Reduce television viewing and promote playing

A rapid increase in the prevalence of obesity in children has been seen in England, the United States, and around the world.1^–3 In this issue of the BMJ, Bundred and colleagues report that among 3 to 4 year old English children there was a 60% increase in the prevalence of being overweight (having a body mass index >85th centile) and a 70% increase in the prevalence of obesity (body mass index >95th centile) between 1989 and 1998.4 Growth data were standardised for age and sex using the British Growth Reference Charts, and the analyses seem sound. The surprising finding in this study is that the increases in the prevalence of obesity are occurring among such young children.

Given what we know about the natural history of being overweight in childhood and obesity in children these findings should heighten concern. Although the risk of obesity in adulthood is not increased among children who are overweight at 1 and 3 years old, the …