title: Short- and mid-term effects of a setting based prevention program to reduce obesity risk factors in children: a cluster-randomized trial.
abstract: OBJECTIVE
  To assess the effects of a low cost behavioral prevention program in a preschool setting.
  
  
  METHODS
  64 Kindergartens in 4 Bavarian regions were randomly assigned as intervention or controls in a 2:1 ratio. Samples of 1318 and 1340 children examined in the school entrance health examination at 5.7+/-2.6 and 17.6+/-2.3 months (mean+/-standard deviation for first and second sample) after the start of the program were analysed.
  
  
  METHODS
  Main outcome measures were the prevalence of high fruit and vegetable consumption, low consumption of high caloric drinks assessed in parental questionnaires, overweight and obesity, and secondary, further dietary habits and results of motoric testing.
  
  
  RESULTS
  The program led to an increased proportion of children with high fruit and vegetable consumption already after 6 months, which was sustainable with adjusted odds ratios of 1.59 (1.26: 2.01) and 1.48 (1.08: 2.03) after 18 months. Subgroup analyses by gender, overweight and parental education, performed in order to assess consistency of effects, showed similar results. Prevalence of overweight and obesity as well as motoric testing results were not statistically different between intervention and control groups.
  
  
  CONCLUSIONS
  This low cost setting based behavioral intervention achieved sustainable effects on fruit and vegetable consumption in young children 18 months after the start of the intervention and showed effects also in the high risk groups of children from families with lower education levels, and children already overweight.
authors.affiliation: Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University, Heiglhofstr. 63, 81377 Munich, Germany.
authors.forename: Otmar
authors.initials: O
authors.lastname: Bayer
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Angelika
authors.initials: A
authors.lastname: Strauss
authors.forename: Christine
authors.initials: C
authors.lastname: Mitschek
authors.forename: A Michael
authors.initials: AM
authors.lastname: Toschke
authors.forename: Alexander
authors.initials: A
authors.lastname: Hose
authors.forename: Berthold V
authors.initials: BV
authors.lastname: Koletzko
mesh_terms: D000293:Adolescent; D001628:Beverages; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004032:Diet / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D005858:Germany; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014675:Vegetables