Valoración de una intervención educativa y actividad física en niños y adolescentes con sobrepeso y obesidad

Résumé

ABSTRACT According to the World Health Organization (WHO) "obesity and overweight are defined as an abnormal or excessive accumulation of fat that can be harmful to health." The values of obesity in the adult population between 25 and 64 years old are estimated with a prevalence of 15.5% in Spain. Childhood obesity is one of the public health problems of the 21st century. Worldwide, the combined prevalence of overweight and childhood obesity has increased by 47.1% between 1980 and 2013. It affects most developed countries around the world and prevalence is increasing. Among the risk factors for noncommunicable diseases, obesity causes special worry, it can disappear many of the health benefits that have contributed to the improvement of life expectancy. Obesity is a risk factor for many health complications, including low self-esteem and depression, type 2 diabetes, pulmonary complications such as asthma, sleep apnea, hypertension, cardiovascular diseases, some cancers, and arthritis. Previous studies have provided convincing evidence that childhood obesity persists in adulthood and is associated with an increase in mortality. Eating habits and physical inactivity are the main contributors to obesity in young people. Diet and physical activity are where obesity prevention efforts focus. However, despite the need to prevent obesity, are few effective programs have been developed and implemented. According to this background, has been increasing a global recognition of the need for effective intervention to prevent childhood obesity. The bibliography consulted emphasizes that to avoid the rebound effect; the daily habits of the children must be changed. It is recommended to increase physical activity and play in everyday activities, both at school, family and friends. The general objective of the research is to value effectiveness of an educational intervention with physical activity based on play and nutritional recommendations to reduce overweight and obesity in children. The memory of the doctoral thesis project is composed of a compendium of articles that use different methodologies. First, a preliminary prospective descriptive study was conducted to relate obesity to demotivation in the child. Second, a study protocol was elaborated to establish a program of physical activity suitable for application to a group of overweight / obese children. Third, systematic reviews were carried out about the main topics addressed in this study, the main investigations carried out by other authors were reviewed and a theoretical basis was established. Subsequently, a retrospective descriptive study was made to relate weight gain during pregnancy and breastfeeding received, with the obesity of children at 10 years of age. A prospective descriptive study was also carried out to study the prevalence of sleep apnea in overweight / obese children. The last study that was carried out was a randomized clinical trial, where a physical activity program with nutritional advice has been applied to observe the changes in the body composition of children who are overweight / obese. The main results of this research establish the following conclusions: 1. Children who are overweight and obese have low motivational states, evidencing a greater frustration with difficulties in reaching the goals, situations that require drawing educational interventions in this regard. 2. Overweight during pregnancy and the decrease in breastfeeding are related to the child's obesity at 10 years of age. 3. Overweight and childhood obesity are related to sleep disturbances and apnea-hypopnea syndrome (SAHS) in children. 4. A 9-month intervention program based on play and nutritional recommendations decreases BMI and fat percentage of children aged 8 to 12 years. 5. The participation of the family is important for the motivation of the children and to achieve the establishment of healthy habits in the child and avoid the rebound effect.