Exploring the Influence of a Physical Activity and Healthy Eating Program on Childhood Well-Being: A Comparative Study in Primary School Students

Childhood is a crucial stage in human development when the lifestyles children adopt can have a significant impact on their well-being throughout their lives. The habits and behavioral patterns that children acquire at this stage can condition their physical and mental health in the future. Early life experiences have a significant impact on the course of development, influencing health, behavior, and learning throughout life [1,2]. Both favorable and unfavorable experiences in childhood contribute to the formation of brain development, which is reflected in the structure of brain architecture during the most malleable stage [2,3].

In recent decades, interest in child-related studies has increased, mainly due to growing concerns about children’s long-term health and well-being [4]. The quality of early relationships and caregiving experiences can have a significant impact on a child’s ability to establish strong and healthy relationships in later life [5,6]. It is therefore vital to understand and attend to children’s lifestyles from a multidisciplinary perspective.

In addition, nutrition and physical activity in childhood have been the subject of significant enquiry in the scientific literature [7]. On the one hand, this research underlines the importance of eating habits in childhood, pointing out that eating patterns formed in childhood often persist into adulthood [8,9], as well as sports habits [10]. Promoting these healthy habits from an early age will help children develop a healthy lifestyle that will benefit them throughout their lives [2]. It is also important to remember that adult support and example are essential for children to adopt these habits [11].

The World Health Organization (WHO) has globally implemented various policies and strategies to address and prevent unhealthy habits in children, particularly those related to unhealthy eating, lack of physical activity, and the rising rates of childhood obesity. Some notable policies include the WHO Global Strategy on Diet, Physical Activity and Health, focusing on combating childhood obesity through guidelines promoting breastfeeding, reducing consumption of added sugars and saturated fats, and advocating for physical activity and nutrition education [12]. Additionally, the European strategy for child and adolescent health and development by WHO aims to enhance the health and well-being of children and adolescents, addressing factors such as nutrition, physical activity, mental health, and safety [13]. The Global Strategy for Women’s, Children’s, and Adolescents’ Health (2016–2030), a UN-driven initiative, is more comprehensive and ambitious, emphasizing equity and aligning with the Sustainable Development Goals [14].

WHO works closely with governments, health organizations, educators, and communities to promote these healthy habits worldwide and prevent chronic diseases, such as obesity, which can have their roots in childhood [15]. Along these lines, Spain has implemented a series of policies and actions aimed at promoting healthy habits among children; some of the specific policies and measures include the following: The NAOS Strategy (Nutrition, Physical Activity and Obesity Prevention) is an initiative of the Spanish Ministry of Health that aims to promote healthy lifestyle habits in the population, with a special focus on the prevention of obesity and related diseases. This strategy includes awareness-raising campaigns, healthy eating guidelines, and physical activity promotion programs [16]. Food Safety and Nutrition Law is specific legislation in Spain that regulates aspects such as food advertising to children, nutrition labeling, and the composition of school food [17]. Physical activity programs in schools have been promoted to encourage regular physical activity among students [18].

On the other hand, education is positively associated with health as it helps to maintain healthy lifestyles [19]. In this sense, the Primary Education curriculum gives importance to healthy habits through the general objectives, giving value to hygiene and health, using physical education, sport, and nutrition as means to favor personal and social development [20]. Educational actions aimed at promoting healthy behaviors in the school environment are essential to prevent obesity and overweight in children, and teachers of various subjects, especially physical education teachers, play a crucial role in this promotion [11].

Likewise, in the Physical Education curriculum in Primary Education, a subject related to the promotion of healthy habits involving body hygiene, posture, and nutrition in both physical activity and daily life is adopted. In addition, the aim of this subject is to foster students’ motor skills, which involves the integration of knowledge, methods, attitudes, and emotions related to physical behavior [21]. Therefore, the subject of Physical Education becomes a fundamental resource in the prevention of problems derived from sedentary lifestyles such as childhood obesity.

Obesity has become a 21st century epidemic affecting the general population. Globally, in 2016, more than 41 million children under 5 years of age were overweight or obese [22]. In Spain, the situation is similar, as in 2015, 23.2% of children aged 6–9 years were overweight, and 18.1% were obese. Its growth and prevalence are a cause for alarm and concern for health institutions [22,23,24]. The PASOS study [25], representative of the Spanish population aged 8 to 16 years, found a prevalence of 33.2% of overweight children and adolescents, placing childhood obesity at 11.6% in Spain.

Several studies have pointed out that overweight children and adolescents are at increased risk of cardiometabolic diseases, musculoskeletal capacity problems, among others [22,26,27]. Technological devices in the home easily provide entertainment options that replace previously outdoor activities involving physical activity. Together with sedentary lifestyles and unhealthy foods, they contribute to weight gain and obesity [28,29], triggering detrimental health problems in the general population [22,26,27,30,31,32].

Due to this situation, different Autonomous Communities in Spain have implemented various intervention programs in Spanish schools to promote healthy habits, mainly nutrition and physical activity. These strategies have provided some positive results, mainly improving eating habits and impacting to a lesser extent on physical activity [33,34]. The effectiveness of healthy habits programs is recognized, but information on their long-term sustainability is often lacking.