Regional variation in lifestyle patterns and BMI in young children: the GECKO Drenthe cohort.

BACKGROUND: A better understanding of lifestyle behaviours of children < 7 years and the relation with childhood overweight is needed. The aim of our prospective study was to examine how lifestyle patterns in young children are associated with the development of childhood overweight. As ecological models suggest focusing on not only the child as an individual, but also their environment, we also considered the role of socio-economic status (SES) and spatial clustering of lifestyle and body mass index (BMI). METHODS: In 1792 children (aged 3-6 years) participating in the GECKO Drenthe cohort, diet, screen time, outdoor play and sleep were assessed by questionnaires and moderate-to-vigorous physical activity and sedentary time by accelerometry (Actigraph GT3X). At 10-11 years, height and weight were measured to calculate age- and sex-specific standardized BMI z-scores (zBMI). Lifestyle patterns were identified using principal component analysis. To assess spatial clustering for the lifestyle patterns and zBMI, we calculated the Global Moran's I statistic. Linear- and logistic regression models, taking into account SES, were performed to examine the association between the lifestyle patterns and the development of overweight. For the spatial analyses, we added spatial terms for the determinants, the outcome, and the error term. RESULTS: Three lifestyle patterns were identified: (1) 'high activity', (2) 'low screen time, high sleep and healthy diet', and (3) 'high outdoor play'. No associations were observed between the 'high activity' or 'high outdoor play' patterns at young age with the development of childhood overweight (all p > 0.05). In contrast, children who adhered to the 'low screen time, high sleep and healthy diet' pattern had lower odds to become overweight and a lower zBMI at 10-11 years (odds ratio [95% CI] = 0.766 [0.65; 0.90]). These findings remained similar after taking SES into account. Regarding the spatial analyses, we found spatial clustering of zBMI, but no spatial clustering of the lifestyle patterns. CONCLUSIONS: Low screen time, high sleep duration and a healthy diet cluster into a pattern that seems favourable in the prevention of childhood overweight, independent of individual SES. The spatial analyses suggest that there are likely other neighbourhood factors that contribute to the spatial clustering of childhood overweight.

The association among SES, screen time, and outdoor play in children at different ages: The GECKO Drenthe study.

Introduction: This study examined the association among socioeconomic status (SES), screen time, and outdoor play in children at different ages in the GECKO Drenthe birth cohort study. Methods: Valid data were obtained from two surveys at ages 3-4 years and 10-11 years. Screen time (TV watching and computer use) and outdoor play were reported by parents. Childhood SES was derived by a synthetic "Equivalized Household Income Indicator," an estimated disposable income. Quantile regression models (cross-sectional analysis) and linear regression models (change between 3-4 and 10-11 years) were used. Results: In general, screen time increased strongly from a median of 51 min/day at 3-4 years (n = 888) to 122 min/day at 10-11 years (n = 1023), whereas time spent on outdoor play remained stable over age (77 min/day at 3-4 years and 81 min/day at 10-11 years). More time spent on outdoor play (50th quantile) was found in children with low SES families at 3-4 years, while at 10-11 years, more outdoor play was found in the high SES group. At 10-11 years, in the higher ranges of screen time, children from high SES had relatively lower screen time [50th quantile: -10.7 (-20.8; -0.6); 75th quantile: -13.6 (-24.4; -2.8)]. In the longitudinal analysis (n = 536), high SES was associated with an increasing time spent on outdoor play [11.7 (2.7; 20.8)]. Conclusion: Socioeconomic disparities in children's outdoor play and screen behavior may be more obvious with increasing age. Low SES may facilitate both outdoor play (at 3-4 years) and screen time (at 10-11 years); however, children from high SES families develop slightly more favorable behavior patterns with age.

Adiposity and High Blood Pressure during Childhood: A Prospective Analysis of the Role of Physical Activity Intensity and Sedentary Time in the GECKO Drenthe Cohort.

Whereas in adults, physical inactivity is strongly related to obesity and hypertension, in young children the evidence is inconsistent and scarce. We examined the association between physical activity (PA) behaviours at 5-6 years of age and adiposity and blood pressure (BP) at 10-11 years in 947 children (51% boys) from the Groningen Expert Center for Kids with Obesity (GECKO) Drenthe cohort. Sedentary time (ST) and light, moderate, and vigorous PA were assessed using accelerometry (ActiGraph GT3X, wear time > 600 min/day, ≥3 days). Body mass index (BMI), waist circumference (WC), and systolic and diastolic BP were measured at 5-6 and 10-11 years of age and standardized as age- and sex-adjusted (and height-adjusted, for BP) z-scores. Adjusted linear and logistic regression models showed that most PA behaviours were not related to standardized BMI or WC, overweightness/obesity, abdominal overweightness/obesity, standardized systolic or diastolic BP, pulse pressure, or prehypertension at 10-11 years of age. Only if children spent more time in vigorous PA was WC slightly lower (B (95% CI) = -0.08 (-0.16, -0.01) SD, stdß = -0.068) and the increase in WC over the years was less (B (95% CI) = -0.10 (-0.18, -0.01) SD; stdß = -0.083). To conclude, at this very young age, PA behaviours are not a strong predictor for overweightness/obesity or hypertension later in childhood.

Effects of physical activity interventions on cognitive outcomes and academic performance in adolescents and young adults: A meta-analysis.

The aim was to provide a meta-analysis of studies investigating the effects of physical activity interventions on cognitive outcomes and academic performance in adolescents or young adults. A systematic review with meta-analysis was performed using the following databases: Embase, ERIC, MEDLINE, PsycINFO and Web of Science. Studies had to meet the following criteria: controlled study design, investigating the effects of physical activity interventions on cognitive outcomes and academic performance in healthy adolescents or young adults (12-30 years). Results showed that acute interventions (n=44) significantly improved processing speed (ES=0.39), attention (ES=0.34) and, inhibition (ES=0.32). In a subsequent meta-regression, shorter duration of intervention was significantly associated with greater improvements in attention (ß=-0.02) and cognitive flexibility (ß=-0.04), whereas age, percentage of boys, intensity and dose were not. Chronic interventions (n=27) significantly improved processing speed (ES=0.30), attention (ES=0.50), cognitive flexibility (ES=0.19), working memory (ES=0.59) and language skills (ES=0.31). In the meta-regression, higher percentage of boys was significantly associated with greater improvements in attention (ß=0.02) and working memory (ß=0.01) whereas age, duration, frequency, dose and load were not. In conclusion, acute and chronic physical activity interventions might be a promising way to improve several cognitive outcomes and language skills in adolescents and young adults.

Unravelling the association between accelerometer-derived physical activity and adiposity among preschool children: A systematic review and meta-analyses.

Evidence on the association between physical activity (PA) and adiposity in young children is inconclusive. A systematic review and meta-analyses were conducted to examine associations between accelerometer-derived PA and varying adiposity outcomes in preschool children. Searches were conducted in Embase, MEDLINE and Web of Science to identify studies on the association between total PA, sedentary behaviour or different PA intensities and adiposity in children aged 2 to 7 years. Separate random effects meta-analyses were performed for varying PA intensities and adiposity outcomes. Fifty-six articles were included in the review and 48 in the meta-analyses. There was substantial evidence of an inverse association between moderate-to-vigorous- or vigorous PA and body fat percentage (stdß [SE] = -0.162[0.041]; 5 studies), weight status (r = -0.120, P<.001; 11 studies), fat mass (stdß [SE] = -0.103[0.051]; 5 studies), fat mass index (stdß [SE] = -0.121[0.036]; 2 studies) and skinfold thickness (stdß [SE] = -0.145[0.036]; 4 studies). However, total PA, sedentary behaviour, and different PA intensities were not associated with body mass index (BMI) or waist circumference. Adiposity levels were lower among preschool children engaged in more (moderate-to-) vigorous PA compared with their peers, but no associations between PA and BMI or waist circumference were found.

Physical activity around the clock: objectively measured activity patterns in young children of the GECKO Drenthe cohort.

BACKGROUND: Given the widespread problem of physical inactivity, and the continued growth in prevalence of childhood and adolescent obesity, promotion of regular physical activity (PA) among young people has become a public priority. A greater understanding of children's PA patterns throughout the day is needed to effectively encourage children to be more physically active. Hence this study looking at the distribution of PA in young children throughout the day and its relevance to overweight. METHODS: Accelerometers (ActiGraph GT3X, weartime > 600 min/day, ≥3 days) were used to measure the PA of 958 children (aged 5.7 ± 0.8 years, 52% boys) enrolled in the GECKO Drenthe cohort. Levels of sedentary time (ST), light PA (LPA) and moderate-to-vigorous PA (MVPA) were recorded throughout the day and analysed in segments (07:00-09:00, 09:00-12:00, 12:00-15:00, 15:00-18:00, 18:00-21:00). Body mass index was measured by Preventive Child Healthcare nurses and Cole's (2012) definition of overweight was used. General linear mixed models, adjusted for age, sex and season, were used to analyse patterns of PA and ST throughout the day. RESULTS: Children were most sedentary in the early morning (07:00-09:00) and evening (18:00-21:00), and exhibited the most time spent engaged in LPA and MVPA in the afternoon (12:00-15:00) and late afternoon (15:00-18:00). The greatest inter-individual variation in ST, LPA and MVPA among the children occurred in the late afternoon and evening (approximately 40, 30 and 15 min difference per time segment between 25th and 75th percentile, respectively). The most active children (highest quartile of MVPA) were found to be more active and less sedentary throughout the entire day than the least active children (lowest quartile of MVPA). Furthermore, children with overweight were no less active than children without overweight. CONCLUSIONS: At this young age, the relevance of different PA patterns to childhood overweight was minimal. Children were most active in the afternoon and late afternoon. To encourage PA in general, ST can be reduced and PA increased in the early morning and evening. Targeted PA interventions to specifically stimulate the least active children could take place in the late afternoon or evening.

Development of 1500-m Pacing Behavior in Junior Speed Skaters: A Longitudinal Study.

PURPOSE: To provide insight on the development of pacing behavior in junior speed skaters and analyze possible differences between elite, subelite, and nonelite juniors. METHODS: Season-best times (SBTs) in the 1500-m and corresponding pacing behavior were obtained longitudinally for 104 Dutch male speed skaters at age 13-14 (U15), 15-16 (U17), and 17-18 (U19) y. Based on their U19 SBT, skaters were divided into elite (n = 17), subelite (n = 64), and nonelite (n = 23) groups. Pacing behavior was analyzed using the 0- to 300-m, 300- to 700-m, 700- to 1100-m, and 1100- to 1500-m times, expressed as a percentage of final time. Mixed analyses of variance were used for statistical analyses. RESULTS: With age, pacing behavior generally developed toward a slower 0- to 300-m and 1100- to 1500-m and a faster midsection relative to final time. While being faster on all sections, the elite were relatively slower on 0- to 300-m (22.1% ± 0.27%) than the subelite and nonelite (21.5% ± 0.44%) (P < .01) but relatively faster on 300- to 700-m (24.6% ± 0.30%) than the nonelite (24.9% ± 0.58%) (P = .002). On 700- to 1100-m, the elite and subelite (26.2% ± 0.25%) were relatively faster than the nonelite (26.5% ± 0.41%) (P = .008). Differences in the development of pacing behavior were found from U17 to U19, with relative 700- to 1100-m times decreasing for the elite and subelite (26.2% ± 0.31% to 26.1% ± 0.27%) but increasing for the nonelite (26.3% ± 0.29% to 26.5% ± 0.41%) (P = .014). CONCLUSIONS: Maintaining high speed into 700 to 1100 m, accompanied by a relatively slower start, appears crucial for high performance in 1500-m speed skating. Generally, juniors develop toward this profile, with a more pronounced development toward a relatively faster 700- to 1100-m from U17 to U19 for elite junior speed skaters. The results of the current study indicate the relevance of pacing behavior for talent development.

Factors of physical activity among Chinese children and adolescents: a systematic review.

BACKGROUND: Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development. METHODS: A systematic search was finished on Jan 10th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method. RESULTS: Forty two papers (published 2002-2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents' physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents. CONCLUSIONS: The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.