1. Introduction
obesity, dyslipidemia, obstructive sleep apnea
OBESITY, NONALCOHOLIC FATTY LIVER, SECONDARY, CHILDHOOD OBESITY, METABOLIC SYNDROME, TYPE 2 DIABETES, HIGH BLOOD PRESSURE
Physical inactivity and a sedentary lifestyle are risk factors for excess weight and obesity in childhood. It is, therefore, necessary to adopt strategies which can modify these behaviors during childhood, the age at which habits are formed. This study aimed to evaluate the impact of an educational intervention using digital media and face-to-face activities involving children, parents, and the school community on the level of physical activity and sedentary behavior among schoolchildren. This was a secondary analysis of data obtained from a community trial in which students from four primary schools in Mexico City participated. Two schools were assigned to the intervention group (IG) and two to the control group (CG). The intervention lasted 12 months and included a face-to-face component, which involved sessions and workshops for parents and children, as well as visual material for children and a distance component utilizing electronic means (web portal and text messages to mobile phones) for parents. Anthropometric measurements were taken and information was collected on moderate to vigorous physical activity performed by the children and on the time that the schoolchildren spent in front of screens at the beginning of the study and at 6 and 12 months. Information on 201 children from the IG and 167 children from the CG was included in the analysis. At 12 months, the IG showed a mean decrease of 33.4 min/d [95% CI: −53.5 to −13.3] in screen time, while the CG showed an increase of 12.5 min/d [CI 95%: −10.5 to 35.6], Childhood obesity constitutes a public health problem because of its high prevalence worldwide and the severity of its comorbidities, which include metabolic syndrome, type 2 diabetes, high blood pressure, dyslipidemia, obstructive sleep apnea, and nonalcoholic fatty liver [Globally, Mexico is among the countries with the highest rates of overweight and obesity in childhood. In the National Health and Nutrition Survey (ENSANUT) of 2020, a combined prevalence of excess weight and obesity of 38.2% was identified among the population aged between 5 and 11 years [Healthy eating and physical activity habits are learned and fostered at home; parents have a transcendental role in promoting participation in sports and active lifestyles in children and adolescents [Therefore, greater efforts are needed to promote PA through research and the implementation of interventions, which may subsequently support the development of policies aimed at addressing this health problem. Systematic reviews that have assessed educational interventions in children have determined that those that modify habits are characterized by including the following items in their planning: social support of the participant, greater parental involvement, and parental responsibility for carrying out the intervention with their children [