On the issue of the trophological status and the incidence of obesity in preschool children

Background. The problem of body weight deficiency or excess in children of different ages is relevant in the practice of a pediatrician and a pediatric endocrinologist. The preschool period is considered as one of the significant stages of a child's life, associated with the formation and consolidation of stereotypes of eating behavior and physical activity, the great influence of family traditions, behavioral patterns of parents.

Objective. To evaluate the features of the trophological status and the frequency of diagnosis of obesity in preschool children living in the Moscow region.

Materials and methods. A single-stage, single-center, non-randomized study was conducted. The anthropometric indicators (height (cm) and weight (kg)) of 385 preschool children (4-6 years old inclusive) (201 boys (52.2%), 184 girls (47.8%)), obtained on the basis of data from an annual preventive examination, were analyzed by random sampling. The calculation of body mass index (BMI) and standard sigma deviation (SDS) was carried out according to the WHO AnthroPlus program.

Results. Trophic status disorders were detected in 141 (36.6%) children (boys – 76 (37.8%), girls – 65 (35.3%). Malnutrition was registered in 41 children (10.6%), of which boys – 20 (48.8%), girls – 21 (51.2%), while 2 of them (4.9%) (all girls) had severe body weight deficiency (SDS BMI < -3). Overweight was observed in 79 children (20.5%) (boys – 46 (58.2%), girls – 33 (41.8%). Obesity was diagnosed in 21 (5.5%) children (boys – 10 (47.6%), girls – 11 (52.4%): grade I –9 (42.8%) children (boys – 4 (44.4%), girls – 5 (55.6%), grade II – 6 (28.6%) of children, and III and morbid obesity had three children (14.3% each), boys and girls equally.

Conclusion. It was found that more than a third of children aged 4-6 years (36.6%), regardless of gender, had trophic status disorders. Excess body weight was registered in every fourth child and was 2 times more common than its deficiency (20.5% and 10.6%, respectively). In 4.9% of children with signs of malnutrition, body weight deficiency was considered severe (SDS BMI < -3). Obesity was diagnosed in 5.5% of children, while 28.6% of them had high degrees (III, morbid). There were no significant differences in gender. The data obtained on the state of trophological status and the frequency of diagnosis of obesity in preschool children complement the results of the examination of schoolchildren in the Moscow region presented earlier, and confirm the need for regular preventive examinations of organized and unorganized children of younger age groups and timely implementation of a set of therapeutic and preventive measures to prevent the progression of metabolic disorders and the development of complications at an older age.

1. Obesity and overweight. Information sheet WHO. https://www.who.int/ru/ news-room/fact-sheets/detail/obesity-and-overweight.

2. Ogden C. L., Fryar C. D., Martin C. B. and others. Trends in Obesity Prevalence by Race and Hispanic Origin-1999-2000 to 2017-2018. JAMA. 2020; 324 (12): 1208-1210. DOI: 10.1001/jama.2020.14590.

3. Obesity in children. Clinical recommendations. 2024. https://cr.minzdrav. gov.ru/preview-cr/229_3.

4. Prevention of obesity in children. Еdited by A. P. Fisenko, V. A. Peterkova, S. G. Makarova. 2nd ed. expanded. FSAU NMIC of Children's Health of the Ministry of Health of Russia. Cherepovets: IP Mochalov S. V., 2025. (Information materials). 184 p. (In Russ.)

5. Bokova T. A., Gribova E. E., Kartashova D. A., Bevz A. S. On the issue of the true incidence of obesity in school-age children in the Moscow region. RMZh. Meditsinskoe obozrenie. 2025; 9 (10): 698-701. DOI: 10.32364/2587-6821-2025-9-10-1. (In Russ.)

6. Berezina N. O., Stepanova M. I. Physical development of modern preschoolers: the results of dynamic observations. Pediatriya. 2019; 98 (5): 208-212. (In Russ.)

7. Thurstans S., Opondo C., Seal A., Wells J., et al. Boys are more likely to be undernourished than girls: a systematic review and meta-analysis of sex differences in undernutrition. BMJ Glob. Health. 2020; 5 (12): e004030. https://doi.org/10.1136/bmjgh-2020-004030.

8. Bokova T. A., Kartashova D. A., Bevz A. S., Bokova O. A. Metabolic syndrome in children: algorithms for diagnostic, treatment and preventive measures. Eksperimentalnaya i klinicheskaya gastroenterologiya. 2022; 6 (202): 19-26. DOI: 10.31146/1682-8658-ecg-202-6-19-26. (In Russ.)