Pedometer-measured physical activity patterns of youth: a 13-country review

Global Accelerometer-derived Physical Activity Levels from Preschoolers to Adolescents: A Multilevel Meta-analysis and Meta-regression

BACKGROUND

Global level physical activity surveillance studies were primarily based on self-report data that could generate inaccurate results.

PURPOSE

To investigate global accelerometer-measured daily moderate to vigorous physical activity (MVPA) changes from preschool age to adolescence as well as gender differences in MVPA while adjusting for the geographic regions and major MVPA cut points.

METHODS

A comprehensive search was conducted through August 2020 that includes 30 databases such as Academic Search Ultimate, Child Development & Adolescent Studies, Education Full Text, ERIC, General Science, PsycINFO, ScienceDirect, and SPORTDiscuss. We included both cross-sectional and longitudinal MVPA tracking studies with daily MVPA being measured by waist-worn accelerometers and determined by either Freedson 3 METs, 4 METs, or Evenson cut points for preschoolers, children, and adolescents.

RESULTS

Researchers analyzed 84 studies reporting on 124 effect sizes with a total of 57,587 participants. The combined data showed significant MVPA differences among various continents of participants (p < .001) or cut points (p < .05-.001) for both preschoolers, children, and adolescents. Globally, when continents and cut points were controlled, individuals' daily MVPA time decreased every year by an average of 7.88, 10.37, and 6.68 min from preschool age to adolescence, preschool age to children, and children to adolescence, respectively. When cut points and continents were controlled, boys had significantly higher daily MVPA than girls for all three age groups (p < .001).

CONCLUSIONS

Globally, individuals' daily MVPA starts to decline dramatically as early as the beginning of preschool age. Early intervention is needed to counteract the high decline rate in MVPA.

Sibling Resemblance in Physical Activity Levels: The Peruvian Sibling Study on Growth and Health

Physical activity is associated with a host of positive health outcomes and is shaped by both genetic and environmental factors. We aim to: (1) estimate sibling resemblance in two physical activity phenotypes [total number of steps∙day^-1 and minutes for moderate steps per day (min∙day^-1)]; and (2) investigate the joint associations of individual characteristics and shared natural environment with intra-pair sibling similarities in each phenotype. We sampled 247 biological siblings from 110 nuclear families, aged 6-17 years, from three Peruvian regions. Physical activity was measured using pedometers and body mass index was calculated. In general, non-significant variations in the intraclass correlation coefficients were found after adjustment for individual characteristics and geographical area for both phenotypes. Further, no significant differences were found between the three sib-ship types. Sister-sister pairs tended to take fewer steps than brother-brother (β = -2908.75 ± 954.31). Older siblings tended to walk fewer steps (β = -81.26 ± 19.83), whereas body mass index was not associated with physical activity. Siblings living at high-altitude and in the Amazon region had higher steps/day (β = 2508.92 ± 737.94; β = 2213.11 ± 776.63, respectively) compared with their peers living at sea-level. In general, we found no influence of sib-types, body mass index, and/or environment on the two physical activity phenotypes.

The Impact of Different Pedagogical Models on Moderate-to-Vigorous Physical Activity in Physical Education Classes

The aims of this study were twofold: (i) to examine differences in physical activity (PA) variables regarding the length of Physical Education (PE) lessons (45 vs. 90 min) and teaching methodology (Teaching Games for Understanding (TGfU) or hybrid TGfU-sports education (SE)); and (ii) to estimate the percentage of time spent in moderate-to-vigorous (MV) PA assessed via an accelerometer based on total step count, BMI, age, and sex, considering the pedagogical models and the class length. This study was carried out in three classes of invasion games in PE. Two classes were taught based on TGfU (44 students, 18 males, 12.6 ± 0.55), and one was taught based on a hybrid TGfU-SE (17 students, 9 males, 13.7 ± 0.90). The same students were assessed twice, first in a 45 min class and then in a 90 min class. The students' MVPA was assessed using the Actigraph GT3X Activity Monitor. The results revealed significant differences in PA intensity regarding the length of the PE lesson (45 vs. 90 min) and the teaching methodology. The 45 min classes using TGfU were more intense and had less sedentary time than the 90 min classes. When using a hybrid TGfU-SE, the 90 min classes had higher intensities than the 45 min classes. Generally, when comparing the two types of pedagogical intervention, the TGfU model provided more active lessons and less sedentary time in class than a hybrid TGfU-SE. The TGfU model is more profitable for increasing MVPA in class. Due to the issues related to the organization and management of sports practice in class, several recommendations for maximizing MVPA in a hybrid TGfU-SE class must be considered.

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.

Parent Perceptions of Changes in Child Physical Activity During COVID-19 Stay-At-Home Orders

Purpose: The purpose of this study was to explore parent perceptions of changes in child physical activity during COVID-19 stay-at-home orders. Design: A cross-sectional study. Setting: The research team used social media, relevant organizations, and neighborhood groups to distribute the survey link in May and June of 2020. Subjects: A convenience sample of parents of children aged 5-12. Measures: Survey to assess parental perceptions of changes in children's physical activity before and during stay-at-home orders, and environmental and social barriers to physical activity. Analysis: Results were analyzed using descriptive statistics, bivariate comparisons, and multinomial-logistic regression models with covariates of environmental factors, social factors, and frequency of factors as barriers on association with perceived physical activity change. Results: Data from 245 parents were analyzed. A majority (63.7%) of parents reported a decrease in children's physical activity during stay-at-home orders. More parents indicated social barriers (e.g., lack of access to playmates) than environmental barriers (e.g., lack of access to neighborhood play spaces) to children's physical activity. In multivariate analyses, the odds of parents reporting decreased physical activity was greater for those reporting lack of playmates (OR = 4.72; 95% CI: 1.99-11.17) and lack of adult supervision (OR = 11.82; 95% CI: 2.48-56.28) as barriers. No environmental barriers were significantly associated with decreased children's physical activity. Conclusion: The unique aspects of the COVID-19 pandemic provide a natural experiment for developing social and environmental strategies to improve children's overall physical activity. Assessing parental perceptions is a way to inform these future efforts.

A 20-Year Follow-Up Study of Objectively Measured Physical Activity

BACKGROUND

The objectives of this study were to explore the effect of time, long-term tracking, and the proportion of objectively measured physical activity (PA) from early adolescence to the mid-thirties.

METHODS

PA was measured as mean steps per day (SPD) with pedometers during 2000 (T1), 2003 (T2), 2005 (T3), 2010 (T4), 2016 (T5) and 2020 (T6). Data from 64 participants (n = 32 males) were analysed from their early adolescence (T1) to their mid-thirties (T6).

RESULTS

SPD decreased in the total sample and among males and females (all, p < 0.001). Males took more mean SPD than females during T1 (p = 0.002), whereas females took more mean SPD during T2 (p = 0.009) and T6 (p = 0.008). Males' mean SPD tracked between T1 and T2 (p = 0.021), T2 and T3 (p = 0.030), T3 and T4 (p = 0.015) and T4 and T5 (p = 0.003). Females' mean SPD tracked between T3 and T4 (p = 0.024) and T5 and T6 (p < 0.001). In the total sample, more mean SPD were found on weekdays compared to weekend days at T3 (p = 0.017) and T5 (p < 0.001).

CONCLUSIONS

SPD decreased between T1 and T6. Mean SPD tracked low-to-moderate in the short time span. From late adolescence to the mid-thirties, more mean SPD was observed during weekdays compared to weekend days.

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.

Secular Trends in the Achievement of Physical Activity Guidelines: Indicator of Sustainability of Healthy Lifestyle in Czech Adolescents

(1) Background: The increasing socio-economic and educational demands on adolescents should be reflected in their lifestyles accordingly. The aim of the study was therefore to identify the trends in the achievement of physical activity (PA) guidelines by Czech adolescents through objective and subjective PA monitoring. (2) Methods: The research was carried out between 2010 and 2017 and involved 49 secondary schools, 2 higher vocational schools, and 8 universities in the Czech Republic. In total, the projects involved 1129 girls and 779 boys. PA monitoring was performed by Yamax SW-700 pedometers and IPAQ-long questionnaires. (3) Results: The results according to the average number of steps/day confirm a decrease in the amount of PA in boys and girls and in the achievement of the recommended 11,000 steps/day. However, the estimates of meeting the recommended weekly PA expressed as MET-min/week based on the IPAQ-long questionnaire are not so convincing about the decrease. (4) Conclusions: The combination of objective monitoring of weekly PA using wearables and subjective estimates of weekly PA using a questionnaire regarding the ease of application, appears to be a sufficient indicator of the status of and trend in PA and thus the sustainability of a healthy lifestyle in youths.

Comparisons of pedometer-determined weekday physical activity among Swedish school children and adolescents in 2000 and 2017 showed the highest reductions in adolescents

AIM

This study compared differences in weekday physical activity among school children and adolescents in middle-class communities in south-eastern Sweden in 2000 and 2017.

METHODS

Data were drawn from two independent cross-sectional cohorts of children and adolescents aged 8, 11 and 14. The same six schools, protocols, procedures and instruments were used in both years, with 332 subjects in 2000 and 562 in 2017. Mean steps per day (SPD) were measured with a Yamax SW-200 pedometer.

RESULTS

The mean weekday SPD was similar among eight-year-old girls in both years, but 8% (p = 0.040) higher among eight-year-old boys in 2017. However, among 11-year-old children, the mean SPD were 12% lower among both girls (p = 0.033) and boys (p = 0.001). The SPD among 14-year-old adolescents were 24% (p = 0.012) and 30% (p < 0.001) lower among girls and boys, respectively.

CONCLUSION

This school-based study from south-eastern Sweden showed that weekday physical activity differed between age groups in 2000 and 2017. The highest reductions were seen among older children and adolescents, particularly 14-year-old girls and boys. The only group that increased was eight-year-old boys, with no significant change in eight-year-old girls. A possible explanation might be the dramatically increased use of the Internet on phones and tablets.

Objectively Measured Physical Activity and Sedentary Time among Children and Adolescents in Morocco: A Cross-Sectional Study

Background

Regular physical activity in childhood and adolescent plays an important role in reducing the risk of cardiovascular health diseases, diabetes, and obesity in adulthood. However, little is known about physical activity levels (PA) and sedentary time among children and adolescents in Morocco.

Objective

To examine gender, type of day, and age grade differences in objectively measured sedentary time, physical activity levels, and physical activity guideline attainment among children and adolescents in Morocco.

Method

172 children/adolescents (mean age = 10.92 ± 1.55 years, 49.4% are boys) were recruited for this study and wore a tri-axial accelerometer (GT3X+) for 7 consecutive days. Time spent in sedentary, PA levels, and daily steps were measured and compared according to gender, age grade, and the type of day (weekdays/weekends).

Results

In weekdays children/adolescents spent more time in sedentary than weekends (p < 0.001). Boys were eight times more likely to meet the recommendation for at least 60 min of moderate to vigorous physical activity per day than girls (OR: 8.569; 95% [CI]: 4.23–17.32), p < 0.001.

Conclusion

These findings highlight the need for effective and sustainable strategies and programs aiming to promote physical activity and to reduce sedentary behavior among children and adolescents in Morocco.

Step Counting: A Review of Measurement Considerations and Health-Related Applications

Step counting has long been used as a method of measuring distance. Starting in the mid-1900s, researchers became interested in using steps per day to quantify ambulatory physical activity. This line of research gained momentum after 1995, with the introduction of reasonably accurate spring-levered pedometers with digital displays. Since 2010, the use of accelerometer-based “activity trackers” by private citizens has skyrocketed. Steps have several advantages as a metric for assessing physical activity: they are intuitive, easy to measure, objective, and they represent a fundamental unit of human ambulatory activity. However, since they measure a human behavior, they have inherent biological variability; this means that measurements must be made over 3–7 days to attain valid and reliable estimates. There are many different kinds of step counters, designed to be worn on various sites on the body; all of these devices have strengths and limitations. In cross-sectional studies, strong associations between steps per day and health variables have been documented. Currently, at least eight prospective, longitudinal studies using accelerometers are being conducted that may help to establish dose–response relationships between steps/day and health outcomes. Longitudinal interventions using step counters have shown that they can help inactive individuals to increase by 2500 steps per day. Step counting is useful for surveillance, and studies have been conducted in a number of countries around the world. Future challenges include the need to establish testing protocols and accuracy standards, and to decide upon the best placement sites. These challenges should be addressed in order to achieve harmonization between studies, and to accurately quantify dose–response relationships.

Combining Activity Trackers With Motivational Interviewing and Mutual Support to Increase Physical Activity in Parent-Adolescent Dyads: Longitudinal Observational Feasibility Study

BACKGROUND

An essential component of any effective adolescent weight management program is physical activity (PA). PA levels drop dramatically in adolescence, contributing to the rising prevalence of adolescent obesity. Therefore, finding innovative interventions to address this decline in PA may help adolescents struggling with weight issues. The growing field of health technology provides potential solutions for addressing chronic health issues and lifestyle change, such as adolescent obesity. Activity trackers, used in conjunction with smartphone apps, can engage, motivate, and foster support among users while simultaneously providing feedback on their PA progress.

OBJECTIVE

The objective of our study was to evaluate the effect of a 10-week pilot study using smartphone-enabled activity tracker data to tailor motivation and goal setting on PA for overweight and obese adolescents and their parents.

METHODS

We queried enrolled adolescents, aged 14 to 16 years, with a body mass index at or above the 85th percentile, and 1 of their parents as to behaviors, barriers to change, and perceptions about exercise and health before and after the intervention. We captured daily step count and active minutes via activity trackers. Staff made phone calls to dyads at weeks 1, 2, 4, and 8 after enrollment to set daily personalized step-count and minutes goals based on their prior data and age-specific US national guidelines. We evaluated dyad correlations using nonparametric Spearman rank order correlations.

RESULTS

We enrolled 9 parent-adolescent dyads. Mean adolescent age was 15 (SD 0.9) years (range 14-16 years; 4 female and 5 male participants); mean parent age was 47 (SD 8.0) years (range 36-66 years). On average, adolescents met their personalized daily step-count goals on 35% (range 11%-62%) of the days they wore their trackers; parents did so on 39% (range 3%-68%) of the days they wore their trackers. Adolescents met their active-minutes goals on 55% (range 27%-85%) of the days they wore their trackers; parents did so on 83% (range 52%-97%) of the days. Parent and adolescent success was strongly correlated (step count: r=.36, P=.001; active minutes: r=.30, P=.007). Parental age was inversely correlated with step-count success (r=-.78, P=.01).

CONCLUSIONS

Our findings illustrate that parent-adolescent dyads have highly correlated PA success rates. This supports further investigation of family-centered weight management interventions for adolescents, particularly those that involve the parent and the adolescent working together.

The GReat-Child™ Trial: A Quasi-Experimental Intervention on Whole Grains with Healthy Balanced Diet to Manage Childhood Obesity in Kuala Lumpur, Malaysia

Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: -0.12; 95% CI: -0.21, -0.03; p = 0.009), body fat percentage (weighted difference: -2.6%; 95% CI: -3.7, -1.5; p < 0.001) and waist circumference (weighted difference: -2.4 cm; 95% CI: -3.8, -1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: -3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: -2.1 cm; 95% CI: -3.7, -0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.

Tracking of Pedometer-Determined Physical Activity: A 16-Year Follow-Up Study

Background: The aims of this study were to explore the effect of time and long-termed tracking on pedometer-determined physical activity (PA) from early adolescent to the 30s. Methods: PA was measured with pedometers [Yamax™ (SW-200)] during 2000 (time 1), 2003 (time 2), 2005 (time 3), 2010 (time 4), and 2016 (time 5). Anthropometric data were collected during time 1. Data from 59 participants (n = 32 males) were analyzed from early adolescent (time 1) to the 30s (time 5). Results: There was an effect of time for males (P = .005, η2 = .76) and females (P = .002, η2 = .50) where steps per day decreased. Males steps per day tracked between time 1 and time 2 (r = .41, P = .021), time 1 and time 3 (r = .38, P = .03), time 3 and time 4 (r = .42, P = .015), and time 4 and time 5 (r = .50, P = .003). Females steps per day tracked between time 4 and time 5 (r = .39, P = .04). Males took more steps per day than females during time 1 (P = .018), whereas females took more steps per day during time 2 (P = .043) and time 3 (P = .03). Conclusion: There was a significant effect of time, where steps per day decreased between the 5 times of measurement. Steps per day tracked low to moderate in the short time span, yet tracked nonsignificantly from early adolescent to the 30s.

Age-Related Changes in Locomotor Performance Reveal a Similar Pattern for Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens

Locomotion is one of the major physiological functions for most animals. Previous studies have described aging mechanisms linked to locomotor performance among different species. However, the precise dynamics of these age-related changes, and their interactions with development and senescence, are largely unknown. Here, we use the same conceptual framework to describe locomotor performances in Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens. We show that locomotion is a consistent biomarker of age-related changes, with an asymmetrical pattern throughout life, regardless of the type of effort or its duration. However, there is variation (i) among species for the same mode of locomotion, (ii) within species for different modes of locomotion, and (iii) among individuals of the same species for the same mode of locomotion. Age-related patterns are modulated by genetic (such as selective breeding) as well as environmental conditions (such as temperature). However, in all cases, the intersection of the rising developmental phase and the declining senescent phase reveals neither a sharp transition nor a plateau, but a smooth transition, emphasizing a crucial moment: the age at peak performance. This transition may define a specific target for future investigations on the dynamics of such biological interactions.

Pedometer-determined physical activity among youth in the Tokyo Metropolitan area: a cross-sectional study

Background

Providing large-scale descriptive data of objectively measured physical activity in youth is informative for practitioners, epidemiologists, and researchers. The purpose of this study was to present the pedometer-determined physical activity among Japanese youth using the Tokyo Metropolitan Survey of Physical Fitness, Physical Activity and Lifestyle 2011.

Methods

This study used a school-based survey. The Tokyo Metropolitan Board of Education originally collected pedometer-determined steps per day in the fall of 2011. Data were collected from 15,471 youth aged 6 to 18 years living in Tokyo. Participants were asked to wear pedometers for 14 consecutive days, and daily steps logged in the final 7 days were selected for this analysis.

Results

At the primary and junior high school levels, boys (12,483 and 9476, respectively) had a significantly higher mean number of steps per day than did girls (10,053 and 8408, respectively). There was no significant difference in the mean number of steps per day between the sexes at the high school level. Mean steps per day decreased consistently with age and grade level; the lowest overall steps per day was observed in the last year of junior high school, although there was a slight increase in the subsequent year, the first year of high school.

Conclusions

This study demonstrates a trend toward reduced physical activity with age in Japanese youth and a substantial difference in the number of steps per day between boys and girls in Tokyo. The age-related reduction in steps per day was greater in boys because they attained a higher peak value prior to this reduction, and sex-related differences in the step count disappeared in high school students.

Step Counts on Weekdays, Weekends, and During Physical Education of Navajo High School Students

BACKGROUND

Understanding the physical activity patterns of youth is important for the implementation and evaluation of programming and interventions designed to change behavior. To date, little is known about the objectively measured physical activity patterns of Native American youth. Therefore, the purpose of the study was to examine the step counts of Navajo youth during weekdays, weekend days, and physical education classes.

METHODS

Participants included 63 high school students (mean age = 15.14 ± 1.37 years). Youth wore a pedometer (Walk-4-Life 2505) for seven consecutive days. Means and standard deviations were calculated for weekdays, weekend days, and physical education.

RESULTS

Boys averaged 11,078 ± 4400 steps/weekday compared to 6493 ± 5651 on weekend days. Girls averaged 7567 ± 5614 on weekdays compared to 7589 ± 7712 on weekend days. Both boys (20 %) and girls (26 %) accumulated a large percentage of their weekday step counts from physical education classes.

CONCLUSIONS

Findings highlight the importance of additional physical activity opportunities in the community. Youth are falling well short of recommended levels of physical activity with physical education being an important source of physical activity.

[Analysis of the reliability and validity of three self-report questionnaires to assess physical activity among Spanish adolescents]

OBJECTIVE

To analyse the reliability and validity of the Weekly Activity Checklist (WAC), the One Week Recall (OWR), and the Godin-Shephard Leisure Time Exercise Questionnaire (GLTEQ) in Spanish adolescents.

METHODS

A total of 78 adolescents wore a pedometer for one week, filled out the questionnaires at the end of this period and underwent a test to estimate their maximal oxygen consumption (VO2max). The reliability of the questionnaires was determined by means of a factor analysis. Convergent validity was obtained by comparing the questionnaires' scores against the amount of physical activity quantified by the pedometer and the VO2max reported.

RESULTS

The questionnaires showed a weak internal consistency (WAC: α=0.59-0.78; OWR: α=0.53-0.73; GLTEQ: α=0.60). Moderate statistically significant correlations were found between the pedometer and the WAC (r=0.69; p <0.01) and the OWR (r=0.42; p <0.01), while a low statistically significant correlation was found for the GLTEQ (r=0.36; p=0.01). The estimated VO2max showed a low level of association with the WAC results (r=0.30; p <0.05), and the OWR results (r=0.29; p <0.05). When classifying the participants as active or inactive, the level of agreement with the pedometer was moderate for the WAC (k=0.46) and the OWR (r=0.44), and slight for the GLTEQ (r=0.20).

CONCLUSION

Of the three questionnaires analysed, the WAC showed the best psychometric performance as it was the only one with respectable convergent validity, while sharing low reliability with the OWR and the GLTEQ.

Physical Activity, Blood Glucose and C-Peptide in Healthy School-Children, a Longitudinal Study

Aim

To further elucidate the relationship between physical activity and several risk factors for development of diabetes (glucose, C-peptide and obesity) over time.

Methods

A prospective longitudinal study where physical activity was measured on 199 children from Kalmar and Linköping at age 8, and the same 107 children from Linköping again at age 12. Anthropometric data was collected and blood was analyzed for C-peptide and f-glucose. The children in the study were representative for the general Swedish child population, and on an average lean.

Results

High physical activity was related to lower C-peptide at age 8 and 12. This correlation was especially pronounced in boys, who also were more physically active than girls at both time points. The association seen at 8 years of age was similar at age 12 in most children. Children with higher BMI Z-Score had a higher fasting C-peptide (age 12) but linear regression showed that children with more steps per day were less likely to have a higher fasting C-peptide irrespective of BMI. Longitudinal follow-up showed that a decrease in physical activity increased insulin resistance and β-cell load.

Conclusions

Already in young children, physical activity improves insulin sensitivity and decreases the need of C-peptide over time. This seems to become even more pronounced with increasing age when children are followed longitudinally. Low physical activity increases the load on insulin producing β-cells, might increase the risk for both type 1- and 2 diabetes.

CANPLAY study: Secular trends in steps/day amongst 5-19year-old Canadians between 2005 and 2014

INTRODUCTION

The Canadian Physical Activity Levels Among Youth (CANPLAY) study collected pedometer data from eight surveys between 2005 and 2014, making it a unique database of objective population physical activity surveillance. The purpose of this study was to describe secular physical activity trends for 5-19year olds.

METHODS

Canadian children from nationally representative samples (10,000 recruited, n≅5500 per survey) were mailed a pedometer kit, asked to wear the pedometer for 7 consecutive days, log steps daily, then return the log by mail. Weighted medians and prevalence estimates were calculated. Trends were tested by χ(2) test of independence.

RESULTS

An overall median of 10,935 steps/day was taken by Canadian children 5-19years of age (n=43,806) across the eight surveys. Steps/day increased between 2005-06 and 2007-08, then decreased in 2012-14. The prevalence of taking sufficient steps/day (defined as ≥10,000 steps/day for 5year olds, ≥13,000 steps/day for 6-11year-old boys; ≥11,000 steps/day for 6-11year-old girls; and ≥10,000 steps/day for 12-19year olds;) also increased then decreased over time, whereas the prevalence of accumulating <7000 steps/day generally increased over time. Trends were significant for boys, girls and each age group.

DISCUSSION

The CANPLAY surveillance system provided comparable data at multiple time points over 9years. An overall shift in the distribution of steps/day towards a less active lifestyle occurred between 2005-06 and 2012-14 for boys, girls and each age group. This provides evidence that the national policy goal to increase children's steps/day by 2015 has not been met.

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

Background

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

Methods

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

Results

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

Conclusions

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

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

Background

Targeting specific time periods of the day or week may enhance physical activity (PA) interventions in youth. The most prudent time segments to target are currently unclear.

Objectives

To systematically review the literature describing differences in young people’s objectively measured PA on weekdays vs. weekends, in school vs. out of school, weekends vs. out of school and lesson time vs. break time.

Methods

Electronic databases were searched for English-language, cross-sectional studies of school-aged children (4–18 years) reporting time-segment-specific accelerometer-measured PA from 01/1990 to 01/2013. We meta-analysed standardised mean differences (SMD) between time segments for mean accelerometer counts per minute (TPA) and minutes in moderate-to-vigorous PA (MVPA). SMD is reported in units of standard deviation; 0.2, 0.5 and 0.8 represent small, moderate and large effects. Heterogeneity was explored using meta-regression (potential effect modifiers: age, sex and study setting).

Results

Of the 54 included studies, 37 were eligible for meta-analyses. Children were more active on weekdays than weekends [pooled SMD (95 % CI) TPA 0.14 (0.08; 0.20), MVPA 0.42 (0.35; 0.49)]. On school days, TPA was lower in school than out of school; however, marginally more MVPA was accumulated in school [TPA −0.24 (−0.40; −0.08), MVPA 0.17 (−0.03; 0.38)]. TPA was slightly lower on weekends than out of school on school days, but a greater absolute volume of MVPA was performed on weekends [TPA −0.10 (−0.19; −0.01), MVPA 1.02 (0.82; 1.23)]. Heterogeneity between studies was high (I² 73.3–96.3 %), with 20.3–53.1 % of variance between studies attributable to potential moderating factors.

Conclusions

School-aged children are more active on weekdays than weekend days. The outcome measure influences the conclusions for other comparisons. Findings support the tailoring of intervention strategies to specific time periods.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-014-0215-5) contains supplementary material, which is available to authorized users.

Pedometer-determined physical activity patterns in a segmented school day among Hong Kong primary school children

Background/Objective

This study aimed to characterize pedometer-determined physical activity (PA) patterns in segmented school days among Hong Kong primary school children.

Methods

Participants were instructed to wear pedometers for 4 consecutive days. The overall step counts and counts at specific periods (e.g., after school, recess, and lunch) during the test days were recorded.

Results

Of the 74 recruited participants, 68 (41.2% boys, aged 10 and 11 years old) provided valid data. The mean total daily steps over the 4 test days ranged from 9064 to 9714 (standard deviation = 3140-3471 steps). The periods that contributed most toward total daily steps were after school (34.2%), recess (14.0%), and physical education (PE) classes (12.3%). Overall, Student t tests revealed that boys were more active than girls. More active children (daily step average above the sex-specific median value) accumulated significantly more steps during recess and after school than less active children (daily step average below the sex-specific median value) in both sexes (mean differences ranged from 507 steps to 1977 steps). A mixed model analysis of variance (ANOVA) revealed that students accumulated 914 steps more on days that included PE classes than on days without PE classes. A three-way ANOVA found no significant differences in body weight status (normal weight vs. overweight and obesity) and travel mode (active vs. passive modes).

Conclusion

The findings provide a better understanding of PA patterns and the contribution of the distinct segments within a school day to children's PA. This information may assist in developing more effective, appropriate, and timely school-based PA interventions for children in Hong Kong.

A randomized controlled design investigating the effects of classroom-based physical activity on children’s fluid intelligence and achievement

Existing literature shows promising effects of physical activity on children’s cognitive outcomes. This study assessed via a randomized, controlled design whether additional curricular physical activity during the school day resulted in gains for children’s fluid intelligence and standardized achievement outcomes. Participants were children ( N = 460) from four urban schools in the Southeast United States. Schools were randomly assigned to treatment and control conditions. Treatment schools received additional physical activity breaks throughout the school day while control schools maintained a typical schedule without curricular activity breaks. Results from the one-year study show positive effects for children’s mathematics and reading achievement but no differences across treatment and control groups for children’s fluid intelligence scores. Implications for school psychologists in promoting physical activity breaks on a systems-wide level are discussed.

Influence of physical education on moderate-to-vigorous physical activity of urban public school children in St. Louis, Missouri, 2011-2014

We quantified the moderate-to-vigorous physical activity (MVPA, heart rate ≥140 bpm) of urban public elementary school children on school days with and school days without physical education (PE) class by using continuous heart rate monitoring. The heart rate of 81 students (93.8% black) in grades 3 and 5 was recorded in 15-second intervals. On the basis of 575 school-day observations (mean 7.1 days/student), students accumulated 44.4 (standard deviation [SD], 34.4) minutes of MVPA on days with PE and 30.6 (SD, 29.9) MVPA minutes on days without PE (P < .001). School policies should promote daily PE to help children in under-resourced areas achieve the recommended 60 minutes per day of MVPA.

Daily physical activity and screen time, but not other sedentary activities, are associated with measures of obesity during childhood

Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.

Validity of SC-StepRx pedometer-derived moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth

BACKGROUND

The purpose of this study was to determine the validity of the SC-StepRx pedometer to assess moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth aged 10-17 years.

METHODS

Physical activity intensity assessed via indirect calorimetry served as the criterion standard. A convenience sample of 40 participants (20 boys, 20 girls) wore 6 SC-StepRx pedometers, 2 ActiGraph GT3X accelerometers, 2 Actical accelerometers, 1 Walk4Life MVP pedometer and 1 NL-1000 pedometer while walking/running at speeds approximating 2, 3, 4, 6 and 7 METs. Associations between indirect calorimetry and each activity monitor were assessed using linear regression analyses in SAS 9.2.

RESULTS

Estimates of moderate and vigorous physical activity from all monitors were significantly associated with the criterion standard of indirect calorimetry. The strongest associations with the criterion measure were observed for the SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute(-1), and the NL-1000 (R2 = 0.82, p <0.05). The SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute(-1) also exhibited the highest combined sensitivity (92.9%) and specificity (96.5%) for correctly identifying a bout of moderate-to-vigorous physical activity.

CONCLUSIONS

This study demonstrates that the SC-StepRx pedometer is a valid tool for the measurement of moderate and vigorous physical activity in children and youth.

Walking activity of children with cerebral palsy and children developing typically: a comparison between the Netherlands and the United States

PURPOSE

To compare walking activity of children with and without cerebral palsy (CP) between the Netherlands and the United States.

METHODS

A cross-sectional analysis on walking activity data from an international retrospective comparison study including a convenience sample of 134 walking children aged 7-12 years with spastic CP, classified as Gross Motor Function Classification System (GMFCS) level I (N = 64), II (N = 49) or III (N = 21), and 223 typically developing children (TDC) from the Netherlands and the United States. Walking activity was assessed during a one-week period using a StepWatch™ activity monitor. Outcomes were the daily number of strides, daily time being inactive and spent at low (0-15 strides/min), moderate (16-30 strides/min) and high stride rate (31-60 strides/min). Walking activity was compared between countries using multiple linear regression analyses.

RESULTS

Walking activity of TDC was not significantly different between countries. Compared to their American counterparts, Dutch children in GMFCS level I and II showed less walking activity (p < 0.05), whereas Dutch children in GMFCS level III showed more walking activity (p < 0.05).

CONCLUSION

The absence of differences in walking activity between Dutch and American TDC, and the presence of differences in walking activity between Dutch and American children with CP suggest that between-country differences affect walking activity differently in children with CP.

IMPLICATIONS FOR REHABILITATION

Physical activity of children with CP should be promoted in both the United States and the Netherlands. The between-country differences in walking activity illustrate that apart from the severity of the CP walking activity seems to be influenced by environmental aspects. In the promotion of physical activity, practitioners should pay attention to environmental barriers that families may experience for increasing physical activity.

Daily physical activity in asthmatic children with distinct severities

OBJECTIVE

The objective of this study was to evaluate daily physical activity (DPA) in asthmatic children with different levels of disease severity, but with good asthma control, relative to a control group.

METHODS

This was a cross-sectional study in which a total of 121 children between the ages of 7 and 12 years old were evaluated; 72 were asthmatic children (32 mild, 24 moderate and 23 severe), and 42 children were not asthmatics. The asthmatic children studied had been in medical treatment for at least 6 months and experienced no change in symptoms during the 4 weeks prior to the study. The DPA was monitored over 6 days (4 weekdays and 2 weekend days). Motor activity was recorded with an accelerometer that measured the total number of steps (TNS), the number of steps in moderate physical activity (NS-MPA) and the duration, in minutes, of physical activity performed at moderate intensity.

RESULTS

There were no differences among the TNS performed by children with mild, moderate or severe persistent asthma and the control group (14 410 ± 4379, 14 710 ± 4892, 13 838 ± 3341 and 12 968 ± 3682 steps, respectively). The NS-MPA was also similar among all of the groups (6589 ± 2065, 6605 ± 2324, 6223 ± 1689 and 5990 ± 1840 steps, respectively). Sedentary asthmatic children were overweight more often than asthmatic children who were physically active, although lung function was not different between these groups.

CONCLUSION

Children with good asthma control, independent of disease severity, had DPA levels similar to children without asthma. However, more asthmatic children were overweight if sedentary as compared to physically active asthmatic children.

The freedom to explore: examining the influence of independent mobility on weekday, weekend and after-school physical activity behaviour in children living in urban and inner-suburban neighbourhoods of varying socioeconomic status

BACKGROUND

Children's independent mobility (CIM) is critical to healthy development in childhood. The physical layout and social characteristics of neighbourhoods can impact opportunities for CIM. While global evidence is mounting on CIM, to the authors' knowledge, Canadian data on CIM and related health outcomes (i.e., physical activity (PA) behaviour) are missing. The purpose of this study was to examine if CIM is related to multiple characteristics of accelerometry-measured PA behaviour (total PA, light PA, moderate-to-vigorous PA, time spent sedentary) and whether associations between CIM and PA behaviour systematically vary by place of residence, stratifying by gender and type of day/period (weekdays, after-school, weekend).

METHODS

Participants were recruited through Project BEAT (Built Environment and Active Transport; http://www.beat.utoronto.ca). Children (n = 856) were stratified into four neighbourhood classifications based on the period of neighbourhood development (urban built environment (BE) (old BE) versus inner-suburban BE (new BE)) and socioeconomic status (SES; low SES and high SES). Physical activity was measured via accelerometry (ActiGraph GT1M). CIM was assessed via parental report and two categories were created (low CIM, n = 332; high CIM, n = 524). A series of two-factor ANOVAs were used to determine gender-specific differences in PA for weekdays, weekend days and the after-school period, according to level of CIM, across four neighbourhood classifications.

RESULTS

Children who were granted at least some independent mobility (high CIM) had more positive PA profiles across the school week, during the after-school period, and over the weekend; they were also less sedentary. The influence of CIM on PA behaviour was particularly salient during the after-school period. Associations of CIM with PA varied by gender, and also by neighbourhood classification. CIM seemed to matter more in urban neighbourhoods for boys and suburban neighbourhoods for girls.

CONCLUSION

Our findings highlight the importance of independent mobility to multiple characteristics of children's PA behaviour across the week. Furthermore, they emphasize that independent mobility-activity relationships need to be considered by gender and the type of neighbourhood independent mobility is offered in. Future work will focus on developing a predictive model of CIM that could be used to inform decision-making around alleviating barriers to CIM.

Effect of BMI on pedometers in early adolescents under free-living conditions

PURPOSE

Pedometers may provide valuable information regarding the ambulatory patterns of adolescents, but the effects of body mass index (BMI) on pedometer accuracy in this population are unknown.The purpose of this study was twofold: 1) to determine whether the New Lifestyles NL-2000 (NL) and the Digi-Walker SW-200 (DW) (New Lifestyles, Inc., Lees Summit, MO) yield similar step counts as compared with an ankle-mounted criterion, StepWatch 3, when worn by early adolescents in a free-living environment and 2) to study whether BMI percentile affects the accuracy of waist-mounted pedometers in adolescents.

METHODS

Seventy-four early adolescents (13.0 ± 1.1 yr) wore the devices during one weekday. The study population included 33 normal weight, 21 overweight, and 20 obese participants. Two-way repeated-measures ANOVA was used to determine whether the BMI and the device were related to the number of steps per day and percentage of actual steps.

RESULTS

The NL and DW recorded fewer steps than the StepWatch 3 in each BMI category (P < 0.05). In the obese group, the DW underestimated the steps more than the NL (P < 0.001). For the normal weight, overweight, and obese groups, the NL counted 89.1%, 89.1%, and 91.6% of the steps, respectively, whereas the DW counted 86.7%, 84.6%, and 72.7%, respectively.

CONCLUSION

Researchers must be cognizant of the limitations of waist-mounted pedometers and carefully choose a device that suits the needs of their investigations. Because of the inaccuracies of the DW when measuring steps in obese adolescents, careful consideration must be given before choosing this device for research and interventions. The NL is a better device for assessment of adolescents' steps than the DW, especially for those who are obese.

Weekday and weekend physical activity patterns of French and Spanish adolescents

Adolescents' objectively assessed physical activity (PA) patterns during specific segments of the day remain unclear. In order to develop a clearer understanding this study examined country and gender differences in moderate to vigorous physical activity (MVPA) levels during specific segments of weekdays and weekend days, and explored the contribution of each segment to PA guidelines. Morpho-demographic, socio-economic and PA data were collected from a sample of 829 French and Spanish adolescents (45.0% Spanish; 55.2% females; 14.33±.73 years). Actigraph GT3X accelerometers were worn for seven days to assess adolescents' MVPA for three segments of weekdays (school-travel-time, school-time, and non-school-time), and weekend days (morning-time, afternoon-time and night-time). Data were analysed using multilevel modelling. The most active segments were non-school-time (29.2±17.5 min) and school-time (25.8±14.2 min) during weekdays, and morning-time (28.2±25.8 min) on weekend days. Except for school-time, Spanish adolescents were more significantly active than French adolescents during all segments. Significant gender differences were found in all segments. Country differences highlight the need to recognise cultural contexts that influence adolescents' PA. Common European-wide strategies may be insufficient to increase MVPA levels if cultural variability is not considered. Spanish and French PA intervention programmes should target girls and low-active boys during non-school-time and weekends.

Longitudinal 2-year follow-up on the effect of a non-randomised school-based physical activity intervention on reducing overweight and obesity of Czech children aged 10-12 years

Background: This study assessed whether the benefits of a 2-year longitudinal non-randomised school-based physical activity (PA) intervention programme to reduce overweight and obesity were still apparent two years after completion of the controlled intervention. Methods: The study involved 84 girls (G) and 92 boys (B) aged 10–12 years who had participated in the PA intervention in 2006–2008 as 6- to 9-year olds and were included in the intervention (I) (43 G and 45 B) and the control (C) groups (41 G and 47 B). Participants’ overweight/obesity was assessed using the percentile graph of Body Mass Index (BMI) from the World Health Organization for girls and boys aged 5–19. Logistic regression (Enter method) determined the overweight/obesity occurrence in a follow-up measurement (2010) two years after completion of the controlled intervention was used. Results: Two years after the controlled PA intervention had finished, the intervention children were less likely to be overweight/obese than the control children (2.3%_GIvs. 17.1%_GC, 6.7%_BIvs. 23.4%_BC, odds ratio: 0.25; 95% confidence interval: 0.12; 0.53; p < 0.001). Conclusions: The current study indicates favourable effects of an everyday school-based PA intervention programme on lower overweight/obesity incidence, which was maintained two years after the end of the direct involvement of the researchers.

Female university students' physical activity levels and associated factors--a cross-sectional study in southwestern Saudi Arabia

Background: The high prevalence of physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to examine the prevalence of physical activity (PA) and associated factors among female university students. Methods: This cross-sectional study involved 663 randomly selected female university students who completed the Arab Teens Life Style questionnaire. Data included measurements of anthropometric, socioeconomic and environmental factors, as well as self-reported PA. Ordinal regression was used to identify associated factors with low, moderate and high PA levels. Results: The mean age of participants was 20.4 years (SD 1.5). Mean BMI of the students in relation to PA were 23.0, 22.9, 22.1 for high, moderate and low levels of activity, respectively. The analysis revealed significantly higher PA levels among married students, those with high educated mothers, and those who lived far from parks, and lower activity levels among underweight students. Conclusions: This study raises four important determinants for female university students’ PA levels. These factors could be of great importance in the endeavor to prevent the health-threatening increase in physical inactivity patterns and thus non-communicable diseases and obesity where the focus should be on the specific situation and needs of women in Saudi Arabia.

Longitudinal patterns of physical activity in children aged 8 to 12 years: the LOOK study

BACKGROUND

Data on longitudinal monitoring of daily physical activity (PA) patterns in youth over successive years is scarce but may provide valuable information for intervention strategies aiming to promote PA.

METHODS

Participants were 853 children (starting age ~8 years) recruited from 29 Australian elementary schools. Pedometers were worn for a 7-day period each year over 5 consecutive years to assess PA volume (steps per day) and accelerometers were worn concurrently in the final 2 years to assess PA volume (accelerometer counts (AC) per day), moderate and vigorous PA (MVPA), light PA (LPA) and sedentary time (SED). A general linear mixed model was used to examine daily and yearly patterns.

RESULTS

A consistent daily pattern of pedometer step counts, AC, MVPA and LPA emerged during each year, characterised by increases on school days from Monday to Friday followed by a decrease on the weekend. Friday was the most active and Sunday the least active day. The percentage of girls and boys meeting international recommendations of 11,000 and 13,000 steps/day respectively on a Monday, Friday and Sunday were 36%, 50%, 21% for boys and 35%, 45%, 18% for girls. The equivalent percentages meeting the recommended MVPA of >60 min/day on these days were 29%, 39%, 16% for boys and 15%, 21%, 10% for girls. Over the 5 years, boys were more active than girls (mean steps/day of 10,506 vs 8,750; p<0.001) and spent more time in MVPA (mean of 42.8 vs 31.1 min/day; p<0.001). Although there was little evidence of any upward or downward trend in steps/day from age 8 to 12 years, there was a trend toward lower MVPA, LPA and a corresponding increase in SED from age 11 to 12 years.

CONCLUSION

A weekly pattern of PA occurred in children as young as age 8 on a day by day basis; these patterns persisting through to age 12. In addition to supporting previous evidence of insufficient PA in children, our data, in identifying the level and incidence of insufficiency on each day of the week, may assist in the development of more specific strategies to increase PA in community based children.

Social support from teachers mediates physical activity behavior change in children participating in the Fit-4-Fun intervention

BACKGROUND

Few studies have examined the mediators of behavior change in successful school-based physical activity interventions. The aim of this study was to explore potential mediators of physical activity in the Fit-4-Fun program for primary school children.

DESIGN

Group randomized controlled trial.

METHODS

Four primary schools were recruited in April, 2011 and randomized by school into intervention or control conditions. Participants included 213 children (mean age = 10.7 years ± 0.6; 52.2% female) with the treatment group (n = 118) completing the 8-week multi-component Fit-4-Fun program. Participants were assessed at baseline, 3- and 6-months. Physical activity was measured using Yamax SW700 pedometers (mean steps/day) and questionnaires were used to assess constructs from Social Cognitive Theory and Competence Motivation Theory. Hypothesized mediators measured included social support from peers, parents and teachers; physical activity self-efficacy (barrier and task); enjoyment; and perceived school physical environment. Mediation was assessed using Preacher and Hayes' multiple mediation regression SPSS macro. Action theory (A), conceptual theory (B) and the significance of the product of coefficients (AB) are reported.

RESULTS

The intervention had a significant effect on physical activity (p<0.001). The action theory test results revealed significant treatment effects at 3-months for perceived school environment (A=0.28, p<0.001); and at 6-month follow-up for perceived school environment (A=0.058, p<0.001), teacher social support (A=0.54, p<0.05) and enjoyment (A=-0.23, p<0.05). The conceptual theory test revealed a significant relationship between changes in teacher social support and changes in physical activity at 6-month follow-up (B=828, P<0.05). Teacher social support was shown to have a significant mediating effect on physical activity (AB = 445, CI = 77-1068 steps, proportion= 13%), and perceived school environment approached significance (AB = 434, CI= -415 to 1507 steps, proportion= 13%).

CONCLUSIONS

The Fit-4-Fun program successfully targeted social support for physical activity provided by classroom teachers which contributed to improved physical activity in children. These results demonstrate that classroom teachers play a key role in influencing physical activity behavior outcomes in children.Trial Registration No: ACTRN12611000976987.

An international comparison of patterns of participation in leisure activities for children with and without disabilities in Sweden, Norway and the Netherlands

PURPOSE

To investigate whether there are differences in participation in leisure activities between children with and without disabilities in Sweden, Norway and the Netherlands and how much personal and environmental factors explain leisure performance.

METHODS

In a cross-sectional analytic design, the Children's Assessment of Participation and Enjoyment, CAPE, was performed with 278 children with disabilities and 599 children without disabilities aged 6-17 years. A one-way between-groups ANOVA explored the differences in participation between the countries. Hierarchical multiple regression analysis assessed if age, gender, educational level, living area and country of residence explained the variance in participation.

RESULTS

Scandinavian children with disabilities participated in more activities with higher frequency compared to Dutch children. The strongest predictor was country of residence. For children without disabilities, differences existed in informal activities, the strongest predictor was gender.

CONCLUSION

Differences in school- and support systems between the countries seem to influence patterns of participation, affecting children with disabilities most.

Estimated energy expenditures for school-based policies and active living

BACKGROUND

Despite overwhelming evidence of the health benefits of physical activity, most American youth are not meeting the 60 minutes per day recommendation for moderate- to vigorous-intensity physical activity (MVPA). Policy changes have the potential to bring about substantial increases in physical activity in youth, within school and community settings.

PURPOSE

The purpose of this study was to quantify the increase in energy expenditure for school-based policies and built environment changes.

METHODS

Scientific literature reviews were consulted, and more than 300 published studies (1995-2011) in English were identified based on titles and abstracts. After an initial screening, 85 articles were included. Study quality was assessed, and the impact of various strategies for increasing physical activity in youth was estimated from objective measurements/direct observation.

RESULTS

Within school settings, the average minutes of MVPA gained per school day for studies in each intervention category were as follows: mandatory physical education (23 minutes); classroom activity breaks (19 minutes); afterschool activity programs (10 minutes); standardized physical education curricula (6 minutes more than traditional physical education); modified playgrounds (6 minutes); and modified recess (5 minutes more than traditional recess). Within community settings, significant MVPA was associated with active commuting (16 minutes) and park renovations (12 minutes), but proximity to parks had a small effect (1 minute). No conclusions could be drawn regarding joint-use agreements, because of a lack of studies quantifying their impact on energy expenditure.

CONCLUSIONS

Of the various policies and built environment changes examined, the largest effects were seen with mandatory physical education, classroom activity breaks, and active commuting to school. Policymakers can use this information along with estimates of the cost, feasibility, and population reach, to identify the best options for increasing physical activity in youth.

A step-defined sedentary lifestyle index: <5000 steps/day

Step counting (using pedometers or accelerometers) is widely accepted by researchers, practitioners, and the general public. Given the mounting evidence of the link between low steps/day and time spent in sedentary behaviours, how few steps/day some populations actually perform, and the growing interest in the potentially deleterious effects of excessive sedentary behaviours on health, an emerging question is "How many steps/day are too few?" This review examines the utility, appropriateness, and limitations of using a reoccurring candidate for a step-defined sedentary lifestyle index: <5000 steps/day. Adults taking <5000 steps/day are more likely to have a lower household income and be female, older, of African-American vs. European-American heritage, a current vs. never smoker, and (or) living with chronic disease and (or) disability. Little is known about how contextual factors (e.g., built environment) foster such low levels of step-defined physical activity. Unfavorable indicators of body composition and cardiometabolic risk have been consistently associated with taking <5000 steps/day. The acute transition (3-14 days) of healthy active young people from higher (>10 000) to lower (<5000 or as low as 1500) daily step counts induces reduced insulin sensitivity and glycemic control, increased adiposity, and other negative changes in health parameters. Although few alternative values have been considered, the continued use of <5000 steps/day as a step-defined sedentary lifestyle index for adults is appropriate for researchers and practitioners and for communicating with the general public. There is little evidence to advocate any specific value indicative of a step-defined sedentary lifestyle index in children and adolescents.

Physical activity and self-concept: the SEARCH for diabetes in youth case control study

In this study, the relationship between physical activity (PA) and 3 self-concept constructs (physical abilities, physical appearance, and general self-concept) was examined. Youth with type 1 diabetes (n = 304), type 2 diabetes (n = 49), and nondiabetic controls (n = 127) aged 10-20 years wore pedometers over 7 days. Youth completed the Self-Description Questionnaire and correlation coefficients were calculated. Mean steps/day were 7413 ± 3415, 4959 ± 3474 and 6870 ± 3521 for type 1, type 2 and control youth, respectively. Significant correlations were found between steps/day and perception of physical abilities (r = .29; r = .31; r = .31) for type 1, type 2, and control youth, respectively. The other correlations were not significant. Among youth with type 2 diabetes, steps/day were significantly correlated with physical appearance (r = .46). The positive correlation between PA and physical abilities suggests a reciprocal relationship between behavior and perception.

Device-based monitoring in physical activity and public health research

Measurement of physical activity is important, given the vital role of this behavior in physical and mental health. Over the past quarter of a century, the use of small, non-invasive, wearable monitors to assess physical activity has become commonplace. This review is divided into three sections. In the first section, a brief history of physical activity monitoring is provided, along with a discussion of the strengths and weaknesses of different devices. In the second section, recent applications of physical activity monitoring in physical activity and public health research are discussed. Wearable monitors are being used to conduct surveillance, and to determine the extent and distribution of physical activity and sedentary behaviors in populations around the world. They have been used to help clarify the dose-response relation between physical activity and health. Wearable monitors that provide feedback to users have also been used in longitudinal interventions to motivate research participants and to assess their compliance with program goals. In the third section, future directions for research in physical activity monitoring are discussed. It is likely that new developments in wearable monitors will lead to greater accuracy and improved ease-of-use.

Does school-based physical activity decrease overweight and obesity in children aged 6-9 years? A two-year non-randomized longitudinal intervention study in the Czech Republic

Background

Globally, efforts aimed at the prevention of childhood obesity have led to the implementation of a range of school-based interventions. This study assessed whether augmenting physical activity (PA) within the school setting resulted in increased daily PA and decreased overweight/obesity levels in 6-9-year-old children.

Methods

Across the first to third primary school years, PA of 84 girls and 92 boys was objectively monitored five times (each for seven successive days) using Yamax pedometer (step counts) and Caltrac accelerometer (activity energy expenditure AEE - kcal/kg per day). Four schools were selected to participate in the research (2 intervention, 2 controls), comprising intervention (43 girls, 45 boys) and control children (41 girls, 47 boys). The study was non-randomized and the intervention schools were selected on the basis of existing PA-conducive environment. Analyses of variance (ANOVA) for repeated measures examined the PA programme and gender effects on the step counts and AEE. Logistic regression (Enter method) determined the obesity and overweight occurrence prospect over the course of implementation of the PA intervention.

Results

There was a significant increase of school-based PA during schooldays in intervention children (from ≈ 1718 to ≈ 3247 steps per day; and from 2.1 to ≈ 3.6 Kcal/Kg per day) in comparison with the control children. Increased school-based PA of intervention children during schooldays contributed to them achieving >10,500 steps and >10.5 Kcal/Kg per school day across the 2 years of the study, and resulted in a stop of the decline in PA levels that is known to be associated with the increasing age of children. Increased school-based PA had also positive impact on leisure time PA of schooldays and on PA at weekends of intervention children. One year after the start of the PA intervention, the odds of being overweight or obese in the intervention children was almost three times lower than that of control children (p < 0.005), and these odds steadily decreased with the duration of the intervention.

Conclusions

The findings suggest that school-based PA (Physical Education lessons, PA during short breaks and longer recesses, PA at after-school nursery) in compatible active environments (child-friendly gym and school playground, corridors with movement and playing around corners and for games) has a vital role in obesity and overweight reduction among younger pupils.

School day segmented physical activity patterns of high and low active children

Background

Variability exists in children’s activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.

Methods

Two hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling.

Results

The HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed.

The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group.

Conclusions

HIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured afterschool physical activity programs may be beneficial.

Association of self-reported physical activity patterns and socio-demographic factors among normal-weight and overweight Japanese men

Background

It is still not known whether overweight men have different patterns and socio-demographic correlates of self-reported physical activity (PA) compared with normal-weight men. Thus, this study examined the perceived PA patterns and associated socio-demographic factors among normal-weight and overweight Japanese men.

Methods

Data were analyzed for 1,420 men (aged 44.48.3years) who responded to an Internet-based cross-sectional survey relating to socio-demographic variables, BMI status, and a short version of the International Physical Activity Questionnaire. Mann-Whitney, chi-square, and binary logistic regression analyses were employed.

Results

Normal-weight men were significantly more likely to attain 150 minutes per week of moderate-to-vigorous PA than overweight men (26.6% vs. 21.3%; p=0.035), whereas there were no significant proportional differences in total PA and walking between the two BMI subgroups. With PA, a significant interaction was observed between BMI status and household income (p=0.004 for total PA; p=0.02 for walking). In the subgroup analyses, having a lower household income (odds ratio, 0.63; 95% confidence interval, 0.41-0.96) was negatively associated with attaining 150 minutes of walking per week among normal-weight men. No significant associations between household income and attaining 150 minutes per week of total PA and walking were found among overweight men.

Conclusions

The results revealed that patterns and socio-demographic correlates of self-reported PA in overweight men are different from those in normal-weight men. This finding suggests the necessity of developing specific strategies for PA intervention among overweight men. Socio-demographic correlates of PA may be more important for normal-weight than overweight men.

Out and about: association of the built environment with physical activity behaviors of adolescent females

Locational data, logged on portable GPS units and matched with accelerometer data, was used to examine associations of the built environment with physical activity and sedentary behaviors of adolescent females. In a sample of 293 adolescent females aged 15 to 18 years old in Minneapolis and San Diego, the built environment around each GPS point and its corresponding sedentary, light, and moderate-to-vigorous intensity physical activity was examined using random intercept multinomial logistic regression models. The odds of higher physical activity intensity (3-level outcome: sedentary, light, MVPA) were higher in places with parks, schools, and high population density, during weekdays, and lower in places with more roads and food outlets. Understanding the places where physical activity and sedentary behaviors occur appears to be a promising strategy to clarify relationships and inform policy aimed at increasing physical activity and reducing sedentary behaviors.