Available population data suggest that a high proportion of European children and young people eat less fruit and vegetables than desirable. School based health promotion strategies fostering healthy eating practices and regular physical activity has the potential for a major impact on health and wellbeing during childhood and later stages in life. The aim of Pro-Children project is to estimate the consumption of fruit and vegetables as well as its main determinants among 11 year old European children and their families. It also aims to develop and assess the effectiveness of a school-based intervention program to promote adequate consumption levels of fruit and vegetables among school children. In the first phase of the project, cross-sectional studies were carried out on random population samples in nine European countries. The study protocol included assessment of fruit and vegetable consumption and a questionnaire to ascertain key determinants. A school-based intervention program was designed based on the Attitude, Social Influence and Self-Efficacy model (ASE). Theoretically similar but culturally relevant interventions were designed to be tested in Norway, The Netherlands and Spain during two school years. Each intervention site follows-up 10 intervention schools implementing the program and 10 control schools. Intervention planning and design followed an intervention mapping procedure. Key behaviours and determinants to be addressed through the intervention were identified in order to develop a matrix of educational objectives. The provision of fruit and vegetables in the school is an outstanding element. Program activities include guided classroom activities, computer tailored messages for children, activities to be completed at home with the family and family targeted specific actions. Additionally, optional components for community reinforcement include mass media, school health services participation and implication of grocery stores in the project. Despite cultural and social diversity, common school-based strategies to increase fruit and vegetable consumption among children are feasible across Europe. Understanding specific situations will enhance implementation and gain support.
EPIC is a prospective multi-center study coordinated by the International Agency for Research on Cancer (IARC) operating under the WHO which commenced in 1993 with the collecting of data and blood samples at twenty-three centers in ten European countries (Germany, Denmark, Spain, France, Greece, the Netherlands, Italy, Norway, the United Kingdom and Sweden). In Spain, this study was conducted in five geographic areas (Asturias, Granada, Guipuzcoa, Murcia and Navarre). This study included a total of 519,978 individuals (366,521 of whom were females), blood samples for laboratory analysis being available for a total of 385,719 of these individuals. To date, a total of 24,195 incident cancer cases have been identified. The results of the food intake comparison among the twenty-three European centers were published in 2002, in a European Nutrition journal supplement. The initial EPIC results concerning the relationship between diet and cancer show the intake of fiber, fruits and vegetables to have an effect on protect against colon and rectal cancer, the intake of fruits to have an effect on protect against lung cancer and the intake of fruits and vegetables on the upper digestive tract, whilst a high intake of fruits and vegetables has been shown to have no effect on prostate cancer. Using a seven-day diary for evaluating saturated fat intake, a high intake of saturated fats has been shown to increase the risk of breast cancer.