Influence of Guideline Operationalization on Youth Activity Prevalence in the International Children’s Accelerometry Database

ABSTRACT Introduction The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 min of moderate- to vigorous-intensity PA (MVPA) every day, to an average of 60 min of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. This study used the International Children’s Accelerometry Database to compare approaches to calculating youth PA compliance and associations with health indicators. Methods Cross-sectional accelerometer data (n = 21,612, 5–18 yr) were used to examine compliance with four guideline definitions: daily method (DM; ≥60 min MVPA every day), average method (AM; average of ≥60 min MVPA per day), AM5 (AM compliance and ≥5 min of vigorous PA [VPA] on ≥3 d), and AM15 (AM compliance and ≥15 min VPA on ≥3 d). Associations between compliance and health indicators were examined for all definitions. Results Compliance varied from 5.3% (DM) to 29.9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (−0.28 [−0.33 to −0.23]), AM5 (−0.28 [−0.33 to −0.23], and AM15 (−0.30 [−0.35 to −0.25]). Associations between compliance and health indicators for DM were similar/weaker, possibly reflecting fewer DM-compliant participants with health data and lower variability in exposure/outcome data. Conclusions Youth completing 60 min of MVPA every day do not experience superior health benefits to youth completing an average of 60 min of MVPA per day. Guidelines should encourage youth to achieve an average of 60 min of MVPA per day. Different guideline definitions affect inactivity prevalence estimates; this must be considered when analyzing data and comparing studies.

[1]  L. Boddy,et al.  Physical activity guidelines and cardiovascular risk in children: a cross sectional analysis to determine whether 60 minutes is enough , 2015, BMC Public Health.

[2]  H. Krumholz,et al.  The Utility of Shorter Epochs in Direct Motion Monitoring , 2009, Research quarterly for exercise and sport.

[3]  F. Bull,et al.  Progress in physical activity over the Olympic quadrennium , 2016, The Lancet.

[4]  L. Mâsse,et al.  Physical activity in the United States measured by accelerometer. , 2008, Medicine and science in sports and exercise.

[5]  P. Freedson,et al.  Using objective physical activity measures with youth: how many days of monitoring are needed? , 2000, Medicine and science in sports and exercise.

[6]  R. Davey,et al.  Variations in accelerometry measured physical activity and sedentary time across Europe – harmonized analyses of 47,497 children and adolescents , 2020, International Journal of Behavioral Nutrition and Physical Activity.

[7]  Charlene A. Wong,et al.  Association of Physical Activity With Income, Race/Ethnicity, and Sex Among Adolescents and Young Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2007-2016 , 2018, JAMA pediatrics.

[8]  Marsha Dowda,et al.  Compliance With National Guidelines for Physical Activity in U.S. Preschoolers: Measurement and Interpretation , 2011, Pediatrics.

[9]  F. Ortega,et al.  Vigorous physical activity rather than sedentary behaviour predicts overweight and obesity in pubertal boys: A 2-year follow-up study , 2015, Scandinavian journal of public health.

[10]  M. Sjöström,et al.  Recommended levels of physical activity to avoid an excess of body fat in European adolescents: the HELENA Study. , 2010, American journal of preventive medicine.

[11]  C. Abraham,et al.  Are We Overestimating Physical Activity Prevalence in Children? , 2018, Journal of physical activity & health.

[12]  U. Ekelund,et al.  International children's accelerometry database (ICAD): Design and methods , 2011, BMC public health.

[13]  R. Davey,et al.  Cross-Sectional Associations of Reallocating Time Between Sedentary and Active Behaviours on Cardiometabolic Risk Factors in Young People: An International Children’s Accelerometry Database (ICAD) Analysis , 2018, Sports Medicine.

[14]  I. Janssen,et al.  Dose-response relation between physical activity and blood pressure in youth. , 2008, Medicine and science in sports and exercise.

[15]  S. Brage,et al.  Frequency and duration of physical activity bouts in school-aged children: A comparison within and between days , 2016, Preventive medicine reports.

[16]  M. Tremblay,et al.  Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. , 2017, Health reports.

[17]  J. Stevens,et al.  Cardiometabolic Correlates of Physical Activity and Sedentary Patterns in U.S. Youth , 2017, Medicine and science in sports and exercise.

[18]  G. Welk,et al.  Youth Physical Activity Patterns During School and Out-of-School Time , 2018, Children.

[19]  Claire LeBlanc,et al.  Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. , 2016, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[20]  Stewart G Trost,et al.  Comparison of accelerometer cut points for predicting activity intensity in youth. , 2011, Medicine and science in sports and exercise.

[21]  W. van Mechelen,et al.  Meeting the 60-min physical activity guideline: effect of operationalization. , 2009, Medicine and science in sports and exercise.

[22]  C. Craig,et al.  Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. , 2011, Health reports.

[23]  E. Waters,et al.  How should activity guidelines for young people be operationalised? , 2007, The international journal of behavioral nutrition and physical activity.

[24]  Kong Y. Chen,et al.  Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents , 2018, PloS one.

[25]  R. Davey,et al.  Age-related patterns of vigorous-intensity physical activity in youth: The International Children's Accelerometry Database , 2016, Preventive medicine reports.

[26]  J. Mäestu,et al.  Different Methods Yielded Two-Fold Difference in Compliance with Physical Activity Guidelines on School Days , 2016, PloS one.

[27]  Stephanie T. Broyles,et al.  Harmonising data on the correlates of physical activity and sedentary behaviour in young people: Methods and lessons learnt from the international Children’s Accelerometry database (ICAD) , 2017, International Journal of Behavioral Nutrition and Physical Activity.

[28]  William L. Haskell,et al.  Effects of Varying Epoch Lengths, Wear Time Algorithms, and Activity Cut-Points on Estimates of Child Sedentary Behavior and Physical Activity from Accelerometer Data , 2016, PloS one.

[29]  B. Koletzko,et al.  BMI and recommended levels of physical activity in school children , 2017, BMC Public Health.

[30]  F. Sera,et al.  Predictors of non-response in a UK-wide cohort study of children's accelerometer-determined physical activity using postal methods , 2013, BMJ Open.

[31]  C. Lonsdale,et al.  Measuring Adolescent Boys' Physical Activity: Bout Length and the Influence of Accelerometer Epoch Length , 2014, PloS one.

[32]  R. Mcmurray,et al.  Calibration of two objective measures of physical activity for children , 2008, Journal of sports sciences.

[33]  T. Gorely,et al.  Epoch length and its effect on physical activity intensity. , 2010, Medicine and science in sports and exercise.

[34]  D. Buchan,et al.  Comparing physical activity estimates in children from hip-worn Actigraph GT3X+ accelerometers using raw and counts based processing methods , 2018, Journal of sports sciences.

[35]  I. Janssen,et al.  Dose-response relationship between physical activity and dyslipidemia in youth. , 2010, The Canadian journal of cardiology.

[36]  Eivind Aadland,et al.  The multivariate physical activity signature associated with metabolic health in children , 2018, International Journal of Behavioral Nutrition and Physical Activity.

[37]  KAMLESH KHUNTI,et al.  Compliance of Adolescent Girls to Repeated Deployments of Wrist-Worn Accelerometers , 2018, Medicine and science in sports and exercise.

[38]  U. Ekelund,et al.  Does adiposity mediate the relationship between physical activity and biological risk factors in youth?: a cross-sectional study from the International Children’s Accelerometry Database (ICAD) , 2018, International Journal of Obesity.