Associations between sport and screen-entertainment with mental health problems in 5-year-old children

<p>Abstract</p> <p>Background</p> <p>Few studies have examined the benefits of regular physical activity, and risks of sedentary behaviour, in young children. This study investigated associations between participation in sports and screen-entertainment (as components of physical activity and sedentary behaviour), and emotional and behavioural problems in this population.</p> <p>Methods</p> <p>Cross-sectional analysis of data from 13470 children (50.9% boys) participating in the nationally representative UK Millennium Cohort Study. Time spent participating in sports clubs outside of school, and using screen-entertainment, was reported by the child's mother at child age 5 years, when mental health was also measured using the Strengths and Difficulties Questionnaire.</p> <p>Results</p> <p>45% of children did not participate in sport clubs and 61% used screen-entertainment for ≥ 2 hours per day. Children who participated in sport had fewer total difficulties; emotional, conduct, hyperactivity-inattention and peer relationship problems; and more prosocial behaviours. These relationships were similar in boys and girls. Boys and girls who used screen-entertainment for any duration, and participated in sport, had fewer emotional and behavioural problems, and more prosocial behaviours, than children who used screen-entertainment for ≥ 2 hours per day and did not participate in sport.</p> <p>Conclusions</p> <p>Longer durations of screen-entertainment usage are not associated with mental health problems in young children. However, our findings suggest an association between sport and better mental health. Further research based on longitudinal data is required to examine causal pathways in these associations and to determine the potential role of this and other forms of physical activity in preventing mental health disorders.</p

Research Associations Between Sport and Screen-Entertainment With Mental Health Problems in 5-Year-Old Children

Background: Few studies have examined the benefits of regular physical activity, and risks of sedentary behaviour, in young children. This study investigated associations between participation in sports and screen-entertainment (as components of physical activity and sedentary behaviour), and emotional and behavioural problems in this population. Methods: Cross-sectional analysis of data from 13470 children (50.9% boys) participating in the nationally representative UK Millennium Cohort Study. Time spent participating in sports clubs outside of school, and using screen-entertainment, was reported by the child\u27s mother at child age 5 years, when mental health was also measured using the Strengths and Difficulties Questionnaire. Results: 45% of children did not participate in sport clubs and 61% used screen-entertainment for ≥ 2 hours per day. Children who participated in sport had fewer total difficulties; emotional, conduct, hyperactivity-inattention and peer relationship problems; and more prosocial behaviours. These relationships were similar in boys and girls. Boys and girls who used screen-entertainment for any duration, and participated in sport, had fewer emotional and behavioural problems, and more prosocial behaviours, than children who used screen-entertainment for ≥ 2 hours per day and did not participate in sport. Conclusions: Longer durations of screen-entertainment usage are not associated with mental health problems in young children. However, our findings suggest an association between sport and better mental health. Further research based on longitudinal data is required to examine causal pathways in these associations and to determine the potential role of this and other forms of physical activity in preventing mental health disorders

Physical activity among children with asthma: Cross‐sectional analysis in the UK millennium cohort

Background: Although beneficial for health and well‐being, most children do not achieve recommended levels of physical activity. Evidence for children with asthma is mixed, with symptom severity rarely considered. This paper aimed to address this gap. Methods: We analyzed cross‐sectional associations between physical activity and parent‐reported asthma symptoms and severity for 6497 UK Millennium Cohort Study 7−year‐old participants (3321, [49%] girls). Primary outcomes were daily moderate‐to‐vigorous physical activity (MVPA, minutes) and proportion of children achieving recommended minimum daily levels of 60 minutes of MVPA. Daily steps, sedentary time, and total activity counts per minute (cpm) were recorded, as were parent‐reported asthma symptoms, medications, and recent hospital admissions. Associations were investigated using quantile (continuous outcomes) and Poisson (binary outcomes) regression, adjusting for demographic, socioeconomic, health, and environmental factors. Results: Neither asthma status nor severity was associated with MVPA; children recently hospitalized for asthma were less likely to achieve recommended daily MVPA (risk ratio [95% confidence interval [CI]]: 0.67 [0.44, 1.03]). Recent wheeze, current asthma, and severe asthma symptoms were associated with fewer sedentary hours (difference in medians [95% CI]: −0.18 [−0.27, −0.08]; −0.14 [−0.24, −0.05]; −0.15, [−0.28, −0.02], respectively) and hospital admission with lower total activity (−48 cpm [−68, −28]). Conclusion: Children with asthma are as physically active as their asthma‐free counterparts, while those recently hospitalized for asthma are less active. Qualitative studies are needed to understand the perceptions of children and families about physical activity following hospital admission and to inform support and advice needed to maintain active lifestyles for children with asthma

Is obesity more likely among children sharing a household with an older child with obesity?

Objectives We used a dynamic method of identifying household members from Electronic Health Records (EHRs) linked to National Child Measurement Programme (NCMP) data to estimate the likelihood of children with obesity sharing a household with an older child with obesity, accounting for individual and household characteristics. Methods We included 126,829 NCMP participants in four London boroughs and assigned households from encrypted Unique Property reference Numbers (UPRNs) at NCMP date for 115,466 (91%). We categorised the ethnic-adjusted body mass index of the youngest and oldest household child (underweight/healthy weight<91st, ≥91st to <98th overweight, obesity≥98th centile) and explored associations of the youngest child’s weight status with: oldest child’s weight status, number of household children (two, three or ≥4), youngest child’s sex, ethnicity and school year of NCMP participation (reception or year 6). We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) of obesity in the youngest child. Results 19,702 UPRNs were shared by two or more NCMP participants (youngest children: 51.2% male, 69.5% reception). 10.4% of youngest (95% CI: 10.0,10.9) and 13.0% of oldest (12.5,14.3) children were living with obesity. One third of youngest children with obesity shared a household with another child with obesity (33.2%; 31.2,35.2), compared with 9.2% (8.8,9.7) of those with a healthy weight. Youngest children living with an older child with overweight (aOR: 2.33; 95% CI: 2.06,2.64) or obesity (4.59, 4.10,5.14), those from South Asian ethnic backgrounds (1.89; 1.64,2.19) or taking part in NCMP in year 6 (2.21; 2.00,2.43) were more likely, and girls (0.73; 0.67,0.81), children living with just one other child (0.87; 0.77,0.98) and from Black ethnic backgrounds (0.78; 0.66,0.93) less likely, to be living with obesity. Conclusion Linked EHRs can provide novel insights into the shared weight status of children sharing the same household. Further qualitative research is needed to understand how household food practices may vary by other household characteristics to improve our understanding of how the home environment influences childhood obesity

Validation of a dynamic method of measuring households and populations from primary care Electronic Health Records: Cross-sectional comparison with Office for National Statistics Census 2021 estimates

Objectives We have developed a dynamic method for identifying household members from Electronic Health Records (EHR). We compared the 2021 Census estimates of household number and demography with similar estimates derived from primary care EHRs on the Census date using primary care EHRs for the population of north east London (NEL). Method We included 2,115,017 patients registered with a general practitioner on the 2021 Census date in NEL and assigned households from encrypted Unique Property Reference Numbers. We compared household number and size by Local Authority (LA), Middle Layer Super Output Area (MSOA) and area’s Index of Multiple Deprivation quintiles (IMDq) to Office for National Statistics (ONS) 2021 Census estimates and by LA to ONS Admin Based Housing Stock (ABHS) 2020 estimates. We assessed differences in EHR and Census 2021 populations by sex, age, LA, MSOA and IMDq. Sensitivity analyses will exclude those without a recent recorded clinical encounter. Results EHR population estimates (2,115,017) were 116,346 (5.8%) higher than Census estimates (1,998,671), higher among men (9.2%) than women (2.5%) in almost all age groups, especially men aged 30-50 years and higher in the most (8.7%), than in the least (2.5%) deprived IMDq. EHR household estimates (660,789) were 68,047 (9.3%) lower than Census estimates (728,836), and 19,719 (3.1%) higher than ABHS occupied addresses (641,070). EHR household size estimates were 15.6%, 29.2%,12.5% and 8.4% lower for household sizes 1,2 3 and 4, and 13.3%, 42.1%, 82.1% and 195.8% higher for household sizes 5, 6,7 and 8 respectively when compared to Census estimates. EHR population and household estimates were respectively 5-10% higher and 5-11% lower for almost all NEL local authorities. Conclusion EHR- and Census-derived population and household estimates differ, mainly in the prevalence of larger households. While data were extracted on the same date, person-level validation was not possible. Differences may reflect deregistration delay in EHR when changing residence. Analyses based on clinical encounters recency may identify registered patients who are no longer residents

Childhood asthma prevalence: cross-sectional record linkage study comparing parent-reported wheeze with general practitioner-recorded asthma diagnoses from primary care electronic health records in Wales

Introduction Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood asthma. The relation of these estimates to those obtained from parent-reported wheezing suggestive of asthma is unclear. We hypothesised that parent-reported wheezing would be more prevalent than general practitioner (GP)-recorded asthma diagnoses in preschool-aged children. Methods 1529 of 1840 (83%) Millennium Cohort Study children registered with GPs in the Welsh Secure Anonymised Information Linkage databank were linked. Prevalences of parent-reported wheezing and GP-recorded asthma diagnoses in the previous 12 months were estimated, respectively, from parent report at ages 3, 5, 7 and 11 years, and from Read codes for asthma diagnoses and prescriptions based on GP EHRs over the same time period. Prevalences were weighted to account for clustered survey design and non-response. Cohen’s kappa statistics were used to assess agreement. Results Parent-reported wheezing was more prevalent than GP-recorded asthma diagnoses at 3 and 5 years. Both diminished with age: by age 11, prevalences of parent-reported wheezing and GP-recorded asthma diagnosis were 12.9% (95% CI 10.6 to 15.4) and 10.9% (8.8 to 13.3), respectively (difference: 2% (−0.5 to 4.5)). Other GP-recorded respiratory diagnoses accounted for 45.7% (95% CI 37.7 to 53.9) and 44.8% (33.9 to 56.2) of the excess in parent-reported wheezing at ages 3 and 5 years, respectively. Conclusion Parent-reported wheezing is more prevalent than GP-recorded asthma diagnoses in the preschool years, and this difference diminishes in primary school aged children. Further research is needed to evaluate the implications of these differences for the characterisation of longitudinal childhood asthma phenotypes from EHRs

Associations between children’s behavioural and emotional development and objectively measured physical activity and sedentary time: Findings from the UK Millennium Cohort Study

Physical activity (PA) can have a positive influence on mental health. Less is known about the influence of mental health on current and later PA and sedentariness in childhood. This study investigated cross-sectional and distal associations between behavioural and emotional development, and objectively measured moderate-to-vigorous PA (MVPA) and sedentary time, in seven-year-old children participating in the Millennium Cohort Study (n = 6,497). Markers of behavioural/emotional development (scores for total difficulties, internalising and externalising problems) were obtained using the Strengths and Difficulties Questionnaire at ages three, five and seven years. Associations between sedentary time or MVPA (outcomes) and behavioural/emotional development (exposures) were analysed using median regressions, stratified by sex. In cross-sectional analyses, boys’ sedentary time decreased with higher total difficulties scores (-1.1 minutes/day per score unit), boys’ and girls’ sedentary time decreased with higher externalising scores (-2.3 minutes/day per unit), and girls with higher internalising scores were more sedentary (1.4 minutes/day per unit). In analyses of MVPA, boys and girls were marginally more active with higher externalising scores (0.4 and 0.5 minutes/day per unit), and boys were less active for higher internalising scores (-0.7 minutes/day per unit). Distal associations showed similar patterns: children with increasing total difficulty and externalising scores at all ages were less sedentary at age seven; girls with increasing internalising scores particularly so. Boys and girls with increasing externalising scores were more active at age seven, whilst increasing internalising scores reduced MVPA for boys. In conclusion, behavioural/emotional development is associated with mid-childhood sedentary time and, more weakly, MVPA; this is of relevance to public health interventions aimed at increasing activity levels and the wellbeing of our young people