Search

We tested whether objectively assessed neighbourhood characteristics are associated with moderate-to vigorous physical activity (MVPA) and cycling in Swiss children and adolescents and assessed the mediating role of the perception of the environment. The cross-sectional analyses were based on data of 1306 participants aged 6–16 years of the population-based SOPHYA study. MVPA was measured by accelerometry, time spent cycling and the perceived environment by questionnaire. Objective environmental parameters at the residential address were GIS derived. In all analyses, personal, social and environmental factors were considered. MVPA showed significant positive associations with perceived personal safety and perceived access to green spaces but not with respective objective parameters. Objectively assessed main street density and shorter distance to the next public transport were associated with less cycling in adolescents. Parents’ perceptions did not mediate the observed associations of the objectively assessed environment with MVPA and cycling. Associations between the environment and physical activity differ by domain. In spatial planning efforts to improve objective environments should be complemented with efforts to increase parental sense of security.

BACKGROUND: The COVID-19 pandemic and the resulting containment measures had and still have a profound impact on everyday life. Both the fear of infection and the imposed restrictions can have biopsychosocial consequences. The aim of the present study was to analyze whether there is a difference in the health-related quality of life (HRQoL) of primary school children in 2014/15 compared to in 2020, the first year of the COVID-19 pandemic. METHODS: The present study included 1,712 children aged 5 to 11 years who either participated in the baseline assessment of the SOPHYA cohort study in 2014/15 or were newly recruited during follow-up of the cohort in 2020. In both surveys, the children invited for participation were identified based on registry data. HRQoL was assessed with the validated KINDL-R questionnaire, which scores HRQoL along six different dimensions.CONCLUSION: The SOPHYA-study showed that HRQoL, and especially emotional well-being, was lower in 5 to 11-year-old children in Switzerland during the first year of the pandemic compared to the results from the survey conducted in 2014/15. In the year of the pandemic, the scores were lowest at the height of the COVID-19 waves and their associated restrictions. As it cannot be distinguished whether fear of the disease itself or the restrictions caused this decrease in HRQoL, containment policies should keep COVID-19 infections as low as possible, but still enable children to profit from protective factors such as leisure activities, physical activity and social contact. RESULTS: The overall scores (82.4 [81.8; 83.0] vs. 79.6 [79,1; 80.2]), and in particular the emotional well-being scores (85.6 [84.6; 86.6] vs. 83.3 [82.4; 84.2]), were lower during the year of the pandemic (2020) compared to the survey year 2014/15. The highest decrease between 2014/15 and 2020 in the adjusted models was seen for the youngest age group (-3.9 points), followed by children from families with a high income (-3.2 points), girls (-3.1 points), Swiss citizens (-3.1 points) and children from the German-speaking part of Switzerland (-3.1 points). HRQoL was particularly low during periods with restrictions and at the height of the COVID-19 waves in 2020. CONCLUSION: The SOPHYA-study showed that HRQoL, and especially emotional well-being, was lower in 5 to 11-year-old children in Switzerland during the first year of the pandemic compared to the results from the survey conducted in 2014/15. In the year of the pandemic, the scores were lowest at the height of the COVID-19 waves and their associated restrictions. As it cannot be distinguished whether fear of the disease itself or the restrictions caused this decrease in HRQoL, containment policies should keep COVID-19 infections as low as possible, but still enable children to profit from protective factors such as leisure activities, physical activity and social contact.

Background Prehospital delay reduces the proportion of patients with stroke treated with recanalization therapies. We aimed to identify novel and modifiable risk factors for prehospital delay. Methods and Results We included patients with an ischemic stroke confirmed by diffusion‐weighted magnetic resonance imaging, symptom onset within 24 hours and hospitalized in the Stroke Center of the University Hospital Basel, Switzerland. Trained study nurses interviewed patients and proxies along a standardized questionnaire. Prehospital delay was defined as >4.5 hours between stroke onset—or time point of wake‐up—and admission. Overall, 336 patients were enrolled. Prehospital delay was observed in 140 patients (42%). The first healthcare professionals to be alarmed were family doctors for 29% of patients (97/336), and a quarter of these patients had a baseline National Institute of Health Stroke Scale score of 4 or higher. The main modifiable risk factor for prehospital delay was a face‐to‐face visit to the family doctor (adjusted odds ratio, 4.19; 95% CI , 1.85–9.46). Despite transport by emergency medical services being associated with less prehospital delay (adjusted odds ratio, 0.41; 95% CI , 0.24–0.71), a minority of patients (39%) who first called their family doctor were transported by emergency medical services to the hospital. The second risk factor was lack of awareness of stroke symptoms (adjusted odds ratio, 4.14; 95% CI , 2.36–7.24). Conclusions Almost 1 in 3 patients with a diffusion‐weighted magnetic resonance imaging–confirmed ischemic stroke first called the family doctor practice. Face‐to‐face visits to the family doctor quadrupled the odds of prehospital delay. Efforts to reduce prehospital delay should address family doctors and their staffs as important partners in the prehospital pathway. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02798770.

Introduction This study aims to assess (i) the prevalence of having regular family breakfast, lunch, dinner (i.e. 5–7 days/week together with their family) among 10–12 year olds in Europe, (ii) the association between family meals and child weight status, and (iii) potential differences in having family meals according to country of residence, gender, ethnicity and parental levels of education. Methods 7716 children (mean age: 11.5 ± 0.7 years, 52% girls) in eight European countries (Belgium, Greece, Hungary, The Netherlands, Norway, Slovenia, Spain, Switzerland) participated in a cross-sectional school-based survey in 2010. Data on family meals were self-reported by the parents and children's height and weight were objectively measured to determine overweight status. Binary regression analyses assessed the associations of having regular family meals (adjusted for potential confounders) with children's overweight/obesity and to assess potential differences in having family meals according to gender, ethnicity and parental education, in the total sample and for each country respectively. Results The prevalence of regular family meals was 35%, 37% and 76% for breakfast, lunch and dinner respectively. Having regular family breakfast, but not lunch or dinner, was inversely associated with overweight (OR = 0.78 (95% CI 0.67–0.91)). Children of higher educated parents were more likely to have regular family breakfast (1.63 (95% CI 1.42–1.86)) and less likely to have regular family lunch (0.72 (95% CI 0.63–0.82)) compared to children of lower educated parents. Conclusion This study showed that having regular family breakfast – but not other family meals- was inversely associated with children's weight status., Highlights • Having regular family breakfast, but not other family meals, was inversely associated with children's overweight. • Having regular family breakfast was associated with high parental education. • Having regular family lunch was inversely associated with high parental education.

Both parents' and children's perception of children's weight status may be important predictors of slimming and energy-balance related behaviours, independent of children's actual weight status.; We examined the cross-sectional association of children's self-reported slimming and energy-balance related behaviours with children's (i) actual, (ii) self-perceived and (iii) parent-perceived weight status.; Data of 10- to 12-year-old European children and their parents were used. Multilevel logistic and linear regression analyses were performed, adjusting for age, gender, parental weight controlling behaviours, education, marital status and ethnicity.; Independent of their actual weight status, a higher proportion of children reported slimming when they or their parents perceived them as too fat. Children's self-perceived weight status was more strongly associated with slimming than their parents' perception or their actual weight status. Moreover, children who perceive themselves as overweight reported less physical activity and more screen time. Children whose parents perceive them as overweight reported less physical activity.; Children's own perception of their weight status appears to be more important for their self-reported slimming than their actual or their parent's perceptions of their weight status. Additionally, children's self-perceived weight status seems important in engaging more physical activity and reduces screen time.

BACKGROUND Non-communicable diseases (NCDs) account for the vast majority of deaths in Switzerland. Insufficient physical activity (PA) is an established NCD risk factor and PA is known to be beneficial for physical and mental wellbeing. Sedentary behaviour (SB) is an additional, independent risk factor and associated with frailty in older adults. This study aimed at describing cross-sectional PA patterns in a general population sample of subjects aged 52 years and older (52+) from eight areas across different language regions of Switzerland. Additionally, the predictive association of self-reported PA for objectively measured PA was tested. METHODS Participants 52+ of the Swiss Cohort Study on Air Pollution And Lung and Heart Disease In Adults (SAPALDIA) who completed accelerometer data collection at the most recent follow-up (SAPALDIA4 in 2017/18) and provided information on determinants of interest (sex, age, body mass index [BMI], language region, education, employment status, civil status, smoking) were included in the analysis (n = 1314). The accelerometer-derived average time spent in different PA intensities (SB, light PA [LPA], moderate-to-vigorous PA [MVPA]) was estimated according to participant characteristics with control for season and wear time using multiple linear regressions. In further analyses, the predictive effect of changes in self-reported PA over roughly ten years between SAPALDIA2 (2001/02) and SAPALDIA3 (2010/11) (remaining inactive [RI]; becoming inactive [BI]; becoming active [BA]; remaining active [RA]) on the objectively measured SB, LPA and MVPA obtained seven years later by accelerometry (SAPALDIA4), was assessed using multiple linear regression models. RESULTS Overall, 21.7% of 52+ participants met the Swiss recommendations for subjectively assessed PA. Obese participants, 75+ year-olds, smokers and subjects living alone spent more time in SB and less time in LPA and MVPA compared with participants with a BMI below 25 kg/m2, between 52 and 64 years old, not smoking and being married, respectively. Residents living in the French-speaking part of Switzerland were less likely to engage in MVPA compared with residents from the German-speaking part and thus were less likely to meet the PA recommendations. A trend for increasing PA and decreasing SB was observed consistently across the four groups (RI, BI, BA, RA) of predictive self-reported PA patterns with participants remaining active over the course of roughly ten years showing highest levels of PA and lowest levels of SB measured objectively at SAPALDIA4. CONCLUSION The high proportion of SB points to the need of physical activity promotion for the older part of the population in Switzerland. According to our data, behavioural changes in PA are possible and sustainable as we can see in the group of participants becoming active and this is essential for health promotion recommendations.

Background Evidence for the context-specific influence of parental modelling on physical activity (PA) in childhood remains inconclusive. This nationwide Swiss study assessed the cross-sectional association between objectively measured PA of parents and their children and whether it varied across different levels of sociodemographic and environmental factors. In a second step a structural equation-model (SEM) was used to assess, whether associations between children’s PA and sociodemographic and environmental factors are mediated by the parental PA behaviour. Methods The population-based sample of the SOPHYA-study consisted of 889 children aged 6 to 16 years living in Switzerland and 1059 parents. PA was measured using accelerometers. Information on sociodemographics, sports behaviour, family characteristics, and perceived environment was obtained by telephone interview and parental questionnaire. Objective environmental data was allocated to each family’s residential address using GIS (geographic information system). A structural equation model tested these factors for both independent associations with children’s PA and associations mediated through the parental PA behaviour. Results Parental moderate to vigorous physical activity (MVPA) was associated with MVPA of their children in general (p

Physical activity is essential for healthy aging. Evidence suggests that vigorous-intensity physical activity (VPA) may be more beneficial than moderate-intensity physical activity (MPA). We examined physical activity levels (MPA, VPA and total physical activity), and their socio-demographic determinants in 2311 participants (15–93 years; 68% women) of the MZIMA Open Community Cohort, who had complete relevant data. Physical activity levels were estimated in minutes per week across three domains—work, leisure and transport. We created three outcome variables: low MPA (heterogeneity < 0.001), on the associations between education and IPA, and between age, occupation and low VPA. In conclusion, low levels of VPA, which were more pronounced in women, support the monitoring and promotion of VPA alongside overall physical activity. Leisure-related activities should also be promoted towards gains in vigorous-intensity and total physical activity in this setting.

Some children are inactive on weekends but active on weekdays. Correlates of such behavior remain to be clarified. We assessed school, out-of-school and family correlates of compliance with physical activity (PA) recommendations during weekdays among weekend non-compliant youth in Switzerland. Cross-sectional data collected in 2013–2015 from the SOPHYA study. PA was objectively measured during one week using waist-worn accelerometers. Compliance with PA recommendations (≥ 60 min/day of moderate-to-vigorous PA) was assessed separately for weekend and weekdays. Data on school sport, transport to school, sports club participation, household income, parent's PA and education were collected by phone interview and questionnaires. Data from 540 youth (316 girls) aged 6–16 years were available for analysis. Participants who were compliant to recommendations during weekdays were more frequently boys (50.3% vs. 31.4%, p, Highlights • Correlates of weekday activity among weekend inactive Swiss youth are studied. • 540 children and adolescents measured by waist-worn accelerometry during 7 days. • Sports club participation or having physically active parent related to week activity. • Sports club should be promoted to combat week inactivity among weekend inactives.

Objective: This study examined the occurrence and duration of sedentary bouts and explored the cross-sectional association with health indicators in children applying various operational definitions of sedentary bouts. Methods: Accelerometer data of 647 children (10-13 years old) were collected in five European countries. We analyzed sedentary time (. 100. cpm within bouts. Health indicators included anthropometrics (i.e. waist circumference and body mass index (BMI)) and in a subsample from two European countries (n. =. 112) fasting capillary blood levels of glucose, C-peptide, high-density- and low-density cholesterol, and triglycerides. Data collection took place from March to July 2010. Associations were adjusted for age, gender, moderate-to-vigorous physical activity, total wear time and country. Results: Occurrence of sedentary bouts varied largely between the various definitions. Children spent most of their sedentary time in bouts of >. 5. min while bouts of >. 20. min were rare. Linear regression analysis revealed few significant associations of sedentary time accumulated in bouts of >. 5-30. min with health indicators. Moreover, we found that more associations became significant when allowing no tolerance time within sedentary bouts. Conclusion: Despite a few significant associations, we found no convincing evidence for an association between sedentary time accumulated in bouts and health indicators in 10-13 year old children.

Published version of an article in the journal: PLoS One. Also available from the publisher: http://dx.doi.org/10.1371/journal.pone.0111775 Open Acces Objective: To design interventions that target energy balance-related behaviours, knowledge of primary schoolchildren’s perceptions regarding soft drink intake, fruit juice intake, breakfast consumption, TV viewing and physical activity (PA) is essential. The current study describes personal beliefs and attitudes, home- and friend-related variables regarding these behaviours across Europe. Design: Cross-sectional study in which personal, family and friend -related variables were assessed by validated questionnaires, and dichotomized as favourable versus unfavourable answers. Logistic regression analyses were conducted to estimate proportions of children giving unfavourable answers and test between-country differences. Setting: A survey in eight European countries. Subjects: A total of 7903 10–12 year old primary schoolchildren. Results: A majority of the children reported unfavourable attitudes, preferences and subjective norms regarding soft drink, fruit juice intake and TV viewing accompanied with high availability and accessibility at home. Few children reported unfavourable attitudes and preferences regarding breakfast consumption and PA. Many children reported unfavourable health beliefs regarding breakfast consumption and TV viewing. Substantial differences between countries were observed, especially for variables regarding soft drink intake, breakfast consumption and TV viewing. Conclusion: The surveyed children demonstrated favourable attitudes to some healthy behaviours (PA, breakfast intake) as well as to some unhealthy behaviours (soft drink consumption, TV viewing). Additionally, many children across Europe have personal beliefs and are exposed to social environments that are not supportive to engagement in healthy behaviours. Moreover, the large differences in personal, family and friend-related variables across Europe argue for implementing different strategies in the different European countries.

Screen-time activities are often used as proxies for sedentary time. We studied associations of self-reported television (TV), computer and total screen-time with accelerometer-derived total sedentary time in European children (10-12 years). Analyses showed significant positive associations between TV, computer and total screen-time with total sedentary time for the total sample, however, the explained variance was low and stratified analyses only revealed a significant positive association between total screen-time and total sedentary time in boys and between computer time and total sedentary time in Dutch children. This suggests that self-reported TV and computer time do not adequately reflect total sedentary time in schoolchildren.

AimThe aim of the present study was to explore if children who spend more time on screen-based sedentary behaviors (i.e.TV viewing and computer use) drink more sugar-sweetened soft drinks. The study also assessed whether these associations were independent of individual and home environmental correlates of soft drink consumption and whether they were moderated by parental education.MethodsData were collected from 7886 children participating in the EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) survey conducted in eight European countries. Self-report questionnaires were used. Multilevel linear regression analyses with soft drink consumption as dependent variable, TV viewing and computer use as independent variables and age, gender, parental education, attitude towards soft drinks, self-efficacy, parental modelling, parental rules and home availability of soft drinks as covariates were conducted. Further interactions were tested to explore if these associations were moderated by parental education. Country-specific analyses were conducted.ResultsIn six of the eight included countries, a significant positive association was observed between TV viewing (min/day) and soft drink consumption (ml/day), independent of individual and home environmental correlates of soft drink consumption (B = 0.46 (0.26–0.66) in Greece, B = 0.77 (0.36–1.17) in Norway, B = 0.82 (0.12–1.51) in Hungary, B = 1.06 (0.67–1.46) in Spain, B = 1.21 (0.67–1.74) in Belgium and B = 1.49 (0.72–2.27) in Switzerland). There was no significant association between computer use and soft drink consumption in six of the eight included countries in the final models. Moderation effects of parental education in the association between TV viewing and soft drink consumption were found in Norway and Hungary, the association being stronger among those with low parental education.ConclusionsTV viewing appears to be independently associated with soft drink consumption and this association was moderated by parental education in two countries only. Reducing TV time might therefore favorably impact soft drink consumption.

Objective. To assess whether prevalence of active commuting and regular car trips to school varies across communities and language regions in Switzerland and to determine personal and environmental correlates. Methods. During the school year 2004/2005, 1345 parental questionnaires (response rate 65%) of children attending 1st, 4th and 8th grades were completed, 1031 could be linked to a GIS environmental database. A German-speaking, a French-speaking and a bilingual study area were included. Usual mode of transportation and frequency of regular car trips to school were assessed. Associations with personal and environmental factors were evaluated with multivariate regression models. Results. Seventy-eight percent of the children actively traveled to school. Twelve percent were regularly driven at least once a week by car. Major road crossings and distance were significantly related to usual mode of transportation, but not to regular car trips. Age, daycare attendance, parental safety concerns, number of cars in the household and belonging to French-speaking population were significantly associated with increased regular car trips. Conclusion. Objective predictors are main deciding factors for active commuting to school as main mode of transport whereas personal and lifestyle factors are important factors associated with frequency of car use. Not only objective but also differing cultural attitudes should be considered when promoting non-motorized travel.

OBJECTIVE: We evaluated whether regional differences in physical activity (PA) and sedentary behaviour (SB) existed along language boundaries within Switzerland and whether potential differences would be explained by socio-demographics or environmental characteristics. METHODS: We combined data of 611 children aged 4 to 7 years from four regional studies. PA and SB were assessed by accelerometers. Information about the socio-demographic background was obtained by questionnaires. Objective neighbourhood attributes could be linked to home addresses. Multivariate regression models were used to test associations between PA and SB and socio-demographic characteristics and neighbourhood attributes. RESULTS: Children from the German compared to the French-speaking region were more physically active and less sedentary (by 10-15 %, p < 0.01). Although German-speaking children lived in a more favourable environment and a higher socioeconomic neighbourhood (differences p < 0.001), these characteristics did not explain the differences in PA behaviour between French and German speaking. CONCLUSIONS: Factors related to the language region, which might be culturally rooted were among the strongest correlates of PA and SB among Swiss children, independent of individual, social and environmental factors.

To examine the usefulness of exhaled and nasal nitric oxide (NO) measurements to detect primary ciliary dyskinesia (PCD) in children.The study population consisted of 34 children with symptoms suggestive of PCD who were previously referred to our pediatric university respiratory disease clinic for a diagnostic workup including analysis of ciliary structure and function by respiratory mucosal biopsy. PCD was diagnosed in 17 of the 34 children according to the ciliary biopsy results. Measurements of nasal and exhaled NO were performed according to European Respiratory Society and American Thoracic Society guidelines in the patients with and without biopsy-proven PCD, and also in 24 healthy age-matched subjects.Nasal NO was significantly lower in those children with proven PCD (geometric mean; 13.7 parts per billion [ppb]), compared to those who had negative biopsy results (132.7 ppb) and healthy control subjects (223.7 ppb). The measurement of nasal NO in our study population showed, below a cut-off level of105 ppb, a specificity of 88% for PCD, and positive predictive value of 89%. Nasal NO above a cut-off level of 105 ppb excluded PCD with a 100% certainty. The lower levels of exhaled NO in patients with PCD did not reach statistical significance.The measurement of nasal NO appears to be a useful tool to screen children for PCD and to exclude this disease in those with high nasal NO levels.

Supplemental digital content is available in the text., Purpose Awareness of being monitored can influence participants’ habitual physical activity (PA) behavior. This reactivity effect may threaten the validity of PA assessment. Reports on reactivity when measuring the PA of children and adolescents have been inconsistent. The aim of this study was to investigate whether PA outcomes measured by accelerometer devices differ from measurement day to measurement day and whether the day of the week and the day on which measurement started influence these differences. Methods Accelerometer data (counts per minute [cpm]) of children and adolescents (n = 2081) pooled from eight studies in Switzerland with at least 10 h of daily valid recording were investigated for effects of measurement day, day of the week, and start day using mixed linear regression. Results The first measurement day was the most active day. Counts per minute were significantly higher than on the second to the sixth day, but not on the seventh day. Differences in the age-adjusted means between the first and consecutive days ranged from 23 to 45 cpm (3.6%–7.1%). In preschoolchildren, the differences almost reached 10%. The start day significantly influenced PA outcome measures. Conclusions Reactivity to accelerometer measurement of PA is likely to be present to an extent of approximately 5% on the first day and may introduce a relevant bias to accelerometer-based studies. In preschoolchildren, the effects are larger than those in elementary and secondary schoolchildren. As the day of the week and the start day significantly influence PA estimates, researchers should plan for at least one familiarization day in school-age children and randomly assign start days.

Background Neighborhood attributes are modifiable determinants of physical activity (PA) and sedentary behavior (SB). We tested whether the objectively-assessed built and social environment was associated with PA and SB in Swiss youth and whether sex, age and the socioeconomic position (Swiss-SEP) modified such associations. Methods We combined data of 1742 youth (ages 4 to 17) from seven studies conducted within Switzerland between 2005–2010. All youth provided accelerometer data and a home address, which was linked to objective environmental data and the Swiss-SEP-index. Associations between neighborhood attributes and PA were analyzed by multivariable multilevel regression analyses. Results The extent of green areas and building density was positively associated with PA in the total sample (p, Highlights • Comprehensive assessment of objectively measured neighborhood attributes in Europe • Effects of neighborhood attributes on PA differed by age-group, sex and socioeconomic neighborhood. • Associations between neighborhood attributes and PA were more pronounced in youth from low socioeconomic areas. • Strongest associations with green spaces and centrally located areas

Objective: To investigate associations of family-related factors with children's breakfast consumption and BMI-z-score and to examine whether children's breakfast consumption mediates associations between family-related factors and children's BMI-z-score. Subjects: Ten-to twelve-year-old children (n = 6374; mean age = 11.6 +/- 0.7 years, 53.2% girls, mean BMI-z-score = 0.4 +/- 1.2) and one of their parents (n = 6374; mean age = 41.4 +/- 5.3 years, 82.7% female, mean BMI = 24.5 +/- 4.2 kg/m(2)) were recruited from schools in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain, and Switzerland). The children self-reported their breakfast frequency per week. The body weight and height of the children were objectively measured. The parents responded to items on family factors related to breakfast (automaticity, availability, encouragement, paying attention, permissiveness, negotiating, communicating health beliefs, parental self-efficacy to address children's nagging, praising, and family breakfast frequency). Mediation analyses were performed using multi-level regression analyses (child-school-country). Results: Three of the eleven family-related variables were significantly associated with children's BMI-z-score. The family breakfast frequency was negatively associated with the BMI-z-score; permissiveness concerning skipping breakfast and negotiating about breakfast were positively associated with the BMI-z-score. Children's breakfast consumption was found to be a mediator of the two associations. All family-related variables except for negotiating, praising and communicating health beliefs, were significantly associated with children's breakfast consumption. Conclusions: Future breakfast promotion and obesity prevention interventions should focus on family-related factors including the physical home environment and parenting practices. Nevertheless, more longitudinal research and intervention studies to support these findings between family-related factors and both children's breakfast consumption and BMI-z-score are needed.

Background Overweight in children and adolescents have increased significantly and are a major public health problem. To allow international comparisons, Switzerland joined the European study ‘ENERGY’ cross sectional survey consortium that investigated the prevalence of overweight and obesity as well as selected dietary, physical and sedentary behaviors of 10–12 years old pupils across seven other countries in Europe. The aims of the present study was to compare body composition and energy-balance related behaviors of Swiss schoolchildren to those of the seven European ENERGY-countries and to analyze overweight and energy-balance related behaviors of Swiss children according to socio-demographic factors. Methods A school-based cross-sectional study among 10–12 year old children was conducted in Switzerland and seven other European countries using a standardized protocol. Body height, weight and waist-circumference were measured by trained research assistants. Energy-balance related behaviors –i.e. selected dietary, physical activity and screen-viewing behaviors were assessed by questionnaires. Weight status and behaviors in Switzerland were compared to the seven European ENERGY countries. Within the Swiss sample, analyses stratified by gender, parental education and ethnicity were performed. Results Data of 546 Swiss children (mean age 11.6±0.8y, 48% girls) were obtained and compared to the ENERGY- results (N=7.148; mean age 11.5±0.8y, 48% girls). In Switzerland significantly less children were overweight (13.9%) or obese (2.3%) compared to the average across the ENERGY-countries (23.7% and 4.7%, respectively), and were even somewhat lower than the ENERGY countries with the lowest prevalence. Sugar sweetened beverage intakes and breakfast habits of Swiss children did not differ significantly from those of ENERGY. However, the mean time devoted by Swiss children to walking or cycling to school and attending sports activities was significantly higher and screen time significantly lower compared to the other ENERGY-countries. Within the Swiss, sample relatively large and consistent differences were observed between children from native and non-native ethnicity. Conclusions The prevalence of overweight and obesity among Swiss children are substantial but significantly lower compared to all other European ENERGY-Partners, probably due to the fact that Swiss children were found to be more active and less sedentary comparing to the rest of the European sample.

Accurately measuring children’s physical activity and their sedentary behavior is challenging. The present study compared 189 parental responses to a questionnaire surveying physical activity and sedentary behavior of children aged 6–14 years, to accelerometer outputs and time activity diaries for the same group. Responses were analyzed taking age, sex and maternal education into account. Correlation coefficients between questionnaire reports and accelerometer-based physical activity across all age groups were acceptable (up to r = .55). Yet, adjustment for age markedly attenuated these associations, suggesting concomitant influences of biological and behavioral processes linked to age. The comparisons of general time indications in the questionnaire with 24h-diary records suggested that parents tended to under- and over-report single activities, possibly due to social desirability. We conclude that physical activity questionnaires need to be designed for specific age groups and be administered in combination with objective measurements.

The aim of this study is to investigate associations of family-related factors with children's fruit drink/juice and soft drink consumption. A cross-sectional survey among 10- to 12-year-old children and their parents in eight European countries was conducted to gather this data. Key variables of interest were children's self-reported fruit drink/juice and soft drink intake per day (outcome) and family-related factors (based on parents' report) related to these two behaviors (modeling, automaticity, availability, monitoring, permissiveness, negotiating, communicating health beliefs, avoid negative modeling, self-efficacy, rewarding, and family consumption). 7915 Children (52% girls; mean age=11.7 ± 0.8 years) and 6512 parents (83% women; mean age=41.4 ± 5.3 years) completed the questionnaire. Multilevel regression analyses were used to examine the aforementioned associations. Three of the 11 family-related factors (modeling, availability, and family consumption) were positively associated with children's fruit drink/juice and soft drink intake. Additionally, three family-related factors (permissiveness, monitoring, and self-efficacy) were solely associated with soft drink intake and one family-related factor (communicating health beliefs) was related to fruit drink/juice intake. Future interventions targeting children's fruit drink/juice and soft drink intake should focus on the home environment, parents and their practices, especially on parents' fruit drink/juice and soft drink intake and availability of these beverages at home.

Background Physical activity and sedentary behaviour among children should be measured accurately in order to investigate their relationship with health. Accelerometry provides objective and accurate measurement of body movement, which can be converted to meaningful behavioural outcomes. The aim of this study was to evaluate the best evidence for the decisions on data collection and data processing with accelerometers among children resulting in a standardized protocol for use in the participating countries. Methods/Design This cross-sectional accelerometer study was conducted as part of the European ENERGY-project that aimed to produce an obesity prevention intervention among schoolchildren. Five countries, namely Belgium, Greece, Hungary, Switzerland and the Netherlands participated in the accelerometer study. We used three different Actigraph models-Actitrainers (triaxial), GT3Xs and GT1Ms. Children wore the device for six consecutive days including two weekend days. We selected an epoch length of 15 seconds. Accelerometers were placed at children's waist at the right side of the body in an elastic belt. In total, 1082 children participated in the study (mean age = 11.7 ± 0.75 y, 51% girls). Non-wearing time was calculated as periods of more than 20 minutes of consecutive zero counts. The minimum daily wearing time was set to 10 hours for weekdays and 8 hours for weekend days. The inclusion criterion for further analysis was having at least three valid weekdays and one valid weekend day. We selected a cut-point (count per minute (cpm)) of 5200 cpm for vigorous physical activity. We also created time filters for school-time during data cleaning in order to explore school-time physical activity and sedentary behaviour patterns in particular. Discussion This paper describes the decisions for data collection and processing. Use of standardized protocols would ease future use of accelerometry and the comparability of results between studies.

Objectives To evaluate the combined effects and relative importance of socio-cultural factors as well as parents' subjectively perceived and objectively assessed environment on time children spent vigorously playing outdoors. Methods Cross-sectional study conducted in Berne, Biel-Bienne, and Payerne (Switzerland) during the school year 2004/2005. Included 1345 parental questionnaires from children out of three age groups (6/7, 9/10, and 13/14 years). A total of 1081 (80%) provided a home address, which could be linked to environmental data using a geographic information system (GIS). Results GIS-derived main street density in a buffer of 100 m around the home was inversely associated with time playing outdoors in adolescents and younger children, but only in more urbanized areas. In addition and independently of GIS-based main street density, parental concern about traffic safety was associated with less time playing outdoors in primary school children. Girls, adolescents, and children from the French speaking part of the country spent less time playing outdoors. A non-Swiss nationality and having younger siblings increased time playing vigorously outdoors in adolescents. Conclusion In addition to socio-cultural factors, parents' perceptions and objectively measured environmental factors were significantly associated with the time spent vigorously playing outdoors. These associations differed by age group.

Background Appropriately measuring habitual physical activity (PA) in children is a major challenge. Questionnaires and accelerometers are the most widely used instruments but both have well-known limitations. The aims of this study were to determine activity type/mode and to quantify intensity and duration of children's everyday PA by combining information of a time activity diary with accelerometer measurements and to assess differences by gender and age. Methods School children (n = 189) aged 6/7 years, 9/10 years and 13/14 years wore accelerometers during one week in winter 2004 and one in summer 2005. Simultaneously, they completed a newly developed time-activity diary during 4 days per week recording different activities performed during each 15 min interval. For each specific activity, the mean intensity (accelerometer counts/min), mean duration per day (min/d) and proportion of involved children were calculated using linear regression models. Results For the full range of activities, boys accumulated more mean counts/min than girls. Adolescents spent more time in high intensity sports activities than younger children (p < 0.001) but this increase was compensated by a reduction in time spent playing vigorously (p = 0.04). In addition, adolescents spent significantly more time in sedentary activities (p < 0.001) and accumulated less counts/min during these activities than younger children (p = 0.007). Among moderate to vigorous activities, children spent most time with vigorous play (43 min/day) and active transportation (56 min/day). Conclusion The combination of accelerometers and time activity diaries provides insight into age and gender related differences in PA. This information is warranted to efficiently guide and evaluate PA promotion.

Background: Changing occurrence rates of asthma, allergic rhinitis and atopic dermatitis are of public health concern and require surveillance. Changes in prevalence rates of these atopic diseases were monitored during 10 years and their trend with time was determined taking into account the influence of personal and environmental risk factors. Methods: Four cross-sectional surveys in 5–7-year old children were performed in seven different communities in Switzerland between 1992 and 2001. Prevalence of respiratory and allergic symptoms and of affecting risk factors including parental environmental concern were assessed using a standardized parental questionnaire. Results: A total of 988 (74.1%), 1778 (79.0%), 1406 (82.6%) and 1274 (78.9%) children participated, respectively, in the 1992, 1995, 1998 and 2001 surveys. Prevalence rates of asthma and hay fever symptoms remained quite stable over time (wheeze/past year: 8.8%, 7.8%, 6.4% and 7.4%, sneezing attack during pollen season: 5.0%, 5.6%, 5.4% and 4.6%). Rates of reported atopic dermatitis symptoms (specific skin rash/past year: 4.6%, 6.5%,7.4% and 7.6%) showed an increase over time, but those of diagnosis of eczema did not show a clear pattern (18.4%, 15.7%, 14.0% and 15.2%). Stratified analysis by parental environmental concern and by parental atopy showed similar trends. Rates of atopic dermatitis symptoms showed significant increase in girls but stayed stable in boys. Conclusion: Results of these four consecutive surveys suggest that the increase in prevalence of asthma and hay fever in 5–7-year old children living in Switzerland may have ceased. However, symptoms of atopic dermatitis may still be on the rise, especially among girls.

Background The study aim was to objectively assess levels of sedentary time, light, moderate and vigorous physical activity (PA) among 10-12 year olds across five European countries and to examine differences in sedentary time and PA according to gender and country. Methods 686 children (mean age = 11.6 ± 0.8 years, 53% girls, mean BMI = 19.0 ± 3.4 kg/m2) from Belgium, Greece, Hungary, the Netherlands and Switzerland wore Actigraph accelerometers and had at least 2 weekdays with minimum 10 h-wearing time and 1 weekend day with minimum 8 h-wearing time. Data were analyzed using multivariate analyses of covariance. Results Girls spent significantly more time sedentary (500 minutes/day) than boys (474 minutes/day) and significantly less time in light (267 minutes/day) and moderate-to-vigorous PA (32 minutes/day) than boys (284 minutes/day; 43 minutes/day respectively; p < 0.001). 4.6% of the girls and 16.8% of the boys met moderate-to-vigorous PA recommendations of at least 60 minutes/day. Greek boys were more sedentary (510 minutes/day; all at p < 0.05) than other boys. Dutch girls were less sedentary (457 minutes/day; all at p < 0.05) than other girls. Swiss girls displayed more moderate-to-vigorous PA (43 minutes/day; at p < 0.05) than other girls. Conclusions Large proportions of children across different European countries did not meet PA recommendations and spent a lot of time sedentary. Mean time spent in moderate-to-vigorous PA was significantly lower than the recommended 60 minutes. Obesity prevention programmes focusing on both decreasing sedentary time and increasing light, moderate and vigorous PA are needed for European children, particularly girls.

Background Giving the rising trend in childhood obesity in many countries including Switzerland, strategies to increase physical activity such as promoting active school travel are important. Yet, little is known about time trends of active commuting in Swiss schoolchildren and factors associated with changes in walking and biking to school. Methods Between 1994 and 2005, information about mobility behaviour of children aged 6-14 years was collected within three Swiss population based national travel behaviour surveys. Mode of transport to school was reported for 4244 children. Weighted multivariate logistic regression analyses were used to assess active school travel time trends and their influencing factors. Results More than 70% of Swiss children walked or biked to school. Nevertheless, the proportion of children biking to school decreased (p = 0.05, linear trend), predominately in urban areas, and motorized transportation increased since 1994 (p = 0.02). Distance to school did not change significantly over time but availability of bikes decreased (p < 0.001) and number of cars per household increased (p < 0.001). The association between survey year and bike use was significantly modified by living in an urban area (OR (95%CI): 1.0, 0.63 (0.44-0.90), 0.71 (0.49-1.03), respectively for 1994, 2000 and 2005) and by distance to school (OR (95%CI): 1.0, 0.65 (0.40-1.05), 0.50 (0.23-0.79) for the same years and for children who lived more than a mile away from school). Conclusions Programs to encourage safe biking and to limit car use as mode of transport to school are warranted to stop this trend.