Physical Activity Guidelines For Children Research Articles

A comparative study of the physical activity guidelines for children and adolescents from five countries and WHO.

This study presented a narrative review of the six latest sets of guidelines on physical activity for children and adolescents from Australia, Canada, China, the United Kingdom, the United States and WHO, and analysed the history of the development of the guidelines; the policy context in which the guidelines were developed; and the main subjects of the guidelines. The core elements of the latest guidelines were identified and compared, including frequency, intensity, duration (time), and type of physical activity, assessment intensity of physical activity, and risk prevention for physical activity participation. There is an urgent need for obtaining the latest scientific evidence to support and update the contents of the Chinese guidelines. We therefore make the following recommendations for future revisions of the Chinese guidelines based on the findings of this study: (1) to update the recommended frequency, intensity, duration, and type of physical activities that meet the needs for Chinese children and adolescents; (2) to update the methods for assessing physical activity intensity, and identifying and managing the risk factors in participating in physical activity; and (3) to incorporate analyses and reviews of school physical education curriculum for effectively achieving the adequate levels of physical activity.

O3-4 Progress on addressing the cornerstones of physical activity policy for children and youth in England

BackgroundThere has been an increasing focus on the importance of national policy to address population levels of physical inactivity. It has been suggested that the four ?cornerstones' of policy comprise: 1) national guidelines on physical activity levels; 2) setting population goals and targets; 3) surveillance or health monitoring systems; and 4) public education. The aim of the current paper was to analyse the policy actions which have addressed each of these elements for children and youth in England and to identify areas of progress and remaining challenges.MethodsA literature search was undertaken to identify past and present documents relevant to physical activity policy for children and youth in England. Each document was analysed to identify content relevant to the four ?cornerstones' of policy.ResultsPhysical activity guidelines for children and youth have been in place since 1998 and reviewed periodically to ensure they reflect the latest scientific evidence. The setting of physical activity targets has focused on the provision of opportunities for physical activity, particularly through physical education (PE) in schools, rather than in relation to the proportion of children meeting recommended physical activity levels. There has been much surveillance of children's physical activity but this has been undertaken infrequently over time, by a wide range of organisations, and with varying inclusion of different domains of activity such as school PE, leisure time activity and active travel. There has only been one campaign in England targeted at children and their intermediaries (Change4Life), which was an obesity campaign focussing on dietary behaviour in combination with physical activity. Most recently an infographic supporting the physical activity guidelines for children and young people was developed, but details of its dissemination and usage are unknown.ConclusionsThere have been many developments in physical activity policy in England targeted at children and youth. The area of greatest progress is national physical activity guidelines. Establishing prevalence targets, streamlining surveillance systems, and investing in public education would strengthen national policy efforts to reduce physical inactivity.

The concurrent and predictive validity of a tool to measure strength engagement during inclusive equestrian vaulting

Participation in muscle strengthening activities is a less examined component of public health physical activity guidelines for children and youth compared to participation in physical activity. In part, the lack of focus on strength is associated with the difficultly of measuring strength activities during participation. The aim of this pilot study was to develop and provide evidence of the concurrent and predictive validity of the Strength Observation during Vaulting (SOV) tool. Six female youth (4 with a disability and 2 without a disability) ranging in age from 11 – 22 years (Mage = 14.2 y, SD = 4.0) participating in a 5-day inclusive equestrian vaulting camp were recruited. Participants completed three measures of strength, and video of vaulters engaging in camp activities was coded using the System for Observing Fitness Instruction Time (SOFIT) and SOV tools. From a linear regression model (significant p = .020), the three measures of strength accounted for 98.7% of the shared variance with time spent in SOV levels 4 and 5. Bivariate correlation coefficients comparing SOV levels 4 and 5 and moderate-vigorous physical activity (MVPA) from SOFIT were r = .73 for all contexts, r = .89 for floor-work, r = .64 for barrel vaulting, r = .76 for horse vaulting, and r = .81 for stable chores. The predictive and concurrent validity of the SOV tool was more than adequate. Based on these results, the systematic observation is a feasible approach to assess engagement in strength activities during vaulting.

Meeting 24-hour movement behavior guidelines in young children: Improved quantity estimation and self-regulation

ABSTRACT Research Findings: The present study examined the associations among meeting 24-hour movement behavior recommendations set by the World Health Organization (2019) and young children’s self-regulation and quantity estimation skills in a sample of 123 children (n = 65 female; 4.9 ± 0.7 years) in mid-Michigan. Meeting screen time recommendations alone, meeting physical activity recommendations in combination with either sleep or screen time recommendations, meeting more recommendations overall, and being active more days weekly were associated with superior quantity estimation. Meeting more guidelines and accruing more moderate-to-vigorous physical activity daily related to better self-regulation. Improvements in self-regulation partially mediated the relation between physical activity and quantity estimation. Practice or Policy: Our findings identify benefits for adopting specific physical activity guidelines for children (e.g., physical activity, screen time, and sleep duration) and integrating these into early learning standards so both families and schools can support children’s capacity to meet 24-hr movement guidelines and thus support cognitive health. An active lifestyle in early childhood may support young children’s self-regulation and early educational outcomes, with physical activity promotion efforts during early childhood serving as a viable means to address growing expulsion rates in preschool-aged children.

Longitudinal trends and predictors of muscle-strengthening activity guideline adherence among Canadian youths

ObjectivesMuscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5–17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths. DesignLongitudinal. MethodsData were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity). ResultsFor the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p < 0.001 for linear trend). Population sub-groups less likely to meet the guideline at each wave included females, youth who were underweight or obese, those reporting insufficient aerobic physical activity, those from large urban settings, and youth who identify as Asian. ConclusionsAmong a large sample of Canadian youths, approximately half met the MSE guideline, with this prevalence declining over time. Large-scale MSE interventions are needed to address the low and decreasing adherence to this key modifiable health-related behavior among Canadian youths.

Vigorous physical activity is important in maintaining a favourable health trajectory in active children: the CHAMPS Study-DK

Physical activity (PA) is critical to improving health factors such as weight, adiposity, and aerobic fitness. However, children who meet PA guideline recommendations demonstrate developmental differences in health-related outcomes. To investigate prospective associations between PA behaviour (overall PA and PA intensity) and trajectories of health-related factors among physically active children. This prospective study (2.5 years) included 391 children (baseline age: 8.1 ± 1.4 years; girls 36.3%) from ten public schools. All children performed 60-min or more of moderate-to-vigorous physical activity (MVPA) per day objectively measured. Trajectories of BMI, waist circumference, and aerobic fitness were constructed with a group-based multi-trajectory model. Three trajectory subgroups were identified: ‘high fitness/normal weight’ (48.4% of children), ‘moderate fitness /normal weight’ (42.5% of children), and ‘low fitness/overweight-obese’ (9.1% of children). Children performing higher overall PA, were less likely of being classified as members of the ‘Low Fitness/Overweight-Obese’ [Relative Risk Ratio (RRR and 95% CI) = 0.56 (0.37 to 0.85) compared to ‘high fitness/normal weight’ subgroup. Each additional 5% in light PA time was associated with approximately twofold [RRR 2.12 (1.24–3.61)] increased risk of being in the ‘low fitness/overweight-obese’ trajectory relative to the ‘high fitness/normal weight’ trajectory. Each additional 2% in vigorous-PA time was associated with a 42% and 85% reduced risk (relative to ‘high fitness/normal weight’) of being in the ‘moderate fitness/normal weight’ [RRR 0.58 (0.38–0.96)] and ‘low fitness/overweight-obesity’ [RRR 0.15 (0.06–0.37)] trajectory, respectively. Overall PA and additional time in vigorous-PA was associated with improved health-related outcomes, while light PA was negatively associated with health-related outcomes among children who adhere to PA guideline recommendations. Vigorous PA was the strongest predictor of the health trajectories. All PA guidelines for children should place greater emphasis on the importance of vigorous PA.

The relationship between sleep habits, lifestyle factors, and achieving guideline-recommended physical activity levels in ten-to-fourteen-year-old Japanese children: A cross-sectional study.

The current focus of meeting the physical activity guidelines for children and young people include preventing conditions such as high blood cholesterol, high blood pressure, metabolic syndrome, obesity, low bone density, depression, and injuries. However, the relationship between sleep habits and meeting physical activity guidelines is still unclear. This study aimed to assess this relationship among fifth- to eighth-grade (ages 10–14) Japanese children. This cross-sectional study included 3,123 children (boys: 1,558, girls: 1,565, mean age: 12.5 ± 1.2 years). Questionnaires were used to assess parameters such as moderate-to-vigorous physical activity per day, school and weekend night sleep durations, social jetlag, daytime sleepiness, napping, screen time, and breakfast intake. Participants were divided into an achievement and a non-achievement group depending on their physical activity guideline achievement status (i.e., whether they met the children’s physical activity guideline of 60 min or more of moderate-to-vigorous physical activity per day). Then, to determine the sleep habits in relation to the children’s achievement of guideline-recommended physical activity levels, multivariate logistic regression analyses were conducted. In fifth- and sixth-grade (ages 10–12) boys, an inverse association was observed between physical activity guideline achievement and daytime sleepiness. In seventh- and eighth-grade (ages 12–14) boys, physical activity guideline achievement was inversely associated with social jetlag and skipping breakfast. Additionally, in seventh- and eighth-grade girls, physical activity guideline achievement was inversely associated with inappropriate sleep duration on weekends and screen time. These results suggest that meeting the physical activity guideline is related to favorable sleep habits in Japanese children. However, their relevance may differ by school type and gender.

Effects of an Activity Tracker and App Intervention to Increase Physical Activity in Whole Families-The Step It Up Family Feasibility Study.

(1) Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in whole families. Further, few family-centered interventions have actively involved both parents and assessed physical activity effects separately for children, mothers and fathers. Objective: To examine the feasibility and short-term effects of an activity tracker and app intervention to increase physical activity in the whole family (children, mothers and fathers). (2) Methods: This was a single-arm feasibility study with pre-post intervention measures. Between 2017–2018, 40 families (58 children aged 6–10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults; Garmin Australasia Pty Ltd., Sydney, Australia), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages and an introductory session. Parent surveys were used to assess physical activity effects measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. Objective Garmin activity tracker data was recorded to assess physical activity levels (steps, active minutes) during the intervention. (3) Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p < 0.001). In mothers, MVPA increased by 27 min/day (p < 0.001) and in fathers, it increased by 31 min/day (p < 0.001). The percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p < 0.001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p < 0.001) in mothers and from 21% to 68% (p < 0.001) in fathers. The percentage of families with ‘at least one child and both parents’ meeting the physical activity guidelines increased from 0% to 41% (p < 0.001). Objective activity tracker data recorded during the intervention showed that the mean (SD) number of active minutes per day in children was 82.1 (17.1). Further, the mean (SD) steps per day was 9590.7 (2425.3) in children, 7397.5 (1954.2) in mothers and 8161.7 (3370.3) in fathers. (4) Conclusions: Acknowledging the uncontrolled study design, the large pre-post changes in MVPA and rather high step counts recorded during the intervention suggest that an activity tracker and app intervention can increase physical activity in whole families. The Step it Up Family program warrants further efficacy testing in a larger, randomized controlled trial.

Impact of School-Based Fitness Testing Awards on Physical Activity Guidelines for Children With Disabilities: NHANES 2013-2016.

The purpose of this study is to determine the association between school-based fitness testing awards and meeting physical activity guidelines among children with disabilities. Cross-sectional secondary data analysis using NHANES 2013-2016. Data from NHANES 2013-2016 were used. 3915 children without disabilities and 647 children with disabilities between ages of 5 to 15 years. Self-reported from children or proxy response from guardians in above parameters. Chi-square test and multivariable logistic regression. There is no significant different between children with and without disabilities in receiving school-based fitness testing awards (×2 = 4.14, p = .05). According to both crude and adjusted model, children with disabilities are more likely to received school-based fitness testing awards than children without disabilities (OR = 1.44, 95% C.I. [.98, 2.12]; OR = 1.27, 95% C.I. [.85, 1.89]). Also, for children with disabilities, children who did not received school-based fitness testing awards are more likely to meet PA guidelines than children who received school-based fitness testing awards according to both crude and adjusted models (OR = 1.71, 95% C.I. [.66, 4.47]; OR = 1.37, 95% C.I. [.59, 3.16]). Receiving school-based fitness testing could potentially increase self-efficacy in engaging in physical activity among children with disabilities. However, there is a need to determine if the current approach of utilizing awards are sufficient enough to promote physical activity among children with disabilities.

Physical Activity and Sedentary Behavior of Children in Afterschool Programs: An Accelerometer-Based Analysis in Full-Day and Half-Day Elementary Schools in Germany.

Background: Regular physical activity (PA) and reduced sedentary behavior (SB) are positively related to children's health and considered as pillars of a healthy lifestyle. Full-day schools with their afterschool programs (ASPs) have an impact on children's daily PA and SB. Studies investigating PA and SB in ASPs, which compare PA and SB between the organizational forms full-day and half-day schools, are rare. The aim of this study is to describe elementary school children's PA and SB during ASPs and to compare the results to other time periods of the day, e.g., teaching hours and leisure time. Additionally, PA and SB of children in full-day and half-day schools are compared. Further, relevant factors influencing the achievement of the World Health Organization's (WHO's) PA guidelines for children, e.g., time spent in ASPs, are investigated.Methods: PA and SB of 332 German students (n = 198 full-day school children; n = 134 half-day school children) from 11 different elementary schools were measured via accelerometry for 5 consecutive days within one school week in 2017. PA and SB during ASPs and other times of the day were analyzed via one-way and factorial ANOVA, correlation, and logistic regression.Results: Children attending full-day schools show the highest percentage of moderate-to-vigorous PA (MVPA) (13.7%) and the lowest percentage of SB (49.5%) during ASPs, in comparison with teaching hours and leisure time. In the afternoon hours, full-day school children show 20 min less SB than half-day school children. Children spending more time in ASPs obtain significantly more SB (r = 0.23) and less MVPA (r = −0.15). Further, they less likely reach WHO's PA guidelines odds ratio (OR = 0.98).Conclusion: Peers and the choice as well as offer of extracurricular activities promote PA in ASPs. Media availability leads to higher SB in leisure time. ASPs help to be more active and less sedentary. Time spent in ASPs should be limited, so that full-day school children still have the possibility to join other PA offers in leisure time. ASP time should contain a certain minimum amount of MVPA in line with ASP guidelines.

What are the effects of ketogenic diets on drug-resistant epilepsy? A Cochrane Review summary with commentary.

What are the effects of ketogenic diets on drug-resistant epilepsy? A Cochrane Review summary with commentary.

Children’s physical activity levels during organised sports practices

ObjectivesThis study measured the physical activity levels of children during practice sessions of four popular organised sports in Australia. DesignCross-sectional observational design. MethodsParticipants comprised children from four local organised sports clubs in suburban Adelaide, South Australia. The sports examined were Australian Rules Football (AFL), girls’ netball, boys’ soccer and girls’ soccer. Each participant wore a waist-mounted GT3X or GT3X+Actigraph accelerometer in either one or two of the practice sessions. ResultsParticipants typically spent 40–50% of each sport practice session in moderate to vigorous physical activity (MVPA). Participants in the boys’ soccer teams spent significantly greater time in MVPA (mean=47% of practice time, 95% CI=37%, 57%) than participants in the girls’ netball teams (mean=40%, 95% CI=30%, 50%), participants in the girls’ soccer teams (mean=38%, 95% CI=28%, 48%) and participants in the boys’ AFL teams (mean=40%, 95% CI=36%, 44%). The practice sessions contributed approximately half of the 60min of MVPA per day recommended by physical activity guidelines for children and young people. ConclusionsThe results suggested that organised sports provide a supportive environment for physical activity accrual; however, one practice session is insufficient for children to reach the amount of MVPA recommended in daily physical activity guidelines.

Background and Methodology of the Development of German Physical Activity Guidelines

This paper describes the process used to develop the physical activity guidelines for German children and adolescents (0-17 years), adults (18-64 years), older adults ≥65 years and adults with chronic diseases. The German physical activity guidelines were developed by an interdisciplinary working group based on existing guidelines using a 3-phased process. Phase 1: Systematic literature searches for current physical activity guidelines; expert consultation-based development of quality criteria. Phase 2: Evaluation of physical activity guidelines based on the quality criteria; identification and content analysis of high-quality guidelines. Phase 3: Synthesis of content analysis and deduction of German physical activity guidelines. Expert consultation generated 28 quality criteria classified into the 4 domains "A: scope and purpose" (3 items), "B: rigour of development" (10 items), "C: clarity and comprehensiveness of content" (12 items), "D: arrangement and presentation" (3 Items). We identified 66 guidelines scoring ≥60% of the possible rating points in domain A and B as high-quality "source-guidelines" (children and adolescents n=4, adults=16, older adults n=9, 7 chronic diseases n=37). Source-guidelines constitute the database for the development of the German physical activity guidelines. The national physical activity guidelines for children and adolescents, adults, older adults and persons with chronic diseases serve as an evidence-based and quality-controlled basis for physical activity promotion in Germany.

Walking the talk? Teachers’ and early years’ practitioners’ perceptions and confidence in delivering the UK Physical Activity Guidelines within the curriculum for young children

ABSTRACTThis study explored early years’ practitioners’ and teachers’ attitudes and confidence in delivering the UK Physical Activity guidelines [National Health Service (NHS). (2013). Physical activity guidelines for children and young people. Retrieved July 15, 2015, from www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-young-peopole.aspx] within the curriculum for young children [Department for Education (DfE). (2013). The national curriculum in England. Key stages 1 and 2 framework document. London: Department for Education, Crown; Department for Education (DfE). (2014). Statutory framework for the early years’ foundation stage. Setting the standards for learning, development and care for children from birth to five. London: Department for Education, Crown]. Using an online questionnaire, data were analysed using thematic framework and statistically. Fifty-nine respondents came from early years’ settings, including nurseries, pre-schools and primary schools. The findings suggest that there is a lack of confidence in knowing what to do to support and sustain physical activity. Further research is needed to identify if this is a national trend; this is the next steps of our research, as is the development of resources to help support confidence and the delivery of physical activity for young children.

Changes in indicators of child and youth physical activity in Canada, 2005-2016.

Physical activity trend analysis enables the monitoring and surveillance of physical activity indicators and the identification of areas that should be targeted for intervention and promotion, which is particularly important at present because so few school-aged children and youth in Canada adhere to the Canadian Physical Activity Guidelines for Children and Youth. In this commentary, we demonstrate through a descriptive temporal trend analysis of grade changes in the ParticipACTION Report Card on Physical Activity for Children and Youth that there have been positive changes in several indicators of physical activity support (family, school, community and environment, government, non-government) in Canada over the last 12 years. However, these changes have seldom resulted in the desired behavioural-level modifications or been associated with any meaningful increase in the prevalence of children and youth meeting the Canadian Physical Activity Guidelines for Children and Youth. This suggests that physical activity intervention and promotion efforts may need to focus more on directly targeting the physical activity behaviours of Canadian children and youth, or that alternate approaches are required.

WHO Recommended Structured Physical Activity Intervention Improves Psychomotor Speed And Neuro-cognitive Functions In Adolescent Students.

PURPOSE: To study the effect of six months of structured and unstructured physical activity interventions on psychomotor speed and neuro-cognitive functions in adolescents. METHODS: In our randomized, single blinded, parallel group, active controlled trial (CTRI/2013/08/003897) the recruited healthy school student volunteers, aged 12 - 17 years (n = 439), were allocated into Structured Physical Activity (SPA) and Unstructured Physical Activity (USPA) intervention groups by age and gender stratified block randomization. SPA designed as per World Health Organization (WHO) Physical Activity Guidelines for children and youth, and USPA which included any indoor or outdoor recreational activity of the participant’s choice, were administered by physical education instructors for two hours a day, six times a week, for six months. Auditory and visual reaction times (ART and VRT), Letter Cancellation test (LCT), Trail Making test A and B (TTA and TTB), Ruff Figural Fluency test (RFFT) were recorded pre and post intervention that was successfully completed by 347 participants. Data analysis was done by an investigator blinded to the allocation sequence using student ‘t’ tests by following per-protocol analysis (SPA n = 172 and USPA n = 175). RESULTS: LCT and TTB times (seconds) were significantly reduced in structured physical activity group [(LCT - USPA: 105.33 ± 19.54 vs. 104.61 ± 15.22, p = 0.528; SPA: 107.08 ± 21.87 vs. 100.03 ± 18.12, p = < 0.001) (TTB - USPA: 93.19 ± 21.88 vs. 88.50 ± 18.29, p = < 0.001, SPA: 94.31 ± 26.61 vs. 87.44 ± 20.27, p = < 0.001)]. TTA time was not significantly altered in both the groups. VRT and ART (milliseconds) were significantly reduced in both the groups however the improvement was better in structured physical activity group [(VRT - USPA: 212.54 ± 29.88 vs. 192.10 ± 25.26, p = < 0.001, effect size = 0.76; SPA: 214.36 ± 31.09 vs. 187.23 ± 28.31, p = < 0.001, effect size = 0.87) (ART - USPA: 187.65 ± 19.29 vs. 175.15 ± 19.31, p = < 0.001, effect size = 0.65; SPA: 188.54 ± 23.71 vs. 169.61 ± 22.79, p = < 0.001, effect size = 0.79)]. CONCLUSION: Structuring the physical training intervention (as per WHO guidelines) in a cognitively engaging manner leads to greater improvements in psychomotor speed and neuro-cognitive executive functions of adolescents, probably due to cognitive loading and contextual interference.

Assessment of Diet and Physical Activity in Paediatric Non-Alcoholic Fatty Liver Disease Patients: A United Kingdom Case Control Study.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children, with prevalence rising alongside childhood obesity rates. This study aimed to characterise the habitual diet and activity behaviours of children with NAFLD compared to obese children without liver disease in the United Kingdom (UK). Twenty-four biopsy-proven paediatric NAFLD cases and eight obese controls without biochemical or radiological evidence of NAFLD completed a 24-h dietary recall, a Physical Activity Questionnaire (PAQ), a Dutch Eating Behavior Questionnaire (DEBQ) and a 7-day food and activity diary (FAD), in conjunction with wearing a pedometer. Groups were well matched for age and gender. Obese children had higher BMI z-scores (p = 0.006) and BMI centiles (p = 0.002) than participants with NAFLD. After adjusting for multiple hypotheses testing and controlling for differences in BMI, no differences in macro- or micronutrient intake were observed as assessed using either 24-h recall or 7-day FAD (p > 0.001). Under-reporting was prevalent (NAFLD 75%, Obese Control 87%: p = 0.15). Restrained eating behaviours were significantly higher in the NAFLD group (p = 0.005), who also recorded more steps per day than the obese controls (p = 0.01). In conclusion, this is the first study to assess dietary and activity patterns in a UK paediatric NAFLD population. Only a minority of cases and controls were meeting current dietary and physical activity recommendations. Our findings do not support development of specific dietary/ physical activity guidelines for children with NAFLD; promoting adherence with current general paediatric recommendations for health should remain the focus of clinical management.

Auditory and visual reaction times in school going adolescents: effect of structured and unstructured physical training - a randomized control trial.

Cognitive development of adolescents is influenced by their physical activity status. Exercises requiring greater cognitive engagement are likely to have a stronger effect on their executive cognitive functions than simpler exercises. In our randomized, single blinded, parallel group, active controlled trial (CTRI/ 2013/08/003897) the recruited healthy student volunteers, aged 12-17 years (n=439), were allocated into structured physical activity (SPA) and unstructured physical activity (USPA) groups by age and gender stratified block randomization. Physical training for the respective groups was administered by physical education instructors for 2 h per day, 6 times per week, continuously for 6 months. SPA was designed as recommended by the WHO physical activity guidelines for children and young people, while USPA included any indoor or outdoor recreational activity of the participant's choice. This paper describes a part of our findings: comparison of auditory and visual reaction times (ART and VRT), recorded pre- and post-intervention. Data analysis was done by an investigator blinded to the allocation sequence using paired and unpaired t-test for inter- and intra-group comparisons, respectively, by following per-protocol analysis [SPA (n=172) and USPA (n=175)]. Both ART and VRT significantly improved in either group but the effect size was more in SPA group vs. USPA group (VRT: 0.87 vs. 0.76; ART: 0.79 vs. 0.65). Thus structuring the physical training in a cognitively engaging manner leads to greater improvements in the perceptual, executive cognitive response phenomenon of growing adolescents.

P1239 : Assessment of diet and physical activity in paediatric non-alcoholic fatty liver disease patients: A UK case control study

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children, with prevalence rising alongside childhood obesity rates. This study aimed to characterise the habitual diet and activity behaviours of children with NAFLD compared to obese children without liver disease in the United Kingdom (UK). Twenty-four biopsy-proven paediatric NAFLD cases and eight obese controls without biochemical or radiological evidence of NAFLD completed a 24-h dietary recall, a Physical Activity Questionnaire (PAQ), a Dutch Eating Behavior Questionnaire (DEBQ) and a 7-day food and activity diary (FAD), in conjunction with wearing a pedometer. Groups were well matched for age and gender. Obese children had higher BMI z-scores (p = 0.006) and BMI centiles (p = 0.002) than participants with NAFLD. After adjusting for multiple hypotheses testing and controlling for differences in BMI, no differences in macro- or micronutrient intake were observed as assessed using either 24-h recall or 7-day FAD (p > 0.001). Under-reporting was prevalent (NAFLD 75%, Obese Control 87%: p = 0.15). Restrained eating behaviours were significantly higher in the NAFLD group (p = 0.005), who also recorded more steps per day than the obese controls (p = 0.01). In conclusion, this is the first study to assess dietary and activity patterns in a UK paediatric NAFLD population. Only a minority of cases and controls were meeting current dietary and physical activity recommendations. Our findings do not support development of specific dietary/ physical activity guidelines for children with NAFLD; promoting adherence with current general paediatric recommendations for health should remain the focus of clinical management.

Physical Activity Guidelines for Children and Youth

The aim of this review is to provide a scientific update on evidence related to the biological and psycho-social health benefits of physical activity in school-aged children and youth. To accomplish this aim, the first part of the paper reviews existing physical activity guidelines for school-aged children and youth, with an emphasis placed on how India’s guidelines compare and contrast with those of other countries and organizations. The paper then provides an overview of physical activity levels of Indian children and youth, which indicates that few Indian youngsters meet current physical activity recommendations. The next section of the paper summarizes the literature that informs how much physical activity is required to promote health and well-being in children and youth. The paper then provides suggestions on modifications that could be made to India’s physical activity guidelines for children and youth. Specifically, consideration should be given to setting both minimal (‡60 min/d) and optimal (up to several hours per day) physical activity targets. The final section identifies future research needs. In this section, a need is noted for comprehensive dose-response studies of physical activity and health in the paediatric age group.