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Sedentary Behavior in Preschoolers: How Many Days of Accelerometer Monitoring Is Needed?

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      Abstract

      The reliability of accelerometry for measuring sedentary behavior in preschoolers has not been determined, thus we determined how many days of accelerometry monitoring are necessary to reliably estimate daily time spent in sedentary behavior in preschoolers. In total, 191 and 150 preschoolers (three to five years) wore ActiGraph accelerometers (15-s epoch) during the in-school (≥4 days) and the total-day (≥6 days) period respectively. Accelerometry data were summarized as time spent in sedentary behavior (min/h) using three different cutpoints developed for preschool-age children (<37.5, <200, and <373 counts/15 s). The intraclass correlations (ICCs) and Spearman-Brown prophecy formula were used to estimate the reliability of accelerometer for measuring sedentary behavior. Across different cutpoints, the ICCs ranged from 0.81 to 0.92 for in-school sedentary behavior, and from 0.75 to 0.81 for total-day sedentary behavior, respectively. To achieve an ICC of ≥0.8, two to four days or six to nine days of monitoring were needed for in-school sedentary behavior and total-day sedentary behavior, respectively. These findings provide important guidance for future research on sedentary behavior in preschool children using accelerometry. Understanding the reliability of accelerometry will facilitate the conduct of research designed to inform policies and practices aimed at reducing sedentary behavior in preschool children.

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      Prevalence of childhood and adult obesity in the United States, 2011-2012.

      More than one-third of adults and 17% of youth in the United States are obese, although the prevalence remained stable between 2003-2004 and 2009-2010. To provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults. Weight and height or recumbent length were measured in 9120 participants in the 2011-2012 nationally representative National Health and Nutrition Examination Survey. In infants and toddlers from birth to 2 years, high weight for recumbent length was defined as weight for length at or above the 95th percentile of the sex-specific Centers for Disease Control and Prevention (CDC) growth charts. In children and adolescents aged 2 to 19 years, obesity was defined as a body mass index (BMI) at or above the 95th percentile of the sex-specific CDC BMI-for-age growth charts. In adults, obesity was defined as a BMI greater than or equal to 30. Analyses of trends in high weight for recumbent length or obesity prevalence were conducted overall and separately by age across 5 periods (2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012). In 2011-2012, 8.1% (95% CI, 5.8%-11.1%) of infants and toddlers had high weight for recumbent length, and 16.9% (95% CI, 14.9%-19.2%) of 2- to 19-year-olds and 34.9% (95% CI, 32.0%-37.9%) of adults (age-adjusted) aged 20 years or older were obese. Overall, there was no significant change from 2003-2004 through 2011-2012 in high weight for recumbent length among infants and toddlers, obesity in 2- to 19-year-olds, or obesity in adults. Tests for an interaction between survey period and age found an interaction in children (P = .03) and women (P = .02). There was a significant decrease in obesity among 2- to 5-year-old children (from 13.9% to 8.4%; P = .03) and a significant increase in obesity among women aged 60 years and older (from 31.5% to 38.1%; P = .006). Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012. Obesity prevalence remains high and thus it is important to continue surveillance.
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        Calibration of two objective measures of physical activity for children.

        A calibration study was conducted to determine the threshold counts for two commonly used accelerometers, the ActiGraph and the Actical, to classify activities by intensity in children 5 to 8 years of age. Thirty-three children wore both accelerometers and a COSMED portable metabolic system during 15 min of rest and then performed up to nine different activities for 7 min each, on two separate days in the laboratory. Oxygen consumption was measured on a breath-by-breath basis, and accelerometer data were collected in 15-s epochs. Using receiver operating characteristic curve (ROC) analysis, cutpoints that maximised both sensitivity and specificity were determined for sedentary, moderate and vigorous activities. For both accelerometers, discrimination of sedentary behaviour was almost perfect, with the area under the ROC curve at or exceeding 0.98. For both the ActiGraph and Actical, the discrimination of moderate (0.85 and 0.86, respectively) and vigorous activity (0.83 and 0.86, respectively) was acceptable, but not as precise as for sedentary behaviour. This calibration study, using indirect calorimetry, suggests that the two accelerometers can be used to distinguish differing levels of physical activity intensity as well as inactivity among children 5 to 8 years of age.
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          Tracking of childhood overweight into adulthood: a systematic review of the literature.

          Overweight and obesity in youth are important public health concerns and are of particular interest because of possible long-term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search--restricted to studies with a prospective or retrospective longitudinal design--was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high-quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.
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            Author and article information

            Affiliations
            [1 ]Department of Health, Nutrition, and Exercise Sciences, Department of Public Health, North Dakota State University, Fargo, ND 58108, USA
            [2 ]Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; E-Mails: beets@ 123456mailbox.sc.edu (M.W.B.); rpate@ 123456mailbox.sc.edu (R.R.P.)
            Author notes
            [* ]Author to whom correspondence should be addressed; E-Mail: w.byun@ 123456ndsu.edu ; Tel.: +1-701-231-6738; Fax: +1-701-231-8872.
            Contributors
            Role: Academic Editor
            Journal
            Int J Environ Res Public Health
            Int J Environ Res Public Health
            ijerph
            International Journal of Environmental Research and Public Health
            MDPI
            1661-7827
            1660-4601
            20 October 2015
            October 2015
            : 12
            : 10
            : 13148-13161
            26492261 4627022 10.3390/ijerph121013148 ijerph-12-13148
            © 2015 by the authors; licensee MDPI, Basel, Switzerland.

            This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

            Categories
            Article

            Public health

            sedentary, reliability, activity monitor, children, preschool

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