Physical activity patterns in French youth-From childhood to adolescence-Monitored with high-frequency accelerometry

The Use of Wearable Technologies in the Assessment of Physical Activity in Preschool- and School-Age Youth: Systematic Review

In recent years, physical activity assessment has increasingly relied on wearable monitors to provide measures for surveillance, intervention, and epidemiological research. This present systematic review aimed to examine the current research about the utilization of wearable technology in the evaluation in physical activities of preschool- and school-age children. A database search (Web of Science, PubMed and Scopus) for original research articles was performed. A total of twenty-one articles met the inclusion criteria, and the Cochrane risk of bias tool was used. Wearable technology can actually be a very important instrument/tool to detect the movements and monitor the physical activity of children and adolescents. The results revealed that there are a few studies on the influence of these technologies on physical activity in schools, and most of them are descriptive. In line with previous research, the wearable devices can be used as a motivational tool to improve PA behaviors and in the evaluation of PA interventions. However, the different reliability levels of the different devices used in the studies can compromise the analysis and understanding of the results.

Fair play? Participation equity in organised sport and physical activity among children and adolescents in high income countries: a systematic review and meta-analysis

BACKGROUND

Physical activity and sport have numerous health benefits and participation is thought to be lower in disadvantaged children and adolescents. However, evidence for the disparity in physical activity is inconsistent, has not been reviewed recently, and for sport has never been synthesised. Our aim was to systematically review, and combine via meta-analyses, evidence of the socioeconomic disparities in physical activity and sport participation in children and adolescents in high income countries.

METHODS

We conducted searches of five electronic databases using physical activity, sport, and socioeconomic disparity related terms. Two independent reviewers assessed 21,342 articles for peer-reviewed original research, published in English that assessed socioeconomic disparities in physical activity and sport participation in children and adolescents. We combined evidence from eligible studies using a structural equation modelling approach to multilevel meta-analysis.

RESULTS

From the 104 eligible studies, we meta-analysed 163 effect sizes. Overall, children and adolescents living in higher socioeconomic status households were more likely to participate in sport (OR: 1.87, 95% CIs 1.38, 2.36) and participated for a longer duration (d = 0.24, 95% CIs 0.12, 0.35). The socioeconomic disparity in the duration of sport participation was greater in children (d = 0.28, 95% CIs 0.15, 0.41) compared with adolescents (d = 0.13, 95% CIs - 0.03, 0.30). Overall, children and adolescents living in higher socioeconomic status households were more likely to meet physical activity guidelines (OR: 1.21, 95% CIs 1.09, 1.33) and participated for a longer duration (d = 0.08, 95% CIs 0.02, 0.14). The socioeconomic disparity in the duration of total physical activity between low and high socioeconomic status households was greater in children (d = 0.13, 95% CIs 0.04, 0.21) compared with adolescents (d = 0.05, 95% CIs - 0.05, 0.15). There was no significant disparity in leisure time physical activity (d = 0.13, 95% CIs - 0.06, 0.32).

CONCLUSIONS

There was evidence of socioeconomic disparities in sport participation and total physical activity participation among children and adolescents. Socioeconomic differences were greater in sport compared to total physical activity and greater in children compared with adolescents. These findings highlight the need importance of targeting sport programs according to socio-economic gradients, to reduce inequities in access and opportunity to organised sport.

The Gender Difference in Association between Home-Based Environment and Different Physical Behaviors of Chinese Adolescents

Purpose: The aim of this study was to evaluate the home-based physical activity (PA) environmental characteristics, and different types of physical behavior level of adolescents in different genders, and explore the impact of different domains of home-based PA environmental factors on different physical behaviors of adolescents in different genders. Methods: Five hundred forty-four adolescents aged from 12 to 18 years old (males: n = 358, females: n = 186) and their parents were analyzed in this cross-sectional survey. The volume of various physical behaviors of all adolescent subjects were measured by the ActiGraph wGT3X-BT accelerometer, and the level in different domains of home-based environmental characteristics were assessed by the Gattshall’s home-based PA environment questionnaire, which was answered by adolescents’ parents. The difference in the volume of different physical behaviors was examined using Kruskal–Wallis analysis. The difference in home physical environment and home social environment for adolescents was examined using one-way analysis of variance (ANOVA). Multiple linear regression analysis in the adjusted model was used to evaluate the influence of different home-based PA environmental domains (PA availability, PA accessibility, Parental role-modeling of PA, and Parental policies around PA) on different physical behaviors (sedentary behavior, SB; light-intensity physical activity, LPA; and moderate-vigorous physical activity, MVPA) of adolescents (boys and girls). Results: The volume of LPA and MVPA, the score of PA accessibility in the home physical environment, and the score of home social environment of boys are significantly higher than those of girls, while the SB volume of boys is significantly lower than that of girls. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads are significantly associated with adolescents’ decreased SB and increased LPA and MVPA. Conclusion: There is significant gender difference in adolescents’ physical behaviors and home-based environmental characteristics, as well as in the association between adolescents’ physical behaviors and their home-based environment. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads can significantly promote adolescents’ healthy physical behaviors.

A Systematic Review of Children's Physical Activity Patterns: Concept, Operational Definitions, Instruments, Statistical Analyses, and Health Implications

Despite the widespread use of the expression “physical activity pattern” (PAP), there apparently is no general consensus regarding its definition. This systematic review aimed to examine available research focussing on (1) definitions of PAP, (2) instruments/techniques used to describe PAP, (3) statistical approaches used to analyse PAP, and (4) implications of PAP on children’s health. A systematic review of the available literature was done to identify studies published up to October 2019, and 76 studies were eligible. None of the studies presented a formal definition of PAP; a wide range of instruments were used to investigate children’s PAP, and most of the revised studies did not explicitly present a formal statistical model to define PAP. Twenty-four papers purported to examine associations between PAP and health indicators. The review highlights no consensus on a clear PAP definition whatever the instrument used to capture it, and we did not find any agreement regarding how best to analyse PAP. We suggest that PAP should be used when targeting the investigation of similarities/dissimilarities, as well as stabilities and/or changes in children’s PA at an intra-personal level. In sum, PAP should be used to best describe individual streams of behaviours, and not exclusively PA levels/intensities.

Play as a Method to Reduce Overweight and Obesity in Children: An RCT

Background: Overweight and obesity are the result of a complex interaction between genetic and environmental factors, which begins prenatally. Aim: To analyse an intervention based on play as a means of improving the body composition of children who are overweight or obese. Methods: The Kids-Play study is a randomized clinical trial (RCT) consisting of 49 children aged 8–12 years on a nine-month intervention programme based on physical activity, play and nutritional advice. Controls had another 49 children, who received only nutritional advice. Results: The play-based intervention achieved a moderate-vigorous level of physical activity in the study group of 81.18 min per day, while the corresponding level for the control group was only 37.34 min. At the start of the intervention, the children in the study group had an average body fat content of 41.66%, a level that decreased to 38.85% by the end of the programme. Among the control group, body fat increased from 38.83% to 41.4% during the same period. Conclusions: The intervention programme considered, based on both play and nutritional recommendations, produced a decrease in body fat among children aged 8–12 years. However, the control group, which received only nutritional recommendations, experienced an increase in body weight.

[Which variables influence compliance with physical activity recommendations in young children?]

INTRODUCTION

There are established European guidelines for physical activity in childhood. The main goal of our study was to determine the factors that may influence compliance with European recommendations for physical activity in young children.

METHODS

We included 136 children (aged 2-8 years) classified by weight status, calculated based on the body mass index z-score using the growth standards of the World Health Organization. We measured physical activity over 5 consecutive days with accelerometers and recorded the food intake.

RESULTS

A greater level of physical activity was associated with a lower weight status category (B=-1.55; 95% CI: -2.02 to -1.08; P<.001), lower age (B=-1.33; 95% CI: -1.72 to -0.93; P<.001) and greater energy expenditure (B=0.02; 95% CI: 0.02 to 0.03; P<.001). The overall physical activity in the sample was light (mean=589 cpm/day). Children with overweight and obesity spent less time engaged in moderate to vigorous physical activity (P=.005) and more time engaged in sedentary activities (P=.005) compared to children with normal weight. All groups spent between 90 and 130minutes a day in sedentary activities, with a mean time spent that amounted to 15.5% of their time (excluding time spent sleeping). The adherence to European recommendations varied in association with sex (P=.010) and weight status (P=.038).

CONCLUSION

Young children spent more than 100minutes a day engaged in sedentary activities. Most of the sample met the European recommendations for daily moderate to vigorous physical activity. However, the degree of adherence depended on sex and weight status.

Physical Activity During the Early Years: A Systematic Review of Correlates and Determinants

CONTEXT

Being physically active during the early years (age 0-6 years) is vital for healthy development. Identifying correlates and determinants of physical activity (PA) is crucial to guide effective interventions. This systematic review synthesized studies investigating potential correlates and determinants of PA during the early years, accounting for different types of PA assessment.

EVIDENCE ACQUISITION

Nine electronic databases were searched from inception year (1900) until September 2014; data were analyzed/interpreted in April 2015. The following inclusion criteria were used: written in English, published in peer-reviewed journals, participants not in statutory/school education, and an observational design investigating associations between an exposure/variable, and a quantitative measure of PA. Correlates/determinants of total, moderate to vigorous, and light PA were reported using an ecologic model.

EVIDENCE SYNTHESIS

Of 22,045 identified studies, 130 were included. All took place in high-income countries and few (6%) were of high quality. Correlates of total PA were sex (male, ++); parental PA (+); parental support (+); and time outdoors (+). Determinants of total PA were sex (+) and time spent playing with parents (+). The only correlate of moderate to vigorous PA was sex (male, ++). No determinants of moderate to vigorous or light PA were found. PA correlates/determinants were relatively consistent between objective and subjective PA measures.

CONCLUSIONS

Numerous studies investigated potential correlates and determinants of PA, but overall quality was low. A small number of demographic/biological and social/cultural factors were associated with PA. There is a need for high-quality studies exploring correlates/determinants across all domains of the ecologic model.

Gender and grade differences in objectively measured physical activity and sedentary behavior patterns among Japanese children and adolescents: a cross-sectional study

Background

Physical activity levels in childhood have decreased, making the promotion of children’s physical activity an important issue. The present study examined gender and grade differences in objectively measured sedentary behavior, physical activity, and physical activity guideline attainment among Japanese children and adolescents.

Methods

In total, 329 boys and 362 girls age 3–15 years completed the survey. School grade, gender, height, and weight were collected by questionnaires and physical activity objectively measured using an accelerometer (Lifecorder Suzuken Co.). Physical activity level (in MET) was classified as sedentary (<1.5), light (≥1.5 to <3), moderate (≥3 to <6), or vigorous (≥6). Continuous zero accelerometer counts for ≥20 min were censored and a valid accelerometry study required at least 3 days (2 weekdays and 1 weekend day) with > 600 min/day total wear time. Two-way analysis of covariance and logistic regression analyses, adjusted for weight status and accelerometer wear time, were used to examine gender and grade differences in physical activity variables and the likelihood of physical activity guideline attainment by gender and grade level.

Results

Participants were sedentary 441.4 (SD, 140.1) min/day or 53.7 % of the average daily accelerometer wear time of 811.2 (118.7) min, engaged in light physical activity 307.1 (70.0) min or 38.4 % of wear time, moderate physical activity 34.6 (14.8) min (4.3 %), vigorous physical activity 28.3 (19.1) min (3.6 %), and took 12462.6 (4452.5) steps/day. Boys were more physically active and took more steps/day than girls. Students in higher grades were less active than those in lower grades. Boys were significantly more likely to meet physical activity guidelines than girls (OR: 2.07, 95 % CI: 1.45–2.96). Preschoolers (6.66, 4.01–11.06), lower-grade elementary school students (17.11, 8.80–33.27), and higher-grade elementary school students (7.49, 4.71–11.92) were more likely to meet guidelines than junior high school students.

Conclusions

Boys and lower-grade students engaged in more physical activity and were more likely to attain guidelines than girls and higher-grade students. These findings highlight the need for effective and sustainable strategies to promote physical activity in Japanese school children.

Quantitative physical activity assessment of children and adolescents in a rural population from Eastern Nepal

OBJECTIVES

We report cross-sectional, objectively measured physical activity data for 399 children and adolescents aged 6 to 18 years. We evaluated physical activity of children and adolescents, considered time spent in each activity intensity category, and explored the impact of growth disruption (stunting and wasting) on physical activity patterns.

METHODS

Participants wore an Actical (Mini-Mitter, Bend, OR) omnidirectional accelerometer for one week as part of their annual visit to the Jiri Growth Study. The percentage of time spent in standard activity intensities were computed using standard metabolic equivalents (METS) cutpoints and compared by chronological age, sex, and school versus non-school days.

RESULTS

Primary findings include (1) children are more active on non-school days and adolescents are more active during the school week; (2) Jirel children do not exhibit the reduction in physical activity that most Western populations experience during the transition from childhood to adolescence; and (3) Jirel children and adolescents routinely meet the suggested one hour/day MVPA threshold; (4) Stunting is prevalent and factors leading to this growth disruption may contribute to the amount of time in sedentary or light physical activity.

CONCLUSIONS

We report child and adolescent physical activity patterns from the Jirel population of eastern Nepal. In this rural context, children and adolescents are more active than populations reported from Western contexts. This key finding has important biomedical implications for the maintenance of healthy body composition, skeletal health, and other health traits.

Measuring adolescent boys' physical activity: bout length and the influence of accelerometer epoch length

OBJECTIVES

Accurate, objective measurement is important for understanding adolescents' physical activity (PA) behaviour. When using accelerometry to objectively measure PA, a decision must be made regarding how frequently data is recorded (i.e., epoch length). The purpose of this study was to examine i) PA bout length, and ii) the effect of variations in accelerometer epoch length on PA estimates during physical education (PE) and leisure time in adolescent boys.

DESIGN

Cross-sectional study.

METHODS

Year 9 boys (N = 133; mean age ±SD  = 14.36±0.48 years) wore accelerometers during two PE lessons, and for a period of seven consecutive days. Data were reintegrated from 1s into longer periods of 2, 5, 10, 30, and 60 seconds. ANOVAs were used to test for differences in PA estimates between epochs in leisure time and PE.

RESULTS

The mean length of vigorous PA (VPA) bouts was 3.5±2.0 seconds for PE and 2.5±1.7 seconds for leisure time, and mean length of moderate PA (MPA) bouts was 2.3±0.5 seconds for PE and 2.9±0.5 seconds for leisure time. During PE, estimates of MVPA, MPA, and light PA (LPA) increased as epoch increased from 1 second to 60 seconds, while VPA and sedentary behaviour estimates decreased. During leisure time, estimates of all PA intensities decreased as epoch increased from 1 second to 60 seconds, with the exception of sedentary behaviour, which increased as epoch length increased.

CONCLUSION

The context in which PA occurs can influence PA bout length measurement and the effect of variations in epoch length on PA estimates. Researchers measuring PA with accelerometry should be conscious of the possible influence of context on PA estimates.

A national survey of physical activity and sedentary behavior of Chinese city children and youth using accelerometers

PURPOSE

The purpose of this study was to objectively assess levels of physical activity (PA) and sedentary behavior (SB) of Chinese city children and youth aged 9 to 17 years old using accelerometers and to examine their differences by gender, age, grade, and weight status.

METHOD

The PA and SB of 2,163 students in 4th grade through 11th grade (M(age) = 160.87 +/- 27.00 months [13.41 +/- 2.25 years], 50.21% boys) from 11 cities in China were measured by accelerometers. The amount of time spent in SB, light PA, moderate PA, vigorous PA, and moderate-to-vigorous PA (MVPA) was computed based on cutoff points developed specifically for the Chinese children and youth. The participants were classified into normal-weight, overweight, and obese groups based on their body mass index (BMI). Paired-sample t tests were conducted to examine the differences in PA and SB between weekdays and weekend days. Multivariate analysis of variance was used to test the differences in PA and SB variables by gender, age, grade, and weight status, respectively.

RESULTS

Chinese city children and youth spent an average of 28.26 +/- 17.66 min/day in MVPA and 521.50 +/- 110.02 min/day in SB. Only 9.4% of boys and 1.9% of girls met the recommendation of 60 min/day of MVPA. Chinese city children and youth were more active during weekdays than during weekend days, and boys were more active than girls; older children and youth spent more daily time in MVPA, but also spent more time being sedentary. No differences in PA and SB were found across different BMI categories.

CONCLUSION

The findings warn of the insufficiency of PA and the excess of SB in Chinese city children and youth.

Level of physical activity among children and adolescents in Europe: a review of physical activity assessed objectively by accelerometry

This study explored the proportion of European youth who are sufficiently active according to physical activity (PA) recommendations, based exclusively on objective assessment through accelerometers. A systematic electronic search of studies published up to March 2012 was conducted. PubMed was used to identify accelerometry-assessed PA studies that involved European youth. Within the 131 European studies, only 35 clearly reported the proportion of youth meeting the PA recommendations. Different thresholds lying between 1000 and 4000 counts/min (cpm) were used to define moderate-to-vigorous PA (MVPA). Overall, up to 100% of youth may be sufficiently active when using a threshold of approximately >1000-1500 cpm. With the most cited cut-off point (i.e. >2000 cpm), up to 87% of European youth might be considered physically active with reference to the current recommendations. Alternatively, with a cut-off point >3000 cpm, no more than 3-5% of them appeared to achieve these recommendations. The large discrepancy in outcomes released by accelerometer data is mainly due to the variety of cut-off points for MVPA among youth, hindering the definition of a clear goal towards PA promotion in Europe. Standardization of methods is urgently required.

Physical activity in 3-6 year old children measured by SenseWear Pro®: direct accelerometry in the course of the week and relation to weight status, media consumption, and socioeconomic factors

BACKGROUND

Data on objectively measured physical activity (PA) in preschoolers are controversial. Direct accelerometry was performed in children aged 3-6 years, and differences in PA patterns over the course of the week were evaluated. Data were analyzed with gender, BMI, lifestyle, and socioeconomic parameters as covariates.

METHODS

PA was measured in 119 children by the SensewearPro® accelerometer and analyzed in the 92 (40 girls) that wore it for at least 4 days including one day of the weekend. Median measuring time in this group was 7 consecutive days (median/mean daily measuring time: 23.5 h/d and 21.8 h/d, respectively), corresponding to 834,000 analyzed minutes. PA questionnaires were completed by 103 parents and 87 preschool teachers to collect anthropometric, lifestyle, and socioeconomic data.

RESULTS

Median daily PA (MET>3) was 4.3 hours (mean: 4.4 hours). Boys spent an estimated 52 min/week more being very active (MET>6) than girls (95% CI [6, 96] min/week, p = 0.02). PA was lower during the weekend (3.7 h/d) compared to weekdays (4.5 h/d), p = 3 × 10(-6)), where a 95% CI for the difference is [0.5, 1.0] h/d. PA levels did not differ between overweight/obese children (median 4.7 h/d) and normal-weight peers (median 4.2 h/d). Daily media consumption increased with decreasing social class on weekdays (p = 0.05) and during the weekend (p = 0.01), but was not related to the amount of daily PA. A multivariate regression with BMI-SDS as independent variable and gender, age, amount of PA>6 MET, parental BMI, media time and socioeconomic status as explanatory variables revealed that only SES had a significant contribution.

CONCLUSION

The negative impact of obesity-promoting factors in older children is rather low for preschoolers, but there is evidently a gradient in PA between weekdays and weekends already in this age group. Weight status of preschoolers is already considerably influenced by SES, but not physical activity levels.

Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

OBJECTIVE

To identify family- and school-based correlates of specific energy balance-related behaviours (physical activity, sedentary behaviour, breakfast consumption, soft drink consumption) among 10-12-year-olds, using the EnRG framework (Environmental Research framework for weight Gain prevention).

DESIGN

A literature review to identify observational studies exploring at least one family- or school-based correlate of the specific behaviours, resulting in seventy-six articles.

SETTING

Eighteen studies were conducted in Europe, forty-one studies in North America and seventeen studies in Australasia.

SUBJECTS

Healthy children aged 10-12 years.

RESULTS

Parental and maternal physical activity, doing physical activities with parents and parental logistic support were identified as the most important, positive correlates of physical activity. Parental rules was the most important correlate of sedentary behaviour and was inversely related to it. School socio-economic status was positively related to physical activity and inversely related to sedentary behaviour. The available studies suggested a positive relationship between soft drink availability at home and consumption. Soft drink availability and consumption at school were the most important school-based correlates of soft drink consumption. A permissive parenting style was related to more soft drink consumption and less breakfast consumption.

CONCLUSIONS

An important role has been awarded to parents, suggesting parents should be involved in obesity prevention programmes. Despite the opportunities a school can offer, little research has been done to identify school-environmental correlates of energy balance-related behaviours in this age group. Obesity prevention programmes can focus on the most important correlates to maximize the effectiveness of the programme. Future research should aim at longitudinal studies.