Physical Activity In School-aged Children Research Articles

Insulin resistance, C-reactive protein, diastolic to systolic blood pressure ratio and epicardial fat are related to sedentary time, and inversely related to physical activity in school-aged children.

Physical activity (PA) is beneficial for the overall health. Objectives are: (1) To compare metabolic (MRM) and cardiovascular-risk-markers (CRM) in children according to their PA-level; (2) to explore the associations of MRM and CRM with PA and sedentary time (ST); and (3) to identify the associations between MRM and CRM in less (LA) and more active (MA) children. A total of 238 apparently healthy school-aged children were enrolled (132 boys/106 girls; 9.1 ± 1.8 years) and body mass index standard deviation score (BMI SDS) and blood pressure were assessed. Fasting venous blood sampling was performed to assess insulin resistance (HOMA-IR) and high-sensitivity-C-reactive protein (hsCRP). Epicardial fat, interventricular septal and left ventricular posterior wall thicknesses were assessed by high-resolution ultrasonography. PA and ST were assessed by enKid-questionnaire. Children were classified based on enKid-score as being LA and MA (below and above 50th percentile for PA). MA-children had lower values for: BMI SDS, diastolic-to-systolic blood pressure ratio, HOMA-IR and hsCRP (7.02 to 61.5% lower, p = 0.040 to p < 0.0001) compared to LA-children. MRM and CRM were positively associated with ST (p = 0.003 to p < 0.001), and negatively associated with PA (p = 0.044 to p < 0.001). Finally, MRM were positively associated with CRM (p = 0.008 to p < 0.0001). Interestingly, the latter associations were observed in LA-children but were not present in MA-children. More PA is associated with better cardio-metabolic profile in school-aged children. PA seems to modulate the associations between MRM and CRM, thus reinforcing the idea that fostering PA in children may lower the risk for development of a cardio-metabolic disease.

Hypohydration, Functional Constipation, and Physical Activity in Elementary School Students.

This school-based, cross-sectional study aimed to evaluate whether hypohydration is related to functional constipation and physical activity in school-aged children. The study included 452 students aged 6-12 years. Hypohydration, defined as urinary osmolality >800 mOsm/kg, was more prevalent ( P = 0.002) in boys (72.1%) than in girls (57.5%). The difference in the prevalence of functional constipation according to sex (20.1% in boys and 23.8% in girls) was not statistically significant ( P = 0.81). In bivariate analysis, functional constipation was associated with hypohydration in girls (odds ratio = 1.93, 95% confidence interval: 1.07-3.49), and multiple logistic regression did not reach statistical significance ( P = 0.082). Low proportions of active commuting to school in both sexes were associated with hypohydration. However, there were no associations between functional constipation, active commuting to school, and physical activity scores. In conclusion, multiple logistic regression did not demonstrate an association between hypohydration and functional constipation in school-aged children.

Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective.

High prevalence of physical inactivity and obesity in children and adolescents has become a global problem. This systematic review aimed to examine the existing literature regarding the factors that influence participation in physical activity (PA) in children and adolescents with reference to the social ecological model (SEM) proposed by McLeroy et al. (1988). The SEM provides a framework under which the influencing factors are categorized into five levels: intrapersonal, interpersonal, organizational, community, and public policy. A systematic search of relevant literature published before July 2020 was conducted through Ebsco, ProQuest, PubMed Central, Scopus, and Web of Science. A total of fourteen studies met the inclusion criteria. The selected articles were all of high quality as assessed using the Mixed Methods Appraisal Tool (2018). The results indicated that gender, age, ethnicity, and self-concept were the most common influencing factors at the intrapersonal level. At the interpersonal and organization levels, supports from friends, parents, and teachers were positive predictors of students’ PA participation. Accessibility of facilities and safe neighborhoods was a crucial factor that influenced children and adolescents’ participation in PA at the community level. Future studies on the effective types of policies or practices that could successfully promote facilities’ accessibility and improve neighborhood safety are required. The outcomes of this systematic review are expected to inform practice and support the development and implementation of sound policies for the promotion of PA participation in children or adolescents from a comprehensive social ecological viewpoint.

Culinary Health Education and Fitness (C.H.E.F.): A Large-Scale Program to Reduce Rural Health Disparity Through Networking and Relationship Building

Abstract Objectives The Culinary Health Education and Fitness (C.H.E.F.) program is a 3-year program designed to help children and families in three Oregon counties (Lincoln, rural Benton and East Linn) achieve higher-quality lives through the promotion of physical activity and nutrition. The program utilized nutrition-focused culinary education that included cooking classes and tasting tables to empower families to be self-sufficient in the kitchen, make healthy food choices and increase exposure to fruits and vegetables. The program also sought to strengthen relationships among health-advocacy stakeholders, train future physicians to deliver nutrition education, and to integrate the Coordinated Approach to Child Health (CATCH) program at school sites as a sustainable program for increasing physical activity in school-aged children. Methods Quantitative and qualitative data were gathered from classes, schools and stakeholders through pre- and post-surveys, interviews, program records, and observation to assess program reach, process evaluation, cooking self-efficacy, physical activity and change in nutrition knowledge. Our mixed methods approach was organized around the concepts of Exposure, Integrity and Intensity (for the process evaluation) and Outcomes. Results The program had extensive reach with &amp;gt;3200 children served at tasting tables, &amp;gt;800 participants in culinary education classes, and &amp;gt;2500 students participated in CATCH at their schools. Nearly 100 community partners, medical students and volunteers were trained to deliver the evidence-based culinary education. The implementation of CATCH increased vigorous physical activity in children. Culinary education courses effectively introduced children to new vegetables and fruits and raised confidence in their ability to prepare healthy foods at home. Relationships flourished through the various meetings, trainings and conferences related to the program. A robust network of health advocacy stakeholders continues to grow across the tri-county area through various activities related to this program work. Conclusions Through a wide array of relationships and community partnerships, the C.H.E.F. program promotes healthy lifestyles and a culture of health in rural Oregon communities. Funding Sources HRSA Rural Network Development Grant.

Parental and peer support and modelling in relation to domain-specific physical activity participation in boys and girls from Germany.

Physical activity (PA) as a precondition of child development is related with social environmental correlates. However, domain-specific PA and gender issues have been neglected in studies on social support and modelling and PA in school-aged children. The aim of this study was to assess the relationships of parental and peer modelling and social support with domain-specific PA participation in a large sample of school-aged children, taking gender into account. 3,505 school children aged 6 to 17 years old participated in the German nationwide 'MoMo' cohort-study. By using the MoMo-PAQ the participants and their parents provided self-report data on perceived social support and social modelling and domain-specific PA participation. Relationships of social environmental variables and the physical outcomes were analysed by logistic regression analyses. At secondary school level, girls were less likely than boys to participate in physical activity in and outside of sports clubs, extra-curricular physical activity and in outdoor play (p < 0.05), but at primary school level this pattern only applied to club sport (p < 0.01). Girls also received less social support than boys (p < 0.01). Physical activity participation in all domains was associated with any of the social support and modelling variables and differences between physical activity domains and between boys and girls occurred. Most consistently physical activity in sports clubs was related with the social environmental correlates in boys (primary school: R2 = 0.60; secondary school: R2 = 0.45) and girls (primary school: R2 = 0.53; secondary school: R2 = 0.47). In future, reciprocal relationships of social environmental variables and PA should be considered in longitudinal studies to obtain insights into the direction of the associations. Furthermore, interventions encompassing the social environment and focussed particularly on the promotion of domain-specific PA in girls in secondary school-age are warranted.

Parent Perceptions on a Walking School Bus Program Among Low-Income Families: A Qualitative Study.

The walking school bus (WSB) is a promising intervention to increase walking to school and physical activity in school-age children. The aim of this qualitative study was to assess parent perceptions of a WSB program that was part of a randomized controlled trial to inform future programs. The authors interviewed 45 parents whose children had participated in a WSB program in the Seattle area, in which third- and fifth-grade students walked to/from school with adult chaperones along a set route. The authors performed a qualitative analysis of the interview transcripts and coded interview segments into 4 broad categories as follows: facilitators, barriers, general positive sentiments, and proposals. Most parents spoke of the benefits of the WSB program; in particular, parents frequently applauded exercise/physical health benefits. Of the barriers, the most frequently cited was time, with work schedule and commute changes leading some families to walk less frequently. Most parents voiced support for the WSB program as a means to improve child health, to learn pedestrian safety, and to interact with positive adult role models. Parents made several suggestions to improve the program, including better recruitment methods, logistical improvements, and a platform for communicating with other parents.

Does participation in targeted programs such as Walking School Bus or Safe Routes to School increase physical activity in school-aged children?

University of Wisconsin Department of Family Medicine and Community Health, Madison, WI The authors declare no conflicts of interest.

Effects of school-based interventions on motivation towards physical activity in children and adolescents: protocol for a systematic review

BackgroundRecent studies have observed low levels of physical activity in children and adolescents worldwide. Physical activity interventions are increasingly carried out to counteract this development. The school environment is an ideal setting for such interventions to take place as large numbers of children and adolescents can be addressed. With the assumption that motivation is the key to initiate and sustain beneficial health behaviors, theory-based intervention studies apply motivational strategies to increase students’ participation in physical activity. The main objective of this systematic review will be to analyze the effects of school-based physical activity interventions on a variety of motivational outcomes towards physical activity in school-aged children and adolescents.MethodsComprehensive literature searches will be conducted in multiple electronic databases, including MEDLINE, Scopus, PsycINFO, ERIC, PSYNDEX, Physical Education Index, and SPORTDiscus. We will include randomized controlled trials (RCTs) and quasi-experimental studies examining the effects of school-based physical activity interventions (e.g., physical activity components during school lessons including physical education, or during morning, lunch and afternoon breaks). Primarily extracurricular physical activity interventions will not be considered. The primary outcomes will be students’ motivation, basic psychological needs, goal orientation, enjoyment, and motivational teaching climate in physical education. Secondary outcomes will be the students’ physical activity behaviors in-class, during school, and in leisure time. Only peer-reviewed articles published in English will be considered. Three reviewers will independently screen all citations and full-text articles, and two reviewers will abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration’s tool for assessing risk of bias for RCTs and the GRADE methodology will be used to assess the certainty of the body of retreived evidence.DiscussionIn order to increase and maintain physical activity levels in children and adolescents, motivation towards physical activity should be sustained. It is anticipated that the results of this systematic review will provide information as to which strategies implemented in the school setting are effective in increasing students’ motivation towards physical activity, and hence increase their physical activity during school and after-school hours.Systematic review registrationPROSPERO CRD42018110306

Sex Differences in Birth Weight and Physical Activity in Japanese Schoolchildren

BackgroundLower birth weight (BW) is associated with increased chronic disease risk later in life. Previous studies suggest that this may be mediated principally via physical activity (PA). However, the association between BW and PA in children has not been clarified. The purpose of this study was to examine the association between BW and PA in school-aged children in Japan.MethodsParticipants were children from a prospective birth cohort study (Project Koshu) who were born from 1996 through 2002 in rural Japan. BWs were obtained from the Maternal and Child Health Handbook. Data on PA during childhood were collected using a self-reported questionnaire when participants were 9–15 years of age in July 2011. Analysis of covariance was used to evaluate exercise duration; Poisson regression analysis was used to evaluate if the recommended PA amount was met.ResultsData from 657 children (boys: 54.8%, follow-up rate: 77.6%) were analyzed. Compared with the normal BW group, only girls in the low-BW group had significantly lower PA level (normal BW, 11.4 [standard error, 1.0] hours/week; low BW, 5.8 [standard error, 3.6] hours/week, P = 0.010), and were more likely to not meet the recommended PA level (prevalence ratio 1.57; 95% CI, 1.14–2.16).ConclusionLow BW was associated with a lower PA level in school-aged girls but not boys. Earlier consideration of BW may be an important public health strategy to prevent physical inactivity in school-aged girls.

The longitudinal relationship between generalized self-efficacy and physical activity in school-aged children

Our understanding of the longitudinal relationship between generalized self-efficacy (GSE) and physical activity in children and youth is limited. The purpose of this study was to investigate the effect of GSE towards physical activity on sedentary behaviours and physical activity in school-aged children over time. A total of 2278 nine-year-old children (1120 girls and 1158 boys) were recruited at baseline and followed for seven waves of data collection from 2005 to 2008. All children completed questionnaires at each wave assessing their GSE (adequacy, predilection, and enjoyment), sedentary behaviours, free play, and organized activity. Mixed-effects models were used to estimate changes in physical activity and GSE within individuals over time, controlling for gender and motor ability. The results showed that participation in free play significantly increased over time, whereas organized activity significantly decreased over the same period. Children with high perceived adequacy and predilection had higher free play and organized activity participation relative to other children over time. However, the effect of perceived adequacy diminished over time, while the gaps between groups with different levels of predilection widened over time. While sedentary behaviours were lower over time in children with high predilection, these behaviours were consistently higher in children with high enjoyment. The differences in sedentary behaviours between groups increased over time for both predilection and enjoyment. This study highlights the importance of different components of GSE on physical activity participation. In addition, interventions targeting the enhancement of predilection may facilitate physical activity and reduce sedentary behaviours.

Step it up: Promoting physical activity in school-aged children and adolescents in China

Step it up: Promoting physical activity in school-aged children and adolescents in China

Using Novel Technology within a School-Based Setting to Increase Physical Activity: A Pilot Study in School-Age Children from a Low-Income, Urban Community.

Background Less than half of American children meet national physical activity (PA) recommendations. This study tested the feasibility, acceptability, and preliminary effectiveness of using wearable PA monitors to increase PA in school-age children. Methods In Phase 1 of this study, conducted in 2014, 32 fifth-grade students enrolled in a low-resource middle school were given a waist-worn Fitbit Zip monitor for 4 weeks to test its feasibility (adherence) and acceptability. Adherence, wear time of ≥8 hours per day, was examined. Feedback was solicited from parents through structured interviews. In Phase 2, conducted in 2015, 42 sixth-grade students were assigned, by classroom, to one of three conditions (Fitbit + goal and incentive-based intervention, Fitbit only, or control) to test the feasibility of the wrist-worn Fitbit Charge and its preliminary effectiveness in increasing PA over 6 weeks. Results In Phase 1, average adherence was 64.1%. In Phase 2, it was 73.4% and 80.2% for participants in the Fitbit + intervention and Fitbit only groups, respectively (p = .07). After controlling for baseline values, weight status, and sex, there were no significant group differences in changes in MVPA or steps from baseline to follow-up. Conclusions While moderately acceptable, wearable PA monitors did not increase PA levels in this sample. They may be more effective within a coordinated school-based physical activity program.

Diagnóstico nutricional e elaboração de material didático para educação nutricional de escolares

http://dx.doi.org/10.5007/1807-0221.2016v13n24p49Objetivou-se avaliar o estado nutricional e o consumo alimentar de escolares, e a partir desse diagnóstico, elaborar um plano de ação organizado em um material didático para a educação nutricional de escolares no ambiente escolar. O estado nutricional foi avaliado pelo índice de massa corporal e o consumo alimentar através do Questionário do Consumo Alimentar e Atividade Física de Escolares (webCAAFE). Entre março e novembro de 2014, 640 escolares de 7 a 10 anos da rede pública de Florianópolis foram avaliados, sendo observados 20% de sobrepeso, 13% de obesidade e elevado consumo de alimentos não saudáveis. O material didático organizado em uma cartilha abordou oito temáticas, estruturada com texto de apoio ao professor, exemplo de aula dialogada, texto de apoio ao aluno e atividades lúdico-educativas. Espera-se que a cartilha contribua para o incremento das ações de educação nutricional e auxilie na promoção de hábitos alimentares saudáveis desde a infância.

Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children.

Regional differences in physical activity in school-aged children and adults even within one country with the same political and health care system have been observed and could not be explained by sociodemographic or individual variables. We analysed whether such differences were already present in preschool children. Swiss children from 84 childcare centres in five cantons (Aargau, Bern, Fribourg, Vaud, Zurich) comprising about 50% of the population of the country participated. Physical activity was quantified with accelerometers (ActiGraph, wGT3X-BT) and potential correlates were assessed with measurements at the childcare centre or questionnaires. Mixed regression models were used to test associations between potential correlates of total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) or sedentary behaviour with a special focus on regional differences. 394 of 476 children (83%) provided valid physical activity data (at least 2 weekdays and 1 weekend day with 10 h recording; mean age 3.9 ± 0.7 years, 54% boys) with 26% and 74% living in the French- and German-speaking parts of Switzerland, respectively. Days consisted of (mean ± standard deviation) 1.5 ± 0.5 h MVPA, 5.0 ± 0.6 h LPA, and 6.3 ± 0.8 h sedentary behaviour with an average of 624 ± 150 counts/min TPA. TPA and MVPA (but not sedentary behaviour or LPA) increased with age, were higher in boys and children with better motor skills. Despite controlling for individual characteristics, familial factors and childcare exposure, children from the French-speaking part of Switzerland showed 13% less TPA, 14% less MVPA, 6% less LPA and 8% more sedentary behaviour than German-speaking children. Beside motor skills and non-modifiable individual factors, the regional sociocultural difference was the most important correlate of phyical activity and sedentary behaviour. Therefore, regionally adapted public health strategies may be needed.

Decreased Vigorous Physical Activity in School-Aged Children with Human Immunodeficiency Virus in Johannesburg, South Africa

To describe physical activity in South African children with and without HIV. Study measurements were obtained in 218 children with perinatal HIV and 180 children without HIV aged 5-9years in a study conducted in Johannesburg, South Africa. Weight-for-age z-score, height-for-age z-score, frequency and duration of moderate and vigorous physical activity, and sedentary behaviors were obtained. These measurements were compared between children with and without HIV. Weight-for-age z-score and height-for-age z-score were significantly lower for children with HIV compared with those without HIV. Among children who attended school, fewer children with HIV than children without HIV participated in physical education (41% vs 64%; P=.0003) and organized after-school sports (38% vs 64%; P<.001). The proportion of children in both groups meeting World Health Organization recommendations for physical activity was similar (84% overall); however, girls with HIV spent less time in vigorous physical activity than girls without HIV (420 vs 780minutes/week; P=.001). This difference remained significant even when girls with a medical condition with the potential to limit physical activity were excluded, and after adjusting for age. Time spent in sedentary behaviors did not differ significantly between the two groups. Although children with HIV with well-controlled disease after initiating antiretroviral therapy early in life achieve high levels of physical activity, vigorous physical activity is lower in girls with HIV than in healthy controls. This finding may reflect lower participation in school-based physical education and organized after-school physical activity.

Physical Activity in School-Aged Children with Asthma in an Urban City of Taiwan

It has been reported that physical activity is limited in children with asthma. The aims of this study were to compare and quantify the physical activity levels between asthmatic children and their healthy peers. Factors associated with limitation of physical activity in asthmatic children were also investigated. A total of 120 asthmatic children and 262 age-matched healthy controls were enrolled in this study. Clinical phenotype including severity and lung function were obtained from medical records. A questionnaire addressing physical activity, asthma diagnosis, symptoms, parental health beliefs, physician's advice and, community resources was accomplished by children and their parents. The physical activity levels of children with and without asthma were compared. Factors that might limit the activity level were analyzed. Children with asthma were less active than their peers. The significant difference was between normal controls and moderate-to-severe asthmatic children, but not children with mild asthma. Among children with asthma, physical activity was associated with the severity level but not parental health beliefs, physician's advice, or the convenience for physical activity. Children with moderate or severe persistent asthma were more likely to be inactive. Children with asthma had a lower level of physical activity, particularly those with moderate-to-severe asthma. To achieve an appropriate level of physical activity, improvement of asthma management and control is considered important.

Preschoolers in the Playground: a pilot cluster randomised controlled trial of a physical activity intervention for children aged 18 months to 4 years

BackgroundThe preschool years are considered critical for establishing healthy lifestyle behaviours such as physical activity. Levels of physical activity track through childhood into adulthood and establishing habitual physical activity early in life is therefore vital. Time spent outdoors is associated with greater physical activity and playground interventions have been shown to increase physical activity in school-aged children. There are few preschool, playground-based interventions and these have given inconclusive results. A report published by the UK’s Chief Medical Officer (CMO) highlighted the need for new interventions to promote movement in the early years (0–5 years).ObjectivesThis study aimed to undertake a pilot cluster randomised controlled trial (RCT) of an outdoor playground-based physical activity intervention for parents and their children aged from 18 months to 4 years (Preschoolers in the Playground or PiP) and to assess the feasibility of conducting a full-scale cluster RCT.DesignThe study was a two-armed pilot cluster RCT with economic and qualitative evaluations. Participants were randomised on a 1 : 1 basis to the PiP intervention (n = 83) or usual practice (control;n = 81).SettingBradford, West Yorkshire, UK.ParticipantsChildren aged from 18 months to 4 years.InterventionThe PiP intervention is grounded in behavioural theory (social cognitive theory) and is in accordance with CMO guidance for physical activity in the early years. It is informed by existing literature and data collected from focus groups with parents. The intervention was delivered in primary school playgrounds. Six 30-minute PiP sessions per week were available for 30 weeks; families were encouraged to come to three a week. The 10-week initiation phase was facilitated by a member of school staff and the maintenance phase was unsupervised.Main outcome measuresRecruitment and retention of schools and families to the trial were the main outcome measures. The acceptability of trial procedures and the intervention, the feasibility of collecting health outcome data and the fidelity of the implementation of the intervention were also evaluated. A preliminary assessment of cost-effectiveness and a sample size calculation for a full trial were conducted.ResultsIn total, 37% of schools and 48% of parents approached agreed to take part. Levels of retention were good at 10 and 52 weeks’ follow-up (82.3% and 83.5% respectively). Both the trial procedures and the intervention were acceptable. However, attendance was low during the autumn and winter/spring initiation phases but somewhat better in the summer initiation phase. Attendance was poor throughout all maintenance phases. The accelerometry protocol for measuring physical activity requires modification. The fidelity of intervention implementation was good (81% adherence). The intervention was borderline cost-effective. A sample size of 600 children from 38 schools is required for a full trial.ConclusionA full RCT of the PiP intervention is feasible. The PiP intervention requires some modification, for example running the intervention during the summer term only, but was found to be acceptable to schools and families.Trial registrationCurrent Controlled Trials ISRCTN54165860.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 5. See the NIHR Journals Library website for further project information.

Physical Activity Interventions to Improve Fundamental Motor Skills in Preschoolers

PURPOSE: To evaluate interventions for improving fundamental motor skills (FMS) and physical activity (PA) levels in preschoolers. Mastery in FMS is associated with greater participation in PA in school aged children. Early childhood has been identified as the critical time for engaging in FMS development, however, there is limited research investigating this relationship in preschoolers aged 3-5 years. METHOD: We conducted a systematic search of electronic databases up until 31st October 2014. Randomised control trials (RCTs) using PA interventions with FMS as outcome measures in preschoolers were eligible for inclusion. Studies including children with disabilities or developmental delays were excluded. Between group mean differences, relative effect sizes (ES) and 95% confidence intervals were calculated for each outcome. RESULTS: Search terms yielded 1411 articles of which 8 RCTs and 2747 participants met the inclusion criteria. Studies were dichotomised into two groups (i) Teacher-Led (TL) Interventions (n=7) and (ii) Child-Centred (CC) Interventions (n=1). Mean age of children studied was 4.0±0.8yrs, with an equal gender distribution. Mean body mass index (BMI) was 16.52±0.23. On average interventions ran for 24±10wks, 3±1 times per week for 27±6mins. Five of the 7 TL studies reported significant improvements in FMS (ES Range 0.21-0.85;p≤0.01). The CC intervention also reported significant improvements in FMS, p≤0.001. Five TL interventions reported changes in PA levels, with one reporting significant improvements (ES 0.47;p≤0.01). Four studies reported body composition, with one reporting a significant decrease in BMI (p=0.02) and waist circumference (p=0.002). CONCLUSION: There is emerging evidence that PA interventions can improve FMS in preschoolers; however, there is a dearth of evidence on CC interventions, where an intervention is delivered directly to children by a trained professional. Targeting FMS development in this age group may promote higher PA levels throughout childhood, however more study is needed. Long term follow up is required to determine if improving FMS at preschool age increases participation in sports and PA. In addition, will it lead to lifestyle patterns throughout adolescence and adulthood, that will reduce the risk of metabolic and cardiovascular diseases.

A systematic literature review with meta-analyses of within- and between-day differences in objectively measured physical activity in school-aged children.

BackgroundTargeting specific time periods of the day or week may enhance physical activity (PA) interventions in youth. The most prudent time segments to target are currently unclear.ObjectivesTo systematically review the literature describing differences in young people’s objectively measured PA on weekdays vs. weekends, in school vs. out of school, weekends vs. out of school and lesson time vs. break time.MethodsElectronic databases were searched for English-language, cross-sectional studies of school-aged children (4–18 years) reporting time-segment-specific accelerometer-measured PA from 01/1990 to 01/2013. We meta-analysed standardised mean differences (SMD) between time segments for mean accelerometer counts per minute (TPA) and minutes in moderate-to-vigorous PA (MVPA). SMD is reported in units of standard deviation; 0.2, 0.5 and 0.8 represent small, moderate and large effects. Heterogeneity was explored using meta-regression (potential effect modifiers: age, sex and study setting).ResultsOf the 54 included studies, 37 were eligible for meta-analyses. Children were more active on weekdays than weekends [pooled SMD (95 % CI) TPA 0.14 (0.08; 0.20), MVPA 0.42 (0.35; 0.49)]. On school days, TPA was lower in school than out of school; however, marginally more MVPA was accumulated in school [TPA −0.24 (−0.40; −0.08), MVPA 0.17 (−0.03; 0.38)]. TPA was slightly lower on weekends than out of school on school days, but a greater absolute volume of MVPA was performed on weekends [TPA −0.10 (−0.19; −0.01), MVPA 1.02 (0.82; 1.23)]. Heterogeneity between studies was high (I 2 73.3–96.3 %), with 20.3–53.1 % of variance between studies attributable to potential moderating factors.ConclusionsSchool-aged children are more active on weekdays than weekend days. The outcome measure influences the conclusions for other comparisons. Findings support the tailoring of intervention strategies to specific time periods.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-014-0215-5) contains supplementary material, which is available to authorized users.

Correlates of objectively measured overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-Kenya

BackgroundChildhood overweight/obesity and inadequate physical activity burden Western countries, and now, pose a growing threat to the health of children in low and middle income countries. Behavioural transitions toward more sedentary lifestyles coupled with increased consumption of high calorie foods has resulted in rising proportions of overweight/obesity and decreasing levels of physical activity in school-aged children. The objective of this study was to determine the prevalence and to investigate factors associated with overweight/obesity and physical activity in Kenyan children aged 9 to 11 years.MethodsBody composition and physical activity measures of participating children were accomplished by anthropometric assessment, accelerometry, and administration of questionnaires related to diet and lifestyle, and the school and neighbourhood environments. Data collection was conducted in the city of Nairobi as part of a larger International Study of Childhood Obesity, Lifestyle and Environment.ResultsA total of 563 participants (46.5% boys, 53.5% girls) were included in the analyses. Of these, 3.7% were underweight, 14.4% were overweight, and 6.4% were obese based on WHO cut-points. Mean daily sedentary time was 398 minutes, time spent in light physical activity was 463 minutes, and time spent in moderate-to-vigorous physical activity was 36 minutes based on activity cut-points developed by Treuth et al. Only 12.6% of participating children were meeting the recommendation of ≥ 60 minutes of daily moderate-to-vigorous physical activity, and 45.7% of participants used active transportation to/from school. Increasing parental education level, total annual household income, and attending a private rather than public school were associated positively with being overweight/obese and negatively with meeting physical activity guidelines.ConclusionsThis study provided the evidence for an existing prevalence of childhood overweight/obesity in Nairobi. Children were spending a considerable amount of time in sedentary and light intensity physical activity, with few meeting physical activity guidelines. Higher socioeconomic status and parental education attainment were associated with a higher likelihood of children being overweight/obese and a lower likelihood of children meeting the physical activity recommendations. Interventions and strategies should be attentive to the potential health consequences of lifestyle transitions resulting from urbanisation and economic prosperity.