Energy expenditure and enjoyment of common children's games in a simulated free-play environment

A 5-Week Guided Active Play Program Modulates Skin Microvascular Reactivity in Healthy Children

PURPOSE

Children's poor levels of physical activity (PA) participation and early-onset vascular aging are identified as global health challenges. Children's guided activity play (GAP)-based PA programs have emerged as effective strategies to improve cardiovascular risk factors and health-related fitness. This study proposes to investigate whether GAP improves children's cutaneous microvascular reactivity and health-related fitness.

METHODS

Children's (n = 18; 9.8 [1.5] y) PA during a 5-week (4 d/wk; 1 h/d) GAP program was assessed (accelerometry) with preassessments and postassessments for anthropometric, musculoskeletal fitness, blood pressure, estimated aerobic power, and cutaneous microvascular reactivity.

RESULTS

PA averaged 556 (132) kcal·week-1 at 34.7% (7.5%) time at moderate to vigorous intensity. Resting heart rate (-9.5%) and diastolic blood pressure (-7.8%) were reduced without changes in health-related fitness indices. Cutaneous microvascular reactivity to sodium nitroprusside iontophoresis increased the average perfusion (+36.8%), average cutaneous vascular conductance (+30%), the area under the curve (+28.8%), and a faster rise phase (+40%) of perfusion (quadratic modeling; P ≤ .05). Chi-square and crosstabulation analysis revealed significant association between children's PA levels and sodium nitroprusside average perfusion levels, where children with PA levels ≥205.1 kcal.55 minute-1 were overrepresented in the medium/high levels of sodium nitroprusside perfusion.

CONCLUSION

A 5-week GAP modified the microvascular reactivity in children without changes in body mass, musculoskeletal fitness, or estimated aerobic power.

Cost Utility Analysis of an After-School Sports Sampling Program

PURPOSE

The purposes of this study are to describe the costs of implementing an after-school physical activity intervention in three diverse, low-resourced, schools and to understand the potential aerobic impact of this program by cost.

DESIGN

We conducted a cost utilization study from an 8.5-month physical activity intervention.

SETTING

Three diverse, low-resourced, middle schools in the Midwest; The sample (N = 178) were mostly males (52.2%), African American or Black (54.8%), and divided between 6th, 7th, and 8th grades.

METHOD

Costs were collected from contracts, invoices, payroll, and receipts. Metabolic equivalents were collected from past literature. Costs/MET-hour were calculated for the schools and entire program by dividing costs by total MET-hours engaged in physical activity.

RESULTS

Costs were $2.51/MET-hour, $8.96/MET-hour, and $10.73/MET-hour for the three schools. On average, the intervention had a cost of $4.73/MET-hour.

CONCLUSIONS

Cost/MET-hour for the present study is comparable or lower than other school-based physical activity interventions that require additional staff time and programming outside of standard classroom activities. Scale-up of after-school programs may be one way to improve the costs of programs in both schools and districts.

Effects of a games-based physical education lesson on cognitive function in adolescents

Despite the importance of physical education (PE) lessons for physical activity in adolescents, the acute cognitive responses to PE lessons have not been explored; a gap in the literature that this study addresses. Following familiarisation, 76 (39 female) adolescents (12.2 ± 0.4 y) completed two trials (60 min games-based PE lesson and 60 min academic lesson) separated by 7-d in a counterbalanced, crossover design. Attention, executive function, working memory, and perception were assessed 30 min before, immediately post, and 45 min post-lesson in both trials. Participants were split into high-and low-fit groups based on a gender-specific median split of distance run on the multi-stage fitness test. Furthermore, participants were split into high and low MVPA groups based on a gender-specific median split of MVPA time (time spent >64% HR max) during the PE lesson. Overall, a 60 min games-based PE lesson had no effect on perception, working memory, attention, or executive function in adolescents (all p > 0.05) unless MVPA time is high. The physical activity-cognition relationship was moderated by MVPA, as working memory improved post-PE lesson in adolescents who completed more MVPA during their PE lesson (time*trial*MVPA interaction, p < 0.05, partial η2 = 0.119). Furthermore, high-fit adolescents displayed superior cognitive function than their low-fit counterparts, across all domains of cognitive function (main effect of fitness, all p < 0.05, partial η2 0.014–0.121). This study provides novel evidence that MVPA time moderates the cognitive response to a games-based PE lesson; and emphasises that higher levels of fitness are beneficial for cognitive function in adolescents.

An After-School Football Session Transiently Improves Cognitive Function in Children

The aim of the present study was to evaluate the effect of a real-world after-school football session on subsequent cognitive function in primary school children. Following ethical approval, 100 children (aged 8−9 year) from the same after-school football club were randomly assigned to either an intervention (60 min football activity) or control (continued to rest) group. Cognitive function (selective visual attention, short term memory and long-term memory) was assessed prior to, immediately following and 45 min following the football session (and at the respective timepoints in the control group). Data were analysed via two-way (group * time) mixed methods ANOVA. The pattern of change in all domains of cognition over time, was different between the football and control groups (group * time, all p < 0.001). Specifically, performance on all cognitive tasks was greater immediately following the football session in the intervention group compared to the control group (selective visual attention, p = 0.003; short-term memory, p = 0.004; long-term memory, p < 0.001). However, there was no difference between the group 45 min following the football session (p = 0.132−0.393). These findings suggest that an after-school football session enhances cognition immediately post-activity in primary school children.

Stable physical activity tracking during children's guided active play

Objective

Physical activity (PA) decreases during childhood with PA tracking statistics showing moderate coefficients in early childhood moving to poor coefficients in late childhood. The age-related instability of PA tracking is attributed to variations in age-related PA behaviors when quantifying PA in different settings (in/out of school, sports camps, and habitual PA). This study has examined the stability of age-related PA for children (from 7 to 11 years) during self-paced guided active play (GAP) sessions separated by 12 months.

Methods

Children (n = 65) recruited from community camps in two consecutive years were assessed for growth and PA participation during GAP sessions (1 h^.d⁻¹ on 2 d^.wk⁻¹) using cooperative games. Accelerometer outputs were used to quantify PA and estimate energy expenditure (EE) and moderate-to-vigorous PA (MVPA). Tracking statistics were assessed by Spearman coefficients (r) and agreement scores for percentile rankings (Kappa (k)) after a 1-year interval.

Results

Grouped data for PA tracking (EE) over the 1-year interval showed strong coefficients (r = 0.88, p = 0.001) and moderate agreement scores (k = 0.54). Boys and girls showed similar results. During the 1-year interval, the MVPA tracking coefficient was r = 0.54 (p = 0.01) with a moderate k score of 0.47. Age-related PA (EE) tracking coefficients at 7 (r = 0.90), 8 (r = 0.88), 10 (r = 0.82), and 11 (r = 0.83) years showed strong coefficients except at 9 years (r = 0.51).

Conclusion

Children's age-related PA tracking (EE and MVPA) is stable during self-paced GAP assessed over a 1-year interval. Since PA tracking is stable in self-paced GAP, GAP should be included in children's PA intervention strategies to improve health and fitness.

Effect of Differing Durations of High-Intensity Intermittent Activity on Cognitive Function in Adolescents

Exercise duration may influence the acute effects on cognition. However, only one study to date has explored the dose-response relationship between exercise duration and cognition in adolescents. Thus, the purpose of this study was to investigate the effect of differing durations of high-intensity intermittent running on cognition in adolescents. Thirty-eight adolescents (23 girls) completed three trials separated by 7 d: 30 min exercise, 60 min exercise, and rest; in a randomised crossover design. The exercise was a modified version of the Loughborough Intermittent Shuttle Test (LIST), which elicited high-intensity intermittent exercise. Cognitive function tests (Stroop test, Sternberg paradigm, Flanker task) were completed 30 min pre, immediately post, and 45 min post exercise. Response times on the incongruent level of the Flanker task improved to a greater extent 45 min following the 30 min LIST, compared to rest (p = 0.009). Moreover, response times improved to a greater extent on the three-item level of Sternberg paradigm 45 min following the 30 min LIST, compared to the 60 min LIST (p = 0.002) and rest (p = 0.013), as well as on the five-item level 45 min following the 30 min LIST, compared to the 60 min LIST (p = 0.002). In conclusion, acute exercise enhanced subsequent cognition in adolescents, but overall, 30 min of high-intensity intermittent running is more favourable to adolescents' cognition, compared to 60 min.

Activity patterns of primary school children during participation in The Daily Mile

The Daily Mile is a popular physical activity initiative in primary schools, yet little is known regarding the activity patterns of children during The Daily Mile. Eighty children (10.4 ± 0.7 years) participated in The Daily Mile (20-min). Activity patterns were assessed using global positioning systems (total distance and age-specific speed zones), alongside heart rate. Cardiorespiratory fitness was assessed using the Multi-Stage Fitness Test. Participants covered a distance of 2511 ± 550 m during The Daily Mile, and heart rate was 163 ± 27 beats^.min^-1. Participants travelled the furthest distance, and were most intermittent, during the first 5 min (main effect of time, both p < 0.001). Boys ran further and their activity was more intermittent compared to girls (main effect of sex, both p < 0.001). Moreover, the highest fit children ran further than less fit children (main effect of fitness, p < 0.001). This study provides novel evidence of the nature of physical activity during The Daily Mile; demonstrating that children covered, on average, 1.5-miles and exercised at a moderate-to-vigorous intensity. Furthermore, boys covered a greater distance and were more intermittent than girls; whilst higher fit children ran further than lower fit children. In summary, The Daily Mile makes a valuable contribution to in-school physical activity targets in all children.

Effect of acute football activity and physical fitness on glycaemic and insulinaemic responses in adolescents

The present study examined the metabolic responses to an acute bout of football and the overall and moderating role of physical fitness on these responses, in adolescents. Thirty-six adolescents (16 girls, 20 boys; 12.6±0.5 y) completed two trials (60-min football and 60-min seated rest) separated by 7-d. Capillary blood samples were taken at baseline (60-min prior to exercise/rest), immediately, 30- and 60-min post-exercise and 30-, 60- and 120-min following a standardised lunch (1.5-, 2- and 3-h post-exercise), for the determination of blood glucose and plasma insulin concentrations. The median split of distance covered on the multi-stage fitness test was used to define high- and low-fit groups. Overall plasma insulin tAUC following lunch was lower in high-fit participants compared to low-fit (high-fit: 3784.2±1653.1 pmol·L^-1x120min, low-fit: 6457.3±3290.7 pmol·L^-1x120min; p<0.001), although there was no acute effect of the football session (p>0.05). Football reduced blood glucose concentration 1-h post-exercise compared to control (exercise: 3.8±0.6 mmol·L^-1, rest: 4.6±0.8 mmol·L^-1; p<0.001), but this was similar for the high- and low-fit participants (p>0.05). Blood glucose tAUC was not affected by exercise or physical fitness (p>0.05). These data emphasise the importance of physical fitness for metabolic health in adolescents, as well as the utility of football as a popular form of games-based activity for improving glucose regulation.

Four Minutes of Sprint Interval Training Had No Acute Effect on Improving Alertness, Mood, and Memory of Female Primary School Children and Secondary School Adolescents: A Randomized Controlled Trial

We investigated whether a 4-min sprint interval training (SIT) protocol had an acute effect (15 min after) on improving alertness, mood, and memory recall in female students. Sixty-three children and 131 adolescents were randomly assigned to either a SIT or control (CON) group by the class Physical Education (PE) teachers. The SIT intervention was delivered twice a week for 3 weeks. SIT participants performed three, 20-s 'all-out' effort sprints interspersed with 60-s intervals of walking while CON group sat down and rested. PE lessons were arranged such that the first two sessions were to familiarise participants with the SIT protocol leading to acute assessments conducted on the third session. On that occasion, both groups rated their alertness and mood on a single-item hedonic scale and underwent an adapted memory recall test. The same assessments were administered to both groups fifteen minutes after delivery of SIT intervention. A 4-min SIT involving three, 20 s 'all-out' effort intensity sprints did not have an acute main effect on improving alertness, mood and, memory recall in female children (η_p² = 0.009) and adolescents (η_p² = 0.012). Students' exercise adherence and feedback from PE teachers are indicatives of the potential scalability of incorporating SIT into PE programmes. Different work-to-rest ratios could be used in future studies.

Effect of football activity and physical fitness on information processing, inhibitory control and working memory in adolescents

Background

Whilst an acute bout of exercise has been shown to enhance subsequent cognition, including in adolescents, the effects of team games (of which Football is the most popular) has received little attention. Therefore, this study examined: the effect of an acute bout of outdoor Football activity on information processing, inhibitory control, working memory and circulating brain-derived neurotrophic factor (BDNF) in adolescents; the effect of physical fitness on cognition and; the moderating effect of physical fitness on the acute exercise responses.

Methods

Following familiarisation, 36 adolescents (16 girls) took part in two trials (60-min Football and 60-min seated rest) separated by 7-d in a counterbalanced, crossover design. Information processing and inhibitory control (Stroop Test), and working memory (Sternberg Paradigm) were assessed 30-min before exercise/rest and immediately, 45- and 90-min post-exercise/rest. Capillary blood samples were obtained before exercise/rest and up to 120-min post-exercise/rest. The median split of distance covered on the MSFT was used to divide the group into high- and low-fit groups.

Results

Performance on the cognitive function tasks was similar between Football and seated rest (trial*time interactions; all p > .05). However, the high-fit group had overall quicker response times on both levels of the Stroop Task and all three levels of the Sternberg Paradigm (main effect of fitness; all p < .001). Furthermore, the exercise-cognition relationship was moderated by physical fitness, with improvements in working memory response times seen post-exercise, only in the high-fit group (trial*time*fitness interaction, p < .05). Circulating BDNF was unaffected by the Football activity and physical fitness (p > .05).

Conclusion

The present study shows that higher levels of physical fitness are beneficial for cognitive function and provides novel evidence that an ecologically valid, and popular, form of exercise is beneficial for working memory following exercise, in high-fit participants only.

Effect of Exercise Duration on Postprandial Glycaemic and Insulinaemic Responses in Adolescents

High-intensity intermittent exercise (HIIE) is a potential intervention to manage hyperglycaemia and insulin resistance in adolescents. The aim of this study was to determine the optimum duration of HIIE to reduce postprandial glycaemic and insulinaemic responses in adolescents and the longevity of the response. Thirty-nine participants (12.4 ± 0.4 year) completed a 30- and 60-min exercise trial (Loughborough Intermittent Shuttle Test) and a rested control trial in a randomised crossover design. Capillary blood samples were taken at baseline, immediately and 1-h post-exercise; and 30, 60 and 120 min following a standardised lunch (day one) and a standardised breakfast 24-h post-exercise. Plasma insulin total area under the curve (tAUC) following lunch was lower following 60-min HIIE (21754 ± 16861 pmol·L^-1 × 120 min, p = 0.032) and tended to be lower following 30-min HIIE (24273 ± 16131 pmol·L^-1 × 120 min, p = 0.080), when compared with the resting condition (26931 ± 21634 pmol·L^-1 × 120 min). Blood glucose concentration was lower 1-h post-exercise following 30-min HIIE (3.6 ± 0.6 mmol·L^-1) when compared to resting (4.1 ± 0.9 mmol·L^-1, p = 0.001). Blood glucose and plasma insulin concentration did not differ across trials on day two. Shorter bouts of HIIE (30-min), as well as a 60-min bout, reduced the postprandial insulinaemic response to lunch, an ecologically valid marker of insulin sensitivity. As the beneficial effects of HIIE were limited to 3 h post-exercise, adolescents are recommended to engage daily HIIE to enhance metabolic health.

Active Gaming Prevalence and Correlates by Type of Day in Spanish Youth

BACKGROUND

Active gaming has emerged as a new option to foster physical activity in youth. The aim of this study was to estimate the prevalence of active gaming in adolescents, to determine differences between active and nonactive gamers by type of day, and to examine predictors of being an active gamer.

METHODS

A cross-sectional study was conducted with 3095 Spanish adolescents aged 12 to 18 years who self-reported their involvement in moderate to vigorous physical activity, sedentary behaviors, and active gaming. Those engaging in active gaming for at least 10 minutes per day were considered active gamers. Student's 2-tailed t tests, chi-square test, and binomial logistic regression were performed.

RESULTS

About 25.9% of the adolescents were active gamers. They were younger, had higher body mass index, and spent more time on moderate to vigorous physical activity, television viewing, and sedentary video games with computer/console than nonactive gamers. There were more active gamers on weekends than on weekdays. On weekdays, more males than females were active gamers. Adolescents who did not meet sleep time guidelines were more likely to be active gamers on weekdays, whereas on weekends, being a girl, overweight/obese, and having a high socioeconomic status were predictors of being an active gamer.

CONCLUSION

Because active gaming may contribute to meeting physical activity guidelines, the present findings could enable better targeting of physical activity promotion programs.

Measurement of Children's Real-Time Physical Activity Enjoyment Using a New Visual Analog Scale

Background: This study validated the How(e) Happy Scale (HHS) for measuring children's real-time physical activity (PA) enjoyment across PA type, intensity, sex, and weight status and compared state versus trait enjoyment. Methods: Children's (N = 31; 9.7 [1.7] y) PA intensity was measured during sport, play, and locomotive PA. Following each activity, children rated their perceived state (HHS) of enjoyment across 4 constructs (social engagement). Questionnaires measured trait PA enjoyment prior to play. Rasch Rating Scale analysis assessed model-data fit and probability distribution of HHS responses. Analyses of variance compared state versus trait PA enjoyment across main effects, and correlations assessed relationships between measured PA intensity versus state and trait PA enjoyment. Results: Trait PA enjoyment was neither different across sex and weight status nor correlated with PA intensity (r = -.16 to .22). By contrast, HHS responses differed across sex, weight status, and PA type and intensity and correlated with PA type (r = -.56 to -.28) and intensity (r = -.29 to -.32). HHS responses were ordered along the probability curve and showed good infit (0.76-1.22) and outfit (0.71-1.28) statistics and good person (r = .62) and item (r = .88) reliability. Conclusion: HHS is valid for detecting differences in real-time enjoyment across PA type and intensity in all children.

Cytokine, glycemic, and insulinemic responses to an acute bout of games-based activity in adolescents

An acute bout of endurance exercise in adults stimulates a same‐day anti‐inflammatory response which may affect low‐grade chronic inflammation and insulin resistance and benefit cardio‐metabolic health. The anti‐inflammatory responses to intermittent games‐based exercise and to exercise in young people beyond 2 hours post‐exercise are unknown. Thus, the purpose of the present study is to examine the anti‐inflammatory, glycemic and insulinemic response to games‐based activity in adolescents. Following ethical approval and familiarization, 39 adolescents (12.3 ± 0.7 years) completed an exercise (E) and rested (R) trial in a counterbalanced, randomized crossover design. Following a standardized breakfast, participants completed 1‐hour games‐based activity. Capillary blood samples were taken at baseline, immediately and 1 hour post‐exercise, and 30, 60 and 120 minutes following a standardized lunch. A final blood sample was taken the next morning. Data were analyzed using repeated measures ANOVA. IL‐6 concentration was higher on day one of the exercise trial (E:3.4 ± 0.4, R:2.7 ± 0.4 pg/mL; P = 0.006), as was the anti‐inflammatory IL‐6:TNF‐α ratio (E:5.53 ± 0.93, R:3.75 ± 0.45; P = 0.027). Levels of the anti‐inflammatory cytokine IL‐10 increased on day two of the exercise trial (E:2.11 ± 0.23, R:1.66 ± 0.16 pg/mL; P = 0.032). Insulin sensitivity was enhanced on the exercise trial with a reduction in iAUC following the standardized lunch (E:2310 ± 834, R:3122 ± 1443 mU/L × 120 minutes; P < 0.001). Games‐based activity stimulated an anti‐inflammatory response up to 24 hours post‐exercise and improved insulin sensitivity in response to a standardized meal in healthy adolescents. These novel findings suggest that games‐based activity is an ecologically valid mode of exercise to elicit beneficial effects on cardio‐metabolic risk factors in young people.

Does Wearing a Portable Metabolic Unit Affect Youth's Physical Activity or Enjoyment During Physically Active Games or Video Games?

Portable metabolic units (PMUs) are used to assess energy expenditure, with the assumption that physical activity level and enjoyment are unaffected due to the light weight and small size.

PURPOSE

To assess differences in physical activity level and enjoyment while wearing and not wearing a PMU.

METHOD

Youth (8-17 y; N = 73) played children's games or active video games while wearing and not wearing a PMU (crossover design). Participants wore an accelerometer and heart rate monitor and responded to questions about enjoyment on a facial affective scale. A repeated-measures analysis of variance was used to determine if accelerometer measures, heart rate, or enjoyment differed between conditions overall and by sex and weight status.

RESULTS

Steps per minute were lower while wearing the PMU than not wearing the PMU (40 vs 44, P = .03). There was an interaction between PMU condition and weight status for enjoyment (P = .01), with overweight participants reporting less enjoyment when wearing the PMU compared with not wearing the PMU (72 vs 75 out of 100). Heart rate, vector magnitude, and counts per minute were not different.

CONCLUSION

There may be psychosocial effects of wearing the PMU, specifically in overweight participants. Activity level was minimally affected, but the practical significance for research is still unknown.

Comparison of Accelerometer-Based Cut-Points for Children's Physical Activity: Counts vs. Steps

Background: Accelerometers measure complex movements of children’s free play moderate-vigorous physical activity (MVPA), including step and non-step movements. Current accelerometer technology has introduced algorithms to measure steps, along with counts. Precise interpretation of accelerometer-based cadence (steps/min) cut-points is necessary for accurately measuring and tracking children’s MVPA. The purpose of this study was to assess the relationships and agreement between accelerometer-based cut-points (cadence and counts/min) to estimate children’s MVPA compared to measured values. Methods: Forty children (8–12 years; 25 boys) played 6–10 games while wearing a portable metabolic analyzer and GT3X⁺ to measure and estimate MVPA, respectively. Correlation, kappa, sensitivity, and specificity assessed the relationships and agreement between measured and estimated MVPA. Results: Games elicited, on average, 6.3 ± 1.6 METs, 64.5 ± 24.7 steps/min, and 3318 ± 1262 vertical (V) and 5350 ± 1547 vector-magnitude (VM) counts/min. The relationship between measured and estimated MVPA intensity was higher for cadence (r = 0.50) than V and VM counts/min (r = 0.38 for both). Agreement using V and VM counts/min for measuring PA intensity varied by cut-points (range: 6.8% (κ = −0.02) to 97.6% (κ = 0.49)), while agreement was low using cadence cut-points (range: 4.0% (κ = 0.0009) to 11.3% (κ = 0.001)). Conclusion: While measured and estimated values were well correlated, using cadence tended to misclassify children’s free-play MVPA.

Effect of Sex and Body Mass Index on Children's Physical Activity Intensity during Free Play at an Indoor Soft Play Center: An Exploratory Study

Background: Indoor soft play can provide a safe but exciting physical activity opportunity regardless of environmental conditions. Relatively little is known about the quality or quantity of physical activity engaged in by children during indoor free soft play. The aim of this study was to evaluate the contribution indoor free soft play can make in enabling children to meet physical activity guidelines and to evaluate the effects of sex and body mass index category. Methods: Seventy-two boys and girls aged five to 10 years engaged in un-controlled indoor free soft play with a mean duration of 120.7 (27.1) min, during which physical activity was monitored using Actigraph accelerometers. Results: Children spent an average of 61.7 (24.2) min engaging in moderate to vigorous physical activity (MVPA) and 51.4% (n = 37) achieved the recommended 60 min of MVPA through the single visit to the indoor soft play center. Boys (68.3 (25.7) min) engaged in significantly (p < 0.05) more MVPA than girls (55.8 (21.4) min). Normal weight (65.7 (23.3) min) children engaged in significantly more MVPA than overweight children (48.0 (18.9) min). Conclusions: Attendance at a soft play indoor center has the potential to support children to engage in sufficient MVPA and overcome environmental factors that can restrict physical activity opportunities.

The efficacy of a discontinuous graded exercise test in measuring peak oxygen uptake in children aged 8 to 10 years

As children's natural activity patterns are highly intermittent in nature, and characterised by rapid changes from rest to vigorous physical activity, discontinuous exercise tests may be considered ecologically valid for this population group. This study compared the peak physiological responses from a discontinuous and continuous graded exercise test (GXT_D, GXT_C, respectively) during treadmill exercise in children. Twenty-one healthy children (9.6 ± 0.6 y) completed GXT_D and GXT_C in a randomised order, separated by 72-hours. Following each GXT, and after a 15-minute recovery, participants completed a verification test at 105% of the velocity attained at peak oxygen consumption (VO2peak). There were no differences in VO2peak (55.3 ± 8.2 cf. 54.4 ± 7.6 mL·kg-1·min-1) or maximal heart rate (202 ± 10 cf. 204 ± 8 b·min-1) between GXT_C and GXT_D, respectively (P>.05). Peak running speed (10.7 ± 0.9 cf. 12.1 ± 1.3 km·h-1) and respiratory exchange ratio (1.04 ± 0.05 cf. 0.92 ± 0.05) were however different between tests (P<.001). Although similar peak physiological values were revealed between GXT_C and the corresponding verification test (P>.05), VO2peak (53.3 ± 7.3 mL·kg-1·min-1) and heart rate (197 ± 13 b·min-1) were significantly lower in the GXT_D verification test (P<.05). In conclusion, a discontinuous GXT is an accurate measure of VO2peak in children aged 8 to 10 years and may be a valid alternative to a continuous GXT, despite its longer duration.

Low muscle mass is associated with metabolic syndrome in Korean adolescents: the Korea National Health and Nutrition Examination Survey 2009-2011

Little is known about the relationship between low muscle mass (LMM) and metabolic risk factors in adolescents. We hypothesized that LMM in adolescents is associated with metabolic syndrome (MetS) and its components in Korean adolescents. This cross-sectional study included 1420 participants (749 males and 671 females), aged 12 to 19 years, who participated in the 2009-2011 Korea National Health and Nutrition Examination Surveys. Appendicular skeletal muscle mass was divided by body weight, and any value below the lower quintile of the study population, according to each age and sex category, was considered to represent LMM. A participant was considered to have MetS if he/she demonstrated at least 3 of the National Cholesterol Education Program-Adult Treatment Panel III criteria. The overall prevalence of MetS was 4.9%, with a prevalence of 7.1% in males and 2.3% in females. Low muscle mass significantly increased the risk of MetS, after adjusting for potential covariates (odds ratio [OR], 5.28; 95% confidence interval, 2.76-10.13). Similarly, the ORs for the MetS components were significantly higher in individuals with LMM than in those without LMM. In the subgroup analysis, LMM was significantly associated with MetS in both adolescent boys and girls. In addition, the adjusted OR was significantly higher in individuals with LMM than in those without, after stratifying the groups by age. In conclusion, our results suggest that adolescents with LMM may have a high risk of MetS. Public health initiatives are needed to develop interventions for preventing and treating LMM in adolescents.

Effects of continuous and intermittent exercise on executive function in children aged 8-10 years

Understanding the effects of acute exercise on executive function in prepubescent children may be important for the enhancement of school performance. This study assessed the effect of an acute bout of continuous (CONT) or intermittent (INT), moderate-intensity treadmill exercise on executive function in young children. Twenty healthy children, mean (SD); age: 8.8 (0.8) years; height: 140 (9) cm; weight: 36 (11) kg; boys: n = 9, performed a graded-exercise test to determine maximal oxygen uptake, and two 15-min submaximal bouts of treadmill exercise; protocols were either CONT or INT. During CONT, participants ran at 90% of gas exchange threshold. During INT, participants performed six consecutive 2.5 min blocks of exercise, which were designed to reflect children's typical activity patterns, comprising 45 s at a heavy intensity, 33 s at a moderate intensity, 10 s at a severe intensity, and 62 s at a low intensity. Participants performed the Stroop task before the submaximal exercise bouts and after, at 1-, 15-, and 30-min intervals. Near-infrared spectroscopy (NIRS) measured cerebral perfusion and oxygenation. Regardless of condition, Stroop performance was improved at 1 min after compared to before, 54.9 (9.8) s versus 57.9 (11) s, respectively, p < .01, and improvements were maintained until 30 min after. NIRS (oxyhemoglobin, total hemoglobin) explained a significant amount of variance in the change in Stroop performance for INT only (49%, p < .05). An acute bout of exercise, of either an intermittent or continuous nature, improves executive function in children, and effects are maintained for ≤ 30 min following exercise cessation. Accordingly, it is recommended that children should engage in physical activity during periods of school recess.

Sprint-based exercise and cognitive function in adolescents

Moderate intensity exercise has been shown to enhance cognition in an adolescent population, yet the effect of high-intensity sprint-based exercise remains unknown and was therefore examined in the present study. Following ethical approval and familiarisation, 44 adolescents (12.6 ± 0.6 y) completed an exercise (E) and resting (R) trial in a counter-balanced, randomised crossover design. The exercise trial comprised of 10 × 10 s running sprints, interspersed by 50 s active recovery (walking). A battery of cognitive function tests (Stroop, Digit Symbol Substitution (DSST) and Corsi blocks tests) were completed 30 min pre-exercise, immediately post-exercise and 45 min post-exercise. Data were analysed using mixed effect models with repeated measures. Response times on the simple level of the Stroop test were significantly quicker 45 min following sprint-based exercise (R: 818 ± 33 ms, E: 772 ± 26 ms; p = 0.027) and response times on the complex level of the Stroop test were quicker immediately following the sprint-based exercise (R: 1095 ± 36 ms, E: 1043 ± 37 ms; p = 0.038), while accuracy was maintained. Sprint-based exercise had no immediate or delayed effects on the number of items recalled on the Corsi blocks test (p = 0.289) or substitutions made during the DSST (p = 0.689). The effect of high intensity sprint-based exercise on adolescents' cognitive function was dependant on the component of cognitive function examined. Executive function was enhanced following exercise, demonstrated by improved response times on the Stroop test, whilst visuo-spatial memory and general psycho-motor speed were unaffected. These data support the inclusion of high-intensity sprint-based exercise for adolescents during the school day to enhance cognition.

The influence of a six-week, high-intensity games intervention on the pulmonary oxygen uptake kinetics in prepubertal obese and normal-weight children

The pulmonary oxygen uptake response is deleteriously influenced by obesity in prepubertal children, as evidenced by a slower phase II response. To date, no studies have investigated the ability of an exercise intervention to ameliorate this. The objective of the study was to investigate the influence of a 6-week, high-intensity, games-orientated intervention on the oxygen uptake kinetic response of prepubertal obese and normal-weight children during heavy-intensity exercise. Thirteen normal-weight and 15 obese children participated in a twice-weekly exercise intervention involving repeated bouts of 6-min high-intensity, games-orientated exercises followed by 2 min of recovery. Sixteen normal-weight and 11 obese children served as a control group. At baseline and post-intervention, each participant completed a graded-exercise test to volitional exhaustion and constant work-rate, heavy-intensity exercise. Post-intervention, obese children demonstrated a reduced phase II τ (pre-intervention: 30 ± 8 cf. post-intervention: 24 ± 7 s), mean response time (pre-intervention: 50 ± 10 cf. post-intervention: 38 ± 9 s) and phase II amplitude (pre-intervention: 1.51 ± 0.30 cf. post-intervention: 1.34 ± 0.27 L·min−1). No changes were evident in the normal-weight children. In conclusion, the present findings demonstrate that a 6-week, high-intensity intervention can have a significant positive impact on the dynamic oxygen uptake response of obese prepubertal children.

The effectiveness of a high-intensity games intervention on improving indices of health in young children

This study assessed the effectiveness of a 6-week, high-intensity, games-based intervention on physiological and anthropometric indices of health, in normal weight (n = 26; 32.5 ± 8.9 kg) and obese (n = 29; 49.3 ± 8.9 kg) children (n = 32 boys, 23 girls), aged 8-10 years. Children were randomised into an exercise or control group. The exercise group participated in a twice-weekly, 40 min active games intervention, alongside their usual school physical education classes. The control group did not take part in the intervention. Before and after the intervention, participants completed both a maximal and submaximal graded exercise test. The submaximal exercise test comprised of a 6 min, moderate- and 6 min heavy-intensity bout, interspersed with a 5 min recovery. The exercise group demonstrated improvements in maximal oxygen uptake (51.4 ± 8.5 vs 54.3 ± 9.6 ml · kg(-1) · min(-1)) and peak running speed (11.3 ± 1.6 vs 11.9 ± 1.6 km · h(-1)), and a reduction in the oxygen cost of submaximal exercise between assessments (P < .05). A decrease in waist circumference and increase in muscle mass were observed between assessments for the obese participants randomised to the intervention (both P < .05). This study demonstrates that a short-term, high-intensity games intervention may elicit positive changes in physiological and anthropometric indices of health in normal weight and obese children.

Exercise dose and diabetes risk in overweight and obese children: a randomized controlled trial

CONTEXT

Pediatric studies have shown that aerobic exercise reduces metabolic risk, but dose-response information is not available.

OBJECTIVES

To test the effect of different doses of aerobic training on insulin resistance, fatness, visceral fat, and fitness in overweight, sedentary children and to test moderation by sex and race.

DESIGN, SETTING, AND PARTICIPANTS

Randomized controlled efficacy trial conducted from 2003 through 2007 in which 222 overweight or obese sedentary children (mean age, 9.4 years; 42% male; 58% black) were recruited from 15 public schools in the Augusta, Georgia, area.

INTERVENTION

Children were randomly assigned to low-dose (20 min/d; n = 71) or high-dose (40 min/d; n = 73) aerobic training (5 d/wk; mean duration, 13 [SD, 1.6] weeks) or a control condition (usual physical activity; n = 78).

MAIN OUTCOME MEASURES

The prespecified primary outcomes were postintervention type 2 diabetes risk assessed by insulin area under the curve (AUC) from an oral glucose tolerance test, aerobic fitness (peak oxygen consumption [VO2]), percent body fat via dual-energy x-ray absorptiometry, and visceral fat via magnetic resonance, analyzed by intention to treat.

RESULTS

The study had 94% retention (n = 209). Most children (85%) were obese. At baseline, mean body mass index was 26 (SD, 4.4). Reductions in insulin AUC were larger in the high-dose group (adjusted mean difference, -3.56 [95% CI, -6.26 to -0.85] × 10(3) μU/mL; P = .01) and the low-dose group (adjusted mean difference, -2.96 [95% CI, -5.69 to -0.22] × 10(3) μU/mL; P = .03) than the control group. Dose-response trends were also observed for body fat (adjusted mean difference, -1.4% [95% CI, -2.2% to -0.7%]; P < .001 and -0.8% [95% CI, -1.6% to -0.07%]; P = .03) and visceral fat (adjusted mean difference, -3.9 cm3 [95% CI, -6.0 to -1.7 cm3]; P < .001 and -2.8 cm3 [95% CI, -4.9 to -0.6 cm3]; P = .01) in the high- and low-dose vs control groups, respectively. Effects in the high- and low-dose groups vs control were similar for fitness (adjusted mean difference in peak VO2, 2.4 [95% CI, 0.4-4.5] mL/kg/min; P = .02 and 2.4 [95% CI, 0.3-4.5] mL/kg/min; P = .03, respectively). High- vs low-dose group effects were similar for these outcomes. There was no moderation by sex or race.

CONCLUSION

In this trial, after 13 weeks, 20 or 40 min/d of aerobic training improved fitness and demonstrated dose-response benefits for insulin resistance and general and visceral adiposity in sedentary overweight or obese children, regardless of sex or race.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00108901.

Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study

Background

Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day. Within this time frame, children accumulate most of their activity within the first 10 min. This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. The STEP study is a cluster randomized controlled study designed to examine the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on during-school physical activity (PA) in preschoolers.

Methods/Design

Ten preschool centers serving low-income families were randomized into SBS-PA versus unstructured PA (UPA). SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting, twice daily, followed by 20 min of usual unstructured playtime. UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily. Interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for six months. Outcome measures were between group difference in during-preschool PA (accelerometers and direct observation) over six-months. Ten preschool centers, representing 34 classrooms and 315 children, enrolled in the study. The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile, respectively. Participants spent 74% and 6% of their preschool day engaged in sedentary and MVPA, respectively.

Discussion

Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers’ PA levels.

Trial registration

Clinicaltrials.gov, NCT01588392

Is Enhanced Physical Activity Possible Using Active Videogames?

Our research indicated that 10-12-year-old children receiving two active Wii^™ (Nintendo^®; Nintendo of America, Inc., Redmond, WA) console videogames were no more physically active than children receiving two inactive videogames. Research is needed on how active videogames may increase physical activity.

Impact of an active video game on healthy children's physical activity

OBJECTIVE

This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods, who might not be allowed to play outside.

METHODS

Participants were children 9 to 12 years of age, with a BMI >50th percentile, but <99th percentile; none of these children a medical condition that would preclude physical activity or playing video games. A randomized clinical trial assigned children to receiving 2 active or 2 inactive video games, the peripherals necessary to run the games, and a Wii console. Physical activity was monitored by using accelerometers for 5 weeks over the course of a 13-week experiment. Neighborhood safety was assessed with a 12 item validated questionnaire.

RESULTS

There was no evidence that children receiving the active video games were more active in general, or at anytime, than children receiving the inactive video games. The outcomes were not moderated by parent perceived neighborhood safety, child BMI z score, or other demographic characteristics.

CONCLUSIONS

These results provide no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children.

A recess intervention to promote moderate-to-vigorous physical activity

BACKGROUND

Schools provide a prime environment for interventions that attempt to increase physical activity and prevent obesity.

OBJECTIVE

This study examined the effect of a 30-min, structured recess using 22 games of known energy expenditure on moderate-to-vigorous physical activity when compared to free play implemented with third graders from two elementary schools over 9 weeks.

METHODS

Moderate-to-vigorous physical activity and other cardiovascular risk factors were assessed pre- and post-intervention in 27 children.

RESULTS

Moderate-to-vigorous physical activity during recess increased significantly in intervention school children from 6.9 ± 0.8 to 14.9 ± 0.9 min pre- and post-intervention, respectively (adjusted mean change 8.0 ± 1.1; P < 0.0001), with no differences by gender or body mass index (BMI). In-school, moderate-to-vigorous physical activity also increased significantly more for intervention compared to control children (adjusted mean change 14 ± 4 min vs. 3 ± 3 min; P = 0.014, respectively).

CONCLUSION

There was no significant difference in BMI and cardiovascular risk factors. A structured recess is feasible to implement and can significantly increase moderate-to-vigorous physical activity.

Classroom-based physical activity, cognition, and academic achievement

BACKGROUND

There is increasing evidence for the association between physical activity, cardiovascular fitness, fatness, and cognitive function during childhood and adolescence. Evidence also suggests that these variables are linked to academic achievement. Classroom-based physical activity provides a viable approach to improve fitness, body mass index (BMI), cognitive function, and ultimately academic achievement.

METHODS

Studies examining the relation between physical activity, fitness, fatness, cognitive function, and academic achievement are described. The results of a large-scale, longitudinal, cluster randomized trial to examine the impact of classroom based physical activity on body mass index and academic achievement will be presented.

RESULTS

Overall, the data support the link between physical activity, cognitive function, and academic achievement. The role of physical activity in the classroom was also supported by the Physical Activity Across the Curriculum (PAAC) project. Physically active academic lessons of moderate intensity improved overall performance on a standardized test of academic achievement by 6% compared to a decrease of 1% for controls (p<0.02). Body mass index increased less from baseline to 3 years in students with greater than 75 minutes of PAAC lessons per week (1.8 BMI) compared to students with less than 75 minutes of PAAC per week (2.4 BMI), p<0.00.

CONCLUSIONS

Future research examining the effects of physically active academic instruction is warranted. The impact of physically active academic lessons of greater intensity may provide larger benefits for body mass index and academic achievement.