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Efficacy of a multi-compartmental obesity prevention program (the 3P Project) in South Italy preschoolers
Abstracts / Digestive and Liver Disease 47S (2015) e237–e276
P021
P022
NUTRITIONAL STATUS AND DIETARY INTAKES IN NEUROLOGICALLY IMPAIRED CHILDREN AND ADOLESCENTS
EFFICACY OF A MULTI-COMPARTMENTAL OBESITY PREVENTION PROGRAM (THE 3P PROJECT) IN SOUTH ITALY PRESCHOOLERS
F. Penagini 1,∗ , D. Dilillo 1 , S. Bova 2 , D. Brunetti 1 , S. Del Sesto 1 , M. Mastrangelo 2 , G.V. Zuccotti 1
M. Poeta 1,∗ , G. Massa 1 , D. Di Salvio 1 , S. Guercio Nuzio 2 , L. Pierri 1 , M. Di Stasi 1 , R. Savastano 1 , A. Bisogno 1 , M. Tripodi 1 , F. Belmonte 1 , O. Lausi 1 , G. Alfano 1 , M. Terminiello 3 , G. Cersosimo 4 , G. Savarese 5 , P. Vajro 1
1 Clinica Pediatrica, Ospedale dei Bambini V. Buzzi, Università degli Studi di Milano, Italy 2 Unità di Neurologia Pediatrica, Ospedale dei Bambini V. Buzzi, Milano, Italy
Neurologically impaired (NI) children are at increased risk of malnutrition due to non-nutritional and nutritional factors influencing dietary patterns and nutrient intakes. The present study evaluated dietary patterns, nutrient intakes and nutritional status of 48 subjects (aged 6–15 years) with various degrees of cognitive and/or motor dysfunction. Diagnoses were as follows: 29% (14/48) cerebral palsy (CP), 8.3% (4/48) epileptic encephalopathy, 18.7% (9/48) symptomatic epilepsy, 22.9% (11/48) idiopathic and genetic epilepsy, 14.6% (7/48) syndromes, 4.2% (2/48) other diagnosis. Half of subjects (47.9%, 23/48) presented difficulty feeding characterized by either prolonged feeding time, dependency on a caretaker or reduced ability of communicating hunger and/or satiety. Four percent (2/48) of subjects were gastrostomy fed. One third of subjects had a poor nutritional status with either body mass index (BMI) < 3◦ c.le (33.3%, 16/48) or triceps skinfold thickness (TST) < 10◦ c.le (33.3%, 16/48). Direct correlation was found between BMI z-score, TST (mm) and the degree of motor impairment, measured by Gross Motor Function Classification Scale (GMFCS) (p < 0.0001). With regards to dietary intakes: 62.5% (30/48) and 50% (24/48) had an insufficient intake of energy and protein respectively. Micronutrient intakes were insufficient in 75% (36/48), 79.2% (38/48), 52.08% (25/48) and 90% (43/48) of subjects for calcium, iron, zinc and vitamin D respectively. The present study confirms a high prevalence of undernutrition in NI children, with a direct correlation between malnutrition and severity of motor impairment. Evaluation of nutritional status and nutritional intervention are crucial in clinical management and prognosis of NI patients. http://dx.doi.org/10.1016/j.dld.2015.07.069
e245
1 Pediatrics, Department of Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy 2 Pediatric Residency Program, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy 3 Salerno Municipality, School Canteens, Nutrition Section, Salerno, Italy 4 Sociology, Dept Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy 5 Clinical Psychology, Dept Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy
3P Project is a 7-mo pilot study to test the efficacy of a universitymunicipality-agreed obesity preventive intervention for improving physical activity (PA), nutrition and Mediterranean Diet knowledge/preferences in 3–6-year-old preschoolers. Methods: 76 preschoolers of Salerno-area (intervention group n = 56, control group n = 20), clinically/anthropometrically characterized at baseline and FU. Questionnaires on obesogenic risk factors (KidMed, Neophobia, Sleep Disturbance, Visual Body Weight, PA scores) and pictures-based interviews on children’s food and PA knowledge/preferences. Intervention group exposed to classroom activities (coloring book illustrating foods/activities, seminars for parents, weekly yogurt and fruit snacks, CONI-experts monitored daily physical activity sessions). Results: At 7-mo FU, anthropometry remained unchanged in both groups. While the intervention group improved nutritional knowledge (+1.3 vs. basal score, p = 0.0006), food (+1.3, p = 0.0003) and physical activity preferences (+0.8, p = 0.0027), increased non-sedentary activity (+23 minutes, p = 0.042) and decreased food-neophobia scores (−0.9, p = 0.028), the control group did worse in all sections. MD adherence improved only in the intervention group (KidMed scores +8.6% and −4.3% for high and poor adherence, respectively). Sleep quality/quantity and child’s and mother’s body weight misperception changes did not reach statistical significance in both groups. Cost-effectiveness evaluation was found advantageous. Conclusion: This cost-effective and easy to perform multicompartment obesity prevention-program rapidly improved most healthy habits’ knowledge and preferences in preschoolers. Our results suggest it may warrant testing also in other geographic/economic settings. http://dx.doi.org/10.1016/j.dld.2015.07.070
P021
P022
NUTRITIONAL STATUS AND DIETARY INTAKES IN NEUROLOGICALLY IMPAIRED CHILDREN AND ADOLESCENTS
EFFICACY OF A MULTI-COMPARTMENTAL OBESITY PREVENTION PROGRAM (THE 3P PROJECT) IN SOUTH ITALY PRESCHOOLERS
F. Penagini 1,∗ , D. Dilillo 1 , S. Bova 2 , D. Brunetti 1 , S. Del Sesto 1 , M. Mastrangelo 2 , G.V. Zuccotti 1
M. Poeta 1,∗ , G. Massa 1 , D. Di Salvio 1 , S. Guercio Nuzio 2 , L. Pierri 1 , M. Di Stasi 1 , R. Savastano 1 , A. Bisogno 1 , M. Tripodi 1 , F. Belmonte 1 , O. Lausi 1 , G. Alfano 1 , M. Terminiello 3 , G. Cersosimo 4 , G. Savarese 5 , P. Vajro 1
1 Clinica Pediatrica, Ospedale dei Bambini V. Buzzi, Università degli Studi di Milano, Italy 2 Unità di Neurologia Pediatrica, Ospedale dei Bambini V. Buzzi, Milano, Italy
Neurologically impaired (NI) children are at increased risk of malnutrition due to non-nutritional and nutritional factors influencing dietary patterns and nutrient intakes. The present study evaluated dietary patterns, nutrient intakes and nutritional status of 48 subjects (aged 6–15 years) with various degrees of cognitive and/or motor dysfunction. Diagnoses were as follows: 29% (14/48) cerebral palsy (CP), 8.3% (4/48) epileptic encephalopathy, 18.7% (9/48) symptomatic epilepsy, 22.9% (11/48) idiopathic and genetic epilepsy, 14.6% (7/48) syndromes, 4.2% (2/48) other diagnosis. Half of subjects (47.9%, 23/48) presented difficulty feeding characterized by either prolonged feeding time, dependency on a caretaker or reduced ability of communicating hunger and/or satiety. Four percent (2/48) of subjects were gastrostomy fed. One third of subjects had a poor nutritional status with either body mass index (BMI) < 3◦ c.le (33.3%, 16/48) or triceps skinfold thickness (TST) < 10◦ c.le (33.3%, 16/48). Direct correlation was found between BMI z-score, TST (mm) and the degree of motor impairment, measured by Gross Motor Function Classification Scale (GMFCS) (p < 0.0001). With regards to dietary intakes: 62.5% (30/48) and 50% (24/48) had an insufficient intake of energy and protein respectively. Micronutrient intakes were insufficient in 75% (36/48), 79.2% (38/48), 52.08% (25/48) and 90% (43/48) of subjects for calcium, iron, zinc and vitamin D respectively. The present study confirms a high prevalence of undernutrition in NI children, with a direct correlation between malnutrition and severity of motor impairment. Evaluation of nutritional status and nutritional intervention are crucial in clinical management and prognosis of NI patients. http://dx.doi.org/10.1016/j.dld.2015.07.069
e245
1 Pediatrics, Department of Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy 2 Pediatric Residency Program, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy 3 Salerno Municipality, School Canteens, Nutrition Section, Salerno, Italy 4 Sociology, Dept Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy 5 Clinical Psychology, Dept Medicine and Surgery, University of Salerno, Baronissi-Salerno, Italy
3P Project is a 7-mo pilot study to test the efficacy of a universitymunicipality-agreed obesity preventive intervention for improving physical activity (PA), nutrition and Mediterranean Diet knowledge/preferences in 3–6-year-old preschoolers. Methods: 76 preschoolers of Salerno-area (intervention group n = 56, control group n = 20), clinically/anthropometrically characterized at baseline and FU. Questionnaires on obesogenic risk factors (KidMed, Neophobia, Sleep Disturbance, Visual Body Weight, PA scores) and pictures-based interviews on children’s food and PA knowledge/preferences. Intervention group exposed to classroom activities (coloring book illustrating foods/activities, seminars for parents, weekly yogurt and fruit snacks, CONI-experts monitored daily physical activity sessions). Results: At 7-mo FU, anthropometry remained unchanged in both groups. While the intervention group improved nutritional knowledge (+1.3 vs. basal score, p = 0.0006), food (+1.3, p = 0.0003) and physical activity preferences (+0.8, p = 0.0027), increased non-sedentary activity (+23 minutes, p = 0.042) and decreased food-neophobia scores (−0.9, p = 0.028), the control group did worse in all sections. MD adherence improved only in the intervention group (KidMed scores +8.6% and −4.3% for high and poor adherence, respectively). Sleep quality/quantity and child’s and mother’s body weight misperception changes did not reach statistical significance in both groups. Cost-effectiveness evaluation was found advantageous. Conclusion: This cost-effective and easy to perform multicompartment obesity prevention-program rapidly improved most healthy habits’ knowledge and preferences in preschoolers. Our results suggest it may warrant testing also in other geographic/economic settings. http://dx.doi.org/10.1016/j.dld.2015.07.070