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HELENA-IDEFICS-PROCHILDREN joint symposium

EUFIC is pleased to bring you a short update on the outcomes of an important event that recently took place in Stockholm, Sweden as a Satellite Symposium to the 2007 Annual Meeting of the International Society for Behavioural Nutrition and Physical Activity (ISBNPA). This symposium highlighted the key achievements and future perspectives of three EU-funded research programmes all undertaking lifestyle interventions in children and adolescents. All three projects have been or are being funded by the European Commission:

HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence, www.helenastudy.com);

IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infants, www.ideficsstudy.eu); and

ProChildren (Promoting and Sustaining Health through Increased Vegetable and Fruit Consumption among European Schoolchildren, www.univie.ac.at/prochildren/).

Professors Lea Maes (Ghent University, Belgium) and Luis Moreno (Zaragoza University, Spain) presented the main components of the HELENA Study, which includes four different studies. The cross-sectional study has been designed to gain a complete situational overview of the nutrition and lifestyle habits of adolescents in ten European cities. The behaviour and food studies are assessing adolescent's food choices and preferences in order to develop new healthy foods that should appeal to the adolescents. The assessment includes testing the physiological effects and acceptability of a healthy snack. An innovative web-based physical activity and nutrition intervention that is tailored to the individual’s needs has been developed in four languages and is being evaluated in six European centres. Both the physical activity and nutrition modules provide immediate tailored feedback and advice that best matches the individual’s needs whilst deviating as little as possible from their current dietary behaviour and lifestyle patterns (ensuring maximum acceptability).

Professor Wolfgang Ahrens (Bremen University, Germany) outlined the interplay of causal factors of overweight, obesity and related disorders in early childhood, currently being examined in the IDEFICS epidemiological prevention study. The study aims to develop an evidence-based intervention to help counteract the epidemic of diet and lifestyle-induced morbidity in young children aged between 2 – 10 years.

The IDEFICS Study is surveying 17,000 children in nine European countries using a standardised set of measurements. A culturally adapted programme that addresses stress, dietary habits and physical activity is currently being developed and implemented. Once completed, the IDEFICS Study will allow comparisons to be made between ethnic, regional and sex and the specific distributions of obesity and its related disorders, assisting with the identification of key risk factors for children. The impact of lifestyle and environmental factors, food preferences, differences in sensory perception and children's consumer behaviour patterns will also be studied and risk profile inventories for children susceptible to obesity and its co-morbid conditions will be identified. Based upon these findings, guidelines for health promotion and disease prevention will be developed and implemented in controlled intervention studies.

Professor Knut-Inge Klepp (Oslo University, Norway) presented the lessons learned from the ProChildren lifestyle intervention study that aimed to increase fruit and vegetable consumption by 20% in 10 – 12 year olds, through activities including the provision of fruits and vegetables in the schools, guided classroom activities, computer tailored feedback and advice for children as well as activities that had to be completed at home in the family environment.

The programme overall was much appreciated by the school children and their teachers. The intervention schools reported a significant increase in their fruit and vegetable intakes and the effects were maintained one year after the intervention study. Among the elements identified as crucial for successful interventions are the availability and accessibility of quality fruits and vegetables, the creation of a sustainable environment for change, and the focus in diminishing social inequalities.

In addition to the presentations of the latest EU-funded research results, several other interesting research initiatives were presented.

Professor Carolyn Summerbell (University of Teeside, UK) presented systematic reviews on the evidence and recommendations for research around lifestyle interventions in children and adolescents conducted in 2005 for the World Health Organisation (WHO). Professor Summerbell concluded that even though most interventions seemed to improve the dietary intake and/or physical activity levels, they had little or no impact on obesity status. The most successful interventions involve the whole school, the family (parental involvement) and a wider environment and are underpinned by a theoretical model. An update of the review is planned before the end of 2007.

Dr Yannis Manios (Harokopio University of Athens, Greece) presented a school-based intervention programme called “Cretan Health & Nutrition Education Programme”, based on social cognitive theory, in elementary schools in Greece comprising workbook activities on diet, physical activity and fitness, audio-taped fairy-tales, posters and interactive activities. The programme significantly improved biochemical indices (such as total cholesterol, HDL or LDL) and anthropometric measures (such as skinfold thickness and Body Mass or BMI), and these changes were associated with changes in physical activity and dietary behaviour in comparison to the control group. These favourable changes could mainly be attributed to the high level of parental involvement as well as to the integration of the programme into the school curriculum. Some of the changes (cholesterol levels, levels of leisure time physical activity or BMI) remained 4 years after the intervention stopped.

Professor Elizabeth Waters (Deakin University, Australia) introduced the context for the emergence of a number of community-based interventions in Australia to tackle the obesity epidemic and presented data from two major interventions, Be Active Eat Well, conducted in a rural area, and Fun ‘n’ Healthy in Moreland, conducted in an urban area. Their findings highlight the possibility of addressing social determinants and making an impact on health inequalities through multi-level community strategies while stressing the importance of strong evaluation designs to ensure the contribution to the evidence base.

Dr Jean Michel Borys (Lille, France) presented the most recent data from the Fleurbaix-Laventie Ville Santé Study, a whole-community prevention programme on the prevalence of overweight and obesity over 12 years compared to control towns. The prevalence of child obesity in Fleurbaix-Laventie was roughly half of the prevalence in control towns and this was particularly true for children in the middle and lower socio-economic classes.

Professor Ilse De Bourdeaudhuij (Ghent University, Belgium) presented a two-year physical activity and healthy eating intervention in secondary school children, which included a tailored computer software component paired with environmental changes. Professor De Bourdeaudhuij concluded that school based strategies combining environmental and personal intervention can effectively improve physical activity and eating behaviour in secondary school children and that tailored computer software interventions seem to be a promising tool.

Professor John J. Reilly (Glasgow University, UK) presented some of the key lessons learned from randomised controlled trials for childhood obesity prevention studies from the United Kingdom. He emphasised the difficulties that exist to assess and tackle the problem of obesity, highlighting the gaps in scientific literature, identification of behaviour targets as well as the need for objective outcome measures as hurdles that need to be overcome. He also stressed the importance of physical activity promotion as an intervention strategy, the role of the environment and the potential for interventions, which take place in early childhood.

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