Intervenciones en obesidad infantil. Una revisión sistemática de la literatura

Antecedentes: se observa un aumento creciente en la prevalencia de sobrepeso y obesidad en la población infantil y se multiplican iniciativas para su prevención y control. Objetivo: caracterizar las intervenciones en obesidad infantil publicadas en literatura científica reciente. Materiales y Método...

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Fecha de publicación:: 2021

Institución:: Universidad de Caldas

Repositorio:: Repositorio Institucional U. Caldas

Idioma:: spa

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repository_id_str
dc.title.none.fl_str_mv	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura Interventions in child obesity. A systematic review of the literature
title	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
spellingShingle	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura Obesidad pediátrica salud del niño revisión sistemática promoción de la salud prevención primaria Pediatric obesity child health systematic review health promotion primary prevention Obesidade pediátrica saúde do menino revisão sistemática promoção da saúde prevenção primaria
title_short	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
title_full	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
title_fullStr	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
title_full_unstemmed	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
title_sort	Intervenciones en obesidad infantil. Una revisión sistemática de la literatura
dc.subject.none.fl_str_mv	Obesidad pediátrica salud del niño revisión sistemática promoción de la salud prevención primaria Pediatric obesity child health systematic review health promotion primary prevention Obesidade pediátrica saúde do menino revisão sistemática promoção da saúde prevenção primaria
topic	Obesidad pediátrica salud del niño revisión sistemática promoción de la salud prevención primaria Pediatric obesity child health systematic review health promotion primary prevention Obesidade pediátrica saúde do menino revisão sistemática promoção da saúde prevenção primaria
description	Antecedentes: se observa un aumento creciente en la prevalencia de sobrepeso y obesidad en la población infantil y se multiplican iniciativas para su prevención y control. Objetivo: caracterizar las intervenciones en obesidad infantil publicadas en literatura científica reciente. Materiales y Métodos: se realizó una revisión sistemática de investigaciones empíricas cuantitativas sobre intervenciones en obesidad infantil, en las bases de datos Web ofScience, Scopus y Scielo entre los años 2013 y 2019. Se seleccionaron 30 artículos que describían 30 intervenciones distintas. Resultados: las&nbsp; intervenciones se centraron en promover una alimentación saludable y ejercicio físico, con énfasis en la reducción del peso corporal y medidas antropométricas como principales variables de resultado. La duración se concentró entre los 4 y 6 meses y se desarrollaron mayoritariamente en contextos escolares. Conclusiones: los estudios coinciden en la importancia de abordar la problemática a un nivel individual, grupal y comunitario, y cautelar la pertinencia de las intervenciones en función de la especificidad social y cultural del grupo objetivo. Persisten desafíos en relación con el diseño de intervenciones fundamentadas teóricamente, promover la adherencia a los programas y extender periodos de seguimiento para conocer su efectividad en el largo plazo.&nbsp;
publishDate	2021
dc.date.none.fl_str_mv	2021-01-01 2022-01-01T00:00:00Z 2022-01-01T00:00:00Z 2025-10-08T21:26:30Z 2025-10-08T21:26:30Z
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identifier_str_mv	0121-7577 10.17151/hpsal.2022.27.1.15 2462-8425
url	https://repositorio.ucaldas.edu.co/handle/ucaldas/24041 https://doi.org/10.17151/hpsal.2022.27.1.15
dc.language.none.fl_str_mv	spa
language	spa
dc.relation.none.fl_str_mv	233 1 213 27 Hacia la Promoción de la Salud World Health Organization (WHO). Descriptive Note. Obesity and Overweight [Internet]. WHO; 2020 [citado 15 julio 2020]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight World Health Organization (WHO). Report of the Commission on Ending Childhood Obesity: implementation plan: executive summary 2017 [Internet]. WHO; 2017 [citado 15 julio 2020]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/259349/WHO-NMH-PND-ECHO-17.1- Showell N, Fawole O, Segal J, Wilson R, Cheskin L, Bleich S, et al. A systematic review of home-based childhood obesity prevention studies. Pediatrics. 2013; 132:e193-e200. Brown E, Buchan D, Baker J, Wyatt F, Bocalini D, Kilgore L. A systematised review of primary school whole class child obesity interventions: effectiveness, characteristics, and strategies. Biomed Res. Int. 2016; 1-15. Owen M, Curry W, Kerner C, Newson L, Fairclough S. The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Prev Med. 2017; 105:237-249. Lewis K, Brown S. Searching for Evidence of an Anti-Inflammatory Diet in Children: A Systematic Review of Randomized Controlled Trials for Pediatric Obesity Interventions with a Focus on Leptin, Ghrelin, and Adiponectin. Biol Res Nurs. 2017; 19(5):511-530. Nagle B, Holub C, Barquera S, Sánchez-Romero L, Eisenberg C, Rivera-Dommarco J, et al. Interventions for the treatment of obesity among children and adolescents in Latin America: A systematic review. Salud Publica Mex. 2013; 55):434-440. Perestelo-Pérez L. Standards on how to develop and report systematic reviews in Psychology and Health. Int J Clin Health Psychol. 2013; 13(1):49-57. Akdemir M, Donmez L, Polat H. The Effect of Nutrition Intervention on Nutritional Status, Exercise and Obesity in Primary Schools. Kuwait Med J. 2017; 41:187-204. Alexander A, Grant W, Pedrino K, Lyons P. A prospective multifactorial intervention on subpopulations of predominately hispanic children at high risk for obesity. Obesity. 2014; 22(1):249-253. Anderson J, Newby R, Kehm R, Barland P, Hearst M. Taking steps together: A family- and community-based obesity intervention for urban, multiethnic children. Health Educ Behav. 2015; 42(2):194-201. Aparco J, Bautista-Olórtegui W, Pillaca J. Impact evaluation of educational-motivational intervention “como jugando” to prevent obesity in school children of cercado de lima: Results in the first year. Rev Peru Med Exp Salud Publica. 2017; 34:386-394 Benjamin S, Namenek R, Østbye T, Evenson K, Neelon B, Martinie A, et al. A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina. Child Obes. 2015; 11(3):297-303. Cohen T, Hazell T, Vanstone C, Rodd C, Weiler H. Changes in eating behavior and plasma leptin in children with obesity participating in a family-centered lifestyle intervention. Appetite. 2018; 125:81-89. Danielsen Y, Nordhus I, Júlíusson P B, Mæhle M, Pallesen S. Effect of a family-based cognitive behavioural intervention on body mass index, self-esteem and symptoms of depression in children with obesity (aged 7-13): A randomised waiting list controlled trial. Obes Res Clin Pract. 2013; 7(2):116-128. Elizondo-Montemayor L, Gutierrez N, Moreno D, Martínez U, Tamargo D, Treviño M. School-based individualised lifestyle intervention decreases obesity and the metabolic syndrome in Mexican children. J Hum Nutr Diet. 2013; 26:82-89. Esfarjani F, Khalafi M, Mohammadi F, Mansour A, Roustaee R, Zamani-Nour N, et al. Family-based intervention for controlling childhood obesity: An experience among iranian children. Int J Prev Med. 2013; 4(3):358-365. Falbe J, Cadiz A, Tantoco N, Thompson H, Madsen K. Active and healthy families: A randomized controlled trial of a culturally tailored obesity intervention for latino children. Acad Pediatr. 2015; 15(4):386-395. Flattum C, Draxten M, Horning M, Fulkerson J, Neumark-Sztainer D, Garwick A et al. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children’s sedentary behavior, and prevent obesity. Int J Behav Nutr Phys Act. 2015; 12(1):1-9. Huang T, Larsen K, Jepsen J, Møller N, Thorsen A, Mortensen E, et al. Effects of an obesity intervention program on cognitive function in children: A randomized controlled trial. Obesity. 2015; 23(10):2101-2108. Contreras O, Pastor-Vicedo J, Gil P. Tortosa M. Intervención escolar para corregir el sobrepeso y la obesidad. Diseño, implementación y evaluación de un programa de educación física para primer ciclo de ESO. Trauma. 2014; 25(4):200-207. Kain J, Concha F, Moreno L, Leyton B. Comment on school-based obesity prevention intervention in chilean children: Effective in controlling, but not reducing obesity. J Obes. 2015; 15:1-8. Karczewski S, Carter J, DeCator D. The role of ethnicity in school-based obesity intervention for school-aged children: A pilot evaluation. J School Health. 2016; 86(11):778-786. Kobel S, Lämmle C, Wartha O, Kesztyüs D, Wirt T, Steinacker J. Effects of a randomised controlled school-based health promotion intervention on obesity related behavioural outcomes of children with migration background. J Immigr Minor Health. 2017; 19(2):254-262. Kolotourou M, Radley D, Chadwick P, Smith L, Orfanos S, Kapetanakis V et al. Is BMI alone a sufficient outcome to evaluate interventions for child obesity? Child Obes. 2013; 9(4): 350-356. Chin H, Koon B, Abd R. The GReat-childTM trial: A quasi-experimental intervention on whole grains with healthy balanced diet to manage childhood obesity in Kuala Lumpur, Malaysia. Nutrients. 2018; 10(2):1-13. Morales-Rua M, Shamah-Levy T, Amaya-Castellanos C, Salazar-Coronel A, Jiménez-Aguilar A., Amaya-Castellanos M, et al. Effects of an intervention strategy for school children aimed at reducing overweight and obesity within the state of Mexico. Salud Publica Mex. 2014; 56:113-122. Morano M, Rutigliano I, Rago A, Pettoello-Mantovani M, Campanozzi A. A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children. Nutrition. 2016; 32(10):1075-1080. Rito A, Carvalho M, Ramos C, Breda J. Program Obesity Zero (POZ) - A community-based intervention to address overweight primary-school children from five Portuguese municipalities. Public Health Nutr. 2013; 16(6):1043-1051. Rodrigues A, Azevedo O, Lima E. Impact of the Childhood Obesity Intervention Project on primary school children from a cluster of schools. Rev Enf Ref. 2015; 4:57-64. Safdie M, Lévesque L, González-Casanova I, Salvo D, Islas A, Hernández-Cordero S, et al. Promoting healthful diet and physical activity in the mexican school system for the prevention of obesity in children. Salud Publica Mex. 2013; 55:357-373. Sigmund E, Sigmundová D. Longitudinal 2-year follow-up on the effect of a non-randomised school-based physical activity intervention on reducing overweight and obesity of Czech children aged 10-12 years. Int J Env Res Pub He. 2013; 10(8):3667-3683. Swinburn B, Malakellis M, Moodie M, Waters E, Gibbs L, Millar L, et al. Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project. Pediatr Obes. 2014; 9(6):455-462. Vásquez F, Diaz E, Lera L, Vásquez L, Anziani A, Leyton B, et al. Longitudinal assessment of body composition by different methods as product of an integral intervention for treating obesity in Chilean children school. Nutr Hosp. 2013; 28(1):148-154. Waters E, Gibbs L, Tadic M, Ukoumunne O, Magarey A, Okely A D et al. Cluster randomised trial of a school-community child health promotion and obesity prevention intervention: Findings from the evaluation of fun ’n healthy in Moreland!. BMC Public Health. 2017; 18:1-16. Weaver S, Kelley L, Griggs J, Weems S, Meyer M. Fit and healthy family camp for engaging families in a child obesity intervention: A community health center pilot project. Fam Community Health. 2014; 37(1):31-44. Gatica-Domínguez G, Moreno-Saracho J, Cortés J, Henao-Moran S, Rivera J. Physical fitness of school age children post-implementation of an educational intervention to prevent childhood obesity in Morelos, Mexico. Salud Pública Méx. 2018; 61(1):78-85. Zacarías G, Shamah-Levy T, Elton-Puente E, Garbus P, García O. Development of an intervention program to prevent childhood obesity targeted to Mexican mothers of school-aged children using intervention mapping and social cognitive theory. Eval Program Plan. 2019; 74:27-37. Blake-Lamb T, Locks L, Perkins M, Baidal J, Cheng E, Taveras E. Interventions for childhood obesity in the first 1,000 days a systematic review. Am J Prev Med. 2016; 50(6):780-789. Sung-Chan P, Sung YW, Zhao X, Brownson RC. Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obes Rev. 2013; 14(4): 265-278. Ho M, Garnett S, Baur L, Burrows T, Stewardt L, Neve M, et al. Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics. 2012; 130(6):e1647-e1671. Nixon C, Moore H, Douthwaite W, Gibson EL, Vogele C, Kreichauf S, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4–6-year-olds: a systematic review. Obes Rev. 2012; 13:106-117. Verstraeten R, Roberfroid D, Lachat C, Leroy JL, Holdsworth M, Maes L, et al. Effectiveness of preventive school-based obesity interventions in low-and middle-income countries: a systematic review. Am J Clin Nutr. 2012; 96(2):415-438. Barlow, S. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007; 120:S164-S192. Golan M, Kaufman V, Shahar DR. Childhood obesity treatment: targeting parents exclusively vs. parents and children. Br J Nutr. 2006; 95(5):1008-1015. Pont SJ, Puhl R, Cook SR, Slusser W. Stigma experienced by children and adolescents with obesity. Pediatrics [Internet]. 2017; 140(6). Disponible en: https://bit.ly/3F0CsDi Suárez-Obando F, Gómez-Restrepo C, Castro S. Ciencias de la implementación: de la evidencia a la práctica. Acta Med Colomb. 2018; 43(4):207-16. Brown CH, Curran G, Palinkas LA, Aarons GA, Wells KB, Jones L, et al. An overview of research and evaluation designs for dissemination and implementation. Annu Rev Public Health. 2017; 38:1-22. McEwan PJ. Cost-effectiveness analysis of education and health interventions in developing countries. J Dev Effect. 2012; 4(2):189-213. Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. Jama. 2016; 316(10):1093-103. Núm. 1 , Año 2022 : Enero - Junio https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/download/6762/6123
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dc.publisher.none.fl_str_mv	Universidad de Caldas
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spelling	Intervenciones en obesidad infantil. Una revisión sistemática de la literaturaInterventions in child obesity. A systematic review of the literatureObesidad pediátricasalud del niñorevisión sistemáticapromoción de la saludprevención primariaPediatric obesitychild healthsystematic reviewhealth promotionprimary preventionObesidade pediátricasaúde do meninorevisão sistemáticapromoção da saúdeprevenção primariaAntecedentes: se observa un aumento creciente en la prevalencia de sobrepeso y obesidad en la población infantil y se multiplican iniciativas para su prevención y control. Objetivo: caracterizar las intervenciones en obesidad infantil publicadas en literatura científica reciente. Materiales y Métodos: se realizó una revisión sistemática de investigaciones empíricas cuantitativas sobre intervenciones en obesidad infantil, en las bases de datos Web ofScience, Scopus y Scielo entre los años 2013 y 2019. Se seleccionaron 30 artículos que describían 30 intervenciones distintas. Resultados: las&nbsp; intervenciones se centraron en promover una alimentación saludable y ejercicio físico, con énfasis en la reducción del peso corporal y medidas antropométricas como principales variables de resultado. La duración se concentró entre los 4 y 6 meses y se desarrollaron mayoritariamente en contextos escolares. Conclusiones: los estudios coinciden en la importancia de abordar la problemática a un nivel individual, grupal y comunitario, y cautelar la pertinencia de las intervenciones en función de la especificidad social y cultural del grupo objetivo. Persisten desafíos en relación con el diseño de intervenciones fundamentadas teóricamente, promover la adherencia a los programas y extender periodos de seguimiento para conocer su efectividad en el largo plazo.&nbsp;Background: There is a growing increase in the prevalence of overweight and obesity in the child population and initiatives for their prevention and control are multiplying. Objective: To characterize the interventions in child obesity published in recent scientific literature. Materials and Methods: A systematic review of quantitative empirical research on interventions in child obesity was carried out in the Web of Science, Scopus and Scielodatabases between the years 2013 and 2019. A total of 30 articles describing 30 different interventions were selected. Results: The interventions were mainly focused on promoting a healthy diet and physical exercise, with an emphasis on reducing body weight and anthropometric measures as the main outcome variables. The duration was concentrated between 4 and 6 months and they were developed mainly in school contexts. Conclusions:The studies agree on the importance of addressing the problem at an individual, group and community level and ensuring the relevance of the interventions based on the social and cultural specificity of the target group. Challenges persist in relation to the design of theoretically-based interventions, promoting adherence to programs, and extending follow-up periods to determine their long-term effectiveness.Universidad de Caldas2022-01-01T00:00:00Z2025-10-08T21:26:30Z2022-01-01T00:00:00Z2025-10-08T21:26:30Z2021-01-01Artículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_dcae04bcTextinfo:eu-repo/semantics/articleJournal articlehttp://purl.org/redcol/resource_type/ARTREVinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1application/pdf0121-7577https://repositorio.ucaldas.edu.co/handle/ucaldas/2404110.17151/hpsal.2022.27.1.152462-8425https://doi.org/10.17151/hpsal.2022.27.1.15https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/6762spa233121327Hacia la Promoción de la SaludWorld Health Organization (WHO). Descriptive Note. Obesity and Overweight [Internet]. WHO; 2020 [citado 15 julio 2020]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweightWorld Health Organization (WHO). Report of the Commission on Ending Childhood Obesity: implementation plan: executive summary 2017 [Internet]. WHO; 2017 [citado 15 julio 2020]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/259349/WHO-NMH-PND-ECHO-17.1-Showell N, Fawole O, Segal J, Wilson R, Cheskin L, Bleich S, et al. A systematic review of home-based childhood obesity prevention studies. Pediatrics. 2013; 132:e193-e200.Brown E, Buchan D, Baker J, Wyatt F, Bocalini D, Kilgore L. A systematised review of primary school whole class child obesity interventions: effectiveness, characteristics, and strategies. Biomed Res. Int. 2016; 1-15.Owen M, Curry W, Kerner C, Newson L, Fairclough S. The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Prev Med. 2017; 105:237-249.Lewis K, Brown S. Searching for Evidence of an Anti-Inflammatory Diet in Children: A Systematic Review of Randomized Controlled Trials for Pediatric Obesity Interventions with a Focus on Leptin, Ghrelin, and Adiponectin. Biol Res Nurs. 2017; 19(5):511-530.Nagle B, Holub C, Barquera S, Sánchez-Romero L, Eisenberg C, Rivera-Dommarco J, et al. Interventions for the treatment of obesity among children and adolescents in Latin America: A systematic review. Salud Publica Mex. 2013; 55):434-440.Perestelo-Pérez L. Standards on how to develop and report systematic reviews in Psychology and Health. Int J Clin Health Psychol. 2013; 13(1):49-57.Akdemir M, Donmez L, Polat H. The Effect of Nutrition Intervention on Nutritional Status, Exercise and Obesity in Primary Schools. Kuwait Med J. 2017; 41:187-204.Alexander A, Grant W, Pedrino K, Lyons P. A prospective multifactorial intervention on subpopulations of predominately hispanic children at high risk for obesity. Obesity. 2014; 22(1):249-253.Anderson J, Newby R, Kehm R, Barland P, Hearst M. Taking steps together: A family- and community-based obesity intervention for urban, multiethnic children. Health Educ Behav. 2015; 42(2):194-201.Aparco J, Bautista-Olórtegui W, Pillaca J. Impact evaluation of educational-motivational intervention “como jugando” to prevent obesity in school children of cercado de lima: Results in the first year. Rev Peru Med Exp Salud Publica. 2017; 34:386-394Benjamin S, Namenek R, Østbye T, Evenson K, Neelon B, Martinie A, et al. A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina. Child Obes. 2015; 11(3):297-303.Cohen T, Hazell T, Vanstone C, Rodd C, Weiler H. Changes in eating behavior and plasma leptin in children with obesity participating in a family-centered lifestyle intervention. Appetite. 2018; 125:81-89.Danielsen Y, Nordhus I, Júlíusson P B, Mæhle M, Pallesen S. Effect of a family-based cognitive behavioural intervention on body mass index, self-esteem and symptoms of depression in children with obesity (aged 7-13): A randomised waiting list controlled trial. Obes Res Clin Pract. 2013; 7(2):116-128.Elizondo-Montemayor L, Gutierrez N, Moreno D, Martínez U, Tamargo D, Treviño M. School-based individualised lifestyle intervention decreases obesity and the metabolic syndrome in Mexican children. J Hum Nutr Diet. 2013; 26:82-89.Esfarjani F, Khalafi M, Mohammadi F, Mansour A, Roustaee R, Zamani-Nour N, et al. Family-based intervention for controlling childhood obesity: An experience among iranian children. Int J Prev Med. 2013; 4(3):358-365.Falbe J, Cadiz A, Tantoco N, Thompson H, Madsen K. Active and healthy families: A randomized controlled trial of a culturally tailored obesity intervention for latino children. Acad Pediatr. 2015; 15(4):386-395.Flattum C, Draxten M, Horning M, Fulkerson J, Neumark-Sztainer D, Garwick A et al. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children’s sedentary behavior, and prevent obesity. Int J Behav Nutr Phys Act. 2015; 12(1):1-9.Huang T, Larsen K, Jepsen J, Møller N, Thorsen A, Mortensen E, et al. Effects of an obesity intervention program on cognitive function in children: A randomized controlled trial. Obesity. 2015; 23(10):2101-2108.Contreras O, Pastor-Vicedo J, Gil P. Tortosa M. Intervención escolar para corregir el sobrepeso y la obesidad. Diseño, implementación y evaluación de un programa de educación física para primer ciclo de ESO. Trauma. 2014; 25(4):200-207.Kain J, Concha F, Moreno L, Leyton B. Comment on school-based obesity prevention intervention in chilean children: Effective in controlling, but not reducing obesity. J Obes. 2015; 15:1-8.Karczewski S, Carter J, DeCator D. The role of ethnicity in school-based obesity intervention for school-aged children: A pilot evaluation. J School Health. 2016; 86(11):778-786.Kobel S, Lämmle C, Wartha O, Kesztyüs D, Wirt T, Steinacker J. Effects of a randomised controlled school-based health promotion intervention on obesity related behavioural outcomes of children with migration background. J Immigr Minor Health. 2017; 19(2):254-262.Kolotourou M, Radley D, Chadwick P, Smith L, Orfanos S, Kapetanakis V et al. Is BMI alone a sufficient outcome to evaluate interventions for child obesity? Child Obes. 2013; 9(4): 350-356.Chin H, Koon B, Abd R. The GReat-childTM trial: A quasi-experimental intervention on whole grains with healthy balanced diet to manage childhood obesity in Kuala Lumpur, Malaysia. Nutrients. 2018; 10(2):1-13.Morales-Rua M, Shamah-Levy T, Amaya-Castellanos C, Salazar-Coronel A, Jiménez-Aguilar A., Amaya-Castellanos M, et al. Effects of an intervention strategy for school children aimed at reducing overweight and obesity within the state of Mexico. Salud Publica Mex. 2014; 56:113-122.Morano M, Rutigliano I, Rago A, Pettoello-Mantovani M, Campanozzi A. A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children. Nutrition. 2016; 32(10):1075-1080.Rito A, Carvalho M, Ramos C, Breda J. Program Obesity Zero (POZ) - A community-based intervention to address overweight primary-school children from five Portuguese municipalities. Public Health Nutr. 2013; 16(6):1043-1051.Rodrigues A, Azevedo O, Lima E. Impact of the Childhood Obesity Intervention Project on primary school children from a cluster of schools. Rev Enf Ref. 2015; 4:57-64.Safdie M, Lévesque L, González-Casanova I, Salvo D, Islas A, Hernández-Cordero S, et al. Promoting healthful diet and physical activity in the mexican school system for the prevention of obesity in children. 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