Objectively measured physical activity and sedentary time in children with overweight, obesity and morbid obesity: a cross-sectional analysis

Gabrielle Ten Velde, Guy Plasqui, Elke Dorenbos, Bjorn Winkens, Anita Vreugdenhil, Gabrielle Ten Velde, Guy Plasqui, Elke Dorenbos, Bjorn Winkens, Anita Vreugdenhil

Abstract

Background: Limited physical activity (PA) and a high level of sedentary time (ST) are associated with childhood obesity and are a target for intervention. This study aimed to assess objectively measured PA and ST in Dutch children across weight categories, age groups and sex.

Methods: 202 children with overweight, obesity and morbid obesity (55% girls, 12 ± 3y of age, BMI z-score + 3.15 ± 0.73), referred to the Centre for Overweight Adolescents and Children's Healthcare (COACH, Maastricht UMC+) were included. PA (total PA, light PA and moderate to vigorous PA (MVPA)) and ST were measured with the GT3X Actigraph accelerometer. Wear time validation was set to include at least four days, 480 min/day, including one weekend day.

Results: PA levels in children with morbid obesity were higher compared to children with obesity, also after correction for age and sex (corrected difference (B) 118 counts per minute (cpm), p = .006). ST was lower in children with morbid obesity compared to children with obesity (B - 51 min/day, p = .018). Girls performed significantly less MVPA than boys (B - 11 min/day, p < .001) and for each year increase of age, children performed less PA (B - 46 cpm, p < .001) and ST increased (B 18 min/day, p < .001).

Conclusion: PA and ST is different in subgroups of children with overweight, obesity and morbid obesity, depending on sex, age and overweight severity. In particular, children with obesity perform less PA and more ST compared to children with morbid obesity. Future research could explore the preferences and needs for PA and ST in children in the different weight categories.

Trial registration: The trial is registered with Clinicaltrials.gov NCT02091544 at March 19, 2014.

Keywords: Accelerometer; Childhood obesity; Morbid obesity; Physical activity.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
flowchart of study enrolment. Abbreviations: OV overweight; OB obese; MO morbid obese

References

    1. CBS. Gezondheid, leefstijl, zorggebruik en -aanbod, doodsoorzaken; kerncijfers 2020 [Gezondheid, leefstijl, zorggebruik en -aanbod, doodsoorzaken; kerncijfers]. Available from: .
    1. Van Dommelen P, Schönbeck Y, Van Buuren S, HiraSing RA. Trends in a life threatening condition: morbid obesity in Dutch, Turkish and Moroccan children in the Netherlands. PLoS One. 2014;9(4):e94299. doi: 10.1371/journal.pone.0094299.
    1. Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, Urbina EM, Ewing LJ, Daniels SR, American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young, Council on Nutrition, Physical Activity and Metabolism, and Council on Clinical Cardiology Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation. 2013;128(15):1689–1712. doi: 10.1161/CIR.0b013e3182a5cfb3.
    1. Bass R, Eneli I. Severe childhood obesity: an under-recognised and growing health problem. Postgrad Med J. 2015;91(1081):639–645. doi: 10.1136/postgradmedj-2014-133033.
    1. Collaboration PS Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–1096. doi: 10.1016/S0140-6736(09)60318-4.
    1. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150(1):12–7. e2. doi: 10.1016/j.jpeds.2006.08.042.
    1. Li C, Ford ES, Zhao G, Mokdad AH. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among US adolescents: National Health and nutrition examination survey 2005–2006. Diabetes Care. 2009;32(2):342–347. doi: 10.2337/dc08-1128.
    1. Singh AS, Mulder C, Twisk JW, Van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–488. doi: 10.1111/j.1467-789X.2008.00475.x.
    1. Schwarzfischer P, Gruszfeld D, Stolarczyk A, Ferre N, Escribano J, Rousseaux D, et al. Physical activity and sedentary behavior from 6 to 11 years. Pediatrics. 2019;143(1).
    1. Organization WH . Global recommendations on physical activity for health: World Health Organization. 2010.
    1. RIVM . Beweeggedrag bij personen van 4 jaar en ouder in 2020. 2020.
    1. Chaput J-P, Willumsen J, Bull F, Chou R, Ekelund U, Firth J, et al. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence. Int J Behav Nutr Phys Act. 2020;17(1):1–9. doi: 10.1186/s12966-020-01037-z.
    1. Salawi HA, Ambler KA, Padwal RS, Mager DR, Chan CB, Ball GD. Characterizing severe obesity in children and youth referred for weight management. BMC Pediatr. 2014;14(1):154. doi: 10.1186/1471-2431-14-154.
    1. Sylvia LG, Bernstein EE, Hubbard JL, Keating L, Anderson EJ. Practical guide to measuring physical activity. J Acad Nutr Diet. 2014;114(2):199–208. doi: 10.1016/j.jand.2013.09.018.
    1. Elmesmari R, Martin A, Reilly JJ, Paton JY. Comparison of accelerometer measured levels of physical activity and sedentary time between obese and non-obese children and adolescents: a systematic review. BMC Pediatr. 2018;18(1):106. doi: 10.1186/s12887-018-1031-0.
    1. Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen SA. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (the European youth heart study) Lancet. 2006;368(9532):299–304. doi: 10.1016/S0140-6736(06)69075-2.
    1. Whitt-Glover MC, Taylor WC, Floyd MF, Yore MM, Yancey AK, Matthews CE. Disparities in physical activity and sedentary behaviors among US children and adolescents: prevalence, correlates, and intervention implications. J Public Health Policy. 2009;30(1):S309–SS34. doi: 10.1057/jphp.2008.46.
    1. Rijks JM, Plat J, Mensink RP, Dorenbos E, Buurman WA, Vreugdenhil AC. Children with morbid obesity benefit equally as children with overweight and obesity from an ongoing care program. J Clin Endocrinol Metabolism. 2015;100(9):3572–3580. doi: 10.1210/jc.2015-1444.
    1. Reilly JJ, Penpraze V, Hislop J, Davies G, Grant S, Paton JY. Objective measurement of physical activity and sedentary behaviour: review with new data. Arch Dis Child. 2008;93(7):614–619. doi: 10.1136/adc.2007.133272.
    1. Trost SG. State of the art reviews: measurement of physical activity in children and adolescents. Am J Lifestyle Med. 2007;1(4):299–314. doi: 10.1177/1559827607301686.
    1. Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. J Sports Sci. 2008;26(14):1557–1565. doi: 10.1080/02640410802334196.
    1. Groeistudie TFRVL. TNO. Leiden: TNO; 2010.
    1. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obesity. 2012;7(4):284–294. doi: 10.1111/j.2047-6310.2012.00064.x.
    1. Lohman TG, Hingle M, Going SB. Body composition in children. Pediatr Exerc Sci. 2013;25(4):573–590. doi: 10.1123/pes.25.4.573.
    1. Page A, Cooper A, Stamatakis E, Foster L, Crowne E, Sabin M, et al. Physical activity patterns in nonobese and obese children assessed using minute-by-minute accelerometry. Int J Obes. 2005;29(9):1070–1076. doi: 10.1038/sj.ijo.0802993.
    1. Schneller MB, Bentsen P, Nielsen G, Brønd JC, Ried-Larsen M, Mygind E, et al. Measuring children's physical activity: compliance using skin-taped accelerometers. Med Sci Sports Exerc. 2017;49(6):1261–1269. doi: 10.1249/MSS.0000000000001222.
    1. Taylor RW, Williams SM, Dawson AM, Haszard JJ, Brown DA. Parental motivation to change body weight in young overweight children. Public Health Nutr. 2015;18(10):1807–1814. doi: 10.1017/S1368980014002171.
    1. Nemet D, Arieli R, Meckel Y, Eliakim A. Immediate post-exercise energy intake and macronutrient preferences in normal weight and overweight pre-pubertal children. Int J Pediatr Obes. 2010;5(3):221–229. doi: 10.3109/17477160903311538.
    1. Feito Y, Bassett DR, Tyo B, Thompson DL. Effects of body mass index and tilt angle on output of two wearable activity monitors. Med Sci Sports Exerc. 2011;43(5):861–866. doi: 10.1249/MSS.0b013e3181fefd40.
    1. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–975. doi: 10.1097/00005768-200005000-00014.
    1. Ishii K, Shibata A, Adachi M, Nonoue K, Oka K. Gender and grade differences in objectively measured physical activity and sedentary behavior patterns among Japanese children and adolescents: a cross-sectional study. BMC Public Health. 2015;15(1):1254. doi: 10.1186/s12889-015-2607-3.
    1. Labbrozzi D, Robazza C, Bertollo M, Bucci I, Bortoli L. Pubertal development, physical self-perception, and motivation toward physical activity in girls. J Adolesc. 2013;36(4):759–765. doi: 10.1016/j.adolescence.2013.06.002.
    1. Willenberg LJ, Ashbolt R, Holland D, Gibbs L, MacDougall C, Garrard J, Green JB, Waters E. Increasing school playground physical activity: a mixed methods study combining environmental measures and children's perspectives. J Sci Med Sport. 2010;13(2):210–216. doi: 10.1016/j.jsams.2009.02.011.
    1. Reimers AK, Schoeppe S, Demetriou Y, Knapp G. Physical Activity and Outdoor Play of Children in Public Playgrounds-Do Gender and Social Environment Matter? Int J Environ Res Public Health. 2018;15(7):1356.
    1. Ten Hoor G, Rutten G, Van Breukelen G, Kok G, Ruiter R, Meijer K, et al. Strength exercises during physical education classes in secondary schools improve body composition: a cluster randomized controlled trial. Int J Behav Nutr Phys Act. 2018;15(1):1–13. doi: 10.1186/s12966-017-0635-3.
    1. Karnebeek K, Thapar S, Willeboordse M, van Schayck OC, Vreugdenhil AC. Comorbidities in primary vs secondary school children with obesity and responsiveness to lifestyle intervention. J Clin Endocrinol Metabol. 2019;104(9):3803–11.

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