***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*** 
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    Input: OBJECTIVE To evaluate the impact of nutrition education in kindergartens and to promote healthy dietary habits in children . DESIGN Prospect i ve cohort study . Four kindergartens with 1252 children were r and omized to the intervention group and three with 850 children to the control group . The personal nutritional knowledge , attitudes and dietary behaviours of the parents were also investigated . Each month , children and parents in the intervention group participated in nutrition education activities . The main outcome measures were anthropometrics and diet-related behaviours of the children and the nutritional knowledge and attitudes of the parents at baseline , 6 months ( mid-term ) and 1 year ( post-test ) . Baseline demographic and socio-economic characteristics were also collected . SETTING Seven kindergartens from Hefei , the capital city of Anhui Province , eastern China . SUBJECTS Two thous and one hundred and two 4- to 6-year-old pre-schoolers from seven kindergartens participated . RESULTS The prevalence of children 's unhealthy diet-related behaviours decreased significantly and good lifestyle behaviours increased in the group receiving nutrition education compared with controls . Parental eating habits and attitudes to planning their children 's diets also changed appreciably in the intervention group compared with the control group ( P < 0.05 ) . However , there were no statistically significant differences in children 's height , weight , height-for-age Z-score or weight-for-age Z-score between the two groups . CONCLUSIONS Kindergarten-based nutrition education improves pre-schoolers ' lifestyle behaviours and brings about beneficial changes in parents ' attitudes to planning their children 's diets and their own personal eating habits Background The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development . However , no information on the cost-effectiveness of interventions in China is available . The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity . We hypothesized the integrated intervention which combined nutrition education and physical activity ( PA ) is more cost-effective than the same intensity of single intervention . Methods And Findings : A multi-center r and omized controlled trial conducted in six large cities during 2009 - 2010 . A total of 8301 primary school students were categorized into five groups and followed one academic year . Nutrition intervention , PA intervention and their shared common control group were located in Beijing . The combined intervention and its ’ control group were located in other 5 cities . In nutrition education group , ‘ nutrition and health classes ’ were given 6 times for the students , 2 times for the parents and 4 times for the teachers and health workers . " Happy 10 " was carried out twice per day in PA group . The comprehensive intervention was a combination of nutrition and PA interventions  . BMI and BAZ increment was 0.65 kg/m2 ( SE 0.09 ) and 0.01 ( SE 0.11 ) in the combined intervention , respectively , significantly lower than that in its ’ control group ( 0.82±0.09 for BMI , 0.10±0.11 for BAZ ) . No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its ’ control , which is the same case in the nutrition intervention . The single intervention has a relative lower intervention costs compared with the combined intervention . Labor costs in Guangzhou , Shanghai and Jinan was higher compared to other cities . The cost-effectiveness ratio was $ 120.3 for BMI and $ 249.3 for BAZ in combined intervention , respectively . Conclusions The school-based integrated obesity intervention program was cost-effectiveness for children in urban China . Trial Registration Chinese Clinical Trial Registry ChiCTR-PRC-09000402 URL : Exercise has been found to be effective for prevention of weight gain and maintenance of a stable weight in adults . The objective of this study was to evaluate the effect of a school-based aerobic exercise program on the obesity indexes of preschool children . Subjects were 292 second-year elementary school pupils from 2 kindergartens in Hat Yai municipality , Songkhla province , southern Thail and . A specially design ed exercise program , including a 15-min walk before beginning the morning class and a 20-min aerobic dance session after the afternoon nap , 3 times a week , was conducted for 29.6 wk . Weight , height , and triceps skinfold thickness were measured 4 times . At the end of the study , the prevalence of obesity , using 95th percentile National Center for Health Statistics triceps-skinfold-thickness cutoffs , of both the exercise and control groups decreased . That of the exercise group decreased from 12.2 % at baseline to 8.8 % ( Wilcoxon signed-rank test , P = 0.058 ) , whereas that of the control group decreased from 11.7 % to 9.7 % ( Wilcoxon signed-rank test , P = 0.179 ) . A sex difference in the response of body mass index ( BMI ) to exercise was observed . Girls in the exercise group had a lower likelihood of having an increasing BMI slope than the control girls did ( odds ratio : 0.32 ; 95 % CI : 0.18 , 0.56 ) . In conclusion , our study suggests that a 29.6-wk school-based exercise program can prevent BMI gain in girls and may induce a remission of obesity in preschool-age children The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox- study , aim ing to identify young children 's key behaviours and their determinants related to early childhood obesity . The ToyBox-intervention is a multi-component , kindergarten-based , family-involved intervention with a cluster-r and omized design , focusing on the promotion of water consumption , healthy snacking , physical activity and the reduction/ breaking up of sedentary time in preschool children and their families . The intervention was implemented during the academic year 2012 - 2013 in six European countries : Belgium , Bulgaria , Germany , Greece , Pol and and Spain . St and ardized protocol s , methods , tools and material were used in all countries for the implementation of the intervention , as well as for the process , impact , outcome evaluation and the assessment of its cost-effectiveness . A total sample of 7,056 preschool children and their parents/caregivers , stratified by socioeconomic level , provided data during baseline measurements and participated in the intervention . The results of the ToyBox- study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention . The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline , prior to the implementation of the intervention Increasing prevalence of childhood obesity calls for comprehensive and cost-effective educative measures in developing countries such as India . School-based educative programmes greatly influence children 's behaviour towards healthy living . We aim ed to evaluate the impact of a school-based health and nutritional education programme on knowledge and behaviour of urban Asian Indian school children . Benchmark assessment of parents and teachers was also done . We educated 40 196 children ( aged 8 - 18 years ) , 25 000 parents and 1500 teachers about health , nutrition , physical activity , non-communicable diseases and healthy cooking practice s in three cities of North India . A pre-tested question naire was used to assess r and omly selected 3128 children , 2241 parents and 841 teachers before intervention and 2329 children after intervention .  Low baseline knowledge and behaviour scores were reported in 75 - 94 % government and 48 - 78 % private school children , across all age groups . A small proportion of government school children gave correct answers about protein ( 14 - 17 % ) , carbohydrates ( 25 - 27 % ) and saturated fats ( 18 - 32 % ) . Private school children , parents and teachers performed significantly better than government school subjects ( P < 0.05 ) . Following the intervention , scores improved in all children irrespective of the type of school ( P < 0.001 ) . A significantly higher improvement was observed in younger children ( aged 8 - 11 years ) as compared with those aged 12 - 18 years , in females compared with males and in government schools compared with private schools ( P < 0.05 for all ) . Major gaps exist in health and nutrition-related knowledge and behaviour of urban Asian Indian children , parents and teachers . This successful and comprehensive educative intervention could be incorporated in future school-based health and nutritional education programmes Background Childhood obesity has been a serious public health problem . An effective school-based physical activity ( PA ) intervention is still lacking in China . This study aim ed to assess the effectiveness of a school-based physical activity intervention during 12 weeks on obesity and related health outcomes  in school children . Methods It was a non-r and omized controlled trial . Altogether 921 children aged 7 to 15 years were recruited at baseline survey . Children in the intervention group ( n = 388 ) participated in a multi-component physical activity intervention during 12 weeks that included improvement of physical education , extracurricular physical activities for overweight/obese students , physical activities at home , and health education lectures for students and parents . Children ( n = 533 ) in the control group participated in usual practice .  Results Participants had mean age of 10.4 years , mean body mass index ( BMI ) of 19.59 kg/m2 , and 36.8 % of them were overweight or obese at baseline survey . The change in BMI in intervention group ( −0.02 ± 0.06 kg/m2 ) was significantly different from that in control group ( 0.41 ± 0.08 kg/m2 ) . The adjusted mean difference was −0.43 kg/m2 ( 95 % CI : −0.63 to −0.23 kg/m2 , P < 0.001 ) . The effects on triceps , subscapular , abdominal skinfold thickness and fasting glucose were also significant in intervention group compared with control group ( all P < 0.05 ) . The change in duration of moderate to vigorous physical activity ( MVPA ) in intervention group ( 8.9 ± 4.3 min/day ) was significantly different from that in control group ( −13.8 ± 3.3 min/day ) . The adjusted mean difference was 22.7 min/day ( 95 % CI : 12.2 to 33.2 min/day , P < 0.001 ) . Conclusions The school-based , multi-component physical activity intervention was effective to decreasing levels of BMI , skinfold thickness , fasting glucose and increasing duration of MVPA . These findings provided evidence for the development of effective and feasible school-based obesity interventions .Trial registration Clinical trials.gov Identifier : NCT02074332 ( 2014 - 02 - 26 OBJECTIVES To determine whether a large-scale physical activity intervention could affect body composition in primary school students in Beijing , China . METHODS The study design was one-year cluster r and omized controlled trial of physical activity intervention ( 20 min of daily exercise in the classroom ) with an additional year of follow-up among 4 700 students aged 8 - 11 years at baseline . RESULTS After the one-year intervention , BMI increased by 0.56 kg/m(2 ) ( SD 1.15 ) in the intervention group and by 0.72 kg/m(2 ) ( SD 1.20 ) in the control group , with a mean difference of -0.15 kg/m(2 ) ( 95 % CI : -0.28 to -0.02 ) . BMI z score decreased by -0.05 ( SD 0.44 ) in the intervention group , but increased by 0.01 ( SD 0.46 ) in the control group , with a mean difference of -0.07 ( -0.13 to -0.01 ) . After another year of follow up , compared to the control group , children in the intervention group had significantly lower BMI ( -0.13 , -0.25 to -0.01 ) , BMI z score ( -0.05 , -0.10 to -0.01 ) , fat mass ( -0.27 kg , -0.53 to -0.02 ) and percent body fat ( -0.53 , -1.00 to -0.05 ) . The intervention had a more pronounced effect on weight , height , BMI , BMI z score , and body composition among obese children than among normal weight or overweight children . Compared to the control group , the intervention group had a significantly higher percentage of children who maintained or reduced their BMI z score at year 1 ( P=0.008 ) and year 2 ( P=0.04 ) . CONCLUSIONS These findings suggest that 20 min of daily moderate to vigorous physical activity during the school year is a feasible and effective way to prevent excessive gain of body weight , BMI , and body fatness in primary school students Background The prevalence of childhood obesity among adolescents has been rapidly rising in Mainl and China in recent decades , especially in urban and rich areas . There is an urgent need to develop effective interventions to prevent childhood obesity . Limited data regarding adolescent overweight prevention in China are available . Thus , we developed a school-based intervention with the aim of reducing excess body weight in children . This report described the study design . Methods / design We design ed a cluster r and omized controlled trial in 8 r and omly selected urban primary schools between May 2010 and December 2013 . Each school was r and omly assigned to either the intervention or control group ( four schools in each group ) . Participants were the 4th grade rs in each participating school . The multi 
    Output:
    
Targeting preschool setting s and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes