***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE . The study tested whether a combined environmental and educational intervention solely promoting water consumption was effective in preventing overweight among children in elementary school . METHODS . The participants in this r and omized , controlled cluster trial were second- and third- grade rs from 32 elementary schools in socially deprived areas of 2 German cities .  Water fountains were installed and teachers presented 4 prepared classroom lessons in the intervention group schools ( N = 17 ) to promote water consumption .  Control group schools ( N = 15 ) did not receive any intervention . The prevalence of overweight ( defined according to the International Obesity Task Force criteria ) , BMI SD scores , and beverage consumption ( in glasses per day ; 1 glass was defined as 200 mL ) self-reported in 24-hour recall question naires , were determined before ( baseline ) and after the intervention . In addition , the water flow of the fountains was measured during the intervention period of 1 school year ( August 2006 to June 2007 ) . RESULTS . Data on 2950 children ( intervention group : N = 1641 ; control group : N = 1309 ; age , mean ± SD : 8.3 ± 0.7 years ) were analyzed . After the intervention , the risk of overweight was reduced by 31 % in the intervention group , compared with the control group , with adjustment for baseline prevalence of overweight and clustering according to school . Changes in BMI SD scores did not differ between the intervention group and the control group . Water consumption after the intervention was 1.1 glasses per day greater in the intervention group . No intervention effect on juice and soft drink consumption was found . Daily water flow of the fountains indicated lasting use during the entire intervention period , but to varying extent . CONCLUSION . Our environmental and educational , school-based intervention proved to be effective in the prevention of  overweight among children in elementary school , even in a population from socially deprived areas OBJECTIVE A multidimensional lifestyle intervention performed in 652 preschoolers ( 72 % of migrant , 38 % of low educational level ( EL ) parents ) reduced body fat , but not BMI and improved fitness . The objective of this study is to examine whether the intervention was equally effective in children of migrant and /or low EL parents . METHODS Cluster-r and omized controlled single blinded trial , conducted in 2008/09 in 40 r and omly selected preschools in Switzerl and . The culturally tailored intervention consisted of a physical activity program and lessons on nutrition , media use and sleep . Primary outcomes included BMI and aerobic fitness . Secondary outcomes included % body fat , waist circumference and motor agility . RESULTS Children of migrant parents benefitted similarly from the intervention compared to their counterparts ( p for interaction≥ 0.09 ) . However , children of low EL parents benefitted less , although these differences did not reach statistical significance ( p for interaction≥ 0.06 ) . Average intervention effect sizes for BMI were -0.10 , -0.05 , -0.11 and 0.04 kg/m(2 ) and for aerobic fitness were 0.55 , 0.20 , 0.37 and -0.05 stages for children of non-migrant , migrant , middle/high EL and low EL parents , respectively . CONCLUSIONS This intervention was similarly effective among preschoolers of migrant parents compared to their counterparts , while children of low EL parents benefitted less PURPOSE A positive outcome in self-reported behavior could be detected erroneously if an intervention caused over-reporting of the targeted behavior . Data collected from a multi-site r and omized trial were examined to determine if adolescent girls who received a physical activity intervention  over-reported their activity more than girls who received no intervention .  METHODS Activity was measured using accelerometers and self-reports ( 3-Day Physical Activity Recall , 3DPAR ) in cross-sectional sample s preintervention ( 6th grade , n = 1,464 ) and post-intervention ( 8th grade , n = 3,114 ) .  Log-transformed accelerometer minutes were regressed on 3DPAR blocks , treatment group , and their interaction , while adjusting for race , body mass index , and timing of data collection . RESULTS Preintervention , the association between measures did not differ between groups , but post-intervention 3DPAR blocks were associated with fewer log-accelerometer minutes of moderate-vigorous physical activity ( MVPA ) in intervention girls than in control girls ( p = 0.002 ) . The group difference was primarily in the upper 15 % of the 3DPAR distribution , where control girls had > 1.7 more accelerometer minutes of MVPA than intervention girls who reported identical activity levels . Group differences in this sub sample were 8.5%-16.2 % of the mean activity levels ; the intervention was powered to detect a difference of 10 % . CONCLUSION Self-report measures should be interpreted with caution when used to evaluate a physical activity intervention Objective To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children . Design Cluster r and omised controlled single blinded trial ( Ballabeina study ) over one school year ; r and omisation was performed after stratification for linguistic region . Setting 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerl and . Participants 652 of the 727 preschool children had informed consent and were present for baseline measures ( mean age 5.1 years ( SD 0.7 ) , 72 % migrants of multicultural origins ) . No children withdrew , but 26 moved away . Intervention The multidimensional culturally tailored lifestyle intervention included a physical activity programme , lessons on nutrition , media use ( use of television and computers ) , and sleep and adaptation of the built environment of the preschool class . It lasted from August 2008 to June 2009 . Main outcome measures Primary outcomes were aerobic fitness ( 20 m shuttle run test ) and body mass index ( BMI ) . Secondary outcomes included motor agility , balance , percentage body fat , waist circumference , physical activity , eating habits , media use , sleep , psychological health , and cognitive abilities . Results Compared with controls , children in the intervention group had an increase in aerobic fitness at the end of the intervention ( adjusted mean difference : 0.32 stages ( 95 % confidence interval 0.07 to 0.57 ; P=0.01 ) but no difference in BMI ( −0.07 kg/m2 , −0.19 to 0.06 ; P=0.31 ) . Relative to controls , children in the intervention group had beneficial effects in motor agility ( −0.54 s , −0.90 to −0.17 ; P=0.004 ) , percentage body fat ( −1.1 % , −2.0 to −0.2 ; P=0.02 ) , and waist circumference ( −1.0 cm , −1.6 to −0.4 ; P=0.001 ) . There were also significant benefits in the intervention group in reported physical activity , media use , and eating habits , but not in the remaining secondary outcomes . Conclusions A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children . Trial registration Clinical Trials NCT00674544 Background The prevalence of infant obesity is increasing , but there is a lack of evidence -based approaches to prevent obesity at this age . This study tested the acceptability and feasibility of evaluating a theory-based intervention aim ed at reducing risk of obesity in infants of overweight/obese women during and after pregnancy : the Healthy and Active Parenting Programme for Early Years ( HAPPY ) . Methods A feasibility r and omised controlled trial was conducted in Bradford , Engl and . One hundred twenty overweight/obese pregnant women ( Body Mass Index [ BMI ] ≥25 kg/m2 ) were recruited between 10–26 weeks gestation . Consenting women were r and omly allocated to HAPPY ( 6 antenatal , 6 postnatal sessions : N = 59 ) or usual care ( N = 61 ) . Appropriate outcome measures for a full trial were explored , including : infant ’s length and weight , woman ’s BMI , physical activity and dietary intake of the women and infants . Health economic data were collected . Measurement occurred before r and omisation and when the infant was aged 6 months and 12 months . Feasibility outcomes were : recruitment/attrition rates , and acceptability of : r and omisation , measurement , and intervention . Intra-class correlations for infant weight were calculated . Fidelity was assessed through observations and facilitator feedback . Focus groups and semi-structured interviews explored acceptability of methods , implementation , and intervention content . Results Recruitment targets were met ( ~20 women/month ) with a recruitment rate of 30 % of eligible women ( 120/396 ) . There was 30 % attrition at 12 months ; 66 % of recruited women failed to attend intervention sessions , but those who attended the first session were likely to continue to attend ( mean 9.4/12 sessions , range 1–12 ) . Reaction to intervention content was positive , and fidelity was high . Group clustering was minimal ; an adjusted effect size of −0.25 st and ard deviation scores for infant weight at 12 months ( 95 % CI : −0.16–0.65 ) favouring the intervention was observed using intention to treat analyses . No adverse events were reported . Conclusions The HAPPY intervention appeared feasible and acceptable to participants who attended and those delivering it , however attendance was low ; adaptations to increase initial attendance are recommended . Whilst the study was not powered to detect a definitive effect , our results suggest a potential to reduce risk of infant obesity . The evidence reported provides valuable lessons to inform progression to a definitive trial . Trial Registration Current Controlled Trials IS RCT Objective To assess feasibility and acceptability of a multifaceted , culturally appropriate intervention for preventing obesity in South Asian children , and to obtain data to inform sample size for a definitive trial . Design Phase II feasibility study of a complex intervention . Setting 8 primary schools in inner city Birmingham , UK , within population s that are predominantly South Asian . Participants 1090 children aged 6–8 years took part in the intervention . 571 ( 85.9 % from South Asian background ) underwent baseline measures . 85.5 % ( n=488 ) were followed up 2 years later . Interventions The 1-year intervention consisted of school-based and family-based activities , targeting dietary and physical activity behaviours . The intervention was modified and refined throughout the period of delivery . Main outcome measures Acceptability and feasibility of the intervention and of measurements required to assess outcomes in a definitive trial . The difference in body mass index ( BMI ) z-score between arms was used to inform sample size calculations for a definitive trial . Results Some intervention components ( increasing school physical activity opportunities , family cooking skills workshops , signposting of local leisure facilities and attending day event at a football club )  were feasible and acceptable . Other components were acceptable , but not feasible . Promoting walking groups was neither acceptable nor feasible . At follow-up , children in the intervention compared with the control group were less likely to be obese ( OR 0.41 ; 0.19 to 0.89 ) , and had lower adjusted BMI z-score ( −0.15 kg/m2 ; 95 % CI −0.27 to −0.03 ) . Conclusions The feasibility study informed components for an intervention programme . The favourable direction of outcome for weight status in the intervention group supports the need for a definitive trial . A cluster r and omised controlled trial is now underway to assess the clinical and cost-effectiveness of the intervention . Trial registration number IS RCT N51016370 OBJECTIVE To determine risk factors for consumption of soda and other sugar-sweetened beverages ( SSB ) among 2-year-old children . DESIGN The analysis was performed using three linked data sets : the 2004 - 2005  Oregon Pregnancy Risk Assessment Monitoring Survey ( PRAMS ) ; its longitudinal follow-up , 2006 - 2007 Oregon PRAMS-2 ; and 2004 - 2005 Oregon birth certificates . SETTING PRAMS is a surveillance programme supported by the federal Centers for Disease Control and Prevention and implemented by participating state health departments . Using mixed methods , PRAMS surveys women 2 - 6 months after a live birth . Oregon PRAMS-2 re-interviews respondents shortly after the index child 's second birthday . Oregon PRAMS over sample s minority women . SUBJECTS Using monthly cohorts , we r and omly selected 5851 women from the 2004 - 2005 birth certificates . In total 1911 women completed both PRAMS and PRAMS-2 . The weighted response rate of PRAMS-2 was 43.5 % . RESULTS Almost half of mothers ( 49.9 % ) reported that their child drank SSB on at least 1 d/week . Mothers whose children drank SSB at least once weekly were more likely to have low income ( adjusted OR=2.83 , 95 % CI 2.09 , 3.83 ) and to eat out on ≥2 d/week ( OR=2.11 % , 95 % CI 1.66 , 2.70 ) . Hispanic and non-Hispanic black women were most likely to report that their child drank SSB at least once weekly . CONCLUSIONS Half of mothers reported that their 2-year-old children  drank SSB at least once weekly . Public health interventions and policies should address childhood SSB consumption including educating health-care providers and parents OBJECTIVES The purpose of this study 
    Output:
    
In general , modest positive effects were found but interventions were limited by a short follow-up duration .