Nutritional solutions to major health problems of preschool children: how to optimise growth and development

Despite major economic development in the last few decades, childhood nutrition remains a great challenge for the human species. A combination of undernutrition, overnutrition, and poor dietary quality affect to a variable extent all of the world's populations, and are often combined in the same areas and even in the same families. Malnutrition is part of the life of many individuals since conception and is transmitted by 1 generation to the next. Countries with lower income per capita and poor socioeconomic strata are mainly affected and, in turn, malnutrition hampers their development. The eradication of child malnutrition is crucial in the fight against poverty. This article examines whether this goal will be achieved within the time frame the United Nations has set.     

Language disorders and behavioral problems in preschool children

Preschoolers who present with resistant behavioral problems may have an accompanying language disorder. This paper describes a representative case of a child whose behavioral problem improved subsequent to identification of a language disorder, modification in parents' expectations and responses, and involvement in early education. Possible relationships among behavioral and language disorders, attentional and activity problems, and otitis media are discussed, and recommendations for early diagnosis and remediation are presented.     

Evaluating oral health needs in preschool children

Pediatricians and family physicians can play a significant role in the initiation of dental care for preschool children because they are seen more often by a physician than a dentist. The Committee on Standards for Child Health Care of the American Academy of Pediatrics recommends inspection of the mouth, teeth, and gums at every pediatric visit. This article describes the oral tissues in health and in disease as well as the role physicians can play in preventive dental care.     

Psychosocial determinants of behaviour problems in Brazilian preschool children

BACKGROUND: This investigation aimed at examining, through an epidemiological study, the social demographic, family and individual determinants of behaviour problems in preschool children. METHOD: Six hundred and thirty-four children, age four years, and their mothers, belonging to a cohort of 5,304 children being followed from birth, took part in the study. During a home visit, the child's behaviour problems and IQ were examined, as well as the prevalence of maternal psychiatric disorder, the quality of the home environment, and other social demographic, family and individual factors. RESULTS: The results revealed a prevalence of children's behaviour problems of 24% (clinical and borderline groups). Regression analysis showed that maternal psychiatric disorder, education and age, number of younger siblings and quality of the home environment explained 28% of the variance of the child's behaviour problems. CONCLUSIONS: The results point to the multi-determination of child behaviour problems.     

Major differences in prevalence of overweight according to nationality in preschool children living in Germany: determinants and public health implications

Aims: To investigate the prevalence of overweight according to nationality in preschool children living in Germany, and to establish the determinants responsible for differences in body mass index. Methods: The study was performed within the context of the 2001/2002 obligatory health examination before school entry in the city of Aachen, Germany. Of 2020 eligible children 1979 children were recruited (participation rate: 98%). Children''s height and weight were measured using a standardised protocol. The parents completed a standardised questionnaire on sociodemographic factors and possible determinants of nutritional status. Being overweight was defined according to age and sex specific reference values for German children as well as according to international reference values. Results: The study population included 452 (22.9%) children with other than German nationality. Among these children the prevalence of overweight was twice as high than among German children (14.8% v 7.2%). Prevalence of most known risk factors for overweight, such as low physical activity, high consumption of soft drinks, and frequent visits to fast-food restaurants was higher in the children with other nationalities than in the German children. Multivariate analyses revealed that most of the difference in prevalence of obesity by nationality is explained by known risk factors of overweight, especially education of mother and watching TV. Conclusions: The apparent ethnic differences could be explained by two non-ethnic but socioeconomic factors. In preventing overweight in children, there is the need to identify and deal with high risk environments rather than high risk ethnic groups.     

Major differences in prevalence of overweight according to nationality in preschool children living in Germany: determinants and public health implications.

AIMS: To investigate the prevalence of overweight according to nationality in preschool children living in Germany, and to establish the determinants responsible for differences in body mass index. METHODS: The study was performed within the context of the 2001/2002 obligatory health examination before school entry in the city of Aachen, Germany. Of 2020 eligible children 1979 children were recruited (participation rate: 98%). Children's height and weight were measured using a standardised protocol. The parents completed a standardised questionnaire on sociodemographic factors and possible determinants of nutritional status. Being overweight was defined according to age and sex specific reference values for German children as well as according to international reference values. RESULTS: The study population included 452 (22.9%) children with other than German nationality. Among these children the prevalence of overweight was twice as high than among German children (14.8% v 7.2%). Prevalence of most known risk factors for overweight, such as low physical activity, high consumption of soft drinks, and frequent visits to fast-food restaurants was higher in the children with other nationalities than in the German children. Multivariate analyses revealed that most of the difference in prevalence of obesity by nationality is explained by known risk factors of overweight, especially education of mother and watching TV. CONCLUSIONS: The apparent ethnic differences could be explained by two non-ethnic but socioeconomic factors. In preventing overweight in children, there is the need to identify and deal with high risk environments rather than high risk ethnic groups.     

Depression in mothers and behaviour problems with their preschool children

A follow-up study of 224 families of a birth cohort of 272 families in a multi-ethnic poor socio-economic municipality in Melbourne when the children were 4 years old showed that 27% of the mothers were depressed. There was no difference in the depression rate between Australian-born and immigrant mothers, a finding in marked contrast to the first year of the study when the depression rate was significantly higher in those immigrant mothers who had been in Australia for less than 3 years, were unable to speak English and who did not have an extended family or close friends. Depression in this group of mothers was attributed to resettlement problems, which over a period of three years had ameliorated. At 4 years the most important factor associated with depression in both Australian-born and immigrant mothers was the quality of marital relationships. Lack of an intimate support relationship made mothers more vulnerable to the stresses of child care and rearing, home-making and life events. In Australian-born mothers only, another significant factor in vulnerability to depression, was their early childhood experiences of being reared in a disruptive home or in an institution and of being unwanted. In immigrant mothers, but not in Australian-born mothers, life events were significantly correlated with depression. The depressed mothers, both Australian-born and immigrant, perceived their 4 year old children to have significantly more behavioural problems than mothers who were not depressed.     

Sleep problems in preschool and school aged rural Indian children

We assessed 513 children (2–6 y = 252; 7–12 y = 261) who visited the pediatric outpatient of a rural medical college hospital, for sleep problems using ‘BEARS’ tool. Sleep problems detected in the BEARS domains for preschool (2–6 years, n=252) and school children (7–12 years, n=261) were as follows: bedtime problems (33.3% vs 14.9%, P<0.001), excessive daytime sleepiness (32.5% vs 1.9%, P<0.001), awakening during night (25% vs 11.87%, P<0.001), regularity and duration of sleep (19.84% vs 4.98%, P<0.001), and sleep disordered breathing (4.8% vs 5%, P=0.1). We conclude that sleep problems are common among rural Indian children and should be routinely screened for during health visits.