Objectively Measured Physical Activity in South African Children Attending Preschool and Grade R: Volume, Patterns, and Meeting Guidelines

in Pediatric Exercise Science
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  • 1 University of Cape Town
  • 2 Deakin University
  • 3 University of Wollongong
  • 4 University of the Witwatersrand
  • 5 Umeå University
  • 6 INDEPTH Network
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Purpose: To assess physical activity (PA) and determine the proportion of preschoolers meeting PA recommendations in different income settings in South Africa. Methods: Preschoolers from urban high-income (UH), urban low-income (UL), and rural low-income (RL) settings wore an ActiGraph GT3X+ accelerometer for 7 days. PA variables of interest included volume moderate- to vigorous-intensity PA (MVPA) and total PA (light- to vigorous-intensity PA), hourly PA patterns, and percentage of children meeting guidelines (180 min/d of total PA, inclusive of 60 min/d of MVPA). Between-sex differences were assessed using t tests and Mann–Whitney U tests; between-setting differences assessed using 1-way analyses of variance and Kruskal–Wallis tests. Results: For all children (n = 229, aged 5.17 [0.69] y), average MVPA was 124.4 (37.5) minutes per day and total PA was 457.0 (61.1) minutes per day; 96.9% of children met guidelines. Boys did significantly more MVPA than girls (136.7 [39.37] vs 111.5 [30.70] min/d, P < .001), and UH preschoolers were significantly less active than UL and RL preschoolers (UH 409.1 [48.4] vs UL 471.1 [55.6] and RL 461.6 [61.4], P < .001). Conclusion: In both practice and research, it is necessary to explore ways to ensure that South African preschoolers from all income settings continue to engage in and benefit from healthy volumes of PA. This is especially important as preschoolers transition to a formal school environment.

Tomaz and Draper are with the Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa. Hinkley is with the Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. Jones is with Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia. Twine and Kahn are with the SAMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Kahn is also with the Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden; and the INDEPTH Network, Accra, Ghana. Norris and Draper are with the SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Tomaz (tmzsim@gmail.com) is corresponding author.
  • 1.

    Aguilar-Farías N, Martino-Fuentealba P, Espinoza-Silva M. Objectively measured physical activity and sedentary behaviour patterns in Chilean pre-school children. Nutr Hosp. 2015;32:260612.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Brasholt M, Chawes B, Kreiner-Møller E, Vahlkvist S, Sinding M, Bisgaard H. Objective assessment of levels and patterns of physical activity in preschool children. Pediatr Res. 2013;74(3):3338. PubMed ID: 23770920 doi:10.1038/pr.2013.99

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Brown WH, Pfeiffer KA, Mclver KL, Dowda M, Almeida MJCA, Pate RR. Assessing preschool children’s physical activity: the observational system for recording physical activity in children-preschool version. Res Q Exerc Sport. 2006;77(2):16776. PubMed ID: 16898273

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Carson V, Lee E-Y, Hewitt L, et al. Systematic review of the relationships between physical activity and health indicators in the early years (0–4 years). BMC Public Health. 2017;17 Suppl 5:4063.

    • Search Google Scholar
    • Export Citation
  • 5.

    Chaput J-P, Colley RC, Aubert S, et al. Proportion of preschool-aged children meeting the Canadian 24-hour movement guidelines and associations with adiposity: results from the Canadian Health Measures Survey. BMC Public Health. 2017;17 Suppl 5:829. PubMed ID: 29219075 doi:10.1186/s12889-017-4854-y

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Chow CM, Wong SN, Shin M, et al. Defining the rest interval associated with the main sleep period in actigraph scoring. Nat Sci Sleep. 2016;8:3218. PubMed ID: 27920587 doi:10.2147/NSS.S114969

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Cliff DP, McNeill J, Vella SA, et al. Adherence to 24-hour movement guidelines for the early years and associations with social-cognitive development among Australian preschool children. BMC Public Health. 2017;17(5):857. doi:10.1186/s12889-017-4858-7

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Cliff DP, Reilly JJ, Okely AD. Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0–5 years. J Sci Med Sport. 2009;12(5):55767. PubMed ID: 19147404 doi:10.1016/j.jsams.2008.10.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Craig E, Bland R, Reilly J. Objectively measured physical activity levels of children and adolescents in rural South Africa: high volume of physical activity at low intensity. Appl Physiol Nutr Metab. 2013;38(1):814. PubMed ID: 23368832 doi:10.1139/apnm-2012-0115

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    De Craemer M, McGregor D, Androutsos O, Manios Y, Cardon G. Compliance with 24-h movement behaviour guidelines among Belgian pre-school children: the ToyBox-study. Int J Environ Res Public Health. 2018;15(10):2171. doi:10.3390/ijerph15102171

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Draper CE, Tomaz SA, Basset SH. Results from the healthy active kids South Africa 2018 report card. S Afr J Child Health. 2019;13(3):1306. doi:10.7196/SAJCH.2019.v13i3.1640

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Draper CE, Tomaz SA, Biersteker L, et al. The South African 24-hour movement guidelines for birth to five years: an integration of physical activity, sitting behaviour, screen time and sleep. J Phys Act Health. 2020;17(1):10919. PubMed ID: 31877557 doi:10.1123/jpah.2019-0187

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Draper CE, Tomaz SA, Stone M, et al. Developing intervention strategies to optimise body composition in early childhood in South Africa. Biomed Res Int. 2017;2017(1):5283457.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Hesketh KR, McMinn AM, Ekelund U, et al. Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day. Int J Behav Nutr Phys Act. 2014;11(1):1. doi:10.1186/1479-5868-11-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Hinkley T, O’Connell E, Okely AD, Crawford D, Hesketh K, Salmon J. Assessing volume of accelerometry data for reliability in preschool children. Med Sci Sports Exerc. 2012;44(12):243641. PubMed ID: 22776873 doi:10.1249/MSS.0b013e3182661478

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Hnatiuk JA, Salmon J, Hinkley T, Okely AD, Trost S. A review of preschool children’s physical activity and sedentary time using objective measures. Am J Prev Med. 2014;47(4):48797. PubMed ID: 25084681 doi:10.1016/j.amepre.2014.05.042

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Janssen X, Basterfield L, Parkinson KN, et al. Objective measurement of sedentary behavior: impact of non-wear time rules on changes in sedentary time. BMC Public Health. 2015;15(1):504. doi:10.1186/s12889-015-1847-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Janssen X, Cliff DP, Reilly JJ, et al. Predictive validity and classification accuracy of ActiGraph energy expenditure equations and cut-points in young children. PLoS One. 2013;8(11):e79124. PubMed ID: 24244433 doi:10.1371/journal.pone.0079124

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Jáuregui A, Villalpando S, Rangel-Baltazar E, Lara-Zamudio YA, Castillo-García MM. Physical activity and fat mass gain in Mexican school-age children: a cohort study. BMC Pediatr. 2012;12(1):109. doi:10.1186/1471-2431-12-109

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Jones S, Hendricks S, Draper CE. Assessment of physical activity and sedentary behavior at preschools in Cape Town, South Africa. Child Obes. 2014;10(6):50110. PubMed ID: 25353264 doi:10.1089/chi.2014.0097

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Lindsay AC, Greaney ML, Wallington SF, Mesa T, Salas CF. A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries. J Spec Pediatr Nurs. 2017;22(3):e12182. doi:10.1111/jspn.12182

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Lundeen EA, Norris SA, Adair LS, Richter LM, Stein AD. Sex differences in obesity incidence: 20-year prospective cohort in South Africa. Pediatr Obes. 2016;11(1):7580. PubMed ID: 25988503 doi:10.1111/ijpo.12039

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Micklesfield LK, Pedro TM, Kahn K, et al. Physical activity and sedentary behavior among adolescents in rural South Africa: levels, patterns and correlates. BMC Public Health. 2014;14(1):40. doi:10.1186/1471-2458-14-40

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Ministry of Health. Sit Less, Move More, Sleep Well: Active Play Guidelines for Under Fives. Wellington, New Zealand: Ministry of Health; 2017. Available from https://www.health.govt.nz/system/files/documents/publications/active-play-guidelines-for-under-fives-may17.pdf

    • Search Google Scholar
    • Export Citation
  • 25.

    Okely AD, Ghersi D, Hesketh KD, et al. A collaborative approach to adopting/adapting guidelines—the Australian 24-hour movement guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep. BMC Public Health. 2017;17 Suppl 5:370. doi:10.1186/s12889-017-4867-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Pate RR, Almeida MJ, McIver KL, Pfeiffer KA, Dowda M. Validation and calibration of an accelerometer in preschool children. Obesity. 2006;14(11):20006. PubMed ID: 17135617 doi:10.1038/oby.2006.234

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):20208. PubMed ID: 30418471 doi:10.1001/jama.2018.14854

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Poitras VJ, Gray CE, Borghese MM, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6) Suppl 3:S19739. PubMed ID: 27306431 doi:10.1139/apnm-2015-0663

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Reilly JJ. Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention. Proc Nutr Soc. 2008;67(3):31725. PubMed ID: 18700053 doi:10.1017/S0029665108008604

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Reilly JJ, Coyle J, Kelly L, Burke G, Grant S, Paton JY. An objective method for measurement of sedentary behavior in 3- to 4-year olds. Obes Res. 2003;11(10):11558. PubMed ID: 14569038 doi:10.1038/oby.2003.158

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Reilly JJ, Hughes A, Janssen X, et al. UK physical activity guidelines: Draft review and recommendations for the under 5s. 2018. Available from http://www.bristol.ac.uk/media-library/sites/sps/documents/cmo/under-5s-technical-report.pdf

    • Search Google Scholar
    • Export Citation
  • 32.

    Sadeh A, Sharkey M, Carskadon MA. Activity-based sleep-wake identification: an empirical test of methodological issues. Sleep. 1994;17(3):2017. PubMed ID: 7939118 doi:10.1093/sleep/17.3.201

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Said-Mohamed R, Bernard JY, Ndzana A-C, Pasquet P. Is overweight in stunted preschool children in Cameroon related to reductions in fat oxidation, resting energy expenditure and physical activity? PLoS One. 2012;7(6):e39007. PubMed ID: 22701741 doi:10.1371/journal.pone.0039007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Schmutz EA, Leeger-Aschmann CS, Radtke T, et al. Correlates of preschool children’s objectively measured physical activity and sedentary behavior: a cross-sectional analysis of the SPLASHY study. Int J Behav Nutr Phys Act. 2017;14(1):1. PubMed ID: 28057008 doi:10.1186/s12966-016-0456-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Tomaz SA, Jones R, Hinkley T, et al. Physical activity in early childhood education and care settings in a low-income, rural South African community: an observational study. Rural Remote Health. 2019;19(4):5249. PubMed ID: 31670971

    • Search Google Scholar
    • Export Citation
  • 36.

    Tomaz SA, Prioreschi A, Watson ED, et al. Adiposity, physical activity, sedentary behaviour, sleep and gross motor skill proficiency in preschool children from a low- to middle-income, urban setting. J Phys Act Health. 2019;16(7):52532. PubMed ID: 31154894 doi:10.1123/jpah.2018-0133

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Tremblay MS, Chaput J-P, Adamo KB, et al. Canadian 24-hour movement guidelines for the early years (0–4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health. 2017;17 Suppl 5:15. doi:10.1186/s12889-017-4859-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Tremblay MS, LeBlanc AG, Carson V, et al. Canadian physical activity guidelines for the early years (aged 0–4 years). Appl Physiol Nutr Metab. 2012;37(2):34556. PubMed ID: 22448608 doi:10.1139/h2012-018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    van Cauwenberghe E, Jones RA, Hinkley T, Crawford D, Okely AD. Patterns of physical activity and sedentary behaviour in preschool children. Int J Behav Nutr Phys Act. 2012;9(1):138. doi:10.1186/1479-5868-9-138

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    van Sluijs EMF, McMinn AM, Inskip HM, et al. Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children. PLoS One. 2013;8(9):e74934. PubMed ID: 24040365 doi:10.1371/journal.pone.0074934

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. doi:10.1371/journal.pmed.0040296

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    World Medical Association. World Medical Association declaration of Helsinki. JAMA. 2013;310(20):21914. doi:10.1001/jama.2013.281053

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