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- Papa Bem: Uma Abordagem à Obesidade InfantilPublication . Câmara, Gisele; Goes, Ana Rita; Bourbon, Mafalda; Nunes, Luís; Bragança, Graciete; Cargaleiro, Helena; Heitor, Maria João; Rito, Ana Isabel; Maia, Maria Teresa; Do Ó, Dulce; Gomes, José Carlos; Sardinha, Luís; Loureiro, IsabelIntrodução: As estratégias mais utilizadas para a prevenção da obesidade infantil focam-se na promoção de hábitos saudáveis de alimentação e atividade física em contexto escolar. Apesar de importantes, estas estratégias têm demonstrado pouca efectividade no combate a esta epidemia. A vida intra-uterina e os primeiros anos de vida são períodos críticos que programam a regulação do balanço energético a longo prazo. Por outro lado, os primeiros cinco anos de vida são cruciais para a aquisição de hábitos. Durante este período, o contexto familiar é a principal influência da criança. Assim, intervir em crianças até aos cinco anos de idade, utilizando uma abordagem centrada na família deve ser uma prioridade. O projecto Papa Bem aborda o período crítico compreendido entre a gravidez e os cinco anos de vida e foca-se no papel parental para a aquisição de hábitos saudáveis de alimentação e actividade física e para o crescimento saudável da criança. Objetivos: O projecto Papa Bem faz parte do Programa Harvard Medical School (HMS) Portugal, que envolve a criação de um Website de informação em saúde para o público. O projecto visa aumentar a literacia em saúde dos pais, casais grávidos e outros cuidadores de crianças, através de um conjunto de materiais escritos e audiovisuais acerca da obesidade infantil. Métodos: O projecto Papa Bem está organizado em 4 etapas interdependentes: estudo exploratório, produção de conteúdos, avaliação de conteúdos e implementação. O estudo exploratório visa a recolha de dados a partir da literatura, de bases de dados de referência e de atores-chave para orientar a produção dos conteúdos. Os conteúdos produzidos são avaliados por especialistas e pela população-alvo. O processo de implementação testa uma metodologia de disseminação. Resultados parciais: Após a organização dos dados foi possível desenvolver o plano editorial para a seção Obesidade Infantil do Website do Programa HMS Portugal. Conclusões: A evidência científica e o envolvimento dos atores-chave têm sido a base para o desenvolvimento do plano editorial da seção Obesidade Infantil do Website do Programa HMS Portugal. A participação e o envolvimento da comunidade têm viabilizado uma abordagem mais abrangente, a translação do conhecimento científico em informação útil para a população, e o processo de implementação.
- Community-based interventions in the European Region – a reviewPublication . Sousa Machado, Rita; Rito, Ana Isabel; Breda, JoãoIntroduction: The increased prevalence of overweight and especially obesity affects the entire population in the world regardless of age, sex and race, and has become a global public health problem. Following the WHO European Charter on counteracting Obesity and the EC White Paper “A strategy for Europe on Nutrition, overweight and Obesity related health issues”, highlighting the role of local authorities which have the great potential in creating the environments and opportunities for healthy living and that action should be taken at both micro and macro levels and in different settings. Therefore, governments from the European countries have created, developed and implemented, several obesity prevention and interventions/programs at national, regional and local levels. Objective: The aim of this review was to find and subsequently gather information about interventions/programs at local or municipal level in the European Region, which are intended to prevent overweight and/or obesity in children, adolescents, adults and elderly through the promotion of physical activity and change of food habits. Methods: The search included scientific and gray literature. The scientific search engine was focused on PubMed, Medline and the World Health Organization, while gray literature was found using Google browser. Results: From the 659 papers and websites found, 62 papers and websites (from 2006 to 2011) were included in this review comprising 23 interventions/programs. 10 were community-based, 6 community- and school-based 6 school-based, and 1 family-based community interventions. Most of these 73,9% aimed to intervene in children, adolescents and families to change or improve food habits and promote physical activity; 21,7% aimed to intervene in children, adolescents, adults and elderly to promote physical activity and 4,3% aimed to intervene in children to change or improve food habits. Conclusions: Overall 60,8% of the programs/interventions found proved to be effective in preventing and/or reducing overweight and/or obesity and improvement of food habits and physical activity levels on the target groups mentioned at the local or municipality level in the European Region.
- Childhood obesity and overweight prevalence trends in Portugal – COSI 2008 and 2010Publication . Rito, Ana Isabel; Carvalho, Maria Ana; Ramos, CarlosINTRODUCTION: Previous data indicated that the estimated prevalence of childhood overweight and obesity was above 30%, being Portugal one of the European countries with the highest prevalence. OBJECTIVE: The purpose of this study was to monitor trends in childhood overweight and obesity in Portugal, based on the first and second data collection (2008 and 2010) from the National Nutritional Surveillance System - COSI Portugal. METHODS. Specific prevalence of overweight and obesity was determined, using 2 different diagnostic criteria from the first and second data collection (2008 and 2010) of the National Nutritional Surveillance System - COSI Portugal - among the seven geographic regions. The survey is affiliated with the World Health Organization European Childhood Obesity Surveillance Initiative and followed a standardized methodological protocol. 3765 children (6-8 years old) were enrolled from 181 schools in 2008 and 4020 children from 172 schools in 2010 (national representative samples). Height and weight were directly measured by trained fieldworkers. Overweight (including obesity) and obesity prevalence were calculated using the international body mass index cut-offs according to CDC and IOTF criteria. RESULTS: According to IOTF criteria the mean crude prevalence of overweight decreased from 28,1% (2008) to 26,5% (2010) (p=0,49), and childhood obesity varied from 8,9% (2008) to 9,1% (2010). With the CDC criteria we found that the prevalence of overweight and obesity varied from 32,3% and 14,6% in 2008 to 30,3% and 14,2% in 2010. Gender differences have remained relatively stable from 2008-2010, according to IOTF criteria, i.e. the prevalence of overweight was significantly higher in boys (30,0%-2008 and 26,8%-2010) than in girls (26,1%-2008 and 25,8%-2010). CONCLUSION: Overall we observed that the prevalence of overweight decreased suggesting that childhood overweight and obesity in Portugal might be leveling off. However, these results reinforce that Portugal continues to be, consistently, one of the countries with the highest magnitude of childhood obesity and that the reference used to define it is important, since it provides different estimates.