Application of e-health programs in physical activity and health promotion

Sedentary behavior has been identified as one of the major causes of many chronic diseases,such as cardiovascular diseases,stroke,cancer,osteoporosis,and type 2 diabetes.1 Modern technology plays a complex role in sedentary behavior—much like a double-edged sword.Specifically,some modern technologies,such as sedentary video games and computer games,have contributed to the epidemic of sedentary behavior and physical inactivity,whereas other novel technologies such as e-health have been increasingly used to promote physical activity(PA)and health.2,3 Indeed,e-health encompasses more than just Internet and medicine.It can include many sophisticated applications that deal with disease prevention and wellness,mobile decision making,emergency interventions,monitoring health,and remote care via mobile devices.     

Segmented sedentary time and physical activity patterns throughout the week from wrist-worn ActiGraph GT3X+ accelerometers among children 7-12 years old

Background:This study examined the volume and patterns of physical activity(PA) and sedentary time(ST) across different segments of the week among boys and girls.Methods:A total of 188 children aged 7-12 years wore a wrist-mounted ActiGraph GT3 X+accelerometer for 7 days.Time spent in PA and ST was calculated using ActiLife software.The mean number of minutes of light PA,moderate PA,vigorous PA,moderate-to-vigorous PA(MVPA),and ST were calculated per weekday(before school,during school,and after school) and per weekend day(morning and afternoon-evening).Results:After school represented the greatest accumulation of ST compared with before school and during school segments.Boys engaged in225.4 min/day of ST(95% confidence interval(CI):216-235),and girls engaged in 222.2 min/day of ST(95%CI:213-231).During school,boys engaged in significantly more MVPA than girls(46.1 min/day(95%CI:44-48) vs.40.7 min/day(95%CI:39-43)).Across the whole weekday,boys participated in significantly more MVPA than girls(103.9 min/day(95%CI:99-109) vs.95.7 min/day(95%CI:90-101)).The weekend afternoon—evening segment represented the larger accumulation of ST,where boys were significantly more sedentary than girls(367.5 min/day(95%CI:353-382) vs.339.8 min/day(95%CI:325-355),respectively).Conclusion:Our findings suggest that children are highly sedentary and spend little of their time in school in MVPA,especially girls.Routine breaks in school elicit increases in light PA and MVPA.Future work should consider the use of more active breaks within school time to encourage PA and reduce ST.     

Using compositional data analysis to explore accumulation of sedentary behavior,physical activity and youth health

Purpose:The study aimed to describe youth time-use compositions,focusing on time spent in shorter and longer bouts of sedentary behavior and physical activity(PA),and to examine associations of these time-use compositions with cardiometabolic biomarkers.Methods:Accelerometer and cardiometabolic biomarker data from 2 Australian studies involving youths 7-13 years old were pooled(complete cases with accelerometry and adiposity marker data,n=782).A 9-component time-use composition was formed using compositional data analysis:time in shorter and longer bouts of sedentary behavior;time in shorter and longer bouts of light-,moderate-,or vigorous-intensity PA;and"other time"(i.e.,non-wear/sleep).Shorter and longer bouts of sedentary time were defined as<5 min and>5 min,respectively.Shorter bouts of light-,moderate-,and vigorous-intensity PA were defined as<1 min;longer bouts were defined as≥1 min.Regression models examined associations between overall time-use composition and cardiometabolic biomarkers.Then,associations were derived between ratios of longer activity patterns relative to shorter activity patterns,and of each intensity level relative to the other intensity levels and"other time",and cardiometabolic biomarkers.Results:Confounder-adjusted models showed that the overall time-use composition was associated with adiposity,blood pressure,lipids,and the summary score.Specifically,more time in longer bouts of light-intensity PA relative to shorter bouts of light-intensity PA was significantly associated with greater body mass index z-score(zBMI)(β=1.79;SE=0.68)and waist circumference(β=18.35,SE=4.78).When each activity intensity was considered relative to all higher intensities and"other time",more time in light-and vigorous-intensity PA,and less time in sedentary behavior and moderate-intensity PA,were associated with lower waist circumference.Conclusion:Accumulating PA,particularly light-intensity PA,in frequent short bursts may be more beneficial for limiting adiposity compared to accumulating the same amount of PA at these intensities in longer bouts.     

Movement behaviors and their association with depressive symptoms in Brazilian adolescents: A cross-sectional study

Background:Physical activity,sleep,and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms.However,it is not clear whether it is the movement behavior itself or other contextual factors that are related to depressive symptoms.The objective of the present study was to examine the associations between self-reported and accelerometer-measured movement behaviors and depressive symptoms in adolescents.Methods:Cross-sectional data from 610 adolescents(14-18 years old)were used.Adolescents answered questions from the Center for Epidemiological Studies Depression scale and reported time spent watching videos,playing videogames,using social media,time spent in various physical activities,and daytime sleepiness.Wrist-worn accelerometers were used to measure sleep duration,sleep efficiency,sedentary time,and physical activity.Mixed-effects logistic regressions were used.Results:Almost half of the adolescents(48%)were classified as being at high risk for depression(score≥20).No significant associations were found between depressive symptoms and accelerometer-measured movement behaviors,self-reported non-sport physical activity,watching videos,and playing videogames.However,higher levels of self-reported total physical activity(odd ratio(OR)=0.92,95%confidence interval(95%CI):0.86-0.98)and volume of sports(OR=0.88,95%CI:0.79-0.97),in minutes,were associated with a lower risk of depression,while using social media for either 2.0-3.9 h/day(OR=1.77,95%CI:1.58-2.70)or>3.9 h/day(OR=1.67,95%CI:1.10-2.54),as well as higher levels of daytime sleepiness(OR=1.17,95%CI:1.12-1.22),were associated with a higher risk of depression.Conclusion:What adolescents do when they are active or sedentary may be more important than the time spent in the movement behaviors because it relates to depressive symptoms.Targeting daytime sleepiness,promoting sports,and limiting social media use may benefit adolescents.     

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students

Background:Active video games are a new method for increasing physical activity(PA).Fully immersive virtual reality(VR)is a hardware device on which an active video game can run.Active(video games in)VR(AVR),might increase immersion,game engagement,and moderate-to-vigorous PA(MVPA),thereby yielding greater exercise-related benefits,e.g.,cognitive performance.Methods:We examined the induction of MVPA via an AVR and a sedentary VR(SVR)as well as the effects of VR play on cognitive performance,which was monitored using 2 different methods.Each of 29 sedentary college students attended three 20-min laboratory sessions(AVR,SVR,or control)in a randomized order;during the control session,they sat quietly doing nothing.A fully immersive headset was used for the 2 video game sessions.We monitored and computed participants’PA using hip-wom accelerometers(wGT3 x-bt;ActiGraph,Pensacola,FL,USA)and a heart rate band(Polar H7;Polar,Kempele,Finland).After each session,the participants completed a mnemonic similarity test(MST)to measure recognition memory.They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire.Results:The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method.AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion,challenge,and positive affect than did SVR.The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session.Conclusion:AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.     

Social correlates of sedentary behavior in young people:The UP&DOWN study

Purpose:The aim of the present study was to analyze the associations of youths' sedentary behavior(SB) with parents' and siblings' SB and physical activity(PA),as well as the associations of youths' coparticipation with parents,siblings,and friends in PA and SB with youths' SB.Methods:The sample consisted of 1543 youths(12.02±2.51 years;788 boys) enrolled in the baseline cohort of the UP&DOWN study.SB was assessed by accelerometry and questionnaire.Participants reported the time spent by their parents and siblings watching television,playing videogames,surfing the Internet,sitting/resting,and doing PA.Further,participants reported coparticipation with parents,siblings,and friends in these activities.Linear mixed models,including school and city as random effects,were performed.Results:Parents' television time was positively associated with youths' screen-based SB.Coparticipation with friends in playing videogames(in boys) and in surfing the Internet(in girls) showed a positive association with screen-based SB and a negative association with educational-based SB.Moreover,coparticipation with siblings and friends in PA was inversely associated with accelerometer-based SB in boys and girls.Conclusion:Our results emphasize the important role of social modeling in the development of sedentary lifestyles in youths.Interventions aimed at reducing health risk behaviors in youths could be more effective if they are oriented from a social perspective that involves their families and networks of their closest friends.     

Land-walking vs.water-walking interventions in older adults:Effects on aerobic fitness

Background:Low cardiorespiratory fitness is an independent predictor of all-cause and cardiovascular mortality,and interventions that increase fitness reduce risk.Water-walking decreases musculoskeletal impact and risk of falls in older individuals,but it is unclear whether water-walking improves aerobic fitness in the same way as weight-dependent land-walking.This randomized controlled trial involved 3 intervention groups—a no-exercise control group(CG),a land-walking(LW)group,and a water-walking(WW)group—to investigate the comparative impacts of LWandWWto CG on fitness.Methods:Both exercise groups attended individually tailored,center-based,intensity-matched 3×weekly sessions for 24 weeks,which progressed to 150 min of exercise per week.This was followed by a 24-week no-intervention period.Maximal graded exercise tests were performed on a treadmill at Weeks 0,24,and 48.Results:Maximal oxygen uptake increased from Week 0 to Week 24 in both exercise groups(0.57±0.62 mL/kg/min,0.03±0.04 L/min for LW;0.93±0.75 mL/kg/min,0.06±0.06 L/min for WW,mean±SE)compared to the CG(-1.75±0.78 mL/kg/min,-0.16±0.05 L/min)(group×time,p<0.05).Time to exhaustion increased significantly following LW only(123.4±25.5 s),which was significantly greater(p=0.001)than the CG(24.3±18.5 s).By Week 48,the training-induced adaptations in the exercise groups returned to near baseline levels.Conclusion:Our study supports current physical-activity recommendations that 150 min/week of moderate-intensity exercise produces improvements in fitness in previously sedentary older individuals.Also,LW andWW elicit similar improvements in fitness if conducted at the same relative intensities.Exercise-na?ve older individuals can benefit from the lower impact forces and decreased risk of falls associated withWWwithout compromising improvements in cardiorespiratory fitness.     

The effects of resistance training on muscular strength and hypertrophy in elderly cancer patients: A systematic review and meta-analysis

Background:One of the most life-threatening comorbidities in elderly cancer patients is cancer cachexia,which is characterized by the ongoing loss of skeletal muscular strength and mass and is also associated with aging.There is a lack of recommendations for optimal resistance training(RT) for those patients.The purpose of this study was to systematically review and quantify the effects of RT on muscular strength and hypertrophy in elderly cancer patients.Methods: Five electronic databases were searched(until January 2020) for studies that met the following criteria:(i) cancer patients aged>60 years;(ii) structured and supervised RT intervention for>6 weeks;and(iii) measured muscular strength and/or hypertrophy.Results:Thirteen studies(717 participants,average age=66 years) met the inclusion criteria.RT significantly increased muscular strength(mean effect size=0.87,95% confidence interval(95%CI):0.43-1.32,p <0.001) and did not significantly induce muscle hypertrophy(mean effect size=0.09,95%CI:-0.14 to 0.31,p=0.45).In subgroup analyses for muscle strength,higher weekly frequency was significantly associated with larger effect size.Egger’ s test showed no significant publication bias for the 2 outcomes.Conclusion:The results suggest that RT improves muscular strength but does not significantly induce muscle hypertrophy in elderly cancer patients.     

A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children

PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions in increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5–11 years, as well as to explore their effectiveness in relation to categories of the theory of expanded, extended, and enhanced opportunity (TEO).MethodsAdhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using predefined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a 5-level rating system utilising a published decision tree.ResultsOverall evidence ratings for interventions implemented within school settings were: no evidence of effects on moderate-to-vigorous physical activity (MVPA) and inconclusive evidence of effects on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention, there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect, and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analyses of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size = 0.51; 95% confidence interval (CI): 0.02–0.99) and a large but nonsignificant effect for ST (effect size = 1.15; 95%CI: –1.03 to 3.33); both meta-analyses demonstrated low precision, considerable inconsistency, and high heterogeneity.ConclusionThe findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation.     

Associations between aerobic and muscle-strengthening physical activity,sleep duration,and risk of all-cause mortality: A prospective cohort study of 282,473 U.S. adults

PurposeTo examine the joint associations between meeting guidelines for physical activity (PA) and sleep duration and all-cause mortality risk among adults.MethodsParticipants were adults (n = 282,473) aged 18–84 years who participated in the 2004–2014 U.S. National Health Interview Survey. Mortality status was ascertained using the National Death Index through December 2015. Self-reported PA (Active: meeting both aerobic (AER) and muscle-strengthening (MSA) guidelines, AER only (AER), MSA only (MSA), or not meeting either AER or MSA (Inactive)) and sleep duration (Short, recommended (Rec), or Long) were classified according to guidelines, and 12 PA–sleep categories were derived. Adjusted hazard ratios and 95% confidence intervals (95%CIs) for all-cause mortality risk were estimated using Cox proportional hazards regression models.ResultsA total of 282,473 participants (55% females) were included; 18,793 deaths (6.7%) occurred over an average follow-up of 5.4 years. Relative to the Active-Rec group, all other PA-sleep groups were associated with increased mortality risk except for the Active-Short group (hazard ratio = 1.08; 95%CI: 0.92–1.26). The combination of long sleep with either MSA or Inactive appeared to be synergistic. For a given sleep duration, mortality risk progressively increased among participants classified as AER, MSA, and Inactive. Within each activity level, the mortality risk was greatest among adults with long sleep.ConclusionRelative to adults meeting guidelines for both PA and sleep duration, adults who failed to meet guidelines for both AER and muscle strengthening PA and who also failed to meet sleep duration guidelines had elevated all-cause mortality risks. These results support interventions targeting both PA and sleep duration to reduce mortality risk.     

Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study

ObjectiveThis cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.MethodsData were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3–6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.ResultsMultiple linear regression analysis showed that “having grandparents as primary caregivers” (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1–57.2); LTSB (ln): 0.19 (0.11–0.28)) and “having a television (for LTSB (ln): 0.13 (0.00–0.25)) or computer (for LTSB (ln): 0.13 (0.03–0.23)) in the child's bedroom” were both associated with higher SB. Furthermore, “having grandparents as primary caregivers” was associated with less MVPA (β (95%CI): ?7.6 (?14.1 to ?1.2)), and “active commuting to school by walking” correlated with more MVPA (β (95%CI): 9.8 (2.2–17.4)). The path model showed that “more neighborhood PA facilities close to home” was indirectly related to higher LTPA (ln), which was partly mediated by “outdoor play” (path coefficients (95%CI): 0.005 (0.002–0.008)) and “going to these facilities more often” (path coefficients (95%CI): 0.013 (0.008–0.018)). Traffic safety was not a correlate.ConclusionFamily structure and media exposure in the home maybe important factors in shaping preschoolers’ PA patterns. Built environmental correlates could indirectly influence preschoolers’ LTPA through parental help with engaging in active behaviors.     

Associations of accelerometer-determined physical activity and sedentary behavior with sarcopenia and incident falls over 12 months in community-dwelling Swedish older adults

PurposeThis study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior, light physical activity (LPA), and moderate-to-vigorous PA (MVPA) with sarcopenia and incident falls over 12 months.MethodsA total of 3334 Swedish 70-year-olds were assessed for sarcopenia, as defined by the revised definition of the European Working Group on Sarcopenia in Older People. Assessments were based on low scores for appendicular lean mass (dual-energy X-ray absorptiometry), hand grip strength, and the Timed Up and Go test. For 7 days after baseline, total time and total number of bouts (≥10 min of continuous activity at a given intensity) of activity performed at sedentary, LPA, and MVPA intensities were assessed by accelerometer. Incident falls were self-reported 6 months and 12 months after baseline.ResultsOnly 1.8% of participants had probable or confirmed sarcopenia. After multivariable adjustment for other levels of activity, only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass, low hand grip strength, and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria (all p < 0.05), and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia (odds ratio = 0.80, 95% confidence interval: 0.71–0.91 h/week). Similar associations were identified for total number of bouts, with no evidence of threshold effects for longer duration of bouts of MVPA. A total of 14% of participants reported ≥1 fall, but neither total time nor bouts of activity was associated with incident falls (all p > 0.05).ConclusionHigher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components, regardless of the length of bouts or amounts of sedentary behavior.     

Motivational processes in physical education and objectively measured physical activity among adolescents

PurposeGrounded in self-determination theory (SDT), the present study tested how students’ perceptions of autonomy support from physical education teachers predicts objectively measured moderate-to-vigorous physical activity (MVPA) of adolescents. According to SDT, it was expected that psychological needs and autonomous and controlled forms of motivation would mediate these relationships.MethodsStudents (n = 397) aged from 11 to 15 years in 17 different schools filled in questionnaires regarding SDT variables. In addition, objective MVPA was measured using an accelerometer (ActiGraph GT3X; ActiGraph, Pensacola, FL, USA) for 7 days. Structural equation modelling was used to examine the hypothesized relationships among the study variables.ResultsThe theory-based model showed a good fit with the data: χ² = 642.464, df = 257; comparative fit index = 0.932; non-normed fit index = 0.921; root mean square error of approximation = 0.062; root mean square error of approximation 90% confidence interval: 0.054–0.067. As hypothesized, there was a significant and positive direct relationship between autonomy support and need satisfaction (β = 0.81, p = 0.001). In turn, need satisfaction positively predicted intrinsic motivation (β = 0.86, p = 0.001). Intrinsic motivation was positively related to MVPA (β = 0.29, p = 0.009). A significant indirect effect (β = 0.20, p = 0.004) supported the mediating role of psychological need satisfaction and intrinsic motivation in the relationship between perceived autonomy support and objectively measured MVPA.ConclusionThe findings of the current study support the applicability of the SDT-based model in explaining the antecedents of objectively measured MVPA of adolescents. To enhance adolescents’ daily MVPA, special focus should be put on increasing their intrinsic motivation toward physical education.     

Associations of physical activity,sedentary time,and physical fitness with mental health during pregnancy: The GESTAFIT project

PurposeThis study was aimed to analyze the associations of objectively measured physical activity (PA), sedentary time, and physical fitness with mental health in the early second trimester (16 ± 2 gestational weeks) of pregnancy.MethodsFrom 229 women initially contacted, 124 pregnant women participated in the present cross-sectional study. Data were collected between November 2015 and March 2017. The participants wore Actigraph GT3X+ Triaxial accelerometers for 9 consecutive days to objectively measure their PA levels and sedentary time. A performance-based test battery was used to measure physical fitness. Self-report questionnaires assessed psychological ill-being (i.e., negative affect, anxiety, and depression), and psychological well-being (i.e., emotional intelligence, resilience, and positive affect). Linear regression analyses were adjusted for age, educational level, accelerometer wear time, miscarriages, and low back pain.ResultsModerate-to-vigorous PA was negatively associated with depression (β = –0.222, adjusted R² = 0.050, p = 0.041). Higher levels of sedentary time were negatively associated with positive affect (β = –0.260, adjusted R² = 0.085, p = 0.017). Greater upper-body flexibility was positively associated with better emotional regulation (β = 0.195, adjusted R²= 0.030, p = 0.047). The remaining associations were not significant (all p > 0.05).ConclusionAn active lifestyle characterized by higher levels of moderate-to-vigorous PA and lower levels of sedentary time during pregnancy might modestly improve the mental health of pregnant women. Although previous research has focused on the benefits of cardiorespiratory exercise, the present study shows that only upper-body flexibility is related to emotional regulation in early pregnant women. If the present findings are corroborated in further experimental research, physical exercise programs should focus on enhancing flexibility to promote improvements in emotional regulation during early second-trimester of pregnancy.     

Inter-participant variability in daily physical activity and sedentary time among male youth sport footballers: independent associations with indicators of adiposity and cardiorespiratory fitness

Participation in youth sport is assumed to promote and contribute towards more physically active lifestyles among children and adolescents. The aim of this study was to examine inter-participant variability in objectively measured habitual physical activity (PA) behaviours and sedentary time among youth sport participants and their implications for health. One-hundred-and-eighteen male youth sport footballers (Mean ± s = 11.72 ± 1.60) wore a GT3X accelerometer for 7 days. Average daily PA [min · day^?1, in light (LPA), moderate (MPA), vigorous (VPA) and combined moderate-to-vigorous (MVPA)] and sedentary time were calculated. Participants’ body mass index adjusted for age and sex (BMI–standard deviation score), per cent body fat (BF%), waist circumference and cardiorespiratory fitness were assessed. Results revealed that variability in daily PA behaviours and sedentary time (min · day^?1) was associated with BMI–standard deviation score [VPA (?), MVPA (?)], BF% [sedentary time (+), VPA (?), MVPA (?)], waist circumference [sedentary time (+), LPA (?)] and cardiorespiratory fitness [sedentary time (?), MPA (+), VPA (+), MVPA (+)]. Whilst sedentary time and MVPA were not related to health outcomes independent of one another, associations with markers of adiposity and cardiorespiratory fitness were stronger for sedentary time. Sedentary time was also significantly positively related to waist circumference independent of VPA. Results demonstrate inter-participant variability in habitual PA and sedentary time among youth sport participants which holds implications for their health. Thus, promoting PA and, in particular, reducing sedentary time may contribute towards the prevention of adverse health consequences associated with a physically inactive lifestyle for children and adolescents active in the youth sport context.     

Objectively measured physical activity and psychosocial functioning in young children: The GECKO Drenthe cohort

ABSTRACT

The global trend in inactivity in children may be related to psychosocial problems. We investigated the cross-sectional association between physical activity (PA) levels and psychosocial functioning in 3.4–7.3-year-old children. Children from the Dutch GECKO birth cohort (N = 898; 51.6% boys) had PA levels assessed objectively by accelerometry (ActiGraph GT3X) for at least three days. Linear regression analysis was used for associations with psychosocial functioning (parent report of the Strengths and Difficulties Questionnaire), controlling for gender, age and socio-economic status. Higher total and moderate-to-vigorous PA levels (MVPA) were associated with higher Total Difficulty scores, and sedentary time to lower Total Difficulty scores. More time spent in MVPA was significantly associated to “hyperactivity/inattention” in both boys (Standardized B_BOYS = 0.192) and girls (Std.B_GIRLS = 0.139) whereas for the time in sedentary behaviour, a reverse association was found only in boys (Std.B_BOYS = ?0.230). In boys only, more time in MVPA (Std.B_BOYS = 0.154) and less time in sedentary behaviour (Std.B_BOYS = ?0.147), were significant determinants for ‘behavioural problems’. When using objectively measured PA, parents report more hyperactivity/inattention and behavioural problems in the more active children, and less in the more sedentary children, most clearly for boys. High levels of PA might be an indicator of psychosocial problems in young children.     

Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis

BackgroundPhysical activity (PA) in the early years is associated with a range of positive health outcomes. Fundamental motor skill (FMS) competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood. However, to date, no studies have meta-analyzed the association between PA and FMS in the early years.MethodsSix electronic databases were searched for articles published up to April 2019. Cross-sectional and longitudinal studies were included if they targeted children (ages 3–6 year) as the population of the study and assessed the association between objectively measured PA and FMS. Total FMS, total physical activity (TPA), and moderate-to-vigorous physical activity (MVPA) data were meta-analyzed using a random effects model.ResultsWe identified 24,815 titles and abstracts. In total, 19 studies met the inclusion criteria, including 14 cross-sectional and 4 longitudinal studies, as well as 1 study with cross-sectional and longitudinal analysis. There was a significant but small positive association between FMS and MVPA (r = 0.20, 95% confidence interval (CI): 0.13–0.26) and TPA (r = 0.20, 95%CI: 0.12–0.28). Findings from longitudinal studies revealed that PA drives FMS in early childhood. Mediation was explored in 1 study, which found that perceived motor competence did not mediate the association between FMS and PA.ConclusionUsing a meta-analysis, this study is the first to show a positive association between FMS, MVPA, and TPA in the early years of childhood, suggesting that the association begins at an early age. Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood. More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.     

Dose-dependent associations of joint aerobic and muscle-strengthening exercise with obesity: A cross-sectional study of 280,605 adults

BackgroundEmerging epidemiological evidence suggests that compared to engaging in 1 activity mode alone, a combination of moderate-to-vigorous physical activity (MVPA: brisk walking/jogging, cycling) and muscle-strengthening exercise (MSE: push-ups/sit-ups, using weight machines) has more favorable associations with optimal weight status. However, few studies have examined the dose-dependent and joint associations of MVPA and MSE with obesity.MethodsBased on cross-sectional analyses of the European Health Interview Survey Wave 2 (2013–2014), we examined prevalence ratios (PRs) of joint and stratified associations between MVPA (4 categories: (i) 0 min/week, (ii) 1–149 min/week, (iii) 150–299 min/week, and (iv) ≥300 min/week) and MSE (3 categories: (i) 0 day/week, (ii) 1 day/week, and (iii) ≥2 days/week) with body mass index-defined obesity (body mass index of ≥30.0 kg/m²) using Poisson regression with robust error variance. PRs were examined unadjusted and adjusted for sociodemographic and lifestyle characteristics (e.g., sex, age, education, income, and smoking status).ResultsData were available for 280,456 adults (≥18 years), of which 46,166 (15.5%) were obese. The interaction MVPA × MSE guideline adherence was statistically significant for obesity (p ≤ 0.05). The joint MVPA–MSE analysis showed that compared to the reference group (i.e., no MVPA and no MSE), the PRs followed a dose-dependent pattern, with the lowest observed among those reporting ≥150 MVPA min/week and ≥1 MSE days/week (PR: 0.43; 95% confidence interval: 0.41–0.46). When stratified across each MVPA strata, the PRs were mostly lower among those engaging in MSE 1 day/week, as compared to those doing MSE ≥2 days/week.ConclusionThere was evidence for a dose-dependent association between joint MVPA–MSE with a reduced prevalence of obesity. Public health strategies for the prevention and management of obesity should recommend both MVPA and MSE.