Improving fitness and reducing obesity in preschool children

We are now in the midst of a global obesity epidemic that extends into early childhood; the World Health Organization estimated in 2010 that more than 42 million children under the age of 5 were overweight.1 Excess fat gain during this crucial developmental period can lay the groundwork for adverse psychological, social, and health outcomes.2 During the preschool years children approach an “adiposity rebound”—a rise in body mass index that occurs between 3-7 years—the timing of which determines the probability of developing obesity later in life.3 Of particular concern is the comparatively high prevalence of overweight and obesity among children from migrant communities and socially disadvantaged backgrounds.4 5 Finding ways to reduce the burden of obesity in these high risk populations is a key priority in many counties. In the linked randomised trial (doi:10.1136/bmj.d6195), Puder and colleagues assess the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children.6

Poor aerobic fitness has been suggested as an important contributor to obesity in …