The role of childcare educators is important given that 81% of preschoolers living in developed countries receive childcare outside their home. Since children learn by observing and imitating others, childcare educators may play a role in promoting healthy eating behaviours and physical activity in young children.Six databases were searched for quantitative peer-reviewed, English or French primary studies reporting the correlates, predictors or effectiveness of childcare educators' practices and behaviours on preschoolers' healthy eating and physical activity behaviours. Risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. Fifteen articles were included in this review: ten measured physical activity levels and five assessed eating behaviours. The quality score was rated as low for eight of these articles, and as moderate for the remaining seven. Two of four cross-sectional studies reported a positive relationship between educators and children's behaviours. Eleven intervention studies reported significant favourable effects of interventions. Educators may play a positive role in promoting healthy behaviours in children, but this is mainly based on studies of low or moderate qualityfew intervention type studies of low or moderate quality. The influence of specific components of educators' practices and behaviours on children's healthy eating and physical activity behaviours remains inconclusive.

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Background: Childhood obesity is a growing concern for public health. Given a majority of children in many countries spend approximately 30 h per week in early childcare centers, this environment represents a promising setting for implementing strategies to foster healthy behaviours for preventing and controlling childhood obesity. Healthy Start-Départ Santé was designed to promote physical activity, physical literacy, and healthy eating among preschoolers. The objectives of this study are to assess the effectiveness of the Healthy Start-Départ Santé intervention in improving physical activity levels, physical literacy, and healthy eating among preschoolers attending early childcare centers.

IntroductionChildcare educators may be role models for healthy eating and physical activity (PA) behaviours among young children. This study aimed to identify which childcare educators’ practices are associated with preschoolers’ dietary intake and PA levels.MethodsThis cross-sectional analysis included 723 preschoolers from 50 randomly selected childcare centres in two Canadian provinces. All data were collected in the fall of 2013 and 2014 and analysed in the fall of 2015. PA was assessed using Actical accelerometers during childcare hours for 5 consecutive days. Children’s dietary intake was measured at lunch on 2 consecutive days using weighed plate waste and digital photography. Childcare educators’ nutrition practices (modelling, nutrition education, satiety recognition, verbal encouragement and not using food as rewards) and PA practices (informal and formal PA promotion) were assessed by direct observation over the course of 2 days, using the Nutrition and Physical Activity Self-Assessment for Child Care tool. Associations between educators’ practices and preschoolers’ PA and dietary intake were examined using multilevel linear regressions.ResultsOverall, modelling of healthy eating was positively associated with children’s intake of sugar (β=0.141, 95% CI 0.03 to 0.27), while calorie (β=−0.456, 95% CI −1.46 to –0.02) and fibre intake (β=−0.066, 95% CI −0.12 to –0.01) were negatively associated with providing nutrition education. Not using food as rewards was also negatively associated with fat intake (β=−0.144, 95% CI −0.52 to –0.002). None of the educators’ PA practices were associated with children’s participation in PA.ConclusionsModelling healthy eating, providing nutrition education and not using food as rewards are associated with children’s dietary intake at lunch in childcare centres, highlighting the role that educators play in shaping preschoolers’ eating behaviours. Although PA practices were not associated with children’s PA levels, there is a need to reduce sedentary time in childcare centres.

ObjectivesChildren learn by observing and imitating others, meaning that their eating behaviors and physical activity may be influenced by their peers. This paper systematically reviews how preschoolers’ eating behaviors and physical activity relate to their peers’ behaviors, and discusses avenues for future research.MethodsSix databases were searched for quantitative, peer-reviewed studies published up to July 2015 reporting on the correlates, predictors or effectiveness of peers on eating behaviors and physical activity in preschoolers. Risk of bias was independently assessed by two evaluators using the Quality Assessment Tool for Quantitative Studies.ResultsThirteen articles were included: six measured physical activity, and seven assessed eating behaviors. Four of the six physical activity studies reported that children were more active when peers were present, while large peer group size was negatively associated with physical activity in two cross-sectional studies. All nutrition interventions reported that children’s eating behaviors may be influenced by their peers.ConclusionsAlthough supported by weak evidence, peers appear to influence children’s eating behaviors and physical activity. However, this influence may be moderated by the number of peers, gender, age and the perceived status of the role models. Future obesity prevention interventions should consider involving peers as agents for positive eating behaviors and physical activity in preschoolers.

BACKGROUND: School environmental characteristics may be associated with youth's participation in different types of physical activities (PA). This study aimed to identify which school policies and built environmental characteristics were associated with participation in organized, non-organized, individual and group-based activities. METHODS:This cross-sectional analysis included 776 Grade 5 and 6 students from 16 schools. The school environment was assessed through school-based questionnaires completed by school representatives. Types of PA and attainment of PA recommendations were obtained using self-administered student questionnaires. Associations between environment and student PA were examined using multilevel logistic regressions. RESULTS:

Preschoolers observe and imitate the behaviors of those who are similar to them. Therefore, peers may be important role models for preschoolers' dietary intake and physical activity in childcare centers. This study examined whether peers' behaviors predict change in preschoolers' dietary intake and physical activity in childcare centers over 9 months.A total of 238 preschoolers (3 to 5 years old) from 23 childcare centers in two Canadian provinces provided data at the beginning (October 2013 and 2014) and the end (June 2014 and 2015) of a 9-month period for this longitudinal study. Dietary intake was collected at lunch using weighed plate waste and digital photography on two consecutive weekdays. Physical activity was assessed using accelerometers over five days. Multilevel linear regressions were used to estimate the influence of peers' behaviors on preschoolers' change in dietary intake and physical activity over 9 months.Results showed that preschoolers whose dietary intake or physical activity level deviated the most from those of their peers at the beginning of the year demonstrated greater change in their intakes and activity levels over 9 months (all p values<0.05), which enabled them to become more similar to their peers. This study suggests that preschoolers' dietary intake and physical activity may be influenced by the behaviors of their peers in childcare centers. Since peers could play an important role in promoting healthy eating behaviors and physical activity in childcare centers, future studies should test interventions based on positive role modeling by children.4

Background: Nearly 50% of Canadians are overweight and their number is increasing rapidly. The majority of obese subjects are treated by primary care physicians (PCPs) who often feel uncomfortable with the management of obesity. The current research proposal is aimed at the development and implementation of an innovative, integrated, interdisciplinary obesity care management system involving both primary and secondary care professionals.