Dataset Information

Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

ABSTRACT: This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers' step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01) and clearly reflected the kindergartens' daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers.

SUBMITTER: Van Stappen V

PROVIDER: S-EPMC5858360 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

Van Stappen Vicky V Van Dyck Delfien D Latomme Julie J De Bourdeaudhuij Ilse I Moreno Luis L Socha Piotr P Iotova Violeta V Koletzko Berthold B Manios Yannis Y Androutsos Odysseas O Cardon Greet G De Craemer Marieke M

International journal of environmental research and public health 20180207 2

This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers' step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multil ...[more]

PMID: 29414916

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Project description:ObjectivesAlthough previous studies have reported lower mortality and morbidity in people with higher daily step counts, the association between frailty and objectively measured step counts has not been evaluated well. We investigated the association between step counts and prevalence of frailty in community-dwelling older adults.DesignA cross-sectional study.SettingThe Kyoto-Kameoka study in Japan.ParticipantsWe used data of 3,616 Japanese older adults, aged 65 years or older, with valid daily step count data, obtained by an accelerometer-based pedometer.MeasurementsThe step count during 4 or more days was objectively obtained by a validated triaxial accelerometer. Participants were classified by quartiles (Qs) based on their step counts. Frailty was defined using the Fried phenotype (FP) model and the Kihon Checklist (KCL). We evaluated the association between prevalence of frailty and step counts using multivariate logistic regression and the restricted cubic spline model.ResultsMean step counts across low-to-high Qs of distribution were 1,759, 2,988, 4,377, and 7,200 steps/day, respectively. The prevalence of frailty, as defined by the FP model and KCL, was 11.3% and 26.8%, respectively. After adjusting for confounders, there was a negative association between the odds ratio (OR) and prevalence of frailty, as defined by the FP model among people with higher step counts (Q1: reference; Q2: OR = 0.73; 95% confidence interval (CI) = 0.56-0.96; Q3: OR = 0.56; 95% CI = 0.42-0.76; and Q4: OR = 0.41; 95% CI = 0.30-0.57; P for trend <.001). The mean step count of the population was 4,081. The OR of frailty for a 1,000-steps/day increment was 0.74 (95% CI = 0.58-0.91) and 0.85 (95% CI = 0.72-0.97) below 4,000 steps and above 4,000 steps, respectively. In the spline model, this relationship was similar between the FP model and KCL.ConclusionThese findings suggest that slightly increasing the current step count, as by 1,000 steps/day (about 10 minutes of activity), may potentially prevent frailty. J Am Geriatr Soc 68:2310-2318, 2020.

Project description:BackgroundWithin the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers.MethodA sample of 4964 preschoolers (4.7 ± 0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed.ResultsLimited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores.ConclusionThe ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.

Project description:BACKGROUND:In preschoolers, high levels of sedentary behaviour are associated with several adverse health outcomes. The purpose of this study is to report the effects of the ToyBox-intervention (a European 24-week cluster randomised controlled trial) on sedentary behaviour in preschoolers. METHODS:In Belgium, 859 preschoolers from 27 kindergartens (15 intervention and 12 control) wore an accelerometer to objectively measure their sedentary time and 1715 parents/caregivers completed a questionnaire to assess sedentary activities in which preschoolers participate at home. Main outcomes were objectively measured sedentary time, time spent watching TV, using the computer and time spent in quiet play. Multilevel repeated measures analyses were conducted to take clustering into account. Intention to treat analysis was used to handle missing data. RESULTS:A sample of 859 (29.5% of all contacted children) preschoolers (4.4?±?0.6 years, 54.4% boys) provided valid accelerometer data at either baseline or follow-up and parents of 1715 (58.9% of all contacted children) preschoolers (4.4?±?0.5 years, 52.5% boys) completed a questionnaire at either baseline or follow-up. No intervention effects were found on objectively and subjectively measured total sedentary time in the total sample. However, some effects on objectively and subjectively measured sedentary time were found in specific subgroups. Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time, while preschoolers from the control group increased their sedentary time. Girls in the intervention group decreased their TV viewing time during weekend days (-5.83 min/day), while girls' &TV viewing in the control group increased (+4.15 min/day). In low SES kindergartens, a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens (+6.06 min/day) than in control kindergartens (+12.49 min/day). CONCLUSION:While some small positive effects were found in some sub-groups, the ToyBox-intervention had no effect on objectively and subjectively measured sedentary time in the total sample. A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects. The ToyBox-study is registered with the clinical trials registry clinicaltrials.gov, ID: NCT02116296.

Project description:BACKGROUND:The ToyBox-intervention is a theory- and evidence-based intervention delivered in kindergartens to improve four- to six-year-old children's energy balance-related behaviours and prevent obesity. The current study aimed to (1) examine the effect of the ToyBox-intervention on increasing European four- to six-year-old children' steps per day, and (2) examine if a higher process evaluation score from teachers and parents was related to a more favourable effect on steps per day. METHODS:A sample of 2438 four- to six-year-old children (51.9% boys, mean age 4.75 ± 0.43 years) from 6 European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) wore a motion sensor (pedometer or accelerometer) for a minimum of two weekdays and one weekend day both at baseline and follow-up to objectively measure their steps per day. Kindergarten teachers implemented the physical activity component of the ToyBox-intervention for 6 weeks in total, with a focus on (1) environmental changes in the classroom, (2) the child performing the actual behaviour and (3) classroom activities. Children's parents received newsletters, tip cards and posters. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and the six intervention countries separately. In addition, process evaluation questionnaires were used to calculate a total process evaluation score (with implementation and satisfaction as a part of the overall score) for teachers and parents which was then linked with the physical activity outcomes. RESULTS:No significant intervention effects on four- to six-year-old children' steps per weekday, steps per weekend day and steps per average day were found, both in the total sample and in the country-specific samples (all p > 0.05). In general, the intervention effects on steps per day were least favourable in four- to six-year-old children with a low teachers process evaluation score and most favourable in four- to six-year-old children with a high teachers process evaluation score. No differences in intervention effects were found for a low, medium or high parents' process evaluation score. CONCLUSION:The physical activity component of the ToyBox-intervention had no overall effect on four- to six-year-old children' steps per day. However, the process evaluation scores showed that kindergarten teachers that implemented the physical activity component of the ToyBox-intervention as planned and were satisfied with the physical activity component led to favourable effects on children's steps per day. Strategies to motivate, actively involve and engage the kindergarten teachers and parents/caregivers are needed to induce larger effects.

Project description:PURPOSE:A systematic primary literature review was conducted to evaluate the relationship of physical activity-as measured by daily step counts-with all-cause mortality, cardiovascular disease mortality, incident cardiovascular disease, and type 2 diabetes mellitus; to evaluate the shape of dose-response relationships; and to interpret findings in the context of development of the Physical Activity Guidelines for Americans, Second Edition. METHODS:A primary literature search encompassing 2011 to March 2018 for existing literature reporting on these relationships was conducted. RESULTS:Eleven pertinent articles were identified. Seven longitudinal studies examined the relationship between daily step counts and mortality, disease incidence, or risk. Two studies examined objectively measured steps per day and all-cause mortality; one was restricted to a relatively small elderly population. One study examined cardiovascular events, defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. The other four longitudinal studies addressed incident type 2 diabetes. All longitudinal studies reported an inverse relationship between steps per day and outcome risk. In one study, 531 cardiovascular events occurred during more than 45,000 person-years of follow-up. Before intervention, each increment of 2000 steps per day up to 10,000 steps was associated with a 10% lower cardiovascular event rate. Also, for every increase of 2000 steps per day over baseline, there was an 8% yearly reduction in cardiovascular event rate in individuals with impaired glucose tolerance. CONCLUSIONS:Daily step count is a readily accessible means by which to monitor and set physical activity goals. Recent evidence supports previously limited evidence of an inverse dose-response relationship of daily steps with important health outcomes, including all-cause mortality, cardiovascular events, and type 2 diabetes. However, more independent studies will be required before these observations can be translated into public health guidelines.

Dataset Information

Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

Publications

Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

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