Habitual physical activity and sedentary behaviour in a clinical sample of obese children

Comparison of habitual physical activity in French Bulldogs, Pugs and normocephalic dogs by accelerometry

Brachycephalic obstructive airway syndrome (BOAS) is a major welfare concern in flat-faced dog breeds. As BOAS causes respiratory difficulties and exercise intolerance, it can reduce dogs' daily quality of life (QOL). However, evaluation of QOL in dogs is difficult, and many owners perceive BOAS signs as 'normal' for the breed. Accelerometers that measure frequency, duration and intensity of activities can offer an objective way of evaluating dogs' daily activity and thereby deliver potential insights into QOL. The aim of this study was to assess habitual physical activity of 48 brachycephalic and 23 non-brachycephalic dogs using accelerometers. The accelerometers were used for one week and owners filled in a questionnaire regarding their dog's well-being and activities. Veterinary-assessed BOAS grading for brachycephalic dogs was determined. Compared with controls, more severely affected French Bulldogs and Pugs had significantly lower total activity counts and spent less time in high activity. In Pugs, mildly affected dogs were also less active, but age can be a contributing factor here, as older age decreased activity in Pugs and controls showed a wider age range. In French Bulldogs, those dogs with no or mild signs of BOAS did not differ from controls regarding their daily activity. In conclusion, accelerometers were easy to use for objective measurement of daily activity in bracycephalic dogs, although a degree of discomfort due to the collar was reported. Results showed that BOAS signs were associated with decreased habitual physical activity. These findings emphasise the importance of actions taken to reduce incidence of BOAS in brachycephalic breeds.

Associations between naturalistically assessed physical activity patterns, affect, and eating in youth with overweight and obesity

Insufficient physical activity (PA) and excessive stationary behavior (SB) are contributors to pediatric obesity, though antecedents and consequences of these behaviors in this population are relatively unknown. This pilot study examined affect, loss of control eating (LOCE), overeating, and hunger surrounding PA and SB in 17 youth with overweight/obesity. Participants completed a 14-day ecological momentary assessment (EMA) wearing accelerometers. At the momentary level, higher negative affect and lower positive affect predicted SB increases and PA decreases following EMA prompts; higher PA and lower SB also predicted increases in positive affect. Higher LOCE predicted SB increases and PA decreases, while increases in PA and decreases in SB predicted short-term increases in LOCE and overeating. At the individual level, higher SB and lower PA were related to lower positive affect and higher negative affect, LOCE, overeating, and hunger. Findings suggest affect is a relevant antecedent and consequence of PA/SB, and dysregulated eating may acutely impact PA/SB.

Relation between Dietary Habits, Physical Activity, and Anthropometric and Vascular Parameters in Children Attending the Primary School in the Verona South District

The aim of this school-based study was to identify the possible association between diet and physical activity, as well as the anthropometric, vascular, and gluco-lipid parameters. We administered two validated questionnaires for diet and physical activity (Food Frequency questionnaire (FFQ), Children-Physical Activity Questionnaire (PAQ-C)) to children at four primary schools in Verona South (Verona, Italy). Specific food intake, dietary pattern, and physical activity level expressed in Metabolic Equivalent of Task (MET) and PAQ-C score were inserted in multivariate linear regression models to assess the association with anthropometric, hemodynamic, and gluco-lipid measures. Out of 309 children included in the study, 300 (age: 8.6 ± 0.7 years, male: 50%; Obese (OB): 13.6%; High blood pressure (HBP): 21.6%) compiled to the FFQ. From this, two dietary patterns were identified: "healthy" and "unhealthy". Direct associations were found between (i) "fast food" intake, Pulse Wave Velocity (PWV), and (ii) animal-derived fat and capillary cholesterol, while inverse associations were found between vegetable, fruit, and nut intake and capillary glucose. The high prevalence of OB and HBP and the significant correlations between some categories of food and metabolic and vascular parameters suggest the importance of life-style modification politics at an early age to prevent the onset of overt cardiovascular risk factors in childhood.

[Family environment, physical activity and sedentarism in preadolescents with childhood obesity: ANOBAS case-control study]

Objetivo

Comparar los niveles de actividad física y sedentarismo en niños con obesidad y normopeso, y analizar el nivel de actividad física del cuidador principal junto con el ambiente familiar.

Diseño

Estudio caso-control.

Emplazamiento

Un centro de salud y colegios de la Comunidad de Madrid.

Participantes

Un total de 50 niños con obesidad entre 8 y 12 años (GO; P > 97) y sus madres, fueron emparejados por edad, sexo y estatus socioeconómico de sus padres (1:1) con 50 niños con normopeso (GN; P < 85).

Mediciones principales

Los niveles de actividad física se midieron por acelerometría (ActiGraph GT3X), la actividad física del cuidador principal con el cuestionario de actividad física (IPAQ) y el ambiente con el cuestionario de ambiente familiar (HES-S).

Resultados

El grupo GO presentó menos actividad física de tipo vigoroso al compararse con el grupo GN. La actividad física vigorosa en el GO se asoció al modelado y las políticas parentales respecto a la actividad física. Un análisis de regresión múltiple muestra que el 21% de la varianza del estatus de peso de los niños se explicaba por la actividad física vigorosa y el índice de masa corporal materno.

Conclusiones

Los niveles de actividad física vigorosa y el ambiente familiar difieren entre los niños con obesidad y normopeso. Por lo tanto, es importante seguir trabajando la conciencia de enfermedad y la promoción de hábitos saludables desde Atención Primaria y el contexto escolar e institucional.

Comparison of accelerometer measured levels of physical activity and sedentary time between obese and non-obese children and adolescents: a systematic review

Background

Obesity has been hypothesized to be associated with reduced moderate-to-vigorous physical activity (MVPA) and increased sedentary time (ST). It is important to assess whether, and the extent to which, levels of MVPA and ST are suboptimal among children and adolescents with obesity. The primary objective of this study was to examine accelerometer-measured time spent in MVPA and ST of children and adolescents with obesity, compared with MVPA recommendations, and with non-obese peers.

Methods

An extensive search was carried out in Medline, Cochrane library, EMBASE, SPORTDiscus, and CINAHL, from 2000 to 2015. Study selection and appraisal: studies with accelerometer-measured MVPA and/or ST (at least 3 days and 6 h/day) in free-living obese children and adolescents (0 to 19 years) were included. Study quality was assessed formally. Meta-analyses were planned for all outcomes but were precluded due to the high levels of heterogeneity across studies. Therefore, narrative syntheses were employed for all the outcomes.

Results

Out of 1503 records, 26 studies were eligible (n = 14,739 participants; n = 3523 with obesity); 6/26 studies involved children aged 0 to 9 years and 18/26 involved adolescents aged 10.1 to19 years. In the participants with obesity, the time spent in MVPA was consistently below the recommended 60 min/day and ST was generally high regardless of the participant’s age and gender. Comparison with controls suggested that the time spent in MVPA was significantly lower in children and adolescents with obesity, though differences were relatively small. Levels of MVPA in the obese and non-obese were consistently below recommendations. There were no marked differences in ST between obese and non-obese peers.

Conclusions

MVPA in children and adolescents with obesity tends to be well below international recommendations. Substantial effort is likely to be required to achieve the recommended levels of MVPA among obese individuals in obesity treatment interventions.

This systematic review has been registered on PROSPERO (International Database of Prospective Register Systematic Reviews; registration number CRD42015026882).

Electronic supplementary material

The online version of this article (10.1186/s12887-018-1031-0) contains supplementary material, which is available to authorized users.

Perceived neighborhood safety related to physical activity but not recreational screen-based sedentary behavior in adolescents

BACKGROUND

A growing proportion of adolescents have poor cardiovascular health behaviors, including low levels of physical activity and high levels of sedentary behavior, thus increasing the likelihood of poor heart health in later years. This study tested the hypothesis that low perceived neighborhood safety would be associated with low levels of physical activity and high levels of recreational sedentary behavior in high-school students.

METHODS

Using cross-sectional, weighted data from the 2015 Pennsylvania (USA) State and Philadelphia city Youth Risk Behavior Survey, multivariable logistic regression modeling was used to examine the association between perceived neighborhood safety, and physical activity levels and recreational screen-based sedentary behavior time respectively, while controlling for potential confounders.

RESULTS

After adjustment for other significant correlates of physical activity, students with low perceived neighborhood safety had a 21% reduced odds of being physically active on 5 or more days of the last week as compared to those who felt safe (p = 0.044). Perceived safety was not related to sedentary behavior; but sports team participation emerged as a strong correlate of low screen-based sedentary behavior (OR = 0.73, p = .002).

CONCLUSION

These data add to a growing body of work demonstrating the importance of perceived safety with physical activity levels in youth. Sports team participation may be a viable target to reduce screen-based sedentary time.

BMI and recommended levels of physical activity in school children

Background

Physical activity (PA) and its health benefits are a continuous point of discussion. Recommendations for children’s daily PA vary between guidelines. To better define the amount of PA necessary to prevent overweight and obesity in children, further research is needed. The present study investigates children’s compliance to physical activity guidelines (PAGs) and the association between objectively measured PA and body mass index (BMI).

Methods

Participating children were 11 years old (n = 419) and part of the European CHOP trial, which was conducted in Germany, Belgium, Poland, Spain, Italy. At least 2 days of PA measurements were collected from each child using a SenseWear™ armband. BMI was calculated from children’s height and weight. Thresholds of min·day⁻¹ in PA needed to differentiate between normal and excess weight (overweight/obesity) were determined with Receiver Operator Characteristics (ROC) analysis. Additionally, adjusted linear and logistic regressions models were calculated for group differences and effects of a 5, 15 and 60 min·day⁻¹ increases in PA on BMI.

Results

Median time spent in total PA was 462 min·day⁻¹ (25th percentile; 75th percentile: 389; 534) and 75 min·day⁻¹ (41; 115) in moderate to vigorous PA (MVPA). Girls spent 36 min·day⁻¹ less in MVPA than boys and overweight/obese children 24 min·day⁻¹ less than normal weight children (linear regression, p < 0.001). 63.2% of the children met PAGs of 60 min·day⁻¹ in MVPA. The optimal threshold for min·day⁻¹ in MVPA determined with ROC analysis was 46 min·day⁻¹. Comparing 5, 15 and 60 min·day⁻¹ increases in PA revealed that an additional 15 min·day⁻¹ of vigorous PA had the same effect as 60 min·day⁻¹ of MVPA. Sedentary time and light PA showed contrary associations to one another, with light PA being negatively and sedentary time being positively associated with excessive weight.

Conclusions

Current PAGs are met by 2/3 of children and seem appropriate to prevent excess weight in children. An official recommendation of daily 15–20 min of vigorous PA and further reduction of sedentary time could help to fight youth overweight and thus be of potential public health importance.

Trial registration

ClinicalTrials.gov Identifier: NCT00338689. Registered: June 19, 2006 (retrospectively registered).

Overweight dogs exercise less frequently and for shorter periods: results of a large online survey of dog owners from the UK

Canine obesity is now the number one health concern in dogs worldwide. Regular physical activity can improve health, and owners are advised to exercise their dogs on a regular basis. However, limited information exists about associations between overweight status of dogs and walking activity. An online survey was conducted between June and August in 2014, coinciding with the broadcast of a national UK television programme, exploring dog behaviour. Information gathered included signalment, overweight status, and owner-reported information on duration and frequency of dog walking. The University of Liverpool Ethics Committee approved the project, and owners consented to data use. Simple and multiple logistic regression analyses were used to determine associations between overweight status and dog walking activity. Data were available from 11 154 adult dogs, and 1801 (16·1 %) of these were reported as overweight by their owners. Dogs reported to be overweight dogs were more likely to be neutered (P < 0·0001) and older (P < 0·0001). Various breeds were over-represented including beagle, Cavalier King Charles spaniel, golden retriever, Labrador retriever and pug (P < 0·0001 for all). Both frequency and duration of walking were negatively associated with overweight status (P < 0·0001 for both). On multiple regression analysis, duration and frequency were independently and negatively associated with the odds of being overweight, along with a range of other factors including age, neuter status and breed. This study has identified associations between overweight status and exercise. In the future, studies should determine the reason for this association, and whether changes in walking activity can influence weight status.

Cross-Sectional Associations of Objectively-Measured Physical Activity and Sedentary Time with Body Composition and Cardiorespiratory Fitness in Mid-Childhood: The PANIC Study

BACKGROUND

The minimum intensity of physical activity (PA) that is associated with favourable body composition and cardiorespiratory fitness (CRF) remains unknown.

OBJECTIVE

To investigate cross-sectional associations of PA and sedentary time (ST) with body composition and CRF in mid-childhood.

METHODS

PA, ST, body composition and CRF were measured in a population-based sample of 410 children (aged 7.6 ± 0.4 years). Combined heart-rate and movement sensing provided estimates of PA energy expenditure (PAEE, kJ/kg/day) and time (min/day) at multiple fine-grained metabolic equivalent (MET) levels, which were also collapsed to ST and light PA (LPA), moderate PA (MPA) and vigorous PA (VPA). Fat mass index (FMI, kg/m2), trunk fat mass index (TFMI, kg/m2) and fat-free mass index (FFMI, kg/m2.5) were derived from dual-energy X-ray absorptiometry. Maximal workload from a cycle ergometer test provided a measure of CRF (W/kg FFM). Linear regression and isotemporal substitution models were used to investigate associations.

RESULTS

The cumulative time above 2 METs (221 J/min/kg) was inversely associated with FMI and TFMI in both sexes (p < 0.001) whereas time spent above 3 METs was positively associated with CRF (p ≤ 0.002); CRF increased and adiposity decreased dose-dependently with increasing MET levels. ST was positively associated with FMI and TFMI (p < 0.001) but there were inverse associations between all PA categories (including LPA) and adiposity (p ≤ 0.002); the magnitude of these associations depended on the activity being displaced in isotemporal substitution models but were consistently stronger for VPA. PAEE, MPA and to a greater extent VPA, were all positively related to CRF (p ≤ 0.001).

CONCLUSIONS

PA exceeding 2 METs is associated with lower adiposity in mid-childhood, whereas PA of 3 METs is required to benefit CRF. VPA was most beneficial for fitness and fatness, from a time-for-time perspective, but displacing any lower-for-higher intensity may be an important first-order public health strategy. Clinical trial registry number (website): NCT01803776 ( https://clinicaltrials.gov/ct2/show/NCT01803776 ).

Association between physical activity and health-related quality of life in children: a cross-sectional study

Background

Research suggests that physical activity plays a role to improve health related- quality of life (QoL), however studies examining the association between physical activity and HRQOL are limited in the paediatric literature. The aim of this study is to explore the relationship between physical activity and HRQoL among Malaysian children.

Methods

Participants (n = 78 normal weight; 78 obese children) aged 9–11 years completed a validated quality of life (QoL) inventory and wore an accelerometer to objectively measure physical activity for 1 week.

Results

Psychosocial Health domain and Total QoL (all p < 0.05) were significantly lower for obese compared to normal weight children. Children who spent more time in sedentary behaviour had significantly lower QoL on Psychosocial Health domain and Total QoL except for the Physical Health domain. There was also a strong positive correlation between QoL and moderate-vigorous physical activity (MVPA) indicating that children who are physically active have a better quality of life.

Conclusions

Physical activity promotion should be emphasised to improve QoL in children.

Physical activity and sedentary behavior in obese youth

OBJECTIVE

To determine whether directly measured physical activity and sedentary behavior patterns of obese children presenting to a weight-management clinic differs from nationally representative samples of obese and normal-weight children.

STUDY DESIGN

A cross-sectional comparison study of 3 groups of boys and girls between 8 and 18 years (mean, 13.4 years) was performed. A clinical group (n=56) seeking specialized care for obesity was compared with 2 nationally representative samples of children from the Canadian Health Measures Survey (CHMS): (1) body mass index>95th percentile (n=143); and (2) body mass index<85th percentile (n=958).

RESULTS

Obese clinical and obese CHMS boys did not differ in daily moderate-to-vigorous physical activity (MVPA). Both obese groups engaged in less MVPA than normal-weight boys in the CHMS (P<.0006). Compared with normal-weight boys, obese boys had fewer days in which they accrued 60 or 30 minutes of MVPA (P=.006 and .01, respectively). Daily MVPA did not differ among the 3 groups of girls. Light activity in clinical boys was lower than in the normal weight CHMS boys, whereas clinical girls engaged in less light activity than both CHMS comparators. No differences were observed between groups for sedentary behavior.

CONCLUSIONS

Obese youth, whether in clinic or the community, were not more sedentary than their normal-weight CHMS comparators. Although obese youth were less active, overall MVPA was low in all groups. This finding highlights the need for health professionals to target both physical activity and sedentary behavior in all children, rather than focusing on only children with obesity.

Objectively measured habitual physical activity and sedentary behaviour in obese and non-obese Malaysian children

The present study examined objectively measured physical activity in Malaysian children and compared the differences in physical levels between obese and healthy weight children. Eighty-six obese children were matched for age and sex with 86 healthy weight children with median age 9.5 years. Habitual physical activity and sedentary behaviour were measured over 5 days using Actigraph accelerometers. Time spent sedentary was significantly higher in the obese group (90% vs. 86% of daytime; p = 0.001). Moderate-to-vigorous-intensity physical activity was significantly higher in the healthy weight group (1.2 vs. 0.7% of daytime, p < 0.001). In both healthy weight and obese children, physical activity levels were exceptionally low, although moderate-to-vigorous-intensity physical activity was significantly lower in the obese group than the healthy weight group. Efforts to prevent and treat obesity in Malaysian children will need a substantial focus on the promotion of reductions in sedentary behaviour and increases in physical activity.

Objectively determined physical activity levels of primary school children in south-west Germany

Background

Only a small proportion of children and adolescents meet current recommendations of at least 60 min of moderate to vigorous physical activity (MVPA) daily. Most of the available data, however, relies on subjective reports; there is limited objective data on physical activity (PA) levels in German primary school children. The purpose of this study, therefore, was to accurately determine how much time children spend undertaking different intensities of PA and being sedentary during weekdays and weekend using objective assessment tools. Gender-specific and age-related differences were examined along with differences between normal weight and overweight/obese children.

Methods

Children’s height and weight were measured according to standard procedures and objective PA measurements were determined in a sub-cohort of 384 primary school children (20% of the whole cohort), participating in a large school-based intervention study in south-west Germany (n = 1947). Baseline data collection occurred on six consecutive days, including weekend days, using multi-sensor accelerometry (Actiheart, CamNtech Ltd., Cambridge UK). 318 children (7.1 ± 0.6 years, male: 50%, first grade: 51%) provided data for at least 3 days including one weekend day. According to the amount of energy expended, defined as metabolic equivalents (METs), different activity intensities were categorised as follows: sedentary < 1.5 METs; light = 1.5-3.0 METs; moderate = 3.0-6.0 METs, and vigorous > 6.0 METs.

Results

Average wear time was 1403 ± 94 min/day. Children spent 808 ± 97 min/day being sedentary; 497 ± 72 min/day in light; 128 ± 54 min/day in moderate, and 8 ± 10 min/day in vigorous intensity. 48% of children met the current MVPA guidelines. MVPA was significantly higher on weekdays compared to weekend days (144 ± 66 vs. 113 ± 66 min/day; p < 0.001). Furthermore, boys displayed higher MVPA levels compared to girls (164 ± 57 vs. 106 ± 50 min/day; p < 0.001).

Conclusion

Measured objectively, less than half of primary school children in the study met current PA recommendations, emphasising the necessity for early intervention to promote PA. Consistent with previous research, PA levels were higher in boys and during weekdays. These results indicate that PA levels of girls should especially be promoted in primary schools and that parents should be more involved in interventions to improve PA, particularly during weekends.

Fatores associados ao comportamento sedentário em escolares de 9-12 anos de idade

São recentes os estudos que investigaram impactos do comportamento sedentário (CS) sobre a saúde, principalmente em crianças. O objetivo foi investigar fatores associados ao CS em escolares do município de Uberaba, MG. Trata-se de estudo epidemiológico, transversal, com amostra probabilística (n = 649). Foram coletadas e consideradas variáveis independentes: medidas antropométricas, pressão arterial, exames bioquímicos, tempo gasto em atividade física (AF). CS foi considerado variável dependente, caracterizado pelo tempo de tela (TT), e verificado fatores associados pela regressão de Poisson. Meninas apresentaram valores maiores de dobras cutâneas, triglicerídeos e HDL-c e meninos, maior concentração de glicose sanguínea, atenderam mais à recomendação de 60 min de AF/dia e maior CS. O TT > 2 h/dia foi prevalente em 76,9 % da amostra. CS não foi associado a variáveis sociodemográficas, de saúde e comportamentais em crianças de 9-12 anos de idade. Mais pesquisas são necessárias para elucidar as inter-relações complexas entre TT e fatores associados.

Promoting healthy weight in primary school children through physical activity and nutrition education: a pragmatic evaluation of the CHANGE! randomised intervention study

BACKGROUND

This pragmatic evaluation investigated the effectiveness of the Children's Health, Activity and Nutrition: Get Educated! (CHANGE!) Project, a cluster randomised intervention to promote healthy weight using an educational focus on physical activity and healthy eating.

METHODS

Participants (n = 318, aged 10-11 years) from 6 Intervention and 6 Comparison schools took part in the 20 weeks intervention between November 2010 and March/April 2011. This consisted of a teacher-led curriculum, learning resources, and homework tasks. Primary outcome measures were waist circumference, body mass index (BMI), and BMI z-scores. Secondary outcomes were objectively-assessed physical activity and sedentary time, and food intake. Outcomes were assessed at baseline, at post-intervention (20 weeks), and at follow-up (30 weeks). Data were analysed using 2-level multi-level modelling (levels: school, student) and adjusted for baseline values of the outcomes and potential confounders. Differences in intervention effect by subgroup (sex, weight status, socio-economic status) were explored using statistical interaction.

RESULTS

Significant between-group effects were observed for waist circumference at post-intervention (β for intervention effect =-1.63 (95% CI = -2.20, -1.07) cm, p<0.001) and for BMI z-score at follow-up (β=-0.24 (95% CI = -0.48, -0.003), p=0.04). At follow-up there was also a significant intervention effect for light intensity physical activity (β=25.97 (95% CI = 8.04, 43.89) min, p=0.01). Interaction analyses revealed that the intervention was most effective for overweight/obese participants (waist circumference: β=-2.82 (95% CI = -4.06, -1.58) cm, p<0.001), girls (BMI: β=-0.39 (95% CI = -0.81, 0.03) kg/m2, p=0.07), and participants with higher family socioeconomic status (breakfast consumption: β=8.82 (95% CI = 6.47, 11.16), p=0.07).

CONCLUSIONS

The CHANGE! intervention positively influenced body size outcomes and light physical activity, and most effectively influenced body size outcomes among overweight and obese children and girls. The findings add support for the effectiveness of combined school-based physical activity and nutrition interventions. Additional work is required to test intervention fidelity and the sustained effectiveness of this intervention in the medium and long term.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN03863885.

Comparison of BMI and physical activity between old order Amish children and non-Amish children

OBJECTIVE

The Old Order Amish (OOA) is a conservative Christian sect of European origin living in Pennsylvania. Diabetes is rare in adult OOA despite a mean BMI rivaling that in the general U.S. non-Hispanic white population. The current study examines childhood factors that may contribute to the low prevalence of diabetes in the OOA by comparing OOA children aged 8-19 years with National Health and Nutrition Examination Survey (NHANES) data and children from Maryland's Eastern Shore (ES), a nearby, non-Amish, rural community. We hypothesized that pediatric overweight is less common in OOA children, that physical activity (PA) and BMI are inversely correlated, and that OOA children are more physically active than ES children.

RESEARCH DESIGN AND METHODS

We obtained anthropometric data in 270 OOA children and 229 ES children (166 non-Hispanic white, 60 non-Hispanic black, 3 Hispanic). PA was measured by hip-worn accelerometers in all ES children and in 198 OOA children. Instrumentation in 43 OOA children was identical to ES children.

RESULTS

OOA children were approximately 3.3 times less likely than non-Hispanic white ES children and NHANES estimates to be overweight (BMI ≥85th percentile, Centers for Disease Control and Prevention). Time spent in moderate/vigorous PA (MVPA) was inversely correlated to BMI z-score (r = -0.24, P = 0.0006). PA levels did not differ by ethnicity within the ES group, but OOA children spent an additional 34 min/day in light activity (442 ± 56 vs. 408 ± 75, P = 0.005) and, impressively, an additional 53 min/day in MVPA (106 ± 54 vs. 53 ± 32, P < 0.0001) compared with ES children. In both groups, boys were more active than girls but OOA girls were easily more active than ES boys.

CONCLUSIONS

We confirmed all three hypotheses. Together with our previous data, the study implies that the OOA tend to gain their excess weight relatively late in life and that OOA children are very physically active, both of which may provide some long-term protection against diabetes.

Influence of overweight on the active and the passive fraction of the plantar flexors series elastic component in prepubertal children

The influence of overweight, as a precursor to obesity, was analyzed on the elastic properties of the triceps surae. Based on body mass index (BMI), children (9 years ± 4 mo) were classified as control (CON; n = 23; BMI -1SD>Z score<1SD) or overweight (OW; n = 21, BMI 1SD>Z score<3SD) with regard to reference data from the World Health Organization. Musculotendinous (MT) stiffness of the series elastic component (SEC) was determined using quick-release tests to obtain 1) the MT stiffness index from the slope of either linear stiffness-torque (SI(MT-Torque)) or stiffness-EMG (SI(MT-EMG)) relationships and 2) passive stiffness from the intercept point with the ordinate. Finally, the SEC active (α(0)) and passive fractions (C(passive)) were separated as described by Morgan (Am J Physiol, 1977), using alpha-torque (α(0-Torque,) C(passive-Torque)) or alpha-EMG (α(0-EMG,) C(passive-EMG)) relationships. No significant differences in SI(MT-Torque) or α(0-Torque) were observed between OW and CON. SI(MT-EMG) or α(0-EMG) values were significantly different between OW and CON, which indicate an increase in MT stiffness. In all cases, passive stiffness (K(p), C(passive-torque), C(passive-EMG)) was significantly greater in OW but independent of the activation capacities. These results indicate that a weight-related additional loading of the MT structures in OW children caused the MT system to response accordingly to the functional demand, i.e., higher stiffness of the MT structures due to a concomitant increase in the stiffness of the SEC passive and active fraction. This study also reveals that possible differences in the activation capacities influence the determination of MT stiffness of the SEC active fraction.

The importance of Active Transportation to and from school for daily physical activity among children

OBJECTIVE

To investigate if students who use of Active Transportation (AT) to and from school among urban and rural Canadian children are more likely to meet physical activity recommendations.

METHODS

The Raising healthy Eating and Active Living in Alberta (REAL Kids Alberta) study is a population-based health survey among Grade 5 students. In 2009, physical activity levels were measured using time-stamped pedometers (number of steps/hour) among 688 children. Parents reported mode of transportation to and from school (AT/non-AT). Multilevel multiple linear regression analyses with corresponding β coefficients were conducted to quantify the relationship between mode of transportation to and from school with (1) overall step count, and (2) the likelihood of achieving at least 13,500 steps per day recommended for optimal growth and development.

RESULTS

Among urban children, those who used AT to and from school accumulated more steps [β=1124(95% CI=170,2077)] and although not significant, were more likely to achieve the recommended 13,500 steps/day compared to those not using AT to and from school [OR=1.61(95% CI=0.93,2.81)].

CONCLUSION

Using AT to and from school appears to be beneficial to children by supplementing their physical activity, particularly those living in urban regions. Strategies to promote physical activity are needed, particular for children residing in rural regions and smaller towns.

Physical Activity Patterns and Quality of Life of Overweight Boys: A Preliminary Study

Objective

We compared the physical activity (PA) patterns and the quality of life (QoL) between overweight and normal-weight boys, and examined the relationship between PA and QoL of overweight boys.

Methods

Eighteen overweight boys (age range: 8–10 years, mean ± standard deviation: 9.36 ± 0.82 years) and 18 age-matched, normal-weight counterparts (age range: 8–10 years, mean ± standard deviation: 9.01 ± 0.65 years) participated in this study. All participants were in the 3rd or 4th grade. Each boy completed a QoL questionnaire and wore an accelerometer on his waist for a week to measure his PA during that period. Independent t tests were used to examine the differences in QoL and PA between the overweight and normal-weight boys. Paired t tests were used to test the differences in PA between weekdays and weekend days for each group. Finally, Pearson correlations were used to analyze the relationships between PA and QoL in overweight boys.

Results

Overweight boys reported a significantly lower QoL, and participated in significantly less PA on weekends than did normal-weight boys. A moderate and marginally significant correlation was found between PA on weekends and QoL in overweight boys.

Conclusion

Our findings suggest the importance of increasing weekend PA for overweight boys. Occupational therapists should encourage overweight boys to engage in PA that the boys are interested in on weekends, and conduct a PA program for overweight boys.

Perceptions of exercise in obese school-aged children

BACKGROUND

Although the prevalence of obesity continues to increase worldwide, information related to obese school-aged children's perceptions of exercise remains limited.

PURPOSE

This study aimed to explore perceptions of exercise held by obese school-aged children.

METHODS

This study used a qualitative research design. Using purposive sampling, 11 obese students who were 11 to 13 years old, currently enrolled at two primary schools, and in the precontemplation stage were recruited from a total population of 1,714 to participate in the study. An interview guide with five open-ended questions was used to guide focus group discussions. Data were analyzed using content analysis to identify significant themes.

RESULTS

Six themes emerged from collected data, including (a) positive impressions about doing exercise, (b) recognition of negative effects associated with not doing exercise, (c) feelings of discomfort after exercise, (d) self-ambivalence, (e) false beliefs about exercise, and (f) making excuses for not doing exercise.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Study findings provided information giving a better understanding of exercise perceptions among obese children. Such may be used to assist obese children to increase exercise levels as part of efforts to improve health in this vulnerable population.

Objectively measured physical activity, physical activity related personality and body mass index in 6- to 10-yr-old children: a cross-sectional study

Background

The prevalence and level of overweight in childhood is rapidly increasing. One potential contributor to the rise in overweight is a decline in physical activity (PA). The purpose of this study was to compare levels and patterns of PA and PA related personality in normal-weight (NW) and overweight (OW) 6- to 10-yr-old children.

Methods

Subjects were grouped into OW (N = 59, BMI = 24.2 ± 4.8 kg/m²) or NW (N = 61, BMI = 15.7 ± 1.5 kg/m²) according to International Obesity Task Force cut-offs. PA was assessed by accelerometry. Parents filled in a questionnaire on PA and sedentary behaviour and PA related personality of their child (born tired, moves slowly, is often tired, lacks energy, avoids physical efforts, prefers watching playing children instead of joining them, is always active, needs to let himself/herself go, has a lot of energy).

Results

NW children spent on average 77 min/day in MVPA, whereas OW children only 57 min/day (p = .001). OW children had fewer 5, 10 and 20 min bouts of MVPA (p = .01). OW and NW children showed identical PA patterns on both week days and weekends, although at different levels. According to parents' report, a greater percentage of OW children was not engaged in any sport (46% versus 23%, chi² = 6.3, p = .01). OW children had a less active personality (p < .001), watched more TV during weekend (p < .01), but no differences were found in outside play or non-active play. BMI of mother and father explained 29% of the variance in children's BMI z-score (p < .001). PA related personality, screen behaviour during weekend and MVPA explained an additional 12% (p < 0.01).

Conclusion

The results of this study demonstrate that NW children spent on average 20 min per day more in MVPA. PA patterns were similar in NW versus OW children, although at different levels. Greatest differences in PA according to weight status were found in the afternoon during after school hours. This is the first study to show distinct PA related personality traits in OW children compared to NW peers.

Objectively measured habitual physical activity in a highly obesogenic environment

BACKGROUND

While the prevalence of overweight and obesity among children continues to grow nationally, prevalence in the North-East of England is among the highest in the UK. The objective of this study was to investigate the habitual physical activity levels in a particularly obesogenic environment in the North-East of England.

METHODS

Eight primary schools were selected using a stratified random sampling frame ranking average deprivation levels. Participating children (n = 246, mean age 10 years) wore an accelerometer (Actigraph, GT-256) over five consecutive days (weekend plus three weekdays). Total daily moderate-to-vigorous intensity physical activity was calculated using thresholds by Puyau and colleagues.

RESULTS

Only 7% (17/246) of children were sufficiently active. Boys were more physically active than girls (766 +/- 268 vs. 641 +/- 202 counts/min, 95% CI for the difference 63-186 cpm.). Total physical activity was not influenced significantly by deprivation levels or weight status, and there were no significant differences in physical activity between school or weekend days.

CONCLUSIONS

The North-East of England is a recognized 'hot spot' for paediatric obesity and the present study shows that low levels of habitual physical activity are typical. Choice of accelerometry threshold affects both the apparent amount of physical activity and the ability to detect groups with particularly low levels of physical activity.

Evidence-based behavioral treatment of obesity in children and adolescents

Obesity is the most common childhood disease and is widely acknowledged as having become a global epidemic. Well-recognized health consequences of childhood obesity exist, both during childhood and adulthood, affecting health and psychological and economic welfare. The importance of finding effective strategies for the management of childhood obesity has international significance with the publication of various expert reports and evidence-based guidelines in recent years.

State of the Art Reviews: Development of Fitness in Children: The Influence of Gender and Physical Activity

The influences of gender and physical activity on the development of fitness are reviewed from early childhood to late adolescence. Changes in parameters of fitness prior to puberty are driven predominantly by neuroendocrine-mediated factors, although physical activity level may be influenced largely by sociocultural factors prior to and following puberty. Thus, it is still unclear to what extent environment versus genetics accounts for gender differences in fitness. Future studies need to account for all factors known to explain gender differences in fitness to better differentiate intrinsic versus environmental causes. Consequently, one must consider if and to what extent a gender comparison study actually reveals true, inherent gender differences compared with sociocultural and/or cultural influences. Nevertheless, differences in fitness between girls and boys that are influenced by sociocultural factors should be considered when devising programs to promote physical activity and enhance fitness in youth. Fundamentally, the role of parents and primary caregivers in modeling physical activity and influencing the fitness level of their child cannot be overestimated.

Daily differences in patterns of physical activity among overweight/obese children engaged in a physical activity program

The aim of this study was to compare the physical activity of overweight/obese children during days when they attended a physical activity program, and days when they did not. This is a cross-sectional intervention study of daily physical activity. The participants were referred by family, doctors, or hospital pediatricians to take part in a 10-month interdisciplinary, outpatient obesity intervention program for children. The subjects included 41 overweight and obese children aged 8-16 years, 19 boys (46%) and 22 girls (54%); BMI: 25.7 + 3.3 kg m(-2). The MTI Actigraph was used as an objective measure of daily physical activity over seven consecutive days. Physical activity program days presented a significantly higher percentage of time (4.68%) spent in moderate-to-vigorous activity compared with no physical activity program days (3.16%) and weekend (2.7%). The results of this study suggest that a physical activity program can help increasing daily physical activity in obese children, with a special focus on MVPA level. Our data point that obese children are less active at weekend than during weekdays.