Differences in energy balance-related behaviours in European preschool children: The ToyBox-study

Abstract

Introduction 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 ( http://www.toybox-study.eu ) [1] , [2] . Methods 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. Results 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 (43.3 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 unhealthy snacks was the highest in Belgian preschoolers (73.1 g/day) and the lowest in Greek preschoolers (53.3 g/day). Conclusions Future interventions should target European preschoolers’ energy balance-related behaviours simultaneously, but should apply country-specific adaptations.