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Relationship between physical activity levels and body fat of children aged 8–9, from UK schools in low socioeconomic areas

Authors:

Abstract

Relationship between physical activity levels and body fat of children aged 8–9, from UK schools in low socioeconomic areas S. Lowton-Smith, A. King, M. Duncan, E. Eyre, S. Oxford Relevance: Increasing levels of obesity, sedentary lifestyles and lower levels of physical activity (PA) in children is concerning both in the UK and globally. This is particularly important in low socioeconomic status (SES) areas, where lower levels of engagement with public health initiatives have been identified. Health behaviour patterns in childhood are important for long-term health and well-being. It is therefore important to understand PA behaviours in children from low SES areas and to explore possible relationships with obesity. Purpose: This study aimed to measure current levels of PA and their relationship with obesity in primary school children in low SES of a West Midlands, UK city. The secondary aim was to identify any differences between PA levels on school days compared to the weekend. Methods/analysis: This cross-sectional observation study was employed, following ethical approval, from a Coventry University, Ethics Committee. A purposive sample of 128 children (8–9 years) were recruited from 4 schools in low SES areas from one West Midlands city. Height and mass of each child were measured, from which BMI was calculated (kg/m2). Body fat (%) was estimated using foot–foot bioelectrical impedance. Each child was fitted with a non-dominant, wrist-worn GENEActive Accelerometer for 4 days (2 weekdays and 2 weekend days). Data which met inclusion criteria (>10 hours wear time, per day) was included in the analysis, leaving a final sample of 71 children (37 male, 34 female, 47 of Caucasian origin). Minutes spent in sedentary, light, moderate and vigorous PA were calculated according to Phillips et al. (2013). Comparisons were made between days for mean % time spent in each level of PA across using repeated measures ANOVA. Pearson's correlations were calculated for body composition variables (BMI, % body fat) and sedentary, light, moderate and vigorous PA. Results: 71.8% of children met the WHO global guideline of 60 minutes of moderate-vigorous PA (MVPA) per day. Children spent significantly more time in sedentary behaviour on Sundays (57.3% vs. (49.7–51.9%), p < .01) and significantly less time in vigorous activity on Sundays compared to each of the other 3 days (p < .05). Increasing % time in MVPA was negatively correlated with both BMI (−.42, p < .001) and body fat % (−.58, p < .001). Discussion and conclusions: Nearly a third of recorded 8–9 year-old UK school children in low SES areas were not meeting global PA guidelines. Increasing MVPA in children may reduce body fatness, considering the moderate negative correlation reported between the two. Further interventional studies would be required to confirm this. Furthermore, the findings suggest that interventions may need to focus on increasing levels of MVPA and reducing sedentary behaviours on Sundays in children from low SES areas. The mechanisms for successful implementation require further exploration in this population. Multi-factorial causation also requires consideration. Impact and implications: The potential for Physiotherapists to engage in public health practice has long been recognised. This collaborative study by Physiotherapists and Exercise Scientists provides baseline data for PA levels in UK school children in low SES areas, essential to test subsequent interventions, and to inform local policy formation and funding bids. Funding acknowledgement: No external funding was received for this study.
Relationship between physical activity levels
and body fat of children aged 8-9, from UK
schools in low socioeconomic areas
Sean Lowton-S m i th, Dr Andrew King, Profe s s or Mic h a e l Duncan, Dr Emma
Eyre a n d Dr Sam Oxford
Faculty O f Health And Life Sciences, Cove n try University
Prevalence of childhood obesity + impact on health
Increasing levels of obesity, sedentary lifestyles and lower levels of
physical activity (PA) in children is concerning both in the UK and globally
(Public Health England, 2016), (World Health Organisation, 2016).
UK children's obesity/overweight currently 30% PHE (2016).̴
Sahoo, et al., (2015) suggest that obesity is associated with multiple
conditions and can negatively effect children:
Physical activity reduces risk
of adverse health
Cardiovascular: Hypertension, (50%), Ischemic Heart
Disease, (40%), Cerebrovascular Disease (27%) (Jones, et
al., 2012).
Cancer: Colon, (30-40%) Breast, (20-80%), Lung, (20%),
Endometrial, (20-40%), (National Cancer Institute, 2009).
Musculoskeletal: Hip #, (36-68%), Falls, (30%) (Davies, et
al., 2011).
Metabolic: Type II Diabetes Mellitus, (30%) Jones, et al.,
(2012).
Mental: Depression (20-30%) (Davies, et al., 2011).
The combined direct and indirect UK costs of physical
inactivity are an estimated £8.2 billion per year (Jones, et
al., 2012).
Health behaviour and obesity in
childhood predictive in adulthood
Health behaviour patterns in childhood are important for long-
term health and well-being. For example:
1. 21 year study reports high level of PA in childhood age 9-18
significantly predicts high level of PA in adults (Telama, et
al., 2005).
2. 14.6% normal weight children obese in adulthood whereas
overweight (64.6%) and obese (82.3%) children are obese in
later life (Juonala, et al., 2011).
•. It is therefore important to understand PA behaviours in
children and to explore possible relationships with obesity.
•. Especially required in low socioeconomic (SES) areas, where
lower levels of engagement with public health initiatives have
been identified (Michie, et al., 2008).
Aims
Primary aim = to measure current levels of PA and explore their
relationship with obesity in primary school children in low SES of
a West Midlands, UK city.
Secondary aim = to identify any differences between PA levels on
school days compared to the weekend.
Methodology – study design, sample and
body composition
This cross-sectional observation study was
employed, following ethical approval, from
Coventry University, Ethics committee.
A purposive sample of 128 children (8-9 years)
were recruited from 4 schools in low SES areas
from one West Midlands city.
Low SES determined via lowest quartile
deprivation on electoral ward.
Height and mass of each child were measured,
from which BMI was calculated (kg/m2).
Body fat (%) was estimated using foot-foot
bioelectrical impedance analysis (BIA). Tanita
SC-330.
Methodology - accelerometry
Accelerometry objective and reliable method
to measure children's activity levels (Hussey,
Bell and Gormley, 2007).
Each child was fitted with a non-dominant,
wrist-worn GENEActive Accelerometer for 4
days (2 weekdays and 2 weekend days).
Data which met inclusion criteria (>10hours
wear time, per day) was included in the
analysis, leaving a final sample of 71 children.
Minutes spent in sedentary, light, moderate
and vigorous PA were calculated according to
Phillips, et al cut points (2013).
Resultsdescriptive
* WHO global guideline of 60
minutes of moderate-vigorous PA
(MVPA) per day.
No significant differences between
gender for BMI, Fat% and MVPA
were found in this study.
Variable Mean
MVPA (Mins) 78.49 ± 33.07
BMI (kg/m2) 17.43 ± 3.24
Fat % 21.14 ± 8.59
Variable Frequency
Met
Guideline*
51 (72%)
Did not meet 20 (28%)
Under fat 10 (14%)
Normal fat 42 (59%)
Over
fat/Obese
19 (27%)
Variable Frequency
Sample Size N = 71
Gender Male 37(52%)
Female 34 (48%)
Ethnicity 47 (66%) Caucasian
20 (28%) South Asian
3 (4%) Black/African
Caribbean
1 (1%) Chinese
Results –relationship between MVPA with BMI and body fat %
Key Messages:
Increased % time in MVPA had a negative moderate Pearson correlation with both BMI
(-.42, p<.001) and body fat % (-.58, p<.001).
More direct measures of fatness such as BIA should be used for classification (Sahoo, et al., 2015).
ResultsBIA + physical activity
guideline
Normal Fat (87.19 mins ± 20.87) and Under fat
children (97.65 mins ± 22.97) spent
significantly more time in MVPA compared to
Over fat/Obese children (49.16 mins ± 23.00)
(p<.001).
Effect size Cohen's; d = 2.11 Under vs Over,
d = 1.40 Normal vs Over
The mean estimated body fat percentage
was significantly lower (17.9% ± 6.2%) for
those who met WHO (2010) PA guidelines
compared to those who did not (29.4% ±
8.4%) (p<.001).
Key Message:
Children spent significantly more time in sedentary behaviour on Sundays (57.3% vs.
(49.7-51.9%) (p<.01) and significantly less time in vigorous activity on Sundays
compared to each of the other 3 days (p<.05).
Sunday:
The day of
rest
Key:
% Sed
%Light
% Mod
% Vig
Fig 3.1 PA levels across 4 days
Discussion
Nearly a third of recorded 8-9 year-old UK school children
in low SES areas were not meeting global PA guidelines.
Increasing MVPA in children may reduce body fatness,
considering the moderate negative correlation reported
between the two or vice versa.
Further interventional studies would be required to confirm
this.
Interventions may need to focus on increasing levels of
MVPA and reducing sedentary behaviours on Sundays in
children from low SES areas.
The mechanisms for successful implementation require
further exploration in this population.
Multi-factorial causation also requires consideration.
Limitations Cross sectional observational study – Unable
to establish if low PA is a cause or effect of
Obesity.
High attrition rate (44.53%).
Those who did not meet inclusion criteria had
similar BMI (17.23 ± 2.13) Fat %(19.35 ± 5.70)
to those included (17.43 ± 3.24) (21.14 ± 8.59)
respectively.
Foot-Foot Bioelectrical impedance –
Systematic review suggests BIA practical
method to estimate body fat %, however
validity is unsatisfactory (Talma, et al., 2013).
0.85 correlation between body fat % from foot-
to-foot BIA with DEXA in children, (Goldfield,
et al., 2006).
Conclusion
This collaborative study by
Physiotherapists and Exercise Scientists
provides baseline data for PA levels in UK
school children in low SES areas.
There was a negative moderate
relationship between PA + obesity,
however cause or effect cannot be
established.
Children were more sedentary and spent
less time in vigorous activity on Sundays.
This data can be used to inform
subsequent interventions, local policy
formation and funding bids.
References
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References
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Thank you
Any questions welcome
Please contact myself for correspondence via e-mail on: ab9186@coventry.ac.uk
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