Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database

Catherine Gammon; Andrew J Atkin; Kirsten Corder; Ulf Ekelund; Biorge Herman Hansen; Lauren B Sherar; Lars Bo Anderson; Sigmund Alfred Anderssen; Rachel Davey; Pedro C Hallal; Russell  Jago; Susi Kriemler; Peter Lund Kristensen; Soyang Kwon; Kate Northstone; Russell R Pate; Jo Salmon; Luis B Sardinha; Esther van Sluijs

doi:10.1249/MSS.0000000000002884

Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database

Catherine Gammon^*, Andrew J Atkin, Kirsten Corder, Ulf Ekelund, Biorge Herman Hansen, Lauren B Sherar, Lars Bo Anderson, Sigmund Alfred Anderssen, Rachel Davey, Pedro C Hallal, Russell Jago, Susi Kriemler, Peter Lund Kristensen, Soyang Kwon, Kate Northstone, Russell R Pate, Jo Salmon, Luis B Sardinha, Esther van Sluijs

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

7 Citations (Scopus)

82 Downloads (Pure)

Abstract

Introduction: The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 minutes of moderate-vigorous PA (MVPA) every day, to an average of 60 minutes of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. Further, inconsistent guideline operationalization impairs understanding of physical inactivity prevalence. This study used the International Children’s Accelerometry Database to compare approaches to calculating PA compliance among youth and associations with health indicators.

Methods: Cross-sectional accelerometer data for 21,612 youth (5-18y) was used to examine compliance with four guideline definitions: daily method (DM; ≥60 minutes MVPA every day), average method (AM; average of ≥60 minutes MVPA per day), AM5 (compliance with AM and ≥five minutes of vigorous PA [VPA] on ≥three days), AM15 (compliance with AM and ≥15 minutes VPA on ≥three days). Associations between compliance and health indicators were examined for all definitions.

Results: Compliance varied from 5·3% (DM) to 29·9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (-0.28 [-0.33,-0.23]), AM5 (-0.28 [-0.33,-0.23], AM15 (-0.30, [-0.35,-0.25]). Associations between compliance and health indicators for DM were similar or weaker, possibly reflecting fewer DM-compliant participants with health data (n=250-1,127) and lower variability in exposure/outcome data.

Conclusion: Youth who complete 60 minutes of MVPA every day do not experience superior health benefits to youth who complete an average of 60 minutes of MVPA per day. Guidelines should encourage youth to achieve an average of 60 minutes of MVPA per day over a week. Different guideline definitions impact inactivity prevalence estimates; this must be considered when analyzing data and making cross-study comparisons.

Original language	English
Pages (from-to)	1114-1122
Number of pages	9
Journal	Medicine and Science in Sports and Exercise
Volume	54
Issue number	7
Early online date	21 Feb 2022
DOIs	https://doi.org/10.1249/MSS.0000000000002884
Publication status	Published - 1 Jul 2022

Bibliographical note

Funding Information:
The pooling of the data was funded through a grant from the National Prevention Research Initiative (grant no. G0701877) ( http://www.mrc.ac.uk/research/initiatives/national-prevention-research-initiative-npri/ ). The funding partners relevant to this award are the following: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; and Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [MC_UU_12015/3; MC_UU_12015/7], The Research Council of Norway (249932/F20), Bristol University, Loughborough University and Norwegian School of Sport Sciences.

Funding Information:
The authors are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and Wellcome (grant no. 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and Catherine Gammon, Andrew J. Atkin, Kirsten Corder, Ulf Ekelund, Bjørge Herman Hansen, Lauren Sherar, and Esther van Sluijs will serve as guarantors for the contents of this article. A comprehensive list of grants funding is available on the ALSPAC Web site. This research was specifically funded by the Wellcome Trust (grant no. 086676/Z/08/Z) and NIH (grant no. 5R01HL071248-07).

Funding Information:
The ICAD was made possible thanks to the sharing of data from the following contributors (study name): Prof. L. B. Andersen, Faculty of Teacher Education and Sport, Western Norway University of Applied Sciences, Sogndal, Norway (Copenhagen School Child Intervention Study [CoSCIS]); Prof. S. Anderssen, Norwegian School for Sport Science, Oslo, Norway (European Youth Heart Study [EYHS], Norway); Prof. G. Cardon, Department of Movement and Sports Sciences, Ghent University, Belgium (Belgium Pre-School Study); Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Hyattsville, MD (National Health and Nutrition Examination Survey [NHANES]); Dr. R. Davey, Centre for Research and Action in Public Health, University of Canberra, Australia (Children’s Health and Activity Monitoring for Schools [CHAMPS]); Dr. P. Hallal, Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil (1993 Pelotas Birth Cohort); Prof. K. F. Janz, Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, IA (Iowa Bone Development Study); Prof. S. Kriemler, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland (Kinder-Sportstudie (KISS)); Dr. N. Møller, University of Southern Denmark, Odense, Denmark (European Youth Heart Study [EYHS], Denmark); Dr. K. Northstone, School of Social and Community Medicine, University of Bristol, UK (Avon Longitudinal Study of Parents and Children [ALSPAC]); Dr. A. Page, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK (Personal and Environmental Associations with Children’s Health (PEACH)); Prof. R. Pate, Department of Exercise Science, University of South Carolina, Columbia, SC (Physical Activity in Pre-school Children [CHAMPS-US] and Project Trial of Activity for Adolescent Girls [Project TAAG]); Dr. J. J. Puder, Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland (Ballabeina Study); Prof. J. Reilly, Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK (Movement and Activity Glasgow Intervention in Children [MAGIC]); Prof. J. Salmon, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia (Children Living in Active Neigbourhoods [CLAN] and Healthy Eating and Play Study [HEAPS]); Prof. L. B. Sardinha, Exercise and Health Laboratory, Faculty of Human Movement, Universidade de Lisboa, Lisbon, Portugal (European Youth Heart Study [EYHS], Portugal); and Dr. E. M. F. van Sluijs, MRC Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, UK (Sport, Physical activity and Eating behavior: Environmental Determinants in Young people [SPEEDY]).

Publisher Copyright:
© Lippincott Williams & Wilkins.

Research Groups and Themes

SPS Exercise, Nutrition and Health Sciences

Keywords

ICAD
ACCELEROMETER
PHYSICAL ACTIVITY
COMPLIANCE
VIGOROUS-INTENSITY PHYSICAL ACTIVITY

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Gammon, C., Atkin, A. J., Corder, K., Ekelund, U., Hansen, B. H., Sherar, L. B., Anderson, L. B., Anderssen, S. A., Davey, R., Hallal, P. C., Jago, R., Kriemler, S., Kristensen, P. L., Kwon, S., Northstone, K., Pate, R. R., Salmon, J., Sardinha, L. B., & van Sluijs, E. (2022). Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database. Medicine and Science in Sports and Exercise, 54(7), 1114-1122. https://doi.org/10.1249/MSS.0000000000002884

@article{272ac09275f04535a929ae5c7ae99758,

title = "Influence of guideline operationalization on youth activity prevalence in the International Children{\textquoteright}s Accelerometry Database",

abstract = "Introduction: The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 minutes of moderate-vigorous PA (MVPA) every day, to an average of 60 minutes of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. Further, inconsistent guideline operationalization impairs understanding of physical inactivity prevalence. This study used the International Children{\textquoteright}s Accelerometry Database to compare approaches to calculating PA compliance among youth and associations with health indicators. Methods: Cross-sectional accelerometer data for 21,612 youth (5-18y) was used to examine compliance with four guideline definitions: daily method (DM; ≥60 minutes MVPA every day), average method (AM; average of ≥60 minutes MVPA per day), AM5 (compliance with AM and ≥five minutes of vigorous PA [VPA] on ≥three days), AM15 (compliance with AM and ≥15 minutes VPA on ≥three days). Associations between compliance and health indicators were examined for all definitions. Results: Compliance varied from 5·3\% (DM) to 29·9\% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95\% CI]): AM (-0.28 [-0.33,-0.23]), AM5 (-0.28 [-0.33,-0.23], AM15 (-0.30, [-0.35,-0.25]). Associations between compliance and health indicators for DM were similar or weaker, possibly reflecting fewer DM-compliant participants with health data (n=250-1,127) and lower variability in exposure/outcome data. Conclusion: Youth who complete 60 minutes of MVPA every day do not experience superior health benefits to youth who complete an average of 60 minutes of MVPA per day. Guidelines should encourage youth to achieve an average of 60 minutes of MVPA per day over a week. Different guideline definitions impact inactivity prevalence estimates; this must be considered when analyzing data and making cross-study comparisons. ",

keywords = "ICAD, ACCELEROMETER, PHYSICAL ACTIVITY, COMPLIANCE, VIGOROUS-INTENSITY PHYSICAL ACTIVITY",

author = "Catherine Gammon and Atkin, \{Andrew J\} and Kirsten Corder and Ulf Ekelund and Hansen, \{Biorge Herman\} and Sherar, \{Lauren B\} and Anderson, \{Lars Bo\} and Anderssen, \{Sigmund Alfred\} and Rachel Davey and Hallal, \{Pedro C\} and Russell Jago and Susi Kriemler and Kristensen, \{Peter Lund\} and Soyang Kwon and Kate Northstone and Pate, \{Russell R\} and Jo Salmon and Sardinha, \{Luis B\} and \{van Sluijs\}, Esther",

note = "Funding Information: The pooling of the data was funded through a grant from the National Prevention Research Initiative (grant no. G0701877) ( http://www.mrc.ac.uk/research/initiatives/national-prevention-research-initiative-npri/ ). The funding partners relevant to this award are the following: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; and Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [MC\_UU\_12015/3; MC\_UU\_12015/7], The Research Council of Norway (249932/F20), Bristol University, Loughborough University and Norwegian School of Sport Sciences. Funding Information: The authors are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and Wellcome (grant no. 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and Catherine Gammon, Andrew J. Atkin, Kirsten Corder, Ulf Ekelund, Bj{\o}rge Herman Hansen, Lauren Sherar, and Esther van Sluijs will serve as guarantors for the contents of this article. A comprehensive list of grants funding is available on the ALSPAC Web site. This research was specifically funded by the Wellcome Trust (grant no. 086676/Z/08/Z) and NIH (grant no. 5R01HL071248-07). Funding Information: The ICAD was made possible thanks to the sharing of data from the following contributors (study name): Prof. L. B. Andersen, Faculty of Teacher Education and Sport, Western Norway University of Applied Sciences, Sogndal, Norway (Copenhagen School Child Intervention Study [CoSCIS]); Prof. S. Anderssen, Norwegian School for Sport Science, Oslo, Norway (European Youth Heart Study [EYHS], Norway); Prof. G. Cardon, Department of Movement and Sports Sciences, Ghent University, Belgium (Belgium Pre-School Study); Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Hyattsville, MD (National Health and Nutrition Examination Survey [NHANES]); Dr. R. Davey, Centre for Research and Action in Public Health, University of Canberra, Australia (Children{\textquoteright}s Health and Activity Monitoring for Schools [CHAMPS]); Dr. P. Hallal, Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil (1993 Pelotas Birth Cohort); Prof. K. F. Janz, Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, IA (Iowa Bone Development Study); Prof. S. Kriemler, Epidemiology, Biostatistics and Prevention Institute, University of Z{\"u}rich, Switzerland (Kinder-Sportstudie (KISS)); Dr. N. M{\o}ller, University of Southern Denmark, Odense, Denmark (European Youth Heart Study [EYHS], Denmark); Dr. K. Northstone, School of Social and Community Medicine, University of Bristol, UK (Avon Longitudinal Study of Parents and Children [ALSPAC]); Dr. A. Page, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK (Personal and Environmental Associations with Children{\textquoteright}s Health (PEACH)); Prof. R. Pate, Department of Exercise Science, University of South Carolina, Columbia, SC (Physical Activity in Pre-school Children [CHAMPS-US] and Project Trial of Activity for Adolescent Girls [Project TAAG]); Dr. J. J. Puder, Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland (Ballabeina Study); Prof. J. Reilly, Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK (Movement and Activity Glasgow Intervention in Children [MAGIC]); Prof. J. Salmon, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia (Children Living in Active Neigbourhoods [CLAN] and Healthy Eating and Play Study [HEAPS]); Prof. L. B. Sardinha, Exercise and Health Laboratory, Faculty of Human Movement, Universidade de Lisboa, Lisbon, Portugal (European Youth Heart Study [EYHS], Portugal); and Dr. E. M. F. van Sluijs, MRC Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, UK (Sport, Physical activity and Eating behavior: Environmental Determinants in Young people [SPEEDY]). Publisher Copyright: {\textcopyright} Lippincott Williams \& Wilkins.",

year = "2022",

month = jul,

day = "1",

doi = "10.1249/MSS.0000000000002884",

language = "English",

volume = "54",

pages = "1114--1122",

journal = "Medicine and Science in Sports and Exercise",

issn = "0195-9131",

publisher = "Lippincott Williams and Wilkins",

number = "7",

}

Gammon, C, Atkin, AJ, Corder, K, Ekelund, U, Hansen, BH, Sherar, LB, Anderson, LB, Anderssen, SA, Davey, R, Hallal, PC, Jago, R, Kriemler, S, Kristensen, PL, Kwon, S, Northstone, K, Pate, RR, Salmon, J, Sardinha, LB & van Sluijs, E 2022, 'Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database', Medicine and Science in Sports and Exercise, vol. 54, no. 7, pp. 1114-1122. https://doi.org/10.1249/MSS.0000000000002884

TY - JOUR

T1 - Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database

AU - Gammon, Catherine

AU - Atkin, Andrew J

AU - Corder, Kirsten

AU - Ekelund, Ulf

AU - Hansen, Biorge Herman

AU - Sherar, Lauren B

AU - Anderson, Lars Bo

AU - Anderssen, Sigmund Alfred

AU - Davey, Rachel

AU - Hallal, Pedro C

AU - Jago, Russell

AU - Kriemler, Susi

AU - Kristensen, Peter Lund

AU - Kwon, Soyang

AU - Northstone, Kate

AU - Pate, Russell R

AU - Salmon, Jo

AU - Sardinha, Luis B

AU - van Sluijs, Esther

N1 - Funding Information: The pooling of the data was funded through a grant from the National Prevention Research Initiative (grant no. G0701877) ( http://www.mrc.ac.uk/research/initiatives/national-prevention-research-initiative-npri/ ). The funding partners relevant to this award are the following: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; and Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [MC_UU_12015/3; MC_UU_12015/7], The Research Council of Norway (249932/F20), Bristol University, Loughborough University and Norwegian School of Sport Sciences. Funding Information: The authors are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and Wellcome (grant no. 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and Catherine Gammon, Andrew J. Atkin, Kirsten Corder, Ulf Ekelund, Bjørge Herman Hansen, Lauren Sherar, and Esther van Sluijs will serve as guarantors for the contents of this article. A comprehensive list of grants funding is available on the ALSPAC Web site. This research was specifically funded by the Wellcome Trust (grant no. 086676/Z/08/Z) and NIH (grant no. 5R01HL071248-07). Funding Information: The ICAD was made possible thanks to the sharing of data from the following contributors (study name): Prof. L. B. Andersen, Faculty of Teacher Education and Sport, Western Norway University of Applied Sciences, Sogndal, Norway (Copenhagen School Child Intervention Study [CoSCIS]); Prof. S. Anderssen, Norwegian School for Sport Science, Oslo, Norway (European Youth Heart Study [EYHS], Norway); Prof. G. Cardon, Department of Movement and Sports Sciences, Ghent University, Belgium (Belgium Pre-School Study); Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Hyattsville, MD (National Health and Nutrition Examination Survey [NHANES]); Dr. R. Davey, Centre for Research and Action in Public Health, University of Canberra, Australia (Children’s Health and Activity Monitoring for Schools [CHAMPS]); Dr. P. Hallal, Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil (1993 Pelotas Birth Cohort); Prof. K. F. Janz, Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, IA (Iowa Bone Development Study); Prof. S. Kriemler, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland (Kinder-Sportstudie (KISS)); Dr. N. Møller, University of Southern Denmark, Odense, Denmark (European Youth Heart Study [EYHS], Denmark); Dr. K. Northstone, School of Social and Community Medicine, University of Bristol, UK (Avon Longitudinal Study of Parents and Children [ALSPAC]); Dr. A. Page, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK (Personal and Environmental Associations with Children’s Health (PEACH)); Prof. R. Pate, Department of Exercise Science, University of South Carolina, Columbia, SC (Physical Activity in Pre-school Children [CHAMPS-US] and Project Trial of Activity for Adolescent Girls [Project TAAG]); Dr. J. J. Puder, Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland (Ballabeina Study); Prof. J. Reilly, Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK (Movement and Activity Glasgow Intervention in Children [MAGIC]); Prof. J. Salmon, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia (Children Living in Active Neigbourhoods [CLAN] and Healthy Eating and Play Study [HEAPS]); Prof. L. B. Sardinha, Exercise and Health Laboratory, Faculty of Human Movement, Universidade de Lisboa, Lisbon, Portugal (European Youth Heart Study [EYHS], Portugal); and Dr. E. M. F. van Sluijs, MRC Epidemiology Unit and Centre for Diet and Activity Research, University of Cambridge, UK (Sport, Physical activity and Eating behavior: Environmental Determinants in Young people [SPEEDY]). Publisher Copyright: © Lippincott Williams & Wilkins.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - Introduction: The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 minutes of moderate-vigorous PA (MVPA) every day, to an average of 60 minutes of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. Further, inconsistent guideline operationalization impairs understanding of physical inactivity prevalence. This study used the International Children’s Accelerometry Database to compare approaches to calculating PA compliance among youth and associations with health indicators. Methods: Cross-sectional accelerometer data for 21,612 youth (5-18y) was used to examine compliance with four guideline definitions: daily method (DM; ≥60 minutes MVPA every day), average method (AM; average of ≥60 minutes MVPA per day), AM5 (compliance with AM and ≥five minutes of vigorous PA [VPA] on ≥three days), AM15 (compliance with AM and ≥15 minutes VPA on ≥three days). Associations between compliance and health indicators were examined for all definitions. Results: Compliance varied from 5·3% (DM) to 29·9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (-0.28 [-0.33,-0.23]), AM5 (-0.28 [-0.33,-0.23], AM15 (-0.30, [-0.35,-0.25]). Associations between compliance and health indicators for DM were similar or weaker, possibly reflecting fewer DM-compliant participants with health data (n=250-1,127) and lower variability in exposure/outcome data. Conclusion: Youth who complete 60 minutes of MVPA every day do not experience superior health benefits to youth who complete an average of 60 minutes of MVPA per day. Guidelines should encourage youth to achieve an average of 60 minutes of MVPA per day over a week. Different guideline definitions impact inactivity prevalence estimates; this must be considered when analyzing data and making cross-study comparisons.

AB - Introduction: The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 minutes of moderate-vigorous PA (MVPA) every day, to an average of 60 minutes of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. Further, inconsistent guideline operationalization impairs understanding of physical inactivity prevalence. This study used the International Children’s Accelerometry Database to compare approaches to calculating PA compliance among youth and associations with health indicators. Methods: Cross-sectional accelerometer data for 21,612 youth (5-18y) was used to examine compliance with four guideline definitions: daily method (DM; ≥60 minutes MVPA every day), average method (AM; average of ≥60 minutes MVPA per day), AM5 (compliance with AM and ≥five minutes of vigorous PA [VPA] on ≥three days), AM15 (compliance with AM and ≥15 minutes VPA on ≥three days). Associations between compliance and health indicators were examined for all definitions. Results: Compliance varied from 5·3% (DM) to 29·9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (-0.28 [-0.33,-0.23]), AM5 (-0.28 [-0.33,-0.23], AM15 (-0.30, [-0.35,-0.25]). Associations between compliance and health indicators for DM were similar or weaker, possibly reflecting fewer DM-compliant participants with health data (n=250-1,127) and lower variability in exposure/outcome data. Conclusion: Youth who complete 60 minutes of MVPA every day do not experience superior health benefits to youth who complete an average of 60 minutes of MVPA per day. Guidelines should encourage youth to achieve an average of 60 minutes of MVPA per day over a week. Different guideline definitions impact inactivity prevalence estimates; this must be considered when analyzing data and making cross-study comparisons.

KW - ICAD

KW - ACCELEROMETER

KW - PHYSICAL ACTIVITY

KW - COMPLIANCE

KW - VIGOROUS-INTENSITY PHYSICAL ACTIVITY

U2 - 10.1249/MSS.0000000000002884

DO - 10.1249/MSS.0000000000002884

M3 - Article (Academic Journal)

C2 - 35195101

SN - 0195-9131

VL - 54

SP - 1114

EP - 1122

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

IS - 7

ER -

Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database

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