Sociodemographic differences in patterns of sedentary and physically active behavior in children and adolescents

Article (PDF Available)inActa Paediatrica 90(4):429-35 · May 2001with124 Reads
DOI: 10.1111/j.1651-2227.2001.tb00445.x · Source: PubMed
Abstract
Numerous studies have found that involvement in moderate-intensity and strenuous activity has positive effects on health. This study considered the prevalence of different aspects of physical activity and sedentary behavior in 11–16-y-olds based on a representative national survey of 3270 Icelandic primary schoolchildren (91% response rate). All-day sedentary behavior was extremely rare (<1%), and the vast majority (91%) were physically active (≫3 times per week) during school or leisure time, thanks largely to school physical education. Only 39% were physically active (≫3 times per week) during leisure time, and only 29% engaged in regular (≫3 times per week) leisure time strenuous exercise. Girls were more sedentary, less leisure time physically active, and less involved in leisure time strenuous exercise. Sedentary behavior increased and physically active behavior decreased with age, especially after early adolescence. However, there were no age differences in strenuous leisure time exercise. Upper-class students were less sedentary and more physically active during leisure time than working-class students. Finally, rural students were more sedentary during leisure time, and less physically active than students from urban areas. An interaction was found between age and residence when predicting leisure time physical activity, indicating that the inverse age-activity relationship in urban areas is partly reversed in rural areas. Conclusion: Compulsory school physical education frequently failed to translate into voluntary physical involvement. Sociodemographic differences in physical activity were greater during leisure time, than during school and leisure time combined.
Soc iodemogra phic differenc es in patterns of seden tary and physically
ac tive behavior in older childre n and adolescents
G K ristjansdott ir a nd R Vilhjalmsson
Faculty of Nursing, University of Iceland
Kristjansdottir G, Vilhjalmsson R. Sociodemographic diffe rences in patterns of sedentary and
physically active behavior in older children and adolescents. Acta Pædiatr 2001: 90: 429–435.
Stockholm. ISSN 0803-5253
Numerous studies have found that involvement in moderate-intensity and strenuous activity ha s
positive effects on health. This study considered the prevalence of different aspects of physical
activity and sedentary behavior in 11–16-y-olds based on a representative nationa l survey of 3270
Icelandic primary schoolchildren (91% response rate). All-day sedentary behavior was extremely
rare (< 1%), and the vast majority (91%) were physically active (3 times per week) during school
or leisure time, thanks largely to school physical education. Only 39% were physically a ctive (3
times per week) during leisure time, and only 29% engaged in regular (3 times per w eek) leisure
time strenuous exercise. Girls were more sedentary, less leisure time physically active, and less
involve d in leisure time strenuous exercise. Sedentary behavior inc reased and physically active
behavior decreased with age, especially after early adolescence. However, there were no age
differences in strenuous leisure time exercise. Upper-class students were less sedentary and more
physically active during leisure time than working-class students. Finally, rural students were more
sedentary during leisure time, and less physically active than students from urban areas. An
interaction was found between age and residence when predicting leisure time physical activity,
indicating that the inverse age–activity relationship in urban areas is partly reversed in rural areas.
Conclusion: Compulsory school physical education frequently failed to translate into voluntary
physical involvement. Sociodemogra phic dif ferences in physical activity were greater during
leisure time, than during school and leisure time combined.
K ey words:
Exercise, physical activity, physical education, sedentary behavior, sociodemographic
differences
Gudrun Kristjansdottir, Faculty of Nursing, University of Iceland, Eiriksgotu 34, IC-101
Reykjavõ
´
k, Iceland (Tel. 354 525 4960, fax. 354 525 4963, e-mail. gkrist@hi.is)
A number of behavioral health risks are established
dur ing late childhood and early adolescence, including
sedenta ry behavior and lack of st renuous exercise (1, 2).
T he relationships between physical activity and ex-
er cise and various aspects of health, including psycho-
logical distress, physical tness, coronary disease, and
m ortality are well established (3–6). The literature has
usua lly focused on the bene ts of regular involvement
in vigorous activity, but recent investiga tions have
found that the accumulation of moderate-intensity
physic al activity also brings various health bene ts (7).
A lthough it is frequently assumed that physical
ac tivity is an integral part of growing up, numerous
studies show that children and adolescents are often
physic ally inactive (8, 9). Cultural c hanges pertaining to
T V viewing, reading, studying, and using the computer
m ay be associated with decrease in physical activity
am ong young people (10). Developmental transitions
through childhood and adolescence may also have
im plications for physical activity (11).
In recent years, Western nations have placed the
prom otion of regular physical activity among childr en
and adolescents high on their public health agenda
( 12, 13). The assessment of physical activity needs and
im proveme nts in the population depends on information
about local a nd national baselines and trends in relevant
physi cal activity/inactivity indica tors. European and
N orth American studies generally nd that girls are less
physi cally active than boys, especially when consider-
ing the more strenuous activity forms (5, 8, 11, 14, 15).
T here are also indications that involvement in physical
ac tivity declines consistently w ith age (11), although
som e studies indicate a fall off after early adolescence
( 16). Furtherm ore, several studies nd an interaction
betw een age and gender, indicating greater activity
dec lines in girls (11, 17). Som e authors nd no class
dif ference s (15, 17), but others nd that children and
adolesc ents of low socioeconomic status (SES) are
disadvanta ged (18, 19). Few studies have looked at
r egional differences, but the limited evidence suggests
Ó
2001 Taylor & Francis. ISSN 0803-5253
Acta diatr 90: 42 35. 2001
that rural children have lower participation rates than
childre n in urban areas (20, 21). What makes compari-
sons between physical activity studies in children and
youth dif cult is their use of different sampling methods
and populations, as well as their use of different and
some times limited or problematic measures of activity
or inactivity (e.g. measures of only one aspect of
act ivity, or measures of speci c behaviors, such as TV
viewi ng, that in reality can coexist with physically
act ive behaviors).
T he pre sent study considers the prevalence of
physic al activity and sedentary behavior in older
childre n and adolescents. It contributes to this research
ar ea by analyzing a representative national probability
sam ple, considering various aspects of physical activity
and inactivity, extending previous work cross-nation-
ally by focusing on Icelandic school age children, and
analyz ing the prevalence of physical activity/inactivity
patter ns by age, gender, parental social class, and
re sidence, both separa tely and jointly.
S ubjects and methods
Subje cts
The study is based on a nationwide Icelandic survey
which is part of a WHO-Euro cross-national study of
health related behaviors in schoolchildren (22). The
survey com plied with regulations and r ules concerning
hum an subjects research, and was approved by the
re levant human subjects research authorities. A random
sam ple of 3600 students was drawn from a complete list
of schoolchildren in 6th, 8th and 10th grade (schooling
is obligatory for all children in Iceland through the 10th
grade ). Anonymous questionnaires were administered
to respondents in the classroom. Subjects returned 3270
valid questionnaires, resulting in a response rate of
90.8% (23, 24). For ty-nine percent of the respondents
ar e female; 38.1% are from working-class families and
61.9 from middle-class or upper-class families; 49.4%
ar e from the Reykjavõ´k metropolitan area (which
includes the capital city of Reykjavõ´k and the surround-
ing towns of Hafnarfjo
¨
r dur, Ko´pavogur, Gardabær,
Selt jarna rnes, and Mosfellsbær), 44.7% are from other
towns around the country, and 5.9% fr om rura l areas.
I celandic primary schools are required by law to
provide students com pulsory gym and swimming
cla sses that vary in content and degree of individual
choice . In the lower grades, the classes are either single
gende r or co-educational, but the former arrangement is
the rule in the upper grades. Normally, Icelandic
school s do not organize sporting activities beyond
m andatory physical education classes. The formal
organiza tion of leisure time youth sport centers on
private sports clubs that are found in every community.
The y are nancially supported by local government
contributions, a national lottery, enrollment fees, and
adver tising. Soccer and tea m handball are the most
popula r club sports, but swimming a nd skiing are
popula r activities performed mostly outside the club
system (25). In this national sample, 13.1% of the
re spondents never participated in sports or other
physic al activities outside school, whereas 68.7%
par ticipated once a week or more, and 39.4% three
tim es a week or more. Of those who participated at all,
56.9% were involved in club sports and 81.4% in non-
club team or individual sports and physical activities.
Me asures
T he analysis broke down the prevalence of sedentary
and physically active behavior into four sociodemo-
gra phic variables—age, gender, parental socia l class,
and residence. Age was a trichotomous variable
re presenting 11–12, 13–14, and 15–16-y-olds. Social
cla ss, determined by the parent who had the higher class
status, was a tr ichotomous measure based on occupa-
tional titles (or brie f description of parent’s job in the
absenc e of a title). The working class included skilled
and unskilled manual workers, shermen, and farmers;
the middle, service occupations, such as skilled health
ser vice workers, elementary school teachers, of ce
cle rks and salespeople; the upper, business-owners,
exec utives, and university-educated specialists and
prof essionals. Residence was a trichotomous variable
indicat ing whether respondents lived in the Reykjavõ´k
m etropolit an area, in other small- or medium-sized
towns around the country, or in rural areas (village or
fa rm) .
Five separate measures were used to assess sedentary
and physically active behavior. All-day sedentary
behavior was based on six questions about participation
in gym a nd swimming classes during school hours,
lei sure time involvement in physical activities, a nd
m ode of transportation to school and transportation
tim e. The students were de ned as all-day sedentary if
they did not participate in gym or swimming classes
during school hours, participated less than once a week
in le isure time physical acti vities (sports, swimming,
gymna stics, or other physical activitie s), and were
drive n to school or biked/walked for less than 15 min
(one way). (All indicators of sedentary behavior used
we re substantia lly a nd signi cantly associated
[p < 0.001] with the students’ self-assessment of their
heal th, and t heir perceived level of tness, both
m easur ed on a 4-point single-item scale). Leisure time
sedentary behavior was de ned as participating less
than once a week in leisure time physical activities
(spor ts, swimming, gymnastics, or other physical
ac tivities). To assess regular leisure time stre nuous
ex ercise the respondents were asked how often and for
how long they participated in “sport or physical exercise
so that they sweate d or got out of breath” (5). In line
wi th previous research and recom mendations (9, 26),
we de ned the students as following a regular strenuous
exer cise schedule if they reported engaging in sport or
430 G Kristjansdottir and R Vilhjalmsson
ACTA PÆDIATR 90 (2001)
exer cise with exertion (by sweating or getting out of
bre ath”) at lea st three times a week, for an average of at
lea st 20 min per session. Recent studies indicate that the
ac cumul ation of moderate-intensity physical activity
bene t s health in addition to strenuous, continuous
exer cise (7). Therefore, we also assessed whether the
students were school or leisure time physically active by
asking them whether they participated at least three
tim es a week in any combination of physical activity,
including gym and swimming classes during school
hour s, and leisure time sports, gymnastics, swimming,
or other leisure time physical activities. (All indicator s
of being school or leisure time physically active were
subst antially and signi cantly associated [p < 0.001]
wit h the students’ self-assessment of their health, and
their perceived level of tness). Finally, we considered
whe ther the students were leisure time physically active
by participating at least three times a week in leisure
tim e sports, gymnastics, swimming or other leisure time
physic al activities.
Statistical analysis
T he analysis compared prevalence in term s of percen-
tage s and odds ratios of sedentary and physically active
behavior by sociodemographic background (age, gen-
der , parental social class, and residence). Relationships
wit h background variables were considered individually
(bivar iate analysis), and jointly using multivariate logit
anal ysis. All signi cance levels (p) were based on the
likeli hood-ratio chi- square statistic.
R esults
T he data showed that 78.2% of the students participated
in physic al education classes in school (gym and
swim ming classes) at least three times a week, and
98.9% at least once a week. Leisure time physical
ac tivity averaged 2.3 times and 3.3 h a week, and
stre nuous leisure time physical exercise (resulting in
per spiration and shortness of bre ath) averaged 2.1 times
and 2.4 h a week.
T able 1 displays frequency distributions for all study
var iables. It shows that only 0.7% of the respondents
we re all-day sedentary, 31.3% were sedentary during
leisur e time, 90.8% were physically active during
school or leisure time, 39.4% were leisure time active,
and 28.8% followed a regular strenuous exercise
schedule during their leisure time.
T able 2 presents results from bivariate cross-classi-
cations of sedentary and physically active behavior by
sociodem ographic background. Although rare, all-day
sedenta ry behavior was more prevalent among 15–16-y-
olds (1.3%) than younger age groups. (No other group
var iations in all-day sedentary behavior were found.)
L eisure time sedentary behavior was most prevalent
am ong 15–16-y-olds, girls, residents of rural areas, and
wor king-class students. Being physic ally active during
school or leisure time was most prevalent among
younger students, and students in towns. Furthermore,
the youngest students, boys, town residents, and m iddle-
or upper-class students had the highest prevalence of
being physically active in their leisure time. Finally,
r egular leisure time strenuous exerci se was most
pre valent among boys, town residents, and students of
m iddle- or upper-class backgrounds.
Ta ble 3 reports adjusted odds ratios of sedentary and
physi cally active behavior by sociodemographic back-
ground based on multivariate logit analysis. Previously
observe d group differences at the bivariate level
gener ally remained signi cant in the multivariate
ana lysis. However, in the case of being physically
ac tive during leisure time , an interaction was found
betw een residence and age, due to the fact that being
ac tive was related to younger age in the Reykjavõ´k area
and towns, whereas the oldest age group was the most
ac tive in rural areas. (No other interactions were
sta tistically signi cant.)
Gene rally, Tables 2 and 3 show that group differ-
enc es were more often signi cant when considering
le isure time than school and leisure time combined. In
f act, although boys wer e more active than girls during
le isure hours, the re were no gender differences when
school and leisure hours were combined. Likewise, the
Table 1. Descriptive statistics for study variables (n = 3270).
% n
Age
1516 y olds 31.9 1042
1314 y olds 33.5 1097
1112 y olds 34.6 1131
Gender
Girls 49.5 1608
Boys 50.5 1642
Residence
Reykjavõ´k area 49.4 1603
Town 44.7 1449
Rural area 5.9 192
Social class
Upper class 32.3 974
Middle class 29.7 896
Working class 38.1 1150
All-day sedentary
Yes 0.7 23
No 99.3 3239
Leisure time sedentary
Yes 31.3 1010
No 68.7 2216
School or leisure time physically
active
Yes 90.8 2789
No 9.2 281
Leisure time physically active
Yes 39.4 1272
No 60.6 1954
Regular leisure time strenuous
exercise
Yes 28.8 933
No 71.2 2305
ACTA PÆ DIATR 90 (2001)
Prevalence of physical activity and sedentary behavior 431
disadvantage s of working-class students were restricted
to leisure a ctivities, and rural area disadvantages were
not observed in the case of all-day se dentary behavior.
Di scussion
As expected, this national study of older children and
adolesc ents found that girls were more sedentary than
boys, and less involved in physical activities and
str enuous exercise during leisure time. However, there
we re no gender differences in overall (school or leisur e
tim e) physical activity or inactivity. Furthermore, the
study found that physical activity decreases, and
sedenta ry behavior increases with age, especially after
ea rly adolescence, which comports wit h other research
(16) . However, there was no age diff erence in leisure
tim e str enuous activity. This can be explained by the
fa ct that although older students were less frequently
ac tive, their bouts of activity lasted longer and were
m ore vigorous. Consistent with several studies (18, 19),
uppe r-cla ss students were le ss leisure time sedentary
and more leisure time physically active that working-
cla ss students, with middle-class students in between.
Al so consistent with some previous studies (20, 21), we
found that rural students were more sedentary and less
invol ved in strenuous exercise during their leisure time
than students in other areas, and rur al and Reykjavõ´k
ar ea students were less active than students in towns
whe n school and leisure act ivities were combined.
Rela tively high activity levels among town students
m ay perhaps be explained by good sports facilities and a
str ong emphasis on youth sport in many municipalities,
as well as the absence of many leisure time attractions
found in the Reykjavõ´k metropolitan area. The interac-
tion of age and residence predicting leisure time
physic al activity (indicating less activity in older age
groups in urban areas, but more activity in the oldest age
group in rural areas) can perhaps be explained by more
re stricted resources and facilities of the rural commu-
nity sport programs in Iceland, which cater primarily to
the older age groups (from adolescence and up) through
com petitive track and eld and team sports. Urban
com muni ty sport programs on the other hand have
enr olled individuals at an earlier age, but have often
been unsuccessful in retaining them.
In line with Zakarian et al. (27), our results indicate
the equalizing effects of school physical education
progra ms, which seem almost to eliminate all-day
sedenta ry behavior during the school ye ar in this
popula tion, and keep the vast ma jority of students in
the various sociodemographic groups actively involved
in physical activities at least three times a week.
Howe ver, it should be noted that although most
students are physically active in school, their compul-
sory school involvement often fails to translate into
lei sure time physical activity, especially in the f orm of
re gular strenuous exercise (27). Only 39% of students in
Table 2. Bivariate analysis of sedentary and physically active behavior by sociodemographic background (n = 3270).
All-day sedentary Leisure time sedentary
School or leisure time physically
active Leisure time physically activ e
Regular leisure time strenuous
exercise
OR (95% CI) % p OR (95% CI) % p OR (95% CI) % p OR (95% CI) % p OR (95% CI) % p
Age
15–16 y olds 5.1 (1.6, 30.7) 1.3 2.1 (1.8, 2.5) 40.2 0.3 (0.3, 0.5) 85.2 0.7 (0.6, 0.9) 35.7 1.0 (0.9, 1.3) 29.7
13–14 y olds 2.4 (0.6, 14.2) 0.5 1.3 (1.1, 1.6) 29.0 0.9 (0.6, 1.2) 93.4 0.9 (0.7, 1.0) 39.8 1.0 (0.8, 1.2) 27.9
11–12 y olds 1.0 0.2 < 0.01 1.0 24.1 < 0.001 1.0 94.4 < 0.001 1.0 43.2 < 0.01 1.0 28.8 NS
Gender
Girls 1.9 (0.8, 4.5) 0.9 1.2 (1.1, 1.4) 33.7 1.3 (1.0, 1.6) 91.9 0.7 (0.6, 0.8) 35.6 0.7 (0.6, 0.8) 25.1
Boys 1.0 0.5 NS 1.0 29.0 < 0. 01 1.0 89.9 NS 1.0 43.0 < 0.001 1.0 32.5 < 0.001
Residence
Reykjavõ´k area 1.6 (0.2, 12.0) 0. 8 0.8 (0.6, 1.2) 33.3 0.9 (.6, 1.5) 88.5 1.2 (0.9, 1.7) 37.7 1.3 (0.9, 1.8) 27.2
Town 1.1 (0.1, 8 .5) 0.6 0.7 (0.5, 0.9) 28.4 1.7 (1.0, 2.9) 93.5 1.4 (1.0, 2.0) 42.1 1.6 (1.1, 2.3) 31.6
Rural area 1.0 0.5 NS 1.0 37.2 < 0. 01 1.0 89.3 < 0.001 1.0 33.5 < 0.05 1.0 22.4 < 0.01
Social c lass
Upper class 0.4 (0.1, 1.4) 0.3 0.7 (0.6, 0.9) 27.1 1 .0 (0.8, 1.4) 91.2 1.3 (1.1, 1.5) 42.7 1.4 (1.1, 1,7) 32.5
Middle class 0.7 (0.2, 2.1) 0.6 0.8 (0.7, 1.0) 30.1 1.1 (0.8, 1.5) 91.6 1.2 (1.0, 1.4) 41.4 1.3 (1.0, 1.5) 30.9
Working class 1.0 0.8 NS 1.0 34.4 < 0. 01 1.0 90.8 NS 1.0 36.9 < 0.05 1.0 26.0 < 0.01
Reported p-levels are based on likeli hood- ratio c hi-square tests.
432 G Kristjansdottir and R Vilhjalmsson
ACTA PÆDIATR 90 (2001)
Table 3. Multivariate logit analysis of sedentary and physically active behavior by sociodemographic background (n = 3270).
All-day sedentary Leisure time sedentary
School o r leisure time
physically active Leisure time physically active
Regular leisure time strenuous
exercise
OR (95% CI) p OR (95% CI) p OR (95% CI) p OR (95% CI) p OR (95% CI) p
Age
15–16 y olds 5.1 (1.1, 23.6) 2.1 (1.7, 2.6) 0.3 (0.2, 0.5) 1.0 (0.9, 1.3)
13–14 y olds 2.4 (0.5, 12.4) 1.2 (1.0, 1.5) 1.0 (0.6, 1.4) 1.0 (0.8, 1.2)
11–12 y olds 1.0 < 0.05 1.0 < 0.001 1.0 < 0.001 1.0 NS
Gender
Girls 1.9 (0.7, 5.1) 1.3 (1.1, 1.5) 1.2 (0.9, 1.5) 0.7 (0 .6, 0.9) 0.7 (0.6, 0.8)
Boys 1.0 NS 1.0 < 0.05 1.0 NS 1.0 < 0.001 1.0 < 0.001
Residence
Reykjavõ´k area 2.1 (0.3, 16.8) 1.0 (0.7, 1.4) 0.8 (0.4, 1.4) 1.3 (0.9, 1.9)
Town 0.8 (0.1, 7.0) 0.7 (0.5, 0.9) 1.8 (1.0, 3.2) 1.6 (1.1, 2.4)
Rural area 1.0 NS 1.0 < 0.001 1.0 < 0.001 1.0 < 0. 01
Social c lass
Upper class 0.3 (0.1, 1.1) 0.6 (0.5, 0.8) 1.3 (0.9, 1.7) 1.4 (1 .1, 1.6) 1.4 (1.2, 1.8)
Middle class 0.6 (0.2, 1.8) 0.8 (0.6, 0.9) 1.2 (0.9, 1.7) 1.2 (1 .0, 1.5) 1.3 (1.1, 1.6)
Working class 1.0 NS 1.0 < 0.001 1.0 NS 1.0 < 0.01 1.0 < 0.001
Residence by Age
Reykjavõ´k area
15–16 y olds 0.9 (0.4, 1.9)
13–14 y olds 1.1 (0.5, 2.3)
11–12 y olds 1.4 (0.7, 2.9)
Town
15–16 y olds 1.2 (0.5, 2.4)
13–14 y olds 1.5 (0.7, 3.2)
11–12 y olds 1.6 (0.7, 3.3)
Countryside
15–16 y olds 1.5 (0.6, 3.6)
13–14 y olds 0.6 (0.2, 1.5)
11–12 y olds 1.0 < 0.05
Reported p-levels are based on likeliho od ratio chi-s quare differential tests comparing inclusion versus exclusion of a variable, controlling for main effects of all other variables.
ACTA PÆ DIATR 90 (2001)
Prevalence of physical activity and sedentary behavior 433
the total sample were actively involved (3 times per
we ek) in leisure time physical activity, and 29% in
re gular strenuous exercise (3 times per week). Since
curr ent leisure time involvement in physical activity,
espec ially competitive and strenuous involvement, is
im portant for later physical involvement (2), and f or
m ental and physical health (6), the observed lack of
continuation in physical activity presents a c onsiderable
public health challenge. Schools appear to aff ect leisure
tim e physical activity primarily through positive phy-
sica l education experiences, and sport and exercise
re lated instruction (25). The observed physical activity
disadvantages of students in the oldest age group in this
study may perhaps be partly explained by the fact that
they had lower average involvement in physical
educat ion classes in school than the younger students
(p < 0.001). But parents and friends appear t o be the
m ost important agents of socializ ation into physical
act ivity, both as role models and agents of encourage-
m ent and support (25, 28). Physical activity difference s
betwe en girls and boys, adolescents and younger
childre n, and working-class versus middle- and upper-
cla ss students, appear to result partly from variations in
physic al activity involvement and encouragement
am ong these socialization agents. Also, the leisure time
opport unities of children and youth are of critical
im portance, particularly access to community sports
fa cilities and programs (6, 29). Such access is more
re stricted in rural areas, and there are indications that
gende r differences in leisure time physical activity in
Ic eland are largely explained by the different access of
boys and girls to organized sports clubs, presumably
beca use program content (emphasizing competitive
tea m sports) re ects boys’ interests more than girls’
(29). Finally, TV viewing and involvement in paid work
dur ing the school year are associated with lower levels
of leisure time physical activity in youth (25), and these
vari ables may help explain observed sociodemographic
differences.
T he ndings indicate the importance of school
physic al education classes in raising physica l act ivity
levels in children a nd adolescents and reducing socio-
dem ographic differ ences. However, activating children
and adolescents in their leisure time involves different
sociali zation agents and domains of life, and coherent
and comprehensive efforts are needed to obtain further
im provements in physical activity in this population,
contribute to sustained physical activity into adulthood,
and ultimately enhance public health and well- being
(30). Our results, as well as those of other authors,
suggest that individuals in mid-adolesce nce, girls,
re sidents of rural areas (perhaps especially children
and young adolescents), and working-class students,
should be the primary target groups of such intervention
ef forts. Further longitudinal research is needed to better
under stand wha t risk f actors of sedentary behavior (low
act ivity) are most important within each of these target
groups. Such studies provide important information f or
inter vention efforts, because their success depends on
tai loring program content to the different needs of the
var ious youth subgroups (15).
Acknowledgements.—The Icelandic part of the WHO-Euro collaborative
study was sponsored by the Ministry of Health in Iceland and directed by
Hrafn V. Fridriksson, in cooperation with Hrolfur Kjartansson and
Thorolfur Thorlindsson.
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ACTA PÆ DIATR 90 (2001)
Prevalence of physical activity and sedentary behavior 435
    • "Boys tended to have an even lower risk of over-nutrition than girls and the gender difference became widened with age until adolescence. One possible explanation might be due to sex difference in behavioural factors since boys are generally more physically active than girls especially during adolescence [76,77]. Another possible explanation may be that girls move into pubertal transition earlier than boys [78]and puberty is associated with weight gain [79]. "
    [Show abstract] [Hide abstract] ABSTRACT: Chinese children are facing dual burden of malnutrition-coexistence of under-and over-nutrition. Little systematic evidence exists for explaining the simultaneous presence of under-and over-nutrition. This study aims to explore underlying mechanisms of under-and over-nutrition among children in rural China. This study used a nationwide longitudinal dataset of children (N = 5,017) from 9 provinces across China, with four exclusively categories of nutritional outcomes including under-nutrition (stunting and underweight), over-nutrition (overweight only including obesity), paradox (stunted overweight), with normal nutrition as reference. Multinomial logit models (Level-1: occasions; Level-2: children; Level-3: villages) were fitted which corrected for non-independence of observations due to geographic clustering and repeated observations of individuals. A mixture of risk factors at the individual, household and neighbourhood levels predicted under-and over-nutrition among children in rural China. Improved socioeconomic status and living in more urbanised villages reduced the risk of stunted overweight among rural children in China. Young girls appeared to have higher risk of under-nutrition, and the risk decreased with age more markedly than for boys up to age 5. From age 5 onwards, boys tended to have higher risk of under-nutrition than girls. Girls aged around 12 and older were less likely to suffer from under-nutrition, while boys' higher risk of under-nutrition persisted throughout adolescence. Children were less likely to suffer from over-nutrition compared to normal nutrition. Boys tended to have an even lower risk of over-nutrition than girls and the gender difference widened with age until adolescence. Our results have important policy implications that improving household economic status, in particular, maternal education and health insurance for children, and living environment are important to enhance rural children's nutritional status in China. Investments in early years of childhood can be effective to reduce gender inequality in nutritional health in rural China.
    Full-text · Article · Jul 2016
    • "In the present analysis most of the studied adolescents were physically active, which is similar to previous results reported in developed countries [43][44][45][46][47], and higher than in developing countries [48,49], measured by means of self-reported instruments of PA assessment similar to the method used in this study. In agreement with previous findings [1,[41][42][43][44][45][46][47][48][49][50][51], boys were more active than girls, younger adolescents were physically more active than their older counterparts, low parental income was associated with increased likelihood of being physically inactive, and time spent watching TV was inversely associated with PA. Displacement of PA by TV viewing decreases energy expenditure [41]. "
    [Show abstract] [Hide abstract] ABSTRACT: This study assessed the relationship between physical activity and beverage consumption among adolescents with a population based cross-sectional survey was carried out in the Balearic Islands, Spain (n = 1988; 12-17 years old). Body composition, educational and income level, physical activity (PA), and beverage consumption and energy intake were assessed. Sixty-two percent of adolescents engaged in >300 min/week of PA. Boys were more active than girls, younger adolescents were more active than older counterparts, low parental income was associated with physical inactivity, and time spent watching TV (including, TV, Internet or handheld cellular devices) was inversely associated with PA practice. The average beverage intake of the studied adolescents was 0.9 L/day, higher in boys than in girls. Beverage intake was positively associated with PA practice, and the highest amount of energy intake from beverages was observed in active boys and girls. Most of the studied adolescent population met the PA recommendations. Gender, age, parental income, and time spent watching TV were significant determinants of PA. Type and amount of beverages drunk varied according to gender and PA, and general daily total beverage intake was lower than recommended adequate fluid intake. PA behavior should be considered when analyzing beverage consumption in adolescents.
    Full-text · Article · Jun 2016
    • "Youth may also stop regular physical activity during their adolescence, which may lead to weight gain (Slater & Tiggemann, 2010 ). Moreover, there are some other wellidentified contributors to physical inactivity, namely the lack of access to physical education at school (Brownson et al., 2000), being a racial/ethnic minority group (Brodersen, Steptoe, Boniface, & Wardle, 2007), having low socioeconomic status (Kristjansdottir & Vilhj almsson, 2001), and engaging in prolonged television watching (Hu, Li, Colditz, Willett, & Manson, 2003). As part of screen-based activities, video game playing is increasing among youth, and has changed significantly from arcade games to accessible video games (Lenhart et al., 2008). "
    [Show abstract] [Hide abstract] ABSTRACT: This study compared the movement patterns of forty-six college students, playing bouts of swimming exergame, while categorized based on their playing performance, gender, and prior experience of real swimming and exergames. Swimming events were divided into normal (controlled by visual feedback) and fast (no feedback) phases and upper limb kinematics were monitored during front crawl event. Those who performed better, completed the game with fewer upper limb cycles and in a shorter time (p < 0.003). Prior exergame experience resulted in higher start velocity (p = 0.019) and those who were familiarized with this swimming exergame, completed the front crawl event with fewer cycles (p = 0.022). Gender and real swimming experience did not affect biomechanical variables. With various playing styles and differences to real swimming movements, the data suggest that the motion capture device is not able to detect complex movements of swimming and previous knowledge of real swimming do not necessarily transfer into better exergame performance. These changes might have happened due to higher adaptation to the exergame. Understanding these patterns may help in the development of more realistic sport exergames and meaningful gameplay.
    Full-text · Article · May 2016
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