Sports Medicine

, Volume 37, Issue 12, pp 1045–1070 | Cite as

Physical Activity in Preschoolers

Understanding Prevalence and Measurement Issues
  • Melody Oliver
  • Grant M. Schofield
  • Gregory S. Kolt
Review Article

Abstract

Accurate physical activity quantification in preschoolers is essential to establish physical activity prevalence, dose-response relationships between activity and health outcomes, and intervention effectiveness. To date, best practice approaches for physical activity measurement in preschool-aged children have been relatively understudied. This article provides a review of physical activity measurement tools for preschoolers, an overview of measurement of preschoolers’ physical activity, and directions for further research. Electronic and manual literature searches were used to identify 49 studies that measured young children’s physical activity, and 32 studies that assessed the validity and/or reliability of physical activity measures with preschool-aged children. While no prevalence data exist, measurement studies indicate that preschool children exhibit low levels of vigorous activity and high levels of inactivity, boys are more active than girls, and activity patterns tend to be sporadic and omnidirectional. As such, measures capable of capturing differing activity intensities in very short timeframes and over multiple planes are likely to have the most utility with this population. Accelerometers are well suited for this purpose, and a number of models have been used to objectively quantify preschoolers’ physical activity. Only one model of pedometer has been investigated for validity with preschool-aged children, showing equivocal results. Direct observation of physical activity can provide detailed contextual information on preschoolers’ physical activity, but is subjective and impractical for understanding daily physical activity. Proxy-report questionnaires are unlikely to be useful for determining actual physical activity levels of young children, and instead may be useful for identifying potential correlates of activity. Establishing validity is challenging due to the absence of a precise physical activity measure, or ‘criterion’, for young children. Both energy expenditure (EE) and direct observation have been considered criterion measures in the literature; however, EE is influenced by multiple variables, so its use as a physical activity ‘criterion’ is not ideal. Also, direct observation is inherently subjective, and coding protocols may result in failure to capture intermittent activity, thereby limiting its utility as a physical activity criterion. Accordingly, these issues must be taken into account where EE or direct observation are used to validate physical activity instruments. A combination of objective monitoring and direct observation may provide the best standard for the assessment of physical activity measurement tools. Ideally, the convergent validity of various physical activity tools should be investigated to determine the level of agreement between currently available measures. The correlational approaches commonly employed in the assessment of physical activity measures do not reveal this relationship, and can conceal potential bias of either measure.

Notes

Acknowledgements

This review was supported in part by funding from Sport and Recreation New Zealand and also through a Tertiary Education Commission of New Zealand Doctoral Scholarship for the primary author. There are no potential conflicts of interest that may affect ability to provide an unbiased review.

References

  1. 1.
    Kelly JL, Stanton WR, McGee R. Tracking relative weight in subjects studied longitudinally from ages 3 to 13 years. J Paediatr Child Health 1992; 28 (2): 158–61PubMedGoogle Scholar
  2. 2.
    Guo SS, Roche AF, Chumlea WC, et al. The predictive value of childhood body mass index values for overweight at age 35 y. Am J Clin Nutr 1994; 59 (4): 810–9PubMedGoogle Scholar
  3. 3.
    Janz KF, Dawson JD, Mahoney LT. Tracking physical fitness and physical activity from childhood to adolescence: the Muscatine study. Med Sci Sports Exerc 2000; 32 (7): 1250–7PubMedGoogle Scholar
  4. 4.
    Malina RM. Physical activity and fitness: pathways from childhood to adulthood. Am J Hum Biol 2001; 13: 162–72PubMedGoogle Scholar
  5. 5.
    Trost SG, Sirard JR, Dowda M, et al. Physical activity in overweight and nonoverweight preschool children. Int J Obes 2003; 27: 834–9Google Scholar
  6. 6.
    Khoury P, Claytor RP, Daniels SR. Association of accelerometry and measures of body habitus in preschoolers [abstract]. Med Sci Sports Exerc 2004; 36 Suppl. 5: S32Google Scholar
  7. 7.
    Moore LL, Di Gao AS, Bradlee ML, et al. Does early physical activity predict body fat change throughout childhood? Prev Med 2003; 37: 10–7PubMedGoogle Scholar
  8. 8.
    Sääkslahti A, Numminen P, Varstala V, et al. Physical activity as a preventive measure for coronary heart disease risk factors in early childhood. Scand J Med Sci Sports 2004; 14: 143–9PubMedGoogle Scholar
  9. 9.
    Janz KF, Burns TL, Torner JC, et al. Physical activity and bone measures in young children: the Iowa Bone Development Study. Pediatrics 2001; 107 (6): 1387–93PubMedGoogle Scholar
  10. 10.
    Janz KF, Burns TL, Levy SM, et al. Everyday activity predicts bone geometry in children: the Iowa Bone Development Study. Med Sci Sports Exerc 2004; 36 (7): 1124–31PubMedGoogle Scholar
  11. 11.
    Fisher A, Reilly JJ, Kelly LA, et al. Fundamental movement skills and habitual physical activity in young children. Med Sci Sports Exerc 2005; 37 (4): 684–8PubMedGoogle Scholar
  12. 12.
    Gillis LJ, Kennedy LC, Bar-Or O. Overweight children reduce their activity levels earlier in life than healthy weight children. Clin J Sport Med 2006; 16 (1): 51–5PubMedGoogle Scholar
  13. 13.
    Rose D, Bodor JN. Household food insecurity and overweight status in young school children: results from the Early Childhood Longitudinal Study. Pediatrics 2006; 117 (2): 464–73PubMedGoogle Scholar
  14. 14.
    Proctor MH, Moore LL, Gao D, et al. Television viewing and change in body fat from preschool to early adolescence: the Framingham Children’s Study. Int J Obes Relat Metab Disord 2003; 27 (7): 827–33PubMedGoogle Scholar
  15. 15.
    Sirard JR, Pate RR. Physical activity assessment in children and adolescents. Sports Med 2001; 31 (6): 439–54Google Scholar
  16. 16.
    Noland M, Danner F, DeWalt K, et al. The measurement of physical activity in young children. Res Q Exerc Sport 1990; 61 (2): 146–53PubMedGoogle Scholar
  17. 17.
    Engelhard S, Stubbs J, Weston P, et al. Methodological considerations when conducting direct observation in an outdoor environment: our experience in local parks. Aust NZ J Public Health 2001; 25 (2): 149–51Google Scholar
  18. 18.
    Heelan KA, Eisenmann JC. Physical activity, media time, and body composition in young children. J Phys Act Health 2006; 3 (2): 200–9Google Scholar
  19. 19.
    Cliff D, Okely AD, Mickle K, et al. Are pre-school children meeting current Australian physical activity recommendations? [abstract]. J Sci Med Sport 2005; 8 (4): 36Google Scholar
  20. 20.
    Lucas P, Schofield G. Physical activity and environmental correlates of physical activity in New Zealand preschool children [abstract]. 9th International Congress of Behavioral Medicine; 2006 Nov 29-Dec 2; BangkokGoogle Scholar
  21. 21.
    Pate RR, Pfeiffer KA, Trost S, et al. Physical activity among children attending preschools. Pediatrics 2004; 114 (5): 1258–63PubMedGoogle Scholar
  22. 22.
    Trost S, Fees B, Dzewaltowski D. Objectively measured physical activity behavior in children attending a half day preschool program [abstract]. Med Sci Sports Exerc 2005; 37 Suppl. 5: S63Google Scholar
  23. 23.
    Kelly LA, Reilly JJ, Grant S, et al. Effect of socioeconomic status on habitual physical activity and inactivity in young children measured using accelerometry [abstract]. Int J Obes 2002; 26 Suppl. 1: S28Google Scholar
  24. 24.
    Reilly JJ, Jackson DM, Montgomery C, et al. Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet 2004; 363 (9404): 211–2PubMedGoogle Scholar
  25. 25.
    Fisher A, Reilly JJ, Montgomery C, et al. Seasonality in physical activity and sedentary behavior in young children. Pediatr Exerc Sci 2005; 17: 31–40Google Scholar
  26. 26.
    Jackson DM, Reilly JJ, Kelly LA, et al. Objectively measured physical activity in a representative sample of 3- to 4-year old children. Obes Res 2003; 11 (3): 420–5Google Scholar
  27. 27.
    Janz KF, Levy SM, Burns TL, et al. Fatness, physical activity, and television viewing in children during the adiposity rebound period: the Iowa Bone Development Study. Prev Med 2002; 35: 563–71PubMedGoogle Scholar
  28. 28.
    Worobey J, Adler AL, Worobey HS. Diet, activity, and risk for overweight in a sample of Head Start children. J Child Health 2004; 2 (2): 133–44Google Scholar
  29. 29.
    Worobey J, Worobey HS, Adler AL. Diet, activity and BMI in preschool-aged children: differences across settings. Ecol Food Nutr 2005; 44 (6): 455–66Google Scholar
  30. 30.
    Cardon GM, De Bourdeaudhuij IMM. Are preschool children active enough? Objectively measured physical activity levels [abstract]. 9th International Congress of Behavioral Medicine; 2006 Nov 29-Dec 2; BangkokGoogle Scholar
  31. 31.
    Kelly LA, Reilly JJ, Jackson DM, et al. Tracking physical activity and sedentary behavior in young children. Pediatr Exerc Sci 2007; 19 (1): 51–60PubMedGoogle Scholar
  32. 32.
    Metallinos-Katsaras ES, Freedson PS, Fulton JE, et al. The association between an objective measure of physical activity and weight status in preschoolers. Obesity 2007; 15 (3): 686–94PubMedGoogle Scholar
  33. 33.
    Roemmich JN, Epstein LH, Raja S, et al. Association of access to parks and recreational facilities with the physical activity of young children. Prev Med 2006; 43 (6): 437–41PubMedGoogle Scholar
  34. 34.
    Reilly JJ, Kelly L, Montgomery C, et al. Physical activity to prevent obesity in young children: cluster randomized controlled trial. BMJ 2006; 33 (7577): 1041Google Scholar
  35. 35.
    Finn K, Johannsen N, Specker B. Factors associated with physical activity in preschool children. J Pediatr 2002; 140: 81–5PubMedGoogle Scholar
  36. 36.
    Finn K, Ullmann J. Does seasonal changes in temperature affect levels of vigorous physical activity in preschool-aged children? [abstract]. Med Sci Sports Exerc 2004; 36 Suppl. 5: S298Google Scholar
  37. 37.
    Firrincieli V, Keller A, Ehrensberger R, et al. Decreased physical activity among Head Start children with a history of wheezing: use of an accelerometer to measure activity. Pediatr Pulmonol 2005; 40: 57–63PubMedGoogle Scholar
  38. 38.
    Specker B, Binkley T. Randomized trial of physical activity and calcium supplementation on bone mineral content in 3- to 5-year old children. J Bone Miner Res 2003; 18 (5): 885–92PubMedGoogle Scholar
  39. 39.
    Butte NF, Cai G, Cole SA, et al. Viva la Familia Study: genetic and environmental contributions to childhood obesity and its comorbidities in the Hispanic population. Am J Clin Nutr 2006; 84 (3): 646–54PubMedGoogle Scholar
  40. 40.
    Moore LL, Lombardi DA, White MJ, et al. Influence of parent’s physical activity levels on activity levels of young children. J Pediatr 1991; 118 (2): 215–9PubMedGoogle Scholar
  41. 41.
    Moore LL, Nguyen UDT, Rothman KJ, et al. Preschool physical activity level and change in body fatness in young children: the Framingham Children’s Study. Am J Epidemiol 1995; 142: 982–8PubMedGoogle Scholar
  42. 42.
    Khoury PR, Claytor RP, Daniels SR. Predictors of physical activity in preschoolers [abstract]. Med Sci Sports Exerc 2003; 35 Suppl. 5: S340Google Scholar
  43. 43.
    Claytor RP, Khoury PR, Daniels SR. Physical activity assessment in preschool children [abstract]. Med Sci Sports Exerc 2003; 35 Suppl. 5: S340Google Scholar
  44. 44.
    Claytor RP, Khoury P, Daniels LA. Physical activity and body composition: parent-child relationships [abstract]. Med Sci Sports Exerc 2004; 36 Suppl. 5: S328Google Scholar
  45. 45.
    Vásquez F, Salazar G, Andrade M, et al. Energy balance and physical activity in obese children attending day-care centres. Eur J Clin Nutr 2006; 60 (9): 1115–21PubMedGoogle Scholar
  46. 46.
    Broyles SL, Sallis JF, Zive MM, et al. Correlations among physical activity and eating behaviors in 4- to 7-year-old Anglo- and Mexican-American children. J Dev Behav Pediatr 1999; 20 (6): 405–10PubMedGoogle Scholar
  47. 47.
    Sallis JF, Berry CC, Broyles SL, et al. Variability and tracking of physical activity over two years in young children. Med Sci Sports Exerc 1995; 27: 1042–9PubMedGoogle Scholar
  48. 48.
    Elder JP, Broyles SL, McKenzie TL, et al. Direct home observations of the prompting of physical activity in sedentary and active Mexican- and Anglo-American children. J Dev Behav Pediatr 1998; 19 (1): 26–30Google Scholar
  49. 49.
    McKenzie TL, Sallis JF, Nader PR, et al. Anglo- and Mexican-American preschoolers at home and at recess: activity patternsand environmental influences. J Dev Behav Pediatr 1992; 13 (3): 173–80PubMedGoogle Scholar
  50. 50.
    McKenzie TL, Sallis JF, Elder JP, et al. Physical activity levels and prompts in young children at recess: a two-year study of a bi-ethnic sample. Res Q Exerc Sport 1997; 68 (3): 195–202PubMedGoogle Scholar
  51. 51.
    Sallis JF, Nader PR, Broyles SL, et al. Correlates of physical activity at home in Mexican-American and Anglo-American preschool children. Health Psychol 1993; 12 (5): 390–8PubMedGoogle Scholar
  52. 52.
    Baranowski T, Thompson WO, DuRant RH, et al. Observations on physical activity in physical locations: age, gender, ethnicity and month effects. Res Q Exerc Sport 1993; 64 (2): 127–33PubMedGoogle Scholar
  53. 53.
    DuRant RH, Baranowski T, Johnson M, et al. The relationship among television watching, physical activity, and body compoition of young children. Pediatrics 1994; 94 (4): 449–55PubMedGoogle Scholar
  54. 54.
    Jago R, Baranowski T, Thompson D, et al. Sedentary behavior, not TV viewing, predicts physical activity among 3- to 7-year-old children. Pediatr Exerc Sci 2005; 17: 364–76Google Scholar
  55. 55.
    Sallis JF, Patterson TL, McKenzie TL, et al. Family variables and physical activity in preschool children. J Dev Behav Pediatr 1988; 9 (2): 57–61PubMedGoogle Scholar
  56. 56.
    Klesges RC, Malott JM, Boschee PF, et al. The effects of parental influences on children’s food intake, physical activity, and relative weight. Int J Eat Disord 1986; 5 (2): 335–46Google Scholar
  57. 57.
    Dowda M, Pate RR, Trost SG, et al. Influences of preschool policies and practices on children’s physical activity. J Community Health 2004; 29 (3): 183–96PubMedGoogle Scholar
  58. 58.
    Eck LH, Klesges RC, Hanson CL, et al. Children at familial risk for obesity: an examination of dietary intake, physical activity and weight status. Int J Obes Relat Metab Disord 1992; 16 (2): 71–8PubMedGoogle Scholar
  59. 59.
    Klesges RC, Eck LH, Hanson CL, et al. Effects of obesity, social interactions, and physical environment on physical activity in preschoolers. Health Psychol 1990; 9 (4): 435–49PubMedGoogle Scholar
  60. 60.
    Carson L, Ayers S. Viability of pedometer use in the assessment of the activity levels in preschool children. Res Q Exerc Sport 2003; 74 Suppl. 1: A–4Google Scholar
  61. 61.
    Boldemann C, Blennow M, Dal H, et al. Impact of pre-school environment upon children’s physical activity and sun exposure. Prev Med 2006; 42 (4): 301–8Google Scholar
  62. 62.
    Cardon G, de Bourdeaudhuij I. Comparison of pedometer and accelerometer measures of physical activity in preschool children. Pediatr Exerc Sci 2007; 19 (2): 205–14PubMedGoogle Scholar
  63. 63.
    Al-Hazzaa HM, Al-Rasheedi AA. Adiposity and physical activity levels among preschool children in Jeddah, Saudi Arabia. Saudi Med J 2007; 28 (5): 766–73Google Scholar
  64. 64.
    Hart CH, Sheehan R. Preschoolers’ play behavior in outdoor environments: effects of traditional and contemporary playgrounds. Am Educ Res J 1986; 23 (4): 668–78Google Scholar
  65. 65.
    Schneider PL, Crouter SE, Bassett Jr DR. Pedometer measures of free-living physical activity: comparison of 13 models. Med Sci Sports Exerc 2004; 36 (2): 331–5PubMedGoogle Scholar
  66. 66.
    Schneider PL, Crouter SE, Lukajic O, et al. Accuracy and reliability of 10 pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc 2003; 35 (10): 1779–84PubMedGoogle Scholar
  67. 67.
    Nishikido N, Kashiwazaki H, Suzuki T. Preschool children’s daily activities: direct observation, pedometry or questionnaire. J Hum Ergol 1982; 11 (2): 214–8Google Scholar
  68. 68.
    Louie L, Chan L. The use of pedometry to evaluate the physical activity levels among preschool children in Hong Kong. Early Child Dev Care 2003; 173 (1): 97–107Google Scholar
  69. 69.
    McKee DP, Boreham CAG, Murphy MH, et al. Validation of the Digiwalker pedometer for measuring physical activity in young children. Pediatr Exerc Sci 2005; 17: 345–52Google Scholar
  70. 70.
    Oliver M, Schofield GS, Kolt GK, et al. Pedometer accuracy in physical activity assessment of preschool children. J Sci Med Sport 2007; 10 (5): 303–10PubMedGoogle Scholar
  71. 71.
    Puhl J, Greaves KA, Hoyt M, et al. Children’s Activity Rating Scale (CARS): description and calibration. Res Q Exerc Sport 1990; 61 (1): 26–36PubMedGoogle Scholar
  72. 72.
    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; I (8476): 307–10Google Scholar
  73. 73.
    Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135–60PubMedGoogle Scholar
  74. 74.
    Bouten CV, Westerterp KR, Verduin M, et al. Assessment of energy expenditure for physical activity using a triaxial accelerometer. Med Sci Sports Exerc 1994; 26: 1516–23PubMedGoogle Scholar
  75. 75.
    de Vries SI, Bakker I, Hopman-Rock M, et al. Clinimetric review of motion sensors in children and adolescents. J Clin Epidemiol 2006; 59: 670–80PubMedGoogle Scholar
  76. 76.
    Rowlands AV. Accelerometer assessment of physical activity in children: an update. Pediatr Exerc Sci 2007; 19 (3): 252–66PubMedGoogle Scholar
  77. 77.
    Welk GJ, Corbin CB. The validity of the Tritrac-R3D activity monitor for the assessment of physical activity in children. Res Q Exerc Sport 1995; 66 (3): 202–9PubMedGoogle Scholar
  78. 78.
    Eston RG, Rowlands AV, Ingledew DK. Validity of heart rate, pedometry, and accelerometry for predicting the energy cost of children’s activities. J Appl Physiol 1998; 84 (1): 362–71PubMedGoogle Scholar
  79. 79.
    McIver K, Pfeiffer KA, Almeida J, et al. Validity of the ActiGraph and Actical accelerometers in 3- to 5-year-old children [abstract]. Pediatr Exerc Sci 2005; 17 (1): 97Google Scholar
  80. 80.
    Pfeiffer KA, McIver KL, Dowda M, et al. Validation and calibration of the Actical accelerometer in preschool children. Med Sci Sports Exerc 2006; 38 (1): 152–7PubMedGoogle Scholar
  81. 81.
    Klesges LM, Klesges RC. The assessment of children’s physical activity: a comparison of methods. Med Sci Sports Exerc 1987; 19 (5): 511–7PubMedGoogle Scholar
  82. 82.
    Klesges RC, Klesges LM, Swenson AM, et al. A validation of two motion sensors in the prediction of child and adult physical activity levels. Am J Epidemiol 1985; 122 (3): 400–10PubMedGoogle Scholar
  83. 83.
    Klesges RC, Haddock CK, Eck LH. A multimethod approach to the measurement of childhood physical activity and its relationship to blood pressure and body weight. J Pediatr 1990; 116 (6): 888–93PubMedGoogle Scholar
  84. 84.
    Mukeshi M, Gutin B, Anderson W, et al. Validation of th CALTRAC movement sensor using direct observation in young children. Pediatr Exerc Sci 1990; 2: 249–54Google Scholar
  85. 85.
    Pate RR, Almeida MJ, McIver KL, et al. Validation and calibration of an accelerometer in preschool children. Obesity 2006; 14 (11): 2000–6PubMedGoogle Scholar
  86. 86.
    Sirard JR, Trost SG, Pfeiffer KA, et al. Calibration and evaluation of an objective measure of physical activity in preschool children. J Phys Act Health 2005; 2 (3): 345–57Google Scholar
  87. 87.
    Fairweather SC, Reilly JJ, Grant S, et al. Using the Computer Science and Applications (CSA) activity monitor in preschool children. Pediatr Exerc Sci 1999; 11: 413–20Google Scholar
  88. 88.
    Reilly JJ, Coyle J, Kelly L, et al. An objective method for measurement of sedentary behavior in 3- to 4-year olds. Obes Res 2003; 11 (10): 1155–8PubMedGoogle Scholar
  89. 89.
    Montgomery C, Reilly JJ, Jackson DM, et al. Relation between physical activity and energy expenditure in a representative sample of young children. Am J Clin Nutr 2004; 80: 591–6PubMedGoogle Scholar
  90. 90.
    Kelly LA, Reilly JJ, Fairweather SC, et al. Comparison of two accelerometers for assessment of physical activity in preschool children. Pediatr Exerc Sci 2004; 16: 324–33Google Scholar
  91. 91.
    Finn KJ, Finn KK, Flack T. Validation of the Actiwatch activity monitor in children [abstract]. Med Sci Sports Exerc 2001; 33 Suppl. 5: S250Google Scholar
  92. 92.
    Finn KJ, Specker B. Comparison of Actiwatch® activity monitor and Children’s Activity Rating Scale in children. Med Sci Sports Exerc 2000; 32 (10): 1794–7PubMedGoogle Scholar
  93. 93.
    Lopez-Alarcon M, Merrifield J, Fields DA, et al. Ability of the Actiwatch accelerometer to predict free-living energy expenditure in young children. Obes Res 2004; 12: 1859–65PubMedGoogle Scholar
  94. 94.
    Bassett Jr DR, Ainsworth BE, Swartz AM, et al. Validity of four motion sensors in measuring moderate intensity physical activity. Med Sci Sports Exerc 2000; 32 Suppl. 9: S471–80Google Scholar
  95. 95.
    Masse LC, Fuemmeler BF, Anderson CB, et al. Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables. Med Sci Sports Exerc 2005; 37 Suppl. 11: S544–54Google Scholar
  96. 96.
    Penpraze V, Reilly JJ, Montgomery C, et al. Effect of accelerometer cut-points on apparent levels of physical activity and inactivity in young children. Med Sci Sports Exerc 2006; 38 Suppl. 5: S565Google Scholar
  97. 97.
    Cliff DP, Okely AD. Comparison of two sets of accelerometer cut-off points for calculating moderate-to-vigorous physical activity in young children. J Phys Act Health 2007; 4 (4): 509–13PubMedGoogle Scholar
  98. 98.
    Repp AC, Nieminen GS, Olinger E, et al. Direct observation: factors affecting the accuracy of observers. Except Child 1988; 55 (1): 29–36Google Scholar
  99. 99.
    Brown WH, Pfeiffer KA, McIver KL, et al. Assessing preschool children’s physical activity: the Observational System for Recording Physical Activity in Children-preschool version. Res Q Exerc Sport 2006; 77 (2): 167–76PubMedGoogle Scholar
  100. 100.
    McKenzie TL, Sallis JF, Patterson TL, et al. BEACHES: an observational system for assessing children’s eating behaviors and associated events. J Appl Behav Anal 1991; 24 (1): 141–51PubMedGoogle Scholar
  101. 101.
    O’Hara NM, Baranowski T, Simons-Morton BG, et al. Validity of the observation of children’s physical activity. Res Q Exerc Sport 1989; 60 (1): 42–7PubMedGoogle Scholar
  102. 102.
    Klesges RC, Coates TJ, Moldenhauer LM, et al. The FATS: an observational system for assessing physical activity in children and associated behavior. Behav Assess 1984; 6: 333–45Google Scholar
  103. 103.
    DuRant RH, Baranowski J, Puhl J, et al. Evaluation of the Children’s Activity Rating Scale (CARS) in young children. Med Sci Sports Exerc 1993; 25 (12): 1415–21PubMedGoogle Scholar
  104. 104.
    Tulve NS, Jones PA, McCurdy T, et al. A pilot study using an accelerometer to evaluate a caregiver’s interpretation of an infant or toddler’s activity level as recorded in a time activity diary. Res Q Exerc Sport 2007; 78 (4): 375–82PubMedGoogle Scholar
  105. 105.
    Chen X, Sekine M, Hamanishi S, et al. The validity of nursery teachers’ report on the physical activity of young children. J Epidemiol 2002; 12 (5): 367–74PubMedGoogle Scholar
  106. 106.
    Burdette HL, Whitaker RC, Daniels SR. Parental report of outdoor playtime as a measure of physical activity in pre-school-aged children. Arch Pediatr Adolesc Med 2004; 158 (4): 353–7PubMedGoogle Scholar
  107. 107.
    Harro M. Validation of a questionnaire to assess physical activity of children ages 4-8 years. Res Q Exerc Sport 1997; 68 (4): 259–68PubMedGoogle Scholar
  108. 108.
    Goran MI, Hunter G, Nagy TR, et al. Physical activity related energy expenditure and fat mass in young children. Int J Obes 1997; 21 (3): 171–8Google Scholar
  109. 109.
    Saris WH, Binkhorst RA. The use of the pedometer and actometer in studying daily physical activity in man, part II: validity of pedometer and actometer measuring daily physical activity. Eur J Appl Physiol 1977; 37 (3): 229–35Google Scholar
  110. 110.
    Janz KF, Broffitt B, Levy SM. Validation evidence for the Netherlands Physical Activity Questionnaire for Young Children: the Iowa Bone Development Study. Res Q Exerc Sport 2005; 76 (3): 363–9PubMedGoogle Scholar
  111. 111.
    Telama R, Viikari J, Valimaki I, et al. Atherosclerosis precursors in Finnish children and adolescents, X: leisure-time physical activity. Acta Paediatr Scand Suppl 1985; 318: 169–80PubMedGoogle Scholar
  112. 112.
    Sirard JR, Trost SG, Dowda M, et al. Calibration of the Computer Science and Applications, Inc. physical activity monitor in preschool children [abstract]. Med Sci Sports Exerc 2001; 33 Suppl. 5: S144Google Scholar
  113. 113.
    Welk GJ, Corbin CB, Dale D. Measurement issues in the assessment of physical activity in children. Res Q Exerc Sport 2000; 71 (2): 59–73Google Scholar
  114. 114.
    Sallis JF. Self-report measures of children’s physical activity. J Sch Health 1991; 61 (5): 215–9PubMedGoogle Scholar
  115. 115.
    Fontvieille AM, Harper IT, Ferraro RT, et al. Daily energy expenditure by five-year-old children, measured by doubly labeled water. J Pediatr 1993; 123 (2): 200–7PubMedGoogle Scholar
  116. 116.
    Bouchard C, Perusse L, Deriaz O, et al. Genetic influences on energy expenditure in humans. Crit Rev Food Sci Nutr 1993; 33 (4-5): 345–50PubMedGoogle Scholar
  117. 117.
    Sun M, Gower BA, Bartolucci AA, et al. A longitudinal study of resting energy expenditure relative to body composition during puberty in African American and white children. Am J Clin Nutr 2001; 73 (2): 308–15PubMedGoogle Scholar
  118. 118.
    Goran MI, Nagy TR, Gower BA, et al. Influence of sex, seasonality, ethnicity, and geographic location on the components of total energy expenditure in young children: implications for energy requirements. Am J Clin Nutr 1998; 68 (3): 675–82PubMedGoogle Scholar
  119. 119.
    Rahman SMM, Kabir I, Akter BMD, et al. Energy intake and expenditure of obese and non-obese urban Bangladeshi children: energy intake and expenditure of obese and non-obese urban Bangladeshi children. Bangladesh Med Res Counc Bull 2002; 28 (2): 54–60PubMedGoogle Scholar
  120. 120.
    Tang RB, Lee PC, Chen SJ, et al. Cardiopulmonary response in obese children using treadmill exercise testing. Zhonghua Yi Xue Za Zhi 2002; 65 (2): 79–82PubMedGoogle Scholar
  121. 121.
    Goran MI, Shewchuk R, Gower BA, et al. Longitudinal changes in fatness in white children: no effect of childhood energy expenditure. Am J Clin Nutr 1998; 67 (2): 309–16PubMedGoogle Scholar
  122. 122.
    Ekelund U, Yngve A, Brage S, et al. Body movement and physical activity energy expenditure in children and adolescents: how to adjust for differences in body size and age. Am J Clin Nutr 2004; 79 (5): 851–6PubMedGoogle Scholar
  123. 123.
    Johnson MS, Figueroa-Colon R, Herd SL, et al. Aerobic fitness, not energy expenditure, influences subsequent increase in adiposity in black and white children. Pediatrics 2000; 106 (4): e50PubMedGoogle Scholar
  124. 124.
    Durnin JVGA. Methods to assess physical activity and the energy expended for it by infants and children. In: Schürch B, Scrimshaw NS, editors. Activity, energy expenditure and energy requirements of infants and children. Proceedings of the International Dietary Energy Consultancy Group Workshop; 1989 Nov 14-17; Cambridge (MA) Lausaunne: IDECG, 1990Google Scholar
  125. 125.
    McArdle WD, Katch FI, Katch VL. Exercise physiology: energy, nutrition, and human performance. 4th ed. Baltimore (MD): Williams & Wilkins, 1996Google Scholar
  126. 126.
    Logan N, Reilly JJ, Grant S, et al. Resting heart rate definition and its effect on apparent levels of physical activity in young children. Med Sci Sports Exerc 2000; 32 (1): 162–6PubMedGoogle Scholar
  127. 127.
    Therrell JA, Brown P, Sutterby JA, Age determination guidelines: relating children’s ages to toy characteristics and play behavior. Washington, DC: United States Consumer Product Safety Commission, 2002Google Scholar
  128. 128.
    Parten M. Social participation among preschool children. J Abnorm Soc Psychol 1932; 27: 242–69Google Scholar
  129. 129.
    Keen M. Early development and attainment of normal mature gait. J Prosthet Orthot 1993; 5 (2): 35–8Google Scholar
  130. 130.
    Nilsson A, Ekelund U, Yngve A, et al. Assessing physical activity among children with accelerometers using different time sampling intervals and placements. Pediatr Exerc Sci 2002; 14: 87–96Google Scholar
  131. 131.
    Pellegrini AD, Smith PK. Physical activity play: the nature and function of a neglected aspect of play. Child Dev 1998; 69: 577–98PubMedGoogle Scholar
  132. 132.
    Bailey RC, Olson J, Pepper SL, et al. The level and tempo of children’s physical activities: an observational study. Med Sci Sorts Exerc 1995; 27 (7): 1033–41Google Scholar
  133. 133.
    Sallo M, Silla R. Physical activity with moderate to vigorous intensity in preschool and first-grade school children. Pediatr Exerc Sci 1997; 9: 44–54Google Scholar
  134. 134.
    Dietz WH. The role of lifestyle in health: the epidemiology and consequences of inactivity. Proc Nutr Soc 1996; 55: 829–40PubMedGoogle Scholar
  135. 135.
    Taveras EM, Sandora TJ, Shih M, et al. The association of television and video viewing with fast food intake by pre-school-age children. Obesity 2006; 14 (11): 2034–41PubMedGoogle Scholar
  136. 136.
    Burdette HL, Whitaker RC. A national study of neighborhood safety, outdoor play, television viewing, and obesity in pre-school children. Pediatrics 2005; 116 (3): 657–62PubMedGoogle Scholar
  137. 137.
    Robinson JL, Winiewicz DD, Fuerch JH, et al. Relationship between parental estimate and an objective measure of child television watching. Int J Behav Nutr Phys Act 2006 Nov; 3 (1): 43PubMedGoogle Scholar
  138. 138.
    Reilly JJ, Armstrong J, Dorosty AR, et al. Early life risk factors for obesity in childhood: cohort study. BMJ 2005; 330 (7504): 1357PubMedGoogle Scholar
  139. 139.
    Dennison BA, Erb TA, Jenkins PL. Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 2002; 109 (6): 1028–35PubMedGoogle Scholar
  140. 140.
    Mendoza JA, Zimmerman FJ, Christakis DA. Television viewing, computer use, obesity, and adiposity in US preschool children. Int J Behav Nutr Phys Act 2007 Sep; 4 (1): 44PubMedGoogle Scholar
  141. 141.
    Certain LK, Kahn RS. Prevalence, correlates, and trajectory of television viewing among infants and toddlers. Pediatrics 2002; 109 (4): 634–42PubMedGoogle Scholar
  142. 142.
    Duncan JS, Schofield G, Duncan EK, Effects of age, walking speed, and body composition on pedometer accuracy in children. Res Q Exerc Sport.Google Scholar
  143. 143.
    Coleman KL, Smith DG, Boone DA, et al. Step activity monitor: long-term, continuous recording of ambulatory function. J Rehabil Res Dev 1999; 36 (1): 8–18PubMedGoogle Scholar
  144. 144.
    Corder K, Brage S, Wareham NJ, et al. Comparison of the ActiGraph models 7164 and GT1M during 7 days of free living activity in Indian children [abstract]. Proceedings of the Satellite Meeting of the ICDAM6 Conference-Objective Measurement of Physical Activity; 2006 Apr 26; Odense: University of Southern DenmarkGoogle Scholar
  145. 145.
    Zhang K, Werner P, Sun M, et al. Measurement of human daily physical activity. Obes Res 2003; 11 (1): 33–40PubMedGoogle Scholar
  146. 146.
    Hämmerle E, Winton P, Fett S. A multipath-mitigating indoor carrier-phase position tracking system. Auckland: The University of Auckland and Paric Limited, 2005Google Scholar
  147. 147.
    Eldridge B, Galea M, McCoy A, et al. Uptime normative values in children aged 8 to 15 years. Dev Med Child Neurol 2003; 45: 189–93PubMedGoogle Scholar
  148. 148.
    Elgethun K, Fenske RA, Palcisko GJ, et al. Time-location analysis for exposure assessment studies of children using a novel global positioning system instrument. Environ Health Perspect 2003; 111 (1): 115–22PubMedGoogle Scholar
  149. 149.
    Milat AJ, Stubbs J, Engelhard S, et al. Measuring physical activity in public open space: an electronic device versus direct observation. Aust N Z J Public Health 2002; 26 (1): 50–1PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Melody Oliver
    • 1
  • Grant M. Schofield
    • 1
  • Gregory S. Kolt
    • 1
    • 2
  1. 1.Centre for Physical Activity and Nutrition Research, Faculty of Health and Environmental SciencesAuckland University of TechnologyNew Zealand
  2. 2.School of Biomedical and Health SciencesUniversity of Western SydneyPenrithAustralia

Personalised recommendations