Maximizing children's physical activity using the LET US Play principles

BackgroundStaff in settings that care for children struggle to implement standards designed to promote moderate-to-vigorous physical activity (MVPA), suggesting a need for effective strategies to maximize the amount of time children spend in MVPA during scheduled PA opportunities. The purpose of this study was to compare the MVPA children accumulate during commonly played games delivered in their traditional format versus games modified according to the LET US Play principles.MethodsChildren (K–5th) participated in 1-hour PA sessions delivered on non-consecutive days (summer 2014). Using a randomized, counterbalanced design, one of the six games was played for 20 min using either traditional rules or LET US Play followed by the other strategy with a 10 min break in between. Physical activity was measured via accelerometry. Repeated-measures, mixed-effects regression models were used to estimate differences in percent of time spent sedentary and in MVPA.ResultsA total of 267 children (age 7.5 years, 43% female, 29% African American) participated in 50, 1-hour activity sessions. Games incorporating LET US Play elicited more MVPA from both boys and girls compared to the same games with traditional rules. For boys and girls, the largest MVPA difference occurred during tag games (+ 20.3%). The largest reduction in the percent of time sedentary occurred during tag games (boys − 27.7%, girls − 32.4%). Overall, the percentage of children meeting 50% time in MVPA increased in four games (+ 18.7% to + 53.1%).ConclusionLET US Play led to greater accumulation of MVPA for boys and girls, and can increase the percent of children attaining the 50% of time in MVPA standard.     

Objectively measured sedentary time and associations with insulin sensitivity: Importance of reallocating sedentary time to physical activity

ObjectiveThe aim of this study is to quantify associations between objectively measured sedentary time and markers of insulin sensitivity by considering allocation into light-intensity physical activity or moderate- to vigorous-intensity physical activity (MVPA).MethodsParticipants with an increased risk of impaired glucose regulation (IGR) were recruited (Leicestershire, United Kingdom, 2010–2011). Sedentary, light-intensity physical activity and MVPA time were measured using accelerometers. Fasting and 2-hour post-challenge insulin and glucose were assessed; insulin sensitivity was calculated by HOMA-IS and Matsuda-ISI. Isotemporal substitution regression models were used. Data were analysed in 2014.Results508 participants were included (average age = 65 years, female = 34%). Reallocating 30 min of sedentary time into light-intensity physical activity was associated a 5% (95% CI 1, 9%; p = 0.024) difference in Matsuda-ISI after adjustment for measured confounding variables. Reallocation into MVPA was associated with a 15% (7, 25%; p < 0.001) difference in HOMA-IS and 18% (8, 28%; p < 0.001) difference in Matsuda-ISI. Results for light-intensity physical activity were modified by IGR status with stronger associations seen in those with IGR.ConclusionsReallocating sedentary time into light-intensity physical activity or MVPA was associated with differences in insulin sensitivity, with stronger and more consistent associations seen for MVPA.     

Physical Activity and Sedentary Time Among Mothers of School-Aged Children: Differences in Accelerometer-Derived Pattern Metrics by Demographic,Employment, and Household Factors

BackgroundDynamic patterns of how physical activity and sedentary time are accumulated across the day are associated with health outcomes, independent of total activity levels. Individual factors may influence activity patterns in mothers, but these associations are unknown. This study examined multivariable associations between demographic, employment, and household factors and day-level pattern metrics.MethodsMothers (N = 200) of school-aged children (ages 8–12 years) participated in 6 semi-annual 7-day assessments. Waist-worn Actigraph GT3X accelerometers assessed daily moderate-to-vigorous physical activity (MVPA; minutes, number of short bouts [<10 minutes], proportion of long bouts [≥20 minutes]) and sedentary time (minutes, number of breaks, proportion of long bouts [≥60 minutes], temporal dispersion). Multilevel models examined associations between individual characteristics and activity metrics.ResultsThere were 4,930 day-level observations. Having a college degree was associated with fewer short MVPA bouts (B = ?2.67), more sedentary minutes (B = 21.66), greater long sedentary bouts (odds ratio = 1.50), and having sedentary time less evenly distributed across the day (B = 0.01). Working full-time was associated with more short MVPA bouts (B = 1.39) and breaks in sedentary time (B = 2.08). Having at least 1 infant (<6 months old) in the same household was associated with fewer MVPA minutes (B = ?0.11) and short MVPA bouts (B = ?4.46), whereas having at least 1 young child (6 months–5 years old) in the same household was associated with fewer sedentary minutes (B = ?11.85) and fewer long sedentary bouts (odds ratio = 0.70).ConclusionsDay-level pattern metrics show differences not captured when examining total volume alone. Results provide more nuanced information as to how activity is accumulated in terms of bouts and breaks, which can inform programs to increase MVPA and reduce sedentary time by elucidating subpopulations that should be targeted by health behavior interventions.     

Physical activity and self-reported sleep quality in adults with multiple sclerosis

BackgroundThere is a fourfold higher prevalence of sleep problems in multiple sclerosis (MS) than the general population.ObjectiveThis study examined cross-sectional associations among device-measured sedentary and physical activity behavior with perceived sleep quality in adults with MS.MethodsAdults with MS (N = 290) completed the Pittsburgh Sleep Quality Index (PSQI) and wore an accelerometer for seven days providing a measure of time spent in sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) using MS-specific cut-points. We conducted multiple linear regression analysis to identify the independent contributions of variables for explaining PSQI scores.ResultsThe overall model accounted for 2% of the variance in global PSQI scores, and MVPA was significantly and independently associated with global PSQI scores (β = ─0.123; p = 0.045; partial r = ─0.118) when accounting for average wear time, sedentary behavior, and time spent in LPA. There were no other significant associations with PSQI global score.ConclusionsOur results suggest that time spent in MVPA may be associated with better sleep quality in adults with MS, but adults with MS do not spend sufficient time in physical activity. Researchers should evaluate these relationships in longitudinal study designs and behavior change interventions, as physical activity may provide a unique opportunity to improve sleep quality outcomes.     

Physical activity and vascular comorbidity in Black and White persons with multiple sclerosis: A cross-sectional study

BackgroundPhysical activity and sedentary behavior have been associated with vascular comorbidity in multiple sclerosis (MS), yet the associations have not been thoroughly investigated in MS subpopulations as a function of race.ObjectivesThis study examined if physical activity levels/sedentary time and vascular comorbidity differed between Black and White persons with MS, and further examined the associations between the variables within the two MS subpopulations.MethodsParticipants (n = 208) completed the comorbidity questionnaire in MS and wore accelerometers for seven days as a device-measure of physical activity levels/sedentary time. We examined the effect of race on physical activity levels/sedentary time and vascular comorbidity, controlling for covariates, using ANCOVA. We further performed bivariate correlations among variables in Black and White persons with MS separately.ResultsOnly moderate-to-vigorous physical activity (MVPA) was significantly different between Black and White persons with MS, even after controlling for age, disease duration, marital status, education level, and income [F(1,177) = 9.01, p = .003, d = 0.16]. There was only a significant and moderate association between MVPA and vascular comorbidity in White persons with MS (r = ?0.33).ConclusionsThe findings indicate that MVPA is higher in White than Black persons with MS, and that more MVPA was associated with lower vascular comorbidity in White persons with MS. Physical activity behavior might be a potential target for managing vascular comorbidity in White persons with MS.     

Prospective COVID-19 related changes in physical activity and sedentary time and associations with symptoms of depression and anxiety

ProblemThe COVID-19 pandemic is associated with psychological distress. Decreased moderate-vigorous physical activity (MVPA) and increased sedentary time may be exacerbating pandemic-related symptoms of anxiety and depression, but existing studies exploring these associations are almost entirely cross-sectional.MethodsReported data from 2018 and Summer 2020 were used to create change categories based on compliance with MVPA guidelines and relative sedentary time. Participants completed the Patient Health Questionnaire-4 (PHQ-4) in Summer 2020. Associations among changes in MVPA and sedentary time (separately and jointly) with psychological distress (total PHQ-4 score) were examined with ordinal logistic regression and associations with depressive or anxiety symptoms were examined with logistic regression.ResultsAmong 2,240 participants (65% women, mean age 57.5 years), 67% increased sedentary time and 21% became inactive between the two time points. After multivariate adjustment, participants who became (OR = 1.71, 95% CI: 1.05–2.78) or remained inactive (OR = 2.07, 1.34–3.22) were more likely to experience depressive symptoms compared to those who remained active. Participants who increased sedentary time were also more likely to experience depressive symptoms compared to those who maintained sedentary time (OR = 1.78, 1.13–2.81). Jointly, those who increased sedentary time while remaining (OR = 3.67, 1.83–7.38) or becoming inactive (OR = 3.02, 1.44–6.34) were much more likely to have depressive symptoms compared to the joint referent (remained active/maintained sedentary time). Associations with anxiety symptoms were not statistically significant.ConclusionsThese findings support the value of promoting MVPA and limiting sedentary time during stressful events associated with psychological distress, like the COVID-19 pandemic.     

Sedentary Behavior,Physical Activity,and All-Cause Mortality: Dose-Response and Intensity Weighted Time-Use Meta-analysis

ObjectivesPrevious studies have placed those with excessive sedentary behavior at increased risk of all-cause mortality. There is evidence of interdependency of sedentary behavior with physical activity, and its elucidation will have implications for guidelines and practice. This study investigated if sedentary behavior–related mortality risk can be offset by moderate- to vigorous-intensity physical activity (MVPA) considered in a time-use fashion.DesignPubMed was searched (from its inception till May 2018) for studies or meta-analyses that used data harmonized for MVPA. Of the 17 data-custodians located, 7 provided data on sitting time or TV viewing time, or both. A dose-response meta-analysis modeling log relative risks of all-cause mortality against uncompensated sedentary behavior metabolic equivalent hours (USMh) was run using the robust error meta-regression method. (Registration: CRD42017062439)SettingIndividual subject data held by data custodians on this topic.ParticipantsGeneral adults.MeasurementsSedentary time, MVPA.ResultsFive harmonized cohorts of sitting time (258,688 participants) and 4 of TV viewing time (156,593 participants) demonstrated that sedentary behavior was significantly associated with mortality, but this risk was attenuated with increasing energy expenditure through MVPA modeled in a time-use fashion. The average increment in mortality per USMh spent on sitting was 1% [relative risk (RR) 1.01, 95% confidence interval (CI) 1.00, 1.02; P = .01] and that per USMh spent on TV viewing was 7% (RR 1.07, 95% CI 1.04, 1.10; P < .001). The thresholds for risk started at 7 USMh for sitting and 3 USMh for TV viewing.Conclusions/ImplicationsOur findings suggest that overall daily sitting time energy expenditure of 7 MET-hours (or TV viewing of 3 MET-hours) in excess of that expended on MVPA is independently related to all-cause mortality. These findings support the view that sitting is strongly influenced by consideration of concurrent MVPA in its impact on adverse health consequences and that the USMh is a more practical metric of sedentary behavior.     

Joint effects of objectively-measured sedentary time and physical activity on all-cause mortality

ObjectiveExamine the joint effects of objectively-measured sedentary time and moderate-to-vigorous physical activity (MVPA) on all-cause mortality.MethodsThe present study included data from the 2003–2006 National Health & Nutrition Examination Survey, with mortality follow-up data (via National Death Index) through 2011 (N = 5575 U.S. adults). Sedentary time (activity counts/min between 0 and 99) and MVPA (activity counts/min ≥ 2020) were objectively measured using the ActiGraph 7164 accelerometer.ResultsThe median age of the participants was 50 yrs; proportion of men was 50.2%; proportion of whites was 53.8%, 18.7% for blacks; median follow-up was 81 months; and 511 deaths occurred over the follow-up period. After adjusting for age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein and comorbid illness (summed score of 0–8 chronic diseases), and for a 1 min increase in MVPA and sedentary time, both MVPA (HR_adjusted = 0.98; 95% CI: 0.96–0.99; P = 0.04) and sedentary time (HR_adjusted = 1.001; 95% CI: 1.0003–1.002; P = 0.008) were independently associated with all-cause mortality. Further, MVPA was associated with all-cause mortality among those with greater (above median) sedentary time (HR_adjusted = 0.95; 95% CI: 0.93–0.97; P < .001). Sedentary time was not associated with all-cause mortality among those engaging in above median levels of MVPA (HR_adjusted = 0.998; 95% CI: 0.996–1.001; P = .32), but sedentary time was associated with increased mortality risk among those below median levels of MVPA (HR = 1.002; 95% CI: 1.001–1.003; P < 0.001).ConclusionsSedentary time and MVPA are independently associated with all-cause mortality. Above median sedentary time levels did not negate the beneficial effects of MVPA on all-cause mortality risk.     

Tri-axial accelerometer-assessed physical activity and its association with weight status in a sample of elementary-school children

Background and aimsObjective assessment of physical activity (PA) using accelerometers and pedometers has become more accurate and common practice in the study of childhood overweight. The study aimed: i) to compare PA levels and body shape of boys and girls, and assess compliance of active children with the PA recommendation; ii) to analyse associations between the risk of overweight and the moderate-to-vigorous physical activity (MVPA) in children.MethodsThe sample comprised 395 children (198 girls) aged 6–10 years. Height and weight were measured, and BMI was calculated subsequently. A tri-axial accelerometer was used to obtain seven consecutive days of MVPA, as well as the weekly time being sedentary. Logistic regression analysis was used to examine the afore-mentioned relationship among the risk of obesity and MVPA, controlling for confounders.ResultsAfter controlling for wearing time, boys spent significantly more minutes in the moderate-to-vigorous portion of PA than their female counterparts. About 47% of boys were active on week days by achieve the mean value of 60 min/day of MVPA; corresponding percentage for the weekend was just 32%. Among girls, only 22% were active on week days and 29% at the weekend. MVPA was not significantly associated with the risk of being overweight nor in female neither in male children. The final regression model revealed that girls of mothers with high educational level were less likely to be classified as overweight girls.ConclusionsFindings revealed no significantly relation between MVPA and obesity risk among Portuguese children. Future research should extend similar design to other lifestyle features of children to clarify potential predictors of being overweight at early ages.     

Patterns of sedentary time and cardiometabolic risk among Canadian adults

ObjectiveThe aim of this study is to examine the associations of total sedentary time and patterns of sedentary time with cardiometabolic biomarkers in a large representative sample of Canadian adults.MethodsThe study is based on 4935 adults aged 20–79 years, from the 2007/09 and 2009/11 Canadian Health Measures Survey. Total sedentary time, patterns of sedentary time (≥ 20 minute prolonged sedentary bouts, number of sedentary breaks), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Waist circumference, systolic and diastolic blood pressure, high-density lipoprotein (HDL) cholesterol, and C-reactive protein were measured. Triglycerides, low-density lipoprotein (LDL) cholesterol, insulin, and glucose were also measured in a fasting sub-sample (n = 2551).ResultsTotal sedentary time and time in ≥ 20 minute prolonged sedentary bouts were associated with higher insulin and lower diastolic blood pressure levels (P < 0.05). On average, each additional 10 breaks/day was associated with 0.83 (95%CI: 1.35, 0.31) cm lower waist circumference, 0.32 (0.62, 0.02) mm Hg lower systolic blood pressure, 0.01 (0.00, 0.02) mmol/l higher HDL-cholesterol, 3.72 (1.34, 6.13) % lower triglycerides, 0.57 (0.23, 0.92) % lower glucose, and 4.19 (1.80, 6.63) % lower insulin.ConclusionThese findings in a large representative sample of Canadian adults indicate that breaking up sedentary time may be particularly important for cardiometabolic health.     

Evaluation of policies to promote physical activity in afterschool programs: Are we meeting current benchmarks?

BackgroundPolicies now recommend afterschool programs (ASP, 3–6 pm) provide children a minimum amount of physical activity daily. We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity (PA).MethodsAccelerometer-derived physical activity (light and moderate-to-vigorous, MVPA) of 253 children (5–13 years) was compared to policies that recommend varying amounts of PA children should achieve during an ASP.ResultsThe proportion of children achieving a policy ranged from 0.0% (California 60 min MVPA and North Carolina 20% of daily program time devoted to MVPA), 1.2% (California 30 min MVPA), to 48.2% (National Afterschool Association 30 min light plus MVPA). Random effects logistic models indicated boys (odds ratio [OR] range 2.0 to 6.27) and children from a minority background (Black/Hispanic, OR range 1.87 to 3.98) were more likely to achieve a recommended level of physical activity, in comparison to girls and White children. Neither age nor BMI were related to achieving a policy.ConclusionsThe PA of children attending ASP falls below policy recommended levels; however, these policies were developed in absence of data on expected PA levels during ASPs. Thus, concerted effort towards building a stronger ASP evidence-base for policy refinement is required.     

Associations of Sleep With Sedentary Behavior and Physical Activity Patterns Across Pregnancy Trimesters

IntroductionSleep, sedentary behavior, and moderate-to-vigorous physical activity (MVPA) are altered in pregnancy and may affect pregnancy health; however, how these behaviors are associated with each other is unclear.MethodsPregnant women (N = 120) completed the Pittsburgh Sleep Quality Index and wore an activPAL3 micro and ActiGraph GT3X for 7 days in each trimester to assess sleep, sedentary behavior, and MVPA, respectively. Latent trajectories described patterns of sleep duration, efficiency, and quality as well as sedentary behavior and MVPA. Multinomial logistic regression examined associations of sleep patterns with sedentary behavior and MVPA patterns and, in exploratory analyses, with adverse pregnancy outcomes.ResultsTrajectories were identified for sleep duration (consistently short, 20.7% of sample; consistently adequate, 79.3%), efficiency (consistently low, 17.5%; consistently high, 82.5%), and quality (consistently poor, 15.1%; worsening, 23.5%; and consistently good, 61.5%). Compared with those in more optimal sleep groups, women in the short duration, low efficiency, and worsening quality groups had lower odds of being in the moderate and/or high sedentary behavior group (odds ratio range, 0.21–0.31; 95% confidence interval range, 0.09–0.65). Women in the worsening quality group had greater odds of being in the low MVPA group (odds ratio, 2.51; 95% confidence interval, 1.18–5.38). Trends were observed with women in less optimal sleep groups having greater odds of adverse pregnancy outcomes and lower odds of excessive gestational weight gain.ConclusionsLess optimal sleep patterns in pregnancy are associated with less sedentary behavior and MVPA; additional research is needed to confirm associations between sleep and pregnancy outcomes.     

Physical activity levels and sedentary time during school hours of 6th-grade girls in Germany

Aim

Regular physical activity and low levels of sedentary time have positive health effects on youth, and data are needed to base public health recommendations on. Here, findings of device-based physical activity and sedentary time in sixth graders are presented. Data below are presented as mean (SD).

Subject and methods

Three hundred and eight sixth-grade girls [11.6 (0.6) years] from the CReActivity study in Germany wore accelerometers (ActiGraph GT3X) for 7 consecutive days. Moderate to vigorous physical activity (MVPA), light physical activity (LPA), and sedentary time (ST) was obtained during school days with a focus on recess times.

Results

Girls spent 79.9 (23.2) minutes in MVPA and 9.4 (1.2) hours in ST during schooldays, of which 20.5 (8.2) minutes and 3.8 (0.4) hours respectively were accumulated during school hours. On average, students had 35.4 (4.5) minutes break, of which 6.3 (3.2) minutes (17.8%) were spent in MVPA activity and 16.5 (6.2) minutes (46.6%) in ST.

Conclusion

School setting is an important factor for physical activity and sedentary time. Therefore policy, curriculums, and school environment should promote physical activity und reduce sedentary time during school hours.

     

Objectively assessed physical activity,fitness and subjective wellbeing

BackgroundThe existing evidence for a cross-sectional association between physical activity and subjective wellbeing is inconsistent, mainly because of the reliance on self reported physical activity, which might have conceptual overlap with subjective health.PurposeTo examine associations of objectively assessed physical activity and cardiorespiratory fitness with subjective wellbeing.MethodsA sub-sample of participants (921 men and women, mean age 44.6 ± 15.0 yrs, 46.4% men) from the 2008 Health Survey for England completed objective measures of physical activity (Actigraph) and an 8 min sub-maximal step test to estimate levels of cardiorespiratory fitness. The General Health Questionnaire and self-rated health was used as indicators of subjective wellbeing.ResultsThe recorded levels of moderate to vigorous physical activity (MVPA) were higher in participants reporting very good health (adjusted mean difference = 6.7, 95% CI, 1.1–12.4 min/d, p = 0.019) compared with participants reporting fair–poor health after adjustment for various confounders and fitness level. Neither physical fitness, objectively assessed sedentary time or light activity was related to self-rated health. There was also no association between objectively measured physical activity and fitness with psychological health, despite a robust association with self reported MVPA in the overall sample.ConclusionsObjectively assessed MVPA is independently associated with self-rated health. Self reported, but not objectively assessed MVPA, was associated with psychological health. The null findings with regards to psychological health might partly reflect selection biases associated with the healthy nature of this sub-sample of participants.     

Understanding the impact of the installation of outdoor fitness equipment and a multi-sports court on park visitation and park-based physical activity: A natural experiment

IntroductionThis natural experiment examined the impact of the installation of outdoor fitness equipment and one multi-sports court in a park located in Melbourne, Australia on park visitation and park-based physical activity compared to a control park. Barriers and facilitators to use of this equipment among adult park visitors were also explored.MethodsPark visitation and moderate-vigorous physical activity (MVPA) in the two parks were assessed before (T1, 2016) and after the intervention (T2, 2019) using observations of park visitors from children to older adults across four days (7.30am-5.00pm). The relative change in observed counts in visitors from T1-T2 in the intervention park compared to the control park was used to assess the effect of the park refurbishment. Intercept surveys regarding barriers and facilitators were conducted with adult park visitors.ResultsOver the three-year period, total visitor counts increased by 16% and the number of park visitors observed engaging in MVPA increased by 24% in the intervention park. However, there were no significant intervention effects on total visitor counts (IRR = 0.89, 95%CI: 0.62, 1.30) or MVPA (IRR = 0.80, 95%CI: 0.53, 1.19) relative to the control park. Examples of frequently mentioned facilitators to increase use of the sports court and fitness equipment included having someone to use the facilities with and instructional signage, and common barriers included poor weather and lack of time.ConclusionsThe impact of the park upgrade on visitation and MVPA was not significant. A better understanding of the broader appeal of outdoor fitness equipment and a multi-sports court among different segments of the population is needed.     

小学生体力活动久坐行为与超重肥胖风险关系

  目的  探讨中度到大强度体力活动(moderate to vigorous physical activity, MVPA)和久坐行为与小学生超重/肥胖风险之间的关联, 为改善小学生不良生活方式提供参考。  方法  2018年11—12月对广东省某市949名9~12岁小学生进行横断面调查。根据体质量指数(BMI)将小学生划分为正常和超重/肥胖两组。实验对象24 h戴腕表式Gene active加速度计, 对MVPA和久坐时间进行区分和记录。由父母记录并提供小学生的屏幕时间。采用Possion回归分析MVPA、久坐时间、屏幕时间与超重/肥胖风险之间独立关联。  结果  20.8%(197名)的小学生超重/肥胖。小学生符合MVPA推荐值比例为22.1%(210名), 上学日久坐时间(不包括睡眠时间)为60.8%(577名), 高达8.5 h/d。仅有12.3%(117名)的小学生屏幕时间≤2 h/d。与Q4相比, MVPA为Q1的小学生与正常组小学生相比, 其超重/肥胖的风险比体质量正常的小学生高出4.38倍(P < 0.01), 且与久坐时间无关。与符合MVPA推荐值的小学生相比, 未达到MVPA推荐值的小学生的超重/肥胖风险增加了2.54倍(95%CI=1.59~3.77)。每天>2 h的小学生超重/肥胖的风险比每天≤2 h的小学生增加了1.87倍(95%CI=1.21~3.02)。  结论  MVPA时间越长, 超重/肥胖的风险越低。能达到MVPA时间要求的小学生比例偏低, 小学生的屏幕时间大多超出推荐值。     

The effects of objectively measured sedentary behavior on all-cause mortality in a national sample of adults with diabetes

BackgroundDiabetes is a highly prevalent chronic disease that has been increasing globally and is the seventh leading cause of death in the United States. Sedentary behavior is associated with increased risk of diabetes and is unfavorably related to all-cause mortality, but there are limited studies examining the sedentary–mortality relationship among those with diabetes, which was the purpose of this study.MethodsUsing data from the 2003–2006 NHANES, 712 adult participants with evidence of diabetes had complete data on the study variables. A multivariable Cox proportional hazard model was used to examine the association between objectively measured sedentary behavior and all-cause mortality among this diabetic sample.ResultsResults showed that for every 60 min/day increase in sedentary behavior, independent of moderate-to-vigorous physical activity (MVPA) and other covariates, adults with diabetes had a 13% increased risk of all-cause mortality (HR_adjusted = 1.13; 95% CI = 1.03–1.24; P = 0.01). However, after adjusting for total physical activity (light and MVPA), sedentary behavior was no longer associated with mortality risk (HR_adjusted = 1.04; 95% CI = 0.92–1.16; P = 0.46).ConclusionAmong those with diabetes, sedentary behavior may not have increased mortality risk independent of total physical activity behavior.     

Developmental trajectories of physical activity during elementary school physical education

ObjectivePhysical education (PE) during school provides an opportunity for children to be physically active. Few empirical studies have investigated developmental trajectories and determinants of objective moderate to vigorous physical activity (MVPA) during PE classes. The purpose of this study was to examine the developmental trajectories and determinants of MVPA during PE lessons in young children (8–12 years of age) in primary schools.MethodsStudents in grades 5–7 (n = 1202; 51.2% girls) were recruited from 17 elementary schools from the Geneva canton in 2012–2013. The percentage of time spent in accelerometer-assessed MVPA during regular PE lessons was used as a dependent variable.ResultsLinear mixed-model analyses revealed (a) that boys had a higher percentage of MVPA than girls, but none of the children reached the recommended activity levels (i.e., 50% of the PE class time spent in MVPA), (b) a linear decrease in the percentage of MVPA with age, (c) that higher perceived competence predicted a higher percentage of MVPA, and (d) that higher perceived competence reduced the negative linear effect of age among boys, but not among girls.ConclusionThe percentage of PE time spent in MVPA did not reach recommendations made by Centers for Disease Control and Prevention and decreased from 8 to 12 years old both for boys and girls. Perceived competence appears crucial to reduce MVPA decline for boys, but not for girls.     

Activité physique de l’enfant scolarisé en France. Le paradoxe d’une priorité de santé publique !

BackgroundFor their health and an appropriate development, it is recommended that schoolchildren get on a daily basis a minimum of 60 min of moderate-to-vigorous physical activity (MVPA). With only about 11% of girls and 25% of boys completing these recommendations, French children are among the least active in the world. In addition, most of them spend almost 3 h/day in front of a screen while it is generally suggested to limit children's screen time to less than 2 h/day.MethodsAn inspection of available opportunities in the French context reveals many occasions for sufficient physical activity at school, at home, in the neighbourhood, and during commuting to and from school.ResultsAvailable opportunities which encompass about 245 min/day, could contribute to at least 100 min/day of MVPA to all children, considering sport as a subsidiary and economically constraint opportunity. Moreover, in France there is an interesting legal background and political willpower to promote physical activity in the general population, and especially among children. Several factors may explain the high level of physical inactivity among French children, including the lack of investments for strategies aiming to uphold physical activity when compared to other major risks of diseases such as smoking or alcoholism. Furthermore, there may be a failure of the main actors (e.g., parents, teachers, health, sport and physical activity professionals) directly involved in the promotion of physical activity in children. Given its influence on many dimensions of a child's health, it is necessary that adults’ attitudes towards physical activity and sedentary lifestyles change more quickly.ConclusionIt is important to increase awareness of the adult population, in that education/knowledge, role modelling, encouragement and counselling in physical activity undertaken by trained professionals are of paramount value for the integration of physical activity as part of the children's routine. These actions should be based on an accurate assessment/surveillance system and an adequate characterization of physical activity profiles of children.     

Physical activity outcomes in afterschool programs: A group randomized controlled trial

IntroductionAfterschool programs (ASPs) across the US are working towards achieving the standard of all children accumulating 30 min of moderate-to-vigorous physical activity (MVPA) during program time. This study describes the two-year impact of an intervention designed to assist ASPs meeting the 30 min/day MVPA standard.MethodsUsing a two-year delayed treatment, group randomized controlled trial, 20 ASPs serving ~ 1700 children/year (6–12 yrs) were randomized to either an immediate (n = 10, baseline-2013 and 2 yrs intervention fall-2013-to-spring-2015) or delayed group (n = 10, baseline 2013–2014 and 1 yr intervention fall-2014-to-spring-2015). The intervention, Strategies-To-Enhance-Practice (STEPs), focused on programming MVPA in the daily schedule, training of staff and leaders, and ongoing technical support/assistance. Accelerometry-derived proportion of children meeting the 30 min/day MVPA standard was measured in the spring of each year. Mixed model logistic regressions were used to examine the change in the odds of achieving the MVPA standard. Analyses were conducted in 2015. Data were collected in one southeastern US state.ResultsImmediate boys (n = 677) and delayed girls (n = 658) increased the percent achieving 30 min MVPA/day from 35.9% to 47.0% (odds ratio [OR] = 1.88, 95% CI 1.18–3.00) and 13.1% to 19.1% (OR = 1.42, 95% CI 1.03–1.96). Immediate girls (n = 613) and delayed boys (n = 687) exhibited a nonsignificant increase from 19.1% to 21.6% (OR = 1.20, 95% CI 0.84–1.72) and 29.0% to 31.3% (OR = 1.13, 95%CI 0.80–1.58).ConclusionsSTEPs can have an impact on children's MVPA and time spent sedentary, yet was unable to fully achieve the goal of all children accumulating 30 min MVPA/day. Additional efforts are need to identify strategies ASPs can use to meet this important public health standard.