A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial
Background In Ecuador, adolescents’ food intake does not comply with guidelines for a healthy diet. Together with abdominal obesity adolescent’s inadequate diets are risk factors for non-communicable diseases. We report the effectiveness of a school-based intervention on the dietary intake and waist...
| Autores principales: | , , , , , , , , , |
|---|---|
| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Springer
2017
|
| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/146203 |
| _version_ | 1855536061411753984 |
|---|---|
| author | Ochoa-Avilés, Angélica Verstraeten, Roosmarijn Huybregts, Lieven Andrade, Susana Van Camp, John Donoso, Silvana Ramírez, Patricia Liliana Lachat, Carl Maes, Lea Kolsteren, Patrick |
| author_browse | Andrade, Susana Donoso, Silvana Huybregts, Lieven Kolsteren, Patrick Lachat, Carl Maes, Lea Ochoa-Avilés, Angélica Ramírez, Patricia Liliana Van Camp, John Verstraeten, Roosmarijn |
| author_facet | Ochoa-Avilés, Angélica Verstraeten, Roosmarijn Huybregts, Lieven Andrade, Susana Van Camp, John Donoso, Silvana Ramírez, Patricia Liliana Lachat, Carl Maes, Lea Kolsteren, Patrick |
| author_sort | Ochoa-Avilés, Angélica |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background In Ecuador, adolescents’ food intake does not comply with guidelines for a healthy diet. Together with abdominal obesity adolescent’s inadequate diets are risk factors for non-communicable diseases. We report the effectiveness of a school-based intervention on the dietary intake and waist circumference among Ecuadorian adolescents. Methods A pair-matched cluster randomized controlled trial including 1430 adolescents (12–14 years old) was conducted. The program aimed at improving the nutritional value of dietary intake, physical activity (primary outcomes), body mass index, waist circumference and blood pressure (secondary outcomes). This paper reports: (i) the effect on fruit and vegetable intake, added sugar intake, unhealthy snacking (consumption of unhealthy food items that are not in line with the dietary guidelines eaten during snack time; i.e. table sugar, sweets, salty snacks, fast food, soft drinks and packaged food), breakfast intake and waist circumference; and, (ii) dose and reach of the intervention. Dietary outcomes were estimated by means of two 24-h recall at baseline, after the first 17-months (stage one) and after the last 11-months (stage two) of implementation. Dose and reach were evaluated using field notes and attendance forms. Educational toolkits and healthy eating workshops with parents and food kiosks staff in the schools were implemented in two different stages. The overall effect was assessed using linear mixed models and regression spline mixed effect models were applied to evaluate the effect after each stage. Results Data from 1046 adolescents in 20 schools were analyzed. Participants from the intervention group consumed lower quantities of unhealthy snacks (−23.32 g; 95% CI: −45.25,-1.37) and less added sugar (−5.66 g; 95% CI: −9.63,-1.65) at the end of the trial. Daily fruit and vegetable intake decreased in both the intervention and control groups compared to baseline, albeit this decrease was 23.88 g (95% CI: 7.36, 40.40) lower in the intervention group. Waist circumference (−0.84 cm; 95% CI: −1.68, 0.28) was lower in the intervention group at the end of the program; the effect was mainly observed at stage one. Dose and reach were also higher at stage one. Conclusions The trial had positive effects on risk factors for non-communicable diseases, i.e. decreased consumption of unhealthy snacks. The program strategies must be implemented at the national level through collaboration between the academia and policy makers to assure impact at larger scale. |
| format | Journal Article |
| id | CGSpace146203 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1462032025-12-08T10:29:22Z A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial Ochoa-Avilés, Angélica Verstraeten, Roosmarijn Huybregts, Lieven Andrade, Susana Van Camp, John Donoso, Silvana Ramírez, Patricia Liliana Lachat, Carl Maes, Lea Kolsteren, Patrick adolescents non-communicable diseases health randomized controlled trial schools diet overweight obesity Background In Ecuador, adolescents’ food intake does not comply with guidelines for a healthy diet. Together with abdominal obesity adolescent’s inadequate diets are risk factors for non-communicable diseases. We report the effectiveness of a school-based intervention on the dietary intake and waist circumference among Ecuadorian adolescents. Methods A pair-matched cluster randomized controlled trial including 1430 adolescents (12–14 years old) was conducted. The program aimed at improving the nutritional value of dietary intake, physical activity (primary outcomes), body mass index, waist circumference and blood pressure (secondary outcomes). This paper reports: (i) the effect on fruit and vegetable intake, added sugar intake, unhealthy snacking (consumption of unhealthy food items that are not in line with the dietary guidelines eaten during snack time; i.e. table sugar, sweets, salty snacks, fast food, soft drinks and packaged food), breakfast intake and waist circumference; and, (ii) dose and reach of the intervention. Dietary outcomes were estimated by means of two 24-h recall at baseline, after the first 17-months (stage one) and after the last 11-months (stage two) of implementation. Dose and reach were evaluated using field notes and attendance forms. Educational toolkits and healthy eating workshops with parents and food kiosks staff in the schools were implemented in two different stages. The overall effect was assessed using linear mixed models and regression spline mixed effect models were applied to evaluate the effect after each stage. Results Data from 1046 adolescents in 20 schools were analyzed. Participants from the intervention group consumed lower quantities of unhealthy snacks (−23.32 g; 95% CI: −45.25,-1.37) and less added sugar (−5.66 g; 95% CI: −9.63,-1.65) at the end of the trial. Daily fruit and vegetable intake decreased in both the intervention and control groups compared to baseline, albeit this decrease was 23.88 g (95% CI: 7.36, 40.40) lower in the intervention group. Waist circumference (−0.84 cm; 95% CI: −1.68, 0.28) was lower in the intervention group at the end of the program; the effect was mainly observed at stage one. Dose and reach were also higher at stage one. Conclusions The trial had positive effects on risk factors for non-communicable diseases, i.e. decreased consumption of unhealthy snacks. The program strategies must be implemented at the national level through collaboration between the academia and policy makers to assure impact at larger scale. 2017 2024-06-21T09:06:10Z 2024-06-21T09:06:10Z Journal Article https://hdl.handle.net/10568/146203 en Open Access Springer Ochoa-Avilés, Angélica; Verstraeten, Roosmarijn; Huybregts, Lieven; Andrade, Susana; Van Camp, John; Donoso, Silvana; Ramírez, Patricia Liliana; Lachat, Carl; Maes, Lea; and Kolsteren, Patrick. 2017. A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial. Nutrition Journal 16:79. https://doi.org/10.1186/s12937-017-0299-5 |
| spellingShingle | adolescents non-communicable diseases health randomized controlled trial schools diet overweight obesity Ochoa-Avilés, Angélica Verstraeten, Roosmarijn Huybregts, Lieven Andrade, Susana Van Camp, John Donoso, Silvana Ramírez, Patricia Liliana Lachat, Carl Maes, Lea Kolsteren, Patrick A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title | A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title_full | A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title_fullStr | A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title_full_unstemmed | A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title_short | A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial |
| title_sort | school based intervention improved dietary intake outcomes and reduced waist circumference in adolescents a cluster randomized controlled trial |
| topic | adolescents non-communicable diseases health randomized controlled trial schools diet overweight obesity |
| url | https://hdl.handle.net/10568/146203 |
| work_keys_str_mv | AT ochoaavilesangelica aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT verstraetenroosmarijn aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT huybregtslieven aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT andradesusana aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT vancampjohn aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT donososilvana aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT ramirezpatricialiliana aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT lachatcarl aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT maeslea aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT kolsterenpatrick aschoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT ochoaavilesangelica schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT verstraetenroosmarijn schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT huybregtslieven schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT andradesusana schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT vancampjohn schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT donososilvana schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT ramirezpatricialiliana schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT lachatcarl schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT maeslea schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial AT kolsterenpatrick schoolbasedinterventionimproveddietaryintakeoutcomesandreducedwaistcircumferenceinadolescentsaclusterrandomizedcontrolledtrial |