BackgroundThe aim was to describe levels, patterns and correlates of physical activity and sedentary behavior in a sample of Swedish children, two years of age, with normal weight, overweight and obese parents.MethodsData from 123 children, 37 with normal-weight parents and 86 with overweight/obese parents, enrolled in the Early Stockholm Obesity Prevention Project study was used. Children wore an Actigraph GT3X+ accelerometer for seven days. Average activity (counts per minute), number of steps and time spent in low and high-intensity physical activity and in sedentary was assessed. Differences between weekdays and weekend days were examined as were correlations with sex, body mass index (BMI), motor skills and family-related factors.ResultsChildren were active at high intensity 11% of the day. On average 55% of the day was spent being sedentary. Number of steps and time in low-intensity physical activity differed between weekdays and weekend days: on weekdays, 363 more steps (p = 0.01) and six more minutes in low physical activity (p = 0.04). No differences were found for any physical activity or sedentary behavior variable by sex, BMI, motor skills or any family-related variable (p = 0.07 – 0.95).ConclusionsTwo-year-old children have an intermittent activity pattern, that is almost similar on weekdays and they spend about half of the daytime active. The absence of any association with sex, BMI, motor skills or parental factors indicates that the individual variation in this age group is primarily due to endogenous factors.Trial registrationClinicaltrials.gov: NCT01198847.

IntroductionTo determine time spent at different physical activity intensities, accelerometers need calibration. The aim of this study was to develop and cross-validate intensity thresholds for the Actigraph GT3X+ accelerometer for wrist and hip placement in four-year-old children.MethodsIn total 30 children (49 months, SD 3.7) were recruited from five preschools in Stockholm. Equipped with an accelerometer on the wrist and another on the hip, children performed three indoor activities and one free-play session while being video recorded. Subsequently, physical activity intensity levels were coded every 5th second according to the Children’s Activity Rating Scale. Receiver Operating Characteristic (ROC) curves was used to develop wrist and hip intensity thresholds, the upper threshold for sedentary, and lower threshold for moderate-to-vigorous physical activity (MVPA), for the vertical axis (VA) and for the vector magnitude (VM). A leave-one-out method was used to cross-validate the thresholds.ResultsIntensity thresholds for wrist placement were ≤ 178 (VA) and ≤ 328 (VM) for sedentary and ≥ 871 (VA) and ≥ 1393 (VM) counts/5 seconds for MVPA. The corresponding thresholds for hip placement were ≤ 43 (VA) and ≤ 105 (VM) for sedentary and ≥ 290 (VA) and ≥ 512 (VM) for MVPA. The quadratic weighted Kappa was 0.92 (95% CI 0.91–0.93) (VA) and 0.95 (95% CI 0.94–0.96) (VM) for the wrist-worn accelerometer and 0.76 (98% CI 0.74–0.77) and 0.86 (95% CI 0.85–0.87) for the hip-worn.ConclusionUsing wrist placement and the VM when measuring physical activity with accelerometry in 4-year-old children is recommended.

BackgroundOverweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, Early STOPP, combating multiple obesity-promoting behaviors such unbalanced diet, physical inactivity and disturbed sleeping patterns. We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents. This protocol outlines methods for the recruitment phase of the study.Design and methodsThis randomized controlled trial (RCT) targets overweight and/or obese parents with infants, recruited from the Child Health Care Centers (CHCC) within the Stockholm area. The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach (dietitian, physiotherapist or a nurse). The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC, which include advices on healthy food choices and eating patterns, increasing physical activity/reducing sedentary behavior and regulating sleeping patterns.DiscussionThe Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population, defining a feasible, theory-based intervention and assessing multiple measurements to validate and interpret the program effectiveness. The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge, this longitudinal RCT is the first attempt to demonstrate whether an early, long-term, targeted health promotion program focusing on healthy eating, physical activity/reduced sedentary behaviors and normalizing sleeping patterns could be effective. If proven so, Early STOPP may protect children from the development of overweight and obesity.Trial registrationThe protocol for this study is registered with the clinical trials registry clinicaltrials.gov, ID: ES-2010)

This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Johansson, E., Ekelund, U., Nero, H., Marcus, C., Hagströmer, M. (2015).Calibration and cross-validation of a wrist-worn Actigraph in young preschoolers. Pediatric Obesity, 10, 1-6.Dette er siste tekst-versjon av artikkelen, og den kan inneholde små forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på www. and scored into sedentary, low and high intensity physical activity based on Children´s Activity Rating Scale (CARS) and combined with accelerometer data using a 5 second epoch. Conclusion:Data from a wrist mounted Actigraph activity monitor appears accurate to categorize young preschoolers into physical activity intensity categories.