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Haugland ES, Nilsen AKO, Okely AD, Aadland KN, Aadland E. Multivariate physical activity association patterns for fundamental motor skills and physical fitness in preschool children aged 3-5 years. J Sports Sci 2023:1-14. [PMID: 37419662 DOI: 10.1080/02640414.2023.2232219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/25/2023] [Indexed: 07/09/2023]
Abstract
Physical activity (PA) is important for children's development of fundamental motor skills (FMS) and physical fitness (FIT) but evidence regarding which intensities are associated with these outcomes in early childhood is limited. The aim of this study was to determine the cross-sectional multivariate PA intensity signatures associated with FMS and FIT in children aged 3-5 years. We used a sample of 952 Norwegian preschoolers (4.3 years, 51% boys) who provided data on PA (ActiGraph GT3X+), at least one FMS (locomotor, object control and/or balance skills) or FIT (speed agility, standing long jump, and/or handgrip strength) outcome, body mass index, and socioeconomic status in 2019-2020. We created 17 PA intensity variables (0-99 to ≥15000 counts per minute) from the vertical axis and used multivariate pattern analysis for analyses. The PA intensity spectrum (including sedentary time) was significantly associated with all outcomes. Associations for PA intensities were positive (negative for sedentary time), strongest for moderate and vigorous intensities, and were significant across sex and age groups. Our findings show that the PA intensity spectrum is associated with FMS and FIT in young children and that promotion of PA, in particular moderate- and vigorous-intensity activity, from an early age benefits children's physical development.
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Affiliation(s)
- Elisabeth Straume Haugland
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Ada Kristine Ofrim Nilsen
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Anthony David Okely
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
- Early Start and School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Katrine Nyvoll Aadland
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Eivind Aadland
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
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Le S, Törmäkangas T, Wang X, Lei SM, Møller NC, Brønd JC, Wedderkopp N, Wiklund P, Cheng S. Bidirectional associations between adiposity and physical activity: a longitudinal study from pre-puberty to early adulthood. Front Endocrinol (Lausanne) 2023; 14:1135852. [PMID: 37404302 PMCID: PMC10315841 DOI: 10.3389/fendo.2023.1135852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Objective This study aimed to investigate directional influences in the association between adiposity and physical activity (PA) from pre-puberty to early adulthood. Methods In the Calex-study, height, weight, body fat and leisure-time physical activity (LTPA) were measured at age11.2-years, 13.2-years and 18.3-years in 396 Finnish girls. Body fat was measured by dual-energy X-ray absorptiometry, calculating fat mass index (FMI) as total fat mass in kilograms divided by height in meters squared. LTPA level was evaluated using a physical activity questionnaire. In the European Youth Heart Study (EYHS), height, weight and habitual PA were measured at age 9.6-years, 15.7-years and 21.8-years in 399 Danish boys and girls. Habitual PA and sedentary behaviour were assessed with an accelerometer. Directional influences of adiposity and PA were examined using a bivariate cross-lagged path panel model. Results The temporal stability of BMI from pre-puberty to early adulthood was higher than the temporal stability of PA or physical inactivity over the same time period both in girls and boys. In the Calex-study, BMI and FMI at age 11.2-years were both directly associated with LTPA at age 13.2-years (β = 0.167, p = 0.005 and β = 0.167, p = 0.005, respectively), whereas FMI at age 13.2-years showed an inverse association with LTPA at age 18.3-years (β = - 0.187, p = 0.048). However, earlier LTPA level was not associated with subsequent BMI or FMI. In the EYHS, no directional association was found for physical inactivity, light-, moderate-, and vigorous-PA with BMI during the follow-up in girls. In boys, BMI at age 15.7-years was directly associated with moderate PA (β = 0.301, p = 0.017) at age 21.8-years, while vigorous PA at age 15.7-years showed inverse associations with BMI at age 21.8-years (β = - 0.185, p = 0.023). Conclusion Our study indicates that previous fatness level is a much stronger predictor of future fatness than level of leisure-time or habitual physical activity during adolescence. The directional associations between adiposity and physical activity are not clear during adolescence, and may differ between boys and girls depending on pubertal status.
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Affiliation(s)
- Shenglong Le
- Exercise Health and Technology Center, Physical Education Department, Shanghai Jiao Tong University, Shanghai, China
- Department of Physical Therapy, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Timo Törmäkangas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Xiuqiang Wang
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Si Man Lei
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
- Faculty of Education, University of Macao, Macao, China
| | - Niels Christian Møller
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jan Christian Brønd
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Niels Wedderkopp
- The Research Unit of Pediatrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Petri Wiklund
- Exercise Health and Technology Center, Physical Education Department, Shanghai Jiao Tong University, Shanghai, China
- Huawei Helsinki Research Center, Huawei Technologies Oy (Finland) Co. Ltd, Helsinki, Finland
| | - Sulin Cheng
- Exercise Health and Technology Center, Physical Education Department, Shanghai Jiao Tong University, Shanghai, China
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Aadland E, Nilsen AKO. The influence of reliability and variability of objectively measured physical activity on associations with lower body muscle strength in young children. J Sports Sci 2023; 41:190-199. [PMID: 37082806 DOI: 10.1080/02640414.2023.2204587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
It is not known how extended or multiple monitoring periods affect associations between accelerometer-measured physical activity and outcomes. The aim of this study was to examine how accelerometer monitoring length influenced cross-sectional and prospective associations for physical activity with lower body muscle strength in young children. 176 Norwegian 2-6-year-old children had 3 valid 14-day periods of accelerometer monitoring (ActiGraph GT3×+) between September 2015 and May 2016 (baseline) as well as baseline and 4-year follow-up measurements of standing long jump. We analysed physical activity using a descriptor with 4 intensities using 6 different monitoring lengths both within and across monitoring periods (1 day, 3 days, 1 week, 2 weeks, 3 weeks, 6 weeks) and determined associations with lower body muscle strength using multivariate pattern analysis. We found that the strength of cross-sectional associations with lower body muscle strength improved for longer monitoring periods (explained variances = 7.7%, 9.8%, 11.8%, 15.8%, 18.4% and 22.9% for 1 day, 3 days, 1 week, 2 weeks, 3 weeks and 6 weeks of measurement). Longitudinal associations were weaker and less clear. Our findings suggest that multiple extended physical activity monitoring periods improve the validity of the study findings regarding associations between physical activity and relevant outcomes.
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Affiliation(s)
- Eivind Aadland
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Sogndal, Norway
| | - Ada Kristine Ofrim Nilsen
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Sogndal, Norway
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Skou ST, Nyberg M, Dideriksen M, Overgaard JA, Bodilsen C, Soja AMB, Attarzadeh AP, Bieder MJ, Dridi NP, Heltberg A, Gæde PH, Reventlow JL, Arnfred S, Bodtger U, Thygesen LC, Jäger M, Bricca A. Study protocol for a multicenter randomized controlled trial of personalized exercise therapy and self-management support for people with multimorbidity: The MOBILIZE study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231154447. [PMID: 36762033 PMCID: PMC9903016 DOI: 10.1177/26335565231154447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 12/01/2022] [Accepted: 01/15/2023] [Indexed: 02/04/2023]
Abstract
Background Despite the great individual and societal burden associated with multimorbidity, little is known about how to effectively manage it. Objective The aim of this multicenter randomized controlled trial (RCT) is to investigate the 12-month effects of a personalized exercise therapy and self-management support program in addition to usual care in people with multimorbidity. Design This is a protocol for a pragmatic, parallel-group (1:1 ratio), superiority RCT conducted at five intervention sites (two hospitals, a private practice physiotherapy clinic and two municipal rehabilitation centers) in Region Zealand, Denmark. A total of 228 persons with multimorbidity aged 18 years or older, will be randomly allocated to one of two groups. Both groups will receive usual care, defined as routine care for multimorbidity at the discretion of the treating doctor, while the intervention group will also participate in a 12-week exercise therapy and self-management support program tailored to people with multimorbidity at one of the intervention sites. The primary outcome will be the between-group difference in change in EQ-5D-5L from baseline to the follow-up at 12 months. Secondary outcomes include objectively-measured physical function and physical activity, inflammatory markers, disease and treatment burden, anxiety, depression, stress, sleep, pain and other self-reported parameters. In parallel with the RCT, an observational cohort will follow persons aged ≥18 years with multimorbidity not adhering to all eligibility criteria, as well as people fulfilling all eligibility criteria, but unwilling to participate in the RCT. This study was approved by the Regional Committee on Health Research Ethics for Region Zealand (SJ-857) and results will be communicated in scientific papers, at relevant conferences and to a broader audience. Discussion Exercise therapy and self-management support is safe and effective in people with single conditions. However, it is still unclear whether this holds true for individuals with multimorbidity. This pragmatic, multicenter RCT will provide high-quality evidence on the benefits and harms of exercise therapy and self-management support and, if the results support it, lead to the development of a plan for implementation in clinical practice.
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Affiliation(s)
- Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark,Søren T Skou, Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense M 5230, Denmark.
| | - Mette Nyberg
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | - Mette Dideriksen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Jan A Overgaard
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark,Department of Rehabilitation, Lolland Municipality, Maribo, Denmark
| | - Christine Bodilsen
- Department of Exercise and Health, Roskilde Municipality, Roskilde, Denmark
| | - Anne MB Soja
- Department of Internal Medicine 1, Section of Cardiology, Holbæk Hospital, Holbæk, Denmark
| | - Amir P Attarzadeh
- Centre for Evidence-Based Orthopaedics, Department of Orthopedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Manuel J Bieder
- Department of Orthopaedic Surgery, Næstved Hospital, Næstved, Denmark
| | - Nadia P Dridi
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Andreas Heltberg
- Department of General Practice, Institute of Public Health, University of Copenhagen, København K, Denmark
| | - Peter H Gæde
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark,Institute for Regional Health Research, University of Southern Denmark, Odense M, Denmark
| | | | - Sidse Arnfred
- Psychiatric Research Unit, Copenhagen University Hospital – Psychiatry Region Zealand, Slagelse, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Uffe Bodtger
- Institute for Regional Health Research, University of Southern Denmark, Odense M, Denmark.,Pulmonary Research Unit Region Zealand (PLUZ), Department of Respiratory Medicine, Zealand University Hospital Næstved, Næstved, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Madalina Jäger
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark,Danish Centre for Motivation and Behaviour Science, University of Southern Denmark, Odense M, Denmark
| | - Alessio Bricca
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Prospective Association Patterns for the Physical Activity Intensity Spectrum With Body Mass Index and Lower Body Muscle Strength in Norwegian Children Aged 3-9 Years. J Phys Act Health 2023; 20:20-27. [PMID: 36476968 DOI: 10.1123/jpah.2022-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/04/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Limited evidence exists regarding prospective associations for physical activity (PA) and sedentary time (SED) with body mass index (BMI) and muscle strength in young children. We aimed to determine prospective associations for PA and SED with change in BMI and standing long jump over 2 and 4 years in children aged 3-5 years at baseline. METHODS A sample of 262 Norwegian children (50% girls) was followed from 2015 to 2017 and/or 2019. PA and SED (hip-worn ActiGraph GT3X+) were measured at baseline and BMI and standing long jump at baseline and at follow-ups. Multivariate pattern analysis was used to determine prospective associations between the triaxial PA intensity spectrum (0-99 to ≥15,000 counts per minute) and the change in outcomes. RESULTS We found significant prospective associations between the PA intensity spectrum and standing long jump at 2- (explained variance = 5.8%-7.7%) and 4-year (explained variance = 4.8%-5.6%) follow-ups. Associations were negative for SED and positive for all PA intensities. We found no associations between PA/SED and BMI. CONCLUSIONS Our findings suggest that PA and SED can predict future lower body muscle strength but not BMI in early childhood.
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Aadland E, Nilsen AKO, Haugland ES, Vabø KB, Aadland KN. The multivariate physical activity signatures associated with body mass index and waist-to-height ratio in 3–5-year-old Norwegian children. Prev Med Rep 2022; 29:101930. [PMID: 35942297 PMCID: PMC9356261 DOI: 10.1016/j.pmedr.2022.101930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/08/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Eivind Aadland
- Corresponding author at: Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Box 133, 6851 Sogndal, Norway.
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Okawara H, Sawada T, Hakukawa S, Nishizawa K, Okuno M, Nakamura M, Hashimoto T, Nagura T. Footsteps required for reliable and valid in-shoe plantar pressure assessment during gait per foot region in people with hallux valgus. Gait Posture 2022; 97:21-27. [PMID: 35858528 DOI: 10.1016/j.gaitpost.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Plantar pressure assessment is commonly performed to identify pathognomonic gait characteristics and evaluate therapeutics against them in people with various foot disorders. Little is known about the reliability and validity of this assessment in people with hallux valgus (HV) per foot region. RESEARCH QUESTION This study aimed to assess the reliability and validity of the in-shoe plantar pressure measurement method during gait in people with HV and the required number of footsteps, as an intra-subject sample size, to ensure a reliable and valid use of this method. METHODS With an inserted disposable insole plantar pressure sensor in shoes, 17 females with HV (HV angle > 15°) completed three gait trials over the ground at a comfortable speed. Peak plantar pressure data and its distribution in 15 stance phases on the foot clinically diagnosed with HV in each participant were extracted by dividing the foot into eight regions. The intraclass correlation coefficient per foot region and the number of footsteps required to produce a valid peak plantar pressure and distribution (intraclass correlation coefficient > 0.90) were used to measure reliability. Based on the limit of agreement analysis, the coefficient of variation between the averaged value from each incremental footstep (2-14 footsteps) and 15 reference footsteps was calculated. RESULTS The intraclass correlation coefficient of plantar pressure assessment with the in-shoe sensor was 0.606-0.847 in the eight foot regions in people with HV. Additionally, the number of steps required for a valid assessment ranged from two to nine. Hence, the application of averaged values from more than nine footsteps is recommended for this evaluation. SIGNIFICANCE This reference sample size is intended to be used in future studies and clinical settings to determine the efficacy of HV treatment.
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Affiliation(s)
- Hiroki Okawara
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Tomonori Sawada
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Satoshi Hakukawa
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Kohei Nishizawa
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Masahiro Okuno
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan; Rapithela Corporation, Seto, Aichi 489-0979, Japan; Tomei Brace Co., Ltd, Seto, Aichi 489-0979, Japan.
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
| | - Takeshi Hashimoto
- Sports Medicine Research Center, Keio University, Yokohama, Kanagawa 223-8521, Japan.
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan; Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.
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KARIIPPANON KATHARINAE, CHONG KARHAU, JANSSEN XANNE, TOMAZ SIMONEA, RIBEIRO EVELYNHC, MUNAMBAH NYARADZAI, CHAN CECILIAHS, CHATHURANGANA PWPRASAD, DRAPER CATHERINEE, EL HAMDOUCHI ASMAA, FLORINDO ALEXA, GUAN HONGYAN, HA AMYS, HOSSAIN MOHAMMADSOROWAR, KIM DONGHOON, VAN KIM THANH, KOH DENISECL, LÖF MARIE, PHAM BANGNGUYEN, POH BEEKOON, REILLY JOHNJ, STAIANO AMANDAE, SUHERMAN ADANG, TANAKA CHIAKI, TANG HONGKIM, TREMBLAY MARKS, WEBSTER EKIPLING, WICKRAMASINGHE VPUJITHA, WONG JYHEIIN, OKELY ANTHONYD. Levels and Correlates of Objectively Measured Sedentary Behavior in Young Children: SUNRISE Study Results from 19 Countries. Med Sci Sports Exerc 2022; 54:1123-1130. [PMID: 35142711 PMCID: PMC9203875 DOI: 10.1249/mss.0000000000002886] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE There is a paucity of global data on sedentary behavior during early childhood. The purpose of this study was to examine how device-measured sedentary behavior in young children differed across geographically, economically, and sociodemographically diverse populations, in an international sample. METHODS This multinational, cross-sectional study included data from 1071 children 3-5 yr old from 19 countries, collected between 2018 and 2020 (pre-COVID). Sedentary behavior was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation, and seated transport duration were calculated. Linear mixed models were used to examine the differences in sedentary behavior variables between sex, country-level income groups, urban/rural settings, and population density. RESULTS Children spent 56% (7.4 h) of their waking time sedentary. The longest average bout duration was 81.1 ± 45.4 min, and an average of 61.1 ± 50.1 min·d-1 was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, compared with children from low-income and lower-middle-income countries. Sex and urban/rural residential setting were not associated with any outcomes. Higher population density was associated with several higher sedentary behavior measures. CONCLUSIONS These data advance our understanding of young children's sedentary behavior patterns globally. Country income levels and population density appear to be stronger drivers of the observed differences, than sex or rural/urban residential setting.
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Affiliation(s)
- KATHARINA E. KARIIPPANON
- Early Start, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, NSW, AUSTRALIA
| | - KAR HAU CHONG
- Early Start, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, NSW, AUSTRALIA
| | - XANNE JANSSEN
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland, UNITED KINGDOM
| | - SIMONE A. TOMAZ
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Scotland, UNITED KINGDOM
| | | | - NYARADZAI MUNAMBAH
- Rehabilitation Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, ZIMBABWE
| | - CECILIA H. S. CHAN
- Faculty of Education, The Chinese University of Hong Kong, Hong Kong, THE PEOPLE’S REPUBLIC OF CHINA
| | | | - CATHERINE E. DRAPER
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, SOUTH AFRICA
| | - ASMAA EL HAMDOUCHI
- Unité Mixte de Recherche Nutrition et Alimentation, CNESTEN-Université Ibn Tofail URAC 39, Regional Designated Center of Nutrition Associated with AFRA/IAEA, Rabat, MOROCCO
| | | | - HONGYAN GUAN
- Department of Early Childhood Development, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, CHINA
| | - AMY S. HA
- Faculty of Education, The Chinese University of Hong Kong, Hong Kong, THE PEOPLE’S REPUBLIC OF CHINA
| | | | - DONG HOON KIM
- Korea Institute of Child Care and Education, Seoul, REPUBLIC OF KOREA
| | - THANH VAN KIM
- Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VIETNAM
| | - DENISE C. L. KOH
- Centre of Community Education and Well-being, Faculty of Education, Universiti Kebangsaan Malaysia, Kuala Lumpur, MALAYSIA
| | - MARIE LÖF
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - BANG NGUYEN PHAM
- Papua New Guinea Institute of Medical Research, Goroka, PAPUA NEW GUINEA
| | - BEE KOON POH
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, MALAYSIA
| | - JOHN J. REILLY
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland, UNITED KINGDOM
| | | | - ADANG SUHERMAN
- Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, INDONESIA
| | - CHIAKI TANAKA
- Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, JAPAN
| | - HONG KIM TANG
- Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VIETNAM
| | - MARK S. TREMBLAY
- Healthy Active Lifestyle and Obesity (HALO) Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, CANADA
| | - E. KIPLING WEBSTER
- Institute of Public and Preventive Health, Augusta University, Augusta, GA
| | | | - JYH EIIN WONG
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, MALAYSIA
| | - ANTHONY D. OKELY
- Early Start, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, NSW, AUSTRALIA
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Aadland E, Nilsen AKO. Accelerometer epoch length influence associations for physical activity intensities with body mass index and locomotor skills in young children. J Sports Sci 2022; 40:1568-1577. [PMID: 35758298 DOI: 10.1080/02640414.2022.2092979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The epoch length is decisive for the capture of physical activity intensities from accelerometry and possibly for associations between physical activity intensities and outcomes in children. The aim of the present study was to determine the multivariate physical activity intensity signatures related to body mass index and locomotor skills in preschool children using different epoch lengths. A sample of 1054 Norwegian children (mean age 4.8 years, 52% boys) from the Sogn og Fjordane Preschool Physical Activity Study provided data on physical activity (ActiGraph GT3X+), body mass index and locomotor skills in 2015-2016. Multivariate pattern analysis was used to determine associations between the physical activity intensity spectrum (0-99 to ≥15000 counts per minute) and the outcomes using files aggregated using 8 different epoch lengths from 1 to 60 seconds. We observed that associations across the intensity spectrum, from sedentary time to vigorous intensities, differed for data derived using different epoch lengths. For both outcomes, associations for moderate intensities became stronger and vigorous intensities became weaker for longer as compared to shorter epoch lengths. Aggregation of accelerometer data using different epoch lengths influences the capture of physical activity intensities and associations between physical activity intensities and related outcomes.
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Affiliation(s)
- Eivind Aadland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Ada Kristine Ofrim Nilsen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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Aadland E, Okely AD, Nilsen AKO. Trajectories of physical activity and sedentary time in Norwegian children aged 3-9 years: a 5-year longitudinal study. Int J Behav Nutr Phys Act 2022; 19:67. [PMID: 35690755 PMCID: PMC9188121 DOI: 10.1186/s12966-022-01286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limited evidence exists regarding the longitudinal development of physical activity during early to mid childhood. The aim of this study was to determine physical activity and sedentary time trajectories in children aged 3‒9 years from Western Norway. METHODS A sample of 294 children (51% boys; aged 3‒5 years at baseline) from the Sogn og Fjordane Preschool Physical Activity Study was followed annually over 5 years (2015‒2019). Physical activity was measured every autumn during this period using hip-based accelerometry (ActiGraph GT3X+). Data was processed as counts. We used linear mixed models to analyse the data. Primary analyses included trajectories for total and intensity-specific physical activity (light, moderate, vigorous, and moderate to vigorous intensity) and sedentary time for boys and girls using 1-s epoch. Secondary analyses included trajectories for weekdays versus weekend days, preschool/school hours versus after school hours, and 1- versus 60-s epoch lengths. RESULTS Over the total day, significant associations with age were found for boys and girls for all physical activity intensities and sedentary time (p < .001). Total physical activity peaked at age 5, whereas intensity-specific physical activity levels peaked at age 3 to 8 years (light intensity: 3-4 years; moderate intensity: 4-7 years; vigorous intensity: 7-8 years; moderate to vigorous intensity: 5-8 years). Boys had higher physical activity levels and more favourable trajectories than girls. Sedentary time increased from ages 3 to 9. Changes over time were larger for weekdays than for weekend days and larger for preschool/school hours than for after school hours. The use of a 60-s epoch resulted in larger changes over time than a 1-s epoch. CONCLUSIONS Our findings suggest physical activity levels peaked between the ages of 3 and 8 years. Finding ways to prevent decline in physical activity during the transition from preschool to primary school is important, especially for girls. Standardising epoch length will help when comparing physical activity and sedentary behaviour across studies.
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Affiliation(s)
- Eivind Aadland
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Campus Sogndal, Sogndal, Norway.
| | - Anthony D Okely
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Campus Sogndal, Sogndal, Norway.,University of Wollongong, Early Start and School of Health and Society, Wollongong, Australia
| | - Ada Kristine Ofrim Nilsen
- Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Campus Sogndal, Sogndal, Norway
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11
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Vabø KB, Aadland KN, Howard SJ, Aadland E. The Multivariate Physical Activity Signatures Associated With Self-Regulation, Executive Function, and Early Academic Learning in 3-5-Year-Old Children. Front Psychol 2022; 13:842271. [PMID: 35478740 PMCID: PMC9037291 DOI: 10.3389/fpsyg.2022.842271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
The evidence regarding associations between intensity-specific physical activity and cognitive and learning outcomes in preschoolers is inconsistent and limited by low sample sizes and analytical approaches that cannot handle the multicollinearity among multiple physical activity intensity variables. We aimed to determine the multivariate physical activity intensity signatures associated with self-regulation, executive function, and early academic learning in preschool children aged 3–5 years. A 711 Norwegian preschool children (mean age 4.6 years, 52% boys) provided valid data on physical activity (ActiGraph GT3X+), self-regulation, executive function, and early academic learning during 2019–2020. Multivariate pattern analysis was used to determine associations between uniaxial and triaxial intensity spectra (time spent in intensities from 0–99 to ≥15,000 counts per minute) and the outcomes in the total sample and in subgroups split by sex and age (median split). Uniaxial data led to the highest explained variances (R2) and were reported as the primary findings. We found significant association patterns between physical activity and numeracy (R2 = 4.28%) and inhibition (R2 = 1.48%) in the total sample. The associations with numeracy were negative for time spent sedentary (0–99 counts per minute) and positive for time spent in moderate to vigorous intensities (≥ 1,000 counts per minute). The associations with inhibition were positive for time spent sedentary (0–99 counts per minute) and in vigorous intensities (≥ 8,500 counts per minute) and negative for time spent in low to moderate intensities (100–3,499 counts per minute). Associations with numeracy were stronger in boys (R2 = 5.58%) and older children (R2 = 7.27%), and associations with inhibition were stronger in girls (R2 = 3.12%) and older children (R2 = 3.33%). In conclusion, we found weak associations with numeracy and inhibition across the physical activity intensity spectrum in preschool children.
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Affiliation(s)
- Kristoffer Buene Vabø
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Katrine Nyvoll Aadland
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Steven James Howard
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
| | - Eivind Aadland
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
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12
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Jago R, Tibbitts B, Willis K, Sanderson E, Kandiyali R, Reid T, MacNeill S, Kipping R, Campbell R, Sebire SJ, Hollingworth W. Peer-led physical activity intervention for girls aged 13 to 14 years: PLAN-A cluster RCT. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/zjqw2587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Increasing physical activity among girls is a public health priority. Peers play a central role in influencing adolescent behaviour. Peer-led interventions may increase physical activity in adolescent girls, and a feasibility trial had shown that PLAN-A (Peer-led physical Activity iNtervention for Adolescent girls) had evidence of promise to increase physical activity in adolescent girls.
Objective
The objective was to test whether or not PLAN-A can increase adolescent girls’ physical activity, relative to usual practice, and be cost-effective.
Design
This was a two-arm, cluster-randomised controlled trial, including an economic evaluation and a process evaluation.
Participants
State-funded secondary schools in the UK with girls in Year 9 (aged 13–14 years) participated in the trial. All Year 9 girls in participating schools were eligible.
Randomisation
Schools were the unit of allocation. They were randomised by an independent statistician, who was blinded to school identities, to the control or intervention arm, stratified by region and the England Index of Multiple Deprivation score.
Intervention
The intervention comprised peer nomination (i.e. identification of influential girls), train the trainers (i.e. training the instructors who delivered the intervention), peer supporter training (i.e. training the peer-nominated girls in techniques and strategies underpinned by motivational theory to support peer physical activity increases) and a 10-week diffusion period.
Outcomes
The primary outcome was accelerometer-assessed mean weekday minutes of moderate to vigorous physical activity among Year 9 girls. The follow-up measures were conducted 5–6 months after the 10-week intervention, when the girls were in Year 10 (which was also 12 months after the baseline measures). Analysis used a multivariable, mixed-effects, linear regression model on an intention-to-treat basis. Secondary outcomes included weekend moderate to vigorous physical activity, and weekday and weekend sedentary time. Intervention delivery costs were calculated for the economic evaluation.
Results
A total of 33 schools were approached; 20 schools and 1558 pupils consented. Pupils in the intervention arm had higher Index of Multiple Deprivation scores than pupils in the control arm. The numbers randomised were as follows: 10 schools (n = 758 pupils) were randomised to the intervention arm and 10 schools (n = 800 pupils) were randomised to the control arm. For analysis, a total of 1219 pupils provided valid weekday accelerometer data at both time points (intervention, n = 602; control, n = 617). The mean weekday moderate to vigorous physical activity was similar between groups at follow-up. The central estimate of time spent engaging in moderate to vigorous physical activity was 2.84 minutes lower in the intervention arm than in the control arm, after adjustment for baseline mean weekday moderate to vigorous physical activity, the number of valid days of data and the stratification variables; however, this difference was not statistically significant (95% confidence interval –5.94 to 0.25; p = 0.071). There were no between-arm differences in the secondary outcomes. The intervention costs ranged from £20.85 to £48.86 per pupil, with an average cost of £31.16.
Harms
None.
Limitations
The trial was limited to south-west England.
Conclusions
There was no evidence that PLAN-A increased physical activity in Year 9 girls compared with usual practice and, consequently, it was not cost-effective.
Future work
Future work should evaluate the utility of whole-school approaches to promote physical activity in schools.
Trial registration
This trial is registered as ISRCTN14539759.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information. This trial was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a United Kingdom Clinical Research Commission (UKCRC)-registered Clinical Trials Unit that, as part of the Bristol Trials Centre, is in receipt of NIHR Clinical Trials Unit support funding. The sponsor of this trial was University of Bristol, Research and Enterprise Development www.bristol.ac.uk/red/. The costs of delivering the intervention were funded by Sport England.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Byron Tibbitts
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kathryn Willis
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Emily Sanderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Rebecca Kandiyali
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Tom Reid
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Stephanie MacNeill
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Ruth Kipping
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Rona Campbell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Simon J Sebire
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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Criterion validity of a research-based application for tracking screen time on android and iOS smartphones and tablets. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022. [DOI: 10.1016/j.chbr.2021.100164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Sjöros T, Vähä-Ypyä H, Laine S, Garthwaite T, Löyttyniemi E, Sievänen H, Kalliokoski KK, Knuuti J, Vasankari T, Heinonen IHA. Influence of the Duration and Timing of Data Collection on Accelerometer-Measured Physical Activity, Sedentary Time and Associated Insulin Resistance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094950. [PMID: 34066552 PMCID: PMC8125504 DOI: 10.3390/ijerph18094950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023]
Abstract
Accelerometry is a commonly used method to determine physical activity in clinical studies, but the duration and timing of measurement have seldom been addressed. We aimed to evaluate possible changes in the measured outcomes and associations with insulin resistance during four weeks of accelerometry data collection. This study included 143 participants (median age of 59 (IQR9) years; mean BMI of 30.7 (SD4) kg/m2; 41 men). Sedentary and standing time, breaks in sedentary time, and different intensities of physical activity were measured with hip-worn accelerometers. Differences in the accelerometer-based results between weeks 1, 2, 3 and 4 were analyzed by mixed models, differences during winter and summer by two-way ANOVA, and the associations between insulin resistance and cumulative means of accelerometer results during weeks 1 to 4 by linear models. Mean accelerometry duration was 24 (SD3) days. Sedentary time decreased after three weeks of measurement. More physical activity was measured during summer compared to winter. The associations between insulin resistance and sedentary behavior and light physical activity were non-significant after the first week of measurement, but the associations turned significant in two to three weeks. If the purpose of data collection is to reveal associations between accelerometer-measured outcomes and tenuous health outcomes, such as insulin sensitivity, data collection for at least three weeks may be needed.
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Affiliation(s)
- Tanja Sjöros
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
- Correspondence: ; Tel.: +358-29-45-02-085
| | - Henri Vähä-Ypyä
- The UKK-Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland; (H.V.-Y.); (H.S.); (T.V.)
| | - Saara Laine
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
| | - Taru Garthwaite
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
| | | | - Harri Sievänen
- The UKK-Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland; (H.V.-Y.); (H.S.); (T.V.)
| | - Kari K. Kalliokoski
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
| | - Juhani Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
| | - Tommi Vasankari
- The UKK-Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland; (H.V.-Y.); (H.S.); (T.V.)
- Faculty of Medicine and Health Technology, Tampere University, 33720 Tampere, Finland
| | - Ilkka H. A. Heinonen
- Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland; (S.L.); (T.G.); (K.K.K.); (J.K.); (I.H.A.H.)
- Rydberg Laboratory of Applied Sciences, University of Halmstad, 30118 Halmstad, Sweden
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15
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Aadland E, Holmøy OK, Nilsen AKO. The multivariate physical activity signature associated with body mass index in young children. Prev Med 2021; 145:106437. [PMID: 33493523 DOI: 10.1016/j.ypmed.2021.106437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 11/27/2020] [Accepted: 01/17/2021] [Indexed: 01/18/2023]
Abstract
The evidence regarding associations between intensity-specific physical activity and adiposity in young children is conflicting. Moreover, the evidence is limited by analytical approaches that cannot handle the multicollinearity among multiple variables across the entire intensity spectrum. We aimed to determine the multivariate physical activity intensity signature associated with body mass index in a large sample of preschool children aged 3-6 years. 1182 Norwegian preschool children (mean age 4.7 years, 51% boys) provided data on physical activity (ActiGraph GT3X+) and body mass index during 2015-2016. Multivariate pattern analysis was used to determine associations between the entire triaxial intensity spectra (time spent in intensities from 0-99 to ≥ 15000 counts per minute) and body mass index in the total sample and in subgroups split by sex and age (median split). The association patterns were comparable across the three axes. For the vertical axis, associations were negative for time spent sedentary (0-99 counts per minute), positive for time spent in lower intensities (100-2999 counts per minute), and negative for time spent in vigorous intensities (4000-12,999 counts per minute). Associations were stronger in older than in younger children and no associations were observed for vigorous intensities among younger children. Association patterns were comparable for boys and girls. In conclusion, we found clear associations with body mass index across the physical activity intensity spectrum in preschool children. However, the age-specific association patterns suggest negative (unfavorable) associations with vigorous physical activity intensities develop around 5-6 years of age.
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Affiliation(s)
- Eivind Aadland
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Sogndal, Norway.
| | - Oddbjørn Kvalheim Holmøy
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Sogndal, Norway.
| | - Ada Kristine Ofrim Nilsen
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Sogndal, Norway.
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