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Despite childcare providers' substantial interaction with toddlers, very little is known about providers' perception of toddlers' physical activity (PA) and how to facilitate toddler PA. This qualitative study examines facilitators, barriers, and components of a PA intervention to improve toddlers' PA within the childcare setting. Providers from three childcare centers completed Qualtrics survey and participated in focus group meetings. Semi-structured focus group meetings were recorded, transcribed, and systematically analyzed. Providers viewed PA as essential for toddlers' health. Providers felt that toddlers' classroom behavior, attention span, and basic needs should be considered when engaging toddlers in PA. Providers expressed that a PA intervention targeting toddlers should be non-structured, include music and motor skill-related activities, occur 2-3 days/week, and last 10-30 min. However, structured activities should last < 5 min. This study highlights our understanding of providers' perceptions of PA, challenges they faced in getting toddlers to be active, and intervention components needed improving toddlers' PA.

AbstractBackgroundMost preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day. Within this time frame, children accumulate most of their activity within the first 10 min. This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. The STEP study is a cluster randomized controlled study designed to examine the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on during-school physical activity (PA) in preschoolers.Methods/DesignTen preschool centers serving low-income families were randomized into SBS-PA versus unstructured PA (UPA). SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting, twice daily, followed by 20 min of usual unstructured playtime. UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily. Interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for six months. Outcome measures were between group difference in during-preschool PA (accelerometers and direct observation) over six-months. Ten preschool centers, representing 34 classrooms and 315 children, enrolled in the study. The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile, respectively. Participants spent 74% and 6% of their preschool day engaged in sedentary and MVPA, respectively.DiscussionResults from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers’ PA levels.Trial registrationClinicaltrials.gov, NCT01588392

Background: We examined the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on preschoolers PA. Methods: Preschools were randomized to SBS-PA (centers, N = 5; participants, N = 141) or unstructured free playtime (UPA) (centers, N = 5; participants, N = 150). SBS-PA consisted of structured PA implemented in the classroom during the first 10 minutes of gross-motor playtime followed by 20 minutes of free playtime. UPA consisted of 30 minutes of unstructured free playtime. Teachers implemented both conditions for 5 days/week for 6 months. PA was assessed with accelerometers (preschool-day) and direct observation (30-minute sessions). Generalized linear mixed models were used to examine the impact of the intervention. Results: Regarding the 30-minute sessions, significant group main effects were observed for intervals spent at light (p < 0.001) and moderate-to-vigorous PA (MVPA, p < 0.001). Regarding the preschool-day PA, significant group by visit interaction was observed for percent time spent in total preschool-day MVPA (F (2, 254) = 3.54, p = 0.03). Percent of time spent in MVPA significantly decreased in both groups at 3 months and at 6 months. Conclusion: SBS-PA can be implemented in classroom settings; however, further research is needed to examine its impact on preschoolers PA levels.

The impact of additional structured outdoor playtime on preschoolers'; physical activity (PA) level is unclear. The purpose of this pilot study was to explore the effects of increasing structured outdoor playtime on preschoolers'; PA levels. Eight full-day classrooms (n = 134 children) from two preschool programmes were randomised into a treatment (STRUCT, n = 4) or control (CON, n = 4) condition. Both groups received an additional 30 minutes of outdoor playtime three days per week for four weeks. The STRUCT intervention consisted of previously tested structured outdoor playtime activities/games. The CON intervention consisted of free outdoor playtime. Children were individually recruited (n = 75) for the objective assessment of PA levels. The PA levels of 67 children (age, 4.1 [plus or minus] 0.8 years; STRUCT, n = 38; CON, n = 29) were assessed at baseline and during week four for seven consecutive days using Actigraph accelerometers. Data were analysed using mixed-model analysis of variance. Time spent in vigorous PA significantly increased during the 30-minute intervention time for the STRUCT group compared with the CON group (group x time interaction: F(1, 36) = 4.91, p = 0.04). Compared with baseline, a significant increase was observed in the STRUCT group's time spent engaged in moderate-to-vigorous PA (MVPA) during the intervention time, but this increase was not significant compared with the CON group (baseline: STRUCT, 1.7 [plus or minus] 2.0 min; CON, 1.9 [plus or minus] 2.4 min; week four: STRUCT, 4.9 [plus or minus] 3.1 min; CON, 3.3 [plus or minus] 2.5 min). Compared with the CON group, the STRUCT group spent a significantly greater percentage of time engaged in MVPA and a significantly lower percentage of time engaged in sedentary activity during the preschool day. In conclusion, this study provides preliminary evidence that increasing preschoolers'; exposure to structured activities during outdoor playtime could lead to improvements in their PA levels. The present intervention could be used to help preschoolers meet the recommended levels of PA. (Contains 2 tables and 1 note.)

Background: For a health behavior intervention to be sustainable within preschool centers, the intervention should be implemented by classroom teachers. Unfortunately, teachers are constrained by demands such as meeting early childhood education standards. Therefore, the purpose of this pilot study was to examine the feasibility and preliminary efficacy of integrating a health behavior intervention into early education learning standards on physical activity (PA), diet, and sleep (PADS) behavior of preschoolers. Methods: Two preschool centers were randomized to either the PADS (children, n = 60) or the control (CON; children, n = 54) group. The PADS intervention consisted of PADS lesson plans and activities embedded into Massachusetts early learning standards and were implemented for 4 days per week for 12 weeks. The CON preschool participated in their usual curriculum. PA was assessed using accelerometers for 7 consecutive days at baseline, 6 weeks, and 12 weeks. Other outcome variables were assessed with parental surveys at baseline and 12 weeks. Results: Significant group by time interactions were observed for moderate to vigorous PA (percentage of time) during the preschool day (PADS: baseline = 10.6% (4.2%), 12 wk = 13.2% (2.3%); CON: baseline = 12.4% (3.9%), 12 wk = 11.2% (3.6%); P =.02). Conclusion: This pilot study provides preliminary evidence that integrating health behaviors into learning standards is feasible and potentially an effective way for increasing preschoolers' PA levels. [ABSTRACT FROM AUTHOR]

Background: Poor adaptive learning behaviors (ie, distractibility, inattention, and disruption) are associated with behavior problems and underachievement in school, as well as indicating potential attention-deficit hyperactivity disorder. Strategies are needed to limit these behaviors. Physical activity (PA) has been suggested to improve behavior in school-aged children, but little is known about this relationship in preschoolers. This study examined the effects of a PA intervention on classroom behaviors in preschool-aged children. Methods: Eight preschool classrooms (n = 71 children; age = 3.8 ± 0.7 y) with children from low socioeconomic environments were randomized to a locomotor-based PA (LB-PA) or unstructured free playtime (UF-PA) group. Both interventions were implemented by classroom teachers and delivered for 30 minutes per day, 5 days per week for 6 months. Classroom behavior was measured in both groups at 3 time points, whereas PA was assessed at 2 time points over a 6-month period and analyzed with hierarchical linear modeling. Results: Linear growth models showed significant decreases in hyperactivity (LB-PA: -2.58 points, P = .001; UF-PA: 2.33 points, P = .03), aggression (LB-PA: -2.87 points, P = .01; UF-PA: 0.97 points, P = .38) and inattention (LB-PA: 1.59 points, P < .001; UF-PA: 3.91 points, P < .001). Conclusions: This research provides promising evidence for the efficacy of LB-PA as a strategy to improve classroom behavior in preschoolers. [ABSTRACT FROM AUTHOR]

An A to Z Weight Loss Study was conducted to examine the effects of four weight-loss diets, that is, Atkins, Zone, LEARN and Ornish, and gradations of carbohydrate intake on weight loss and related metabolic variables in overweight and obese premenopausal women. Results of the randomized trial revealed that the Atkins diet with the lowest carbohydrate content was most effective, indicating that a low-carbohydrate, high-protein, high-fat diet might be considered effective for weight loss.

Purpose: The purpose of this study was to cross-validate previously developed Actiwatch (AW; Ekblom et al. 2012) and AcitGraph (AG; Sirard et al. 2005; AG-P, Pate et al. 2006) cut-point equations to categorize free-living physical activity (PA) of preschoolers using direct observation (DO) as the criterion measure. A secondary aim was to compare output from the AW and the AG from previously developed equations. Methods: Participants' (n = 33; age = 4.4 ± 0.8 yrs; females, n=12) PA was directly observed for three 10-min periods during the preschool-day while wearing the AW (nondominant wrist) and AG (waist). Device specific cutpoints were used to reduce the AW-E (Ekblom et al. 2012) and AG (AG-S, Sirard et al. 2005; AG-P, Pate et al. 2006) data into intensity categories. Spearman correlations (rsp) and agreement statistics were used to assess associations between the DO intensity categories and device data. Mixed model regression was used to identify differences in times spent in activity intensity categories. Results: There was a significant correlation between AW and AG output across all data (rsp = 0.41, p < .0001) and both were associated with the DO intensity categories (AW: rsp = 0.47, AG: rsp = 0.47; p < .001). At the individual level, all devices demonstrated relatively low sensitivity but higher specificity. At the group level, AW-E and AG-P provided similar estimates of time spent in moderate-to-vigorous PA (MVPA, AW-E: 4.7 ± 4.1, AG-P: 4.4 ± 3.3), compared with DO (5.1 ± 3.5). Conclusion: The AW-E and AG-P estimated times spent in MVPA were similar to DO, but the weak agreement statistics indicate that neither device cut-point equations provided accurate estimates at the individual level. [ABSTRACT FROM AUTHOR]

Background: Thirty-five percent of the activities assigned MET values in the Compendium of Energy Expenditures for Youth were obtained from direct measurement of energy expenditure (EE). The aim of this study was to provide directly measured EE for several different activities in youth. Methods: Resting metabolic rate (RMR) of 178 youths (80 females, 98 males) was first measured. Participants then performed structured activity bouts while wearing a portable metabolic system to directly measure EE. Steady-state oxygen consumption data were used to compute activity METstandard (activity VO2/3.5) and METmeasured (activity VO2/measured RMR) for the different activities. Results: Rates of EE were measured for 70 different activities and ranged from 1.9 to 12.0 METstandard and 1.5 to 10.0 METmeasured. Conclusion: This study provides directly measured energy cost values for 70 activities in children and adolescents. It contributes empirical data to support the expansion of the Compendium of Energy Expenditures for Youth. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine the temporal patterns of preschoolers' physical activity (PA) levels during a typical outdoor free playtime. Methods: Baseline playtime accelerometer counts (4.3 ± 0.8 days) from 3 preschool PA intervention studies were used (n = 326 children, age = 4.0 ± 0.8 years). Data were collected using 15-second epochs and classified into sedentary, light, or moderate-tovigorous physical activity (MVPA). Patterns of change during playtime were analyzed using orthogonal polynomial comparisons. Results: For all ages, there was a U-shaped pattern of change for the percent of epochs classified as sedentary [F(1, 323) = 47.12, P < .001) and an inverted U-shaped pattern of change for the percent of epochs classified as MVPA [F(1,323) = 32.15, P < .001]. Age-stratified analyses indicated that the 3-year-olds maintained the decrease in sedentary time [F(2,323) = 6.408, P = .002] and the increase in MVPA [F(2,323) = 3.2, P = .04] to a greater extent than the 4- and 5-year-olds. Conclusions: Preschool children gradually became more active during the first 10 to 15 minutes of outdoor gross motor playtime and less active over the final 10 to 15 minutes of playtime. During the second half of playtime 3-year-olds maintained these changes to a greater degree than 4- and 5-year-olds. [ABSTRACT FROM AUTHOR]

Background: The Compendium of Energy Expenditures for Youth assigns MET values to a wide range of activities. However, only 35% of activity MET values were derived from energy cost data measured in youth; the remaining activities were estimated from adult values. Purpose: To determine the energy cost of common activities performed by children and adolescents and compare these data to similar activities reported in the compendium. Methods: Thirty-two children (8-11 years old) and 28 adolescents (12-16 years) completed 4 locomotion activities on a treadmill (TRD) and 5 age-specific activities of daily living (ADL). Oxygen consumption was measured using a portable metabolic analyzer. Results: In children, measured METs were significantly lower than compendium METs for 3 activities [basketball, bike riding, and Wii tennis (1.1-3.5 METs lower)]. In adolescents, measured METs were significantly lower than compendium METs for 4 ADLs [basketball, bike riding, board games, and Wii tennis (0.3-2.5 METs lower)] and 3 TRDs [2.24 m⋅-1, 1.56 m⋅-1, and 1.34 m⋅s-1 (0.4-0.8 METs lower)]. Conclusion: The Compendium of Energy Expenditures for Youth is an invaluable resource to applied researchers. Inclusion of empirically derived data would improve the validity of the Compendium of Energy Expenditures for Youth. [ABSTRACT FROM AUTHOR]