Physical activity in early childhood education and care settings in a low-income, rural South African community: an observational study.

INTRODUCTION: Research has not been conducted on physical activity in early child education and care (ECEC) settings in low-income, rural communities in South Africa. This study aimed to describe the physical activity environment of these settings and identify child and contextual factors associated with physical activity in these settings. By understanding physical activity in this environment, it will be possible to identify context-specific opportunities, including with teachers, to overcome potential challenges and maximise physical activity in a low- and middle-income country setting. METHODS: The study was conducted in rural Bushbuckridge, Mpumalanga in 2014. Preschool-aged children (n=55) were recruited from five ECEC settings, including three preschools and two primary schools, where preschool-aged children are in their reception year, grade R. Preschool environment characteristics were assessed using an observational tool adapted from existing tools. Children's physical activity was assessed using the Observational System for Recording Physical Activity in Children - Preschool Version. Differences between preschool and grade R settings were assessed using χ2 analyses, and multinomial logistic regression analysis was used to determine factors associated with physical activity in the ECEC settings. RESULTS: The physical activity environment differed between preschool and grade R ECEC settings in terms of space (preschoolpgrade R, p<0.001). On average, children spent 28.7% of their day in the ECEC settings engaged in physical activity, of which 22.3% was moderate- to vigorous-intensity physical activity (MVPA). Children spent the greatest proportion of the day in sedentary activities (69.9%) and this differed significantly between preschool (63.2%) and grade R children (81.3%, p<0.001). Preschool children were significantly more active than grade R children, and spent greater proportions of time in light-intensity physical activity (8.6% v 2.7%, p<0.001) and MVPA (25.4% v 15.3%, p<0.001). Irrespective of ECEC setting, children were significantly more likely to participate in MVPA if they were outdoors (p=0.001), and significantly less likely to do MVPA if they were overweight/obese (p=0.006). CONCLUSION: These findings provide insight into child-level and contextual factors associated with preschool-aged children's physical activity within ECEC settings in a low-income, rural community in South Africa. Particularly, the physical and social features of ECEC settings are important in the promotion of physical activity. Findings from this study suggest that it is necessary to upskill and encourage teachers in ECEC settings to maximise opportunities for physical activity in rural low-income communities in South Africa.

Control microbiológico de las comidas servidas en centros de educación infantil del Ministerio de Defensa durante el año 2017 / Microbiological control of the food served in children's education centres of the Ministry of Defense in 2017

Introducción: La población infantil es más vulnerable a las enfermedades de transmisión alimentaria que otros grupos demográficos. En los últimos años se han notificado brotes de enfermedades de origen alimentario en guarderías causados por agentes patógenos como Salmonella spp., Listeria monocytogenes o Cronobacter sakazakii. Objetivos: Determinar la calidad microbiológica de las comidas servidas en los comedores de las guarderías en relación con los criterios de seguridad alimentaria y de higiene de los procesos. Materiales y Métodos: Se analizaron 241 muestras del menú de iniciación y del menú completo en 13 guarderías. Se investigó la presencia de Salmonella spp. y Cronobacter spp. y se realizó el recuento de L. moncytogenes y de los microorganismos indicadores de la higiene de los procesos (aerobios mesófilos, enterobacterias totales, coliformes totales, Escherichia coli ß-glucuronidasa positivos y Staphylococcus aureus). Resultados: Salmonella spp. y L. monocytogenes no se detectaron en ninguna de las muestras analizadas. Cronobacter spp. se aisló en la guarnición de ensalada de un segundo plato. E. coli no se detectó en ninguna muestra y para el resto de indicadores de higiene las prevalencias fueron las siguientes: aerobios mesófilos 36,10 %, enterobacterias 13,28 %, coliformes totales 7,47 % y S. aureus 4,14 %. El grupo de frutas fue siempre el que presentó mayor prevalencia en todos los parámetros, seguido por los segundos platos debido principalmente a la presencia de ensaladas en la guarnición. Conclusiones: Conforme a los resultados microbiológicos obtenidos, se considera que las comidas servidas tienen un alto grado de calidad microbiológica

Introduction: Infants and children are more vulnerable to foodborne illnesses than other demographic population. In recent years, foodborne outbreaks have been reported in kindergartens because of the presence of pathogenic agents like Salmonella spp., Listeria monocytogenes and Cronobacter sakazakii. Objective: To determine the microbiological quality of foods ready for consumption in kindergarten foodservices regarding food safety and process hygiene criteria. Materials and Methods: 241 food samples from the initiation menu and full menu were analyzed in 13 kindergartens. Salmonella spp. and Cronobacter spp. were investigated and an enumeration of L. monocytogenes and of the hygiene indicator microorganisms (mesophilic aerobes, enterobacteriaceae, ß-glucuronidase positive Escherichia coli, total coliforms and Staphylococcus aureus) was carried out. Results: No Salmonella spp. or L. monocytogenes were isolated from any of the samples. Cronobacter spp. was isolated in the fresh salad of a second plate. E. coli was not detected in any sample and the results shown in the rest of the hygiene indicators were the following: mesophilic aerobes 36,10 %, enterobacteriaceae 13,28 %, total coliforms 7,47 % and S. aureus 4,14 %. The fruits group was always the one that showed the highest prevalence in all the parameters, followed by the second courses mainly due to the presence of fresh salads. Conclusions: According to the microbiological results obtained, it is considered that the meals served have a high level of microbiological quality

Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

OBJECTIVE: Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. DESIGN: We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. SETTING: Philadelphia, Pennsylvania, USA. SUBJECTS: Philadelphia children and adolescents aged 4-18 years. RESULTS: A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. CONCLUSIONS: Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

[Hygienic principles of the design of the space and architectural environment of kindergartens].

In the article there are considered current requirements for the design of the architectural environment of preschool institutions. These requirements provide conditions ofpreservation and promotion of health ofpreschool children. Among them are: the association of rooms according to a functional purpose; division of children collectives according to the age; rational placement of main rooms for the prevention ofpenetration of noise and pollution; ensuring convenientfunctional connections between different premises and group rooms and the parcel ofpreschool institutions; optimal solution of the light mode; rational air and thermal mode. There are made proposals for the expansion of the list of hygienic principles of the design of buildings of kindergartens: provision of conditions for realization of physical activity of children, the safe use of electronic educational equipment, and the creation of the barrier-free environment. There was established the insufficiency of areas of group rooms for the realization of voluntary motor activity of children in modern kindergartens and the need of the revision of the standard of the area of the group room per one child.

Systematic dissemination of a preschool physical activity intervention to the control preschools.

For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools that participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap.

Influencing factors of children's fruit, vegetable and sugar-enriched food intake in a Finnish preschool setting - Preschool personnel's perceptions.

INTRODUCTION: A large proportion of young children spend most of their weekdays at preschool in Western countries. In Finland, three meals are included in a full day at preschool. These meals have the potential to promote healthy eating. This study aimed to obtain the personnel's (preschool teachers, day-care nurses) views on the factors influencing children's fruit, vegetable, and sugar-enriched food intake at preschool. STUDY DESIGN: Four focus groups, in all 14 preschool personnel. Two researchers independently analysed the data using a socio-ecological framework. RESULTS: At the child level, age, peers, and the child's personality were recognized as factors influencing the fruit and vegetable (FV) and sugar-enriched food intake. At the preschool level, both the physical and social environments were discussed thoroughly, whereas at the societal level, policies of the EU, the state, and the municipality were mentioned as factors that influence what children eat in preschool. The personnel also discussed the interactions between factors both between levels and within levels. CONCLUSIONS: In Finnish preschools, children's food intake is influenced on and within several levels of the socio-ecological model. The identification of the factors influencing food intake allows different methods of intervention at multiple levels to promote healthy eating behaviours in preschools.

Análisis de la situación de salud en el Círculo Infantil Mis primeros años: Unión de Reyes, 2013-2014 / Analysis of health situation in the Day Care Center Mis primeros años: Unión de Reyes, 2013-2014

Introducción: el análisis de la situación de salud es un elemento básico para la planificación estratégica a nivel local, en tanto permite entender las causas y las consecuencias de los problemas de salud. Objetivo: determinar el estado de salud de los trabajadores y los niños del Círculo Infantil Mis primeros años, y abordar los principales problemas encontrados con la participación intersectorial, se realizó este análisis.Materiales y métodos: se ejecutó un estudio observacional, descriptivo, en un círculo infantil del municipio Unión de Reyes, en el curso escolar 2013-2014. El universo estuvo constituido por la totalidad de los trabajadores (34) y niños (62). Se contó con el consentimiento informado de los involucrados. Se trabajó con el sexo, la edad, los factores de riesgo y la dispensarización. Se utilizaron entrevistas estructuradas, el Método de Trillaje, Ranqueo y la matriz DAFO; en el análisis estadístico, frecuencias absolutas y relativas. Presentando los resultados en tablas y gráficos.Resultados: los trabajadores y los niños se encontraron dispensarizados (100 por ciento), predominó el grupo II (64,8 por ciento en los trabajadores y 82,2 por ciento en los niños). Prevaleció la hipertensión arterial entre los trabajadores (35,2 por ciento), las infecciones respiratorias (66 por ciento) y gastrointestinales en los niños (23 por ciento). Los principales problemas identificados estuvieron relacionados con las malas condiciones estructurales del centro. Conclusiones: con la ejecución y cumplimiento de un programa de intervención que implique la participación de todos los sectores se logra mejorar el estado de salud de los trabajadores y los niños del centro(AU)

Background: the analysis of the situation of health is a basic element for the strategic planning at local level, as long as he/she allows to understand the causes and the consequences of the problems of health. Aim: determining the state of the workers' health and the children of the Infantile Circle My first years, and to approach the main opposing problems with the intersector participation, he/she was carried out this analysis. Materials and methods: an observational, descriptive study was executed, in an infantile circle of the municipality Union of Reyes, in the school course 2013-2014. The universe was constituted by the entirety of the workers (34) and children (62). He/she had the informed consent of those involved. One worked with the sex, the age, the factors of risk and the dispensarización. Structured interviews, the Method of Trillaje, Ranqueo and the main DAFO were used; in the statistical analysis, absolute and relative frequencies. Presenting the results in charts and graphics. Results: the workers and the children were dispensarizados (100 percent), the group prevailed II (64,8 percent in the workers and 82,2 percent in the children). the arterial hypertension Prevailed among the workers (35,2 percent), the breathing infections (66 percent) and gastrointestinal in the children (23 percent). The main identified problems were related with the bad structural conditions of the center. Conclusions: with the execution and execution of an intervention program that it implies the participation of all the sectors it is possible to improve the state of the workers' health and the children of the center(AU)

ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update.

The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.

Experimental impacts of a teacher professional development program in Chile on preschool classroom quality and child outcomes.

We assessed impacts on classroom quality and on 5 child language and behavioral outcomes of a 2-year teacher professional-development program for publicly funded prekindergarten and kindergarten in Chile. This cluster-randomized trial included 64 schools (child N = 1,876). The program incorporated workshops and in-classroom coaching. We found moderate to large positive impacts on observed emotional and instructional support as well as classroom organization in prekindergarten classrooms after 1 year of the program. After 2 years of the program, moderate positive impacts were observed on emotional support and classroom organization. No significant program impacts on child outcomes were detected at posttest (1 marginal effect, an increase in a composite of self-regulation and low problem behaviors, was observed). Professional development for preschool teachers in Chile can improve classroom quality. More intensive curricular approaches are needed for these improvements to translate into effects on children.

Assessing diets for energy and nutrients content in nursery school children from Lodz, Poland.

BACKGROUND: Balanced meals eaten by toddlers at nursery school play an important nutritional role in satisfying a child's daily demand for energy and nutrients as well in preventing any dietary deficiencies or excesses from occurring. OBJECTIVE: To evaluate the energy and nutritional value of children's diets at nursery schools in Lodz, Poland. MATERIALS AND METHODS; Analyses were performed at 30 nursery schools throughout the Lodz city municipality on the basis of 10 day menus and food inventory reports. Results were calculated using the 'Dieta 5.0' computer programme according to the databas at the Warsaw Institute for Food and Nutrition. These were related to nutritional standards for children aged 1-3 years. RESULTS: On verage, dietary calorific values exceeded those of current nutritional recommendations, where protein was found to be 3 times higher than current standards although falling within the range of reference values. Dietary fat intake was f ound to be rather low, with a high content of saturated fat coupled with low intakes of polyunsaturated fatty acids. Dietary carbohydrates agreed with recommended limits however these were exceeded by the mean sucrose intake. Significant deficiencies were most noted in vitamin D and iodine intake and additionally vitamin E and iron intakes were also low. However, intakes of sodium, phosphorus, magnesium, zinc, vitamin A, B2, B6 and B12 were above the recommended values. CONCLUSIONS: The diets surveyed in nursery schools need to be better balanced to comply with current standards and dietary guidelines.

La asistencia a la guardería aumenta no solo la morbilidad, sino también el uso de recursos sanitarios / Daycare attendance not only increases morbidity, also the use of healthcare resources

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ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2012 update.

Appropriate management and prevention of anaphylaxis in the school, pre-school and childcare settings requires advanced planning and communication. The Australasian Society of Clinical Immunology and Allergy has developed Guidelines for Prevention of Anaphylaxis in Schools, Pre-schools and Childcare to assist school, pre-school and childcare staff in appropriate implementation of risk-minimisation strategies. Risk-minimisation strategies recommended take into consideration the needs of the allergic child; effectiveness of measures; stresses on parents and staff, the allergic child and their peers; and the implications of the recommended risk-minimisation strategies. These Guidelines address risk-minimisation strategies for food, insect and medication allergies; however, the majority of strategies relate to food allergy due to the higher risk of exposure in these settings. Training in recognition of allergic symptoms (including anaphylaxis), appropriate response and treatment, as well as how to prevent exposure to known allergens are essential for effective anaphylaxis management in the school, pre-school and childcare settings.

Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad / Influence of day care attendance on morbidity in children under 12 months of age

Introducción: la estructura actual de la sociedad española favorece la asistencia de los niños a guarderías infantiles a edades cada vez más tempranas. Esto es un factor de riesgo por sí solo para el padecimiento de infecciones del tracto respiratorio superior e inferior, otitis media aguda, infecciones gastrointestinales y otras infecciones. Objetivo: evaluar la influencia de la asistencia a la guardería sobre el riesgo de padecer infecciones en los niños menores de 12 meses de edad. Población y métodos: estudio longitudinal prospectivo. Se incluyeron en el estudio los niños nacidos entre el 1 de enero y el 30 de septiembre de 2010 que acuden a consulta de Pediatría de Atención Primaria. Se excluyeron los niños que presentaban patología respiratoria o cardiaca grave o inmunodeficiencias graves. Los datos se obtuvieron de la historia clínica informatizada y de las entrevistas en visitas programadas a los padres a los 6 y a los 12 meses. Para el análisis estadístico de los datos se utilizó el programa estadístico R® (R Development Core Team, 2011). Resultados: los niños que acuden a la guardería presentan más episodios infecciosos que los que no lo hacen, siendo estadísticamente significativas (p-valor <0,05) las diferencias respecto a bronquiolitis, bronquitis, conjuntivitis, faringoamigdalitis, gastroenteritis aguda, laringitis, neumonía, otitis media aguda, resfriado común, sibilancias, sinusitis y para el total de patologías. Los niños que asisten a guarderías tienen un riesgo dos o más veces mayor de padecer bronquiolitis, bronquitis, faringoamigdalitis y otitis media, que los que no acuden. Conclusión: teniendo en cuenta estos resultados, parece aconsejable intentar otras fórmulas diferentes para el cuidado de los niños en edades tempranas (AU)

Introduction: the current structure of Spanish society favors the attendance of children at day care to increasingly early ages. This is a risk factor in itself to the condition of infection of the upper and lower respiratory tract, as well as acute otitis media, gastrointestinal infections and other infections. Objective: to evaluate the influence of day care attendance on the risk of infections in children under 12 months of age. Population and methods: prospective longitudinal study. Children born between 1 January and 30 September 2010, attending primary care pediatrics’ offices, were included. We excluded children who had severe respiratory or cardiac disease or severe immune deficiency. The data were obtained from computerized medical records and interviews with parents in scheduled visits at 6 and 12 months. In the statistical analysis of the data the statistical software R© (R Development Core Team, 2011) was used. Results: children who attend day care have one or more infectious episodes in higher percentages with statistically significant (p-value <0.05) differences for bronchiolitis, bronchitis, conjunctivitis, tonsillopharyngitis, acute gastroenteritis, laryngitis, pneumonia, acute otitis media, common cold, wheezing, sinusitis and for total pathologies. Attendance at nursery could be responsible for between 35% and 50% of the acute otitis, gastroenteritis, bronchiolitis and bronchitis. Conclusion: taking into account these results, it seems advisable to try other different ways for the care of children in early ages (AU)

Contenido en metales (Na, K, Ca, Mg, Fe, Mn, Cu y Zn) en el menú mensual de una guardería pública de Tenerife / Metal content (Na, K, Ca, Mg, Fe, Mn, Cu and Zn) in the monthly menu of a Tenerife public preschool

Fundamento: Determinación de las concentraciones de Na, K, Ca, Mg, Fe, Mn, Cu y Zn en el menú de una guardería pública de Tenerife. Estimación y evaluación de las ingestas metálicas. Métodos: 47 muestras del menú mensual de una guardería pública fueron analizadas. Los metales fueron determinados mediante Espectroscopia de Absorción Atómica con Llama. Para la estimación de las ingestas se usó el peso de las raciones servidas. La evaluación de las ingestas se hizo por comparación con las Ingestas Dietéticas de Referencia (IDRs) establecidas para la población infantil española. Resultados: El contenido medio de Na, K, Ca, Mg, Fe, Mn, Cu y Zn en el menú fue de 1882,14; 1690,94; 192,61; 193,15; 2,35; 0,37; 0,49 y 4,76 mg/kg, respectivamente. Las ingestas diarias estimadas de Na obtenidas de este almuerzo (1047,18 mg para niños de 0-1 año y 1038,2 mg Na para niños de 1-3 años) son superiores a las IDRs. Asimismo, el menú servido no cubre los valores de ingestas de Fe, Mn y Ca recomendados para el almuerzo (35% de las recomendaciones diarias). Conclusiones: Se recomienda un rediseño del menú servido en este centro escolar (AU)

Background: To determine the Na, K, Ca, Mg, Fe, Mn, Cu and Zn concentrations in a public preschool's menu from Tenerife . Assessment and evaluation of the metals estimated daily intakes. Methods: 47 samples corresponding to the monthly menu of the public preschool were analyzed. Metals were determined by Flame Atomic Absorption Spectroscopy. Metal daily intakes were estimated using the portions? weight. The estimated intakes were compared with Dietary Reference Intakes (RDIs) set for the Spanish infant population. Results: The average contents of Na, K, Ca, Mg, Fe, Mn, Cu and Zn in the menu were 1882,14; 1690,94; 192,61; 193,15; 2,35; 0,37; 0,49 and 4,76 mg/kg, respectively. The estimated Na intakes obtained from this lunch (1047,18 mg for children aged 0-1 years and 1038,2 mg Na for children aged 1-3 years) are higher than the recommended IDRs. Furthermore, the served menu does not cover the Fe, Mn and Ca intakes that are recommended for a lunch (35% of the total daily recommendation). Conclusions: A redesign of the menu served in this school has been recommended (AU)

Is something better than nothing? An evaluation of early childhood programs in Cambodia.

This study evaluated the relative effectiveness of home-based, community-based, and state-run early childhood programs across Cambodia. A total of 880 five-year-olds (55% girls) from 6 rural provinces in Cambodia attending State Preschools, Community Preschools, Home-Based Programs, or no programs were assessed twice using the Cambodian Developmental Assessment Test. Controlling for baseline differences, children who participated in any early childhood programs performed significantly better in posttest than those of children who did not participate in any programs. Children in State Preschools scored significantly higher than those in either Community Preschools or Home-Based Programs; scores did not differ as a function of attending Community Preschools or Home-Based Programs. The results indicate that some preschool experience is better than none at all.

Making child care centers SAFER: a non-regulatory approach to improving child care center siting.

Licensed child care centers are generally considered to be safe because they are required to meet state licensing regulations. As part of their licensing requirements, many states inspect child care centers and include an assessment of the health and safety of the facility to look for hazardous conditions or practices that may harm children. However, most states do not require an environmental assessment of the child care center building or land to prevent a center from being placed on, next to, or inside contaminated buildings. Having worked on several sites where child care centers were affected by environmental contaminants, the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry (ATSDR) endeavor to raise awareness of this issue. One of ATSDR's partner states, Connecticut, took a proactive, non-regulatory approach to the issue with the development its Child Day Care Screening Assessment for Environmental Risk Program.

Compliance with national guidelines for physical activity in U.S. preschoolers: measurement and interpretation.

OBJECTIVE: The National Association for Sport and Physical Education (NASPE) guidelines for preschoolers recommend 120 minutes of physical activity daily. Two issues, however, create a situation whereby substantial variation in estimated prevalence rates of (in)active preschoolers are reported. First, NASPE guidelines have been interpreted in multiple ways. Second, objective monitoring via accelerometry is the most widely accepted measure of preschoolers' physical activity, yet multiple cut points provide vastly different estimates of physical activity. This study aimed to estimate the prevalence of preschoolers meeting NASPE guidelines and illustrate the differences among rates, given guideline interpretations, and cut points. PATIENTS AND METHODS: Three- to 5-year-old children (n = 397) wore ActiGraph accelerometers for an average of 5.9 days. NASPE guidelines were expressed in 3 ways: 120 minutes daily of light-to-vigorous physical activity; 120 minutes daily of moderate-to-vigorous physical activity; and 60 minutes daily of moderate-to-vigorous physical activity. Estimates of 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity were calculated on the basis of 4 common accelerometer cut points for preschoolers: Pate, Reilly and Puyau, Sirard, and Freedson. RESULTS: Prevalence rates varied considerably, with estimates ranging from 13.5% to 99.5%, 0.0% to 95.7%, and 0.5% to 99.5% for 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity, respectively. CONCLUSIONS: The variation in NASPE guidelines, coupled with different accelerometer cut points, results in disparate estimates of (in)active preschoolers. This limits the ability to estimate population prevalence levels of physical activity that can be used to guide public health policy. Development of new guidelines should focus on an explicit delineation of physical activity and attempt to standardize the measurement of preschoolers' physical activity.