A systematic literature review with meta-analyses of within- and between-day differences in objectively measured physical activity in school-aged children

Inequality in Children's Physical Activity Across Time-Segmented Youth Sport Practice

Purpose: Youth sport (YS) is a community system for promoting children's physical activity (PA). Studies have examined mean PA during YS practices, but few have examined inequalities in the distribution of PA among children during practice time. This study examined PA inequality in time-segmented YS practices and differences in inequality by time segment characteristics. Methods: Children's PA and YS practices were examined using accelerometer and video observation data from a sample of YS teams (n = 36 teams, n = 101 practices) for third- through sixth-grade children (n = 392), approximately eight to 12 years old, in two rural U.S. communities. Practices were time-segmented into smaller units (episodes; n = 991). Episodes were assigned codes for purpose (e.g. warm-up), member arrangement (e.g. whole group), and setting demand (i.e. fosters participation, creates exclusion). Group accelerometer data were paired with episodes, and the Gini coefficient quantified inequality in activity counts and minutes of moderate-to-vigorous PA (MVPA). Beta generalized estimating equations examined the influence of episode structure on PA inequality. Results: Warm-up (Gini = 0.22), fitness (Gini = 0.24), and sport skill (Gini = 0.24) episodes had significantly lower inequality (p < .05) in activity counts than other purpose types. Management (Gini = 0.32) and strategy (Gini = 0.40) episodes had significantly greater inequality (p < .05) in MVPA minutes than other purpose types. Episodes fostering participation (Gini = 0.32) had significantly lower activity count inequality (p < .05) than episodes creating exclusion (Gini = 0.35). Conclusion: PA inequality among children during YS varied by practice structure. Metrics such as the Gini coefficient can illuminate inequalities in PA and may be useful for guiding efforts to improve population PA in children. Trial Registration: This study is registered at www.clinicaltrials.gov (Identifier: NCT03380143).

Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence

BACKGROUND

Increased physical activity (PA) may mitigate the negative cardiovascular health effects of sedentary behavior in adolescents. However, the relationship of PA and sedentary time from childhood with cardiac function in adolescence remains underexplored. Therefore, we investigated the associations of cumulative sedentary time and PA from childhood to adolescence with cardiac function in adolescence.

METHODS AND RESULTS

Participants were 153 adolescents (69 girls) who were aged 6 to 8 years at baseline, 8 to 10 years at 2-year follow-up, and 15 to 17 years at 8-year follow-up. Cumulative sedentary time and PA exposure between baseline and 2-year follow-up and between baseline and 8-year follow-up were measured using a combined accelerometer and heart rate monitor. Cardiac function was assessed using impedance cardiography at 8-year follow-up. The data were analyzed using linear regression analyses adjusted for age and sex. Cumulative moderate to vigorous PA (standardized regression coefficient [β]=-0.323 [95% CI, -0.527 to -0.119]) and vigorous PA (β=-0.295 [95% CI, -0.508 to -0.083]) from baseline to 8-year follow-up were inversely associated with cardiac work at 8-year follow-up. Conversely, cumulative sedentary time had a positive association (β=0.245 [95% CI, 0.092-0.398]). Cumulative vigorous PA from baseline to 8-year follow-up was inversely associated with cardiac work index at 8-year follow-up (β=-0.218 [95% CI, -0.436 to 0.000]).

CONCLUSIONS

Higher levels of sedentary time and lower levels of PA during childhood were associated with higher cardiac work in adolescence, highlighting the importance of increasing PA and reducing sedentary time from childhood.

Children and chrono-exercise: Timing of physical activity on school and weekend days depends on sex and obesity status

Recommendations for physical activity (PA) typically focus on frequency, intensity, duration, and type, but timing (chrono-exercise) is also important. The objective of this study is to describe when children are active on school and weekend days and explore PA timing across sex and body mass index (BMI) categories. 359 children (53% male), aged 9.6 (0.9) y, were categorized as normal weight (≥-1 standard deviations (SD) and <1SD; n = 193), overweight (≥1SD and <2SD; n = 80), or obese (≥2SD; n = 86) using WHO BMIz. Moderate-to-vigorous PA (MVPA) was assessed using ActiGraph LS-7164. The results are described as Mean(SD). ANOVA evaluated MVPA across sexes and BMI categories. Normal weight boys were more active than boys with obesity on school (Δ20.33 min; p < 0.001) and weekend days (Δ15.04 min; p < 0.05). On school days, significant differences existed between 9:00 h-11:00 h and 12:00 h-14:00 h (p < 0.017), while on weekends, smaller differences existed throughout the day. Girls' MVPA was similar across BMI categories, on all days (p > 0.05). On school days, 12:00 h-13:00 h represented the most active hour for all participants (~14% total daily MVPA). Peak weekend MVPA was distributed across multiple hours. Differences in MVPA timing emerged on school-days and weekends. Timing may be important when examining the nuances of MVPA in relation to sex and bodyweight in children.

Physical Literacy for Communities (PL4C): physical literacy, physical activity and associations with wellbeing

BACKGROUND

Physical literacy (PL) is considered an important determinant of children's physical activity through which health benefits may be derived. The purpose of this study is to describe a sample of Canadian children's baseline levels of PL and movement behaviors, and explore whether the associations between PL and their mental wellbeing, if any, are mediated by moderate-to-vigorous physical activity (MVPA).

METHODS

All grade two children in 14 elementary schools in the West Vancouver School District, Canada were invited to participate in a two-year longitudinal project. PL was assessed through PLAYfun and PLAYself tools. Physical activity was measured by wrist-worn accelerometers (GT3X + BT) for seven days. Children's mental well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ). A score of total difficulties was aggregated for internalizing and externalizing problems.

RESULTS

A total of 355 children aged 7-9 (183 boys, 166 girls, 6 non-binary) participated with 258 children providing valid accelerometer data. Children exhibited an average of 111.1 min of MVPA per day, with 97.3% meeting the physical activity guidelines. Approximately 43% (108/250) of participants were meeting the Canadian 24-h movement guidelines. Children were at an 'emerging' level of overall physical competence (45.8 ± 5.6) and reported a mean score of 68.9 (SD = 12.3) for self-perceived PL, with no significant differences between boys and girls. PL was significantly associated with MVPA (r = .27) and all SDQ variables (rs = -.26-.13) except for externalizing problems. Mediation analyses showed PL was negatively associated with internalizing problems and total difficulties when the association with MVPA was considered. However, the mediating role of MVPA was found only between PL and internalizing problems, β = -.06, 95%CI [-.12, -.01].

CONCLUSIONS

Although most of our sample was physically active and showed higher adherence to 24-H movement guidelines than comparable population data, the motor competence and self-perceived PL of our sample were similar to those of previous studies. PL has an independent association with children's internalizing problems and total difficulties. Ongoing assessment will investigate the relationships between PL and children's mental health from a longitudinal perspective.

Validity of the Xiaomi Mi Band 2, 3, 4 and 5 Wristbands for Assessing Physical Activity in 12-to-18-Year-Old Adolescents under Unstructured Free-Living Conditions. Fit-Person Study

The purpose was to assess the validity of four generations of Xiaomi Mi Band wristbands for the assessment of step count and physical activity (PA) levels among adolescents aged 12-18 years under free-living conditions. One hundred adolescents were invited to participate in the present study. The final sample consisted of 62 high-school students (34 females), aged 12-18 years old (Mage = 14.1 ± 1.6 years), who wore an ActiGraph accelerometer on their hip (PA and step count reference measures) and four activity wristbands (Xiaomi Mi Band 2, 3, 4, and 5) on their non-dominant wrist during the waking time of one day. Results showed that the agreement between daily PA levels (i.e., slow, brisk, and slow-brisk pace walking, total PA and moderate-to-vigorous PA) measured by Xiaomi Mi Band wristbands and the accelerometer were poor (ICC, 95% CI = 0.06-0.78, 0.00-0.92; MAPE = 50.1-150.6%). However, agreement between daily step count measured by the accelerometer and the Xiaomi Mi Band wristbands were between acceptable (MAPE = 12.2-13.6%) to excellent (ICC, 95% CI = 0.94-0.95, 0.90-0.97). Furthermore, the Xiaomi Mi Band wristbands have a good to excellent validity for correctly classifying adolescents as meeting or not meeting the recommended 10,000 steps per day (P = 0.89-0.95, k = 0.71-0.87) and the recommended 60 minutes of moderate-to-vigorous PA per day (P = 0.89-0.94, k = 0.69-0.83). Furthermore, comparability between the four Xiaomi Mi Band generations were poor to excellent (ICC, 95% CI = 0.22-0.99, 0.00-1.00) for the daily PA levels outputs, although it was excellent (ICC, 95% CI = 0.99-1.00, 0.96-1.00; MAPE = 0.0-0.1%) for daily step count. Different models of Xiaomi Mi Band wristbands were comparable and presented good validity for measuring adolescents' step count, and they accurately classified adolescents as meeting or not meeting the PA recommendations under free-living conditions.

Fourth-Grade Cooking and Physical Activity Intervention Reveals Associations With Cooking Experience and Sex

OBJECTIVE

Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index.

DESIGN

Randomized controlled trial.

SETTING

Eight elementary schools in 2 Northern Colorado districts.

PARTICIPANTS

Fourth-grade students; 7-month interventions: school (S.FFF)-theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities.

MAIN OUTCOME MEASURE(S)

Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight.

ANALYSIS

Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05.

RESULTS

The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable.

CONCLUSIONS AND IMPLICATIONS

Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions.

Physical activity, sedentary behaviour, and sleep in the Thai population: A compositional data analysis including 135,824 participants from two national time-use surveys

PURPOSE

To determine the amounts of time spent in physical activity (PA), sedentary behaviour (SB), and sleep in the Thai population, as well as their sociodemographic correlates and changes over time.

METHODS

We analysed cross-sectional data collected in a population-representative, stratified random sample of 135,824 Thais aged 10 years and over as part of the two most recent Thai National time-use surveys (2009 and 2015). Daily activities reported by the participants were coded using the International Classification of Activities for Time-Use Statistics (ICATUS) and categorised as PA, SB, or sleep.

RESULTS

In the latest survey, participants spent on average the largest amount of time sleeping (geometric mean [g] = 9.44 h/day; 95% confidence interval [CI]: 9.42, 9.47), followed by PA (g = 8.60 h/day; 95% CI: 8.55, 8.64) and SB (g = 5.96 h/day; 95% CI: 5.93, 6.00). The time spent in PA was higher on weekdays, while the amounts of SB and sleep were higher on weekends (p < 0.05). Males, older age groups, and unemployed people spent less time in PA and more time in SB, compared with other population groups (p < 0.05). We found a relatively large increase in SB (mean difference [d] = 39.64 min/day; 95% CI: 36.18, 42.98) and decrease in PA (d = 54.33 min/day; 95% CI: -58.88, -49.30) over time. These findings were consistent across most sociodemographic groups, with the most concerning shifts from active to sedentary lifestyle found among people with a higher education degree and on weekends.

CONCLUSIONS

Our findings revealed a shift to a more sedentary lifestyle in the Thai population. Public health interventions should focus on improving time use among males, older age groups, and unemployed people, while preventing the rapid decrease in PA and increase in SB among those with a higher education degree and on weekends.

Compensation of overall physical activity in (pre)adolescent girls - the CReActivity project

BACKGROUND

According to the ActivityStat hypothesis more physical activity (PA) in one timespan is compensated by increased sedentary time (ST) in the following timespan and vice versa to maintain an overall stable PA level. Until now, existing literature revealed inconsistent results regarding compensatory behaviour across children and adolescents. Thus, the aim of the present study is (1) to investigate whether ST in the morning is compensated by active behaviour in the afternoon and (2) whether ST during the week is compensated by active behaviour during the weekend in (pre)adolescent girls. Additionally, we aimed to differentiate between positive and negative compensatory behaviour and examine whether it is moderated by socioeconomic status (SES), age or weight status.

METHODS

The participants were 370 sixth grade school girls (mean age 11.6 years) from Munich that participated in the CReActivity study, a school based intervention study aiming to identify the mechanisms of behavioural changes in PA among girls. ST and PA were measured over seven consecutive days using accelerometery. Descriptive determination of compensatory behaviour, as well as Bayesian multivariate multilevel analysis were conducted with data clustered on the individual (ID), class and school level.

RESULTS

Descriptive analysis revealed rather constant compensatory behaviour of about 60% for after-school days and weekends over all observation points. However, regarding all girls, compensation was predominantly negative. Differentiated analysis indicated that all girls with low ST levels in the morning or on weekdays, compensated for this behaviour with lower PA levels in the afternoon or on weekends. Multilevel covariate analysis indicated great variability between the participants. Furthermore, differences in compensatory behaviour can also be seen on class and school levels. Interestingly, PA compensatory behaviour is not associated with age, weight status or SES.

CONCLUSION

Our findings could neither confirm nor reject the ActivityStat Hypothesis. Overall, due to the great variability across the girls, it seems that compensation depends on individual factors. In the future, to prevent negative compensation, school-based interventions that have the potential to provide opportunities to be physically active, should not neglect (pre)adolescents' leisure time behaviour.

TRIAL REGISTRATION

DRKS00015723 (date of registration: 2018/10/22 retrospectively registered).

High School Students' Accelerometer-Measured Physical Activity and Sedentary Behavior by Motivational Profiles Toward Physical Activity

Purpose: Based on a Self-Determination Theory with a person-centered approach, the purposes were: (1) to identify motivational profiles toward physical activity (PA) among high school students, and (2) to compare students' accelerometer-measured PA and sedentary behavior (SB) levels between the motivational profiles toward PA. Methods: The present study followed a cross-sectional design. A total of 394 high school students (173 females; final sample = 360 and 198 for the purposes 1 and 2, respectively) aged 12-16 years completed the study. Participants' PA and SB levels were objectively measured by ActiGraph GT3X+ accelerometers (right hip) during seven consecutive days. Later, motivation toward PA was measured by the Behavioral Regulation in Exercise Questionnaire. Results: Based on a two-stage cluster analysis approach, the results identified three clusters: (1) "Self-determined motivational profile toward PA" (65.3%); (2) "Non-self-determined motivational profile toward PA" (23.9%), and (3) "Controlled motivational profile toward PA" (10.8%). The results of the chi-square test showed that a statistically significantly higher percentage of males were represented in cluster 1 (p < .001). The results of the one-way analysis of variance showed that students from cluster 1 had statistically significantly lower levels of SB, and higher levels of light PA, moderate-to-vigorous PA and total PA than those from cluster 2 (p < .05; |d| = 0.40-0.61). Conclusions: In line with the Self-Determination Theory, the students within the self-determined motivational profile had lower SB and higher PA. This preliminary evidence could inform and guide future policy regarding students' PA promotion.

Differences in physical activity between weekdays and weekend days among U.S. children and adults: Cross-sectional analysis of NHANES 2011–2014 data

This study investigates differences in physical activity between weekdays and weekend days, and its associations with sociodemographic and anthropometric characteristics in the U.S population using the NHANES 2011–2014 data. Physical activity was measured using ActiGraph GT3X+. Raw acceleration data were converted to Monitor-Independent Movement Summary units (MIMS-units) that account for inter-device variability and eliminates non-human movement. The daily MIMS-units were averaged for weekdays and weekend days. Demographic characteristics were self-reported. Height and weight were objectively measured. The sample included 6611 adults aged ≥ 20 years and 3520 children aged between 6 and 19 years. The results show that more MIMS-units were registered on weekdays compared to weekend days for adults (652, 95%CI = 533, 770) and children (889, 95%CI = 702, 1076). Factors associated with physical activity in adults (gender, age, marital status, ethnicity, education level, and weight status) were similar for weekdays and weekend days. In children, physical activity was associated with ethnicity, weight status, and age. The level of differences in physical activity between weekdays and weekend days among adults was larger for men, Hispanic Americans, and those with lower education levels. Differences among children were similar across subgroups, except for those aged 16–19 years who had smaller level of difference compared to those aged 12–15 years. In conclusion, adults and children were more active on weekdays than weekend days. The effects of structured days (i.e., weekdays) on physical activity appeared to be similar across most child subgroups but more heterogeneous for adult subgroups. Interventions increasing physical activity opportunities during weekend days are warranted.

Activity Behaviors in British 6-Year-Olds: Cross-Sectional Associations and Longitudinal Change During the School Transition

BACKGROUND

To explore activity behaviors at school entry, we describe temporal/demographic associations with accelerometer-measured physical activity in a population-based sample of British 6-year-olds, and examine change from ages 4 to 6.

METHODS

A total of 712 six-year-olds (308 at both ages) wore Actiheart accelerometers for ≥3 (mean 6.0) days. We derived minutes per day sedentary (<20 cpm) and moderate to vigorous physical activity (MVPA, ≥460 cpm), also segmented across mornings (06:00 AM to 09:00 AM), school (09:00 AM to 3:00 PM), and evenings (3:00 PM to 11:00 PM). Using mixed effects linear regression, we analyzed associations between temporal/demographic factors and children's activity intensities at age 6, and change between ages 4 and 6.

RESULTS

Six-year-old children engaged in MVPA (mean [SD]): 64.9 (25.7) minutes per day (53% met UK guidelines). Girls did less MVPA than boys, particularly during school hours. Children were less active on weekends (vs weekdays) and more active on spring/summer evenings (vs winter). Longitudinally, 6-year-old children did less light physical activity (-43.0; 95% confidence interval, -47.5 to -38.4 min/d) but were more sedentary (29.4; 24.6 to 34.2), and engaged in greater MVPA (7.1; 5.2 to 9.1) compared to when they were aged 4.

CONCLUSION

Half of 6-year-old children met current activity guidelines; MVPA levels were lower in girls and at weekends. UK children became more sedentary but did more MVPA as they entered formal schooling. Physical activity promotion efforts should capitalize on these changes in MVPA, to maintain positive habits.

Catch me if you can! How French adolescents seize social occasions and opportunities to be active

BACKGROUND

Following an ecological framework, the aim of this study was to highlight the way adolescents invested their time in opportunities to engage in moderate to vigorous physical activity (MVPA) according to whether they were profiled as more or less active. This study's innovation lies in the analysis of MVPA according to social occasions which are understood as opportunities to be active throughout the day (e.g. home, school, transport).

METHODS

PA data measured by accelerometry (ActiGraph GT3X) for seven consecutive days were compiled, with adolescents' social occasions during the week recorded in a daily digital diary (n = 135). The opportunity ratio of MVPA at each social time is the ratio between time spent in MVPA and the duration of a corresponding social occasion. Following the literature, participants were categorised into three profiles according to their reported amount of MVPA: HEPA active, minimally active and inactive. Non-parametric Wilcoxon signed rank and Kruskal Wallis tests were performed to determine the relative intensity of PA performed at different social occasions, and to investigate whether intensities differed between adolescents with various activity profiles.

RESULTS

Results showed that engagement in MVPA at different social occasions differed according to participant profiles. Mismatch was noticed between the opportunity ratio and the duration of the most and least favorable social occasions for MVPA. For all three profiles, the social occasion "physical education lesson" revealed an opportunity ratio of MVPA (23.6% vs 17.0% vs 13.8%) significantly higher than the overall opportunity ratio of the week (6.9% vs 2.9% vs 1.2%), but of lower duration. Conversely, "home" (5.3% vs 0.0% vs 0.0%) and "school" (outside of PE time) (2.4% vs 0.0% vs 0.0%) represented the two least opportune social occasions for PA in an adolescent's week.

CONCLUSIONS

Rethinking engagement with MVPA in the context of temporal opportunities would allow potential ways to intervene within an educational supervised setting to help young people adopt a physically active lifestyle at the end of the key period of adolescence. These results reinforced the importance of context in interventions for PA promotion, opening for "time education" in people.

Accelerometer-Measured Physical Activity Levels and Patterns Vary in an Age- and Sex-Dependent Fashion among Finnish Children and Adolescents

Background: The purpose of this study was to measure physical activity (PA), sedentary behavior (SB), and hour-by-hour PA patterns with an accelerometer in a population-based sample of Finnish children and adolescents. Methods: A total of 3274 participants (3rd, 5th, 7th, 9th graders) from 176 schools wore a hip-worn triaxial accelerometer for seven days during waking hours. Mean amplitude deviation of the acceleration data was used to assess PA intensity that was converted to metabolic equivalents and categorized into light, moderate, and vigorous PA. Angle for posture estimation was used to measure SB and standing. Results: The majority of participants’ PA consisted of light PA, and they were sedentary for more than half of their waking hours. Children were more active than adolescents, and boys were more active than girls. Participants took, on average, 9890 steps daily, and one third met the PA recommendation. The participants were divided into tertiles based on daily steps to investigate the variation in PA patterns. Compared to the least active tertile, the most active tertile took twice as many steps on weekdays and nearly three times as many steps on the weekend. Conclusions: The majority of the participants were not active enough, and there was a great variation in PA levels and patterns, especially among the adolescents and on weekends.

Relations between physical activity, sedentary time, and body fat from childhood to adolescence: Do they differ by sex?

BACKGROUND

Efforts to reveal the direction of influence between physical activity (PA), sedentary time (ST) and body fat in youth have produced inconsistent results, possibly due to a lack of adjustment for confounders and other factors. Sex-specific associations have rarely been studied.

METHODS

A sample from two Norwegian birth cohorts (n = 809) were followed biennially over five waves from the age of 6-14 years. Physical activity and ST were recorded by accelerometers, and body fat was assessed by bioelectrical impedance measurements.

RESULTS

By applying a dynamic panel model (DPM) that adjusts for all time-invariant confounding factors, it was found that among boys, increased fat mass index (FMI) at ages 8, 10 and 12 years predicted decreased PA two years later (8-10 years: B = -0.67, (95% CI: -1.1, -0.24); 10-12 years: B = -0.33, (95% CI: -0.61, -0.05); 12-14 years: B = -0.29, (95% CI: -0.52, -0.06)). Regarding the opposite direction of influence, more PA at age 12 forecasted reduced FMI at age 14 (B = -0.16, (95% CI: -0.24, -0.07)), whereas increased FMI predicted increased ST across all time points in boys only (6-8 years: B = 0.23, (95% CI:0.02.43); 8-10 years: B = 0.23, (95% CI:.08.39); 10-12 years: B = 0.13, (95% CI:.03.23); 12-14 years: B = 0.17, (95% CI:.07, 26)). The revealed relationships were significantly stronger in boys compared to the (absent) relations in girls. Sensitivity analyses examining moderate to vigorous PA (MVPA) rather than total PA were in accordance with the main findings.

CONCLUSIONS

In boys, increased FMI predicted reduced PA and increased ST two years later from childhood to adolescence. The opposite direction of influence was evident from only ages 12-14. There were no prospective relationships between FMI and PA or ST among girls.

Weekday and Weekend Physical Activity of Preschool Children in Relation to Selected Socioeconomic Indicators

Physical activity (PA) is as vital for improving the health of young children as it is positively associated with a broad range of psychological, cognitive, and cardio-metabolic outcomes. The aims of this study were to: (1) to assess the level of PA and meeting the WHO recommendations: moderate-to-vigorous physical activity (MVPA) and the number of steps in Polish preschool boys and girls on weekdays and on weekends; (2) to investigate the relationship between selected socioeconomic indicators (self-reported by parents) and PA, including meeting the WHO recommendation for daily MVPA and the number of steps on weekdays and on weekends among Polish preschoolers. Data were collected in the 2017/2018 school year. The study included a total of 522 boys and girls both aged between 5 and 6 years. The ActiGraph GT3X-BT tri-axial accelerometer was used to measure PA. Selected socioeconomic indicators as well as parental body weight and body height were self-reported by parents/caregivers using a questionnaire. In most of the PA indicators analyzed for girls (moderate, vigorous, total MVPA, and steps/day), the averages were higher during the week than during the weekend. Moreover, significantly more boys met the criteria of MVPA, both on weekdays and over the weekend (32.3% boys and 19.2% girls on weekdays and 31.1% boys and 18.1% girls on weekends). Additionally, more boys met the step recommendations, but only on weekends (15.5% boys and 6.6% girls). It was found that if there were two people in a household, there was an almost a three-fold greater chance (adj. OR = 2.94, p = 0.032) of meeting the MVPA criterion with an even stronger association (over fivefold greater chance) in meeting the step recommendation (adj. OR = 5.56, p = 0.033). The differences in the day schedule may potentially contribute with the level of PA in girls. Among the analyzed selected socioeconomic indicators, only the number of people in a household had a significant association on PA.

Active and sedentary behaviors in youth (6–14 years old): Data from the IAN-AF survey (2015–2016)

Background:

Strategic health interventions must be guided by effective surveillance systems that monitor population trends and patterns, therefore we aimed to provide youth's (6–14 years) national prevalence estimates of physical activity (PA), active outdoor play (AOP), sedentary behaviur (SB), and structured PA (SPA).

Methods:

Measures of moderate-to-vigorous PA, SB, AOP, and SPA, were obtained for 719 participants in 2 groups (6–9 and 10–14 years) using diaries and questionnaires. National estimates were calculated, by sex, region, and parental education.

Results:

While 54% (95%CI: 47.4–61.3) of youth meet PA recommendations, the prevalence is lower for the older group (P = .034). Similarly, AOP decreases with age both on weekends, from 94.3% (95%CI: 90.8–97.8) to 68.7% (95%CI: 62.2–75.1), and on weekdays from 84% (95%CI: 76.5–91.5) to 64.8% (95%CI: 59–70.6). Watching TV for ≥2 h/day is extremely high on weekends [71.3% (95%CI: 65.4–77.2)] and more prevalent in boys than girls on weekdays (P = .043). Higher parental education significantly increased SPA and active time. Time in SB was greater in boys [7.26 h (95%CI: 6.87–7.65)] than girls [6.48 h (95%CI: 6.09–6.87)] and increased with age (P < .001).

Conclusions:

Almost half of the youth failed to achieve PA guidelines, whereas 71% exceeded recommended TV time on weekends, suggesting the urgency of intervention measures.

Prospective associations between dietary patterns, screen and outdoor play times at 2 years and age at adiposity rebound: The EDEN mother-child cohort

Although an early adiposity rebound (AR) is an established risk factor for later obesity, little is known regarding its determinants, especially modifiable ones. Using data from the French EDEN mother–child cohort (1903 children born in 2003–2006), we aimed to examine the association between diet and activity-related behaviors at 2 years of age and the timing of the AR. Two-year-old children (n = 1138) with parent-reported data on their foods/drinks intake, TV/DVD watching time, outdoor playtime, and with an estimated (via growth modelling) age at AR were included in the present study. Two dietary patterns, labelled 'Nutrient-dense foods' and 'Processed and fast foods', were identified in a previous study. Multivariable linear and logistic regression models were used to assess the association between dietary patterns and activity-related behaviors and, respectively, the age at AR (continuous) and the likelihood of having a very early AR (before 3.6 years for girls and 3.8 years for boys, i.e., below the 10th percentile of sex-specific distribution). A higher score on the ‘Processed and fast foods’ dietary pattern was associated with a higher likelihood of having a very early AR (OR = 1.23; 95% CI: 1.00 to 1.50). No significant association was observed between the ‘Nutrient-dense foods’ dietary pattern, TV/DVD watching and outdoor playing times and the timing of the AR. This finding emphasizes the importance of reducing nutrient-dense and processed foods from the early years of life, and provides further support for early interventions aimed at helping parents establish healthy eating habits for their growing child from the complementary period.

On the Move or Barely Moving? Age-Related Changes in Physical Activity, Sedentary, and Sleep Behaviors by Weekday/Weekend Following Pandemic Control Policies

This study examined pre-pandemic (2017-early March 2020) to early-pandemic (Spring 2020) changes in moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary behavior/sleep (SS), by weekday/weekend, and age (preschool, elementary, middle school). We re-enrolled children from two pre-pandemic obesity prevention trials and examined differences in accelerometer-measured PA from pre-pandemic to early-pandemic across age groups using linear mixed models. Children (n = 75) were 51% multiple race/ethnicities, 29% preschool, 28% elementary, 43% middle school, 65% suburban, 21% rural, and 13% urban. Pre-pandemic to early-pandemic changes in weekday MVPA (p = 0.006), LPA (p = 0.018), and SS (p = 0.003) differed by age. On weekdays, middle schoolers' MVPA decreased 15.36 min/day (p = 0.002) and SS increased 94.36 min/day (p < 0.001) with non-significant changes among preschoolers and elementary schoolers. Compared to elementary schoolers, middle schoolers' changes in weekday MVPA (b = -16.34, p = 0.036) and SS (b = 63.28, p = 0.039) significantly differed. Declines in weekday MVPA and increases in SS among middle schoolers suggest that, compared with younger children, middle schoolers are dependent on school and recreational facilities for PA, and in their absence engage in more sedentary activities and sleep.

Research on the Difference Between Recreational Walking and Transport Walking Among the Elderly in Mega Cities With Different Density Zones: The Case of Guangzhou City

Walking is the easiest method of physical activity for older people, and current research has demonstrated that the built environment is differently associated with recreational and transport walking. This study modelled the environmental characteristics of three different building density zones in Guangzhou city at low, medium, and high densities, and examined the differences in walking among older people in the three zones. The International Physical Activity Questionnaire (IPAQ) was used to investigate the recreational and transport walking time of older people aged 65 years and above for the past week, for a total of three density zones (N = 597) and was analysed as a dependent variable. Geographic Information Systems (GIS) was used to identify 300, 500, 800, and 1,000 m buffers and to assess differences between recreational and transport walking in terms of the built environment [e.g., land-use mix, street connectivity, Normalised Difference Vegetation Index (NDVI) data]. The data were processed and validated using the SPSS software to calculate Pearson's correlation models and stepwise regression models between recreation and transit walking and the built environment. The results found that land use mix and NDVI were positively correlated with transport walking in low-density areas and that transport walking was negatively correlated with roadway mediated centrality (BtE) and Point-of-Interest (PoI) density. Moreover, recreational walking in medium density areas was negatively correlated with self-rated health, road intersection density, and PoI density while positively correlated with educational attainment, population density, land use mix, street connectivity, PoIs density, and NDVI. Transport walking was negatively correlated with land-use mix, number of road crossings while positively correlated with commercial PoI density. Street connectivity, road intersection density, DNVI, and recreational walking in high-density areas showed negative correlations. Moreover, the built environment of older people in Guangzhou differed between recreational and transport walking at different densities. The richness of PoIs has different effects on different types of walking.

Self-reported physical activity and sedentary behaviour amongst adolescents in Sweden vary depending on sex, age and parental education

AIM

The aim of this study was to investigate self-reported physical activity and sedentary behaviour by sex, age and parental education in a large representative sample of Swedish adolescents.

METHODS

This study is based on data from the national dietary survey Riksmaten Adolescents, which was conducted by the Swedish Food Agency in 2016-2017. In total, 3477 students from grade five (11-12 years), eight (14-15 years) and eleven (17-18 years) were included. A web questionnaire was used to collect information about physical activity and sedentary behaviour.

RESULTS

In total, 53% reported active transport to and from school, 93% that they usually participate in the physical education, 76% reported a physically active leisure time, and 66% reported that they participated in organised physical activities. In addition, 12% and 6% reported two hours or less of screen time on weekdays and weekends, respectively. Participation in physical activity was generally lower amongst girls, older adolescents and for those from families with low-parental education.

CONCLUSION

This study provide reference values for self-reported physical activities and sedentary behaviours amongst adolescents in Sweden. Strategies to increase physical activity and reduce screen time are needed, particularly amongst girls, older adolescents and amongst those with low-parental education.

Paternal and maternal support of moderate-to-vigorous physical activity in children on weekdays and weekends: a cross-sectional study

BACKGROUND

Most studies of associations between parental support behaviours for physical activity (PA) and children's moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children's MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China.

METHODS

Cross-sectional data of 517 father-child dyads and 1422 mother-child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children's PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week.

RESULTS

Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009-1.195) and maternal (OR = 1.076, 95% CI: 1.021-1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055-1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025-1.313), weekends (OR = 1.241, 95% CI: 1.097-1.403), and throughout the week (OR = 1.214, 95% CI: 1.076-1.369).

CONCLUSIONS

Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children's MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day.

Children with Autism Spectrum Disorder Spent 30 Min Less Daily Time in Moderate-to-Vigorous Physical Activity than Typically Developing Peers: a Meta-Analysis of Cross-sectional Data

It remains unclear if participation in moderate-to-vigorous physical activity (MVPA) differs between children with ASD and typically developing children (TDC). We compared daily MVPA, time spent in MVPA during physical education (PE) and recess, and odds of not meeting MVPA recommendation (60 min/day) between children with ASD and TDC. Nine studies reporting accelerometer-measured MVPA were included in the meta-analyses. MVPA was 30 min lower/day, 12% and 8% lower during PE and recess, respectively, in children with ASD, and they had 4 times higher odds of not meeting MVPA recommendation when compared to TDC. Children with ASD engage in daily MVPA less than TDC and below the guidelines. Tailored interventions to increase MVPA in children with ASD are warranted.

Segmented physical activity and sedentary behavior patterns among children in Maasai village and Nairobi city

OBJECTIVES

Urban-rural comparisons between those who maintain traditional lifestyles such as pastoralist Maasai children, and those who live in cities such as Nairobi, provide implications on how urbanization is associated with children's physical activity (PA) and sedentary behavior (SB) patterns. This study compares PA and SB volumes and patterns across different segments of the week among children in Maasai village and Nairobi city in Kenya.

METHOD

A total of 261 children (11.4 ± 1.3 years) from Maasai (n = 118) and Nairobi (n = 143) participated in this cross-sectional study. Moderate- to vigorous-intensity PA (MVPA) and SB on weekdays (before, during, and after school) and weekends (morning, afternoon, and evening) were calculated using accelerometers (ActiGraph). Screen time and sleep duration were assessed using questionnaires.

RESULTS

Maasai children were more physically active than Nairobi children with MVPA (min/day) of 166.6 and 81.4 for Maasai and Nairobi boys and 116.4 and 77.4 for Maasai and Nairobi girls, respectively. Our week segments analyses suggested that Maasai children were more active both in and out of school than Nairobi children. Additionally, Nairobi children spent more time watching television and playing computer games than Maasai children. There was no significant difference in sleep duration between Maasai and Nairobi children.

CONCLUSION

Our findings suggest that urbanization is negatively associated with activity patterns both in and out of school in Kenyan children. This is concerning given that Kenya is currently undergoing rapid urbanization, which may lead to further reductions in PA among Kenyan children.

Relationships of physical activity and sedentary behaviour with the previous and subsequent nights' sleep in children and youth: A systematic review and meta-analysis

The interrelationships between sleep and daytime movement behaviours have been examined at interindividual level. Studies of within-person, temporal relationships of daytime physical activity (PA) and sedentary behaviour with the previous and subsequent nights' sleep are increasing. The present systematic review and meta-analysis synthesised the results of studies in school-aged children and youth. Eight databases (MEDLINE, PsycINFO, EMBASE, Global Health, PubMed, Web of Science, SPORTDiscus, and CINAHL) were searched for peer-reviewed articles that examined the association between daytime movement behaviours (including PA, sedentary time, or sedentary recreational screen time) and night-time sleep on the same day, or the association between night-time sleep and daytime movement behaviours the next day, in children and youth. A total of 11 studies comprising 9,622 children and youth aged 5-15 years met the inclusion criteria. Sedentary time was negatively associated with the subsequent night's sleep duration (r = -0.12, 95% confidence interval -0.23 to -0.00; I²  = 93%; p = .04). Positive relationships between PA and the previous or subsequent night's sleep duration were observed only for studies that adjusted for accelerometer wear time. There was some evidence suggesting that a longer sleep duration was associated with less sedentary time and a higher proportion of the daytime spent being physically active and vice versa, although the association was weak and based on a limited number of studies. From a clinical perspective, promotion of either sleep hygiene or daytime PA should be planned with considerations of the virtuous or vicious circle between these behaviours and monitor concurrent effects on the others.

Are all MVPA minutes equal? Associations between MVPA characteristics, independent of duration, and childhood adiposity

BACKGROUND

The inverse relationship between moderate-to-vigorous physical activity (MVPA) duration and childhood adiposity is well established. Less is known about how characteristics of MVPA accumulation may be associated with adiposity, independent of MVPA duration. This study aimed to investigate how the MVPA characteristics of children, other than duration (bout length, time of day, day-to-day consistency, intensity), were associated with adiposity.

METHODS

Cross-sectional study of the Australian arm of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) (participants: n = 424, age range 9-11, 44% male). Adiposity was determined by percent body fat via bioelectrical impedance. MVPA duration and characteristics (bout length, time of day, consistency, intensity) were derived from 7-day, 24-h accelerometry. Generalised estimating equations were used to examine the individual and multivariate associations between MVPA characteristics and adiposity.

RESULTS

Univariate analyses showed that higher MVPA duration (β range = - 0.26,-0.15), longer bouts of MVPA (β range = 0.15,0.22) and higher MVPA intensity (β range = - 0.20,-0.13) were all inversely associated with adiposity (all p < 0.05). When models were adjusted for MVPA duration, only MVPA intensity (β range = - 0.16,-0.04) showed consistent significant associations with adiposity.

CONCLUSIONS

Characteristics of MVPA other than duration and intensity appear to be unrelated to adiposity.

The use of coping strategies "shift-persist" mediates associations between physical activity and mental health problems in adolescents: a cross-sectional study

Background

Self-perceived mental health problems among adolescents has had an upward trend. Concurrently, adolescents’ physical activity (PA) has been falling whilst sedentary time (SED) has increased. There is a lack of research using accelerometer measured PA and SED to study their relationships to perceived stress and psychosomatic symptoms, both frequently observed mental health problems among adolescents. Whether coping strategies is one of the mechanisms underlying such relationship is less clear.

Methods

A total of 2283 13-year olds were enrolled in the baseline examination of the STARS (STudy of Adolescence Resilience and Stress) study in Western Sweden. Light-, moderate-, vigorous-intensity PA (LPA, MPA and VPA) and SED were measured using hip-worn ActiGraph GT3X+ accelerometer. A total of 1284 adolescents provided valid accelerometer data (at least 4 days with ≥10 h per day). PA and SED during school-time and leisure-time were analysed separately. Surveys were utilized to monitor perceived stress, psychosomatic symptoms and the use of coping strategies “shift-persist”. Logistic regression and mediation analyses were performed adjusting for gender, ethnicity, socioeconomic status and puberty development.

Results

We observed that more time spent in PA was associated with less stress in adolescents. The associations were observed for LPA (Odds ratio for LPA per 60 min: 0.557 (95% CI 0.399–0.776), VPA (Odds ratio for VPA per 15 min: 0.688 (95% CI 0.588–0.806) and MVPA (Odds ratio for MVPA per 15 min: 0.795 (95%CI 0.718–0.879) during leisure time, but not during school time. Similar associations were observed between leisure time PA and psychosomatic symptoms. The associations remained statistically significant even after adjusting for the confounders. Further, our data showed that adolescents who engaged more time in PA during leisure time were more likely to adopt the coping strategies of “shift-persist”. Mediation analysis showed that the use of “shift-persist” mediated the associations between leisure time PA and stress/psychosomatic symptoms.

Conclusions

Leisure time physical activity, irrespective of intensity, may facilitate successful coping with stress and stress-related mental health problems in adolescents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11158-0.

Physical Activity and Sedentary Behavior Patterns Across Weekdays and Weekend Days in Youth With Multiple Sclerosis and Controls

Background:

This study quantified and compared weekday and weekend patterns of device-measured physical activity (PA) and sedentary behavior between youth with pediatric multiple sclerosis (MS) and controls for the purpose of informing future PA behavior change interventions.

Methods:

Participant data were obtained from 3 ongoing observational studies, and the sample included 40 participants with pediatric MS and 41 controls. Light PA (LPA), moderate to vigorous PA (MVPA), and sedentary behavior data were collected using activity monitors (ActiGraph LLC) over 1 week. The main analysis involved a 2-way mixed factor analysis of variance with group as a between-subjects factor (pediatric MS vs control) and day as a within-subjects factor (weekday vs weekend day).

Results:

There was no group by day interaction from the analysis of variance for percentage of activity monitor wear time spent in LPA, MVPA, or sedentary behavior. There was no effect of group for LPA, MVPA, or sedentary behavior. There was an effect of day of week on percentage of day spent in LPA, MVPA, and sedentary behavior.

Conclusions:

These results suggest that youth with pediatric MS and controls were less physically active and more sedentary on weekends than on weekdays, but there were no differences between groups in PA and sedentary behavior overall or by day of the week. Physical activity interventions may be more successful by initially targeting weekend day activity.

Dynamics of sleep, sedentary behavior, and moderate-to-vigorous physical activity on school versus nonschool days

STUDY OBJECTIVES

Studies examining time-use activity behaviors (sleep, sedentary behavior, and physical activity) on school days compared with nonschool days have examined these behaviors independently, ignoring their interrelated nature, limiting our ability to optimize the health benefits of these behaviors. This study examines the associations of school-day (vs. nonschool day) with time-use activity behaviors.

METHODS

Time series data (6,642 days) from Fitbits (Charge-2) were collected (n = 196, 53% female, 5-10 years). We used a variable-centered dynamic structural equation modeling approach to estimate day-to-day associations of time-use activity behaviors on school days for each child. We then used person-centered cluster analyses to group individuals based on these estimates.

RESULTS

Within-participant analysis showed that on school days (vs. nonschool days), children (1) slept less (β = -0.17, 95% CI = -0.21, -0.13), (2) were less sedentary (β = -0.05, 95% CI = -0.09, -0.02), and (3) had comparable moderate-to-vigorous physical activity (MVPA; β = -0.05, 95% CI = -0.11, 0.00). Between-participant analysis showed that, on school days, children with higher sleep carryover experienced greater decreases in sleep (β = 0.44, 95% CI = 0.08, 0.71), children with higher body mass index z-score decreased sedentary behavior more (β = -0.41, 95% CI = -0.64, -0.13), and children with lower MVPA increased MVPA more (β = -0.41, 95% CI -0.64, -0.13). Cluster analysis demonstrated four distinct patterns of connections between time-use activity behaviors and school (High Activity, Sleep Resilient, High Sedentary, and Dysregulated Sleep).

CONCLUSIONS

Using a combination of person-centered and more traditional variable-centered approaches, we identified patterns of interrelated behaviors that differed on school, and nonschool days. Findings can inform targeted intervention strategies tailored to children's specific behavior patterns.

Changes in 24-hour movement behaviours during the transition from primary to secondary school among Australian children

This study examined concurrent changes in all components of 24-h movement behaviours (24-h MB) (sleep, sedentary behaviour [SB] and physical activity [PA]) and compliance with the Australian 24-Hour Movement Guidelines over the primary to the secondary school transition period. The analytical sample included 83 children (60.2% girls) who provided valid accelerometer-measured 24-h MB data during their final year of primary school (T1) and first year of secondary school (T2). Self-reported participation in domain-specific SB and PA, socio-demographic characteristics and weight status were also assessed. Change in 24-h MB composition from T1 to T2 was analysed using a compositional multivariate linear model for repeated measures. The difference in the proportion of meeting the 24-hour integrated movement guidelines was assessed using a McNemar-Bowker test. An unfavourable change was observed in the 24-h MB composition (p < .0001), with increased time spent in SB (+58 min/day) and decreased time in sleep (-13 min/day), Iight-intensity PA (-13 min/day) and moderate- to vigorous-intensity PA (-14 min/day). Domain-specific SB results indicated an increase in recreational screen time (+45 min/day) and out-of-school educational activities (+25 min/day). No significant changes were observed for domain-specific PA. The proportion of children meeting the 24-hour integrated movement guidelines also declined (20.5% vs. 3.6%; p < .0001). Change in 24-h MB was larger on weekdays than weekends (p < .0001); but this was not moderated by socio-demographic characteristics or weight status. These findings suggest that an integrated intervention approach targeting weekdays may be beneficial to promote adherence to healthy 24-h MB during the primary to the secondary school transition period. HighlightsThis study investigated how the 24-hour movement behaviour composition (i.e., time spent in sleep, sedentary behaviour and physical activity) changes and its impact on children's compliance with the 24-hour integrated movement guidelines during the primary to secondary school transition period.There was an unfavourable change in the accelerometer-measured 24-hour movement behaviour composition, with increased time spent in sedentary behaviour and decreased time in sleep, light-intensity physical activity and moderate- to vigorous-intensity physical activity. The change in weekday composition was significantly more prominent than change on weekends.The observed increase in sedentary behaviour may be attributed in part to an increase in recreational screen time and out-of-school educational activities in secondary schools.These behavioural changes were reflected in decreased compliance rates with the individual and integrated 24-hour movement guidelines, with the largest decline observed in the sleep guideline.Our findings highlight the need for an integrated intervention approach to support children to develop and/or maintain healthy movement behaviour habits throughout the school transition period.

Randomized Controlled Trial to Increase Physical Activity Among Hispanic-American Middle School Students

BACKGROUND

Moderate-to-vigorous physical activity (MVPA) declines during adolescence, particularly among girls. In this randomized control trial, we examined MVPA in a physical activity intervention compared to physical education (PE) class as usual (TAU), stratified by sex and weight classification. Standardized BMI (zBMI) overtime was also examined.

METHODS

Hispanic-American middle school students (N = 193) were recruited from a school district in Houston, Texas. Participants were randomized to either a circuit-based physical activity intervention or TAU (PE class as usual). MVPA was assessed using accelerometry at baseline and 6 months. Repeated measures ANCOVA were conducted to examine changes in MVPA, overall and stratified by sex and weight classification. This procedure was repeated for zBMI.

RESULTS

Participants were 12.10 ± 0.63 years old and 53% were girls. Overall those in intervention increased weekday MVPA more than TAU (F(1,190) = 7.03, p < .01). Intervention girls increased weekday MVPA; whereas TAU girls decreased weekday MVPA (F(1,99) = 7.36, p < .01). Among those with obesity, there was no difference in MVPA between conditions (F(1, 56) = 0.33, p = .57), but Intervention decreased zBMI significantly more than TAU (F(1, 56) = 6.16, p < .05).

CONCLUSIONS

Structured PE classes grounded in behavioral theory may be an important strategy to prevent typical decreases in MVPA during adolescence, particularly among girls and for youth with obesity.

Familial Correlates of Leisure Time Activities among Polish Early School-Age Children: A Cross-Sectional Study

The after-school period may play a critical role in the accumulation of children’s physical activity and sedentary time. The study aimed to characterize familial correlates of early school-age children’s leisure time activities. A cross-sectional study was conducted among a group of 223 children (mean age 8.7 ± 0.5) and their parents. The percentage of children with daily leisure time physical activity (LTPA) >1 h was 23.32%, and with daily screen time <2 h was 32.74%. The average children’s leisure time physical activity was significantly higher on weekend days than on weekdays (114.85 vs. 89.43 min, p = 0.005). Similarly, the average screen time was higher on weekend days than on weekdays (95.50 vs. 66.10 min, p < 0.001). The multivariate regression analysis revealed that independent predictors of children’s leisure time physical activity were the father’s education level and the father’s occupational status, whereas at least one parent with higher education correlated negatively with children’s longer screen time. The study showed that children’s leisure time activities are associated with parental education and differ significantly between weekdays and weekend days. These findings underline the need for screening for unfavorable health behaviors among early school-age children, and indicate that health promotion programs should be oriented on both parents and children aiming to improve parental health consciousness, reduce screen time and increase physical activity, especially during the weekend.

Objective environmental exposures correlate differently with recreational and transportation walking: A cross-sectional national study in the Netherlands

Background Walking is a good and simple way to increase people's energy expenditure, but there is limited evidence whether the neighborhood environment correlates differently with recreational and transportation walking. AimTo investigate how recreational walking and transportation walking are associated with the natural and built environmental characteristics of the living environment in the Netherlands, and examine the differences in their associations between weekdays and weekends. Method and data We extracted the total duration of daily walking (in minutes per person) for recreation and transportation of adults aged 18 years and above from the Dutch National Travel Survey 2015-2017 (N = 65,785) and analyzed it as an outcome variable. Objective measures of the natural (i.e., normalized difference vegetation index (NDVI), blue space and meteorological conditions) and built environment (i.e., crossing density, land-use mix, and residential building density) around respondents' home addresses were determined for buffers with 300, 600, and 1000 m radii using a geographic information system. To assess associations between recreational and transportation walking and the environmental exposures separately, we fitted Tobit regression models to the walking data, adjusted for multiple confounders. ResultsOn weekdays, people living in areas with less NDVI, higher land-use mix, and higher crossing density were more likely to engage in transportation walking. Recreational walking was negatively associated with NDVI, blue space, crossing density, precipitation and daily average temperature. At weekends, land-use mix supports both recreational and transportation walking. A negative association appeared for NDVI and transportation walking. Daily average rainfall and temperature were inversely correlated with recreational walking. Sensitivity tests indicated that some associations depend on the buffer size. ConclusionsOur findings suggest that the built and natural environments are differently associated with people's recreational and transportation walking. We also found differences in the walking-environment associations between weekdays and weekends. Place-based policies to design walking-friendly neighborhoods may have different implications for different types of walking.

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis

Purpose

The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.

Methods

Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.

Results/findings

Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.

Conclusions

Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Do Adolescents Who Meet Physical Activity Recommendations on Weekdays Also Meet Them on Weekends? A Cross-Sectional Study in Colombia

The purpose of this study was to examine whether Colombian adolescents fulfill physical activity (PA) recommendations by type of day depending on several variables. A cross-sectional study was carried out on a sample of 2624 adolescents from Neiva (Colombia) using the Seven Day PA Recall and the Family Affluence Scale II self-reported questionnaires. Statistical analyses were performed to find any differences by gender, socioeconomic status, PA recommendations accomplishment, participation in organized and non-organized PA, parents' involvement in sport, and adolescents' academic achievement, and to determine the probability of complying with the PA guidelines. Only 12.3% of the participants met the PA recommendations on weekdays and weekends. Girls maintained their (in)active patterns during the week more than boys (84.4% vs. 70.7%, respectively), while more boys than girls changed them according to the type of day (25.3% vs. 19.6%). Participation in organized sports was the predictor variable with the highest probability of both boys and girls complying with the PA recommendations on weekdays. Non-organized activities were more likely to make girls more active on weekends. In conclusion, a wider offer of organized and non-competitive PA over the weekend and broader sports schedules should be provided to youth in Neiva.

Effect of Linear and Nonlinear Pedagogy Physical Education Interventions on Children's Physical Activity: A Cluster Randomized Controlled Trial (SAMPLE-PE)

Background: School-based interventions are a key opportunity to improve children’s physical activity (PA); however, there is lack of evidence about how pedagogical approaches to motor learning in physical education (PE) might affect PA in children. Therefore, this study aimed to assess how different pedagogical approaches in PE might affect children’s PA. Methods: Participants (n = 360, 5–6 years) from 12 primary schools within the SAMPLE-PE randomized controlled trial were randomly allocated to either Linear Pedagogy (LP: n = 3) or Nonlinear Pedagogy (NP: n = 3) interventions, where schools received a 15-week PE intervention delivered by trained coaches, or to a control group (n = 6), where schools followed usual practice. ActiGraph GT9X accelerometers were used to assess PA metrics (moderate-to-vigorous PA, mean raw acceleration and lowest acceleration over the most active hour and half hour) over whole and segmented weeks at baseline, immediately post-intervention and 6 months follow-up. Intention to treat analysis employing multilevel modelling was used to assess intervention effects. Results: LP and NP interventions did not significantly affect children’s PA levels compared to the control group. Conclusion: PE interventions based on LP and NP alone might not be effective in improving habitual PA in children.

Children's outdoor active mobility behaviour and neighbourhood safety: a systematic review in measurement methods and future research directions

BACKGROUND

Numerous studies have examined the association between safety and primary school-aged children's forms of active mobility. However, variations in studies' measurement methods and the elements addressed have contributed to inconsistencies in research outcomes, which may be forming a barrier to advancing researchers' knowledge about this field. To assess where current research stands, we have synthesised the methodological measures in studies that examined the effects of neighbourhood safety exposure (perceived and measured) on children's outdoor active mobility behaviour and used this analysis to propose future research directions.

METHOD

A systematic search of the literature in six electronic databases was conducted using pre-defined eligibility criteria and was concluded in July 2020. Two reviewers screened the literature abstracts to determine the studies' inclusion, and two reviewers independently conducted a methodological quality assessment to rate the included studies.

RESULTS

Twenty-five peer-reviewed studies met the inclusion criteria. Active mobility behaviour and health characteristics were measured objectively in 12 out of the 25 studies and were reported in another 13 studies. Twenty-one studies overlooked spatiotemporal dimensions in their analyses and outputs. Delineations of children's neighbourhoods varied within 10 studies' objective measures, and the 15 studies that opted for subjective measures. Safety perceptions obtained in 22 studies were mostly static and primarily collected via parents, and dissimilarities in actual safety measurement methods were present in 6 studies. The identified schematic constraints in studies' measurement methods assisted in outlining a three-dimensional relationship between 'what' (determinants), 'where' (spatial) and 'when' (time) within a methodological conceptual framework.

CONCLUSIONS

The absence of standardised measurement methods among relevant studies may have led to the current diversity in findings regarding active mobility, spatial (locality) and temporal (time) characteristics, the neighbourhood, and the representation of safety. Ignorance of the existing gaps and heterogeneity in measures may impact the reliability of evidence and poses a limitation when synthesising findings, which could result in serious biases for policymakers. Given the increasing interest in children's health studies, we suggested alternatives in the design and method of measures that may guide future evidence-based research for policymakers who aim to improve children's active mobility and safety.

Accelerometer-Measured Physical Activity and Sedentary Behavior Levels and Patterns in Female Sixth Graders: The CReActivity Project

Regular physical activity (PA) and low levels of sedentary behavior (SB) have positive health effects on young people. Adolescent girls of low socioeconomic background represent a high-risk group with regard to physical inactivity and SB. In this study, accelerometer-measured levels of PA and SB of female sixth graders attending lower secondary schools in Germany are presented, patterns of PA and SB throughout the day are described and differences between weekdays and weekend days are analyzed. Data of 425 students of the CReActivity project were analyzed. Sampling and processing of accelerometer data followed recent recommendations, which had not been applied to data of a German-speaking sample before. The WHO recommendation of daily 60 min moderate-to-vigorous PA was fulfilled by 90.4% of the girls on weekdays and by 57.4% on weekend days. The significant weekday-weekend differences were mainly associated with active commuting to and from school. Students engaged in SB for more than 8 h on weekdays and for over 7 h on weekend days. The results suggest a strong need for interventions increasing PA and reducing SB, especially during school hours and on weekends. Furthermore, a comparison with methods and results of previous studies highlights the need to follow recent criteria in accelerometer data sampling and processing to ensure an accurate and valid differentiation between PA-related risk groups and non-risk groups.

Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis

BACKGROUND

Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804).

METHODS

Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex.

RESULTS

A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school.

CONCLUSION

Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.

Formative Evaluation of Open Goals: A UK Community-Based Multi-Sport Family Programme

Community parks provide opportunities for physical activity (PA) and facilitate social interactions. This formative evaluation assesses the implementation of ‘Open Goals’ (OG), a novel multi-sport programme aiming to increase family PA and community cohesion, delivered weekly by Liverpool Football Club’s charitable foundation to local parks in Liverpool, North West England. Three Open Goals parks were chosen for the evaluation settings. Formative evaluation measures included: System for Observing Play and Recreation in Communities (SOPARC) observations (n = 10), direct session observations (n = 8), semi-structured interviews with Open Goals coaching staff (n = 3), and informal feedback from families (n = 5) about their experiences of Open Goals. Descriptive statistics and thematic analysis were applied to quantitative and qualitative data, respectively. Within the three evaluation parks, Open Goals reached 107 participants from May–July 2019, through 423 session attendances. Fidelity of the programme was high (M = 69% of session content delivered as intended). Overall park use when OG was offered compared to when it was not offered was not statistically significant (p = 0.051), however, target area use was significantly increased (p = 0.001). Overall physical activity levels in parks were significantly (p = 0.002) higher when Open Goals was being offered, compared to when it was not. Coaches reported that engagement in OG positively affected family co-participation and children’s behavioural development. Contextual issues included environmental and social barriers to programme engagement, including the co-participation element of the programme and criticism of the marketing of OG. It is evident that community-based multi-sport PA programmes endorsed by professional football clubs are well positioned to connect with local communities in deprived areas and to encourage PA and community engagement. This study suggests that such programmes may have the ability to improve park usage in specific areas, along with improving physical activity levels among families, although further research is required. Effective marketing strategies are needed for promotional purposes. Upskilling of coaches in the encouragement of family co-participation may support regular family engagement in PA in local parks.

Autonomic Profile, Physical Activity, Body Mass Index and Academic Performance of School Students

The aim of this study was to analyze the autonomic modulation, physical activity, body mass index, and academic performance of preschool and school students by grade. Extracurricular physical activity, heart rate variability, body mass index, and objective and subjective academic performance were analyzed in 180 preschool and primary school students (7.91 ± 2.29 years). Significant lower heart rate and higher parasympathetic modulation were found in 10–12-year-old primary education students. The 8–9-year-old students obtained the worst results in English and in five of the subjective academic performance items. Students aged 10–12 years old presented the highest body composition values. No significant differences were found on the extracurricular physical activity by age. No correlation between autonomic profile, physical activity, and body composition with objective academic performance was found. Nerveless subjective academic performance perception of teachers presented a negative correlation with body composition and the parasympathetic modulation. School students presented an increased body mass index and parasympathetic modulation by age. Physical activity of all students, independently of the age, were lower than the official recommendations.

Changes in physical activity and sedentary time during adolescence: Gender differences during weekdays and weekend days

OBJECTIVES

The objective of this study was to determine the gender-specific and time-segmented changes in accelerometer measured physical activity (PA) and sedentary time (ST) during adolescence.

METHODS

The study population (N = 970) consisted of children from nine schools throughout Finland. At the baseline, the children were in grades 4-7 (ages 10-13). Five times during the two-year follow-up period, hip-worn accelerometers (ActiGraph GT3X+) were deployed for seven consecutive days in order to monitor the pupils' PA. The daily time spent in vigorous (VPA), moderate to vigorous (MVPA), and light physical activity(LPA), as well as sedentary time(ST), were assessed.

RESULTS

Significant gender differences were observed in terms of the changes in MVPA and ST during the follow-up period. The total MVPA declined significantly in boys (by 2.2min/day/year from 60 min/d at baseline) but not in girls (49 min/d at baseline). The total ST increased both in boys (by 20.7%-points/y) and in girls (by 16.1%-points/y, P < .001). However, when we compared the results during the weekdays and weekend days separately, we observed that the declines in MVPA and increases in ST were greater in boys than in girls during the weekend days.

CONCLUSION

A greater decrease in PA and a greater increase in ST during adolescence were observed among boys than among girls, especially during weekend days. In order to diminish these unfavorable behavioral changes during adolescence, we encourage the separate tailoring of interventions for boys and girls and for weekdays and weekends.

Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial

BACKGROUND

Less than 20% of adolescents globally meet recommended levels of physical activity, and not meeting these recommended levels is associated with social disadvantage and rising disease risk. The determinants of physical activity in adolescents are multilevel and poorly understood, but the school's social environment likely plays an important role. We conducted a cluster randomised controlled trial to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) among adolescents.

METHODS AND FINDINGS

Non-fee-paying, co-educational schools including Year 9 students in the UK counties of Cambridgeshire and Essex were eligible for inclusion. Within participating schools (n = 16), all Year 9 students were eligible and invited to participate. Participants were 2,862 13- to 14-year-olds (84% of eligible students). After baseline assessment, schools were computer-randomised, stratified by school-level pupil premium funding (below/above county-specific median) and county (control: 8 schools, 1,319 participants, mean [SD] participants per school n = 165 [62]; intervention: 8 schools, 1,543 participants, n = 193 [43]). Measurement staff were blinded to allocation. The iteratively developed, feasibility-tested 12-week intervention, aligned with self-determination theory, trained older adolescent mentors and in-class peer-leaders to encourage classes to conduct 2 new weekly activities. Students and classes gained points and rewards for engaging in any activity in or out of school. The primary outcome was average daily minutes of accelerometer-assessed MVPA at 10-month follow-up; a mixed-methods process evaluation evaluated implementation. Of 2,862 recruited participants (52.1% male), 2,167 (76%) attended 10-month follow-up measurements; we analysed the primary outcome for 1,874 participants (65.5%). At 10 months, there was a mean (SD) decrease in MVPA of 8.3 (19.3) minutes in the control group and 10.4 (22.7) minutes in the intervention group (baseline-adjusted difference [95% confidence interval] -1.91 minutes [-5.53 to 1.70], p = 0.316). The programme cost £13 per student compared with control; it was not cost-effective. Overall, 62.9% of students and 87.3% of mentors reported that GoActive was fun. Teachers and mentors commented that their roles in programme delivery were unclear. Implementation fidelity was low. The main methodological limitation of this study was the relatively affluent and ethnically homogeneous sample.

CONCLUSIONS

In this study, we observed that a rigorously developed school-based intervention was no more effective than standard school practice at preventing declines in adolescent physical activity. Interdisciplinary research is required to understand educational-setting-specific implementation challenges. School leaders and authorities should be realistic about expectations of the effect of school-based physical activity promotion strategies implemented at scale.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN31583496.

Multi-level validation of the German physical activity self-efficacy scale in a sample of female sixth-graders

BACKGROUND

The majority of children and adolescents are insufficiently physically active. Self-efficacy is considered one of the most important determinants of physical activity (PA). The purpose of this study was to validate the German version of the physical activity self-efficacy scale by means of a multi-level approach. Factorial validity, internal consistency and criterion validity were examined for the individual and the class level.

METHODS

The final sample comprised 454 female sixth-graders of 33 classes. To examine the factorial validity of the translated 8-item scale, a multi-level confirmatory factor analysis was conducted with the lavaan package in R. Internal consistency was estimated with the alpha function of the psych package. Criterion validity was examined by correlating self-efficacy with moderate-to-vigorous physical activity (MVPA) assessed with accelerometers.

RESULTS

In contrast to previous validation studies, a unidimensional structure of the scale was not supported. Instead, two highly correlated (r_individual = .87; r_class = .69) but distinct latent factors, representing PA self-efficacy and social support from family and friends, were differentiated on both the individual and class level. The best overall fit exhibited a multi-level 1 × 1-model, including only the six items measuring PA self-efficacy (χ2 = 32.10, CFI = .986, TLI = .976, RMSEA = .059, SRMR = .035). Internal consistencies for the complete 8-item scale and the 6-item scale were good on the individual level and excellent on the class level. For the two items measuring social support, Cronbach's alpha was low on the individual and excellent on the class level. Weak relations between self-efficacy and MVPA were found for the individual level, strong associations were found for the class level.

CONCLUSIONS

The validation speaks for the use of the abridged 6-item scale, which allows for a unidimensional assessment of PA self-efficacy. Generally, the results support the relevance of a multi-level approach, which not only differentiates between self-efficacy on the individual level and on the class level but also between the respective implications regarding reliability and criterion validity on both levels. Thereby, this study offers a rigorously validated scale and further illustrates possible consequences of the usual neglect of group-level variance in scale validation.

Effectiveness of a Family Intervention to Increase Physical Activity in Disadvantaged Areas-A Healthy Generation, a Controlled Pilot Study

There are large social inequalities in health. The purpose of this study was to evaluate the effects of a family intervention on physical activity (PA) and sedentary time (ST) in children and their parents. In this controlled pilot study, all 8–9-year-old children from four schools from a socioeconomically disadvantaged area in Sweden were invited and 67 children and 94 parents were included. The intervention was run by a foundation in co-operation with the municipality. The 9-month program included: (1) activity sessions, (2) healthy meals, (3) health information and (4) parental support groups. PA was primary outcome and ST was secondary outcome, measured by accelerometry. In total, 40 of the children (60%) and 45 of the adults (50%) had at least one day of valid accelerometer data at both baseline and follow-up. Significant intervention effects for the whole group were found in total PA (p = 0.048, mean difference (MD) intervention/control 150 counts per minute) and in vigorous PA (p = 0.02, MD 8 min/day) during the weekends. There were no differences between groups in the other PA variables or ST. This pilot study shows that it is possible to influence PA in families from a disadvantaged area through a family program.

Becoming a parent: A systematic review and meta-analysis of changes in BMI, diet, and physical activity

Obesity prevalence rises fastest during young adulthood when weight, diet, and physical activity may be influenced by life events, including becoming a parent, but the impact is uncertain. We searched six electronic databases to July 2019 for longitudinal studies (both sexes) aged 15 to 35 years with a prospective pre-pregnancy/parenthood and post-delivery outcome. Of 11 studies (across 15 papers), six studies (women only) were eligible for meta-analysis of the difference in change in body mass index (BMI; kg/m2 ) between remaining without children and becoming a parent. Mean (±SD) BMI gain for non-mothers was 2.8 ± 1.3 kg/m2 (~7.5 kg for 164-cm woman) over 5.6 ± 3.1 years; 12.3% of baseline BMI (22.8 ± 2.5 kg/m2 ). Becoming a mother was associated with an additional BMI increase of 0.47 ± 0.26 kg/m2 (~1.3 kg), 4.3% of baseline BMI (22.8 ± 5.6 kg/m2 ); the one study including men reported no difference in change. Physical activity results were equivocal; 2/4 studies (women) and 2/2 (men) showed a greater decline in parents versus non-parents; diet (three studies) varied by dietary measure, mostly indicating no difference. Becoming a mother is associated with 17% greater absolute BMI gain than remaining childless. Motherhood BMI gain is additional to an alarming BMI increase among young women, highlighting the need for obesity prevention among all young women, including mothers.

Effects of a Need-Supportive Motor Skill Intervention on Children's Motor Skill Competence and Physical Activity

A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this study aimed to (a) investigate the effect of a need-supportive fundamental movement skill (FMS) program on children’s FMS competence and moderate-to-vigorous physical activity (MVPA), and (b) explore potential gender differences in these effects. Thirty-six children (63.8% girls; M_age = 6.52 ± 0.97) participated and were divided into two groups: an intervention group (24 need-supportive FMS sessions over eight weeks) and a control group. A repeated-measures multivariate analysis of variance (MANOVA) was used to examine the influence of the motor skill intervention on FMS competence and MVPA over time by group (intervention, control) and gender (boys, girls). The results showed (a) significant group differences between the intervention and control group in FMS competence and MVPA (p < 0.001), (b) non-significant gender differences between boys and girls in FMS competence and MVPA (p = 0.85), and (c) non-significant interaction effects over time (p = 0.52). The findings highlight that a need-supportive FMS program may enhance FMS development and daily physical activity for both genders during the early school years.

Association of physical activity and sedentary behavior at school with cardiovascular risk factors in adolescents

Abstract The association of moderate to vigorous physical activity and sedentary behavior performed in the school context with cardiovascular risk factors is unclear. Thus, the purpose of this study was to evaluate whether MVPA and SB during school time are associated with single and clustered cardiovascular risk factors in 10- to 16-year-old school students. This study used the baseline data from a non-randomized controlled clinical trial (“MEXA-SE”) conducted on 6th to 9th-grade students from schools in Florianopolis, Brazil. Skinfolds, resting blood pressure, 20-m shuttle-run test, fasting glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and white blood cell counts were obtained. MVPA and SB were objectively measured with accelerometers. A minimum of 180 minutes was considered valid school-time for analysis. Multiple linear regression adjusted for age, sex and habitual physical activity was used. School-time MVPA was positively associated with the peak VO2 (β = 0.17 ml.kg.min-1), and inversely associated with sum of four skinfolds (β = -0.96 mm), diastolic blood pressure (β = -0.36 mmHg), systolic blood pressure (β = -0.301 mmHg); triglycerides (β = -1.49 mg.dL-1), and clustered cardiovascular risk factors (β = -0.123). School-time SB was positively associated with clustered cardiovascular risk factors (β = 0.033). In conclusion, independently of habitual physical activity level, school-time MVPA and a lower time in SB were associated to single and clustered cardiovascular risk factors. Thus, the promotion of strategies aimed increase MVPA and reduce SB at school may prevent the onset and early accumulation of cardiovascular risk factors in adolescence.