Skip to main content
    • Aa
    • Aa

Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention: Symposium on ‘Behavioural nutrition and energy balance in the young'

  • John J. Reilly (a1)

Prevalence of obesity in preschool children has increased dramatically in recent years. The preschool years (age 3–6 years) have been regarded as critical for the programming of energy balance, via the concept of early ‘adiposity rebound’. Children who undergo early adiposity rebound are at increased risk of later obesity. Recent evidence suggests that associations between timing of adiposity rebound and later obesity may not reflect programming, but might denote that ‘obesogenic’ growth trajectories are often established by the preschool period. Studies of objectively-measured physical activity and sedentary behaviour in preschool children show that levels of physical activity are typically low and sedentary behaviour high. The review of evidence presented here is supportive of the hypothesis that physical activity is protective against obesity in the preschool period, and that sedentary behaviour, particularly television viewing, is obesogenic. Definitive evidence on dose–response relationships between physical activity, sedentary behaviour and obesity remain unclear. Dose–response evidence could be obtained fairly readily by intervention and longitudinal observational studies that use accelerometry in preschool children. The generalisability of much of the evidence base is limited and there is a need for research on the influence of physical activity and sedentary behaviour in the preschool years in the aetiology of obesity in the developing world.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention
      Available formats
Corresponding author
Corresponding author: Professor John J. Reilly, fax +44 141 201 0710, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. T Lobstein , L Baur & R Uauy (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5, 485.

2. JJ Reilly (2006) Tackling the obesity epidemic: new approaches. Arch Dis Child 91, 724726.

5. RC Whitaker , MS Pepe , JA Wright , KD Seidel & WH Dietz (1998) Early adiposity rebound and the risk of adult obesity. Pediatrics 101, e5e11.

6. WH Dietz (2000) Adiposity rebound: reality or epiphenomenon? Lancet 356, 20272029.

7. TJ Cole (2004) Children grow and horses race: is the adiposity rebound a critical period for later obesity? BMC Pediatr 4, 69.

8. RW Taylor , AM Grant , A Goulding & SM Williams (2005) Early adiposity rebound. Curr Op Clin Nutr Met Care 8, 607612.

9. RW Taylor , A Goulding , NJ Lewis-Barned & SM Williams (2004) Rate of fat gain is faster in girls undergoing early adiposity rebound. Obes Res 12, 12281230.

10. JJ Reilly , DM Jackson , C Montgomery , LA Kelly , A Fisher , JY Paton & S Grant (2004) Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet 363, 211212.

11. J Armstrong , AR Dorosty , JJ Reilly & PM Emmett (2003) Co-existence of social inequalities in under-nutrition and obesity in preschool children: population-based cross-sectional study. Arch Dis Child 88, 671675.

12. S Kinra , RP Nelder & GJ Lewenden (2000) Deprivation and childhood obesity: a cross-sectional study of 20,973 children in Plymouth, UK. J Epidemiol Comm Health 54, 456460.

13. G Davey-Smith (2007) Life-course approaches to inequalities in adult chronic disease risk. Proc Nutr Soc 66, 216236.

14. M Wake , P Hardy , L Cantesford , M Sawyer & JB Carlin (2007) Overweight, obesity, and girth of Australian preschoolers: prevalence and socio-economic correlates. Int J Obes (Lond) 31, 10441051.

15. BL Sherry , Z Mei , KS Scanlon , A Mokdad & L Grummer-Strawn (2004) Trends in state-specific prevalence of overweight and underweight in 2–4 year old children from low income families 1984–2000. Arch Pediatr Adolesc Med 158, 11161124.

16. J Armstrong & JJ Reilly (2003) Use of the National Child Health Surveillance System for monitoring obesity, overweight, and underweight in Scottish children. Scot Med J 48, 3237.

17. H Kalies , J Lerz & R Von Kries (2002) Prevalence of overweight and obesity and trends in BMI in German preschool children, 1982–1997. Int J Obes (Lond) 26, 12111217.

18. JV Freeman , TJ Cole , S Chinn , PRM Jones , EM White & MA Preece (1995) Cross sectional stature and weight reference curves for the UK. Arch Dis Child 73, 1724.

19. RC Whitaker & SM Orzol (2006) Obesity among US urban preschool children: relationship to race, ethnicity, and socio-economic status. Arch Pediatr Adolesc Med 160, 578584.

20. AR Dorosty , F Siassi & JJ Reilly (2002) Obesity in Iranian children. Arch Dis Child 87, 388391.

21. SS Hawkins , TJ Cole & C Law (2008) Maternal employment and early childhood overweight. Int J Obes (Lond) 32, 3038.

22. JJ Reilly , J Armstrong , AR Dorosty , PM Emmett , AR Ness , I Rogers , C Steer & A Sherriff (2005) Early life risk factors for childhood obesity: cohort study. Br Med J 330, 13571362.

24. K Huus , JF Ludvigsson , K Enska & J Ludvigsson (2007) Risk factors in childhood obesity: findings from the All Babies in South-East Sweden (ABIS) cohort. Acta Paediatr 96, 13211325.

25. C Li , MI Goran , H Kaur , N Nollen & JS Ahluwalia (2007) Developmental trajectories of overweight during childhood: role of early life factors. Obesity 15, 760771.

26. PR Nader , M O'Brien , R Houts , R Bradley , J Belsky , R Crosroe , S Friedmanm , Z Mei & EJ Susman (2006) Identifying risk for obesity in early childhood. Pediatrics 118, e594e601.

27. DS Freedman , LK Khan , LK Serdula , WH Dietz , SR Srinivasan & GS Berenson (2005). Racial differences in the tracking of childhood BMI to adulthood. Obes Res 13, 928935.

28. AR Hughes , L Stewart , J Chapple , M Donaldson , M Zabihollah , SF Ahmed , CZH Kelnar & JJ Reilly (2008) Randomized controlled trial of a best practice individualized behavioral program for treatment of childhood overweight: Scottish Childhood Overweight Treatment Trial (SCOTT). Pediatrics 121, e539e546.

29. T Quattrin , E Liu & N Shaw (2005) Obese children who are referred to the pediatric endocrinologist: characteristics and outcome. Pediatrics 115, 348351.

30. JJ Reilly , A Kelly , P Ness , AR Dorosty , WHB Wallace , BES Gibson & PM Emmett (2001) Premature adiposity rebound in children treated for acute lymphoblastic leukemia. J Clin Endocrinol Metab 86, 27752778.

32. J Baird , D Fisher , P Lucus , J Kleinjen , H Roberts & C Law (2005) Being big or growing fast?: systematic review of size and growth in infancy and later obesity. Br Med J 331, 929934.

33. KF Janz , JM Gilmore , SM Levy , EM Letuchy , TL Burns & TJ Beck (2007) Physical activity and femoral neck bone strength during childhood: the Iowa Bone Development Study. Bone 41, 216222.

35. KJ Finn , N Johannsen & B Specker (2002) Factors associated with physical activity in preschool children. J Pediatr 140, 8185.

36. DM Jackson , JJ Reilly , LA Kelly , C Montgomery , S Grant & JY Paton (2003) Objectively measured physical activity in 3–4 year old children. Obes Res 11, 420425.

37. JJ Reilly , J Coyle , LA Kelly , GB Burke , S Grant & JY Paton (2003) An objective method for measurement of sedentary behavior in 3–4 year olds. Obes Res 11, 11551158.

38. JJ Reilly , C Montgomery , DM Jackson , J MacRitchie & J Armstrong (2001) Energy intake by multiple pass 24-hour recall and total energy expenditure: a comparison in a representative sample of 3–4 year olds. Br J Nutr 86, 601605.

40. JJ Reilly , V Penpraze , J Hislop , G Davies , S Grant & JY Paton (2008) Objective measurement of physical activity and sedentary behaviour: review with new data. Arch Dis Child (In the Press).

41. JJ Reilly , AR Ness & A Sherriff (2007) Epidemiological and physiological approaches to understanding the etiology of pediatric obesity: finding the needle in the haystack. Pediatr Res 61, 646652.

42. AR Ness , SD Leary , IS Rogers , JC Wells , C Mattocks , JJ Reilly , G Davey-Smith & C Riddoch (2007) Objectively measured physical activity and fat mass in a large cohort of children. PLOS Med 4, e97e101.

43. LB Andersen , M Nacro , LB Sardinha , K Froberg , U Ekelund , S Brage & SA Andersen (2006) Physical activity and clustered cardiovascular risk in children. Lancet 368, 299304.

44. KJ Finn & B Specker (2000) Comparison of Actiwatch activity monitor and Children's Activity Rating Scale in children. Med Sci Sports Exerc 32, 17941797.

46. RR Pate , MJ Almeida , KL McIver , KA Pfeiffer & M Dowda (2006) Validation and calibration of an accelerometer in preschool children. Obesity 14, 20002006.

48. RP Troiano , D Berrigan , KW Dodd , LC Masse , T Tilert & M McDowell (2008). Physical activity in the US measured by accelerometer. Med Sci Sports Exerc 40, 181188.

49. SJ Biddle , T Gorely , SJ Marshall , I Murdey & NJ Cameron (2004) Physical activity and sedentary behaviours in youth: issues and controversies. J Roy Soc Health 124, 2933.

52. TN Robinson (1999) Reducing children's television viewing to prevent obesity: a randomised controlled trial. JAMA 282, 15611567.

53. JJ Reilly , L Kelly , C Montgomery , A Williamson , A Fisher , JH McColl , R Lo Conte , JY Paton & S Grant (2006) Physical activity to prevent obesity in young children: cluster randomised controlled trial. Br Med J 333, 10411045.

54. RR Pate , KA Pfeiffer , SG Trost , P Ziegler & M Dowda (2004) Physical activity among children attending preschools. Pediatrics 114, 12581263.

55. R Jago , T Baranowski , JC Baranowski , D Thompson & KA Greaves (2005) BMI from 3–6 years of age is predicted by TV viewing and physical activity, not diet. Int J Obes (Lond) 29, 557564.

57. NJ Wareham , EM Ven Sluis & U Ekelund (2005) Physical activity and obesity prevention: a review of the current evidence. Proc Nutr Soc 64, 229247.

58. M Stead , G Hastings & L McDermott (2007) The meaning, effectiveness and future of social marketing. Obes Rev 8, Suppl. 1, 189193.

59. A Must & DJ Tybor (2005) Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth. Int J Obes (Lond) 29, s84s96.

61. G Cardon & I de Bourdeauhuij (2007) Comparison of pedometer and accelerometer measures of physical activity in preschool children. Pediatr Exerc Sci 19, 205214.

62. DP McKee , CAG Boreham , MH Murphy & AM Nevill (2005) Validation of the Digiwalker pedometer for measuring physical activity in young children. Pediatr Exerc Sci 17, 345352.

63. HL Burdette & RC Whitaker (2005) Resurrecting free play in young children: looking beyond fitness and fatness to attention, affiliation, and affect. Arch Pediatr Adolesc Med 159, 4650.

64. DA Christakis , FJ Zimmerman , DL Di-Giuseppe & CA McCarty (2004) Early television exposure and subsequent attentional problems in children. Pediatrics 113, 708713.

65. BA Dennison , TA Erb & PL Jenkins (2002) Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 109, 10281035.

66. EM Taveras , TJ Sandora , MC Shih , DR Degnan , DA Goldman & MW Gillman (2006) The association of television and video viewing with fast food intake by preschool-age children. Obesity 14, 20342041.

67. RJ Hancox & R Poulton (2006) Watching television is associated with childhood obesity but is it clinically important? Int J Obes (Lond) 30, 171175.

68. RM Viner & TJ Cole (2005) Television viewing in early childhood predicts adult body mass index. J Pediatr 147, 429435.

69. EA Vandewater , VJ Rideout , EA Wartella , X Huang , JH Lee & MS Shim (2007) Digital childhood: electronic media and technology use among infants, toddlers, and preschoolers. Pediatrics 119, e1006e1015.

70. CD Summerbell , V Ashton , KJ Campbell , L Edmunds , S Kelly & E Waters (2003) Interventions for treating obesity in children. The Cochrane Database of Systematic Reviews 2003, issue 3, CD001872. Chichester, West Sussex: John Wiley and Sons Ltd.

71. CD Summerbell , E Waters , LD Edmunds , S Kelly , T Brown & KJ Campbell (2005) Interventions for preventing obesity in children. The Cochrane Database of Systematic Reviews 2005, issue 1, CD001871. Chichester, West Sussex: John Wiley and Sons Ltd.

72. JJ Reilly , M Wilson , CD Summerbell & DC Wilson (2002) Obesity diagnosis, prevention, and treatment: evidence based answers to common questions. Arch Dis Child 86, 312395.

76. LK Certain & RS Kahn (2002) Prevalence, correlates, and trajectory of television viewing among infants and toddlers. Pediatrics 109, 634642.

78. WB Strong , RM Malina , CJR Blinke (2005) Evidence-based physical activity for school-age youth. J Pediatr 146, 732737.

79. SS Hawkins & C Law (2006) A review of risk factors for overweight in preschool children: a policy perspective. Int J Pediatr Obes 1, 195209.

80. EM Van Sluijs , AM McMinn & SJ Griffin (2007) Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. Br Med J 335, 703707.

81. KF Janz (2006) Physical activity in epidemiology: moving from questionnaire to objective measurement. Br J Sports Med 40, 191192.

82. ML Fitzgibbon , MR Stolley , L Schiffer , L Van-Horn , K Kaufer-Christoffel & A Dyer (2006) Hip Hop to Health Junior for Latino preschool children. Obesity 14, 16161625.

83. ML Fitzgibbon , MR Stolley , L Schiffer , L VanHorn , K Kaufer-Christoffel & A Dyer (2005) Two-year follow-up results for Hip Hop to Health Junior. J Pediatr 146, 618625.

84. KF Janz , TL Burns & SM Levy (2005) Tracking of activity and sedentary behaviors in childhood. Am J Prev Med 29, 172178.

85. X Yang , R Telema , E Leskinen , K Mansikkaniemi , J Viikari & OT Raitakari (2007) Testing a model of physical activity and obesity tracking from youth to adulthood. Int J Obes (Lond) 31, 521527.

86. JC Lumeng , S Rahnama , D Appugliese , N Kacioti & RH Bradley (2006) Television exposure and overweight risk in preschoolers. Arch Pediatr Adolesc Med 160, 417422.

89. ES Metallinos-Katsaras , PS Freedson , JE Fulton & B Sherry (2007) The association between an objective measure of physical activity and weight status in preschoolers. Obesity 15, 686694.

90. G Moschonis , E Grammatikakis & Y Manios (2008) Perinatal predictors of overweight at infancy and preschool childhood: the GENESIS Study. Int J Obes (Lond) 32, 3947.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 62
Total number of PDF views: 752 *
Loading metrics...

Abstract views

Total abstract views: 701 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th June 2017. This data will be updated every 24 hours.