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Al-walah MA, Donnelly M, Heron N. Barriers, enablers and motivators of the "I'm an active Hero" physical activity intervention for preschool children: a qualitative study. Front Pediatr 2024; 12:1333173. [PMID: 38357506 PMCID: PMC10864600 DOI: 10.3389/fped.2024.1333173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Background Insufficient physical activity (PA) in early childhood is linked to adverse health outcomes and a heightened risk of obesity. Successful PA programmes often require input from key stakeholders, such as parents and educators. However, research on stakeholders' perspectives regarding PA programmes for preschool children is limited, impeding effective programme design and implementation. Objectives This study aims to explore the perspectives of key stakeholders to gain insights into the challenges, facilitators, and motivators that influence the planning, execution, and sustainability of the "I'm an Active Hero (IAAH) intervention component," a preschool-based initiative designed to promote PA among young children. Methods Semi-structured interviews were conducted in Saudi Arabia with individual preschool principals (n = 2), and focus group discussions were held, respectively, with preschool staff members (n = 4, all female) and parents (4 mothers, 5 fathers). Results A thematic analysis identified four main themes: (1) Barriers to parental involvement in preschool PA interventions, such as time constraints, lack of flexibility, limited space, and a shortage of trained staff; (2) Risks and benefits of children's programme participation; (3) Motivators including rewards, non-financial incentives, and concerns about childhood obesity and a sedentary lifestyle; (4) Facilitating factors for overcoming barriers, including staff training, time reallocation, staff coordination, space optimization, non-financial incentives, and sustaining partnerships. Conclusion This study's findings are crucial for childcare professionals, preschools, education authorities, and policymakers, offering valuable insights for future research. However, further collaboration with key stakeholders is essential to enhance individual attitudes and preschool policies for effective intervention implementation.
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Affiliation(s)
- Mosfer A. Al-walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, England
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Prvulović N, Djordjević M, Pantelić S. Gender differences and climate zones in overweight and obesity prevalence in European elementary school children from 2000 to 2020: a systematic review and meta-analysis. Front Public Health 2023; 11:1198877. [PMID: 37808999 PMCID: PMC10558048 DOI: 10.3389/fpubh.2023.1198877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction After 2000, there are more obese than underweight people in the world. We face a rapid increase in average global warming of 1.5°C, reported as a syndemic problem of three interconnected epidemics: obesity, global warming, and undernutrition. We aimed to analyze the impact and association between global warming and obesity in children and differences by gender across Europe after 2000. Methods We searched PubMed, MEDLINE, Google Scholar, ScienceDirect, and Embase databases. The considered population were children aged 6-14. Only cross-sectional studies that defined obesity by the IOTF cutoffs and the subjects' place of residence, used to determine precise climate zones, were included. We assessed the prevalence of obesity and overweight using a random-effects and the Mantel-Haenszel fixed-effect method when heterogeneity was greater/lower than 50%. We did a subgroup analysis for prevalence across gender, obesity, and overweight, two decades, regions, countries, and the Köppen-Geiger climate zones. Random effects of the meta-regression were used to study the global warming impact and differences in trends across European countries by gender for both conditions separately. Results We identified 114 studies that included 985,971 children from 39 European countries. A significant difference between genders was in favor of obese girls 4.78 (95% CI: 3.85-5.93) versus boys 5.76% (95% CI: 5.11-6.48, p = 0.03), respectively, but not for overweight children. Most of the obese girls were in South Europe 7.51% (95% CI: 6.61-8.51) versus East Europe 2.86% (95% CI: 23-3.12), versus boys in South Europe 8.66% (95% CI: 7.68-9.74) and North Europe 3.49% (95% CI: 2.90-4.19), respectively. The "cold" Köppen-Geiger climate zone, with lowest temperatures, has the largest trend rise between two decades of 2.8% and 1.53% for obese girls and boys, and 5.31% and 1.81% for overweight girls and boys, respectively, followed by the smallest number of obese girls 3.28% (95% CI: 2.17-4.92) and boys 3.58% (95% CI: 2.39-5.33), versus the zone with the highest temperatures "hot" for girls 7.02% (95% CI: 6.30-7.82) and for boys 8.23% (95% CI: 7.55-8.96), respectively. The meta-regression proved global warming has a significant impact on the distribution of obesity and overweight across climate zones, R2 = 0.52 and R2 = 0.22. No significant gender differences, or significant interaction, was noted. Conclusion Our meta-analysis provides a comprehensive overview of the association between and impact of global warming on obesity. This impact increases obesity among children in Europe throughout all climate zones, and emphasizes an urgent call for further preventive methods in schools, since obesity differences continue their trend of disappearing into the future.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021282127, identifier: CRD42021282127.
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Affiliation(s)
- Nikola Prvulović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | | | - Saša Pantelić
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
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Ramírez-Coronel AA, Abdu WJ, Alshahrani SH, Treve M, Jalil AT, Alkhayyat AS, Singer N. Childhood obesity risk increases with increased screen time: a systematic review and dose-response meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:5. [PMID: 36691087 PMCID: PMC9869536 DOI: 10.1186/s41043-022-00344-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND The role of screen time in promoting obesity among children has been reported in previous studies. However, the effects of different screen types and the dose-response association between screen time and obesity among children is not summarized yet. In the current meta-analysis we systematically summarized the association between obesity and screen time of different screen types in a dose-response analysis. METHODS A systematic search from Scopus, PubMed and Embase electronic databases was performed. Studies that evaluated the association between screen time and obesity up to September 2021 were retrieved. We included 45 individual studies that were drawn from nine qualified studies into meta-analysis. RESULTS The results of the two-class meta-analysis showed that those at the highest category of screen time were 1.2 times more likely to develop obesity [odds ratio (OR) = 1.21; confidence interval (CI) = 1.113, 1.317; I2 = 60.4%; P < 0.001). The results of subgrouping identified that setting, obesity status and age group were possible heterogeneity sources. No evidence of non-linear association between increased screen time and obesity risk among children was observed (P-nonlinearity = 0.310). CONCLUSION In the current systematic review and meta-analysis we revealed a positive association between screen time and obesity among children without any evidence of non-linear association. Due to the cross-sectional design of included studies, we suggest further studies with longitudinal or interventional design to better elucidate the observed associations.
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Affiliation(s)
- Andrés Alexis Ramírez-Coronel
- Catholic University of Cuenca, Azogues Campus, Azogues, Ecuador
- University of Palermo, Buenos Aires, Argentina
- National University of Education, Azogues, Ecuador
- CES University, Medellín, Colombia
| | | | - Shadia Hamoud Alshahrani
- Medical Surgical Nursing Department, King Khalid University, Khamis Mushate, Almahala, Saudi Arabia.
| | - Mark Treve
- School of Languages and General Education, Walailak University, Nakhon Si Thammarat, Thailand
| | - Abduladheem Turki Jalil
- Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, 51001, Iraq
| | - Ameer S Alkhayyat
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Nermeen Singer
- Department of Media and Children's Culture, Ain Shams University, Cairo, Egypt
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Sundberg F, deBeaufort C, Krogvold L, Patton S, Piloya T, Smart C, Van Name M, Weissberg-Benchell J, Silva J, diMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Managing diabetes in preschoolers. Pediatr Diabetes 2022; 23:1496-1511. [PMID: 36537520 PMCID: PMC10108244 DOI: 10.1111/pedi.13427] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Frida Sundberg
- The Queen Silvia Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Carine deBeaufort
- Clinique Pédiatrique, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.,Department of Pediatric Endocrinology, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium
| | - Lars Krogvold
- Paediatric Department, Oslo University Hospital, Oslo, Norway
| | - Susana Patton
- Center for Healthcare Delivery Science, Nemours Children's Health, Jacksonville, Florida, USA
| | - Thereza Piloya
- Department of Paediatrics & Child Health, School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Carmel Smart
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital and School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jose Silva
- SummitStone Health Partners, Fort Collins, Colorado, USA
| | - Linda A diMeglio
- Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Haghjoo P, Siri G, Soleimani E, Farhangi MA, Alesaeidi S. Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis. BMC PRIMARY CARE 2022; 23:161. [PMID: 35761176 PMCID: PMC9238177 DOI: 10.1186/s12875-022-01761-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/03/2022] [Indexed: 01/03/2023]
Abstract
Background Adolescence is a critical period in human life, associated with reduced physical activity and increased sedentary behaviors. In this systematic review and dose-response meta-analysis, we evaluated the association between screen time and risk of overweight/obesity among adolescents. Methods A systematic search in electronic databases, including PubMed, Embase, and Scopus was performed up to September 2021. All published studies evaluating the association between screen time and risk of overweight/obesity among adolescents were retrieved. Finally, a total of 44 eligible studies were included in the meta-analysis. Results The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.27 times more likely to develop overweight/obesity (OR = 1.273; 95% CI = 1.166–1.390; P < 0.001; I-squared (variation in ES attributable to heterogeneity) = 82.1%). The results of subgrouping showed that continent and setting were the possible sources of heterogeneity. Moreover, no evidence of non-linear association between increased screen time and risk of overweight/obesity among adolescents was observed (P-nonlinearity = 0.311). Conclusion For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and overweight/obesity among adolescents without any dose-response evidence. Trial registration The protocol of the current work has been registered in the PROSPERO system (Registration number: CRD42021233899). Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01761-4.
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Affiliation(s)
- Purya Haghjoo
- Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensiye Soleimani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samira Alesaeidi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Manzano-Sánchez D, Palop-Montoro MV, Arteaga-Checa M, Valero-Valenzuela A. Analysis of Adolescent Physical Activity Levels and Their Relationship with Body Image and Nutritional Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053064. [PMID: 35270754 PMCID: PMC8910452 DOI: 10.3390/ijerph19053064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 12/04/2022]
Abstract
The main objective of this research article was to make a cluster analysis in Compulsory Secondary Education students with regard to their physical activity levels, their relationship with nutritional habits and body perception. In this study, a total of 1089 students participated, to whom a battery of tests was given in order to assess three aspects: levels of physical activity, food consumption habits and perception of body image. The main results indicated that the adolescent sample presented high levels of physical activity in comparison with other studies. In addition, a profile analysis was carried out, showing that there were no differences in physical activity, in nutritional habits or in body-image index. Taking into account gender, women who practice light physical activity had better nutritional habits. On the other hand, boys dominated in the group of moderate-to-high physical activity, while the girls were mainly included in the profile of low physical activity. Finally, body-image index was greater in men than women. It was concluded that is necessary to promote the importance of adequate nutritional habits in addition to physical activity, and it is necessary to promote body image, particularly among adolescent girls, given their low values of physical activity and worse body-image perception in relation to boys.
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Affiliation(s)
- David Manzano-Sánchez
- Faculty of Sport Sciences, University of Murcia, 30100 Murcia, Spain;
- Correspondence:
| | | | - Milagros Arteaga-Checa
- Grupo de Investigación CTS-1018 Physical Activity for Health Promotion, Faculty of Humanities and Education Sciences, University of Jaén, 23071 Jaén, Spain;
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Libuy N, Bann D, Fitzsimons E. Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence. SSM Popul Health 2021; 16:100978. [PMID: 34950761 PMCID: PMC8671115 DOI: 10.1016/j.ssmph.2021.100978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/05/2021] [Accepted: 11/20/2021] [Indexed: 11/20/2022] Open
Abstract
We use longitudinal data across a key developmental period, spanning much of childhood and adolescence (age 5 to 17, years 2006-2018) from the UK Millennium Cohort Study, a nationally representative study with an initial sample of just over 19,000. We first examine the extent to which inequalities in overweight, obesity, BMI and body fat over this period are consistent with the evolution of inequalities in health behaviours, including exercise and healthy diet markers (i.e., skipping breakfast) (n = 7,220). We next study the links between SES, health behaviours and adiposity (BMI, body fat), using rich models that account for the influence of a range of unobserved factors that are fixed over time. In this way, we improve on existing estimates measuring the relationship between SES and health behaviours on the one hand and adiposity on the other. The advantage of the individual fixed effects models is that they exploit within-individual changes over time to help mitigate biases due to unobserved fixed characteristics (n = 6,883). We observe stark income inequalities in BMI and body fat in childhood (age 5), which have further widened by age 17. Inequalities in obesity, physical activity, and skipping breakfast are observed to widen from age 7 onwards. Ordinary Least Square estimates reveal the previously documented SES gradient in adiposity, which is reduced slightly once health behaviours including breakfast consumption and physical activity are accounted for. The main substantive change in estimates comes from the fixed effects specification. Here we observe mixed findings on the SES associations, with a positive association between income and adiposity and a negative association with wealth. The role of health behaviours is attenuated but they remain important, particularly for body fat.
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Affiliation(s)
- Nicolás Libuy
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Corresponding author.
| | - David Bann
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Institute for Fiscal Studies, London, UK
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Zovko V, Djuric S, Sember V, Jurak G. Are Family Physical Activity Habits Passed on to Their Children? Front Psychol 2021; 12:741735. [PMID: 34552541 PMCID: PMC8450430 DOI: 10.3389/fpsyg.2021.741735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Studies of the familial association of physical activity (PA) and sedentary behavior (SB) have increased in recent years. However, there is a lack of studies that have objectively examined the correlates between parents, grandparents, and childrens' PA. Therefore, the purpose of this study was to measure PA using accelerometers to determine the extent to which PA and SB correlate among parents, grandparents, and children. A sample of 169 children between 11 and 14 years (77 boys and 97 girls), 225 parents (98 males and 127 females), and 52 grandparents (16 males and 36 females) were recruited for the current study. Accelerometers RM42 (UKK Terveyspalvelut Oy, Tampere, Finland) were used to determine PA levels of children, parents, and grandparents. Epoch length was 6 s. Mothers' moderate-to-vigorous PA (MVPA) was associated with children's MVPA (p < 0.05). After adjusting for age, BMI (child), and educational status, the results remain the same. Results of linear regression analyses for boys' sedentary time showed that fathers' sedentary time was significantly associated with boys (p < 0.01), but not with girls. The association of grandmothers' and grandfathers' MVPA activity with that of children showed that grandparents' MVPA, when adjusted for age, BMI, and educational status, was not a significant predictor (p > 0.05) of children's MVPA (total sample). In contrast, grandfathers' sedentary behavior was a significant predictor (β = 0.269; p < 0.05) of children's sedentary behavior (total sample). The results of the current study suggest that parental involvement in PA, particularly by mothers, is important for children's PA and, accordingly, healthy outcomes.
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Affiliation(s)
- Vinko Zovko
- Institute of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.,Educational Unit for Sports, School of Economics and Business, University of Ljubljana, Ljubljana, Slovenia
| | - Sasa Djuric
- Institute of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Vedrana Sember
- Institute of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Jurak
- Institute of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Fang H, Jing Y, Chen J, Wu Y, Wan Y. Recent Trends in Sedentary Time: A Systematic Literature Review. Healthcare (Basel) 2021; 9:969. [PMID: 34442106 PMCID: PMC8394097 DOI: 10.3390/healthcare9080969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research.
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Affiliation(s)
- Hui Fang
- Library, Zhejiang University of Technology, Hangzhou 310023, China; (H.F.); (J.C.); (Y.W.)
- Institute of Information Resource, Zhejiang University of Technology, Hangzhou 310023, China
| | - Yuan Jing
- Library, Zhejiang Sci-Tech University, Hangzhou 310018, China;
| | - Jie Chen
- Library, Zhejiang University of Technology, Hangzhou 310023, China; (H.F.); (J.C.); (Y.W.)
- Institute of Information Resource, Zhejiang University of Technology, Hangzhou 310023, China
| | - Yanqi Wu
- Library, Zhejiang University of Technology, Hangzhou 310023, China; (H.F.); (J.C.); (Y.W.)
- Institute of Information Resource, Zhejiang University of Technology, Hangzhou 310023, China
| | - Yuehua Wan
- Library, Zhejiang University of Technology, Hangzhou 310023, China; (H.F.); (J.C.); (Y.W.)
- Institute of Information Resource, Zhejiang University of Technology, Hangzhou 310023, China
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Almulla AA, Zoubeidi T. Association of overweight, obesity and insufficient sleep duration and related lifestyle factors among school children and adolescents. Int J Adolesc Med Health 2021; 34:31-40. [PMID: 34303322 DOI: 10.1515/ijamh-2021-0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the prevalence of overweight, obesity and Insufficient Sleep Duration (ISD) and to investigate their relationship with related lifestyle factors among school-aged students. Obesity in childhood and adolescence is a serious health concern as it may have long term risk for overweight and obesity in adulthood. METHODS This is a cross-sectional study of 1,611 students aged between 10 and 18 years from Al Ain city, United Arab Emirates. Data were collected using a multistage stratified random sampling method using a validated questionnaire and the level of significance was set at p<0.05. RESULTS The prevalence of overweight and obesity was 42.4%. ISD was 36.6% among students. Higher BMI was significantly related to being a male and inactive (95% CI=0.03-0.23), daily coffee consumption (95% CI=0.03-0.1), older age (95% CI=0.01-0.02), less average sleep duration (95% CI=-0.02 to -0.003) and spending more time on TV/videogames (95% CI=0.01-0.07). The likelihood of ISD was significantly lower among students who consumed breakfast daily (OR=0.58, 95% CI=0.41-0.83), spent less time on smart devices (OR=0.63, 95% CI=0.47-0.84), and never consumed energy drinks or soft drinks (OR=2.64, 95% CI=1.13-6.16, OR=2.02, 95% CI=1.24-3.29, respectively). CONCLUSIONS The prevalence of overweight and obesity among school-aged students is high. ISD and related lifestyle factors are significantly associated with overweight and obesity. Study findings emphasize the need to address and implement successful strategies for a healthy lifestyle starting from early childhood to combat the increasing rates of overweight and obesity in adulthood.
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Affiliation(s)
- Aisha Abdalla Almulla
- Community Nutrition Department, Tawam Hospital, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Taoufik Zoubeidi
- Department of Analytics in the Digital Era, United Arab Emirates University, Abu Dhabi, United Arab Emirates
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García-Hermoso A, Ezzatvar Y, Ramírez-Vélez R, Olloquequi J, Izquierdo M. Is device-measured vigorous physical activity associated with health-related outcomes in children and adolescents? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:296-307. [PMID: 33285309 PMCID: PMC8167335 DOI: 10.1016/j.jshs.2020.12.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/21/2020] [Accepted: 10/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related outcomes in children and adolescents. METHODS Studies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3-18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models. RESULTS Data from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r = -0.09, 95% confidence interval (95%CI): -0.15 to -0.03; p = 0.002; I2 = 89.8%), cardiometabolic risk score (r = -0.13, 95%CI: -0.24 to -0.02, p = 0.020; I2 = 69.6%), cardiorespiratory fitness (r = 0.25, 95%CI: 0.15-0.35; p < 0.001; I2 = 57.2%), and total body bone mineral density (r = 0.16, 95%CI: 0.06 to 0.25; p = 0.001; I2 = 0%). CONCLUSION VPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), IdiSNA, Pamplona 31008, Spain; University of Santiago of Chile (USACH), Sciences of Physical Activity, Sports and Health School, Santiago 71783-5, Chile.
| | - Yasmin Ezzatvar
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, Universitat de València, Valencia 46010, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), IdiSNA, Pamplona 31008, Spain
| | - Jordi Olloquequi
- Institute of Biomedical Sciences, Faculthy of Health Sciences, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), IdiSNA, Pamplona 31008, Spain
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Stand Out in Class: Investigating the Potential Impact of a Sit-Stand Desk Intervention on Children's Sitting and Physical Activity during Class Time and after School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094759. [PMID: 33946984 PMCID: PMC8125156 DOI: 10.3390/ijerph18094759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/18/2022]
Abstract
Sedentary behaviour (sitting) is a risk factor for adverse health outcomes. The classroom environment has traditionally been associated with prolonged periods of sitting in children. The aim of this study was to examine the potential impact of an environmental intervention, the addition of sit–stand desks in the classroom, on school children’s sitting and physical activity during class time and after school. The ‘Stand Out in Class’ pilot trial was a two-arm cluster randomised controlled trial conducted in eight primary schools with children from a mixed socioeconomic background. The 4.5 month environmental intervention modified the physical (six sit–stand desks replaced standard desks) and social (e.g., teachers’ support) environment. All children wore activPAL and ActiGraph accelerometers for 7 days at baseline and follow-up. In total 176 children (mean age = 9.3 years) took part in the trial. At baseline, control and intervention groups spent more than 65% of class time sitting, this changed to 71.7% and 59.1% at follow-up, respectively (group effect p < 0.001). The proportion of class time spent standing and stepping, along with the proportion of time in light activity increased in the intervention group and decreased in the control group. There was no evidence of any compensatory effects from the intervention after school. Incorporating sit–stand desks to change the classroom environment at primary school appears to be an acceptable strategy for reducing children’s sedentary behaviour and increasing light activity especially during class time. Trial registration: ISRCTN12915848 (registered: 09/11/16).
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13
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Mediterranean Diet, Screen-Time-Based Sedentary Behavior and Their Interaction Effect on Adiposity in European Adolescents: The HELENA Study. Nutrients 2021; 13:nu13020474. [PMID: 33573364 PMCID: PMC7911943 DOI: 10.3390/nu13020474] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/23/2021] [Accepted: 01/27/2021] [Indexed: 12/14/2022] Open
Abstract
Childhood obesity is a worldwide epidemic. Mediterranean diet (MD) is inversely associated with childhood obesity, but the interaction with other environmental factors, such screen time, might influence the health benefits of a high MD adherence in adolescents. The aim of the present study was to assess whether an association between MD and screen time exists in European adolescents. Moreover, we also explored whether sedentary time has a modulatory effect on the association between MD and adiposity. Adherence to the MD (24 h recalls), screen time (questionnaire), pubertal development, body mass index (BMI), fat mass index (FMI) and waist circumference (WC) were evaluated in 2053 adolescents (54.7% females), aged 12.5–17.5 years. In females, MD adherence was associated with lower BMI and FMI only when they were exposed to less than 338 min/day of screen time (81.8% of females); MD adherence was also associated with lower WC only when females were exposed to less than 143 min/day of screen time (31.5% of females). No significant MD-screen time interaction was observed in males. In conclusion, screen-time-based sedentary behaviours had a modulatory effect in the association between MD adherence and adiposity in European female adolescents.
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14
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Costa RM, Minatto G, Costa BGG, Silva KS. Clustering of 24-h movement behaviors associated with cardiorespiratory fitness among adolescents: a latent class analysis. Eur J Pediatr 2021; 180:109-117. [PMID: 32556508 DOI: 10.1007/s00431-020-03719-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/31/2020] [Accepted: 06/06/2020] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the clustering of 24-h movement behaviors (moderate to vigorous physical activity, screen time, and sleep duration) and their association with cardiorespiratory fitness among adolescents. We evaluated 561 adolescents (52.1% girls; mean age, 13.0 ± 1.0 years) from Florianópolis, Brazil. A 20-m shuttle run was used to assess cardiorespiratory fitness, while a questionnaire was used to measure 24-h movement behaviors. A latent class analysis was performed to identify the clustering of 24-h movement behaviors, while linear Bayesian mixed-effect regression models were applied to identify their association with cardiorespiratory fitness. Two classes were identified: unhealthy (10.4%), characterized as a high probability of practicing less than 300 min/week of moderate to vigorous physical activity, spending more than 4 h/day in front of screens, and sleeping less than 8 h/day; and healthy (89.6%), characterized by a high probability of practicing more than 420 min/week of moderate to vigorous physical activity, spending less than 2 h/day in front of screens, and sleeping 8-10 h/day. Adolescents in the healthy class had a higher cardiorespiratory fitness level than those in the unhealthy class. Most adolescents were grouped in the healthy class and had higher cardiorespiratory fitness levels than those in the unhealthy class. These results suggest that families and professionals should work toward creating healthier lifestyles for adolescents by increasing opportunities to practice moderate to vigorous physical activity, reduce screen time, and favor healthy sleep to increase their cardiorespiratory fitness levels. What is Known: • Moderate to vigorous physical activity, screen time, and sleep duration are positively, negatively, and inconsistently associated with cardiorespiratory fitness, respectively, when analyzed separately. • Little is known about the clustering of 24-h movement behaviors and how they are associated with cardiorespiratory fitness levels in adolescents. What is New: • The 24-h movement behaviors clustered into almost opposite classes among adolescents (healthy and unhealthy classes). • Adolescents in the healthy class had greater cardiorespiratory fitness levels than those in the unhealthy class.
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Affiliation(s)
- Rafael M Costa
- Research Center for Physical Activity and Health (NuPAF), School of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil.
| | - Giseli Minatto
- Research Center for Physical Activity and Health (NuPAF), School of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Bruno G G Costa
- Research Center for Physical Activity and Health (NuPAF), School of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Kelly S Silva
- Research Center for Physical Activity and Health (NuPAF), School of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil
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15
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Zeng X, Cai L, Wong SHS, Lai L, Lv Y, Tan W, Jing J, Chen Y. Association of Sedentary Time and Physical Activity With Executive Function Among Children. Acad Pediatr 2021; 21:63-69. [PMID: 32112865 DOI: 10.1016/j.acap.2020.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/16/2020] [Accepted: 02/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study aimed to examine individual and combined associations between after-school sedentary time (ST) and daily physical activity (PA) with executive function development in children. METHODS The study included 4304 children aged 6 to 12 years. ST and PA were assessed using the International Physical Activity Questionnaire Short Form, and executive function was assessed using the Behavior Rating Inventory of Executive Function (Parent Version). Participants were classified as low (<2 h per day) or high (≥2 h per day) ST and low (not meeting guidelines) or high (meeting guidelines) PA. Resulting groups were defined as 1) low ST/high PA, 2) low ST/low PA, 3) high ST/high PA, and 4) high ST/low PA. RESULTS Children in group 4 had the highest mean T-scores for BRIEF indices (48.23 ± 8.44, indicating increased symptoms of executive function dysfunction), followed by those in group 3 (47.10 ± 8.05), group 2 (45.81 ± 7.78), and group 1 (44.41 ± 7.31). ST was positively related to the T-score of all indices, independent of moderate-to-vigorous physical activity (MVPA). Significantly negative associations were observed between MVPA and Metacognition Index only in the high ST subgroup. CONCLUSIONS Low ST and high PA were positively associated with executive function development in children. Notably, children with high ST and high PA demonstrated more significant deficits in executive function than those with low ST and low PA, suggesting that intervention efforts should focus on ST reduction in addition to promoting PA.
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Affiliation(s)
- Xia Zeng
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Li Cai
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education (SH-S Wong), the Chinese University of Hong Kong, Hong Kong, China
| | - Lijuan Lai
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Yajie Lv
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China
| | - Weiqing Tan
- Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality (W Tan), Guangdong, China
| | - Jin Jing
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China.
| | - Yajun Chen
- Department of Maternal and Child Health (X Zeng, L Cai, L Lai, Y Lv, J Jing, and Y Chen), School of Public Health, Sun Yat-Sen University, Guangdong, China.
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16
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Intervention Effects of the Health Promotion Programme "Join the Healthy Boat" on Objectively Assessed Sedentary Time in Primary School Children in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239029. [PMID: 33287418 PMCID: PMC7730991 DOI: 10.3390/ijerph17239029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022]
Abstract
Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme "Join the Healthy Boat" promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children's SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children's SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children's SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children's SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.
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17
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Gea-García GM, González-Gálvez N, Espeso-García A, Marcos-Pardo PJ, González-Fernández FT, Martínez-Aranda LM. Relationship Between the Practice of Physical Activity and Physical Fitness in Physical Education Students: The Integrated Regulation As a Mediating Variable. Front Psychol 2020; 11:1910. [PMID: 32849119 PMCID: PMC7405605 DOI: 10.3389/fpsyg.2020.01910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/10/2020] [Indexed: 12/27/2022] Open
Abstract
The practice of physical activity (PA) contributes to the prevention of chronic diseases such as obesity, metabolic syndrome or cardiovascular diseases, being also directly related to the individual’s physical fitness. Therefore, it is necessary to measure and monitoring the levels of PA in childhood and adolescence, since it may be useful to describe their current health status and the association with physical fitness, as well as to reveal putative consequences in the future. Within the educational field, it has been shown that physical education (PE) classes are a favorable context for the creation of healthy physical-sports habits and self-determined motivation could be a key for explaining the level of PA practice. For this reason, the purpose of this research was to study the mediating role of integrated regulation (IR) on the relationship between PA and physical fitness in children and adolescents. A total of 325 students between 11 and 14 years old participated in the study. The level of PA was estimated through the specific Physical Activity Questionnaire for Children (PAQ-C), while motivation and IR were measured by using the Perceived Locus of Causality scale (PLOC-2). In addition, physical fitness was measured through the Eurofit fitness battery of tests, composed of three body composition measures and seven tests of different physical capacities. The physical fitness score showed no differences when genders were compared. After regression analysis, the resulting models revealed a good adjustment and correlation between PA practice and physical fitness (β = 0.173; p < 0.001), being established through the macro Process that this relationship is partially conditioned by the IR (β = 0.122; p = 0.03). ROC curve analysis estimated the score of 5.88 as a cut-off point to discriminate between levels of IR for students, classified as physically active or not (AUC = 0.67; p < 0.001). The conclusions from these main and other complementary analyses reporting complete mediations, suggest that the IR could be decisive in predicting and explaining the relationship between the practice of PA and physical fitness at these ages, highlighting its importance for a greater adherence to the practice.
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Affiliation(s)
- Gemma María Gea-García
- Faculty of Sports, San Antonio Catholic University (UCAM), Murcia, Spain.,Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), San Antonio Catholic University (UCAM), Murcia, Spain
| | - Noelia González-Gálvez
- Faculty of Sports, San Antonio Catholic University (UCAM), Murcia, Spain.,Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), San Antonio Catholic University (UCAM), Murcia, Spain
| | - Alejandro Espeso-García
- Faculty of Sports, San Antonio Catholic University (UCAM), Murcia, Spain.,Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), San Antonio Catholic University (UCAM), Murcia, Spain
| | - Pablo J Marcos-Pardo
- Faculty of Sports, San Antonio Catholic University (UCAM), Murcia, Spain.,Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), San Antonio Catholic University (UCAM), Murcia, Spain
| | | | - Luis Manuel Martínez-Aranda
- Faculty of Sports, San Antonio Catholic University (UCAM), Murcia, Spain.,Neuroscience of Human Movement Research Group, San Antonio Catholic University (UCAM), Murcia, Spain
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18
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Reisberg K, Riso EM, Jürimäe J. Associations between physical activity, body composition, and physical fitness in the transition from preschool to school. Scand J Med Sci Sports 2020; 30:2251-2263. [PMID: 32738168 DOI: 10.1111/sms.13784] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/02/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
The purpose of the study was to assess the longitudinal associations of physical activity (PA) with body composition and physical fitness (PF) at the 12-month follow-up during the transition from kindergarten to school in Estonian children aged 6 to 8 years (n = 147). PA and sedentary behavior (SB) were assessed using the accelerometer. Body composition was measured from triceps and subscapular skinfold thicknesses and PF using PREFIT test battery. SB at the mean age of 6.6 year had negative relation with upper and lower body strength and motor fitness at the mean age of 7.6 year in adjusted models. Light PA (LPA) and moderate PA(MPA) at 6.6 year were positively and SB was negatively associated with fat-free mass index (FFMI) at 7.6 year after adjustments for confounders [vigorous PA (VPA), total awake wear time, child's sex, age at measurement]. Substituting 5 min/d of SB at 6.6 year with 5 min of VPA was related to higher FFMI at 7.6 year. In adjusted models, VPA at 6.6 year was positively associated with cardiorespiratory fitness at 7.6 year, greater baseline VPA or moderate-to-vigorous PA (MVPA) predicted greater upper body strength a year later and LPA, MPA, VPA, MVPA at 6.6 year were positively related to lower body strength at follow-up. In adjusted analysis greater VPA at 6.6 year was related to better motor fitness at follow-up. Promoting higher-intensity PA and reducing SB at preschool may have long-term effects on body composition and PF in children at the first grade.
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Affiliation(s)
- Kirkke Reisberg
- Institute of Sports Sciences and Physiotherapy, Tartu University, Tartu, Estonia.,Tartu Healthcare College, Tartu, Estonia
| | - Eva-Maria Riso
- Institute of Sports Sciences and Physiotherapy, Tartu University, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, Tartu University, Tartu, Estonia
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19
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Barber SE. Sit–stand desks to reduce sedentary behaviour in 9- to 10-year-olds: the Stand Out in Class pilot cluster RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks.
Objectives
The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken.
Design
A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms.
Setting
Primary schools in Bradford, West Yorkshire, UK.
Participants
Children in Year 5 (i.e. aged 9–10 years).
Intervention
Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice.
Main outcome measures
Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour].
Results
Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term modelling estimated an unadjusted incremental cost-effectiveness ratio of Stand Out in Class of £78,986 per quality-adjusted life-year gained.
Conclusion
This study has provided evidence of the acceptability and feasibility of the Stand Out in Class intervention and evaluation methods. Preliminary evidence suggests that the intervention may have a positive direction of effect on weekday sitting time, which warrants testing in a full cluster randomised controlled trial. Lessons learnt from this trial will inform the planning of a definitive trial.
Trial registration
Current Controlled Trials ISRCTN12915848.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | | | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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20
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson CL, McEachan RRC, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Salmon J, Dunstan DW, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial. Int J Behav Nutr Phys Act 2020; 17:55. [PMID: 32349761 PMCID: PMC7189432 DOI: 10.1186/s12966-020-00958-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/15/2020] [Indexed: 12/01/2022] Open
Abstract
Background Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children’s sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. Methods We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9–10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. Results School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of − 30.6 min/day (95% CI: − 56.42 to − 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. Conclusion This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children’s weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. Trial registration ISRCTN12915848 (registered: 09/11/16).
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. .,NIHR Leicester Biomedical Research Centre, Leicester, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | - James Altunkaya
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Department of Physiology, Neuroscience and Behavioral Sciences, St. George's University, West Indies, Grenada
| | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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21
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Sherry AP, Pearson N, Ridgers ND, Barber SE, Bingham DD, Nagy LC, Clemes SA. activPAL-measured sitting levels and patterns in 9-10 years old children from a UK city. J Public Health (Oxf) 2019; 41:757-764. [PMID: 30346570 DOI: 10.1093/pubmed/fdy181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 09/23/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is insufficient evidence of sitting time in UK children from validated objective measures. This study explored sitting patterns in primary school children from Bradford, UK, using the validated activPAL inclinometer. METHODS Overall, 79 children (9.8 (SD 0.3) years old, 52% boys; 70% South Asian) wore activPALs for 7 days. Total sitting time, sitting time accumulated in different bout lengths, and the proportion of wear time spent in these variables were explored and compared across different periods of the week. RESULTS Children spent 614 ± 112 (median ± IQR) min/day on school days and 690 ± 150 min/day on weekend days sitting. The proportion of time spent sitting was significantly higher on weekend days compared to school days (mean±SD: 74 ± 10% versus 68 ± 8%,P < 0.001), as was the proportion of time accumulated in >30 min sitting bouts (mean±CI: 28 ± 27-33% versus 20 ± 20-22%, P < 0.001). The proportion of time spent sitting after school was significantly higher than during school time (mean±SD: 70 ± 8.4% versus 63 ± 8.3%,P < 0.001), as was the proportion of time spent in prolonged (>30 min) sitting bouts (mean±CI: 19 ± 16-22% versus 11 ± 10-14%, P < 0.001). CONCLUSIONS Children spent large proportions of their waking day sitting, often accumulated in prolonged uninterrupted bouts and particularly after school and on weekends. Interventions to reduce sitting time in children are urgently needed.
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Affiliation(s)
- Aron P Sherry
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Liana C Nagy
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
- Faculty of Health Studies, Bradford University, Richmond Road, Bradford, UK
| | - Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
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22
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Ferrari GLDM, Solé D, Pires C, Matsudo V, Katzmarzyk PT, Fisberg M. Correlates of body fat and waist circumference in children from São Caetano do Sul, Brazil. CIENCIA & SAUDE COLETIVA 2019; 24:4019-4030. [PMID: 31664375 DOI: 10.1590/1413-812320182411.30182017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 04/27/2018] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to examine potential correlates of body fat (BF) and waist circumference (WC) in children. The sample included 328 children (169 boys) aged 9-11 years. BF (%) was measured using a bioelectrical impedance scale. WC measurements were made on exposed skin at the end of a normal expiration using a non-elastic anthropometric tape. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were measured using accelerometers. Participants with complete individual, family and home, and school environmental data were included in the analysis. Children averaged 21.3% in boys and 25.8% in girls for BF and 68.0 cm in boys and 67.2 cm in girls for WC. There was higher BF among girls (p<0.001), but no significant sex differences with respect to WC. In boys, breakfast consumption, bad sleep quality, and MVPA were associated with BF. Among girls, the only variables associated with BF were breakfast consumption and bad sleep quantity. Bad sleep quality and MVPA were associated with WC in boys. Among girls, WC was associated with breakfast consumption and bad sleep quantity. We identified correlates of BF and WC in children; however, few correlates were common for both BF and WC, and for both boys and girls.
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Affiliation(s)
- Gerson Luis de Moraes Ferrari
- Centro de Investigación en Fisiologia del Ejercido-CIFE, Universidad Mayor. José Toribio Medina 29. Estacion Central Santiago Chile. .,Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, Universidade Federal de São Paulo. São Paulo SP Brasil
| | - Dirceu Solé
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, Universidade Federal de São Paulo. São Paulo SP Brasil
| | - Carlos Pires
- Centro de Matemática da Universidade de Trás-os-Montes e Alto Douro (CM-UTAD). Vila Real Portugal
| | - Victor Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS). São Caetano do Sul SP Brasil
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center. Baton Rouge Louisiana United States
| | - Mauro Fisberg
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, Universidade Federal de São Paulo. São Paulo SP Brasil
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23
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Garrido-Miguel M, Cavero-Redondo I, Álvarez-Bueno C, Rodríguez-Artalejo F, Moreno LA, Ruiz JR, Ahrens W, Martínez-Vizcaíno V. Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:e192430. [PMID: 31381031 PMCID: PMC6686782 DOI: 10.1001/jamapediatrics.2019.2430] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries. OBJECTIVE To assess prevalence trends in measured overweight and obesity among children across Europe from 1999 to 2016 using a systematic methodology. DATA SOURCES MEDLINE, Embase, CINAHL, and Web of Science were searched from their inception until May 2018. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals. STUDY SELECTION The inclusion criteria were: (1) studies reporting the population-based prevalence of excess weight (overweight plus obesity) or obesity according to body mass index cutoffs proposed by the International Obesity Task Force; (2) cross-sectional or follow-up studies; and (3) studies including populations aged 2 to 13 years. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed established guidelines. The Mantel-Haenszel method was used to compute the pooled prevalence estimates and their 95% CI whenever there was no evidence of heterogeneity (I2 < 50%); otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by study year, country, or European region (Atlantic, Iberian, Central, and Mediterranean) were conducted. Prevalence estimates were calculated as an aggregate mean, weighted by the sample size and the number of individuals in each study. RESULTS A total of 103 studies (477 620 children aged 2 to 13 years) with data from 28 countries were included. The combined prevalence of overweight and obesity in the Iberian region tended to decrease from 30.3% (95% CI, 28.3%-32.3%) to 25.6% (95% CI, 19.7%-31.4%) but tended to increase in the Mediterranean region from 22.9% (95% CI, 17.9%-27.9%) to 25.0% (95% CI, 14.5%-35.5%). No substantial changes were observed in Atlantic Europe or Central Europe, where the overweight and obesity prevalence changed from 18.3% (95% CI, 14.0%-23.9%) to 19.3% (95% CI, 17.7%-20.9%) and from 15.8% (95% CI, 13.4%-18.5%) to 15.3% (95% CI, 11.6%-20.3%), respectively. CONCLUSIONS AND RELEVANCE The prevalence of childhood overweight and obesity is very high, but trends have stabilized in most European countries. There are substantial between-country differences in the current levels and trends of overweight and obesity. The rising prevalence in some Mediterranean countries is worrisome. TRIAL REGISTRATION PROSPERO identifier: CRD42017056924.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz, Madrid, Spain,CIBERESP and IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain ,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; ,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Jonatan R. Ruiz
- Promoting Fitness And Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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24
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Sebire SJ, Banfield K, Campbell R, Edwards MJ, Kipping R, Kadir B, Garfield K, Matthews J, Blair PS, Lyons RA, Hollingworth W, Jago R. A peer-led physical activity intervention in schools for adolescent girls: a feasibility RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background
Girls are less active than boys and few adolescent girls meet physical activity (PA) guidelines. Peers are an important influence on the views and behaviours of adolescent girls, yet many PA interventions involving peers use formal approaches that may not harness the power of peer groups. More informal peer-led PA interventions, which work within proximal peer groups, may hold promise for increasing girls’ PA.
Objectives
To examine the feasibility, evidence of promise and cost of the Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led PA intervention.
Design
Phase 1 comprised formative work and a pilot study conducted in one secondary school. Phase 2 was a feasibility study comprising a pilot randomised controlled trial in six secondary schools, including process and economic evaluations.
Setting
Six secondary schools in South Gloucestershire and Wiltshire, recruited from schools above the median local Pupil Premium (i.e. more deprived).
Participants
Year 8 girls (aged 12–13 years).
Intervention
Year 8 girls nominated other girls in their year who are likely to be influential (e.g. who they look up to, are good listeners); the 18% most nominated were invited to be peer supporters (PSs). PSs attended 2 consecutive days of training (plus a top-up day 5 weeks later) outside the school site, led by pairs of PS trainers, to increase their knowledge about PA and their capabilities and confidence to promote PA in their friendship group.
Main outcome measures
Measures focused on establishing evidence for feasibility and promise: recruitment and retention of Year 8 girls and PSs, data provision rates [accelerometer and questionnaire collected pre randomisation/beginning of Year 8 (T0), end of Year 8 (T1) and beginning of Year 9 (T2)], intervention acceptability, PS training attendance, intervention cost, and the between-arm difference in weekday minutes of moderate to vigorous PA (MVPA). A process evaluation was conducted.
Results
Six schools were recruited: four PLAN-A (n = 269) and two control (n = 158). In total, 94.7% of Year 8 girls participated. A total of 55 (17–24% of Year 8 girls) PSs were trained (attendance rate 91–100%). Five girls were trained as PS trainers. Questionnaire data provision exceeded 92% at all time points. Accelerometer return rates were > 85% and wear-time criteria were met by 83%, 71% and 62% of participants at T0, T1 and T2, respectively. Mean weekday MVPA did not differ between intervention arms at T1 (1.1 minutes, 95% CI –4.3 to 6.5 minutes) but did at T2 (6.1 minutes, 95% CI 1.4 to 10.8 minutes), favouring PLAN-A. The mean cost of intervention delivery was £2685 per school or £37 per Year 8 girl. Process evaluation identified good fidelity, engagement and enjoyment of the PS training and peer-support strategies. PSs needed more guidance on how to start conversations.
Limitations
Accelerometer data provision was lowest at T2, suggesting a need for strategies to increase compliance.
Conclusions
Informal peer-led intervention approaches, such as PLAN-A, hold promise as a means of promoting PA to adolescent girls.
Future work
A definitive randomised controlled trial of PLAN-A is warranted.
Trial registration
Current Controlled Trials ISRCTN12543546.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 16. See the NIHR Journals Library website for further project information. The work was undertaken with the support of the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UKCRC, is gratefully acknowledged. This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a UK CRC-registered clinical trials unit in receipt of NIHR clinical trials unit support funding. The intervention costs were jointly funded by South Gloucestershire Council and Wiltshire Council.
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Affiliation(s)
- Simon J Sebire
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kathryn Banfield
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Rona Campbell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, Cardiff, Wales
| | - Mark J Edwards
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bryar Kadir
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Kirsty Garfield
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Joe Matthews
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Peter S Blair
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - William Hollingworth
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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25
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Sigmundová D, Sigmund E, Tesler R, Ng KW, Hamrik Z, Mathisen FKS, Inchley J, Bucksch J. Vigorous physical activity in relation to family affluence: time trends in Europe and North America. Int J Public Health 2019; 64:1049-1058. [PMID: 31278436 PMCID: PMC6677706 DOI: 10.1007/s00038-019-01271-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/14/2019] [Indexed: 10/30/2022] Open
Abstract
OBJECTIVES The aim of the study was to determine secular trends in vigorous physical activity (VPA) among adolescents in relation to family affluence across 34 countries. METHODS This study used data from the Health Behaviour in School-aged Children (HBSC) study from 34 countries in Europe and North America. Adolescents (N = 501,647) aged 11, 13 and 15 years across three survey cycles (2006, 2010, 2014) self-reported data on VPA and a family affluence scale (FAS) using standardized questionnaires. RESULTS A significant increase in VPA was found in low-FAS boys (girls) in four (10) countries and a decrease in four (three) countries. In high-FAS boys (girls), a significant increase was observed in nine (11) countries and a decrease in two(three) countries. An overall significant increase in meeting the VPA recommendations was found in high-FAS boys (OR 1.11; 95% CI 1.06-1.16) and in all FAS groups in girls, with the largest effect being found among high-FAS girls (OR 1.24; 95% CI 1.18-1.30). CONCLUSIONS A country-specific increase in VPA was observed primarily in the medium- and high-FAS categories. This study suggests a need to focus on increasing VPA efforts, especially in low- and medium-FAS boys.
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Affiliation(s)
- Dagmar Sigmundová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic.
| | - Erik Sigmund
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Riki Tesler
- Department of Health Systems Management, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Kwok W Ng
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Zdenek Hamrik
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | | | - Jo Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.,School of Medicine, University of St. Andrews, North Haugh, St. Andrews, UK
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Faculty of Natural and Human Sciences, Heidelberg University of Education, Heidelberg, Germany
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26
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Zhang Y, Niu L, Zhang D, Ip P, Ho F, Jiang Y, Sun W, Zhu Q, Jiang F. Social-Emotional Functioning Explains the Effects of Physical Activity on Academic Performance among Chinese Primary School Students: A Mediation Analysis. J Pediatr 2019; 208:74-80. [PMID: 30612814 DOI: 10.1016/j.jpeds.2018.11.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/01/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To examine the mediating effects of socioemotional and behavioral functioning in the association between physical activity and academic achievement in Chinese children. STUDY DESIGN Chinese children (n = 17 318; aged 6-11 years) from the Shanghai Children's Health, Education and Lifestyle Evaluation study in 2014 were the source of data. Children reported the time spent in moderate-to-vigorous physical activities (MVPA) during weekdays and weekends. Parents rated their children's socioemotional and behavioral difficulties. Head teachers rated the academic performance of each student. A mediation analysis with multiple mediators was performed to test the mediation effects of 5 socioemotional and behavioral variables (emotional problems, conduct problems, hyperactivity and inattention, peer relationship, and prosocial behaviors) in the association between MVPA and academic achievement, adjusting for demographic and health-related variables. RESULTS Results revealed that MVPA was positively associated with academic performance (b = 0.78; SE = .01; P < .001). Conduct problems, hyperactivity and inattention, and peer problems showed significant mediating effects in the association between MVPA and academic achievement, with hyperactivity and inattention being the strongest mediator (b = 0.38; SE = 0.04; P < .001) accounting for 49% of the total effect. CONCLUSIONS This study provides evidence that MVPA is associated with fewer socioemotional difficulties, which, in turn, is associated with better academic achievement. Promoting physical activity among school-aged children may benefit their overall development.
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Affiliation(s)
- Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Niu
- Department of Psychology, Fordham University, Bronx, NY
| | - Donglan Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Public Health Policy and Management, College of Public Health, University of Georgia, Athens, GA
| | - Patrick Ip
- Department of Pediatrics and Adolescent Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Frederick Ho
- Department of Pediatrics and Adolescent Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China.
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27
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Pfledderer CD, Burns RD, Brusseau TA. Association between Access to Electronic Devices in the Home Environment and Cardiorespiratory Fitness in Children. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E8. [PMID: 30634403 PMCID: PMC6352277 DOI: 10.3390/children6010008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 01/06/2023]
Abstract
This study examined the association between access to electronic devices in the home and cardiorespiratory fitness in children. Participants were children aged 8⁻12 years from a local elementary school (n = 106, mean age = 9.7 + 1.1 years, male = 50). Child access to electronic devices was measured with a 37-item parent-reported questionnaire. Estimated maximal aerobic capacity (VO2 Peak) was calculated from The Progressive Aerobic Cardiovascular Endurance Run (PACER) using a validated algorithm. The association between access to electronic devices in the home and cardiorespiratory fitness was explored by employing hierarchical ridge regression, using the Ordinary Least Squares (OLS) model, controlling for the covariates of sex, age, and Body Mass Index (BMI). Controlling for sex, age, and BMI, the number of electronic items in a child's bedroom was significantly inversely related to the estimated VO2 Peak (b = -1.30 mL/kg/min, 95% C.I.: -2.46 mL/kg/min, -0.15 mL/kg/min, p = 0.028) and PACER laps (b = -3.70 laps, 95% C.I.: -6.97 laps, -0.41 laps, p = 0.028) However, the total number of electronic items in the home and total number of electronic items owned did not significantly relate to the estimated VO2 Peak (p = 0.847, 0.964) or the number of PACER laps (p = 0.847, 0.964). Child health behavior interventions focused on the home environment should devote specific attention to the bedroom as a primary locus of easily modifiable intervention.
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Affiliation(s)
- Christopher D Pfledderer
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Ryan D Burns
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Timothy A Brusseau
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
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28
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Skrede T, Steene-Johannessen J, Anderssen SA, Resaland GK, Ekelund U. The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis. Obes Rev 2019; 20:55-74. [PMID: 30270500 DOI: 10.1111/obr.12758] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 01/03/2023]
Abstract
Sedentary time and moderate-to-vigorous physical activity (MVPA) may be uniquely related to cardiometabolic health. Excessive sedentary time is suggested as an independent cardiometabolic risk factor, while MVPA is favourably associated with cardiometabolic health. This systematic review and meta-analysis summarizes the evidence on a prospective relationship between objectively measured sedentary time, MVPA and cardiometabolic health indicators in youth. PubMed, Embase, CINAHL, PhyscINFO and SPORTDiscus were systematically searched from January 2000 until April 2018. Studies were included if sedentary time and physical activity were measured objectively and examined associations with body mass index, waist circumference, triglycerides, high-density lipoprotein, insulin, blood pressure or the clustering of these cardiometabolic risk factors. We identified 30 studies, of which 21 were of high quality. No evidence was found for an association between sedentary time and cardiometabolic outcomes. The association between MVPA and individual cardiometabolic risk factors was inconsistent. The meta-analysis for prospective studies found a small but significant effect size between MVPA at baseline and clustered cardiometabolic risk at follow-up (ES -0.014 [95% CI, -0.024 to -0.004]). We conclude that there is no prospective association between sedentary time and cardiometabolic health, while MVPA is beneficially associated with cardiometabolic health in youth.
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Affiliation(s)
- T Skrede
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - S A Anderssen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - G K Resaland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - U Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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29
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Zhou Y, Wu J, Zhang S, Yan S, He L, Mkandawire N, Song X, Gan Y, Li W, Yang T, Li J, Zeng X, Wang Z, Lu Z. Prevalence and risk factors of physical inactivity among middle-aged and older Chinese in Shenzhen: a cross-sectional study. BMJ Open 2018; 8:e019775. [PMID: 30327395 PMCID: PMC6194397 DOI: 10.1136/bmjopen-2017-019775] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Investigations on physical inactivity are common around the world; however, little is known about the status of physical inactivity in mainland China. The aim of this study was to examine the prevalence and risk factors associated with physical inactivity in Shenzhen in Southern China. DESIGN A community-based, cross-sectional study. SETTING A multistage-stratified, random cluster survey was conducted in Xixiang Street, Bao'an District of Shenzhen in Southeast China. PARTICIPANTS 3920 adults aged 40 years or more were recruited to the study and completed the International Physical Activity Questionnaire Short Form between 1 March 2015 and 30 July 2016. MAIN OUTCOME MEASURES Physical inactivity was defined as engaging in physical activity levels insufficient to reach the current guidelines. Bivariate and multivariate analyses were undertaken to assess the prevalence and risk factors associated with physical inactivity. RESULTS The prevalence of physical inactivity was 63.1% for all participants, 63.9% for women and 61.9% for men, respectively. Participants who were older (OR=1.31, 95% CI 1.11 to 1.54), who were female (OR=1.22, 95% CI 1.04 to 1.43), who had higher education experience (OR=1.38, 95% CI 1.19 to 1.61), who are under economic pressure (OR=2.17, 95% CI 1.48 to 3.17), who ever smoked a cigarette (OR=1.44, 95% CI 1.13 to 1.82) and drank alcohol (OR=1.42, 95% CI 1.14 to 1.77), and participants in the lowest body mass index category (OR=1.40, 95% CI 1.03 to 1.89), were more likely to report physical inactivity. CONCLUSIONS These findings indicate that physical inactivity is prevalent in Southern China. Interventions and programmes aimed at increasing physical activity among middle-aged and older Chinese adults may also be tailored to participants under economic pressure and those with unhealthy behaviours such as smoking and drinking.
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Affiliation(s)
- Yanfeng Zhou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Xiangnan University, Chenzhou, China
| | - Jiang Wu
- Bao’an Central Hospital of Shenzhen, Shenzhen, China
| | | | - Shijiao Yan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liping He
- Department of Epidemiology and Health Statistics, School of Public Health, Xiangnan University, Chenzhou, China
| | - Naomie Mkandawire
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyue Song
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Yang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaozhou Zeng
- Bao’an Central Hospital of Shenzhen, Shenzhen, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University, Shenzhen, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Verloigne M, Ridgers ND, De Bourdeaudhuij I, Cardon G. Effect and process evaluation of implementing standing desks in primary and secondary schools in Belgium: a cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:94. [PMID: 30261883 PMCID: PMC6161341 DOI: 10.1186/s12966-018-0726-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. Methods We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. Results Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. Conclusions Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. Trial registration NCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12966-018-0726-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation (FWO), Egmontstraat 1, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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O'Brien W, Issartel J, Belton S. Relationship between Physical Activity, Screen Time and Weight Status among Young Adolescents. Sports (Basel) 2018; 6:sports6030057. [PMID: 29937496 PMCID: PMC6162488 DOI: 10.3390/sports6030057] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 11/17/2022] Open
Abstract
It is well established that lack of physical activity and high bouts of sedentary behaviour are now associated with all-cause and cardiovascular mortality. The purpose of this study was to investigate the relationship between physical activity participation, overall screen time and weight status amongst early Irish adolescent youth. Participants were a sample of 169 students: 113 boys (mean age = 12.89 ± 0.34 years) and 56 girls (mean age = 12.87 ± 0.61 years). The data gathered in the present study included physical activity (accelerometry), screen time (self-report) and anthropometric measurements. Overweight and obese participants accumulated significantly more minutes of overall screen time daily compared to their normal-weight counterparts. A correlation between physical activity and daily television viewing was evident among girls. No significant interaction was apparent when examining daily physical activity and overall screen time in the prediction of early adolescents’ body mass index. Results suggest the importance of reducing screen time in the contribution towards a healthier weight status among adolescents. Furthermore, physical activity appears largely unrelated to overall screen time in predicting adolescent weight status, suggesting that these variables may be independent markers of health in youth. The existing relationship for girls between moderate-to-vigorous physical activity and time spent television viewing may be a potential area to consider for future intervention design with adolescent youth.
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Affiliation(s)
- Wesley O'Brien
- School of Education, Sports Studies and Physical Education Department, 2 Lucan Place, Western Road, University College Cork, Cork T12 KX72, Ireland.
| | - Johann Issartel
- Centre of Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin D09 W6Y4, Ireland.
| | - Sarahjane Belton
- Centre of Preventive Medicine, School of Health and Human Performance, Dublin City University, Dublin D09 W6Y4, Ireland.
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Bandelow S, Jaicim NB, Salmon J, Dunstan D, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sedentary behaviour in 9-10-year-olds - study protocol for a pilot cluster randomised controlled trial. Pilot Feasibility Stud 2018; 4:103. [PMID: 29850027 PMCID: PMC5966899 DOI: 10.1186/s40814-018-0295-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms. Methods/Design A two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9-10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools' academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. Discussion The primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children. Trial registration ISRCTN12915848 (retrospectively registered, date registered 9 November 2016).
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Affiliation(s)
- Stacy A Clemes
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,4Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- 5Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- 6Loughborough Design School, Loughborough University, Loughborough, UK
| | - Stephan Bandelow
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Jo Salmon
- 8Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Dunstan
- 9Baker IDI Heart and Diabetes Institute, Melbourne, Australia.,10Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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Riso EM, Kull M, Mooses K, Jürimäe J. Physical activity, sedentary time and sleep duration: associations with body composition in 10-12-year-old Estonian schoolchildren. BMC Public Health 2018; 18:496. [PMID: 29653528 PMCID: PMC5899370 DOI: 10.1186/s12889-018-5406-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 04/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Physical activity, sedentary time, and sleep duration have been associated with body composition among children. The purpose of the present study was to assess the associations of objectively determined daily physical activity, sedentary time, sleep duration and body composition indices in 10–12-year-old children. Methods Two hundred and eleven schoolchildren (96 boys and 115 girls) aged 10.9 ± 0.7 years participated in this study. Objective physical activity intensity and sedentary levels were measured for seven days by accelerometry. Sleep duration was self-reported. Percentage of body fat, waist-to-height ratio and fat free mass were calculated from measured anthropometric parameters. Multiple linear regression models were used to examine the associations between sleep duration, moderate-to-vigorous physical activity (MVPA), vigorous physical activity (VPA) level and body composition indices. Results Boys exceeded girls (p < 0.05) in time spent in MVPA and VPA levels. Only 4.3% of the children met the current daily recommendation of at least 60 min MVPA per day. Sleep duration, MVPA and VPA had a negative association with percentage of body fat and waist-to-height ratio. Vigorous physical activity had a positive association with fat-free mass. Sedentary time had a positive association with percentage of body fat and negative association with fat-free mass. Conclusions The present study suggests that both sleep duration and MVPA are associated with body composition parameters. Higher levels of MVPA are associated with lower percentage of body fat and waist-to-height ratio regardless of sleep duration. Sedentary time is associated with higher values of percentage of body fat and lower fat-free mass independently of sleep duration.
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Affiliation(s)
- Eva-Maria Riso
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 5 Jakobi St, 51014, Tartu, Estonia.
| | - Merike Kull
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 5 Jakobi St, 51014, Tartu, Estonia
| | - Kerli Mooses
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 5 Jakobi St, 51014, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 5 Jakobi St, 51014, Tartu, Estonia
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Development of Step-Count Cut Points for School-Day Vigorous Physical Activity. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9717848. [PMID: 29789809 PMCID: PMC5896213 DOI: 10.1155/2018/9717848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/27/2018] [Indexed: 11/17/2022]
Abstract
Background No study has established step-count cut points for varying amounts of accelerometer-assessed vigorous physical activity (VPA) accrued during the school day in children. The purpose of this study was to establish step-count cut points for discriminating children meeting VPA in 5 minutes, 10 minutes, 15 minutes, and 20 minutes per 7-hour school day. Methods Participants were a convenience sample of 1,053 children (mean age = 8.4 (1.8) years) recruited from 5 schools from the Mountain West region of the USA. Data within students were observed across multiple semesters totaling 2,119 separate observations. Step counts and time in VPA were assessed using ActiGraph wGT3X-BT triaxial accelerometers that were worn during the entirety of a 7-hour school day for one school week. Average censored step counts and minutes in VPA were calculated across 3 to 5 days. Receiver operating characteristic (ROC) curves were employed to derive step counts via calculation of the maximum Youden J statistic. Results Area-under-the-curve (AUC) scores ranged from AUC = 0.81 (95% CI: 0.78–0.83; p < 0.001) for meeting at least 5 minutes of VPA to AUC = 0.94 (95% CI: 0.88–1.00, p < 0.001) for meeting at least 20 minutes of VPA. Approximately 3,460 steps best discriminated children meeting at least 5 minutes of VPA (sensitivity = 74.0%, specificity = 74.0%, and accuracy = 74.1%) and approximately 5,628 steps best discriminated children meeting at least 20 minutes per day of VPA (sensitivity = 85.7%, specificity = 95.1%, and accuracy = 95.1%). Conclusion Step counts can discriminate with reasonable accuracy children that meet at least 5 minutes of school-day VPA and with strong accuracy children that meet 20 minutes of school-day VPA.
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Traub M, Lauer R, Kesztyüs T, Wartha O, Steinacker JM, Kesztyüs D. Skipping breakfast, overconsumption of soft drinks and screen media: longitudinal analysis of the combined influence on weight development in primary schoolchildren. BMC Public Health 2018; 18:363. [PMID: 29548323 PMCID: PMC5857087 DOI: 10.1186/s12889-018-5262-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/06/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Regular breakfast and well-balanced soft drink, and screen media consumption are associated with a lower risk of overweight and obesity in schoolchildren. The aim of this research is the combined examination of these three parameters as influencing factors for longitudinal weight development in schoolchildren in order to adapt targeted preventive measures. METHODS In the course of the Baden-Württemberg Study, Germany, data from direct measurements (baseline (2010) and follow-up (2011)) at schools was available for 1733 primary schoolchildren aged 7.08 ± 0.6 years (50.8% boys). Anthropometric measurements of the children were taken according to ISAK-standards (International Standard for Anthropometric Assessment) by trained staff. Health and lifestyle characteristics of the children and their parents were assessed in questionnaires. A linear mixed effects regression analysis was conducted to examine influences on changes in waist-to-height-ratio (WHtR), weight, and body mass index (BMI) measures. A generalised linear mixed effects regression analysis was performed to identify the relationship between breakfast, soft drink and screen media consumption with the prevalence of overweight, obesity and abdominal obesity at follow-up. RESULTS According to the regression analyses, skipping breakfast led to increased changes in WHtR, weight and BMI measures. Skipping breakfast and the overconsumption of screen media at baseline led to higher odds of abdominal obesity and overweight at follow-up. No significant association between soft drink consumption and weight development was found. CONCLUSION Targeted prevention for healthy weight status and development in primary schoolchildren should aim towards promoting balanced breakfast habits and a reduction in screen media consumption. Future research on soft drink consumption is needed. Health promoting interventions should synergistically involve children, parents, and schools. TRIAL REGISTRATION The Baden-Württemberg Study is registered at the German Clinical Trials Register (DRKS) under the DRKS-ID: DRKS00000494 .
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Affiliation(s)
- Meike Traub
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Romy Lauer
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Tibor Kesztyüs
- Department of Computer Science, Ulm University of Applied Sciences, 89081 Ulm, Germany
- Institute of Medical Systems Biology, Ulm University, 89081 Ulm, Germany
| | - Olivia Wartha
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Jürgen Michael Steinacker
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - Dorothea Kesztyüs
- Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
- Institute of General Medicine, Ulm University, 89081 Ulm, Germany
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Wilkie HJ, Standage M, Gillison FB, Cumming SP, Katzmarzyk PT. Correlates of intensity-specific physical activity in children aged 9-11 years: a multilevel analysis of UK data from the International Study of Childhood Obesity, Lifestyle and the Environment. BMJ Open 2018; 8:e018373. [PMID: 29431128 PMCID: PMC5829668 DOI: 10.1136/bmjopen-2017-018373] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 01/14/2018] [Accepted: 01/17/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Physical activity (PA) can provide numerous physical and psychological health gains, yet a low proportion of children in England are sufficiently active to accrue benefit. Analysing the correlates of PA from a socioecological perspective may help to identify factors that promote versus discourage PA. The purpose of the present study was to: (1) assess the relationships between a wide range of potential correlates and intensity-specific PA and (2) explore which correlates are associated with meeting government PA guidelines. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study on children aged 9-11 years from the South West of England (n=425; 183 males). OUTCOME MEASURES A mixture of self-reported and objective measures (eg, body mass index (BMI), accelerometer-derived PA, self-reported sport participation, etc) were collected from child participants, parents and school teachers. After adjusting for covariates (ie, age, sex and accelerometer wear time), multilevel modelling techniques were employed to examine the relationships between potential correlates and light-intensity, moderate-intensity and vigorous-intensity PA, as measured with an ActiGraph GT3X+ accelerometer. Generalised linear mixed modelling was used to analyse the correlates associated with government-recommended levels of PA. RESULTS Computer use shared a negative association whereas parent support for PA showed a positive relationship with light-intensity PA. In terms of moderate-intensity PA, computer use and BMI z-score shared a negative association whereas positive relationships were found for sport participation, active transport and for outdoor time after school. Children at schools with 25%-49% of pupils attending school sport/PA clubs did more moderate-intensity PA than those attending schools with lower participation rates. For vigorous-intensity PA, a negative relationship was observed for BMI z-score, and positive associations for self-efficacy, active transport, parent support and the presence of crossing guards on routes to school. Correlates associated with meeting the PA guidelines were BMI z-score (negative), sport participation, active transport and outdoor time after school (all positive). CONCLUSION Results demonstrate that factors pertaining to the individual, home and school environment may play an important role in understanding the correlates of differing PA intensities in children. TRIAL REGISTRATION NUMBER NCT01722500.
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Affiliation(s)
- Hannah J Wilkie
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Martyn Standage
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Fiona B Gillison
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Sean P Cumming
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
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Wilkie HJ, Standage M, Gillison FB, Cumming SP, Katzmarzyk PT. Correlates of intensity-specific physical activity in children aged 9-11 years: a multilevel analysis of UK data from the International Study of Childhood Obesity, Lifestyle and the Environment. BMJ Open 2018; 8:e018373. [PMID: 29431128 DOI: 10.1136/bmjopen-2017-01837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES Physical activity (PA) can provide numerous physical and psychological health gains, yet a low proportion of children in England are sufficiently active to accrue benefit. Analysing the correlates of PA from a socioecological perspective may help to identify factors that promote versus discourage PA. The purpose of the present study was to: (1) assess the relationships between a wide range of potential correlates and intensity-specific PA and (2) explore which correlates are associated with meeting government PA guidelines. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study on children aged 9-11 years from the South West of England (n=425; 183 males). OUTCOME MEASURES A mixture of self-reported and objective measures (eg, body mass index (BMI), accelerometer-derived PA, self-reported sport participation, etc) were collected from child participants, parents and school teachers. After adjusting for covariates (ie, age, sex and accelerometer wear time), multilevel modelling techniques were employed to examine the relationships between potential correlates and light-intensity, moderate-intensity and vigorous-intensity PA, as measured with an ActiGraph GT3X+ accelerometer. Generalised linear mixed modelling was used to analyse the correlates associated with government-recommended levels of PA. RESULTS Computer use shared a negative association whereas parent support for PA showed a positive relationship with light-intensity PA. In terms of moderate-intensity PA, computer use and BMI z-score shared a negative association whereas positive relationships were found for sport participation, active transport and for outdoor time after school. Children at schools with 25%-49% of pupils attending school sport/PA clubs did more moderate-intensity PA than those attending schools with lower participation rates. For vigorous-intensity PA, a negative relationship was observed for BMI z-score, and positive associations for self-efficacy, active transport, parent support and the presence of crossing guards on routes to school. Correlates associated with meeting the PA guidelines were BMI z-score (negative), sport participation, active transport and outdoor time after school (all positive). CONCLUSION Results demonstrate that factors pertaining to the individual, home and school environment may play an important role in understanding the correlates of differing PA intensities in children. TRIAL REGISTRATION NUMBER NCT01722500.
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Affiliation(s)
- Hannah J Wilkie
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Martyn Standage
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Fiona B Gillison
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
| | - Sean P Cumming
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
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Peterson NE, Sirard JR, Kulbok PA, DeBoer MD, Erickson JM. Sedentary behavior and physical activity of young adult university students. Res Nurs Health 2018; 41:30-38. [PMID: 29315656 PMCID: PMC10926845 DOI: 10.1002/nur.21845] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/16/2017] [Indexed: 12/31/2022]
Abstract
Movement and non-movement behaviors include sleep, sedentary behavior (SB) and physical activity (PA). While young adults are generally perceived as healthy, the level and relationship of SB and PA in college-age students has not been greatly explored. The purpose of this study was to objectively measure the levels of SB and PA in 18-20 year-old university students, record their self-reported extracurricular activities, and explore the relationship of all these with body mass index (BMI) and waist circumference (WC). Male (n = 48) and female (n = 46) students participated in this cross-sectional study. Hierarchical multiple regression analyses were used to examine time spent in SB, moderate to vigorous physical activity (MVPA), number of self-reported sedentary extracurricular activities, and their relation to the dependent variables of BMI and WC. In correlation analyses, SB (p < .001) and MVPA (p = .017) both were negatively associated with BMI, and "other" race or ethnicity (African American, Hispanic, mixed; p = .013) and number of self-reported sedentary extracurricular activities (p = .006) were positively associated with BMI. In the WC regression model, SB (p = .018) was negatively associated and number of self-reported sedentary extracurricular activities (p = .006) was positively associated with WC. University students may be both highly active and highly sedentary. Future researchers should consider targeting interventions to reduce SB in addition to improving PA.
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Affiliation(s)
| | - John R. Sirard
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Pamela A. Kulbok
- School of Nursing, University of Virginia, Charlottesville, Virginia
| | - Mark D. DeBoer
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Jeanne M. Erickson
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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McCrorie P, Mitchell R, Ellaway A. Comparison of two methods to assess physical activity prevalence in children: an observational study using a nationally representative sample of Scottish children aged 10-11 years. BMJ Open 2018; 8:e018369. [PMID: 29371272 PMCID: PMC5786112 DOI: 10.1136/bmjopen-2017-018369] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe the objectively measured levels of physical activity (PA) and sedentary time in a nationally representative sample of 10-11-year-old children, and compare adherence estimates to the UK PA guidelines using two approaches to assessing prevalence. DESIGN Nationally representative longitudinal cohort study. SETTING Scotland wide in partnership with the Growing up in Scotland (GUS) study. Data collection took place between May 2015 and May 2016. PARTICIPANTS The parents of 2402 GUS children were approached and 2162 consented to contact. Consenting children (n=1096) wore accelerometers for 8 consecutive days and 774 participants (427 girls, 357 boys) met inclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES Total PA (counts per minute, cpm); time spent sedentary and in moderate-to-vigorous PA (MVPA); proportion of children with ≥60 min MVPA on each day of wear (daily approach); proportion of children with ≥60 min of MVPA on average across days of wear (average approach)-presented across boys and girls, index of multiple deprivation and season. RESULTS Mean PA level was 648 cpm (95% CI, 627 to 670). Children spent 7.5 hours (7.4-7.6) sedentary/day and 72.6 min (70.0-75.3) in MVPA/day. 11% (daily) and 68% (average) of children achieved the recommended levels of PA (P<0.05 for difference); a greater proportion of boys met the guidelines (12.5% vs 9.8%, NS; 75.9% vs 59.5%, P<0.001); guideline prevalence exhibited seasonal variation. No significant socioeconomic patterning existed across any outcome measure. CONCLUSIONS PA estimates are significantly influenced by the analytical method used to assess prevalence. This could have a substantial impact on the evaluation of interventions, policy objectives and public health investment. Existing guidelines, which focus on daily PA only may not further our understandings about the underlying construct itself. Gender differences exist within this age-group, suggesting greater investment, with particular consideration of seasonality, is needed for targeted intervention work in younger children.
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Affiliation(s)
- Paul McCrorie
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rich Mitchell
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anne Ellaway
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Loong C, Leo L, Goh D, Lim PS, Loke WM. Promoting physical activity and improving dietary quality of Singaporean adolescents: effectiveness of a school-based fitness and wellness program. Int J Adolesc Med Health 2018; 31:/j/ijamh.ahead-of-print/ijamh-2017-0049/ijamh-2017-0049.xml. [PMID: 29331096 DOI: 10.1515/ijamh-2017-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/10/2017] [Indexed: 11/15/2022]
Abstract
Limited data are available on the effectiveness of the school-based structured fitness and wellness program to influence dietary quality and physical activity levels in Singaporean adolescents. The study examined if a 20-h (over 10 weeks) school-based structured fitness and wellness module affects the diet quality indices, energy intakes, physical activity levels and the associated energy expenditures in a group of healthy, male adolescents with low diet quality and physical activity levels. Participant demography, anthropometry, dietary intake and daily physical activity were obtained at the beginning, mid-point and end of the 10-week program. Physical activity levels were assessed accelerometrically over a 1-weekday period. Dietary intake were taken using a structured 7-day food diary, and diet quality assessed using the Diet Quality Index-International (DQI-I). The 31 enrolled participants (age 19.8 ± 0.6 years) with body mass index (BMI) (19.8 ± 0.6 kg/m2) followed diets of low diet quality scores (48.3 ± 9.6 out of 100) and engaged in 3.87 ± 2.00 h of physical activity daily before the start of the intervention. Their dietary quality and physical activity levels did not change significantly throughout the intervention period. They scored poorly in the moderation and overall balance components of the diet quality assessment. The physical activity duration correlated inversely to the diet quality scores. Our results suggest that the prescribed school-based fitness and wellness module was ineffective in influencing the diet quality and physical activity levels of Singaporean male adolescents with low diet quality and physical activity levels.
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Affiliation(s)
- Claudine Loong
- Centre for Functional Food and Human Nutrition, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
- Food Science and Nutrition Group, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
| | - Latasha Leo
- Food Science and Nutrition Group, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
| | - Danielle Goh
- Food Science and Nutrition Group, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
| | - Pei Sin Lim
- Food Science and Nutrition Group, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
| | - Wai Mun Loke
- Food Science and Nutrition Group, School of Chemical and Life Sciences, Nanyang Polytechnic, Singapore 569830
- Centre for Functional Food and Human Nutrition, School of Chemical and Life Sciences, Nanyang Polytechnic, 180 Ang Mo Kio Ave 8, Singapore 569830, Phone: +65 6550 1504; +65 94378166
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Barker AR, Gracia-Marco L, Ruiz JR, Castillo MJ, Aparicio-Ugarriza R, González-Gross M, Kafatos A, Androutsos O, Polito A, Molnar D, Widhalm K, Moreno LA. Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA study. Int J Cardiol 2017; 254:303-309. [PMID: 29221862 DOI: 10.1016/j.ijcard.2017.11.080] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/31/2017] [Accepted: 11/22/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND To examine the independent associations between physical activity (PA) intensities, sedentary time (ST), TV viewing, cardiorespiratory fitness (CRF) and muscular fitness (MF) with cardiovascular disease (CVD) risk in youth. METHODS A cross-sectional study on 534 European adolescents (252 males, 282 females, 12.5-17.5years). Minutes per day of light (LPA), moderate (MPA) and vigorous (VPA) PA and total ST were measured using accelerometers. TV viewing time was measured using a questionnaire. CRF and MF were measured using the 20m shuttle run test and a hand dynamometer respectively. CVD outcomes included markers of body composition (body mass index (BMI), waist circumference (WC), WC/height (Ht) and sum of skinfolds (SumSF)), blood pressure, blood lipids and insulin resistance (HOMA-IR). Clustered CVD risk was calculated using SumSF, HOMA-IR, blood lipids and blood pressure. RESULTS LPA had a significant positive independent relationship with all body composition outcomes (P<0.001) and clustered CVD risk (P=0.046). VPA was negatively related to SumSF (P<0.001), BMI (P=0.018), WC/Ht (P=0.013) and clustered CVD risk (P=0.001), but was non-significant for all when other exposures were considered (P>0.10). MPA had a negative independent relationship with only WC (P=0.029) and ST was not significantly related to CVD risk (P>0.16). TV viewing had a significant positive independent relationship with HOMA-IR (P<0.001) and clustered CVD risk (P=0.019). CRF (all P<0.002) and MF (all P<0.009) had a negative independent relationship with body composition outcomes and clustered CVD risk. CONCLUSIONS Public health guidelines should prioritize on increasing levels of CRF, MF and VPA, and reducing TV viewing time to lower CVD risk in youth.
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Affiliation(s)
- Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - Luis Gracia-Marco
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel J Castillo
- Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - Raquel Aparicio-Ugarriza
- ImFine Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Spain
| | - Marcela González-Gross
- ImFine Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Odysseas Androutsos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Dénes Molnar
- Department of Pediatrics, University of Pecs, Hungary
| | - Kurt Widhalm
- Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Austria
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Nutrición y la Obesidad (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
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Sundberg F, Barnard K, Cato A, de Beaufort C, DiMeglio LA, Dooley G, Hershey T, Hitchcock J, Jain V, Weissberg-Benchell J, Rami-Merhar B, Smart CE, Hanas R. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes 2017; 18:499-517. [PMID: 28726299 DOI: 10.1111/pedi.12554] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/14/2017] [Accepted: 05/31/2017] [Indexed: 01/09/2023] Open
Affiliation(s)
- Frida Sundberg
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katharine Barnard
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Allison Cato
- Neurology Division, Nemours Children's Health System, Jacksonville, Florida
| | - Carine de Beaufort
- Clinique Pediatrique, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg.,Department of Pediatrics, UZ Brussels, Jette, Belgium
| | - Linda A DiMeglio
- Department of Pediatrics, Section of Pediatric Endocrinology/Diabetology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Tamara Hershey
- Psychiatry Department, Washington University School of Medicine, St. Louis, Missouri.,Radiology Department, Washington University School of Medicine, St. Louis, Missouri
| | | | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jill Weissberg-Benchell
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Birgit Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Carmel E Smart
- Department of Endocrinology, John Hunter Children's Hospital and University of Newcastle, Newcastle, Australia
| | - Ragnar Hanas
- Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Pediatrics, NU Hospital Group, Uddevalla, Sweden
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Cerin E, Sit CHP, Barnett A, Huang WYJ, Gao GY, Wong SHS, Sallis JF. Reliability of self-report measures of correlates of obesity-related behaviours in Hong Kong adolescents for the iHealt(H) and IPEN adolescent studies. Arch Public Health 2017; 75:38. [PMID: 29021899 PMCID: PMC5611613 DOI: 10.1186/s13690-017-0209-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 06/18/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This study examined the reliability of measures of correlates of dietary behaviours (DBs), physical activity (PA) and sedentary behaviour (SB) for Hong Kong adolescents. METHOD Individual, social and environmental correlates of obesity-related behaviours were assessed twice, 15-27 days apart (average 20 days), via self-administered questionnaires. These questionnaire included measures of decisional balance, self-efficacy, enjoyment and social support related to intake of fruits, vegetables, high-fat foods and sugar-sweetened beverages, PA behaviour and SB. They also included measures of perceived barriers to PA, parental rules related to PA and SB, and environmental correlates of DB, PA and SB. The questionnaires were self-completed outside school hours. A sample of 119 12-17 year old Chinese-speaking secondary school students (60 girls; 59 boys) were recruited from four Hong Kong schools located in areas stratified by walkability and socio-economic status. RESULTS The test-retest reliability of the examined measures ranged from poor to excellent (ICC: 0.30-0.99). All measures of correlates of PA and SB had excellent or substantial test-retest reliability, with the exception of self-efficacy for reducing SB (ICC: 0.59). Four of 18 measures of DBs showed moderate, and two poor (ICC < 0.41), test-retest reliability. Evidence of unidimensionality (Cronbach's α ≥ 0.70) was found for 10 of 28 multi-item scales. The evidence for the remaining 18 was either questionable or poor. CONCLUSIONS Most of the self-report measures of correlates of obesity-related behaviours used in the iHealt(H) study have acceptable test-retest reliability in Hong Kong adolescents. The factorial structure of several scales needs to be investigated in a larger sample.
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Affiliation(s)
- Ester Cerin
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Cindy H. P. Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Wendy Y. J. Huang
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Gemma Y. Gao
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Stephen H. S. Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - James F. Sallis
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- Division of Behavioral Medicine, University of California – San Diego, San Diego, CA USA
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del Pozo-Cruz B, Gant N, del Pozo-Cruz J, Maddison R. Relationships between sleep duration, physical activity and body mass index in young New Zealanders: An isotemporal substitution analysis. PLoS One 2017; 12:e0184472. [PMID: 28898295 PMCID: PMC5595318 DOI: 10.1371/journal.pone.0184472] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/24/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The evidence regarding the unique effect of sedentary behaviour on obesity among children is unclear. Moreover, the effect of substituting sedentary behaviour with physical activity of different intensities on the body composition of children has received limited empirical study. OBJECTIVE To examine the mathematical effects on Body Mass Index (BMI) of substituting sedentary behaviours with physical activities of different intensities on children and youth aged 5-14 years old in New Zealand. METHODS Secondary analysis of accelerometer data from the National Survey of Children and Young People's Physical Activity and Dietary Behaviours in New Zealand (2008/09) was conducted. A total of 1812 children and youth aged 5-24 years provided accelerometer-derived data on daily sedentary time (SB), light intensity physical activity (LPA) and moderate to vigorous physical activity (MVPA). Sleep time was assessed with a validated computerised use-of-time tool. BMI was assessed using anthropometric measurements. Multiple linear regression models were used to examine the independent associations of SB, Sleep time, LPA, and MVPA on BMI. The isotemporal substitution approach was used to ascertain the mathematical effect of substituting each of the other behaviours on BMI. Analyses were stratified by age groups. RESULTS SB showed a unique (inverse) association with BMI across all age groups (p<0.05) but 20-24 years (p>0.05). Similarly, MVPA was positively associated (p<0.001) across all age groups. Among age groups 5-9 years, 10-14 years and 15-19 years, the estimated impact of replacing 60 min/day of SB with the same amount of MVPA time resulted in decreased BMI for all age groups (p<0.001), ranging from -1.26 (5-9 years) to -1.43 units (15-19 years). Similar results were achieved when SB was replaced with LPA or sleeping time for children (5-19 years). In young people (age group 20-24), the impact of replacing 30 min/day of SB with MVPA resulted in an estimated -1 BMI units decrease (p<0.001). CONCLUSION MVPA and SB have a unique effect on BMI. Further, substituting SB with LPA or MVPA was associated with a favourable effect on BMI across all age groups; with MVPA having the strongest association.
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Affiliation(s)
- Borja del Pozo-Cruz
- Department of Exercise Sciences, Faculty of Science, University of Auckland (Auckland, New Zealand). TAMAKI BUILDING 731 -, Level 3, Tamaki Campus Gate 1,St Johns, Auckland, New Zealand
- * E-mail:
| | - Nicholas Gant
- Department of Exercise Sciences, Faculty of Science, University of Auckland (Auckland, New Zealand). TAMAKI BUILDING 731 -, Level 3, Tamaki Campus Gate 1,St Johns, Auckland, New Zealand
| | - Jesús del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville (Seville, Spain), Pirotecnia s/n, Seville, Spain
| | - Ralph Maddison
- School of Exercise and Nutrition, Faculty of Health Sciences, Deakin University (Geelong, Australia), Burwood, Victoria, Australia
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Malik AA, Williams CA, Bond B, Weston KL, Barker AR. Acute cardiorespiratory, perceptual and enjoyment responses to high-intensity interval exercise in adolescents. Eur J Sport Sci 2017; 17:1335-1342. [PMID: 28859545 DOI: 10.1080/17461391.2017.1364300] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study aimed to examine adolescents' acute cardiorespiratory and perceptual responses during high-intensity interval exercise (HIIE) and enjoyment responses following HIIE and work-matched continuous moderate intensity exercise (CMIE). Fifty-four 12- to 15-year olds (27 boys) completed 8 × 1-min cycling at 90% peak power with 75-s recovery (HIIE) and at 90% of the gas exchange threshold (CMIE). Absolute oxygen uptake ([Formula: see text]), percentage of maximal [Formula: see text] (%[Formula: see text]), heart rate (HR), percentage of maximal HR (%HRmax) and ratings of perceived exertion (RPE) were collected during HIIE. Enjoyment was measured using the physical activity enjoyment scale (PACES) following HIIE and CMIE. Boys elicited higher absolute [Formula: see text] during HIIE work (p < .01, effect size (ES) > 1.22) and recovery (p < .02, ES > 0.51) intervals but lower %[Formula: see text] during HIIE recovery intervals compared to girls (p < .01, ES > 0.67). No sex differences in HR and %HRmax were evident during HIIE and 48 participants attained ≥90% HRmax. Boys produced higher RPE at intervals 6 (p = .004, ES = 1.00) and 8 (p = .003, ES = 1.00) during HIIE. PACES was higher after HIIE compared with CMIE (p = .003, ES = 0.58). Items from PACES "I got something out of it", "It's very exciting" and "It gives me a strong feeling of success" were higher after HIIE (all p < .01, ES > 0.32). The items "I feel bored" and "It's not at all interesting" were higher after CMIE (all p < .01, ES > 0.46). HIIE elicits a maximal cardiorespiratory response in most adolescents. Greater enjoyment after HIIE was due to elevated feelings of reward, excitement and success and may serve as a strategy to promote health in youth.
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Affiliation(s)
- Adam A Malik
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK.,c Exercise and Sports Science, School of Health Sciences , Universiti Sains Malaysia
| | - Craig A Williams
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Bert Bond
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Kathryn L Weston
- b Health and Social Care Institute , Teesside University , Middlesbrough , UK
| | - Alan R Barker
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
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Quelly SB. Developing and testing adapted measures of children’s self-efficacy, intentions, and behaviors associated with childhood obesity. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Susan B. Quelly
- College of Nursing, University of Central Florida, Orlando, FL
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Mitchell JA, Dowda M, Pate RR, Kordas K, Froberg K, Sardinha LB, Kolle E, Page A. Physical Activity and Pediatric Obesity: A Quantile Regression Analysis. Med Sci Sports Exerc 2017; 49:466-473. [PMID: 27755284 PMCID: PMC5321492 DOI: 10.1249/mss.0000000000001129] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE We aimed to determine whether moderate to vigorous physical activity (MVPA) and sedentary behavior (SB) were independently associated with body mass index (BMI) and waist circumference (WC) in children and adolescents. METHODS Data from the International Children's Accelerometry Database were used to address our objectives (N = 11,115; 6-18 yr; 51% female). We calculated age- and gender-specific BMI and WC z-scores and used accelerometry to estimate MVPA and total SB. Self-reported television viewing was used as a measure of leisure time SB. Quantile regression was used to analyze the data. RESULTS MVPA and total SB were associated with lower and higher BMI and WC z-scores, respectively. These associations were strongest at the higher percentiles of the z-score distributions. After including MVPA and total SB in the same model, the MVPA associations remained, but the SB associations were no longer present. For example, each additional hour per day of MVPA was not associated with BMI z-score at the 10th percentile (b = -0.02, P = 0.170) but was associated with lower BMI z-score at the 50th (b = -0.19, P < 0.001) and 90th percentiles (b = -0.41, P < 0.001). More television viewing was associated with higher BMI and WC, and the associations were strongest at the higher percentiles of the z-score distributions, with adjustment for MVPA and total SB. CONCLUSIONS Our observation of stronger associations at the higher percentiles indicates that increasing MVPA and decreasing television viewing at the population-level could shift the upper tails of the BMI and WC frequency distributions to lower values, thereby lowering the number of children and adolescents classified as obese.
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Affiliation(s)
- Jonathan A Mitchell
- 1Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA; 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 3Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, SC; 4School of Social and Community Medicine, University of Bristol, Bristol, UNITED KINGDOM; 5Centre of Research in Childhood Health, University of Southern Denmark, Odense, DENMARK; 6Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, PORTUGAL; 7Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; and 8Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UNITED KINGDOM
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Poitras VJ, Gray CE, Borghese MM, Carson V, Chaput JP, Janssen I, Katzmarzyk PT, Pate RR, Connor Gorber S, Kho ME, Sampson M, Tremblay MS. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 2017; 41:S197-239. [PMID: 27306431 DOI: 10.1139/apnm-2015-0663] [Citation(s) in RCA: 1067] [Impact Index Per Article: 152.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.
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Affiliation(s)
- Veronica Joan Poitras
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Casey Ellen Gray
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Michael M Borghese
- b School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Valerie Carson
- c Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Jean-Philippe Chaput
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Ian Janssen
- b School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | | | - Russell R Pate
- e Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Sarah Connor Gorber
- f Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michelle E Kho
- g School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Margaret Sampson
- h Library and Media Services, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Mark S Tremblay
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
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Corder K, Sharp SJ, Atkin AJ, Andersen LB, Cardon G, Page A, Davey R, Grøntved A, Hallal PC, Janz KF, Kordas K, Kriemler S, Puder JJ, Sardinha LB, Ekelund U, van Sluijs EM. Age-related patterns of vigorous-intensity physical activity in youth: The International Children's Accelerometry Database. Prev Med Rep 2016; 4:17-22. [PMID: 27413656 PMCID: PMC4929125 DOI: 10.1016/j.pmedr.2016.05.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/16/2016] [Indexed: 11/04/2022] Open
Abstract
Physical activity declines during youth but most evidence reports on combined moderate and vigorous-intensity physical activity. We investigated how vigorous-intensity activity varies with age. Cross-sectional data from 24,025 participants (5.0-18.0 y; from 20 studies in 10 countries obtained 2008-2010) providing ≥ 1 day accelerometer data (International Children's Accelerometry Database (ICAD)). Linear regression was used to investigate age-related patterns in vigorous-intensity activity; models included age (exposure), adjustments for monitor wear-time and study. Moderate-intensity activity was examined for comparison. Interactions were used to investigate whether the age/vigorous-activity association differed by sex, weight status, ethnicity, maternal education and region. A 6.9% (95% CI 6.2, 7.5) relative reduction in mean vigorous-intensity activity with every year of age was observed; for moderate activity the relative reduction was 6.0% (5.6%, 6.4%). The age-related decrease in vigorous-intensity activity remained after adjustment for moderate activity. A larger age-related decrease in vigorous activity was observed for girls (- 10.7%) versus boys (- 2.9%), non-white (- 12.9% to - 9.4%) versus white individuals (- 6.1%), lowest maternal education (high school (- 2.0%)) versus college/university (ns) and for overweight/obese (- 6.1%) versus healthy-weight participants (- 8.1%). In addition to larger annual decreases in vigorous-intensity activity, overweight/obese individuals, girls and North Americans had comparatively lower average vigorous-intensity activity at 5.0-5.9 y. Age-related declines in vigorous-intensity activity during youth appear relatively greater than those of moderate activity. However, due to a higher baseline, absolute moderate-intensity activity decreases more than vigorous. Overweight/obese individuals, girls, and North Americans appear especially in need of vigorous-intensity activity promotion due to low levels at 5.0-5.9 y and larger negative annual differences.
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Affiliation(s)
- Kirsten Corder
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Stephen J. Sharp
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Andrew J. Atkin
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Lars B. Andersen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Norwegian School of Sport Science, Oslo, Norway
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Rachel Davey
- Centre for Research and Action in Public Health, University of Canberra, Canberra, Australia
| | - Anders Grøntved
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Kathleen F. Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, US
| | - Katarzyna Kordas
- School of Social and Community Medicine, University of Bristol, UK
| | - Susi Kriemler
- Epidemiology, Biostatistics and Public Health Institute, University of Zürich, Switzerland
| | - Jardena J. Puder
- Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland
- Division of Pediatric Endocrinology, Diabetology and Obesity, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Luis B. Sardinha
- Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal
| | - Ulf Ekelund
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
- Norwegian School of Sport Science, Oslo, Norway
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
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