Improving Nutrition Habits and Reducing Sedentary Time Among Preschool-Aged Children in Cuenca, Ecuador: A Trial of a School-Based Intervention

INTRODUCTION: In Ecuador, the prevalence of overweight and obesity among school-age children is more than triple that of preschool-age children; however, preschoolers have not been the target of interventions. METHODS: We developed an educational and behavioral intervention that included games, singing, and storytelling. Children were recruited from municipal preschools in Cuenca and were enrolled in the pilot intervention (PI) (N=155) for the 2015–2016 school year, which consisted of a 3-month in-school program. For the 2016–2017 school year, a separate group of children was enrolled in the enhanced intervention (EI) (N=152), which consisted of a 7-month program at both school and home. RESULTS: Parents in both groups reported a post-intervention reduction in their child’s daily at-home consumption of sugar-sweetened beverages (PI: −23.2%, P < .001; EI: −16.8%, P < .001). Additional beneficial effects of the EI not observed with the PI were an increase in drinking water daily at home (+8.3%, P = .04) and eating fruits and vegetables daily for snacks at home (+21.8%, P < .001), a reduction in excessive weekend screen time (−7.6%, P = .03), and a reduction of 0.11 in mean BMI-for-age z score (P = .003). When comparing the PI and EI, the EI was associated with a greater difference in mean BMI-for-age z score (−0.25; P < .001) and fruit and vegetable consumption (+15.9%; P = .01). CONCLUSION: Our preschool-based intervention appeared to be successful in promoting healthy lifestyle habits, especially when combined with a household component. Further research is needed to determine if the intervention had long-term effects, as well as to adapt it for different settings.