Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Nutrition | Research article

Impact of the intervention program “JolinchenKids – fit and healthy in daycare” on energy balance related-behaviors: results of a cluster controlled trial

Authors: Berit Steenbock, Christoph Buck, Hajo Zeeb, Stefan Rach, Claudia R. Pischke

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

The purpose of this study was to evaluate the multi-component health promotion program, JolinchenKids – fit and healthy in daycare, designed to promote physical activity (PA), healthy eating, and mental wellbeing among 3- to 6-year-old preschoolers.

Methods

For this cluster controlled trial, 62 daycare facilities (DFs) from thirteen different federal states in Germany were recruited (31 intervention, 31 control DFs). Outcome measures were children’s habitual PA, fruits and vegetable consumption, consumption of unsweetened beverages and snacks with parents as raters. Study nurses assessed children’s body composition and motor skills. Data was collected at baseline and 12 months later. To track adherence to the implementation of intervention modules at individual DF groups, an implementation calendar was used from baseline to follow-up. Linear mixed models were used to investigate effects for survey, group and their interaction at the individual level while accounting for clustering.

Results

Samples of 831 (baseline) and 641 (follow-up) children aged 4.3 ± 0.8 and 5.2 ± 0.8 years were analysed. More than half of the intervention DFs chose the nutrition or PA module for the first year of implementation while an implementation level of > 50% was only achieved in less than a third. A significant intervention effect (survey × group interaction) was found for the standing long jump favouring children at intervention DFs (β = 3.08; 95% Confidence interval [CI]: (0.09; 6.07)). No significant intervention effects were found for time spent on PA, total screen time, dietary habits, and body composition, i.e. body-mass-index and percentage of body fat.

Conclusions

Participation in JolinchenKids – fit and healthy in daycare led to improvements in some indicators for motor skills. However, other health outcomes and behaviours were not affected by program participation over the course of 1 year.

Trial registration

German Clinical Trials Register DRKS00011065 (Date of registration 16-09-2016).
Appendix
Available only for authorised users
Literature
1.
2.
Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.PubMedCrossRef
3.
Park MH, Sovio U, Viner RM, Hardy RJ, Kinra S. Overweight in childhood, adolescence and adulthood and cardiovascular risk in later life: pooled analysis of three British birth cohorts. PLoS One. 2013;8(7):e70684.PubMedPubMedCentralCrossRef
4.
Paulis WD, Silva S, Koes BW, van Middelkoop M. Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review. Obes Rev. 2014;15(1):52–67.PubMedCrossRef
5.
6.
7.
Bornhorst C, Tilling K, Russo P, Kourides Y, Michels N, Molnar D, et al. Associations between early body mass index trajectories and later metabolic risk factors in European children: the IDEFICS study. Eur J Epidemiol. 2016;31(5):513–25.PubMedCrossRef
8.
9.
Brisbois TD, Farmer AP, McCargar LJ. Early markers of adult obesity: a review. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2012;13(4):347–67.CrossRef
10.
Ong KK, Loos RJ. Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr. 2006;95(8):904–8.PubMedCrossRef
11.
Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. The relation of childhood BMI to adult adiposity: the Bogalusa heart study. Pediatrics. 2005;115(1):22–7.PubMedCrossRef
12.
Cleland V, Dwyer T, Venn A. Which domains of childhood physical activity predict physical activity in adulthood? A 20-year prospective tracking study. Br J Sports Med. 2012;46(8):595–602.PubMedCrossRef
13.
Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J. Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in young Finns study. Br J Nutr. 2005;93(6):923–31.PubMedCrossRef
14.
Lipsky LM, Haynie DL, Liu D, Chaurasia A, Gee B, Li K, et al. Trajectories of eating behaviors in a nationally representative cohort of U.S. adolescents during the transition to young adulthood. Int J Behav Nutr Phys Act. 2015;12(1):138.PubMedPubMedCentralCrossRef
15.
Lioret S, Betoko A, Forhan A, Charles MA, Heude B, de Lauzon-Guillain B. Dietary patterns track from infancy to preschool age: cross-sectional and longitudinal perspectives. J Nutr. 2015;145(4):775–82.PubMedCrossRef
16.
Luque V, Escribano J, Closa-Monasterolo R, Zaragoza-Jordana M, Ferré N, Grote V, et al. Unhealthy dietary patterns established in infancy track to mid-childhood: the EU childhood obesity project. J Nutr. 2018;148(5):752–9.PubMedCrossRef
17.
Manz K, Schlack R, Poethko-Müller C, Mensink G, Finger J, Lampert T, et al. Physical activity and electronic media use in children and adolescents. Results of the KiGGS study: first follow-up (KiGGS wave 1). Bundesgesundheitsbl. 2014;57(7):840–8.CrossRef
18.
Borrmann A, Mensink G, KiGGS Study Group. Fruit and vegetable consumption by children and adolescents in Germany. Results of KiGGS wave 1. Bundesgesundheitsbl. 2015;58:1005–14.CrossRef
19.
Slykerman S, Ridgers ND, Stevenson C, Barnett LM. How important is young children's actual and perceived movement skill competence to their physical activity? J Sci Med Sport. 2016;19(6):488–92.PubMedCrossRef
20.
Kakebeeke TH, Lanzi S, Zysset AE, Arhab A, Messerli-Burgy N, Stuelb K, et al. Association between body composition and motor performance in preschool children. Obes Facts. 2017;10(5):420–31.PubMedPubMedCentralCrossRef
21.
Schmidt M, Egger F, Benzing V, Jager K, Conzelmann A, Roebers CM, et al. Disentangling the relationship between children's motor ability, executive function and academic achievement. PLoS One. 2017;12(8):e0182845.PubMedPubMedCentralCrossRef
22.
Ling J, Robbins LB, Wen F, Peng W. Interventions to increase physical activity in children aged 2-5 years: a systematic review. Pediatr Exerc Sci. 2015;27(3):314–33.PubMedCrossRef
23.
Hodder RK, Stacey FG, O'Brien KM, Wyse RJ, Clinton-McHarg T, Tzelepis F, et al. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev. 2018;25:1.
24.
Pigeot I, Baranowski T, Lytle L, Ahrens W. Prevention of overweight and obesity in children and adolescents : critical appraisal of the evidence base. Bundesgesundheitsbl. 2016;59(11):1423–31.CrossRef
25.
Summerbell CD, Moore HJ, Vogele C, Kreichauf S, Wildgruber A, Manios Y, et al. Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children. Obes Rev. 2012;13(Suppl 1):129–32.PubMedCrossRef
26.
Ling J, Robbins LB, Wen F, Zhang N. Lifestyle interventions in preschool children: a meta-analysis of effectiveness. Am J Prev Med. 2017;53(1):102–12.PubMedCrossRef
27.
Steenbock B, Zeeb H, Rach S, Pohlabeln H, Pischke CR. Design and methods for a cluster-controlled trial conducted at sixty-eight daycare facilities evaluating the impact of "JolinchenKids - fit and healthy in daycare", a program for health promotion in 3- to 6-year-old children. BMC Public Health. 2017;18(1):6.PubMedPubMedCentralCrossRef
28.
Lampert T, Muters S, Stolzenberg H, Kroll LE. KiGGS study group. [measurement of socioeconomic status in the KiGGS study: first follow-up (KiGGS wave 1)]. Bundesgesundheitsbl. 2014;57(7):762–70.CrossRef
29.
Schenk L, Ellert U, Neuhauser H. Children and adolescents in Germany with a migration background. Methodical aspects in the German health interview and examination survey for children and adolescents (KiGGS). Bundesgesundheitsbl. 2007;50(5–6):590–9.CrossRef
30.
31.
Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284–94.PubMedCrossRef
32.
Eisenmann JC, Heelan KA, Welk GJ. Assessing body composition among 3- to 8-year-old children: anthropometry, BIA, and DXA. Obes Res. 2004;12(10):1633–40.PubMedCrossRef
33.
Goran MI, Kaskoun MC, Carpenter WH, Poehlman ET, Ravussin E, Fontvieille AM. Estimating body composition of young children by using bioelectrical resistance. J Appl Physiol (1985). 1993;75(4):1776–1780.PubMedCrossRef
34.
Klein D, Koch B, Dordel S, Strüder H, Graf C. The KiMo test: a motor screening for pre-school children aged 3–6 years. Gazz Med Ital. 2012;171(1):13–26.
35.
Burdette HL, Whitaker RC, Daniels SR. Parental report of outdoor playtime as a measure of physical activity in preschool-aged children. Arch Pediatr Adolesc Med. 2004;158(4):353–7.PubMedCrossRef
36.
Truthmann J, Mensink G, Richter A. Relative validation of the KiGGS food frequency questionnaire among adolescents in Germany. Robert Koch-Institut, Epidemiologie und Gesundheitsberichterstattung; 2011.
37.
Mensink GBM, Burger M. What do you eat? Food frequency questionnaire for children and adolescents. Bundesgesundheitsbl. 2004;47(3):219–26.
38.
39.
40.
Niermann C, Krapf F, Renner B, Reiner M, Woll A. Family health climate scale (FHC-scale): development and validation. Int J Behav Nutr Phys Act. 2014;11(1):30.PubMedPubMedCentralCrossRef
41.
SAS Institute Inc. SAS ® 9.3 System Options: Reference, Second Edition. Cary, NC: SAS Institute Inc; 2011.
42.
Logan SW, Robinson LE, Wilson AE, Lucas WA. Getting the fundamentals of movement: a meta-analysis of the effectiveness of motor skill interventions in children. Child Care Health Dev. 2012;38(3):305–15.PubMedCrossRef
43.
Pinket AS, De Craemer M, Huybrechts I, De Bourdeaudhuij I, Deforche B, Cardon G, et al. Multibehavioural Interventions with a Focus on Specific Energy Balance-Related Behaviours Can Affect Diet Quality in Preschoolers from Six European Countries: The ToyBox-Study. Nutrients. 2017;9:5.CrossRef
44.
Myszkowska-Ryciak J, Harton A. Eating healthy, growing healthy: impact of a multi-strategy nutrition education on the assortments of beverages served in preschools, Poland. Int J Environ Res Public Health. 2018;15(7):1355.PubMedCentralCrossRef
45.
Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50.PubMedCrossRef
46.
Birnbaum J, Geyer C, Kirchberg F, Manios Y, Koletzko B, ToyBox-study G. Effects of a kindergarten-based, family-involved intervention on motor performance ability in 3- to 6-year-old children: the ToyBox-study. J Sports Sci. 2017;35(4):377–84.PubMedCrossRef
47.
De Craemer M, De Decker E, Verloigne M, De Bourdeaudhuij I, Manios Y, Cardon G, et al. The effect of a kindergarten-based, family-involved intervention on objectively measured physical activity in Belgian preschool boys and girls of high and low SES: the ToyBox-study. Int J Behav Nutr Phys Act. 2014;11(1):38.PubMedPubMedCentralCrossRef
48.
Steenbock B, Zeeb H, Liedtke S, Pischke CR. Results of a process evaluation of a program for health promotion targeting 3-to-6-year-old preschoolers: “JolinchenKids – fit and healthy in daycare”. Prävention und Gesundheitsförderung. 2015;11(1):12–9.CrossRef
49.
Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011;12:CD001871.
50.
Ling J, Robbins LB, Wen F. Interventions to prevent and manage overweight or obesity in preschool children: a systematic review. Int J Nurs Stud. 2016;53:270–89.PubMedCrossRef
51.
Wasenius NS, Grattan KP, Harvey ALJ, Naylor PJ, Goldfield GS, Adamo KB. The effect of a physical activity intervention on preschoolers' fundamental motor skills - A cluster RCT. J Sci Med Sport. 2018;21(7):714–9.PubMedCrossRef
52.
Autorengruppe Bildungsberichterstattung (Hrsg.). Education in Germany 2018. An indicator-based report with an analysis on the effects and benefits of education. Bielefeld 2018.
53.
54.
Ahrens W, Pigeot I, Pohlabeln H, De Henauw S, Lissner L, Molnar D, et al. Prevalence of overweight and obesity in European children below the age of 10. Int J Obes. 2014;38(Suppl 2):S99–107.CrossRef
Metadata
Title
Impact of the intervention program “JolinchenKids – fit and healthy in daycare” on energy balance related-behaviors: results of a cluster controlled trial
Authors
Berit Steenbock
Christoph Buck
Hajo Zeeb
Stefan Rach
Claudia R. Pischke
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Nutrition
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1817-8

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue

Research article

Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors

Study protocol

Randomized controlled trial protocol to improve multisensory neural processing, language and motor outcomes in preterm infants

Correction

Correction to: Allogeneic hematopoietic stem cell transplantation in two brothers with DNA ligase IV deficiency: a case report and review of the literature

Research article

Initial and delayed thyroid-stimulating hormone elevation in extremely low-birth-weight infants

Research article

Evaluation of systemic inflammatory response syndrome-negative sepsis from a Chinese regional pediatric network

Research article

The effect of enteral bolus feeding on regional intestinal oxygen saturation in preterm infants is age-dependent: a longitudinal observational study