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Andrew P. Kingsnorth, Mhairi Patience, Elena Moltchanova, Dale W. Esliger, Nicola J. Paine, and Matthew Hobbs

The response to COVID-19 resulted in behavioral restrictions to tackle the spread of infection. Initial data indicates that step counts were impacted by lockdown restrictions; however, there is little evidence regarding changes of light and moderate to vigorous physical activity (MVPA) behavioral intensities. In this study, participants were asked to provide longitudinal wearable data from Fitbit devices over a period of 30 weeks, from December 2019 to June 2020. Self-assessed key worker status was captured, along with wearable estimates of steps, light activity, and MVPA. Bayesian change point analyses of data from 97 individuals found that there was a sharp decrease of 1,473 steps (95% credible interval [CI] [−2,218, −709]) and light activity minutes (41.9; 95% CI [−54.3, −29.3]), but an increase in MVPA minutes (11.7; 95% CI [2.9, 19.4]) in the mean weekly totals for nonkey workers. For the key workers, the total number of steps (207; 95% CI [−788, 1,456]) and MVPA minutes increased (20.5; 95% CI [12.6, 28.3]) but light activity decreased by an average of 46.9 min (95% CI [−61.2, −31.8]). Interestingly, the change in steps was commensurate with that observed during Christmas (1,458; 95% CI [−2,286, −554]) for nonkey workers and behavioral changes occurred at different time points and rates depending on key worker status. Results indicate that there were clear behavioral modifications before and during the initial COVID-19 lockdown period, and future research should assess whether any behavioral modifications were sustained over time.

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Matthew Hobbs, Stuart J.H. Biddle, Andrew P. Kingsnorth, Lukas Marek, Melanie Tomintz, Jesse Wiki, John McCarthy, Malcolm Campbell, and Simon Kingham

Background: This study investigates the association between television (TV) viewing and child adiposity and if parental education and child ethnicity moderate this association. Method: Cross-sectional, pooled (2013/2014–2016/2017) adult and child New Zealand Health Survey were matched resulting in 13,039 children (2–14 y) and parent dyads. Child TV viewing was estimated using self-reported time for each weekday and weekend. The height (in centimeters), weight (in kilograms), and waist circumference of parents and children were measured. Childhood body mass index and obesity were defined using the International Obesity Task Force cutoff values. Effect modification was assessed by interaction and then by stratifying regression analyses by parent education (low, moderate, and high) and child ethnicity (Asian, European/other, Māori, and Pacific). Results: Overall, watching ≥2 hours TV on average per day in the past week, relative to <2 hours TV viewing, was associated with a higher odds of obesity (adjusted odds ratio = 1.291 [1.108–1.538]), higher body mass index z score (b = 0.123 [0.061–0.187]), and higher waist circumference (b = 0.546 [0.001–1.092]). Interactions considering this association by child ethnicity and parent education revealed little evidence of effect modification. Conclusion: While TV viewing was associated with child adiposity, the authors found little support for a moderating role of parental education and child ethnicity.

Open access

Mark W. Orme, Phoebe H.I. Lloyd-Evans, Akila R. Jayamaha, Winceslaus Katagira, Bruce Kirenga, Ilaria Pina, Andrew P. Kingsnorth, Ben Maylor, Sally J. Singh, and Alex V. Rowlands

Albert Einstein taught us that “everything is relative.” People’s experience of physical activity (PA) is no different, with “relativism” particularly pertinent to the perception of intensity. Markers of absolute and relative intensities of PA have different but complimentary utilities, with absolute intensity considered best for PA guideline adherence and relative intensity for personalized exercise prescription. Under the paradigm of exercise and PA as medicine, our Technical Note proposes a method of synchronizing accelerometry with the incremental shuttle walking test to facilitate description of the intensity of the free-living PA profile in absolute and relative terms. Our approach is able to generate and distinguish “can do” or “cannot do” (based on exercise capacity) and “does do” or “does not do” (based on relative intensity PA) classifications in a chronic respiratory disease population, facilitating the selection of potential appropriate individually tailored interventions. By synchronizing direct assessments of exercise capacity and PA, clearer insights into the intensity of PA performed during everyday life can be gleaned. We believe the next steps are as follows: (1) to determine the feasibility and effectiveness of using relative and absolute intensities in combination to personalize the approach, (2) to determine its sensitivity to change following interventions (eg, exercise-based rehabilitation), and (3) to explore the use of this approach in healthier populations and in other long-term conditions.