Process of developing text messages on healthy eating and physical activity for Chilean mothers with overweight or obese preschool children to be delivered via WhatsApp

Figures & data

Figure 1. Phases of the development of text messages

Table 1. Example of modification of 2 messages during the three stages described above

Initial Message	After Focus Group	After Delphi	Final Message
Enjoy your food. Eat slowly and don’t watch TV.	Enjoy your food. Eat slowly, and with company when you can.	Enjoy food again! Set aside time to eat slowly and eat with your family whenever you can.	Enjoy food! Set aside time to eat slowly and eat with your family and without distractions like cell phones, TV and computers whenever possible.
There’s nothing better for your child’s snack then a yogurt or glass of milk (low fat or sugarless).	Seasonal fruit is a healthy, low cost snack that you can easily find in your local market.	Want to spend less on snacks? Choose seasonal fruit. It is a healthy, low cost snack that you can easily find in your neighborhood market!	Want to spend less on snacks? Choose seasonal fruit. It is a healthy, low cost snack that you can easily find in your neighborhood market!

Final List of Messages

Messages

Did you know that children develop food preferences prior to age 5? Let them try healthy foods in a wide range of recipes. It is normal for them to reject them the first time. Don’t give up!

Want to spend less on snacks? Choose seasonal fruit. It is a healthy, low cost snack that you can easily find in your neighborhood market!

Before you sit down to eat, set the table and turn off your TV, cell phone and other devices. Enjoy spending time with family!

Looking for a tasty, health, quick meal? Try a tortilla! You just need eggs, tuna, vegetables and a frying pan! Check out the complete recipe here: http://elplatodetuvida.minsal.cl/recetas/tortilla-de-atun/

We recommend that children engage in at least one hour of physical activity each day in order to grow healthy. Playing outside or in the yard is a great way to develop habits that contribute to an active and healthy lifestyle!

Interested in cooking fish? Try mackerel croquettes. You’ll need eggs, mackerel, bread or oatmeal, milk and onion. Check out the complete recipe here: http://elplatodetuvida.minsal.cl/recetas/hamburguesas-de-jurel-2/

Choose healthy, tasty, fun snacks for your children, including seasonal fruits and vegetables and products without nutrition warning labels such as skim milk or yogurt without sugar or nuts.

Review the list provided by your son’s school so that you will know what he needs to bring each day and you won’t send in extra food. If there’s no list, ask the teacher which items are allowed and which are prohibited at his school. The link below provides ideas for healthy meals for the entire family! http://elplatodetuvida.minsal.cl/#menu_semanal

Bored on the weekends? Get outside! An hour of play is great for the whole family! All you need is the willingness to get out of the house and do something different!

One hour of physical activity each day provides lots of benefits for your son’s health. It strengthens his body, allows him to spend time with other children and fights off stress. Encourage him to climb on the playground, jump rope or go for a walk!

Use the weekend to get out and play as a family. Jump rope or visit a playground. These are fun options for staying active and healthy!

Consuming excessive amounts of salt is harmful to your health and is linked to illnesses like hypertension. In order to decrease the amount of salt that your family consumes, take the salt shaker off the table and use it in moderation during cooking. Try it- you can do it!

If your son has lunch at school, don’t serve lunch again at home. If he is hungry, offer him a light snack like fruit, fat free yogurt or a small plate with the salad left over from lunch.

Enjoy your meal! Set aside time to eat slowly and eat with your family and without distractions like cell phones, TV and computers whenever possible.

Remember that your son should eat every 4 or 5 h. The more time that passes, the more anxious he will feel and he may eat more than he needs to.

Remember that it is very important to drink water and stay hydrated! One of the benefits of water is that it promotes digestion and proper kidney function. In order for your son to reap all of these benefits, he should drink 6 to 8 glasses of water each day.

Ask your son’s teacher for the menu so that you can buy snacks each week. This helps save time and money! Avoid buying junk food at the last minute that doesn’t provide any benefits!

How about making stuffed tomatoes? Wash the tomatoes (one per person), cut a 3 cm cap at the top, and scoop out the inside with a spoon, leaving the wall intact. Place it upside down so that the juices run out. Set the pulp aside. Open a can of tuna or mackerel in water and flake it with a fork. Mix with the tomato pulp (seasoned with salt and pepper), cilantro and onion. Fill tomatoes. Check out the full recipe here: http://elplatodetuvida.minsal.cl/recetas/tomate-relleno-con-jurel/

Turn an everyday salad into a main meal by following this recipe for Salpicón (Serves 6.) [PICTURE OF FINISHED DISH] Directions: Wash and cook potatoes and carrots (do not peel). Remove from the water and let cool. Next, peel the vegetables and cube. Wash lettuce under the faucet one leaf at a time. Destem and chop. Mix all of

The vegetables with the meat, lettuce and imitation mayonnaise. Place in a bowl and garnish with slices of hardboiled egg. You can replace the meat with tuna and add other vegetables depending on which are in season. Check out the full recipe and information on imitation mayonnaise here: http://elplatodetuvida.minsal.cl/recetas/salpicon/

One hour of physical activity each day provides many health benefits for your son. It strengthens his body, allows him to interact with other children and combats stress. Encourage him to climb on the jungle gym, jump rope or go for a walk!

Do you know why it is important to drink water? Water helps combat slow digestion, regulates body temperature and decreases fatigue. In order for your son to reap all of these benefits, he should drink at least 6 glasses of water each day.

Teach your son to eat fruit and vegetables. Just five portions per day are enough to prevent illness, control hunger and provide the nutrients he needs to grow healthy and strong!

Buy fresh fruits and vegetables for your children’s snacks. They provide vitamins and minerals that will make them grow healthy and strong!

Learn about your son’s meal and recess schedule so that you can plan out his snacks! A healthy snack is a small portion of food, preferably natural products or those without warning labels, which is meant to be eaten between meals and only if you aren’t going to eat anything for over 4 h.

Remember to eat fish at least once a week! If you can’t buy it fresh, canned tuna or mackerel in water is always a good choice. You can bake it into croquettes, casseroles or tortillas.

Not sure what to make for lunch? Check out this tasty, nutritious recipe for Tomaticán [PICTURE OF FINISHED DISH] Directions (Serves 6): Julienne the onion and sauté until golden. Set aside. Peel and cube tomatoes. Add onion and sauté. Cut up the corn and grind in a food processer. Add to the mixture and boil until the corn is cooked,

Stirring so that it doesn’t stick to the pan, for 20 min. Add pepper and eggs and stir. Check out the full recipe here: http://elplatodetuvida.minsal.cl/recetas/tomatican/

When you eat meat, choose chicken or turkey because they have less fat than processed meats like cold cuts and sausages. Remember to use natural seasonings to give your dishes more flavor and keep them interesting!

Don’t forget to add legumes to your lunch or dinner twice a week! Check out this bean burger recipe. Everyone will love it! All you need is 1 cup of uncooked beans, ¼ onion, ¼ c parsley, garlic and pepper. Check out the full recipe here: http://elplatodetuvida.minsal.cl/recetas/hamburguesa-de-porotos/

When you buy snacks for your children, select natural foods like fruits or products that don’t have labels indicating that they are high in sugar, sodium or saturated fat. This will help them stay healthy! Click on the link below to learn more about Law 20.606: http://www.minsal.cl/reglamento-de-la-ley-de-etiquetado-de-alimentos- introduccion/

If you’re used to drinking soda, decrease the amount you consume gradually and substitute water on its own or with lemon, orange, mint leaves, cinnamon, ginger or other aromatic herbs.

What about this tasty recipe for a morning snack? [PICTURE OF FINISHED DISH] Oatmeal and Carrot Bites Ingredients: 1 cup carrot, 2 cups oatmeal, 1 cup oat flour, 1 egg, 1 teaspoon of Stevia. Check out the video for this recipe here: http://elplatodetuvida.minsal.cl/recetas/bites-de-zanahoria/

Looking for a fun and inexpensive way to exercise at home? Pick your family’s 10 favorite songs and dance to them! You don’t need to be a professional dancer to have a good time.

Pay attention to your son’s meal schedule. Children should eat every 4–5 h because they will feel more anxious about eating if they wait longer. Ask a nutritionist about the guidelines that are right for your son.

[RECIPE] Tuna Rolls, Serves 6. (PICTURE OF FINISHED DISH) Directions: Drain the tuna and wash in a colander under running water. Season with lemon and chopped parsley. Mix the vegetables (squash, lettuce, corn, pepper) in a bowl. Combine the vegetables with the tuna and use them to fill the tortillas. Check out the full recipe here: http://elplatodetuvida.minsal.cl/recetas/rollitos-de-atun/

Did you know that one example of a healthy snack is a piece of fruit, such as an apple, orange, pear, banana or other seasonal fruit? Your children will benefit from fiber, which is very important for good digestion, as well as vitamins and minerals that will help them grow healthy and strong!

Be sure to limit the amount of time your son spends on his phone or computer or watching TV to 2 h per day. Taking a walk to the plaza as a family will help limit screen time!

Being physically active every day is important for your son. Make exercise more fun by inviting a friend to join him. They will get exercise, strengthen their bodies and have a good time!

Be sure to drink water before, during and after exercising. Stay away from sugar-sweetened beverages and soft drinks, which don’t quench your thirst. Staying hydrated will let you play longer!

Teach your son the importance of staying hydrated, explaining that drinking water is beneficial for his physical and mental performance. Water will always be the best option in addition to being inexpensive and accessible!

Don’t forget to eat fish once a week! Make a tasty salad with tuna and lettuce. You’ll need lettuce, canned tuna in water, lemon, oil and cilantro. Mix the ingredients, and you’re done! You can add other vegetables or seeds that you and your children enjoy.