Intervene in preschool to promote healthy lifestyle

Children are more likely to avoid unhealthy habits linked to obesity and cardiovascular disease later in life if they are “taught properly” about healthy behaviours in preschool, researchers from Mount Sinai in the United States have found.

The researchers focused on children living in an economically depressed community, which is commonly linked with higher rates of obesity, heart disease and other health issues. The trial, known as the FAMILIA Project, was created and lead by Dr Valentin Fuster Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital. The results were published in the April 22 online issue of Journal of the American College of Cardiology.

Dr Fuster said the interventions applied in the trial are “low cost and easy to implement” , adding that his team were hopeful of the interventions being integrated into preschools across the country to promote healthy behaviours among children and to ultimately reduce the risk factors for developing heart disease.

He outlined that although results from this study demonstrate that early intervention is effective in preschool-age children, there is also scope for the study to promote healthy behaviours among caregivers and teachers and have a far-reaching impact.

562 children aged three to five from 15 different Head Start schools in Harlem were recruited for the study. Harlem’s population is predominantly African American and Latino, groups that experience a higher risk of cardiovascular disease. Two groups of children went through the trial for one four-month period between 2015 and 2018.

At the beginning of the study, all children answered a simple questionnaire, which included pictures for easier comprehension, to test their knowledge, attitudes, and behaviours regarding diet, physical activity, how the human body and heart works, and emotions.

For example, the children were asked to pick out which foods were healthier in a cluster that included vegetables, fruits, and cheeseburgers/fries. They were also asked how often they run, jump, and play.

Children in six preschools (the control group) went through their regular classroom curriculum, while children in the other nine preschools (the intervention group) went through a different learning program created by cardiologists, psychologists, and educators.

In 38 hours of classwork over the four-month period, teachers taught the intervention-group preschoolers about healthy diet, physical activity, how the human body works, and managing emotions. Caregivers were also told to engage in 12 hours of specific activities with their children on weekends during the four months, including buying fresh fruit at the grocery store and choosing physical activity over sedentary behaviour.

After the four months, researchers gave that same questionnaire to children in both the control and intervention groups and then compared them.

Preschoolers in the intervention group improved their knowledge and attitudes toward a healthy lifestyle by 12 per cent, more than twice as much as the control group at 5.5 per cent. (The control group was expected to improve, as the regular curriculum included a component of health education.)

Children in the interventional group with the lowest questionnaire scores at the start of the study improved the most, and those who got at least 75 per cent of the interventional curriculum fared better than those who received less than half of it (this also confirms the efficacy of the intervention and if it was if the intervention was successfully implemented).

Additionally, researchers found the curriculum was more effective for four-year-olds than three-year-olds, suggesting that that could be the ideal age for starting the intervention because four-year-olds are more mature and able to better retain information.

The study follows other successful interventions led by Dr Fuster in Colombia and Spain, however the FAMILIA program is unique being the first time the health promotion curriculum was implemented in a multi-ethnic, underprivileged urban population.

Dr. Fuster and his team plan to expand the program across the five boroughs of New York City. also evaluating how family socioeconomic status and teachers´ characteristics may affect the implementation and the efficacy of health promotion programs.

The project was funded by a grant from the American Heart Association, and more information is available here.