title: Promotion of cardiovascular health in preschool children: 36-month cohort follow-up.
abstract: BACKGROUND
  Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low- and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months.
  
  
  METHODS
  Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children's knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children's nutritional status and the mean change in parent's knowledge, attitudes, and habits.
  
  
  RESULTS
  We included 1216 children, 3-5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001).
  
  
  CONCLUSIONS
  After 36 months, the educational intervention maintained a beneficial trend toward a healthy lifestyle in children and their parents.
authors.affiliation: Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia.
authors.forename: Jaime
authors.initials: J
authors.lastname: Céspedes
authors.forename: German
authors.initials: G
authors.lastname: Briceño
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vedanthan
authors.forename: Jorge
authors.initials: J
authors.lastname: Baxter
authors.forename: Martha
authors.initials: M
authors.lastname: Leal
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Marilyn
authors.initials: M
authors.lastname: Hunn
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Dennis
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002675:Child, Preschool; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D006266:Health Education / Q000379:methods* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male
keywords: Cardiovascular disease (CVD); Global health; Health education; Noncommunicable disease (NCD); Preschool children