Abstract

OBJECTIVE:

To assess the evidence for interventions designed to prevent or reduce overweight and obesity in children younger than 2 years.

DATA SOURCES:

MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and references from relevant articles.

STUDY SELECTION:

Included were published studies that evaluated an intervention designed to prevent or reduce overweight or obesity in children younger than 2 years.

DATA EXTRACTION:

Extracted from eligible studies were measured outcomes, including changes in child weight status, dietary intake, and physical activity and parental attitudes and knowledge about nutrition. Studies were assessed for scientific quality using standard criteria, with an assigned quality score ranging from 0.00 to 2.00 (0.00-0.99 is poor, 1.00-1.49 is fair, and 1.50-2.00 is good).

DATA SYNTHESIS:

We retrieved 1557 citations; 38 articles were reviewed, and 12 articles representing 10 studies met study inclusion criteria. Eight studies used educational interventions to promote dietary behaviors, and 2 studies used a combination of nutrition education and physical activity. Study settings included home (n = 2), clinic (n = 3), classroom (n = 4), or a combination (n = 1). Intervention durations were generally less than 6 months and had modest success in affecting measures, such as dietary intake and parental attitudes and knowledge about nutrition. No intervention improved child weight status. Studies were of poor or fair quality (median quality score, 0.86; range, 0.28-1.43).

CONCLUSIONS:

Few published studies attempted to intervene among children younger than 2 years to prevent or reduce obesity. Limited evidence suggests that interventions may improve dietary intake and parental attitudes and knowledge about nutrition for children in this age group. For clinically important and sustainable effect, future research should focus on designing rigorous interventions that target young children and their families.

Background. Despite growing wealth and the growing commitment of China’s government to providing quality education, a significant share of children across rural China still have no access to regular sources of iron-rich foods, vitamins and other micronutrients. Such poor diets may not only result in high incidences of nutritional problems, including anemia, good nutrition has been shown to be an effective input into the creation of human capital.

Objective. To increase our understanding of the extent of anemia in poor Shaanxi Province’s primary schools, and identify structural correlates of anemia in this region. Methods. A cross-section survey was conducted. Data were collected from 4000 grade fourth grand students (ages 9 to 11) in 70 primary schools in poor rural areas of Shaanxi province. Structured questionnaires and standard test were used to gather data. Trained nurses carried out the hemoglobin tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment.

Results. The paper shows that the overall anemia rate is 21.5% (39%) when using a blood hemoglobin cutoff of 115 g/L (120 g/L). We find that those students that are boarding at school and those students that eat lunch away from home are more likely to be anemic. Children with anemia are found to have lower height for age (HAZ) scores and have higher incidences of stunting.

Conclusions. If this part of Shaanxi province is representative of the rest of Shaanxi’s poor rural areas (or all national designed poor counties in China), this means that tens of thousands (or millions) of children in rural Shaanxi (all national designed poor counties in China) may be anemic. Although we were not able to pinpoint the exact determinates and causal effects of anemia, the main implication of this work is that anemia remains a serious health problem for educators and health officials in rural China.