Environmental correlates of sedentary time and physical activity in preschool children living in a relatively rural setting in the Netherlands: a cross-sectional analysis of the GECKO Drenthe cohort

Movement Behaviour and Health Outcomes in Rural Children: A Systematic Review

BACKGROUND

Studies with rural children are limited, and results are divergent regarding the information on movement behaviours.

PURPOSE

to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children.

METHODS

We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study.

RESULTS

A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas.

CONCLUSION

It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.

The association among SES, screen time, and outdoor play in children at different ages: The GECKO Drenthe study

Introduction

This study examined the association among socioeconomic status (SES), screen time, and outdoor play in children at different ages in the GECKO Drenthe birth cohort study.

Methods

Valid data were obtained from two surveys at ages 3-4 years and 10-11 years. Screen time (TV watching and computer use) and outdoor play were reported by parents. Childhood SES was derived by a synthetic "Equivalized Household Income Indicator," an estimated disposable income. Quantile regression models (cross-sectional analysis) and linear regression models (change between 3-4 and 10-11 years) were used.

Results

In general, screen time increased strongly from a median of 51 min/day at 3-4 years (n = 888) to 122 min/day at 10-11 years (n = 1023), whereas time spent on outdoor play remained stable over age (77 min/day at 3-4 years and 81 min/day at 10-11 years). More time spent on outdoor play (50th quantile) was found in children with low SES families at 3-4 years, while at 10-11 years, more outdoor play was found in the high SES group. At 10-11 years, in the higher ranges of screen time, children from high SES had relatively lower screen time [50th quantile: -10.7 (-20.8; -0.6); 75th quantile: -13.6 (-24.4; -2.8)]. In the longitudinal analysis (n = 536), high SES was associated with an increasing time spent on outdoor play [11.7 (2.7; 20.8)].

Conclusion

Socioeconomic disparities in children's outdoor play and screen behavior may be more obvious with increasing age. Low SES may facilitate both outdoor play (at 3-4 years) and screen time (at 10-11 years); however, children from high SES families develop slightly more favorable behavior patterns with age.

Preschool Children's Physical Activity and Community Environment: A Cross-Sectional Study of Two Cities in China

Research on the relationship between preschool children's physical activity (PA) and community environment is limited and inconclusive, yet understanding this relationship is important to acquire sufficient information to guide the development of intervention programs. This study aims to objectively measure preschool children's PA and examine associations between PA and the community environments. A total of 471 preschool children aged 3-6 years old were recruited from eight kindergartens in Beijing and Zhengzhou. PA was measured by accelerometers. Light PA (LPA), moderate PA (MPA), and vigorous PA (VPA) were computed on the basis of cutoff points developed for preschool children. Moderate-to-vigorous PA (MVPA), and total PA (TPA) were obtained by calculation. Children's active transportation modes were indicated by the frequency of active trips (FAT) reported by parents. The community environment was collected by parental scales. Multivariate linear regression was used to analyze the associations between PA and the community environment. In total, 304 preschool children (mean age 5.07 ± 0.94 years, 50.66% boys) were included in the final analysis. Children spent an average of 77.58 ± 18.78 min/day in MVPA and 173.26 ± 30.38 min/day in TPA. Linear regression showed that 'parental perception of appropriate walking distance' was associated with nearly half of the indicators of the children's PA. 'Public activity facilities near the community' was associated with FAT for overall children (B = 0.099, 95% CI = 0.014, 0.183). 'Community transportation environment' was associated with overall children's average day LPA (B = 4.034, 95% CI = 0.012, 8.056), weekend LPA (B = 8.278, 95% CI = 1.900, 14.657), MPA (B = 4.485, 95% CI = 0.613, 8.357), TPA (B = 14.777, 95% CI = 2.130, 27.424), and FAT for girls (B = -0.223, 95% CI = -0.443, -0.003). Furthermore, 'community personal safety' was associated with boys' weekday VPA (B = -3.012, 95% CI = -5.946, 0.079). Parental perception of appropriate walking distances, improvement of PA facilities, community personal safety, and the community transportation environment all contribute to the prevention of preschool children's PA patterns deterioration.

Correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among elementary school children

Understanding the correlates of sedentary behavior among children is essential in developing effective interventions to reduce sitting time in this vulnerable population. This study aimed to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among a sample of children in Japan. Data from 343 children (aged 6-12 years) living in Japan were used. Domain-specific sedentary behaviors were assessed using a questionnaire. Total sedentary time was estimated using hip-worn accelerometers. Twenty-two potential correlates across five categories (parental characteristics, household indoor environment, residential neighborhood environment, school environment, and school neighborhood environment) were included. Multivariable linear regression models were used to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time. Eight correlates were significantly associated with children's domain-specific sedentary behaviors: mother's and father's age, mother's educational level, having a video/DVD recorder/player, having a video console, having a TV one's own room, home's Walk Score^®, and pedestrian/cycling safety. No significant associations were found between potential correlates and accelerometer-based total sedentary time. These findings highlight that strategies to reduce children's sedentary time should consider the context of these behaviors. For example, urban design attributes such as perceived pedestrian and cycling safety can be improved to reduce children's car sitting time.

Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study

OBJECTIVE

This cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.

METHODS

Data were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3-6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.

RESULTS

Multiple linear regression analysis showed that "having grandparents as primary caregivers" (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1-57.2); LTSB (ln): 0.19 (0.11-0.28)) and "having a television (for LTSB (ln): 0.13 (0.00-0.25)) or computer (for LTSB (ln): 0.13 (0.03-0.23)) in the child's bedroom" were both associated with higher SB. Furthermore, "having grandparents as primary caregivers" was associated with less MVPA (β (95%CI): -7.6 (-14.1 to -1.2)), and "active commuting to school by walking" correlated with more MVPA (β (95%CI): 9.8 (2.2-17.4)). The path model showed that "more neighborhood PA facilities close to home" was indirectly related to higher LTPA (ln), which was partly mediated by "outdoor play" (path coefficients (95%CI): 0.005 (0.002-0.008)) and "going to these facilities more often" (path coefficients (95%CI): 0.013 (0.008-0.018)). Traffic safety was not a correlate.

CONCLUSION

Family structure and media exposure in the home maybe important factors in shaping preschoolers' PA patterns. Built environmental correlates could indirectly influence preschoolers' LTPA through parental help with engaging in active behaviors.

Factors Associated with Motor Competence in Preschoolers from a Brazilian Urban Area

Background

Preschool is a crucial period for developing motor skills.

Objective

This study evaluated factors associated with motor competence in preschoolers from a Brazilian urban area.

Methods

A total of 211 preschoolers (51.2% girls and 48.8% boys) were evaluated. Body mass index was calculated; the Brazilian Economic Research Criterion, the Mini-Mental Scale (MMC) and the Early Childhood Environment Rating Scale®, Revised (ECERS-R™) were applied; the Habitual Physical Activity time was recorded; the Test of Gross Motor Development (TGMD-2) was performed. Univariate analysis was performed using simple linear regression for the independent variables, considering the motor test subscales as dependent variables. Variables with p < 0.20 in the univariate analysis were considered for the multiple linear regression model and were entered into the stepwise method.

Results

The independent variables remaining in the Standard Score Locomotor model were BMI, presence of park at school, and MMC (R2 = 0.16). The independent variables remaining in the Standard Object Control score were MMC and gender (R2 = 0.03). The variables associated with the highest scores of Gross Motor Quotient were MMC, body mass index, and presence of a park at school, respectively (R2 = 0.11).

Conclusion

Male eutrophic preschoolers who are physically active and attend schools with parks or courtyards in a Brazilian urban area have the highest scores for global cognitive function and motor competence.

Regional variation in lifestyle patterns and BMI in young children: the GECKO Drenthe cohort

BACKGROUND

A better understanding of lifestyle behaviours of children < 7 years and the relation with childhood overweight is needed. The aim of our prospective study was to examine how lifestyle patterns in young children are associated with the development of childhood overweight. As ecological models suggest focusing on not only the child as an individual, but also their environment, we also considered the role of socio-economic status (SES) and spatial clustering of lifestyle and body mass index (BMI).

METHODS

In 1792 children (aged 3-6 years) participating in the GECKO Drenthe cohort, diet, screen time, outdoor play and sleep were assessed by questionnaires and moderate-to-vigorous physical activity and sedentary time by accelerometry (Actigraph GT3X). At 10-11 years, height and weight were measured to calculate age- and sex-specific standardized BMI z-scores (zBMI). Lifestyle patterns were identified using principal component analysis. To assess spatial clustering for the lifestyle patterns and zBMI, we calculated the Global Moran's I statistic. Linear- and logistic regression models, taking into account SES, were performed to examine the association between the lifestyle patterns and the development of overweight. For the spatial analyses, we added spatial terms for the determinants, the outcome, and the error term.

RESULTS

Three lifestyle patterns were identified: (1) 'high activity', (2) 'low screen time, high sleep and healthy diet', and (3) 'high outdoor play'. No associations were observed between the 'high activity' or 'high outdoor play' patterns at young age with the development of childhood overweight (all p > 0.05). In contrast, children who adhered to the 'low screen time, high sleep and healthy diet' pattern had lower odds to become overweight and a lower zBMI at 10-11 years (odds ratio [95% CI] = 0.766 [0.65; 0.90]). These findings remained similar after taking SES into account. Regarding the spatial analyses, we found spatial clustering of zBMI, but no spatial clustering of the lifestyle patterns.

CONCLUSIONS

Low screen time, high sleep duration and a healthy diet cluster into a pattern that seems favourable in the prevention of childhood overweight, independent of individual SES. The spatial analyses suggest that there are likely other neighbourhood factors that contribute to the spatial clustering of childhood overweight.

Associations between Parent-Child Nature Visits and Sleep, Physical Activity and Weight Status among Finnish 3-6-Year-Olds

Nature visits and nature exposure have been shown to be favorably associated with children’s health and development, but the research regarding their associations with children’s lifestyle habits is limited. The current study aimed to investigate the associations between the frequency of parent–child nature visits and sleep, moderate-to-vigorous physical activity (MVPA) and weight status among three- to six-year-old Finnish preschoolers. Parents and their children (n = 864) participated in a cross-sectional DAGIS (increased health and wellbeing in preschools) study, which was conducted between 2015 and 2016 in Finland. In total, 798 parents answered a questionnaire on the frequency of parent–child nature visits, which also included questions on sociodemographic factors and their children’s sleep habits. Parents also reported children’s bedtimes and wake-up times and children wore an accelerometer for seven days. Trained researchers measured children’s weight and height. Linear and logistic regression analyses were conducted. More frequent parent–child nature visits were associated with children’s longer sleep duration at night, higher amounts of MVPA outside preschool time and, among girls, good sleep consistency. The frequency of parent–child nature visits was not significantly associated with whether children were overweight or obese or not. Promoting parent–child nature visits could be a cost-effective way to increase young children’s MVPA and enhance night-time sleep.

Relationship Between the Physical Environment and Physical Activity Levels in Preschool Children: A Systematic Review

PURPOSE OF REVIEW

The aim of this study was to understand the influence of the physical environment on the physical activity (PA) behavior of preschool children (aged 2 to 6 years), in order to provide an overview of these influences from the perspective of the ecological model.

RECENT FINDINGS

PA is of great importance for the prevention of obesity and cardiovascular diseases since childhood. The physical environment has a direct relationship with the different domains, where people can spend their time being physically active. Nonetheless, despite the importance of the physical environment to engagement in PA, very few reviews have focused on this relationship in the context of the growing problem of physical inactivity among preschool children. Studies that had analyzed the school domain had found that greater availability of a wider variety of portable play equipment, presence of certain fixed playground equipment, and presence of open spaces had favored PA levels. Furthermore, different studies had shown that the natural environment and the presence of hills were important for children's PA. Thus, despite the associations with PA we were able to identify in this review, new studies will still be needed to link the physical environment with PA levels, especially regarding transportation and leisure time. In conclusion, promoting studies on this subject from an early age will allow us to obtain information that could allow the adaptation, design, and construction of healthier homes, neighborhoods, and schools that promote children's health.

Physical Activity and Sedentary Behaviors of Young Children: Trends from 2009 to 2018

Over the last decade, the lives of children in several countries, including Greece, have been affected by recession. The aim of the present study was (a) to examine time trends in physical activity (PA) and screen time (ST) of Greek preschool children, together with their family affluence (FA), from 2009 until 2018, and to explore the associations among them; and (b) to investigate the connections of parental educational level and children's BMIs to their achieving ST (<1h/day) and PA (11,500 steps/day) guidelines. A total of 652 children from four cross-sectional cohorts participated. PA was recorded with Omron HJ-720IT-E2 pedometers, whereas ST, family affluence (FA) and parental educational level were reported by participants' parents. The results of the one-way ANOVAs that were computed revealed statistically significant differences among cohorts, albeit of no practical importance, in PA, ST and FA. According to the regressions calculated, neither BMI nor the educational level was related to membership in ST and PA guidelines groups. ST was a significant predictor of children's PA in all week periods (school-time, leisure-time, weekend), whereas FA was not such a strong predictor. Multilevel interventions aiming at both ST and PA seem to be imperative for the benefit of young children's health.