Fit, Healthy and Smart Preschool Children: PREFIT-Chile
Condition: Child, Preschool
Study type: Observational

Summary: 
      Introduction: Investigating the interrelationship between physical condition, non-invasive
      health markers and executive function in preschoolers, is based on the current health and
      cognitive development situation of this population, especially the low socioeconomic level.
      National figures estimate that the prevalence of overweight / obesity in the preschool
      population reaches 53.6%, exposing not only the development of cardiovascular and metabolic
      diseases, but also affect cognitive potential.

      Physical condition is a powerful health marker independent of nutritional status. Its
      evaluation together with the evaluation of non-invasive health markers and executive function
      in preschoolers inside educational establishments is essential to investigate alterations at
      an early age that could be prevented with adequate interventions in schools. However, to
      achieve this, valid, reliable and comparable tools are needed internationally.

      Objective: to analyze the factors that affect the configuration of a diagnostic model which
      includes the physical fitness and physical activity levels, motor development, non-invasive
      risk factors and neuropsychological development in preschoolers.

      Methods: Observational study, case only, cross sectional. Enrollment 544 preschool child 4 to
      5 years old. Primary Outcome is Physical fitness to "Prefit Battery", Secondary outcome
      non-invasive risk factors (Blood pressure, BMI, Waist circumference, neck circumference)
      Physical activity, Motor skills and Neuropsychological development.

      expected results: Determine the degree of association of physical fitness with non-invasive
      risk factors and neuropsychological development in preschoolers, determine the influence that
      physical activity level and motor development have on physical fitness and development a
      diagnostic model which includes the physical fitness and physical activity levels, motor
      development, non-invasive risk factors and neuropsychological development in Chilean
      preschoolers.
    

Detailed description: 
      In recent years it has been demonstrated that physical fitness , which is linked to a higher
      level of physical activity has a positive effect on the health status of adults, adolescents
      and children, especially by lowering the probability of developing overweight and/or obesity.
      At the same time, recent research has shown that there is a positive relationship between
      fitness with brain structure and executive function in children.

      In Chile, overweight and obesity constitute a public health problem in children. National
      figures show that the prevalence of overweight / obesity among preschool children reached
      53.6% in 2018 exposing the children not only the development of cardiovascular and metabolic
      diseases , but also affecting motor and cognitive development. Obesity has been shown to
      influence a country´s economic development, such as salary and productivity. The Economic
      Commission for Latin America and the Caribbean in 2017 determined that the health cost
      derived from obesity In Chile was equivalent to 0,2% of the national Gross Domestic Product.
      It is expected that by 2078, the estimated annual cost produced by an increasing prevalence
      overweight / obesity will be approximately 1 billion dollars.

      Because it is not economically viable in Chile to determine in every overweight/obese child
      the probability of developing chronic diseases later in life, it is of utmost importance to
      have valid, simple and reliable indicators to discriminate at an early age, children that are
      at greatest risk. In this respect, physical fitness appears as a powerful health marker
      independent of the nutritional status. Evaluation of fitness as well as that of non-invasive
      health markers, motor development and neuropsychological development in preschool children in
      schools, constitute an excellent opportunity to investigate at an early age, alterations that
      could be prevented with adequate interventions in schools that would probably be
      significantly less costly than interventions applied later on. To achieve this goal, valid
      and reliable tools have to be developed that are also comparable with similar ones developed
      elsewhere.

      With this background, The research objective is to analyze the factors that affect the
      configuration of a diagnostic model which includes the physical fitness and physical activity
      levels, motor development, non-invasive risk factors and neuropsychological development in
      preschoolers.

      The hypothesis is that there is a positive association between physical fitness, non-invasive
      health markers and neuropsychological functions in preschool children, thus enabling to
      generate a predictive diagnostic model based on physical fitness.

        1. The primary outcome is to determine the degree of association of physical fitness with
           non-invasive risk factors and neuropsychological development in preschoolers

        2. The second outcome is to determine the influence that physical activity level and motor
           development have on physical fitness among preschool children.

      This research aims a) to establish that physical fitness in preschool children may be
      considered as a diagnostic tool of the health status of children (independent of their
      nutritional status), and b) to determine the possible impact that the physical fitness level
      has on neuropsychological development
    

Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Preschoolers from 4 to 5 years old, incorporated into the school system and attending
        kindergartens and schools, residents of the central area of Chile, to detail IV region of
        "Coquimbo", V region of "Valparaíso", VI region of the "Liberator Bernardo O'Higgins" and
        the "Metropolitan" Region
      
Keywords: Physical fitness; Risk factors; Anthropometrics; Blood pressure; Neuropsychological Tests; Physical activity; Motor skills