Are your kids meeting the minimum recommendations of one hour of physical activity and not more than two hours in front of a TV/computer? While the numbers are getting better, children in the U.S. are still falling short. So where do your kids fit in?

Many Kids Not Meeting Physical Activity Goals

 

By Todd Neale, Senior Staff Writer, MedPage Today

Published: January 07, 2013

Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Only two out of five U.S. children in elementary school met both the physical activity and screen-time recommendations from the federal government and the American Academy of Pediatrics, researchers found.

Although 70% of children were getting at least 60 minutes of moderate-to-vigorous exercise each day and 54% were sitting in front of a screen for no more than 2 hours a day, only 38% met both criteria, according to Tala Fakhouri, PhD, MPH, of the CDC's National Center for Health Statistics in Hyattsville, Md., and colleagues.

Remaining consistent with one recommendation did not necessarily predict meeting the other recommendation, the researchers reported online in JAMA Pediatrics.

"These findings support the distinct recommendations for screen-time viewing and physical activity by the American Academy of Pediatrics and may inform interventions designed to prevent childhood obesity, such as the First Lady Michelle Obama's program to end childhood obesity within a generation (i.e., the Let's Move! initiative)," the authors wrote.

Fakhouri and colleagues examined cross-sectional data on 1,218 children ages 6 to 11 from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). A proxy, usually a parent, reported how much each child exercised and how much time each child spent watching television, playing video games, or using a computer. They also looked at demographic information, including an income measurement called the family income to poverty level ratio (FIPR).

Differences in the likelihood of meeting the physical activity recommendation were seen for several demographic categories. Those less likely to exercise for at least an hour a day included the following:

• Girls (OR 0.68, 95% CI 0.51 to 0.92)
• Children ages 9 to 11 versus younger children (OR 0.60, 95% CI 0.42 to 0.86)
• Hispanics versus non-Hispanic whites (OR 0.60, 95% CI 0.38 to 0.95)
• Children in households with an income between 130% to 349% of the FIPR versus those below 130% (OR 0.59, 95% CI 0.35 to 0.99)
• Children in households with an income of 350% or more of the FIPR versus those below 130% (OR 0.46, 95% CI 0.26 to 0.81)
• Obese children (OR 0.44, 95% CI 0.32 to 0.60)

There were fewer demographic differences in the likelihood of meeting the screen-time recommendation. Older children (OR 0.61, 95% CI 0.42 to 0.89), non-Hispanic blacks (OR 0.57, 95% CI 0.34 to 0.94), and obese children (OR 0.65, 95% CI 0.48 to 0.88) were less likely to have 2 or fewer hours of screen-time each day compared with their respective comparators.

Hispanics, who were less likely than non-Hispanic whites to meet the physical activity recommendation, were more likely to meet the screen-time recommendation (OR 1.69, 95% CI 1.18 to 2.43), which suggests "that screen-time viewing and physical activity may be separate constructs and that low levels of screen-time viewing do not necessarily predict higher levels of physical activity."

Indeed, the odds of meeting the physical activity recommendation did not differ between the children who did or did not meet the screen-time recommendation.

There were even fewer demographic differences in the likelihood of meeting both recommendations at the same time, which was significantly lower only in the children who were older (OR 0.57, 95% CI 0.38 to 0.85) and obese (OR 0.53, 95% CI 0.38 to 0.73).

One issue with the findings pointed out by the researchers is that in the 2009-2010 NHANES, physical activity was measured only through proxy report, which is subject to social desirability bias and can be influenced by the amount of time the parent spends with the child.

Although activity can be objectively measured with accelerometers, those too have some potential problems involving cutoff values, sampling intervals, inadequate capture of certain activities, and expense.

"Because of these measurement issues," Fakhouri and colleagues wrote, "many researchers and physical activity experts are now advocating for the use of multiple methods to assess physical activity accurately."

The authors reported that they had no conflicts of interest.

Primary source: JAMA Pediatrics
Source reference:
Fakhouri T, et al "Physical activity and screen-time viewing among elementary school-aged children in the United States from 2009 to 2010" JAMA Pediatr 2013; DOI: 10.1001/2013.jamapediatrics.122.