Efeito de uma ação de aconselhamento nutricional, com uso de rede social, no enfrentamento à obesidade / Effect of a nutritional counseling activities, by using a social network, in coping with obesity

Estratégias inovadoras precisam ser adotadas para o combate à crescente prevalência de obesidade. Assim, o objetivo desse trabalho é avaliar o efeito de uma ação de aconselhamento nutricional com uso de rede social no enfrentamento à obesidade. Este é um estudo experimental do tipo antes e depois, incluindo 60 indivíduos com excesso de peso e adscritos a uma Unidade Básica de Saúde. Foi realizado de junho-outubro de 2020. As ações educativas (compartilhamento de informações sobre alimentação saudável e saúde e pactuação de desafios) foram realizadas pelo aplicativo WhatsApp®, semanalmente, por 16 semanas. Foram coletadas informações sociodemográficas, econômicas, clínicas, antropométricas, sobre consumo alimentar e exames bioquímicos. Os dados foram comparados por teste de Wilcoxon ou Kappa. A maioria dos participantes era do sexo feminino e 36,4% com diagnóstico de hipertensão. Após a intervenção, verificou-se redução de circunferência da cintura (antes:107,3±11,4; depois:105,6±11,5 cm, p=0,004), colesterol total (antes:205,9±48,3; depois:191,5±34,3 mg/dL, p<0,001) e LDL-c (antes:132,4±37,8; depois:120,2±29,3 mg/dL, p<0,001). A ação foi capaz de promover reduções de marcadores corporais de obesidade e de descompensações metabólicas associadas a obesidade, demonstrando a importância de intervenções inovadoras que possam somar a outras intervenções e facilitar a adesão do público.

Innovative strategies need to be adopted to combat the growing prevalence of obesity. Thus, the aim of this study is to evaluate the effect of a nutritional counseling activity using a social network in coping with obesity. This is a before-and-after experimental study, including 60 overweight individuals enrolled in a Primary Care Center. It was carried out from June to October 2020. Educational actions (sharing information about healthy eating and health and agreeing on challenges) were carried out through the WhatsApp® application, weekly, for 16 weeks. Sociodemographic, economic, clinical, anthropometric, food consumption, and biochemical data were collected. Data were compared by the Wilcoxon or Kappa test. Most participants were female and 36.4% had a diagnosis of hypertension. After the intervention, there was a reduction in waist circumference (before:107.3±11.4; after:105.6±11.5 cm, p=0.004), total cholesterol (before:205.9±48, 3; after:191.5±34.3 mg/dL, p<0.001), and LDL-c (before:132.4±37.8; after:120.2±29.3 mg/dL, p<0.001). The activity was able to promote reductions in body markers of obesity and metabolic imbalances associated with obesity, demonstrating the importance of innovative interventions that can add to other interventions and facilitate public adherence.

Obesity in Singapore: Prevention & Control

Obesity is increasing in prevalence in Singapore. This is part of a worldwide phenomenon. Action is being taken in Singapore to prevent and control obesity. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility. The basic strategy of obesity prevention and control however is quite straightforward and lies in achieving the caloric balance which is to reduce calorie intake and increase physical activity. To be effective however, obesity prevention and control requires multiple prevention and control interventions across the lifespan. There is a need for Health Promotion Board (HPB) to engage and mobilise various partners and stakeholders. Policies and programs have been customised in Singapore for different segments of the population and conducted at various settings – in schools, workplaces, healthcare institutions, and communities. The current efforts to prevent and control obesity in Singapore can be grouped into 5 areas: (1) Health promotion policies;(2) Promoting supportive environments through social programmes; (3) HPB collaborating with partners to promote healthy behaviour; (4)Empowering partners and individuals; and (5) Raising awareness through health education and communication.

Short Term Effects of School-Based Obesity Control Programs Performed on Elementary Students

BACKGROUND: Childhood obesity leads to a high possibility of adult obesity. Previous studies show cases of research on obesity control programs led by doctors specializing in obesity, and dietitians. However, no such research have yet targeted schools, where such obesity control program are led by the school's staff (dietitian, school nurse and physical education teacher) instead. Thus, this research set out to determine whether obesity control programs could be effectively utilized within elementary schools as a part of the school health problems. As a start, a book on Elementary School Obese Children Control Program was used as the main text to provide the basics of the program. METHODS: The research was targeted at an elementary school located in NoWon district, where 16 moderate obese children from grades 3 to 6, were chosen to participate in training once every week for 6 weeks, together with exercises once every week for 5 weeks. RESULTS: The evaluation of the obesity control program showed significant results in obesity index, body fat and HDL-cholesterol. The school nurse contacted each student's teacher every day and an exercise or training was scheduled, so that students could participate in the program. This contributed to a high participation rate, with an overall participation rate reaching 85% and an exercise participation rate reaching 79%. During the evaluation of the program, it was found that the regular exercises carried out once a week in the school led the students to get in the habit of exercising regularly after school. CONCLUSION: It is considered that there would be a considerable change in childhood obesity control if the school nurse, dietitian and physical education teachers each played a part in carrying out an obesity control program as part of the school health care.

Factors influencing weight control behavior and intention of obese children and adolescents / 예방의학회지

This study was undertaken to explain weight control behavior and intention of obese children and adolescents as measured by the elements of the health belief model. A total of 732 obese students from 28 schools in Seoul metropolitan area and their mothers were assessed with a self-administered questionnaire. The analyzed results are as follows; l. Among obese students, 45.3% of male students and 57.2% of female students, a significantly higher portion than male students, reported that they had tried to lose weight within the recent year. Exercise was the most frequently used method to lose weight followed by diet control, drug use, and specialized clinic visits, in descending order. 2. Male students were more likely to try to lose weight if they perceived a low threat level and their mother had a job, and female students were more likely to try to lose weight if they were younger in age, perceived a low threat level and had strong external motivating factors. 3. Female students showed a significantly higher level of intention to obesity control than male students, and the intention level of their mothers also showed the same trend. 4. In male students, the degree of weight dissatisfaction, weight control experience, the level of obesity related beliefs of students, the educational level of the mother and economic status of the family were significant predictors of intention to obesity control, and in females, age, the level of obesity related beliefs of students and intention of their mothers were significant. In the mothers of male students, obesity index of students, age of the mother and the level of obesity related beliefs of the mother were significant predictors of intention of the mother, and in the mothers of female students, obesity index of students, occupational status of the mother and obesity related beliefs of the mother were significant. 5. According to the path model of intention to obesity control, the degree of weight dissatisfaction had the most powerful effect in male students, and perceived net benefit level was the most important variable in female students. Since the weight control behavior and intention of obese students were more predictable by the degree of weight dissatisfaction than the obesity index, we can conclude that only the students dissatisfied with their weight are well motivated for obesity control. There can be a discrepancy between the mother and her child's beliefs and intention status(especially in male students), so the therapists should also assess the student's opinion as well as the mother's. In female students, the perceived net benefit level was the most important predictor of intention to obesity control, therefore the intervention program should pay particular attention to the positive benefits of weight control rather than negative aspects(threats) of obesity.

Development of an OPD-based childhood obesity control program and the effects of its utilization

BACKGROUND: Although childhood obesity is an increasing public health problem in our society and a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to deveIop and measure the effects of an OPD-based childhood obesity control program. METHOD: 'The OPD-based childhood obesity control program was developed by reviewing the preexisting literature and consulting specialists. It was applied to the 4-6th grade obese(obesity index >or=30% ) children. The effects of intervention were assessed by the changes in obesity-related behavior, caloric and nutrient intake and exercise amount. The effects in the OPD-based group (group I) were also compared with the school-based group (group II) and the no intervention group (group III). RESULTS: The OPD-based program was developed based on behavioral modification principles such as self monitoring, stimulus control, positive reinforcement, social support, cognitive change and behavioral contracts and contained diet and exercise therapy. The developed program was applied to 34 pairs(child and mother) in the treatment group of which 21 pairs completed the basic session and 17 pairs completed the additional follow up session. Significant changes, decreases, in obesity index were observed In the OPD-based group. No significant changes were found in the school-based group whereas increased degrees of obesity were found in the no intervention group. Obesity related behavior scores were significantly increased in both the OPD- and school-based groups. The children in both the OPD-based group showed significant decrease in dietary intake and increase in exercise amount. CONCLUSION: Although it was a short-term treatment result, the OPD-based program was more effective than the school-based program in childhood obesity control. We suggest that a control program of comparable intensity and individualization as ours is required, for effective childhood obesity control.