The Importance of Research in Preschool Health Education
Keeping children “healthy” is like a long marathon race that begins with birth and continues throughout childhood and adolescence. It is a race because we are racing against the threats to child health from accidents, injuries, and diseases that can be prevented. Children gradually need to learn how to “take care” of themselves- since parents and teachers cannot always be there to protect them.

This critical learning process must begin early in childhood -since even preschool children make important health decisions every day. These are decisions about safety (shall I touch that sharp knife?), hygiene (shall I wash my hands after I go to the bathroom?), smoking and drugs (shall I move away from that cigarette smoke?), sun-safety (shall I ask Mom or Dad for a hat and T-shirt since the sun is so hot?), nutrition (shall I ask Mom for an apple or a candy bar?); and physical activity (shall I ride my tricycle or watch TV?)

Preschool health education programs most likely to be effective are those designed to help children (a) learn to know what to do to keep themselves healthy (knowledge) , (b) believe that healthy living is really important to them (good attitudes), and ( c ) practice and reinforce good health behaviors, and not just talk about it (actions and behavior). The ultimate goal is to enable young children to make healthy lifestyle choices and develop good health habits in the first place - rather than try to undo bad habits later.

The most effective health education programs are those that have been put to the test and evaluated in the classroom. The evaluations may be designed to measure knowledge, attitudes, behavior, or environmental changes -like changes in the food service at school - or the physical education program. Evaluations may also be more general, such as asking teachers how easy or difficult the program was to implement; how age-appropriate the material was for the classroom; what they liked the best; what the children liked the best; and what they would change to improve the program.
When choosing a health curriculum or other health program, be sure to ask how the program has been evaluated in the classroom - since this is the best measure of how effective the program will be for you. The best programs will have evaluations available for your review - many in the form of published papers.

The Healthy-Start comprehensive preschool program is very unique among early childhood health programs in that it has an excellent record of publications and evaluations. Healthy-Start was shown to be effective in improving nutrition and health knowledge and attitudes among preschool children, making meals and snacks in the preschool centers healthier, and in reducing heart disease risk (lowering cholesterol levels).

None of us need to be reminded that our children are our future, and for this reason we are especially alarmed with the rapid increase in obesity rates in childhood - now a staggering epidemic. To reverse this epidemic we need effective educational programs for children, teachers and parents- starting with preschool and continuing through young adulthood. Programs like “Healthy-Start” “Healthy Hops” and “Animal Trackers” can help - but only if they are “put to work” in the preschool classroom.

-Christine L. Williams, MD

Healthy-Start Published Articles and Abstracts  as of March 1, 2004

To date 13 scientific papers have been published or are in press, and 14 abstracts have been presented at national meetings:


Published Scientific Papers-

1.Williams CL, Strobino BA, Bollella M, Brotanek J. Body size and cardiovascular risk factors in a preschool population. Preventive Cardiology 2004;7:116-121.

Summary Data on weight, height, blood pressure, and blood lipids were obtained for 1215 children entering New York Head Start preschools from 1995‑1997. In this population, 17% were overweight and 15% were obese; the risk was greatest in Hispanic children. Overall, 13% had high blood pressure. African‑American children were at increased risk of elevated blood pressure but had a more favorable lipid profile (high‑density lipoprotein cholesterol level and low triglycerides level) than white or Hispanic children. Body size was  a significant predictor of elevated blood pressure, low high‑density lipoprotein cholesterol, and increased triglycerides. The association between obesity and blood pressure was evident in white and Hispanic children only. Neither ethnicity nor obesity was associated with total cholesterol level. Obese preschoolers had approximately three times the risk of having high systolic blood pressure and twice the risk of low high‑density lipoprotein  cholesterol level compared with nonobese children, indicating that at‑risk populations can be identified and primary prevention begun at a young age.

2. Williams CL, Strobino BA, Bollella M, Brotanek J. Cardiovascular Risk Reduction in Preschool Children: the ‘Healthy Start’ project. Journal American College of Nutrition 2004;23(2):117-123.

This paper describes an evaluation of the impact of a multicomponent cardiovascular health intervention ("Healthy Start") which included a food service modification in a largely minority Head Start preschool population. The primary outcome measure was the change in serum cholesterol from the beginning to the end of the school year. Nine Head Start centers in Upstate N.Y. were assigned to either food service modification or control conditions. In  addition, half of the centers assigned to the food service modification received supplemental nutrition education (FS/NU‑‑food service modification/nutritional education), while the remaining centers were provided with supplemental safety education materials (FS‑‑foodservice modification only). The control preschool centers (CON) also received supplemental safety educational curricula for children but their food services remained unchanged. Children had serum cholesterol, as well as height and weight measured at the beginning and end of the school year. A generalized linear univariate procedure was used with percent change in total serum cholesterol as the outcome variable and intervention group as the primary independent variable. Results showed that there was a significant decrease in total serum cholesterol among preschool children in food service intervention groups, (FS/NU and FS), compared to Controls (‑6.0 versus ‑0.4 mg/dL). In addition to the significant difference in group means, children with elevated cholesterol at baseline were significantly more likely to have a cholesterol level in the normal range (<170 mg/dL) at follow‑up if they attended a preschool in the food service modification group. There was a 30% reduction in risk of elevated cholesterol in the latter compared to controls. Participation in the dietary intervention did not affect short‑term growth. In conclusion, a preschool heart health  intervention, "Healthy Start," designed to reduce the total and saturated fat content of snacks and meals to recommended levels was effective in reducing serum cholesterol in the study population as a whole and specifically children 'at risk'; i.e., those with initial elevated serum cholesterol.

3.Hayman LL, Williams CL, Daniels SR, Steinberger J, Paridon S, Dennison BA, McCrindle BW: Cardiovascular Health Promotion in the Schools. A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110:2216-2275.

Summary: The prevention of heart disease beginning in early childhood is supported by extensive evidence culled from epidemiological, clinical, and laboratory studies. These data provided the impetus for the American Heart Association (AHA) Guidelines for Primary Prevention of Atherosclerotic Cardiovascular Disease Beginning in Childhood and support the need for population‑based approaches to cardiovascular health promotion and risk reduction. The population‑based approach, which is aimed at improving the food and physical activity environments of all children, is a critically important strategy for prevention, since without the proper environment it will be impossible to reduce risk factors for early heart disease - poor nutrition, high blood pressure, cigarette smoking, high cholesterol levels and lack of physical activity.  School health programs initiated in preschool and extending through high school have the potential to improve the cardiovascular health of the greatest number of US children and youth. Toward this goal, this statement is intended for health and education professionals, child health advocates, policymakers, and community leaders who are interested in optimizing the school environment as an integral part of population‑based strategies designed to promote cardiovascular health for all US children and youth.

[*Note: The Healthy- Start Preschool Health Education Program is highlighted as an exemplary program in this publication from the American Heart Association.]

4. Williams CL, Squillace, MM, Bollella MC, Brotanek J, Campanaro L, D'Agostino C, Pfau J, Sprance L, Strobino BA, Spark A and Boccio L (1998). Healthy Start: A comprehensive health education program for preschool children. Prev Med; 27:216-223.2.

Summary: Healthy Start: A Comprehensive Health Education Program for Preschool Children
C. L. Williams, M.D., M.P.H., M. M. Squillace, M.D., M.P.H., M. C. Bollella, M.S., R.D., J. Brotanek, M.D., M.P.H., L. Campanaro, R.N., C. D’Agostino, M.A., J. Pfau, R.D., L. Sprance, M.S., B. A. Strobino, Ph.D., A. Spark, Ed.D., R.D., and Laura Boccia, M.S. Child Health Center, American Health Foundation, 1 Dana Road, Valhalla, New York 10595

Background: Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time.

Methods: Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition.
Results: Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed.

Conclusions: While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.

Preventive Medicine 27, 216-223 (1998)
Article No. PM970278





5. Williams CL, Spark A, Strobino BA, Bollella MC, D'Agostino C, Brotanek J, Campanaro L, Pfau J and Squillace MM (1998). Cardiovascular risk reduction in a preschool population: The Healthy Start Project.(1998) Prev Cardiol; 2:45-55.

Summary: Cardiovascular Risk Reduction in Preschool Children: The “Healthy Start” Project
Christine L. Williams MD, MPH, Barbara A. Strobino MPH, PhD, Marguerite Bollella MD, RD, and Jane Brotanek MD, MPH Columbia University, Institute of Human Nutrition and Department of Pediatrics, New York, New York

Objective: To evaluate the impact of a multicomponent cardiovascular health intervention (“Healthy Start”) which included a food service modification in a largely minority Head Start preschool population. The primary outcome measure was the change in serum cholesterol from the beginning to the end of the school year.

Methods: Nine Head Start centers in Upstate N.Y. were assigned to either food service modification or control conditions. In addition, half of the centers assigned to the food service modification received supplemental nutrition education (FS/NU – food service modification/nutritional education), while the remaining centers were provided with supplemental safety education materials (FS- food service modification only). The control preschool centers (CON) also received supplemental safety educational curricula for children but their food services remained unchanged. Children had serum cholesterol, as well as height and weight measured at the beginning and end of the school year. A generalized linear univariate procedure was used with percent change in total serum cholesterol as the outcome variable and intervention group as the primary independent variable.

Results: There was a significant decrease in total serum cholesterol among preschool children in food service intervention groups, (FS/NU and FS), compared to Controls ( – 6.0 versus – 0.4 mg/dL). In addition to the significant difference in group means, children with elevated cholesterol as baseline were significantly more likely to have a cholesterol level in the normal range (<170mg/dL) at follow-up if they attended a preschool in the food service modification group. There was a 30% reduction in risk of elevated cholesterol in the latter compared to controls. Participation in the dietary intervention did not affect short-term growth.

Conclusions: A preschool heart health intervention, “Healthy Start,” designed to reduce the total and saturated fat content of snacks and meals to recommended levels was effective in reducing serum cholesterol in the study population as a whole and specifically children ‘at risk’; i.e., those with initial elevated serum cholesterol.

Journal of the American College of Nutrition, Vol. 23, No. 2, 117-123 (2004)
Published by the American College of Nutrition

6. D’Agostino C, D’Andrea T, Lieberman L, Sprance L, Williams CL (1999). Healthy Start: A new comprehensive preschool health education program. J Health Educ; 30:9-12.





7. Nix ST, D’Agostino C, Strobino BA, Williams CL (1999) Developing a computer-assisted health knowledge quiz for preschool children. J School Health; 69: 9-11.





8. D’Agostino C, D’Andrea T, Nix S, Williams CL (1999). Increasing nutrition knowledge in preschool children: The Healthy Start project. J Health Educ 30:217-221.

Summary: Increasing Nutrition Knowledge in Preschool Children:The Healthy Start Project, Year 1
Catherine D’Agostino, Tara D’Andrea, Susan Talbot Nix, and Christine L. Williams

Abstract: The first year effectiveness of a new comprehensive nutrition education program for preschool children, Healthy Start, was assessed using a project-developed, multiple choice picture identification test, the Knowledge Quiz. Eight hundred fourteen children in nine Head Start centers in three counties in New York State participated in the study. The two experimental groups (A and B) received either (1) the meal and snack food intervention (FI) and the nutrition curriculum (NUT), or (2) the FI and a control curriculum; the control (C) received the standard Head Start food menu and the control curriculum. A quasi-experimental pre/posttest research design was employed with the appropriate pretest and two contrast-coded variables entered as the predictor variables into separate regression analyses for the nutrition and overall assessments. The results showed that Groups A and B scored higher on average, adjusting for pretest variation, than Group C on both nutrition (p<.002) and overall (p<.001) measures; and that children in Group A improved more on the nutrition posttest than those in Group B (p<.007). Results indicate that the Healthy Start program can be used to increase nutrition and overall health-related knowledge in young children and can be employed as a tool to help reduce the risk of cardiovascular disease.

Journal of Health Education – July/August 1999, Volume 30, No. 4

9. Bollella M, Boccia L, Nicklas T, Leftkowitz K, Pittman B, Zang E, Williams CL (1999). Dietary assessment of children in preschool: Healthy Start. Nutr Res 19: 37-48.

Summary: Assessing Dietary Intake in Preschool Children: The Healthy Start Project – New York
M.C. Bollella, MS, RD, CDN, L.A. Boccia, MS, RD, T.A. Nicklas, DrPH, LDN, K.B. Lefkowitz, MS, CNS, B.P. Pittman, MS, E.A. Zang, PhD, and C.L. Williams, MD, MPH

Abstract: Healthy Start is a three year research project designed to evaluate the effectiveness of a cardiovascular risk reduction program in minority and low-income children and their parents. Baseline 24-hour recall data was collected on 439 three to five year-old children during the Fall of 1995. The methodology used was a combined approach: observation of the children during mealtime to determine quantities of food eaten at school coupled with completion of a food record by the parent/guardian of the child for foods eaten away from school on the same day as the observation. The food record was reviewed by phone with the parent/guardian for accuracy and completeness. In the absence of a completed food record, the parent was asked to recall the child’s intake on the day in question. School meal plus home meal intake was merged for each child to create the 24-hour intake. The collection method was done according to specific criteria. The mean caloric intake was 1449 kcal, with 15% of energy from protein, 54% from carbohydrate, 31% from fat and 12% from saturated fat. This combined approach methodology allows 24-hour intakes to be collected on young children in the school setting as well as the home environment.

Nutrition Research, Vol. 19, No. 1, pp. 37-48, 1999




10. Bollella M, Spark A, Boccia L, Nicklas T, Lefkowitz K, Pittman B, Zang E, Williams CL (1999). Nutrient intake of Head Start children: home vs. school. J Amer Coll Nutr 18: 108-114.

Summary: Nutrient Intake of Head Start Children: Home vs. School
Marguerite C. Bollella, MS, RD, CDN, Arlene Spark, EdD, RD, FACN, Laura A. Boccia, MS, RD, Theresa A. Nicklas, DrPH, LDN, Brian P. Pittman, MS, Christine L. Williams, MD, MPH

Objective: To determine mean intake of energy and protein, total fat, saturated fat, percent energy from total and saturated fat, cholesterol, carbohydrate, calcium, iron, zinc, folate, vitamins A, C, E, B-6 and B-12, thiamin, niacin, riboflavin, magnesium, sodium and fiber of preschool Head Start children at school and away from school.

Design: Twenty-four-hour food intakes for 358 Head Start children were obtained by observing food intake at school and acquiring intake recalls from parents or guardians specifying food their children consumed for the balance of the day. After determining group estimates of energy and nutrient intake, mean intake was compared to standard nutrient recommendations for the entire 24-hour day, i.e., for the time the children were in school and for the remaining hours away from school (“home” intake).

Subjects: The 358 Head Start children attended school either half-day (2- to 3-hour AM and PM sessions) or all-day (5 to 6 hours).

Statistical analyses: Differences in nutrient intake among class times were analyzed using one-way analysis of variance (ANOVA) followed by Tukey’s multiple comparison test. Differences with a p-value <0.05 (two-tailed) were considered to be statistically significant. Total energy, protein, calcium, iron, zinc, vitamins A, C, E, B6, and B-12, thiamin, niacin, riboflavin as well as folate and magnesium were compared to the Recommended Dietary Allowances for the 4- to 6-year-old age group. Other standards that were used for comparisons included the National Cholesterol Education Program (fat, saturated fat and cholesterol), the 1989 National Research Council’s Diet and Health Report (carbohydrate and sodium) and the recommendation for fiber proposed by the American Health Foundation.

Results: At school, half-day children consumed up to 25% of the daily recommendation for energy and nutrients, while all-day children achieved at least a third of the recommended intakes. When intakes at home and school were combined, all three groups of children (AM, PM and all-day) exceeded dietary recommendations for protein, vitamins and minerals. Energy intake remained below 100% of the recommendation, while intake of total fat, saturated fat and cholesterol exceeded recommendations.

Application: Further research is required to explore energy needs and determine nutritional status and nutrient needs of minority and low-income preschool children. Strategies are required to increase nutrient density, but not fat density, of meals and snacks served to children who attend day care for part of the day. Finally, school meals and nutrition education programs such as Team Nutrition should broaden their base to include healthful eating habits for all school children, including the very youngest children in preschool programs.

Journal of the American College of Nutrition, Vol. 18, No. 2, 108-114 (1999)





11. Spark A, Pfau J, Nicklas T Williams CL (1998). Reducing fat in preschool meals: Description of the food service intervention component of Healthy Start. J Nutr Educ; 30:170-177.

Summary: Reducing Fat in Preschool Meals: Description of the Foodservice Intervention Component of Healthy Start
Arlene Spark, Janice Pfau, Theresa A. Nicklas, and Christine L. Williams

Abstract: Healthy Start is a 3-year demonstration and education research project to evaluate the effectiveness of a coronary heart disease risk reduction program in Head Start centers in New York State. The primary goal of the program is to demonstrate that it is possible and safe to reduce young children’s intake of fat to desirable levels. The development and initial implementation of the nutrition intervention component of the program are described in this report. Nutrition intervention includes nutrition education for the children’s care givers and modifications in the foodservice operation in each of the study’s six intervention sites. Recommendations are provided to guide educators in future research and practice.

JNE 30:170-177, 1998





12. Williams CL, Strobino BA, Ibanez C, Liebmann-Smith J (2000). What do preschool children think about cigarettes and smoking? Knowledge, attitudes, and future smoking intentions: The Healthy Start Project. CVD Prevention 3:235-241.

Summary: What Do Preschool Children Think About Cigarettes and Smoking? Knowledge, Attitudes, and Future Smoking Intentions:The Healthy Start Project
C.L. Williams, MD, MPH; B.A. Strobino, MPH, PhD; C. Ibanez, MA; and J. Liebmann-Smith, PhD

Background: Research suggests that children begin to learn about smoking in the first few years of life. Preschoolers become aware of smoking, learn to recognize smoking products and logos, acquire a vocabulary that includes smoking words and products, form attitudes about smoking and smokers, and think about whether they want to smoke in the future. The present survey was designed to assess smoking knowledge, attitudes, and future smoking intentions in a population of preschool children, as well as to evaluate the effect of parental smoking on the latter.

Methods: A predominantly low-income, minority sample of preschool children were interviewed in 1997 with a 13-item computer-assisted survey instrument to assess smoking knowledge, attitudes, presence of smokers in the child’s home, and future intentions to smoke cigarettes.

Results: A total of 503 children participated in the survey; 46% thought it was “cool” to smoke and 57% said they intended to smoke in the future. When asked about individuals in their household, 69% reported that they lived with a smoker. The frequency distribution of the nature of the relationship of the smoker to the child was as follows: 35% mother, 21% father, 15% both parents, and 29% other or unspecified smoker. Odds ratios comparing intention to smoke by presence or absence of parental smoking, and positive or negative attitudes toward smoking revealed that smoking intentions were significantly influenced by parental modeling. The odds ration for a future intention to smoke was 6.7 (95% CL = 3.7, 12.0) among children of smoking mothers compared to children living in homes with no smokers. The odds ratios were somewhat less for children living in homes where the father was the only smoker 3.5 (95% CL = 1.9, 6.6) or homes where both parents smoked 2.7 (95% CL = 1.3, 5.3). Children who thought smoking was “cool” had significantly greater future intention to smoke than those who did not have this perception (P < 0.001). Two-thirds of the children identified “Joe Camel” as a smoker, although the picture contained no cigarettes.

Conclusions: In Summary, a significant proportion of preschool children recognize cigarettes, associate Joe Camel with smoking, think smoking is “cool,” and have future intentions to smoke, especially if their parents or other household members smoke. These findings reinforce the importance of parental involvement in youth tobacco prevention programs, to increase awareness of the powerful influence parents have over children’s health attitudes and behaviors, and to actively facilitate parental smoke cessation.

CVD Prevention 2000; 3:235-241





13. Williams CL, Bollella MC, Strobino BA, Spark A, Nicklas TA, Tolosi LB and Pittman BP (2002) ‘Healthy Start’: Outcome of an intervention to promote a heart healthy diet in preschool children. J Am Coll Nutr 21:62-71.

Summary: “Healthy-Start”: Outcome of an Intervention to Promote a Heart Healthy Diet in Preschool Children
Christine L. Williams, MD, MPH, Marguerite C. Bollella, MS, RD, CDN, Barbara A. Strobino, MPH, PhD, Arlene Spark, EdD, RD, FACN, Theresa A. Nicklas, DrPH, LDN, Laura B. Tolosi, MS, RD, and Brian P. Pittman, MS
Columbia University, Institute of Human Nutrition and Department of Pediatrics (C.L.W., M.C.B., B.A.S.), School of Health Sciences, Hunter College, City University of New York (A.S.), New York, American Health Foundation (L.B.T., B.P.P.), Valhalla, New York, Baylor College of Medicine (T.A.N.), Houston, Texas

Objective: We evaluated the effects of a preschool nutrition education and food service intervention “Healthy Start,” on two-to-five-year-old children in nine Head Start Centers in upstate NY. The primary objective was to reduce the saturated fat (sat-fat) content of preschool meals to <10% daily energy (E) and to reduce consumption of sat-fat by preschoolers to < 10% E.

Methods: Six centers were assigned to the food service intervention and three to control condition. Food service intervention included training workshops for cooks and monthly site visits to review progress towards goals. Child dietary intake at preschool was assessed by direct observation and plate waste measurement. Dietary intake at home was assessed by parental food record and telephone interviews. Dietary data were collected each Fall/Spring over two years, including five days of menus and recipes from each center. Dietary data were analyzed with the Minnesota NDS software.

Results: Consumption of saturated fat from school meals decreased significantly from 11.0%E to 10.4%E after one year of intervention and to 8.0%E after the second year, compared with an increase of 10.2% to 13.0% to 11.4%E, respectively, for control schools (p < 0.001). Total caloric intake was adequately maintained for both groups. Analysis of preschool menus and recipes over the two-year period of intervention showed a significant decrease in sat-fat content in intervention preschools (from 12.5 at baseline to 8.0%E compared with a change of 12.1%E to 11.6%E in control preschools (p < 0.001). Total fat content of menus also decreased significantly in intervention schools (31.0% to 25.0%E) compared with controls (29.9% to 28.4%E).

Conclusions: The Healthy Start food service intervention was effective in reducing the fat and saturated fat content of preschool meals and reducing children’s consumption of saturated fat as preschool without compromising energy intake or intake of essential nutrients. These goals are consistent with current U.S. Dietary Guidelines for children older than two years of age.

Journal of the American College of Nutrition, Vol. 21, No. 1, 62-71 (2002)
Published by the American College of Nutrition




Abstracts presented at national meetings on the Healthy Start project are as follows:
1. (2003) Bollella M, Williams CL, Strobino B, Brotanek J: Dietary predictors of cardiovascular risk factors among children in a 5-year health tracking study: Healthy Start. Presented at the American Dietetic Association (ADA) Food & Nutrition Conference & Expo (FNCE), San Antonio, Texas, October 25-28, 2003.
2. (2003) Strobino B, Williams CL, Brotanek J, Campanaro L, Bollella M: Tracking of Serum Lipids from Pre-School to Elementary School. Presented at the Asia Pacific Scientific Forum 43nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, June 7-9, 2003.
3. (2002) Williams CL, Strobino BA, Brotanek J, Campanaro L, and Bollella M: A five year prospective study of multiethnic preschoolers: Body size and blood pressure. Presented at the Asia Pacific Scientific Forum 42nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, April 25-28, 2002.
4. (2002) Williams CL, Strobino BA, Brotanek J, Campanaro L, and Bollella M: Ethnicity and body size as predictors of blood lipids in early childhood: A prospective study. Presented at the Asia Pacific Scientific Forum 42nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, April 25-28, 2002.
5. (2001) Strobino B, Williams CL, Brotanek J, Bollella, and Campanaro L: The Prevalence of Obesity in a Multiethnic Preschool Population. Presented at the American Heart Association annual meeting, Anaheim, Calif., November 11-14, 2001.
6. (2000) Williams CL, Bollella M, Spark AS, Boccia L, Pittman BP. Promoting a heart healthy diet among preschool children: Outcome of the Healthy Start nutrition education and food service intervention. Presented at the American Heart Association, Lloyd J. Filer, Jr. 3rd International Conference on Atherosclerosis in the Young, San Diego, CA, March 3-5, 2000.
7. (2000) Williams CL, Strobino BA, and Brotanek J, and Campanaro L: Overweight in 2 to 5 year old children is associated with CVD Co-Morbidity. Presented at the 40th American Heart Association, Council on Epidemiology and Prevention Annual Meeting, San Diego, California, March 1-4, 2000.
8. (1998) Williams CL, D_Agostino C, Strobino BA, and Liebmann-Smith J: Preschool smoking knowledge and intention. Presented at the American Heart Association annual meeting, Dallas, Texas, November 8-11, 1998.
9. (1998) Williams CL, Strobino BA, Squillace M, Brotanek J, Campanaro L and Pittman B: Reducing blood cholesterol in preschool children: The Healthy Start Project. Presented at the American Heart Association Annual Meeting, Council on Epidemiology and Prevention, Santa Fe, NM, Mar 20, 1998.
10. (1997) D’Agostino C, D’Andrea T, Nix S, Williams CL: Increasing health knowledge in preschool children: The Healthy Start project Year 1. Presented at the annual meeting of the American School Health Association, Daytona Beach, Fla. October 22-26, 1997.
11. (1997) Williams CL, Squillace M, Strobino BA, Brotanek J, Campanaro L: Cardiovascular risk factors in low income preschool children: Project Healthy Start. Presented at the 4th International Congress on Preventive Cardiology, Montreal Canada, June 29-July 3, 1997.
12. (1997) Spark A, Pfau J, Bollella M, Williams CL: Does switching to 1% lowfat milk affect nutrient intake of preschoolers in day care? Presented at the annual meeting of the American College of Nutrition, New York, NY 1997.
13 (1997) Bollella M, Boccia L, Nicklas C, Williams CL: Sources of nutrient intake in diets of Head Start children: Home vs School. Presented at the annual meeting of the American College of Nutrition, New York, NY 1997.
14. (1997) Bollella M, Boccia L, Nicklas C, Williams CL: Assessing dietary intake in preschool children: Healthy Start, NY. Presented at FASEB, New Orleans, LA, April 1997.