Original Article
Cardiovascular risk factors and health behaviours in elementary school-age Inuvialuit and Gwich’in children Constadina Panagiotopoulos MD FRCPC1,2,3, Duc Nguyen MD PhD1, Jane Smith RN MN NP GNCC4 C Panagiotopoulos, D Nguyen, J Smith. Cardiovascular risk factors and health behaviours in elementary school-age Inuvialuit and Gwich’in children. Paediatr Child Health 2014;19(5):256260.
Les facteurs de risque cardiovasculaire et les comportements de santé des enfants inuvialuits et gwich’ins du primaire
OBJECTIVES: To determine cardiovascular risk factors and health
OBJECTIFS : Déterminer les facteurs de risque cardiovasculaire et les comportements de santé des enfants autochtones de la région de Beaufort-Delta (Territoires du Nord-Ouest). MÉTHODOLOGIE : Les chercheurs ont effectué l’évaluation transversale de l’indice de masse corporelle, du tour de taille, de la tension artérielle et de la capacité aérobique de 91 enfants du primaire. Ils ont également évalué leurs connaissances et leurs comportements liés à un mode de vie sain, y compris la fréquence de l’activité physique (AP) et la consommation alimentaire autodéclarées. RÉSULTATS : Au total, 49,5 % des enfants étaient obèses ou faisaient de l’embonpoint, et 31,9 % avaient une tension artérielle élevée. De plus, 64,4 %, 42,2 % et 15,6 % d’entre eux avaient un, deux ou trois facteurs de risque cardiovasculaire, respectivement. Il n’y avait pas de différence significative entre les garçons et les filles. Dans l’ensemble, les élèves obtenaient des résultats moyens plus élevés en matière d’AP saine, d’image corporelle, d’estime de soi et de connaissances sur les boissons nutritives (89 %, 85 %, 79 % et 71 % des résultats maximaux, respectivement). Les résultats les plus faibles étaient liés à la consommation d’aliments nutritifs et à la fréquence d’AP (46 % et 56 % des résultats maximaux, respectivement). En moyenne, les enfants consommaient 2,7 litres de boissons sucrées par semaine et moins de deux portions de fruits ou de légumes par jour. Les enfants consacraient environ deux heures par jour à regarder la télévision, à jouer à des jeux ou à utiliser l’ordinateur. CONCLUSION : Il est urgent d’adopter des approches communautaires pour atténuer les taux élevés d’obésité et de facteurs de risque cardiovasculaire connexes chez ces enfants autochtones. Étant donné la dichotomie entre les connaissances sur un mode de vie sain et le comportement, les prochains programmes thérapeutiques devront absolument tenir compte des autres obstacles qu’affrontent les populations autochtones des régions rurales et éloignées, y compris l’accès limité à des aliments nutritifs et des boissons de qualité et leur coût élevé, de même que l’accès limité aux activités récréatives intérieures pendant la saison hivernale.
behaviours in Aboriginal children from the Beaufort-Delta region (Northwest Territories). METHODS: A total of 91 elementary school-age children underwent a cross-sectional assessment of body mass index, waist circumference, blood pressure and aerobic fitness. Healthy living knowledge and behaviours, including frequency of self-reported physical activity (PA) and dietary intake, were also evaluated. RESULTS: A total of 49.5% of children were obese/overweight and 31.9% had elevated blood pressure. The percentages having one, two or three cardiovascular risk factor(s) were 64.4%, 42.2% and 15.6%, respectively, with no significant difference between boys and girls. Overall, the students obtained higher mean scores in the areas of healthy PA, body image, self-esteem and nutritious beverage knowledge (89%, 85%, 79% and 71% of the maximum scores, respectively). The lowest scores were in nutritious food consumption and healthy PA frequency (46% and 56% of the maximum scores, respectively). On average, children consumed 2.7 L of sugar-sweetened beverages weekly and 12 years of age from 2001 to 2005 (9). This observation, along with recent study findings that 78% of Inuvialuit children three to five years of age are overweight or
1Department
of Pediatrics, University of British Columbia; 2Child & Family Research Institute; 3British Columbia Children’s Hospital, Vancouver, British Columbia; 4Beaufort-Delta Health and Social Services Authority, Northwest Territories Correspondence: Dr Constadina Panagiotopoulos, Endocrinology & Diabetes Unit, British Columbia Children’s Hospital, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H 3V4. Telephone 604-875-2624, fax 604-875-3231, e-mail [email protected] Accepted for publication January 23, 2014
256
©2014 Pulsus Group Inc. All rights reserved
Paediatr Child Health Vol 19 No 5 May 2014
Cardiovascular risk and health behaviours in Inuvialuit and Gwich’in children
obese (10), have prompted key stakeholders in the Beaufort-Delta region of the Northwest Territories to develop a strategy to reverse this trend. As a first step in the planning of a school-based intervention for this region, we worked collaboratively to conduct a baseline evaluation at one elementary school in the Beaufort-Delta region. The purpose of the present study was to evaluate the prevalence of cardiovascular risk factors, including obesity/overweight status, along with healthy living knowledge and behaviours in school-age Inuvialuit and Gwich’in children from a single elementary school.
METHODS Study design and population The present study was a cross-sectional assessment of children attending grades 2 to 6 within one elementary school in the Beaufort Delta Health and Social Services Authority conducted in November 2010. The Beaufort-Delta region includes eight remote communities, situated north of the Arctic Circle in the Northwest Territories, and is home to approximately 7000 Gwich’in and Inuvialuit residents. The study was approved by the University of British Columbia (Vancouver, British Columbia) Research Ethics Board, the Beaufort Delta Health and Social Services Authority, the Inuvialuit Regional Corporation, the Gwich’in Tribal Council and the Beaufort-Delta Education Council. Parents/guardians provided written informed consent and children provided written assent to participate. All study-related documents (including the consent and assent forms and study questionnaires) were provided in English, which is the language of instruction at the school. A translator was available through both the school and the community health centre if needed. Data collection Anthropometric measurements: Measurements were obtained at the school during regular school hours by trained research assistants. Children were asked to wear light clothes without shoes and socks. Weight, height and waist circumference (WC) were recorded as an average of two readings. Weight was measured in kg (to the nearest 0.1 kg, digital electronic scale, Conair Corporation, USA), and height was measured to the nearest 0.1 cm (Seca 214 Portable Stadiometer). Body mass index (BMI) was calculated (weight [kg]/height squared [m2]) and converted to a z-score (11). Weight status was categorized as obese (BMI ≥95th percentile), overweight (BMI ≥85th and
Cardiovascular risk factors and health behaviours in elementary school-age Inuvialuit and Gwich’in children Constadina Panagiotopoulos MD FRCPC1,2,3, Duc Nguyen MD PhD1, Jane Smith RN MN NP GNCC4 C Panagiotopoulos, D Nguyen, J Smith. Cardiovascular risk factors and health behaviours in elementary school-age Inuvialuit and Gwich’in children. Paediatr Child Health 2014;19(5):256260.
Les facteurs de risque cardiovasculaire et les comportements de santé des enfants inuvialuits et gwich’ins du primaire
OBJECTIVES: To determine cardiovascular risk factors and health
OBJECTIFS : Déterminer les facteurs de risque cardiovasculaire et les comportements de santé des enfants autochtones de la région de Beaufort-Delta (Territoires du Nord-Ouest). MÉTHODOLOGIE : Les chercheurs ont effectué l’évaluation transversale de l’indice de masse corporelle, du tour de taille, de la tension artérielle et de la capacité aérobique de 91 enfants du primaire. Ils ont également évalué leurs connaissances et leurs comportements liés à un mode de vie sain, y compris la fréquence de l’activité physique (AP) et la consommation alimentaire autodéclarées. RÉSULTATS : Au total, 49,5 % des enfants étaient obèses ou faisaient de l’embonpoint, et 31,9 % avaient une tension artérielle élevée. De plus, 64,4 %, 42,2 % et 15,6 % d’entre eux avaient un, deux ou trois facteurs de risque cardiovasculaire, respectivement. Il n’y avait pas de différence significative entre les garçons et les filles. Dans l’ensemble, les élèves obtenaient des résultats moyens plus élevés en matière d’AP saine, d’image corporelle, d’estime de soi et de connaissances sur les boissons nutritives (89 %, 85 %, 79 % et 71 % des résultats maximaux, respectivement). Les résultats les plus faibles étaient liés à la consommation d’aliments nutritifs et à la fréquence d’AP (46 % et 56 % des résultats maximaux, respectivement). En moyenne, les enfants consommaient 2,7 litres de boissons sucrées par semaine et moins de deux portions de fruits ou de légumes par jour. Les enfants consacraient environ deux heures par jour à regarder la télévision, à jouer à des jeux ou à utiliser l’ordinateur. CONCLUSION : Il est urgent d’adopter des approches communautaires pour atténuer les taux élevés d’obésité et de facteurs de risque cardiovasculaire connexes chez ces enfants autochtones. Étant donné la dichotomie entre les connaissances sur un mode de vie sain et le comportement, les prochains programmes thérapeutiques devront absolument tenir compte des autres obstacles qu’affrontent les populations autochtones des régions rurales et éloignées, y compris l’accès limité à des aliments nutritifs et des boissons de qualité et leur coût élevé, de même que l’accès limité aux activités récréatives intérieures pendant la saison hivernale.
behaviours in Aboriginal children from the Beaufort-Delta region (Northwest Territories). METHODS: A total of 91 elementary school-age children underwent a cross-sectional assessment of body mass index, waist circumference, blood pressure and aerobic fitness. Healthy living knowledge and behaviours, including frequency of self-reported physical activity (PA) and dietary intake, were also evaluated. RESULTS: A total of 49.5% of children were obese/overweight and 31.9% had elevated blood pressure. The percentages having one, two or three cardiovascular risk factor(s) were 64.4%, 42.2% and 15.6%, respectively, with no significant difference between boys and girls. Overall, the students obtained higher mean scores in the areas of healthy PA, body image, self-esteem and nutritious beverage knowledge (89%, 85%, 79% and 71% of the maximum scores, respectively). The lowest scores were in nutritious food consumption and healthy PA frequency (46% and 56% of the maximum scores, respectively). On average, children consumed 2.7 L of sugar-sweetened beverages weekly and 12 years of age from 2001 to 2005 (9). This observation, along with recent study findings that 78% of Inuvialuit children three to five years of age are overweight or
1Department
of Pediatrics, University of British Columbia; 2Child & Family Research Institute; 3British Columbia Children’s Hospital, Vancouver, British Columbia; 4Beaufort-Delta Health and Social Services Authority, Northwest Territories Correspondence: Dr Constadina Panagiotopoulos, Endocrinology & Diabetes Unit, British Columbia Children’s Hospital, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H 3V4. Telephone 604-875-2624, fax 604-875-3231, e-mail [email protected] Accepted for publication January 23, 2014
256
©2014 Pulsus Group Inc. All rights reserved
Paediatr Child Health Vol 19 No 5 May 2014
Cardiovascular risk and health behaviours in Inuvialuit and Gwich’in children
obese (10), have prompted key stakeholders in the Beaufort-Delta region of the Northwest Territories to develop a strategy to reverse this trend. As a first step in the planning of a school-based intervention for this region, we worked collaboratively to conduct a baseline evaluation at one elementary school in the Beaufort-Delta region. The purpose of the present study was to evaluate the prevalence of cardiovascular risk factors, including obesity/overweight status, along with healthy living knowledge and behaviours in school-age Inuvialuit and Gwich’in children from a single elementary school.
METHODS Study design and population The present study was a cross-sectional assessment of children attending grades 2 to 6 within one elementary school in the Beaufort Delta Health and Social Services Authority conducted in November 2010. The Beaufort-Delta region includes eight remote communities, situated north of the Arctic Circle in the Northwest Territories, and is home to approximately 7000 Gwich’in and Inuvialuit residents. The study was approved by the University of British Columbia (Vancouver, British Columbia) Research Ethics Board, the Beaufort Delta Health and Social Services Authority, the Inuvialuit Regional Corporation, the Gwich’in Tribal Council and the Beaufort-Delta Education Council. Parents/guardians provided written informed consent and children provided written assent to participate. All study-related documents (including the consent and assent forms and study questionnaires) were provided in English, which is the language of instruction at the school. A translator was available through both the school and the community health centre if needed. Data collection Anthropometric measurements: Measurements were obtained at the school during regular school hours by trained research assistants. Children were asked to wear light clothes without shoes and socks. Weight, height and waist circumference (WC) were recorded as an average of two readings. Weight was measured in kg (to the nearest 0.1 kg, digital electronic scale, Conair Corporation, USA), and height was measured to the nearest 0.1 cm (Seca 214 Portable Stadiometer). Body mass index (BMI) was calculated (weight [kg]/height squared [m2]) and converted to a z-score (11). Weight status was categorized as obese (BMI ≥95th percentile), overweight (BMI ≥85th and
