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Background: To determine if children’s moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods: Data from 6548 children (55% girls) aged 9–11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results: For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. Conclusions: Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.

Barreira is with the Department of Exercise Science, University of Syracuse, Syracuse, NY, USA. Barreira, Broyles, Tudor-Locke, Hu, and Katzmarzyk are with Pennington Biomedical Research Center, Baton Rouge, LA, USA. Tudor-Locke is also with the Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA. Chaput and Tremblay are with the Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. Fogelholm is with the Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland. Kuriyan is with St. John’s Research Institute, Bangalore, Karnataka, India. Lambert is with the Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Maher and Olds are with the Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia. Maia is with CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal. Onywera is with the Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya. Sarmiento is with the School of Medicine, Universidad de Los Andes, Bogota, Colombia. Standage is with the Department for Health, University of Bath, Bath, United Kingdom.

Barreira ( is corresponding author.

Supplementary Materials

    • Supplementary Table S1 (PDF 65 KB)
    • Supplementary Table S2 (PDF 66 KB)