title: Prevalence of overweight/obesity and fitness level in preschool children from the north compared with the south of Europe: an exploration with two countries.
abstract: North-south differences in the prevalence of obesity and fitness levels have been found in European adolescents, yet it is unknown if such differences already exist in very young children.
  
  
  
  This study aims to compare the prevalence of overweight/obesity and fitness levels in preschool children aged 4 years from Sweden (north of Europe) and Spain (south of Europe).
  
  
  
  The sample consisted of 315 Swedish and 128 Spanish preschoolers. Anthropometry (weight, height, waist circumference) and fitness (strength, speed-agility, balance and cardiorespiratory fitness) were assessed. Analysis of covariance adjusted for age, sex and height/body mass index (BMI) was used.
  
  
  
  Preschool children from Sweden had lower prevalence of overweight/obesity than their peers from Spain (World Obesity Federation, mean difference, MD = -9%, P = 0.010; World Health Organization, MD = -11%, P = 0.011). Concerning fitness, preschoolers from Spain were more fit in terms of upper-muscular strength (MD = +0.4 kg, P = 0.010), speed-agility (MD = -1.9 s, P = 0.001), balance (MD = +4.0 s, P = 0.001) and cardiorespiratory fitness (MD = boys = +6.6 laps, girls = +2.3 laps; P < 0.001 for all), yet they had worse lower-muscular strength (MD = -7.1, P ≤ 0.001) than those from Sweden. Differences in upper-muscular strength were largely explained by differences in BMI, and differences in cardiorespiratory fitness should be interpreted cautiously due to some methodological deviations.
  
  
  
  These findings suggest that a higher prevalence of overweight/obesity in Spain compared with Sweden is present already at early childhood, while differences in physical fitness components showed mixed findings.
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain. cadenas@ugr.es.
authors.forename: C
authors.initials: C
authors.lastname: Cadenas-Sanchez
authors.affiliation: Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Nyström
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Sanchez-Delgado
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Martinez-Tellez
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mora-Gonzalez
authors.affiliation: Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: A S
authors.initials: AS
authors.lastname: Risinger
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.|Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: J R
authors.initials: JR
authors.lastname: Ruiz
authors.affiliation: PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.|Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: F B
authors.initials: FB
authors.lastname: Ortega
authors.affiliation: Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Löf
mesh_terms: D000886:Anthropometry; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D010809:Physical Fitness; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
keywords: Body mass index; cardiorespiratory fitness; motor fitness; muscular strength