Arja Sääkslahti

Physical activity as a preventive measure for coronary heart disease risk factors in early childhood

Physical activity causes acute physiological and long‐term adaptive responses in the body. It is a protective factor for coronary heart disease (CHD) in adults. It has been assumed that children younger than 8 years of age may be in general active enough and there would be hardly any relationships between physical activity and CHD risk factors in early childhood. One hundred and fifty‐five children (age 4–7 years) participated in this physical activity study during three consecutive years. Physical activity was examined twice a year with a special‐purpose physical activity diary. CHD risk factors were measured during annual health care visits in the Specific Turku Coronary Risk‐Factor Intervention Project (STRIP). We found that physical activity was related to CHD risk factors in early childhood. Among the girls, low‐activity playing was related to a higher BMI. At the mean age of 6 years, high‐activity playing was negatively related to serum total cholesterol (r=−0.32*) and positively to the high‐density lipoprotein (HDL)/total cholesterol ratio (r=0.37**). The negative relationship between high‐activity playing and triglycerides was highest (r=−0.32*) at the mean age of six. Among 4‐year‐old boys, playing outdoors correlated positively with serum HDL cholesterol concentration (r=0.29*) and the HDL/total ratio (r=0.35**). At the age of 5 years, physically active playing correlated positively with systolic blood pressure (r=0.25*). Playing outdoors and high‐activity playing already have important health‐maintaining effects in 4–7‐year‐old children. These positive effects differ between genders. (*P<0.05 **P<0.01)

Relationship between habitual physical activity and gross motor skills is multifaceted in 5- to 8-year-old children

Adequate motor skills are essential for children participating in age‐related physical activities, and gross motor skills may play an important role for maintaining sufficient level of physical activity (PA) during life course. The purpose of this study was to examine the relationship between gross motor skills and PA in children when PA was analyzed by both metabolic‐ and neuromuscular‐based methods. Gross motor skills (KTK – Körperkoordinationstest für Kinder and APM inventory – manipulative skill test) of 84 children aged 5–8 years (53 preschoolers, 28 girls; 31 primary schoolers, 18 girls) were measured, and accelerometer‐derived PA was analyzed using in parallel metabolic counts and neuromuscular impact methods. The gross motor skills were associated with moderate‐to‐high neuromuscular impacts, PA of vigorous metabolic intensity, and mean level of PA in primary school girls (0.5 < r < 0.7, P < 0.05), and with high impacts in preschool girls (0.3 < r < 0.5, P < 0.05). In preschool boys, moderate impacts, light‐to‐vigorous PA, and mean level of PA were associated with gross motor skills (0.4 < r < 0.7, P < 0.05). In conclusion, the result emphasizes an important relationship between gross motor skills and PA stressing both metabolic and neuromuscular systems in children. Furthermore, PA highly stressing neuromuscular system interacts with gross motor proficiency in girls especially.

Deliberate play and preparation jointly benefit motor and cognitive development : mediated and moderated effects

In light of the interrelation between motor and cognitive development and the predictive value of the former for the latter, the secular decline observed in motor coordination ability as early as preschool urges identification of interventions that may jointly impact motor and cognitive efficiency. The aim of this study was twofold. It (1) explored the outcomes of enriched physical education (PE), centered on deliberate play and cognitively challenging variability of practice, on motor coordination and cognitive processing; (2) examined whether motor coordination outcomes mediate intervention effects on children’s cognition, while controlling for moderation by lifestyle factors as outdoor play habits and weight status. Four hundred and sixty children aged 5–10 years participated in a 6-month group randomized intervention in PE, with or without playful coordinative and cognitive enrichment. The weight status and spontaneous outdoor play habits of children (parental report of outdoor play) were evaluated at baseline. Before and after the intervention, motor developmental level (Movement Assessment Battery for Children) was evaluated in all children, who were then assessed either with a test of working memory (Random Number Generation task), or with a test of attention (from the Cognitive Assessment System). Children assigned to the ‘enriched’ intervention showed more pronounced improvements in all motor coordination assessments (manual dexterity, ball skills, static/dynamic balance). The beneficial effect on ball skills was amplified by the level of spontaneous outdoor play and weight status. Among indices of executive function and attention, only that of inhibition showed a differential effect of intervention type. Moderated mediation showed that the better outcome of the enriched PE on ball skills mediated the better inhibition outcome, but only when the enrichment intervention was paralleled by a medium-to-high level of outdoor play. Results suggest that specifically tailored physical activity (PA) games provide a unique form of enrichment that impacts children’s cognitive development through motor coordination improvement, particularly object control skills, which are linked to children’s PA habits later in life. Outdoor play appears to offer the natural ground for the stimulation by designed PA games to take root in children’s mind.

A family based tailored counselling to increase non-exercise physical activity in adults with a sedentary job and physical activity in their young children: Design and methods of a year-long randomized controlled trial

BackgroundEpidemiological evidence suggests that decrease in sedentary behaviour is beneficial for health. This family based randomized controlled trial examines whether face-to-face delivered counselling is effective in reducing sedentary time and improving health in adults and increasing moderate-to-vigorous activities in children.MethodsThe families are randomized after balancing socioeconomic and environmental factors in the Jyväskylä region, Finland. Inclusion criteria are: healthy men and women with children 3-8 years old, and having an occupation where they self-reportedly sit more than 50% of their work time and children in all-day day-care in kindergarten or in the first grade in primary school. Exclusion criteria are: body mass index > 35 kg/m2, self-reported chronic, long-term diseases, families with pregnant mother at baseline and children with disorders delaying motor development.From both adults and children accelerometer data is collected five times a year in one week periods. In addition, fasting blood samples for whole blood count and serum metabonomics, and diurnal heart rate variability for 3 days are assessed at baseline, 3, 6, 9, and 12 months follow-up from adults. Quadriceps and hamstring muscle activities providing detailed information on muscle inactivity will be used to realize the maximum potential effect of the intervention. Fundamental motor skills from children and body composition from adults will be measured at baseline, and at 6 and 12 months follow-up. Questionnaires of family-influence-model, health and physical activity, and dietary records are assessed. After the baseline measurements the intervention group will receive tailored counselling targeted to decrease sitting time by focusing on commute and work time. The counselling regarding leisure time is especially targeted to encourage toward family physical activities such as visiting playgrounds and non-built environments, where children can get diversified stimulation for play and practice fundamental of motor skills. The counselling will be reinforced during the first 6 months followed by a 6-month maintenance period.DiscussionIf shown to be effective, this unique family based intervention to improve lifestyle behaviours in both adults and children can provide translational model for community use. This study can also provide knowledge whether the lifestyle changes are transformed into relevant biomarkers and self-reported health.Trial registration numberISRCTN: ISRCTN28668090

Preschool Children's Fundamental Motor Skills: A Review of Significant Determinants.

Fundamental motor skills (FMS) affect childrens physical, social, and cognitive development. To plan successful interventions when promoting the development of childrens FMS, the underlying positive determinants for the acquisition of FMS competence during preschool years need to be identified. The purpose of this systematic review was to identify positive determinants of FMS such as stability, locomotor, and manipulative movements in children between the ages of three and six. Five electronic databases (ERIC, PsycINFO, MEDLINE, SPORTDiscus, and Physical Education Index) were used for the systematic search and in our final analysis there were 29 articles. Four categories of determinants were identified: (1) individual characteristics (gender, ethnicity, age, physical activity, physical fitness, and playfulness), (2) education-related (programmes promoting physical activity and motor skill, attendance of physical education lessons, practice schedules), (3) social environments (parent- and family-related variables, older siblings, and sport club participation), and (4) physical environment (population density, size of preschool area, clothing). Age, gender, physical activity, and preschool-based programmes were positive determinants of FMS in preschool-aged children.

Seasonal and daily variation in physical activity among three-year-old Finnish preschool children

The purposes of this study were to assess seasonal, daily, and gender variations in childrens physical activity (PA). ActiGraph GT3X accelerometers were used to record the three-year-old childrens PA levels for five consecutive days in autumn and winter. Complete data for both seasons were obtained for 47 children. Despite a significant difference in seasonal temperatures (p < .001), differences were only found for weekdays light PA (p = .021). No difference in PA was observed between weekdays and weekend days. Only 20% of the sample had ≥120 minutes light-to-vigorous PA (LMVPA), and 46% of children had ≥60 minutes moderate-to-vigorous PA (MVPA). Boys spent more minutes in LMVPA (p = .001) and MVPA (p = .004) than girls. The current findings indicated that season and day of the week only minimally influence childrens PA levels, whereas gender continues to be a significant factor.

Fundamental Movement Skill Proficiency and Body Composition Measured by Dual Energy X-Ray Absorptiometry in Eight-Year-Old Children.

Objective: The main aim was to examine the association between fundamental movement skills (FMS) and objectively measured body composition using dual energy X-ray absorptiometry (DXA). Methods: A study of 304 eight-year-old children in Finland. FMS were assessed with the Test of gross motor development, 2nd ed. Total body fat percentage (BF%), abdominal region fat percentage (AF%) and fat-free mass (FFM) were assessed by DXA. Waist circumference, height and weight were measured, and International Obesity Task Force cut-off values for body mass index were used for the definition of healthy weight and overweight/obesity. Results: Better FMS proficiency (object control, locomotor and total FMS) was significantly and strongly associated with lower BF% and lower AF% measured with DXA. Conclusions: The inverse association between FMS and body composition measured with DXA (BF% and AF%) is an important finding, as body fatness and specifically abdominal fatness are associated with less favourable cardiovascular risk factor status in children.

Muscle inactivity and activity patterns after sedentary time--targeted randomized controlled trial.

PURPOSE Interventions targeting sedentary time are needed. We used detailed EMG recordings to study the short-term effectiveness of simple sedentary time-targeted tailored counseling on the total physical activity spectrum. METHODS This cluster randomized controlled trial was conducted between 2011 and 2013 (InPact, ISRCTN28668090), and short-term effectiveness of counseling is reported in the present study. A total of 133 office workers volunteered to participate, from which muscle activity data were analyzed from 48 (intervention, n = 24; control, n = 24). After a lecture, face-to-face tailored counseling was used to set contractually binding goals regarding breaking up sitting periods and increasing family based physical activity. Primary outcome measures were assessed 11.8 ± 1.1 h before and a maximum of 2 wk after counseling including quadriceps and hamstring muscle inactivity time, sum of the five longest muscle inactivity periods, and light muscle activity time during work, commute, and leisure time. RESULTS Compared with those in the controls, counseling decreased the intervention groups muscle inactivity time by 32.6 ± 71.8 min from 69.1% ± 8.5% to 64.6% ± 10.9% (whole day, P < 0.05; work, P < 0.05; leisure, P < 0.05) and the sum of the five longest inactivity periods from 35.6 ± 14.8 to 29.7 ± 10.1 min (whole day, P < 0.05; leisure, P < 0.01). Concomitantly, light muscle activity time increased by 20.6 ± 52.6 min, from 22.2% ± 7.9% to 25.0% ± 9.7% (whole day, P < 0.05; work, P < 0.01; leisure, P < 0.05), and during work time, average EMG amplitude (percentage of EMG during maximal voluntary isometric contraction (MVC) (%EMG MVC)) increased from 1.6% ± 0.9% to 1.8% ± 1.0% (P < 0.05) in the intervention group compared with that in the controls. CONCLUSIONS A simple tailored counseling was able to reduce muscle inactivity time by 33 min, which was reallocated to 21 min of light muscle activity. During work time, average EMG amplitude increased by 13%, reaching an average of 1.8% of EMG MVC. If maintained, this observed short-term effect may have health-benefiting consequences.

Family-Based Cluster Randomized Controlled Trial Enhancing Physical Activity and Motor Competence in 4–7-Year-Old Children

Little is known of how to involve families in physical activity (PA) interventions for children. In this cluster randomized controlled trial, we recruited families with four- to seven-year-old children to participate in a year-long study where parents in the intervention group families (n = 46) received tailored counseling to increase children’s PA. Structured PA was not served. Control group families (n = 45) did not receive any counseling. PA in all children (n = 91; mean age 6.16 ± 1.13 years at the baseline) was measured by accelerometers at the baseline and after three, six, nine and 12 months. Motor competence (MC) (n = 89) was measured at the baseline and after six and 12 months by a KTK (KörperkoordinationsTest für Kinder) and throwing and catching a ball (TCB) protocols. The effect of parental counseling on study outcomes was analyzed by a linear mixed-effects model fit by REML and by a Mann-Whitney U test in the case of the TCB. As season was hypothesized to affect counseling effect, an interaction of season on the study outcomes was examined. The results show significant decrease of MVPA in the intervention group when compared to the control group (p < .05). The TCB showed a nearly significant improvement at six months in the intervention group compared to the controls (p = .051), but not at 12 months. The intervention group had a steadier development of the KTK when the interaction of season was taken into account. In conclusion, more knowledge of family constructs associating with the effectiveness of counseling is needed for understanding how to enhance PA in children by parents. However, a hypothesis may be put forward that family-based counseling during an inactive season rather than an active season may provide a more lasting effect on the development of KTK in children. Trial Registration Controlled-Trials.com ISRCTN28668090

Directly Observed Physical Activity and Fundamental Motor Skills in Four-Year-Old Children in Day Care.

Physical activity (PA), its location, social interactions and fundamental motor skills (FMS) were investigated in four-year-old Finnish children in day care. Six skills in the stability, locomotor and manipulative domains were assessed in 53 children (24 boys, 29 girls, normal anthropometry) with the APM-Inventory manual for assessing children’s perceptual and FMS and Total Motor Scores (TMS; 0–6 points) calculated. PA intensity, location, group composition and activity type − sitting, squatting, kneeling − were directly observed with a modified version of the Observational System for Recording Physical Activity in Children – Preschool Version (OSRAC – P) during three consecutive days in 14 centres. Altogether, 13,302 PA intervals were analysed. Results: Mean TMS was 2.45 (±1.8) points. Most PA intervals were coded as sedentary. Pearson Chi-squares indicated differences in PA intensities both between indoor and outdoor locations (p < 0.001) and between solitary and non-solitary group composition (p < 0.018). Indoors, more than 70% of intervals were spent being sedentary and 5% in moderate-to-vigorous PA (MVPA). Outdoors, sedentary accounted for 45% and MVPA 19%. When solitary, 57% of intervals were sedentary and 13% MVPA. When non-solitary, 60% of intervals were sedentary and 12% MVPA. Forty-eight per cent of intervals were spent sitting, squatting or kneeling. TMS were not significantly associated with biological factors, PA or social interaction, but outdoor PA tended toward statistical significance (IRR = 1.88, p = 0.070), indicating higher TMS in those who demonstrated more outdoor PA. We concluded that PA in day care may be inadequate to support children’s FMS development.