Be A Fit Kid is a physical activity and nutrition education program for elementary school children. PURPOSE: To determine the efficacy of the program by examining health-related improvements following the intervention and to determine the long-term influence of the program on changes in health behavior habits five years post intervention. METHODS: Body mass index, body fat, lipids and lipoproteins, dietary habits, nutrition knowledge, fitness, and blood pressure were measured before and after the intervention. Parent surveys were used to assess overall changes in eating habits immediately and 5 years following the intervention. RESULTS: Following the intervention, significant improvements were observed in fitness, nutritional habits and knowledge, blood levels of lipids and lipoproteins, and body fat. Adherence to improvements in health behavior habits post-intervention were maintained overtime. CONCLUSION: Comprehensive physical activity and nutrition programs included in the school curriculum can have a major impact on reducing future risk for lifestyle-related diseases.