Features
Screening Tool Aims to Improve Children's Health
U of G profs devise preschooler nutrition checklist to keep kids healthy down the road
BY DEIRDRE HEALEY
Two U of G researchers have helped develop a screening tool aimed at changing the way public health agencies address childhood obesity and malnutrition.
Created by Profs. Heather Keller and Janis Randall Simpson, Family Relations and Applied Nutrition, and Lee Rysdale and Joanne Beyers of the Sudbury and District Health Unit, the tool is a checklist that focuses on children between the ages of three and five, a group that often slips through the cracks when it comes to keeping track of their nutritional behaviour.
“Routine nutrition monitoring with a physician stops after children reach age three, and they don't normally go back to the physician until they need vaccines to start school at age five, so there is little monitoring during that time,” says Keller.
By age three, children are typically finished with breastfeeding and are beginning to form nutritional habits, so this is the optimal time to intervene and make changes to prevent future nutritional problems, adds Randall Simpson.
“In the past, at-risk children were identified only at the clinical stage when they already had nutritional problems,” she says. “We need to be identifying these children before they suffer from obesity or get diabetes.”
The preschool nutrition screening tool is called NutriSTEP and is the first of its kind in Canada. It has the backing of the Ontario government and is being piloted in selected areas across Canada as part of immunization programs and preschool screening fairs.
NutriSTEP has the potential to change the way childhood obesity and malnutrition are addressed because it can be administered by parents without the aid of a medical professional and can be used universally across cultures, says Keller.
“It can be used in a doctor's office, public health clinic, day care or school to identify children who should be further assessed and treated by a dietitian before they have problems.”
The checklist consists of 17 questions covering a child's physical growth, what the child is eating and drinking, physical activity and sedentary behaviour, as well as factors affecting food intake such as how the parents control what the child eats and if parents have challenges with the cost of food.
To ensure that the checklist is valid, the researchers had more than 300 parents fill it out. Each child was then assessed by a dietitian, and the results of the assessment and the questionnaire were compared to ensure they both came to the same conclusions, says Keller.
The results revealed that more than half of the preschoolers in the study weren't getting enough grains and fruit, and 45 per cent weren't getting enough vegetables. Just over 30 per cent were spending more than three hours a day watching TV or doing some other type of sedentary activity, and nearly 13 per cent were eating fast food more than twice a week.
The checklist also found that 37 per cent of parents reported they often control how much their children eat. Randall Simpson says there's some evidence that strict parental control over a child's food intake may play a role in the development of childhood obesity.
“Ultimately, more than one-third of the sample preschoolers were considered to be at moderate to high nutritional risk. These results demonstrate a real need for a screening checklist that can help make parents aware of harmful nutritional habits and intervene before a child becomes high-risk.”