Results from cross-sectional and longitudinal studies such as Alimentación y Valoración del Estado Nutricional en Adolescentes: Food and Assessment of the Nutritional Status of Spanish Adolescents (AVENA) and the European Youth Heart Study (EYHS) respectively, highlight physical fitness as a key health marker in childhood and adolescence. Moderate and vigourous levels of physical activity stimulate functional adaptation of all tissues and organs in the body (i.e. improve fitness), thereby also making them less vulnerable to lifestylerelated degenerative and chronic diseases. To identify children and adolescents at risk for these major public health diseases and to be able to evaluate the effects of alternative intervention strategies in European countries and internationally, comparable testing methodology across Europe has to be developed, tested, agreed upon and included in the health monitoring systems currently under development by the European Commission (EC): the Directorate General for Health and Consumer Affairs (DG SANCO); the Statistical Office of the European Communities (EUROSTAT), etc. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study group plans, among other things, to describe the health-related fitness of adolescents in a number of European countries. Experiences from AVENA and EYHS will be taken advantage of. This review summarises results and experiences from the developmental work so far and suggests a set of healthrelated fitness tests for possible use in future health information systems.

Cardiorespiratory fitness is associated with features of metabolic risk factors in children. Should cardiorespiratory fitness be assessed in a European health monitoring system? The European Youth Heart Study Abstract The question as to whether fitness should be assessed in a European health monitoring system, perhaps from the early stages of life onwards, remains to be answered. We aimed to examine the associations between cardiorespiratory fitness and metabolic risk factors in children. A total of 873 healthy children from Sweden and Estonia aged 9-10 years (444 girls and 429 boys) were randomly selected. A maximal ergometer bike test was used to estimate cardiorespiratory fitness. Additional cardiovascular risk factors were assessed. Significant differences among cardiorespiratory fitness quartiles for the sum of five skinfolds, insulin resistance, triglycerides, and total cholesterol (TC) and high-density lipoprotein cholesterol (HDLc) ratio were shown in girls whereas in boys, the sum of five skinfolds and insulin resistance were significantly different. The lowest sum of five skinfolds and insulin resistance was shown in the highest cardiorespiratory fitness quartile in girls and boys, and the lowest values of triglyceride and TC/HDLc values in the highest cardiorespiratory fitness quartile was observed only in girls. Cardiorespiratory fitness was negatively associated with a clustering of metabolic risk factors in girls and boys. The results add supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker and thus should be considered to be included in a pan-European health monitoring system.

There has been a world-wide increase in scientific interest in health-enhancing physical activity (HEPA). The importance of a physically active lifestyle has now been well established both on the individual and on the population level. At the same time, physical inactivity has become a global problem. While sports for all has a long history, only a few examples of long-term integrated physical activity promotion strategies have been in place in Europe until recently, namely in Finland, the Netherlands and England. A number of countries have now begun to develop their own activities. However, there has been a noticeable lack of a platform for sharing the development and implementation of evidence-based policies and strategies. In order to fill this gap, HEPA Europe, the European Network for the Promotion of Health-Enhancing Physical Activity, was founded in May 2005 in Gerlev, Denmark.

Aim Recent scientific literature reveals a tremendous change in the health status of children and adolescents caused by malnutrition and changes in general lifestyle. Thus, the crucial value of a sustainable nutrition education has long been recognised as a major component of public health nutrition strategies. This paper describes a study that took several requirements for nutrition education programmes into account by developing and evaluating a new age-adapted version of an existing nutrition education programme.Methods The objective of the evaluation was to draw conclusions about the effects of the intervention's success. A quasi-experimental field study design was utilised, arranging subjects into intervention, comparison and control groups. For each group, a pre-and post-test was assessed. Between the pre-test and post-test, a period of 4 months elapsed. In total, data from 616 children, 474 parents and 47 teachers were included in the evaluation. ResultsIn general, all children in the intervention group (IG) across all ages showed a statistically significant improvement of general nutrition-related knowledge between the pre-test and post-test, which was measured in one section of the questionnaire. The comparison between intervention group (IG) and control group (CG) revealed significantly stronger improvement for the intervention group (IG). In comparison with the control group, the intervention group did not show any meaningful improvement in any of the five age groups. Parents, kindergarten-teachers and school teachers of all intervention groups reported serious changes for the healthconscious attitudes in children.Conclusion In summarising, the presented age-adapted nutrition education programme and its evaluation could show a clear improvement of nutrition-related knowledge and less clear improvements in nutrition-related attitudes and behavioural intentions. A sustainable prolongation of the programme could lead to even higher improvement.