OBJECTIVE: To study differences in physical activity between normal-weight and obese children, as well as parent ± child associations of obesity and physical activity. DESIGN: Cross-sectional study. SUBJECTS: 129 obese children (67 girls and 62 boys), 142 normal-weight controls (81 boys and 61 girls), and mothers (n 245) and fathers (n 222) of the children. METHODS: Physical activity was assessed by a 3-day physical activity record (children and parents), by a questionnaire (children), and by one question on habitual physical activity (parents). The data were analysed by stepwise linear and logistic regressions. Obesity was assessed from relative weight (children) and BMI (parents). RESULTS: Parent inactivity was a strong and positive predictor of child inactivity (b-coef®cients 0.25 and 0.16, P`0.001, for mother and father inactivity, respectively). Scores of parent activity were somewhat weaker predictors of child vigorous activity hours and total physical activity level (b-coef®cients 0.13 ± 0.25, P 0.003 ± 0.08). Child obesity was negatively associated with child habitual physical activity (odds ratio 0.88, P`0.001). In addition, parent obesity (body mass index ! 30 kgam 2 ) was another strong predictor of child obesity (odds ratio 2.38 ± 3.50, P`0.002). CONCLUSIONS: The present study underscores the parents' role in childhood activity patterns and obesity. A novel ®nding was that the parent ± child relationship of inactivity appeared to be stronger than that of vigorous activity. Hence, parents who want to reduce their children's inactivity may have to pay attention to their own lifestyle.

Objective: The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. Design and subjects: Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. Outcome measures: Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. Results: Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P ¼ 0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, À5 and À10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P ¼ 0.003) and in BMI-SDS 0.3 vs 0.2 (P ¼ 0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. Conclusions: Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.

Parental overweight conveys a major risk for overweight in children for which both parents' long-term overweight (BMI ≥25 kg m(-2) before pregnancy and after 16-year follow-up) was the strongest single predictor. Preventing intergenerational transmission of obesity by helping parents to maintain a healthy weight is an essential target for public health.

Family-based group treatment is more costly compared with individual routine counseling. Salaries form most of the total costs.

ObjectiveTo investigate the association between sensory-based food education implemented in early childhood education and care (ECEC) centres and children’s willingness to choose and eat vegetables, berries and fruit, and whether the mother’s education level and children’s food neophobia moderate the linkage.DesignThe cross-sectional study involved six ECEC centres that provide sensory-based food education and three reference centres. A snack buffet containing eleven different vegetables, berries and fruit was used to assess children’s willingness to choose and eat the food items. The children’s parents completed the Food Neophobia Scale questionnaire to assess their children’s food neophobia.SettingECEC centres that provide sensory-based food education and reference ECEC centres in Finland.SubjectsChildren aged 3–5 years in ECEC (n 130) and their parents.ResultsSensory-based food education was associated with children’s willingness to choose and eat vegetables, berries and fruit. This association was stronger among the children of mothers with a low education level. A high average level of neophobia in the child group reduced the children’s willingness to choose vegetables, berries and fruit. No similar tendency was observed in the group that had received sensory-based food education. Children’s individual food neophobia had a negative association with their willingness to choose and eat the vegetables, berries and fruit.ConclusionsChild-oriented sensory-based food education seems to provide a promising method for promoting children’s adoption of vegetables, berries and fruit in their diets. In future sensory food education research, more focus should be placed on the effects of the education at the group level.

Eating competence is an attitudinal and behavioral concept, based on The Satter Eating Competence Model. In adults, it has been shown to be associated with a higher quality of diet. Eating competence or its association with the quality of diet has not been studied in adolescents. The aim of the current study was to explore the utility of using a preliminary Finnish translation of the ecSI 2.0 for evaluating presumed eating competence and its association with food selection, meal patterns and related psychobehavioral factors in 10–17 year old adolescents. Altogether 976 10–17 years old Finnish adolescents filled in the study questionnaire. When exploring the construct validity of ecSI 2.0, the confirmatory factor analysis (CFA) indicated acceptable model fit and all four components of the ecSI 2.0 (eating attitudes, food acceptance, internal regulation of food intake, management of eating context) correlated with each other and were internally consistent. Over half (58%) of the adolescents scored 32 or higher and were thus classified as presumably eating competent (pEC). Eating competence was associated with greater meal frequency, more frequent consumption of vegetables and fruits, and more health-promoting family eating patterns. In addition the pEC, adolescents more often perceived their body size as appropriate, had less often tried to lose weight and had a higher self-esteem and a stronger sense of coherence than the not pEC ones. Family eating patterns and self-esteem were the main underlying factors of eating competence. In conclusion, this preliminary study suggests eating competence could be a useful concept to characterize eating patterns and related behaviors and attitudes in adolescents. However, these preliminary findings need to be confirmed in further studies with an instrument fully validated for this age group.

The pupils in the fifth grade appeared to comprise a responsive target group for nutrition education at schools. The curriculum offers a promising approach for developing healthy eating patterns among fifth graders. Collaboration with teachers in developing the curriculum likely enhanced its feasibility and teacher commitment for implementation.

Objective: We investigated the long-term efficacy of two childhood obesity treatment programs, routine counselling (two appointments for children) and group treatment (15 sessions separately for children and parents) in a randomised controlled trial. As published earlier, group treatment was more effective than routine counselling in the treatment of 7-9 year-old obese children in the short term. Design: The children's heights and weights were measured 2 and 3 years after the beginning of the intervention and changes in weight for height, body mass index (BMI) and BMI standard deviation scores were used as outcome measures. Results: There were no significant differences between the treatment arms in the changes of outcome measures from baseline to 2-or 3-years follow-up visits. Conclusion: In conclusion, novel efforts are needed for the improvement of the long-term results of childhood obesity treatment programs.