SEDENTARY BEHAVIOR AND CARDIOVASCULAR RISK IN CHILDREN: A SYSTEMATIC REVIEW

Perspectives of children with physical disabilities, parents and physiotherapists on use of walkers and their potential to increase physical activity. A qualitative exploration

Children with physical disabilities are less physically active than children with typical development. How children's experiences of using walkers relates to their physical activity has not been studied previously. This study aimed to explore perspectives of walker use and their potential to increase physical activity. Four focus groups were conducted with children aged 7-10 (n = 3; 12.5%), aged 9-12 (n = 4; 16.7%), parents (n = 7; 29.2%) and paediatric physiotherapists (n = 10; 41.7%). Groups were audio recorded and transcribed. Data were analysed using framework analysis. An overarching concept of walkers needing flexibility to accommodate individual, interpersonal and environmental variability was underpinned by three themes: (a) contrasting drivers for use/non-use of walkers, (b) trade-offs, (c) acceptance of technology within walkers to increase physical activity. Participants were motivated by differing drivers: social for children, emotional for parents and professional for physiotherapists. These contrasting drivers create trade-offs, for example between quality of movement and independence. To maximise physical activity, walker prescribers and designers should prioritise drivers that motivate children and parents, ensuring goal setting is family-centred and participation orientated. Involving families in co-designing walkers is therefore important. Individual clinical assessment allows for identification of children's specific needs and how a child's, parent's and physiotherapist's goals may differ.

Parental Perceptions of Physical Activity and Risk of Disease Associated with Sedentary Behaviours in Infants and Toddlers

OBJECTIVES

The current study intends to measure parents' perceptions of newborn and toddler physical activity.

METHODS

A Cross-sectional study was conducted at the pediatric clinic at a University Hospital in Riyadh. The parents or guardians of children 0 to 3 years of age, healthy infants, and toddlers who visited the vaccination and pediatric clinic at a University Hospital in Riyadh, were recruited. The Parental Perceptions of Physical Activity Scale (PPPAS) was translated into the Arabic language. The Chi-square test was applied to observe the association between categorical variables. P value < 0.05 was considered to be statistically significant.

RESULTS

A total of 383 parents were recruited. There was a significant association observed between physical activity and income, employment, and education. A significant association was observed between the following perceptions; the child enjoys physical activity, it increases the child's fitness level, the strength of the muscles, flexibility, and life span, improves happiness, keeps the child active, and provides a sense of achievement, and decrease future weight problems.

CONCLUSION FOR PRACTICE

The study determined that parental inclination towards engaging in a physical activity intervention for their infants, as well as identifying any concerns that may impact their children's adherence to physical activity was satisfied.

Effects of a Physical Exercise Program and Health Advice on Sedentary Behavior of Adolescents

Sedentary behavior (SB) is a risk factor for chronic non-communicable diseases. This study aimed to assess the effects of an extracurricular physical exercise program and health advice on SB in adolescents. This was a non-randomized experimental study involving 19 adolescents divided into an intervention group (IG) and a control group (CG), aged 13-16 years from a public school in a Brazilian municipality. SB was measured using self-reports and accelerometers. The intervention included physical exercise and health advice. Repeated measures analysis of variance with a significance level of α = 5% was used. There was a time*group interaction for the subscapular fold ((pre IG = 16.30 mm vs. CG = 13.44 mm, post IG = 14.00 mm vs. CG = 15.89 mm) p = 0.001), and VO2MAX ((pre IG = 32.75 mL/kg/min vs. CG = 30.66 mL/kg/min, post IG = 35.76 mL/kg/min vs. CG = 29.28 mL/kg/min) p = 0.008). The accelerometer showed significant differences between groups in the total SB ((pre IG = 647.49 min/day vs. CG = 535.24 min/day, post IG = 614.02 min/day vs. CG = 586.97 min/day) p = 0.045), with a significant decrease in the IG. In conclusion, an extracurricular physical exercise program and health advice was effective in reducing SB in adolescents.

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.

Consequences of COVID-19 Lockdown Restrictions on Children Physical Activity—A Slovenian Study

During the COVID-19 pandemic, countries took several restrictions to contain the spread of coronavirus. In the second wave of the COVID-19 pandemic, primary schools in Slovenia were closed for a period long time (from October 19th 2020 until January 18th 2021 when they were partially reopened for 6–9 year olds until February 15th 2021 when they were reopened for all children) and organized sport activities for children and adolescents under the age of 15 was not allowed during this period. The aim of the study was to examine how these restrictions were reflected in the amount of different forms of physical activity (PA) of 6–12-year old children (N = 3,936). Data were collected using an online questionnaire (International Physical Activity Questionnaire Short Form) comparing different forms of PA before (BEFORE) and during (DURING) remote schooling. The results show that there has been a decline in children's PA DURING, specifically, only 4.3% of children had their physical education ≥ 45 min (or 77.7% ≤ 30 min), as is the usual duration in Slovenia. There was also a remarkable decline in extracurricular sports activities (p < 0.001), which BEFORE had been participated by 72.2% of children, while DURING remote schooling, as many as 83.5% of children did not participate these activities. 69.7% of children participated in organized sports in clubs at least once a week, while DURING remote schooling, as many as 88.1% (p < 0.001) did not participate in such form of activities. Furthermore, the time spent exercising in moderate to vigorous PA also decreased (BEFORE 8.2% vs. DURING 24.9%; p < 0.001). We found that during lockdown there has been an alarming decrease in the frequency and duration of organized PA at school and at sports clubs. These findings are a good starting point for designing (developing) an effective strategy for promoting health-enhancing PA of children in the event of a future lockdown or similar situations. The strategy should focus on the appropriate implementation of PA curriculum and motivate young people to participate regularly in extracurricular organized and non-organized activities.

What is the role of cardiorespiratory fitness and sedentary behavior in relationship between the genetic predisposition to obesity and cardiometabolic risk score?

Background

Genetic factors along with inadequate lifestyle habits are associated with the development of cardiometabolic alterations. Thus, the present study aimed to examine the role of sedentary behavior on the relationship between rs9939609 polymorphism (fat mass and obesity-associated gene-FTO) and cardiometabolic risk score according to cardiorespiratory fitness (CRF) levels in children and adolescents.

Methods

A cross-sectional study with 1215 children and adolescents (692 girls), aged between 6 and 17 years. Screen time as a marker of sedentary behavior was evaluated through a self-reported questionnaire and CRF was estimated using the 6-min walking and running test. The genotyping of the FTO rs9939609 polymorphism was performed using a real-time polymerase chain reaction. Clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, glucose, systolic blood pressure, and waist circumference, and dividing it by five. Moderation analyses were tested using multiple linear regression models.

Results

The coefficient of the interaction term of FTO (rs9939609) and screen time indicated that screen time was a significant moderator on the relationship between FTO rs9939609 polymorphism and cMetS (p = 0.047) in children and adolescents classified with low CRF (β = 0.001; 95% CI = 0.001; 0.002). It was observed a significant association between genotype risk (AA) of FTO polymorphism and cMetS, in participants that spent more than 378 min a day in front of screen-based devices (β = 0.203; 95% CI = 0.000; 0.405). No interaction term was found for those with high CRF.

Conclusions

High sedentary behavior seems to influence the relationship between genetic predisposition to obesity and cardiometabolic risk factors in children and adolescents with low CRF.

Indicators to Assess Physical Health of Children and Adolescents in Activity Research-A Scoping Review

Sufficient physical activity can help promote and maintain health, while its lack can jeopardize it. Since health and physical activity lay their foundation for later life in childhood and adolescence, it is important to examine this relationship from the beginning. Therefore, this scoping review aims to provide an overview of physical health indicators in children and adolescents in research on the effects of physical activity and sedentary behavior. We identified the indicators used to quantify or assess physical health and summarized the methods used to measure these indicators. We systematically searched Scopus, Pubmed, and Web of Science databases for systematic reviews. The search yielded 4595 records from which 32 records were included in the review. The measurements for physical health reported in the reviews contained measures of body composition, cardiometabolic biomarkers, physical fitness, harm/injury, or bone health. Body composition was the most used indicator to assess and evaluate physical health in children, whereas information on harm and injury was barely available. In future research longitudinal studies are mandatory to focus on the prospective relationships between physical activity or sedentary behavior, and physical health.

Nuances between sedentary behavior and physical inactivity: cardiometabolic effects and cardiovascular risk

OBJECTIVE

The aim of this study was to highlight the differences between the cardiometabolic effects and the cardiovascular risk of physical inactivity and sedentary behavior.

METHODS

A narrative bibliographic review was conducted. In the research, national and international articles were selected from the PubMed, SciELO, and LILACS databases using the descriptors "sedentary lifestyle, cardiovascular risk, physical inactivity, sedentary behavior, and cardiovascular risks."

DISCUSSION

Both physical inactivity and sedentary behavior are related to metabolic and organic changes, promoting a chronic proinflammatory state, cardiac remodeling, increased body adiposity, and skeletal muscle dysfunction. It is possibly stated that both of them result in a higher risk of developing chronic diseases, resulting in higher global and cardiovascular morbidity and mortality, with nuances in their intrinsic effects.

CONCLUSIONS

It is inferred that both physical inactivity and sedentary behavior are cardiovascular risk factors that can be modified with the correct clinical approach. It is necessary to differentiate physically inactive individuals from those with a high number of sedentary behaviors. These concepts need better clinical applicability to improve the prevention of primary and secondary cardiovascular risks.

Movement behaviors and health-related fitness among peripubertal adolescents: 2012 NHANES national youth fitness survey data

BACKGROUND

Less than half of adolescents in the United States meet the recommended levels of moderate-to-vigorous physical activity (MVPA) and health-related fitness (HRF). Using the 2012 NHANES National Youth Fitness Survey data, this study aimed to examine the associations of movement behaviors (i.e., MVPA and screen-based sedentary behaviors) with HRF (i.e., cardiovascular and muscular fitness) among 11-16- year-old peripubertal boys and girls, respectively.

METHODS

A total of 470 adolescents (227 boys, 243 girls; age: 13.59±1.12 years old) from the 2012 NHANES dataset were included. The study variables included movement behaviors (i.e., MVPA and screen-based sedentary behavior), anthropometric indices (i.e., waist circumference, Body Mass Index [BMI]), and HRF (i.e., cardiovascular fitness and muscular fitness). Correlational and hierarchical regression analyses were conducted for boys and girls, respectively.

RESULTS

MVPA significantly predicted cardiovascular fitness for boys (β=0.16, P<0.05) and girls (β=0.15, P<0.05) regardless of weight status; screen-based sedentary behavior and waist circumference in girls significantly predicted muscular fitness (β=-0.13 and β=-0.42, P<0.05).

CONCLUSIONS

To increase overall HRF in peripubertal girls and boys, it is important to help them maintain healthy weight status and to promote MVPA and limit screen-based sedentary behavior, especially in adolescent girls.

Does modality matter? A latent profile and transition analysis of sedentary behaviours among school-aged youth: The UP&DOWN study

The aims of this study were to identify profiles of sedentary behaviour (SB) patterns, based on leisure-time self-reported SB modalities (screen, educative, social, and relaxing) and to evaluate changes in these profiles over 2 years among Spanish youth aged 8-18 years. Latent profile analysis (LPA), a data-driven analytic approach, was used to identify groups of boys and girls (n = 1553; 48% girls; mean±SD age: 12.56 ± 2.49 y) with distinct SB profiles using the SB modalities (time/d) as input variables. Latent transition analysis, an extension of LPA that uses longitudinal data, was used to analyse 2-year changes in these profiles. At baseline, four and three SB profiles were found among boys (labelled: screen, educative, social, and relaxing) and girls (labelled: screen/social, educative, and relaxing), respectively. Overall, more girls (range: 48%-67%) had the same profile over time, than boys (40%-52%). Participants with a screen or relaxing SB profile at baseline were more likely to have an educative profile after 2 years. Youth with a social and an educative SB profile at baseline were more likely to transition to profiles characterized by higher screen and social SB, respectively. Using a novel and person-centered approach, this study identified gender-specific SB profiles that were moderately stable over time.