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Contains fulltext : 172436.pdf (Publisher’s version ) (Open Access) The effectiveness of the "Extra Fit!" (EF!) education program in promoting healthy diet and physical activity to prevent and reduce overweightness among primary school children aged 9 to 11 was evaluated. A randomized controlled design was carried out in 45 primary schools (n = 1112) in the Netherlands, 23 intervention and 22 control schools. The intervention schools received the education program for two successive school years in grades (U.S. system) 4, 5, and 6 (mean 7.6 h during 16 weeks per school per year). The control schools followed their usual curriculum. No positive effects of EF! were found with regard to behavior and anthropometric measures when follow-up measurements were compared to the baseline. However, from baseline to follow-up after one and two school years, the intervention group improved their knowledge score significantly compared to the control group. Moreover, an effect was observed for mean time spent inactively that increased more in the control group than in the intervention group. In conclusion, limited intervention effects were found for the intervention on knowledge and inactivity. To improve the effectiveness of education programs, we advise focusing on parental involvement, attractive lessons to enlarge the acceptability of the program, and multi-component environmental strategies.

The diet of young children is an important determinant of long-term health effects, such as overweight and obesity. We analyzed two-day food consumption records from 1526 young children (10–48 months old) attending 199 daycare centers across The Netherlands. Data were observed and recorded in diaries by caregivers at the day nursery and by parents at home on days that the children attended the daycare center. According to national and European reference values, the children had an adequate nutrient intake with exception of low intakes of total fat, n-3 fatty acids from fish and possibly iron. Intakes of energy and protein were substantially higher than recommended and part of the population exceeded the tolerable upper intake levels for sodium, zinc and retinol. Consumption of fruit, fats, fish, and fluids was substantially less than recommended. The children used mostly (semi-)skimmed milk products and non-refined bread and cereals, as recommended. Two thirds of the consumed beverages, however, contained sugar and contributed substantially to energy intake. In young children, low intakes of n-3 fatty acids and iron are a potential matter of concern, as are the high intakes of energy, protein, sugared beverages, and milk, since these may increase the risk of becoming overweight.