Children 's Moderate-to-vigorous Physical Activity Research Articles

Investigating young children’s physical activity through time and place

BackgroundPrevious research indicates the start of primary school (4-5-year-old) as an essential period for the development of children’s physical activity (PA) patterns, as from this point, the age-related decline of PA is most often observed. During this period, young children are exposed to a wider variety of environmental- and social contexts and therefore their PA is influenced by more diverse factors. However, in order to understand children’s daily PA patterns and identify relevant opportunities for PA promotion, it is important to further unravel in which (social) contexts throughout the day, PA of young children takes place.MethodsWe included a cross-national sample of 21 primary schools from the Startvaardig study. In total, 248 children provided valid accelerometer and global positioning (GPS) data. Geospatial analyses were conducted to quantify PA in (social) environments based on their school and home. Transport-related PA was evaluated using GPS speed-algorithms. PA was analysed at different environments, time-periods and for week- and weekend days separately.ResultsChildren accumulated an average of 60 min of moderate-to-vigorous PA (MVPA), both during week- and weekend days. Schools contributed to approximately half of daily MVPA during weekdays. During weekends, environments within 100 m from home were important, as well as locations outside the home-school neighbourhood. Pedestrian trips contributed to almost half of the daily MVPA.ConclusionsWe identified several social contexts relevant for children’s daily MVPA. Schools have the potential to significantly contribute to young children’s PA patterns and are therefore encouraged to systematically evaluate and implement parts of the school-system that stimulate PA and potentially also learning processes. Pedestrian trips also have substantial contribution to daily MVPA of young children, which highlights the importance of daily active transport in school- and parental routines.

Children's motivation for moderate-to-vigorous physical activity during the Daily Mile: A theory of planned behaviour perspective

Sustained motivation for Daily Mile participation at higher physical activity intensities may contribute to the attainment of children's daily moderate-to-vigorous physical activity (MVPA) targets and long-term health benefits. However, individual variability exists in the amount of MVPA accumulated by children during the Daily Mile. The current study explored children's motivation for participating in the Daily Mile at MVPA intensity, using a theory of planned behaviour framework. Twenty-five children (mean age = 10.07 ± 0.60 years) from the Northwest of England were recruited to the study; 52% were female and 88% were White. Participants completed a questionnaire, with an open-ended response format, probing behavioural, control, and normative beliefs for participation in the Daily Mile at MVPA intensity. Template analysis was conducted independently by two researchers to identify main themes and subthemes. Findings showed that children possessed a range of behavioural, control, and normative beliefs about MVPA participation during the Daily Mile. Prominent behavioural beliefs included fitness enhancement, implications for concentration and learning, positive affective states, and pain and discomfort. Key control beliefs included weather, space and health restrictions, and distractions from peers. Finally, peers and parents were salient normative beliefs. Children possessed a range of modal beliefs in relation to MVPA participation during the Daily Mile. Implications of the findings, and methods for practitioners seeking to maximise the contribution of the Daily Mile to children's daily MVPA targets are discussed.

Are low-income preschoolers physically active at preschool settings? A cross-sectional study.

Preschools may provide opportunities for children to engage in physical activity (PA), to benefit their health, although little is known when concerning low-income preschoolers. This study aimed (1) to describe time spent in PA among low-income children during preschool hours and (2) to analyse how many children meet the PA recommendations during preschool hours. A total of 204 low-income preschoolers (4.51 ± 0.79 years) from João Pessoa/Brazil provided valid accelerometer (Actigraph, WGT3-X) data during the preschool period. Children were grouped in quartiles of PA in counts per minute, according to sex and age. The General Linear Model Univariate was used to examine the differences in PA intensities between the quartiles and the time spent in total PA (TPA) and moderate-to-vigorous PA (MVPA) by quartiles, according to age. An hour-by-hour description of children's PA was presented. TPA during preschool hours ranged from 68.33% to 113.89% of the recommended and from 28.34% to 81.68% of the MVPA recommendations. Among 5-year-old children, those in the highest quartile met the PA recommendations. All children were more active outdoors than indoors. For the less actives, preschool time corresponded to 30% of the recommended daily MVPA. The current results reinforce the importance of preschool settings for promoting preschoolers' PA and provide particularly important and useful information for tailoring preschool-based interventions focused on those who need it most. Strategies to increase children's MVPA should be prioritized during free-play time.

O.4.5-9 Moderate-to-vigorous physical activity assessed by tri-axial Accelerometers and its association with the risk of obesity in 6-10 years-old children

Abstract Purpose There is a worldwide agreement that children should participate in at least 60 min of moderate-to-vigorous physical activity (MVPA) daily to achieve substantial health benefits. Furthermore, using triaxial-accelerometers has become more accurate practice in the study of childhood obesity. The present study aimed: i) to compare PA intensity levels and Body Mass Index (BMI) of boys and girls, and assess MVPA recommendation compliance of active children; ii) to examine associations between the risk of overweight and the MVPA in children. Methods The sample of 395 children (198 girls) aged 6-10 years was assessed. Height and weight were measured, and BMI was calculated subsequently. A tri-axial accelerometer was used to obtain seven consecutive days of MVPA, as well as the weekly time being sedentary. Logistic regression analysis was used to analyse the above-mentioned relationship between MVPA and the risk of obesity, controlling for potential confounders. Results About 47% of boys were active on week days by achieve the mean value of 60 min/day of MVPA; corresponding percentage for the weekend was just 32%. Among girls, only 22% were active on week days and 29% at the weekend. MVPA was not significantly associated with the risk of being overweight nor in female neither in male children. The final regression model revealed that girls of mothers with high educational level were less likely to be classified as overweight girls. Conclusions Findings of the present study revealed no significantly relation between MVPA and obesity risk among Portuguese children. Future research should extend similar design to other lifestyle features of children to clarify potential predictors of being overweight at early ages. Support/Funding Source Fundação para a Ciência e a Tecnologia [PEst-OE/SADG/UI0283/2013].

Neighborhood Places for Preschool Children's Physical Activity: A Mixed-Methods Study Using Global Positioning System, Geographic Information Systems, and Accelerometry Data.

This study adds to the current literature by using a novel device-based method to explore where preschool children are physically active outside of home and childcare settings. This study combined accelerometry with geospatial data to explore the influence of the environment on preschool children's physical activity by objectively identifying the locations where preschool children engage in moderate to vigorous physical activity (MVPA) within and outside of their neighborhood. Accelerometry, Global Positioning System, and Geographic Information Systems data from 168 preschool children aged 2-5years were processed in ArcGIS Pro to identify locations (per 25 × 25-m fishnet cell) with high MVPA counts. Locations with high MVPA counts were defined as those with the top 20% of MVPA counts per fishnet cell. The land use for high MVPA count location was determined for 3 domains: <500m from home, 500 to 1600m from home, and >1600m from home. Locations with high MVPA counts <500m from home were playgrounds (66.6%), schools (16.7%), and parks (16.7%). Locations with high MVPA counts 500 to 1600m from home included playgrounds (33.3%), nonhome residential (29.6%), childcare centers (11.1%), and parks (3.7%). Locations with high MVPA counts >1600m from home included nonhome residential (54.7%), sports and recreation centers (11.1%), playgrounds (6.8%), and parks (5.3%). Our findings highlight that local parks and playgrounds provide physical activity opportunities for preschool children, yet beyond the local neighborhood, the homes of others are important locations for preschool children to accumulate MVPA. These findings can be used to inform the design of current and future neighborhood places to better accommodate preschool children's MVPA.

MVPA and Motor Proficiency between Children with ADHD and Typical Development: Associations with Sleep Quality.

This study examined the associations of motor proficiency with moderate-to-vigorous physical activity (MVPA) and sleep quality in children with attention-deficit/hyperactivity disorder (ADHD) and children with typical development (TD). This cross-sectional study included 88 medical-naive children with ADHD age 6-12 yr (mean (SD) age, 8.43 (1.38) yr; 81.8% boys) and 40 age-matched children with TD (mean (SD) age, 8.46 (1.44) yr; 60% boys). MVPA was recorded by a wGT3X-BT accelerometer for 7 consecutive days. Motor proficiency was assessed using the Test of Gross Motor Development-Third Edition. Sleep quality was assessed using a self-report questionnaire. Children with ADHD spent significantly less time in MVPA daily, displayed less proficiency in locomotor and ball skills, and reported poorer sleep quality (e.g., longer sleep latency, less sleep duration, and lower sleep efficiency) than children with TD. MVPA guideline attainment and sleep duration significantly predicted locomotor skills development; in turn, locomotor skills predicted MVPA guideline attainment. MVPA and ball skills increased by age in children with ADHD. Our results highlight the importance of promoting MVPA, motor proficiency, and sleep duration in children with ADHD and TD since childhood.

The mediating role of resilience in the association between MVPA and psychological ill-being in children with ADHD.

This study investigated the mediating role of resilience in the association between moderate-to-vigorous physical activity (MVPA) and psychological ill-being, as well as the moderating role of age in the direct and indirect relationship between MVPA and psychological ill-being in children with attention-deficit/hyperactivity disorder (ADHD). Eighty-five children aged 6-12 years (Mage =8.41 ± 1.44 years) diagnosed with ADHD were recruited. Participants wore an accelerometer on their non-dominant wrist for seven consecutive days to record MVPA. Resilience and psychological ill-being were assessed using self-reported questionnaires. MVPA was positively associated with resilience but negatively related to depression and stress. Resilience was negatively correlated with depression and stress. Using the bootstrapping method, the indirect effect of resilience was found between MVPA and depression (-0.006%, 95% confidence interval [CI]=[-0.060, -0.020]) in children with ADHD, supporting partial mediation. Moderated mediation analysis further demonstrated that the indirect effect of MVPA on depression via resilience was stronger in older children (-0.008, 95% CI=[-0.023, -0.001]) than in younger children with ADHD. The findings may inform future empirical studies on designing exercise interventions with MVPA levels that help to improve resilience and depression in children with ADHD.

Associations of emotional/behavioral problems with accelerometer-measured sedentary behavior, physical activity and step counts in children with autism spectrum disorder.

BackgroundThe evidence for associations of emotional/behavioral status with sedentary behavior (SB), physical activity (PA) and step counts is scarce in children with autism spectrum disorder (ASD). Also, ASD-related deficiencies may affect actual levels of PA. We aimed to describe accelerometer-measured SB, PA and step counts in children with ASD, and to examine the associations of emotional/behavioral problems with SB, PA and step counts after assessing associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies.MethodsA total of 93 ASD children, aged 6–9 years, were recruited from the Center for Child and Adolescent Psychology and Behavioral Development of Sun Yat-sen University in Guangzhou, China. Participants wore an accelerometer for seven consecutive days. Of the original 93, 78 participants' accelerometer-measured valid PA were obtained, and the data were shown as time spent in SB, light, moderate, moderate-to-vigorous and vigorous PA, and step counts. Participants' emotional/behavioral problems were assessed via the Strengths and Difficulties Questionnaire (SDQ), and anxiety symptoms were evaluated by the Screen for Child Anxiety Related Emotional Disorders (SCARED). ASD-associated deficiencies include restricted repetitive behaviors (Repetitive Behavior Scale-Revised), poor social competence (Social Responsiveness Scale Second Edition) and motor development restrictions (Developmental Coordination Disorder Questionnaire).ResultsOf the 78 participants, daily vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) averaged 15.62 and 51.95 min, respectively. After adjustment for covariates, SDQ emotional symptoms (β = −0.060, p = 0.028) were inversely associated with the average daily minutes in VPA. Meanwhile, SDQ emotional symptoms (β = −0.033, p = 0.016) were inversely associated with the average daily MVPA minutes in the crude model. After adjustment for covariates, SCARED somatic/panic (β = −0.007, p = 0.040) and generalized anxiety (β = −0.025, p = 0.014) were negatively associated with the average daily VPA minutes; SCARED total anxiety (β = −0.006, p = 0.029) was conversely associated with daily MVPA duration. After adjustment for covariates, no significant associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies were found (p > 0.05).ConclusionsAccelerometer-measured SB, PA and step counts showed no associations with ASD-related deficiencies. On this basis, we further found that the emotional symptoms were inversely associated with VPA and MVPA. These results emphasize the importance of VPA and MVPA in children with ASD. The longitudinally investigations on the directionality of these associations between emotional symptoms with VPA and MVPA are needed in the future.

Наукове обгрунтування нормативів оздоровчої рухової активності для дітей молодшого шкільного віку

The aim of the study was to determine the optimal volume of primary-school-age children's physical activity to improve their adaptive capabilities. Materials and methods. The features of physical activity, social factors, anthropometric, and physiological parameters of 297 students in grades 1-4 of schools in Sumy were studied using diaries that parents filled out during the week and examination by a paediatrician (2016). The duration of moderate-to-vigorous physical activity (MVPA) was determined. The adaptive-reserve capabilities (ARV) integral indicator was calculated. ARV due to the characteristics of physical development, and the functioning of the autonomic nervous and cardiovascular systems of the child. Descriptive statistics, contingency tables, dispersion, correlation analysis, and linear regression models were used. Results. We have established that the proportion of children with an unsatisfactory level of adaptive-reserve capabilities among primary-school-age children was about 40%. A trend towards a decrease in ARV in children with chronic diseases was revealed. A relationship between ARV and the duration of sports activities was established (p&lt;0.01). The total value of MVPA was 215.2±16.6 min/week for boys and 189.0±14.0 min/week for girls (p&gt;0.2). The weekly duration of MVPA in children who play organized sports is higher than in those who do it on their own (p&lt;0.001). Estimated health-saving values of MVPA are from 43 to 68 minutes/day with an average value of 55 minutes for boys and from 37 to 61 minutes/day with an average value of 50 minutes for girls. Non-compliance with these norms can lead to a decrease in ARV, especially in the group of children with chronic diseases. Conclusions: The average duration of daily MVPA (with energy consumption of more than 3 METs) should be 55 minutes for boys and 50 minutes for girls for increasing the adaptive-reserve capabilities of children in the age group of 6-10 years.

Relationship Between Engagement In A Pediatric Obesity Treatment Program And Post Intervention Activity

Children living in rural areas have a higher risk for overweight/obesity and are less likely to be active. Research examining the relationship between comprehensive metrics of engagement and treatment outcomes is lacking in pediatric obesity treatments. PURPOSE: To investigate the influence of engagement in group sessions on post intervention moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SED) after an 8 month pediatric obesity treatment program. METHODS: 141 rural families with a child with overweight/obesity participated in an 8 month family based pediatric obesity treatment. During the intervention families attended 14 group sessions. Engagement was coded during 2 sessions using the Group Engagement Measure (GEM). Activity data (MVPA and SED) was collected at baseline and post intervention (8 month). Multilevel modeling analyses accounted for the cluster design of families nested within schools. RESULTS: 50 families attended at least one group session and were included in analyses. Over 8 months, on average, children (8.4 ± 1.4 years; 59% female) reduced their MVPA by 3.4 ± 19.5 min/day and increased their SED by 24.9 ± 54.3 min/day. Families had an average GEM score of 73.6 ± 6.6. There was a 7 min/day difference in child MVPA between families scoring high/low (+/- 1 SD from mean) on the GEM but this difference was not statistically significant. The difference in SED between high/low GEM scores was nonsignificant and not meaningful (1 min/day). CONCLUSIONS: Findings support that ratings of engagement during the intervention had a stronger relationship with MVPA than just participating in the intervention, though it provided limited insights into changes in MVPA and SED in this intervention. Further research is needed to quantify and investigate other factors that may be better predictors of success in treatment interventions for children with overweight/obesity in pursuit of developing innovative ways to increase children’s activity.

An Intervention Pattern of Family Parent-Child Physical Activity Based on a Smartphone App for Preschool Children during COVID-19.

Objective Children's lifestyles, behaviors, and educational activities were affected by COVID-19. The preschool children struggled with the challenge of learning at home and avoiding a rapid decrease in physical activity (PA). This study tested the effectiveness of a family-based intervention that integrated the family and preschool based on a smartphone app to improve the moderate-to-vigorous PA (MVPA) and physical fitness of preschool children during COVID-19. Methods This 8-week study was conducted using a quasiexperimental pre- and posttest design with a comparison group. A total of 66 pairs of preschool children (30 boys) and their parents and 44 preschool children (24 boys) and their parents composed the experimental group (EG) and the control group (CG), respectively. PA was measured using a GENEActiv waveform triaxial accelerometer. Children's physical fitness was assessed using a battery test from the Chinese National Measurement Standards on People's Physical Fitness for preschool children. Results Preschool children and their parents in the EG participated in less sedentary (p < 0.01) and more light PA (p < 0.01) and MVPA (p < 0.01) compared with those in the CG at the late PA assessment. The EG significantly improved the mean performance of tennis ball throw (p < 0.05), balance beam walk (p < 0.01), and continuous jumping on both feet (p < 0.01) compared to the CG. Conclusions The family parent-child PA intervention based on a smartphone app can effectively increase the MVPA of preschool children and their parents, reduce sedentary time, and improve preschool children's physical fitness. Overall, the family parent-child PA intervention model based on a smartphone app for preschool children designed in this study is feasible and effective.

Parent Support Is Related to Physical Activity among Children and Youth with Disabilities during the COVID-19 Pandemic: Findings from the National Physical Activity Measurement (NPAM) Study

Physical activity (PA) among children and youth with disabilities (CYD) has been negatively impacted by the COVID-19 pandemic. Parent PA support and parent PA modelling (i.e., parents engaging in PA themselves) have been shown to be associated with PA in CYD. However, parents’ influence on the PA behaviours of CYD during the pandemic remains unknown. The purpose of this study was to examine the relationship between parent PA support and parent PA modelling (i.e., parent moderate-to-vigorous PA (MVPA)) and the PA behaviours of CYD. It was hypothesized that higher levels of parent PA support and parent PA modelling would significantly relate to both child MVPA and child PA at any intensity. An online survey was sent to parents of CYD in November 2020 (i.e., during the second wave of the COVID-19 pandemic in Canada) that assessed the MVPA and total PA (any intensity), parent PA support (e.g., encouraging PA, providing transportation for PA), and parent MVPA. Separate linear regression models assessed the relationships between parent PA support and parent PA modelling with (a) child MVPA and (b) child PA at any intensity. Parent and child age, child gender and disability group, marital status, and household type were controlled for in all analyses. A total of 86 parents (Mage = 43 years, SD = 5.9; 93% mothers) of CYD (Mage = 11 years, SD = 3.3; 20% girls; 77% with a developmental disability) completed the survey. Parent PA support was significantly associated with child MVPA (β = 0.30, CI = 0.067–0.438, p = 0.008) but not child PA at any intensity. No significant relationship was shown between parent PA modelling and either child MVPA or child PA at any intensity. Findings suggest that parent PA support, but not parent PA modelling, was associated with PA in CYD, at least during the acute period of the pandemic. Greater efforts must be directed towards developing effective parent PA support interventions to reduce the detrimental effects of the COVID-19 pandemic on PA in CYD.

Day-level associations of physical activity and sedentary time in mother-child dyads across three years: a multi-wave longitudinal study using accelerometers.

Understanding associations between mothers' and children's physical activity and sedentary behavior on more fine-grained timescales can provide insights into real-time intervention opportunities. This study examined the extent to which mothers' and their children's device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time (SDT) were associated at the day level during non-school time. Mother-child dyads (N = 193; baseline Mean ages = 40.69 ± 6.11 [mother] and 9.57 ± 0.89 [child] years) provided 3,135 paired days of accelerometry data from six bi-annual waves across threeyears. Controlling for covariates, multilevel models revealed that mothers' and their children's MVPA and SDT were positively associated at the day level during non-school time, both on weekdays and weekends. During weekdays, the day-level association for SDT was stronger for older than younger children, and the day-level association for MVPA was stronger for boys than girls. Designing family-based interventions targeting school-age children and their mothers during non-school time across the week may be useful for promoting active lifestyles.

A253 IMPACT OF THE COVID-19 PANDEMIC LOCKDOWN ON PHYSICAL ACTIVITY LEVELS IN CHILDREN AND ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE IN QUEBEC

BackgroundAn average daily moderate-to-vigorous physical activity (MVPA) of at least 60 minutes was recommended by the Canadian Guidelines for children. Because of lockdown restrictions during the COVID-19 pandemic, maintaining physical activity levels (PAL) has been a challenge for youth.AimsThe primary aim of this study was to compare MVPA levels in children with inflammatory bowel diseases (IBD) before and after this period. The secondary aims were to assess clinical factors that might influence any changes in MVPA patterns.MethodsPatients with IBD, age ≥5 years, were enrolled in a prospective study on PAL starting June 2018 (self-reported questionnaires during outpatient visits). They were then surveyed online at the end of the second lockdown in July-August 2021. PAL were assessed with the Canadian Health Measure Survey Children-Physical Activity Questionnaire. The responses were converted into metabolic equivalents of tasks by using validated tables. Influence of clinical factors of IBD on changes in MVPA was assessed. A multivariate logistic regression was performed to investigate the association between several risk factors and PAL.ResultsWe included 72 patients (38 males; mean (SD) age 17.0 (2.89) years, 48 (66.7%) diagnosed with Crohn’s disease, 19 (26.4%) with ulcerative colitis, and 5 (6.9%) with indeterminate colitis). At last follow-up, 90.3% were in clinical remission according to validated disease activity score. During summer 2021, 16.7% of patients reached the Canadian PAL target, compared to 38.9% before the pandemic. The median daily duration of MVPA in summer 2021 decreased from 37 (Interquartile range (IQR) = 3–82) to 21 (IQR=3–40) minutes. The proportion of sedentary patients increased by 1.4% (37.5% to 38.9%). The proportion of extremely active patients decreased by 16.7% (27.8% to 11.1%), while moderately active patients increased by 20.9% (8.3% to 29.2%). Age, gender, disease type and activity were not significantly associated with the PAL at baseline or at follow-up.ConclusionsThis study found a significant decrease in PAL and time spent doing MVPA in children with IBD in Quebec following the COVID-19 pandemic lockdown. While the recommended target was far from being met before the pandemic, the gap has widened further during the pandemic. We found no clinical factors associated with the PAL. The impact of low PAL on well-being, weight, disease activity and quality of life will be assessed during the follow-up of this cohort.Funding AgenciesNone

Physical activity, quality of life and parenting stress in children with cerebral palsy

Children with cerebral palsy (CP) are less physically active than their typically developing peers. The effects of decreased physical activity on children's quality of life (QOL) or caregiver's lives are not well understood. This study aimed to investigate the association between physical activity, QOL, and parenting stress in children with CP. A prospective cross-sectional study was done in children with CP. Daily physical activity was measured over 7 days using an accelerometer (ActiGraph™). Caregivers completed the Child Health Questionnaire - Parent Form 50 and Parenting Stress Index - Short Form. Multiple regression analysis was used. In total, data from 65 children with Gross Motor Function Classification System (GMFCS) levels I-V, aged 4-13 years, were analyzed. Non-ambulatory (GMFCS IV-V) children had significantly lower activity counts and moderate to vigorous physical activity (MVPA) in comparison with ambulatory (GMFCS I-II) and marginally ambulatory (GMFCS III) children. The ambulatory group had better physical QOL than the non-ambulatory group. Caregivers of the non-ambulatory or marginally ambulatory children with CP reported higher parenting stress levels than those of the ambulatory group. Time spent in MVPA and activity counts were positively associated with physical QOL in children with CP. Low activity counts and low amounts of MVPA of children with CP were significant predictors of high parenting stress. Physical activity in children with CP is associated with children's QOL and parenting stress. These results suggest that clinicians should conduct physical activity assessment and counseling to promote physical activity.

Parental-perceived home and neighborhood environmental correlates of accelerometer-measured physical activity among school-going children in Uganda.

The benefits of physical activity (PA) on children's health and well-being are well established. However, many children do not meet the PA recommendations, increasing their risk of being overweight, obese, and non-communicable diseases. Environmental characteristics of homes and neighborhoods may constrain a child's ability to engage in PA, but evidence is needed to inform country-specific interventions in understudied low-income countries. This study assessed the associations between parental-perceived home and neighbourhood, built environment characteristics, and moderate-to-vigorous physical activity (MVPA) among children in Kampala city, Uganda. In this cross-sectional study, data were obtained from 256 children (55.5% girls) aged between 10 and 12 years and their parents. Children's MVPA was measured using waist-worn ActiGraph accelerometers. The environments were assessed using a valid self-reported parent survey. Linear regression models with standard errors (clusters) were used to analyze the relationship between environmental variables and children's MVPA. Sex-specific relationships were assessed using sex-stratified models. Play equipment at home (β = -2.37, p <0.001; unexpected direction), residential density (β = 2.70, p<0.05), and crime safety (β = -5.29, p <0.05; unexpected direction) were associated with children's MVPA. The sex-specific analyses revealed more inconsistent patterns of results with a higher perception of land use mix associated with less MVPA in girls (irrespective of school type attended), and higher perceptions of sidewalk infrastructure (β = -12.01, p <0.05) and walking and cycling infrastructure (β = -14.72, p <0.05) associated with less MVPA in girls attending public schools only. A better perception of crime safety was associated with less MVPA among boys and girls attending private schools (β = -3.80, p <0.05). Few environmental characteristics were related to children's MVPA in Uganda, and findings were largely inconsistent, especially among girls. Future studies are needed to understand the ecological determinants of health-related PA behaviors among children in Uganda.

Are Young Children With Asthma More Likely to Be Less Physically Active?

To investigate longitudinally whether asthma or wheeze at age 4 years of age was associated with lower physical activity levels at the age of 6 years.In the study, the researchers included 391 children from the Australian HealthNuts cohort who had follow-up at the ages of 4 and 6 years, agreed to wear an accelerometer, and returned valid data. At the age of 4 years, 8.7% had current asthma, and 14.6% had ever wheezed or had asthma.Asthma and wheeze data were collected by using a standardized, validated questionnaire at the ages of 4 and 6 years. Physical activity was measured through accelerometry after the age 6 visit. Participants wore an accelerometer watch on the wrist of their nondominant hand 24 hours per day for 8 consecutive days, even while sleeping, swimming, and bathing. Associations were investigated by using linear adjusted regression models. The primary outcome was daily minutes spent in moderate-to-vigorous physical activity (MVPA).There was no evidence of difference in time spent in MVPA at the age of 6 years between children with and without asthma at the age of 4. Children with asthma spent 8.3 minutes more time physically active per day (95% confidence interval [CI]: −5.6 to 22.1; P = .24) than children without asthma did. Children with current wheeze spent 5.8 minutes per day more than those without did (95% CI: −5.9 to 17.5; P = .33), and those who had ever experienced wheeze or asthma spent 7.7 minutes per day more than those who had never done so (95% CI: −4.8 to 20.2; P = .23). Null results were also observed in the cross-sectional analyses. Interaction with BMI could not be assessed. Earlier asthma or wheeze status and sex were not found to modify these associations.In this study, the researchers found no evidence of an association between asthma and reduced physical activity in young Australian children.Physical inactivity is a considerable risk factor for the development of a variety of illnesses. Asthma is the most common chronic condition in childhood and may result in unnecessary restrictions on physical activity in children, despite guidelines encouraging the opposite. With this prospective study, the authors provides evidence that there is no association between asthma or wheeze and decreased MVPA in Australian children. This reveals that Australian children are successfully maintaining physical activity despite asthma or wheezing. This success should be emulated in other settings and populations, to ensure that patients with asthma and their families are aware that physical activity is beneficial and should be encouraged in asthmatics.

The Effects of Socioeconomic Status on Parent and Child Moderate-to-Vigorous Physical Activity and Body Mass Index

ABSTRACT Purpose: Physical inactivity and overweight status has been linked to low socioeconomic status (SES) in youth. Parents are known to influence both their child’s weight and physical activity (PA). The relationship between parent and child PA is of interest to many researchers; however, previous research typically relies on self-reported measures. The purpose of this study was to examine the relationship between parent and child moderate-to-vigorous PA (MVPA) and body mass index (BMI) in a sample of children (4–11 years old) using wrist-worn accelerometers and to explore mediating processes by which SES influences child MVPA and BMI through their parents MVPA and BMI. Methods: Parent and child dyads (n = 174) wore an ActiGraph GT3X+ accelerometer on their non-dominant wrist for 7 days. Mediation analyses were conducted to understand the indirect relationships between SES and child MVPA and BMI. Results: Weekend parent and child MVPA was significantly related (p < .01). Parent and child BMIs were also significantly related (p < .001). There was a significant negative direct effect of SES on child BMI (p < .05). Additionally, we observed a significant negative indirect effect of SES on child BMI via their parents BMI (B = −.04, SE .02, 95% CI = −.07 to −.01). Conclusions: Whilst parent and child MVPA were significantly related during the weekend, there were no associations between SES and MVPA. Future interventions aiming to improve health outcomes in children should consider the influence SES can have as well as parental activity on children’s weekend MVPA.

Validation of the Apple Watch for Estimating Moderate-to-Vigorous Physical Activity and Activity Energy Expenditure in School-Aged Children.

The Apple Watch is one of the most popular wearable devices designed to monitor physical activity (PA). However, it is currently unknown whether the Apple Watch accurately estimates children’s free-living PA. Therefore, this study assessed the concurrent validity of the Apple Watch 3 in estimating moderate-to-vigorous physical activity (MVPA) time and active energy expenditure (AEE) for school-aged children under a simulated and a free-living condition. Twenty elementary school students (Girls: 45%, age: 9.7 ± 2.0 years) wore an Apple Watch 3 device on their wrist and performed prescribed free-living activities in a lab setting. A subgroup of participants (N = 5) wore the Apple Watch for seven consecutive days in order to assess the validity in free-living condition. The K5 indirect calorimetry (K5) and GT3X+ were used as the criterion measure under simulated free-living and free-living conditions, respectively. Mean absolute percent errors (MAPE) and Bland-Altman (BA) plots were conducted to assess the validity of the Apple Watch 3 compared to those from the criterion measures. Equivalence testing determined the statistical equivalence between the Apple Watch and K5 for MVPA time and AEE. The Apple Watch provided comparable estimates for MVPA time (mean bias: 0.3 min, p = 0.91, MAPE: 1%) and for AEE (mean bias: 3.8 kcal min, p = 0.75, MAPE: 4%) during the simulated free-living condition. The BA plots indicated no systematic bias for the agreement in MVPA and AEE estimates between the K5 and Apple Watch 3. However, the Apple Watch had a relatively large variability in estimating AEE in children. The Apple Watch was statistically equivalent to the K5 within ±17.7% and ±20.8% for MVPA time and AEE estimates, respectively. Our findings suggest that the Apple Watch 3 has the potential to be used as a PA assessment tool to estimate MVPA in school-aged children.

Self-Reported Physical Activity and Asthma Risk in Children

Increased physical activity (PA) may protect against asthma but PA can trigger asthma symptoms. To investigate relationships between moderate-to-vigorous PA (MVPA) assessed during routine care visits and incident asthma. For this retrospective cohort, 542,486 children between 2 and 17 years from 2010 to 2017 were included who had an MVPA assessment (exercise vital sign) during routine care visits. The association of MVPA and asthma was analyzed using Cox proportional hazards regression models as a function of age, with MVPA and body mass index (BMI) being time-varying factors, adjusted for race and ethnicity, socioeconomic status, and air pollution. The mean MVPA was 5.4 (standard deviation: 4.4) hours/week. Crude asthma incidence density rate (IDR) was highest in children with <1 hour/week of MVPA (IDR: 9.07, 95% confidence interval [CI]: 8.79, 9.36) and lowest in children engaging in 4 to 7 hours/week of MVPA (IDR: 6.55, 95% CI: 6.33, 6.77). In adjusted models, an increase in MVPA wasassociated with lower asthma risk in children reporting 0 hour/week of MVPA (hazard ratio: 0.981, 95% CI: 0.973, 0.990). In children with ≥8 hours/week of MVPA, an increase in MVPA was associated with higher asthma risk (1.005, 95% CI: 1.002, 1.009). There was no significant BMI by MVPA interaction. Increasing MVPA in children with low activity levels is associated with lower asthma risk; children reporting high levels of activity may experience greater asthma risk as their activity levels increase further. Understanding the role of PA in the development of asthma and assessing MVPA during routine care visits in children may help to develop targeted interventions and guide asthma management.