The use of a musical play in the transfer of knowledge on nutrition, a healthy lifestyle and the prevention of obesity
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Background: South Africa is experiencing a unique double burden of disease due to the nutrition transition, facing diseases related to both under and over nutrition. Childhood obesity is associated with a poor childhood diet, physical inactivity and sedentary lifestyle. Promoting healthy eating and physical activity is important. Promoting healthy eating patterns and regular activity are essential components of lifestyle modification of children. An obesity prevention programme with elements of music and dance for children aimed at improved nutritional knowledge to combat ignorance of healthy diets and highlight importance of physical activity seemed to be an ideal solution. Aim :The aim of this study was to investigate the effect of a novel nutrition intervention programme based on the South African food-based dietary guidelines (SAFBDG; musical play) on the transfer of nutritional knowledge towards a healthy lifestyle (healthy dietary behaviour and physical activity) in primary school children. Methods: Children (n=203; boys=93; girls=110), aged 6 to 12 years from different ethnic groups were recruited. Participation was voluntary. Only children whose parents/guardians gave written informed consent were included. Children were randomly assigned to a control group (n=99) exposed to the standard school nutrition curriculum and to an experimental group (n=104) who also participated in a musical play with short messages based on the SAFBDG for two sessions a week for five weeks. After each session pamphlets on the relevant SAFBDG message were given to the children to take home. At the end of the intervention the children performed the musical play for their parents/guardians. At baseline demographic information was obtained, anthropometrical measurements taken, a validated nutritional knowledge questionnaire administered and a 24-hour dietary recall completed. All measurements except the demographic questionnaire were repeated after the intervention. Results: Overall nutritional knowledge of the children exposed to the musical play increased with statistical and practical significance [11.9% (p < 0.05) versus. 11.1% (d> 0.05)]. Children 6 to 12 years consumed more grains and less dairy, vegetables, :fruit and meat than the recommended intakes. No measurable changes occurred in food group consumption after the intervention except for : fruit intake which increased in girls aged 8 -10 years in the experimental group (p < 0.05). Boys and girls aged 6 12 years have inadequate intakes « 67% of the Recommended Dietary Allowances (RDA)) of calcium, vitamins A, C, D, and B12, iron and folate. No statistically significant changes anthropometrical measurements were found after the intervention. Z-scores showed that children from the lower grades (grade 1 3) were more prone to stunting while children from the higher grades (grade 4 -6) were more prone to be obese. Furthermore, a high prevalence of overweight and obesity was found amongst white boys, whereas stunting was more prevalent amongst black boys and girls. Conclusion: The results of the study showed that the musical play based on the SAFBDG improved overall nutritional knowledge in a group of primary school children. Diet quality based on food group recommendations and nutrient intakes remained low which suggests that other factors apart from nutritional knowledge influenced food choices and, therefore, the diet quality in this group of children.
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