rendere facili le scelte salutari 1 Studia le parole a partire dalle cose, non le cose a partire dalle parole. (Misone VII sec. A.C. ) OKkio alla SALUTE è stato realizzato grazie al finanziamento del Ministero del Lavoro, della Salute e delle Politiche Sociali/Centro per la prevenzione ed il Controllo delle Malattie (capitolo 4393/2005-CCM) 3 $FXUDGL 'U2VFDU&RUDUHIHUHQWH2.NLRDOOD6DOXWH$8/66'RWWVVD*UD]LHOOD'HOO¶$QWRQH +DQQRFRQWULEXLWRDOODUHDOL]]D]LRQHGHOODUDFFROWDGDWL DOLYHOORQD]LRQDOH $QJHOD6SLQHOOL$QQD/DPEHUWL*LRYDQQL%DJOLR3DROD1DUGRQH0DXUR%XFFLDUHOOL6LOYLD$QGUHR]]L0DULQD 3HGLFRQL 6RQLD 5XELPDUFD *UXSSR GL FRRUGLQDPHQWR QD]LRQDOH &1(636 &HQWUR 1D]LRQDOH GL (SLGHPLRORJLD6RUYHJOLDQ]DH3URPR]LRQHGHOOD6DOXWH±,VWLWXWR6XSHULRUHGL6DQLWj *LRYDQQL%DJOLR*LXOLD&DLUHOOD0DUFHOOR&DSXWR0DUJKHULWD&DUROL&KLDUD&DWWDQHR)UDQFR&DYDOOR/DXUD &HQVL $PDOLD 'H /XFD %DUEDUD 'H 0HL 'DQLHOD *DOHRQH *LRUGDQR *LRVWUD $QQD /DPEHUWL *LDQIUDQFR 0D]]DUHOOD3DROD1DUGRQH*LXVHSSH3HUUD0DULD7HUHVD6LODQL$QQD5LWD6LOYHVWUL$QJHOD6SLQHOOL/RUHQ]R 6SL]]LFKLQR&RPLWDWR7HFQLFR2.NLRDOOD6$/87( DOLYHOORUHJLRQDOH 3LHUR9LR±5HVSRQVDELOH836$,$6HUYL]LR6DQLWj$QLPDOHH,JLHQH$OLPHQWDUH5HJLRQHGHO9HQHWR 5LFFDUGR*DOHVVR±5HIHUHQWH5HJLRQDOHHGRFHQWHDOLYHOORUHJLRQDOHSHU2.NLRDOOD6DOXWH 6HUYL]LR ,JLHQH$OLPHQWL1XWUL]LRQHH$FTXH±6HUYL]LR6DQLWj$QLPDOHH,JLHQH$OLPHQWDUH5HJLRQHGHO9HQHWR 2VFDU&RUD±5HVSRQVDELOHVFLHQWLILFRHGRFHQWHDOLYHOORUHJLRQDOHSHU2.NLRDOOD6DOXWH±5HIHUHQWH 6FKHGD7HPDWLFD³6RUYHJOLDQ]D1XWUL]LRQDOH´$UHD7HPDWLFD6LFXUH]]D1XWUL]LRQDOHGHO376$6$ ±5HVSRQVDELOH6,$1$]LHQGD8/66QGL%HOOXQR 6WHIDQLD 7HVVDUL 'RFHQWH D OLYHOOR UHJLRQDOH SHU 2.NLR DOOD 6DOXWH ± 5HIHUHQWH 6FKHGD 7HPDWLFD ³,QIRUPD]LRQH LQ DPELWR QXWUL]LRQDOH´ $UHD 7HPDWLFD ³6LFXUH]]D 1XWUL]LRQDOH´ GHO 37$6$ ± 5HVSRQVDELOH821XWUL]LRQH6,$1$]LHQGD8/66QGL3DGRYD $QJLROD9DQ]R±'RFHQWHDOLYHOORUHJLRQDOHSHU2.NLRDOOD6DOXWH±5HIHUHQWH$UHD7HPDWLFD³6LFXUH]]D 1XWUL]LRQDOH´GHO376$6$±5HVSRQVDELOHGHO6,$1$]LHQGD8/66QGL9LFHQ]D &KLDUD9HU]HOHWWL&RQVXOHQWHSHUODUHYLVLRQHGHOUHSRUWGL2.NLRHFXUDGHOODVXDHGL]LRQHDVWDPSD *LDQQD0LROD±8659HQHWR'LUH]LRQH*HQHUDOH 0LFKHOD3RVVDPDL'LULJHQWH6FRODVWLFR8IILFLR,9GHOO¶8659HQHWR DOLYHOORSURYLQFLDOH 'RWWVVD6LOYLD&DVRQ5HIHUHQWHDOODVDOXWHGHOO¶8IILFLR6FRODVWLFR7HUULWRULDOHGL%HOOXQR ,'LULJHQWLJOL,QVHJQDQWLL*HQLWRULHGDOXQQLGHOOHVFXROHFDPSLRQDWHQHOO¶$8/66Q 5HIHUHQWLHGRSHUDWRULDOLYHOORD]LHQGDOH 6,$1$8/66 2VFDU&RUDUHIHUHQWH*UD]LHOOD'HOO¶$QWRQH0LFKHOD'D5ROG0DULDQJHOD6FUHPLQ 8QULQJUD]LDPHQWRSDUWLFRODUHDLGLULJHQWLVFRODVWLFLHDJOLLQVHJQDQWLFKHKDQQRSDUWHFLSDWR LQWHQVDPHQWHDOODUHDOL]]D]LRQHGHOO¶LQL]LDWLYDLOORURFRQWULEXWRqVWDWRGHWHUPLQDQWHSHUOD EXRQDULXVFLWDGHOODUDFFROWDGHLGDWLTXLSUHVHQWDWLLQRPLQRQYHQJRQRFLWDWLSHUSURWHJJHUH ODSULYDF\GHLORURDOXQQLFKHKDQQRSDUWHFLSDWRDOODUDFFROWDGHLGDWL 8Q ULQJUD]LDPHQWR DOOH IDPLJOLH H DJOL DOXQQL FKH KDQQR SUHVR SDUWH DOO¶LQL]LDWLYD SHUPHWWHQGRFRVuGLFRPSUHQGHUHPHJOLRODVLWXD]LRQHGHLEDPELQLGHOODQRVWUDUHJLRQHLQ YLVWDGHOO¶DYYLRGLD]LRQLGLSURPR]LRQHGHOODVDOXWH &RSLDGHOYROXPHSXzHVVHUHULFKLHVWDD 'U2VFDU&RUD6,$18/66Q9LD6$QGUHD%HOOXQRRVFDUFRUD#XOVVEHOOXQRLW 6LWLLQWHUQHWGLULIHULPHQWRSHUORVWXGLR ZZZRNNLRDOODVDOXWHLW ZZZHSLFHQWURLVVLWRNNLRDOODVDOXWH /DYHUVLRQHGLJLWDOHGHO5HSRUWGHOOD5HJLRQHGHO9HQHWRqLQROWUHVFDULFDELOHGDLVLWL KWWSZZZYHQHWRQXWUL]LRQHLW KWWSSUHYHQ]LRQHXOVVYHURQDLWVLDQKWPO KWWSZZZLVWUX]LRQHEHOOXQRHX,QWHUYHQWLHGXFDWLYLSURJHWWLKWP 4 Indice Introduzione .................................................................................................8 Metodologia dell’immagine ........................................................................10 Descrizione della popolazione ...................................................................12 La situazione nutrizionale dei bambini.......................................................14 Le abitudini alimentari dei bambini ............................................................19 L’uso del tempo dei bambini: l’attività fisica ...............................................25 L’uso del tempo dei bambini: le attivita sedentarie ....................................30 La percezione delle madri sulla situazione nutrizionale e sull’attività fisica dei bambini ................................................................................................32 L’ambiente scolastico e il suo ruolo nella promozione di una sana alimentazione e dell’attività fisica ..............................................................36 Conclusioni generali ..................................................................................44 Materiali bibliografici ..................................................................................47 5 PREFAZIONE Guadagnare salute” questo è l’ambizioso programma varato dalla Comunità Europea per la Sanità Pubblica e fatto proprio dal Ministero della Sanità e dalla nostra Regione. La protezione della salute della popolazione ed in particolare delle nuove generazioni rappresenta infatti una delle sfide attualmente più importanti per la Sanità Pubblica Mondiale e per la sostenibilità dei sistemi sanitari. I successi assicurati negli ultimi decenni nei confronti di molte malattie infettive tramite la disponibilità di vaccini sempre più efficaci, degli antibiotici, l’adeguamento delle infrastrutture a servizio degli agglomerati urbani (acquedotti e fognature in particolare), le migliori condizioni di vita e di nutrizione, nonché il grande progresso delle varie specializzazioni mediche e chirurgiche in tema di diagnosi e cura, hanno determinato un netto miglioramento delle condizioni di vita e della sua durata. Il rovescio della medaglia è tuttavia rappresentato da un progressivo aumento delle malattie croniche legate spesso al sovrappeso ed all’obesità (cardiopatie, diabete mellito, alcuni tipi di tumori, ecc) conseguenti, non in piccola parte, alle abitudini e stili di vita: alimentazione eccessiva ed incongrua, sedentarietà, fumo, abuso di alcool soprattutto, malattie che hanno assunto andamento epidemico in molti paesi, non solo occidentali. La maggior frequenza e gravità di tali patologie è a carico delle fasce di popolazione più deboli, spesso con minori conoscenze in tale ambito e minori capacità economiche. Esse possono essere prevenute, o comunque se ne può ritardare alquanto la comparsa, con un cambiamento dello stile di vita ed in particolare con una più corretta alimentazione abbinata all’attività motoria. La necessità di questo adeguamento delle abitudini per mantenere, e possibilmente migliorare un buono stato di salute, deve essere una consapevolezza della Comunità, delle Amministrazioni Comunali, della Scuola, dei medici curanti ed particolare dei genitori, proprio al fine di evitare la comparsa precoce nei loro figli di tali malattie croniche, un tempo tipiche dell’adulto, già in età giovanile. La comparsa e la cronicizzazione della malattia, oltre naturalmente alla perdita della salute, comportano notevoli costi finanziari, per l’individuo e per la società, la necessità di somministrare farmaci per lungo tempo con conseguente possibilità di effetti collaterali; la terapia inoltre, pur rallentando la progressione di queste patologie, non è in grado di restituire l’integrità ad organi nel frattempo danneggiati. Lo spostamento in avanti negli anni della comparsa di queste patologie assicura quindi un maggior periodo di buona salute e di efficienza e significa effettivamente “Guadagnare Salute”. Proprio per conoscere meglio la situazione dei nostri bambini relativamente al sovrappeso ed obesità, le loro abitudini e quelle delle loro famiglie, i comportamenti sia alimentari che in tema di attività fisica e, più in generale, alcuni fattori che favoriscono o meno comportamenti corretti per la salvaguardia della salute, l’ ULSS n. 1 ha partecipato allo Studio Okkio alla Salute 2010, organizzato dall’Istituto Superiore di Sanità e che ha visto coinvolte tutte le ULSS del Veneto. La nostra ULSS, tramite il SIAN (Servizio Igiene degli alimenti e della Nutrizione), ha assicurato come nel 2008, anche nel 2010 il coordinamento dell’attività di tutti i SIAN della Regione Veneto, che hanno provveduto alla raccolta dei dati regionali ed ha avuto la funzione di capofila nel Progetto curando anche la pubblicazione del report. I risultati di questa ricerca a livello locale sono riportati in questo volume che raccoglie gli aspetti più significativi emersi e rappresenta un primo passo per conoscere l’entità, anche nelle nostre zone, del problema al fine di saperlo meglio affrontare. Non resta quindi che augurarsi che questo contributo favorisca una maggior consapevolezza dell’importanza di non trascurare la “dote” di buona salute che fortunatamente molti di noi hanno a disposizione, la cui importanza è sempre stata riassunta ed auspicata nel tradizionale e saggio saluto di questo territorio, da rivalutare alquanto, “Sani!!“. dott. F. 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