Promotion of healthy weights at preschool public health vaccination clinics in Calgary: an obesity surveillance program.

OBJECTIVE: To evaluate the acceptability and feasibility of a surveillance program of overweight and obesity in preschool children in Calgary, and to provide advice for families to promote healthy weights. PARTICIPANTS AND SETTING: Children (mean age 4.9+/-0.6 years) attending pilot-site clinics in September 2002 and all clinics in Calgary between February 2003-December 2003 (n=7048). INTERVENTION: The growth assessment protocol and resources supported a three-pronged approach to promote healthy weights (healthy eating, active living and positive body image). Public health nurses were trained in standardized measurement techniques and information resources. Links with physicians were made to facilitate continuity of care. Children's weight and height measurements were plotted on the Weight-for-Stature growth chart and used to identify children as obese (> or =95th percentile), healthy weight (> or =5th, <95th) or underweight (<5th). Subsequent analysis calculated the Body Mass Index (BMI)-for-Age to identify overweight children (> or =85th, <95th percentile). The protocol was pilot tested and subsequently implemented in all Calgary public health clinics. OUTCOMES: The majority (98%) of parents were either very happy or happy with information received during the visit. Public health nurse counselling confidence significantly improved after the pilot (p<0.001). Data indicated that 9% of children were obese, 15% were overweight and 3% were underweight. INTERPRETATION: This approach to identifying children's weight status appeared satisfactory to stakeholders, maximized use of existing resources to establish a surveillance program for Calgary, and provided an opportunity to give parents health-promoting advice on healthy weights.

Diet, obesity and education in three age groups of Saskatchewan women.

Research on relationships between socioeconomic status and Canadians' diet is limited. The current study investigated differences by education in dietary variables shown to be related to obesity; it included three age groups of Saskatchewan women who participated in the 1992 to 1993 Heart Health Intervention Evaluation baseline study. Multistage sampling was used to select randomly from the Saskatchewan Health Insurance Registration File. The overall response rate was 42.6%; a sample representative of the general Saskatchewan population was obtained. Three-day estimated food records and demographic information from 396 women aged 18 to 74 years were subdivided into three age categories: 18 to 34 years, 35 to 54 years, and 55 to 74 years. For the 18- to 34-year group, obesity was significantly more prevalent with lower education; trends were similar for the older age groups. Under-reporting of energy intake (indicated by an energy intake:basal metabolic rate ratio of <1.1) was related to obesity but not to education. The greatest differences in diet between educational groups were observed in the 18- to 34-year group; fewer differences existed in the 35- to 54-year group, and none in the 55- to 74-year group. Health promotion efforts need to be targeted appropriately, and based on differences in dietary intakes by socioeconomic group. Research should help promote an understanding of the reasons for differences in diet by socioeconomic status.