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Contardo Ayala AM, Ridgers ND, Timperio A, Arundell L, Dunstan DW, Hesketh KD, Daly RM, Salmon J. The association between device-measured sitting time and cardiometabolic health risk factors in children. BMC Public Health 2024; 24:1015. [PMID: 38609909 PMCID: PMC11010425 DOI: 10.1186/s12889-024-18495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND There is limited evidence of the associations between postural-derived sitting time, waist-worn derived sedentary time and children's health and the moderation effect of physical activity (PA). This study examined associations of children's device-measured sitting time with cardiometabolic health risk factors, including moderation by physical activity. METHODS Cross-sectional baseline data from children (mean-age 8.2 ± 0.5 years) in Melbourne, Australia (2010) participating in the TransformUs program were used. Children simultaneously wore an activPAL to assess sitting time and an ActiGraph GT3X to assess sedentary time and physical activity intensity. Cardiometabolic health risk factors included: adiposity (body mass index [BMI], waist circumference [WC]), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglycerides, fasting plasma glucose (FPG), serum insulin, and 25-hydroxyvitaminD (25[OH]D). Linear regression models (n = 71-113) assessed associations between sitting time with each health risk factor, adjusted for different PA intensities (i.e. light [LIPA], moderate-vigorous intensities [MVPA], separately on each model), age, sex, adiposity, and clustering by school. Interaction terms examined moderation. The analyses were repeated using device-measured sedentary time (i.e. ActiGraph GT3X) for comparison. RESULTS Sitting time was positively associated with SBP (b = 0.015; 95%CI: 0.004, 0.026), DBP (b = 0.012; 95%CI:0.004, 0.020), and FPG (b = 0.001; 95%CI: 0.000, 0.000), after adjusting for higher PA intensities. The association between sitting time and insulin (b = 0.003; 95%CI: 0.000, 0.006) was attenuated after adjusting for higher PA intensities. When the models were adjusted for LIPA and MVPA, there was a negative association with LDL (b=-0.001; 95%CI: -0.002, -0.000 and b=-0.001; 95%CI: -0.003, -0.000, respectively). There was a negative association of sedentary time with WCz (b=-0.003; 95%CI: -0.005, 0.000) and BMIz (b=-0.003; 95%CI: -0.006, -0.000) when the models were adjusted by MVPA. Sedentary time was positively associated with triglycerides (b = 0.001; 95%CI: 0.000, 0.001) but attenuated after adjusting for MVPA. No evidence of moderation effects was found. CONCLUSIONS Higher volumes of sitting and sedentary time were associated with some adverse associations on some cardiometabolic health risk factors in children. These associations were more evident when sitting time was the predictor. This suggests that reducing time spent sitting may benefit some cardiometabolic health outcomes, but future experimental research is needed to confirm causal relationships and identify the biological mechanisms that might be involved. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12609000715279.
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Affiliation(s)
- Ana María Contardo Ayala
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - David W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
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Xie ZW, Wang LJ, Chen H, Liang G, Yang XL. Accelerometer-measured sedentary volume and bouts during the segmented school day among Chinese school students. J Exerc Sci Fit 2024; 22:145-151. [PMID: 38435333 PMCID: PMC10907796 DOI: 10.1016/j.jesf.2024.02.003] [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: 11/05/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background This study examined sedentary volume and bouts of Chinese primary and middle school students during different segments of a school day and determined whether gender and school level are associated with their sedentary volume and bouts. Methods A total of 472 students participated in this study. Accelerometers were used to measure the sedentary volume and sedentary bouts of different durations (i.e., 1-4 min, 5-9 min and ≥10 min) during all segments. Results The participants spent the majority of their time in sitting (61.7%) and sitting bouts of ≥10 min (37.3%). They spent higher percentages of time in sitting during regular classes (76.7%) and out-of-school time (54.5%), and lower during physical education (PE) classes (32.2%), lunch break (35.4%) and recess (38.0%). The highest proportions of time were in sedentary bouts of ≥10 min during regular classes (50.2%), out-of-school time (28.0%) and lunch break (18.8%), while the greatest percentages occurred in sitting bouts of 1-4 min during PE class (16.4%) and recess (18.6%). Girls and middle school students had higher percentages of sedentary volume than boys and primary school students during most segments. They spent greater proportions of time in sitting bouts of ≥10 min during regular classes, lunch break, and out-of-school time, and higher proportions in sedentary bouts of 1-4 min than boys and primary students during PE classes. Conclusion Regular class and out-of-school time were identified as key segments for reducing sedentary volume and breaking up prolonged sitting. Interventions on interrupting prolonged sitting during lunch break should also be explored. Girls and middle school students should receive more attention in future interventions.
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Affiliation(s)
- Zhen-wen Xie
- Shanghai University of Sport, School of Physical Education, 200 Hengren Street, Yangpu District, Shanghai, CN 200438, China
| | - Li-juan Wang
- Shanghai University of Sport, School of Physical Education, 200 Hengren Street, Yangpu District, Shanghai, CN 200438, China
| | - Huan Chen
- Shanghai University of Sport, School of Physical Education, 200 Hengren Street, Yangpu District, Shanghai, CN 200438, China
| | - Guo Liang
- Shanghai University of Sport, School of Physical Education, 200 Hengren Street, Yangpu District, Shanghai, CN 200438, China
| | - Xing-long Yang
- Shanghai University of Sport, School of Physical Education, 200 Hengren Street, Yangpu District, Shanghai, CN 200438, China
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Tallon CM, Nowak‐Flück D, Reiger MG, Green DJ, Tremblay MS, Ainslie PN, McManus AM. Exercise breaks prevent attenuation in cerebrovascular function following an acute bout of uninterrupted sitting in healthy children. Exp Physiol 2023; 108:1386-1399. [PMID: 37731204 PMCID: PMC10988444 DOI: 10.1113/ep091314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023]
Abstract
The purpose of this study was to examine the effect of an acute bout of prolonged sitting with and without exercise breaks on cerebrovascular function in 7- to 13-year-old children. Forty-two children and adolescents were recruited to a crossover trial, with 15 girls (mean age 10.1 ± 2.5 years) and 16 boys (mean age 10.5 ± 1.3 years) completing the two trial conditions: SIT, uninterrupted sitting for 3 h and CYCLE, 3 h of sitting interrupted hourly with a 10-min moderate intensity exercise break. Cerebrovascular function was measured Pre and Post SIT and CYCLE from blood flow (Q ̇ ${\dot{Q}}$ ), diameter, and shear rate of the internal carotid artery (ICA) at rest and in response to CO2 . Blood velocity in the middle (MCA) and posterior (PCA) cerebral arteries was assessed at rest, during a neurovascular coupling task (NVC) and in response to CO2 . We demonstrate that SIT but not CYCLE reduced ICA cerebrovascular reactivity to CO2 (%Δ ICAQ ̇ ${\dot{Q}}$ /Δ end-tidal CO2 : SIT: Pre 5.0 ± 2.4%/mmHg to Post 3.3 ± 2.8%/mmHg vs. CYCLE: Pre 4.4 ± 2.3%/mmHg to Post 5.3 ± 3.4%/mmHg, P = 0.05) and slowed the MCA blood velocity onset response time to hypercapnia (SIT: Pre 57.2 ± 32.6 s to Post 76.6 ± 55.2 s, vs. CYCLE: Pre 64.1 ± 40.4 s to Post 52.3 ± 28.8 s, P = 0.05). There were no changes in NVC. Importantly, breaking up prolonged sitting with hourly exercise breaks prevented the reductions in cerebrovascular reactivity to CO2 and the slowed intracranial blood velocity onset response time to hypercapnia apparent with uninterrupted sitting in children. NEW FINDINGS: What is the central question of this study? What are the effects of interrupting prolonged sitting on cerebrovascular function in children? What is the main finding and its importance? Prolonged sitting results in declines in cerebrovascular reactivity, a valuable index of cerebrovascular health. Breaking up prolonged sitting with hourly 10 min exercise breaks prevented these changes. These initial findings suggest excessive sedentary behaviour does impact cerebrovascular function in childhood, but taking exercise breaks prevents declines.
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Affiliation(s)
- Christine M. Tallon
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise SciencesUniversity of British ColumbiaKelownaBritish ColumbiaCanada
| | - Daniela Nowak‐Flück
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise SciencesUniversity of British ColumbiaKelownaBritish ColumbiaCanada
| | - Mathew G. Reiger
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise SciencesUniversity of British ColumbiaKelownaBritish ColumbiaCanada
| | - Daniel J. Green
- School of Human Science (Sport and Exercise Sciences)The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Mark S. Tremblay
- Children's Hospital of Eastern Ontario Research InstituteOttawaOntarioCanada
| | - Phil N. Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise SciencesUniversity of British ColumbiaKelownaBritish ColumbiaCanada
| | - Ali M. McManus
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise SciencesUniversity of British ColumbiaKelownaBritish ColumbiaCanada
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Milther C, Winther L, Stahlhut M, Curtis DJ, Aadahl M, Kristensen MT, Sørensen JL, Dall CH. Validation of an accelerometer system for measuring physical activity and sedentary behavior in healthy children and adolescents. Eur J Pediatr 2023; 182:3639-3647. [PMID: 37258775 PMCID: PMC10460328 DOI: 10.1007/s00431-023-05014-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 06/02/2023]
Abstract
The study aims to assess the concurrent validity of the SENS motion® accelerometer system for device-based measurement of physical activity and sedentary behavior in healthy children and adolescents. Thirty-six healthy children and adolescents (mean ± standard deviation (SD) age, 10.2 ± 2.3 years) were fitted with three SENS sensors while performing standardized activities including walking, fast walking, sitting/lying, and arm movements. Data from the sensors were compared with video observations (reference criteria). The agreement between SENS motion® and observation was analyzed using Student's t-test and illustrated in Bland-Altman plots. The concurrent validity was further evaluated using intraclass correlation coefficient (ICC) and was expressed as standard error of measurement (SEM) and minimal detectable change (MDC). Strong agreement was found between SENS and observation for walking time, sedentary time, and lying time. In contrast, moderate agreement was observed for number of steps, sitting time, and time with and without arm movement. ICC2.1 values were overall moderate to excellent (0.5-0.94), with correspondingly low SEM% for walking time, sedentary time, lying time, and time with arm movement (2-9%). An acceptable SEM% level was reached for both steps and sitting time (11% and 12%). For fast walking time, the results showed a weak agreement between the measurement methods, and the ICC value was poor. CONCLUSION SENS motion® seems valid for detecting physical activity and sedentary behavior in healthy children and adolescents with strong agreement and moderate to excellent ICC values. Furthermore, the explorative results on arm movements seem promising. WHAT IS KNOWN • Inactivity and sedentary behavior follow an increasing trend among children and adolescents. • SENS motion® seems to be valid for measuring physical activity and sedentary behavior in adults and elderly patients. WHAT IS NEW • SENS motion® seems valid with strong agreement between video observations and SENS measurement, and ICC values are moderate to excellent when measuring physical activity and sedentary behavior in healthy children and adolescents. • SENS motion® seems promising for detection of arm movements.
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Affiliation(s)
- Camilla Milther
- Juliane Marie Centre and Mary Elizabeths Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Lærke Winther
- Juliane Marie Centre and Mary Elizabeths Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Michelle Stahlhut
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Derek John Curtis
- Child Centre Copenhagen, The Child and Youth Administration, City of Copenhagen, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Morten Tange Kristensen
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Jette Led Sørensen
- Juliane Marie Centre and Mary Elizabeths Hospital, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Have Dall
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
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Burahmah E, Shanmugam S, Williams D, Stansfield B. Validity and Reliability of the activPAL4 TM for Measurement of Body Postures and Stepping Activity in 6-12-Year-Old Children. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094555. [PMID: 37177759 PMCID: PMC10181769 DOI: 10.3390/s23094555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/28/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
A link between inappropriate physical behaviour patterns (low physical activity and high sedentary behaviour) and poor health outcomes has been observed. To provide evidence to quantify this link, it is important to have valid and reliable assessment tools. This study aimed to assess the validity and reliability of the activPAL4TM monitor for distinguishing postures and measuring stepping activity of 6-12-year-old children. Thirteen children (8.5 ± 1.8 years) engaged in pre-determined standardised (12 min) and non-standardised (6 min) activities. Agreement, specificity and positive predictive value were assessed between the activPAL4TM and direct observation (DO) (nearest 0.1 s). Between-activPAL4TM (inter-device) and between-observer (inter-rater) reliability were determined. Detection of sitting and stepping time and forward purposeful step count were all within 5% of DO. Standing time was slightly overestimated (+10%) and fast walking/jogging steps underestimated (-20%). For non-standardised activities, activPAL4TM step count matched most closely to combined backward and forward purposeful steps; however, agreement varied widely. The activPAL4TM demonstrated high levels of reliability (ICC(1, 1) > 0.976), which were higher in some instances than could be achieved through direct observation (ICC(2, 1) > 0.851 for non-standardised activities). Overall, the activPAL4TM recorded standardised activities well. However, further work is required to establish the exact nature of steps counted by the activPAL4TM.
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Affiliation(s)
- Esraa Burahmah
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Sivaramkumar Shanmugam
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Daniel Williams
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Ben Stansfield
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
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Salmon J, Arundell L, Cerin E, Ridgers ND, Hesketh KD, Daly RM, Dunstan D, Brown H, Della Gatta J, Della Gatta P, Chinapaw MJM, Shepphard L, Moodie M, Hume C, Brown V, Ball K, Crawford D. Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers. Br J Sports Med 2023; 57:311-319. [PMID: 36428089 PMCID: PMC9985722 DOI: 10.1136/bjsports-2022-105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the efficacy of the Transform-Us! school- and home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. METHODS A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed. RESULTS At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI: -47.3 to -5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI: -50.6 and -16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters. CONCLUSIONS The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging. TRIAL REGISTRATION ISRCTN83725066; ACTRN12609000715279.
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Affiliation(s)
- Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Lauren Arundell
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University Faculty of Health Sciences, Melbourne, Victoria, Australia
| | - Nicola Dawn Ridgers
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Robin M Daly
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - David Dunstan
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Helen Brown
- School of Exercise and Nutrition Sciences, Deakin University Centre for Sport Research, Geelong, Victoria, Australia
| | - Jacqui Della Gatta
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Paul Della Gatta
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lauren Shepphard
- Institute for Health Transformation, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Marj Moodie
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Clare Hume
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vicki Brown
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Kylie Ball
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - David Crawford
- School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
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McLellan G, Arthur R, Donnelly S, Bakshi A, Fairclough SJ, Taylor SL, Buchan DS. Feasibility and Acceptability of a Classroom-Based Active Breaks Intervention for 8-12-Year-Old Children. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:813-824. [PMID: 34748469 DOI: 10.1080/02701367.2021.1923627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/23/2021] [Indexed: 06/13/2023]
Abstract
Purpose: This study explored the feasibility of conducting a classroom-based active breaks intervention on sedentary behavior (SB), physical activity (PA) and attention in 8-12-year-old children. Methods: Eight schools were randomized on a 1:1 basis to the control or intervention. Teachers selected 10 cards detailing an activity break at random. Children then undertook each of the ten activity breaks for 30 s, three times per day for 6 weeks. School and participant recruitment, attrition rates, percentage of outcome measures collected, and acceptability were used to explore the feasibility of the study. Mixed effects models were undertaken to examine intervention effects upon measures of PA, SB and attention. Results: Two hundred and thirty-nine consent forms were issued and 153 were returned (64%). Of the 153 consents, 146 children (95%) were measured at baseline, and 117 participated in the follow-up measures (80%) 6 weeks later suggesting the intervention was acceptable for the participants. From teacher interviews, it was noted that the intervention was feasible to implement, and teachers observed positive classroom behavior changes in children. Inclusion rates for outcome measures ranged from 49% to 66%. Significant, intervention effects were observed for sitting time (B = -27.19; 95%CI: -36.84, -17.17), standing time (B = 23.51; 95%CI 14.1, 32.45) and the number of sit to stand transitions (B = 16.1; 95%CI 4.7, 26.79). Conclusion: Findings suggest that it was feasible and acceptable to implement an active breaks intervention within the classroom setting. Future work should consider the effectiveness of implementing this intervention across a full academic year.
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Affiliation(s)
| | - Rosie Arthur
- The University of the West of Scotland, Lanarkshire Campus
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Alkalih HY, Pesola AJ, Arumugam A. A new accelerometer (Fibion) device provides valid sedentary and upright time measurements compared to the ActivPAL4 in healthy individuals. Heliyon 2022; 8:e11103. [PMID: 36281387 PMCID: PMC9586911 DOI: 10.1016/j.heliyon.2022.e11103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/03/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Thigh-worn accelerometers can accurately measure time spent sitting, standing and walking in free-living settings. Aim To investigate the concurrent validity of a new Fibion accelerometer and a validated ActivPAL4 accelerometer for estimating sedentary and upright time in healthy individuals. Methods A total of 29 healthy individuals, aged between 18 and 50 years, wore the Fibion and ActivPAL4 devices on the same thigh with a medical adhesive tape during one typical weekday. Concurrent validity of the Fibion and ActivPAL4 was assessed by comparing time spent in sitting, walking and standing using intraclass correlation coefficient and Bland-Altman plots. Results Intraclass correlation coefficients were ≥0.843 which indicated good to excellent validity between the two devices for measuring sedentary (sitting) and upright (standing and walking) time. Analysis of the Bland Altman plots revealed a reasonable agreement for sitting, standing and walking time between both devices. No proportional bias was evident in the Bland-Altman plots. Conclusion The Fibion demonstrated good to excellent validity in measuring sedentary and upright time compared to the ActivPAL4 in healthy individuals.
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Affiliation(s)
- Hanan Youssef Alkalih
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
| | - Arto J. Pesola
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Finland
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates,Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates,Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates,Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India,Corresponding author:
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Carlson JA, Ridgers ND, Nakandala S, Zablocki R, Tuz-Zahra F, Bellettiere J, Hibbing PR, Steel C, Jankowska MM, Rosenberg DE, Greenwood-Hickman MA, Zou J, LaCroix AZ, Kumar A, Natarajan L. CHAP-child: an open source method for estimating sit-to-stand transitions and sedentary bout patterns from hip accelerometers among children. Int J Behav Nutr Phys Act 2022; 19:109. [PMID: 36028890 PMCID: PMC9419346 DOI: 10.1186/s12966-022-01349-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hip-worn accelerometer cut-points have poor validity for assessing children's sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. METHODS Participants were 278, 8-11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). RESULTS Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. CONCLUSIONS There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children.
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Affiliation(s)
- Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA.
- Department of Pediatrics, University of Missouri - Kansas City, Kansas City, MO, USA.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Supun Nakandala
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Rong Zablocki
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Fatima Tuz-Zahra
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Paul R Hibbing
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Jingjing Zou
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Arun Kumar
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
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Barboza LLS, Werneck AO, Ohara D, Ronque ERV, Romanzini M, Silva DRPD. Comparison between ActiGraph GT3X and ActivPAL to assess sedentary behavior during the school period. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220012021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tallon CM, Smith KJ, Nowak-Flück D, Koziol AV, Rieger MG, Lutes LD, Green DJ, Tremblay MS, Ainslie PN, McManus AM. The influence of sex and maturation on carotid and vertebral artery hemodynamics and associations with free-living (in)activity in 6-17-year-olds. J Appl Physiol (1985) 2021; 131:1575-1583. [PMID: 34617820 DOI: 10.1152/japplphysiol.00537.2021] [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: 11/22/2022] Open
Abstract
We explored the influence of sex and maturation on resting cervical artery hemodynamics (common carotid artery, CCA; internal carotid artery, ICA; and vertebral artery, VA), free-living physical activity, and sedentary behavior in children 6-17 yr of age. In addition, we investigated the relationship between physical activity, sedentary behavior, and cervical artery hemodynamics. Seventy-eight children and adolescents, girls (n = 42; mean age, 11.4 ± 2.5 yr) and boys (n = 36; mean age, 11.0 ± 2.6 yr), completed anthropometric measures, duplex ultrasound assessment of the cervical arteries, and wore an activPAL accelerometer to assess physical activity (indexed by steps/day) and sedentary behavior for 7 days. The ICA and VA diameters were similar between prepubertal and pubertal groups, as was volumetric blood flow (Q); however, the CCA diameter was significantly larger in the pubertal group (P < 0.05). Boys were found to have larger diameters in all cervical arteries than girls, as well as higher QCCA, QICA, and global cerebral blood flow (P < 0.05). The pubertal group was more sedentary (100 min/day more; P < 0.05) and took 3,500 fewer steps/day than the prepubertal group (P < 0.05). Shear rate (SR) and Q of the cervical arteries showed no relationship to physical activity or prolonged bouts of sedentary behavior; however, a significant negative relationship was apparent between total sedentary time and internal carotid artery shear rate (ICASR) after covarying for steps/day and maturation (P < 0.05). These findings provide novel insight into the potential influence sedentary behavior may have on cerebrovascular blood flow in healthy girls and boys.NEW & NOTEWORTHY Cerebral blood flow is known to change with age; however, assessing these age-related changes is complex and requires consideration of pubertal status. This, to our knowledge, is the first study to investigate the influence of sex and maturation on resting cervical artery hemodynamics and subsequently explore associations with physical activity and sedentary behavior in healthy children and adolescents. Our findings suggest that habitual sedentary behavior may influence cervical artery hemodynamics in youth, independent of physical activity, maturation, and sex.
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Affiliation(s)
- Christine M Tallon
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kurt J Smith
- Cerebrovascular Health, Exercise, and Environmental Research Sciences Laboratory, School of Exercise Science and Physical Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Daniela Nowak-Flück
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Alyssa V Koziol
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Mathew G Rieger
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Lesley D Lutes
- Department of Psychology, Centre for Obesity and Well-Being Research Excellence, University of British Columbia, Kelowna, British Columbia, Canada
| | - Daniel J Green
- School of Human Science (Sport and Exercise Science), The University of Western Australia, Perth, Western Australia, Australia
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ali M McManus
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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Effects of Physically Active Lessons on Movement Behaviors, Cognitive, and Academic Performance in Elementary Schoolchildren: ERGUER/Aracaju Project. J Phys Act Health 2021; 18:757-766. [PMID: 34030123 DOI: 10.1123/jpah.2020-0604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To evaluate the effects of the introduction of physically active lessons on movement behaviors, cognitive, and academic performance in schoolchildren. METHODS This was a cluster-controlled trial. A total of 61 students from the second year of elementary school in a public school in Brazil made up 2 intervention classes (n = 34) with the introduction of physically active lessons and 2 control classes (n = 27). Sedentary behavior, physical activity, cognitive, and academic performance were evaluated in 3 moments, which were compared using models of generalized estimating equations. RESULTS The intervention was effective for reducing the standing time between the baseline and 3 months while increasing the walking time between baseline and 3 months and baseline and 9 months. There was a reduction in time in stationary activities and increased time in light physical activities between all moments. The intervention group increased their performance in the go/no go test, showing a smaller number of errors between the baseline and 3 months and baseline and 9 months, and a reduction in the test time between baseline and 3 months. No impact on students' academic performance was observed. CONCLUSION Physically active lessons improve movement behaviors and cognitive functions among elementary schoolchildren.
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Kracht CL, Beyl RA, Maher JP, Katzmarzyk PT, Staiano AE. Adolescents' sedentary time, affect, and contextual factors: An ecological momentary assessment study. Int J Behav Nutr Phys Act 2021; 18:53. [PMID: 33858416 PMCID: PMC8047569 DOI: 10.1186/s12966-021-01121-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect. METHODS Adolescents (n = 284; 10-16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates. RESULTS Adolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p < 0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p < 0.001). CONCLUSIONS Both contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent's positive affect in home settings.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Jaclyn P Maher
- University of North Carolina Greensboro, 1408 Walker Ave., Greensboro, NC, 27412, USA
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Taylor JB, Ford KR, Queen RM, Owen EC, Gisselman AS. Incorporating Internal and External Training Load Measurements in Clinical Decision Making After ACL Reconstruction: A Clinical Commentary. Int J Sports Phys Ther 2021; 16:565-578. [PMID: 33842052 PMCID: PMC8016425 DOI: 10.26603/001c.21152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/11/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND PURPOSE Poor outcomes after anterior cruciate ligament reconstruction (ACLr), including the relatively high risk of suffering a subsequent ACL injury, suggest the need to optimize rehabilitation and return-to-sport testing. The purpose of this commentary is to introduce clinicians to the concept of monitoring training load during rehabilitation, to review methods of quantifying internal and external loads, and to suggest ways that these technologies can be incorporated into rehabilitation progressions and return-to-sport decisions after anterior ACLr. DESCRIPTION OF TOPIC WITH RELATED EVIDENCE Quantifying and identifying the effects of training load variables, external (distance, impacts, decelerations) and internal (heart rate, heart rate variability) workload, during rehabilitation can indicate both positive (improved physical, physiological, or psychological capacity) or negative (heightened risk for injury or illness) adaptations and allow for the ideal progression of exercise prescription. When used during return-to-sport testing, wearable technology can provide robust measures of movement quality, readiness, and asymmetry not identified during performance-based testing. DISCUSSION / RELATION TO CLINICAL PRACTICE Researchers have reported the actual in-game demands of men and women of various ages and competition levels during multi-directional sport. Wearable technology can provide similar variables during rehabilitation, home exercise programs, and during on-field transition back to sport to ensure patients have met the expected fitness capacity of their sport. Additionally, clinicians can use internal load measures to objectively monitor patient's physiological responses to rehabilitation progressions and recovery rather than relying on subjective patient-reported data. LEVEL OF EVIDENCE 5.
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Design and validation of a smart garment to measure positioning practices of parents with young infants. Infant Behav Dev 2021; 62:101530. [PMID: 33548894 DOI: 10.1016/j.infbeh.2021.101530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/26/2022]
Abstract
The aim of this cross-sectional study was to evaluate the feasibility, construct validity, and reliability of a smart garment to characterize parent-child positioning practices in infants less than six months old. The smart garment (Get Around Garment, GG) was developed through feedback from seven infants and their parents. The final system was then tested with sixteen infants (M = 3.1 ± 1.1 months) assessed in their homes during one visit that consisted of a: 1) Structured Play Assessment (2.5 min): infant was placed in each of five positions (prone, supine, reclined/inclined, and upright) for 30 s, 2) Free Play Assessment (40-60 min): parents were asked to engage in typical daily activities, and 3) second Structured Play Assessment. Infants' body position was both coded from video and identified from sensor data using a custom program. Feasibility was measured by data from a Daily Wearing Log and Garment Perception Questionnaire. Validity was evaluated by comparing the coding and sensor data. Reliability was measured by comparing the sensor data between the two Structured Play Assessments. The GG was considered feasible for use. The smart wearable system showed high levels of accuracy for classifying body position secondby- second and when comparing cumulative duration across time. Reliability of the smart garment was excellent. Young infants spent more time in supine and supported upright positions relative to prone, reclined, or inclined positions. The results suggest that accelerometers can be integrated into garments in a manner that is feasible to provide accurate and consistent data about positioning practices of parents with young infants. Monitoring early positioning practices is important because these practices impact future motor and cognitive developmental trajectories.
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Fisher D, Louw Q, Thabane L. Sedentariness and Back Health in Western Cape Primary School Students: Protocol for a Pragmatic Stepped-Wedge Feasibility Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18522. [PMID: 33089783 PMCID: PMC7735899 DOI: 10.2196/18522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 11/17/2022] Open
Abstract
Background Despite growing evidence of deleterious health outcomes associated with sedentary behavior, prolonged static sitting in classrooms remains ubiquitous in primary schools. Sedentary behavior is associated with the development of cardio-metabolic conditions and poor back health. Preventative strategies to reduce sedentary behavior and its negative health effects may be required in a resource-constrained environment such as South Africa. Objective The primary objective of this study is to assess the feasibility of conducting a full trial to evaluate the effects of a multifaceted intervention comprising novel multifunctional classroom furniture and a video-based curriculum versus usual care on sedentary behavior among students aged 10-11 years in primary schools. The secondary objective is to assess the preliminary effects of the intervention on sedentary behavior and postural dynamism. Methods Eighty grade 5 or 6 students, aged 10 and 11 years, in mixed-gender schools within the Western Cape metropolitan urban area in Cape Town, South Africa are eligible to participate in this pilot cluster stepped-wedge trial design with classroom as the unit of randomization. Data will be collected at the schools. The intervention will comprise multifunctional classroom furniture that allows for sitting and standing as well as a video-based curriculum on sedentary behavior. Usual practice is the absence of the intervention. The primary outcomes assessed will be (1) adherence to the intervention and (2) project pragmatics. The secondary outcomes will be (1) sedentariness measured using activPAL3 microsensors and (2) postural dynamism measured using Noraxon Myomotion inertial measurement units. We randomized the school to the first or second start of the intervention. This is an open-label trial and therefore blinding will not be possible for any group. Descriptive analysis of the feasibility and physiological outcomes will be presented. We will report the preliminary estimates of the effects of the intervention on sedentariness and postural dynamism using the mean difference and 95% CI. Results At the time of submission, two classrooms have been recruited into the study. Baseline physical activity and postural dynamism data have been collected from 10 participants from each class. Conclusions The results of this feasibility stepped-wedge cluster randomized controlled trial will be useful in informing the design of the main trial to assess whether this multifaceted intervention of multifunctional classroom furniture that allows for sitting and standing as well as a video-based curriculum versus usual care has any effect on sedentary behavior in low-resource-setting primary schools. Trial Registration Pan African Trials Registry PACTR201811799476016; https://tinyurl.com/y4upoys8 International Registered Report Identifier (IRRID) RR1-10.2196/18522
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Affiliation(s)
- Dominic Fisher
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette Louw
- Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact (formerly the Department of Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, ON, Canada.,Departments of Anesthesia and Pediatrics, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, St Joseph's Healthcare, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
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DiPietro L, Al-Ansari SS, Biddle SJH, Borodulin K, Bull FC, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Willumsen JF. Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group. Int J Behav Nutr Phys Act 2020; 17:143. [PMID: 33239105 PMCID: PMC7690200 DOI: 10.1186/s12966-020-01042-2] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In July, 2019, the World Health Organization (WHO) commenced work to update the 2010 Global Recommendations on Physical Activity for Health and established a Guideline Development Group (GDG) comprising expert public health scientists and practitioners to inform the drafting of the 2020 Guidelines on Physical Activity and Sedentary Behavior. The overall task of the GDG was to review the scientific evidence and provide expert advice to the WHO on the amount of physical activity and sedentary behavior associated with optimal health in children and adolescents, adults, older adults (> 64 years), and also specifically in pregnant and postpartum women and people living with chronic conditions or disabilities. METHODS The GDG reviewed the available evidence specific to each sub-population using systematic protocols and in doing so, identified a number of gaps in the existing literature. These proposed research gaps were discussed and verified by expert consensus among the entire GDG. RESULTS Evidence gaps across population sub-groups included a lack of information on: 1) the precise shape of the dose-response curve between physical activity and/or sedentary behavior and several of the health outcomes studied; 2) the health benefits of light-intensity physical activity and of breaking up sedentary time with light-intensity activity; 3) differences in the health effects of different types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; screen time; television viewing); and 4) the joint association between physical activity and sedentary time with health outcomes across the life course. In addition, we acknowledge the need to conduct more population-based studies in low- and middle-income countries and in people living with disabilities and/or chronic disease, and to identify how various sociodemographic factors (age, sex, race/ethnicity, socioeconomic status) modify the health effects of physical activity, in order to address global health disparities. CONCLUSIONS Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda.
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Affiliation(s)
- Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
| | | | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - Katja Borodulin
- Age Institute, Helsinki, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Fiona C Bull
- Physical Activity Unit, Department of Health Promotion, World Health Organization, Geneva, Switzerland
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, USA
| | - Greet Cardon
- Department of Movement and Sports Sciences, University of Ghent, Ghent, Belgium
| | - Catherine Carty
- UNESCO Chair, Institute of Technology Tralee, Tralee, Ireland
| | - Jean-Philippe Chaput
- Department of Pediatrics, University of Ottawa, Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Group, Ontario, Canada
| | - Sebastien Chastin
- School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Roger Chou
- Departments of Medicine, and Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Paddy C Dempsey
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Ulf Ekelund
- Department of Chronic Disease and Ageing, Norwegian Institute of Public Health, Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Canada
| | - Leandro Garcia
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Muthoni Gichu
- Department of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Russell Jago
- Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Peter T Katzmarzyk
- Population and Public Health Sciences, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Estelle Lambert
- Research Centre for Health through Physical Acivity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Karen Milton
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Francisco B Ortega
- PROFITH (PROmoting FITness and Health through physical activity) research group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Spain 26. Sports and Exercise Medicine Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chathuranga Ranasinghe
- Charles Perkins Centre, University of Sydney, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Emmanuel Stamatakis
- Institute for Musculoskeletal Health, The University of Sydney, and Sydney Local Health District, Sydney, Australia
| | - Anne Tiedemann
- Epidemiology and Genomics Research Program, National Cancer Institute, Bethesda, USA
| | - Richard P Troiano
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Juana F Willumsen
- Physical Activity Unit, Department of Health Promotion, World Health Organization, Geneva, Switzerland
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Bernal CMM, Lhuisset L, Fabre N, Bois J. School-Based Multicomponent Intervention to Promote Physical Activity and Reduce Sedentary Time of Disadvantaged Children Aged 6-10 Years: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e17815. [PMID: 32965238 PMCID: PMC7542411 DOI: 10.2196/17815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/28/2020] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background In our modern society, physical activity (PA) is decreasing and sedentary time (ST) is increasing, especially for children from disadvantaged neighborhoods. School-based interventions to promote PA and decrease ST are therefore required among this population in order to change children’s lifestyle habits. Moreover, attentional capacities and academic achievement can be enhanced by chronic PA during childhood. The relationships between these variables have been poorly studied with this population. Objective The objective of this study is to present the rationale and methods for a randomized controlled trial among 6-10-year-old children with low socioeconomic status that will (1) evaluate the effectiveness of a school-based intervention designed to promote PA and reduce ST and (2) study the relationships between PA, ST, motor skills, attentional capacities, and academic achievement. Methods A randomized controlled trial was conducted in 2 eligible primary schools. During academic year 2016-2017, 1 school was randomly assigned as the experiment one and the other was assigned as the control one. Five assessments times were used: baseline (T1 [November 2016] to T2 [June 2017]), follow-up (T3 [November 2017] to T4 [June 2018]), and final assessment (T5 [June 2019]). The school-based intervention included various components on different levels of the socioecological model: (1) curriculum-based program for children; (2) sensitization workshops and newsletters for parents; (3) training workshops for teachers; (4) environmental adaptation of playgrounds and reorganization of recess time; (5) time adaptation of lunch breaks; and (6) collaboration with political groups. PA, ST, motor skills, and attentional capacities were evaluated and academic achievement was recorded. Results The presented intervention and its different assessments have been successfully implemented. In order to achieve the 2 objectives of this randomized controlled trial, data analyses are about to be completed. Conclusions The implementation of this randomized controlled trial can help to determine effective strategies to promote PA in the context of increasing prevalence of physical inactivity among children with sedentary lifestyle which will be useful for researchers, stakeholders, and public policy makers. Trial Registration ClinicalTrials.gov NCT03983447; https://clinicaltrials.gov/ct2/show/NCT03983447 International Registered Report Identifier (IRRID) RR1-10.2196/17815
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Affiliation(s)
| | - Lena Lhuisset
- Universite de Pau & des Pays de l'Adour, e2s UPPA, MEPS, Tarbes, France
| | - Nicolas Fabre
- Universite de Pau & des Pays de l'Adour, e2s UPPA, MEPS, Tarbes, France
| | - Julien Bois
- Universite de Pau & des Pays de l'Adour, e2s UPPA, MEPS, Tarbes, France
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Verswijveren SJJM, Salmon J, Daly RM, Arundell L, Cerin E, Dunstan DW, Hesketh KD, Della Gatta PA, Ridgers ND. Reallocating sedentary time with total physical activity and physical activity bouts in children: Associations with cardiometabolic biomarkers. J Sports Sci 2020; 39:332-340. [PMID: 32960145 DOI: 10.1080/02640414.2020.1822584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This cross-sectional study examined theoretical effects of reallocating sedentary time (SED) with total physical activity, and physical activity bouts of varying intensities, on children's cardiometabolic biomarkers. Baseline data from the Transform-Us! trial (Melbourne, Australia) was used. Participant data were included if accelerometer and blood biomarker data were complete (n = 169; 8.7 [0.4] years; 56% girls). Isotemporal substitution models assessed the impact of replacing 10 minutes of SED with 10 minutes of total physical activity or physical activity in bouts of varying intensities on cardiometabolic biomarkers. In adjusted models, replacing 10 minutes of SED with vigorous-intensity physical activity (VPA) was associated with lower triglycerides in the whole sample. Replacing SED with VPA was associated with better high-density lipoprotein cholesterol (HDL-C) and triglycerides in children with healthy weight. Replacing SED with MPA was associated with better homoeostatic model assessment of insulin resistance (HOMA-IR) and HDL-C, in children with healthy weight and overweight, respectively. Substituting SED with VPA specifically accumulated in ≥1-min bouts was detrimentally associated with HOMA-IR in children with healthy weight but beneficially with the cardiometabolic summary score in the overweight sample. This suggests that replacing SED with MPA or VPA may have some benefits on cardiometabolic health.
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Affiliation(s)
- Simone J J M Verswijveren
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
| | - Robin M Daly
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia.,Mary Mackillop Institute for Health Research, Australian Catholic University , Melbourne, Australia
| | - Lauren Arundell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia.,School of Public Health, The University of Hong Kong , Hong Kong, China
| | - Ester Cerin
- Mary Mackillop Institute for Health Research, Australian Catholic University , Melbourne, Australia.,School of Public Health, The University of Hong Kong , Hong Kong, China
| | - David W Dunstan
- Mary Mackillop Institute for Health Research, Australian Catholic University , Melbourne, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute , Melbourne, Australia
| | - Kylie D Hesketh
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
| | - Paul A Della Gatta
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
| | - Nicola D Ridgers
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
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20
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Validity of Items Assessing Self-Reported Number of Breaks in Sitting Time among Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186708. [PMID: 32942586 PMCID: PMC7558442 DOI: 10.3390/ijerph17186708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022]
Abstract
Background: Sedentary behaviour guidelines recommend that individuals should regularly break up sitting time. Accurately monitoring such breaks is needed to inform guidelines concerning how regularly to break up sitting time and to evaluate intervention effects. We investigated the concurrent validity of three “UP4FUN child questionnaire” items assessing the number of breaks in sitting time among children and adolescents. Methods: Fifty-seven children and adolescents self-reported number of breaks from sitting taken at school, while watching TV, and during other screen time activities. Participants also wore an activPAL monitor (PAL Technologies, Glasgow, UK) to objectively assess the number of sitting time breaks (frequency/hour) during the school period and the school-free period (which was divided in the periods “after school” and “during the evening”). Concurrent validity was assessed using Spearman rank correlations. Results: Self-reported number of breaks/hour at school showed good concurrent validity (ρ = 0.676). Results were moderate to good for self-reported number of breaks/hour while watching TV (ρ range for different periods: 0.482 to 0.536) and moderate for self-reported number of breaks/hour in total screen time (ρ range for different periods: 0.377 to 0.468). Poor concurrent validity was found for self-reported number of breaks/hour during other screen time activities (ρ range for different periods: 0.157 to 0.274). Conclusions: Only the questionnaire items about number of breaks at school and while watching TV appear to be acceptable for further use in research focussing on breaks in prolonged sitting among children and adolescents.
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21
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Sprengeler O, Hebestreit A, Gohres H, Bucksch J, Buck C. Effects of Installing Height-Adjustable Standing Desks on Daily and Domain-Specific Duration of Standing, Sitting, and Stepping in 3rd Grade Primary School Children. Front Public Health 2020; 8:396. [PMID: 32903373 PMCID: PMC7434830 DOI: 10.3389/fpubh.2020.00396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Aim of this intervention study was to evaluate whether availability of standing desks in classrooms may reduce sitting time and enhance standing and stepping time during lessons and breaks. Further, we evaluated if differences in standing desk use differed by physical fitness (PF) levels of children. Methods: To assess sitting, standing and stepping during a typical school week in 3rd grade primary school children (N = 52), activPAL monitors were used at baseline: T0, 1st follow-up: T1 and 2nd follow-up: T2. At baseline, PF was measured using the standing long jump and the 6-min jog-walk to assign children as having low PF (LPF) or high PF (HPF). Standing desks were assigned randomly to intervention and control groups at T1 (group 1) and T2 (group 2) with a cross-over design. Changes of sitting, standing and stepping were analyzed to investigate intervention effects at follow-up, using linear mixed models. Results: At baseline, children spent about 60 and 30% of time sitting during lessons and breaks, respectively. After installing standing desks (T1), significantly lower proportions of sitting were observed in the intervention group 1 [−13.1%, 95%-CI: (−20.5; −5.72)] and the control group 2 [−9.78%, 95%-CI: (−17.3; −2.28)]. Compared to the baseline measurement (T0), lower proportions of sitting were particularly expressed during school breaks in group 1 and 2 after intervention in T1 [group 1: −10.3%, 95%-CI: (−16.4; −4.25)] or in T2 [group 2: −8.59%, 95%-CI: (−15.2; −1.94)]. In general, children with higher physical fitness were less sedentary and more active, but intervention effects did not differ by fitness levels. Conclusion: Standing desks provide an opportunity to reduce sedentary time during lessons and breaks at school in primary school children, but do not directly increase PA of high intensity such as stepping. Future studies should consider potential bandwagon effects caused by structural interventions.
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Affiliation(s)
- Ole Sprengeler
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Antje Hebestreit
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hannah Gohres
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Jens Bucksch
- Department of Sociological and Human Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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22
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Simple Method for the Objective Activity Type Assessment with Preschoolers, Children and Adolescents. CHILDREN-BASEL 2020; 7:children7070072. [PMID: 32630836 PMCID: PMC7401882 DOI: 10.3390/children7070072] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022]
Abstract
Background: The objective and accurate assessment of children's sedentary and physical behavior is important for investigating their relation to health. The purpose of this study is to validate a simple and robust method for the identification of sitting, standing, walking, running and biking performed by preschool children, children and adolescents in the age from 3 to 16 years from a single thigh-worn accelerometer. Method: A total of 96 children were included in the study and all subjects followed a structured activity protocol performed in the subject's normal kindergarten or school environment. Thigh acceleration was measured using the Axivity AX3 (Axivity, Newcastle, UK) device. Method development and accuracy was evaluated by equally dividing the subjects into a development and test group. Results: The sensitivity and specificity for identifying sitting and standing was above 99.3% and for walking and running above 82.6% for all age groups. The sensitivity and specificity for identifying biking was above 85.8% for children and adolescents and above 64.8% for the preschool group using running bikes. Conclusion: The accurate assessment of sitting, standing, walking, running and biking from thigh acceleration and with children in the age range of 3 to 16 is valid, although not with preschool children using running bikes.
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Sherry AP, Pearson N, Ridgers ND, Barber SE, Bingham DD, Nagy LC, Clemes SA. activPAL-measured sitting levels and patterns in 9-10 years old children from a UK city. J Public Health (Oxf) 2020; 41:757-764. [PMID: 30346570 DOI: 10.1093/pubmed/fdy181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 09/23/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is insufficient evidence of sitting time in UK children from validated objective measures. This study explored sitting patterns in primary school children from Bradford, UK, using the validated activPAL inclinometer. METHODS Overall, 79 children (9.8 (SD 0.3) years old, 52% boys; 70% South Asian) wore activPALs for 7 days. Total sitting time, sitting time accumulated in different bout lengths, and the proportion of wear time spent in these variables were explored and compared across different periods of the week. RESULTS Children spent 614 ± 112 (median ± IQR) min/day on school days and 690 ± 150 min/day on weekend days sitting. The proportion of time spent sitting was significantly higher on weekend days compared to school days (mean±SD: 74 ± 10% versus 68 ± 8%,P < 0.001), as was the proportion of time accumulated in >30 min sitting bouts (mean±CI: 28 ± 27-33% versus 20 ± 20-22%, P < 0.001). The proportion of time spent sitting after school was significantly higher than during school time (mean±SD: 70 ± 8.4% versus 63 ± 8.3%,P < 0.001), as was the proportion of time spent in prolonged (>30 min) sitting bouts (mean±CI: 19 ± 16-22% versus 11 ± 10-14%, P < 0.001). CONCLUSIONS Children spent large proportions of their waking day sitting, often accumulated in prolonged uninterrupted bouts and particularly after school and on weekends. Interventions to reduce sitting time in children are urgently needed.
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Affiliation(s)
- Aron P Sherry
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Liana C Nagy
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK.,Faculty of Health Studies, Bradford University, Richmond Road, Bradford, UK
| | - Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre-Lifestyle Theme, Loughborough University, Loughborough, UK
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24
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Kinnear FJ, Hamilton-Shield JP, Stensel DJ, Bayly G, Searle A, Thackray AE, Lithander FE. Nutrition and physical activity intervention for families with familial hypercholesterolaemia: protocol for a pilot randomised controlled feasibility study. Pilot Feasibility Stud 2020; 6:42. [PMID: 32266080 PMCID: PMC7115059 DOI: 10.1186/s40814-020-00584-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 03/11/2020] [Indexed: 12/22/2022] Open
Abstract
Background Untreated heterozygous familial hypercholesterolaemia (FH) causes high low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. Despite pharmacological treatment, many treated individuals remain at higher CVD risk than non-affected individuals. This may be due to LDL-C targets not being met and presence of other CVD risk factors. Adhering to dietary and physical activity (PA) recommendations developed for individuals with FH may further reduce CVD risk. However, there is insufficient research to support the efficacy of adhering to these guidelines on LDL-C and other CVD risk factors. The need for studies to investigate the effectiveness of nutrition and PA interventions in the FH population has been widely recognised and recommended. This paper describes the protocol of a pilot, randomised controlled trial designed to evaluate the feasibility and acceptability of a specifically developed nutrition and PA intervention aimed at improving the dietary intakes and PA levels of families with FH. Methods A two-arm randomised waitlist-controlled pilot trial will be conducted across three National Health Service (NHS) sites in England, UK. Twenty-four young people with FH, aged 10-18 years, and their affected parent, will be recruited and randomly assigned to the intervention or waitlist and usual care control. The primary aim is to provide evidence for the feasibility and acceptability of delivering the intervention, explored quantitatively (rates of recruitment, retention and outcome measure completeness) and qualitatively (qualitative interviews). The secondary aim is to provide evidence for the potential efficacy of the intervention on dietary intake, PA, sedentary time, body composition, CVD risk factors and quality of life determined at baseline and endpoint assessments. The intervention will involve an hour-long consultation with a dietitian at baseline and four follow-up contacts across the 12-week intervention. It has been specifically developed for use with individuals with FH and incorporates behavioural change techniques to target identified enablers and barriers to adherence in this population. Discussion This trial will estimate the feasibility and acceptability of the nutrition and PA intervention delivered to young people and parents with FH. If appropriate, this study can be used to inform the design of an adequately powered definitive trial. Trial registration ISRCTN, ISRCTN24880714. Registered 07/06/2018, http://www.isrctn.com/ISRCTN24880714.
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Affiliation(s)
- Fiona J Kinnear
- 1NIHR Bristol Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Julian P Hamilton-Shield
- 1NIHR Bristol Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - David J Stensel
- 2National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, UK.,3University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, UK
| | - Graham Bayly
- 4Department of Clinical Biochemistry, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Aidan Searle
- 1NIHR Bristol Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Alice E Thackray
- 2National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, UK.,3University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, UK
| | - Fiona E Lithander
- 1NIHR Bristol Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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25
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Barnett TA, Kelly AS, Young DR, Perry CK, Pratt CA, Edwards NM, Rao G, Vos MB. Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e142-e159. [PMID: 30354382 DOI: 10.1161/cir.0000000000000591] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
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26
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Agreement Between GT3X Accelerometer and ActivPAL Inclinometer for Estimating and Detecting Changes in Different Contexts of Sedentary Time Among Adolescents. J Phys Act Health 2019; 16:780-784. [DOI: 10.1123/jpah.2018-0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 04/22/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
Background: This investigation aimed to analyze the agreement between the GT3X accelerometer and the ActivPAL inclinometer for estimating and detecting changes in sedentary behavior of different contexts among adolescents. Methods: Secondary data from an intervention using standing desks in the classroom conducted within 2 sixth-grade classes (intervention [n = 22] and control [n = 27]) were used. The intervention took place over 16 weeks, with activity assessments (ActivPAL and GT3X) being performed 7 days before and in the last week of the intervention. Baseline information from both groups was considered for cross-sectional analysis (209 valid days), while data from 20 participants (intervention group) were used for longitudinal analysis. Results: The authors observed that GT3X overestimated sedentary time at school (16.8%), after school (13.5%), and during weekends (7.3%) compared with ActivPAL (P < .05). Outside the school (after school [r = −.188] and on weekends [r = −.260]), there was a trend to higher overestimation among adolescents with less sedentary behavior. Longitudinally, the GT3X was unable to detect changes resulting from an intervention in school hours (ActivPAL = −34.7 min·9 h−1 vs GT3X = +6.7 min·9 h−1; P < .05). Conclusions: The authors conclude that GT3X (cut-point of <100 counts·min−1) overestimated sedentary time of free-living activities and did not detect changes resulting from a classroom standing desk intervention in adolescents.
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27
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Carlson JA, Bellettiere J, Kerr J, Salmon J, Timperio A, Verswijveren SJ, Ridgers ND. Day-level sedentary pattern estimates derived from hip-worn accelerometer cut-points in 8-12-year-olds: Do they reflect postural transitions? J Sports Sci 2019; 37:1899-1909. [PMID: 31002287 PMCID: PMC6594870 DOI: 10.1080/02640414.2019.1605646] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
Improving sedentary measurement is critical to understanding sedentary-health associations in youth. This study assessed agreement between the thigh-worn activPAL and commonly used hip-worn ActiGraph accelerometer methods for assessing sedentary patterns in children. Both devices were worn by 8-12-year-olds (N = 195) for 4.6 ± 1.9 days. Two ActiGraph cut-points were applied to two epoch durations: ≤25 counts (c)/15 s, ≤75c/15s, ≤100c/60s, and ≤300c/60s. Bias, mean absolute deviation (MAD), and intraclass correlation coefficients (ICCs) tested agreement between devices for total sedentary time and 11 sedentary pattern variables (usual bout duration, sedentary time accumulated in various bout durations, breaks/day, break rate, and alpha). For most sedentary pattern variables, ActiGraph 25c/15s, 75c/15s, and 100c/60s had poor ICCs, with bias and MAD >20%. ActiGraph 300c/60s had a better agreement than the other cut-points, but all ICCs were <0.587. ActiGraph underestimated sedentary time in longer bouts and usual bout duration, and overestimated sedentary time in shorter bouts, breaks/day, and alpha. For total sedentary time, ActiGraph 25c/15s, 300c/60s, and 75c/15s had good/fair ICCs, with bias and MAD <20%. Sedentary patterns derived from two commonly used ActiGraph cut-points did not appear to reflect postural changes. These differences between measurement devices should be considered when interpreting findings from sedentary pattern studies.
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Affiliation(s)
| | - John Bellettiere
- University of California San Diego, La Jolla, California, USA
- Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, California, USA
| | - Jacqueline Kerr
- University of California San Diego, La Jolla, California, USA
| | - Jo Salmon
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Anna Timperio
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Simone J.J.M. Verswijveren
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Nicola D. Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
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28
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Mazzoli E, Teo WP, Salmon J, Pesce C, He J, Ben-Soussan TD, Barnett LM. Associations of Class-Time Sitting, Stepping and Sit-to-Stand Transitions with Cognitive Functions and Brain Activity in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091482. [PMID: 31027380 PMCID: PMC6539435 DOI: 10.3390/ijerph16091482] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/18/2022]
Abstract
Previous research showed that children’s physical activity is positively related to executive functions, whilst screen time shows negative associations. However, it is unclear how school-based sitting time and transitions from sitting to standing relate to cognition. We investigated the relationship between class time sitting/stepping/sit-to-stand transitions and cognitive functions in Grade 1–2 children. Overall, 149 children (7.7 ± 0.6 years old, 54% boys) participated. Measures included class time sitting/stepping/sit-to-stand transitions and: (i) response inhibition (i.e., response time and accuracy); (ii) lapses of attention; (iii) working memory; and (iv) brain activity (cortical haemodynamic response). Linear mixed-models, adjusting for age, sex, and clustering at the classroom level, found that more sitting time was associated with higher lapses of attention (β = 0.12, p < 0.05). Children who stepped more had quicker inhibition response time (β = −0.95, p < 0.01); however, they were less accurate in their responses (β = −0.30, p < 0.05) and this was also observed with sit-to-stand transitions (β = −0.26, p < 0.05). No associations were found with brain activity. In conclusion, reducing and breaking up sitting may help keep children focused, but the evidence regarding response inhibition is unclear.
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Affiliation(s)
- Emiliano Mazzoli
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong VIC 3220, Australia.
| | - Wei-Peng Teo
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education (NIE), Nanyang Technological University, Singapore 637616, Singapore.
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong VIC 3220, Australia.
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong VIC 3220, Australia.
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong VIC 3220, Australia.
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, Italian University of Sport and Movement, 00135 Rome, Italy.
| | - Jason He
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong VIC 3220, Australia.
| | - Tal Dotan Ben-Soussan
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, 06081 Assisi, Italy.
| | - Lisa M Barnett
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong VIC 3220, Australia.
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong VIC 3220, Australia.
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Verloigne M, Ridgers ND, De Bourdeaudhuij I, Cardon G. Effect and process evaluation of implementing standing desks in primary and secondary schools in Belgium: a cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:94. [PMID: 30261883 PMCID: PMC6161341 DOI: 10.1186/s12966-018-0726-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. Methods We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. Results Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. Conclusions Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. Trial registration NCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12966-018-0726-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation (FWO), Egmontstraat 1, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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Use of Objective Measures to Estimate Sedentary Time in Youth. JOURNAL FOR THE MEASUREMENT OF PHYSICAL BEHAVIOUR 2018; 1:136-142. [PMID: 32705076 DOI: 10.1123/jmpb.2018-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of the study was to conduct a comprehensive evaluation of the ActiGraph GT3X+ (AG) and activPAL (AP) for assessing time spent in sedentary behaviors (SB) in youth using structured and free-living activities. Forty-four participants (mean±SD; age, 12.7±0.8 yrs) completed up to 8 structured activities and approximately 2-hrs of free-living activity while wearing an AG (right hip) and AP (right thigh). A Cosmed K4b2 was used for measured energy expenditure (METy; activity VO2 divided by resting VO2). Direct observation was used during the structured activities. SB time was estimated using the inclinometer function of the AP and AG, and count thresholds with AG (<75 vector magnitude (VM) counts/10-s, < 25 vertical axis (VA) counts/10-s, and <50, 100, 150, and 200 VA counts/min). For the structured activities, the AG inclinometer and AP correctly classified supine rest about 45% of the time, seated activities 54.6% and 65.1% of the time, respectively, and walking and running >96% of the time. For the free-living measurement, the VA <25 counts/10-s has the lowest RMSE (20.6 min), while the VM <75 counts/10-s had the lowest MAPE (69.2%). The AG inclinometer was within 0.2 minutes of measured time, but had the highest MAPE (107.1%). The AP was within 1.6 minutes of measured time, but had the highest RMSE (28.5 minutes). Compared to measured SB time, the VA <25 counts/10-s and VM <75 counts/10-s provided the most precise estimates of SB during free-living activity. Further refinement is needed to improve the AP and AG posture estimates.
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Aadland E, Kvalheim OM, Anderssen SA, Resaland GK, Andersen LB. The multivariate physical activity signature associated with metabolic health in children. Int J Behav Nutr Phys Act 2018; 15:77. [PMID: 30111365 PMCID: PMC6094580 DOI: 10.1186/s12966-018-0707-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/25/2018] [Indexed: 11/21/2022] Open
Abstract
Background Physical activity is a cornerstone for promoting good metabolic health in children, but it is heavily debated which intensities (including sedentary time) are most influential. A fundamental limitation to current evidence for this relationship is the reliance on analytic approaches that cannot handle collinear variables. The aim of the present study was to determine the physical activity signature related to metabolic health in children, by investigating the association pattern for the whole spectrum of physical activity intensities using multivariate pattern analysis. Methods We used a sample of 841 children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) from the Active Smarter Kids study, who provided valid data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created 16 physical activity variables covering the whole intensity spectrum (from 0–100 to ≥ 8000 counts per minute) and used multivariate pattern analysis to analyze the data. Results Physical activity intensities in the vigorous range (5000–7000 counts per minute) were most strongly associated with metabolic health. Moderate intensity physical activity was weakly related to health, and sedentary time and light physical activity were not related to health. Conclusions This study is the first to determine the multivariate physical activity signature related to metabolic health in children across the whole intensity spectrum. This novel approach shows that vigorous physical activity is strongest related to metabolic health. We recommend future studies adapt a multivariate analytic approach to further develop the field of physical activity epidemiology. Trial registration The study was registered in Clinicaltrials.gov (www.clinicaltrials.gov) 7th of April 2014 with identification number NCT02132494.
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Affiliation(s)
- Eivind Aadland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus Sogndal, Box 133, 6851, Sogndal, Norway.
| | | | - Sigmund Alfred Anderssen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus Sogndal, Box 133, 6851, Sogndal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Box 4014 Ullevål Stadion, 0806, Oslo, Norway
| | - Geir Kåre Resaland
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus Sogndal, Box 133, 6851, Sogndal, Norway.,Center for Health Research, Førde Central Hospital, Box 1000, 6807, Førde, Norway
| | - Lars Bo Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Campus Sogndal, Box 133, 6851, Sogndal, Norway
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Biddle SJ, Pearson N, Salmon J. Sedentary Behaviors and Adiposity in Young People: Causality and Conceptual Model. Exerc Sport Sci Rev 2018; 46:18-25. [DOI: 10.1249/jes.0000000000000135] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kovalskys I, Rausch Herscovici C, Indart Rougier P, De Gregorio MJ, Zonis L, Orellana L. Study Protocol of MINI SALTEN: a technology-based multi-component intervention in the school environment targeting healthy habits of first grade children and their parents. BMC Public Health 2017; 17:401. [PMID: 28477624 PMCID: PMC5420097 DOI: 10.1186/s12889-017-4327-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 04/27/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND MINI SALTEN is a program developed to increase moderate to vigorous physical activity (PA) and improve eating habits at home and school in first grade children. It aims to assess the effects of a technology family-based and PA school-based intervention. The purpose of this manuscript is to describe the protocol design and the MINISALTEN intervention. METHODS This is cluster-randomized controlled trial designed to run from July 2015 to November 2016 in 12 public schools of the city of Buenos Aires, matched for socio-demographic characteristics. The intervention is based on two main components: (a) "active breaks" (AB): implemented during school breaks by a PA instructor; (b) "virtual" (V): web-based contents delivered to the families via a multiplatform application. Using a computer generated random sequence participants are allocated to one of four intervention conditions: (AB), (V), (AB + V), and control (C). Outcomes are measured at baseline and 12 months post intervention, and will include data collected from the child and her/his mother/father or guardian. Primary outcome measures are: PA and sedentary behaviour (measured with accelerometers). Secondary outcome measures related are: percentage of kilocalories (kcal) from added sugars, and from total and saturated fats; grams of fruits and vegetables; and number of snacks and kcal coming from their added sugars and total and saturated fats. Family socio-economic level, home environment, and school environment will also be assessed. Statistical analysis is on an intention-to-treat principle. Baseline characteristics are described using summary measures and mixed models (with school as random effect). The effect of the two interventions will be estimated using a generalized mixed linear model with link and distribution selected according to the type of outcome. Included random effects are: child (or mother/father or guardian) accounting for repeated measures; school accounting for cluster induced by school. The most parsimonious model for each outcome will be reported. The False Discovery Rate criterion will be used to correct for multiple testing in non-planned analyses. DISCUSSION It is a pioneer assessment of the impact of a technology-based virtual intervention and a school-based PA program, designed to prevent obesity, and involving the parents at public schools of Buenos Aires. TRIAL REGISTRATION Current Controlled Trials ISRCTN58093412 . Registered March 14th, 2016 (retrospectively registered).
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Affiliation(s)
- Irina Kovalskys
- International Life Sciences Institute (ILSI), Autonomous City of Buenos Aires, Argentina
- Favaloro University, Autonomous City of Buenos Aires, Argentina
| | | | - Paula Indart Rougier
- International Life Sciences Institute (ILSI), Autonomous City of Buenos Aires, Argentina
- Favaloro University, Autonomous City of Buenos Aires, Argentina
| | | | - Luciana Zonis
- International Life Sciences Institute (ILSI), Autonomous City of Buenos Aires, Argentina
- Favaloro University, Autonomous City of Buenos Aires, Argentina
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Mitchell T, Borner K, Finch J, Kerr J, Carlson JA. Using Activity Monitors to Measure Sit-to-Stand Transitions in Overweight/Obese Youth. Med Sci Sports Exerc 2017; 49:1592-1598. [PMID: 28288011 DOI: 10.1249/mss.0000000000001266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Reducing sedentary behavior has emerged as an important health intervention strategy. Although hip-worn, and more recently wrist-worn, accelerometers are commonly used for measuring physical activity and sedentary behavior, they may not provide accurate measures of postural changes. The current study examined the validity of commonly used hip- and wrist-worn accelerometer cut points and the thigh-worn activPAL activity monitor for measuring sit-to-stand transitions as compared with direct observation in youth with overweight and obesity. METHODS Nine children wore three activity monitors while being directly observed. The monitors included a hip- and wrist-worn ActiGraph and thigh-worn activPAL. The hip-worn ActiGraph was processed with the normal- and low-frequency filters and the inclinometer function. Cut points of ≤25 counts per 15-s epoch for the hip and ≤105 counts per 15-s epoch for the wrist were applied to the vertical axis to identify sit-to-stand transitions. Epoch-level absolute agreement, Bland-Altman plots, mixed-effects linear regression, and intraclass correlation coefficients (ICC) were investigated. RESULTS The hip and wrist accelerometer cut points and the hip inclinometer function overestimated the number of hourly sit-to-stand transitions by approximately triple as compared with direct observation. ICC values between the ActiGraph methods and the direct observation were all <0.12. Sit-to-stand transitions assessed from activPAL were within 17% of direct observation; ICC was 0.26. CONCLUSION Despite the common use of the 100-count hip-worn accelerometer cut point for assessing sedentary time, these processing decisions should be used with caution for assessing sit-to-stand transitions. Future research should investigate other processing methods for ActiGraph data, and studies investigating postural changes should consider including devices such as activPAL.
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Affiliation(s)
- Tarrah Mitchell
- 1University of Kansas, Lawrence, KS; 2Children's Mercy Hospital, Kansas City, MO; 3University of California San Diego, La Jolla, CA; and 4University of Missouri Kansas City, Kansas City, MO
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Hislop J, Palmer N, Anand P, Aldin T. Validity of wrist worn accelerometers and comparability between hip and wrist placement sites in estimating physical activity behaviour in preschool children. Physiol Meas 2016; 37:1701-1714. [DOI: 10.1088/0967-3334/37/10/1701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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