Weight gain is determined by the cumulative effect of low levels of physical activity, high levels of sedentary behaviour, and unhealthy dietary behaviours, also referred to as energy balance-related behaviours. The aim of the current study was to compare levels of energy balance-related behaviours in 3.5–5.5 year-old children from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) within the ToyBox-study (www.toybox-study.eu/) [1Hill J.O., Wyatt H.R., Reed G.W., Peters J.C. Obesity and the environment: where do we go from here? Science 2003 ;  299 : 853-855 [cross-ref]

Cliquez ici pour aller à la section Références, 2Kremers S.P., de Bruijn G.J., Visscher T.L., van Mechelen W., de Vries N.K., et al. Environmental influences on energy balance-related behaviors: a dual-process view Int J Behav Nutr Phys Act 2006 ;  3 : 9 [cross-ref]

Cliquez ici pour aller à la section Références].

A sample of 4045 preschoolers (4.77±0.43 years; 52.2% boys) had valid physical activity data (steps per day), parents/caregivers of 8117 preschoolers (4.78±0.46 years; 53.0% boys) completed a parental questionnaire with questions on sedentary behaviours (TV/DVD viewing, PC/video games, and quiet play), and parents of 7244 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.

Across six European countries, significant differences in preschoolers’ energy balance-related behaviours were found. 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 (9777 and 9656 steps/day on weekdays, respectively). German preschoolers spent the least amount of time in television viewing (43.3min/day on weekdays), while Greek preschoolers spent the most time in television viewing (88.5min/day on weekdays). A considerable amount of time was spent in quiet play in all countries, with the highest levels in Poland (104.9min/day on weekdays), and the lowest levels in Spain (60.4min/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 unhealthy snacks was the highest in Belgian preschoolers (73.1g/day) and the lowest in Greek preschoolers (53.3g/day).

Future interventions should target European preschoolers’ energy balance-related behaviours simultaneously, but should apply country-specific adaptations.