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      Physical activity behaviour and screen time in Dutch children during the COVID‐19 pandemic: Pre‐, during‐ and post‐school closures

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          Summary

          Background

          Measures during the COVID‐19 pandemic, including the closure of schools and sports facilities, may have lasting impact on the physical activity (PA) of children that persists for a long time.

          Objective

          To investigate the effect of COVID‐19 measures on screen time and PA in Dutch children pre‐, during‐ and post‐school closures.

          Methods

          In cohort A (n = 102, 10.5 ± 3.6 years, 42.4% boys), data on PA and screen time during the lockdown were collected using a questionnaire. In cohort B (n = 131, 10.2 ± 0.9 years, 43.5% boys), data on PA and screen time were collected using a questionnaire and accelerometry 1 year before and after school closure.

          Results

          In cohort A, 62% reported less total PA. Self‐reported screen time on week days increased 34 ± 105 min/d during the lockdown. In cohort B, sedentary time as measured by accelerometry, increased by 45 ± 67 min/d and only 20% reached PA levels of 60 min/d compared to 64% in May 2019. Self‐reported screen time increased by 59 ± 112 min/d and 62 ± 130 min/d during week and weekend days, respectively.

          Conclusions

          Children were less physically active, and screen time was higher during and after the school closures due to the COVID‐19 lockdown. This is alarming as an active lifestyle in children is crucial in preventing chronic diseases such as obesity.

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          Most cited references28

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          Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity : Extended international BMI cut-offs

          The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m(-2)) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. the World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. The new cut-offs were virtually identical to the originals, giving prevalence rates differing by < 0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.
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            Systematic review of the health benefits of physical activity and fitness in school-aged children and youth

            Background The purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings. Methods The systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered. Results Physical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required. Conclusion The following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].
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              Effects of COVID‐19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study

              Abstract Objective To test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the COVID‐19 pandemic, will display unfavorable trends in lifestyle behaviors. Methods The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors were collected at baseline and three weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t‐tests. Results There were no changes in reported vegetable intake; fruit intake increased (p=0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (p‐value range, 0.005 to <0.001). Time spent in sports activities decreased (X±SD) by 2.30±4.60 hours/week (p=0.003) and sleep time increased by 0.65±1.29 hours/day (p=0.003). Screen time increased by 4.85±2.40 hours/day (p<0.001). Conclusions Recognizing these adverse collateral effects of the COVID‐19 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child’s or adolescent’s adult adiposity level.
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                Author and article information

                Contributors
                a.vreugdenhil@mumc.nl
                Journal
                Pediatr Obes
                Pediatr Obes
                10.1111/(ISSN)2047-6310
                IJPO
                Pediatric Obesity
                John Wiley & Sons, Inc. (Chichester, UK )
                2047-6302
                2047-6310
                23 February 2021
                : e12779
                Affiliations
                [ 1 ] Department of Pediatrics Maastricht University Medical Centre Maastricht The Netherlands
                [ 2 ] School of Nutrition and Translational Research in Metabolism (NUTRIM) MUMC+ Maastricht The Netherlands
                Author notes
                [*] [* ] Correspondence

                Anita Vreugdenhil, Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.

                Email: a.vreugdenhil@ 123456mumc.nl

                Author information
                https://orcid.org/0000-0001-6389-6762
                https://orcid.org/0000-0003-1499-5937
                Article
                IJPO12779
                10.1111/ijpo.12779
                7995017
                33624443
                f9336eda-01ef-4253-be1c-7ec83a02c8bd
                © 2021 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 21 January 2021
                : 27 October 2020
                : 08 February 2021
                Page count
                Figures: 1, Tables: 4, Pages: 7, Words: 5556
                Funding
                Funded by: Province Limburg
                Award ID: SAS‐2015‐04956
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.9 mode:remove_FC converted:26.03.2021

                accelerometry,baecke,children,covid‐19 pandemic,physical activity,screen time

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