Agentes Educativos vs Obesidade

(In)Dependências AlimentaresAgentes Educativos vs. Obesidade Infantil

André BentoTéc. Sup. Desporto – CPSS

Membro SPEO

andrebento@CPSSbeja.org

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

ESTUDO DA COMPOSIÇÃO CORPORAL NO CPSS

CLASSIFICAÇÕES PERCENTÍLICASIMC

andrebento@CPSSbeja.org

%MG

PRÉ-ESCOLAR vs IMC - CPSS[n=138; 63 raparigas; 3, 4 e 5 anos]

(Bento & Colaço, 2012)[unpublished data]

26,1%

CATL vs IMC - CPSS[n=96; 44 raparigas; 1º Ciclo]

(Bento, 2012)[unpublished data]

28,1%

CATL vs %MASSA GORDA - CPSS[n=96; 44 raparigas; 1º Ciclo]

(Bento, 2012)[unpublished data]

40,6%

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(Bento, Banana & Furtado 2012)[unpublished data]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

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)

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)

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)

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)

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]

"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

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)

Escolaridade dos pais

Prevalência de Obesidade

Infanto-Juvenil

OBESIDADE vs ESCOLARIDADE PARENTAL[n=4803; 2508 raparigas; 2-15 anos ]

(adap. Miranda et al, 2010)

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)

ESTRATÉGIAS E PROMOÇÃO DE AF

Children tend to be more active during schooldays than at week-ends (Brettschneider & Naul, 2004)

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

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.

• 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

• 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

• 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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OBRIGADO PELA ATENÇÃO

andrebento@CPSSbeja.org