A public health approach to the prevention of childhood overweight

Objective: To develop and pilot test a growth assessment program in the Calgary Health Region that would provide continuous measured data on the prevalence of overweight among pre-school children attending for vaccination and assessment, and promote lifestyle behaviours that help children achieve healthy growth.

Methods: Resources were developed to support a three-strategy approach to promote healthy growth (feel good about yourself, have fun being physically active and enjoy healthy eating). A protocol for growth assessment was developed with multidisciplinary input. Public health nurses (PHN) were trained in standardized measurement techniques and resources for families. Children's weight and height measurements were plotted on the CDC Growth Charts (2000) and were used to identify children as overweight ([Symbol Not Transcribed] [greater or equal to]95[Symbol Not Transcribed] percentile), healthy weight ([Symbol Not Transcribed] [greater or equal to]5[Symbol Not Transcribed] <95[Symbol Not Transcribed] percentile) or underweight (<5[Symbol Not Transcribed] percentile). Data was analyzed centrally to convert Weight-for-Stature to BMI-for-Age to identify children at-risk of overweight ([Symbol Not Transcribed] [greater or equal to]85[Symbol Not Transcribed] percentile <95[Symbol Not Transcribed] percentile). Parent evaluations were conducted to examine the acceptability of the growth assessment. PHN questionnaires were conducted to examine perceptions of the visit and adequacy of resources.

Results: Data from 383 children was obtained. Overweight occurred in 8% of children (8% of boys and 8% of girls); 17% were at risk of overweight (22% of boys and 14% of girls) and 2% (1% of boys and 3% of girls) were underweight. Parent evaluations indicated that the majority were either very happy/happy with the information received during the visit. PHN counseling confidence significantly improved.

Implications and conclusions: This approach to identifying overweight children appeared satisfactory to families and PHN in an environment with limited resources for treatment of childhood overweight.