Habits of Healthy Living, Nutrition and Physical Activity in Children Aged 8-12 Years in Tijuana, Mexico

Research Article

Fam Med. 2018; 5(4): 1150.

Habits of Healthy Living, Nutrition and Physical Activity in Children Aged 8-12 Years in Tijuana, Mexico

Rodriguez-Mortis A1, Espinoza-Gonzalez CM1, Bermudez-Villalpando VI1, Rodriguez-Mortis AS2, Gonzalez-Villa JE3 and Ramirez-Leyva DH4*

¹Department of Family Medicine, Family Medicine Unit #27 (IMSS), Baja California Delegation, Mexico

²Department of General Medicine, Xochicalco University, Baja California Delegation, Mexico

³Department of General Medicine, Autonomous University of Sinaloa, Sinaloa Delegation, Mexico

4Department of Family Medicine, Family Medicine Unit #37 (IMSS), Sinaloa Delegation, Mexico

*Corresponding author: Ramirez-Leyva Diego Hazael, Department of Family Medicine, Family Medicine Unit #37 (IMSS), Sinaloa Delegation, México

Received: September 17, 2018; Accepted: October 11, 2018; Published: October 18, 2018


Background: Obesity has increased alarmingly in developed countries and in developing countries such as Mexico, is the main problem of malnutrition in adults and is a disease that is increasing in the child population. In Baja California, according to the National Health and Nutrition Survey (2012), it is reported that in school age there is a prevalence of overweight of 24.9% and obesity of 17.3%.

Aim: The purpose of this study is to identify the habits of healthy living, nutrition and physical activity in school children from 8 to 12 years of age in Tijuana, Mexico.

Design and Setting: Descriptive cross-sectional study.

Methods: In 265 patients in the Family Medicine Unit #27, Tijuana, Mexico; a descriptive cross-sectional study was conducted in patients of school age from 8 to 12 years old. We obtained general data such as height, age, weight, sex and a questionnaire validated in Mexico about healthy life habits, nutrition and physical activity for schoolchildren. For statistical analysis, we applied descriptive statistics; for qualitative variables frequencies and percentages were used and for quantitative variables mean and standard deviation were used.

Results: The majority of the participants were in the category of insufficient habits, 60.4% (n=160); Sufficient habits corresponds to 29.4% (n=78) and healthy habits were only 10.2% (n=27).

Conclusion: The study reveals that the majority of children aged 8 to 12 years do not comply with proper habits of healthy living, nutrition and physical activity, which is related to the high rate of obesity and overweight in Tijuana.

Keywords: Childhood Obesity; Habits of Life; Physical Activity; Eating Habits


Obesity is defined as an abnormal or excessive accumulation of fat that can be harmful to health. The body mass index (BMI) is a simple indicator of the relationship between weight and height that is frequently used to identify overweight and obesity in adults. In the case of children, overweight is the BMI for age with more than one standard deviation above the median established in the WHO child growth patterns, and obesity is greater than two standard deviations [1]. Currently Obesity and Overweight have become "emerging diseases of the 21st century" or "global epidemic of the 21st century"[2]. Worldwide, the number of infants and young children (0-5 years old) who have overweight or obesity increased from 32 million in 1990 to 42 million in 2013. In developing countries with emerging economies (classified by the World Bank as low and middle income countries) the prevalence of childhood overweight and obesity among preschool children exceeds the 30% [3].

The habits of life, nutrition and physical activity are defined as the set of daily behaviors of a person in a given environment [4]. There are clear environmental, commercial and cultural factors that modify nutrition, physical activity and exercise. These are of great importance, because they have their greatest effect on children of school age and are potentially modifiable in childhood, since they have been specifically associated with an accelerated rate of weight gain for age, weight for height, weight for BMI and other measures of adiposity at school age [5]. Studies are increasingly showing that food transgressions during the first year of life, mainly during the period of breastfeeding, are associated with the development of overweight or obesity at later ages. In most of the large studies there is an inverse relationship between the duration of breastfeeding and the presence of excess weight (overweight or obesity) in children and young people [6].

The metabolic disease that occurs with the highest prevalence, both in developed and underdeveloped countries, is obesity. It is estimated that, worldwide, about 22 million children under the age of five are overweight. Of the countries of Latin America, Mexico has the highest prevalence of obesity in children, reaching approximately 20%. The region with the highest affected child population is Mexico City with 38%. Childhood obesity is associated with hyperinsulinemia, lower tolerance to glucose and alterations in the blood lipid profile. The metabolic changes observed in children and adolescents with obesity are also known as metabolic syndrome and may be related to the endocrine disorders observed in obesity, such as growth hormone deficiency or hyperlipidemia. Orthopedic problems have also been described that are accompanied by alterations in physical mobility and inactivity, disorders in the immune response with increased susceptibility to infections, skin alterations that reduce the ability to heal wounds and infections, and nocturnal respiratory problems such as sleep apnea. The psychosocial consequences of the distortion of the physical image for the child with obesity can be important and even more severe than physical ones such as low self-esteem, social isolation, discrimination and abnormal behavior patterns as the most frequent [7].

Clinical practice guidelines propose physical activity, the reduction of television hours and breastfeeding as the method of infant feeding of choice as preventive action for obesity. In the case of treatment, it is proposed the early identification of obesity and overweight and should be treated immediately, it should not be postponed to adolescence or adulthood, the recommended non-pharmacological measures are diet modification, increase of physical activity, decrease in sedentary activity, family participation and behavior modification, psychological support is important; Pharmacological or surgical measures such as the use of metformin, orlistat and bariatric surgery are recommended after adolescence [8]. The main objective of the study is to identify healthy lifestyle habits, nutrition and physical activity that may favor the development of overweight or obesity in children from 8 to 12 years of age in Tijuana, Mexico.

Materials and Methods

A descriptive cross-sectional study was carried out, in the Family Medicine Unite #27, of the Instituto Mexicano del Seguro Social (IMSS), located in Tijuana, Mexico; in patients which were selected by a consecutive sampling techniques; that met the following inclusion criteria: age between 8 to 12 years, that accepted and signed informed assent and informed consent signed by the parents; patients with psychiatric or neurological illness were not included and eliminated those who did not complete the survey or those with incomplete information. The following data were obtained directly from the patients: age, sex, weight, height, BMI and habits of health living, nutrition and physical activity. The procedure for the data collection was as follows: age was calculated in years according to the year of birth, sex was determined by the phenotype characteristics of each individual, weight-height was calculated on a scale with stadiometer (Transcell technology model TI-540-SL), BMI was calculated based on the Quetelet index (BMI = weight/height2), school children will be classified with obesity with Z scores higher than +2 standard deviations (SD), and overweight with Z scores higher than +1 and less than +2 SD.

Habits of health living, nutrition and physical activity were measured through a validated questionnaire (0.76 Cronbach alpha) in Mexico in 2014 by the researcher Guerrero et al. [9], this instrument has 27 items with five response options, which are translated into numbers, from 1 to 5. If the opinion is favorable to the attitude, the answer "daily" will be coded with a 5 and "never or less than once a month" with a 1; if it is unfavorable, "daily" will be coded with a 1 and "never or less than once a month" with a 5, at the end we will add all the answers and the highest score always indicates the healthiest behavior. Therefore, the minimum total score will be 27 points and the maximum score will be 135 points. In this way, those who have 95 points or less will be classified as having poor nutrition and physical activity habits, since the child's lifestyle has many risk factors. Those who present a score within the range of 96 to 109 points, will be considered with sufficient nutrition and physical activity habits, which indicates that the lifestyle has health benefits, but also presents risks. Children who score 110-135 points will be considered as patients with healthy nutrition and physical activity habits.

The recollected data was integrated into data collection sheets and analyzed using the SPSS program version 20 in Spanish, where we applied descriptive statistics; for qualitative variables, frequencies and percentages were used and for quantitative variables, mean and standard deviation were used. The Kolmogorov-Smirnoff test was used to establish the normality of the data. The Protocol was authorized by the Local Committee of Research and Ethics in Health Research.


There were 265 surveys to children from 8 to 12 years of age. The sex of the participants was slightly higher male with 50.9% (n=135) than female with 49.1% (n=130). It can be seen that the population studied has a good distribution by sex (Graphic 1). The average age of the participants was 9.86 ± 1.5 years, the frequency by age was the following: 8 years with 29.4% (n=78), 9 years with 15.8% (n=42), 10 years with 17% (n=45), 11 years with 14.3% (n=38), and 12 years with 23.4% (n=62), a total of 265 patients (Graphic 2). The weight of the participants had an average of 37.68 ± 11 kilograms, with a minimum range of 17 and a maximum of 73 kilograms.