Across all sampled countries, children were exposed to high volumes of television advertising for unhealthy foods, featuring child-oriented persuasive techniques. Because of the proven connections between food advertising, preferences, and consumption, our findings lend support to calls for regulation of food advertising during children's peak viewing times.

Objective: To assess the effectiveness of a brief face-to-face health promotion intervention which included a 'pledge' using brief negotiation techniques, compared with standard advice-giving techniques, delivered in a community setting. Design: A parallel group pre-post design using randomised matched groups. Lifestyle helpers delivered the intervention (one consultation per participant). Diet, physical activity and anthropometric measurements were collected at baseline, 6 months and 12 months. Qualitative data were also collected. Setting: Middlesbrough (UK). Subjects: Adults living in low socio-economic areas. Results: Recruitment and engagement of lifestyle helpers was difficult, and initial expectations that local health authority staff working in the community and community champions would act as lifestyle helpers were not realised. As a consequence, recruitment of participants was lower than anticipated. One hundred and twenty-eight adults were recruited and the retention rate was 48 % at 12 months. Barriers to participation included poor health and competing commitments. No significant differences in change in diet or physical activity behaviours, or BMI, between the intervention and control groups were observed. The control group had a significantly greater decrease in waist circumference at 12 months compared with the intervention group. Conclusions: This exploratory trial provides important insights in terms of recruiting lifestyle helpers for community-based health promotion interventions, specifically (i) the priorities and limitations in terms of time (regardless of their general enthusiasm) for staff employed by the local health authority, and (ii) the willingness of potential community champions to serve their local community in areas where community identity and 'spirit' are seen as lacking. Keywords Public health Behaviour change Food ExerciseThe increasing prevalence of obesity in the UK general population is a major public health concern. By 2050 we might expect 60 % of men and 50 % of women to be clinically obese, with obesity-related diseases costing a predicted extra £45?5 billion per year (1) . Lifestyle behavioural factors play a key role in the development of obesity as well as serious health conditions such as diabetes, coronary disease and cancer. As a result, there is a growing acknowledgment that the emphasis should shift from curative approaches to preventive strategies that target lifestyle behaviours such as diet and physical activity.Many conventional health promotion interventions targeting unhealthy diets and low levels of physical activity continue to be based upon traditional advicegiving approaches (i.e. provision of unsolicited advice and direct persuasion). This approach can be appropriate for the management of many medical conditions, but may not be effective in public health preventive programmes (2) . The often frustratingly small percentage of people who respond positively to advice on behaviour change, and the tendency for clinicians to label patients as 'res...

Effective interventions to prevent obesity in children have never been more necessary. There have been over 30 published reviews and meta-analyses on such interventions (randomized and controlled trials) since 2008. In summary, interventions which involve the whole community (community-based) in complex interventions (promoting healthy eating, reduction in sedentary behaviours and increase in physical activity) that target environments and upstream determinants appear to be more effective. In this article the strengths and weaknesses of community-based complex interventions which aim to prevent obesity in children will be discussed and a selection of recent and ongoing interventions that are shaping the evidence-base in this field will be highlighted (beyond those reported in other papers in this supplement: KOPS, CHILT, TigerKids, IDEFICS and TrinkFit). This paper reviews the challenges and opportunities associated with designing and evaluating community-based complex interventions and initiatives. These include a) design issues (strengths and weaknesses of different types of evidence), b) measurement of (effectiveness) outcomes, c) development of interventions (pilot work, planning frameworks and underpinning theories), d) partnership working and community engagement and e) health inequalities.

Background: Evidence suggests that many contemporary urban environments do not support healthy lifestyle choices and are implicated in the obesity pandemic. Middlesbrough, in the northeast of England is one such environment and a prime target for investigation. Methods: To measure physical activity (PA) levels in a sample of 28 adolescents (aged 11 to 14 years) and describe the environmental context of their activity and explore where they are most and least active over a 7-day period, accelerometry and Global Positioning System (GPS) technology were used. Twenty-five of these participants also took part in focus groups about their experiences and perceptions of PA engagement. Results: Findings indicated that all participants were relatively inactive throughout the observed period although bouts of moderate-vigorous physical activity (MVPA) were identified in 4 contexts: school, home, street, and rural/urban green spaces, with MVPA levels highest in the school setting. Providing access to local facilities and services (such as leisure centers) is not in itself sufficient to engage adolescents in MVPA. Conclusion: Factors influencing engagement in MVPA were identified within and across contexts, including 'time' as both a facilitator and barrier, perceptions of 'gendered' PA, and the social influences of peer groups and family members.

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