Health endangering overweight in preschool children: Relationship between body composition and physical fitness

Background: Body mass index (BMI) is the dominant diagnostic parameter for obesity, but its suitability is controversial. Physical fitness (PF) can be used as an indicator for unhealthy body composition. Objectives: To characterize groups of overweight children via different anthropometric parameters and their respective PF. Sample and Methods: Anthropometric measurements (BMI, waist circumference (WC), skinfold thickness (SF), mid-upper arm circumference (MUAC) were assessed in 147 preschool children (age 4.7 ± 1.8 years) at 12 German Kindergartens. Measurements were related to a field battery for PF, assessing musculoskeletal fitness and motor fitness. Results: All anthropometric measurements characterize different children as overweight, only four children are classified as overweight by all measurements. Children with elevated triceps SF alone or in combination with high subscapular SF or WC but not BMI showed lower PF compared with non-overweight children (long jump (p < 0.001), high jump (p = 0.002), shuttle run (p = 0.032)). Conclusions: Triceps SF measuring peripheral fat mass alone and in combination with parameters of central fat might be an effective method to detect poor PF indicating health impairing overweight in 3- to 6-year-old children while preventive examinations should not be placed exclusively on the BMI.