title: Increased periosteal circumference remains present 12 months after an exercise intervention in preschool children. Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial Utilization of the PICO framework to improve searching PubMed for clinical questions Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children. Promoting fundamental movement skill development and physical activity in early childhood settings: a cluster randomized controlled trial. GRADE guidelines: 4. Rating the quality of evidence--study limitations (risk of bias). Weight status and gender-related differences in motor skills and in child care - based physical activity in young children Physical activity to prevent obesity in young children: cluster randomised controlled trial The Effects of SPARK Physical Education Program on Fundamental Motor Skills in 4-6 Year-Old Children Total body bone mineral content and tibial cortical bone measures in preschool children. Longitudinal study of calcium intake, physical activity, and bone mineral content in infants 6-18 months of age. Dietary intakes and physical activity among preschool-aged children living in rural American Indian communities before a family-based healthy lifestyle intervention. Risk factors for overweight in 2- to 6-year-old children in Beijing, China. A prospective study of familial aggregation of blood pressure in young children. Association among serum lipid and lipoprotein concentrations and physical activity, physical fitness, and body composition in young children. Does physical education modify the body composition?--results of a longitudinal study of pre-school children. Relationships between weight status and child, parent and community characteristics in preschool children. Fundamental movement skills and habitual physical activity in young children. Acute exercise enhances preschoolers' ability to sustain attention. Randomized trial of physical activity and calcium supplementation on bone mineral content in 3- to 5-year-old children. Risk Factors for Deformational Plagiocephaly at Birth and at 7 Weeks of Age: A Prospective Cohort Study THE IMPACT OF PHYSICAL‐PHYSIOLOGICAL ACTIVITY ON INFANTS' GROWTH AND DEVELOPMENT Risk factors of obesity in preschool children in China: a population-based case–control study Obesity prognosis: a longitudinal study of children from the age of 6 months to 9 years. Role of physical activity and sleep duration in growth and body composition of preschool-aged children.
abstract: We previously reported that calcium intake enhanced the leg bone response to physical activity of preschool children in a 12-month r and omized trial of calcium supplementation and physical activity . To determine whether the intervention-induced changes in leg bone mineral content and size were maintained through the subsequent 12-month follow-up period , total body bone measurements by DXA and 20 % distal tibia pQCT bone measurements were obtained at 24 months ( 12 months post-intervention ) . Children also were measured for height and weight , and accelerometer readings were obtained in a subset of children at 18 and 24 months ( 6 and 12 months post-intervention ) . Regression analyses were performed controlling for covariates and indicated that increases from 12 to 24 months were greater in the gross motor ( GM ) activity group ( bone loading , large muscle exercises ) vs. fine motor ( FM ) activity group ( arts and crafts program ) for arm bone area ( BA ) ( P < 0.01 ) , total body ( P=0.04 ) and arm ( P < 0.01 ) bone mineral content ( BMC ) . There were no differences in BA or BMC changes from 12 to 24 months by calcium supplementation . Differences in tibia periosteal circumference by pQCT persisted at 24 months ( GM 51.4 + /- 0.4 mm vs. FM 50.2 + /- 0.4 mm , P=0.03 ) with a trend for greater endosteal circumferences in the children in the GM vs. FM groups at both 12 and 24 months ( both , P=0.08 ) . There were no significant differences in cortical area or thickness by activity or supplement group at 24 months . Children in the GM group had greater accelerometer counts/day ( P=0.04 ) and more time in vigorous activity ( P=0.05 ) at 18 months compared to FM group . No differences in accelerometer readings were noted at 24 months . In conclusion , we found higher activity levels in children r and omized to gross motor vs. fine motor activities 6 months after the intervention program ceased . Whether the greater periosteal circumference that was observed 12 months post-intervention was a persistent biological bone effect or due to persistently higher activity levels is not known Background Little is known about preschool-aged children ’s levels of  physical activity ( PA ) over the course of the day . Using time-stamped data , we describe the levels and patterns of PA in a population -based sample of four-year-old British children . Methods Within the Southampton Women ’s Survey the PA levels of 593 4-year-old children ( 51 % female ) were measured using ( Actiheart ) accelerometry for up to 7 days . Three outcome measures : minutes spent sedentary ( < 20 cpm ) ; in light ( LPA : ≥20 – 399 cpm ) and in moderate-to-vigorous activity ( MVPA : ≥400 cpm ) were derived . Average daily activity levels were calculated and then segmented across the day ( morning , afternoon and evening ) . MVPA was log-transformed . Two-level r and om intercept models were used to analyse associations between activity level and temporal and demographic factors . Results Children were active for 67 % ( mean 568.5 SD 79.5 minutes ) of their daily registered time on average , with 88 % of active time spent in LPA . All children met current UK guidelines of 180 minutes of daily activity . There were no differences in children ’s average daily levels of sedentary activity and LPA by temporal and demographic factors : differences did emerge when activity was segmented across the day . Sex differences were largest in the morning , with girls being more sedentary , spending fewer minutes in LPA and 18 % less time in MVPA than boys . Children were more sedentary and less active ( LPA and MVPA ) in the morning if they attended childcare full-time compared to part-time , and on weekend mornings compared to weekdays . The reverse was true for weekend afternoons and evenings . Children with more educated mothers were less active in the evenings . Children were less sedentary and did more MVPA on summer evenings compared to winter evenings . Conclusions Preschool-aged children meet current physical activity guidelines , but with the majority of their active time spent in LPA , investigation of the importance of activity intensity in younger children is needed . Activity levels over the day differed by demographic and temporal factors , highlighting the need to consider temporality in future interventions . Increasing girls ’ morning activity and providing opportunities for daytime activity in winter months may be worthwhile Objective To assess the effect of a governmentally-led center based child care physical activity program ( Youp’là Bouge ) on child motor skills . Patients and methods We conducted a single blinded cluster r and omized controlled trial in 58 Swiss child care centers . Centers were r and omly selected and 1:1 assigned to a control or intervention group . The intervention lasted from September 2009 to June 2010 and included training of the educators , adaptation of the child care built environment , parental involvement and daily physical activity .  Motor skill was the primary outcome and body mass index ( BMI ) , physical activity and quality of life secondary outcomes . The intervention implementation was also assessed . Results At baseline , 648 children present on the motor test day were included ( age 3.3 ± 0.6 , BMI 16.3 ± 1.3 kg/m2 , 13.2 % overweight , 49 % girls ) and 313 received the intervention . Relative to children in the control group ( n = 201 ) , children in the intervention group ( n = 187 ) showed no significant increase in motor skills ( delta of mean change ( 95 % confidence interval : -0.2 ( −0.8 to 0.3 ) , p = 0.43 ) or in any of the secondary outcomes . Not all child care centers implemented all the intervention components . Within the intervention group , several predictors were positively associated with trial outcomes : 1 ) free-access to a movement space and parental information session for motor skills 2 ) highly motivated and trained educators for BMI 3 ) free-access to a movement space and purchase of mobile equipment for physical activity ( all p < 0.05 ) . Conclusion This “ real-life ” physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs . Trial registration Clinical trials.gov Background Supporting 21st century health care and the practice of evidence -based medicine ( EBM ) requires ubiquitous access to clinical information and to knowledge-based re sources to answer clinical questions . Many questions go unanswered , however , due to lack of skills in formulating questions , crafting effective search strategies , and accessing data bases to identify best levels of evidence . Methods This r and omized trial was design ed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system . Two of the search interfaces utilized a specific framework called PICO , which was design ed to focus clinical questions and to prompt for publication type or type of question asked . The third interface was the st and ard PubMed interface readily available on the Web . Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US . Thirty-one subjects were r and omized to one of the three interfaces , given 3 clinical questions , and asked to search PubMed for a set of relevant articles that would provide an answer for each question . The success of the search results was determined by a precision score , which compared the number of relevant or gold st and ard articles retrieved in a result set to the total number of articles retrieved in that set . Results Participants using the PICO templates ( Protocol A or Protocol B ) had higher precision scores for each question than the participants who used Protocol C , the st and ard PubMed Web interface . ( Question 1 : A = 35 % , B = 28 % , C = 20 % ; Question 2 : A = 5 % , B = 6 % , C = 4 % ; Question 3 : A = 1 % , B = 0 % , C = 0 % ) 95 % confidence intervals were calculated for the precision for each question using a lower boundary of zero . However , the 95 % confidence limits were overlapping , suggesting no statistical difference between the groups . Conclusion Due to the small number of search es for each arm , this pilot study could not demonstrate a statistically significant difference between the search protocol s. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results Exercise has been found to be effective for prevention of weight gain and maintenance of a stable weight in adults . The objective of this study was to evaluate the effect of a school-based aerobic exercise program on the obesity indexes of preschool children . Subjects were 292 second-year elementary school pupils from 2 kindergartens in Hat Yai municipality , Songkhla province , southern Thail and . A specially design ed exercise program , including a 15-min walk before beginning the morning class and a 20-min aerobic dance session after the afternoon nap , 3 times a week , was conducted for 29.6 wk . Weight , height , and triceps skinfold thickness were measured 4 times . At the end of the study , the prevalence of obesity , using 95th percentile National Center for Health Statistics triceps-skinfold-thickness cutoffs , of both the exercise and control groups decreased . That of the exercise group decreased from 12.2 % at baseline to 8.8 % ( Wilcoxon signed-rank test , P = 0.058 ) , whereas that of the control group decreased from 11.7 % to 9.7 % ( Wilcoxon signed-rank test , P = 0.179 ) . A sex difference in the response of body mass index ( BMI ) to exercise was observed . Girls in the exercise group had a lower likelihood of having an increasing BMI slope than the control girls did ( odds ratio : 0.32 ; 95 % CI : 0.18 , 0.56 ) . In conclusion , our study suggests that a 29.6-wk school-based exercise program can prevent BMI gain in girls and may induce a remission of obesity in preschool-age children The aim of this study was to assess the feasibility , acceptability and potential efficacy of a physical activity program for preschool children . A 20-week , 2-arm parallel cluster r and omized controlled pilot trial was conducted . The intervention comprised structured activities for children and professional development for staff . The control group participated in usual care activities , which included design ated inside and outside playtime . Primary outcomes were movement skill development and objective ly measured physical activity . At follow-up , compared with children in the control group , children in the intervention group showed greater improvements in movement skill proficiency , with this improvement statically significant for overall movement skill development ( adjust diff . = 2.08 , 95 % CI 0.76 , 3.40 ; Cohen 's d = 0.47 ) and significantly greater increases in objective ly measured physical activity ( counts per minute ) during the preschool day ( adjust diff . = 110.5 , 95 % CI 33.6 , 187.3 ; Cohen 's d = 0.46 ) . This study demonstrates that a physical activity program implemented by staff within a preschool setting is feasible , acceptable and potentially efficacious In the GRADE approach , r and omized trials start as high- quality evidence and observational studies as low- quality evidence , but both can be rated down if most of the relevant evidence comes from studies that suffer from a high risk of bias . Well-established limitations of r and omized trials include failure to conceal allocation , failure to blind , loss to follow-up , and failure to appropriately consider the intention-to-treat principle . More recently recognized limitations include stopping early for apparent benefit and selective reporting of outcomes according to the results . Key limitations of observational studies include use of inappropriate controls and failure to adequately adjust for prognostic imbalance . Risk of bias may vary across outcomes ( e.g. , loss to follow-up may be far less for all-cause mortality than for quality of life ) , a consideration that many systematic review s ignore . In deciding whether to rate down for risk of bias -- whether for r and omized trials or observational studies -- authors should not take an approach that averages across studies . Rather , for any individual outcome , when there are some studies with a high risk , and some with a low risk of bias , they should consider including only the studies with a lower risk of bias Background Over the last decades , a decline in motor skills and in physical activity and an increase in obesity has been observed in children . However , there is a lack of data in young children . We tested if differences in  motor skills and in physical activity  according to weight or gender were already present in 2- to 4-year-old children . Methods Fifty-eight child care centers in the French part of Switzerl and were r and omly selected for the Youp'là bouge study .  Motor skills were assessed by an obstacle course including 5 motor skills , derived from the Zurich Neuromotor Assessment test . Physical activity was measured with accelerometers ( GT1 M , Actigraph , Florida , USA ) using age-adapted cut-offs .  Weight status was assessed using the International Obesity Task Force criteria ( healthy weight vs overweight ) for body mass index ( BMI ) . Results Of the 529 children ( 49 % girls , 3.4 ± 0.6 years , BMI 16.2 ± 1.2 kg/m2 ) , 13 % were overweight . There were no significant weight status-related differences in the single skills of the obstacle course , but there was a trend ( p = 0.059 ) for a lower performance of overweight children in the overall motor skills score . No significant weight status-related  differences in child care-based physical activity  were observed . No gender-related differences were found in the overall motor skills score , but boys performed better than girls in 2 of the 5 motor skills ( p ≤ 0.04 ) . Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12 - 25 % higher and sedentary activity 5 % lower in boys compared to girls ( all p < 0.01 ) . Conclusions At this early age , there were no significant weight status- or gender-related differences in global motor skills . However , in accordance to data in older children , child care-based physical activity  was higher in boys compared to girls . These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children Objective To assess whether a physical activity intervention reduces body mass index in young children . Design Cluster r and omised controlled single blinded trial over 12 months . Setting Thirty six nurseries in Glasgow , Scotl and . Participants 545 children in their preschool year , mean age 4.2 years ( SD 0.2 ) at baseline . Intervention Enhanced physical activity programme in nursery ( three 30 minute sessions a week over 24 weeks ) plus home based health education aim ed at increasing physical activity through play and reducing sedentary behaviour . Main outcome measure Body mass index , expressed as a st and ard deviation score relative to UK 1990 reference data . Secondary measures were objective ly measured physical activity and sedentary behaviour ; fundamental movement skills ; and evaluation of the process . Results Group allocation had no significant effect on the primary outcome measure at six and 12 months or on measures of physical activity and sedentary behaviour by accelerometry . Children in the intervention group had significantly higher performance in movement skills tests than control children at six month follow-up ( P=0.0027 ; 95 % confidence interval 0.3 to 1.3 ) after adjustment for sex and baseline performance . Conclusions Physical activity can significantly improve motor skills but did not reduce body mass index in young children in this trial . Trial registration Current Controlled Trials IS RCT N36363490 Objective The purpose of this study was to investigate the effect of SPARK Physical Education ( PE ) program on fundamental motor skills in 4 - 6 year children .  SPARK ( Sports , Play , and Active Recreation for Kids ) is an evidence based PE program design ed in order to promote the lifelong wellbeing . Methods In total , 90 children aged 4 to 6 years were selected r and omly . The children were allocated into 3 groups with separate PE programs : 1-SPARK , 2-Gymnastics and 3-Routine activity . Using the Test of Gross Motor Development ( TGMD-2 ) , a pretest was done in all groups . Afterwards , SPARK and Gym PE programs were performed for 8 weeks and 3 sessions each week . The third group used to do the routine physical education program in their daycare . After 8 weeks ( 24 sessions ) , the post tests were done for all groups with the same scoring system as the pretest . Findings The results showed that the SPARK program had a higher efficacy on the promotion of the fundamental motor skills comparing to the routine physical education programs or gymnastics PE group . Conclusion SPARK can be used as an appropriate alternative in order to promote the children 's motor skills This study was undertaken to identify factors that influence total body bone area ( TBBA ) , total body bone mineral content ( TB BMC ) , and tibial cortical bone measures in 239 children aged 3 - 5 years . We obtained information on demographic and anthropometric characteristics and measurements of diet , physical activity , and strength . In multiple regression analysis , TBBA correlated with height ( p < 0.001 ) , weight ( p < 0.001 ) , percent body fat ( p < 0.001 ) , and calcium intake ( p = 0.02 ) . TB BMC correlated with TBBA ( p < 0.001 ) , age ( p = 0.001 ) , and weight ( p = 0.02 ) and inversely correlated with height ( p < 0.001 ) and percent body fat ( p < 0.001 ) . Children born preterm had lower TB BMC compared with children born at term ( p = 0.02 ) . Both periosteal and endosteal circumferences were correlated with weight ( both , p < 0.001 ) and inversely correlated with age ( p = 0.006 and p = 0.003 , respectively ) and percent body fat ( p = 0.002 and p = 0.005 respectively ) . Endosteal circumference was greater and cortical bone area was lower in children born preterm compared with those born at term ( both , p = 0.04 ) . Findings of higher TBBA and lower TB BMC in children with high percent body fat indicate undermineralization of bone and suggest that obesity in preschool children may have detrimental effects on total body bone mass accretion . A smaller tibial periosteal circumference and thus cross-sectional area in children with the same weight but higher percent body fat also would lead to a biomechanical disadvantage in these children . Findings of low TB BMC and cortical bone area among children born preterm need to be confirmed in other population s. We speculate that differences in these measurements between children born preterm and at term may be caused by differences in activity Although increased physical activity early in life is recommended for optimizing bone health , no controlled trials on the effect of activity on bone mass accretion during periods of rapid growth have been reported . The purpose of this study was to determine whether infants r and omized to a 1 year gross motor activity program  had a greater bone mass accretion than infants r and omized to a fine motor activity program .  The gross motor program included activities that focused on loading the skeleton and were performed for 15 - 20 minutes/day , 5 days/week by study personnel . Infants ( n = 72 ) were enrolled at 6 months of age , and total body bone mineral content ( BMC ) , 3-day diet records , and activity levels were obtained at 6 , 9 , 12 , 15 , and 18 months . BMC was associated with weight , length , and bone area at all ages and correlated with earlier calcium intakes . Calcium intake appeared to modify the effect of  gross motor activity  on bone mass accretion ; infants in both groups had similar bone accretion at moderately high calcium intakes , but at low calcium intakes infants in the gross motor program had less bone accretion than infants in the fine motor program . Compliant infants in the gross motor group had lower BMC at 18 months compared with noncompliant infants . These results indicate that BMC in infants is related to calcium intake , and we speculate that participation in a gross motor program during rapid bone growth may lead to reduced bone accretion in the presence of a moderate to moderately low calcium intake OBJECTIVE To report dietary intake and physical activity among preschool-aged children living in rural American Indian communities before participation in a family-based healthy lifestyle intervention  and to compare data to current age-specific recommendations . SUBJECTS/ DESIGN One hundred thirty-five preschool-aged children , living in rural American Indian communities , provided diet and physical activity data before participating in a 2-year r and omized healthy lifestyle intervention .  Three 24-hour dietary recalls assessed nutrient and food and added sugar intake , which were compared to the National Academy of Science 's Dietary Reference Intakes , the US Department of Agriculture 's MyPyramid , and American Heart Association recommendations . Time watching television and moderate plus vigorous activity was compared to MyPyramid and American Academy of Pediatrics recommendations . STATISTICAL ANALYSIS Nutrient , food group , added sugar intake , and time watching television and in moderate or vigorous activity  were compared to recommendations by computing the percent of recommendations met . Nonparametric tests identified differences in diet and physical activity among age groups and normal and overweight children ( body mass index < 85th and > or = 85th percentile ) . RESULTS Average nutrient intakes met recommendations whereas food group intakes did not . Mean fruit and vegetable intakes for 2- to 3-year-olds were 0.36 c/day fruit and 0.45 c/day vegetables and , for 4- to 5-year-olds , 0.33 c/day fruit and 0.48 c/day vegetables . Both age groups reported consuming more than 50 g added sugar , exceeding the recommendation of 16 g. Overweight vs normal weight children reported significantly more sweetened beverage intake ( 8.0+/-0.10 vs 5.28+/-0.08 oz/day , P<0.01 ) . On average , all children reported watching television 2.0 hours/day and significant differences were observed for total television viewing and nonviewing time between overweight and normal weight children ( 8.52+/-0.6 vs 6.54+/-0.6 hours/day , P<0.01 ) . All children engaged in < 20 minutes/day of moderate or vigorous activity . CONCLUSIONS Overall , children in this sample did not meet MyPyramid recommendations for fruits or vegetables and exceed added sugar intake recommendations . Television viewing time and time when the television was on in the home was highly prevalent along with low levels of moderate or vigorous activity . The Healthy Children Strong Families intervention we studied has potential for improving nutrition and physical activity among preschool-aged children living in rural American Indian communities OBJECTIVE To assess the prevalence of overweight among Chinese preschool children and to explore risk factors of childhood obesity focusing on parental characteristics , feeding practice and lifestyle . METHODS Data on 930 families with 2- to 6-year-old children in five kindergartens were obtained in a cross sectional study . Families were r and omly selected from two of all six urban districts in Beijing , China . Information on parental characteristics , dietary habits , lifestyle habits , and feeding practice was collected by parental self-report question naires . The children 's stature and weight were measured in light clothing and without shoes . Overweight and obesity were defined according to international cut-off values , as proposed by the International Obesity Task Force . Multivariate regression analysis was used to explore risk factors of child overweight . RESULTS The overall prevalence of overweight and obesity was 10.7 % and 4.2 % , respectively , and increased with age . The prevalence of child overweight was 14.1 % and 7.5 % in obese and non-obese families , respectively . Significant associations were observed between child and parent characteristics for overweight , frequency of eating in restaurant , television hours , and hours of physical activity . Child overweight was associated with parental overweight ( Odds Ratio [ OR ] 2.43 , 95 % CI 0.78 , 6.59 ) , low maternal education level ( OR 2.22 , 95 % CI 1.39 , 3.55 ) , food restriction ( OR 2.68 , 95 % CI 1.64 , 4.29 ) , and television watching > 2h/d ( OR 1.56 , 95 % CI 1.17 , 2.09 ) , after adjusting for sex , age , family income and kindergarten ( for cluster study design ) . CONCLUSIONS Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries . Prevention strategies should include identified lifestyle risk factors In a prospect i ve study , we evaluated familial aggregation of blood pressure in a sample of 175 normotensive families with children 3 to 6 yr old .  Systolic and diastolic blood pressure measurements of parents and children were correlated at 1 , 2 , and 3 yr intervals . Spearman rank-order correlation coefficients between parents and children were significant for mother-son pairs . In particular , mother-son blood pressure correlation coefficients were significant for systolic blood pressure across all 3 yr and for diastolic blood pressure during yr 2 . Further analyses were performed adjusting for body mass index ( BMI ) , age , physical activity , sodium intake , potassium intake , and parental smoking status , and alcohol use . The Spearman correlation coefficients for mother-son pairs remained significant for yr 1 and 3 after adjusting for these blood pressure correlates . These results are consistent with cross-sectional studies and suggest that both genetic and environmental contributions to blood pressure status are important in young children OBJECTIVE To examine the relationships among indicators of physical activity , physical fitness , and body composition with serum lipid and lipoprotein levels in young children . DESIGN Cross-sectional and 1-year prospect i ve cohort . SETTING Studies of Child Activity and Nutrition ( SCAN ) program , Galveston , Tex . SUBJECTS One hundred twenty-three 4- or 5-year-old black , Hispanic ( of Mexican origin ) , and white children . MEASUREMENTS Body composition , resting heart rate , and cardiovascular fitness variables and serum lipid and lipoprotein levels were measured at age 3 or 4 years ( study year 1 ) and at age 4 or 5 years ( study year 2 ) , and day-long heart rate was measured and the Children 's Activity Rating Scale was administered between study years 1 and 2 . RESULTS Year-1 waist/hip ratios were inversely correlated with total serum cholesterol ( TSC ) and low-density lipoprotein ( LDL ) levels . Mean activity level was inversely correlated with waist/hip ratios . On the basis of multiple regression analysis , the sum of seven skin-fold measurements , height , and gender explained 15.4 % of the variation in triglyceride levels . The sum of seven skin-fold measurements was inversely correlated with the high-density lipoprotein ( HDL ) level . Resting heart rate , waist/hip ratio , and the slope of the exercise heart rate during fitness testing explained 19.5 % of the variation in the concentration of an HDL subclass , HDL2 . These children 's levels of physical activity were associated with higher fitness levels . Year-1 waist/hip ratios and year-2 sum of seven skin-fold measurements were positively correlated with the LDL/HDL and TSC/HDL ratios . CONCLUSION Higher levels of cardiovascular fitness and lower levels of fatness were associated with more favorable serum lipid and lipoprotein levels in these young children .  Physical activity appeared to have an indirect association with serum lipid and lipoprotein values through its relationship with higher fitness levels and lower levels of fatness The aim of the study is the analysis of body composition , motor development and cardiovascular parameters of preschool-children . In 2001/2002 a longitudinal study started in 17 nursery schools in Berlin . A total of 160 children out of the 264 children participated in a regular exercise programme . After 24 months of training significant differences of body composition , motor skills and cardiovascular parameters between 5 complete year old children of the intervention and the control group were observed . The results show that such an exercise programme is successful as a preventive measure to decrease the risk of obesity OBJECTIVE To examine , using an Ecological Systems Theoretical framework , relationships between weight status and child , parent and community characteristics and risk factors among preschool children . METHODS Cross-sectional data was collected from 140 children and their parents from 11 r and omly selected preschools . Outcome variables included : motor development ; perceived competence ; objective ly measured physical activity ; time spent in active and quiet play ; location and number of televisions ; parental rules around physical activity and time spent watching television ; availability of sport and physical activity programs ; and parks and open spaces and access to footpaths .  RESULTS Overweight children spent more time in quiet play and watching television  and less time in active play and physical activity . Perceived competence and motor development were similar for both overweight and non-overweight children . Associations between weight status and several parent and community characteristics were not evident , except for access to footpaths . Overweight children had greater access to footpaths  compared with non-overweight children ( p=0.046 ) . CONCLUSION The results reported here showed little difference between overweight and non-overweight children in relation to a variety of child , parent and community variables . However , for some characteristics , differences in older children have been reported . Longitudinal studies are required to confirm when these characteristics begin to differ , what effects these differences have on behaviour and weight-status , and therefore when targeted treatment should be provided during a child 's development PURPOSE To test for relationships between objective ly measured habitual physical activity and fundamental movement skills in a relatively large and representative sample of preschool children . METHODS Physical activity was measured over 6 d using the Computer Science and Applications ( CSA ) accelerometer in 394 boys and girls ( mean age 4.2 , SD 0.5 yr ) . Children were scored on 15 fundamental movement skills , based on the Movement Assessment Battery , by a single observer . RESULTS Total physical activity ( r=0.10 , P<0.05 ) and percent time spent in moderate to vigorous physical activity ( MVPA ) ( r=0.18 , P<0.001 ) were significantly correlated with total movement skills score . Time spent in light-intensity physical activity was not significantly correlated with motor skills score ( r=0.02 , P>0.05 ) . CONCLUSIONS In this sample and setting , fundamental movement skills were significantly associated with habitual physical activity , but the association between the two variables was weak . The present study questions whether the widely assumed relationships between motor skills and habitual physical activity actually exist in young children A growing body of research has illuminated beneficial effects of a single bout of physical activity ( i.e. , acute exercise ) on cognitive function in school-age children . However , the influence of acute exercise on preschoolers ' cognitive function has not been reported . To address this shortcoming , the current study examined the effects of a 30-min bout of exercise on preschoolers '  cognitive function .  Preschoolers ' cognitive function was assessed following a single bout of exercise and a single sedentary period . Results revealed that , after engaging in a bout of exercise , preschoolers exhibited markedly better ability to sustain attention , relative to after being sedentary ( p = .006 , partial eta square = .400 ) . Based on these findings , providing exercise opportunities appears to enhance preschoolers ' cognitive function A meta- analysis of adult exercise studies and an infant activity trial show a possible interaction between physical activity and calcium intake on bone . This r and omized trial of activity and calcium supplementation was conducted in 239 children aged 3 - 5 years ( 178 completed ) . Children were r and omized to participate in either gross motor or fine motor activities for 30 minutes/day , 5 days per week for 12 months . Within each group , children received either calcium ( 1000 mg/day ) or placebo .  Total body and regional bone mineral content by DXA and 20 % distal tibia measurements by peripheral quantitative computed tomography ( pQCT ) were obtained at 0 and 12 months . Three-day diet records and 48-h accelerometer readings were obtained at 0 , 6 , and 12 months . Higher activity levels were observed in gross motor versus fine motor activity groups , and calcium intake was greater in calcium versus placebo ( 1354 + /- 301 vs. 940 + /- 258 mg/day , p < 0.001 ) . Main effects of activity and calcium group were not significant for total body bone mineral content or leg bone mineral content by DXA . However , the difference in leg bone mineral content gain between gross motor and fine motor was more pronounced in children receiving calcium versus placebo ( interaction , p = 0.05 ) . Children in the gross motor group had greater tibia periosteal and endosteal circumferences by pQCT compared with children in the fine motor group at study completion ( p < 0.05 ) . There was a significant interaction ( both p < or = 0.02 ) between supplement and activity groups in both cortical thickness and cortical area : among children receiving placebo , thickness and area were smaller with gross motor activity compared with fine motor activity , but among children receiving calcium , thickness and area were larger with gross motor activity . These findings indicate that calcium intake modifies the bone response to activity in young children OBJECTIVE . The purpose of this work was to identify risk factors for deformational plagiocephaly within 48 hours of birth and at 7 weeks of age . PATIENTS AND METHODS . This was a prospect i ve cohort study in which 380 healthy neonates born at term in Bernhoven Hospital in Veghel were followed at birth and at 7 weeks of age . Data regarding obstetrics , sociodemographics , asymmetry of the skull , anthropometrics , motor development , positioning , and care factors related to potentially provoking deformational plagiocephaly were gathered , with special interest for putative risk factors . The main outcome measure at birth and at 7 weeks of age was deformational plagiocephaly , assessed using the plagiocephalometry parameter oblique diameter difference index , a ratio variable , calculated as the longest divided by the shortest oblique diameter of the skull × 100 % . A cutoff point of ≥104 % was used to indicate severe deformational plagiocephaly . RESULTS . Only in 9 of 23 children who presented deformational plagiocephaly at birth was deformational plagiocephaly present at follow-up , whereas in 75 other children , deformational plagiocephaly developed between birth and follow-up . At birth , 3 of 14 putative risk factors were associated with severe flattening of the skull : gender , birth rank , and brachycephaly . At 7 weeks of age , 8 of 28 putative risk factors were associated with severe flattening : gender , birth rank , head position when sleeping , position on chest of drawers , method of feeding , positioning during bottle-feeding , and tummy time when awake . Early achievement of motor milestones was a protective factor for developing deformational plagiocephaly . Deformational plagiocephaly at birth was not a predictor for deformational plagiocephaly at 7 weeks of age . There was no significant relation between supine sleeping and deformational plagiocephaly . CONCLUSIONS . Three determinants were associated with an increased risk of deformational plagiocephaly at birth : male gender , first-born birth rank , and brachycephaly . Eight factors were associated with an increased risk of deformational plagiocephaly at 7 weeks of age : male gender , first-born birth rank , positional preference when sleeping , head to the same side on chest of drawers , only bottle feeding , positioning to the same side during bottle feeding , tummy time when awake <3 times per day , and slow achievement of motor milestones . This study supports the hypothesis that specific nursing habits , as well as motor development and positional preference , are primarily associated with the development of deformational plagiocephaly . Earlier achievement of motor milestones probably protects the child from developing deformational plagiocephaly . Implementation of practice s based on this new evidence of preventing and diminishing deformational plagiocephaly in child health care centers is very important Forty‐seven infants four to 40 weeks of age in Dumaguete City , the Philippines , were given a cycling motion exercise of the upper and lower limbs for Jour five‐minute periods a day , six days a week , for two months . They were measured , against a control group of 17 infants of the same age and sex . Pretest , mid test , and pastiest measurements were taken for weight gain , length gain , and development of motor , language , adaptive , and personal‐social behaviors . Significant differences were found between the two groups of infants to substantiate the hypothesis that increases in growth and development of infants who receive physical care and emotional support plus planned physical‐physiological activity in the form of passive cycling exercises would be greater than those of infants who receive only physical care and , emotional support OBJECTIVE : To identify the risk factors of obesity in preschool children in China . DESIGN : A nationwide case — control study in eight cities in China . SUBJECTS : A total of 748 boys and 574 girls ( age 0.1–6.9 y ) , including the obese and non-obese . One obese child was matched with one non-obese child by sex and age . MEASUREMENTS : Weight , height and other measurements were taken for all the subjects . The information on child activity , feeding pattern and family background was collected by our study team from the parents and the kindergarten teacher . RESULTS : Birth weight ≥ 4.0 kg , high eating speed , obesity among the child 's relatives ≥ 25 % , mother 's body mass index ( BMI ) > 25 kg/m2 and father 's BMI > 25 kg/m2 were identified as the major significant ( P<0.05 ) risk factors of obesity in preschool children in China . CONCLUSION : Family history of obesity , high birth weight and eating speed were identified as the risk factors of obesity in preschool children in China . Our results show the need for family therapy as part of an intervention program for childhood obesity , which includes behavior modification The development of body fatness and leanness is examined in an ongoing prospect i ve nutrition and growth study .  Individual skinfold thicknesses , relative weights , weight gains , activity levels , and caloric intakes  were examined at seven ages between 6 months and 9 years .  Changes in body fatness in this group of children provide evidence that the obese infant usually does not become the obese child . Weight gain in infancy is also a poor predictor of 9-year old obesity . Changes from obese to non-obese or lean are often not linear . There is evidence that impending or actual obesity begins at ages 6 to 9 years with some predictability provided as early as age 2 years for girls , age 3 years for boys OBJECTIVE The impact of physical activity patterns and sleep duration on growth and body composition of preschool-aged children remains unresolved . Aims were ( 1 ) to delineate cross-sectional associations among physical activity components , sleep , total energy expenditure ( TEE ) , and body size and composition ; and ( 2 ) to determine whether physical activity components , sleep , and TEE predict 1-year changes in body size and composition in healthy preschool-aged children . METHODS Anthropometry , body composition , accelerometry , and TEE by doubly labeled water were measured at baseline ; anthropometry and body composition were repeated 1 year later ( n = 111 ) . RESULTS Cross-sectionally , positive associations between sedentary activity and weight and fat-free mass ( FFM ) ( P = 0.009 - 0.047 ) , and a negative association between moderate-vigorous physical activity ( MVPA ) and percent fat mass ( FM ) ( P = 0.015 ) were observed . TEE and activity energy expenditure ( AEE ) were positively associated with weight , body mass index ( BMI ) , FFM , and FM ( P = 0.0001 - 0.046 ) . Prospect ively , TEE , AEE , physical activity level , and MVPA , but not sedentary activity , were positively associated with changes in BMI ( P = 0.0001 - 0.051 ) and FFM ( P = 0.0001 - 0.037 ) , but not percent FM . Sleep duration inversely predicted changes in FM ( P = 0.005 ) and percent FM ( P = 0.006 ) . CONCLUSIONS Prospect ively , MVPA , TEE , AEE , and physical activity level promote normal growth and accretion of FFM , whereas sleep duration inversely predicts changes in adiposity in preschool-aged children
target: Physical activity interventions were consistently ( > 60 % of studies ) associated with improved motor and cognitive development , and psychosocial and cardiometabolic health .
  Across observational studies , physical activity was consistently associated with favourable motor development , fitness , and bone and skeletal health .
  For intensity , light- and moderate-intensity physical activity were not consistently associated with any health indicators , whereas moderate- to vigorous-intensity , vigorous-intensity , and total physical activity were consistently favourably associated with multiple health indicators .
  Across study design s , consistent favourable associations with health indicators were observed for a variety of types of physical activity , including active play , aerobic , dance , prone position ( infants ; ≤1 year ) , and structured/organized .
  Apart from ≥30 min/day of the prone position for infants , the most favourable frequency and duration of physical activity was unclear .
  However , more physical activity appeared better for health .
  Conclusions Specific types of physical activity , total physical activity , and physical activity of at least moderate- to vigorous-intensity were consistently favourably associated with multiple health indicators .
background: Background Given the rapid development during the early years ( 0 - 4 years ) , an underst and ing of the health implication s of physical activity is needed .
  The purpose of this systematic review was to examine the relationships between objective ly and subjectively measured physical activity and health indicators in the early years .