Age-related change in children’s physical activity and sedentary time: The International Children’s Accelerometry Database (ICAD)

Background
Many young people fail to achieve the minimum recommended amount of physical activity to benefit their health. Understanding the nature of age-related changes in behaviour and how this varies for population sub-groups is informative for intervention design. The aim of this study was to describe age-related changes in physical activity and sedentary time and examine variability in patterns of change across demographic sub-groups.

Methods
Data are from 13 studies in the International Children’s Accelerometry Database (ICAD), all of which provided ≥2 waves of waist-worn accelerometer data. Annual change in sedentary time, light intensity physical activity (LPA) and moderate to vigorous intensity physical activity (MVPA) were estimated using three level mixed effects linear regression models, using participant age as the exposure variable. In interaction models, we examined whether changes in behaviour differed by day of the week (weekday / weekend), age at baseline assessment (<10 / ≥10 years), sex, weight category, maternal education and ethnicity.

Results
In total, 6567 participants provided two or more waves of valid accelerometer data (44.5% boys, mean (SD) baseline age 10.6 (2.1) years (range 4.1-15.8 years)). Across the week and for all studied sub-groups, sedentary time increased by approximately 25 minutes/day/year of age, LPA decreased by approximately 22 minutes/day/year of age and MVPA decreased by approximately 3 minutes/day/year of age. The annual increase in sedentary time was greater in girls compared to boys (β (95% confidence interval) change (min) for each additional year of age: girls, 25.9 (25.4, 26.4); boys, 23.6 (23.0, 24.2)) and in adolescents compared to children (adolescents, 27.0 (26.5, 27.6); children, (23.5 (22.9, 24.2)). The annual decrease in MVPA was greater in boys compared to girls (boys, -2.7 (-3.0, -2.5); girls, -2.2 (-2.4, -2.0)) and at the weekend compared to during the week (weekend, -3.0 (-3.3, -2.8); weekday -2.3 (-2.5, -2.1)).

Conclusion
Accelerometer assessed sedentary time increased whilst LPA and MVPA decreased during childhood and adolescence. This overall pattern was observed across the week and in all studied sub-groups, but small differences in the magnitude of changes can be used to guide the timing and targeting of behaviour change interventions, such as designing physical activity interventions which focus on weekends where a child’s time is less structured.