Electronic media time and sedentary behaviors in children: Findings from the Built Environment and Active Play Study in the Washington DC area

Synergies of affordances and place-based relationality in Forest School practice: implications for socio-emotional well-being

Research shows that the human-nature relationship positively impacts human well-being. Forest School (FS) practice offers young children a structured program of nature connection through activities, aiming to enhance their self-esteem and social skills. FS is now adapted in countries such as Australia, Canada and New Zealand where a unique cultural interface occurs between European settlers and Indigenous peoples. Responding to socio-cultural diversities, geographical contexts, and the traditional ecological knowledges, FS needs to go beyond play pedagogy and incorporate theoretical perspectives that promote human-nature relationship in local context-specific environments. We argue that the synergies between Western perspectives on affordances perceived in person-environment relationship and Indigenous place-based relationality perspective provide a more suitable approach for developing reciprocal relationships between FS participants and land/place/nature. We propose that the synergies between affordances perceived in FS and place-based relationality cultivated in participants will enhance social and emotional well-being. We call for specific research investigating such synergies supporting participant well-being. Future research on FS practice should be directed toward initiating and exploring co-designed studies by Indigenous and non-Indigenous researchers incorporating methodologies that study participant experience as well as evaluating the impact of FS programs embedding affordances and place-based relationality perspectives.

Leisure screen time predicts free sugar consumption in children

OBJECTIVE

This study aimed to investigate free sugar consumption (FSC) in relation to leisure screen time in children.

METHODS

Cross-sectional data of 424 healthy Saudi children ages 6 to 12 y were included in this study. Data pertaining to sociodemographic characteristics and leisure screen time (including time spent viewing TV, gaming, and use of electronic devices [e.g., computer, tablet, and smartphone]) in children were collected from mothers via an online questionnaire. A phone interview was later conducted with the mother and child to assess FSC using a previously validated 40-item food frequency questionnaire.

RESULTS

Our data found that a large proportion of children exceeded the maximum limit of screen time recommended for children, of ≤2 h/d (61.7%; n = 262). Child and maternal ages and child's birth order among siblings were significantly associated with the duration of leisure screen time (screen time within the recommendation of ≤2 h/d versus screen time that exceeded the recommendation; P < 0.050). Exceeding the recommendation of screen time predicted an increase of 8.96 g/d of FSC from liquid foods, 10.7 g/d of FSC from solid foods, and 19.3 g/d of total FSC.

CONCLUSIONS

Exceeding the recommendation of screen time is associated with greater FSC in children. Future interventions should be directed toward restricting screen time and FSC in children.

Clusters of Activity-Related Social and Physical Home Environmental Factors and Their Association With Children's Home-Based Physical Activity and Sitting

PURPOSE

Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics.

METHODS

Altogether, 235 children (55% girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the HomeSPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children's device-measured home-based activity behaviors, and background characteristics.

RESULTS

The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with home-based activity behaviors in the hypothesized directions.

CONCLUSION

Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families, are warranted.

Urban-Rural Differences in Physical Fitness and Out-of-School Physical Activity for Primary School Students: A County-Level Comparison in Western China

Rapid urbanization of China has brought lifestyle changes resulting in a continuous decline in children's physical fitness (PF) and out-of-school physical activity (PA). To date, studies have been focused on correlates of PF and out-of-school PA, and patterns and trends based on geographic diversity and urban-rural contrasts. Western China, with a large rural population, has substantial urban-rural differences, but little work has been done to compare its children's physical fitness (PF) and out-of-school physical activity (PA) at a county level. A total of 715 primary school students (grades 3-6) were surveyed from one urban school (n = 438) and four rural schools (n = 277) in a county-level administrative unit, Yangling District, Shaanxi, in western China. Physical fitness index (PFI) was measured and calculated based on the revised Chinese Student Physical Fitness Standards. Out-of-school PA and other variables of demographics, behavior and perception were collected using questionnaires. Statistical analyses explored urban-rural differences and correlates of PFI and out-of-school PA. We found that the PFI (72.86 vs. 79.67) and weekly moderate-to-vigorous physical activity (MVPA) duration (167.57 vs. 220.08) of urban students were significantly lower than those of rural students. Weekly MVPA duration had the largest positive impact on PFI. Perceived availability of PA spaces was positively associated with both the urban and rural students' PF and PA, while screen time was negatively associated with PF and PA, especially for rural students. Facilitators of PA frequency include the perceived availability of PA time and parental educational level. Parents' PA habits had a positive impact on urban students' PA. No association between active school commuting and PF or PA was found. Our findings revealed that PF and out-of-school PA of urban students were clearly lower than among rural students. The health of rural children at the county level in western China should be paid much more attention during the process of rapid urbanization.

Are individual and social factors specific to the home associated with children's behaviour and physical environment at home

This study used linear regression analyses to investigate the influence of parent-reported home-specific social and individual factors on: (i) 235 children's home-based objectively measured overall sitting time, breaks in sitting, and PA, and; (ii) the home physical environment via an audit. Parental importance assigned to active play for children was positively associated with PA equipment (accessibility and availability), as well as light physical activity (LPA) and sitting breaks on both weekdays and weekend days. Parental preference for being active at home and limits on screen-time were associated with less household media equipment and portable media equipment, respectively. Greater parental importance placed on playing electronic games/using computers for fun was associated with less LPA and more sitting on weekdays. Further, children who preferred being sedentary sat more and engaged in less moderate-vigorous physical activity (MVPA) on weekdays. Parental and child preferences and priorities, as well as parental rules for activity at home, were associated with children's home-based sitting and PA, especially on weekdays. Such factors were also associated with the physical environment in the expected directions. The findings suggest interventions need to target social and individual factors, alongside adapting the physical environment to create homes more promotive of physical activity.

Electronic Devices as Correlates of Sedentary Behavior and Screen Time Among Diverse Low-Income Adolescents During the School Year and Summer Time

Excessive screen time among adolescents increases risk for overweight and obesity. Having electronic devices in the adolescent's bedroom is associated with more screen time. The present study expanded on previous studies by also examining portable personal electronic devices and social media membership as correlates of screen time use and total sedentary time in the school year and summer among diverse low-income adolescents. Adolescents aged 10-17 years were recruited from lower-income areas; n=150 (34 African Americans, 23 American Indians, 16 Asian/Pacific Islanders, 39 Latinos, and 38 White/non-Hispanics) completed surveys and wore accelerometers in both the school year and summer. Total sedentary time was computed from accelerometers. Recreational screen time was assessed with a 3-item validated scale. Adolescents reported the presence of 6 electronic devices in their bedrooms, ownership of 4 portable devices, and social media membership. General linear modeling was conducted for both time periods, with demographic covariates and interactions with sex and race/ethnicity. More electronic devices in bedrooms were related to more screen time during the school year and summer, and to more total sedentary time in summer. Personal electronics were related only to more screen time in the school year. Social media membership was related to more total sedentary time in summer, but only among African Americans, American Indians, and non-Hispanic Whites. Electronic devices in bedrooms was confirmed as a risk factor for sedentary behavior among low-income adolescents of color. Social media membership and use should be further studied with diverse adolescents.

The Influence of Maturity Status on Anthropometric Profile and Body Composition of Youth Goalkeepers

The anthropometric profile assessment is an important aspect to consider during the growth stages of youth sport practitioners due to its usefulness in controlling maturity status and overall health. We performed an anthropometric profile evaluation in a sample of youth goalkeepers (n = 42) during a training camp, dividing them into three categories based on their years from peak height velocity (YPHV). We also checked if the selection of goalkeepers was associated with the birth quartile. The results showed that most of the participants' anthropometric parameters followed the normal trend according to the maturation stages. However, several subjects showed an overweight/obese condition and/or high waist circumference. Non-optimal values were found, mostly in the group of goalkeepers around the PHV. In addition, no selection based on birth quartile was seen. Therefore, the anthropometric profile and body composition of youth goalkeepers are physiologically affected by maturity status. However, several subjects were found to be overweight/obese and at cardiometabolic risk, suggesting that children and adolescents, although practicing sport, should pay attention to potentially contributing factors such as the attainment of the recommended levels of physical activity, lowering sedentary time, and adopt a healthy lifestyle.

Are neighborhood characteristics associated with sedentary behavior in adolescents? A systematic review

Sedentary behavior (SB) has emerged as a potential risk factor for chronic diseases. SB includes activities requiring low energy expenditure (≤1.5 metabolic equivalents) performed in a sitting or reclining posture. Our study aimed to gather evidence on the association between SB outcomes in adolescents (10-19 years) and neighborhood characteristics. This systematic review (PROSPERO registration number: CRD42018076877) examined studies indexed in PubMed Central®, LILACS, ScienceDirect, and SPORTDiscus databases. Sixteen articles were included. Insecurity during daytime hours, crime incidence, physical and social disorders, a higher neighborhood socioeconomic level, and time spent with peers were associated with higher levels of SB. Traffic, availability of a favorable environment for physical activity, and higher residential density were associated with lower levels of SB. Despite great variability in the SB cutoff points and methodology used for evaluating SB and neighborhood characteristics among studies, the evidence suggests that adolescent SB might be influenced by neighborhood characteristics.

Associations between the Home Physical Environment and Children's Home-Based Physical Activity and Sitting

It is important to understand the correlates of children's physical activity (PA) and sitting at home, where children spend significant time. The home social environment has an important influence; however, much less is known about the home physical environment. Therefore, the study aimed to assess relationships between the physical environment and children's sitting and PA at home. In total, 235 child-parent dyads were included in the analyses. Children spent 67% of their time at home sitting. Linear regression analyses examined associations between physical home environmental factors obtained via an audit and children's (55% girl, 10.2 ± 0.7) objective PA and sitting at home. Following adjustment for socio-demographics and social environmental factors, an open plan living area (OPLA), musical instrument accessibility and availability, and perceived house size were negatively and positively associated, whereas media equipment accessibility and availability was positively and negatively associated with sitting and standing, respectively. Additionally, an OPLA was positively associated with total and moderate-to-vigorous PA. Furthermore, sitting breaks were positively associated with objective garden size and negatively associated with digital TV. The physical home environment may have an important influence on children's sitting, standing and PA at home; therefore, interventions that target this environment are needed.

Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association

This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.

Effects of Full Body Exergaming in Virtual Reality on Cardiovascular and Muscular Parameters: Cross-Sectional Experiment

BACKGROUND

In recent years, many studies have associated sedentary behavior in front of screens with health problems in infants, children, and adolescents. Yet options for exergaming-playing video games that require rigorous physical exercise-seem to fall short of the physical activity levels recommended by the World Health Organization.

OBJECTIVE

The purpose of this study was to investigate the effect of a fully immersive virtual reality (VR)-based training system on cardiovascular and muscular parameters of young adults.

METHODS

A cross-sectional experiment design was used to analyze muscle activity (surface electromyography), heart rate, perceived exertion (RPE), cybersickness symptoms, perceived workload, and physical activity enjoyment (PACES) in 33 participants performing two 5-minute flights on a new training device.

RESULTS

Participants' performance of the planking position required to play the game resulted in moderate aerobic intensity (108 [SD 18.69] bpm). Due to the mainly isometric contraction of the dorsal muscle chain (with a mean activation between 20.6% [SD 10.57] and 26.7% [SD 17.39] maximum voluntary isometric contraction), participants described the exercise as a moderate to vigorous activity (RPE 14.6 [SD 1.82]). The majority reported that they enjoyed the exercise (PACES 3.74 [SD 0.16]). However, six participants had to drop out because of cybersickness symptoms and two because of muscle pain due to prior injuries.

CONCLUSIONS

Our findings suggest that fully immersive VR training systems can contribute to muscle-strengthening activities for healthy users. However, the dropout rate highlights the need for technological improvements in both software and hardware. In prevention and therapy, movement quality is a fundamental part of providing effective resistance training that benefits health. Exergaming on a regular basis has the potential to develop strong muscles and a healthy back. It is essential that future VR-based training systems take into account the recommendations of sport and exercise science.

Generational Differences: A Comparison of Weight-Related Cognitions and Behaviors of Generation X and Millennial Mothers of Preschool Children

A ‘generation’ is an identifiable group sharing birth years and significant life events at critical developmental ages. There is a paucity of literature examining how parental cognitions and lifestyle behaviors differ by generation and whether generational differences are substantial enough to warrant consideration during the development of health interventions. This study compared generational differences in weight-related cognitions and lifestyle behaviors of mothers of young children who were categorized as Generation X (born 1965–1981, n = 158) and Generation Y (aka Millennials; born 1982–1999, n = 162). Survey results indicated that Generation X had significantly higher family affluence; thus, this was controlled in subsequent analyses. Analysis of covariance indicated that Millennials had more positive expectations about the benefits of engaging in healthy eating and physical activity than comparators, but not significantly so. Millennial mothers placed significantly higher value on physical activity for themselves than Generation X mothers, but both generations were neutral on the value of personal physical activity. No generational differences were noted in self-efficacy of mothers for promoting childhood obesity-prevention practices to children and self-efficacy for personally engaging in weight-protective behaviors. Millennial mothers had significantly more family meals/week, however generations did not differ on the value placed on family meals, where family meals were eaten, or whether media devices were used at mealtime. Few differences were noted between the generations for most child feeding behaviors, except that Millennials reported placing significantly less pressure on children to eat. Mothers’ modeling of weight-related behaviors as a means for children’s observational learning about healthy eating, physical activity, and sedentary behaviors did not differ by generational group. The eating behaviors of mothers differed little between generations. Millennial mothers allowed significantly more media devices in children’s bedrooms and personally engaged in more screen time daily than comparators. Overall, the two generational groups were more similar than different in weight-related cognitions as well as for personal and parenting lifestyle behaviors. The results suggest that tailoring interventions for individuals at a similar life-stage (e.g., mothers of young children) by generation may not be warranted.

Leisure-Time Sedentary Behavior and Obesity Among 116,762 Adolescents Aged 12-15 Years from 41 Low- and Middle-Income Countries

OBJECTIVE

Rates of adolescent obesity are increasing worldwide, with steeper increases being observed in low- and middle-income countries (LMICs). Sedentary behavior (SB) has been associated with various physical and mental health conditions. Little is known about the association between SB and obesity among adolescents in LMICs. This cross-sectional study explored the associations between SB and obesity in adolescents from 41 LMICs.

METHODS

Obesity was measured using BMI; SB was assessed through self-report and was considered for all times except when subjects were at school or doing homework.

RESULTS

Data from the Global School-based Student Health Survey were analyzed in 116,762 adolescents (mean [SD] age 13.8 [1.0] years; 48.6% female). The overall prevalence of obesity was 4%, and the prevalence of ≥ 3 h/d of SB was 26%. The prevalence of obesity and SB were lowest in low-income countries and highest in upper-middle-income countries. SB for ≥ 3 h/d was associated with higher odds of obesity in 32 countries. This relationship was strongest among low-income countries.

CONCLUSIONS

Being sedentary for ≥ 3 h/d is associated with increased odds of obesity in adolescence. Future longitudinal data are required to confirm these findings and to inform interventions targeting SB among adolescents in LMICs, thereby reducing the prevalence of obesity.

Influence of individual and family factors on physical activity among Saudi girls: a cross-sectional study

BACKGROUND

Physical inactivity is a major public health problem and one of the main causes of noncommunicable diseases among children. The physical activity (PA) of children has been studied extensively in other countries, but not in Saudi Arabia, most especially among school-based girls.

OBJECTIVES

Assess the PA among older Saudi girls (10-15 years old) and determine the influence of various personal and family factors on PA.

DESIGN

Descriptive, cross-sectional study.

SETTING

Primary and middle schools in Riyadh, Saudi Arabia.

SUBJECTS AND METHODS

Using a multi-stage stratified sampling technique, school girls were surveyed using the Physical Activity Questionnaire for Older Children (PAQ-C). Personal and familial factors that influenced PA levels were assessed by multiple regression analysis.

MAIN OUTCOME MEASURES

PA levels of Saudi school girls.

SAMPLE SIZE

464 girls.

RESULTS

The mean (SD) score of the respondents in the PAQ-C was 2.63 (0.57, range=1.27-4.24). The majority of the older children re.ported a moderate level of PA in the last seven days (73.5%), whereas 22.4% and 4.1% of them reported low and high levels of PA, respectively. Employment status of the parents and monthly family income were significant factors that influenced the PA of children.

CONCLUSIONS

The findings reiterate the significance of improving the PA of school girls and the critical role of the family in improving chil.dren's PA. Multisectoral coordination between schools, health agencies, families, and other concerned agencies to plan and implement interventions should help increase the PA of school girls.

LIMITATIONS

The use of self-report may have introduced some levels of social desirability bias. The study was only conducted in a single city.

CONFLICT OF INTEREST

None.

Obesity, sedentary lifestyle, and video games: The new thrombophilia cocktail in adolescents

Rates of venous thromboembolism have increased in the adolescent population over the last two decades, likely due to advanced diagnostics, increased use of central venous catheters, chronic medical conditions, obesity, and oral contraceptive use. Of these factors, a modifiable risk factor for adolescents is obesity. Sedentary lifestyle and prolonged immobilization are additional prothrombotic risk factors that are often associated with obesity. With ever-increasing screen time, sedentary behavior has risen accordingly, especially among gamers. We present four cases of adolescents who developed life-threatening venous thromboembolic events in the setting of obesity, sedentary lifestyle and/or immobilization, and prolonged video game use.

Sedentary Behaviour in Swiss Children and Adolescents: Disentangling Associations with the Perceived and Objectively Measured Environment

Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time (SBT). A comprehensive set of factors at different levels of influence across the ecological model were taken into account and analysed for mediating and modifying effects. Analyses were based on 1306 children and adolescents (6⁻16 years) participating in the population-based SOPHYA-study. Accelerometers were used to assess SBT, the perceived environment was examined by a validated parental questionnaire, and objective environmental data were allocated using GIS (ArcMap 10.2, Esri, Redlands, CA, USA) for each family’s residential address. A high perceived safety was associated with less SBT. Boys, those whose residential neighbourhood was characterized by dead ends in urban areas, a low main street density in the neighbourhood of children and greenness were less likely to exhibit SBT. The association of the objective environment with the respective parental perceptions was low and no significant mediating effect was found for the perceived environment. We conclude for land-use planning to reduce sedentary behaviour objective environments should be complemented with efforts to increase parental sense of security.