Percorrer por autor "Silva, Ana Lúcia"
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- Características socioeconómicas e obesidade infantil no âmbito do projeto comunitário MUN-SI 2008-2011Publication . Doroana, Érica; Silva, Ana Lúcia; Carvalho, Maria Ana; Rito, Ana Isabel
- Demographic variables and childhood obesity community-based programme in PortugalPublication . Baptista, Patrícia; Silva, Ana Lúcia; Ramos, Carlos; Carvalho, Maria Ana; Rito, AnaBACKGROUND: It is well known that obesity is one of the most Public Health’s concerns especially among children. Recent data reports that childhood obesity in Portugal increased in the last years, representing nowadays 32.1% of overweight and 14.5% of obesity (1). Family, as the primary children source of social learning, habits and behaviors’ influence and exposure have shown a basic determinant to food and physical activity children’ choices (2,3,4). The role of family and parental factors in childhood obesity suggests that single-parent, no siblings and small family size are associated with larger increases in BMI (2,3,5,6). Family provides social and interpersonal support that is instrumental in shaping and maintaining eating and physical activity behaviors, community-based health programmes focus also on family educational policies and strategies have been developed in some European Countries, showing relevant impact on health patterns and a decrease on childhood obesity prevalence’s (7,8). METHODS: This study is framed from a longitudinal municipal project (MUNSI), which included 3173 children (6-9 years old) from 167 public schools conducted on five municipalities (Viana do Castelo, Fundão, Oeiras, Seixal and Montijo). Childhood nutritional status was assessed by anthropometric parameters (weight and height) considering the CDC growthcharts criteria percentiles of BMI. Children’s food habits, socioeconomic condition and parent’s level education were collected by a family questionnaire. The Odds Ratio was calculated with a 95% Confidence Intervals. RESULTS: Prevalence of childhood overweight (BMI≥P85) was 32.1%, and 14.3% for obesity (BMI≥P95). According to family characteristics the data showed that a small family size is associated with larger increases in BMI (OR=1.6; 95%CI: 1.1-2.3). It was also observed that having a lower level of education, a lower socioprofessional status and a household income of less than €1500 were risk factors statistically significant (p <0.05) for the development of childhood obesity, with an inversely association with the prevalence of childhood obesity. CONCLUSION: The data have shown that obesity was not independent from parent's socioeconomic and educative level, where these two conditions seem to be more likely to develop childhood Overweight. This knowledge identifies additional childhood obesity causes that could be useful as effective interventions at local level in order to reverse the obesity trends in Portuguese children and promote a future healthy life style.
- Demographic variables and childhood obesity in a community-based program in PortugalPublication . Silva, Ana Lúcia; Ramos, Carlos; Carvalho, Maria Ana; Rito, AnaINTRODUCTION: The prevalence of overweight and obesity have been increasing consistently throughout the European Union, especially in Portugal, affecting everyday a higher number of children and adolescents. A community-based program in health promotion can identify the main areas of action for the protection of the population against health threats and the promotion of guidelines that can lead to healthier life-styles. Adequate urban environments could be one of the main areas of action for obesity prevention. METHODS: This study is framed from a longitudinal municipal project (MUNSI), which included 3173 children (6-9 years old) from 167 public schools. Childhood obesity was assessed by anthropometric parameters (weight and height) considering the Centers for Disease and Control and Prevention (CDC) growthcharts criteria of percentiles of Body Mass Index (BMI). Demographic variables (typology of urban area and familiy household) were collected by a self-response family questionnaire. The Odds Ratio was calculated with a 95% Confidence Intervals. RESULTS: Children who lived in urban areas showed higher obesity prevalence (14.6%) compared with those residing in rural areas (13.3%) associated also with higher odds (OR= 1.15; 0.8-1.66). According to Family household, single child families showed higher obesity prevalence (17.1%) with a OR=1.6 (1.1 - 2.3) compared to families who had more than one child. CONCLUSION: Environmental factors such the typology of urban area and family household should be considered important contributing factors for childhood obesity. Future research should attempt to quantify and elucidate, more precisely, the epidemiology of these conditions.
- Influence of child and maternal variables on childhood obesity in the municipalities of Fundão, Montijo, Oeiras, Seixal and Viana do CasteloPublication . Coelho, Filipa; Silva, Ana Lúcia; Ramos, Carlos; Carvalho, Maria Ana; Rito, AnaBACKGROUND: Childhood obesity has been considered a global epidemic and its prevalence has increased worldwide in the last decades. Such trends as gain special interest in the scientific community and their causes have been large studied. In this context it is recognized the importance of more study on obesity’ influences. According to the literature childhood obesity is linked with some child and maternal features. This study aims to evaluate the relationship between child and maternal variables and childhood obesity in school aged children from Fundão, Montijo, Oeiras, Seixal and Viana do Castelo municipalities. METHODS: Longitudinal study developed into three periods (2008-2011). The present data results from the first stage. 167 public schools were selected from the 5 municipalities, where 3851 children were included. The nutritional status was evaluated according the Centers for Disease Control and Prevention (CDC, 2000) growthcharts criteria percentiles of Body Mass Index (BMI) and the child and maternal variables was obtained from a self-response family’ questionnaire. The statistics analysis was obtained through descriptive analysis and Binomial Logistic Regression Model was used and the odds ratios for confidence intervals were set at 95 %. RESULTS: 3173 children was evaluated, 50.6% were female with a mean age of 7.5 years (± dp=0.8). The prevalence of overweight was 32.1% (BMI≥P85) and 14.3% was obese (BMI≥P95). Childhood breastfeeding occurred in almost children (90.1%) and showed a protective association with childhood obesity (childhood not-breastfeeding OR=1.6; 95%CI: 1.1-2.2). High children birthweight was positively associated with childhood obesity (OR=2.5; 95%CI: 1.3-4.6). The durability of breastfeeding, maternal weight, gestational age and maternal age did not show relevant link with childhood obesity. CONCLUSION: The child and maternal variables are associated with the development of childhood obesity, however in the present study, just not-breastfeeding and children birth weight showed a statistic link with childhood obesity. Furthermore investigation is useful in order to validate these results, and better understand the influence of child and maternal factors on child development.
- Munsi: A Community-based ProgrammePublication . Silva, Ana Lúcia; Ramos, Carlos; Carvalho, Maria Ana; Rito, AnaBACKGROUND: The prevalence of overweight and obesity have been increasing consistently throughout the European Union (EU), especially in Portugal, affecting, everyday, a higher number of children and adolescents. Portugal has one of the most negative scenarios in Europe, one of the countries with the highest prevalence of childhood obesity, representing nowadays 32.2% of overweight and 14.6% of obesity, and also one of the highest prevalence of physical inactivity in the EU. A community-based action program in health promotion can identify the main areas of action for the protection of the population against health threats and the promotion of guidelines that can lead to healthier life-styles. Therefore, nutrition and physical activity-linked problems, in particularly obesity, are specific health concerns for which health promotion strategies are set, where the role of local authorities is clear, whether in physical activity interventions, creation of adequate urban environments and the availability of healthy foods in the school community. MUNSI Project works from the cooperation between the Ministry of Health (DGS/PCO), the Municipalities of Fundão, Oeiras, Montijo, Seixal and Viana no Castelo, and University Atlântica, which has, as main objective, the development of a local Integrated System of childhood Nutritional surveillance at family and school level. METHODS: A cross-sectional study was conducted on five municipalities (Viana do Castelo, Fundão, Oeiras, Seixal and Montijo), which included 3173 children (6-9 years old), attending the universe of public elementary schools (n=167).This Project embodies three stages (from 2008 to 2011): assessment of the nutritional status of children according to the classification criteria of the Centers for Disease Control and Prevention (CDC, 2000) for body mass index (BMI), relating with socioeconomic, demographics and environmental factors with health, collected by a family questionnaire. The children BMI and school characteristics were collected by Municipality examiners/field workers, submitted to anthropometric training sessions and information of children’s nutritional status. A specific intervention in health promotion for children was implemented at school level through a set of training activities involving teachers, school assistants and cookers, based on healthy lifestyle and healthy food habits, specially fruits and vegetables, also physical activity promotion at school and family environment. The impact of the program has been assessed during the scholar year (2010/2011) through monitoring and evaluating the dimensions firstly selected. RESULTS: During the first year of the project, 150 schools participated and 3173 children were assessed. 50.6% were female and the mean age was 7.5 years (±0.8). The prevalence of childhood overweight was 32.1% (BMI≥P85), of which 14.3% were obese (BMI≥P95). Family, as the primary children source of social learning, habits and behaviors’ influence, was associated with children´s food choices and physical activity. According to this dimension the data showed that small family size was associated with higher children´s BMI (OR=1.6; 95%CI: 1.1-2.3). It was also observed that having a lower level of education, a lower socioprofessional status and an household income of less than €1500 were risk factors for the development of childhood obesity, statistically significant (p <0.05). Children’ short sleep duration (≤8 hours/day) showed also an association with childhood obesity (OR=1.5; 95%CI: 1.1-2.1). In relation to child and maternal variables, 90.1% of mothers breastfed their children. Children with high birth weight and that were not breastfed showed an association with overweight: (OR=2.5; 95%CI: 1.3-4.6) (OR=1.6; 95%CI: 1.1-2.2) respectively. The duration of breastfeeding, maternal weight, gestational age and maternal age did not show to be a risk factor for childhood obesity. Related to children food frequency we observed that most children (96.9%) took breakfast every day; a large part of the children ate lunch at school (84.1%) and 15.8% ate lunch at home. The results showed that children who had a daily consumption of sweets showed higher risk in developing obesity (OR=2.3; 95%CI: 1.2-4.3)and the opposite was observed for those who include more than once a day a vegetable soup on their daily diet, representing a protective factor for childhood obesity (OR=0.6; 95%CI: 0.3-1.0). CONCLUSION: The results confirm the trends in children´s lifestyle that have been found in others Portuguese studies. Environmental factors such as family’s and demographics’ dimension should be considered as an important contributing factors for childhood obesity so, to better understand the epidemiology of these factors, future research should attempt to quantify and elucidate this on more precise way. The MUNSI showed to be an effective approach as a community-based programme to a better understanding of childhood obesity factors.
- Parental socioeconomic and educational level and chil overweight - lessons from a municipality based studyPublication . Silva, Ana Lúcia; Lopes, Sara; Breda, João; Rito, AnaINTRODUCTION: The prevalence of childhood obesity is rising rapidly in Portugal, reaching one of the worst positions in the European Union. Inadequate food habits with high intake of high energy dense foods, seems to be one of the main factor behind this epidemic. Family socioeconomic status also appears to be an obesogenic factor, particularly parents’ educational level and their income. To better understand the association of unbalanced dietary habits and socioeconomic environment on children nutritional status and to develop effective prevention strategies, are the main aims of this municipality study METHODS: A cross-sectional study was conducted on five municipalities (Viana do Castelo, Fundão, Oeiras, Seixal and Montijo), which included 3275 children (6-9 years old), attending the universe of public elementary schools. Childhood nutritional status was assessed by anthropometric parameters (weight and height) considering the CDC growthcharts criteria percentiles of BMI. Children’s food habits, socioeconomic condition and parent’s level education were collected by a family questionnaire. RESULTS: Prevalence of childhood overweight (BMI≥P85) was 32,1%, and over 14% of children were obese (BMI≥P95). Pre-obesity (P85≤ BMI< P95) prevalence was higher among girls (18,1%) than boys (17,8%). The consumption of fast food group and candies occurred mainly in every 15 days (48,4% and 35,5% respectively), pastry products showed a higher frequency of 1-3 times a week (41,5%). The percentage of children consuming vegetables, at least daily, varied with nutritional status: 23,0%; 25,7%; 26,2%; 21,0% in underweight, normal, pre-obese and obese children. Overweight was associated with parent´s low socioeconomic status, and middle parents educational level. CONCLUSION: Further careful analysis will help to better understand the role of obesogenic factors. This knowledge may identify additional potential effective interventions at local level in order to reverse the obesity trends in Portuguese children.
- Portuguese Gastronomy against childhood obesity projectPublication . Ramos, Carlos; Carrito, Madalena; Carvalho, Maria Ana; Silva, Ana Lúcia; Rito, AnaObesity is essentially linked to poor eating habits and low levels of physical activity. Beyond the individual behaviors, the social and economic factors as those related to agriculture, transport, urban planning, environment, food distribution, processing, marketing and education have a significant impact on this epidemic where the governments and societies have an obligation to contribute. The most effective policies are certainly those that involve different government sectors, civil society, private sector and other stakeholders. Additionally, modern times are characterized by a more demanding way of life where the practice of traditional eating habits have been replaced by an exaggerated consumption of processed foods with poor nutritional value, due to the lack of time to prepare and cook meals, along with less commitment to the family environment. The gastronomy belongs to science, politics and culture and can be a vehicle for the promotion of cultural habits and protectors of health through the preservation of good dietary habits and traditions of Portuguese cultural value and recognized as part of health protection. Thus, the Portuguese Federation of Gastronomic Confraternities in collaboration with the Atlantic University created the project "Portuguese gastronomy Against Obesity" which combines the preservation of healthy eating habits and traditions with the promotion of its elements such as the consumption of healthier fruit and vegetables, the cereals and olive oil, among others, and that includes the spread of cooking and healthy practices and to promote health, contributing to the preservation of Portuguese food culture, to adopt healthy eating habits to promote national products. Similarly, this project fits initiatives and nutrition counseling, a fundamental tool in the promotion and dissemination of good practices and food to the community. The "Portuguese gastronomy Against Obesity" project’s main objectives are to develop in all regions of the country programs of support and nutritional counseling with the local authorities, health centers and schools to provide basic knowledge about the preparation of cooking healthy food based on the traditional Portuguese food. The project takes place through workshops on nutrition, where consumption of fruits and vegetables, cereals and olive oil are promoted as the main ingredients of traditional Portuguese food. Through practical cooking activities (workshops) guided by a renowned “Chef” targeted towards children and their parents is also promoted the inclusion of fruit and vegetables, cereals and oil in the kitchen, based on traditional Portuguese food. And finally, training is directed to teachers of the 1st cycle of basic education where it is expected that they recognize the importance of an adequate school environment to promote healthy eating habits and prevent childhood obesity.
- Relação entre as dimensões socioeconómicas, demográficas e ambientais com a obesidade infantil em Portugal no âmbito do projecto Comunitário - MUNSIPublication . Silva, Ana Lúcia; Ramos, Carlos; Carvalho, Maria Ana; Breda, João; Rito, AnaINTRODUÇÃO: O excesso de peso e a obesidade têm vindo a aumentar consistentemente na União Europeia (EU) e particularmente em Portugal, afectando cada vez mais crianças e adolescentes. O programa de acção comunitário no campo da saúde identifica como áreas prioritárias de actuação a protecção dos cidadãos contra as ameaças à saúde e a promoção de políticas que conduzam a estilos de vida mais saudáveis. Neste sentido é particularmente determinante o papel das autarquias locais, pela sua intervenção ao nível da promoção da actividade física, da existência de um ambiente urbano adequado e na disponibilização dos cidadãos particularmente na comunidade escolar de alimentos saudáveis. O Projecto MUNSI (2008 a 2011) desenvolve-se nos municípios do Fundão, de Oeiras, do Montijo, do Seixal e de Viana do Castelo e tem como objectivo a concepção e operacionalização de um Sistema Integrado de Vigilância Nutricional de suporte a políticas locais. MÉTODOS: O estado nutricional da população infantil inscrita no 2º ano do 1º ciclo do ensino básico da comunidade escolar dos Municípios envolvidos (n=167), no ano 2008/2009, foi avaliado segundo o critério do CDC (2000) e relacionado com as dimensões socioeconómicas, demográficas e ambientais recolhidas através de um questionário aplicado às famílias das crianças em estudo. RESULTADOS: 3173 crianças foram avaliadas, 50,6% eram do sexo feminino, com uma média de idades de 7,5 anos (±0,8). A prevalência de excesso de peso foi de 32,1% (IMC≥P85), das quais 14,3% eram obesas (BMI≥P95). Verificou-se que crianças sem irmãos e cujas famílias apresentavam baixos níveis socioeconómicos (<1500€/mês) apresentavam um factor associado de risco ao desenvolvimento da obesidade (OR=1,6; 95%CI: 1,1-2,3) e (OR=3,9; 95%CI: 1,4-10,8). Comportamentos sedentários como o visionamento televisivo (>2horas) mostraram associações semelhantes (OR=1,3; 95%CI: 1,0-1,7) e igualmente em crianças com uma duração de sono ≤8horas (OR=1,5; 95%CI: 1,1-2,1). Crianças que não foram amamentadas e macrossómicas também mostraram maior risco associado à obesidade (OR=1,6; 95%CI: 1,1-2,2) e (OR=2,5; 95%CI: 1,3-4,6). Observou-se ainda que a maior parte das crianças tomava o pequeno-almoço diariamente (96,9%) e almoçava na escola (84,1%). O consumo diário de doces demonstrou uma maior tendência no desenvolvimento da obesidade (OR=2,3; 95%CI: 1,2-4,3) contrariamente ao verificado naquelas que consumiam sopa diariamente (OR=0,6; 95%CI: 0,3-1,0). CONCLUSÕES: Conclui-se que programas de acção comunitária identificam dimensões prioritárias de actuação na prevenção da obesidade, designadamente de carácter socioeconómico, demográfico e ambiental na promoção de políticas que conduzam a estilos de vida mais saudáveis.
- Relação entre hábitos de sono e obesidade infantilPublication . Cunha, Catarina; Silva, Ana Lúcia; Rito, Ana Isabel
- Relationship between family socioeconomic and educational level and childhood overweight from a Portuguese municipality based studyPublication . Ramos, Carlos; Silva, Ana Lúcia; Carvalho, Maria Ana; Rito, AnaINTRODUCTION: The prevalence of childhood obesity is rising rapidly in Portugal, reaching one of the worst positions in the European Union. Inadequate food habits with high intake of high energy dense foods, seems to be one of the main factor behind this epidemic. Family socioeconomic status also appears to be an obesogenic factor, particularly parents’ educational level and their income. To better understand the association of unbalanced dietary habits and socioeconomic environment on children nutritional status and to develop effective prevention strategies, are the main aims of this study. METHODS: A cross-sectional study (MUNSI) was conducted on five, which included 3173 children (6-9 years old), attending the universe of public elementary schools. Childhood nutritional status was assessed by anthropometric parameters considering the CDC growthcharts criteria percentiles of BMI. Children’s food habits, socioeconomic condition and parent’s level education were collected by a family questionnaire. RESULTS: Prevalence of overweight (BMI≥P85) was 32.1%, and 14.3% for obesity (BMI≥P95). The risk of obesity was higher in medium income families (851-1500€: OR=4.0 (1.1-14.1)), compared with families’ incomes over 3750€/month. We also found that parents’ educational level was correlated with the risk of obesity in children. Lower mother´s educational level showed higher prevalence (20,8%) and risk of childhood obesity: OR=2.8 (1.8-4.5) and again for lower fathers educational level with higher childhood obesity (16.7%) and OR=2.1 (1.2-3.4) CONCLUSION: Data showed that obesity is not independent from parents’ socioeconomic status and parents’ educational level, where this condition seem to be related with the likelihood to develop childhood obesity.