International Journal of Child Health and Nutrition

Number 11/2, 2022

60-71
The Effects of a Yearlong Recess Intervention on Body Fat Shifts in Elementary-Aged Children

Authors: David J. Farbo, Deborah J. Rhea

Abstract

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Introduction: Obesity has continued to rise in recent years due to a lack of physical activity. The school environment contributes to this problem as opportunities for physical activity are eliminated for more classroom time. Recess, defined as unstructured, outdoor play, can increase MVPA and improve current obesity trends. This study aimed to examine body fat category shift differences in children who received 40-60 minutes and those who received 30 minutes. A secondary purpose was to examine differences by district, sex, grade, and race across both groups since they received more than the national average for recess. Methods:Students in 2nd-5th grade (7-11 years old) (N=393) were selected from schools serving as an intervention (N=190) or control school (N=203) in a larger longitudinal intervention titled Let’s Inspire Innovation N’ Kids (LiiNK). Bio-electrical impedance analysis was used to categorize students as either underfat, healthy, overfat, or obese. These categories were then used to determine if students shifted a category between pre and post-measurements. Results: At least 30 minutes of recess was significantly associated with a body fat shift in 2nd graders and females. Additionally, the percentage of obese students did not change over the school year. There was no association between the group, sex, or race. Conclusion: Due to this study occurring during COVID-19, it is hard to make definitive conclusions on the effects of increased recess time on obesity. However, some positive trends are pointing towards recess as a successful method of preventing a rise in childhood obesity

72-79
Always Open, Seven-Eleven: Education Targeting Healthier Food Choices in a High Convenience Store Density Area in Taipei

Authors: Chia-Liang Dai, Ching-Ying Chen, Ziying Wang, Cheng-Liang Chang

Abstract

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Number of views: 102

To enhance children's health, the promotion of nutrition literacy in school is vital as it helps prevent the development of health conditions and diseases and maintain healthy lifestyles. Taiwan features the top highest ratio of convenience stores per population density. Convenience stores, an increasingly popular dining place, were linked to the development of eating behavior and body weight issues in children. An eight-week classroom-based nutrition intervention, employing the Traffic Light Diet as a framework, targeting children's perception of and intention to visit the convenience store was implemented. The study conducted a quasi-experimental pretest-posttest research design with a comparison group. A total of 49 students participated in the study, with 25 in the intervention and 24 in the comparison group. Data were collected by utilizing surveys, interviews, and observations. The study's findings demonstrated the positive trajectory of the impact of this intervention on increasing food-and-nutrition-related knowledge and improving healthier diet choices at convenience stores among children. One main theme was identified in coding interviews: parent involvement in meal preparation may reduce convenience store use and increase consumption of vegetables among children. Assessing the influence of parental support for healthy dietary choices, eating nutritious foods at home, and involving the family in meal preparation is an area for future research

80-97
Measurement Tools of Pediatric Nutrition and Health Suitable or Adaptable for Low- and Middle-Income Countries in Field Research Settings

Authors: Venus S. Kalami, Laurie C. Miller, Lynne Ausman, Beatrice Rogers

Abstract

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Number of views: 105

Background:Micronutrient status, body composition, gastrointestinal (GI) functioning, and neurological functioning are important facets of pediatric nutrition and health. When studied in low- and middle-income countries (LMIC), information about these elements is usually obtained via standardized surveys and traditional anthropometry. While convenient, these evaluations offer limited information that may be prone to error and bias. However, a variety of underutilized objective measurement tools exist which can promote a more objective, comprehensive, and deeper understanding of these aspects of pediatric nutrition and health in LMIC. Objective: Identify field-friendly, relatively low-cost, and portable tools that provide objective measurements of micronutrient status, body composition, GI functioning, and neurological functioning in young children. Methods: A narrative review of the literature was conducted to assess the state-of-the-art field-friendly research tools targeting micronutrient status, body composition, GI functioning, and neurological functioning in children in LMIC.Results:A number of field-friendly tools addressing the domains of micronutrient status, GI health, body composition, and neurological functioning were identified. While many tools remain to be fully validated, these tools have yet to be used to their full potential in field-based pediatric nutrition and health research in LMICs. Conclusions: More robust, field-friendly assessment methods will help to refine knowledge on the state of pediatric health of vulnerable children in LMIC. Such awareness could contribute to the design of interventions, programs and policies, and further research

98-109
Clinical and Radiographic Dependences of Functional Status, Indices of the Hip Joint, and Femur Migration in Children with Cerebral Palsy

Authors: Mykhailo B. Yatsuliak, Mykhailo M. Nemesh, Stepan M. Martsyniak, Mykhailo V. Melnyk, Miroslaw S. Kabatsii, Viktor V. Filipchuk

Abstract

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Relevance: Significant incidence of hip pathology in different groups of children with cerebral palsy and factors that may affect its formation are relevant objects of the study. The Goal of the Study: To establish the features of the hip joint’s formation, examining the clinical and radiographic dependences of the functional status and indices of the hip joint in patients with cerebral palsy. Materials and Methods: We conducted a clinical and radiographic examination of the hip joints using our own methods and standard anterior-posterior radiography, and statistical analysis of hip parameters and factors that may have influenced their formation. The total number of patients was 47 persons (86 joints). Results: Correlation relationships have been established between hip parameters and factors that may affect them: Gross Motor Function Classification System (GMFCS), gait function, level of lesion, developmental dysplasia of the hip, and adductor myotomy in medical history. Conclusions: The Reimers’ index showed greater reliability compared to the Wiberg angle. Positioning the patient's body using our own method can be used to screen the hip joints in cerebral palsy based upon the Reimers index while obtaining the true parameters of the femoral neck-shaft angle and torsion of the femur

110-118
Validation of MUAC Cut-Offs of WHO for Diagnosis of Acute Malnutrition among Children under 5 Years in Karachi, Pakistan

Authors: Mehreen Qadri, Lubna Ansari Baig, Zaeema Ahmer, Aimen Asim, Syed Moin Aly

Abstract

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Objective: To validate the WHO recommended Mid-Upper Arm Circumference (MUAC) cut-offs for acute malnutrition screening in children younger than five in Karachi, Pakistan. Methods: A cross-sectional study was conducted, including an anthropometric examination following WHO guidelines. Height was measured using Stadiometer and Infantometer. The link between MUAC and Weight-for-Height-Z score (WHZ) for different cut-offs of MUAC for Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM) was shown using Receiver Operator Characteristics (ROC) curves and the Youden index. Sensitivity and specificity of MUAC <11.5 cm and ≥11.5 to <12.5cm were determined using WHZ scores of -3 Standard Deviation (SD) and ≥-3 to <-2 SD for SAM and MAM, respectively. Results: Among 499 children, as per WHZ score, 9.6% and 27.1% had SAM and MAM, respectively, whereas according to MUAC, 6.4% and 3.6% had MAM and SAM, respectively. At the maximum value of the Youden index of 55.6%, an optimum cut-off of 12.7cm for screening of SAM with MUAC was found compared to the recommended cut-off of 11.5cm. Similarly, at the maximum value of the Youden index of 57.7%, an optimum cut-off of 13.9cm for screening of MAM with MUAC was found compared to the recommended cut-off of 12.5cm. Conclusion: The current MUAC cut-off of WHO for screening SAM and MAM cases captures only a small percentage of children under five. This needs to be revised to capture children with acute malnutrition for timely treatment in Pakistan.