Trajectories of objectively measured physical activity and childhood overweight: longitudinal analysis of the IDEFICS/I.Family cohort

Abstract

Background Since only few longitudinal studies with appropriate study designs investigated the relationship between objectively measured physical activity (PA) and overweight, the degree PA can prevent excess weight gain in children, remains unclear. Moreover, evidence is limited on how childhood overweight determines PA during childhood. Therefore, we analyzed longitudinal trajectories of objectively measured PA and their bi-directional association with weight trajectories of children at 2- and 6-year follow-ups. Methods Longitudinal data of three subsequent measurements from the IDEFICS/I.Family cohort study were used to analyze the bi-directional association between moderate-to-vigorous PA (MVPA) and weight status by means of multilevel regression models. Analyses comprised 3393 (2-year follow-up) and 1899 (6-year follow-up) children aged 2–15.9 years from eight European countries with valid accelerometer data and body mass index (BMI) measurements. For categorized analyses, children’s weight status was categorized as normal weight or overweight (cutoff: 90th percentile of BMI) and children’s PA as (in-) sufficiently active (cutoffs: 30, 45 and 60 min of MVPA per day). Results Children engaging in at least 60 min MVPA daily at baseline and follow-ups had a lower odds of becoming overweight (odds ratio [OR] at 2-year follow-up: 0.546, 95% CI: 0.378, 0.789 and 6-year follow-up: 0.393, 95% CI: 0.242, 0.638), compared to less active children. Similar associations were found for 45 min MVPA daily. On the other side, children who became overweight had the lowest odds to achieve 45 or 60 min MVPA daily (ORs: 0.459 to 0.634), compared to normal weight children. Conclusions Bi-directional associations between MVPA and weight status were observed. In summary, at least 60 min MVPA are still recommended for the prevention of childhood overweight. To prevent excess weight gain, 45 min MVPA per day also showed preventive effects.

A longitudinal causal graph analysis investigating modifiable risk factors and obesity in a European cohort of children and adolescents

“…Although we found no clear evidence for a causal impact of physical activity, healthy diet or well-being on obesity, associations were previously found in the IDEFICS/I.Family cohort e.g. in a smaller subset using an objective accelerometer-based measure of PA [39][40][41] . Overall, our results suggested that cultural, perinatal and familial variables have direct links to obesity, unlike individually modifiable risk factors.…”

The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index: A comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States

“…Other studies that share this limitation have also found null results (Côté-Lussier et al, 2015). In contrast, a recent large-scale study that used uniaxial accelerometry found significant protective effects of moderate-to-vigorous physical activity on child weight trajectories (Sprengeler et al, 2021). Hence, survey-reported measures that do not distinguish between light, moderate and vigorous activityas used in this studymay miss the weight-reducing benefits of certain types of activity.…”

Physical activity in early childhood: a five-year longitudinal analysis of patterns and correlates

“…An apparent limitation in the present study is the number of missing cases. Attrition of the study sample is unfortunately common in longitudinal studies ( [ 68 , 69]) and when following families during the toddler years it is expected to lose participants. However, the statistical method was chosen with this limitation in mind and LMM is a flexible tool with the advantage of being able to deal with missing values [ 55 ].…”