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When we talk about antibodies against COVID-19, we tend to mean the so-called neutralising antibodies, that offer protection by blocking the virus from invading our cells. Now, a new study from Lund University in Sweden has revealed that non-neutralising antibodies may also be important in providing protection against Covid.
“Our results indicate that non-neutralising antibodies could also provide protection. This would mean that we have broader protection from antibodies than previously thought, making us less vulnerable to mutations of the virus. It warrants further investigation,” says Pontus Nordenfelt who led the study and is a researcher at Lund University.
In its efforts to produce vaccines and treatments, the research community has focused on neutralising antibodies, which prevent the spike protein of the virus from binding to the surface protein on our cells.
In a large project led by researchers at Lund University, a more detailed study has been carried out on how the immune system also fights off the virus by means of phagocytosis, the ability to ingest foreign particles, in Covid-19 patients.
Phagocytosis is a type of cleansing mechanism during which the immune system’s players target potential threats, such as bacteria or viruses, and ingests them, and this mechanism is facilitated if the harmful substance is marked by an antibody. The results, published in a themed issue of Frontiers in Immunology, indicate that non-neutralising antibodies are also important in the fight against Covid — through this mechanism.
“We observed that many of the antibodies that develop in response to Covid-19 are opsonising, i.e. they signal to the immune system’s phagocytes to ingest the virus. Our results indicate that non-neutralising antibodies, so long as they are able to opsonise, are also able to provide an effective response to the virus,” says Pontus Nordenfelt.

It is important that multiple sclerosis (MS) is diagnosed and treated as early as possible in order to delay progression of the disease. The technique of magnetic resonance imaging (MRI) plays a key role in this process. In the search for ever better methods, a new MRI technique has been used at MedUni Vienna as part of a research project that could pave the way to quicker assessment of disease activity in MS. The study was conducted by a research team led by Wolfgang Bogner at MedUni Vienna’s Department of Biomedical Imaging and Image-guided Therapy and was recently published in the journal Radiology.
Multiple sclerosis is a disease of the central nervous system that manifests itself in changes (lesions) primarily in the brain. As yet, there is no cure for MS, but it can be effectively treated. Early diagnosis is critical to the prognosis, with highly detailed imaging techniques playing a major role. Although conventional MRI can detect brain lesions, scientists are researching methods to detect the changes at an earlier microscopic or biochemical stage. The method known as proton MR spectroscopy has been identified as a promising tool for this purpose.
Using this technique, the research group led by Eva Niess (formerly Heckova) and Wolfgang Bogner from MedUni Vienna’s Department of Biomedical Imaging and Image-guided Therapy, working with scientists from MedUni Vienna’s Department of Neurology, went one step further in their recently published study. The team used MR spectroscopy with a 7-tesla magnet to compare the neurochemical changes in the brains of 65 MS patients with those of 20 healthy controls. This particularly powerful imaging tool was co-developed by MedUni Vienna researchers and has been used for scientific studies, e.g., of the brain, at MedUni Vienna’s Center of Excellence for High-Field MR since it was commissioned in 2008.
Identifying and predicting changes
Using 7-tesla MRI, MedUni Vienna researchers have now been able to identify MS-relevant neurochemicals, i.e. chemicals involved in the function of the nervous system. “This allowed us to visualize brain changes in regions that appear normal on conventional MRI scans,” says study leader Wolfgang Bogner, pointing to one of the study’s main findings. According to the study’s lead author, Eva Niess, these findings could play a significant role in the care of MS patients in the future: “Some neurochemical changes that we’ve been able to visualize with the new technique occur early in the course of the disease and might not only correlate with disability but also predict further disease progression.”
Clinical studies and further developments follow
More research is needed before these findings can be incorporated into clinical applications, explain Niess and Bogner. They say that the results already show 7-tesla spectroscopic MR imaging to be a valuable new tool in the diagnosis of multiple sclerosis and in the treatment of MS patients.
“If the results are confirmed in further studies, this new neuroimaging technique could become a standard imaging tool for initial diagnosis and for monitoring disease activity and treatment in MS patients,” says Wolfgang Bogner, looking to the future. The method is currently only available on the only 7-Tesla MRI scanner in Austria at MedUni Vienna and only for research purposes. However, the scientific team led by Eva Niess and Wolfgang Bogner is working on refining the new method for use in routine clinical MRI scanners.
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Materials provided by Medical University of Vienna. Note: Content may be edited for style and length.

Researchers at Columbia University Mailman School of Public Health have developed a new blood test to measure the pace of biological aging. Based on an analysis of chemical tags on the DNA contained in white blood cells, called DNA methylation marks, the new test is named DunedinPACE, after the Dunedin Birth Cohort used to develop it. DunedinPACE (stands for Pace of Aging Computed from the Epigenome) is a new addition to a fast-growing list of DNA methylation tests designed to measure aging and contributes value-added over and above the current state of the art. The findings are published online in the journal e-Life.
“What makes DunedinPACE unique is that, whereas other tests aim to measure how old or young a person is, DunedinPACE measures whether you are aging quickly or slowly,” said Daniel Belsky, PhD, assistant professor of epidemiology at Columbia Mailman School and a researcher at the Columbia Aging Center. This design could make DunedinPACE more a more sensitive tool to detect effects of interventions that aim to slow aging or of exposures that accelerate aging processes. “Whereas other measures of aging are designed to capture all aging-related change accumulated across the life course, our measure is focused on changes occurring over the recent past,” explained Belsky. “What is striking is that, even with this more restricted focus, DunedinPACE is equally precise as the best of the currently available tests in predicting disease, disability, and mortality in the future, and it adds value to risk assessments over and above these measures.”
Developed by Belsky and colleagues at Duke University and the University of Otago, DunedinPACE tracks changes in 19 biomarkers of organ-system integrity in the 1000-member Dunedin Study birth cohort, who were first enrolled in the study at birth in 1972-1973 and have been followed up ever since, most recently at the time of their 45th birthday. This study used data collected from the participants when they were all aged 26, 32, 38, and 45 years.
The use a single-year birth cohort to develop the measure ensures DunedinPACE is not contaminated by biases that may affect studies that compare older to younger people, including survival bias, historical differences in exposure. The analysis of changes that occurred within Study members’ bodies as they aged over the 20-year follow-up also ensures that DunedinPACE measures aging-related changes occurring during adult life.
In addition to the Dunedin Study, the researchers also used data from the Understanding Society Study, the Normative Aging Study, the Framingham Heart Study, and the Environmental Risk (E- Risk) Longitudinal Twin Study.
In the current analysis, midlife and older adults with faster DunedinPACE were at increased risk for incident chronic disease, disability, and mortality; across the lifespan, DunedinPACE was correlated with measures of biological age derived from blood chemistry and DNA methylation data, and with research participants’ subjective perceptions of their own health. It also indicated faster Pace of Aging in young adults with histories of exposure to poverty and victimization.
“In sum, DunedinPACE represents a novel measure of aging that can complement existing DNA methylation measures of aging to help advance the frontiers of geroscience,” noted Belsky, who is also with the Robert N. Butler Columbia Aging Center, Columbia Mailman School.
The current analysis establishes DunedinPACE as a novel single-time-point measure that quantifies Pace of Aging with whole blood samples, that can be readily implemented in most DNA methylation datasets, making it immediately available for testing in a wide range of existing datasets as a complement to existing methylation measures of aging.
“There is growing interest in technologies to measure a biological age, defined as how much older or younger a person is biologically than their birthdate would predict. Our study reveals that it is also possible to measure Pace of Aging, or how fast a person’s body is declining. Together, these measurements can help us understand the factors that drive accelerated aging in at-risk populations and identify interventions that can slow aging to build aging health equity.”
Co-authors are A Caspi, TE Moffitt, King’s College, UK and Duke University; K Sugden, K Chamarti, HL Harrington, R Houts, B Williams, Duke University; R Poulton, University of Otago, NZ; L Arseneault, King’s College, UK; A. Baccarelli, Columbia University Mailman School of Public Health; X Gao, Peking University; E Hannon, J Mill, University of Exeter, UK; M Kothari, D Kwon, Robert N. Butler Columbia Aging Center, Columbia Mailman School of Public Health; J Schwartz, C Wang, Harvard TH Chan School of Public Health; and P Vokonas, Veterans Affairs Boston Healthcare System, Boston University School of Medicine
The research was supported by National Institute on Aging (grants AG032282,AG061378,AG066887); Medical Research Council (grant P005918).

One viral protein could provide information to deter pneumonia causing the body’s exaggerated inflammatory response to respiratory viruses, including the virus that causes COVID-19.
That viral protein is NS2 of Respiratory Syncytial Virus (RSV), and a study has found that if the virus lacks this protein, the human body’s immune response can destroy the virus before exaggerated inflammation begins. The research, conducted at Washington State University’s College of Veterinary Medicine, was published Jan. 18 in the journal MBio.
Like other respiratory viruses, including the COVID-19-causing SARS-CoV-2 virus, RSV infects the lung cells responsible for exchanging gases and uses them as factories to make more viruses. Uncontrollable virus multiplication in these cells leads to their destruction and manifestation of severe inflammation; lung diseases like pneumonia; and sometimes death.
“Exaggerated inflammation clogs the airways and makes breathing difficult,” said Kim Chiok, a WSU post-doctoral researcher who led the study. “This is why people who have these long-term and severe inflammatory responses get pneumonia and need help breathing, and it’s why they end up in the hospital in the ICU.”
Chiok and fellow WSU researchers are laying the framework to break that cycle by understanding how respiratory viruses, like RSV, persist in the cell. RSV causes 160,000 deaths annually primarily in infants, children, elderly and immune-compromised individuals, according to National Institute of Allergy and Infectious Diseases.
The research was conducted in the laboratory of Professor Santanu Bose, who is part of WSU’s Veterinary Microbiology and Pathology research unit. Chiok, a Fulbright Scholar from Peru who completed her Ph.D. at WSU, has spent the past two and a half years in the Bose laboratory exploring the mechanisms that regulate the virus-host battle.

SharecloseShare pageCopy linkAbout sharingImage source, Tonga Geological ServicesPeople in Tonga are being advised to remain indoors after the eruption of a nearby volcano on Saturday, which showered the Pacific islands with ash and triggered a tsunami.As the eruption happened, they were told to get to high ground for safety. Now, the priority is to find safe shelter, clean water and to escape the volcanic smog. The plumes of gas, smoke and debris from the volcano reached 20km into the sky. More eruptions are still possible. Locals have been advised to drink bottled water and wear masks if they do go outdoors, to avoid breathing in the ash. Communication lines with the affected islands are down and getting aid to where it is most needed is not yet possible. Other countries are trying to fly in clean drinking water and other supplies, but so far have been unable to land.While some of the islands are unscathed, surveillance flights and satellite images reveal mass destruction on others – on one, an entire village is gone. There are fears that communities may not have access to safe and clean drinking water as a result of saltwater inundation caused by the tsunami waves, and ashfall from the volcanic eruption. This video can not be playedTo play this video you need to enable JavaScript in your browser.The Red Cross charity has some relief workers on the ground, but hasn’t been able to make contact with them for days. Phone and internet communications are extremely limited, meaning the situation in some areas remains unknown.Satellite phones are not working due to the ash cloud and Tonga’s main undersea communications cable is broken. A spokesman for Red Cross explained: “The last time we spoke to colleagues was on Saturday. That is a concern. They are trained to provide help and support and will be doing that, but we don’t know the extent of need for the 100,000 residents who live in Tonga.”The teams will be supporting evacuations, providing first aid and distributing relief supplies which are already on the islands. “We have enough to support 1,200 families in Tonga, but there could be many more who need them,” he said.The kits contain essential items such as tarpaulins, blankets, kitchen sets, sanitary products and water purification tablets. Clearing up the debris and repairing all of the damage is a priority, but will take time – and the people doing it will need protecting. Tonga’s deputy head of mission in Australia, Curtis Tu’ihalangingie, has been speaking to the BBC from the capital Canberra: “There will be health concerns as people are breathing it, especially with a huge clean-up mission that is happening in Tonga now. “About 200 volunteers, people coming to sweep the runway for the airport. We have to do it but we know that there will be a long-term problem because people are breathing this ash, which is very dangerous.”While aid is urgently needed, Tonga is concerned about the risk of deliveries spreading Covid to the islands, which have avoided the pandemic virus so far. Volcanic ash exposure can irritate the lungs, eyes and skin. In the long term, it can cause silicosis – permanent scarring of the lungs. Associate Professor Carol Stewart, of the College of Health, Massey University, and co-director of the International Volcanic Health Hazards Network, said: “Ashfall on the ground is not hazardous to breathing, but fine ash in the air can be inhaled. “Very fine particles can travel deep into the lungs where in the short term they can cause asthma symptoms to flare up. Slightly larger particles irritate the nose and throat, and cause coughs and sore throats.”Fresh ash particles typically have an acidic surface coating, and if they get in the eyes they can sting and cause scratching damage, and can irritate skin.The clean-up operation will include ships from Australia and New Zealand to help with pumping out water. Stagnant pools could be a breeding ground for diseases such as cholera. Most of the people in Tonga are involved in agriculture and farming, meaning the longer-term devastation to lives and livelihoods will be huge. Are you, or a family member, in Tonga? Share your experiences by emailing haveyoursay@bbc.co.uk.Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:WhatsApp: +44 7756 165803Tweet: @BBC_HaveYourSayUpload pictures or videoPlease read our terms & conditions and privacy policy

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SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesHong Kong plans to cull some 2,000 hamsters and other small mammals over a Covid-19 outbreak linked to a pet shop in the city.An outbreak of the Delta variant linked to a worker in the shop prompted officials to test hundreds of animals there – with 11 hamsters positive.Unlike many other places, Hong Kong has maintained a “zero Covid” strategy focused on eliminating the disease.Officials said it may be an example of animal-to-human Covid transmission.Only the hamsters at the pet shop seemed to be affected, with negative results for other animals there such as rabbits and chinchillas. But as a “preventative measure”, 2,000 hamsters and other small mammals will be killed.The animals are spread across 34 different pet shops and animal storage centres. And any new pet owners who bought a hamster since 22 December, perhaps as a Christmas gift, will need to hand the animal over to authorities for euthanasia.A telephone hamster hotline is being set up, and a ban on the import and sale of hamsters and other small mammals will also be enacted, agriculture officials said.Image source, Getty ImagesA pet-shop employee, a customer, and the customer’s spouse have now tested positive or provisionally positive, health authorities said.The virus that causes Covid-19 – Sars-Cov-2 – can be caught by animals including dogs, cars, ferrets and rodents, all commonly kept as pets. But there is no clear evidence that pets can easily pass the infection to humans.First UK Covid case in pet dog confirmed by vetSnotty-nosed hippos test positive for Covid”Pet owners should keep a good hygiene practice, including washing hands after touching the animals, handling their food or other items, and avoid kissing the animals,” Hong Kong’s agriculture department director Leung Siu-fai told reporters at a news conference.Hamster owners in particular “should keep them at home”, she said.She also promised that the 2,000 animals scheduled for culling would be put down “humanely”.In late 2020 millions of farmed mink in Denmark were put down amid fears around mutations to the virus potentially occurring within the animals.

FAYETTEVILLE, Ark. — For years, Zara Banks had been looking forward to her 14th birthday — the moment, last June, when her life would no longer be on pause.Ever since Zara, a transgender girl, was 8, she has been certain she wanted to grow up to be a woman. After conversations with her parents and sessions with a therapist, she began transitioning socially: changing her name to Zara and pronouns to she/her. When she turned 9, she began treatment with puberty blockers, drugs that would place her physiological development in limbo until she was old enough — 14 according to her doctor — to begin estrogen therapy and develop a feminine body.But last spring Arkansas enacted a law, the first of its kind in the nation, barring physicians from administering hormones or puberty blockers to transgender people younger than 18. The bill, called the Save Adolescents from Experimentation (SAFE) Act, overrode a veto by Gov. Asa Hutchinson and was to go into effect on July 28, about a month after Zara’s birthday. It is now on pause because of a legal challenge from the American Civil Liberties Union.Zara has been able to get hormones while the court case proceeds, but worries about what the future holds. “I was just really happy, after finally waiting so long, to get something that I’ve needed for a very long time,” she said, sitting in her suburban backyard with her parents, Jasmine and Mo Banks, amid buzzing cicadas.In recent years a growing number of American teenagers have come out as transgender and sought medical care to better align their bodies with their gender identities. Even as the medical community grapples with how best to provide such care, states across the country have introduced legislation banning it outright; medical groups have condemned these laws as dangerous.Leading medical associations, including the Endocrine Society and the American Academy of Pediatrics, recommend that such care be made available to patients under 18. Still, clinicians remain divided over best practices. Last month an international group of experts focused on transgender health released a draft of new care guidelines recommending a more cautious stance on minors, who typically cannot give full legal consent until they are 18.Puberty blockers and hormone therapy, the two treatments primarily given to minors, are most effective around the ages of 8 to 14, as they can prevent the need for future surgeries in adulthood; for example, a transgender boy who took puberty blockers might not need a mastectomy later. There are risks to the drug therapies, including slowed bone growth and fertility loss, but evidence suggests that denying the care to adolescents who need it raises the risk of depression and suicide.The push to outlaw such care altogether gained momentum last year as Republicans across the country adopted the issue. Arkansas and Tennessee are the only states that have passed such laws — Tennessee banned gender-affirming care for children who have yet to reach puberty, a population that does not currently receive such care — and 19 more states have considered them, according to the Williams Institute at the U.C.L.A. School of Law.If upheld, the Arkansas law would also prohibit doctors from referring patients to other medical professionals for drugs or surgeries in gender-affirming care, even out of state. Any physicians who provided such care could lose their licenses or be subject to civil litigation. The law would also allow private insurers to refuse coverage of such care to transgender patients of all ages.A week before the law was to go into effect, however, it was temporarily blocked by a federal judge in response to the A.C.L.U.’s legal challenge. The trial is set for July. Transgender adolescents and their families are now living with uncertainty.“It’s pretty excruciating as a parent to be told by the state that it will become illegal to give your child what she needs to exist,” Jasmine Banks said.Zara added, “It’s not, like, other people’s decision who I am and what I’m not.”A year on the defenseSabrina Jennen, 16, and her family have joined a lawsuit filed by the American Civil Liberties Union against Arkansas’ Save Adolescents from Experimentation ActLiz Sanders for The New York TimesSabrina Jennen, 16, who lives in Fayetteville, has been thinking about ghosts — whether they exist, and what it would be like to encounter one.“People are much scarier than ghosts,” she said on a gusty day in Gulley Park, a sloping green space near her neighborhood.Transgender teenagers are generally prescribed gender-affirming hormones after they have gone through mental health assessments and displayed persistent distress from the gap between their bodies and their gender identities.Sabrina came out to her family in July 2020 at age 15. She saw a therapist, received a diagnosis of gender dysphoria and had many conversations with her parents, Lacey and Aaron Jennen. By last January, she felt ready to start hormone therapy. Then the SAFE Act was passed.“It felt like my life was being signed away,” Sabrina said. She stayed awake at night imagining her future. “If it went into place, it would truly be the death of Sabrina,” she said. “I wouldn’t be able to live and be myself.”When the bill passed, her parents asked if she wanted to be a plaintiff in the A.C.L.U. lawsuit. She did. “If it’s not me, it’s going to be someone else,” she said. “And if it’s not someone else, it’s going to be nobody.”In March 2021, Representative Robin Lundstrum, a sponsor of the bill, compared gender-affirming surgery to “mutilation” in a committee hearing on the bill. Representative Alan Clark, another of the bill’s sponsors, described hormone therapies as “experimental.” (Ms. Lundstrum and Mr. Clark did not respond to numerous interview requests.)(The latest suggested standards of care recommend 15 as the minimum age for chest surgery and 17 for genital surgery, with each patient’s case considered individually. No doctors in Arkansas currently perform any gender-affirming surgery on minors.)Dylan Brandt, 16, from Greenwood, is another plaintiff. He and his mother, Joanna Brandt, were in the State House during a hearing on the bill.“It was hard to listen to because they were saying awful things again about me and so many other people,” he said.Dr. Michele Hutchison, a pediatric endocrinologist who treats transgender adolescents in Arkansas, was one of several medical experts who testified in opposition to the bill. She told legislators that several of her young patients had attempted suicide after learning of the bill.Ms. Brandt, who also spoke at the hearing, called the experience “heartbreaking.” Dylan stood behind her; as she testified, Ms. Lundstrum approached and began talking to him, he said.Tips for Parents to Help Their Struggling TeensCard 1 of 6Are you concerned for your teen?

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesChildren who have become “fussy eaters” could be displaying a post-Covid smell and taste disorder, experts said.Parosmia, a symptom where people experience strange smell distortions, is a well-documented side-effect in adults who have had Covid.The University of East Anglia (UEA) and charity Fifth Sense have created a guide to recognising it in children.”I expect there are a lot of parents at their wits’ end and really worried,” said Prof Carl Philpott of the UEA.”In many cases the condition is putting children off their food, and many may be finding it difficult to eat at all.”‘Has not been recognised’The disorder, which he said affected an estimated 25,000 adults as a result of Covid, can mean food gives off an unpleasant odour or taste, such as rotten meat or chemicals.Vitamin A treatment trial for Covid loss of smell Since I had Covid, food makes me want to vomitCovid smell loss made meat taste like petrolProf Philpott, a rhinologist and olfactologist at the university’s medical school in Norwich, said he had begun to see teenage patients with parosmia for the first time in his career.”It’s something that until now hasn’t really been recognised by medical professionals, who just think the kids are being difficult eaters without realising the underlying problem,” he added.”For some children – and particularly those who already had issues with food, or with other conditions such as autism – it can be really difficult.” ‘He just stopped eating’Image source, Kafi family Since coming down with Covid in September, Malisse Kafi, 11, found it difficult to eat or drink because everything tastes “like poo and rotten eggs”.His mum Dawn Kafi, from Liverpool, said food made him retch and gag. Within two months, he was rushed to hospital with dehydration, having lost 2kg (4.5lb).”It was horrendous,” she said.”It was really hard to know what to do. We tried everything to try and get him to eat, cooking all his favourite foods, but it all just made him feel really sick.”Malisse was diagnosed with parosmia and given a steroid nasal spray, but it did not help and when in hospital he had to be fed via a tube.”We had never heard of parosmia,” Ms Kafi added.”It has been absolutely heart-breaking to see him deteriorate; he stopped eating all together.”Malisse now has safe foods including salmon and Dairylea, but he was “extremely tired and cold all the time,” his mother said, and had on-going health issues.Duncan Boak of Fifth Sense, a charity for people affected by smell and taste disorders, said it had heard anecdotal evidence that children were really struggling with their food after Covid.”We’ve heard from some parents whose children are suffering nutritional problems and have lost weight, but doctors have put this down to just fussy eating,” he said.”We’re really keen to share more information on this issue with the healthcare profession so they’re aware that there is a wider problem here.”The guide, put together by Prof Philpott and Fifth Sense, shows that parents can help by keeping a diary of safe foods and those that are triggers.Children should be encouraged to try blander foods, to see what they can cope with or enjoy, and to try a soft nose clip while eating, to block out flavours. The guide also advocates a simple “smell training” technique of sniffing at least four different odours twice a day for several months, to aid recovery.Find BBC News: East of England on Facebook, Instagram and Twitter. If you have a story suggestion please email eastofenglandnews@bbc.co.ukApollo Trial – Rhinology and ENT Research GroupVitamin A – NHSThe BBC is not responsible for the content of external sites.

Implementing school-based programs aimed at teaching healthy cardiovascular health habits as early as preschool can achieve lasting lifestyle changes in children, according to a review published today in the Journal of the American College of Cardiology.
Previous studies have found that unhealthy lifestyle habits such as a nutritionally poor diet, sedentary lifestyle and smoking, all of which contribute to cardiovascular disease risk, are prevalent among children and adolescents. Additional research has also found a relationship between poor cardiovascular health in childhood and poor cardiometabolic health in adults.
“The SI! Program (Salud Integral — Comprehensive Health) was developed as a multilevel and multicomponent school-based program for the promotion of cardiovascular health and achieving lasting lifestyle changes in children from preschool age. It was implemented in three countries from year 2009 onwards,” said Valentin Fuster, MD, PhD, general director at Centro Nacional de Investigaciones Cardiovasculares (CNIC), director of Mount Sinai Heart and principal investigator of the project.
“The school environment is a great area to introduce lifestyle interventions, because children are spending so much of their time there,” said Rodrigo Fernández-Jiménez, MD, PhD, group leader of the cardiovascular health and imaging lab at CNIC and author on the study. “There are specific times in a child’s life when improvements can be made to enhance long-term cardiovascular health status. Our review, and previous studies, suggest that 4-5 years of age is the most favorable time to start a school-based intervention focused on healthy habits.”
The authors reviewed the 10-year results of the SI! Program, which included more than 3,800 children, aged 3-5 years, from 50 schools across Colombia, Spain and the U.S. Children were assessed on how their knowledge, attitudes and habits changed toward a healthy lifestyle. Those who received the program showed a significant increase in knowledge, attitudes and habits after the implementation of a four-month health promotion program.
To evaluate the success of the program, assessment tools were adapted to the maturation of the children. Questionnaires included simple pictures and were modified to the sociocultural contexts of each country by using names and pictures of local foods, pictures of local playgrounds and images reflecting ethnic diversity. Compared to children who received less than 50% of the program, children who received more than 75% of the program were found to have a significant change from baseline in overall knowledge, attitudes and habits.
To review the lessons learned from the SI! Program, the authors looked at dissemination (conveying information about the program to the school), adoption (the decision by the school to try the program), implementation (executing the health intervention effectively), evaluation (assessing how well the program achieved its goals) and institutionalization (long-term incorporation of the program).
“Most preschool interventions focus solely on physical activity and diet. The SI! Program breaks down cardiovascular health into four components. Through the first two components, children are learning how a well-balanced diet and physically active life are directly connected to a healthy heart. Next, they learn about emotion management, which seeks to instill behavior mechanisms against substance abuse — mainly smoking — and dietary decisions later in life. Finally, the children are taught about how the human body works and how it is affected by behavior and lifestyle,” said Gloria Santos-Beneit, PhD, scientific coordinator of the SHE-la Caixa Foundation and lead author of the study.
In order to accommodate the learning styles of preschool-aged children, the SI! Program used a heart-shaped mascot named “Cardio” to teach about the recommended healthy behaviors, along with the Sesame Street character Dr. Ruster, a Muppet based on Dr. Fuster, to introduce and convey messages and activities. Other materials include video segments and printed materials (a colorful storybook, an interactive board game, flash cards and a teacher’s guide). The activities and messages used were tailored based on the country in which the program was implemented, keeping in mind cultural health beliefs or practices related to food, facilities allocated for physical activity, transportation methods to school, meals provided in school, popular songs or stories, and local everyday rituals and celebrations.
Some of the challenges to be considered in implementing the program include family involvement, family socioeconomic status, the amount of time dedicated to the program and long-term adherence strategies.
“Further research is needed to identify specific socioeconomic status factors that influence child health and effectiveness of intervention in the long term, and the issue of sustainability or need for re-intervention,” Fuster said. The SI! Program has expanded across the five boroughs of New York City through the Children’s Health and Socioeconomic Implications (CHSEI) project. “The diverse ethnic and socioeconomic backgrounds in New York City offer a unique opportunity to explore which socioeconomic factors, at both the family and borough level, may eventually affect children’s health, how they are implicated in the intervention’s effectiveness, and how they can be addressed to reduce the gap in health inequalities.”