Abstract

Background/ObjectivesThe aim of this study was to examine the effect of physical activity (PA) and sedentary behaviour (SB) on body mass index (BMI) and fat mass index (FMI) in children over the course of five years and identify potential bi-directional associations.Subjects/MethodsData were drawn from the EU Childhood Obesity Project (CHOP). PA and SB were measured with the SenseWear Armband 2 at the ages of 6 (T1), 8 (T2) and 11 (T3) years. Height and weight were measured and BMI was calculated at each time point, resulting in 1254 complete observations from 600 children. Bio impedance analysis was used to measure body fat mass and eventually calculate FMI. To examine the longitudinal association between PA/SB and BMI/FMI as well as to account for repeated measure on these children, mixed model analysis was employed.ResultsHigher levels of total PA and moderate-to-vigorous PA (MVPA) were associated with lower BMI and FMI and higher SB with higher BMI and FMI over the five year period. When looking at the age dependent effects, negative associations of MVPA (βMVPA x age: − 0.05, 95% confidence interval (CI): − 0.09 – -0.01, p = 0.007) and positive associations of SB (βSB x age: 0.04, 95% CI: 0.02–0.06, p < 0.001) increased with each year of age. In a model combining these two effects, only SB x age interaction remained significant (βSB x age: 0.04, 95% CI: 0.03–0.06, p = 0.01). No significant interaction between MVPA and SB could be discerned. Light Physical activity showed no significant associations with BMI or FMI. When reversing outcome and predictor; higher BMI or FMI showed a negative association with MVPA and a positive association with SB, but no age dependency.ConclusionsMore time per day in SB was associated with a higher BMI over the course of five years, whereas higher MVPA had an inverse effect. In a combined model, only effects of higher SB remained significant, emphasizing the importance of SB in obesity prevention. Present bidirectional associations, where lower body size was associated with higher PA and lower SB, indicated the need for an integrated approach of activity and weight control for obesity prevention.Trial registrationClinicalTrials.gov Identifier: NCT00338689. Registered: June 19, 2006 (retrospectively registered).

Highlights

  • The increase of childhood obesity is a major public health problem in Europe and other affluent countries [1,2,3]

  • When looking at the age dependent effects, negative associations of moderate-to-vigorous physical activity (PA) (MVPA) (βMVPA x age: − 0.05, 95% confidence interval (CI): − 0.09 – -0.01, p = 0.007) and positive associations of sedentary behaviour (SB) increased with each year of age

  • When reversing outcome and predictor; higher body mass index (BMI) or fat mass index (FMI) showed a negative association with MVPA and a positive association with SB, but no age dependency

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Summary

Introduction

The increase of childhood obesity is a major public health problem in Europe and other affluent countries [1,2,3]. Changes in childhood movement behaviour might play an important role in childhood obesity risk. High levels of physical activity (PA) are thought to be protective against excess body weight [4]. A recent systematic review showed that sedentary behaviour (SB) is related to many adverse health indicators, including unfavourable body composition [5]. Many of the studies included in the systematic review used subjective methods for measuring SB. Subjective methods can be a good estimate for context-specific SB like screen time, device-based methods can provide a more reliable and valid assessment of overall SB [6]

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