Kathleen F. Janz

Tracking physical fitness and physical activity from childhood to adolescence: the muscatine study.

PURPOSE Physical fitness and physical activity tracking data enhance our understanding as to when children settle into their long-term exercise and fitness patterns and, therefore. provide insight as to when programs focusing on preventing sedentary adults behaviors should be initiated. METHODS In this paper, the tracking of physical fitness and physical activity was examined in a 5-yr population-based study of children and adolescents in Muscatine, IA. Study subjects (N = 126) were pre- or early-pubescent at baseline (mean age boys 10.8 yr and girls 10.3 yr). Physical fitness was measured using direct determination of oxygen uptake and maximal voluntary isometric contraction while physical activity was assessed via questionnaire. RESULTS Boys classified as sedentary based on initial measurements of TV viewing and video game playing were 2.2 times more likely than their peers to also be classified as sedentary at follow-up. Tracking of most physical fitness and physical activity variables was moderate to high, indicating some predictability of early measurements for later values. Sedentary behavior tracked better in boys, whereas vigorous activity tended to track better in girls. CONCLUSION These observations suggest that preventive efforts focused on maintaining physical fitness and physical activity through puberty will have favorable health benefits in later years.

The stability of children's physical activity as measured by accelerometry and self-report.

The Computer Science Application (CSA) accelerometer uses integrated circuitry and memory to provide a continuous recording of minute-by-minute movement counts. It has been previously validated as an objective monitor of childrens physical activity in field and laboratory settings. Our purpose was to derive accelerometry summary variables reflective of different physical activity intensity levels, evaluate the stability of these summary variables, and define the number of days needed to adequately measure usual physical activity. A secondary study purpose was to compare three self-report questionnaires to accelerometry. Thirty children (7-15 yr) wore accelerometers for 12 h.d-1 for 6 d. Daily summary variables of average movement count (total physical activity) and daily frequency of sedentary through vigorous activity were constructed. Intraclass correlation coefficients (R) and 95% confidence intervals (CI) were used to analyze the data. Accelerometry stability using 1 monitored day to represent usual physical activity was R = 0.42-0.47. When 6 d were used, stability increased to R = 0.81-0.84. Acceptable intraclass correlations and CI were achieved with 4 d of monitoring (R = 0.75-0.78, CI = 0.60-0.88). The self-report questionnaires were poorly to moderately correlated to accelerometry variables (r = -0.03-0.51). Data indicate that in field settings: 1) accelerometry can be used to assess the intensity of childrens activity and 2) 4 or more days of activity monitoring are needed to achieve satisfactory reliability.

Measuring Activity in Children and Adolescents Using Self-Report: PAQ-C and PAQ-A

PURPOSE This study examined the psychometric properties of two versions of a commonly used physical activity 7-d self-report, the Physical Activity Questionnaire for Older Children (PAQ-C) and Physical Activity Questionnaire for Adolescents (PAQ-A). METHODS We longitudinally examined the internal consistency, stability, and situational effects of the PAQ-C and PAQ-A in a cohort of children (N = 210) at ages 11 and 13 yr. Statistical analysis included factor loading and standardized Cronbach coefficient alphas. We cross-sectionally examined concurrent validity of the PAQ-A in a subsample of our cohort (N = 49) at age 13 by comparing it with concurrently measured physical activity using an activity monitor (Actigraph). Spearman correlation coefficients were used for this analysis. RESULTS Standardized Cronbach alphas ranged from 0.72 to 0.88. A subsample analysis suggested that completing the questionnaires during the summer months slightly reduced the standardized alpha for the PAQ-C, but not the PAQ-A. Associations between the PAQ-A (revised) summary score and activity monitor variables were rho = 0.56 for total PA and rho = 0.63 for moderate through vigorous activity (P < 0.05). Associations between individual PAQ-A questions and activity monitor variables for the same time frame ranged from rho = 0.41 to 0.62 (P < 0.05). CONCLUSION The PAQ-C and PAQ-A show good internal consistency. The PAQ-A has acceptable validity.

Sustained Effect of Early Physical Activity on Body Fat Mass in Older Children

BACKGROUND Physical activity is assumed to reduce excessive fatness in children. This study examined whether the benefits of early childhood moderate-to-vigorous physical activity (MVPA) on fatness are sustained throughout childhood. METHODS MVPA minutes per day (min/d) and fat mass (kilograms; kg) were measured using accelerometry and dual-energy x-ray absorptiometry in 333 children aged 5, 8, and 11 years who were participating in the Iowa Bone Development Study. Mixed regression models were used to test whether MVPA at age 5 years had an effect on fat mass at age 8 years and age 11 years, after adjustment for concurrent height, weight, age, maturity, and MVPA. The analysis was repeated to control for fat mass at age 5 years. Using mixed-model least-squares means, adjusted means of fat mass at age 8 years and age 11 years were compared between the highest and lowest quartiles of MVPA at age 5 years. Data were collected between 1998 and 2006 and analyzed in 2008. RESULTS For boys and girls, MVPA at age 5 years was a predictor of adjusted fat mass at age 8 years and age 11 years (p<0.05). In girls, the effect of MVPA at age 5 years was not significant when fat mass at age 5 years was included. Boys and girls in the highest quartile of MVPA at age 5 years had a lower fat mass at age 8 years and age 11 years than children in the lowest MVPA quartile at age 5 years (p<0.05; mean difference 0.85 kg at age 8 years and 1.55 kg at age 11 years). CONCLUSIONS Some effects of early-childhood MVPA on fatness appear to persist throughout childhood. Results indicate the potential importance of increasing MVPA in young children as a strategy to reduce later fat gains.

Early Physical Activity Provides Sustained Bone Health Benefits Later in Childhood

PURPOSE This study examined the potential effect of early childhood moderate and vigorous physical activity (MVPA) on later bone health. METHODS Three hundred and thirty-three children, participating in the Iowa Bone Development Study, were studied at ages 5, 8, and 11 yr. MVPA (min x d(-1)) was measured using an accelerometry-based physical activity monitor. Bone mineral content (BMC; g) of the whole body, lumbar spine, and hip was measured using dual-energy x-ray absorptiometry. Mixed regression models were used to test whether MVPA at age 5 yr had an effect on BMC at ages 8 and 11 yr after adjustment for concurrent height, weight, age, maturity, and MVPA. The analysis was repeated to control for bone outcomes at age 5 yr. Mixed-model least-squares mean values at the person level of covariates for age group were used to compare the BMC at ages 8 and 11 yr of children in the highest and lowest quartiles of MVPA at age 5 yr. RESULTS For boys and girls, MVPA at age 5 yr predicted BMC adjusted for concurrent height, weight, age, maturity, and MVPA at ages 8 and 11 yr (P < 0.05). When the analysis was repeated to also control for BMC at age 5 yr, the effect of MVPA at age 5 yr was significant for boys but not for girls. Boys and girls in the highest quartile of MVPA at age 5 yr had 4%-14% more BMC at ages 8 and 11 yr than those in the lowest quartile of MVPA at age 5 yr (P < 0.05). CONCLUSIONS These results provide support for the benefits of early MVPA on sustained bone health during childhood especially for boys. Results indicate the importance of increasing MVPA as a strategy to improve BMC later in childhood.

Everyday activity predicts bone geometry in children: The Iowa Bone Development Study

PURPOSE Bone adapts to changing mechanical loads by altering the structure appropriately. These adaptations should be evident in the bone cross-sectional area (CSA) and section modulus (Z), indices of axial and bending strength, respectively. In this cross-sectional study, we investigated associations between physical activity, CSA, and Z in 467 young children (mean age 5.2 yr). We also examined whether lean tissue mass, which is predominantly muscle, mediates the relationship between physical activity and bone structural measures. METHODS Physical activity was assessed using accelerometry and questionnaire. Proximal femur measures of the neck, intertrochanteric, and shaft CSA (cm) and Z (cm) were derived from dual-energy x-ray absorptiometry (DXA) scans using the Hip Structure Analysis program. Total body lean mass (kg) was also measured using DXA. RESULTS Boys were more physically active than girls. Boys also had greater CSA, Z, and lean mass than girls. At each region, time spent in vigorous activity was positively and consistently associated with CSA and Z in boys and girls (r = 0.19 to 0.32). After adjustment for age, body mass, and height, vigorous activity explained, on average, 6.9% of the variability in CSA and Z. With additional adjustment for lean mass, vigorous activity explained 3.7% of the remaining variability in CSA and Z. CONCLUSION This study demonstrates that everyday amounts of physical activity in healthy, normal children are associated with bone geometry and that differences in lean mass explain some, but not all, of this association. This suggests that, even in young, nonathletic children, bone may adapt to physical activity by structurally remodeling.

Redefining the roles of sensors in objective physical activity monitoring

BACKGROUND Because physical activity researchers are increasingly using objective portable devices, this review describes the current state of the technology to assess physical activity, with a focus on specific sensors and sensor properties currently used in monitors and their strengths and weaknesses. Additional sensors and sensor properties desirable for activity measurement and best practices for users and developers also are discussed. BEST PRACTICES We grouped current sensors into three broad categories for objectively measuring physical activity: associated body movement, physiology, and context. Desirable sensor properties for measuring physical activity and the importance of these properties in relationship to specific applications are addressed, and the specific roles of transducers and data acquisition systems within the monitoring devices are defined. Technical advancements in sensors, microcomputer processors, memory storage, batteries, wireless communication, and digital filters have made monitors more usable for subjects (smaller, more stable, and longer running time) and for researchers (less costly, higher time resolution and memory storage, shorter download time, and user-defined data features). FUTURE DIRECTIONS Users and developers of physical activity monitors should learn about the basic properties of their sensors, such as range, accuracy, and precision, while considering the data acquisition/filtering steps that may be critical to data quality and may influence the desirable measurement outcome(s).

Gene polymorphisms, bone mineral density and bone mineral content in young children:the Iowa bone development study

We examined the association of candidate gene polymorphisms with bone mineral density (BMD) and bone mineral content (BMC) in a cohort of 428 healthy non-Hispanic white children participating in the Iowa Bone Development Study, a longitudinal study of determinants of bone accrual in childhood. BMD and BMC measurements of the hip, spine and whole body were made using a Hologic 2000 Plus densitometer in 228 girls and 200 boys ages 4.5–6.5 years. Genotypes at 14 loci representing eight candidate genes [type I collagen genes (COL1A1 and COL1A2), osteocalcin, osteonectin, osteopontin, vitamin D receptor (VDR), estrogen receptor (ER), androgen receptor (AR)] were determined. Gender-specific and gender-combined prediction models for bone measures that included age, weight, height (and gender) were developed using multiple linear regression analysis. COL1A2 and osteocalcin genotypes were identified as having the strongest and most consistent association with BMD/BMC measures. Osteonectin, osteopontin and VDR translation initiation site polymorphisms were associated with some individual bone measures, but none of the associations was as consistent as those identified for the COL1A2 and osteocalcin genes. No association was identified with COL1A1 (RsaI and Sp1), VDR (BsmI) and ER polymorphisms (PvuII, XbaI, TA) and BMD/BMC. However, we identified significant gene-by-gene interaction effects involving the ER and both VDR and osteocalcin, which were associated with BMD/BMC. Our data suggest that genetic variation at multiple genetic loci is important in bone accrual in children. Moreover, the combination of genotypes as several loci may be as important as a single genotype for determining BMD and BMC.

Physical activity among adults with intellectual disabilities living in community settings

OBJECTIVE The aim was to objectively monitor steps accrued by a sample of adults with intellectual disabilities and to describe physical activity patterns by monitoring steps taken across weekdays, weekends, and hours of the day using time-stamped technology. METHOD This study used pedometers with time-stamped recording capabilities to measure physical activity behavior of 131 adults with mild to moderate levels of intellectual disabilities living in community-based supported living group settings in Iowa. Participants wore a pedometer for seven consecutive days. All data was collected in 2006 and analyzed in 2007. RESULTS The participants accrued 6508+/-3296 steps/day. Controlling for age, participants with mild intellectual disability were more active than participants with moderate intellectual disability (F=7.03, p<.01). A total of 14.1% accumulated 10,000 steps/day. Participants were more active on weekdays than on weekends (Z=-7.36, p<.01), and least active during the evening period compared to the morning and afternoon hours (F(r)=103.3, p<.01). CONCLUSION Physical activity (steps/day) achieved by the majority of this population is insufficient for health benefits, particularly among individuals with moderate intellectual disability. Evenings and weekends are especially inactive time periods.

Cross-validation of the slaughter skinfold equations for children and adolescents

Prior to sexual maturation, children and adolescents have more water and less bone mineral content than adults, resulting in less dense fat-free body mass (FFM). This suggests that previously established adult skinfold/density equations are inappropriate for use with children and adolescents for the prediction of body fatness (%BF) and FFM. To overcome this problem, Slaughter and colleagues have introduced new skinfold (SKF) equations that take into account the changing density of FFM in children and adolescents as they mature. The purpose of our study was to cross-validate a select set of the Slaughter SKF equations by comparing them with a criterion measurement (Lohmans Siri age-adjusted body density equation) in 122 subjects ranging in sexual maturation from pre- to post-pubescent and ranging in age from 8-17. Our cross-validation found very high intraclass (reliability) correlations (ICCs = 0.98-0.99) and high validity correlations (rs = 0.79-0.99). The standard errors of the estimate for %BF ranged from 3.5-4.6% and total errors for %BF ranged from 3.6-4.6%. The Slaughter equation using tricep and calf SKF for females was significantly different (P < 0.05) from the criterion measure in its prediction of %BF. In males, there was an interaction between the SKF equation and subject maturation level. The data indicate that the Slaughter SKF equations hold promise for estimating body composition in children and adolescents but are still in need of refinement.