Short Orals: Monitoring physical activity

Background: Women’s physical activity levels vary across their lifespans, and there may be different trajectories at young ages. In this study, we used 18 years of data from women born in 1973–78 to identify: (1) different physical activity trajectories in the transition from youth to midlife and (2) determinants of these physical activity trajectories. Methods: Data were from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (n = 8157). Surveys were mailed at three-year intervals from 2000 (age 22–27) to 2018 (age 40–45) to collect data on physical activity, sociodemographic factors, health indicators and health behaviours. Group-based trajectory modelling was used to identify trajectories of physical activity. Multinomial logistic regression models were used to examine the associations of sociodemographic factors, behavioural and health characteristics at age 22–27, with the different physical activity trajectories. Results: Four trajectories were identified: Low (58.7% of participants), Declining (16.9%), Increasing (18.0%), and High (6.5%). The 18-year cumulative median of physical activity (MET.minutes/week) was 550 in the Low, 1225 in the Declining, 1288 in the Increasing, and 2134 in the High group. The most significant determinants of physical activity trajectories were cohabitation status, physical function and mental health. Conclusions: Although physical activity levels in young women may temporarily decline due to major life events, the cumulative median of physical activity was above the lower levels of the current physical activity guidelines, even in the Low group. The data suggest that women in this group are characterised by living with a partner and/or children, and poor physical function and mental health. Practical implications: Increasing opportunities for activity in low active women may increase population-level physical activity during young to mid-age. Funding: The Australian Longitudinal Study on Women’s Health is funded by the Australian Government Department of Health.

Introduction: Randomised controlled trials are accepted as a ‘gold standard’ approach in physical activity (PA) epidemiology. While they are suited to investigating the efficacy of treatment approaches at specific life stages, cohort studies are crucial for answering questions about the patterns of PA and associated health outcomes across the lifespan, in the ‘real world’. Purpose: To present two examples of how data from a large cohort study of women have challenged conventional thinking about the behavioural epidemiology of physical activity in women. Methods: Narrative review of findings from the Australian Longitudinal Study on Women’s Health (ALSWH), which has included repeated measures of self-reported PA for >25 years. Results: ALSWH researchers have published >100 papers on changes in PA across the lifespan, dose-response relationships between PA and health outcomes, interactions of PA with other health behaviours (including sitting time and weight), and relationships between PA and health service use and costs. In this presentation we highlight two examples which challenge conventional thinking in PA epidemiology: 1) PA does not decline at a fixed rate across the adult lifespan in women, and trajectories of physical activity reflect life stages and key events in women’s lives, possibly more so than socio-economic and physical environment factors. 2) Although habitual physical activity confers a benefit of 14-16 years of additional healthy life for women, the rate of functional decline in older age is remarkably similar in active and inactive women, and vigorous PA does not necessarily mean greater benefits at this later life stage. Conclusions. Cohort studies provide data which are imperative to understanding relationships between PA and health, which cannot always be demonstrated in RCTs. Practical implications: Cohort studies should not be regarded as ‘second class’ contributors to PA epidemiology. Funding: The ALSWH is funded by the Australian Government Department of Health.  

Background. The Global 4.0 matrix emanated from the Active Healthy Kids Global Alliance assessing global levels and trends in child and adolescent physical activity. The South African 2022 Report Card included for the second time, data on nutritional status and body composition. Physical activity and nutrition can have an impact on body composition and overall health hence the inclusion of the latter indicator. More than 50% of South African children lived below poverty line and so the inclusion of nutrition as an indicator is important. Purpose. This study aims to report the physical activity, body composition and nutrition status of South African children and adolescents, based on the findings from the 2022 Healthy Active Kids South Africa Report Card. Methods. A comprehensive literature search of online databases along with hand searching and a grey literature search was conducted based on the indicators of physical activity, body composition and nutrition indicators defined by the Active Healthy Kids Global Alliance. These indicators were compared with results from the 2018 Healthy Active Kids South Africa Report Card. Results. Compared to 2018, there was an improvement in the majority of physical activity indicators. Body composition and most of the nutrition indicators remained unchanged. The indicators that regressed from 2018-2022 included community and environmental influences, as well as organised sports participation. Despite the apparent improvement in overall physical activity levels in children and adolescents, there is a lack of tangible evidence of the actual implementation of new policies and programmes. There was also a lack of nationally representative data for most indicators. Conclusion. Overall, there is a need to identify intersectoral, equitable approaches for promoting physical activity and healthy eating in South African children and adolescents. Practical Implications. There is a need for further research, including surveillance, on all indicators, for future Report Cards.

Background: Persistent gaps between Physical Education (PE) policies and their implementation remain a challenge in many countries. GoPE! is a new surveillance system1 of PE and school-based physical activity (PA) policies, monitoring initiatives, and research. GoPE! is composed of five dimensions: 1) country demographics, 2) PA prevalence in children and adolescents, 3) PE policy, 4) PE monitoring, and 5) research on PE and school-based PA interventions. In this abstract, we aim to present the standardized methodology developed to collect data on PE policy and monitoring systems. Purpose: To describe the standardized data collection protocol for worldwide PE policies and monitoring systems. Methods: The data collection involved the collaboration of the GoPE!’s Country Contacts network (CC) and Research Working Group (RWG). The RWG is researching for 218 countries on the existence of 1) national official PE curriculum, 2) national policies requiring mandatory PE, and 3) national policies requiring minimum PE time, regarding the compulsory school years of primary and secondary education. This methodology consisted of a search 1) on governmental websites, 2) international reports, 3) Google Scholar, and 4) search databases. On the other hand, the CC will provide data on national monitoring systems to evaluate PE policy implementation. Results: GoPE!’s standardized methodology will inform the Country Card on PE policies and monitoring systems for each country. Conclusions and practical implications: The GoPE! will enable policymakers, practitioners, and researchers to assess PE policies and monitoring systems globally, empowering leaders to enact necessary changes to promote physical activity and health in youth. Funding: The authors declare to have received no funding for conducting the study. References: UNESCO. World-wide survey of school physical education final report 2013. 2014. Martins J, Onofre M, Hallal PC. Launch of the Global Observatory for Physical Education (GoPE!). Journal of Physical Activity and Health. 2023 Jul 1;20(7):573–4.

Background: The World Health Organization (WHO) suggests that children under the age of 5 should have minimal daily screen time and sedentary activities while encouraging regular physical activity and sufficient sleep. However, factors like increased technology use and other environmental influences might make it challenging for young children to meet these recommendations. Considering health disparities, it is essential to investigate these behaviors among children from lower socioeconomic backgrounds or ethnic minority groups. Purpose: This study investigates weekday and weekend adherence to the WHO-24-hour movement guidelines in primarily African American children with household incomes at or below the US federal poverty line. Methods: Participants (n=48) were drawn from the baseline assessment of Cohort 1 in the Promoting Activities and Trajectories of Health study. We assessed 24-hour movement behavior using two methods: a) measuring children’s moderate-to-vigorous physical activity (MVPA) using wrist-worn accelerometers on weekdays and weekends and b) gathering sleep duration and screen time usage data from parental questionnaires. Results: Regarding the WHO-24-hour guidelines, children exhibited lower adherence rates to MVPA and sleep guidelines during the weekdays compared to weekends (49%vs71% for MVPA and 58%vs90% for sleep, respectively, p<0.05. Adherence rates to screen time guidelines remained similar during weekdays and weekends (36%vs33%). Adherence to multiple components of the WHO-24-hour movement guidelines was lower during weekdays (ranging from 10%-23%) compared to weekends (ranging from 27%-93%, p<0.05). Only one child (3%) met all three guidelines during weekdays, while seven children (26%) met all three guidelines on weekends. Conclusions: Preliminary US data suggests weekday-to-weekend variability in adherence to the WHO-24-hour movement guidelines among low-income African American children. Specifically, there is a higher adherence rate on weekends versus weekdays. Practical implications: More educational programs are needed to inform parents of the WHO-24-hour movement guidelines and how they shape their child’s health and development. Funding: NIH R01HL132979

Background: Sedentary behavior, including prolonged sitting, is a significant global public health issue. However, comprehensive population-wide trend data on sitting time are scarce, hindering effective monitoring of temporal changes. Purpose: This study aimed to explore the trends of overall and domain-specific sitting time among the German population between 2014 and 2023. Methods: The data were obtained from a series of cross-sectional telephone surveys conducted in Germany among adults aged 18 or above in the years 2014, 2016, 2018, 2021, and 2023. Participants completed the domain-specific Marshall sitting questionnaire, reporting sitting time during travel, work, television viewing, leisure computer use, and other leisure activities. Descriptive analyses were conducted, including 95% confidence intervals. Results: Mean overall sitting time increased from 460.3 min / day [CI: 452.8 – 467.8 min / day] in 2014 to 554.2 min / day [546.3 – 562.1 min / day] in 2023. The most notable increases were observed in sitting time during work from 135.5 min/ day [129.7 – 141.3 min / day] in 2014 to 205.4 min / day [198.4 – 212.3 min / day] in 2023 and in leisure-time computer use rising from 57.0 min / day [54.4 – 59.6 min / day] in 2014 to 83.0 min / day [80.0 – 86.1 min / day] in 2023. Conclusions: Cross-sectional trend data from Germany indicate a substantial increase in overall sitting time from 2014 to 2023, predominantly driven by work-related and leisure computer sitting. These findings underscore the urgent need for interventions and strategies to reduce domain-specific sitting time and promote physical activity. Practical implications: Effective interventions and strategies are increasingly necessary to mitigate the rise in overall and domain-specific sitting time. Funding: ERGO Health insurance funded the data acquisition and the data analyses.

Background: In 2019, World Health Organization (WHO) released the first global guidelines on physical activity, sedentary behaviour and sleep (collectively known as movement behaviours) for children under five years of age. It is important to determine the global proportion of children meeting the guidelines to inform efforts to promote healthy movement behaviours in early childhood. Purpose: This study presents a pooled analysis on the proportion of 3- and 4-year-old children meeting WHO guidelines across the globe using a harmonised data processing protocol. Methods: Data were sourced from 14 cross-sectional studies conducted between 2008 and 2022. Physical activity was assessed using accelerometers and processed with a harmonised approach, while sedentary behaviour (operationalised as screen time) and sleep duration were proxy-reported by parents or caregivers. The proportion of children meeting WHO guidelines was estimated at a global level and by World Bank income group and WHO region using a meta-analysis approach. Results: Our pooled analyses involving 7,017 children (51.1% boys) from 33 countries and territories revealed that only 14.3% (95% confidence interval 9.7,20.7) met the overall WHO guidelines for physical activity, screen time and sleep duration. The lowest proportion of meeting guidelines was observed in upper-middle-income countries (11.9% [5.9,22.5]) and the Americas (7.7% [3.6,15.8]), while the highest proportion was in low- and lower-middle-income countries (16.6% [10.4,25.3]) and Africa (23.9% [11.6,43.0]). Conclusions: Less than one in six preschool children worldwide met the WHO guidelines for physical activity, sedentary behaviour and sleep. While differences were noted among regions and income groups, the proportion meeting guidelines was low for all. Practical implications: Understanding key factors and implementing contextually appropriate and effective programs and policies are essential to promote healthy movement behaviours in preschool age group. Funding: No funding was received for conducting this pooled analysis.

Background: Little is known about device-measured levels of physical activity and sedentary behavior among primary-school aged children in Morocco. Purpose: To examine the proportion of children meeting the World Health Organisation’s (WHO) physical activity guideline and day type (weekday and weekend) differences in device-measured moderate- to vigorous-intensity physical activity (MVPA) and sedentary behaviour among primary school children in Rabat, Morocco. Methods: Consenting Grade 5 and 6 students from nine primary schools wore a wrist-worn Axivity (AX3) accelerometer for seven consecutive days. Data files were processed in R (version 4.3.0) using the GGIR package (version 3.0.6). For data inclusion, accelerometer wear time criteria were ≥10 h/day for a minimum of four days (including one weekend day). Means and standard deviations were reported for average time spent in MVPA and sedentary behaviour, and independent samples t-tests were conducted to examine the differences in these behaviours across day types. Results: The analytical sample included 401 students, of which 65% met the physical activity guideline. Children spent an average of 76.26 (± 30.48) minutes per day in MVPA across the week. Minutes in MVPA were significantly lower (73.48 ± 28.08 vs. 83.21 ± 43.30 min/day; p < 0.001) and minutes in sedentary behaviour were significantly higher (656.36 ± 78.95 vs. 593.45 ± 110.66 min/day; p < 0.001) on weekdays compared to weekend days, respectively. Conclusions: Just over half of primary school children in this sample met the physical activity guideline. Lower levels of MVPA and higher levels of sedentary behaviour on school days are concerning. Practical implications: These findings justify investment into school-based interventions to promote healthier levels of physical activity and sedentary behaviour in this under-researched population. Funding: This project was funded by the Royal Moroccan Federation of School Sports