International Journal of Child Health and Nutrition

1-13

Authors: "Mo'ez Al-Islam" Faris, Suneetha Epuru, Saud Al-Shimmari, Egab Al-Shimmari

Saudi Arabia (KSA) is one among the countries for top energy drink markets. Amid growing controversies globally surrounding the increasing usage of energy drinks by children, it is felt important to understand how these trends are reflected in KSA. A cross-sectional survey was conducted to explore the trends of energy drink consumption among, and differences between, middle and secondary school children, and the associated socioeconomic and behavioral factors. Randomly selected 1006 male children from secondary and middle schools from Hail region in KSA were included in the study, using a self-administered validated questionnaire. Results revealed that about 60% of school children were current energy drink consumers. Secondary school children were significantly (P<0.001) higher than middle schoolers in terms of both frequency and quantity. Concomitantly, unhealthy dietary and lifestyle behaviors were reported in significantly higher proportions (P<0.001) among secondary school children. Home was the first place for exposure for majority of children while unreliable resources were the major sources of knowledge about energy drink composition and health effects. Poor knowledge concerning energy drink composition was reported. Taste and being energized were the major driving forces for energy drink consumption. Higher disposable income on hand and poor lifestyle behaviors were all significantly associated with energy drink consumption. It can be concluded that high proportion of energy drink consumption was reported among school children in Hail, with higher proportions in secondary than middle schools. This matter raises the significance of mounting awareness of community concerning the ingredients and potential hazards of energy drinks.

33-39

Authors: Jayna M. Dave, Tzu-An Chen, Amanda M. Oceguera, Karen W. Cullen, Deborah I. Thompson

Background: Every school day, over 31 million U.S. children eat school lunches. Unfortunately, students often do not choose the healthy options in the school cafeteria. This paper describes outcome results of a pilot study using “nudges” to improve elementary school students’ fruits and vegetables selections. Methods: A pilot study was conducted from January to May 2012, in six intervention schools and 2 control schools. A behavioral economics-based intervention was conducted using “nudges” or cues from the cafeteria (staff encouragement to select fruit and vegetables, food labels, “Harvest of the Month” posters), school (morning announcement messages, prompts regarding cafeteria food selections), and parents (school newsletter articles, parent listserve messages) to promote students’ selection of fruits and vegetables in the school cafeteria. The serving data from the point-of-servic e machine provided fruits and vegetables served per student per day. Results:There were no significant differences in the number of servings of fruits and vegetables served per student per day, averaged over the study period. Process data revealed low implementation of the intervention components, which may partially explain results. Conclusions: Low implementation of nudges led to non-significant results in this pilot study. However, providing environmental cues are important and warrant further research with full implementation. Starting 2012, the new meal pattern includes two vegetables and a fruit serving for lunch; and two fruit servings for breakfast. Minimal cost interventions should be explored to facilitate successful implementation of new school meal guidelines.

50-53

Authors: Aurea Lumbau, Giovanni Spano, Silvio Mario Meloni, Francesca Sanna, Pietrina Francesca Lugliè

Aim: To analyze the knowledge and experience of dentists with private practices in the Sassari district with regard to eating disorders and clinical stomatology manifestations. Methods: A questionnaire to investigate dentists’ knowledge and experience was created and submitted to a random sample of dentists. Data were collected and analysed using the Stata SE 10 software. Results: In total, 150 dentists were enrolled (a representative sample). After questionnaire evaluation, the following results were obtained: 80.7% (121) of the participants had a degree in dentistry and 19.3% (29) had degrees in medicine with a dentistry master of science diploma, 46% (69) were males and 54% (81) were females, their age range was 25-62 (mean, 36.1) years, and the average work experience was 11.5 (range, 1-36) years. More than 90% of the participants defined eating disorders only as bulimia and anorexia. Of the dentists, 77.3% (116) correctly identified Western populations as the most affected, whereas 52.7% identified only whites as the most affected people. In total, 80% of the dentists recognised dental erosion and abrasion as typical oral manifestations. Only 62% stated that salivary pH decreases in these conditions, and 63% did not recognise parotid gland tumefaction as a clinical sign. Regarding operator experience, 60.7% (91 dentists) had clinical experience of patients with eating disorders: 43.9% of them had made diagnoses from oral manifestations, 51.3% (77) were not able to treat these patients, and 69.3% (104) would refer patients to specialized centres for treatment. Moreover, 119 (79.3%) considered that a dental hygienist was a valid collaborator for the treatment of oral cavity manifestations. Regarding prophylaxis, 16.7% (25) suggested fluoride prophylaxis and 21.3% (32) oral hygiene education. Only 1.3% indicated the use of bicarbonate to change salivary pH values, suggested conservative or prosthetic restorations, suggested the use of saliva substitutes, or the sealing of permanent teeth. Difficulties in clinically treating these patients were related to a lack of knowledge for 72% (108) of participants. Of them, 36.7% (55) had studied the clinical aspects of this pathology while attending dental school and 24.7% (37) after their degree. In total, 94.7% (142) expressed the need for further information and only 2% (3) considered they had sufficient clinical knowledge. Conclusions: It is evident that there is a lack of knowledge regarding the problem and there would seem to be an urgent need to provide more training programs and to establish guidelines for the diagnosis and treatment of eating disorders among dentists. In our opinion, the acquisition of such knowledge will change the approach to related pathology, improving clinical skills, and subsequently diagnosis and treatment.

61-66

Authors: Zahra Gholampour, Mina Hosseininasab, Gholamreza Khademi, Majid Sezavar, Nooshin Abdollahpour, Bahareh Imani

Background & Objective: Malnutrition is very common in hospitalized children and is associated with related clinical consequences such as increased risk of infections, increased muscle loss, impaired wound healing, longer hospital stay and higher morbidity and mortality. The estimated prevalence of acute malnutrition in hospitalized children varies from 6.1 to 40.9% in different countries. The current study was conducted with the aim of evaluating the efficiency of STRONGkids (Screening Tool for Risk On Nutritional Status and Growth) tool for assessing malnutrition in hospitalized children in Iran. Methods: All children older than 28 days admitted to the pediatric hospital (Dr. Sheikh, Mashhad, Iran) were enrolled in this study and the screening tool named STRONGkids was applied for them. The anthropometric measurements were measured by a trained operator using standard methods and equipments. The children were classified in three groups of being at high risk, moderate risk and low risk of malnutrition. Results: According to STRONGkids score; 17% of children were classified as low risk, 75% as moderate risk and 8% as high risk group. According to WFH, HFA and WFA z-scores31.4%, 19.2% and 28% of children were identified as moderately and severely malnourished respectively. According to MUAC cut-offs, 3.4% of children were classified as having moderate malnutrition and there was no child with severe malnutrition. Conclusion: It is very important to recognize the nutritional status of the children as early as possible because of its effects on children’s growth. Therefore, evaluating the nutritional status of the hospitalized children is an essential step inclinical assessment. We suggest to apply the STRONGkids score aside with other clinical and anthropometric data.