Details of the 3 Components of the Intervention Program

1. Training of kindergarten staffTo increase knowledge base, skills, and confidence for planning and cooking of healthy meals to influence dietary behavior1. Before the start of the trial, eight 40-min sessions (twice a wk for a mo) on dietary management in children and daily food purchasing were organized for school doctors and kitchen staff.
2. During the trial, lectures (every 2 mo) on general knowledge in nutrition focusing on the promotion of healthy food and restriction of unhealthy food were given to all preschool staff.
3. Kitchen staffs were trained to use the dietary software for planning balanced menus appropriate for preschool-aged children.
2. A curriculum promoting healthy diet and lifestyle1. To promote a habit of healthy eating among children1. An additional weekly 20-min health education lesson was included in the curriculum, in which children had learning activities and games covering healthy food choice, appropriate portion sizes, and eating pace. This involved the use of various learning aids such as picture story books, cards, food models, and nursery rhymes.
2. To increase the amount of time for physical activity2. Physical activities were mandatory in the intervention group. Teachers were trained to act as play group leaders and organize activities after lunch. Daily 10-min dance sessions were included. Children were asked to dance to rhythm music in the activity room.
3. Collaboration between families and schools1. To equip families with the knowledge about child development and healthy lifestyle and skills to monitor their children’s growth1. A series of lectures designed for parents were organized every 2 mo during the intervention period, covering topics such as what BMI is, reference BMI for preschool-aged children, how to use growth curves, the cause and harms of childhood obesity, and advice on healthy diet (increasing consumption of vegetables and fruit, reducing consumption of meat, snacks, and fast food, and avoiding sugary drinks).
2. To improve communication between the school and parents2. A handbook was issued to every family, in which children’s health behaviors were documented to be reviewed by teachers and parents weekly.
3. To engage parents as facilitators of their children’s health after the intervention period3. Parents were notified of their children’s anthropometric measurements every 3 mo, so that they could plot and interpret their children’s growth curves themselves.