Abstract
BackgroundToddlerhood is an important age for physical activity (PA) promotion to prevent obesity and support a physically active lifestyle throughout childhood. Accurate assessment of PA is needed to determine trends/correlates of PA, time spent in sedentary, light, or moderate-vigorous PA (MVPA), and the effectiveness of PA promotion programs. Due to the limited availability of objective measures that have been validated and evaluated for feasibility in community studies, it is unclear which subgroups of toddlers are at the highest risk for inactivity. Using Actical ankle accelerometry, the objectives of this study are to develop valid thresholds, examine feasibility, and examine demographic/ anthropometric PA correlates of MVPA among toddlers from low-income families.MethodsTwo studies were conducted with toddlers (12–36 months). Laboratory Study (n = 24)- Two Actical accelerometers were placed on the ankle. PA was observed using the Child Activity Rating Scale (CARS, prescribed activities). Analyses included device equivalence reliability (correlation: activity counts of two Acticals), criterion-related validity (correlation: activity counts and CARS ratings), and sensitivity/specificity for thresholds. Community Study (n = 277, low-income mother-toddler dyads recruited)- An Actical was worn on the ankle for > 7 days (goal >5, 24-h days). Height/weight was measured. Mothers reported demographics. Analyses included frequencies (feasibility) and stepwise multiple linear regression (sMLR).ResultsLaboratory Study- Acticals demonstrated reliability (r = 0.980) and validity (r = 0.75). Thresholds demonstrated sensitivity (86 %) and specificity (88 %). Community Study- 86 % wore accelerometer, 69 % had valid data (mean = 5.2 days). Primary reasons for missing/invalid data: refusal (14 %) and wear-time ≤2 days (11 %). The MVPA threshold (>2200 cpm) yielded 54 min/day. In sMLR, MVPA was associated with age (older > younger, β = 32.8, p < 0.001), gender (boys > girls, β = −11.21, p = 0.032), maternal MVPA (β = 0.44, p = 0.002) and recruitment location (suburban > urban, β = 19.6, p < 0.001), or race (non-Black > Black, β = 18.5, p = 0.001). No association with toddler weight status.ConclusionsAnkle accelerometry is a valid, reliable, and feasible method of assessing PA in community studies of toddlers from low-income families. Sub-populations of toddlers may be at increased risk for inactivity, including toddlers that are younger, female, Black, those with less active mothers, and those living in an urban location.
Highlights
Toddlerhood is an important age for physical activity (PA) promotion to prevent obesity and support a physically active lifestyle throughout childhood
The limited PA research on young children has focused on preschoolers, with relatively few studies focusing on toddlers, despite the fact that active play contributes to toddler cognitive, physical, social, and emotional wellbeing among [9]
Laboratory study Recruitment Toddlers were recruited through mothers groups, flyers at daycare centers, and word of mouth to participate in a 1-day PA study
Summary
Toddlerhood is an important age for physical activity (PA) promotion to prevent obesity and support a physically active lifestyle throughout childhood. International PA guidelines have been developed for toddlers which recommend 180 min/day of total PA (light, moderate, and vigorous) [10,11,12], progressing toward 60 min of moderate-vigorous PA (MVPA) by age 5 [11]. These guidelines are based on limited empirical data, and studies are needed that objectively evaluate PA among toddlers in community settings in order to provide either support for existing guidelines or evidence for the need for updated guidelines
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