agentes educativos vs obesidade
TRANSCRIPT
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(In)Dependências AlimentaresAgentes Educativos vs. Obesidade Infantil
André BentoTéc. Sup. Desporto – CPSS
Membro SPEO
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FACTO
Andrew Midllebrook in PRACTICE 2008, Lisboa
80% das crianças obesas podem tornar-se adultos, também, obesos, sendo esta probabilidade ainda mais elevada quando ocorre na adolescência
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ESTUDO DA COMPOSIÇÃO CORPORAL NO CPSS
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PRÉ-ESCOLAR vs IMC - CPSS[n=138; 63 raparigas; 3, 4 e 5 anos]
(Bento & Colaço, 2012)[unpublished data]
26,1%
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CATL vs IMC - CPSS[n=96; 44 raparigas; 1º Ciclo]
(Bento, 2012)[unpublished data]
28,1%
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CATL vs %MASSA GORDA - CPSS[n=96; 44 raparigas; 1º Ciclo]
(Bento, 2012)[unpublished data]
40,6%
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PEARSON CORRELATION - CPSS[n=84; 37 raparigas; 1º Ciclo]
(Bento, Banana & Furtado 2012)[unpublished data]
0 2 4 6 8 10 120
1
2
3
4
5
6
7
f(x) = − 0.0904317386231039 x + 3.3486970050564R² = 0.0213473687078831
Correlação Aptidão Aeróbia vs IMC
Percentis P3 a P97 (1 a 11)
Aptid
ão A
erób
ia (0
a 4
)
3 4 5 6 7 8 9 10 110
1
2
3
4
5
6
7
f(x) = − 0.107279308264629 x + 3.46601648904082R² = 0.0193700011707193
Correlação Aptidão Aeróbia vs %MG (Bioimpedância)
Percentis P2 a P98 (1 a 10)
Aptid
ão A
erób
ia (0
a 4
)
ρ=-0,15ρ=-0,14
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H
1º CICLO -----------> 2º CICLO
DecréscimoNº refeições diárias
(p=.033)
Consumo de sopa(p=.000)
Consumo de Fruta(p=.018)
AumentoTelevisão e jogos>2h/dia
(p=.000)
Consumo de molhos(p=.000)
HÁBITOS E OBESIDADE (1º E 2º CICLOS)[n=455; 217 raparigas]
p=,019
p=,095
Prevalência de Excesso de Peso ou Obesidade(adap. Costa et al, 2010)
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Normoponderais Obesidade
+ tempo a
caminhar
(p=.013)
+ tempo a correr
(p=.012)
+ vezes a correr ou
caminhar
(p=.016; p=.023)
+ tempo em pé
paradas
(p=.013)
RECREIO vs DURAÇÃO E FREQUÊNCIA DAS HM[n=30; 14 raparigas; 6-10 anos ]
t-teste
(adap. Santos et al, 2010)
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Much too thin
A bit too thin
About the right size
A bit too fat Much too fat05
1015202530354045 40.6
12.59.2
14.1
30.8
15.611.6
7.511.7
33.3
European Journal of Public Health
BoysGirls
Body Image
Expo
sure
to b
ully
ing
%
OVERWEIGHT, BODY IMAGE AND BULLYING[n=4781; 11, 13 e 15 anos]
(p=,000)U-shaped pattern (adap. Brixval et al, 2011)
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Normal weight Overweight Obese0
5
10
15
20
25
30
10.5
16.919.4
9.9
16.8
27.3
European Journal of Public Health
BoysGirls
Weiht Satus
Expo
sure
to b
ully
ing
%OVERWEIGHT, BODY IMAGE AND BULLYING
[n=4781; 11, 13 e 15 anos]
(pboys=,012 ; pgirls=,001 ) (adap. Brixval et al, 2011)
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JU
5th grade
8th grade
0%10%
20%30%
40%50%
60%70%
80%90%
100%
60%
87%
39.00%
35.40%
Obesityschool w/ junk food
(University of Pennsylvania, 2012)
Instead of blaming schools, the focus should fall more squarely on parents and on advertising.
JUNK FOOD IN SCHOOLS = OBESITY??[n= 19450; 5th to 8th]
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"Interventions to increase physical activity and improve nutrition may be an effective method to improve student academic performance”
Reading Writing Math Citizenship Science0%
5%
10%
15%
20%
25%
30%
28%
23% 23%
11%
29%
NUTRITION, PHYSICAL ACTIVITY BOOST SCHOOL PERFORMANCE (ACSM, 2006)
NUTRIÇÃO ACTIVIDADE FÍSICA E A ESCOLA
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Excesso de Peso Obesidade0%
10%20%30%40%50%60%70%80%90%
100%
71,2%
22,6%Série 1
IMC vs PERCEPÇÃO PARENTAL[n=495; 235 raparigas; 9-13 anos ]
(Kappa=0,343; 95%IC:0,267-0,419; p<0,001) (Silva et al, 2010)
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Escolaridade dos pais
Prevalência de Obesidade
Infanto-Juvenil
OBESIDADE vs ESCOLARIDADE PARENTAL[n=4803; 2508 raparigas; 2-15 anos ]
(adap. Miranda et al, 2010)
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Parent Training Intervention Group
Control Group-20%
-15%
-10%
-5%
0%
5%
10%
15%
9%
-16%
Redu
ction
in o
verw
eigh
t an
d ob
ese
child
ren
"This study suggests that parents are in the ideal position to influence the long-term dietary and physical activity of their children,"
PEDIATRIC OBESITY RATES CURBED BY PARENT-TRAINING INTERVENTION
(adap. UCLA, 2012)
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ESTRATÉGIAS E PROMOÇÃO DE AF
Children tend to be more active during schooldays than at week-ends (Brettschneider & Naul, 2004)
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ESTRATÉGIAS E PROMOÇÃO DE AF
• Os pais:– Dar um bom exemplo sendo
fisicamente activos– Elogiar, mostrar interesse e
encorajar– Envolver-se nos programas
de actividades na escola e/ou comunidade
– Encorajar as crianças a serem activas em casa
– Transporte SÓ o necessário
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EXEMPLO NORTE AMERICANO
“cookery classes” for parents and their children within school community programmes, applying “learning by doing” to enhance their “calorie awareness” and restrict and modify their nutritional consumption.
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• Os pais (cont.):– Restringir TV a um n.º
limitado de horas/sem– + TV se mais tempo EM– Informar-se na escola
sobre a saúde, IMC, deficiências motoras…
– Actividades Familiares
When parents spend money on their children’s holidays and trips they should pay attention to the exercise and sport programmes in the brochures (ACE, 2006)
ESTRATÉGIAS E PROMOÇÃO DE AF
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• The researchers concluded that clinicians should focus on encouraging
parents to lose weight to help their overweight or obese child in weight
management.
• "Breast-feeding support represents an important clinical and public health
strategy to reduce the risk of childhood obesity,"
• 72 %of parents have bought things like chocolate, sweets, crisps and sugary
drinks or cereals in the last month when they didn’t intend to, after being
pestered by their child
• "the mother is the family member who best knows the nutritional needs of
children and has the strongest nutritional knowledge for the preparation of
children's meals"
CITAÇÕES INTERNACIONAIS
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• Strategies that have been linked to better outcomes include:
– As a family, identify specific behaviors that should be changed.
– Set goals and monitor progress. The goals should be clearly defined, such as reducing or
limiting television screen time to no more than two hours per day.
– Provide a home environment that encourages healthier choices. For example, limit
temptations at home, such as higher calorie desserts, while providing access to a variety of
fruits from which children can choose.
– Parents should praise their children's progress and, instead of criticizing, use "slips" as an
opportunity to help children identify ways to make different choices if the same situation
arises again.
– Food shouldn't be a reward or withheld as punishment.
– Keep track of progress toward goals, using a written or online tracker.
CITAÇÕES INTERNACIONAIS
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DESCULPAS PARA (não) SE EXERCITAR?