Diet and physical activity in pre-school children: a pilot project for surveillance in three regions of Italy

Objective: To test a surveillance system on diet and physical activity based on data gathered at well-child visits. Design: Cross-sectional data collection on growth, diet, physical activity and sociodemographic variables. Setting: Offices of 179 paediatricians in three Italian regions. Subjects: 26 898 children for a total of 32 915 well-child visits at 1, 3, 5-6, 8-9, 12, 18, 24, 36 and 60-72 months of age. Results: The BMI Z-score was lower than the WHO standard at 1 and 3 months but higher from 8-9 months onwards. The rates of breast-feeding at 1, 3, 5-6, 8-9 and 12 months were 88%, 75%, 64%, 52% and 32%, respectively, with 5% and 3% continuing up to 24 and 36 months. Exclusive breast-feeding was 64%, 54% and 20% at 1, 3 and 5-6 months, respectively; 57% at 5 months and 85% at 6 months were given complementary foods. Only 8% and 10% of children were taking five portions of fruit and vegetables daily, while 47% and 51% were consuming sugar-sweetened beverages at 36 and 60-72 months, respectively. At 60-72 months, less than 10% reported at least 1 h of moderate-to-vigorous physical activity on 5-7 d/week, and 32% watched television or played video-games for more than 2 h/d, every day. The majority of paediatricians rated the surveillance system as reliable and feasible. Conclusions: Surveillance for diet and physical activity in pre-school children, with data gathered during well-child visits, is feasible and potentially useful to plan and evaluate activities for the prevention of obesity.