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Summary: Objective: The objective of the study is to evaluate the effectiveness of interventions to increase physical activity (PA) in 0–5 year olds and to determine what works, for whom, in what circumstances. Design Systematic review, meta‐analysis and realist synthesis. Data sources Embase and EBSCOhost (Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with full text), up to and including April 2017. Eligibility criteria: Published in a peer‐reviewed English language journal; randomized or controlled trial design; aimed to increase children's PA levels; reported on objectively assessed PA in children between 0 and 5.9 years at baseline and post‐intervention. Results: Thirty‐four studies were included in the review, mostly conducted in the preschool/childcare setting. Meta‐analyses showed an overall non‐significant (Z = 0.04, p = 0.97) mean difference of 0.03 (95% CI = −1.57, 1.63) minutes/day for light‐intensity PA (n = 11). The overall mean difference for moderate‐intensity to vigorous‐intensity PA (n = 21) was 2.88 (95% CI = 1.54, 4.23) minutes/day, indicating a small but significant overall positive effect (Z = 4.20, p < 0.001). The realist synthesis provided insights into the key contexts and mechanisms that appeared to be effective at changing children's PA. Conclusion: Based on a quantitative and qualitative examination of the evidence, this review provides specific recommendations for effective early childhood PA interventions for practitioners and policymakers. [ABSTRACT FROM AUTHOR]

Background: Physical activity is considered to have health benefits across the lifespan but levels, patterns, and correlates have not been well described in infants and toddlers under the age of two years., Methods: This study aimed to describe objectively and subjectively measured physical activity in a group of South African infants aged 3- to 24-months (n = 140), and to investigate individual and maternal correlates of physical activity in this sample. Infants' physical activity was measured using an Axivity AX3 wrist-worn accelerometer for one week and the mean vector magnitude was calculated. In addition, mothers reported the average amount of time their infant spent in various types of activities (including in front of the TV), their beliefs about infants' physical activity, access to equipment in the home environment, and ages of motor development milestone attainment. Analysis of variance (ANOVA) and pair-wise correlations were used to test age and sex differences and associations with potential correlates., Results: There were significant age and sex effects on the distribution of time spent at different physical activity intensities (Wilks' lambda = 0.06, p < 0.01). In all cases, the trend was for boys to spend more time in higher intensity physical activity and less time in lower intensity activity than girls; and for time spent in higher intensity activities to be higher in older children. Time spent outside was higher in boys, and this reached significance at 18-months (F = 3.84, p = 0.02). Less concern around floor play was associated with higher physical activity at 12-months in females only (p = 0.03, r = 0.54), and no other maternal beliefs were correlated with physical activity. The majority (94%) of children were exceeding TV time recommendations. When controlling for age and sex, overall TV time was positively associated with BMI z-score (β=0.01, p = 0.05)., Conclusion: This study is the first to show sex and age differences in the patterns of physical activity, and to report on objectively measured and maternal reported physical activity and sedentary behaviour in the first two years of life in South Africa infants. Infants and toddlers should be provided with as many opportunities to be active through play as possible, and TV time should be limited.

Background: Parental modeling has been shown to be important for school-aged children's physical activity (PA) and television (TV) viewing, yet little is known about its impact for younger children. This study examined cross-sectional and 3-year longitudinal associations between PA and TV viewing behaviors of parents and their preschool children., Methods: In 2008-2009 (T1), parents in the Healthy Active Preschool and Primary Years (HAPPY) cohort study (n = 450) in Melbourne, Australia, self-reported their weekly PA and TV viewing and proxy-reported their partner's PA and TV viewing and their 3- to 5-year-old preschool child's TV viewing. Children's PA was assessed via accelerometers. Repeat data collection occurred in 2011-2012 (T2)., Results: Mothers' and fathers' PAs were associated with PA among preschool girls at T1, but not boys. Parents' TV viewing times were significant correlates of girls' and boys' TV viewing at T1. Longitudinally, mothers' PA at baseline predicted boys' PA at T2, whereas sex-specific associations were found for TV viewing, with mothers' and fathers' TV viewing at T1 associated with girls' and boys' TV viewing respectively at T2., Conclusions: The PA and TV viewing of both parents are significantly associated with these behaviors in preschool children. The influence of the sex-matched parent appears to be important longitudinally for children's TV viewing.

Sedentary behavior has negative health outcomes, evident even in young children. Identifying the prevalence of sedentary behavior in children <2years is important for determining the necessity for intervention strategies. The aim of this systematic review was to determine the prevalence of sedentary behavior in children <2years. Medline, PsycINFO, SPORTDiscus, and Education Research Complete electronic databases were searched, as were reference lists of included articles and the authors' own collections. Inclusion criteria were: published in a peer-reviewed English language journal; mean age of children <2years; and a reported measure of the prevalence of sedentary behavior. Twenty-four studies met the inclusion criteria. Most studies used parent-reported screen time as the sedentary behavior measure; only one study reported time spent restrained (i.e., kept inactive) and no studies reported objectively assessed sedentary time. Estimates of young children's screen time ranged from 36.6 to 330.9min/day. The proportion of children meeting the zero screen time recommendation ranged from 2.3% to 83.0%. In conclusion, very little is known about sedentary behaviors other than screen time in this age group. Although highly variable, findings suggest that children are already engaging in high levels of screen time by age 2 and the majority exceed current recommendations., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Young children are at risk of not meeting physical activity recommendations. Identifying factors from the first year of life which influence toddlers' physical activity levels may help to develop targeted intervention strategies. The purpose of this study was to examine early childhood predictors of toddlers' physical activity across the domains of maternal beliefs and behaviours, infant behaviours and the home environment., Methods: Data from 206 toddlers (53% male) participating in the Melbourne InFANT Program were collected in 2008-2010 and analysed in 2012. Mothers completed a survey of physical activity predictors when their child was 4- (T1) and 9- months old (T2). Physical activity was assessed by ActiGraph GT1M accelerometers at 19- months (T3) of age., Results: One infant behaviour at T1 and one maternal belief and two infant behaviours at T2 showed associations with physical activity at T3 and were included in multivariate analyses. After adjusting for the age at which the child started walking and maternal education, the time spent with babies of a similar age at 4-months (β = 0.06, 95% CI [0.02, 0.10]) and the time spent being physically active with their mother at 9-months (β = 0.06, 95% CI [0.01, 0.12]) predicted children's physical activity at 19-months of age., Conclusions: Promotion of peer-interactions and maternal-child co-participation in physical activity could serve as a health promotion strategy to increase physical activity in young children. Future research is required to identify other early life predictors not assessed in this study and to examine whether these factors predict physical activity in later life stages.

Purpose: It is a commonly held perception that most young children are naturally active and meet physical activity recommendations. However, there is no scientific evidence available on which to confirm or refute such perceptions. The purpose of this study was to describe the physical activity levels and patterns of Australian toddlers., Methods: Physical activity and demographic data of two hundred ninety-five 19-month-old children from the Melbourne InFANT Program were measured using accelerometers and parent surveys. Validated cut points of 192-1672 and >1672 counts per minute were used to determine time spent in light- (LPA) and moderate-to-vigorous- (MVPA) intensity physical activity, respectively. To be included in the analysis, children were required to have four valid days of accelerometer data to provide an acceptable (>0.70) reliability estimate of LPA and MVPA. Physical activity data for different periods of the day were examined., Results: On average, toddlers engaged in 184 min of LPA and 47 min of MVPA daily, and 90.5% met the current Australian physical activity recommendations for 0- to 5-yr-olds (180 min of LPA/MVPA per day). Physical activity levels during mid morning and mid afternoon were higher than those during other periods. Physical activity patterns for boys and girls were similar, although boys engaged in more physical activity during the morning hours than girls did., Conclusions: Most children meet the physical activity recommendations, although the majority of activity undertaken in the study was of light intensity. Boys were more active than girls were in the morning hours, but there were no differences between sexes over the entire day. Certain periods of the day may hold more promise for intervention implementation than others do.