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Obesity in preschool children: an intervention programme in primary health care in Singapore
Insights
This study on childhood obesity prevention found that nurse-led counseling improved outcomes for preschool children. Over 40% of participants showed improved obesity status after one year.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Childhood obesity is a growing public health concern requiring effective prevention and management strategies.
- Preschool-aged children are a critical demographic for early intervention to mitigate long-term health risks.
- Obesity in young children is associated with increased risk of comorbidities like diabetes and hypertension.
Purpose of the Study:
- To evaluate the effectiveness of a prevention and management program for obesity in preschool children.
- To analyze demographic and familial factors associated with obesity in this age group.
- To assess the impact of nurse-led counseling on obesity status over a one-year period.
Main Methods:
- A prospective study involving 1128 preschool children (aged 3-6 years) diagnosed with obesity.
- Classification of obesity into mild, moderate, and severe categories based on weight-for-height criteria.
- Intervention included dietitian referral for severe cases and nurse-led counseling for mild to moderate cases.
Main Results:
- Malay children exhibited more severe obesity grades compared to Chinese and Indian children.
- A significant family history of obesity and hypertension was noted across all groups (P < 0.001).
- After one year, 40.4% of children improved their obesity status, with 20.2% reaching normal weight. Significant reductions were observed in all obesity categories (P < 0.05).
Conclusions:
- Nurse-led counseling and early intervention are effective in managing and reducing childhood obesity in preschool settings.
- Family history is a significant risk factor for childhood obesity and related comorbidities.
- Targeted interventions tailored to demographic groups may be necessary for optimal obesity management in children.
Abstract:
The Programme on Prevention and Management of Obesity in Preschool Children, aged three to six years, was implemented in 17 Primary Health Clinics in November 1991. The study sample comprised 1128 preschool children who qualified to enter the obesity register, using the defined criteria for obesity of 2 standard deviations above the normal weight for height and age. This group was divided into three categories, namely, mildly overweight (120% to below 140%), moderately overweight (140% to below 160%), and severely overweight (above 160%). The severely overweight category was referred to dietitians for follow-up management, while the other two categories were managed by the clinic staff through pre-planned nurse-conducted counselling sessions. In this paper, we analysed the first 1128 preschool children aged three to six years on the Programme with respect to their demographic characteristics; medical conditions; family history of obesity, diabetes, hypertension and ischaemic heart disease; number of siblings and parents' educational and occupational status. The Malay children showed significantly more severe grades of obesity compared to the Chinese and Indian children. A family history of obesity and hypertension among the three groups were significant (P < 0.001). After one year of follow-up with the intervention programme, the following were found: 40.4% (456) of the children improved in their obesity status and 20.2% (228) reached normal status. The severe, moderate and mild categories reduced from 6.3% to 5.9%, 29.3% to 23.2% and 64.4% to 50.7% respectively and was found to be statistically significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)