Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings

Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings

Maternal prenatal, with or without postpartum, vitamin D3 supplementation does not improve maternal iron status at delivery or infant iron status at 6 months of age: secondary analysis of a randomised controlled trial

Background Vitamin D may modify iron status through regulation of hepcidin and inflammatory pathways. This study aimed to investigate effects of maternal vitamin D supplementation on iron status in pregnancy and early infancy.Methods In a trial in Dhaka, Bangladesh, women (n=1300) were randomised to one of five vitamin D3 regimens from 17 to 24 weeks’ gestation until 26 weeks postpartum (prenatal; postpartum doses): 0;0, 4200;0, 16 800;0, 28 000;0 or 28 000;28 000 IU/week. All participants received standard iron-folic acid supplementation. In this secondary analysis (n=998), we examined effects of prenatal;postpartum vitamin D on serum ferritin and other biomarkers of maternal iron status (transferrin saturation, total iron binding capacity, soluble transferrin receptor and hepcidin) at delivery, and infant ferritin and haemoglobin at 6 months of age. Using linear regression, we estimated per cent mean differences between each intervention group and placebo with 95% CIs, with and without adjustment for baseline ferritin or inflammatory biomarkers (C reactive protein and α-1-acid glycoprotein (AGP)).Results At delivery, ferritin concentrations were similar between each intervention group and placebo in unadjusted (n=998) and baseline ferritin-adjusted analyses (n=992; p>0.05). Compared with placebo, AGP was lower in each intervention group (per cent difference (95% CI) = −11% (−21 to –1.0), −14% (−23 to –3.5) and −11% (−19 to –2.0) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=779). In the subgroup of women with baseline 25-hydroxyvitamin D < 30 nmol/L, ferritin was lower in each intervention group versus placebo (−23% (−37 to –5.0), −20% (−35 to –1.9) and −20% (−33 to –4.1) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=645); effects were slightly attenuated after adjustment for inflammation (n=510). There were no effects of vitamin D on other iron biomarkers among women at delivery or infants aged 6 months.Conclusion These findings do not support improvement of iron status by vitamin D. The effect of prenatal vitamin D supplementation on ferritin may reflect an anti-inflammatory mechanism