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HYSICAL INACTIVITY IS CONnected to an increase in obesity and the associated morbidity and chronic diseases among youth. 1-4 Expert opinion 5-8 and empirical studies 9 suggest that children need a minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA) per day, a standard proposed by the US Department of Agriculture. 10 How many youth meet this standard is unclear. Most populationbased surveys have relied on selfreport data with questionable validity, and studies that have used objective measures of physical activity have typically involved small samples. Accelerometers provide objective measurement of physical activity and the feasibility of collecting accelerometer data on large samples has been demonstrated. 11 To describe patterns and demographic determinants of physical activity relative to recommended guidelines, our study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development birth cohort, a large sample of US children from 10 geographic locations. Monitored physical activity data were collected longitudinally beginning in 2000 when children were 9 years old until they were 15 years old. METHODS Study Population The NICHD Study of Early Child Care and Youth Development is a multisite study originally designed to determine the effects of nonmaternal care on the development of children. Participants were recruited in 1991 from designated community hospitals at 10 university-based data collection sites: (1) Little Rock, Arkansas; (2) Irvine, California; (3) Lawrence, Kansas; (4) Boston, Massachusetts; (5) Philadelphia,

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The data from this study indicate that children with BMIs > 85th percentile, as well as with BMIs in the high reference range are more likely than children whose BMI is < 50th percentile to continue to gain weight and reach overweight status by adolescence. Pediatricians can be confident in counseling parents to begin to address the at-risk child's eating and activity patterns rather than delaying in hopes that overweight and the patterns that support it will resolve themselves in due course. Identifying children at risk for adolescent obesity provides physicians with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain that results in the development of obesity-related morbidity.