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Dan M. Cooper

The purpose of this review is to focus on several intersecting journeys, new pathways necessary to advance the field of exercise medicine and exercise science in child health. We will cover the journey of concept and discovery in which novel technologies are reshaping how we measure and gauge

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Leon Straker, Erin Kaye Howie, Dylan Paul Cliff, Melanie T. Davern, Lina Engelen, Sjaan R. Gomersall, Jenny Ziviani, Natasha K. Schranz, Tim Olds and Grant Ryan Tomkinson

Background:

Australia has joined a growing number of nations that have evaluated the physical activity and sedentary behavior status of their children. Australia received a “D minus” in the first Active Healthy Kids Australia Physical Activity Report Card.

Methods:

An expert subgroup of the Australian Report Card Research Working Group iteratively reviewed available evidence to answer 3 questions: (a) What are the main sedentary behaviors of children? (b) What are the potential mechanisms for sedentary behavior to impact child health and development? and (c) What are the effects of different types of sedentary behaviors on child health and development?

Results:

Neither sedentary time nor screen time is a homogeneous activity likely to result in homogenous effects. There are several mechanisms by which various sedentary behaviors may positively or negatively affect cardiometabolic, neuromusculoskeletal, and psychosocial health, though the strength of evidence varies. National surveillance systems and mechanistic, longitudinal, and experimental studies are needed for Australia and other nations to improve their grade.

Conclusions:

Despite limitations, available evidence is sufficiently convincing that the total exposure and pattern of exposure to sedentary behaviors are critical to the healthy growth, development, and wellbeing of children. Nations therefore need strategies to address these common behaviors.

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Deanna M. Hoelscher, Andrew Springer, Tiffni H. Menendez, Peter W. Cribb and Steven H. Kelder

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Natasha Schranz, Tim Olds, Dylan Cliff, Melanie Davern, Lina Engelen, Billie Giles-Corti, Sjaan Gomersall, Louise Hardy, Kylie Hesketh, Andrew Hills, David Lubans, Doune Macdonald, Rona Macniven, Philip Morgan, Tony Okely, Anne-Maree Parish, Ron Plotnikoff, Trevor Shilton, Leon Straker, Anna Timperio, Stewart Trost, Stewart Vella, Jenny Ziviani and Grant Tomkinson

Background:

Like many other countries, Australia is facing an inactivity epidemic. The purpose of the Australian 2014 Physical Activity Report Card initiative was to assess the behaviors, settings, and sources of influences and strategies and investments associated with the physical activity levels of Australian children and youth.

Methods:

A Research Working Group (RWG) drawn from experts around Australia collaborated to determine key indicators, assess available datasets, and the metrics which should be used to inform grades for each indicator and factors to consider when weighting the data. The RWG then met to evaluate the synthesized data to assign a grade to each indicator.

Results:

Overall Physical Activity Levels were assigned a grade of D-. Other physical activity behaviors were also graded as less than average (D to D-), while Organized Sport and Physical Activity Participation was assigned a grade of B-. The nation performed better for settings and sources of influence and Government Strategies and Investments (A- to a C). Four incompletes were assigned due to a lack of representative quality data.

Conclusions:

Evidence suggests that physical activity levels of Australian children remain very low, despite moderately supportive social, environmental and regulatory environments. There are clear gaps in the research which need to be filled and consistent data collection methods need to be put into place.

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Ralph Maddison, Leila Pfaeffli Dale, Samantha Marsh, Allana G. LeBlanc and Melody Oliver

Background:

This brief report provides grades for the 2014 New Zealand Report Card on Physical Activity for Children and Youth. The Report Card presents a review of current evidence across 9 key indicators, including physical activity (PA), organized sport and free play, sedentary behavior, and community and government initiatives across New Zealand.

Methods:

Nationally representative survey data were collated by researchers at the University of Auckland, New Zealand, between June and December 2013. The grade for each indicator is based on the percentage of children and youth meeting a defined benchmark: A is 81%−100%; B is 61%−80%; C is 41%−60%, D is 21%−40%; F is 0%−20%; INC is incomplete data.

Results:

Overall PA received a score of B, as did Organized Sport Participation and Active Play. PA participation in School Environment scored slightly less with a score of B-. Sedentary Behaviors, Family and Peers, and Community and Built Environment scored a grade of C. Active transportation received a score of C-. An inconclusive grade was given for the Government indicator due to a lack of established international criteria for assessment.

Conclusions:

PA participation in New Zealand is satisfactory, but could improve. However, sedentary behavior is high. Of particular concern is the age-related decline in PA participation, particularly among adolescent females, and the increase in sedentary behavior.

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Jorge Mota, Manuel João Coelho-e-Silva, Armando M. Raimundo and Luís B. Sardinha

Background:

This article describes the procedures and development of the first Portuguese Report Card on Physical Activity in Children and Adolescents.

Methods:

Comprehensive searches for data related to indicators of physical activity (PA) were completed by a committee of physical activity and sports specialists. Grades were assigned to each indicator consistent with the process and methodology outlined by the Active Healthy Kids Canada Report Card model.

Results:

Nine indicators of PA were graded. The following grades were assigned: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, D; Active Transportation, C; Sedentary Behaviors, D; Family and Peers, C; Schools, B; Community and the Built Environment, D; and Government, C.

Conclusions:

Portuguese children and adolescents do not reach sufficient physical activity levels and spend larger amounts of time spent in sedentary behaviors compared with recommendations. Effective policies of PA promotion and implementation are needed in different domains of young people’s daily lives.

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Lisbeth Runge Larsen, Jens Troelsen, Kasper Lund Kirkegaard, Søren Riiskjær, Rikke Krølner, Lars Østergaard, Peter Lund Kristensen, Niels Christian Møller, Bjørn Friis Neerfeldt Christensen, Jens-Ole Jensen, Charlotte Østergård and Thomas Skovgaard

Background:

The first Danish Report Card on Physical Activity (PA) for Children and Youth describes Denmark’s efforts in promoting and facilitating PA and PA opportunities for children and youth.

Methods:

The report card relies primarily on a synthesis of the best available research and policy strategies identified by the Report Card Research Committee consisting of a wide presentation of researchers and experts within PA health behaviors and policy development. The work was coordinated by Research and Innovation Centre for Human Movement and Learning situated at the University of Southern Denmark and the University College Lillebaelt. Nine PA indicators were graded using the Active Healthy Kids Canada Report Card development process.

Results:

Grades from A (highest) to F (lowest) varied in Denmark as follows: 1) Overall Physical Activity (D+), 2) Organized Sport Participation (A), 3) Active Play (INC; incomplete), 4) Active Transportation (B), 5) Sedentary Behaviors (INC), 6) Family and Peers (INC), 7) School (B), 8) Community and the Built Environment (B+), and 9) Government strategies and investments (A-).

Conclusions:

A large proportion of children in Denmark do not meet the recommendations for PA despite the favorable investments and intensions from the government to create good facilities and promote PA.

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Bradley M. Appelhans and Hong Li

Purpose:

This study tested associations of organized sports participation and unstructured active play with overall moderate and vigorous physical activity (MVPA) in low-income children and examined factors associated with participation frequency.

Method:

Research staff visited 88 low-income Chicago households with children ages 6–13 years. MVPA was assessed through 7-day accelerometry. Researchers documented the home availability of physical activity equipment. Caregivers reported on child participation in organized sports and unstructured active play, family support for physical activity, perceived neighborhood safety, and access to neighborhood physical activity venues.

Results:

Despite similar participation in organized sports and unstructured active play, boys accumulated more MVPA than girls. MVPA was predicted by an interaction between gender and unstructured active play. Boys accumulated 23–45 additional minutes of weekday MVPA and 53–62 additional minutes of weekend MVPA through unstructured active play, with no such associations in girls. Higher reported neighborhood safety and family support for physical activity were associated with engagement in unstructured active play for both genders, and with participation in organized sports for girls.

Conclusion:

Physical activity interventions for low-income, urban children should emphasize unstructured active play, particularly in boys. Fostering family support for physical activity and safe play environments may be critical intervention components.

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Melody Oliver, Philip J. Schluter, Genevieve N. Healy, El-Shadan Tautolo, Grant Schofield and Elaine Rush

Background:

Breaks in sedentary behavior are associated with reduced body size in general populations. This study is the first to consider the relationship between objectively assessed sedentary breaks and body size in Pacific children and their mothers.

Methods:

Pacific children aged 6 years (n = 393) and their mothers (n = 386) residing in New Zealand were invited to participate in 2006. Sedentary time was assessed via accelerometry. Average frequency, duration, and intensity of breaks in sedentary time per hour were calculated. Waist circumference was assessed and demographic factors collected via questionnaire. Relationships between waist circumference and potential associated factors for participants were assessed using linear regression analyses.

Results:

Accelerometer data were obtained from 126 children (52 boys) and 108 mothers. Mean (standard deviation) waist circumference values for mothers and children were 114 cm (20.1 cm) and 59.4 cm (7.8 cm), respectively. For mothers, time spent sedentary and being an ex/nonsmoker were positively related to waist circumference. For children, watching television every day and having a mother with a high waist circumference was associated with a greater waist circumference.

Conclusion:

Strategies that focus on reducing sedentary time in Pacific mothers and on encouraging television free days in young Pacific children are recommended.