight and its relationship with duration of breastfeeding in children 48 to 60 months. Methods - Cross-sectional study in which anthropometric data (weight and height) of children 48-60 months of public schools of CapitólioMG, for calculation of body mass index (BMI) and their nutritional classification. Were also collected, through a questionnaire answered by the child\'s mother, data of breastfeeding duration, introduction of tea, other kind of milk and current feeding, as well as demographic and socioeconomic variables. Overweight was considered the outcome variable. The main explanatory variable was breastfeeding and the control variables were current feeding and demographic and socioeconomic variables. The relationship between the outcome and explanatory variables was assessed through logistic regression. Results - The prevalence of overweight children was 9.59 per cent . Exclusive breastfeeding (EBF) until 6 months or more was offered to 32.11 per cent of children, with 18.81 per cent of the surveyed population never received EBF. This study suggests a positive relationship between the presence of EBF and prevention of overweight in children 48 to 60 months for the category of EBF for 6 months or more ( OR = 0.15, 95 per cent CI 0.03 to 0.77, p = 0.023). Similar relationship was not found for total breastfeeding. Final Thoughts: The EBF, and its benefits have been proven in the literature, the present study showed a protective effect against childhood obesity, even after multivariable logistic analysis that included control variables. The investment in promotion, protection and encouragement of breastfeeding policies become increasingly relevant

Pediatric obesity is a major public health epidemic with serious physical and psychological consequences. Difficulty engaging families in treatment is a significant obstacle in addressing pediatric obesity, especially among underserved populations. Motivational interviewing (MI) is a collaborative, person-centered communication style that has been shown to reduce attrition, increase attendance, and improve patient treatment adherence; however, little is known about the process of MI and how it improves treatment engagement. This study examined clinician and parent language in a pre-treatment MI session that increased initial engagement in a parent- focused pediatric obesity intervention (N= 81). Results showed that increased parent change talk, and preparatory language in particular, was positively related to the likelihood of initial attendance at baseline. Additionally, certain types of MI consistent clinician strategies were positively associated with parent change talk. Complex positive reflections were correlated with preparatory language and overall change talk, suggesting this might be a particularly important MI skill. Findings have implications for better understanding the process of MI and mechanisms through which MI can improve treatment engagement.