Differences in energy balance-related behaviours in European preschool children: The ToyBox-study.

Introduction Weight gain is determined by the cumulative effect of low levels of physical activity, high levels of sedentary behaviour, and unhealthy dietary behaviours, also referred to as energy balance-related behaviours. The aim of the current study was to compare levels of energy balance-related behaviours in 3.5–5.5 year-old children from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) within the ToyBox-study ( http://www.toybox-study.eu ) [1,2] . Methods A sample of 4045 preschoolers (4.77 ± 0.43 years; 52.2% boys) had valid physical activity data (steps per day), parents/caregivers of 8117 preschoolers (4.78 ± 0.46 years; 53.0% boys) completed a parental questionnaire with questions on sedentary behaviours (TV/DVD viewing, PC/video games, and quiet play), and parents of 7244 preschoolers (4.77 ± 0.44 years; 52.0% boys) completed a food frequency questionnaire with questions on water consumption, sugar-sweetened beverage consumption and unhealthy snacking. Results Across six European countries, significant differences in preschoolers’ energy balance-related behaviours were found. The highest levels of physical activity were found in Spain (12,669 steps/day on weekdays), while the lowest levels were found in Bulgaria and Greece (9777 and 9656 steps/day on weekdays, respectively). German preschoolers spent the least amount of time in television viewing (43.3 min/day on weekdays), while Greek preschoolers spent the most time in television viewing (88.5 min/day on weekdays). A considerable amount of time was spent in quiet play in all countries, with the highest levels in Poland (104.9 min/day on weekdays), and the lowest levels in Spain (60.4 min/day on weekdays). Belgian, German, and Polish preschoolers had the lowest intakes of water and the highest intakes of sugar-sweetened beverages. The intake of unhealthy snacks was the highest in Belgian preschoolers (73.1 g/day) and the lowest in Greek preschoolers (53.3 g/day). Conclusions Future interventions should target European preschoolers’ energy balance-related behaviours simultaneously, but should apply country-specific adaptations. [ABSTRACT FROM AUTHOR]