title: Differences in energy balance-related behaviours in European preschool children: the ToyBox-study.
abstract: BACKGROUND
  The aim of the current study was to compare levels of energy balance-related behaviours (physical activity, sedentary behaviour, and dietary behaviours (more specifically water consumption, sugar-sweetened beverage consumption and unhealthy snacking)) in four- to six-year-old preschoolers from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) within the ToyBox cross-sectional study.
  
  
  METHODS
  A sample of 4,045 preschoolers (4.77 ± 0.43 years; 52.2% boys) had valid physical activity data (steps per day), parents of 8,117 preschoolers (4.78 ± 0.46 years; 53.0% boys) completed a parental questionnaire with questions on sedentary behaviours (television viewing, computer use, and quiet play), and parents of 7,244 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
  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 (9,777 and 9,656 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 snacks was the highest in Belgian preschoolers (73.1 g/day) and the lowest in Greek preschoolers (53.3 g/day).
  
  
  CONCLUSIONS
  Across six European countries, differences in preschoolers' energy balance-related behaviours were found. Future interventions should target European preschoolers' energy balance-related behaviours simultaneously, but should apply country-specific adaptations.
authors.affiliation: Ghent University, Ghent, Belgium.
authors.forename: Marieke
authors.initials: M
authors.lastname: De Craemer
authors.affiliation: Medical University Varna, Varna, Bulgaria.
authors.forename: Mina
authors.initials: M
authors.lastname: Lateva
authors.affiliation: Medical University Varna, Varna, Bulgaria.
authors.forename: Violeta
authors.initials: V
authors.lastname: Iotova
authors.affiliation: Ghent University, Ghent, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: De Decker
authors.affiliation: Ghent University, Ghent, Belgium; Research Foundation Flanders, Brussels, Belgium.
authors.forename: Maïté
authors.initials: M
authors.lastname: Verloigne
authors.affiliation: Ghent University, Ghent, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.affiliation: Harokopio University, Athens, Greece.
authors.forename: Odysseas
authors.initials: O
authors.lastname: Androutsos
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Socha
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kulaga
authors.affiliation: University of Zaragoza, Zaragoza, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Moreno
authors.affiliation: University of Munich Medical Centre, Munich, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.affiliation: Harokopio University, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.affiliation: Ghent University, Ghent, Belgium.
authors.forename: Greet
authors.initials: G
authors.lastname: Cardon
mesh_terms: D001628:Beverages; D002648:Child; D002652:Child Behavior / Q000208:ethnology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000208:ethnology; D005060:Europe; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D064427:Nutritive Sweeteners; D057185:Sedentary Behavior / Q000208:ethnology; D062410:Snacks / Q000208:ethnology; D011795:Surveys and Questionnaires
chemical_list: D064427:Nutritive Sweeteners