Original report
Compliance with Physical Activity Guidelines: Prevalence in a Population of Children and Youth

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Abstract

PURPOSE: To use objective monitoring of physical activity to determine the percentages of children and youth in a population that met physical activity guidelines.

METHODS: A total of 375 students in grades 1–12 wore an accelerometer (CSA 7164) for seven consecutive days. Bouts of continuous activity and accumulation of minutes spent in physical activity at various intensities were calculated to determine how many students met three physical activity guidelines.

RESULTS: Over 90% of students met Healthy People 2010, Objective 22.6 and nearly 70% met the United Kingdom Expert Consensus Group guideline, both of which recommend daily accumulation of moderate physical activity. Less than 3% met Healthy People 2010, Objective 22.7, which calls for bouts of continuous vigorous physical activity. For the United Kingdom Expert Consensus Group guideline, compliance decreased markedly with age, but gender differences were not statistically significant.

CONCLUSIONS: Prevalence estimates for compliance with national physical activity guidelines varied markedly for the three guidelines examined. Objective monitoring of physical activity in youth appears to be feasible and may provide more accurate prevalence rates than self-report measures.

Introduction

Physical inactivity is a well-documented risk factor for coronary heart disease (1) and is associated with increased risk for other chronic diseases, including obesity, Type II diabetes mellitus, hypertension, colon cancer, depression, and osteoporosis (2). Accordingly, promoting physical activity has become a public health priority in the United States (3). Although the chronic diseases associated with physical inactivity rarely manifest before middle adulthood, promotion of physical activity in children and youth is important because lower levels of activity early in life are associated with less favorable physiological risk factor status (3). Limited physical activity may also predispose youth to developing a sedentary lifestyle later in life 4, 5. Because of the growing awareness of the health benefits of regular physical activity, public health guidelines for physical activity have been established (6). Several of these guidelines focus on youth 7, 8, 9.

To track compliance with these guidelines, measures of physical activity have been incorporated into several public health surveillance systems, including the Youth Risk Behavior Surveillance System (YRBS) 10, 11, the National Health Interview Survey (NHIS) (12), and the National Health and Nutrition Examination Survey (NHANES). Each of these systems relies exclusively on self-report methods, the applicability and validity of which are in considerable question 13, 14, 15. Self-report measures of physical activity are considered inappropriate for use with children under age 12, and are known to have limitations with people of all ages 13, 14, 16. Consequently, there is uncertainty concerning the true prevalence of compliance with physical activity guidelines in American children and youth.

Recently, increasing use has been made of accelerometers for measurement of physical activity 17, 18, 19. These devices provide objective and highly detailed information on physical activity as observed over relatively long periods, and they have been shown to be useful in children of all ages 17, 18, 20, 21, 22. To date, however, accelerometers have been used primarily in research settings with small groups of subjects. To our knowledge, accelerometers have not been used previously to measure physical activity in a population. Hence, the purpose of this study was to use objective monitoring of physical activity to determine the percentages of children and youth in a defined population that met recommended physical activity guidelines.

Section snippets

Subjects

Subjects for this study (n = 400) were randomly selected from the pool of participants in the Amherst Health and Activity Study, a cross-sectional observational study that examined determinants of physical activity in school-age children and youth. Subjects were recruited from seven elementary schools, one junior high school, and one senior high school in and near Amherst, MA. All 3648 students enrolled in physical education in those schools were invited to participate. Thirty-eight percent of

Results

Table 3 presents the distributions for time spent in moderate-to-vigorous and vigorous physical activity by boys and girls in each grade group. Medians for physical activity were consistently higher for boys than girls, but more distinctly so for vigorous than moderate-to-vigorous activity.

Over 90% of the students in this study met the Healthy People 2010, Objective 22.6 guideline (⩾ 30 min, ⩾ 5 d/wk, ⩾ 3 METS) (Table 4). Compliance with this guideline was not significantly different across the

Discussion

This is the first study of youth physical activity using objective measures to evaluate compliance with national guidelines in a population-based sample. Our major finding was that prevalence estimates for compliance with the guidelines were dramatically different for the three guidelines examined. Virtually all elementary school-age subjects met Healthy People 2010, Objective 22.6 for moderate physical activity (⩾ 30 min, ⩾ 5 d/wk, ⩾ 3 METS), though a significant decline was observed in grades

Acknowledgements

The authors thank Edward Debold, M.S. and Devra Hendelman, M.S. for their assistance with data collection and Gaye Groover Christmus, MPH for her assistance with manuscript preparation. This study was supported by a grant from the Cowles Media Foundation. The study was approved by the University of Massachusetts Human Subjects Review Board and by the University of South Carolina Institutional Review Board. Subjects agreed to participate and their parent or guardian provided informed consent.

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