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ObjectiveTo describe levels of physical activity, sedentary time and adherence to Chief Medical Officers (CMO) physical activity guidelines among primary school-aged children across the UK using objective accelerometer-based measurements.DesignNationally representative prospective cohort study.SettingChildren born across the UK, between 2000 and 2002.Participants6497 7-year-old to 8-year-old singleton children for whom reliable accelerometer data were available for at least 10 h a day for at least 2 days.Main outcome measuresPhysical activity in counts per minute (cpm); time spent in sedentary and moderate-to-vigorous intensity physical activity (MVPA); proportion of children meeting CMO guidelines (≥60 min/day MVPA); average daily steps.Explanatory measuresGender, ethnicity, maternal current/most recent occupation, lone parenthood status, number of children in the household and country/region of residence.ResultsThe median daily physical activity level was 595 cpm (IQR 507, 697). Children spent a median of 60 min (IQR 47–76) in MVPA/day and were sedentary for a median of 6.4 h/day (IQR 6–7). Only 51% met CMO guidelines, with girls (38%) less active than boys (63%). Children took an average of 10 229 (95% CI (8777 to 11 775)) steps each day. Children of Indian ethnicity were significantly less active overall than all other ethnic groups. Children of Bangladeshi origin and those living in Northern Ireland were least likely to meet CMO guidelines.ConclusionsOnly half of 7-year-old children in the UK achieve recommended levels of physical activity, with significant gender, ethnic and geographic variations. Longitudinal studies are needed to better understand the relevance of these (in)activity patterns for long-term health and well-being. In the meantime population-wide efforts to boost physical activity among young people are needed which are likely to require a broad range of policy interventions.

BackgroundWhen using accelerometers to measure physical activity, researchers need to determine whether subjects have worn their device for a sufficient period to be included in analyses. We propose a minimum wear criterion using population-based accelerometer data, and explore the influence of gender and the purposeful inclusion of children with weekend data on reliability.MethodsAccelerometer data obtained during the age seven sweep of the UK Millennium Cohort Study were analysed. Children were asked to wear an ActiGraph GT1M accelerometer for seven days. Reliability coefficients(r) of mean daily counts/minute were calculated using the Spearman-Brown formula based on the intraclass correlation coefficient. An r of 1.0 indicates that all the variation is between- rather than within-children and that measurement is 100% reliable. An r of 0.8 is often regarded as acceptable reliability. Analyses were repeated on data from children who met different minimum daily wear times (one to 10 hours) and wear days (one to seven days). Analyses were conducted for all children, separately for boys and girls, and separately for children with and without weekend data.ResultsAt least one hour of wear time data was obtained from 7,704 singletons. Reliability increased as the minimum number of days and the daily wear time increased. A high reliability (r = 0.86) and sample size (n = 6,528) was achieved when children with ≥ two days lasting ≥10 hours/day were included in analyses. Reliability coefficients were similar for both genders. Purposeful sampling of children with weekend data resulted in comparable reliabilities to those calculated independent of weekend wear.ConclusionQuality control procedures should be undertaken before analysing accelerometer data in large-scale studies. Using data from children with ≥ two days lasting ≥10 hours/day should provide reliable estimates of physical activity. It’s unnecessary to include only children with accelerometer data collected during weekends in analyses.

AimTo undertake a review of the methods and findings of published research evaluating the influence of season on accelerometer-determined sedentary behaviour (SB) and physical activity (PA) in children.MethodsA literature search was carried out using PubMed, Embase, Medline and Web of Science up to, and including, June 2011. The search strategy focused on four key elements: children, SB or PA, season and accelerometer. Articles were eligible for inclusion if they were published in English, included healthy study participants aged ≤ 18 years, reported at least one outcome variable derived from accelerometer-determined measurements, and compared SB or PA between two or more seasons, or controlled for season of measurement. Eligible papers were reviewed and evidence tables compiled reporting on publication year, country studied, study recruitment, consent rate, sample descriptives, study design, accelerometer protocol, valid accelerometer data receipt, season definition, statistical methods and key findings.ResultsSixteen of 819 articles were eligible for inclusion: children aged two to five years, six to twelve, or six to 18 years were included in five, six and five articles respectively. Six articles were from the UK, six from other European countries, three from the USA and one from New Zealand. Study sample sizes ranged from 64 to 5595. PA was reported in all articles but SB in only three. Only four studies were longitudinal and none of these reported SB. Seasonal variation in PA was reported in all UK studies, being highest in summer and lowest in winter. In four non-UK studies seasonal variation in PA was not found. Findings were inconclusive for SB.ConclusionThere is sufficient evidence to support public health interventions aimed at increasing PA during winter in UK children. No conclusions can be drawn regarding the effect of season on children’s SB reflecting few studies of small sample size, lack of repeat measures, incomparable definitions of season and inconsistent accelerometer protocols. Future research should determine factors that drive seasonal patterns in PA and SB in children such as age, sex, and geographic and climatic setting to inform interventions and target populations.

We examined whether the adverse effects of prenatal exposure to tobacco on lung development are limited to the last weeks of gestation by comparing respiratory function in preterm infants whose mothers had and had not smoked during pregnancy. Maximal forced expiratory flow (Vmax FRC) and time to peak tidal expiratory flow as a proportion of total expiratory time (TPTEF:TE) were measured prior to discharge from hospital in 108 preterm infants (mean [SD] gestational age, 33.5 [1.8] wk), 40 of whose mothers had smoked during pregnancy. Infant urinary cotinine was less than 4 ng/ml in those born to nonsmokers, but it was as high as 458 ng/ml in exposed infants (p < 0.0001). TPTEF:TE was significantly lower in infants exposed to tobacco in utero (mean [SD], 0.369 [0.109]) when compared with those who were not (0.426 [0.135]) (p <= 0.02). Vmax FRC was also reduced in exposed infants (mean [SD], 85.2 [41.7] ml/s versus 103.8 [49.7] ml/s) (p = 0.07). After allowing for sex, ethnic group, body size, postnatal age, and socioeconomic status, TPTEF:TE remained significantly diminished in infants exposed prenatally to tobacco (p < 0.05). Thus, impaired respiratory function is evident in infants born on average 7 wk prior to the expected delivery date, suggesting that the adverse effects of prenatal exposure to tobacco are not limited to the last weeks of pregnancy.

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Objectives. We examined cross-sectional and longitudinal associations between obesity and emotional and behavioural problems in a nationally representative sample of young children. Methods. Data were available from 11 202 children (50% boys) participating in the UK's Millennium Cohort Study. Height and weight were measured at 3 and 5 years and children defined as obese using IOTF cut-offs for body mass index (BMI). Emotional and behavioural problems were parentally assessed using the Strengths and Difficulties Questionnaire. Adjusted linear and multinomial regression analyses were conducted separately for boys and girls. Results. At age 3, obese boys had more conduct problems, and obese girls had more prosocial behaviours, than their normal weight counterparts. At age 5, obese boys had more conduct problems, hyperactivity and inattention problems, peer relationship problems and total difficulties. Obese girls only had more peer relationship problems. Obese 3-year-olds were not at increased risk of abnormal scores; in contrast, obese 5-year-old boys were significantly more likely to have abnormal scores for conduct problems, hyperactivity and inattention problems, peer relationship problems, prosocial behaviours and total difficulties. Obesity, at age 3, was also predictive of peer relationship problems at age 5 in boys (95% CI: 0.26 [0.01, 0.52]). Conclusions. Childhood obesity is associated with emotional and behavioural problems from a very young age. Obese boys are at particular risk. Further research is required to examine effect modifiers and mediating factors in these associations. Recognition and response to these mental health problems should be a goal of pediatric obesity interventions and policies.

Initiating and prolonging breastfeeding may reduce excess weight gain by preschool age. Association of the early introduction of solids with rapid weight gain during early childhood is mediated through childhood stature. Although effects sizes are small, at a population level they are of public health importance as these risk factors are potentially modifiable. Strategies to support mothers to follow internationally recommended infant feeding practices are required.