Kimberly P. Grattan

Physical Activity Promotion in the Preschool Years: A Critical Period to Intervene

The primary aim of this paper is to provide a rationale for the necessity of intervening with a physical activity intervention in the preschool years and why the daycare environment is amenable to such intervention. We also review the prevalence of physical activity, sedentary behaviour and obesity in the preschool population and the impact that these lifestyle behaviours and conditions have on the health of preschool aged children, as secondary objectives. Moreover we discuss implications for intervention and research using a “lessons learned” model based on our research team’s experience of conducting a randomized controlled trial aimed at increasing physical activity, reducing sedentary behaviour and improving motor skill development and body composition in preschoolers. Lastly, we make conclusions based on the literature and highlight issues and directions that need to be addressed in future research in order to maximize health promotion and chronic disease prevention in the pediatric population.

Evaluating a Fruit and Vegetable Program: In Eastern Ontario Schools

Purpose: Effectiveness was evaluated for a fruit and vegetable program developed to encourage Canadian elementary school children to eat the recommended number of daily servings. Also examined was whether the program modified children’s personal factors, perceived social environment, and perceived physical environment. Methods: A prospective, quasi-experimental trial was conducted to compare the eight schools receiving the intervention curriculum (Freggie Friday schools [FFS]) with six control schools (CS). A food frequency questionnaire was used to measure differences in fruit and vegetable consumption. Personal factors, perceived social environment, and perceived physical environment supporting fruit and vegetable consumption were assessed with an adapted version of the validated Pro Children study questionnaire. Results: Of the 942 children who completed the baseline assessment, 807 also completed the follow-up questionnaire (FFS, 450; CS, 357). A mixed-effects regression model indicated no significant...PURPOSE Effectiveness was evaluated for a fruit and vegetable program developed to encourage Canadian elementary school children to eat the recommended number of daily servings. Also examined was whether the program modified childrens personal factors, perceived social environment, and perceived physical environment. METHODS A prospective, quasi-experimental trial was conducted to compare the eight schools receiving the intervention curriculum (Freggie Friday schools [FFS]) with six control schools (CS). A food frequency questionnaire was used to measure differences in fruit and vegetable consumption. Personal factors, perceived social environment, and perceived physical environment supporting fruit and vegetable consumption were assessed with an adapted version of the validated Pro Children study questionnaire. RESULTS Of the 942 children who completed the baseline assessment, 807 also completed the follow-up questionnaire (FFS, 450; CS, 357). A mixed-effects regression model indicated no significant intervention effects on fruit or vegetable consumption, snack food consumption, or knowledge or attitudes related to fruit and vegetable consumption. CONCLUSIONS The results suggest that an intervention based on a single visit from an external group, followed by teacher-led programming, may be an ineffective method of eliciting dietary behaviour change in this population. Future programs may need to implement multicomponent intervention designs.

Maternal gestational weight gain and objectively measured physical activity among offspring

Objective Animal studies have suggested that maternal weight-related factors during pregnancy can program offspring physical activity in a sex-dependent manner. However, there is limited evidence in humans. The purpose of this study was to investigate the association between maternal gestational weight gain (GWG) and offspring total physical activity (TPA) level and to determine whether these associations are moderated by sex of offspring or maternal pre-pregnancy weight status. Method We studied 56 boys (mean age = 3.7 years, standard deviation (SD) 0.5) and 57 girls (mean age = 3.5±0.5 years) enrolled in licensed childcare centers. TPA was objectively measured using Actical® accelerometers. Information on pre-pregnancy body mass index (BMI), GWG, and other maternal factors were collected with a maternal health questionnaire. Associations between GWG, as a continuous variable or categorically (inadequate, adequate, and excessive), and offspring TPA were analysed using linear mixed models to take into account the intraclass correlation between the clusters (childcare centers). Models were adjusted for gestational age, accelerometer weartime, socioeconomic status, and pre-pregnancy BMI status. Results We found a significant sex interaction (P-value = 0.009). In boys, greater GWG was associated with decreased offspring TPA (β = -3.2 counts⋅1000−1/d, 95% confidence intervals (CI) = -6.4–0.02, P-value = 0.049). In girls born to mothers categorized as overweight or obese, the association between the GWG and TPA followed an inverted U-shape curve (β for GWG squared = -0.1 counts⋅1000−1/d, 95% CI = (-0.2 –-0.04), P-value = 0.005). In contrast, a U-shaped curve was found in girls born to mothers classified as lean (pre-pregnancy BMI<25 kg/m2) (β for GWG squared = 0.7 counts⋅1000−1/d, 95% CI = 0.2–1.2, P-value = 0.011). In boys, TPA in offspring was higher among women with inadequate GWG compared to adequate GWG (P-value = 0.0137), whereas no significant differences were found in girls (P-value = 0.107). Conclusion Maternal GWG can be an important biological marker of offspring TPA. These findings support the sex-dependent early developmental programming influence of GWG on TPA.

388 The Preschoolers Activity Trial (PAT): a Randomized Controlled Trial of Physical Activity Intervention in the Early Years

Background Physical activity (PA) provides widespread health benefits, including pediatric obesity prevention, but less than 10% of Canadian children meet PA guidelines and one in three are overweight or obese. Since PA levels track from childhood into adulthood, early intervention may increase the likelihood of a physically active lifestyle and associated health benefits throughout the lifespan. Aim To evaluate the efficacy of an intervention with day care providers on volume and intensity of PA, motor skill development, and body mass index (BMI) in 3–5 year old children attending daycares. Methods A randomized controlled trial comparing children (n=40) whose daycare providers received intervention designed to promote PA versus children (n=43) whose providers implemented the normal preschool curriculum. Intervention included two, 3-hour workshops plus 12 bi-monthly “booster” sessions. Children were assessed at baseline and 3-months, with a plan to collect data at 6-months. PA was measured objectively using accelerometry. Motor skills were measured using the Test of Gross Motor Development-2. BMI was assessed by measured heights and weights (kg/metres2). Results Compared to controls, the intervention produced greater increases in mean steps/day (–83 vs. +1,185, p<0.01), gross motor percentile scores (+6 vs. +16, p<0.05) and reductions in BMI (+0.21 vs –0.22, p<0.001) at 3-months but not moderate to vigorous PA (MVPA). Conclusions Intervening with daycare providers may be an efficacious method of increasing preschoolers’ volume of PA, promoting motor skill development that is critical to PA and sport participation later in life, and reducing adiposity.

Correction: Maternal gestational weight gain and objectively measured physical activity among offspring

[This corrects the article DOI: 10.1371/journal.pone.0180249.].

1438 Evaluation of the “Freggie Friday” Program to Promote Fruit and Vegetable Consumption in Canadian Elementary School-Aged Children

Background While Canada is one of the world’s most prosperous nations, the health of our children is dismal, with obesity rates amongst the highest in the world. A healthy diet, including at least 5 to 6 daily servings of fruit and vegetables, is of profound importance to child health. Aim To evaluate the efficacy of a fruit and vegetable program ‘Freggie Fridays’ developed to encourage Canadian elementary school children (grades 1 to 6) to eat the recommended number of fruit and vegetable servings each day. Methods A prospective quasi-experimental trial compared schools receiving the “Freggie Friday” curriculum as the intervention (n= 8) to those not receiving the curriculum as control (n=6). The primary outcome measure was the difference in levels of fruit and vegetable consumption as measured by a food frequency questionnaire. Information on attitudes and knowledge of fruit and vegetable consumption was attained using an adapted version of the validated Pro-Children study questionnaire. Results A total of 807 of the 942 children who completed the baseline questionnaires completed the follow-up questionnaires (450 intervention and 357 control). A mixed effects regression model indicated no significant intervention effects on fruit or vegetable consumption, snack food consumption, or knowledge or attitudes relating to fruit and vegetable consumption. Conclusions Despite clear messaging and a sound program, it appears that adding a nutritional program, which expects busy teachers to add this to their educational curriculum, may not be the most efficacious method of eliciting healthy dietary behaviour change in Canadian elementary school-aged children.