title: Effects of a lifestyle intervention on adiposity and fitness in overweight or low fit preschoolers (Ballabeina).
abstract: OBJECTIVE
  Overweight (OW) and low fit children represent cardiovascular high-risk groups. A multidimensional school-based lifestyle intervention performed in 652 preschoolers reduced skinfold thickness and waist circumference, and improved fitness, but did not affect BMI. The objective of this study is to examine whether the intervention was equally effective in OW (≥90th national percentile) and/or low fit (lowest sex- and age-adjusted quartile of aerobic fitness) children compared to their normal weight and normal fit counterparts.
  
  
  METHODS
  Cluster randomized controlled single blinded trial, conducted in 2008/09 in 40 randomly selected preschool classes in Switzerland. The intervention included a playful physical activity program and lessons on nutrition, media use and sleeps. Primary outcomes were BMI and aerobic fitness; secondary outcomes included sum of four skinfolds, waist circumference and motor agility. Modification of intervention effects by BMI-group and fitness-group was tested by interaction terms.
  
  
  RESULTS
  Compared to their counterparts, OW children (n = 130) had more beneficial effects on waist circumference (p for interaction = 0.001) and low fit children (n = 154) more beneficial effects on all adiposity outcomes (p for interaction ≤0.03). The intervention effects on both fitness outcomes were not modified by BMI- or fitness-group (all p for interaction ≥0.2). Average intervention effect sizes for BMI were -0.12, -0.05, -0.26 and -0.02 kg/m(2) and for aerobic fitness were 0.40, 0.30, 0.12 and 0.36 stages for OW, normal weight, low fit and normal fit children, respectively.
  
  
  CONCLUSIONS
  This multidimensional intervention was equally and for some adiposity measures even more effective in high-risk preschoolers and represents a promising option for these children.
authors.affiliation: Institute of Exercise and Health Sciences, University of Basel, 4052 Basel, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Niederer
authors.forename: F
authors.initials: F
authors.lastname: Bürgi
authors.forename: V
authors.initials: V
authors.lastname: Ebenegger
authors.forename: P
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: C
authors.initials: C
authors.lastname: Schindler
authors.forename: A
authors.initials: A
authors.lastname: Nydegger
authors.forename: S
authors.initials: S
authors.lastname: Kriemler
authors.forename: J J
authors.initials: JJ
authors.lastname: Puder
mesh_terms: D050154:Adiposity / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015444:Exercise; D005178:Faculty; D005260:Female; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D050177:Overweight / Q000453:epidemiology* / Q000517:prevention & control; D010290:Parents / Q000193:education; D010809:Physical Fitness / Q000502:physiology*; D016037:Single-Blind Method; D012885:Skinfold Thickness; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D055105:Waist Circumference