Improving overweight among at-risk minority youth: results of a pilot intervention in after-school programs.

Childhood overweight and obesity disproportionately affect low-income communities. Most school-based health promotion efforts occur during the school day and are limited in scope. This study evaluated the effectiveness of an after-school program among 3rd-5th graders (n=121; 73% 8 to 9 years old; 57% female; 60% Asian) at eight study sites (four intervention, four comparison). After-school staff were trained on implementing the Catch Kids Club Curriculum on nutrition and physical activity. Data were collected on students' nutrition and physical activity knowledge and behavior, and their height and weight measurements. Using Stata 10.1/SE, cross-lagged regression models assessed changes over time. Results showed a reduction in overweight and obesity (defined as body mass index >85th percentile for age and sex) among children in the intervention group, but mixed results regarding diet and physical activity knowledge and behavior. Enhancing after-school physical activity opportunities through evidence-based programs can potentially improve overweight and obesity among low-income children.

Latina mothers' perceptions of healthcare professional weight assessments of preschool-aged children.

To understand Latina mothers' definitions of health and obesity in their children and perceptions of physician weight assessments. 24 low-income Spanish speaking Mexican mothers of children ages 2-5 years were recruited to participate in 4 focus groups. Half of the mothers had overweight or obese children and half had healthy weight children. Focus group comments were transcribed and analyzed using grounded theory. Themes and supporting comments were identified independently by 3 reviewers for triangulation. A fourth reader independently confirmed common themes. Mothers define health as a function of their child's ability to play and engage in all aspects of life. Obesity was defined with declining physical abilities. Mothers state health care provider assessments help determine a child's overweight status. Causative factors of obesity included family role-modeling and psycho-social stress, physical inactivity, and high-fat foods consumed outside the home. Controlling food intake was the primary approach to preventing and managing obesity but mothers described family conflict related to children's eating habits. These findings held constant with mothers regardless of whether their children were overweight, obese, or at a healthy weight. Mothers utilize physical limitations and health care professional's assessment of their child's weight as indicators of an overweight status. These results highlight the importance of calculating and communicating body mass indices (BMI) for Latino children. Eliminating non-nutritive foods from the home, increasing physical activity, and involving family members in the discussion of health and weight maintenance are important strategies for the prevention and management of childhood obesity.

Introduction of solid food to young infants.

Timing of the first introduction of solid food during infancy may have potential effects on life-long health. To understand the characteristics that are associated with the timing of infants' initial exposure to solid foods. The 2000 National Survey of Early Childhood Health (NSECH) was a nationally representative telephone survey of 2,068 parents of children aged 4-35 months, which profiled content and quality of health care for young children. African-American and Latino families were over-sampled. Analyses in this report include bivariate tests and logistic regressions. 62% of parents reported introducing solids to their child between 4-6 months of age. African-American mothers (OR=0.5 [0.3, 0.9]), English-speaking Latino mothers (OR=0.4 [0.2, 0.7]), White mothers with more than high school education (OR=0.5 [0.2, 1.0]), and mothers who breastfed for 4 months or longer (OR=0.4 [0.3, 0.7]) were less likely to introduce solids early. Most parents (92%) of children 4-9 months of age reported that their pediatric provider had discussed introduction of solids with them since the child's birth, and provider discussion of feeding was not associated with the timing of introduction of solids. Although most parents recall discussing the introduction of solid foods with their child's physician, several subgroups of mothers introduce solid foods earlier than the AAP recommendation of 4-6 months. More effective discussion of solid food introduction linked to counseling and support of breastfeeding by the primary health care provider may reduce early introduction of solids.

Participatory prevention research model promotes environmental change for healthier schools.

Barriers exist to healthy eating and physical activity for children in the school environment. Modifiable school environmental factors have led to the development of the Nutrition Friendly Schools and Communities (NFSC) model to prevent the development of overweight in school children and adolescents. The design of the NFSC environmental intervention is to actively engage the school community to prevent overweight in school-aged children. This article presents data measuring the environmental changes achieved by the Los Angeles Unified School District (LAUSD) elementary schools participating in a 3-year participatory research pilot study funded by the Centers for Disease Control and Prevention (CDC). An objective of the pilot study is to determine whether any or all of the 15 steps developed for the NFSC model could be implemented. Further, researchers want to know if any of the study schools could implement the NFSC model as a whole during the allotted time of the pilot study.

A school salad bar increases frequency of fruit and vegetable consumption among children living in low-income households.

OBJECTIVE: To measure change in fruit and vegetable (F&V) consumption among elementary-school children after the introduction of a salad bar programme as a lunch menu option in the US Department of Agriculture's (USDA) reimbursable lunch programme in Los Angeles Unified School District (LAUSD). DESIGN: A cross-sectional sample of children was interviewed before and after a salad bar intervention (1998 and 2000, respectively) utilising a 24-hour food recall questionnaire. Frequencies of F&V consumption were calculated. SETTING: The evaluation took place in three LAUSD elementary schools participating in the salad bar programme and the USDA reimbursable lunch programme. SUBJECTS: Three hundred and thirty-seven children in 2nd-5th grade (7-11 years old). RESULTS: After the salad bar was introduced, there was a significant increase in frequency (2.97 to 4.09, P < 0.001) of F&V consumed among the children studied. The increase in frequency of F&V consumed was almost all due to an increase during lunch (84%). Mean energy, cholesterol, saturated fat and total fat intakes were significantly lower in the children after the salad bar was introduced in the schools compared with the intakes in the children before the salad bar was introduced. CONCLUSION: A salad bar as a lunch menu option in the USDA reimbursable lunch programme can significantly increase the frequency of F&V consumption by elementary-school children living in low-income households.

Overweight in urban, low-income, African American and Hispanic children attending Los Angeles elementary schools: research stimulating action.

OBJECTIVE: This study was undertaken to establish the prevalence and severity of nutritional problems among low-income children of elementary school age in the Los Angeles Unified School District (LAUSD) in order to collect baseline data to inform policy-makers. DESIGN AND METHODS: A cross-sectional survey of children in 14 elementary schools was conducted from January to June, 1998. Nine hundred and nineteen children were measured and interviewed. The planning, design and data analysis were carried out in collaboration with key LAUSD policy-makers. RESULTS: More than 35% of the sample was classified as being at risk for overweight or overweight according to body mass index. CONCLUSION: There is a high prevalence of children who are at risk for overweight or who are overweight in Los Angeles. This finding has triggered the development of multiple school-based intervention programmes.

Breast milk expression in the workplace: a look at frequency and time.

The objective of this article is to study a barrier for breastfeeding women working full-time outside the home: breast milk expression in the workplace. Data are from a large corporation that provides employee benefits. Mothers express breast milk about twice a day when infants are 4 months old (x = 2.2 +/- 0.8) and 6 months old (x = 1.9 +/- 0.6), with a significant decline in frequency (P <.05) comparing the 2 age groups. Most mothers spend 1 hour or less expressing breast milk when infants are 3 (82%) or 6 months old (96%), with a significant difference (P <.05) between the 2 age groups. Mothers of younger infants were no more likely to work fewer days per week than were mothers of older infants. Most women can express breast milk for 3- and 6-month-old infants in less than an hour, distributed in about 2 separate portions, in an employment environment supportive of breastfeeding.