Objective: The purpose of the present study was to evaluate the effects of a school-based, 2-year, multi-component intervention on BMI, eating and physical activity behaviour in Flanders, Belgium, targeting children aged 3-6 years in communities of high and low socio-economic status (SES). Design: Cluster-randomized controlled trial. Setting: Thirty-one pre-primary and primary schools in three different intervention communities and three paired-matched (on SES profile) control communities in Flanders, Belgium. Subjects: BMI Z-scores at baseline and follow-up were calculated for 1102 children. Questionnaires with sociodemographic data and FFQ were available from 694 of these 1102 children. Results: No significant effects were found on BMI Z-scores for the total sample. However, there was a significant decrease in BMI Z-score of 0?11 in the low-SES intervention community compared with the low-SES control community, where the BMI Z-score increased by 0?04 (F 5 6?26, P 5 0?01). No significant intervention effects could be found for eating behaviour, physical activity or screen-time. There were no significant interaction effects of age and gender of the children on the outcome variables. Conclusions: Although no significant effects were found for BMI Z-scores in the total sample, this intervention had a promising effect in the low-SES community of reducing excess weight gain among young children.

Objective: The aim of the present study was to evaluate the effects of a 1-year family-based healthy lifestyle intervention implemented through day-care centres on toddlers' BMI Z-scores and reported activity-and dietary-related behaviours. Design: Pilot cluster-randomized controlled trial. Setting: Seventy child-care centres in three different intervention communities and three paired-matched control communities in Flanders, Belgium. Subjects: A sample of 203 Belgian toddlers aged 9-24 months was included in the study. Objectively assessed weight and height were used to calculate BMI Z-scores. A parental-report questionnaire was used to assess children's lifestyle behaviours. Results: Positive intervention effects were found on BMI Z-score. No intervention effects were found for activity-and dietary-related behaviours targeted by the intervention. In both intervention and control groups, daily consumption of water, soft drinks, sweets and savoury snacks increased while daily consumption of fruit and vegetables decreased over 1 year. Daily physical activity remained stable but screen-time behaviour increased in both groups over time. Conclusions:The study showed that a family-based healthy lifestyle intervention implemented through day-care centres can lead to healthier weight outcomes in toddlers. In both groups, an unhealthier lifestyle pattern was observed over 1 year which underlines the importance of the early childhood period as the focus of future behavioural interventions.

In this study, physical activity (PA) was objectively measured in 213 Belgian preschoolers (M(age) = 4.98, SD = .88 years) over 4 consecutive days including two weekend days. Within-day variability in PA showed a typical activity pattern during weekdays and weekend days. Weekdays clearly reflected a preschool attending day with more peaks and troughs than weekend days and after-school hours were characterized by a decrease in activity. Between-day variability in PA was identified in preschool girls above the age of four, suggesting that the lack of a structured preschool environment is already related with a decrease in PA in this sex-specific age group. The results of this study are informative for the development of future PA interventions and indicate that both the preschool and the home environment should be targeted in the promotion of preschoolers' PA.

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Objective: The increasing prevalence of childhood overweight is an important health issue. There is a need for longitudinal research among children in order to identify risk factors for childhood overweight. The objective of the present research was to identify potential sociodemographic and behavioural risk factors for development of childhood overweight among 3-to 6-year-old children. Design: Longitudinal study. Setting: Sixteen pre-primary and primary schools. Subjects: BMI Z-scores at baseline and two follow-up measurements were calculated for 568 children. Sociodemographic, parental adiposity, familial composition, child's diet, physical activity and sedentary behavioural data were collected through questionnaires. Results: Several risk factors for the development of childhood overweight were found. Being an only child, lower maternal educational level, maternal and paternal overweight, more than 1 h screen time on weekdays and high soft drinks consumption were shown to be positively associated with the development of childhood overweight. Conclusions: Although behavioural factors are important, our findings support the thesis that interventions on the prevention of childhood overweight should focus on high-risk groups, i.e. children from low socio-economic background or with high parental BMI. Interventions should address the whole family and take into account their lifestyle and structure.