Fair Play a Tavola: a school-based framework integrating nutrition education and anthropometric screening for early identification of excess weight in preschool children.

Background: Preschool age is a critical yet underexplored period for the early emergence of dietary behaviours and excess weight. Children aged 3-5 years are largely excluded from national nutrition surveillance systems, limiting the timely identification of excess weight and related behavioural patterns. Methods: A multicenter cross-sectional observational study was conducted between October 2023 and February 2025 in 57 preschools in Lazio, Italy. Approximately 5,000 children aged 3-5 years participated in play-based, multisensory-nutrition-education activities, while anthropometric and questionnaire-based analyses were conducted in a subsample with complete data. Anthropometric measurements and a multilingual parent-reported questionnaire assessed growth parameters, dietary habits, physical activity, screen time, sleep, and family characteristics. BMI categories were defined according to WHO 2006-2007 standards. Results: The final analytical sample included 1,542 children (48% female; mean age 4.4 ± 0.9 years), of whom 38% showed excess weight (17% at risk of overweight, 14% overweight, 7% obesity). Waist circumference increased progressively across BMI categories ( Conclusions: Differences in anthropometric measures and selected parent-reported behaviors were observed across BMI-defined categories. In this cross-sectional study, anthropometric screening conducted within preschool settings allowed the descriptive characterization of excess weight and related behavioural patterns at an early developmental stage. Given the partial participation rates and the absence of longitudinal follow-up, findings should be interpreted descriptively. Further longitudinal and intervention-based studies are required to determine long-term impact and preventive effectiveness.