Weekday and weekend sedentary time and physical activity in differentially active children

Effectiveness of wearable activity trackers on physical activity among adolescents in school-based settings: a systematic review and meta-analysis

BACKGROUND

While inactivity and sedentarism among adolescents are increasing globally, technology-based interventions incorporating wearable activity trackers (WATs) demonstrate the potential to combat the situation. With a focus on schools as critical environments in which to perform interventions among adolescents, this meta-analytic review of literature aimed to examine the effectiveness of wearable trackers in objectively measured physical activity (PA).

METHODS

A systematic search was conducted across six databases-PubMed, CENTRAL, Scopus, SPORTDiscus, the Web of Science Core Collection, and PsycINFO-between January 2012 and March 2024. The language was restricted to English only. Both randomized controlled trials and quasi-experiment studies were included. Risk of bias was assessed using Cochrane RoB2 and ROBINS-I tools. Subgroup analyses and sensitivity analyses were performed. Effect direction for a narrative synthesis was also conducted. GRADE criteria were applied to assess quality of evidence.

RESULTS

Fifteen studies were finally included in the literature review, and ten were adopted for meta-analysis. No statistical significance was found in intervention outcomes involving WATs' effect on PA, whether in terms of total daily steps, moderate-to-vigorous PA (MVPA), or calorie counts. However, the subgroup analysis revealed that one study using research-grade assessment showed a substantial positive effect on steps. There were no data reported regarding the effect of objectively measured sedentary behavior.

CONCLUSION

Further study is needed to explore whether wearable activity trackers raise or decrease PA among adolescents in schools.

REGISTRATION

PROSPERO, registration number: CRD42023421008.

The 24-Hour Activity Checklist for Cerebral Palsy: Translation, Content Validity and Test-Retest Reliability of Portuguese Versions

BACKGROUND

The importance of 24-h movement behaviour, including sleep, physical activity (PA) and sedentary behaviour (SB), has gained prominence due to its significant impact on the health and development of children, including those with cerebral palsy (CP). The 24-h activity checklist for CP, a tool developed in the Netherlands to monitor the activity in CP paediatric population, requires translation and cultural adaptation to Portuguese for use in Brazil and Portugal.

METHODS

This cross-sectional methodological study involved translating and culturally adapting the 24-h activity checklist for CP into Brazilian Portuguese (BP) and European Portuguese (EP) languages. The process included forward translation, synthesis and backward translation, expert panel evaluation and pretesting. Brazilian and Portuguese experts appraised content validity, assessed by the individual item (I-CVI) and scale level content validity index scores (S-CVI/Ave). Sixty parents of children with CP participated in the test-retest analysis, reported with the Intraclass Correlation Coefficients (ICCs).

RESULTS

I-CVI scores were higher than 0.78 for both versions. S-CVI/Ave scores were considered excellent for BP (0.91) and EP version (1.0). Expert's appraisal results in the inclusion of a question about sleep-related time indicators and the split of sleep, PA, and screen time questions for weekdays and weekends. Brazilian and Portuguese parents of children with CP reported understanding on instructions, questions, and answer options. The ICC values range from 0.81 to 0.99 and 0.6 to 0.98, for BP and EP, respectively.

CONCLUSIONS

The BP and EP versions of 24-h activity checklist for CP demonstrated good content validity and test-retest reliability, supporting its use in Brazil and Portugal. This tool can contribute to improving communication between families and healthcare professionals to monitor and develop tailored interventions for healthy movement behaviours in children with CP.

Inequality in Children's Physical Activity Across Time-Segmented Youth Sport Practice

Purpose: Youth sport (YS) is a community system for promoting children's physical activity (PA). Studies have examined mean PA during YS practices, but few have examined inequalities in the distribution of PA among children during practice time. This study examined PA inequality in time-segmented YS practices and differences in inequality by time segment characteristics. Methods: Children's PA and YS practices were examined using accelerometer and video observation data from a sample of YS teams (n = 36 teams, n = 101 practices) for third- through sixth-grade children (n = 392), approximately eight to 12 years old, in two rural U.S. communities. Practices were time-segmented into smaller units (episodes; n = 991). Episodes were assigned codes for purpose (e.g. warm-up), member arrangement (e.g. whole group), and setting demand (i.e. fosters participation, creates exclusion). Group accelerometer data were paired with episodes, and the Gini coefficient quantified inequality in activity counts and minutes of moderate-to-vigorous PA (MVPA). Beta generalized estimating equations examined the influence of episode structure on PA inequality. Results: Warm-up (Gini = 0.22), fitness (Gini = 0.24), and sport skill (Gini = 0.24) episodes had significantly lower inequality (p < .05) in activity counts than other purpose types. Management (Gini = 0.32) and strategy (Gini = 0.40) episodes had significantly greater inequality (p < .05) in MVPA minutes than other purpose types. Episodes fostering participation (Gini = 0.32) had significantly lower activity count inequality (p < .05) than episodes creating exclusion (Gini = 0.35). Conclusion: PA inequality among children during YS varied by practice structure. Metrics such as the Gini coefficient can illuminate inequalities in PA and may be useful for guiding efforts to improve population PA in children. Trial Registration: This study is registered at www.clinicaltrials.gov (Identifier: NCT03380143).

Inequality in Physical Activity in Organized Group Settings for Children: A Cross-Sectional Study

BACKGROUND

Adult-led organized settings for children (eg, classrooms) provide opportunities for physical activity (PA). The structure of setting time may influence inequalities (ie, unequalness) in the distribution of PA. This study examined differences in PA inequality by setting and time-segment purpose in time-segmented organized group settings for children.

METHODS

PA and setting meetings were assessed using accelerometer and video observation data from school, before-/after-school, and youth club groups (n = 30) for third- through sixth-grade children (n = 699) in 2 rural US communities. Meetings (n = 130) were time-segmented into smaller units (sessions; n = 835). Each session was assigned a purpose code (eg, PA). Accelerometer data were paired with the meetings and sessions, and the Gini coefficient quantified inequality in activity counts and moderate to vigorous PA minutes for each segment. Beta generalized estimating equations examined differences in PA inequality by setting and session purpose.

RESULTS

Activity count inequality was lowest (P < .05) during youth club meetings (Gini = 0.17, 95% CI, 0.14-0.20), and inequality in moderate to vigorous PA minutes was greatest (P < .01) during school (Gini = 0.34, 95% CI, 0.30-0.38). Organized PA sessions (Gini = 0.20, 95% CI, 0.17-0.23) had lower activity count inequality (P < .0001) than academic (Gini = 0.30, 95% CI, 0.27-0.34), enrichment (Gini = 0.31, 95% CI, 0.27-0.36), and nonactive recreation (Gini = 0.30, 95% CI, 0.25-0.34) sessions. Inequality in moderate to vigorous PA minutes was lower (P < .05) in organized PA (Gini = 0.26, 95% CI, 0.20-0.32) and free play (Gini = 0.28, 95% CI, 0.19-0.39) than other sessions.

CONCLUSIONS

PA inequality differed by setting time structure, with lower inequality during organized PA sessions. The Gini coefficient can illuminate PA inequalities in organized settings and may inform population PA improvement efforts in rural communities.

Association of Recess Provision With Accelerometer-Measured Physical Activity and Sedentary Time in a Representative Sample of 6- to 11-Year-Old Children in the United States

PURPOSE

To assess the association between the amount of recess provision and children's accelerometer-measured physical activity (PA) levels.

METHODS

Parents/guardians of 6- to 11-year-olds (n = 451) in the 2012 National Youth Fitness Survey reported recess provision, categorized as low (10-15 min; 31.9%), medium (16-30 min; 48.0%), or high (>30 min; 20.1%). Children wore a wrist-worn accelerometer for 7 days to estimate time spent sedentary, in light PA, and in moderate to vigorous PA using 2 different cut points for either activity counts or raw acceleration. Outcomes were compared between levels of recess provision while adjusting for covariates and the survey's multistage, probability sampling design.

RESULTS

Children with high recess provision spent less time sedentary, irrespective of type of day (week vs weekend) and engaged in more light or moderate to vigorous PA on weekdays than those with low recess provision. The magnitude and statistical significance of effects differed based on the cut points used to classify PA (eg, 4.7 vs 11.9 additional min·d-1 of moderate to vigorous PA).

CONCLUSIONS

Providing children with >30 minutes of daily recess, which exceeds current recommendations of ≥20 minutes, is associated with more favorable PA levels and not just on school days. Identifying the optimal method for analyzing wrist-worn accelerometer data could clarify the magnitude of this effect.

The prevalence of sedentary behavior among university students in Saudi Arabia

BACKGROUND

A considerable body of research has demonstrated that reducing sitting time benefits health. Therefore, the current study aimed to explore the prevalence of sedentary behavior (SB) and its patterns.

METHODS

A total of 6975 university students (49.1% female) were chosen randomly to participate in a face-to-face interview. The original English version of the sedentary behavior questionnaire (SBQ) was previously translated into Arabic. Then, the validated Arabic version of the SBQ was used to assess SB. The Arabic SBQ included 9 types of SB (watching television, playing computer/video games, sitting while listening to music, sitting and talking on the phone, doing paperwork or office work, sitting and reading, playing a musical instrument, doing arts and crafts, and sitting and driving/riding in a car, bus or train) on weekdays and weekends.

RESULTS

SBQ indicated that the total time of SB was considerably high (478.75 ± 256.60 and 535.86 ± 316.53 (min/day) during weekdays and weekends, respectively). On average, participants spent the most time during the day doing office/paperwork (item number 4) during weekdays (112.47 ± 111.11 min/day) and weekends (122.05 ± 113.49 min/day), followed by sitting time in transportation (item number 9) during weekdays (78.95 ± 83.25 min/day) and weekends (92.84 ± 100.19 min/day). The average total sitting time of the SBQ was 495.09 ± 247.38 (min/day) and 58.4% of the participants reported a high amount of sitting time (≥ 7 hours/day). Independent t-test showed significant differences (P ≤ 0.05) between males and females in all types of SB except with doing office/paperwork (item number 4). The results also showed that male students have a longer daily sitting time (521.73 ± 236.53 min/day) than females (467.38 ± 255.28 min/day). Finally, 64.1% of the males reported a high amount of sitting time (≥ 7 hours/day) compared to females (52.3%).

CONCLUSION

In conclusion, the total mean length of SB in minutes per day for male and female university students was considerably high. About 58% of the population appeared to spend ≥7 h/day sedentary. Male university students are likelier to sit longer than female students. Our findings also indicated that SB and physical activity interventions are needed to raise awareness of the importance of adopting an active lifestyle and reducing sitting time.

Full-Day Physical Activity and Sedentary Behaviour Levels of Typically Developing Children and Adolescents in the Middle East: A Systematic Review

Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2-18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.

The impact of SNAP-Ed interventions on California students' diet and physical activity during COVID-19

OBJECTIVE

School-based CalFresh Healthy Living (CFHL) (California's SNAP-Ed) interventions adapted to new learning environments necessitated by COVID-19. We examined the impact of these interventions on student diet and physical activity (PA) outcomes.

DESIGN

Quasi-experimental, two-group, pre-post.

SETTING

California public schools with ≥50 % of students Free and Reduced Price Meal-eligible (nintervention = 47; ncomparison = 17).

PARTICIPANTS

Fourth- and fifth-grade students who completed the online Eating and Activity Tool for Students at pre and post (nintervention = 1087; ncomparison = 846 students).

RESULTS

Intervention students reported a significantly greater increase in consumption frequency of total fruit (by 0·16 times/d; P = 0·032), driven primarily by a greater increase in 100 % fruit juice (by 0·11 times/d; P = 0·007). Intervention students reported a significantly greater increase in total vegetable consumption frequency (by 0·45 times/d; P < 0·001) than comparison students. Specifically, intervention students reported increased, whereas comparison students reported decreased, consumption frequencies for starchy vegetables (0·05 v. -0·10 times/d, P < 0·001), salad/green vegetables (0·01 v. -0·11 times/d, P = 0·005) and beans (0·04 v. -0·03 times/d, P = 0·025). Consumption frequency of other vegetables decreased in both groups (-0·01 v. -0·09 times/d) but decreased more among comparison students (P = 0·048). No differences in pre-post change in PA outcomes were detected.

CONCLUSIONS

Findings suggest that despite COVID-19-related challenges necessitating programme modifications, CFHL interventions played a role in protecting student consumption of fruit and vegetables during the 2020-2021 school year. Therefore, it appears that school-based CFHL interventions can be a viable means of safeguarding student nutrition at a time when access to nutritious food and PA opportunities are hindered.

A 24-h activity profile and adiposity among children and adolescents: Does the difference between school and weekend days matter?

BACKGROUND

Twenty-four-hour movement behaviours are gaining attention in the research community. However, no study has addressed how 24-h activity profiles vary between structured and less structured days and whether an unfavourable activity profile is associated with childhood obesity. We aimed to analyse differences between school day and weekend day 24-h activity profiles and their associations with adiposity indicators among children and adolescents.

METHODS

Participants were 382 children and 338 adolescents who wore wrist accelerometers for 24 hours a day for seven consecutive days. The 24-h activity profile expressed by the average acceleration (AvAcc) and intensity gradient (IG) were estimated from multi-day raw accelerometer data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Multiple linear regression of activity profile metrics and adiposity indicators was performed separately for school and weekend days.

RESULTS

Weekend days AvAcc and IG were lower compared to school days in both age groups (p <0.001 for all). Specifically, AvAcc was lower by 9.4% and 11.3% in children and adolescents, respectively. IG on weekend days was lower (more negative) by 3.4% in children and 3.1% in adolescents. Among children, on school days AvAcc and IG were negatively associated with FM%, FMI, and VAT, whilst on weekend days AvAcc was positively associated with BMI z-score, FMI, and VAT (p < 0.05 for all). Among adolescents, negative associations were found between weekend day AvAcc and IG and FM% and FMI (p < 0.05 for all), respectively.

CONCLUSIONS

This study confirms the importance of 24-h activity profile as a potentially protective factor against excess adiposity. The variability of movement behaviours during structured and less structured days should be considered when optimizing the 24-h movement behaviours to prevent childhood obesity.

iEngage: A digital health education program designed to enhance physical activity in young adolescents

iEngage is a modular health education and behavioural change program designed to help adolescents increase moderate to vigorous physical activity (MVPA). The program is delivered through the iEngage app which integrates activity trackers data (Misfit Ray^©) within 10 interactive learning modules. Key features include guidance to set goals, self-monitor and assess achievements, and experiential learning via the connected activity trackers which allows for continuous steps recording during the program. iEngage was implemented in two schools over 5 weeks with 10–12 years old adolescents (n = 57) and PA outcomes compared to control group (n = 26). Results show that adolescents successfully set goals and self-assessed achievements during the program, progressing toward higher physical activity (PA) levels as shown by the 30% increase in daily steps through the program (+ 2647 steps/day, P < .001) with boys increasing goals and achievements faster than girls. The consistency in days totalling at least 11,000 steps/day increased from 35% at the start to 48% at the end of the program. The increase in PA is confirmed through the assessment of MVPA during schooldays pre- and post- program via research grade wrist accelerometers in both iEngage and control participants. Contrasting with the control group, MVPA was increased in the week following the program (~+5 min/day, P = .023) in short bouts, particularly during lunch time, recess and after school. This study shows that a digital program integrating activity trackers data, health education, goals setting and self-monitoring of PA, helped young adolescents enhance PA goals, improve achievements and increase MVPA.

Day-level associations of physical activity and sedentary time in mother-child dyads across three years: a multi-wave longitudinal study using accelerometers

Understanding associations between mothers' and children's physical activity and sedentary behavior on more fine-grained timescales can provide insights into real-time intervention opportunities. This study examined the extent to which mothers' and their children's device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time (SDT) were associated at the day level during non-school time. Mother-child dyads (N = 193; baseline Mean ages = 40.69 ± 6.11 [mother] and 9.57 ± 0.89 [child] years) provided 3,135 paired days of accelerometry data from six bi-annual waves across three years. Controlling for covariates, multilevel models revealed that mothers' and their children's MVPA and SDT were positively associated at the day level during non-school time, both on weekdays and weekends. During weekdays, the day-level association for SDT was stronger for older than younger children, and the day-level association for MVPA was stronger for boys than girls. Designing family-based interventions targeting school-age children and their mothers during non-school time across the week may be useful for promoting active lifestyles.

Association of Recess Provision With Elementary School-Aged Children's Physical Activity, Adiposity, and Cardiorespiratory and Muscular Fitness

PURPOSE

To identify associations between amount of school recess provision and children's physical activity (PA), weight status, adiposity, cardiorespiratory endurance, muscular strength, and muscular endurance.

METHOD

Data from 6- to 11-year-old participants (n = 499) in the 2012 National Youth Fitness Survey were analyzed. Parents/guardians reported children's PA levels and recess provision, categorized as no/minimal (9.0%), low (26.1%), medium (46.0%), or high (18.9%). Children wore a wrist-worn accelerometer for 7 days and completed anthropometric measurements. Fitness was assessed using grip strength and treadmill, pull-up, and plank tests. Cross-sectional linear and logistic regression compared outcomes across levels of recess provision adjusting for the survey's complex sampling design.

RESULTS

Children with high provision of recess were 2.31 times more likely to meet PA guidelines according to parent report than those with no/minimal recess. Accelerometer-measured PA followed a more U-shaped pattern, wherein PA was higher in children with high, compared to low, recess provision but comparable to those with no/minimal recess provision. There were no associations with weight status, adiposity, or fitness.

CONCLUSION

Current recess recommendations (20 min·d-1) may be insufficient as 30 minutes per day of recess was associated with a 2-fold greater likelihood of achieving recommended PA levels. Additional research on recess quantity and quality is needed.

Physical Activity and Related Factors in Pre-Adolescent Southern African Children of Diverse Population Groups

Tailored obesity management includes understanding physical activity (PA) and its context, ideally in childhood before the onset of health risk. This cross-sectional study determined, by sex and population, the PA of Southern African pre-adolescent urban primary school children. PA was measured objectively (step count: pedometer) and subjectively (Physical Activity Questionnaire for Older Children [PAQ-C]), taking confounders (phenotype, school-built environment, and socio-economic environment) into account. Body composition was measured with multifrequency bioelectrical impedance analysis (Seca mBCA). PA was adjusted for phenotypic confounders (body size and composition) using multivariate regression. Sex and population differences in PA were determined with two-way ANOVA. Ninety-four healthy pre-adolescents (60% girls, 52% black) with a similar socio-economic status and access to PA participated. Amidst phenotypic differences, average steps/day in girls (10,212) was lower than in boys (11,433) (p = 0.029), and lower in black (9280) than in white (12,258) (p < 0.001) participants. PAQ-C scores (5-point rating) were lower for girls (2.63) than boys (2.92) (p < 0.001) but higher for black (2.89) than white (2.58) (p < 0.001) participants. Objective and subjective measurements were, however, not significantly (r = −0.02; p = 0.876) related and PAQ-C failed to identify reactive changes in the step count. Objectively measured PA of black participants and of girls was consistently lower than for white participants and boys. Target-group specific interventions should therefore be considered.

Determining total energy expenditure in 3–6-year-old Japanese pre-school children using the doubly labeled water method

The doubly labeled water (DLW, 2H218O) method for calculating the total production of CO2 over several days is currently considered to be the most accurate technique for the measurement of total energy expenditure (TEE), and the results obtained using this method have been used to review energy requirements. Presently, there is limited data available on TEE in Japanese children. The objective of this study was to assess the TEE in pre-school Japanese children using the DLW method. We used a cross-sectional population of 140 children (69 boys and 71 girls) aged 3–6 years. TEE was measured using the DLW method over 8 days under free-living conditions. The average weights (kg) of the boys and girls were 15.6 ± 2.5 and 15.0 ± 2.1 for the 3–4 years old and 19.8 ± 3.8 and 19.6 ± 2.7 for the 5–6 years old, respectively. The corresponding TEE (kcal/day) was 1260.9 ± 357.8 and 1265.2 ± 408.0, and 1682.3 ± 489.0 and 1693.1 ± 473.3, respectively, showing a significant difference with respect to age. Furthermore, TEE per body weight (kcal/kg/day) was 83.2 ± 29.2 and 84.9 ± 26.6, and 85.4 ± 23.2 and 86.7 ± 22.6, respectively. However, when TEE was adjusted for body weight or fat-free mass, there were no age or sex differences. We conclude that in Japanese children, TEE in those aged 3–4 years was similar to the current Ministry of Health recommendations. However, TEE in children aged 5–6 years was slightly higher than the recommendations. Based on these findings, the present results obtained from a large number of participants will provide valuable reference data for Japanese children.

Back to school after lockdown: The effect of COVID-19 restrictions on children's device-based physical activity metrics

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic and national lockdowns took away opportunities for children to be physically active. This study aimed to determine the effect of the COVID-19 lockdown on accelerometer-assessed physical activity (PA) in children in Wales.

METHODS

Eight hundred participants (8-18 years old), stratified by sex, age, and socio-economic status, wore Axivity AX3 accelerometers for 7 days in February 2021, during the lockdown, and in May 2021, while in school. Raw accelerometer data were processed in R-package GGIR, and cut-point data, average acceleration (AvAcc), intensity gradient, and the acceleration above which the most active X minutes are accumulated (MX) metrics were extracted. Linear mixed models were used to assess the influence of time-point, sex, age, and socioeconomic status (SES) on PA.

RESULTS

During lockdown, moderate-to-vigorous PA was 38.4 ± 24.3 min/day; sedentary time was 849.4 ± 196.6 min/day; mean ± SD. PA levels increased significantly upon return to school (all variables p < 0.001). While there were no sex differences during lockdown (p = 0.233), girls engaged in significantly less moderate-to-vigorous PA than boys once back in school (p < 0.001). Furthermore, boys had more favorable intensity profiles than girls (intensity gradient: p < 0.001), regardless of time-point. PA levels decreased with age at both time-points; upper secondary school girls were the least active group, with an average M30 of 195.2 mg (while in school).

CONCLUSION

The lockdown affected boys more than girls, as reflected by the disappearance of the typical sex difference in PA levels during lockdown, although these were re-established on return to school. Upper secondary school (especially girls) might need specific COVID-recovery intervention.

Accelerometer-Measured Physical Activity Levels and Patterns Vary in an Age- and Sex-Dependent Fashion among Finnish Children and Adolescents

Background: The purpose of this study was to measure physical activity (PA), sedentary behavior (SB), and hour-by-hour PA patterns with an accelerometer in a population-based sample of Finnish children and adolescents. Methods: A total of 3274 participants (3rd, 5th, 7th, 9th graders) from 176 schools wore a hip-worn triaxial accelerometer for seven days during waking hours. Mean amplitude deviation of the acceleration data was used to assess PA intensity that was converted to metabolic equivalents and categorized into light, moderate, and vigorous PA. Angle for posture estimation was used to measure SB and standing. Results: The majority of participants’ PA consisted of light PA, and they were sedentary for more than half of their waking hours. Children were more active than adolescents, and boys were more active than girls. Participants took, on average, 9890 steps daily, and one third met the PA recommendation. The participants were divided into tertiles based on daily steps to investigate the variation in PA patterns. Compared to the least active tertile, the most active tertile took twice as many steps on weekdays and nearly three times as many steps on the weekend. Conclusions: The majority of the participants were not active enough, and there was a great variation in PA levels and patterns, especially among the adolescents and on weekends.

Impact of weekdays versus weekend days on accelerometer measured physical behavior among children and adolescents: results from the MoMo study

Structured activities, in which children participate for example at school, are consistent and limited in scope. After-school or weekend activities, by contrast, involve a wider range of behaviors. Studies have shown that physical activity (PA), as measured by accelerometers, is lower on weekends compared to weekdays or school days, whereas PA does not differ between weekdays. In the present study, we examined accelerometer data of children and adolescents living in Germany for the different weekdays and weekend days. The current analysis used cross-sectional data of participants (n = 2743) aged 6–17 years collected between 2014 and 2017. The final valid sample consisted of 2278 children and adolescents divided into three age groups (6–10 years, n = 713; 11–13 years, n = 706; 14–17 years, n = 859) and two gender groups (1072 boys, 1206 girls). Physical behavior, including sedentary behavior, as well as light, moderate, vigorous PA, and wear time were analyzed. Absolute and percentage intensity distributions were evaluated daily. The average wear time was 807 min daily from Monday–Thursday with significant deviations from the mean on Friday (+38 min), Saturday (−76 min), and Sunday (−141 min). Absolute moderate to vigorous PA times were lower on weekends than during the week. However, the percentage intensity distribution remained constant over all days. Girls were less physically active and more sedentary than boys (F1,2272 = 38.3; p < 0.01) and adolescents were significantly less active than younger children (F2,2272 = 138.6; p < 0.01). Waking times increased with age (F2,2272 = 138.6; p < 0.01). Shorter awake periods limit possible active times on weekends, resulting in lower PA and sedentary behavior compared to weekdays. The percentage distributions of the different physical behavior intensity categories are similar over all weekdays and weekend days. We could not find a justification for specific weekend interventions. Instead, interventions should generally try to shift activity away from sedentary behavior towards a more active lifestyle.

The COVID-19 pandemic as a fortuitous disruptor in physical education: the case of active homework

Measures devised to contain the COVID-19, including isolation, social distancing, and quarantine, have profoundly affected people's lives around the world. One of the consequences of these actions has been a general reduction in the habitual daily physical activity among children and young people for whom schools represent the major setting for the promotion of sports, physically active play, movement skills learning, and other activity supportive of healthy, active lifestyles. Whilst acknowledging the seriousness of these changes, and their concomitant health risks, we suggest that COVID-19 offers an opportunity to think again about important features of school-based activity promotion in light of new lessons learnt during lockdown, emerging technologies, and adapted pedagogies. In these specific cases, COVID-19 could be judged a "fortuitous disruptor" to the extent that it has opened a window of opportunity to schools and teachers to reflect on their assumptions about the scope, content, and delivery of their curricula, and on the new professional knowledge that has emerged. Active Homework, or physical activity-related tasks assigned to students by teachers that are meant to be carried out before, after and away from school, that students can do on their own or with family members, is not a new idea, but the enforced changes to school provision have made it considerably more common since the pandemic. Perhaps Active Homework is a concept worth retaining as schools start to return to "normal"? We offer a typology of Active Homework, and examine opportunities to expand, extend, and enhance physical education and physical activity opportunities by breaking down the presumed boundary between school and home. In conclusion, we suggest that Active Homework is worth exploring as a potentially valuable approach to enhancing the quantity and quality of students' school-based health-related physical activity. If so, considerably more research and curriculum development is needed.

The Immediate and Lasting Effects of Resident Summer Camp on Movement Behaviors Among Children

This study aims to examine the immediate and lasting effects of resident summer camp on movement behaviors among children with repeated pre-, during-, and post-intervention measurements. In total, 21 children (aged 10.3 ± 1.2 years, 17 boys and 4 girls) participated in a 31-day nature-based resident summer camp in Japan. Daily children's movement behaviors (moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep) were continuously monitored before, during, and after the summer camp (i.e., 75 continuous days). It was found that the children engaged more time in MVPA (9.6%), less time in SB (58.0%), had more steps (22,405 steps/day), and an earlier midpoint of sleep (0:24 a.m.) in the summer camp as compared to the other periods (before and after the camp). However, the children engaged in unfavorable behaviors [reduction in MVPA (3.6%), increased SB (67.3%), and a later midpoint of sleep (1:32 a.m.)] during the summer vacation after the camp. This study indicates that the resident summer camp was effective in improving children's movement behaviors during the camp. However, the lasting effects were negligible or at least limited after its completion.

On the Move or Barely Moving? Age-Related Changes in Physical Activity, Sedentary, and Sleep Behaviors by Weekday/Weekend Following Pandemic Control Policies

This study examined pre-pandemic (2017-early March 2020) to early-pandemic (Spring 2020) changes in moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary behavior/sleep (SS), by weekday/weekend, and age (preschool, elementary, middle school). We re-enrolled children from two pre-pandemic obesity prevention trials and examined differences in accelerometer-measured PA from pre-pandemic to early-pandemic across age groups using linear mixed models. Children (n = 75) were 51% multiple race/ethnicities, 29% preschool, 28% elementary, 43% middle school, 65% suburban, 21% rural, and 13% urban. Pre-pandemic to early-pandemic changes in weekday MVPA (p = 0.006), LPA (p = 0.018), and SS (p = 0.003) differed by age. On weekdays, middle schoolers' MVPA decreased 15.36 min/day (p = 0.002) and SS increased 94.36 min/day (p < 0.001) with non-significant changes among preschoolers and elementary schoolers. Compared to elementary schoolers, middle schoolers' changes in weekday MVPA (b = -16.34, p = 0.036) and SS (b = 63.28, p = 0.039) significantly differed. Declines in weekday MVPA and increases in SS among middle schoolers suggest that, compared with younger children, middle schoolers are dependent on school and recreational facilities for PA, and in their absence engage in more sedentary activities and sleep.

Associations Between Physical Fitness, Objectively Measured Physical Activity and Academic Performance

There is evidence that physical activity (PA) can improve the academic performance. We recruited healthy adolescent girls, aged 11–12 years, and measured their PA with the accelerometer ActiGraph GT3X for the consecutive 5 days. Physical fitness (PF) was measured with eight motoric tests and three anthropometry measures. Academic performance (AP) was assessed for the six academic narrated school subjects. The results revealed that the girls were more physically active during the week days and less active at weekend (557 vs. 516 counts/min). Physical education grade shows the highest overall correlations with the results of the PF test battery (r = 0.53–0.95, p < 0.01). Nevertheless, correlations surprisingly decrease for the combined daily PA (r = 0.45), especially the weekend PA (r = 0.28). Grade point average and PF correlated moderately (r = 0.43-0.64), while they were moderate to high for PA (r = 0.59–0.87). Many questions arose after the completion of the present study and several new topics opened up, such as the question of how parental education affects the duration of PA and AP of the children and the influence of the place of residence AP of the children.

Age-varying Bi-directional Associations Between Momentary Affect and Movement Behaviors in Children: Evidence From a Multi-wave Ecological Momentary Assessment Study

BACKGROUND

The bi-directional associations between affective states and movement behaviors (e.g., physical activity, sedentary behavior) have been observed in children. It is unclear if the strength of these bi-directional associations varies with age as children transition from childhood to adolescence.

PURPOSE

This multi-wave ecological momentary assessment (EMA) study investigates the acute time-varying associations between affect and movement behaviors among youth.

METHODS

Children (N = 195, baseline mean age = 10.72, range = 8-12 years, mean BMI-z = 0.49, 51% female) participated in a six-wave EMA study across three years. Each EMA survey captured momentary positive and negative affect. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary time in the 15-min window before and after each EMA survey was calculated using accelerometry data. Time-varying effect models (TVEM) examined the acute bi-directional associations between momentary positive/negative affect and MVPA/sedentary time across ages 8 to 14.

RESULTS

Children provided 14,246 valid activity-matched EMA surveys across all waves. TVEM plots revealed that the directionality and the strength (time-varying slopes) of associations between momentary affect and activity levels vary across ages. Positive affect was associated with higher MVPA levels and lower sedentary time at younger ages, whereas negative affect linked to lower MVPA levels and more sedentary time at older ages.

CONCLUSIONS

The acute associations between momentary affect and (in)activity levels may vary as a function of children's age. Applying TVEM to intensive longitudinal data could provide valuable information for developing age-tailored interventions that promote healthy lifestyles among children and adolescents.

Physical Activity and Sedentary Behavior Patterns Across Weekdays and Weekend Days in Youth With Multiple Sclerosis and Controls

Background:

This study quantified and compared weekday and weekend patterns of device-measured physical activity (PA) and sedentary behavior between youth with pediatric multiple sclerosis (MS) and controls for the purpose of informing future PA behavior change interventions.

Methods:

Participant data were obtained from 3 ongoing observational studies, and the sample included 40 participants with pediatric MS and 41 controls. Light PA (LPA), moderate to vigorous PA (MVPA), and sedentary behavior data were collected using activity monitors (ActiGraph LLC) over 1 week. The main analysis involved a 2-way mixed factor analysis of variance with group as a between-subjects factor (pediatric MS vs control) and day as a within-subjects factor (weekday vs weekend day).

Results:

There was no group by day interaction from the analysis of variance for percentage of activity monitor wear time spent in LPA, MVPA, or sedentary behavior. There was no effect of group for LPA, MVPA, or sedentary behavior. There was an effect of day of week on percentage of day spent in LPA, MVPA, and sedentary behavior.

Conclusions:

These results suggest that youth with pediatric MS and controls were less physically active and more sedentary on weekends than on weekdays, but there were no differences between groups in PA and sedentary behavior overall or by day of the week. Physical activity interventions may be more successful by initially targeting weekend day activity.

Physical activity, screen time and the COVID-19 school closures in Europe - An observational study in 10 countries

To date, few data on how the COVID-19 pandemic and restrictions affected children's physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6-18 years. 8395 children were included (median age [IQR], 13 [10-15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4-67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5-57.6]). 19.0% (95%CI, 18.2-19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5-70.5]; weekend: 63.8% [95%CI, 62.7-64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents.Highlights To our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic.Only 1 in 5 children met the WHO Global physical activity recommendations.Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns.

Outdoor Activity Participation Improves Adolescents' Mental Health and Well-Being during the COVID-19 Pandemic

COVID-19 is reshaping human interactions with the natural environment, potentially generating profound consequences for health and well-being. To assess the effects of COVID-19 on the outdoor recreation participation and subjective well-being of adolescents, as well as how participation in outdoor activities may mitigate declines in subjective well-being, we used a Qualtrics XM panel to conduct a nationally representative survey of youth ages 10-18 across the United States (n = 624) between 30 April and 15 June 2020. Survey questions focused on frequency of participation in outdoor activities before and during the pandemic, as well as changes in subjective well-being. Paired t-tests revealed decreases in both outdoor recreation participation (64% reported declines) and subjective well-being (52% reported declines). A regression model examining correlates of changes in subjective well-being (R2 = 0.42) revealed strong associations with changes in outdoor play (B = 0.44, p < 0.001) and nature-based (B = 0.21, p = 0.016) activities. Adolescents' from all backgrounds who participated in these activities during the pandemic reported smaller declines in subjective well-being. Results highlight the critical role that time outdoors and time in nature play in bolstering adolescents' resilience to stressors such as the COVID-19 pandemic and underscore the need to facilitate outdoor recreation opportunities for youth during times of crisis.

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis

Purpose

The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.

Methods

Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.

Results/findings

Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.

Conclusions

Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Do Adolescents Who Meet Physical Activity Recommendations on Weekdays Also Meet Them on Weekends? A Cross-Sectional Study in Colombia

The purpose of this study was to examine whether Colombian adolescents fulfill physical activity (PA) recommendations by type of day depending on several variables. A cross-sectional study was carried out on a sample of 2624 adolescents from Neiva (Colombia) using the Seven Day PA Recall and the Family Affluence Scale II self-reported questionnaires. Statistical analyses were performed to find any differences by gender, socioeconomic status, PA recommendations accomplishment, participation in organized and non-organized PA, parents' involvement in sport, and adolescents' academic achievement, and to determine the probability of complying with the PA guidelines. Only 12.3% of the participants met the PA recommendations on weekdays and weekends. Girls maintained their (in)active patterns during the week more than boys (84.4% vs. 70.7%, respectively), while more boys than girls changed them according to the type of day (25.3% vs. 19.6%). Participation in organized sports was the predictor variable with the highest probability of both boys and girls complying with the PA recommendations on weekdays. Non-organized activities were more likely to make girls more active on weekends. In conclusion, a wider offer of organized and non-competitive PA over the weekend and broader sports schedules should be provided to youth in Neiva.

Sex-Related Differences in the Association of Fundamental Movement Skills and Health and Behavioral Outcomes in Children

This study aimed to assess whether sex moderates the association of fundamental movement skills and health and behavioral outcomes. In 170 children (10.6 ±0.3 years; 98 girls), path analysis was used to assess the associations of fundamental movement skills (Get Skilled, Get Active) with perceived sports competence (Children and Youth—Physical Self-Perception Profile), time spent in vigorous-intensity physical activity, sedentary time, and body mass index z score. For boys, object control skill competence had a direct association with perceived sports competence (β = 0.39; 95% confidence interval, CI [0.21, 0.57]) and an indirect association with sedentary time, through perceived sports competence (β = −0.19; 95% CI [−0.09, −0.32]). No significant association was observed between fundamental movement skills and perceived sports competence for girls, although locomotor skills were found to predict vigorous-intensity physical activity (β = 0.18; 95% CI [0.08, 0.27]). Perceived sports competence was associated with sedentary time, with this being stronger for boys (β = −0.48; 95% CI [−0.64, −0.31]) than girls (β = −0.29; 95% CI [−0.39, −0.19]). The study supports a holistic approach to health-related interventions and highlights a key association of perceived sports competence and the time children spend sedentary.

Influence of meeting weekday and weekend step count recommendations on weight statusin children

The purpose of this study was to investigate the relationship between meeting step count recommendations during the weekday and weekend and the weight status in school-aged children. A convenience sample of 855 fourth and fifth grade students (9.7 ± 1.0 years) was recruited from 4 elementary schools located in the Western United States. Body Mass Index (BMI) was calculated using standard procedures and then stratified to weight status categories (healthy weight, overweight/obese) using age- and sex-specific percentiles. Step counts were monitored for seven consecutive days using NL-1000 piezoelectric pedometers. A multilevel generalized linear mixed effect model was used to estimate the odds ratios of meeting segmented step counts recommendations and weight status. Students meeting weekday step count recommendations associated with 39% lower odds of overweight/obesity compared to those not meeting any recommendations (P = 0.02). Those meeting both weekday and weekend recommendations associated with 67% lower odds of overweight/obesity compared to children not meeting any recommendations (P = 0.01). Meeting weekend step count recommendations did not associate with weight status. This study supports the positive relationship between segmented step counts and the healthy weight status of school-aged children.

Physical Activity Opportunities of Low-Income Elementary School-Aged Children During the Segmented School Day

BACKGROUND

In this study, we examined moderate-to-vigorous physical activity (MVPA) of children in a school district serving children from low-income and minority households.

METHODS

This observational study was conducted in 8 rural elementary schools in South Carolina. Children (N = 719, age = 7.7 years, 48.0% girls, 88.0% African American) wore accelerometers during school hours. Physical activity was distilled into time engaged in MVPA during 4 distinct opportunities. These 4 opportunities were non-activity time (eg, class-time), extended lunch (lunch recess after eating), physical education (PE), and recess. Mixed effects linear regressions estimated MVPA on days that had no activity opportunities, extended lunch, recess, PE, and multiple activity opportunities (eg, PE and recess).

RESULTS

On days with multiple activity opportunities, girls and boys accumulated 8.0 (95% CI = 4.9, 11.1) and 7.1 (95% CI = 3.6, 10.7) additional minutes of MVPA compared to a no activity day. On PE days boys accumulated 5.2 (95% CI = 0.3, 10.2) additional minutes of MVPA, whereas recess days provided girls with 3.0 (95% CI = 0.1, 6.0) additional MVPA minutes. No other activity opportunities provided statistically significant increases in school-day MVPA.

CONCLUSIONS

In low-income schools it may be necessary to provide multiple physical activity opportunities during the school day to increase boys' and girls' MVPA.

Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the U.S

BACKGROUND

COVID-19 restrictions such as the closure of schools and parks, and the cancellation of youth sports and activity classes around the United States may prevent children from achieving recommended levels of physical activity (PA). This study examined the effects of the COVID-19 pandemic on PA and sedentary behavior (SB) in U.S. children.

METHOD

Parents and legal guardians of U.S. children (ages 5-13) were recruited through convenience sampling and completed an online survey between April 25-May 16, 2020. Measures included an assessment of their child's previous day PA and SB by indicating time spent in 11 common types of PA and 12 common types of SB for children. Parents also reported perceived changes in levels of PA and SB between the pre-COVID-19 (February 2020) and early-COVID-19 (April-May 2020) periods. Additionally, parents reported locations (e.g., home/garage, parks/trails, gyms/fitness centers) where their children had performed PA and their children's use of remote/streaming services for PA.

RESULTS

From parent reports, children (N = 211) (53% female, 13% Hispanic, Mage = 8.73 [SD = 2.58] years) represented 35 states and the District of Columbia. The most common physical activities during the early-COVID-19 period were free play/unstructured activity (e.g., running around, tag) (90% of children) and going for a walk (55% of children). Children engaged in about 90 min of school-related sitting and over 8 h of leisure-related sitting a day. Parents of older children (ages 9-13) vs. younger children (ages 5-8) perceived greater decreases in PA and greater increases in SB from the pre- to early-COVID-19 periods. Children were more likely to perform PA at home indoors or on neighborhood streets during the early- vs. pre-COVID-19 periods. About a third of children used remote/streaming services for activity classes and lessons during the early-COVID-19 period.

CONCLUSION

Short-term changes in PA and SB in reaction to COVID-19 may become permanently entrenched, leading to increased risk of obesity, diabetes, and cardiovascular disease in children. Programmatic and policy strategies should be geared towards promoting PA and reducing SB over the next 12 months.

Accelerometer based assessment of daily physical activity and sedentary time in adolescents with idiopathic scoliosis

BACKGROUND

Studies have shown a positive correlation between higher physical activity (PA) and health benefits. However, device-based assessment of PA and sedentary time (ST) in people with adolescent idiopathic scoliosis (AIS) has not been deeply investigated.

OBJECTIVE

Analysis and comparison of weekend and weekdays PA and ST using multiple accelerometers in people with AIS with different curvature severity compared to healthy controls.

METHODS

24 participants with AIS divided into 2 groups of 12 with Cobb angles < 40° and > 40°, along with 12 age and BMI matched healthy controls. Daily PA and ST during four consecutive days were measured using four tri-axial accelerometers. Clinical functional assessment was performed using the scoliosis research society (SRS-22) questionnaire.

RESULTS

The combined weekend and weekdays average daily step count was found to be 22% and 29% lower in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The average ST was also reported to be 5% and 7% higher in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The reported differences were significant in the AIS group with higher Cobb angle (p≤0.05). No significant differences in PA or ST were reported between the AIS groups based on curvature severity.

CONCLUSIONS

Decreased PA and increased ST observed in patients with AIS may have long term health implications and may play a role in the disease process. The device-based assessment of PA to understand potential benefits in clinical practice is recommended.

Changes in physical activity and sedentary time during adolescence: Gender differences during weekdays and weekend days

OBJECTIVES

The objective of this study was to determine the gender-specific and time-segmented changes in accelerometer measured physical activity (PA) and sedentary time (ST) during adolescence.

METHODS

The study population (N = 970) consisted of children from nine schools throughout Finland. At the baseline, the children were in grades 4-7 (ages 10-13). Five times during the two-year follow-up period, hip-worn accelerometers (ActiGraph GT3X+) were deployed for seven consecutive days in order to monitor the pupils' PA. The daily time spent in vigorous (VPA), moderate to vigorous (MVPA), and light physical activity(LPA), as well as sedentary time(ST), were assessed.

RESULTS

Significant gender differences were observed in terms of the changes in MVPA and ST during the follow-up period. The total MVPA declined significantly in boys (by 2.2min/day/year from 60 min/d at baseline) but not in girls (49 min/d at baseline). The total ST increased both in boys (by 20.7%-points/y) and in girls (by 16.1%-points/y, P < .001). However, when we compared the results during the weekdays and weekend days separately, we observed that the declines in MVPA and increases in ST were greater in boys than in girls during the weekend days.

CONCLUSION

A greater decrease in PA and a greater increase in ST during adolescence were observed among boys than among girls, especially during weekend days. In order to diminish these unfavorable behavioral changes during adolescence, we encourage the separate tailoring of interventions for boys and girls and for weekdays and weekends.

Mother-child dyadic influences of affect on everyday movement behaviors: evidence from an ecological momentary assessment study

BACKGROUND

Research has shown that affect is associated with everyday movement behaviors in children and adults. However, limited work to date has investigated dyadic influences of momentary affect on moderate-to-vigorous physical activity (MVPA) and sedentary time among children and their mothers using ecological momentary assessment (EMA).

METHODS

Mothers and their children (eight to 12-years-old at baseline) from the Los Angeles metropolitan area participated in a longitudinal study with six semi-annual measurement waves across three years. During each measurement wave, mothers and children reported momentary negative and positive affect via a custom smartphone-based EMA application across seven days (randomly sampled up to eight times per day). Each dyad member's momentary affective states were used to predict their own and the other dyad member's accelerometer-measured MVPA and sedentary time in the prompt-matched 45-min time window. Multilevel modeling within the actor-partner interdependence model (APIM) framework was applied to accommodate the nested dyadic nature of the data.

RESULTS

At the within-subject level, when children had higher-than-usual positive affect, they engaged in greater MVPA and less sedentary time in the prompt-matched 45-min window (actor effects; ps < .001). When mothers experienced higher-than-usual positive affect, they engaged in more sedentary time in the same 45-min window (actor effect; p < .001). Children's higher-than-usual positive affect also predicted more MVPA time of their mothers (partner effect; p < .05). At the between-subjects level, for mothers who reported higher average negative affect than other mothers, their children overall had less MVPA and more sedentary time (partner effects ps < .05).

CONCLUSIONS

This study extends the literature by demonstrating that mothers' and children's everyday physical activity and sedentary time are not only associated with their own affective states, but also may be influenced by the affective states of each other. Our findings suggest that affective states have the potential to influence movement behaviors in mother-child dyads' everyday lives. Affective underpinnings of physical activity and sedentary behaviors should be further studied in order to develop family-based intervention strategies to influence these behaviors.

Calibration and Validation of the Youth Activity Profile as a Physical Activity and Sedentary Behaviour Surveillance Tool for English Youth

Self-reported youth physical activity (PA) is typically overestimated. We aimed to calibrate and validate a self-report tool among English youth. Four-hundred-and-two participants (aged 9-16 years; 212 boys) wore SenseWear Armband Mini devices (SWA) for eight days and completed the self-report Youth Activity Profile (YAP) on the eighth day. Calibration algorithms for temporally matched segments were generated from the YAP data using quantile regression. The algorithms were applied in an independent cross-validation sample, and student- and school-level agreement were assessed. The utility of the YAP algorithms to assess compliance to PA guidelines was also examined. The school-level bias for the YAP estimates of in-school, out-of-school, and weekend moderate-to-vigorous PA (MVPA) were 17.2 (34.4), 31.6 (14.0), and -4.9 (3.6) min·week^-1, respectively. Out-of-school sedentary behaviour (SB) was over-predicted by 109.2 (11.8) min·week^-1. Predicted YAP values were within 15%-20% equivalence of the SWA estimates. The classification accuracy of the YAP MVPA estimates for compliance to 60 min·day^-1 and 30 min·school-day^-1 MVPA recommendations were 91%/37% and 89%/57% sensitivity/specificity, respectively. The YAP generated robust school-level estimates of MVPA and SB and has potential for surveillance to monitor compliance with PA guidelines. The accuracy of the YAP may be further improved through research with more representative UK samples to enhance the calibration process and to refine the resultant algorithms.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Factors associated with accelerometer measured movement behaviours among White British and South Asian children aged 6-8 years during school terms and school holidays

OBJECTIVES

To investigate factors associated with movement behaviours among White British (WB) and South Asian (SA) children aged 6-8 years during school terms and holidays.

DESIGN

Cross-sectional.

SETTING

Three primary schools from the Bradford area, UK.

PARTICIPANTS

One hundred and sixty WB and SA children aged 6-8 years.

PRIMARY AND SECONDARY OUTCOMES

Sedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) measured by accelerometry during summer, winter and spring and during school terms and school holidays. Data were analysed using multivariate mixed-effects multilevel modelling with robust SEs. Factors of interest were ethnicity, holiday/term, sex, socioeconomic status (SES), weight status, weekend/weekday and season.

RESULTS

One hundred and eight children (67.5%) provided 1157 valid days of data. Fifty-nine per cent of children were WB (n=64) and 41% (n=44) were SA. Boys spent more time in MVPA (11 min/day, p=0.013) compared with girls and SA children spent more time in SB (39 min, p=0.017) compared with WB children in adjusted models. Children living in higher SES areas were more sedentary (43 min, p=0.006) than children living in low SES areas. Children were more active during summer (15 min MVPA, p<0.001; 27 LPA, p<0.001) and spring (15 min MVPA, p=0.005; 38 min LPA, p<0.001) and less sedentary (-42 min and -53 min, p<0.001) compared with winter. Less time (8 min, p=0.012) was spent in LPA during school terms compared with school holidays. Children spent more time in MVPA (5 min, p=0.036) during weekend compared with weekdays. Overweight and obese children spent more time in LPA (21 min, p=0.021) than normal-weight children.

CONCLUSION

The results of our study suggest that significant child level factors associated with movement behaviours are ethnicity, sex, weight-status and area SES. Significant temporal factors are weekends, school holidays and seasonality. Interventions to support health enhancing movement behaviours may need to be tailored around these factors.

Socioeconomic and ethnic differences in children's vigorous intensity physical activity: a cross-sectional analysis of the UK Millennium Cohort Study

OBJECTIVE

To investigate if daily vigorous physical activity (VPA), adjusted for minutes of moderate physical activity (MPA) performed, differs by socioeconomic position or ethnicity in a large sample of UK children with objectively measured physical activity.

DESIGN

Nationally representative prospective cohort study.

SETTING

UK children born between 2000 and 2002.

PARTICIPANTS

5172 children aged 7-8 with valid accelerometer data for ≥10 hour on ≥3 days, including 1 weekend day.

MAIN OUTCOME MEASURES

Time spent in VPA (>3841 counts per min).

EXPLANATORY MEASURES

Maternal education, annual household Organisation for Economic Co-Operation and Development equivalised income, ethnicity.

RESULTS

Multivariable linear regression models fitted to explore differences in average daily minutes of VPA (adjusted for MPA, mean accelerometer wear time, season of measurement, age and sex), revealed significantly higher amounts of VPA accumulated as a child's socioeconomic position increased (highest vs lowest level of maternal education: β: 2.96, p: 0.00; annual household equivalised income: β: 0.58, p: 0.00, per £10 000 annual increase). Additionally, children from certain minority ethnicities (Bangladeshi and Pakistani: β: -3.34, p: 0.00; other ethnic groups: β:-2.27, p: 0.02) accrued less daily VPA compared with their white British counterparts.

CONCLUSIONS

The socioeconomic and ethnic patterning of vigorous activity observed in this study mirrors parallel inequalities in rates of childhood obesity. Given the stronger association of VPA with adiposity than of MPA, intensity specific differences may be contributing to widening inequalities in obesity. Accordingly, these findings suggest that the current global focus on overall moderate-to-vigorous intensity activity may mask important behavioural inequalities.

Active streets for children: The case of the Bogotá Ciclovía

INTRODUCTION

The Ciclovía is a worldwide program in which streets are temporarily closed to motorized transport to create a space for recreation and outdoor play among children and adults. The aim of this study was to assess the associations between physical activity (PA), sedentary time (SED), body mass index and Ciclovía participation among children aged 9 to 13 years.

METHODS

All students in the 4th and 5th grades from the selected schools were invited to participate in the study. The study included 923 children. PA and SED were measured using waist-worn accelerometers, and height and weight were measured using standardized procedures. Ciclovía participation was self-reported. The analyses included multilevel linear, generalized mixed and generalized additive models.

RESULTS

The mean age of the sample was 10.1±0.7 years, and 49.5% were boys. In the last year, 46% of the children participated in the Ciclovía, and 34% reported participating frequently (at least once per month). No differences were found in the mean minutes of moderate-to-vigorous PA on weekdays between frequent Ciclovía users and sporadic and non-Ciclovía users (72 vs 69; p = 0.09). In contrast, frequent Ciclovía users had higher moderate-to-vigorous PA on Sundays than sporadic and non-Ciclovía users (65.6 vs 59.2; p = 0.01), specifically between the hours of 12:00 and 16:00. In addition, frequent Ciclovía users did not differ from the sporadic and non-Ciclovía users in SED (515.3 vs 521.3; p = 0.19). Frequent Ciclovía users had lower SED on Sundays than the sporadic and non-Ciclovía users (437.7 vs 456.5; p = 0.005). Additionally, frequent Ciclovía users were more likely to be overweight (28.3% vs 20.4% p = 0.01). We did not find differences in participation by sex, and low-to-middle income children were more likely to participate.

CONCLUSIONS

The Ciclovías offer an innovative, inclusive recreational space and consequently provide opportunities to increase moderate-to-vigorous PA and reduce SED among children.

Physical Activity during the School Holidays: Parent Perceptions and Practical Considerations

Children’s physical activity decreases during school holidays. Less structured days and reduced participation in organised activities may account for some of the decrease. Little is known about the factors that influence parents’ decision to enrol their child in organised activity such as holiday clubs. This paper sought to explore parents’ perceptions of their child’s physical activity during school holidays and the factors that influence holiday activity-based decision making. Semi-structured telephone interviews were conducted with 42 parents of children aged 10–11 years in July 2017 or March 2018. Data were analysed using a combination of inductive and deductive content analysis to explore parents’ perceptions of holiday-based physical activity and the factors associated with how they provide physical activity opportunities for their children. The data revealed that most parents consider their child’s physical activity levels when planning for the school holidays. However, work commitments in the holidays meant many parents had to rely on both informal and formal childcare. Grandparents were the primary source of informal childcare, despite a perception that children were not as physically active when with them. Holiday clubs were also a viable option, but the cost, location and age-appropriateness of provision inhibit parents signing older children up to these regularly.

Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity

OBJECTIVE

To evaluate the single and joint associations of objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary time on week and weekend days with obesity in children from 12 countries across all inhabited continents.

METHODS

A multinational, 12-country cross-sectional study of 5779 children aged 9-11 years was conducted. Time spent in MVPA and sedentary behaviors was assessed by waist-worn accelerometry. Logistic regression was used to examine the independent and joint associations of MVPA and sedentary time on weekdays and weekend with the odds of obesity.

RESULTS

After adjustment for all confounding factors, the odds ratios (ORs) of childhood obesity were the highest among children with a low level of MVPA on both weekdays and weekend (OR 4.67), high among children with a high level of MVPA on weekdays and a low level of MVPA on weekend (OR 1.99) and high among children with a low level of MVPA on weekdays and a high levels of MVPA on weekend (OR 2.20), compared to those with a high level of MVPA on both weekdays and weekend. Similarly, the ORs of childhood obesity were significantly higher among children with a high level of sedentary time on both weekdays and weekend (OR 1.87) compared with those with low levels of sedentary time on both weekdays and weekend.

CONCLUSIONS

Lower levels of MVPA or higher levels of sedentary time on either weekdays or weekend were associated with increased odds of obesity in 9-11 year old children in 12 countries.

Sedentary behavior and physical activity predicting depressive symptoms in adolescents beyond attributes of health-related physical fitness

BACKGROUND

Sedentary behavior (SB), physical activity (PA), and attributes of physical fitness have been shown to be related to depressive symptoms in adolescents. The purpose of the present study was to investigate whether SB and fitness-producing activity predicted depression in active adolescents over and above gender and fitness attributes.

METHODS

Participants were 249 adolescents (age: 12.85 ± 0.89 years, mean ± SD) from 3 public middle schools who wore Actical accelerometers to assess their SB and PA. Participants also completed the FITNESSGRAM health-related fitness assessment and a brief depression questionnaire. A 3-step hierarchical regression analysis was conducted with gender and fitness attributes (i.e., body mass index (BMI), maximal volume oxygen uptake (VO_2max), curlups, and pushups), moderate- and vigorous-intensity activity, and SB entered in respective steps.

RESULTS

Regression analysis indicated activity variables (i.e., moderate- and vigorous-intensity activity) significantly predicted depression (ΔR ² = 0.12, p < 0.01) beyond gender and fitness attributes. Overall, gender, fitness attributes, activity variables, SB explained 31% of the variance in depression. Structure coefficients revealed VO_2max (r _s = -0.77), moderate-intensity activity (r _s = -0.67), vigorous-intensity activity (r _s = -0.81), and SB (r _s = 0.57) were substantially correlated with the criterion variable; thus, they were the strongest predictors of depression.

CONCLUSION

The findings of the current study indicated SB and PA were both significant predictors of depression; however, sufficient fitness-producing activity and adequate cardiorespiratory fitness may nullify the negative influence of SB on depressive symptoms in active adolescents.

Youth Physical Activity Patterns During School and Out-of-School Time

This study describes age, sex, and season patterns in children’s physical activity behaviors during discrete time periods, both in school and at home. Participants were 135 elementary, 67 middle, and 89 high-school students (128 boys and 163 girls) involved in a larger school activity monitoring project. We examined time spent in moderate-to-vigorous physical activity (MVPA) at recess, physical education (PE), lunch, commuting to/from school, before-school, after-school, evening, and weekend segments. Differences in MVPA by age, sex, and season were examined using a three-way analysis of variance and separately for each individual segment. Moderate-to-vigorous physical activity levels varied by context and were higher during recess (15.4 ± 8.5 min) while at school, and on Saturdays (97.4 ± 89.5 min) when youth were out-of-school. Elementary children were more active than their older counterparts only during lunch time, after-school, and Sunday (p < 0.05). Boys were consistently more active than girls at all segments. Participants were only more active during non-winter than winter months during PE (p = 0.006), after-school (p < 0.001), and Sunday (p = 0.008) segments. These findings showed that activity levels in youth vary during the day and season. The segments reflect discrete time periods that can potentially be targeted and evaluated to promote physical activity in this population.

Describing the diurnal relationships between objectively measured mother and infant physical activity

BACKGROUND

Evidence for the importance of accumulating sufficient physical activity in the early years is mounting. This study aimed to determine the relationship between maternal and infant objectively measured physical activity, and to examine the diurnal interactions between these behaviours while accounting for potential covariates.

METHODS

Mothers and infants (n = 152 pairs; infants aged 3-24 months) were recruited from Soweto, South Africa, and physical activity was measured using a wrist worn accelerometer (Axivity AX3, Axivity Ltd., Newcastle-upon-Tyne, UK) for 3-7 days. Mothers completed sleep diaries recording night time-in-bed (used as a proxy for nocturnal sleep status) for themselves and their infant; and reported times during which their infant was in their personal care (caregiver status) for each day during the measurement period. Significant correlates of infant physical activity, as well as the interactions between mother's physical activity, day of the week, sleep status, and caregiver status, were included in panel regression analyses with infant physical activity as the outcome.

RESULTS

There was an equal distribution of boys and girls, and their age ranged from 2.6 to 24.5 months. The majority of mothers (73%) did not spend any time apart from their infant. During weekdays, the combined effect of mother's physical activity (β=0.11), the interactions between mother's physical activity and caregiver status (β=0.17), and sleep status (β= - 0.04) on infant physical activity was β=0.24; while during weekend days this association was β=0.21; and was largely moderated by the interaction between the mother being with the infant and her activity levels (β=0.23), but partly attenuated by mother's physical activity independent of other variables (β= - 0.04). For each hour of the day, for both mother and infant, peaks of physical activity were higher when the mother was not the primary caregiver.

CONCLUSIONS

Infant physical activity levels were strongly associated with their mother's activity levels particularly during the week; this relationship was stronger when mothers were more active while looking after their infant. Mothers should be encouraged to be active when looking after their children, particularly during the week, and to provide infants with as much opportunity to be active as possible.

Physical Activity and Sedentary Time Patterns in Children and Adolescents With Cystic Fibrosis and Age- and Sex-Matched Healthy Controls

BACKGROUND

Regular physical activity (PA) is increasingly recognized as important in the care of patients with cystic fibrosis (CF), but there is a dearth of evidence regarding physical activity levels or how these are accrued in those with CF.

METHODS

PA was measured by a hip-worn accelerometer for 7 consecutive days in 18 children [10 boys; 12.4 (2.8) y] with mild to moderate CF and 18 age- and sex-matched controls [10 boys; 12.5 (2.7) y].

RESULTS

Both children with CF and healthy children demonstrated similar physical activity levels and patterns of accumulation across the intensity spectrum, with higher levels of PA during weekdays in both groups. Forced expiratory volume in 1 second was predicted by high light PA in children with CF compared with low light PA in healthy children.

CONCLUSION

These findings highlight weekends and light PA as areas warranting further research for the development of effective intervention strategies to increase PA in the youth CF population.

Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis

BACKGROUND

Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential.

DISCUSSION

There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the 'Structured Days Hypothesis' (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children's obesogenic behaviors are more unfavorable during weekend days compared to weekdays.

CONCLUSION

In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development.

Fitness, fatness and the reallocation of time between children's daily movement behaviours: an analysis of compositional data

BACKGROUND

Movement behaviours performed over a finite period such as a 24 h day are compositional data. Compositional data exist in a constrained simplex geometry that is incongruent with traditional multivariate analytical techniques. However, the expression of compositional data as log-ratio co-ordinate systems transfers them to the unconstrained real space, where standard multivariate statistics can be used. This study aimed to use a compositional data analysis approach to examine the adiposity and cardiorespiratory fitness predictions of time reallocations between children's daily movement behaviours.

METHODS

This study used cross-sectional data from the Active Schools: Skelmersdale study, which involved Year 5 children from a low-income community in northwest England (n = 169). Measures included accelerometer-derived 24 h activity (sedentary time [ST], light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], and sleep), cardiorespiratory fitness determined by the 20 m shuttle run test, objectively measured height, weight and waist circumference (from which zBMI and percent waist circumference-to-height ratio (%WHtR) were derived) and sociodemographic covariates. Log-ratio multiple linear regression models were used to predict adiposity and fitness for the mean movement behaviour composition, and for new compositions where fixed durations of time had been reallocated from one behaviour to another, while the remaining behaviours were unchanged. Predictions were also made for reallocations of fixed durations of time using the mean composition of three different weight status categories (underweight, normal-weight, and overweight/obese) as the starting point.

RESULTS

Replacing MVPA with any other movement behaviour around the mean movement composition predicted higher adiposity and lower CRF. The log-ratio model predictions were asymmetrical: when time was reallocated to MVPA from sleep, ST, or LPA, the estimated detriments to fitness and adiposity were larger in magnitude than the estimated benefits of time reallocation from MVPA to sleep, ST or LPA. The greatest differences in fitness and fatness for reallocation of fixed duration of MVPA were predicted at the mean composition of overweight/obese children.

CONCLUSIONS

Findings reinforce the key role of MVPA for children's health. Reallocating time from ST and LPA to MVPA in children is advocated in school, home, and community settings.

Associations between accelerometer-measured physical activity and body fatness in school-aged children

Background

The main aim of the study was to examine the cross-sectional associations between objectively measured physical activity (PA) and body fatness in 7–12-year-old children.

Methods

We performed an analysis of 365 children (209 girls). Participant recruitment was performed in eight randomly selected elementary schools in cities and towns with various numbers of inhabitants. The body composition analysis was performed according to a multi-frequency bioelectrical impedance analysis; PA was monitored using an accelerometer.

Results

In terms of the overall PA, boys were more active than girls. No significant associations (unadjusted and adjusted models) were found between light PA and all body fatness indicators in either sex. Moderate-to-vigorous PA was significantly negatively associated with all body fatness indicators only in girls. These associations strengthened after adjustment for age, height and sedentary time (β ranging from –0.49 to –0.36, P ≤ 0.01). In contrast, vigorous PA was strongly negatively associated with body fatness indicators only in boys. In the fully adjusted model the significant negative associations were found for fat mass percentage (β = –0.15, P = 0.048) and fat mass index (β = –0.15, P = 0.040).

Conclusions

The present study suggests that increasing sex-specific PA of different intensities may be an appropriate approach for decreasing body fatness in children. Longitudinal studies are needed to verify these associations.