Sedentary Behavior In Children Research Articles

Examining child sedentary behaviour in the context of children's current multimedia environment.

Examining child sedentary behaviour in the context of children's current multimedia environment.

Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review.

BackgroundHealth and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults.MethodsSystematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers.ResultsTwenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes.ConclusionsThis review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than stand-alone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0454-y) contains supplementary material, which is available to authorized users.

Isotemporal Substitution Analysis for Sedentary Behavior and Body Mass Index.

This study examined the prospective associations of reallocating time spent in different types of sedentary behavior, physical activity, and sleep with body mass index (BMI) in children using isotemporal substitution analysis. Chinese children in grades 1-3 were recruited to a cohort study in 2009 and were followed up over a 2-yr period. Reports were gathered from the parents on children's sedentary behavior, sleep duration, and sociodemographic variables. The reported sedentary behavior types were then grouped into three categories: screen time (e.g., watching TV), academic-related activities (e.g., doing homework), and other sedentary behaviors (e.g., sitting and talking). Moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity were assessed by ActiGraph accelerometry (ActiGraph, Pensacola, FL). Isotemporal substitution models were performed to examine the effects of time allocation on BMI. A total of 672 children (359 boys, mean age at recruitment = 7.6 yr) who had provided valid accelerometer data for at least one assessment time point were included in the analysis. Controlling for covariates and total behavior time, isotemporal substitution models indicated that the displacement of 30 min·d of other sedentary behaviors with equal amounts of screen time (B = 0.12; 95% confidence interval, 0.04-0.20) or academic-related activities (B = 0.13; 95% confidence interval, 0.04-0.21) was associated with higher BMI. Reallocating 30 min·d of MVPA with each of the sedentary behavior variables resulted in increased BMI. The substitution of screen time or academic-related activities with other sedentary behaviors or MVPA was associated with lower BMI in Chinese children.

A systematic review of the prevalence of sedentary behavior during the after-school period among children aged 5-18 years.

BackgroundIndependent of physical activity levels, youth sedentary behaviors (SB) have negative health outcomes. SB prevalence estimates during discretionary periods of the day (e.g., after-school), inform the need for targeted period-specific interventions. This systematic review aimed to determine children’s and adolescents’ SB prevalence during the after-school period.MethodsA computerized search was conducted in October 2015 (analysed November 2015). Inclusion criteria were: published in a peer-reviewed English journal; participants aged 5-18 years; measured overall after-school sedentary time (ST) objectively, and/or specific after-school SBs (e.g., TV viewing) objectively or subjectively; and provided the percentage of the after-school period spent in ST/SB or duration of behavior and period to calculate this. Where possible, findings were analyzed by location (e.g., after-school care/‘other’ locations). The PRISMA guidelines were followed.ResultsTwenty-nine studies were included: 24 included children (≤12 years), four assessed adolescents (>12 years) and one included both; 20 assessed ST and nine assessed SB. On average, children spent 41 % and 51 % of the after-school period in ST when at after-school care and other locations respectively. Adolescents spent 57 % of the after-school period in ST. SBs that children and adolescents perform include: TV viewing (20 % of the period), non-screen based SB (including homework; 20 %), screen-based SB (including TV viewing; 18 %), homework/academics (13 %), motorised transport (12 %), social SB (9 %), and screen-based SB (excluding TV viewing; 6 %).ConclusionChildren spent up to half of the after-school period in ST and this is higher among adolescents. A variety of screen- and non-screen based SBs are performed after school, providing key targets for interventions.Trial registrationPROSPERO registration number CRD42015010437Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0419-1) contains supplementary material, which is available to authorized users.

Executive function mediates prospective relationships between sleep duration and sedentary behavior in children

Childhood sedentary behavior has been linked to increased obesity risk. Prior work has identified associations between sedentary behavior, executive function (EF), and sleep. This study tested the hypothesis that reduced sleep duration may adversely impact EF and lead to increased childhood sedentary behavior. Southern California schoolchildren participating in the school-based health promotion program Pathways to Health (N=709) were assessed annually from 4th through 6th grades (2010−2013) on self-report measures of sedentary behavior, sleep duration, and executive function. A series of path models were specified treating average nightly sleep duration and weekend wake/bed-time shift at 4th grade as predictors of 6th grade sedentary behavior. Four EF subdomains were tested as potential mediators of longitudinal associations at 5th grade. Significant associations between average nightly sleep duration, EF and sedentary behavior were identified (p<0.05), adjusting for participant gender, physical activity, SES, ethnicity, program group assignment, and the presence/absence of parental screen time rules. Fifth grade overall EF (p<0.05)—and in particular the subdomains of inhibitory control (p<0.05) and organization of materials (p<0.01)—significantly mediated the relationship between 4th grade sleep duration and 6th grade sedentary behavior (p<0.05). Furthermore, delay of weekend bed- or wake-times relative to weekdays was prospectively associated with decreased overall EF (p<0.05), but not increased sedentary behavior (p=0.35 for bed-time delay; p=0.64 for wake-time delay), irrespective of average nightly sleep duration. Findings suggest that sleep promotion efforts may reduce children's sedentary behavior both directly and indirectly through changes in EF.

Development of the System for Observing Student Movement in Academic Routines and Transitions (SOSMART).

National attention on whole-of-school approaches to decrease children's sedentary behavior and increase physical activity includes movement integration (MI) in classrooms. The purpose of this study was to describe instrument development, reliability, and validity of the System for Observing Student Movement in Academic Routines and Transitions (SOSMART), designed to assess MI in elementary classrooms. An a priori conceptual framework was developed based on existing literature. The framework was expanded/refined using videos from elementary classrooms and a Delphi survey. The survey, sent to 85 experts, yielded a 38% response rate. The final system includes 11 MI variables (three categories of teacher variables, two categories of student variables) and uses a 20-second continuous interval recording format. Reliability and validity data were collected in 12 classrooms across four elementary schools. Instrument reliability was tested using interval-by-interval percentage agreement for each category. Construct validity was tested by estimating multilevel random effects logistic regression models comparing student accelerometer derived activity with the presence/absence of each MI variable. Intraobserver reliability resulted in 97.5% agreement and exceeded 80% on all variables. Construct validity was supported for 8 out of 11 MI variables. SOSMART can provide valid, reliable, and objective data about MI in elementary schools.

Effectiveness of intervention strategies exclusively targeting reductions in children's sedentary time: a systematic review of the literature.

An increasing number of interventions targeting sedentary behaviour in children have emerged in recent years. Recently published reviews included sedentary behaviour and physical activity interventions. This review critically summarizes evidence on the effectiveness of intervention strategies that exclusively targeted reducing sedentary time in children and adolescents. We performed a systematic literature search in Pubmed, Embase and the Cochrane Library through November 2015. Two independent reviewers selected eligible studies, extracted relevant data and rated the methodological quality using the assessment tool for quantitative studies. We included 21 intervention studies, of which 8 studies scored moderate on methodological quality and 13 studies scored weak. Four out of eight moderate quality studies reported significant beneficial intervention effects.Although descriptions of intervention strategies were not always clearly reported, we identified encouragement of a TV turnoff week and implementing standing desks in classrooms as promising strategies. Due to a lack of high quality studies and inconsistent findings, we found no convincing evidence for the effectiveness of existing interventions targeting solely sedentary behaviour. We recommend that future studies apply mediation analyses to explore which strategies are most effective. Furthermore, to increase the effectiveness of interventions, knowledge of children’s motives to engage in sedentary behavior is required, as well as their opinion on potentially effective intervention strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0387-5) contains supplementary material, which is available to authorized users.

An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis.

Evidence for adverse health effects of excessive sedentary behaviour in children is predominantly based on cross-sectional studies, measuring TV viewing as proxy for sedentary behaviour. This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time). PubMed, EMBASE, PsycINFO and Cochrane were systematically searched till January 2015. Methodological quality of all included studies was scored, and a best evidence synthesis was applied. We included 109 studies of which 19 were of high quality. We found moderate-to-strong evidence for a relationship of overall sedentary time with some anthropometrics (overweight/obesity, weight-for-height), one cardiometabolic biomarker (HDL-cholesterol) and some fitness indicators (fitness, being unfit). For other health indicators, we found no convincing evidence because of inconsistent or non-significant findings. The evidence varied by type of sedentary behaviour. The meta-analysis indicated that each additional baseline hour of TV viewing (β = 0.01, 95%CI = [-0.002; 0.02]) or computer use (β = 0.00, 95%CI = [-0.004; 0.01]) per day was not significantly related with BMI at follow-up. We conclude that the evidence for a prospective relationship between childhood sedentary behaviour and biomedical health is in general unconvincing.

Atividade física e tempo de tela em jovens de uma cidade de médio porte do Sul do Brasil

ObjectiveTo analyze the associations between sex and age with behaviour related to physical activity practice and sedentary behaviour in children and adolescents. MethodsA cross‐sectional study with 480 (236 boys) subjects enrolled in a public school in the city of Londrina, in the south of Brazil, aged 8–17 years. Measures of physical activity, sports practice and screen times were obtained using the Physical Activity Questionnaire for Older Children. The Mann–Whitney U test was used to compare variables between boys and girls. The Chi squared test was used for categorical analysis and Poisson regression was used to identify prevalence. ResultsGirls (69.6%; PR=1.05 [0.99–1.12]) spent more time with sedentary behaviour than boys (62.2%). Boys (80%; PR=0.95 [0.92–0.98]) were more physically active than girls (91%). Older students aged 13–17 showed a higher prevalence of physical inactivity (91.4%; PR=1.06 [1.02–1.10]) and time spent with sedentary behaviour of ≥2h/day (71.8%; PR=0.91 [0.85–0.97]) when compared to younger peers aged 8–12 (78.7 and 58.5%, respectively). ConclusionsThe prevalence of physical inactivity was higher in girls. Older students spent more screen time in comparison to younger students.

Parents’ experiences of participation in physical activities for children with cerebral palsy – protecting and pushing towards independence

Purpose: To explore how parents of children with cerebral palsy (CP) experience their child’s participation in physical activities and to identify facilitators and barriers for being physically active and reducing sedentary behaviour. Methods: Twenty-five parents of sixteen children, aged 8–11 years old with CP, with varying gross motor, cognitive and communicative functions and with different cultural backgrounds, participated in focus group or individual interviews. Content analysis was used for analysis. Results: Five subcategories addressing children’s participation in physical activity were found: “Belonging and taking space in the family”, “Important persons facilitating and hindering”, “Friends important but hard to get”, “Good for the body but challenging” and “Availability and opting out possibilities”. The subcategories built the main category “Protecting and pushing towards independence”, expressing the challenges parents experienced when their child wanted to be physically active. Conclusions: Parents desire competent persons to be available for support in participation in physical activities. They want support in finding friends for their child to be physically active with. Family culture and attitudes affect their child’s motivation for being physically active and should be taken into account when designing interventions for increased participation in physical activities and for reduced sedentary behaviour in children with disabilities.Implications for RehabilitationFriends and competent adults facilitate participation in physical activities and reduce sedentary behaviour.Information on accessible and tailored physical activities is an important facilitator for participation in physical activities.Service planning and design of interventions may be facilitated by taking the individual family culture into account.

Effects of Varying Epoch Lengths, Wear Time Algorithms, and Activity Cut-Points on Estimates of Child Sedentary Behavior and Physical Activity from Accelerometer Data.

ObjectiveTo examine the effects of accelerometer epoch lengths, wear time (WT) algorithms, and activity cut-points on estimates of WT, sedentary behavior (SB), and physical activity (PA).Methods268 7–11 year-olds with BMI ≥ 85th percentile for age and sex wore accelerometers on their right hips for 4–7 days. Data were processed and analyzed at epoch lengths of 1-, 5-, 10-, 15-, 30-, and 60-seconds. For each epoch length, WT minutes/day was determined using three common WT algorithms, and minutes/day and percent time spent in SB, light (LPA), moderate (MPA), and vigorous (VPA) PA were determined using five common activity cut-points. ANOVA tested differences in WT, SB, LPA, MPA, VPA, and MVPA when using the different epoch lengths, WT algorithms, and activity cut-points.ResultsWT minutes/day varied significantly by epoch length when using the NHANES WT algorithm (p < .0001), but did not vary significantly by epoch length when using the ≥ 20 minute consecutive zero or Choi WT algorithms. Minutes/day and percent time spent in SB, LPA, MPA, VPA, and MVPA varied significantly by epoch length for all sets of activity cut-points tested with all three WT algorithms (all p < .0001). Across all epoch lengths, minutes/day and percent time spent in SB, LPA, MPA, VPA, and MVPA also varied significantly across all sets of activity cut-points with all three WT algorithms (all p < .0001).ConclusionsThe common practice of converting WT algorithms and activity cut-point definitions to match different epoch lengths may introduce significant errors. Estimates of SB and PA from studies that process and analyze data using different epoch lengths, WT algorithms, and/or activity cut-points are not comparable, potentially leading to very different results, interpretations, and conclusions, misleading research and public policy.

Physical activity and screen time in children and adolescents in a medium size town in the South of Brazil

ObjectiveTo analyze the associations between sex and age with behaviour related to physical activity practice and sedentary behaviour in children and adolescents. MethodsA cross-sectional study with 480 (236 boys) subjects enrolled in a public school in the city of Londrina, in the south of Brazil, aged 8–17 years. Measures of physical activity, sports practice and screen times were obtained using the Physical Activity Questionnaire for Older Children. The Mann–Whitney U test was used to compare variables between boys and girls. The Chi squared test was used for categorical analysis and Poisson regression was used to identify prevalence. ResultsGirls (69.6%; PR=1.05 [0.99–1.12]) spent more time with sedentary behaviour than boys (62.2%). Boys (80%; PR=0.95 [0.92–0.98]) were more physically active than girls (91%). Older students aged 13–17 showed a higher prevalence of physical inactivity (91.4%; PR=1.06 [1.02–1.10]) and time spent with sedentary behaviour of ≥2h/day (71.8%; PR=0.91 [0.85–0.97]) when compared to younger peers aged 8–12 (78.7 and 58.5%, respectively). ConclusionsThe prevalence of physical inactivity was higher in girls. Older students spent more screen time in comparison to younger students.

The Influence of Weather Variation, Urban Design and Built Environment on Objectively Measured Sedentary Behaviour in Children.

With emerging evidence indicating that independent of physical activity, sedentary behaviour (SB) can be detrimental to health, researchers are increasingly aiming to understand the influence of multiple contexts such as urban design and built environment on SB. However, weather variation, a factor that continuously interacts with all other environmental variables, has been consistently underexplored. This study investigated the influence of diverse environmental exposures (including weather variation, urban design and built environment) on SB in children. This cross-sectional observational study is part of an active living research initiative set in the Canadian prairie city of Saskatoon. Saskatoon's neighbourhoods were classified based on urban street design into grid-pattern, fractured grid-pattern and curvilinear types of neighbourhoods. Diverse environmental exposures were measured including, neighbourhood built environment, and neighbourhood and household socioeconomic environment. Actical accelerometers were deployed between April and June 2010 (spring-summer) to derive SB of 331 10–14 year old children in 25 one week cycles. Each cycle of accelerometry was conducted on a different cohort of children within the total sample. Accelerometer data were matched with localized weather patterns derived from Environment Canada weather data. Multilevel modeling using Hierarchical Linear and Non-linear Modeling software was conducted by factoring in weather variation to depict the influence of diverse environmental exposures on SB. Both weather variation and urban design played a significant role in SB. After factoring in weather variation, it was observed that children living in grid-pattern neighbourhoods closer to the city centre (with higher diversity of destinations) were less likely to be sedentary. This study demonstrates a methodology that could be replicated to integrate geography-specific weather patterns with existing cross-sectional accelerometry data to understand the influence of urban design and built environment on SB in children.

School-based Interventions to Reduce Sedentary Behaviour in Children: A Systematic Review.

IntroductionProlonged, uninterrupted periods of sedentary time may be associated with increased risk of Type II diabetes, cardiovascular disease and all-cause mortality even if the minimum recommended levels of daily physical activity are achieved. It is reported that children spend approximately 80% of their day engaged in sedentary behaviours. Since children spend a large portion of their waking time at school, school-based interventions targeting excessive or interrupted periods of sedentary time have been investigated in a number of studies. However, results of the effectiveness of studies to-date have been inconsistent.AimTo conduct a systematic review to evaluate the effectiveness of school-based interventions designed to reduce sedentary behaviour on objectively measured sedentary time in children.MethodsFive electronic databases were searched to retrieve peer-reviewed studies published in English up to and including August 2015. Studies that reported objectively measured sedentary time before and after a school-based intervention to reduce sedentary time were included in the review. Risk of bias was assessed using the Cochrane Collaboration method.ResultsOur search identified eleven papers reporting eight interventions. Studies focused on the physical environment, the curriculum, individual in-class activities, homework activities or a combination of these strategies. Three studies reported decreases in sedentary time following intervention. Study follow-up periods ranged from immediately post-intervention to 12 months. None of the studies were judged to have a low risk of bias.ConclusionsMulticomponent interventions which also include the use of standing desks may be an effective method for reducing children's sedentary time in a school-based intervention. However, longer term trials are needed to determine the sustained effectiveness of such interventions on children's sedentary time.

An active video game intervention does not improve physical activity and sedentary time of children at-risk for developmental coordination disorder: a crossover randomized trial.

Children with developmental coordination disorder (DCD) are highly inactive and sedentary. The purpose of this study was to assess the impact of a home-based active video game intervention on objectively measured physical activity and sedentary behaviour in children at risk for DCD. In a crossover randomized clinical trial, 21 children (mean age 11.0, SD 1.0; n = 11 girls) in Perth, Western Australia participated in two 16-week periods: no active video games (AVGs) control period and AVGs intervention period. Two active input consoles were provided to participants along with a selection of non-violent AVGs for participants to play at home. Participants wore accelerometers at baseline and following each period to determine minutes of sedentary, light, moderate and vigorous times in addition to self-reported types of activities in a diary. Linear mixed models, adjusted for the order of periods, compared physical activity and sedentary time during the last week of each period. There were no significant differences between the intervention and control periods in time spent in sedentary (decrease of -1.0 min/day during the intervention period, 95%CI -12.1, 10.1), light (increase of 2.2 min/day, 95%CI -8.8, 13.2), moderate (decrease of 0.7 min/day, 95%CI -4.6, 3.3) or vigorous (decrease of -0.6 min/day, 95%CI -1.6, 0.4). Among children at risk for DCD, participating in this AVG intervention did not improve objectively measured physical activity and sedentary time.

The Active for Life Year 5 (AFLY5) school-based cluster randomised controlled trial: effect on potential mediators.

BackgroundActive for life year 5 (AFLY5) is a school-based intervention, based on social cognitive theory, which aims to promote healthy levels of physical activity and healthy eating by improving a child’s self-efficacy to make healthy choices, their knowledge of how to make such choices and prompting parents to support their children to make healthy choices. Previously published results showed no effect on the three primary outcomes and beneficial effects on three of nine secondary outcomes (time spent screen-viewing at weekends, consumption of snacks and of high energy drinks). This paper aims to determine the effect of the intervention on potential mediators.MethodsWe conducted a cluster RCT of a school-based intervention, with allocation concealed by use of a remote system. The study was undertaken in the South West of England between 2011 and 2013. Participants were school children who were age 8–9 years at baseline assessment and 9–10 years during the intervention. Potential mediators were assessed at the end of the intervention. The intervention consisted of teacher training, provision of all materials required for lessons and homeworks and written materials for school newsletters and parents. The ten potential mediators were child-reported self-efficacy for physical activity and fruit and vegetable consumption, perceived parental logistic support and modelling for their child’s physical activity, parental efforts to limit their child’s sedentary behaviour and modelling of healthy fruit and vegetable consumption, together with a knowledge assessment.ResultsWe successfully recruited 60 schools with over 2,221 children; valid data for the 10 mediators were available for 87 % to 96 % of participants. Three of the ten potential mediators were greater in the intervention, compared with the control group: fruit and vegetable self-efficacy 2.2 units (95 % CI: 0.7 to 3.8), assessed on a scale 26 to 130; child-reported maternal limitation of sedentary behaviour 0.5 (0.1 to 0.8), scale 4 to 16; and knowledge 0.5 (0.2, 0.7) scale 0 to 9. Reported maternal limitation of sedentary behaviour and the child’s knowledge explained 23 % of the effect of the intervention on reducing time spent on sedentary behaviour at the weekend. There was no effect on other mediators.ConclusionsOur findings suggest that the effect of the AFLY5 intervention on reducing screen-viewing at weekends was partially mediated by an effect on mothers limiting their child’s time spent sedentary and on increasing the child’s knowledge about healthy behaviour. However, overall our findings suggest that theory driven interventions, like AFLY5, can fail to influence most potential mediators and this may explain the failure of the intervention to improve most primary and secondary outcomes.Trial registrationCurrent Controlled Trials ISRCTN50133740. Registered 17/03/2011Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2734-5) contains supplementary material, which is available to authorized users.

Dose-response association of screen time-based sedentary behaviour in children and adolescents and depression: a meta-analysis of observational studies.

BackgroundDepression represents a growing public health burden. Understanding how screen time (ST) in juveniles may be associated with risk of depression is critical for the development of prevention and intervention strategies. Findings from studies addressing this question thus far have been inconsistent. Therefore, we conducted a comprehensive systematic review and meta-analysis of data related to this question.MethodsThe meta-analysis was conducted in accordance with the PRISMA guideline. We searched the electronic databases of PubMed, Web of Science and EBSCO systematically (up to 6 May 2015). OR was adopted as the pooled measurement of association between ST and depression risk. Dose–response was estimated by a generalised least squares trend estimation.ResultsTwelve cross-sectional studies and four longitudinal studies (including 1 cohort study) involving a total of 127 714 participants were included. Overall, higher ST in preadolescent children and adolescents was significantly associated with a higher risk of depression (OR=1.12; 95% CI 1.03 to 1.22). Screen type, age, population and reference category acted as significant moderators. Compared with the reference group who had no ST, there was a non-linear dose–response association of ST with a decreasing risk of depression at ST<2 h/day, with the lowest risk being observed for 1 h/day (OR=0.88; 95% CI 0.84 to 0.93).ConclusionsOur meta-analysis suggests that ST in children and adolescents is associated with depression risk in a non-linear dose–response manner.

Obesity, Physical Activity and Sedentary Behaviors in Children with an Autism Spectrum Disorder.

Previous literature using small sample sizes and limited geographic areas report that overweight/obesity and physical inactivity occur at higher rates among children with autism spectrum disorder (ASD) compared to typically developing peers. The purpose of this study was to examine obesity, overweight, physical activity, and sedentary behavior among children and youth with and without ASD using nationally representative data and controlling for secondary conditions, including intellectual and learning disabilities, ADHD, developmental delay, and other mental, physical, and medical conditions, as well as medication use. Data were collected from the 2011-2012 National Survey of Children's Health, a cross-sectional survey of 65,680 (weighted N = 49,586,134) children aged 6-17 (1385 with ASD, weighted N = 986,352). Logistic regression was used to estimate odds ratios, adjusting for demographics and possible secondary conditions. Having a diagnosis of ASD was associated with higher odds of obesity (OR 1.76, CI 1.27-2.43; p = <0.001). However, after additional adjustment for possible secondary conditions, ASD diagnosis was no longer associated with obesity. Those with moderate ASD (OR 0.58, CI 0.36-0.93; p = <0.05) reported lower odds of sedentary behavior, but this association failed to achieve significance after adjustment for secondary conditions and medication use. No significant associations between ASD and overweight or physical activity were found. These findings suggest that ASD diagnosis is not significantly associated with obesity status after adjustment for possible secondary conditions and medication use. Decision makers, clinicians, and researchers developing interventions for children with ASDs should consider how secondary conditions may impact obesity and related activities.

Competitive active video games: Physiological and psychological responses in children and adolescents.

Recent strategies to reduce sedentary behaviour in children include replacing sedentary screen time for active video games. Active video game studies have focused principally on the metabolic consumption of a single player, with physiological and psychological responses of opponent-based multiplayer games to be further evaluated. To determine whether adding a competitive component to playing active video games impacts physiological and psychological responses in players. Sixty-two healthy Caucasian children and adolescents, nine to 14 years years of age, completed three conditions (8 min each) in random order: treadmill walking, and single and opponent-based Kinect active video games. Affect, arousal, rate of perceived exertion, heart rate and percentage of heart rate reserve were measured for each participant and condition. Kinect conditions revealed significantly higher heart rate, percentage of heart rate reserve, rate of perceived exertion and arousal when compared with treadmill walking (P<0.001). Opponent-based condition revealed lower values for the rate of perceived exertion (P=0.02) and higher affect (P=0.022) when compared with single play. Competitive active video games improved children's psychological responses (affect and rate of perceived exertion) compared with single play, providing a solution that may contribute toward improved adherence to physical activity.

Capturing the Interrelationship between Objectively Measured Physical Activity and Sedentary Behaviour in Children in the Context of Diverse Environmental Exposures.

Even though physical activity and sedentary behaviour are two distinct behaviours, their interdependent relationship needs to be studied in the same environment. This study examines the influence of urban design, neighbourhood built and social environment, and household and individual factors on the interdependent relationship between objectively measured physical activity and sedentary behaviour in children in the Canadian city of Saskatoon. Saskatoon’s built environment was assessed by two validated observation tools. Neighbourhood socioeconomic variables were derived from 2006 Statistics Canada Census and 2010 G5 Census projections. A questionnaire was administered to 10–14 year old children to collect individual and household data, followed by accelerometry to collect physical activity and sedentary behaviour data. Multilevel logistic regression models were developed to understand the interrelationship between physical activity and sedentary behaviour in the context of diverse environmental exposures. A complex set of factors including denser built environment, positive peer relationships and consistent parental support influenced the interrelationship between physical activity and sedentary behaviour. In developing interventions to facilitate active living, it is not only imperative to delineate pathways through which diverse environmental exposures influence physical activity and sedentary behaviour, but also to account for the interrelationship between physical activity and sedentary behaviour.