Systematic Review of the Relationships Between Objectively Measured Physical Activity and Health Indicators in School-Aged Children and Youth

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5–17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth

Development of a measurement approach to assess time children participate in organized sport, active travel, outdoor active play, and curriculum-based physical activity

Abstract Background Children participate in four main types of physical activity: organized sport, active travel, outdoor active play, and curriculum-based physical activity. The objective of this study was to develop a valid approach that can be used to concurrently measure time spent in each of these types of physical activity. Methods Two samples (sample 1: n = 50; sample 2: n = 83) of children aged 10–13 wore an accelerometer and a GPS watch continuously over 7 days. They also completed a log where they recorded the start and end times of organized sport sessions. Sample 1 also completed an outdoor time log where they recorded the times they went outdoors and a description of the outdoor activity. Sample 2 also completed a curriculum log where they recorded times they participated in physical activity (e.g., physical education) during class time. Results We describe the development of a measurement approach that can be used to concurrently assess the time children spend participating in specific types of physical activity. The approach uses a combination of data from accelerometers, GPS, and activity logs and relies on merging and then processing these data using several manual (e.g., data checks and cleaning) and automated (e.g., algorithms) procedures. In the new measurement approach time spent in organized sport is estimated using the activity log. Time spent in active travel is estimated using an existing algorithm that uses GPS data. Time spent in outdoor active play is estimated using an algorithm (with a sensitivity and specificity of 85%) that was developed using data collected in sample 1 and which uses all of the data sources. Time spent in curriculum-based physical activity is estimated using an algorithm (with a sensitivity of 78% and specificity of 92%) that was developed using data collected in sample 2 and which uses accelerometer data collected during class time. There was evidence of excellent intra- and inter-rater reliability of the estimates for all of these types of physical activity when the manual steps were duplicated. Conclusions This novel measurement approach can be used to estimate the time that children participate in different types of physical activity

Bi-directional association between sleep and outdoor active play among 10–13 year olds

Abstract Background The purpose of this study was to investigate whether there is a bi-directional relationship between sleep characteristics (time in bed, sleep duration, sleep chronology, and sleep efficiency) and time spent participating in outdoor active play among children. Methods Participants consisted of 433 children aged 10–13 years from Kingston, ON, Canada. Time in bed, sleep duration, sleep chronology, and sleep efficiency were measured for 8 consecutive nights using data from a sleep log and Actical accelerometer. Outdoor active play was measured for the 7 days that fell in between these 8 nights using a combination of data from accelerometers, global positioning system loggers, and geographic information systems. Generalized estimating equation models were used to assess the relationships between sleep characteristics and outdoor active play. These models accounted for the repeated measures nested within participants and adjusted for several confounders (e.g., age, sex, family income, neighborhood traffic and green space). Results Time in bed, sleep duration, sleep chronology, and sleep efficiency were not significantly associated with the following day’s outdoor active play. There was a significant (p = 0.017) association between outdoor active play and the following night’s time in bed, which suggested that each hour increase in outdoor active play was associated with a 4.0 min increase in time in bed. Outdoor active play was not significantly associated with sleep duration, sleep chronology, or sleep efficiency. Conclusions None of the sleep characteristics predicted the following day’s outdoor active play. Increase time spent in outdoor active play predicted a longer time in bed, but not sleep duration, sleep chronology, or sleep efficiency

Pedestrian traffic safety and outdoor active play among 10–13 year olds living in a mid-sized city

This cross-sectional study examined the independent and interactive associations between objective and perceived measures of neighborhood pedestrian traffic safety and outdoor active play. A total of 458 children aged 10–13 years from Kingston, Canada were studied in 2015–2016. Outdoor active play was measured over 7 days using data from activity logs, accelerometers, and Global Positioning System loggers. Geographic Information System data were collected within 1 km of participants' homes and used to create traffic volume, traffic calming, traffic speed, and pedestrian infrastructure indexes. Parents' perceptions of these pedestrian safety domains were obtained by questionnaire. Most of the pedestrian safety measures were not significantly associated with outdoor active play, and there were no interactions between the objective and perceived measures (p > 0.3). The significant relationships are listed here. Children whose parents perceived moderate or high traffic speeds in their neighborhood had outdoor active play values that were 0.35 (SE = 0.10, p = 0.021) and 0.20 (SE = 0.15, p = 0.048) SD units higher, respectively, then children whose parents perceived low traffic speed. By comparison to children from neighborhoods in the lowest tertile, children from the highest traffic volume tertile had higher outdoor active play levels (0.26, SE = 0.12, p = 0.029), while children from neighborhoods in the moderate traffic calming tertile (−0.28, SE = 0.11, p = 0.008) and the moderate pedestrian infrastructure tertile (−0.25, SE = 0.11, p = 0.023) had lower outdoor active play levels. Keywords: Child, Physical activity, Safety, Residence characteristic

Objectively measured active transportation to school and other destinations among 10–13 year olds

Abstract Background Descriptive data on active transportation in children focuses on the trip to school and has relied on subjective reports. The purpose of this study was to use objective measures to describe total active transportation and active transportation to common destinations within children. Methods This was a descriptive study of 388 children aged 10–13 years from Kingston, Ontario, Canada. Participants wore a Garmin GPS watch during waking hours for seven days. Personal Activity Measurement Location System software used the GPS data to identify trips, time spent in each trip and the trip modality (walking, bicycle or vehicle). Google Maps software was used to identify trip destinations. Results A total of 8875 trips were identified. Most (69%) trips were made by vehicle; 25% were made by walking and 6% by bicycle. Mean time spent in active transportation was 10.3 min/day (95% CI: 7.4, 14.5). Time spent in active transportation was higher for boys (12.1 min/day [95% CI: 8.8, 17.0) than for girls (8.5 min/day [95% CI: 6.1, 12.0]) and increased from 7.7 min/day (95% CI: 5.5, 11.1) at age 10 to 14.3 min/day (95% CI: 10.3, 19.9) at age 13. Time spent in active transportation was lower in the winter by comparison to the other seasons. The four most common active transportation destinations were the participant’s home, school, other people’s homes, and parks or greenspace with 69%, 39%, 37% and 32% of participants walking or bicycling to these destinations at least once over the 7-day measurement period. Conclusion Over 65% of trips made and time spent travelling occurred in a vehicle. When active transportation was used, the most common destinations were home, school, other people’s homes, and parks

Is replacing time spent in one type of physical activity with another associated with health in children?

Altering the proportion of total physical activity time accumulated while participating in different types of physical activity may influence health. Our objective was to use observational data to estimate whether replacing time from one physical activity type with another is associated with physical and mental health indicators among children. Participants were 385 children aged 10-13 years. They wore a Global Positioning System watch and accelerometer and completed an activity log for 7 days. Data from these instruments was used to estimate time spent in outdoor active play, organized sport, curriculum-based physical activity at school, and active transportation. A cardiometabolic risk factor score was created from body fat, resting heart rate, and resting blood pressure measures. An internalizing symptoms score was created using anxiety and depression symptom questionnaire items. Isotemporal substitution models estimated if health indicators changed when time in one type of physical activity was replaced with equivalent time from another. The results indicated that time spent in all types of physical activity combined was associated with the cardiometabolic risk factor and internalizing symptom scores. Replacing active transportation with outdoor active play was associated with an increase in the internalizing symptoms score but a decrease in the cardiometabolic risk factor score. The internalizing symptoms score decreased when active transportation was replaced by equivalent time in organized sport. Other time substitutions were not significant. In conclusion, the total time spent participating in physical activity and not a specific type of physical activity was the most consistent correlate of the health indicators.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Objectively measured crime and active transportation among 10–13 year olds

This study examined the temporal relationship between objective measures of neighborhood crime and active transportation among children. A sample of 387 children aged 10–13 years from Kingston, Canada were studied between January 2015 and December 2016. Active transportation was measured over 7 days using Geographic Information System loggers. The number of crimes per capita were measured within a 1 km distance of participants' homes for the 24-month period prior to when their active transportation was measured. Surprisingly, children living in neighborhoods in the highest neighborhood crime rate quartile engaged in significantly more active transportation than children living in neighborhoods in the lowest neighborhood crime rate quartile (16.4 versus 10.2 min/day, p < 0.05). This relationship persisted after adjustment for several individual, family, and environmental covariates. Keywords: Child, Adolescent, Physical activity, Walking, Crim

Validity of SC-StepRx pedometer-derived moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth

Abstract Background The purpose of this study was to determine the validity of the SC-StepRx pedometer to assess moderate and vigorous physical activity during treadmill walking and running in a heterogeneous sample of children and youth aged 10-17 years. Methods Physical activity intensity assessed via indirect calorimetry served as the criterion standard. A convenience sample of 40 participants (20 boys, 20 girls) wore 6 SC-StepRx pedometers, 2 ActiGraph GT3X accelerometers, 2 Actical accelerometers, 1 Walk4Life MVP pedometer and 1 NL-1000 pedometer while walking/running at speeds approximating 2, 3, 4, 6 and 7 METs. Associations between indirect calorimetry and each activity monitor were assessed using linear regression analyses in SAS 9.2. Results Estimates of moderate and vigorous physical activity from all monitors were significantly associated with the criterion standard of indirect calorimetry. The strongest associations with the criterion measure were observed for the SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute−1, and the NL-1000 (R2 = 0.82, p <0.05). The SC-StepRx with moderate/vigorous thresholds of 110/130 steps•minute−1 also exhibited the highest combined sensitivity (92.9%) and specificity (96.5%) for correctly identifying a bout of moderate-to-vigorous physical activity. Conclusions This study demonstrates that the SC-StepRx pedometer is a valid tool for the measurement of moderate and vigorous physical activity in children and youth

Systematic review of the relationships between objectively-measured physical activity and health indicators in school-aged children and youth

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively-measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities and patterns of objectively-measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204,171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) vs lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author