Physical activity and its correlates in children: a cross-sectional study (the GINIplus & LISAplus studies)

BMC Public Health

Holger Schulz⁶  Joachim Heinrich⁶  Barbara Hoffmann⁵  Irina Lehmann⁷  Olf Herbarth¹  Beate Schaaf²  Carl-Peter Bauer⁸  Andrea von Berg³  Dietrich Berdel³  Sibylle Koletzko⁹  Gabriel Schneider⁶  Sandra Ortlieb⁴ 

[1]Faculty of Medicine, Environmental Hygiene and Environmental Medicine, University of Leipzig, Leipzig, Germany

[2]Medical Practice for Pediatrics, Bad Honnef, Germany

[3]Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany

[4]Institut für Medizinische Statistik und Epidemiologie, TUM, Munich, Germany

[5]IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany

[6]Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstrasse 1, Neuherberg, 85764, Germany

[7]Department for Environmental Immunology, Helmholtz Centre for Environmental Research – UFZ, Leipzig, Germany

[8]Department of Pediatrics, Technical University of Munich, Munich, Germany

[9]Dr von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany

关键词: Social;    Environment;    Behavior;    Associations;    Determinants;    Inactivity;    Exercise;    Correlates;    Children;    Activity;   

Others  :  1162331
DOI  :  10.1186/1471-2458-13-349

 received in 2013-01-14, accepted in 2013-04-02,  发布年份 2013

【 摘 要 】

Background

Physical inactivity among children is an increasing problem that adversely affects children’s health. A better understanding of factors which affect physical activity (PA) will help create effective interventions aimed at raising the activity levels of children. This cross-sectional study examined the associations of PA with individual (biological, social, behavioral, psychological) and environmental (East vs. West Germany, rural vs. urban regions) characteristics in children.

Methods

Information on PA and potential correlates was collected from 1843 girls and 1997 boys using questionnaires during the 10-year follow-up of two prospective birth cohort studies (GINIplus and LISAplus). Study regions represent urban and rural sites as well as East and West of Germany. Logistic regression modeling was applied to examine cross-sectional associations between individual as well as environmental factors and PA levels.

Results

Five of fourteen variables were significantly associated with PA. Among children aged 10, girls tended to be less active than boys, especially with respect to vigorous PA (OR = 0.72 for summer). Children who were not a member of a sports club showed a substantially reduced amount of PA in winter (OR = 0.15). Rural environments promote moderate PA, particularly in winter (OR = 1.88), whereas an increased time outdoors primarily promotes moderate PA in summer (OR = 12.41). Children with abnormal emotional symptoms exhibited reduced physical activity, particularly in winter (OR = 0.60). BMI, puberty, parental BMI, parental education, household income, siblings, TV/PC consumption, and method of arriving school, were not associated with PA.

Conclusions

When considering correlates of PA from several domains simultaneously, only few factors (sex, sports club membership, physical environment, time outdoors, and emotional symptoms) appear to be relevant. Although the causality needs to be ascertained in longitudinal studies, variables which cannot be modified should be used to identify risk groups while modifiable variables, such as sports club activities, may be addressed in intervention programs.

【 授权许可】

   
2013 Ortlieb et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]WHO: Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.
• [2]Hallal P, Victora C, Azevedo R, Wells J: Adolescent physical activity and health. A systematic review. Sports Med 2006, 36:1019-1030.
• [3]Strong W, Malina R, Bumke C, Daniels S, Dishman R, Gutin B, Hergenroeder A, Must A, Nixon P, Pivarnik J: Evidence based physical activity for school-age children. J Pediatr 2005, 146:732-737.
• [4]Trudeau F, Laurencelle L, Shephard R: Tracking of physical activity from childhood to adulthood. Med Sci Sports Exerc 2004, 36:1937-1943.
• [5]De Cocker K, Ottevaere C, Sjostrom M, Moreno L, Warnberg J, Valtuena J, Manios Y, Dietrich S, Mauro B, Artero E: Self-reported physical activity in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutr 2011, 14:246-254.
• [6]Kettner S, Wirt T, Fischbach N, Kobel S, Kesztyüs D, Schreiber A, Drenowatz C, Steinacker J: Handlungsbedarf zur Förderung körperlicher Aktivität im Kindesalter in Deutschland. Deutsche Zeitschrift für Sportmedizin 2012, 63:94-101.
• [7]Nelson M, Neumark-Stzainer D, Hannan P, Sirard J, Story M: Longitudinal and secular trends in physical activity and sedentary behaviour during adolescence. Pediatrics 2006, 118:1627-1634.
• [8]Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdaland O, Rasmussen V: Health Behaviour in School-aged Children (HBSC) study: international report from the 2001/2002 survey. In Health Policy for Children and Adolescents volume 4 Edited by Europe WHOROf. 2004, 237.
• [9]Sallis J, Prochaska J, Taylor WC: A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 2000, 32:963-975.
• [10]Van der Horst K, Paw M, Twisk J, Van Mechelen W: A brief review on correlates of physical activity and sedentariness in youth. Med Sci Sports Exerc 2007, 39:1241-1250.
• [11]Biddle S, Gorely T, Stensel D: Health-enhancing physical activity and sedentary behaviour in children and adolescents. J Sports Sci 2004, 22:679-701.
• [12]Vilhjalmsson R, Kristjansdottir G: Gender differences in physical activity in older children and adolescents: the central role of organized sport. Soc Sci Med 2003, 56:363-374.
• [13]Brodersen N, Steptoe A, Boniface D, Wardle J, Hillsdon M: Trends in physical activity and sedentary behaviour in adolescence: ethnic and socioeconomic differences. Br J Sports Med 2007, 41:140-144.
• [14]BHF: Looking at Physical Activity in Children in the UK. In Couch Kids: The Growing Epidemic. Edited by British Heart Foundation. London: BHF; 2000:1-12.
• [15]Tammelin T, Ekelund U, Remes J, Nayha S: Physical activity and sedentary behaviors among Finnish youth. Med Sci Sports Exerc 2007, 39:1067-1074.
• [16]Trost SG, Pate RR, Ward DS, Saunders R, Riner W: Correlates of objectively measured physical activity in preadolescent youth. Am J Prev Med 1999, 17:120-126.
• [17]Riner W, Riner W, Riner W, Riner W, Saunders R, Riner W: Correlates of physical activity behavior in rural youth. Q Exerc Sport 1997, 68:241-248.
• [18]McMinn A, Griffin S, Jones A, Van Sluijs E: Family and home influences on children's after-school and weekend physical activity. Eur J Public Healthin press
• [19]Kriemler S, Meyer U, Martin E, Van Sluijs E, Andersen L, Martin B: Effect of school-based interventions on physical activity and fi tness in children and adolescents: a review of reviews and systematic update. Br J Sports Med 2011, 45:923-930.
• [20]Sausenthaler S, Koletzko S, Schaaf B, Lehmann I, Borte M, Herbarth O, Von Berg A, Wichmann H, Heinrich J: Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Am J Clin Nutr 2007, 85:530-537.
• [21]Heinrich J, Bolte G, Holscher B, Douwes J, Lehmann I, Fahlbusch B, Bischof W, Weiss M, Borte M, Wichmann H, Group oBot LS: Allergens and endotoxin on mothers’ mattresses and total immunoglobulin E in cord blood of neonates. Eur Respir J 2002, 20:617-623.
• [22]Krämer U, Sugiri D, Ranft U, Krutmann J, Von Berg A, Berdel D, Behrendt H, Kuhlbusch T, Hochadel M, Wichmann HE: Eczema, respiratory allergies, and traffic-related air pollution in birth cohorts from small-town areas. J Dermatol Sci 2009, 56:99-105.
• [23]Von Berg A, Filipiak-Pittroff B, Krämer U, Link E, Bollrath C, Brockow I, Koletzko S, Grübl A, Heinrich J, Wichmann H: Preventive effect of hydrolyzed infant formulas persists until age 6 years: long-term results from the German Infant Nutritional Intervention Study (GINI). J Allergy Clin Immunol 2008, 121:1442-1447.
• [24]Von Berg A, Koletzko S, Grubl A, Filipiak-Pittroff B, Wichmann H, Bauer C, Reinhardt D, Berdel D: The effect of hydrolyzed cow’s milk formula for allergy prevention in the first year of life: the German Infant Nutritional Intervention Study, a randomized double-blind trial. J Allergy Clin Immunol 2003, 111:533-540.
• [25]Sausenthaler S, Standl M, Buyken A, Rzehak P, Koletzko S, Bauer CP, Schaaf B, Von Berg A, Berdel D, Borte M: Regional and socio-economic differences in food, nutrient and supplement intake in school-age children in Germany: results from the GINIplus and the LISAplus studies. Public Health Nutr 2011, 14:1724-1735.
• [26]Opper E, Worth A, Wagner M, Bös K: The module „Motorik“in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Motor Fitness and physical activity of children and young people. Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz 2007, 50:579-888.
• [27]Rich C, Griffiths LJ, Dezateux C: Seasonal variation in accelerometer-determined sedentary behaviour and physical activity in children: a review. Int J Behavioral Nutr Physical Activity 2012, 9:49. 2012, 9:1-8 BioMed Central Full Text
• [28]Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiss H, Hesse V, Von Hippel A, Jaeger U, Johnson D, Korte W: Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschr Kinderheilk 2001, 8:807-818.
• [29]Petersen AC, Crockett L, Richards M, Boxer A: A Self-Report Measure of Pubertal Status: Reliability, Validity, and Initial Norms. J Youth Adolesc 1988, 17:117-133.
• [30]WHO: Physical status: the use and interpretation of anthropometry. In Technical Report Series, Volume 854. Edited by Committee Roa WE. Geneva: World Health Organization; 1995.
• [31]Hauser R: Adequacy and poverty among the retired. In Maintaining Prosperity in an Ageing Society volume 3. Edited by Paper AW. Paris: OECD; 1998:25.
• [32]Sausenthaler S, Kompauer I, Mielck A, Borte M, Herbarth O, Schaaf B, Von Berg A, Heinrich J: Impact of parental education and income inequality on children’s food intake. Public Health Nutr 2007, 10:24-33.
• [33]King A, Parkinson K, Adamson A, Murray L, Besson H, Reilly J, Basterfield L: Correlates of objectively measured physical activity and sedentary behaviour in English children. Eur J Public Health 2011, 21:424-431.
• [34]Fisher A, Reilly J, Montgomery C, Kelly L, Williamson A, Jackson D, Paton J, Grant S: Seasonality in physical activity and sedentary behaviour in young children. Pediatr Exerc Sci 2005, 17:31-40.
• [35]Goodman R: Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolescent Psychiatry 2001, 40:1337-1345.
• [36]Goodman R, Renfrew D, Mullick M: Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. Eur Child Adolesc Psychiatry 2000, 9:129-134.
• [37]Woerner W, Becker A, Friedrich C, Klasen H, Goodman R, Rothenberger A: Normal values and evaluation of the German parents’ version of Strengths and Difficulties Questionnaire (SDQ): results of a representative field study. Z Kinder Jugendpsychiatr Psychother 2002, 30:105-112.
• [38]Kahlert D, Brand R: Comparing Self-Report and Accelerometry Data. A Contribution to the Validation of the MoMo-Physical Activity Questionnaire for Children and Adolescents. Deutsche Zeitschrift für Sportmedizin 2011, 62:36-41.
• [39]Going S, Levin S, Harrell J, Stewart D, Kushi L, Cornell C, Hunsberger S, Corbin C, Sallis J: Physical activity assessment in American Indian schoolchildren in the Pathways study. Am J Clin Nutr 1999, 69(Suppl):788--795.
• [40]Freedson PS: Electronic motion sensors and heart rate as measures of physical activity in children. J School Health 1991, 61:220-223.
• [41]Bender J, Brownson R, Elliott M, Haire-Joshu D: Children’s Physical Activity: Using Accelerometers to Validate a Parent Proxy Record. Med Sci Sports Exerc 2005, 37:1409-1413.
• [42]Timperio A, Crawford D, Telford A, Salmon J: Perceptions about the local neighborhood and walking and cycling among children. Preventive Med 2004, 38:39-47.
• [43]Sallis J, Patterson T, Buono M, Atkins C, Nader P: Aggregation of physical activity habits in Mexican-American and Anglo families. J Behavioral Med 1998, 11:31-41.
• [44]Moore L, Lombardi D, White M, Campbell J, Oliveria S, Ellison R: Influence of parents’ physical activity levels on activity levels of young children. J Pediatr 1991, 118:215-219.
• [45]Conrad A, Seiwert M, Hünken A, Quarcoo D, Schlaud M, Groneberg D: The German Environmental Survey for Children (GerES IV): Reference values and distributions for time-location patterns of German children. Int J Hygiene Environ Health 2013, 216:25-34.
• [46]Heath G, Parra D, Sarmiento O, Andersen L, Owen N, Goenka S, Montes F, Brownson RC: PASWG: Evidence-based intervention in physical activity: lessons from around the world. Lancet 2012, 380:272-281.
• [47]Sandercock G, Angus C, Barton J: Physical activity levels of children living in different built environments. Preventive Med 2010, 50:193-198.
• [48]Bundesministerium für Verkehr, Bau und Stadtentwicklung. Deutscher Wetterdienst. http://www.dwd.de/bvbw/appmanager/bvbw/dwdwwwDesktop?_nfpb=true&_pageLabel=dwdwww_klima_umwelt&_nfls=false webcite
• [49]Iannotti RJ, Janssen I, Haug E, Kololo H, Annaheim B, Borraccino A, Group HPAF: Interrelationships of adolescent physical activity, screen-based sedentary behaviour, and social and psychological health. Int J Public Health 2009, 54(Suppl 2):191-198.
• [50]Brodersen N, Steptoe A, Williamson S, Wardle J: Sociodemographic, Developmental, Environmental, and Psychological Correlates of Physical Activity and Sedentary Behavior at Age 11 to 12. Ann Behav Med 2005, 29:2-11.
• [51]Steptoe A, Butler N: Sports participation and emotional wellbeing in adolescents. Lancet 1996, 347:1789-1792.
• [52]De Bourdeaudhuij I: Behavioural factors associated with physical activity in youth. In Young and active? Young people and health enhancing physical activity: evidence and implications. Edited by S. Biddle JS, Cavill N. London: Health Education Authority; 1998:98-118. http://www.nice.org.uk/niceMedia/documents/youngandactive.pdf webcite
• [53]Borraccino A, Lemma P, Iannotti R, Zambon A, Dalmasso P, Lazzeri G, Giacchi M, Cavallo F: Socioeconomic effects on meeting physical activity guidelines: comparisons among 32 countries. Med Sci Sports Exerc 2009, 41:749-756.
• [54]Turrell G, Hewitt B, Patterson C, Oldenburg B: Measuring socio-economic position in dietary research: is choice of socio-economic indicator important? Public Health Nutr 2003, 6:191-200.
• [55]Finne E, Bucksch J, Lampert T, Kolip P: Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS). Int J Behavioral Nutr Physical Activity 2011, 8:1-14. BioMed Central Full Text
• [56]Foundation BH: Couch Kids: The nation’s future… Executive summary. London: British Heart Foundation; 2010:1-7. http://www.bhf.org.uk/plugins/PublicationsSearchResults/DownloadFile.aspx?docid=ce0b6b51-6e44-4163-b588-832f123dbc76&version=-1&title=Couch+kids+executive+summary&resource=G243a webcite
• [57]Nilsson A, Andersen L, Ommundsen Y, Froberg K, Sardinha L, Piehl-Aulin K, Ekelund U: Correlates of objectively assessed physical activity and sedentary time in children (The European Youth Heart Study). BMC Public Health 2009, 9:322. BioMed Central Full Text
• [58]Loucaides CA, Chedzoy SM: Factors influencing Cypriot children´s physical activity levels. Sport Educ Soc 2005, 10:101-118.