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The Effect of Structured Exercise Classes and a Lifestyle Intervention on Cardiovascular Risk Factors in Primary Schoolchildren: An Exploratory Trial (The A-CLASS Project)

Jayne Henaghan, Nicola McWhannell, Lawrence Foweather, N. Tim Cable, Alan M. Batterham, Gareth Stratton, and Keith P. George

This exploratory trial evaluates the effect of a structured exercise (STEX) or lifestyle intervention (PASS) program upon cardiovascular (CV) disease risk factors in children. Sixty-one schoolchildren were randomly assigned by school to an intervention or control (CON) condition. The effect of the STEX (compared with CON) was a mean benefit of −0.018 mm for average maximum carotid intimamedia thickness. The PASS intervention did not result in clinically important effects, and no other substantial changes were observed. Relatively high probability of clinically beneficial effects of the STEX intervention suggests that a larger, definitive randomized trial with longer follow-up is warranted.

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Lifestyle Behaviors Associated With Body Fat Percent in 9- to 11-Year-Old Children

Nils Swindell, Damon Berridge, Melitta A. McNarry, Kelly A. Mackintosh, Lynne M. Boddy, Stuart J. Fairclough, and Gareth Stratton

Purpose:To examine (1) associations between body fat percent (BF) and lifestyle behaviors in children aged 9–11 years and (2) the consistency of these associations over a 10-year period. Methods: In this repeat, cross-sectional study, 15,977 children aged 9–11 years completed an anthropometric assessment and the SportsLinx Lifestyle survey between 2004 and 2013. Body fat was estimated according to the sum of the triceps and subscapular skinfold measurements. Multilevel models were utilized to examine associations between BF and responses to the lifestyle survey while controlling for known covariates. Results: Lifestyle behaviors explained 8.6% of the total variance in body fat. Specifically, negative associations were found between BF and active transport to school ( β = −0.99 [0.19], P < .001), full-fat milk (−0.07 [0.15], P < .001), and sweetened beverage consumption (−0.40 [0.15], P = .007). Relative to the reference group of ≤8:00 PM, later bedtime was positively associated with BF: 8:00 to 8:59 PM ( β = 1.60 [0.26], P < .001); 9:00 to 10:00 PM ( β = 1.04 [0.24], P < .001); ≥10:00 PM ( β = 1.18 [0.30], P < .001). Two-way interactions revealed opposing associations between BF and the consumption of low-calorie beverages for boys ( β = 0.95 [0.25], P < .001) and girls ( β = −0.85 [0.37], P = .021). There was no significant change in these associations over a 10-year period. Conclusions: In this population-level study covering a decade of data collection, lifestyle behaviors were associated with BF. Policies and interventions targeting population-level behavior change, such as active transport to school, sleep time, and consumption of full-fat milk, may offer an opportunity for improvements in BF.

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Clusters of Activity-Related Social and Physical Home Environmental Factors and Their Association With Children’s Home-Based Physical Activity and Sitting

Michael P. Sheldrick, Clover Maitland, Kelly A. Mackintosh, Michael Rosenberg, Lucy J. Griffiths, Richard Fry, and Gareth Stratton

Purpose: Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics. Methods: Altogether, 235 children (55% girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the HomeSPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children’s device-measured home-based activity behaviors, and background characteristics. Results: The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with home-based activity behaviors in the hypothesized directions. Conclusion: Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families, are warranted.

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Results From Wales’ 2016 Report Card on Physical Activity for Children and Youth: Is Wales Turning the Tide on Children’s Inactivity?

Richard Tyler, Marianne Mannello, Rebecca Mattingley, Chris Roberts, Robert Sage, Suzan R Taylor, Malcolm Ward, Simon Williams, and Gareth Stratton

Background:

This is the second Active Healthy Kids Wales Report Card. The 2016 version consolidates and translates research related to physical activity (PA) among children and youth in Wales, and aims to raise the awareness of children’s engagement in PA and sedentary behaviors.

Methods:

Ten PA indicators were graded using the Active Healthy Kids—Canada Report Card methodology involving a synthesis and expert consensus of the best available evidence.

Results:

Grades were assigned as follows: Overall PA, D+; Organized Sport Participation, C; Active and Outdoor Play, C; Active Transportation, C; Sedentary Behaviors, D-; Physical Literacy, INC; Family and Peer Influences, D+; School, B; Community and the Built Environment, C; and National Government Policy, Strategies, and Investments, B-.

Conclusions:

Despite the existence of sound policies, programs, and infrastructure, PA levels of children and youth in Wales are one of the lowest and sedentary behavior one of the highest globally. From the 2014 Report Card, the Family and Peer Influences grade improved from D to D+, whereas Community and the Built Environment dropped from B to C. These results indicate that a concerted effort is required to increase PA and decrease sedentary time in children and young people in Wales.

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Patterns of Objectively Measured Moderate-to-Vigorous Physical Activity in Preschool Children

Mareesa O’Dwyer, Stuart J. Fairclough, Nicola Diane Ridgers, Zoe Rebecca Knowles, Lawrence Foweather, and Gareth Stratton

Background:

Identifying periods of the day which are susceptible to varying levels of physical activity (PA) may help identify key times to intervene and potentially change preschool children’s PA behaviors. This study assessed variability of objectively measured moderate-to-vigorous physical activity (MVPA) during weekdays and weekend days among preschool children.

Methods:

One hundred and eighty-eight children (aged 3 to 5 years; 53.2% boys) from a northwest English city wore uni-axial accelerometers for 7 consecutive days.

Results:

Higher levels of MVPA were recorded in boys, particularly those who attended preschool for a half day. Children who attended preschool for a full day engaged in 11.1 minutes less MVPA than children who attended for a half day. After-school hours were characterized by a decrease in activity for all groups. Patterns of activity during the weekend were smoother with less variability.

Conclusion:

This study identified discrete segments of the week, specifically afterschool and during the weekend, when preschoolers engage in low levels of PA. Higher levels of MVPA among children who attended preschool for less time each day suggests that the structured preschool environment is related to decreased activity. Consequently, there is a need for interventions in young children to focus on school and home environments.

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The Physiological Cost and Enjoyment of Wii Fit in Adolescents, Young Adults, and Older Adults

Lee E.F. Graves, Nicola D. Ridgers, Karen Williams, Gareth Stratton, Greg Atkinson, and Nigel T. Cable

Background:

Active video games (exergames) increase energy expenditure (EE) and physical activity (PA) compared with sedentary video gaming. The physiological cost and enjoyment of exergaming in adolescents, and young and older adults has not been documented, nor compared with aerobic exercise. This study compared the physiological cost and enjoyment of exergaming on Wii Fit with aerobic exercise in 3 populations.

Methods:

Cardiorespiratory and enjoyment measurements were compared in 14 adolescents, 15 young adults, and 13 older adults during handheld inactive video gaming, Wii Fit activities (yoga, muscle conditioning, balance, aerobics), and brisk treadmill walking and jogging.

Results:

For all groups EE and heart rate (HR) of Wii Fit activities were greater than handheld gaming (P < .001) but lower than treadmill exercise (P ≤ .001). Wii aerobics elicited moderate intensity activity in adolescents, young adults, and older adults with respective mean (SD) metabolic equivalents of 3.2 (0.7), 3.6 (0.8), and 3.2 (0.8). HR during Wii aerobics fell below the recommended intensity for maintaining cardiorespiratory fitness. Group enjoyment rating was greater for Wii balance and aerobics compared with treadmill walking and jogging (P ≤ .05).

Conclusions:

Wii Fit appears an enjoyable exergame for adolescents and adults, stimulating light-to-moderate intensity activity through the modification of typically sedentary leisure behavior.

Open access

Motor Competence Among Children in the United Kingdom and Ireland: An Expert Statement on Behalf of the International Motor Development Research Consortium

Michael J. Duncan, Lawrence Foweather, Farid Bardid, Anna L. Barnett, James Rudd, Wesley O’Brien, Jonathan D. Foulkes, Clare Roscoe, Johann Issartel, Gareth Stratton, and Cain C.T. Clark

The United Kingdom and Ireland have a well-established research base in motor competence (MC) research, ranging from reporting and monitoring levels of MC, developing assessment tools for MC, providing innovative curriculum and intervention design to support learning and development, as well as providing advocacy for particular groups, such as those with motor impairments. This expert statement, on behalf of the International Motor Development Research Consortium, draws together what is currently known about levels of MC in the United Kingdom and Ireland as well as current approaches to intervention in both countries. Subsequently presented are recommendations for researchers and practitioners to advance the field of MC for the benefit of children and youth in the United Kingdom, Ireland, and worldwide.

Open access

Results From Wales’ 2018 Report Card on Physical Activity for Children and Youth

Lowri C. Edwards, Richard Tyler, Dylan Blain, Anna Bryant, Neil Canham, Lauren Carter-Davies, Cain Clark, Tim Evans, Ceri Greenall, Julie Hobday, Anwen Jones, Marianne Mannello, Emily Marchant, Maggie Miller, Graham Moore, Kelly Morgan, Sarah Nicholls, Chris Roberts, Michael Sheldrick, Karen Thompson, Nalda Wainwright, Malcolm Ward, Simon Williams, and Gareth Stratton

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Report Card Grades on the Physical Activity of Children and Youth Comparing 30 Very High Human Development Index Countries

Salomé Aubert, Joel D. Barnes, Nicolas Aguilar-Farias, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Peter T. Katzmarzyk, Agata Korcz, Yeon Soo Kim, Eun-Young Lee, Marie Löf, Tom Loney, Shawnda A. Morrison, Jorge Mota, John J. Reilly, Blanca Roman-Viñas, Natasha Schranz, John Scriven, Jan Seghers, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Richard Tyler, Alun Williams, Stephen H.S. Wong, Paweł Zembura, and Mark S. Tremblay

Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards. Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearman’s rank correlation coefficients. Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors. Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.

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Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries

Salomé Aubert, Joel D. Barnes, Chalchisa Abdeta, Patrick Abi Nader, Ade F. Adeniyi, Nicolas Aguilar-Farias, Dolores S. Andrade Tenesaca, Jasmin Bhawra, Javier Brazo-Sayavera, Greet Cardon, Chen-Kang Chang, Christine Delisle Nyström, Yolanda Demetriou, Catherine E. Draper, Lowri Edwards, Arunas Emeljanovas, Aleš Gába, Karla I. Galaviz, Silvia A. González, Marianella Herrera-Cuenca, Wendy Y. Huang, Izzeldin A.E. Ibrahim, Jaak Jürimäe, Katariina Kämppi, Tarun R. Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Asaduzzaman Khan, Agata Korcz, Yeon Soo Kim, Estelle Lambert, Eun-Young Lee, Marie Löf, Tom Loney, Juan López-Taylor, Yang Liu, Daga Makaza, Taru Manyanga, Bilyana Mileva, Shawnda A. Morrison, Jorge Mota, Vida K. Nyawornota, Reginald Ocansey, John J. Reilly, Blanca Roman-Viñas, Diego Augusto Santos Silva, Pairoj Saonuam, John Scriven, Jan Seghers, Natasha Schranz, Thomas Skovgaard, Melody Smith, Martyn Standage, Gregor Starc, Gareth Stratton, Narayan Subedi, Tim Takken, Tuija Tammelin, Chiaki Tanaka, David Thivel, Dawn Tladi, Richard Tyler, Riaz Uddin, Alun Williams, Stephen H.S. Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.