Trina Hinkley

Tracking Physical Activity and Sedentary Behavior in Childhood: A Systematic Review

CONTEXT To date, no reviews have investigated the evidence of tracking of physical activity and sedentary behavior specifically during early childhood (aged 0-5.9 years) or from early childhood to middle childhood (aged 6-12 years). It is important to review the evidence of tracking of these behaviors to determine their stability during the foundational early years of life. EVIDENCE ACQUISITION A literature search of studies was conducted in seven electronic databases (January 1980 to April 2012). Studies were compared on methodologic quality and evidence of tracking of physical activity or sedentary behavior. Tracking was defined as the stability (or relative ranking within a cohort) of behaviors, such as physical activity and sedentary behavior, over time. EVIDENCE SYNTHESIS Eleven studies met the inclusion criteria. All studies reporting physical activity outcomes had high methodologic quality; 71% of studies reporting sedentary behavior outcomes had high methodologic quality. Of the tracking coefficients for physical activity, 4% were large, 60% were moderate, and 36% were small. Of the tracking coefficients for sedentary behavior, 33% were large, 50% were moderate, and 17% were small. Overall, there was evidence of moderate tracking of physical activity during early childhood, and from early childhood to middle childhood, and of moderate-to-large tracking of sedentary behavior during early childhood and from early childhood to middle childhood. CONCLUSIONS This review highlights the importance of establishing recommended levels of physical activity and sedentary behavior during the early years of life. Based on this review, the following recommendations are made: (1) early childhood should be targeted as a critical time to promote healthy lifestyle behaviors through methodologically sound prevention studies; and (2) future tracking studies should assess a broad range of sedentary behaviors using objective measures.

Preschoolers' physical activity, screen time, and compliance with recommendations.

PURPOSE Little evidence exists about the prevalence of adequate levels of physical activity and of appropriate screen-based entertainment in preschool children. Previous studies have generally relied on small samples. This study investigates how much time preschool children spend being physically active and engaged in screen-based entertainment. The study also reports compliance with the recently released Australian recommendations for physical activity (≥3 h·d(-1)) and screen entertainment (≤1 h·d(-1)) and the National Association for Sport and Physical Education physical activity guidelines (≥2 h·d(-1)) and American Academy of Pediatrics screen-based entertainment recommendations (≤2 h·d(-1)) in a large sample of preschool children. METHODS Participants were 1004 Melbourne preschool children (mean age = 4.5 yr, range = 3-5 yr) and their families in the Healthy Active Preschool Years study. Physical activity data were collected by accelerometry during an 8-d period. Parents reported their childs television/video/DVD viewing, computer/Internet, and electronic game use during a typical week. A total of 703 (70%) had sufficient accelerometry data, and 935 children (93%) had useable data on time spent in screen-based entertainment. RESULTS Children spent 16% (approximately 127 min·d(-1)) of their time being physically active. Boys and younger children were more active than were girls and older children, respectively. Children spent an average of 113 min·d(-1) in screen-based entertainment. Virtually no children (<1%) met both the Australian recommendations and 32% met both the National Association for Sport and Physical Education and American Academy of Pediatrics recommendations. CONCLUSIONS The majority of young children are not participating in adequate amounts of physical activity and in excessive amounts of screen-based entertainment. It is likely that physical activity may decline and that screen-based entertainment may increase with age. Compliance with recommendations may be further reduced. Strategies to promote physical activity and reduce screen-based entertainment in young children are required.

Correlates of sedentary behaviours in preschool children: a review

BackgroundSedentary behaviour has been linked with a number of health outcomes. Preschool-aged children spend significant proportions of their day engaged in sedentary behaviours. Research into the correlates of sedentary behaviours in the preschool population is an emerging field, with most research being published since 2002. Reviews on correlates of sedentary behaviours which include preschool children have previously been published; however, none have reported results specific to the preschool population. This paper reviews articles reporting on correlates of sedentary behaviour in preschool children published between 1993 and 2009.MethodsA literature search was undertaken to identify articles which examined correlates of sedentary behaviours in preschool children. Articles were retrieved and evaluated in 2008 and 2009.ResultsTwenty-nine studies were identified which met the inclusion criteria. From those studies, 63 potential correlates were identified. Television viewing was the most commonly examined sedentary behaviour. Findings from the review suggest that childs sex was not associated with television viewing and had an indeterminate association with sedentary behaviour as measured by accelerometry. Age, body mass index, parental education and race had an indeterminate association with television viewing, and outdoor playtime had no association with television viewing. The remaining 57 potential correlates had been investigated too infrequently to be able to draw robust conclusions about associations.ConclusionsThe correlates of preschool childrens sedentary behaviours are multi-dimensional and not well established. Further research is required to provide a more comprehensive understanding of the influences on preschool childrens sedentary behaviours to better inform the development of interventions.

Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta‐analysis

Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate‐intensity to vigorous‐intensity physical activity. Four electronic databases (EMBASE MEDLINE, Ovid EMBASE, PubMed and Scopus) were searched (up to 12 November 2015) to retrieve studies among 2‐ to 18‐year‐olds, which used cross‐sectional, longitudinal or experimental designs, and examined associations with health outcomes (adiposity, cardio‐metabolic, fitness, respiratory, bone/musculoskeletal, psychosocial, cognition/academic achievement, gross motor development and other outcomes). Based on 88 eligible observational studies, level of evidence grading and quantitative meta‐analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate‐intensity to vigorous‐intensity physical activity or focusing on studies with low risk of bias. Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.

Predictive validity and classification accuracy of actigraph energy expenditure equations and cut-points in young children

Objectives Evaluate the predictive validity of ActiGraph energy expenditure equations and the classification accuracy of physical activity intensity cut-points in preschoolers. Methods Forty children aged 4–6 years (5.3±1.0 years) completed a ∼150-min room calorimeter protocol involving age-appropriate sedentary, light and moderate-to vigorous-intensity physical activities. Children wore an ActiGraph GT3X on the right mid-axillary line of the hip. Energy expenditure measured by room calorimetry and physical activity intensity classified using direct observation were the criterion methods. Energy expenditure was predicted using Pate and Puyau equations. Physical activity intensity was classified using Evenson, Sirard, Van Cauwenberghe, Pate, Puyau, and Reilly, ActiGraph cut-points. Results The Pate equation significantly overestimated VO2 during sedentary behaviors, light physical activities and total VO2 (P<0.001). No difference was found between measured and predicted VO2 during moderate-to vigorous-intensity physical activities (P = 0.072). The Puyau equation significantly underestimated activity energy expenditure during moderate-to vigorous-intensity physical activities, light-intensity physical activities and total activity energy expenditure (P<0.0125). However, no overestimation of activity energy expenditure during sedentary behavior was found. The Evenson cut-point demonstrated significantly higher accuracy for classifying sedentary behaviors and light-intensity physical activities than others. Classification accuracy for moderate-to vigorous-intensity physical activities was significantly higher for Pate than others. Conclusion Available ActiGraph equations do not provide accurate estimates of energy expenditure across physical activity intensities in preschoolers. Cut-points of ≤25counts⋅15 s−1 and ≥420 counts⋅15 s−1 for classifying sedentary behaviors and moderate-to vigorous-intensity physical activities, respectively, are recommended.

Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review.

OBJECTIVES Little is known about how health behaviors such as physical activity (PA) and sedentary behaviors (SB) may be associated with psychosocial well-being during the crucial early childhood period. The aim of this study was to undertake a systematic review of associations between PA, SB and psychosocial well-being during early childhood. METHODS In February 2013, MEDLINE, PsycINFO, SPORTDiscus and Embase electronic databases were searched. Inclusion criteria were: 1. peer-reviewed publication since 1980 in English; 2. children aged birth-5 years; 3. PA or SB measured during early childhood; 4. an indicator of child psychosocial well-being; and 5. association between PA/SB and psychosocial well-being reported. Studies could be observational or interventions. Data were extracted by one author and entered into a standardized form in February and March 2013. RESULTS 19 studies were identified: four examined PA, 13 examined SB and two examined PA and SB. No interventions met the inclusion criteria; all included studies were observational. In total, 21 indicators of psychosocial well-being were examined, 13 only once with the remaining eight reported in more than one study. Some dose-response evidence was identified suggesting that PA is positively, and SB inversely, associated with psychosocial well-being. CONCLUSIONS Too few studies exist to draw conclusions regarding associations. Future high-quality cohort and intervention studies are warranted particularly investigating dose-response associations.

Systematic review of sedentary behavior and cognitive development in early childhood

OBJECTIVE To comprehensively review observational and experimental studies examining the relationship between sedentary behavior and cognitive development during early childhood (birth to 5years). METHOD Electronic databases were searched in July, 2014 and no limits were imposed on the search. Included studies had to be peer-reviewed, published, and meet the a priori determined population (apparently healthy children aged birth to 5years), intervention (duration, types, and patterns of sedentary behavior), comparator (various durations, types, or patterns of sedentary behavior), and outcome (cognitive development) study criteria. Data extraction occurred in October and November 2014 and study quality and risk of bias were assessed in December 2014. RESULTS A total of 37 studies, representing 14,487 participants from nine different countries were included. Thirty-one studies used observational study designs and six studies used experimental study designs. Across study designs, increased or higher screen time (most commonly assessed as television viewing (TV)), reading, child-specific TV content, and adult-specific TV content had detrimental (negative) associations with cognitive development outcomes for 38%, 0%, 8%, and 25% of associations reported, respectively, and beneficial (positive) associations with cognitive development outcomes for 6%, 60%, 13%, and 3% of associations reported, respectively. Ten studies were moderate quality and 27 studies were weak quality. CONCLUSIONS The type of sedentary behavior, such as TV versus reading, may have different impacts on cognitive development in early childhood. Future research with reliable and valid tools and adequate sample sizes that examine multiple cognitive domains (e.g., language, spatial cognition, executive function, memory) are needed. Registration no. CRD42014010004.

Children′s physical activity and screen time: qualitative comparison of views of parents of infants and preschool children

BackgroundWhile parents are central to the development of behaviours in their young children, little is known about how parents view their role in shaping physical activity and screen time behaviours.MethodsUsing an unstructured focus group design, parental views and practices around children′s physical activity and screen time (television and computer use) were explored with eight groups of new parents (n=61; child age <12 months) and eight groups of parents with preschool-aged (3–5 year old) children (n=36) in Melbourne, Australia.ResultsParents generally believed children are naturally active, which may preclude their engagement in strategies designed to increase physical activity. While parents across both age groups shared many overarching views concerning parenting for children′s physical activity and screen time behaviours, some strategies and barriers differed depending on the age of the child. While most new parents were optimistic about their ability to positively influence their child′s behaviours, many parents of preschool-aged children seemed more resigned to strategies that worked for them, even when aware such strategies may not be ideal.ConclusionsInterventions aiming to increase children′s physical activity and decrease screen time may need to tailor strategies to the age group of the child and address parents′ misconceptions and barriers to optimum parenting in these domains.

Child, family and environmental correlates of children's motor skill proficiency

OBJECTIVES To identify factors associated with childrens motor skills. DESIGN Cross-sectional. METHODS Australian preschool-aged children were recruited in 2009 as part of a larger study. Parent proxy-report of child factors (age, sex, parent perception of child skill, participation in unstructured and structured activity), self-report of parent factors (confidence in their own skills to support childs activity, parent-child physical activity interaction, parent physical activity) and perceived environmental factors (play space visits, equipment at home) were collected. Moderate to vigorous physical activity (MVPA) (ActiGraph GT1M accelerometer) and motor skills (Test of Gross Motor Development-2) were also assessed. After age adjustment, variables were checked for association with raw object control and locomotor scores. Variables with associations of p<0.20 were entered into two multiple regression models with locomotor/object control as respective outcome variables. RESULTS Motor skills were assessed for 76 children (42 female), mean [SD] age=4.1 [0.68]; 71 completed parent proxy-report and 53 had valid MVPA data. Child age, swimming lessons, and home equipment were positively associated explaining 20% of locomotor skill variance, but only age was significant (β=0.36, p=0.002). Child age and sex, unstructured activity participation, MVPA%, parent confidence, home equipment (all positively associated), and dance participation (inversely associated) explained 32% object control variance. But only age (β=0.67, p<0.0001), MVPA% (β=0.37, p=0.038) and no dance (β=-0.34, p=0.028) were significant. CONCLUSION Motor skill correlates differ according to skill category and are context specific with child level correlates appearing more important.

5-year changes in afterschool physical activity and sedentary behavior.

BACKGROUND The afterschool period holds promise for the promotion of physical activity, yet little is known about the importance of this period as children age. PURPOSE To examine changes in physical activity of children aged 5-6 years and 10-12 years and their sedentary time in the afterschool period over 3 and 5 years, and to determine the contribution of this period to daily physical activity and sedentary behavior over time. METHODS Data from two longitudinal studies conducted in Melbourne, Australia, were used. Accelerometer data were provided for 2053 children at baseline (Children Living in Active Neighbourhoods Study [CLAN]: 2001; Health, Eating and Play Study [HEAPS]: 2002/2003); 756 at 3-year follow-up (time point 2 [T2]); and 622 at 5-year follow-up (T3). Light (LPA), moderate (MPA) and vigorous (VPA) physical activity were determined using age-adjusted cut-points. Sedentary time was defined as ≤ 100 counts/minute. Multilevel analyses, conducted in April 2012, assessed change in physical activity and sedentary time and the contributions of the afterschool period to overall levels. RESULTS Afterschool MPA and VPA decreased among both cohorts, particularly in the younger cohort, who performed less than half of their baseline levels at T3 (MPA: T1=24 minutes; T3=11 minutes; VPA: T1=12 minutes; T3=4 minutes). LPA also declined in the older cohort. Afterschool sedentary time increased among the younger (T1=42 minutes; T3=64 minutes) and older cohorts (T1=57 minutes; T3=84 minutes). The contribution of the afterschool period to overall MPA and VPA increased in the older cohort from 23% to 33% over 5 years. In the younger cohort, the contribution of the afterschool period to daily MPA and VPA decreased by 3% over 5 years. CONCLUSIONS The importance of the afterschool period for childrens physical activity increases with age, particularly as children enter adolescence.