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Background:The purpose of this study was to cross-validate international BMI-referenced steps/d cut points for US girls (12,000 steps/d) and boys (15,000 steps/d) 6 to 12 years of age.Methods:Secondary pedometer-determined physical activity data from US children (N = 1067; 633 girls and 434 boys, 6 to 12 years) were analyzed. Using international BMI classifications, cross-validation of the 12,000 and 15,000 steps/d cut points was examined by the classification precision, sensitivity, and specificity for each age–sex stratum.Results:For girls (boys) 6 to 12 years, the 12,000 (15,000) steps/d cut points correctly classified 42% to 60% (38% to 67%) as meeting (achieved steps/d cut point and healthy weight) and failing (did not achieve steps/d cut point and overweight). Sensitivity ranged from 55% to 85% (64% to 100%); specificity ranged from 23% to 62% (19% to 50%).Conclusion:The utility of pedometer steps/d cut points was minimal in this sample given their inability to differentiate among children who failed to achieve the recommended steps/d and exhibited an unhealthy weight. Caution, therefore, should be used in applying previous steps/d cut points to US children.

Aim: The aims of this study were to identify current levels of physical activity and to study the relationship between physical activity and body mass index (BMI) using international cut-off points. Methods: 871 children, aged 7–14 y, were measured for height and weight and the activity levels were analysed using pedometers to measure mean step counts for 4 consecutive days. Results: Step counts were significantly higher in boys than in girls, and showed stability over age and large in-group differences. BMI showed that 13.2% of the boys and 14.5% of the girls were overweight and 4.5% of both boys and girls were obese. Analysis of step counts and BMIs for boys and girls revealed no significant correlations in any age group. Conclusion: Pedometers differentiate among age groups and gender concerning physical activity and facilitate individual goal-setting. The result of this study provide baseline information, useful as reference data, on youth physical activity as daily step counts, as well as on youth BMI levels according to new international cut-off points.

The purposes of this study included (a) to determine if the Theory of Planned Behavior (TPB) predicted intentions of individuals with and without disabilities to be physically active, (b) to determine if the TPB predicted behaviors of individuals with and without disabilities to be physically active, and (c) to determine if significant differences were present in physical activity opportunities between inclusive and non-inclusive elementary physical education classes taught by the same teacher. Students (N = 114, ages 10-13) completed questionnaires assessing the TPB constructs and had four days of PA evaluated through pedometer measurements. Analyses revealed that subjective norm and perceived behavioral control predicted students’ intentions to be active, while behavioral intention was the only significant predictor of activity level by step count accrued in PE classes. Finally, the inclusion of students with autism did not significantly affect overall physical activity.

Background:The primary purpose of this study was to describe the association between activity time and step counts in children.Methods:Subjects were 590 students (334 girls, 256 boys) with each gender having a mean age of 9.2 ± 1.8 y. All subjects wore the Walk4Life 2505 pedometer for four consecutive weekdays. This pedometer simultaneously measures both step counts and activity time.Results:Boys accumulated significantly more minutes of activity time/day (140.9 ± 39.6 vs. 126.3 ± 38.1), steps/day (13,348 ± 4131 vs. 11,702 ± 3923), and steps per min (93.99 ± 5.8 vs. 91.85 ± 5.8) than girls (P < 0.001) Steps/day was a significant predictor of activity time/day (P < 0.0001).Conclusions:Boys accumulate more steps per day and more activity time per day than girls. There is a strong association between steps per day and activity time in children. Daily steps per minute as a measure of free living physical activity in children is explored

(2006). Enhancing Motivation in Physical Education. Journal of Physical Education, Recreation & Dance: Vol. 77, No. 2, pp. 41-51.

While the FITNESSGRAM® test battery is widely used in schools, not all users are aware of the FITNESSGRAM position paper as outlined in the Reference Manual, and for this reason may fail to use FITNESSGRAM materials as intended. The purpose of this paper is to outline the many appropriate uses, and some inappropriate uses, of FITNESSGRAM. Because California is a state that employs the FITNESSGRAM as its state fitness test, examples from California are used. Suggestions for future uses of fitness testing are included.

Background:The purpose of this study was to describe the pedometer-determined physical activity levels of American youth.Methods:A secondary analysis of six existing data sets including 1839 (1046 females, 793 males; ages 6 to 18) school-aged, predominantly white subjects from the southwest US. Grade clusters for elementary (grades 1 to 3), upper elementary (grades 4 to 6), middle school (grades 7 to 9), and high school (grades 10 to 12) were created for statistical analysis.Results:Males in grades 1 to 3 and 4 to 6 accumulated significantly more steps/d (13,110 ± 2870 and 13,631 ± 3463, respectively; P < 0.001) than males in grades 7 to 9 and 10 to 12 (11,082 ± 3437 and 10,828 ± 3241). Females in grades 1 to 3 and 4 to 6 accumulated significantly more steps/d (11,120 ± 2553 and 11,125 ± 2923; P < 0.001) than females in grades 7 to 9 and 10 to 12 (10,080 ± 2990 and 9706 ± 3051).Conclusions:Results are consistent with those reported for other objective assessments of youth activity indicating that males are typically more active than females and physical activity is less prevalent among secondary school youth than those in elementary school. Pedometer-determined physical activity levels of youth, including secondary school youth, are higher than reported for adult populations.

Pedometers offer an attractive means for student motivation and program accountability, but as with any innovation, questions abound.

Background: Recommended levels of youth physical activity (PA) should emerge from data related to important health outcomes. The purpose of the present study was to establish criterion-referenced standards for PA (using pedometer-assessed steps/day) related to healthy body composition. Methods: This is a secondary analysis of an existing data set (including pedometer-assessed PA and objectively measured BMI) of 1,954 children (995 girls, 959 boys; ages 6-12 years) from the USA, Australia, and Sweden. The contrasting groups method [M.J. Sarif, Introduction to Measurement in Physical Education and Exercise Science, St. Louis, MO: Mosby College Publishing; 1986] for establishing criterion-referenced cut points was used to identify optimal age- and sex-specific standards for steps/day related to international BMI cut points for normal weight and overweight/obesity. Results: The selected cut points for steps/day for 6-12 year olds were 12,000 steps/day for girls and 15,000 steps/day for boys. Conclusions: The analytical process undertaken in this study illuminated the difference in previously used norm-referenced standards vs. criterion-referenced standards based on BMI categories. The steps/day cut points established herein, using an international sample, are higher than previously suggested normative standards but are not inconsistent with recent advances in our understanding of PA needs in youth. This analysis provides the foundation for cross-validation and evaluation of these BMI-referenced steps/day cut points in independent samples and with longitudinal study designs.

This study examined the motivational responses of adolescent girls in the physical education setting to having choices of walking activities. Seventh and 8th grade girls (N = 1,110) in 42 intact physical education classes participated in this study. Classes were randomly assigned to choice (n = 21) and no-choice (n = 21) groups. Participants’ situational and contextual motivation was assessed using the Situational Motivation Scale (SIMS) and the Sport Motivation Scale for PE (SMSPE). The SIMS was administered every 3 days during the intervention. The SMSPE was administered as the pre- and posttest. Significant differences indicated that the choice group (a) was more intrinsically motivated, (b) had higher identified regulation, (c) experienced less external control, and (d) was less amotivated. Moderate to large effect sizes were noted. A significant difference in amotivation at the contextual level was noted. Results suggest that adolescent female PE students may be more motivated if given choices. The notion of emerging adult attitudes is presented and explored.

While research has confirmed a negative relationship between adult depression and physical activity, there is little evidence for children. This study examined the relationship of being classified as physically active or inactive by a parent or a teacher to depressive symptoms in children 8 to 12 years of age (N = 933). It also assessed the relationship of playing sports outside of school, and of meeting health related fitness standards, to symptoms of depression. Relative risk of depressive symptoms for inactive classification was 2.8 to 3.4 times higher than it was for active, 1.3 to 2.4 times higher for children not playing sports outside of school, and 1.5 to 4.0 times higher for those not meeting health related fitness goals.

This study examined effects of a school-based intervention called PLAY (Promoting Lifestyle Activity for Youth) on physical activity levels and body mass index (BMI) of students. Participants included 606 fourth-grade students selected from a stratified sample of 35 schools in Arizona and placed into four groups: PLAY & PE, PLAY Only, PE Only, and No Treatment. A treatment-control, post-measurement design assessed physical activity using the YAMAX pedometer, and height and weight data were collected following the intervention. One-way ANOVAs were used to analyze the data. Results indicated the treatment was effective at increasing the physical activity level of children, especially girls. No significant differences between groups were found for BMI. Programs such as PLAY, which can increase the activity level of children, may have significant health implications for youth.

(2003). Using Pedometers to Promote Physical Activity in Physical Education. Journal of Physical Education, Recreation & Dance: Vol. 74, No. 7, pp. 33-38.

(2003). Physical Education K-12: “All for One and One for All”. Quest: Vol. 55, No. 2, pp. 105-117.

Research has suggested a trend of decreasing activity with age necessitating a renewed emphasis on promoting physical activity for children. The purpose of this study was to assess current physical activity levels of children and to establish initial standards for comparison in determining appropriate activity levels of children based on pedometer counts. Children, 6–12 years old (N = 711), wore sealed pedometers for 4 consecutive days. Mean step counts ranged from 10,479–11,274 and 12300–13989 for girls and boys respectively. Factorial ANOVA found a significant difference between sex (F = 90.16, p < .01) but not among age (F = 0.78, p = .587). Great individual variability existed among children of the same sex. Further analysis found significant differences among children of the same sex above the 80th percentile and below the 20th percentile. A reasonable activity standard might be approximately 11,000 and 13,000 steps per day for girls and boys respectively, although further discussion of this is warranted. The descriptive nature of this study provides insights into the activity patterns of children and the mean step counts for boys and girls at each age can serve as a preliminary guide for determining meaningful activity levels for children based on pedometer counts.

Reactivity is defined as a change in normal activity patterns when people are aware that their activity levels are being monitored. This study investigated reactivity in elementary school children. The step counts of forty-eight participants in second, fourth and sixth grades were monitored with sealed pedometers for eight days. A factorial repeated measures ANOVA revealed no significant differences among days for all participants (F(7,294) = 1.25, p = .279) and no interactions among Sex, Grade, and Day. There is no reactivity in children monitored with a sealed pedometer. Intraclass correlations found that three to four days of monitoring are needed to determine habitual activity levels with a coefficient alpha level of .70 and five days of monitoring are needed to obtain a .80 coefficient alpha. This study demonstrates that there appears to be no reactivity period when sealed pedometers are used to measure physical activity.

(2001). Pedometers, Physical Activity, and Accountability. Journal of Physical Education, Recreation & Dance: Vol. 72, No. 9, pp. 16-19.

Background. Situational interest is articulated theoretically as a construct associated with five dimensional sources: novelty, challenge, attention demand, exploration intention, and instant enjoyment. Aims. This study aimed to examine the influence of the dimensional sources on situational interest. It was hypothesised that the dimensional sources function differently to contribute to situational interest and that the influence of a source might be mediated by others. Sample. Two samples of 7th, 8th, and 9th grade students were used in the study. There were 281 students (57% male, 43% female) in the first sample and 191 (47% male, 53% female) in the second. Method. Students in Sample A evaluated situational interest and the dimensional sources in tasks of analysing jogging and gymnastic stunts on video. Those in Sample B evaluated them in tasks of learning basketball. Correlation and regression analyses and path analyses were used to test the theoretical model. Results. Instant Enjoyment determined situational interest. Exploration and Novelty had positive influences on situational interest via enhancing Instant Enjoyment. Challenge showed little influence. The path analyses for both samples confirmed the inter-dimensional mediation effects of the sources. Conclusion. The analysed data support the hypotheses. The dimensional sources had unequal influences on situational interest and the mediation effects among themselves at times strengthened or weakened each other's influences. The findings suggest that to increase situational interest, educators should offer students ample exploratory opportunities during student-task interaction that can lead to instant enjoyment for learning.

The challenge for helping others enjoy a healthy and active life is to move the focus of instruction from physical fitness toward physical activity. Participation in regular physical activity offers a number of benefits including reduction of the risk of premature mortality. coronary heart disease, diabetes mellitus, hypertension, and colon cancer. The physical fitness of American children has not declined over the years even though teachers and parents often believe it to be true. A significant amount of fitness test performance is explained by heredity. Both the response to training and genetic limitations are limiting factors outside the control of individuals. Not all people can reach a high fitness level, but all can be physically active. The Children's Lifetime Physical Activity Model (C-LPAM) offers guidance in how to prescribe activity for youth. Guidelines suggest youngsters should receive at least 60 minutes or more of physical activity on a daily basis.

The purpose of this study was to validate criterion-referenced standards for cardiovascular endurance tests using the criterion-groups validation model. Adolescent boys and girls assigned to either untrained or trained groups were administered the mile run and Progressive Aerobic Cardiovascular Endurance Run (PACER) tests. Selection of optimal criterion standards was based on finding a cutting score that minimized the probability of misclassification errors and maximized the probability of making correct decisions based on participation in physical activity. The results of this study suggest that recent changes in FITNESSGRAM standards are appropriate, especially for the PACER test. While modifications of standards have corrected somewhat for disparities in passing rates between the mile run and the PACER, especially for girls, further study of standards is necessary.

(2009). Step It Up. Journal of Physical Education, Recreation & Dance: Vol. 80, No. 1, pp. 22-24.

The proliferation of research on physical activity paints a clear picture regarding the health benefits of increasing levels of physical activity. In the present study, the efficacy of a school-based physical activity intervention (Promoting Lifetime Activity for Youth) was examined. Twenty-eight 4th-, 5th-, and 6th-grade elementary school teachers and their students participated in this study. Treatment group classes received the P.L.A.Y. intervention. Control group classes received a placebo. Participants completed 2 questionnaires 3 times during the study. Repeated measures ANOVA was used for all analyses. Results indicate that the treatment group significantly increased physical activity levels. Control group classes did not significantly increase activity levels or attraction to activity.

The best-selling Pedometer Power is back—updated and expanded with 65 thoroughly field-tested and exciting pedometer activities to motivate participants to become more physically active. This edition includes new and improved activities, more activities for high school and college students, an emphasis on using pedometers both in school and community settings, and updated data that clearly support the effectiveness of pedometers in monitoring physical activity. With Pedometer Power: Using Pedometers in School and Community, you can use 65 pedometer-based activities for children and adults at home and in physical education, recreation, and after-school settings;promote physical activity—and your program—to parents and the larger community with take-home and special-event activities; and help participants learn about the importance of duration and intensity of physical activity and about the value of maintaining an active lifestyle. You can use Pedometer Power in a variety of settings, including physical education classes from kindergarten though college, after-school programs, recreation programs, and health-promotion programs.

We analyzed data from the National School Population Fitness Survey (Reiff et al., 1986) and data collected by the authors of the original study to assess the fitness of American children and youth based on the results of additional analyses. We then compared the numbers of children and youth meeting norm-referenced standards to numbers meeting recently adopted criterion-referenced health (CRH) standards for individual test items in the FITNESSGRAM (Institute for Aerobics Research, 1987) and AAHPERD Physical Best (AAHPERD, 1988) test batteries. The number of children and youth meeting CRH standards for multiple items in a test battery was also determined. Finally, data were analyzed to determine if changes in fitness have occurred among American children and youth over recent decades. Our results suggest that, with the exception of measures of arm and shoulder girdle strength/endurance, more children and youth meet criterion-referenced health standards than norm-referenced standards (50th percentile) and the majority of American children and youth meet CRH standards for individual test items. However, the majority of American children and youth cannot meet the CRH standards for a battery of items for either of the two batteries studied. A second look at decade to decade comparisons of fitness produced evidence that questions the idea that youth are less fit now than in previous years.

There have been limited prospective studies investigating physical activity and physical self-perceptions in children. In this investigation, mean steps/day did not significantly change from late elementary to junior high for either boys or girls; however, boys accumulated more steps both at baseline and follow-up. Physical self-perception measures were significantly related to changes in steps/day and accounted for 21% (15% adjusted) of the variance after controlling for demographic/biological variables, R2 change = .21, adjusted R2 change = .15, F(5, 88) = 4.66, p < .001. Sport competence emerged as the most important predictor, t(88) = -3.76, p < .001, and was inversely related to physical activity change. The lack of opportunities to participate in sport activities normally found at the onset of adolescence may help explain this unexpected result.

With continued widespread acceptance of pedometers by both researchers and practitioners, evidence-based steps/day indices are needed to facilitate measurement and motivation applications of physical activity (PA) in public health. Therefore, the purpose of this article is to reprise, update, and extend the current understanding of dose-response relationships in terms of pedometer-determined PA. Any pedometer-based PA guideline presumes an accurate and standardized measure of steps; at this time, industry standards establishing quality control of instrumentation is limited to Japan where public health pedometer applications and the 10,000 steps.d slogan are traceable to the 1960s. Adult public health guidelines promoteor =30 min of at least moderate-intensity daily PA, and this translates to 3000-4000 steps if they are: 1) at least moderate intensity (i.e.,or =100 steps.min); 2) accumulated in at least 10-min bouts; and 3) taken over and above some minimal level of PA (i.e., number of daily steps) below which individuals might be classified as sedentary. A zone-based hierarchy is useful for both measurement and motivation purposes in adults: 1)5000 steps.d (sedentary); 2) 5000-7499 steps.d (low active); 3) 7500-9999 steps.d (somewhat active); 4)or =10,000-12,499 steps.d (active); and 5)or =12,500 steps.d (highly active). Evidence to support youth-specific cutoff points is emerging. Criterion-referenced approaches based on selected health outcomes present the potential for advancing evidence-based steps/day standards in both adults and children from a measurement perspective. A tradeoff that needs to be acknowledged and considered is the impact on motivation when evidence-based cutoff points are interpreted by individuals as unattainable goals.

Limited data are available on the contributory and compensatory relationships between physical education and physical activity in children. Four hundred eighty-five (280 girls) children in first through sixth grades wore sealed pedometers during waking hours, including normally scheduled physical education lessons. The least, moderately, and most active children accumulated approximately 1,700, 1,100, and 2,500 more steps/day, respectively, on school days with physical education. No compensatory increases in physical activity were found on school days that did not offer physical education. The implications of the contributory relationship are highlighted by the evidence that 50% of the least active children were at risk for overweight or overweight and that no compensatory increases in physical activity were found on school days when physical education classes were not scheduled.

Background:The purpose was to determine if waist placement of the pedometer effected accuracy in normal, overweight, and obese children, when attaching the pedometer to the waistband or a belt.Methods:Seventy-seven children (ages 10-12 y) wore five pedometers on the waistband of their pants and a belt at the following placements: navel (NV), anterior midline of the right thigh (AMT), right side (RS), posterior midline of the right thigh (PMT), and middle of the back (MB). Participants walked 100 steps on a treadmill at 80 m · min−1.Results:The RS, PMT, and MB sites on the waistband and the AMT and RS sites on the belt produced the least error.Conclusions:Of these sites the RS placement is recommended because of the ease of reading the pedometer during activity. Using a belt did not significantly improve accuracy except for normal weight groups at the NV placement site.

In 1994 two important documents were published regarding appropriate physical activity for children and youth. The first (Corbin and Pangrazi 1994) suggested guidelines for preadolescent children and the second (Sallis, Patrick, and Long, 1994) suggested guidelines for adolescents. Prior to these statements discourses about whether youth were considered to be physically active were based primarily on guidelines for adults. In their paper proposing specific guidelines for children, Corbin and Pangrazi (1994) noted that children were often considered to be inactive if their heart rates did not exceed relatively high levels for relatively long periods of time. They suggested that these heart rate standards were likely to result in classifying many active children as inactive. This, it was suggested, was because children are intermittent in their activity patterns and a standard of continuous high heart rate was inappropriate. Application of the adult exercise prescription model (EPM) was not best for childre...

The purpose of this study was to examine the day-to-day variability in pedometer-assessed physical activity (steps/day). A total of 1,443 children aged 6-12 years from the United States (195 boys, 254 girls), Sweden (257 boys, 252 girls), and Australia (229 boys, 256 girls) wore a pedometer for 4 consecutive weekdays. Repeated measures analysis of variance was used to examine daily differences in steps/day and the coefficient of variation (CV) was calculated for each individual to describe the day-to-day variability. Overall, mean steps/day were higher among boys (14,698 ± 3,373 steps/day) than girls (12,086 ± 2,929 steps/day). Significant differences were found between the 4 monitoring days for the entire sample; however, the absolute mean differences were small (55-958 steps) with an overall effect size of 0.01. This trend was apparent regardless of age, gender, and country. Individual CVs ranged from 2 to 88% and the overall mean CV approximated 22%. An age-related increase in the mean CV was observed between 6- and 12-year-old children. The age × gender × country interaction was not significant (P > 0.05). These findings have implications toward the proper design, analysis, and interpretation of studies regarding physical activity among children. Beyond this aspect, our results lend insight into potential age-related biological mechanisms that may also influence daily levels and patterns of physical activity. Am. J. Hum. Biol. 19:537-543, 2007

The purpose of this study was to examine children's physical activity during recess and outside of school. Third-, fourth-, and fifth-grade students (N = 270; 121 boys, age = 9.5 +/- 0.9 years; 150 girls, age = 9.6 +/- 0.9 years) wore sealed pedometers during a 15-minute recess period and outside of school for 4 consecutive school days. A factorial analysis of variance (grade by gender) was used to examine differences among grades and between genders for the following variables: recess activity time (RAT), recess step counts (RSC), out-of-school activity time (OAT), and out-of-school step counts (OSC). For all outcome variables, there were no significant interactions between grade and gender and no significant main effect for grade. A significant main effect for gender (F(1,264)= 73.1, p < .001) indicated that boys accumulated more RSC and OSC than girls (1268 +/- 341 vs 914 +/- 261 and 7229 +/- 2877 vs 5808 +/- 2059, respectively) and more RAT and OAT than girls (11.7 +/- 2.4 vs 9.4 +/- 2.2 and 77.3 +/- 28 vs 67.4 +/- 21, respectively). Boys spent 78% and girls spent 63% of their recess time engaged in physical activity. Outside of school, girls spent 20% and boys spent 25% of their time engaged in physical activity. RAT comprised 14% and 16% of total discretionary activity time for girls and boys, respectively. Boys in this study are more active during discretionary time periods compared to girls. Study participants spent the majority of their recess time engaged in physical activity.

Purpose: To describe the sex-specific patterns of school children's daily pedometer-determined physical (PA) during physical education (PE), recess and lunchtime, and before and after school. Methods: Eighty-one sixth-grade students (28 boys, age = 11.9 ± 0.4 yr, BMI = 18.8 ± 4.1 kg·m-2; 53 girls, 11.8 ± 0.5 yr, BMI = 20.2 ± 4.6 kg·m-2) wore pedometers for four school days and were prompted to record steps accumulated at arrival and departure from school and during pre- and postrecess, lunchtime, and PE class. Results: Boys took significantly (P < 0.001) more steps per day than girls: 16,421 ± 5,444 vs 12,332 ± 3,056 steps per day, and more steps during release time (e.g., before-school ? = 1289 steps, recess ? = 479 steps, lunchtime ? = 608 steps, and after-school ? = 1872 steps) but the same number of steps during structured PE classes (1429 ± 567 vs 1410 ± 445 steps; P = 0.87). Lunchtime PA represented the most important source of daily PA (15-16%) obtained during school hours for both boys and girls, whereas recess accounted for 8-9% and PE class accounted for 8-11% of total steps per day. Regardless, almost half of daily steps taken are attributable to after-school activities. Conclusion: These data provide greater understanding of sex-specific PA patterns and the relative contribution of distinct segments of the school day to school children's total PA.

Assess the physical activity and body mass index (BMI) levels of children in the United States, Sweden, and Australia.A total of 1954 children, 6-12 yr old (711 American, 563 Australian, and 680 Swedish) wore sealed pedometers for four consecutive days. Height and weight measures were obtained.Descriptive data for step counts and BMI by sex, age, and country were calculated to determine activity levels and BMI. Three-way multivariate ANOVA for step counts and BMI between countries at each age and sex found that, in general, the Swedish children were significantly more active than the Australian and American children, and the American children were significantly heavier than the Australian and Swedish children. For boys, the mean step counts ranged from 15673 to 18346 for Sweden, 13864 to 15023 for Australia, and 12554 to 13872 for America. For girls, the mean step counts ranged from 12041 to 14825 for Sweden, 11221 to 12322 for Australia, and 10661 to 11383 for America. The activity curve is somewhat level during the preadolescent years. The rate of increase in BMI with age is much greater in the American children than in the Swedish or Australian children. The percent of American, Swedish, and Australian boys classified as overweight/obese was 33.5, 16.6, and 15.8, respectively. The percent of American, Swedish, and Australian girls classified as overweight/obese was 35.6, 16.8, and 14.4, respectively. Correlation analysis found few significant negative relationships between step counts and BMI.American children tend to be the least active and heaviest with the greatest rate of increase in BMI. The Swedish children are the most active group followed by Australia. Swedish and Australian children maintain lower BMI throughout their prepubescent years than do the American children who have a greater percentage who are classified as overweight.