Behavioural strategies to encourage dietary change in primary school aged children to prevent obesity

Systematic Review
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Contents
Abstract............................................................................................................................................3
Title - "Behavioural strategies to encourage dietary change in primary school aged children to
prevent obesity"...............................................................................................................................3
Introduction to review subject.........................................................................................................3
Methods...........................................................................................................................................5
Presentations of results/ Findings....................................................................................................6
Data interpretation and discussion...................................................................................................9
Conclusion.....................................................................................................................................10
References......................................................................................................................................12
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Abstract
Obesity in childhood is now becoming a global issue all over the world and the major
factors which affect regulation of weight and development of obesity among children are the
outcome of large number of environmental, social, economic, behavioural and biological factors
as well as the complex interactions among them which promote positive balance of energy. The
alterations in dietary habits along with sedentary lifestyle adoption increases manifold diseases
related to obesity as well as complications associated with them. An obese child grows up and
become an obese adult. Thus, primary prevention with methodical diet control play a significant
role in reducing the chances of obesity. Apart from this physical activity and behavioural
changes are also important strategies that help in battle against childhood obesity. In this
systematic literature review, the behavioural strategies to promote dietary change children are
reviewed for addressing the issue of obesity in children and preventing it. In order to effectively
intervene with obese and overweight children, it is very important that the primary care givers as
well as the behavioural interventionists work in order to execute healthy behaviours among
children and encourage dietary change among them in order to prevent obesity.
Title - "Behavioural strategies to encourage dietary change in primary school
aged children to prevent obesity"
Introduction to review subject
Childhood obesity in developing and developed countries has reached epidemic level.
Around 70% of adolescent grow up obese and become obese adults. From last 20 to 30 years,
increasingly high overweight and obesity rates have been reported irrespective of income status
and socioeconomic status. An increasing evidence of plateauing is also seen in some of the age
groups. The forces participating in obesity development and weight regulation in children
involved environmental factors, developmental and genetic influences. The relative significance
of each of the mechanism is subject of continuous research as well as probably varies
considerably among populations and individuals. The quickly changing habits of diet with
sedentary lifestyle adoption maximizes enormously the non-communicable diseases related to
obesity involving type 2 diabetes mellitus, insulin resistance, metabolic syndrome, etc. Greater
social inequality related to increased chances of obesity is seen in developed countries, contrary
to developing Nations. Once obesity is developed, it is very much difficult to reverse by
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interventions. In relation to this, primary prevention plays a significant role besides incorporating
strategies associated with diet control, physical activity and behavioural changes.
The criteria for assessment of obesity in childhood have been subject of research and debate.
As various co-morbidities are related to obesity, thorough examination is important and it must
involve linear growth and blood pressure review. Periodic measurement of fasting glucose level
or haemoglobin A1c, fasting lipid profile and aminotransferase levels is recommended for
children with obesity. There are various key determinants related to childhood obesity however,
reduced physical activity and faulty dietary habits remain significant issues. Due to much intake
of energy dense fast foods available in school vending machines, school neighbourhood and
school cafeteria with low knowledge regarding dietary elements in school children, often there is
increased intake of calorie per body weight per day. The overfeeding practice for babies with low
birth weight for catch up growth, if consistent, then later contributes to obesity. Apart from this,
there are urbanisation and social cultural factors like forced feeding by parents, overprotection,
low knowledge regarding nutrition in parents as well as caregivers and false traditional believes
regarding health and nutrition are also contributing to obesity. Moreover, limited availability of
parks and open spaces because of illegal settlements and population expansion along with fast
food outlets as well as eating points abundance maximize the chances of child to become obese.
The American academy of paediatrics administers a staged approach to weight management of
paediatric. Various factors influence the treatment at initial stages involving previous weight
management history, body mass index percentile and age. The recommendations focus on
counselling on prevention of obesity irrespective of previous treatment history or body mass
index percentile. Some additional interventions in order to address obesity or overweight is
classified into stages involving Stage 1 - prevention; Phase 2 - structure weight management;
Phase 3 - comprehensive multidisciplinary evaluation; and Phase 4 - representing escalating
supervision, intervention and counselling degrees. All the care professionals unanimously agree
on the fact that prevention is the main strategy to control current obesity epidemic. It may
involve primary prevention of obesity or overweight itself, secondary avoidance or prevention of
weight regain by following weight loss as well as prevention of further increase in weight in
obese people unable to lose their weight. Currently, the exclusively emphasised approaches are
based on dietary modifications, exercise and behavioural changes of individuals. It is found that
these strategies have had less influence on growing rise of epidemic of obesity. Thus, the
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