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Physical activity is an important determinant of energy balance. However, its impact on overweight/obesity has proved difficult to measure in pre-school children and few studies have found significant associations. A set of simple questions was used to distinguish pre-school children with high and low physical activity, and the association of this classification with childhood overweight/obesity and performance in an established motor test was investigated.
Setting and subjects
Weight and height were measured in 12 556 children taking part in the obligatory school entrance health examination 2004–5 and 2005–6 in three urban and three rural Bavarian regions. Their parents were asked to answer a questionnaire with a set of questions on physical activity.
The mean age of the children evaluated was 5·78 (sd 0·43) years, 6535 (52·1 %) were boys. Physically active children were less likely to be overweight (OR = 0·786, 95 % CI 0·687, 0·898) or obese (OR = 0·655, 95 % CI 0·506, 0·849) and achieved 6·7 (95 % CI 5·8, 7·7) % more jumps per 30 s than less active children in a motor test, adjusted for a number of potentially confounding variables.
Classification of pre-school children as physically active or not, based on a small set of questions, revealed significant associations with overweight/obesity and a motor test. Once further validated, this classification might provide a valuable tool to assess the impact of physical activity on the risk of childhood overweight and obesity.
A number of individual risk factors for childhood obesity have been identified, but only some of these are amenable to prevention. To assess the amount of cases in a general population attributable to these risk factors, adjusted population-attributable fractions were estimated.
Obligatory school entry examination in 2001/2002 in six Bavarian communities (Germany).
5472 children at age 5–6 years.
Anthropometric measures were ascertained by public health nurses, and measures concerning sociodemographics, lifestyle and child behaviour such as child's daily meal frequency were obtained with self-administered parental questionnaires. Obesity was defined according to sex- and age-specific body mass index cut-off points proposed by the International Obesity Task Force. Adjusted population-attributable fractions were calculated based on logistic regression.
A combination of the risk factors low meal frequency, decreased physical activity, watching television >1 h day− 1, formula feeding and smoking in pregnancy accounted for 48.2% of obese children. This combination yielded a maximal achievable prevalence reduction of 1.5% for obesity (3.2% observed prevalence).
A modification of five known risk factors for childhood overweight and obesity could reasonably lower obesity prevalences at school entry. These risk factors should be particularly considered in decision making on preventive measures.
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