Physical activity and sedentary behavior during the early years in Canada: a cross-sectional study

How Does a 12-Week Physical Exercise Program Affect the Motor Proficiency and Cognitive Abilities of Overweight and Normal-Weight Preschool Children?

The objective of this research was to examine a 12-week exercise program and its impact on the motor proficiency and cognitive abilities of preschool children with overweight and normal weight. The study involved a total of 71 participants who were preschool children enrolled in a longitudinal study. Body mass index (BMI) was determined by measuring body height and weight, and the nutritional status of the children was assessed using the World Health Organization's (WHO) criteria. Motor proficiency encompasses both motor abilities and motor skills, and the assessment of motor abilities was conducted using subtests from the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). These subtests measured fine motor integration, manual dexterity, balance, and bilateral coordination. The evaluation of motor skills involved the utilization of the Test of Gross Motor Development (TGMD-2), which examines both locomotor skills and manipulative skills. Cognitive abilities were assessed using the School Maturity Test (TZS). All participants, regardless of weight status, took part in a 12-week physical exercise program. According to the World Health Organization's criteria, 52 children (73.2%) were categorized as having a normal weight, while 19 children (26.8%) were classified as overweight. These findings indicate that every fourth child in the study was overweight. Using a statistical analysis called SPANOVA (2 × 2, group × time), differences were observed in three out of eleven variables. Specifically, there were significant differences in two motor skill variables: manipulative skills (p = 0.006) and total movement skills (p = 0.014). Additionally, there was a significant difference in one cognitive ability variable: visual memory (p = 0.010). No significant differences were found in the remaining variables. The findings of this study aimed to contribute to the understanding of the potential benefits of regular exercise on motor and cognitive development in preschool children, specifically examining the differences between overweight and normal-weight children. By investigating these effects, the study could provide valuable insights for educators, parents, and health professionals involved in promoting the overall well-being of preschool-aged children. Regular physical exercise has been found to have positive effects on motor and cognitive abilities in both overweight and normal-weight preschool children.

Anthropometric Characteristics and Weight Status of Early Adolescents (Aged 12-14) in Montenegro; Urban-Rural and Regional Differences

The aim of this study was to determine urban-rural and regional differences in anthropometric characteristics among adolescents aged 12-14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12-14 from primary schools across Montenegro participated in this cross-sectional study (283 boys, aged 13.52 ± 0.42, body height 169.43 ± 8.89, body weight 60.54 ± 13.47; 251 girls, aged 13.51 ± 0.40, body height 165.54 ± 6.67, body weight 55.28 ± 9.27). The sample was divided by geographic region in Montenegro into northern, central, and coastal regions, and according to settlement type into urban and rural inhabitants. Anthropometric characteristics were assessed using a battery of seven variables: arm span (AS); body height (BH); body weight (BW); waist circumference (WC); hip circumference (HC); body mass index (BMI); and waist-to-hip ratio (WHR). BMI was categorized based on the World Health Organization's (WHO) cut-offs. The results indicate that girls from urban areas exhibited significantly greater body height and lower BMI values compared to their rural counterparts. Similarly, boys from urban areas also demonstrated lower BMI values compared to their rural peers. However, no statistically significant differences were observed in other anthropometric characteristics between these two groups of adolescents. Based on analysis of variance (ANOVA) and post-hoc analysis, it was found that girls from central areas had significantly greater body height compared to those from northern and coastal areas. Likewise, boys from northern areas showed higher body mass and BMI values compared to those from central areas. Additionally, both boys and girls from central areas had higher values compared to those from coastal areas. Nevertheless, no significant differences were detected in other anthropometric characteristics among adolescents from these regions. This study identified significant differences in anthropometric parameters among participants based on urban-rural status and within regional divisions. However, further research encompassing a larger sub-sample and a broader array of anthropometric variables is needed to draw a more comprehensive conclusion.

Dietary habits and physical activity patterns in relation to nutritional status among school-aged children in Pakistan: A cross-sectional study

Background

Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries.

Objective

The study objective was to assess levels of physical activity, patterns of screen time (S.T.), the relationship between physical activity and screen time patterns, and how these factors affect growth status (adjusting for socioeconomic status).

Methodology

A cross-sectional study included 3,834 children between 6-14 years attending pre-selected schools. Teachers, students, and parents were invited to fill out a standardized questionnaire, and Body Mass Index (BMI) was calculated using Center for disease control (CDC) centile charts. A Chi-square was performed to see the possible association between any height and weight abnormalities and all possible risk factors. Multivariate logistic regression was applied to see the effect of variables significantly associated with univariate analysis.

Results

Approximately 2,447 (63.8%) children were between 11-14 years old and 1,387 (36.2%) were between 4-10 years old. The mean height was 143.71 ± 16.51 centimetres, the mean weight was 36.5 ± 12.9 kilogram, and the mean BMI was 17.16 ± 3.52. Multivariate logistic regression status and junk food combined affected stunting socioeconomic status was significantly associated with being underweight p = 0.001.

Conclusion

Childhood obesity and stunting remain significant problems in Pakistani school-going children. These are significantly associated with poverty, a lack of physical activity opportunities, and available food quality.

Early sex-dependent differences in metabolic profiles of overweight and adiposity in young children: a cross-sectional analysis

BACKGROUND

Childhood obesity is a global health concern and can lead to lifetime cardiometabolic disease. New advances in metabolomics can provide biochemical insights into the early development of obesity, so we aimed to characterize serum metabolites associated with overweight and adiposity in early childhood and to stratify associations by sex.

METHODS

Nontargeted metabolite profiling was conducted in the Canadian CHILD birth cohort (discovery cohort) at age 5 years (n = 900) by multisegment injection-capillary electrophoresis-mass spectrometry. Clinical outcome was defined using novel combined measures of overweight (WHO-standardized body mass index ≥ 85th percentile) and/or adiposity (waist circumference ≥ 90th percentile). Associations between circulating metabolites and child overweight/adiposity (binary and continuous outcomes) were determined by multivariable linear and logistic regression, adjusting for covariates and false discovery rate, and by subsequent sex-stratified analysis. Replication was assessed in an independent replication cohort called FAMILY at age 5 years (n = 456).

RESULTS

In the discovery cohort, each standard deviation (SD) increment of branched-chain and aromatic amino acids, glutamic acid, threonine, and oxoproline was associated with 20-28% increased odds of overweight/adiposity, whereas each SD increment of the glutamine/glutamic acid ratio was associated with 20% decreased odds. All associations were significant in females but not in males in sex-stratified analyses, except for oxoproline that was not significant in either subgroup. Similar outcomes were confirmed in the replication cohort, where associations of aromatic amino acids, leucine, glutamic acid, and the glutamine/glutamic acid ratio with childhood overweight/adiposity were independently replicated.

CONCLUSIONS

Our findings show the utility of combining measures of both overweight and adiposity in young children. Childhood overweight/adiposity at age 5 years has a specific serum metabolic phenotype, with the profile being more prominent in females compared to males.

The Influence of Perceptions of Competence on Motor Skills and Physical Activity in Middle Childhood: A Test of Mediation

The mediating effect of perceptions of physical competence (PPC) on the relationship between motor competence and physical activity levels is documented in adolescence. However, it is unclear at what age this begins. In this study, we examined whether PPC mediated the relationship between moderate-vigorous physical activity (MVPA) or sedentary behaviour and motor competence in middle childhood. The participants were 129 children (mean age = 8.3 years) from eight elementary schools. MVPA and sedentary behaviour were measured using Actigraph accelerometers, and motor competence was assessed using the Test of Gross Motor Development, Second Edition. The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children and The Self-Perception Profile for Children were used to assess PPC. In this study, PPC did not predict either MVPA or engagement in sedentary behaviours. Further, structural equation modelling revealed that PPC did not mediate the relationship between motor competence and MVPA or between motor competence and sedentary behaviour. These results suggest that at 8 years of age, children's perceptions do not influence their participation in physical activities. It is possible that factors influencing PPC, such as peer comparisons and performance outcomes, have more impact in later childhood or adolescence. In turn, those perceptions may affect children's or adolescents' choices to opt in or out of physical activities.

Associations between socioeconomic status and screen time among children and adolescents in China: A cross-sectional study

Background

Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents.

Methods

Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents.

Results

Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31–2.57; father] and 1.42 [95% CI 1.02–1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different.

Conclusions

This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

Screen exposure time of children under 6 years old: a French cross-sectional survey in general practices in the Auvergne-Rhône-Alpes region

BACKGROUND

The advent of miniature, easy-to-use and accessible multimedia products is leading to screen exposure that begins in early childhood. Overexposure in preschool may lead to adverse effects. The main objective of this study was to determine the average daily time (ADT) spent by children under 6 years of age, followed in general practice, in front of television or interactive screens.

METHODS

A cross-sectional survey was conducted in the Auvergne-Rhône-Alpes region among randomly selected General Practitioners (GPs). The average daily screen time (ADST), regardless of the type of device (TVs, computers, tablets, smartphones, video game consoles), of the included children aged 0 to 2 years and 2 to 5 years was calculated from a self-questionnaire completed by the parents. A multivariate Poisson regression model was performed to analyse daily screen time, adjusted by factors selected on their clinical relevance and statistical significance.

RESULTS

The 26 participating GPs included 486 parents. They reported an ADST of 26 (± 44) minutes on weekdays and 30 (± 46) minutes on weekends for children under 2 years of age. For children over 2 years of age, the ADST was 66 (± 82) minutes on weekdays and 103 (±91) minutes on weekends. There was an association between the children's average screen time and certain sociodemographic and environmental factors. Children whose parents had higher levels of education, those living in a family without TV screens or those who were well informed about the possible adverse health consequences of overuse of screens had lower average screen time. On the other hand, children of parents who spent more than 2 hours a day in front of screens, were more exposed.

CONCLUSIONS

In our survey, the ADST of children under 6 years of age followed in general practice was higher than the current recommendations. GPs can warn parents of preschool children of the effects of overexposure to screens, particularly parents of at-risk children.

Child temperament and physical activity in young children

BACKGROUND

Children's temperament has been noted to influence their physical activity (PA) levels. Therefore, understanding the influence of temperament during the early years may be helpful for developing appropriate PA habits and tailoring interventions to align with different personality traits.

OBJECTIVE

The purpose of this study was to examine the relationship between child temperament and objectively-measured PA in preschool-aged children.

METHODS

Data were collected as part of the Supporting Physical Activity in the Childcare Environment (SPACE) and SPACE extension studies. Temperament data were collected using the validated Very Short Form of the Children's Behavior Questionnaire, which assessed three dimensions of temperament (i.e., surgency, negative affect and effortful control). Physical activity data were measured during childcare hours over the course of 5 days, using Actical® accelerometers. Total PA was summed, along with light and moderate-to-vigorous PA using age-specific cut-points. Three regression analyses were conducted to evaluate the prediction of PA by the dimensions of temperament.

RESULTS

A total of 399 participants (M_age  = 3.34 years, SD = 0.63) were retained for analyses, wearing an accelerometer an average of 7.21 h/day. Temperament significantly predicted all three PA levels (P < 0.05), with both negative affect and surgency being significantly associated with PA.

CONCLUSION

Surgency is typified by a predisposition towards high activity levels; therefore, it is not surprising that it was the primary predictor of young children's PA. Future research may investigate methods of targeting PA interventions towards children with temperaments that may not predispose them to seeking out increased activity levels.

Relation between Demographics and Physical Activity among Preschoolers Attending Head Start

Limited empirical evidence is available about preschoolers' sedentary behavior (SB) and physical activity (PA) patterns in Head Start programs, we explored (a) preschoolers' SB and PA patterns (ranging from SB to light-moderate-vigorous physical activity [LMVPA]) and (b) their relationships with sociodemographic factors, weight status, and motor development. Participants included 216 preschoolers (M age = 4.32 ± 0.63; girls 56.5%) from six Head Start centers in an urban area in the southwestern region of the United States, assessing Actical® activity monitor-based PA, weight status, and motor development. The findings revealed preschoolers who were female, Hispanic/Latinx, with an at risk weight level, and/or in the below average motor development group tended to engage in less MVPA/LMVPA and also had higher SB patterns while participating in the Head Start program (p < 0.05-0.001, d ranged from 0.23 to 0.62). Head Start stakeholders (e.g., policymakers, leaders, curriculum coordinators, health professionals, and teachers) need to acknowledge the PA and health disparities, and intervene in underserved preschoolers' health-promoting behaviors.

The association of smartphone screen time with sleep problems among adolescents and young adults: cross-sectional findings from India

Background

Although sleep problem is a growing public health issue with the advancement of technology, especially among adolescents and young adults, it received little attention. The study aimed to examine the association of screen time on smartphone with sleep problems among adolescents and young-adults in India.

Methods

We used data from the “Understanding the lives of adolescents and young-adults” (UDAYA, 2018). The effective sample size for the study was 16,292 adolescents and young adults (males-4428 and females-11,864). Descriptive statistics and bivariate analysis with percentages and chi-square test were used to report the preliminary results. Multivariable logistic regression analysis was conducted to examine the association between smartphone screen time and sleep problems, separately for adolescents and young adults.

Results

Nearly 15.6% of males and 23.5% of females had sleep problems in their adolescence in the last 15 days, while these percentage were high among young-adults (18.4% males and 33.24% females). Adolescents [AOR: 1.55; CI: 1.21-1.99] and young adults [AOR: 1.48; CI: 1.24-1.75], who spent more than 2 h on smartphone had higher odds of reporting sleep problems than those who did not use smartphone in the last 24 hours. Adolescent females who used smartphone for less or equal to 2 h and three or more hours respectively, had 2.11 [AOR: 2.11; CI: 1.63-2.73] and 2.94 times [AOR: 2.94; CI: 1.97-4.38] higher odds of reporting sleep problems than adolescent males who did not use smartphones. Additionally, among the young adult females, the odds of sleep problems were 1.66 times [AOR: 1.66; CI: 1.55-2.38] and 2.36 times [AOR: 2.36; CI: 1.59-3.51] greater than the non-users young adult males.

Conclusion

The increased time spent on mobile phones’s screen among adolescents and young-adults, particularly in females is associated with a higher likelihood of reporting sleeping problems. The current findings have important implications for adolescence and young-adults’ mental health programmes. The findings can also be used to further inform how different strategies need to be developed for better sleep outcome during adolescence and young-adults.

Physical Activity Opportunities in US Early Child Care Programs

BACKGROUND AND OBJECTIVES

Physical activity provides health and developmental benefits to young children. The Study of Nutrition and Activity in Child Care Settings describes physical activity opportunities and sedentary occasions for children aged 1 to 5 years at programs participating in the US Department of Agriculture Child and Adult Care Food Program.

METHODS

The Study of Nutrition and Activity in Child Care Settings obtained a nationally representative sample of classrooms within Child and Adult Care Food Program-participating Head Start and child care centers via multistage cluster sampling. For 1 observation day, an observer in each classroom tallied designated outdoor and indoor playspaces; minutes children spent in playspaces; barriers and facilitators to physical activity; and classroom time when most children were physically active (eg, walking, dancing), sedentary (seated, lying down), or neither. Weighted descriptive tabulations by program type compared outdoor physical activity opportunity counts and total physical activity opportunity durations to national guidelines. Multivariate regression analysis investigated association of barriers with physical activity opportunity duration.

RESULTS

The sample included 227 classrooms, 96 in child care centers and 131 in Head Start programs. All had sedentary occasions outside meals, snacks, and naps; virtually all offered opportunities for physical activity. Seventy-four percent of programs met national guidance on sufficient number of outdoor opportunities, weather permitting. Just 50% met guidance of ≥60 to 90 minutes of physical activity, whereas only 43% met both sets of guidance. Weather and staff not joining in outdoor play were associated with 74 and 31 fewer minutes devoted to physical activity, respectively.

CONCLUSIONS

Findings suggest ample room for improvement in provision of physical activity opportunities during child care.

Effect of a Fundamental Motor Skills Intervention on Fundamental Motor Skill and Physical Activity in a Preschool Setting: A Cluster Randomized Controlled Trial

PURPOSE

To determine the effect of a 12-week fundamental motor skill (FMS) program on FMS and physical activity (PA) on preschool-aged children.

METHOD

A cluster randomized controlled trial. The intervention (PhysicaL ActivitY and Fundamental Motor Skills in Pre-schoolers [PLAYFun] Program) was a 12-week games-based program, delivered directly to the children in childcare centers by exercise physiologists. Children in the control arm received the usual preschool curriculum. Outcomes included FMS competence (Test of Gross Motor Development-2) and PA (accelerometer) assessed at baseline, 12 weeks, and 24 weeks (12-wk postintervention).

RESULTS

Fifty children (mean age = 4.0 [0.6] y; 54% male) were recruited from 4 childcare centers. Two centers were randomized to PLAYFun and 2 centers were randomized to the waitlist control group. Children attended on average 2.0 (1.0) 40-minute sessions per week. The PLAYFun participants demonstrated significant increases in object control (P < .001) and total FMS (P = .010) competence at week 12, compared with controls in a group × time interaction. Girls, but not boys, in PLAYFun significantly increased moderate to vigorous PA after the intervention (P = .004). These increases were not maintained 12-week postcompletion of PLAYFun.

CONCLUSIONS

The PLAYFun Program is effective at improving FMS competence in boys and girls and increasing PA in girls. However, improvements are not maintained when opportunities to practice are not sustained.

The Cut-Off Value for Classifying Active Italian Children Using the Corresponding National Version of the Physical Activity Questionnaire

The present study aimed to determine a cut-off value following the filling in of a questionnaire (PAQ-C-It) to identify active Italian children. One-hundred-twenty-nine primary school children (5 Piedmont schools; 47.3% female; mean age = 10 ± 1 years) wore an accelerometer (Actigraph wGT3X-BT) to objectively quantify individual moderate-to-vigorous physical activity during one week. Afterwards, the PAQ-C-It was filled in by participants. A ROC curve procedure was applied to obtain an active/non-active cut-off point. Spearman’s correlation coefficient was also applied to establish the relationship between the two parameters. According to the ROC analysis, the PAQ-C-It cut-off point value is identifiable at >2.75 to indicate active children (area under the curve = 0.62; standard error = 0.05; p = 0.025; coefficient intervals = 0.518−0.716; sensitivity = 0.592, specificity = 0.382), determining that 65 participants (55%) were non-active (mean PAQ-C-It value = 2.3 ± 0.4; active mean PAQ-C-It value = 3.3 ± 0.4). Spearman’s correlation coefficient results were significant but with a small effect size (rho = 0.214; p = 0.008). In conclusion, the present results suggest that the PAQ-C-It can be cautiously used as tool to practically classify active Italian children because of a non-solid relationship between respective accelerometer data and MVPA daily data.

Training Pre-Service Early Childhood Educators in Physical Activity (TEACH): Protocol for a Quasi-Experimental Study

Background: Early childhood educators (ECEs) influence young children’s early uptake of positive health behaviours in childcare settings and serve as important daytime role models. As such, it is imperative that post-secondary early childhood education programs provide students with the foundational knowledge and professional training required to confidently facilitate quality active play opportunities for young children. The primary objective of the Training pre-service EArly CHildhood educators in physical activity (TEACH) study is to develop and implement an e-Learning course in physical activity and sedentary behaviour to facilitate improvements in: pre-service ECEs’ self-efficacy and knowledge to lead physical activity and outdoor play opportunities and minimize sedentary behaviours in childcare. This study will also explore pre-service ECEs’ behavioural intention and perceived control to promote physical activity and outdoor play, and minimize sedentary behaviour in childcare, and the implementation of the e-Learning course. Methods/Design: A mixed-methods quasi-experimental design with three data collection time points (baseline, post-course completion, 3-month follow-up) will be employed to test the e-Learning course in early childhood education programs (n = 18; 9 experimental, 9 comparison) across Canada. Pre-service ECEs enrolled in colleges/universities assigned to the experimental group will be required to complete a 4-module e-Learning course, while programs in the comparison group will maintain their typical curriculum. Pre-service ECEs’ self-efficacy, knowledge, as well as behavioural intention and perceived behavioural control will be assessed via online surveys and module completion rates will be documented using website metrics. Group differences across timepoints will be assessed using linear mixed effects modelling and common themes will be identified through thematic analysis. Discussion: The TEACH study represents a novel, evidence-informed approach to address the existing gap in physical activity and sedentary behaviour-related education in Canadian post-secondary early childhood education programs. Moreover, e-Learning platforms, can be employed as an innovative, standardized, and scalable way to provide ECEs with consistent training across jurisdictions.

Physical environmental opportunities for active play and physical activity level in preschoolers: a multicriteria analysis

Background

Active play opportunities seems to influence the level of physical activity during childhood. However, a gap remains about which environmental opportunities including the daycare physical environment could have a positive impact on the level of physical activity in preschoolers.

Objectives

(1) To develop an index to measure the environmental opportunities of free active play for preschoolers of middle-income countries; (2) to check the relationship and contribution of the index to explain objectively the level of physical activity.

Methods

A quantitative, cross-sectional, exploratory study with 51 preschool children. The established criteria for the index according to the literature were: (1) Outdoor time on typical days of the week. (2) Outdoor time on a typical weekend day. (3) The presence of internal space and external environment in the child’s home that allows playing. (4) Presence of patio with space for games at the school. (5) Presence of a playground with a toy at the school. We applied multi-attribute utility theory for the determination of the multicriteria index of physical environmental opportunities. Pearson’s correlation analysis and simple linear regression were used to verify the association between the index and the physical activity level.

Results

The index showed a positive correlation with the level of physical activity, e.g., the average time of MVPA (r = 0.408, p = 0.003). The univariate linear regression demonstrated that the quality of physical environmental opportunities for physical activity explained 20% of the preschooler’s classification as active and 16% of the time in moderate to vigorous physical activity (p < 0.001).

Conclusion

Physical environmental opportunities for active play have a positive effect on physical activity in preschoolers and should be encouraged in different social segments.

Cross-validation of cut-points in preschool children using different accelerometer placements and data axes

The present study cross-validated various cut-points to assess physical activity and sedentary behaviour in preschoolers, using hip- and wrist-worn accelerometers and both vertical axis and vector magnitude data. Secondly, we examined the influence of epoch length on time estimates of physical activity and sedentary behaviour. Sixty-four preschoolers (34 girls) wore two accelerometers, on their right hip and dominant wrist, during 1 hour of free play. Preschoolers' activities were observed by two trained researchers. Area under the curve (AUC) was calculated for the receiving operating characteristic (ROC) curves as a measure of precision. AUC ranges were 0.603-0.723 for sedentary behaviour, 0.472-0.545 for light physical activity and 0.503-0.661 for moderate-to-vigorous physical activity (MVPA), indicating poor to fair precision. Percentage of time classified as sedentary behaviour, light or MVPA according to observation and accelerometer data varied largely between cut-points, accelerometer placements and axes. The influence of epoch length on time estimates was minimal across cut-points, except for one hip-based vector magnitude cut-point. Across all accelerometer placements and data axes, no set of cut-points demonstrated adequate precision for sedentary behaviour, light physical activity and MVPA. The highly variable and omnidirectional activity pattern of preschoolers may explain the lack of adequate cut-points.

Metabolite profiles and the risk of metabolic syndrome in early childhood: a case-control study

BACKGROUND

Defining the metabolic syndrome (MetS) in children remains challenging. Furthermore, a dichotomous MetS diagnosis can limit the power to study associations. We sought to characterize the serum metabolite signature of the MetS in early childhood using high-throughput metabolomic technologies that allow comprehensive profiling of metabolic status from a biospecimen.

METHODS

In the Family Atherosclerosis Monitoring In earLY life (FAMILY) prospective birth cohort study, we selected 228 cases of MetS and 228 matched controls among children age 5 years. In addition, a continuous MetS risk score was calculated for all 456 participants. Comprehensive metabolite profiling was performed on fasting serum samples using multisegment injection-capillary electrophoresis-mass spectrometry. Multivariable regression models were applied to test metabolite associations with MetS adjusting for covariates of screen time, diet quality, physical activity, night sleep, socioeconomic status, age, and sex.

RESULTS

Compared to controls, thirteen serum metabolites were identified in MetS cases when using multivariable regression models, and using the quantitative MetS score, an additional eight metabolites were identified. These included metabolites associated with gluconeogenesis (glucose (odds ratio (OR) 1.55 [95% CI 1.25-1.93]) and glutamine/glutamate ratio (OR 0.82 [95% CI 0.67-1.00])) and the alanine-glucose cycle (alanine (OR 1.41 [95% CI 1.16-1.73])), amino acids metabolism (tyrosine (OR 1.33 [95% CI 1.10-1.63]), threonine (OR 1.24 [95% CI 1.02-1.51]), monomethylarginine (OR 1.33 [95% CI 1.09-1.64]) and lysine (OR 1.23 [95% CI 1.01-1.50])), tryptophan metabolism (tryptophan (OR 0.78 [95% CI 0.64-0.95])), and fatty acids metabolism (carnitine (OR 1.24 [95% CI 1.02-1.51])). The quantitative MetS risk score was more powerful than the dichotomous outcome in consistently detecting this metabolite signature.

CONCLUSIONS

A distinct metabolite signature of pediatric MetS is detectable in children as young as 5 years old and may improve risk assessment at early stages of development.

Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: A systematic review

BACKGROUND

This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of children and adolescents with intellectual disability.

METHOD

Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty-two studies met criteria for inclusion.

RESULTS

Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited.

CONCLUSIONS

The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well-being; however, more robust randomised controlled trials are required to confirm this.

Self-reported and Accelerometer-Measured Physical Activity in Children With Cardiomyopathy

PURPOSE

Children with cardiomyopathy are at risk of heart failure with reduced physical activity (PA) as a cardinal manifestation. Clinical assessment of PA in children is challenging due to the limited validity of subjective reports. The aim of the study was to compare accelerometery measurement with parental report and to identify factors associated with movement behavior (PA, sedentary time, steps per day).

METHOD

Fifteen patients with cardiomyopathy (mean, 9.7 years; 64% male) were asked to wear an Actigraph GT3X accelerometer in Edmonton, Canada. Demographics, clinical characteristics, parental-reported PA, and health-related quality of life data were also collected.

RESULTS

Participants engaged in a median of 38 minutes of moderate-vigorous PA per day with higher levels in boys versus girls (73.9 [25.03, 78.91] vs 4.13 [2.53, 37.67] minutes, P = .03). Children participating in recreational sports showed a higher level of moderate-vigorous PA (73.92 min/d) compared with those who did not participate (73.9 vs 22.7 min/d, P = .05), and positive family outlook on the child's health was associated with less sedentary time (P = .04).

CONCLUSION

Accelerometer measurement in children with cardiomyopathy is an achievable and more objective measure of PA compared with parental report alone and highlighted low levels of PA among these children.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Impact of the Childcare Physical Activity (PLAY) Policy on Young Children's Physical Activity and Sedentary Time: A Pilot Clustered Randomized Controlled Trial

Background: The importance of daily physical activity is crucial for healthy development during the early years. Currently, a formal written physical activity policy is lacking in Canadian childcare centers, but holds promise for offering consistent physical activity opportunities. With eight recommendations, the Childcare PLAY policy is an evidence-informed, institutional-level document, targeting children’s physical activity, outdoor play, and sedentary time. The purpose of this study was to examine the impact of the Childcare Physical Activity (PLAY) policy on the physical activity and sedentary time of young children (18 months–4 years) in childcare. Methods: Nine childcare centers in London, Ontario participated in the cluster, randomized controlled trial. The centers in the control condition (n = 4) continued their typical daily routines, while the centers in the intervention condition (n = 5) implemented the PLAY policy for eight weeks. To assess physical activity levels, toddlers and preschoolers wore ActiGraph wGT3X-BT accelerometers for five consecutive days during childcare hours, at baseline, mid- and post-intervention, and at the six-month follow-up. Raw accelerometry data were converted to 15 s epochs, and age- and device-specific cut-points were applied. The participants with two or more days of at least 5 h/day of wear-time at baseline, and at one additional time point, were included in the linear mixed-effects models. An adjusted alpha (p < 0.017) was used to account for multiple comparison bias. Results: A total of 148 children (31.92 ± 7.41 months) had valid accelerometry data. The intervention resulted in a significant increase in light physical activity among the participants in the experimental group at the six-month follow-up (+1.07 min/h, an 11.16% increase; p = 0.0017). The intervention did not have a statistically significant effect on the total physical activity, moderate-to-vigorous physical activity, or sedentary time. Conclusions: The findings indicate that the Childcare PLAY policy was effective at increasing the toddlers’ and preschoolers’ light physical activity. This pilot intervention appears promising for supporting some improved movement behaviors among children in childcare settings; however, additional investigations are needed to explore the feasibility and effectiveness with larger and more-diverse samples.

Exploring Preschoolers' Physical Activity and Sedentary Time During Outdoor Play at Childcare: A Cross-Sectional Analysis of the Supporting Physical Activity in the Childcare Environment Study

BACKGROUND

Moderate-to-vigorous physical activity (MVPA) offers many health benefits for preschoolers (2.5-5 y). In childcare, MVPA is predominantly accumulated outdoors, with higher rates purported among children within the first few minutes outside. The Supporting Physical Activity in the Childcare Environment intervention included shorter, more frequent outdoor play sessions; this study sought to explore children's activity levels during various outdoor play schedules.

METHODS

During the final week of the Supporting Physical Activity in the Childcare Environment intervention, preschoolers wore an Actical™ accelerometer for 5 days during childcare and staff logged outdoor times. Separate linear mixed effects models were run to explore the effect of the intervention on preschoolers' physical activity (total and MVPA) and sedentary time during outdoor play. Sex was entered as an interaction effect.

RESULTS

Preschoolers (n = 292) were significantly more active in the first 10 minutes outdoors compared with remaining time (P < .0083). For total outdoor time, children in the experimental group engaged in significantly less sedentary time than those in the control group (P < .017), and experimental group boys and girls engaged in higher MVPA than boys and girls in the control group (P < .017).

CONCLUSIONS

Findings support scheduling more frequent outdoor play sessions in childcare to increase physical activity participation among young children.

Subjective versus Objective Measure of Physical Activity: A Systematic Review and Meta-Analysis of the Convergent Validity of the Physical Activity Questionnaire for Children (PAQ-C)

This study aimed to highlight the relationship between moderate-to-vigorous physical activity (MVPA) as assessed by accelerometer devices and the Physical Activity Questionnaire for Children (PAQ-C) to estimate the convergent validity of the questionnaire. A systematic review and a meta-analysis were applied by collecting pertinent studies (PubMed, Web of Science, PsycINFO, and SCOPUS) from 1997 until November 2020. The relationship between PAQ-C and MVPA scores was estimated considering correlation coefficients such as the effect size. Fisher’s transformation was used to convert each correlation coefficient into an approximately normal distribution. The pooled correlations between PAQ-C and MVPA scores were measured by r values after converting the Fisher’s z values back into correlation coefficients for presentation. A total of 13 studies were included in the meta-analysis, and a random effects model was adopted. The pooled correlation between PAQ-C and MVPA scores was significant but with a moderate effect size (r = 0.34 [0.29, 0.39], Z = 15.00, p < 0.001). No heterogeneity among the studies was observed (I² < 25%). In conclusion, the results highlighted a moderate relationship (around 0.30–0.40) between PAQ-C and accelerometer measurements. These results suggested to concurrently administer both tools to reach a more comprehensive description of children’s PA, in terms of quality and quantity.

The neighbourhood social environment correlates with meeting 24-h movement behaviour recommendations in females: a cross-sectional study using the 2019 National Survey of Children's Health

The purpose of this study was to examine the association between the neighbourhood social environment and meeting recommendations for 24-h movement behaviours in youth. Participants were a sample of children and adolescents from the 2019 National Survey of Children's Health (N = 21 259; 48.2% female). Knowing where to go for help (odds ratio (OR) = 2.66, p = 0.006) and a safe school environment (OR = 1.99, p = 0.020) correlated with high probability of meeting 24-h movement behaviour recommendations in females. Novelty: The neighbourhood social environment associates with meeting 24-h movement recommendations in females.

The Association of Different Sedentary Patterns and Health-Related Physical Fitness in Pre-schoolers

Background: The results of sedentary time (ST) and health-related physical fitness (HPF) are not completely consistent and the studies concentrated on pre-schoolers are very limited. Methods: We measured ST and ST patterns (ST Bouts time, ST Breaks times) by accelerometer. The health-related physical fitness T-score (HPFT) was calculated by five indexes: height-weight standard score, 20 m shuttle-run test, grip strength, standing long jump and 2 × 10 m shuttle-run test. Results: We included 375 pre-schoolers (211 boys, 164 girls) in the final analysis. The total ST and ST Bouts times negatively correlated with HPFT in pre-schoolers. HPFT reduced by 1.69 and 0.70 points per 10 min increased in total ST and ST Bouts times, respectively. HPFT of the highest quartile group reduced by 9.85 points in total ST, and 10.54 points in ST Bouts time compared with the lowest quartile group. However, the HPFT increased by 0.09 points per 10 times increased in ST Breaks times; the HPFT increased by 16.21 and 15.59 points when moderate to vigorous physical activity (MVPA) replaced total ST and ST Bouts time. Conclusions: HPF negatively correlated with the Total ST and ST Bouts times, but positively correlated with ST Breaks times; and HPF significantly improved when MVPA replaced ST in pre-schoolers.

Habitual physical activity levels and sedentary time of children in different childcare arrangements from a nationally representative sample of Canadian preschoolers

BACKGROUND

Children spend substantial time in childcare, and the reasons parents choose a particular childcare type may differ by family. However, little is known about how childcare type influences habitual (full day) activity levels among children. Therefore, exploring patterns between childcare type and habitual physical activity (PA) (i.e., light, moderate-to-vigorous PA (MVPA), and total PA) and sedentary time (ST) in young Canadian children is needed.

METHODS

A nationally representative sample of preschoolers from Cycles 3 and 4 of the Canadian Health Measures Survey was used in this cross-sectional study. Childcare type (e.g., center-based childcare, home-based childcare, home with parent, kindergarten) was reported by parents. Preschoolers wore an Actical accelerometer for 7 days. Device and population-spcific cut-points were applied to delineate PA intensities and ST. Population means and sample totals were calculated to examine average daily and hourly rates of activity.

RESULTS

Preschoolers' rates of MVPA and total PA from the 4 childcare arrangements ranged from 65.99 min/day to 74.62 min/day (5.48-6.18 min/h) and 274.20 min/day to 281.66 min/day 22.69-23.21 min/h), respectively, while ST ranged from 443.13 min/day to 460.57 min/day (36.80-37.31 min/h). No significant differences were observed in daily or hourly rates of activity.

CONCLUSION

This study provides a snapshot of the levels of PA and ST among preschoolers in various childcare settings at a national level, with no differences observed in habitual activity levels based on childcare enrollment. Additional research is needed to clarify the relationship between young children's PA and childcare type, with consideration given to the quality of the childcare settings.

Motor Competence and Attainment of Global Physical Activity Guidelines among a Statewide Sample of Preschoolers

Global physical activity guidelines for preschoolers include 60 min of moderate-to-vigorous physical activity (MVPA) daily. This study, based on the developmental model of motor skill competence, examines how motor competence relates to preschoolers’ likelihood of meeting global guidelines using ankle accelerometry. We measured physical activity using 24-h ankle-placement accelerometry (Actical) for at least two consecutive days (87% with six-seven days), motor competence using the Test of Gross Motor Development-2 (TGMD-2), and BMI-for-age z-scores (BMIz) using anthropometry and age- and sex-specific CDC norms. Caregivers provided demographic characteristics of children’s age, sex, and race. We used multivariable logistic regression to examine how motor competence, BMIz weight status, and demographic characteristics related to meeting global physical activity guidelines. The sample included 588 preschoolers, age 3–5 years; 55% male; 60% white; and 28% overweight/obese; 75% attained the recommended 60 min of MVPA per day. The odds of meeting MVPA guidelines were associated with higher gross motor quotient, higher object control scores, sex (male), age (older), and race (white), but not with BMIz weight status. Findings support the use of 24-h ankle accelerometry among preschoolers and are consistent with the developmental model of motor competence applied to preschoolers, whereby object control competence relates positively to attaining global physical activity guidelines.

Differences in adolescent activity and dietary behaviors across home, school, and other locations warrant location-specific intervention approaches

BACKGROUND

Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents.

METHODS

Participants were adolescents aged 12-16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and "other" locations.

RESULTS

Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to "other" locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≥30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at "other" locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at "other" locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal).

CONCLUSIONS

Adolescents' health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location.

Parents and children active together: a randomized trial protocol examining motivational, regulatory, and habitual intervention approaches

Background

Regular physical activity (PA) is associated with many health benefits during childhood, and tracks into desirable PA patterns and health profiles in adulthood. Interventions designed to support these behaviours among young children are critical. Family-based interventions focusing on parent-child activities together (i.e., co-activity) among preschool-aged children are warranted. Targeting parental support practices can increase the frequency of co-activity, however interventions must move beyond merely building intention and planning skills for successful maintenance. Interventions designed to increase co-activity habit strength may facilitate the sustainability and thus impact child PA. The purpose of this study is to compare the effects of three intervention conditions designed to increase child PA through co-activity: a standard education condition (information about benefits), a planning (action planning, coping planning) + education condition and a habit (context-dependent repetition from prompts and cues) + planning +education condition.

Methods/design

A longitudinal three-arm parallel design randomized trial will compare three conditions over six months. Families are eligible if they have at least one child between 3y and 5y that is not meeting 60mins/day of moderate to vigorous physical activity (MVPA). The primary outcome (child MVPA) is assessed via accelerometry at baseline, six weeks, three months and six months (primary endpoint). Intervention materials targeting co-activity are delivered post baseline assessment, with booster sessions at six weeks and three months. Parental co-activity habit, parent-child co-activity and other behavioural constructs are also assessed via questionnaire at all measurement occasions. As tertiary outcomes, parental PA is measured via accelerometry and co-activity is measured via a Bluetooth-enabled proximity feature. A total of 106 families have been recruited thus far from the Greater Victoria region. The study is ongoing with a minimum target of 150 families and an anticipated recruitment completion date of August 2022.

Discussion

This protocol describes the implementation of a randomized trial evaluating the effectiveness of a habit formation group compared with a planning group and an education only group to increase child PA through targeting parent-child co-activity. This information could prove useful in informing public health initiatives to promote PA among families with preschool-aged children.

Trial registration

This trial was prospectively registered on clinicaltrials.gov in February 2016, identifier NCT03055871.

The effects of intervening with physical activity in the early years (ages 3-5) on health-related quality of life: a secondary analysis of the Activity Begins in Childhood (ABC) trial

PURPOSE

Limited research has measured the effect of physical activity (PA) interventions on health-related quality of life (HRQoL) among pre-school-aged children. This study evaluates the effect of the Activity Begins in Childhood (ABC) cluster-randomized controlled trial designed to increase PA in the ages 3-5 years on HRQoL.

METHODS

This was a cluster-randomized controlled trial where the intervention group included PA education delivered to daycare providers only, or daycare providers and parents. In the current study, the two PA intervention groups were combined. The comparator group received standard daycare curriculum (COM). A total of 215 children were included (PA n = 161, COM n = 54). Parents completed the proxy Pediatric Quality of Life Inventory Generic Core Scale (PedsQL™ 4.0) to measure HRQoL at baseline and the end of the 6-month trial. HRQoL scores were analyzed as physical, psychosocial, and total domains. Baseline and 6-months measurements were compared for PA and COM groups, and mean changes in scores (95% confidence intervals) were measured using absolute values.

RESULTS

No between-group differences were observed for the physical (p = 0.17), psychosocial (p = 0.95) or total scores (p = 0.20). Paired comparisons showed that only the PA group improved psychosocial- (PA mean difference = 2.18 (0.20, 4.15), p = 0.03; COM mean difference = 2.05 (- 1.03, 5.13), p = 0.19) and total-HRQoL scores (PA mean difference = 2.83 (1.83, 3.84), p < 0.001; COM mean difference = 0.19 (- 1.78, 2.16), p = 0.84) after 6 months.

CONCLUSION

Although the within-PA group analysis showed an improvement in psychosocial and total HRQoL scores from baseline, no between-group differences were observed in the HRQoL over time among children aged 3-5 years.

Effects of a Need-Supportive Motor Skill Intervention on Children's Motor Skill Competence and Physical Activity

A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this study aimed to (a) investigate the effect of a need-supportive fundamental movement skill (FMS) program on children’s FMS competence and moderate-to-vigorous physical activity (MVPA), and (b) explore potential gender differences in these effects. Thirty-six children (63.8% girls; M_age = 6.52 ± 0.97) participated and were divided into two groups: an intervention group (24 need-supportive FMS sessions over eight weeks) and a control group. A repeated-measures multivariate analysis of variance (MANOVA) was used to examine the influence of the motor skill intervention on FMS competence and MVPA over time by group (intervention, control) and gender (boys, girls). The results showed (a) significant group differences between the intervention and control group in FMS competence and MVPA (p < 0.001), (b) non-significant gender differences between boys and girls in FMS competence and MVPA (p = 0.85), and (c) non-significant interaction effects over time (p = 0.52). The findings highlight that a need-supportive FMS program may enhance FMS development and daily physical activity for both genders during the early school years.

Prospective associations with physiological, psychosocial and educational outcomes of meeting Australian 24-Hour Movement Guidelines for the Early Years

Background

Several countries have released movement guidelines for children under 5 that incorporate guidelines for sleep, physical activity and sedentary behavior. This study examines prospective associations of preschool children’s compliance with the 24-Hour Australian movement guidelines (sleep, physical activity, screen time) and physiological, psychosocial and educational outcomes during primary school.

Methods

Data were from the Healthy Active Preschool and Primary Years Study (Melbourne, Australia; n = 471; 3–5 years; 2008/9). Follow-ups occurred at 3 (2011/12; 6–8 years), 6 (2014/15; 9–11 years) and 7 (2016; 10–12 years) years post baseline. Multiple regression models assessed associations between compliance with guidelines at baseline and later outcomes.

Results

Children were 4.6 years at baseline (53% boys; 62% high socio-economic families). Most children met physical activity (89%) and sleep (93%) guidelines; 23% met screen-time guidelines; and 20% met all guidelines at baseline. Meeting all of the three guidelines was associated with lower BMI z-scores at 9–11 years of age (b = − 0.26, 95%CI -0.47, − 0.05). Meeting physical activity guidelines was associated with higher total body bone mineral density (b = 0.64, 95%CI 0.15, 1.13), and total body bone mineral content (b = 183.19, 95%CI 69.92, 296.46) at 10–12 years of age. Meeting sleep guidelines was associated with better reading (b = 37.60, 95%CI 6.74, 68.46), spelling (b = 34.95, 95%CI 6.65, 63.25), numeracy (b = 39.09, 95%CI 11.75, 66.44), language (b = 44.31, 95%CI 11.77, 76.85) and writing (b = 25.93, 95%CI 0.30, 51.57) at 8–9 years of age. No associations were evident for compliance with screen-time guidelines or for psychosocial outcomes.

Conclusions

Compliance with different movement behavior guidelines was associated with different outcomes. Strategies to support children in meeting all of the guidelines are warranted to maximize health and educational outcomes. Future research investigating dose-response associations, and potential mechanisms, is necessary.

Are There Any Differences between First Grade Boys and Girls in Physical Fitness, Physical Activity, BMI, and Sedentary Behavior? Results of HCSC Study

The transition from kindergarten to school is associated with a variety of negative changes. After entry to elementary school physical activity level decreases. Moreover, physical fitness level of children over the past decades have rapidly declined. Children are spending an increasing amount of time in the environments that require constant sitting. We evaluated the differences between boys and girls in physical fitness, frequency of undertaking of different forms of physical activity, prevalence of underweight and overweight, and time spent on sedentary behavior. A total of 212 first grade pupils (mean age 6.95 ± 0.43) from two standard urban schools in Poznań participated in the study. Compared to girls, boys obtained better results in 20-meter run (4.9 s and 5.0 s, p < 0.01), sit-ups (16.8 and 15.3, p < 0.05), six-minute run (829.7 m and 766.4 m, p < 0.001), and standing broad jump (106.8 cm and 99.7 cm, p < 0.01). In the sit-and-reach test girls achieved higher results than boys (17.0 cm and 14.4 cm, p < 0.001). There were no gender differences in prevalence of underweight and overweight. In conclusions, difference between genders should be taken into consideration during designing physical activity programs in the aspects of intensity and forms of physical activities.

Unravelling the association between accelerometer-derived physical activity and adiposity among preschool children: A systematic review and meta-analyses

Evidence on the association between physical activity (PA) and adiposity in young children is inconclusive. A systematic review and meta-analyses were conducted to examine associations between accelerometer-derived PA and varying adiposity outcomes in preschool children. Searches were conducted in Embase, MEDLINE and Web of Science to identify studies on the association between total PA, sedentary behaviour or different PA intensities and adiposity in children aged 2 to 7 years. Separate random effects meta-analyses were performed for varying PA intensities and adiposity outcomes. Fifty-six articles were included in the review and 48 in the meta-analyses. There was substantial evidence of an inverse association between moderate-to-vigorous- or vigorous PA and body fat percentage (stdβ [SE] = -0.162[0.041]; 5 studies), weight status (r = -0.120, P<.001; 11 studies), fat mass (stdβ [SE] = -0.103[0.051]; 5 studies), fat mass index (stdβ [SE] = -0.121[0.036]; 2 studies) and skinfold thickness (stdβ [SE] = -0.145[0.036]; 4 studies). However, total PA, sedentary behaviour, and different PA intensities were not associated with body mass index (BMI) or waist circumference. Adiposity levels were lower among preschool children engaged in more (moderate-to-) vigorous PA compared with their peers, but no associations between PA and BMI or waist circumference were found.

Effects of a Fundamental Motor Skill-Based Afterschool Program on Children's Physical and Cognitive Health Outcomes

Globally, more than half of school-aged children do not engage in the recommended 60 minutes of daily moderate to vigorous physical activity (MVPA). Given that developing sufficient fundamental motor skills (FMS) competence during early elementary school years is important for a child’s physical and cognitive development, the purpose of this study was to examine the effects of an 8-week FMS-based afterschool program on physical and cognitive health outcomes among elementary children. Participants were 31 K–2 students (19 girls, 12 boys; Mage = 6.65 ± 0.98) from three public elementary schools in the southwestern United States who were assigned to the intervention group (FMS-based afterschool program; n = 20) or the control group (traditional afterschool program; n = 11). A 2 × 2 repeated measures MANOVA showed significant changes in FMS competence and MVPA between the intervention and the control group over time. However, no significant changes were found in cognitive functioning. The 8-week FMS-based afterschool program showed significant improvements in FMS competence and MVPA, compared to a traditional afterschool program. This finding suggests that structured FMS-focused strategies (e.g., fun games and goal setting) can be a critical component when implementing a physical activity program to enhance children’s motor skills and physical activity behavior.

The Effect of Upgrades to Childcare Outdoor Spaces on Preschoolers' Physical Activity: Findings from a Natural Experiment

Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers' physical activity (aged 2-5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6-12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers' moderate-vigorous physical activity (MVPA) levels compared to control (p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.

Sitting time and long-term weight change in adolescents with severe obesity undergoing surgical and nonoperative weight management

BACKGROUND

Prolonged sitting time has been associated with numerous deleterious effects on humans. The degree to which sitting time influences weight loss outcomes of obesity treatments is poorly understood.

OBJECTIVES

The objective was to characterize and describe the amount of time spent sitting in an adolescent bariatric surgical and nonoperative cohort and evaluate its relationship with long-term change in body mass index (BMI).

SETTING

Tertiary care hospital, United States.

METHODS

From 2011 to 2014, a 1-time study visit was conducted to collect long-term outcomes of Roux-en-Y gastric bypass (RYGB; n = 58) and nonoperative (n = 30) management of adolescents with severe obesity. The International Physical Activity Questionnaire was used to assess sitting time. Linear regression was used to evaluate the association between sitting time and percent BMI change from baseline.

RESULTS

A total of 88 patients participated in the long-term follow-up visit at an average of 8 years from baseline. Percent BMI loss for participants who underwent RYGB (mean age at follow-up 25 yr) and for nonoperative (mean age at follow-up 23 yr) participants was -29% and +8%, respectively. The surgical group reported a median sitting time of 5.1 hr/d, while the nonoperative group reported a median sitting time of 7.0 hr/d (P = .11). Increasing sitting time was significantly associated with decreased percent BMI loss (P < .01).

CONCLUSIONS

RYGB was associated with long-term weight loss. Those participants with and without prior RYGB self-reported similar amounts of time spent sitting each day. Irrespective of whether participants had previously undergone surgery, lower levels of sitting time were found to be associated with greater BMI loss many years later.

Association of cardiorespiratory fitness, physical activity level, and sedentary behavior with overweight in adolescents

Abstract Physical activity and sedentary behavior promote opposite effects on overweight and obesity, in adolescents; however little is known of their combined impact on these outcomes. We aimed to investigate if there were any associations between overweight, and physical activity level, cardiorespiratory fitness, and sedentary behavior, both as isolated variables and in combination. Data of 1,015students from two public and four private schools from the metropolitan area of Rio de Janeiro, Brazil were analyzed. Overweight was classified according to body mass index, whereas physical activity level was assessed by the International Physical Activity Questionnaire (IPAQ), cardiorespiratory fitness by a 9-minute test (T9), and sedentary behavior by a self-completed questionnaire, considering the time spent watching television as the main indicator. Associations were examined by binary logistic regression analysis. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were used to measure the magnitude of the associations. IBM SPSS Statistics version 20 was used for all statistical analyses. Adolescents with poor cardiorespiratory fitness (OR=3.71; 95%CI=1.30-10.6) and a high degree of sedentary behavior (OR=1.73; 95%CI=1.24-2.42) had a bigger chance of being overweight. However the combination of these two categories in the same individual was not statistically associated with overweight. The study indicates that both sedentary behavior and poor performance on cardiorespiratory fitness test are significantly independent associated with overweight in adolescents.

Physical Activity and Fundamental Movement Skills of 3- to 5-Year-Old Children in Irish Preschool Services

The aim of this study was to quantify levels of physical activity (PA) and fundamental movement skills (FMS) of children aged 3 to 5 years in Irish preschool services during care hours, and investigate the relationship between these two variables. Data were collected from 141 children (50.3% boys, ageM = 3.9 ± 0.5 years) across 9 preschool services. Measurements included PA via accelerometry, and proficiency in four FMS (run, vertical jump, throw and catch). The recommended guideline of 15 minutes of PA per hour (min PA/hour) was met by 35% of children (M = 13.6 min PA/hour). Significant differences in mean PA per hour were found by gender, with boys (14.2 min PA/hour) more active than girls (13.0 min PA/ hour), and age, with younger children (14.2 min PA/hour) more active than older (12.6 minutes PA/hour). Percentage of children proficient in the run was high (88.4%), but low across the other skills (4.9%–18.5%). Significant differences were identified by gender for vertical jump with girls scoring higher than boys. No significant relationship was found between FMS and total PA. Low levels of PA and FMS proficiency highlight need for intervention in early years settings to ensure children develop skills to participate in PA.

Physical activity in pre-school children: Trends over time and associations with body mass index and screen time

Background: Pre-school years are important for adopting health behaviours; however, today's children seem to be overweight, present low physical activity (PA) levels and exceed screen time (ST) recommendations.Aim: To examine (a) time trends in PA in Greek pre-school children, (b) the associations among PA, body mass index (BMI) and ST and (c) potential PA differences between boys and girls.Subjects and methods: Data from five cross-sectional cohorts (2005 [n = 252]; 2008 [n = 212]; 2011 [n = 187]; 2014 [n = 194]; 2017 [n = 128]) were compared. PA was assessed using Omron HJ-720IT-E2 pedometers, whereas ST was reported by participants' parents. A 4-way ANOVA was applied on children's average week step counts.Results: A significant association (F = 828.90, p < 0.001, η² = 0.638) between ST and PA was revealed, with children that had ST < 1 hour/day presenting the higher PA levels and being the only ones that met PA recommendations (11,500 steps/day). Statistically significant PA differences, though of no practical importance, were found among cohorts. There were no significant PA differences between boys and girls or among BMI categories. Nevertheless, obesity prevalence was found to exist at alarming levels (24.5% in 2008-41.4% in 2017), and a large percentage of children (23.6% in 2008-63.3% in 2017) presented excessive ST (> 2 hours/day).Conclusion: Effective interventions aiming at reducing ST and enhancing PA seem imperative if children's health is to be safeguarded.

International Comparison of the Levels and Potential Correlates of Objectively Measured Sedentary Time and Physical Activity among Three-to-Four-Year-Old Children

Physical activity (PA) patterns track from childhood through to adulthood. The study aimed to determine the levels and correlates of sedentary time (ST), total PA (TPA), and moderate-to-vigorous PA (MVPA) in preschool-aged children. We conducted cross-sectional analyses of 1052 children aged three-to-four-years-old from six studies included in the International Children’s Accelerometry Database. Multilevel linear regression models adjusting for age, gender, season, minutes of wear time, and study clustering effects were used to estimate associations between age, gender, country, season, ethnicity, parental education, day of the week, time of sunrise, time of sunset, and hours of daylight and the daily minutes spent in ST, TPA, and MVPA. Across the UK, Switzerland, Belgium, and the USA, children in our analysis sample spent 490 min in ST per day and 30.0% and 21.2% of children did not engage in recommended daily TPA (≥180 min) and MVPA (≥60 min) guidelines. There was evidence for an association between all 10 potential correlates analyzed and at least one of the outcome variables; average daily minutes spent in ST, TPA and/or MVPA. These correlates can inform the design of public health interventions internationally to decrease ST and increase PA in preschoolers.

Feasibility of wearable cameras to assess screen time and time spent restrained in children aged 3 to 5 years: a study protocol

INTRODUCTION

Wearable cameras may help overcome the limitations of existing tools to measure young children's sedentary behaviour, but their use introduces a range of ethical challenges. The primary aim of this study is to determine the feasibility of using wearable cameras to measure the two aspects of sedentary behaviour currently included in evidence-based guidelines (ie, screen time and time spent restrained). If shown to be feasible, a secondary aim will be to validate subjective measures against the directly measured screen time and time spent restrained.

METHODS AND ANALYSIS

A convenience sample (n=20) will be recruited via flyers at the University of Strathclyde and advertisements on online forums for parents of young children (aged 3 to 5 years). Children will be provided with a wearable camera, attached to the front of their clothing with a clip, to be worn for 3 days (2 non-childcare days and 1 weekend day) in non-public settings. Once switched on, the camera will record continuous video footage. Parents will complete an online survey providing their feedback on their own and their child's experience of the wearable camera. They will also report their own and their child's demographical characteristics and their child's usual daily screen time and time spent restrained in the past week. Data will be downloaded using specialised software and second-by-second coding will be undertaken. Feasibility and acceptability will be assessed using percentages and by analysing qualitative data. If feasibility is shown, intraclass coefficients will be used to determine agreement between video data and parent-reported sedentary behaviours.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the School of Psychological Sciences and Health Ethics Committee at the University of Strathclyde. Results will be used to inform future studies and will be disseminated in peer-reviewed journals and at major international conferences.

Are preschool children active enough in Shanghai: an accelerometer-based cross-sectional study

OBJECTIVE

Engaging in physical activity (PA) plays an important role in promoting physical and mental health, but the PA data for Chinese preschool children are lacking. This study aims to objectively assess the PA levels of preschool children in Shanghai, China and to evaluate their PA levels relative to age-specific recommendations.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional study was conducted among preschool children in Shanghai, city of China. There were a total of 303 preschool children (boys, 174; girls, 129) recruited from eight kindergarten classes in the Yangpu and Baoshan Districts of Shanghai.

MAIN OUTCOME MEASURES

Daily PA was assessed using ActiGraph GT3X⁺ accelerometers for seven consecutive days. Children were required to have data from at least 2 weekdays and 1 weekend day, with a minimum daily wear time of 480 min to be included in the analysis.

RESULTS

Preschool children in Shanghai accumulated, on average, 70.9 min of moderate-to-vigorous PA (MVPA) and 168.0 min of total PA (TPA) per day (d). Boys engaged in more MVPA and TPA than girls (72.8 min/day vs 68.3 min/day and 171.9 min/day vs 162.9 min/day, respectively). Overall, 72.9% of the participants met the age-specific recommendations of MVPA, while 35.3% met TPA recommendations.

CONCLUSIONS

Findings of this study warn of the insufficiency of PA in Shanghai preschool children, suggesting there is substantial room to improve their PA.

TRIAL REGISTRATION NUMBER

ChiCTR-OOC-15007439; Results.

Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study

BACKGROUND

Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study.

METHODS

CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child's total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score≥65).

RESULTS

Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms (n = 24). Children with more than 2-hours of screen-time/day had a 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). There was no significant association between screen-time and aggressive behaviors (p>0.05).

CONCLUSION

Increased screen-time in pre-school is associated with worse inattention problems.

Greenspace, physical activity, and BMI in children from two cities in northern Mexico

Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded inconsistent results and focused mostly on older children. The purpose of this study was to assess associations between time children spent in greenspace as the primary exposure and our outcomes of interest, including 1) minutes of physical activity, and 2) body mass index (BMI) z-score. Our sample was 102 children ages 3 to 5 years living in Ensenada and Tijuana, Mexico. We fit linear mixed models to estimate associations between greenspace and children's physical activity and BMI z-score. After adjustment for potential confounders, greater time in greenspace was associated with decreased sedentary time (−0.08 min per hour for each additional 30 min in greenspace; 95% CI −0.13, −0.04; p = 0.002) and increased moderate-to-vigorous physical activity (MVPA) (0.06; 95% CI 0.03, 0.10; p < 0.001). Results were driven primarily by children in Tijuana (−0.22; 95% CI −0.38, −0.06; p = 0.008 for sedentary time and 0.15; 95% CI 0.06, 0.38; p = 0.007 for MVPA). Time in greenspace was not associated with BMI z-score in children in Ensenada (0.001; 95% CI −0.008, 0.01; p = 0.83) or Tijuana (−0.009; 95% CI −0.02, 0.004; p = 0.17). Greater time in greenspace was associated with physical activity but not BMI in our sample of children—more so in Tijuana compared to Ensenada. Given high rates of obesity, interventions should aim to increase physical activity in young children in Northern Mexico.

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Greater time in greenspace was associated with decreased sedentary time.

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Greater time in greenspace was associated with increased physical activity.

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Associations were mainly driven by children in Tijuana compared to Ensenada.

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Time spent in greenspace was not associated with body mass index z-score.

Exploring Mothers' Influence on Preschoolers' Physical Activity and Sedentary Time: A Cross Sectional Study

Objectives Physical activity patterns can track from childhood into adulthood; therefore, establishing active behaviors early is imperative. Given the multidimensional nature of a mother's influence on their children, there is a need to utilize more comprehensive measures to assess the relationship between mother and child activity behaviors. Specifically, mothers have been identified as influencing preschoolers' activity behaviors and are often in control of organizing a family's opportunities to be active. The purpose of this study was to explore maternal influence on preschoolers' physical activity and sedentary time. Methods Preschoolers (n = 24) and their mothers (n = 24) wore Actical™ accelerometers for 7 consecutive days (e.g., 5 weekday, 2 weekend days), and mothers completed the adapted Environmental Determinants of Physical Activity in Preschool Children-Parent Survey. Direct entry regression analyses were conducted to explore maternal influence (e.g., role modeling through mothers' activity levels, maternal support, and enjoyment of being active) on preschoolers' activity levels. Results Maternal support was found to be a significant predictor of preschoolers' light and moderate-vigorous physical activity, and sedentary time (p < .05); accounting for 37.3-46.7% of the variation. Conclusions for Practice Mothers supportive behaviors influenced preschoolers' physical activity and sedentary time. Future research is needed to investigate facilitators/barriers that mothers with preschoolers encounter with regard to providing support to be active or modeling active behaviors themselves.

Physical activity among Norwegian preschoolers varies by sex, age, and season

BACKGROUND

Knowledge of physical activity (PA) in preschool populations is important for public health promotion. We investigated levels of PA in a large sample of Norwegian preschoolers and explored variations and development in PA by sex, age, and season.

METHODS

Physical activity levels of 1154 children (mean age 4.7 years, 52% boys) were measured by accelerometry (ActiGraph GT3X+) for 14 consecutive days between autumn 2015 and summer 2016. Additionally, 330 children provided up to 3 repeated measurements of PA across seasons. A linear mixed model was applied to analyze associations and interactions of total PA (cpm), light PA (LPA), moderate PA (MPA), vigorous PA (VPA), moderate-to-vigorous PA (MVPA), sedentary time (SED), sex, age, and season.

RESULTS

Boys and girls spent mean (standard deviation) 72 (21) and 59 (18) min/d in MVPA and had a total PA of 790 (202) and 714 (192) cpm/d, respectively. Boys had higher PA levels than girls, PA increased with age, and PA was higher during spring/summer than autumn/winter (P < 0.001). Boys had a greater increase in PA by age than girls (P < 0.05), mainly due to increased MVPA during spring/summer (p for sex × age × season=0.009).

CONCLUSIONS

Boys were consistently more active and less sedentary than girls, and PA increased with age for both sexes. Boys exhibited a greater increase than girls in PA by age, and PA differed across seasons, with higher levels of MVPA during spring/summer. Differences in MVPA between boys and girls, among age groups, and among seasons seem to be interrelated, indicating that many factors influence preschoolers' PA.

Accelerometry-measured physical activity and sedentary behaviour of preschoolers in Nova Scotia, Canada

The objective of this study was to describe the levels and bouts of physical activity (PA) and sedentary behaviour (SB) among preschoolers in Nova Scotia, Canada, and the proportion meeting PA and step guidelines. Children (75 boys, 49 girls; mean age = 4.2 (range = 3-5 years)) participating in the Physical Literacy in the Early Years (PLEY) study provided data. Average time (minutes, % of day) spent sedentary, in light PA (LPA), moderate-to-vigorous PA (MVPA), and total PA; average frequency; and duration of bouts of MVPA (≥5 min, ≥10 min) and sedentary bouts (≥10 min) per day were determined using published cut-points, using 15-s epochs. The proportion of children meeting PA and step guidelines was determined, and differences by sex explored. Children spent the majority (70.8%) of their day active; nearly all (≥97%) met PA guidelines. Most children met step guidelines on a weekly basis, but not daily. Only LPA differed by sex (greater in girls; p = 0.001). Little time was spent in sustained SB (bouts ≥10 min). Boys had greater and longer bouts of MVPA and spent more of their day in these (p < 0.05). Girls spent less time in sustained SB (p = 0.009). This is the first study to describe the PA and SB of Nova Scotia preschoolers using accelerometry. Findings suggest preschoolers spend the majority of their day active, and that there are sex-related differences in PA and SB, warranting further examination.

Like father, like son. Physical Activity, Dietary Intake, and Media Consumption in Pre-School-Aged Children

An imbalance between energy input and energy needs contributes to the growing incidence of overweight children. Pre-schoolers normally like to move, but even at this young age, they are already affected by a lack of physical activity and a high amount of screen time. Media consumption contributes to unhealthy diets and extends the length of time spent sitting. Longer periods of sitting are, independent of the level of activity, seen as a risk factor for the development of obesity. In the present study, 160 pre-schoolers and their parents (128 mothers, 121 fathers) were examined. The results show deviations from actual recommendations regarding physical activity, time spent sitting, dietary intake, and media consumption. Increased screen time was associated with a higher weight status among pre-school-aged children. To provide a healthy upbringing, prevention and intervention measures should be implemented on a behavioral and relational level.