Body mass index, fitness and physical activity from childhood through adolescence Effects of a physical activity programme in the school setting on physical fitness in preschool children Differences in Aerobic Fitness and Lifestyle Characteristics in Preschoolers according to their Weight Status and Sports Club Participation Reliability and validity of age band 1 of the Movement Assessment Battery for Children--second edition. Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial The Effects of Nutritional-Physical Activity School-based Intervention on Fatness and Fitness in Preschool Children Effects of a lifestyle intervention on adiposity and fitness in overweight or low fit preschoolers (Ballabeina). A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial Effect of multidimensional lifestyle intervention on fitness and adiposity in predominantly migrant preschool children (Ballabeina): cluster randomised controlled trial A policy-driven multifaceted approach for early childhood physical fitness promotion: impacts on body composition and physical fitness in young Chinese children Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Does the CATCH Early Childhood Program Increase Physical Activity Among Low-Income Preschoolers?—Results From a Pilot Study Physical fitness and shapes of subcortical brain structures in children. Effects of extra school-based physical education on overall physical fitness development--the CHAMPS study DK. Effect of a lifestyle intervention on adiposity and fitness in socially disadvantaged subgroups of preschoolers: a cluster-randomized trial (Ballabeina). A feasibility study with process evaluation of a preschool intervention to improve child and family lifestyle behaviours Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Fit 5 Kids TV Reduction Program for Latino Preschoolers: A Cluster Randomized Controlled Trial. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. Promoting Children's Social-Emotional Skills in Preschool Can Enhance Academic and Behavioral Functioning in Kindergarten: Findings From Head Start REDI [Improving physical fitness in adolescents through a school-based intervention: the EDUFIT study]. A Preschool Obesity Treatment Clinical Trial: Reasons Primary Care Providers Declined Referrals. Correlates of preschool children’s objectively measured physical activity and sedentary behavior: a cross-sectional analysis of the SPLASHY study
Background Obesity , sedentary lifestyle and poor cardiorespiratory fitness in childhood may increase the risk of health problems later in life . Purpose The authors studied the association of early childhood weight status with cardiorespiratory fitness and leisure-time physical activity ( LTPA ) in adolescence . The stability and associations of LTPA and fitness from childhood through adolescence were also studied . Methods  Body mass index ( BMI ) was assessed annually since birth in a prospect i ve , longitudinal study . The mean BMI between ages 2 and 7 years indicated weight status at preschool age . Fitness was studied with a shuttle run test at age 9 and with a maximal cycle ergometer test at age 17 . The same question naire was used to assess LTPA at age 9 , 13 and 17 . Complete data on preschool BMI , LTPA at ages 13 and 17 and fitness at age 17 years was provided by 351 children , while fitness and LTPA data were available for 74 children at ages 9 and 17 . Results Preschool BMI was inversely associated with fitness in adolescence independently of adolescent LTPA ( p=0.0001 ) . Children who had a high preschool BMI but whose weight status was reduced in adolescence had similar fitness in adolescence as the children with a persistently low BMI . Regardless of the fitness level in childhood , the children whose LTPA increased between age 9 and 17 had a similar adolescent fitness level as persistently active subjects . Conclusions It is important to maintain a healthy body weight and a physically active lifestyle from very childhood through adolescence to improve fitness during adolescence AIM The purpose of this study was to examine the effects of a 10-week aerobic games programme on physical fitness . METHODS One hundred eleven children , aged 3 to 6 years , participated in this study ; 60 children were male ( age : 4.28 ± 0.61 years old ) , and 51 were female ( age 4.59 ± 0.49 years old ) . Participants were r and omly assigned to an experimental group ( EG ; n = 56 ) and a control group ( CG ; n = 55 ) . A fitness test battery previously vali date d for preschoolers was used . The children in the EG performed 3 weekly training sessions of physical activity in a classroom during a 10-week period . Every EG session lasted about 30 min . RESULTS There were no significant differences in any variable in the pretest between groups . In the posttest , the EG achieved better results in horizontal jump and sprint . In relation to posttest-pretest differences , the EG showed a greater increase in horizontal jump , sprint , and endurance . CONCLUSION An aerobic games programme in the school setting improved physical fitness in preschool children Objective : This study assesses differences in adiposity , aerobic fitness , and lifestyle characteristics in preschoolers according to their weight status and sports club ( SC ) participation . Method : As part of the Ballabeina study , 600 r and omly selected preschoolers ( mean age 5.1 ± 0.6 years ; 50.2 % girls ) were analyzed . Body composition was measured by bioelectrical impedance , aerobic fitness by the 20-meter shuttle run test , and physical activity by accelerometers . Eating habits , media use , and SC participation were assessed by question naires . Results : Overweight children ( Swiss national percentiles ) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts ( all p ≤ 0.028 ) . In addition , children not participating in SC were less physically active , had more media use , and ate less healthy compared to children participating in SC ( all p ≤ 0.023 ) . Controlling for parental sociocultural determinants attenuated differences in % body fat , in physical activity , and in eating habits . Conclusion : Aerobic fitness differs both according to weight status and SC participation in preschoolers . Furthermore , in view of the many differences in lifestyle behaviors , SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status The purpose of this study was to examine specific aspects of the reliability and validity of age b and 1 of the Movement Assessment Battery for Children -- Second Edition ( MABC-2 ) ( Henderson , Sugden , & Barnett , 2007 ) in Greek preschool children . One hundred and eighty-three children participated in the study ; the children ranged in age from 36 to 64 months old ( M = 50 months , SD = 9 months ) .  Test-retest reliability of the MABC-2 was evaluated using intraclass correlation coefficient ( ICC ) . Cronbach 's alpha for the items of each motor domain was estimated to determine internal consistency . Confirmatory factor analysis was used to examine the factorial validity of the MABC-2 test . Correlation coefficients among individual item scores and the total score were also calculated to further examine validity . The ICC for all test items was good , except for the drawing trail task , which was moderate . Cronbach 's alpha coefficient values were .51 , .70 and .66 for manual dexterity , aim ing and catching , and balance , respectively . In the confirmatory factor analysis , goodness-of-fit indices suggested a satisfactory fit of the data to the model . The correlation coefficients between each test item and the total score were moderate . The results suggest that the MABC-2 can be a reliable and valid tool for the assessment of movement difficulties among 3 - 5-year-old children Background Childhood obesity and physical inactivity are increasing dramatically worldwide . Children of low socioeconomic status and /or children of migrant background are especially at risk . In general , the overall effectiveness of school-based programs on health-related outcomes has been disappointing . A special gap exists for younger children and in high risk groups . Methods / Design This paper describes the rationale , design , curriculum , and evaluation of a multicenter preschool r and omized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons . Twenty preschool classes in the German ( canton St. Gallen ) and another 20 in the French ( canton Vaud ) part of Switzerl and were separately selected and r and omized to an intervention and a control arm by the use of opaque envelopes . The multidisciplinary lifestyle intervention aim ed to increase physical activity and sleep duration , to reinforce healthy nutrition and eating behaviour , and to reduce media use . According to the ecological model , it included children , their parents and the teachers . The regular teachers performed the majority of the intervention and were supported by a local health promoter . The intervention included physical activity lessons , adaptation of the built infrastructure ; promotion of regional extracurricular physical activity ; playful lessons about nutrition , media use and sleep , funny homework cards and information material s for teachers and parents . It lasted one school year . Baseline and post-intervention evaluations were performed in both arms . Primary outcome measures included BMI and aerobic fitness ( 20 m shuttle run test ) . Secondary outcomes included total ( skinfolds , bioelectrical impedance ) and central ( waist circumference ) body fat , motor abilities ( obstacle course , static and dynamic balance ) , physical activity and sleep duration ( accelerometry and question naires ) , nutritional behaviour and food intake , media use , quality of life and signs of hyperactivity ( question naires ) , attention and spatial working memory ability ( two vali date d tests ) . Research ers were blinded to group allocation . Discussion The purpose of this paper is to outline the design of a school-based multicenter cluster r and omized , controlled trial aim ing to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerl and with a high migrant population .Trial Registration Trial Registration : clinical trials.gov BACKGROUND Obesity is now the most common chronic pediatric disease . Early health education programs could serve to prevent and treat childhood obesity and its numerous complications . AIM To examine the effects of a r and omized prospect i ve school-based intervention on anthropometric measures , body composition , leisure time habits and fitness in preschool children . CHILDREN Fifty-four preschool children completed a 14-week combined dietary-behavioral-physical activity intervention and were compared to 47 age matched controls ( age 5 - 6 yr ) . RESULTS Daily physical activity was significantly greater in the intervention group compared to the controls ( 6,927 + /- 364 vs 5,489 + /- 284 steps/ day , respectively ; p < 0.003 ) . Favorable changes were observed in weight ( 0.35 + /- 0.08 vs 0.9 + /- 0.1 kg , p < 0.0005 ) , BMI percentile ( -3.8 + /- 1.3 vs 2.9 + /- 1.5 kg/m2 , p < 0.001 ) , fat percent ( by skinfolds , -0.65 + /- 0.3 vs 1.64 + /- 0.3 % , p < 0.028 ) and fitness ( endurance time -3.55 + /- 1.85 vs 3.16 + /- 2.05 % , p < 0.017 ) in the intervention versus control groups . CONCLUSIONS A preschool , dietary/physical activity intervention may play a role in health promotion , prevention and treatment of childhood obesity OBJECTIVE Overweight ( OW ) and low fit children represent cardiovascular high-risk groups . A multidimensional school-based lifestyle intervention performed in 652 preschoolers reduced skinfold thickness and waist circumference , and improved fitness , but did not affect BMI . The objective of this study is to examine whether the intervention was equally effective in OW ( ≥90th national percentile ) and /or low fit ( lowest sex- and age-adjusted quartile of aerobic fitness ) children compared to their normal weight and normal fit counterparts . DESIGN AND METHODS Cluster r and omized controlled single blinded trial , conducted in 2008/09 in 40 r and omly selected preschool classes in Switzerl and . The intervention included a playful physical activity program and lessons on nutrition , media use and sleeps . Primary outcomes were BMI and aerobic fitness ; secondary outcomes included sum of four skinfolds , waist circumference and motor agility . Modification of intervention effects by BMI -group and fitness-group was tested by interaction terms . RESULTS Compared to their counterparts , OW children ( n = 130 ) had more beneficial effects on waist circumference ( p for interaction = 0.001 ) and low fit children ( n = 154 ) more beneficial effects on all adiposity outcomes ( p for interaction ≤0.03 ) . The intervention effects on both fitness outcomes were not modified by BMI - or fitness-group ( all p for interaction ≥0.2 ) . Average intervention effect sizes for BMI were -0.12 , -0.05 , -0.26 and -0.02 kg/m(2 ) and for aerobic fitness were 0.40 , 0.30 , 0.12 and 0.36 stages for OW , normal weight , low fit and normal fit children , respectively . CONCLUSIONS This multidimensional intervention was equally and for some adiposity measures even more effective in high-risk preschoolers and represents a promising option for these children Background Childhood obesity is an increasing health problem globally . Overweight and obesity may be established as early as 2–5 years of age , highlighting the need for evidence -based effective prevention and treatment programs early in life . In adults , mobile phone based interventions for weight management ( mHealth ) have demonstrated positive effects on body mass , however , their use in child population s has yet to be examined . The aim of this paper is to report the study design and methodology of the MINSTOP ( Mobile-based Intervention Intended to Stop Obesity in Preschoolers ) trial . Methods / Design A two-arm , parallel design r and omized controlled trial in 300 healthy Swedish 4-year-olds is conducted . After baseline measures , parents are allocated to either an intervention- or control group . The 6- month mHealth intervention consists of a web-based application ( the MINSTOP app ) to help  parents promote healthy eating and physical activity in children .  MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive , personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children . Parents also register physical activity and intakes of c and y , soft drinks , vegetables as well as fruits of their child and receive feedback through the application . Primary outcomes include body fatness and energy intake , while secondary outcomes are time spent in sedentary , moderate , and vigorous physical activity , physical fitness and intakes of fruits and vegetables , snacks , soft drinks and c and y. Food and energy intake ( Tool for Energy balance in Children , TECH ) , body fatness ( pediatric option for BodPod ) , physical activity ( Actigraph wGT3x-BT ) and physical fitness ( the PREFIT battery of five fitness tests ) are measured at baseline , after the intervention ( six months after baseline ) and at follow-up ( 12 months after baseline ) . Discussion This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children . If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity . Trial registration Clinical Trials.gov NCT02021786 ; 20 Dec 2013 Objective To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children . Design Cluster r and omised controlled single blinded trial ( Ballabeina study ) over one school year ; r and omisation was performed after stratification for linguistic region . Setting 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerl and . Participants 652 of the 727 preschool children had informed consent and were present for baseline measures ( mean age 5.1 years ( SD 0.7 ) , 72 % migrants of multicultural origins ) . No children withdrew , but 26 moved away . Intervention The multidimensional culturally tailored lifestyle intervention included a physical activity programme , lessons on nutrition , media use ( use of television and computers ) , and sleep and adaptation of the built environment of the preschool class . It lasted from August 2008 to June 2009 . Main outcome measures Primary outcomes were aerobic fitness ( 20 m shuttle run test ) and body mass index ( BMI ) . Secondary outcomes included motor agility , balance , percentage body fat , waist circumference , physical activity , eating habits , media use , sleep , psychological health , and cognitive abilities . Results Compared with controls , children in the intervention group had an increase in aerobic fitness at the end of the intervention ( adjusted mean difference : 0.32 stages ( 95 % confidence interval 0.07 to 0.57 ; P=0.01 ) but no difference in BMI ( −0.07 kg/m2 , −0.19 to 0.06 ; P=0.31 ) . Relative to controls , children in the intervention group had beneficial effects in motor agility ( −0.54 s , −0.90 to −0.17 ; P=0.004 ) , percentage body fat ( −1.1 % , −2.0 to −0.2 ; P=0.02 ) , and waist circumference ( −1.0 cm , −1.6 to −0.4 ; P=0.001 ) . There were also significant benefits in the intervention group in reported physical activity , media use , and eating habits , but not in the remaining secondary outcomes . Conclusions A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children . Trial registration Clinical Trials NCT00674544 Background The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade . This study tested the effectiveness of a multifaceted intervention that integrated childcare center , families , and community to promote healthy growth and physical fitness in preschool Chinese children . Methods This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group . The participants were 357 children ( mean age = 4.5 year ) enrolled in three grade levels in two childcare centers in Beijing , China . The intervention included : 1 ) childcare center intervention ( physical activity policy changes , teacher training , physical education curriculum and food services training ) , 2 ) family intervention ( parent education , internet website for support , and family events ) , and 3 ) community intervention ( playground renovation and community health promotion events ) . The study outcome measures included body composition ( percent body fat , fat mass , and muscle mass ) , Body Mass Index ( BMI ) and BMI z-score and physical fitness scores in 20-meter agility run ( 20M-AR ) , broad jump for distance ( BJ ) , timed 10-jumps , tennis ball throwing ( TBT ) , sit and reach ( SR ) , balance beam walk ( BBW ) , 20-meter crawl ( 20M-C ) ) , 30-meter sprint ( 30M-S ) ) from a norm referenced test . Measures of process evaluation included monitoring of children ’s physical activity ( activity time and intensity ) and food preparation records , and fidelity of intervention protocol implementation . Results Children in the intervention center significantly lowered their body fat percent ( −1.2 % , p < 0.0001 ) , fat mass ( −0.55 kg , p < 0.0001 ) , and body weight ( 0.36 kg , p < 0.02 ) and increased muscle mass ( 0.48 kg , p < 0.0001 ) , compared to children in the control center . They also improved all measures of physical fitness except timed 10-jumps ( 20M-AR : −0.74 seconds , p < 0.0001 ; BJ : 8.09 cm , p < 0.0001 ; TBT : 0.52 meters , p < 0.006 ; SR : 0.88 cm , p < 0.03 ; BBW : −2.02 seconds , p < 0.0001 ; 30M-S : −0.45 seconds , p < 0.02 ; 20M-C : −3.36 seconds , p < 0.0001 ) . Process evaluation data showed that the intervention protocol was implemented with high fidelity . Conclusions The study demonstrated that a policy-driven multi-faceted intervention can improve preschool children ’s body composition and physical fitness . Program efficacy should be tested in a r and omized trial . Trial registration ChiCTR-ONRC-14004143 The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight Purpose : To explore whether the physical activity ( PA ) component of the Coordinated Approach to Child Health Early Childhood ( CATCH EC ) program helps increasing preschoolers ’ PA during active times at preschool . Design : Nonr and omized controlled experimental study . Setting : Head Start centers in Houston , Texas , 2009 to 2010 school year . Participants : A total of 439 preschoolers aged 3 to 5 years ( 3 intervention centers , n = 220 ; 3 comparison centers , n = 219 ) . Intervention : The CATCH EC preschool-based teacher-led nutrition and PA program . Measures : Preschoolers ’ PA was measured at baseline and postintervention using the  System for Observing Fitness Instruction Time – Preschool version , a direct observation method measuring PA at the classroom level . Parent surveys provided demographic data . Analysis : Pre-to-post changes in preschoolers ’ PA were examined using the Mann-Whitney U test . Results : Results show a significant decrease in the percentage time preschoolers spent in level 2 PA ( low activity ) at intervention ( P = .005 ) and comparison ( P = .041 ) centers . Indoor vigorous activity increased significantly on an average by + 6.04 % pre-to-post intervention among preschoolers in the intervention group ( P = .049 ) ; no significant change was found in the comparison group . Conclusion : The CATCH EC favorably increased indoor vigorous PA level among low-income children attending Head Start A few studies have recently reported that higher cardiorespiratory fitness is associated with higher volumes of subcortical brain structures in children . It is , however , unknown how different fitness measures relate to shapes of subcortical brain nuclei . We aim ed to examine the association of the main health-related physical fitness components with shapes of subcortical brain structures in a sample of forty-four Spanish children aged 9·7 ( sd 0·2 ) years from the NUtraceuticals for a HEALthier life project . Cardiorespiratory fitness , muscular strength and speed agility were assessed using valid and reliable tests ( ALPHA-fitness test battery ) . Shape of the subcortical brain structures was assessed by MRI , and its relationship with fitness was examined after controlling for a set of potential confounders using a partial correlation permutation approach . Our results showed that all physical fitness components studied were significantly related to the shapes of subcortical brain nuclei . These associations were both positive and negative , indicating that a higher level of fitness in childhood is related to both expansions and contractions in certain regions of the accumbens , amygdala , cau date , hippocampus , pallidum , putamen and thalamus . Cardiorespiratory fitness was mainly associated with expansions , whereas h and grip was mostly associated with contractions in the structures studied . Future r and omised-controlled trials will confirm or contrast our findings , demonstrating whether changes in fitness modify the shapes of brain structures and the extent to which those changes influence cognitive function First , this study aim ed to investigate if four extra physical education ( PE ) lessons per week improved  children 's development in physical fitness . Second , to investigate if the extra PE lessons improved development in physical fitness for children with lower levels of fitness at baseline . This study was a longitudinal controlled school-based study . The study population consisted of 10 Danish public schools with children in preschool to fourth grade ( cohorts 0 - 4 ) with 2.5-year follow-up . Six schools had extra PE and four schools had normal PE . In total 1247 children were included ( normal PE = 536 , extra PE = 711 ) .  Development in fitness was analyzed using a composite z-score from six fitness tests . Multilevel mixed-effects linear regression was used to examine the association between school type and development in fitness .  Extra PE increased the total development of composite z-score units among children enrolled in cohort 4 and borderline in cohort 3 with 1.06 ( 95 % confidence interval 0.48 - 1.65 ) and 0.52 z-score units ( -0.06 to 1.09 ) , respectively . Children in the lower 50 percentiles increased their development with 0.47 ( 0.08 - 0.85 ) z-score units  . Extra PE in schools improved development in fitness for cohort 4 and borderline for cohort 3 among all children . Extra PE  improved fitness development across all cohorts among children with low fitness levels OBJECTIVE A multidimensional lifestyle intervention performed in 652 preschoolers ( 72 % of migrant , 38 % of low educational level ( EL ) parents ) reduced body fat , but not BMI and improved fitness . The objective of this study is to examine whether the intervention was equally effective in children of migrant and /or low EL parents . METHODS Cluster-r and omized controlled single blinded trial , conducted in 2008/09 in 40 r and omly selected preschools in Switzerl and . The culturally tailored intervention consisted of a physical activity program and lessons on nutrition , media use and sleep . Primary outcomes included BMI and aerobic fitness . Secondary outcomes included % body fat , waist circumference and motor agility . RESULTS Children of migrant parents benefitted similarly from the intervention compared to their counterparts ( p for interaction≥ 0.09 ) . However , children of low EL parents benefitted less , although these differences did not reach statistical significance ( p for interaction≥ 0.06 ) . Average intervention effect sizes for BMI were -0.10 , -0.05 , -0.11 and 0.04 kg/m(2 ) and for aerobic fitness were 0.55 , 0.20 , 0.37 and -0.05 stages for children of non-migrant , migrant , middle/high EL and low EL parents , respectively . CONCLUSIONS This intervention was similarly effective among preschoolers of migrant parents compared to their counterparts , while children of low EL parents benefitted less Background Around a fifth of children starting school in Engl and are now overweight/obese . There is a paucity of interventions with the aim of obesity prevention in preschool-age children in the UK . Previous research has demonstrated some positive results in changing specific health behaviours , however , positive trends in overall obesity rates are lacking . Preschool setting s may provide valuable opportunities to access children and their families not only for promoting healthy lifestyles , but also to develop and evaluate behaviour-change interventions . Methods This paper presents a cluster r and omised feasibility study of a theory based behaviour-change preschool practitioner-led intervention tested in four preschool centres in the North East of Engl and . The primary outcome measures were to test the acceptability and feasibility of the data collection measures and intervention . Secondary measures were collected and reported for extra information . At baseline and post intervention , children ’s anthropometric , dietary and physical activity measures as well as family ‘ active ’ time data were collected . The preschool practitioner-led intervention included family intervention tasks such as ‘ family goal - setting activities ’ and ‘ cooking challenges ’ . Preschool activities included increasing physical activity and providing activities with the potential to change behaviour with increased knowledge of and  acceptance of healthy eating . The process evaluation was an on-going monthly process and was collected in multiple forms such as question naires , photographs and verbal feedback . Results ‘ Gatekeeper ’ permission and lower-hierarchal adherence were initially a problem for recruitment and methods acceptance . However , at intervention end the preschool teachers and parents stated they found most intervention methods and activities acceptable , and some positive changes in family health behaviours were reported . However , the preschool centres appeared to have difficulties with enforcing everyday school healthy eating policies . Conclusions The findings from the current study may have implication s for nursery practitioners , nursery setting s , Local Educational Authorities and policy makers , and contributes to the body of literature . However , further work with preschool practitioners is required to determine how personal attitudes and school policy application can be supported to implement successfully such an intervention . Trial registration IS RCT N12345678 ( 16/02/17 ) retrospectively registered Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : INTRODUCTION Reducing Latino preschoolers ' TV viewing is needed to reduce their risk of obesity and other chronic diseases . This study 's objective was to evaluate the Fit 5 Kids ( F5 K ) TV reduction program 's impact on Latino preschooler 's TV viewing . STUDY DESIGN Cluster RCT with r and omization at the center level and N=160 participants . SETTING / PARTICIPANTS Latino children aged 3 - 5 years and their parents were recruited from six Head Start centers in Houston TX in 2010 - 2012 with analyses in 2013 - 2014 . INTERVENTION F5 K was culturally adapted for Latino preschoolers and the overall goal was to reduce TV viewing . Study staff taught F5 K over 7 - 8 weeks during the regular Head Start day directly to intervention students . Control schools provided the usual Head Start curriculum , which did not specifically cover TV viewing . MAIN OUTCOME MEASURES Individual-level outcomes were measured prior to ( Time 1 ) and immediately following ( Time 2 ) the intervention . The primary outcome , TV viewing ( minutes/day ) , was measured by vali date d 7-day TV diaries ( parent-reported ) . Sedentary time was measured by accelerometers . RESULTS Per the adjusted repeated measures linear mixed effects model for TV viewing ( minutes/day ) , intervention children decreased from 76.2 ( 9.9 ) at Time 1 to 52.1 ( 10.0 ) at Time 2 , whereas control children remained about the same from 84.2 ( 10.5 ) at Time 1 to 85.4 ( 10.5 ) at Time 2 . The relative difference from Time 1 to Time 2 was -25.3 ( 95 % CI= -45.2 , -5.4 ) minutes for intervention versus control children ( N=160 , p=0.01 ) . In a similar adjusted model , there was a relative decrease in sedentary time ( minutes/day ) from Time 1 to Time 2 favoring the intervention children ( -9.5 , 95 % CI= -23.0 , 4.1 ) , although not significant at p<0.05 . CONCLUSIONS F5 K reduced Latino preschoolers ' TV viewing by > 25 minutes daily . These findings have implication s for prevention of obesity , related disorders , and health equity . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT01216306 OBJECTIVES To assess the usual nutrient intakes of 3,273 US infants , toddlers , and preschoolers , aged 0 to 47 months , surveyed in the Feeding Infants and Toddlers Study ( FITS ) 2008 ; and to compare data on the usual nutrient intakes for the two waves of FITS conducted in 2002 and 2008 . DESIGN The FITS 2008 is a cross-sectional survey of a national r and om sample of US children from birth through age 47 months .  Usual nutrient intakes derived from foods , beverages , and supplements were ascertained using a telephone-administered , multiple-pass 24-hour dietary recall . SUBJECTS Infants aged birth to 5 months ( n=382 ) and 6 to 11 months ( n=505 ) , toddlers aged 12 to 23 months ( n=925 ) , and preschoolers aged 24 to 47 months ( n=1,461 ) were surveyed . METHODS All primary caregivers completed one 24-hour dietary recall and a r and om sub sample ( n=701 ) completed a second 24-hour dietary recall . The personal computer version of the Software for Intake Distribution Estimation was used to estimate the 10th , 25th , 50th , 75th , and 90th percentiles , as well as the proportions below and above cutoff values defined by the Dietary Reference Intakes or the 2005 Dietary Guidelines for Americans . RESULTS Usual nutrient intakes met or exceeded energy and protein requirements with minimal risk of vitamin and mineral deficiencies . The usual intakes of antioxidants , B vitamins , bone-related nutrients , and other micronutrients were adequate relative to the Adequate Intakes or Estimated Average Requirements , except for iron and zinc in a small subset of older infants , and vitamin E and potassium in toddlers and preschoolers . Intakes of synthetic folate , preformed vitamin A , zinc , and sodium exceeded Tolerable Upper Intake Level in a significant proportion of toddlers and preschoolers . Macronutrient distributions were within acceptable macronutrient distribution ranges , except for dietary fat , in some toddlers and preschoolers . Dietary fiber was low in the vast majority of toddlers and preschoolers , and saturated fat intakes exceeded recommendations for the majority of preschoolers . The prevalence of inadequate intakes , excessive intake , and intakes outside the acceptable macronutrient distribution range was similar in FITS 2002 and FITS 2008 . CONCLUSIONS In FITS 2008 , usual nutrient intakes were adequate for the majority of US infants , toddlers , and preschoolers , except for a small but important number of infants at risk for inadequate iron and zinc intakes . Diet quality should be improved in the transition from infancy to early childhood , particularly with respect to healthier fats and fiber in the diets of toddlers and preschoolers Research Findings : This study examined processes of change associated with the positive preschool and kindergarten outcomes of children who received the Head Start REDI ( REsearch -based , Developmentally Informed ) intervention compared to usual practice Head Start .  Using data from a large-scale r and omized controlled trial ( N = 356 children , 42 % African American or Latino , all from low-income families ) , this study tests the logic model that improving preschool social-emotional skills ( e.g. , emotion underst and ing , social problem solving , and positive social behavior ) as well as language /emergent literacy skills will promote cross-domain academic and behavioral adjustment after children transition into kindergarten . Validating this logic model , the present study finds that intervention effects on 3 important kindergarten outcomes ( e.g. , reading achievement , learning engagement , and positive social behavior ) were mediated by preschool gains in the proximal social-emotional and language /emergent literacy skills targeted by the REDI intervention . It is important to note that preschool gains in social-emotional skills made unique contributions to kindergarten outcomes in reading achievement and learning engagement , even after we accounted for concurrent preschool gains in vocabulary and emergent literacy skills . Practice or Policy : These findings highlight the importance of fostering at-risk children 's social-emotional skills during preschool as a means of promoting school readiness INTRODUCTION AND OBJECTIVES Physical fitness level is a marker of cardiovascular health in young people . The aim of this study was to analyze the effects of a school-based intervention program , focused on increasing the volume and intensity of physical education ( PE ) sessions , on adolescents ' physical fitness . METHODS Sixty-seven adolescents ( 12 - 14 years old ) from three secondary school classes participated in a 16-week intervention . The classes were r and omly allocated to the control group , experimental group 1 ( EG1 ) or experimental group 2 ( EG2 ) . The control group received st and ard PE ( 2 sessions/week ) , the EG1 received 4 st and ard PE sessions/week and the EG2 received four high-intensity PE sessions/week . Aerobic fitness , muscle strength , speed-agility and flexibility were assessed using previously vali date d field-based tests before and after the intervention . RESULTS Doubling the number of PE sessions/week result ed in improvements in aerobic fitness and flexibility ( P=.008 and P=.04 , respectively ) . Further increases in the intensity of the sessions were related to improvements in speed-agility ( P<.001 ) . The maximal oxygen consumption increased by 3 and 5 mL/kg/min in the EG1 and EG2 , respectively . No differences were observed for muscle strength . CONCLUSIONS The results suggest that doubling the frequency of PE sessions is a sufficient stimulus to improve physical fitness , particularly aerobic fitness , which has been shown to be a powerful indicator of cardiovascular health in children and adolescents . Future studies involving larger sample sizes should confirm or refute these findings OBJECTIVE To examine referral by primary care providers ( PCPs ) of preschool children with obesity ( ≥95th percentile for body mass index [ BMI ] ) to a weight management intervention when offered through a r and omized clinical trial ( RCT ) , and identify reasons for not referring children . STUDY DESIGN In phase I , 3 experts in obesity , psychology , and nutrition completed an open card sort and classified PCPs ' reasons for declining referral into groups based on similarity of reasons . Categories were then defined and labeled . In phase II , 2 independent sorters placed each decline into 1 of the categories defined in phase I. RESULTS PCPs referred 78 % of eligible children to the RCT . Compared with children declined for referral , referred children had a significantly higher weight ( 48.4 lb vs 46.1 lb ; P < .001 ) and BMI percentile ( 97.6 vs 97.0 ; P < .001 ) . Eleven categories for decline were identified in phase I. In phase II , excellent reliability was obtained between each independent sorter and the phase I categories , and also between the 2 independent sorters ( κ values , 0.72 - 1.0 ) . The most common reason for declining was " family not a good fit " ( 23.6 % ) , followed by " does n't believe weight is a problem " ( 13.9 % ) , " family would not be interested " ( 12 % ) , and " does n't believe measurement is accurate " ( 11.5 % ) . Appropriately , exclusionary criteria of the RCT was a reason as well ( 11.8 % ) . CONCLUSION The availability of weight management for preschoolers through RCTs appeared to overcome barriers of re sources , time , and credible treatment cited in previous studies . However , concerns about the family 's response or interest in a weight management program remained barriers , as did PCPs ' perceptions about obesity in young children . TRIAL REGISTRATION Clinical Trials.gov : NCT01546727 Background Identifying ways to promote physical activity and decrease sedentary time during childhood is a key public health issue . Research on the putative influences on preschool children ’s  physical activity ( PA ) and  sedentary behavior  ( SB ) is limited and has yielded inconsistent results . Our aim was to identify correlates of PA and SB in preschool children . Methods Cross-sectional data were drawn from the Swiss Preschoolers ’ Health Study ( SPLASHY ) , a Swiss population -based cohort study . Of 476 two to six year old children , 394 ( 54 % boys ) had valid PA data assessed by accelerometry .  Information on exposure data was directly measured or extracted from parental question naires . Multilevel linear regression modeling was used to separately assess associations between 35 potential correlates and  total PA ( TPA ) , moderate-to-vigorous PA ( MVPA ) and SB . Results In total , 12 correlates from different domains were identified . TPA and MVPA were greater in boys than girls , increased with age and were positively associated with gross motor skills . Children from single parent families had a higher level of TPA and spent less time sedentary than those living with two parents . Time spent outdoors was positively associated with TPA and negatively with SB . The child ’s activity temperament was related all three outcomes , whereas parental sports club membership , living area per person and neighborhood safety were associated with SB only . Fixed and r and om factors in the final models accounted for 28 % , 32 % and 22 % of the total variance in TPA , MVPA and SB , respectively . Variance decomposition revealed that age , sex and activity temperament were the most influential correlates of both , TPA and MVPA , whereas the child ’s activity temperament , time outdoors and neighborhood safety were identified as the most important correlates of SB . Conclusions A multidimensional set of correlates of young children ’s  activity behavior has been identified . Personal factors had the greatest influence on PA , whereas environmental-level factors had the greatest influence on SB . Moreover , we identified a number of previously unreported , potentially modifiable correlates of young children ’s PA and SB . These factors could serve to define target groups or become valuable targets for change in future interventions .Trial registration Current Controlled Trials IS RCT N41045021 ( date of registration : 21.03.14 )
Motor fitness , particularly balance , was the most studied fitness component , while cardiorespiratory fitness was the least studied .
While we wait for more evidence to be accumulated in preschool children , the PREFIT battery hereby proposed is a useful tool for assessing physical fitness in children aged 3–5 years
Background Physical fitness is a powerful health marker in childhood and adolescence , and it is reasonable to think that it might be just as important in younger children , i.e. preschoolers .
At the moment , research ers , clinicians and sport practitioners do not have enough information about which fitness tests are more reliable , valid and informative from the health point of view to be implemented in preschool children .
Objective Our aim was to systematic ally review the studies conducted in preschool children using field-based fitness tests , and examine their ( 1 ) reliability , ( 2 ) validity , and ( 3 ) relationship with health outcomes .
Our ultimate goal was to propose a field-based physical fitness-test battery to be used in preschool children .
After analyzing the information retrieved in the current systematic review about fitness testing in preschool children , we propose the PREFIT battery , field-based FITness testing in PREschool children .