In addition, a systematic review of the specialised
literature has reached the conclusion that, to understand
the frequent consumption of sugar-laden foods by
teenagers, one must consider the marketing aspect.
Indeed, sugar is one of the most important items
within a wide range of unhealthy foods that often mine
educational strategies and behaviour modification,
especially among the young(16). A study conducted in
Poland, with 1,829 children and teenagers aged between
10 and 15, showed that most of them consumed
confectionery to excess, which could have a negative
impact on their development and also on their health(17).
Despite the identification of a greater risk for
inappropriate food ingestion frequency among some
participants, it was observed that multidisciplinary
monitoring has contributed to improve such frequencies,
especially among those in the group and less than
six months from the last appointment. Based on this
improvement of nutritional quality, it has been possible
to identify that multiprofessional service has had a
positive result. About this point, it is important to stress
that the encouragement to programmes of food guidance
could bring about the development of an appropriate
nutritional state. The promotion and maintenance of
these habits within this age bracket will lead to healthier
adults who have a lower risk of chronic non-contagious
diseases(18).
For these reasons, in order to avoid complications
in the general health conditions of the teenagers who
are overweight or obese, the nursing division is a kind
of mediator between the health service and the family.
In this perspective, a study of the review has said that
the following types of nursing intervention are essential:
guidance about children’s nutrition; build awareness in
the parents about the importance of prevention of infant
obesity with lectures, educational leaflets and house
visits; inform the family about pathology, including its
causes and consequences; nutritional monitoring of
the children; pay attention to improvement of eating
habits, showing more appropriate menus, setting times
and places; encouragement of physical exercise, play
activities and sporting games; assess the psychic and
social state of the child and the family; show that
healthy food is not any more expensive; analyse to see
if there is any appearance of an opportunistic disease
amid obesity; and also give guidance about need for
medical monitoring of those children who have already
reached a more advanced stage of the disease(19).
Among this intervention, psychological support
is important, as obese children and teenagers face
social discrimination. A study held in the Mexican city
of Tamaulipas, with 24 obese teenagers, said that they
had low self-esteem, difficulty to indulge in physical
activities, and also difficulty to buy clothes to improve
their own image, not to mention prejudice and rejection
from the other adolescents(18).
With guidance and monitoring, the trend now is
that children and teenagers shall change their life habits
(diet and physical exercise), even if they are not able to
carry out all the instructions. Here I stress that it is very
important to give praise, even for the smallest changes,
such as changing a tasty salty snack for fruit while at
school, to encourage them to improve. This treatment
is a long process, and the prevention of metabolic
disturbances is a priority in public health. The change
can even start during the nursing appointments at the
basic health units(19).
Here we highlight that the assessment based on the
personal report on food frequency of overweight children
and adolescents is considered a limiting factor for this
study as, according to specialised literature as here
consulted, there is evidence of underreporting of food
frequencies among overweight individuals(3). However, we
praise the importance of this study, due to its contribution
of recent data to the national scene, in relation to the
monitoring of patients in the reference centre for the
treatment of overweight children and adolescents, as
most of the surveys published address only part of this
population (either children or adolescents). In addition,
the fact that the monitoring has been spread over one
year confirms the value of the investigation.
Finally, we mention that a study carried out in
Mexico about the obesity issue in children or adolescents
discussed, with a qualitative approach, the psychological
aspects that interfere with the social relationships
of young obese people, and the need for nursing
interventions that are specific for this population(18).
The study as presented here is an advancement of
scientific knowledge, on analysing if the specialised and
multiprofessional monitoring may contribute towards
the modification of food frequency and, hence, has the
potential to improve the general health conditions of
children and teenagers who are obese.