Adherence to the obesity-related lifestyle intervention targets in the IDEFICS study.
OBJECTIVE
To address behaviours associated with childhood obesity, certain target values are recommended that should be met to improve children's health. In the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) study such lifestyle recommendations were conveyed as six key messages. Here, we investigate the adherence of European children to these messages.


METHODS
The IDEFICS intervention was based on the intervention mapping approach with the following six targets: increase water consumption (to replace sugar-containing beverages), increase fruit/vegetable consumption, reduce daily screen time, increase daily physical activity, improve the quality of family life and ensure adequate sleep duration. Internationally recommended target values were applied to determine the prevalence of children meeting these targets.


RESULTS
In a cohort of 18,745 children participating in the IDEFICS baseline survey or newly recruited during follow-up, data on the above lifestyle behaviours were collected for a varying number of 8302 to 17,212 children. Information on all six behaviours was available for 5140 children. Although 52.5% of the cohort was classified in the highest category of water consumption, only 8.8% met the target of an intake of fruits/vegetables five times a day. The prevalence of children adhering to the recommendation regarding total screen time-below 1 h for pre-school children and 2 h for school children-was 51.1%. The recommended amount of at least 60 min of moderate-to-vigorous physical activity per day was fulfilled by 15.2%. Family life of the child measured by various indicators was considered as satisfactory in 22.8%. Nocturnal sleep duration of 11 (10) hours or more in pre-school (school) children was achieved by 37.9%. In general, children in northern countries and younger children showed better adherence to the recommendations. Only 1.1% of the children adhered to at least five of these recommendations.


CONCLUSIONS
Current adherence of children to lifestyle recommendations to prevent childhood obesity is low where observed differences with respect to country, age and gender call for targeted intervention.
Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.
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Kovács
Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
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A
Siani
National Institute for Health Development, Tallinn, Estonia.
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Konstabel
Research and Education Institute of Child Health, Strovolos, Cyprus.
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C
Hadjigeorgiou
Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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de Bourdeaudhuij
Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
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G
Eiben
Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
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Lissner
Department of Intercultural Communication and Management, Copenhagen Business School, Frederiksberg, Denmark.
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Gwozdz
Department of Intercultural Communication and Management, Copenhagen Business School, Frederiksberg, Denmark.
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L
Reisch
Department of Preventive and Predictive Medicine, Epidemiology and Prevention Unit, National Tumor Institute, Milan, Italy.
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Pala
GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
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Moreno
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany.
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Pigeot
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
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Pohlabeln
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany.
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Ahrens
Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.
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Molnár
D002648:Child; D002675:Child, Preschool; D004032:Diet; D004326:Drinking; D002149:Energy Intake; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005638:Fruit; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D040242:Risk Reduction Behavior; D012890:Sleep; D013690:Television; D014675:Vegetables; D044465:White People / Q000706:statistics & numerical data*