Short- and mid-term effects of a setting based prevention program to reduce obesity risk factors in children: A cluster-randomized trial

Bayer, Otmar; Kries, Rüdiger von; Strauß, Angelika; Mitschek, Christine; Toschke, André Michael; Hose, Alexander; Koletzko, Berthold

doi:10.1016/j.clnu.2009.01.001

Cited by 107 publications

(161 citation statements)

References 29 publications

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“…Given the potential inaccuracy of extensive food inventories completed by young children or by parents unable to observe their child during the course of the day, we relied instead on parental report of consumption of specific foods or beverages that reflect general eating behaviour. For the assessment of our primary outcomes, fruit and vegetable intakes, we used items developed by Bayer et al (48) : 'How many portions (size of a child's hand) of fruit does your child eat at average per day?' and 'How many portions (size of a child's hand) of vegetables does your child eat at average per day?'…”

Section: Measurementsmentioning

confidence: 99%

Positive impact of a pre-school-based nutritional intervention on children's fruit and vegetable intake: results of a cluster-randomized trial

Bock

Breitenstein

Fischer

2011

Public Health Nutr.

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Objective: To assess the short-term impact of a nutritional intervention aimed at reducing childhood overweight in German pre-school children. Design: Using a cluster-randomized study design with waiting-list controls, we tested a 6-month intervention administered once weekly by a nutrition expert consisting of joint meal preparation and activities for children and parents such as tasting and preparing nutritious, fresh foods. At baseline, 6 and 12 months, a parent-completed questionnaire assessed fruit and vegetable intakes (primary outcomes) and water and sugared drinks consumption (secondary outcomes). Direct measurement assessed BMI, skinfold thickness and waist-to-height-ratio. An intention-to-treat analysis used random-effects panel regression models to assess the intervention effect, adjusted for each child's age, gender, immigrant background and maternal education. Setting: Eighteen pre-schools from three south German regions. Subjects: Healthy children aged 3-6 years. Results: Three hundred and seventy-seven (80 %) eligible pre-school children participated in the study. Of these, 348 provided sufficient data for analysis. The sample mean age was 4?26 (SD 0?78) years; the majority (53?2 %) were boys. Children's fruit and vegetable intakes increased significantly (P , 0?001 and P , 0?05, respectively); no significant changes in the consumption of water, sugared drinks or anthropometric measurements were noted. Conclusions: Nutritional interventions in pre-schools have the potential to change eating behaviours in young children, which in the long term might reduce risk for developing overweight.

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Section: Measurementsmentioning

confidence: 99%

Positive impact of a pre-school-based nutritional intervention on children's fruit and vegetable intake: results of a cluster-randomized trial

Bock

Breitenstein

Fischer

2011

Public Health Nutr.

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“…For example, reports on the difference in BMI among children within minority groups in Israel indicate the need for country-specific as well as cultural-specific reference curves for Israel, which may yield different results from our American counterparts (12,35) . Similarly, other programmes that have focused on initiating behaviour change in lifestyle habits with kindergarten children have demonstrated positive trends in the behavioural outcomes studied (36,37) . However, they also did not achieve statistically significant reductions in BMI.…”

Section: Discussionmentioning

confidence: 99%

An intervention for improving the lifestyle habits of kindergarten children in Israel: a cluster-randomised controlled trial investigation

Lerner‐Geva

Bar-Zvi

Levitan

et al. 2014

Public Health Nutr.

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Objective: To assess the effectiveness of an intervention programme to improve kindergarten children's eating and leisure habits in Israel. Design: A cluster-randomised controlled trial. Setting: Six full-day kindergartens in Israel were randomly divided into three groups. Group A received the full intervention programme, which included lessons on good eating habits and daily physical exercise. Group B received a partial intervention of lessons only. Group C, the reference group, did not receive any intervention. Subjects: Children aged 4-6 years (n 204) were recruited for the study. Methods: Objective data for weight and height were collected to calculate BMI Z-scores. Activity, sedentary time, sleeping hours and daily energy intake were assessed via a parental questionnaire. Nutritional knowledge was assessed by a single dietitian using a questionnaire addressed to the children. Assessments were done at baseline and at the end of the intervention. Results: After adjustment for baseline levels we observed a significant reduction in daily energy intake for the full intervention group A (P 5 0?03). A positive intervention effect was demonstrated on nutritional knowledge in the partial intervention group B (P 5 0?03), although no significant change was demonstrated for BMI Z-score. Conclusions: The study supports the incorporation of education on healthy lifestyle habits and physical activity into the curricula of kindergartens.

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“…22 The 'TigerKids' behavioural intervention programme was developed with the aims to modify children's physical activity level as well as food and beverage choices. The primary objectives are, in detail:…”

Section: Intervention Programmementioning

confidence: 99%

Implementation process and acceptance of a setting based prevention programme to promote healthy lifestyle in preschool children

Herbert

Strauß

Mayer

et al. 2012

Health Education Journal

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Objective: Evaluation of the implementation process of a kindergarten-based intervention ('TigerKids') to promote a healthy lifestyle. Design: Questionnaire survey among kindergarten teachers about programme implementation and acceptance. Setting: Kindergartens in Bavaria, Germany. Methods: Two hundred and fifteen kindergartens were included; 96.3 % returned informative questionnaires. 'TigerKids' is a multi-approach behavioural intervention programme to increase physical activity level and to promote healthy eating in preschool children. Project elements and materials are designed for kindergarten teachers, children, and their parents. The main outcome measures of the study are implementation, acceptance, and estimated effectiveness of the intervention programme. Results: The elements for promoting healthy lifestyle were implemented regularly in the participating kindergartens: 94.2 % used the drinking station daily, 75.8 % prepared the magic fruit plate daily, and 63.3 % carried out the activity programme at least two times per week. The educators reported that the children ate more fruits and vegetables, drank more non-sugared beverages, and were more active. The designed materials and elements for the children, the educators, and the parents were also evaluated positively by the kindergarten teachers. Conclusion: The 'TigerKids' programme is a suitable instrument for health promotion in the kindergarten setting.

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Short- and mid-term effects of a setting based prevention program to reduce obesity risk factors in children: A cluster-randomized trial

Cited by 107 publications

References 29 publications

Positive impact of a pre-school-based nutritional intervention on children's fruit and vegetable intake: results of a cluster-randomized trial

Positive impact of a pre-school-based nutritional intervention on children's fruit and vegetable intake: results of a cluster-randomized trial

An intervention for improving the lifestyle habits of kindergarten children in Israel: a cluster-randomised controlled trial investigation

Implementation process and acceptance of a setting based prevention programme to promote healthy lifestyle in preschool children

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