Angie S. Page

Commuting to School Are Children Who Walk More Physically Active

BACKGROUNDnThe journey to school is an opportunity for increasing childrens daily physical activity. However, the contribution that active commuting to school makes to overall physical activity is unknown. This study used objective measurement to investigate the physical activity patterns of children by mode of travel to school.nnnMETHODSnPrimary-school children wore an accelerometer programmed to record minute-by-minute physical activity for 7 days and completed a brief questionnaire describing their usual travel to school. The total volume of physical activity and the time spent in activity of at least moderate intensity, as recorded by the accelerometer, was estimated for weekdays and the weekend, and groups of children were compared by mode of transport to school. Data were collected in May/June 2002.nnnRESULTSnOf the 114 children (59 boys, 55 girls; aged 10.4+/-0.8 years) who took part in the study, those who walked to school (65%) were significantly more active than those who traveled by car (712.0+/-206.7 vs 629.9+/-207.2 accelerometer counts per minute, p=0.05). Analysis by gender indicated that the major differences in physical activity between travel groups were seen only in boys. Hourly activity patterns demonstrated that boys who walked to school were more active after school and throughout the evening than were car users.nnnCONCLUSIONSnIn boys, walking to school was associated with higher physical activity after school and during the evening. Active transport may contribute to a more physically active profile, at least for boys, supporting walk-to-school initiatives to increase childrens physical activity.

Fitness, fatness and clustering of cardiovascular risk factors in children from Denmark, Estonia and Portugal: the European Youth Heart Study.

BACKGROUNDnLevels of overweight have increased and fitness has decreased in children. Potentially, these changes may be a threat to future health. Numerous studies have measured changes in body mass index (BMI), but few have assessed the independent effects of low fitness, overweight and physical inactivity on cardiovascular (CVD) risk factors.nnnMETHODSnA cross-sectional multi-center study including 1 769 children from Denmark, Estonia and Portugal. The main outcome was clustering of CVD risk factors. Independent variables were waist circumference, skinfolds, physical activity and cardio-respiratory fitness.nnnRESULTSnBoth waist circumference and skinfolds were associated with clustered CVD risk. Odds ratios for clustered CVD risk for the upper quartiles compared with the lowest quartile were 9.13 (95% CI: 5.78-14.43) and 11.62 (95% CI: 7.11-18.99) when systolic blood pressure, triglyceride, insulin resistance homeostasis assessment model (HOMA) score, cholesterol:HDL, and fitness were included in the score. When fitness was removed from the clustered risk variable, the association for fatness attenuated and after further adjustment for fitness, only the highest quartiles of the fatness parameters were significant. Fitness showed the same strength of association with the clustered risk score including systolic blood pressure, triglyceride, HOMA score, and cholesterol:HDL with odds ratio for the upper quartile of 4.97 (95% CI: 3.20-7.73). Physical activity was associated with clustered risk even after adjustment for fitness and fatness with an odds ratio for the upper quartile of 1.81 (95% CI: 1.18-2.76).nnnCONCLUSIONnPhysical activity, fitness, skinfold and waist circumference were all independently associated with clustered CVD risk.

Longitudinal associations of cycling to school with adolescent fitness

OBJECTIVEnTo investigate whether change in transport to school from non-cycling to cycling was associated with change in cardio-respiratory fitness (CRF) over a six-year follow-up.nnnMETHODSnParticipants were 384 children (9.7 (0.5) years) who participated in the Danish arm of the European Youth Heart Study in 1997 and who were followed up 6 years later. CRF was assessed by a maximal cycle ergometer test and travel to school was investigated by questionnaire at both time points. Linear regression models were used to investigate associations between CRF and change in mode of travel to school between baseline and follow-up.nnnRESULTSnHigher CRF was significantly associated with cycling to school in children and adolescents of both sexes. Longitudinal regression models showed that a change in travel mode from non-cycling to cycling was a significant predictor of CRF at follow-up (P<0.001) after adjustment for potential confounders. Participants who did not cycle to school at baseline, but who had changed to cycling at follow-up, were significantly fitter (0.33 W kg(-1)) than those who did not cycle to school at either time point (P=0.001), a difference of 9%.nnnCONCLUSIONnCycling to school may contribute to higher cardiovascular fitness in young people.

Parenting styles, parenting practices, and physical activity in 10- to 11-year olds

Objective The objective of this study was to determine whether parenting styles and practices are associated with childrens physical activity. Methods Cross-sectional survey of seven hundred ninety-two 10- to 11-year-old UK children in Bristol (UK) in 2008–2009 was conducted. Accelerometer-assessed physical activity and mean minutes of moderate-to-vigorous physical activity (mean MVPA) and mean counts per minute (mean CPM) were obtained. Maternal parenting style and physical activity parenting practices were self-reported. Results In regression analyses, permissive parenting was associated with higher mean MVPA among girls (+ 6.0 min/day, p < 0.001) and greater mean CPM (+ 98.9 accelerometer counts/min, p = 0.014) among boys when compared to children with authoritative parents. Maternal logistic support was associated with mean CPM for girls (+ 36.2 counts/min, p = 0.001), while paternal logistic support was associated with boys mean MVPA (+ 4.0 min/day, p = 0.049) and mean CPM (+ 55.7 counts/min, p = 0.014). Conclusions Maternal permissive parenting was associated with higher levels of physical activity than authoritative parenting, but associations differed by child gender and type of physical activity. Maternal logistic support was associated with girls physical activity, while paternal logistic support was associated with boys physical activity. Health professionals could encourage parents to increase logistic support for their childrens physical activity.

Parental Sedentary Restriction, Maternal Parenting Style, and Television Viewing Among 10- to 11-Year-Olds

OBJECTIVE: To examine whether parenting styles or practices were associated with childrens television (TV) viewing. METHODS: A total of 431 parent-child dyads (10- to 11-year-old children) from Bristol, United Kingdom, were included. Child and parent TV viewing were self-reported and categorized as <2, 2 to 4, or >4 hours/day. Children reported maternal parenting style (authoritarian, authoritative, or permissive). Child-reported maternal and paternal sedentary restriction scores were combined to create a family-level restriction score. Multinomial logistic regression was used to examine whether child TV viewing was predicted by parenting style or family restriction. RESULTS: A greater proportion of children with permissive mothers watched >4 hours of TV per day, compared with children with authoritarian or authoritative mothers (P = .033). A greater proportion of children for whom both parents demonstrated high restriction watched <2 hours of TV per day (P < .001). The risk of watching 2 to 4 hours (vs <2 hours) of TV per day was 2.2 times higher for children from low-restriction families (P = .010). The risk of watching >4 hours (vs <2 hours) of TV per day was 3.3 times higher for children from low-restriction families (P = .013). The risk of watching >4 hours of TV per day was 5.2 times higher for children with permissive (versus authoritative) mothers (P = .010). CONCLUSIONS: Clinicians need to talk directly with parents about the need to place limitations on childrens screen time and to encourage both parents to reinforce restriction messages.

Perceptions of the built environment in relation to physical activity in Portuguese adolescents

In this study, we investigated the association between perceptions of the built environment and physical activity among Portuguese boys and girls. Participants were 1124 adolescents (592 girls and 532 boys) 12- to 18-years-old. Physical activity and perceptions of environmental characteristics were assessed by self-report questionnaires. Significantly more girls (p<0.01) were classified as low-active (61.5%) compared to boys (22.9%). Logistic regression analyses (adjusted for age) showed a significant association between girls physical activity and availability of free- or low-cost recreational facilities in the neighbourhood (OR=1.44; 95% CI 0.99-2.11). Among boys, the presence of people being active in the neighbourhood was associated with higher levels of physical activity (OR=1.59; 95% CI 1.05-2.40). Perceptions of some aspects of neighbourhood environment may relate differently to participation in physical activity for boys compared to girls.

Physical activity and sedentary behaviour typologies of 10-11 year olds

BackgroundTargeted interventions may be more effective at increasing childrens physical activity. The aim of this study was to identify clusters of children based on physical activity and sedentary patterns across the week.MethodsParticipants were 761, 10-11 year old children. Participants self-reported time spent in eight physical activity and sedentary contexts and wore an accelerometer. Cluster analysis was conducted on the time spent in the self-reported physical activity and sedentary contexts. Mean minutes of accelerometer derived of moderate to vigorous physical activity (MVPA) and sedentary time were derived for the entire week, weekdays only, weekend days and four different time periods across each type (weekend or weekday) of days. Differences in the physical activity patterns of the groups derived from the cluster analysis were assessed for overall physical activity as well as for the four time periods on weekdays and weekend days.ResultsThree clusters emerged: 1) High active/Low sedentary; 2) Low active/Moderate sedentary; and 3) High Active/High sedentary. Patterns of activity differed across the week for each group and the High Active/High sedentary obtained the most minutes of MVPA.ConclusionsPatterns of physical activity and sedentary time differed across the week for each cluster. Interventions could be targeted to the key periods when each group is inactive.

Screen-viewing and the home TV environment: the European Youth Heart Study.

OBJECTIVEnExamine if home environmental factors are associated with screen-viewing.nnnMETHODSnData are for 2670, 3rd and 9th grade participants in Denmark, Portugal, Estonia and Norway collected between 1997 and 2000. Outcomes were spending >2 h after-school watching television (TV) and >1 h per day playing computer games. Child Autonomy and the home TV Environment were exposures.nnnRESULTSnEach unit increase in Child Autonomy was associated with 9% increase in risk of watching more than 2 h of TV per day after school and a 19% increase in risk of spending more than an hour per day playing computer games. TV Environment was associated with a 31% per unit increase in risk of watching >2 h of TV after school and 11% increase in risk of spending >1 h playing computer games.nnnCONCLUSIONSnA family environment in which after-school TV viewing is part of the home culture and homes where children have more autonomy over their own behavior are associated with an increased risk of watching >2 h of TV per day after school and spending more >1 h per day playing computer games. The home screen-viewing environment and Child Autonomy may be malleable targets for changing screen-viewing.

Better with a buddy: influence of best friends on children's physical activity.

PURPOSEnthe purpose of this study was to examine the extent to which the physical activity modeling and physical activity actions of best friends are associated with the physical activity of 10- to 11-yr-old children.nnnMETHODSndata were collected from 986 children of whom 472 provided complete physical activity and best friend data. Participants identified their best friend within the school and answered how often they took part in physical activity with the friend and if the friend had encouraged them to be active. Physical activity was assessed via accelerometer for all children and friends. Mean minutes of moderate-to-vigorous physical activity per day (MVPA) and mean accelerometer counts per minute (CPM) were obtained for all children and best friends. Regression models were run separately for boys and girls and used to examine associations between child and best friend physical activity.nnnRESULTSnfor girls, mean MVPA was associated with frequency of activity of the best friend (P ≤ 0.02 for all categories) and engaging in physical activity at home or in the neighborhood (t = 2.27, P = 0.030), with similar patterns for mean CPM. Boys mean MVPA was associated with their best friends mean MVPA (t = 3.68, P = 0.001) and being active at home or in the local neighborhood (t = 2.52, P = 0.017).nnnCONCLUSIONSnboys who have active friends spend more minutes in MVPA. Girls who frequently take part in physical activity with their best friend obtain higher levels of physical activity. Boys and girls who take part in physical activity with their best friend at home or in the neighborhood where they live engage in higher levels of physical activity.

The Potential Impact of Displacing Sedentary Time in Adults with Type 2 Diabetes

ABSTRACT Purpose Sedentary time, in particular, prolonged unbroken sedentary time, is detrimental to health and displaces time spent in either light or moderate intensity physical activity. This cross-sectional study aimed to identify the potential impact of reallocating time from sedentary behaviors to more active behaviors on measures of body composition and metabolic health in people with type 2 diabetes. Methods Participants were 519 adults with newly diagnosed type 2 diabetes who had been recruited to the Early Activity in Diabetes (Early ACTID) randomized controlled trial. Waist-worn accelerometers were used to obtain objective measurement of sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) at baseline alongside clinical measurements and fasting blood samples to determine cholesterol, triglycerides, HOMA-IR, and glucose. Isotemporal substitution modeling was performed to determine the potential impact of reallocating 30 min of sedentary time accumulated in a single bout (long bout) with 30 min of interrupted sedentary time, LPA, or MVPA. Results Sedentary time accounted for 65% of the waking day, of which 45% was accumulated in prolonged (≥30 min) bouts. Reallocation of 30 min of long-bout sedentary time with 30 min of short-bout sedentary time was associated with lower body mass index (BMI) (adjusted β, −0.60; 95% confidence interval [CI], −1.00, −0.21) and waist circumference (WC) (adjusted β, −1.16; 95% CI, −2.08, −0.25). Stronger effects were seen for LPA and MVPA. Reallocation of 30 min of long-bout sedentary time with LPA was associated with higher HDL-cholesterol (adjusted β, 0.02; 95% CI, 0.00–0.03 mmol·L−1). Conclusions Encouraging adults with newly diagnosed type 2 diabetes to break up prolonged periods of sedentary time may be an effective strategy for improving body composition and metabolic health.