WHAT'S KNOWN ON THIS SUBJECT:Physical activity plays an important role in the development of preschool-aged children (aged 3-5 years). Public health guidelines exist that specify a minimal level of physical activity preschoolers should accumulate daily. Previous studies conclude that the majority of preschoolers do not meet these guidelines. WHAT THIS STUDY ADDS:Ambiguity in the interpretation of the guidelines, coupled with multiple ways to quantify physical activity, precludes definitive statements regarding the prevalence of sufficiently active preschoolers. Concerted attention is required for developing explicit guidelines and standardization of physical activity measures. abstract OBJECTIVE: The National Association for Sport and Physical Education (NASPE) guidelines for preschoolers recommend 120 minutes of physical activity daily. Two issues, however, create a situation whereby substantial variation in estimated prevalence rates of (in)active preschoolers are reported. First, NASPE guidelines have been interpreted in multiple ways. Second, objective monitoring via accelerometry is the most widely accepted measure of preschoolers' physical activity, yet multiple cut points provide vastly different estimates of physical activity. This study aimed to estimate the prevalence of preschoolers meeting NASPE guidelines and illustrate the differences among rates, given guideline interpretations, and cut points. PATIENTS AND METHODS:Three-to 5-year-old children (n ϭ 397) wore ActiGraph accelerometers for an average of 5.9 days. NASPE guidelines were expressed in 3 ways: 120 minutes daily of light-to-vigorous physical activity; 120 minutes daily of moderate-to-vigorous physical activity; and 60 minutes daily of moderate-to-vigorous physical activity. Estimates of 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-tovigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity were calculated on the basis of 4 common accelerometer cut points for preschoolers: Pate, Reilly and Puyau, Sirard, and Freedson. RESULTS:Prevalence rates varied considerably, with estimates ranging from 13.5% to 99.5%, 0.0% to 95.7%, and 0.5% to 99.5% for 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity, respectively. CONCLUSIONS:The variation in NASPE guidelines, coupled with different accelerometer cut points, results in disparate estimates of (in)active preschoolers. This limits the ability to estimate population prevalence levels of physical activity that can be used to guide public health policy. Development of new guidelines should focus on an explicit delineation of physical activity and attempt to standardize the measurement of preschoolers' physical activity.

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Purpose-No universally accepted ActiGraph accelerometer cutpoints for quantifying moderateto-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d -1 ). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy. Design-Secondary data analysis.Methods-ActiGraph data from a large preschool project (N = 419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. Conversions were made among five different published MVPA cutpoints for children: Pate (PT), Sirard (SR), Puyau (PY), Van Cauwengerghe (VC), and Freedson Equation (FR). A 10 fold cross-validation procedure was used to develop prediction equations using MVPA estimated from each of the five sets of cutpoints as the dependent variable, with estimated MVPA from one of the other four sets of cutpoints (e.g., PT MVPA predicted from FR MVPA).Results-The mean levels of MVPA for the total sample ranged from 22.5 (PY) to 269.0 (FR) min•d -1 . Across the prediction models (5 total), the median proportion of variance explained (R 2 ) was 0.76 (range 0.48 -0.97). The median absolute percent error was 17.2% (range 6.3%-38.4%). Conclusion-The prediction equations developed here allow for direct comparisons between studies employing different ActiGraph cutpoints in preschool-age children. These prediction equations give public health researchers and policy makers a more concise picture of physical activity levels of preschool-aged children.

Background The combined effect of modifiable health factors on the risk of cardiovascular disease (CVD) mortality has not been well established. The objective of this study was to determine the association between five modifiable health factors in combination on the risk of CVD mortality in a sample of adult males. Methods A cohort of 38,110 men (aged 20 to 84 years and of middle and upper socioeconomic strata) was followed over time until their date of death or December 31, 2003. A health profile score (unweighted and weighted) was developed based on cardiorespiratory fitness (CRF; moderate or high vs. low), self-reported physical activity (active vs. inactive), smoking status (not current vs. current), alcohol consumption (1–14 drinks/wk vs. 0 or >14 drinks/wk), and body mass index (BMI; 18.5–24.9 kg/m2 vs. ≥25.0 kg/m2). Results During 16.1 ± 8.4 years of follow-up and 613,571 man-years of exposure, there were 949 deaths from CVD. High CRF, normal BMI, being physically active and not currently smoking were individually associated with reduced risk of CVD mortality, after adjusting for confounders. When considered in combination, a minimum of two out of five positive health factors reduced the risk of CVD mortality (HR=0.67; 95% CI 0.49–0.91). The weighted score indicated that a combination of high CRF, not currently smoking and normal BMI is of most clinical importance to CVD mortality (HR=0.31; 95% CI 0.24–0.39). Conclusions Exposure to increasing numbers of beneficial health factors in adulthood reduced the risk of CVD mortality in men, and multi-behavioral prevention efforts in adulthood should be encouraged.