PURPOSE The purpose of this study was to develop and validate methods for analyzing wrist accelerometer data in youth. METHODS 181 youth (mean±SD; age, 12.0±1.5 yrs) completed 30-min of supine rest and 8-min each of 2 to 7 structured activities (selected from a list of 25). Receiver Operator Characteristic (ROC) curves and regression analyses were used to develop prediction equations for energy expenditure (child-METs; measured activity VO2 divided by measured resting VO2) and cut-points for computing time spent in sedentary behaviors (SB), light (LPA), moderate (MPA), and vigorous (VPA) physical activity. Both vertical axis (VA) and vector magnitude (VM) counts per 5 seconds were used for this purpose. The validation study included 42 youth (age, 12.6±0.8 yrs) who completed approximately 2-hrs of unstructured PA. During all measurements, activity data were collected using an ActiGraph GT3X or GT3X+, positioned on the dominant wrist. Oxygen consumption was measured using a Cosmed K4b2. Repeated measures ANOVAs were used to compare measured vs predicted child-METs (regression only), and time spent in SB, LPA, MPA, and VPA. RESULTS All ROC cut-points were similar for area under the curve (≥0.825), sensitivity (≥0.756), and specificity (≥0.634) and they significantly underestimated LPA and overestimated VPA (P<0.05). The VA and VM regression models were within ±0.21 child-METs of mean measured child-METs and ±2.5 minutes of measured time spent in SB, LPA, MPA, and VPA, respectively (P>0.05). CONCLUSION Compared to measured values, the VA and VM regression models developed on wrist accelerometer data had insignificant mean bias for child-METs and time spent in SB, LPA, MPA, and VPA; however they had large individual errors.

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Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was "combined physical activity and diet" (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed "inconclusive" (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted.

Obesity rates among children and adolescents in developed countries have increased dramatically since the 1970s. During that same period, numerous secular changes have combined to reduce the demand for physical activity in day-to-day life, and many barriers to physical activity are now evident. As a consequence, most children and adolescents do not meet the accepted public health guidelines for physical activity. Accordingly, public health interventions are needed to increase physical activity in adolescence. Such interventions, if successfully implemented, can be expected to improve fitness and health as well as reduce the prevalence of overweight and obesity in young people. Promotion of physical activity in populations of children and adolescents will require comprehensive strategic planning and adoption of new policies in multiple societal sectors. This paper highlights nine initiatives that can address the problem of physical activity in children. The initiatives are to: establish comprehensive school physical activity programming; demand high quality physical education; require physical activity in early child care and education; require physical activity in afterschool programs; create equity in community resources; activate youth sports programs; re-normalize active transport to school; institutionalize clinic-based physical activity assessment and counseling; and build activity-friendly homes. A case will be made for comprehensive national and international strategic planning aimed at effective and large-scale implementation of these initiatives and tactics.

Purpose Youth physical activity (PA) levels differ by race/ethnicity and socioeconomic status (SES). It is well established that various multi-level factors may influence changes in PA. The current study examined whether the association between the change in individual, interpersonal, and environmental factors and the change in PA is modified by race/ethnicity or SES. Methods This study followed 643 youth and their parents from suburban and rural South Carolina participating in the Transitions and Activity Changes in Kids (TRACK) Study in 2008–09 and 2010–11. We assessed total PA in youth using accelerometry and categorized youth and parent survey data into blocks based on the socioecological model. Multivariate regression growth curve models evaluated whether the association between change in independent variables and change in PA was modified by race/ethnicity or SES. Results PA declined from 5th to 7th grade among all racial/ethnic and SES groups. Associations between the range of variables and change in PA were modified by race/ethnicity, but not SES. Blacks did not share any common predictors of change in PA with Whites or Hispanics. However, child-reported number of active friends was associated with total PA, and enjoyment of PA was associated with change in PA among both Whites and Hispanics. Significant interactions by time varied by racial/ethnic group. Conclusions Factors that influence changes in youth PA vary by race/ethnicity but not SES. These findings reinforce the complex nature of addressing PA behavior in diverse samples and further support the need for culturally-appropriate interventions to promote PA in youth.

The results demonstrate that an ActiGraph GT3X+ lux threshold of 240 can accurately assess indoor and outdoor conditions of preschool children in a free-living environment.

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