The Effectiveness Of Maternal Educational Programs On Dietary Habits And Physical Activity Of Preschool Children In Makkah, 2023: A Randomized Controlled Trial Study

Abstract

Background: Childhood overweight and obesity have emerged as major global public health concerns and are now recognized among the most prevalent preventable causes of morbidity and mortality. Beyond their immediate health risks, excess weight in early childhood adversely affects physical, psychological, social, and environmental dimensions of quality of life.

Aim: This study examines the effectiveness of a maternal nutrition-education program in improving mothers’ knowledge of healthy dietary habits and physical activity for preschool children.

Methodology: The study employed a two-phase design. Phase 1 consisted of a cross-sectional survey to determine the prevalence of overweight and obesity among children aged 3–6 years enrolled in selected kindergartens in Makkah, Saudi Arabia. Phase 2 used a two-stage cluster random sampling technique. In the first stage, four kindergartens were randomly selected from 115 facilities across eight districts. In the second stage, the selected kindergartens were randomly assigned to an intervention or control group. Mothers of eligible children were recruited until the required sample size was reached. The intervention group received a structured five-week nutritional education program, whereas the control group received routine one-time dietary and weight-management advice. Data were collected at baseline and three months post-intervention using a screening questionnaire and the General Nutrition Knowledge Questionnaire (GNKQ). Statistical analyses were performed using SPSS version 22.

Results: Of the 350 distributed questionnaires, 176 completed responses were analyzed. The sample included 100 boys and 76 girls (mean age: 5.5 years). Most mothers were college-educated (72.6%) and employed (65%), and the majority of parents were married (94%). Nearly half of the children (48.9%) had normal weight, while 11.9% were overweight and 21% were obese. A significant improvement in maternal nutrition knowledge was observed in the intervention group compared with the control group at post-test (p < 0.0001), with no significant differences at baseline. Dietary and lifestyle patterns revealed that 52.2% of children had mixed feeding during infancy; daily breakfast, lunch, and dinner intake was reported by 38.6%, 67%, and 54.5% respectively; and 36.9% consumed snacks one to two times daily. Lunch was the primary meal for most children (64.2%), and boiled food was the most common cooking method (44.3%). Most mothers reported removing visible fats from meat (84.7%). Screen time ranged between one and three hours daily for half of the children, while 65.9% engaged in some physical activity. Only 22.2% of mothers reported having nutrition-related qualifications, and 7.2% had attended a nutrition-related course.

Conclusion: With the global rise in childhood overweight and obesity, early preventive strategies are essential. The findings highlight the need for sustained, community-based educational interventions targeting parents—particularly mothers—alongside broader efforts by policymakers and educators to promote healthy eating and physical activity habits among Saudi preschool children.