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A burning issue in public health is the obesity epidemic which is prevalent not only among adults but in children as well. Obesity is commonly defined as a body mass index (BMI) which is above the normal range for age and gender. As a consequence, more and more children are suffering from diabetes, hypercholesterolemia and hypertension. It is imperative to prevent and manage obesity to improve the quality of life of children and ensure healthy and productive adults of the future. As obesity is a multifactorial problem, this paper reviews three journal articles on the prevention of obesity from a family, school and community perspective.

The Family and Childhood Obesity

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Junnila et al. (2012) conducted a trial on a family-centered 7-step intervention called The Weighty Matter in Finland. The 12-month trial involved 86 families with overweight preschool children. Four 90-minute discussions were done involving the family and the nurse specialist, pediatrician, physiotherapist and nutritionist. The nurse specialist provided motivation towards adopting a healthier lifestyle maximizing family resources and providing social support. The pediatrician assessed the child and family’s health status and provided information on the health consequences of being overweight. The physiotherapist focused on the family’s physical activity and inspired the sharing of a physically active hobby. The nutritionist promoted nutrition through better food choices.

To complete the seven steps, three activities involving all participants also took place aimed to encourage positive family interaction (attending a cultural event), physical activity (participating in a physical adventure) and healthy diets (participating in a healthy-meal cooking activity). Follow-ups were done to evaluate the family’s progress, reinforced improvements and provided motivation on areas needing further efforts.  Results showed that there were increases in fruit and vegetable intake and decreases in the consumption of high-sugar drinks. These changes, however, were deemed not statistically significant. There were also no commendable decreases in BMI reflecting the difficulty of family lifestyle change.

The School and Childhood Obesity

A study by Graf et al. (2008) documented the implementation of the Children’s Health Intervention Trial (CHILT) in Germany to find out if primary school curriculum interventions had the capacity to boost energy expenditure through physical activities integrated into daily lessons and initiated during breaks, as well as increase student knowledge on health. Twelve schools comprised the CHILT group and five schools the control group with the intervention lasting four years. Height, weight and BMI were noted as baseline and data on physical endurance and performance capacity were also obtained. Tests on motor development were also done. The children were given an extra 30-minute lesson on health every week with content focusing on self-management and nutrition (Graf et al., 2008). One five-minute physical activity break was initiated in the morning. During the main break, participants were given opportunities for physical activity. Moreover, physical education instructors obtained training in order to maximize their lessons for physical activity.

The study results showed that in the CHILT group, a higher normalization of weight was observed among the overweight and obese compared to the control group. However, the number of children with this achievement was small overall. There was no significant reduction in the incidence of overweight and obese children in the CHILT group when compared with control group outcomes. Further, there were significant improvements in motor coordination among the CHILT participants compared to the control. Recommendations were made to implement special programs specifically targeting the overweight and obese and to encourage parental involvement.

The Community and Childhood Obesity

In the community setting, de Silva-Sanigorski et al. (2010) implemented the Romp and Chomp project in Australia which aimed to make the physical and social environment of children more conducive to obesity prevention. Through the combined efforts of government health, education and sports agencies as well as preschools in the community, a campaign was initiated to reduce television time and increase the active play of children, consume more vegetables and fruits, and substitute water for high-sugar drinks. Health care providers and schools were rallied to support the initiative by building client and family awareness of the message. Learning centers were encouraged to adopt matching policies. Radio and print media were maximized for mass education. Compared to other communities, the intervention community showed a highly significant decrease in obesity and overweight prevalence in preschool children. There were also marked increases in fruit, vegetable and water intake compared to baseline, and the amount of time spent watching T.V. dropped.   

Conclusion

  Overall, the three studies showed the various models which can be used for obesity prevention in the family, school and community settings which directly affect children’s nutrition and physical activity. When each setting is targeted individually, it was shown that there is either no or minimal success in reducing both incidence and prevalence of childhood obesity as for example, focusing on the family but not the school or focusing on the school but not the family. Using a community-based approach that targets all three settings has been shown to have the most significant outcomes. This represents a valuable lesson when planning and implementing obesity prevention interventions.

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