title: Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. Randomized, Controlled Trial of a Best-Practice Individualized Behavioral Program for Treatment of Childhood Overweight: Scottish Childhood Overweight Treatment Trial (SCOTT) Decreasing sedentary behaviors in treating pediatric obesity. Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. Physical activity as a substitute for sedentary behavior in youth Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist. Evaluation of a multiple ecological level child obesity prevention program: Switch® what you Do, View, and Chew Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Intervention centred on adolescents' physical activity and sedentary behaviour (ICAPS): concept and 6-month results Reducing children's television viewing to prevent obesity: a randomized controlled trial. Effects of overweight and leisure-time activities on aerobic fitness in urban and rural adolescents. Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children. Depressive symptoms and physical activity in adolescent girls. Socio-economic, behavioural and environmental factors predicted body weights and household food insecurity scores in the Early Childhood Longitudinal Study-Kindergarten. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines The Completeness of Reporting (CORE) index identifies important deficiencies in observational study conference abstracts. Television viewing habits associated with obesity risk factors: a survey of Melbourne schoolchildren. Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index Relation between socioeconomic status and body mass index: evidence of an indirect path via television use. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Influence of a health education intervention on physical activity and screen time in primary school children: 'Switch Off--Get Active'. A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children. Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). Sleep patterns and television viewing in relation to obesity and blood pressure: evidence from an adolescent Brazilian birth cohort Weekend and weekday patterns of physical activity in overweight and normal-weight adolescent girls. Influence of diet, physical activity and parents’ obesity on children’s adiposity: a four-year longitudinal study A longitudinal study of sedentary behavior and overweight in adolescent girls. Compliance with the Australian national physical activity guidelines for children: relationship to overweight status. The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents Adiposity and TV viewing are related to less bone accrual in young children. Sedentariness, small-screen recreation, and fitness in youth. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. The effect of reinforcement or stimulus control to reduce sedentary behavior in the treatment of pediatric obesity. Children's Television Exposure and Behavioral and Social Outcomes at 5.5 Years: Does Timing of Exposure Matter? Overweight and obesity related to activities in Portuguese children, 7-9 years. Reporting of trials presented in conference abstracts needs to be improved. Extensive television viewing and the development of attention and learning difficulties during adolescence.
abstract: OBJECTIVE To test the feasibility , acceptability , and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , among African-American girls . DESIGN Twelve-week , 2-arm parallel group , r and omized controlled trial . SETTING Low-income neighborhoods . PARTICIPANTS Sixty-one 8 - 10-year-old African-American girls and their parents/guardians . INTERVENTIONS The treatment intervention consisted of after-school dance classes at 3 community centers , and a 5-lesson intervention , delivered in participants ' homes , and design ed to reduce television , videotape , and video game use . The active control intervention consisted of disseminating newsletters and delivering health education lectures . MAIN OUTCOME MEASURES Implementation and process measures , body mass index , waist circumference , physical activity measured by accelerometry , self-reported media use , and meals eaten with TV . RESULTS Recruitment and retention goals were exceeded . High rates of participation were achieved for assessment s and intervention activities , except where transportation was lacking . All interventions received high satisfaction ratings . At follow up , girls in the treatment group , as compared to the control group , exhibited trends toward lower body mass index ( adjusted difference = -.32 kg/m2 , 95 % confidence interval [ CI ] -.77 , .12 ; Cohen 's d = .38 st and ard deviation units ) and waist circumference ( adjusted difference = -.63 cm , 95 % CI -1.92 , .67 ; d = .25 ) ; increased after-school physical activity ( adjusted difference = 55.1 counts/minute , 95 % CI -115.6 , 225.8 ; d = .21 ) ; and reduced television , videotape , and video game use ( adjusted difference = -4.96 hours/week , 95 % CI -11.41 , 1.49 ; d = .40 ) . The treatment group reported significantly reduced household television viewing ( d = .73 , P = .007 ) and fewer dinners eaten while watching TV ( adjusted difference = -1.60 meals/week , 95 % CI -2.99 , -.21 ; d = .59 ; P = .03 ) . Treatment group girls also reported less concern about weight ( d = .60 ; P = .03 ) , and a trend toward improved school grade s ( d = .51 ; P = .07 ) . CONCLUSIONS This study confirmed the feasibility , acceptability , and potential efficacy of using dance classes and a family-based intervention to reduce television viewing , thereby reducing weight gain , in African-American girls OBJECTIVE . The objective of this study was to determine whether a generalizable best- practice individualized behavioral intervention  reduced BMI z score relative to st and ard dietetic care among overweight children . METHODS . The design consisted of an assessor-blinded , r and omized , controlled trial involving 134 overweight children ( 59 boys , 75 girls ; BMI ≥ 98th centile relative to United Kingdom 1990 reference data for children aged 5–11 years ) who were r and omly assigned to a best- practice behavioral program ( intervention ) or st and ard care ( control ) .  The intervention used family-centered counseling and behavioral strategies to modify diet , physical activity , and sedentary behavior . BMI z score , weight , objective ly measured physical activity and sedentary behavior , fat distribution , quality of life , and height z score were recorded at baseline and at 6 and 12 months . RESULTS . The intervention had no significant effect relative to st and ard care on BMI z score from baseline to 6 months and 12 months . BMI z score decreased significantly in both groups from baseline to 6 and 12 months . For those who complied with treatment , there was a significantly smaller weight increase in those in the intervention group compared with control subjects from baseline to 6 months . There were significant between-group differences in favor of the intervention for changes in total physical activity , percentage of time spent in sedentary behavior , and light-intensity physical activity . CONCLUSIONS . A generalizable , best- practice individualized behavioral intervention had modest benefits on objective ly measured physical activity and sedentary behavior but no significant effect on BMI z score compared with st and ard care among overweight children . The modest magnitude of the benefits observed perhaps argues for a longer-term and more intense intervention , although such treatments may not be realistic for many health care systems BACKGROUND Epidemiological studies have shown television watching to be a risk factor for the development of obesity in children . The effect of reducing television watching and other sedentary behaviors as a component of a comprehensive obesity treatment program has not been thoroughly tested . OBJECTIVE To compare the influence of targeting decreases in sedentary behavior vs. increases in physical activity in the comprehensive treatment of obesity in 8- to 12-year-old children . DESIGN R and omized , controlled outcome study . SETTING Childhood obesity research clinic . DESIGN Ninety families with obese 8- to 12-year-old children were r and omly assigned to groups that were provided a comprehensive family-based behavioral weight control program that included dietary , and behavior change information but differed in whether sedentary or physically active behaviors were targeted and the degree of behavior change required . RESULTS Results during 2 years showed that targeting either decreased sedentary behaviors or increased physical activity was associated with significant decreases in percent overweight and body fat and improved aerobic fitness . Self-reported activity minutes increased and targeted sedentary time decreased during treatment . Children substituted nontargeted sedentary behaviors for some of their targeted sedentary behaviors . CONCLUSION These results support reducing sedentary behaviors as an adjunct in the treatment of pediatric obesity BACKGROUND The proportion of overweight adolescents has increased , but the behavioral risk factors for overweight youth are not well understood . OBJECTIVE To examine how diet , physical activity , and sedentary behaviors relate to overweight status in adolescents . DESIGN AND SETTING Baseline data from the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition Project , a r and omized controlled trial of adolescents to determine the effects of a clinic-based intervention on physical activity and dietary behaviors . PARTICIPANTS A total of 878 adolescents aged 11 to 15 years , 42 % of whom were from minority background s. MAIN OUTCOME MEASURE Centers for Disease Control and Prevention body mass index-for-age percentiles divided into 2 categories : normal weight ( < 85th percentile ) and at risk for overweight plus overweight ( AR + O ) ( > or=85th percentile ) . RESULTS Overall , 45.7 % of the sample was classified as AR + O with a body mass index for age at the 85th percentile or higher . More girls from minority background s ( 54.8 % ) were AR + O compared with non-Hispanic white girls ( 42 % ) ( chi(2)(1 ) = 7.6 ; P = .006 ) . Bivariate analyses indicated that girls and boys in the AR + O group did fewer minutes per day of vigorous physical activity , consumed fewer total kilojoules per day , and had fewer total grams of fiber per day than those in the normal-weight group . Boys in the AR + O group also did fewer minutes per day of moderate physical activity and watched more minutes per day of television on nonschool days than normal-weight boys . Final multivariate models indicated that independent of socioeconomic status ( as assessed by household education level ) , girls had a greater risk of being AR + O if they were Hispanic or from another minority background ( odds ratio [ OR ] = 1.65 ; 95 % confidence interval [ CI ] , 1.09 - 2.49 ) and a reduced risk of being AR + O as minutes per day of vigorous physical activity increased ( OR = 0.93 ; 95 % CI , 0.89 - 0.97 ) . A low level of vigorous physical activity was the only significant risk factor for boys being AR + O ( OR = 0.92 ; 95 % CI , 0.89 - 0.95 ) . Analyses based on meeting behavioral guidelines supported these findings and showed that failing to meet the 60 min/d moderate to vigorous physical activity guideline was associated with overweight status for both girls and boys . In addition , boys who failed to meet sedentary behavior and dietary fiber guidelines were more likely to be overweight . CONCLUSIONS Of the 7 dietary and physical activity variables examined in this cross-sectional study , insufficient vigorous physical activity was the only risk factor for higher body mass index for adolescent boys and girls . Prospect i ve studies are needed to clarify the relative importance of dietary and physical activity behaviors on overweight in adolescence Background : Youth may choose to be sedentary rather than physically active . Purpose : The purpose of this study was to use behavioral economics methods to investigate how experimental changes in the amount of sedentary behaviors influenced physical activity . Methods : Fifty-eight 8-to 16-year-old youth were studied in a within-subject crossover design with three 3-week phases : baseline , increasing , and decreasing targeted sedentary behaviors by 25 % to 50 % . Results : At baseline , boys were more active than girls ( 518.9 vs. 401.2 accelerometer counts/min , p = .02 ) , and obese youth more sedentary than nonobese youth ( 240.5 vs. 174.4 min/day , p = .003 ) . During the increase sedentary behavior phase , targeted sedentary behaviors increased by 52.1 % , with girls increasing sedentary behaviors more than boys ( 114.7 vs. 79.8 min/day , p = .04 ) . Physical activity decreased ( −48.3 counts/min , p < .01 ) when sedentary behaviors increased , with obese youth decreasing total and moderate to vigorous physical activity ( MVPA ) more than nonobese youth ( −110.4 vs. 8.9 counts/min , p < .001 ; −3.3 vs. −.03%MVPA , p = .013 ) . During the decrease sedentary behavior phase , targeted sedentary behaviors decreased by 55.6 % from baseline as nonobese youth increased physical activity , whereas obese youth decreased physical activity ( 55.8 vs. −48.0 counts/min , p = .042 ; 1.1 vs. −2.1 % MVPA , p = .021 ) . Youth who substituted physical activity when sedentary behaviors were increased had greater st and ardized body mass index ( z-body mass index = 1.4 vs. 0.4 , p = .018 ) , whereas youth who substituted physical activity when sedentary behaviors were decreased were less active at baseline ( 396.1 vs. 513.7 counts/min , p = .035 ) . Conclusions : Behavioral economics provides a methodology to underst and changes in physical activity when sedentary behaviors are modified and to identify factors associated with substitution of physically active for sedentary behaviors BACKGROUND Television is a source from which children gain information about life and experience different types of behavior . The Child Behavior Checklist ( CBCL ) has not been used thoroughly to evaluate the behavioral effects of television viewing  on children . OBJECTIVE To examine the competency and problem behavior correlates of television viewing in school-aged children using the CBCL . DESIGN Cross-sectional survey . SETTING Two r and omly selected grade schools , one from a high-income district and the other from a low-income district . PARTICIPANTS Students in grade s 2 and 3 and their parents . MAIN OUTCOME MEASURES A question naire on  children 's time spent watching television and engaging in other daily activities  and the CBCL were sent to the parents of 888 second- and third- grade students . RESULTS Results of the question naire reported that the overall mean + /- SD daily television viewing time was 2.5 + /- 1.3 hours . Overall television viewing time had a negative correlation with social and school achievement ( r = -0.17 , P<.001 and r = 0.11 , P = .03 , respectively ) subscale scores . Withdrawn ( r = 0.11 , P = .004 ) , social problem ( r = 0.14 , P = .001 ) , thought problem ( r = 0.11 , P = .03 ) , attention problem ( r = 0.20 , P<.001 ) , delinquent behavior ( r = 0.12 , P<.001 ) , aggressive behavior ( r = 0.22 , P<.001 ) , and externalization ( r = 0.19 , P<.001 ) subscales and total problem ( r = 0.15 , P<.001 ) scores were positively correlated with time spent watching television . Stepwise logistic regression analysis revealed that the only significant variables associated with a risk of watching television for more than 2 hours were age , gender , social subscale , and attention problem subscale scores of the CBCL . CONCLUSION As evaluated by the CBCL , television viewing time is positively associated with social problems , delinquent behavior , aggressive behavior , externalization , and total problem scores . Older age , male gender , and decreasing social subscale and increasing attention problem subscale scores on the CBCL increases the risk of watching television for more than 2 hours Background Schools are the most frequent target for intervention programs aim ed at preventing child obesity ; however , the overall effectiveness of these programs has been limited . It has therefore been recommended that interventions target multiple ecological levels ( community , family , school and individual ) to have greater success in changing risk behaviors for obesity . This study examined the immediate and short-term , sustained effects of the Switch program , which targeted three behaviors ( decreasing children 's screen time , increasing fruit and vegetable consumption , and increasing physical activity ) at three ecological levels ( the family , school , and community ) . Methods Participants were 1,323 children and their parents from 10 schools in two states . Schools were matched and r and omly assigned to treatment and control . Measures of the key behaviors and body mass index were collected at baseline , immediately post-intervention , and 6 months post-intervention . Results The effect sizes of the differences between treatment and control groups ranged between small ( Cohen 's d = 0.15 for body mass index at 6 months post-intervention ) to large ( 1.38 ; parent report of screen time at 6 months post-intervention ) , controlling for baseline levels . There was a significant difference in parent-reported screen time at post-intervention in the experimental group , and this effect was maintained at 6 months post-intervention ( a difference of about 2 hours/week ) . The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant . At the 6-month follow-up , parent-reported screen time was significantly lower , and parent and child-reported fruit and vegetable consumption was significantly increased . There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group . The intervention effects were moderated by child sex ( for fruit and vegetable consumption , physical activity , and weight status ) , family involvement ( for fruit and vegetable consumption ) , and child body mass index ( for screen time ) . The perception of change among the experimental group was generally positive with 23 % to 62 % indicating positive changes in behaviors . Conclusion The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children 's fruit and vegetable consumption and minimizing screen time . The Switch program offers promise for use in youth obesity prevention OBJECTIVE To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grade s 6 to 8 . DESIGN R and omized , controlled field trial with 5 intervention and 5 control schools . Outcomes were assessed using preintervention ( fall 1995 ) and follow-up measures ( spring 1997 ) , including prevalence , incidence , and remission of obesity . PARTICIPANTS A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities . INTERVENTION Students participated in a school-based interdisciplinary intervention over 2 school years . Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education . Sessions focused on decreasing television viewing , decreasing consumption of high-fat foods , increasing fruit and vegetable intake , and increasing moderate and vigorous physical activity . MAIN OUTCOME MEASURES Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles . Because schools were r and omized , rather than students , the generalized estimating equation method was used to adjust for individual-level covariates under cluster r and omization . RESULTS The prevalence of obesity among girls in intervention schools was reduced compared with controls , controlling for baseline obesity ( odds ratio , 0.47 ; 95 % confidence interval , 0.24 - 0.93 ; P = .03 ) , with no differences found among boys . There was greater remission of obesity among intervention girls vs. control girls ( odds ratio , 2.16 ; 95 % confidence interval , 1.07 - 4.35 ; P = .04 ) . The intervention reduced television hours among both girls and boys , and increased fruit and vegetable consumption and result ed in a smaller increment in total energy intake among girls . Reductions in television viewing predicted obesity change and mediated the intervention effect . Among girls , each hour of reduction in television viewing predicted reduced obesity prevalence ( odds ratio , 0.85 ; 95 % confidence interval , 0.75 - 0.97 ; P = .02 ) . CONCLUSION Planet Health decreased obesity among female students , indicating a promising school-based approach to reducing obesity among youth OBJECTIVE : To evaluate the 6-month impact of a physical activity ( PA ) multilevel intervention on activity patterns and psychological predictors of  PA among adolescents . The intervention was directed at changing knowledge and attitudes and at providing social support and environmental conditions that encourage PA of adolescents inside and outside school . SUBJECTS AND DESIGN : R and omised , controlled ongoing field trial ( ICAPS ) in middle-school 's first-level adolescents from eight schools selected in the department of the Bas-Rhin ( Eastern France ) with a cohort of 954 adolescents ( 92 % of the eligible students ) initially aged 11.7±0.6 y. The 6-month changes in participation in leisure organised PA ( LOPA ) , high sedentary ( SED ) behaviour ( > 3h/day ) , self-efficacy ( SELF ) and intention ( INTENT ) towards PA  were analysed after controlling for baseline measures and different covariables ( age , overweight , socioprofessional occupation ) , taking into account the cluster r and omisation design . RESULTS : The proportion of intervention adolescents not engaged in organised PA  was reduced by 50 % whereas it was unchanged among control students . After adjustment for baseline covariables , LOPA participation significantly increased among the intervention adolescents ( odds ratio ( 95 % confidence interval ) (OR)=3.38 ( 1.42–8.05 ) in girls ; 1.73 ( 1.12–2.66 ) in boys ) , while high SED was reduced ( OR=0.54 ( 0.38–0.77 ) in girls ; 0.52 ( 0.35–0.76 ) in boys ) . The intervention improved SELF in girls , whatever their baseline LOPA ( P<10−4 ) and INTENT in girls with no baseline LOPA ( P=0.04 ) . SELF tended to improve in boys with no baseline LOPA , without reaching statistical significance . When included in the regression , follow-up LOPA was associated with improvement of SELF in girls ( P=0.02 ) and of INTENT in girls with no baseline PA ( P<0.02 ) . The intervention effect was then attenuated . CONCLUSION : After 6 months of intervention , ICAPS was associated with a significant improvement of activity patterns and psychological predictors , indicating a promising approach for modifying the long-term PA level of adolescents CONTEXT Some observational studies have found an association between television viewing and child and adolescent adiposity .  OBJECTIVE To assess the effects of reducing television , videotape , and video game use on changes in adiposity , physical activity , and dietary intake . DESIGN R and omized controlled school-based trial conducted from September 1996 to April 1997 . SETTING Two sociodemographically and scholastically matched public elementary schools in San Jose , Calif. PARTICIPANTS Of 198 third- and fourth- grade students , who were given parental consent to participate , 192 students ( mean age , 8.9 years ) completed the study . INTERVENTION Children in 1 elementary school received an 18-lesson , 6-month classroom curriculum to reduce television , videotape , and video game use . MAIN OUTCOME MEASURES Changes in measures of height , weight , triceps skinfold thickness , waist and hip circumferences , and cardiorespiratory fitness ; self-reported media use , physical activity , and dietary behaviors ; and parental report of child and family behaviors . The primary outcome measure was body mass index , calculated as weight in kilograms divided by the square of height in meters . RESULTS Compared with controls , children in the intervention group had statistically significant relative decreases in body mass index ( intervention vs control change : 18.38 to 18.67 kg/m2 vs 18.10 to 18.81 kg/m2 , respectively ; adjusted difference -0.45 kg/m2 [ 95 % confidence interval [ CI ] , -0.73 to -0.17 ] ; P = .002 ) , triceps skinfold thickness ( intervention vs control change : 14.55 to 15.47 mm vs 13.97 to 16.46 mm , respectively ; adjusted difference , -1.47 mm [ 95 % CI , -2.41 to -0.54 ] ; P=.002 ) , waist circumference ( intervention vs control change : 60.48 to 63.57 cm vs 59.51 to 64.73 cm , respectively ; adjusted difference , -2.30 cm [ 95 % CI , -3.27 to -1.33 ] ; P<.001 ) , and waist-to-hip ratio ( intervention vs control change : 0.83 to 0.83 vs 0.82 to 0.84 , respectively ; adjusted difference , -0.02 [ 95 % CI , -0.03 to -0.01 ] ; P<.001 ) . Relative to controls , intervention group changes were accompanied by statistically significant decreases in children 's reported television viewing and meals eaten in front of the television . There were no statistically significant differences between groups for changes in high-fat food intake , moderate-to-vigorous physical activity , and cardiorespiratory fitness . CONCLUSIONS Reducing television , videotape , and video game use may be a promising , population -based approach to prevent childhood obesity BACKGROUND The aim of this research was to study the effects of overweight and leisure-time activities on maximal aerobic capacity ( VO(2)max ) in urban and rural Omani adolescents . METHODS A total of 529 ( 245 males , 284 females ) adolescents , aged 15 - 16 years were r and omly selected from segregated urban and rural schools .  Maximal aerobic capacity was estimated using the multistage 20-meter shuttle-run test . RESULTS The body mass index ( BMI ) of urban boys and girls was significantly higher than that of rural boys and girls . Urban boys and girls spent significantly less weekly hours on sports activities  and significantly more weekly hours on TV/computer games  than their rural counterpart . Urban boys and girls achieved significantly less VO(2)max than rural boys and girls ( 44.2 and 33.0 vs. 48.3 and 38.6 mL/kg/min , respectively ) . Maximal aerobic capacity was negatively correlated with BMI in urban boys . CONCLUSION Overweight and inactivity had significant negative effects on cardiorespiratory fitness in urban boys and girls as compared to their rural counterparts . Weight gain in adolescence requires early intervention OBJECTIVES To evaluate the relationship between changes in  physical activity ( PA ) , sedentary behavior , and physical self-perceptions and global self-worth in 30 , 8 - 12 years old , overweight/obese children ( 13 boys , 17 girls ) . METHODS Secondary analyses from a r and omized controlled trial design ed to increase PA and reduce sedentary behavior . PA was measured by accelerometers worn by participants every day for 8 weeks .  Sedentary behavior , defined as minutes per day spent in television viewing , was assessed by self-report . RESULTS Increases in PA were associated with increases in perceived physical conditioning ( r = .54 , p < .01 ) , body satisfaction ( r = .55 , p < .01 ) , and overall physical self-worth ( r = .44 , p < .05 ) independent of changes in body mass index ( BMI ) . Reductions in TV viewing were also related to increased physical and global self-worth . CONCLUSIONS Increases in PA are associated with improvements in physical self-perceptions but not global self-worth , while reductions in TV viewing are associated with increased physical and global self-worth , and these psychosocial benefits appear to be independent of changes in adiposity PURPOSE To evaluate the relationship between depressive symptoms and physical activity in a geographically and ethnically diverse sample of sixth- grade adolescent girls . METHODS The Trial of Activity for Adolescent Girls ( TAAG ) baseline measurement included a r and om sample ( N = 1721 ) of sixth- grade girls in 36 schools at six field sites . Measurements were  accelerometry  and the 3-d Physical Activity Recall ( 3DPAR ) for  physical activity  , and the Center for Epidemiological Studies -Depression scale ( CES-D ) for depressive symptoms . RESULTS Girls with complete data ( N = 1397 ) , mean age 12 yr , had an average  CES-D score of 14.7 ( SD = 9.25 ) and engaged in an average of about 460 min of sedentary activity , < 24 min of moderate to vigorous physical activity ( MVPA ) , and < 6 min of vigorous physical activity ( VPA ) in an 18-h day . Thirty-minute segments of MVPA ranged in number from 3.9 to 1.2 , and METS for these segments ranged from > 3.0 to > 6.5 . Mixed-model regression indicated no relationship between depressive symptoms and physical activity ; however , a significant but modest inverse relationship between sedentary activity and depressive symptoms was observed . CONCLUSION A sufficient sample size , st and ardized procedures , and vali date d instruments characterized this study ; however , a relationship between depressive symptoms and physical activity was not observed for sixth- grade girls from diverse geographic locations . The average CES-D score was lower than is considered clinical ly meaningful for either adolescents or adults , and MET-minutes of sedentary activity were high . This combination of data may be different from other studies and could have contributed to the unexpected finding . This unexpected finding is informative , however , because it shows the need for additional research that includes a wider range of possible combinations of data , especially with young adolescent girls Recent increases in obesity prevalence among children in developed countries are of policy concern . While significant positive associations between households ' food insecurity status and body weights have been reported for adults , it is known from the energy physiology literature that energy requirements depend on BMR , anthropometric measures and physical activity . It is therefore important to model the bi-directional relationships between body weights and households ' food insecurity scores especially for children that have evolving nutrient and energy requirements . The present paper estimated dynamic r and om effects models for children 's body weights and BMI , and households ' food insecurity scores using longitudinal data on 7635 children in the USA enrolled in 1st , 3rd and 5th grade s ( 1999 - 2003 ) of the Early Childhood Longitudinal Study -Kindergarten . The main findings were , first , physical exercise and numbers of siblings were significantly ( P < 0.05 ) negatively associated with body weights , while households ' food insecurity score was not a significant predictor . Moreover , children 's body weights were significantly lower in households with higher parental education and incomes ; time spent watching television and in non-parental care were positively associated with weights . Second , models for households ' food insecurity scores showed that poverty and respondents ' poor emotional and physical health significantly increased food insecurity . Moreover , households with children who were taller and heavier for their ages faced significantly higher food insecurity levels . Overall , the results showed that household food insecurity was unlikely to exacerbate child obesity in the USA and it is important that children receive balanced school meals and perform higher physical activity PURPOSE Although moderate-to-vigorous physical activity is related to premature mortality , the relationship between sedentary behaviors and mortality has not been fully explored and may represent a different paradigm than that associated with lack of exercise . We prospect ively examined  sitting time  and mortality in a representative sample of 17,013 Canadians 18 - 90 yr of age . METHODS Evaluation of  daily sitting time  ( almost none of the time , one fourth of the time , half of the time , three fourths of the time , almost all of the time ) ,  leisure time physical activity , smoking status , and alcohol consumption  was conducted at baseline . Participants were followed prospect ively for an average of 12.0 yr for the ascertainment of mortality status . RESULTS There were 1832 deaths  ( 759 of cardiovascular disease ( CVD ) and 547 of cancer ) during 204,732 person-yr of follow-up . After adjustment for potential confounders , there was a progressively higher risk of mortality across higher levels of sitting time from all causes ( hazard ratios ( HR ) : 1.00 , 1.00 , 1.11 , 1.36 , 1.54 ; P for trend < 0.0001 ) and CVD ( HR:1.00 , 1.01 , 1.22 , 1.47 , 1.54 ; P for trend < 0.0001 ) but not cancer . Similar results were obtained when stratified by sex , age , smoking status , and body mass index . Age-adjusted all-cause mortality rates per 10,000 person-yr of follow-up were 87 , 86 , 105 , 130 , and 161 ( P for trend < 0.0001 ) in physically inactive participants and 75 , 69 , 76 , 98 , 105 ( P for trend = 0.008 ) in active participants across sitting time categories . CONCLUSIONS These data demonstrate a dose-response association between  sitting time  and mortality from all causes and CVD , independent of leisure time physical activity . In addition to the promotion of moderate-to-vigorous physical activity and a healthy weight , physicians should discourage sitting for extended periods OBJECTIVES . Television viewing and physical inactivity increase the risk of obesity in youth . Thus , identifying new interventions that increase physical activity and reduce television viewing would be helpful in the prevention and treatment of pediatric obesity . This study evaluated the effects of open-loop feedback plus reinforcement versus open-loop feedback alone on  physical activity , targeted sedentary behavior , body composition , and energy intake in youth . METHODS . Thirty overweight or obese 8- to 12-year-old children were r and omly assigned to an  intervention ( n = 14 ) or control group ( n = 16 ) . Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors . For children in the open-loop feedback plus reinforcement ( intervention ) group , accumulating 400 counts of physical activity on pedometers earned 1 hour of television/VCR/DVD time , which was controlled by a Token TV electronic device . Open-loop feedback control subjects wore activity monitors but had free access to targeted sedentary behavior . RESULTS . Compared with controls , the open-loop feedback plus reinforcement group demonstrated significantly greater increases in daily physical activity counts ( + 65 % vs + 16 % ) and minutes per day of moderate-to-vigorous physical activity ( + 9.4 vs + 0.3 ) and greater reductions in minutes per day spent in television viewing ( −116.1 vs + 14.3 ) . The intervention group also showed more favorable changes in body composition , dietary fat intake , and energy intake from snacks compared with controls . Reductions in sedentary behavior were directly related to reductions in BMI , fat intake , snack intake , and snack intake while watching television . CONCLUSIONS . Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes OBJECTIVE The aim was to develop , test , and apply an index to assess the completeness of reporting in a cohort of observational studies of conference abstract s. STUDY DESIGN AND SETTING Using rigorous methods , we reduced 245 items generated by literature review to 48 c and i date items . In a r and om sample of 30 conference abstract s of rituximab for nonHodgkin lymphoma , we developed an item impact score using a survey of abstract stakeholders combined with the prevalence of each of the 48 items . We retained 14 independent items representing completeness of reporting , the CORE-14 . Two raters determined the reliability of the instrument . We then applied the CORE-14 in another 78 studies to determine the prevalence of each feature . RESULTS Our survey response rate was 83.9 % ( 47/56 ) . Interrater reliability ( 95 % CI ) of the CORE-14 instrument was 0.56 ( 0.25 , 0.77 ) , which improved by averaging across scores provided by two raters ( 0.72 [ 0.49 , 0.86 ] ) . Applying the CORE-14 in an additional set of 78 abstract s , six items occurred > or = 85 % and four items occurred < or = 40 % of the time . CONCLUSION Opportunities to improve conference abstract reporting exist . This scale could guide future conference abstract su bmi ssions and aid individuals considering conference abstract data to inform clinical practice , systematic review s , guidelines , or policy OBJECTIVES To examine whether children 's  television viewing may be a useful indicator of risk of obesity-promoting versus healthy eating behaviours ,  low-level physical activity ( PA )  and overweight or obesity among children of primary school entry and exit ages . DESIGN Cross-sectional study , stratified by area-level socioeconomic status . PARTICIPANTS AND SETTING 1560 children ( 613 aged 5 - 6 years [ 50 % boys ] , and 947 aged 10 - 12 years [ 46 % boys ] ) from 24 primary schools in Melbourne , Australia , r and omly selected proportionate to school size between 1 November 2002 and 30 December 2003 . MAIN OUTCOME MEASURES Parents ' reports of the time their child spends watching television , their participation in organised physical activities ( PA ) , and their food intake ; each child 's measured height and weight and their PA levels as assessed by accelerometry for one week . RESULTS After adjusting for the age and sex of child , the parents ' level of education , clustering by school , and all other health behaviour variables , children who watched television for > 2 h/day were significantly more likely than children who watched television for < or = 2 h/day to : to have one or more serves/day of high energy drinks ( adjusted odds ratio [ AOR ] , 2.31 ; 95 % CI , 1.61 - 3.32 ) , and to have one or more serves/day of savoury snacks ( AOR , 1.50 ; 95 % CI , 1.04 - 2.17 ) . They were also less likely to have two or more serves/day of fruit ( AOR , 0.58 ; 95 % CI , 0.46 - 0.74 ) , or to participate in any organised PA ( AOR , 0.52 ; 95 % CI , 0.34 - 0.80 ) . CONCLUSIONS Health practitioners in the primary care setting may find that asking whether a child watches television for more than 2 hours daily can be a useful indicator of a child 's risk of poor diet and low physical activity level Background While much cross-sectional data is available , there have been few longitudinal investigations of patterns of electronic media use  in children . Further , the possibility of a bi-directional relationship between electronic media use and body mass index in children has not been considered . This study aim ed to describe longitudinal patterns of television viewing and electronic game/computer use , and investigate relationships with body mass index ( BMI ) . Methods This prospect i ve cohort study was conducted in elementary schools in Victoria , Australia . 1278 children aged 5–10 years at baseline and 8–13 years at follow-up had their BMI calculated , from measured height and weight , and transformed to z-scores based on US 2000 growth data . Weight status ( non-overweight , overweight and obese ) was based on international BMI cut-off points . Weekly  television viewing  and electronic game/computer use were reported by parents , these were summed to generate total weekly screen time . Children were classified as meeting electronic media use guidelines if their total screen time was ≤14 hrs/wk . Results Electronic media use increased over the course of the study ; 40 % met guidelines at baseline but only 18 % three years later . Television viewing and electronic game/computer use tracked moderately and total screen time was positively associated with adiposity cross-sectionally . While weaker relationships with adiposity were observed longitudinally , baseline z- BMI and weight status were positively associated with follow-up screen time and baseline screen time was positively associated with z- BMI and weight status at follow-up . Children who did not meet guidelines at baseline had significantly higher z- BMI and were more likely to be classified as overweight/obese at follow-up . Conclusion Electronic media use in Australian elementary school children is high , increases with age and tracks over time . There appears to be a bi-directional association suggesting that interventions targeting reductions in either screen time or adiposity may have a positive effect on both screen time and adiposity OBJECTIVE To test the hypothesis that media use mediates the relation between socioeconomic status ( SES ) and body mass index ( BMI ) . DESIGN Analysis of 2 large cross-sectional surveys , 1 from Germany and 1 from the United States . SETTING Twenty-seven public schools in northern Germany ; telephone interviews in the United States . PARTICIPANTS A total of 4810 German children and adolescents aged 10 to 17 years ( mean age , 12.8 years ) ; 4473 US children and adolescents aged 12 to 16 years ( mean age , 14.0 years ) recruited using r and om-digit-dial methods . Main Exposures  Media exposure  was assessed via survey questions about the presence of a television in the bedroom , television screen time , computer and video game screen time , and movie viewing .  The SES was derived from type of school ( German sample ) or parental reports of their own education and family income ( US sample ) . MAIN OUTCOME MEASURES The BMI was assessed by the use of self-reports in both sample s , supplemented by parental reports ( US sample ) for height and weight . RESULTS In both sample s , SES was inversely associated with BMI , and media use was directly associated with BMI . The effect of SES on overweight was partially mediated by media exposure , which explained 35 % of the SES- BMI association in the German sample and 16 % in the US sample . In both groups , television in the bedroom and television screen time had statistically significant indirect paths , whereas video game use and movie viewing did not . CONCLUSIONS Students from low-SES background s are at higher risk for overweight in part because of higher levels of television viewing . The change of media use habits could modify this health disparity OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity The association of television viewing and obesity in data collected during cycles II and III of the National Health Examination Survey was examined . Cycle II examined 6,965 children aged 6 to 11 years and cycle III examined 6,671 children aged 12 to 17 years . Included in the cycle III sample were 2,153 subjects previously studied during cycle II . These surveys , therefore , provided two cross-sectional sample s and one prospect i ve sample . In all three sample s , significant associations of the time spent watching television and the prevalence of obesity were observed . In 12- to 17-year-old adolescents , the prevalence of obesity increased by 2 % for each additional hour of television viewed . The associations persisted when controlled for prior obesity , region , season , population density , race , socioeconomic class , and a variety of other family variables . The consistency , temporal sequence , strength , and specificity of the associations suggest that television viewing may cause obesity in at least some children and adolescents . The potential effects of obesity on activity and the consumption of calorically dense foods are consistent with this hypothesis Low levels of physical activity coupled with high levels of television viewing have been linked with obesity in children . The objective of this study was to assess the efficacy of ' Switch Off-Get Active ' , a 16-week controlled health education intervention , in increasing physical activity and reducing screen time and BMI in primary school children . A secondary objective was to compare children with high and low screen time . Participants were 312 children aged 10.2+/-0.7 years , attending nine schools in areas of social disadvantage . The 10-lesson , teacher-led intervention , conducted in spring 2003 , emphasised self-monitoring , budgeting of time and selective viewing . Differences , adjusted for baseline values by ANCOVA , existed between intervention and control children at follow-up for self-reported physical activity ( intervention + 0.84 30 min blocks/day , 95%CI 0.11 - 1.57 , p<0.05 ) and self-efficacy for physical activity ( p<0.05 ) but not self-reported screen time ( intervention--0.41 blocks/day , 95%CI--0.93 - 0.12 , p=0.13 ) or BMI ( p=0.63 ) . Cross-sectional comparisons at baseline indicated lower physical activity , self-efficacy for physical activity and aerobic fitness and a higher BMI in children with high screen time . In conclusion , health education interventions can increase physical activity in primary school children but follow-ups of longer duration may be needed to demonstrate intervention effects on BMI OBJECTIVE To assess the effects of reducing television viewing and computer use on children 's  body mass index ( BMI ) as a risk factor for the development of overweight in young children . DESIGN R and omized controlled clinical trial . SETTING University children 's hospital . PARTICIPANTS Seventy children aged 4 to 7 years whose BMI was at or above the 75th BMI percentile for age and sex . INTERVENTIONS Children were r and omized to an intervention to reduce their television viewing and computer use by 50 % vs a monitoring control group that did not reduce television viewing or computer use . MAIN OUTCOME MEASURES Age- and sex-st and ardized BMI ( z BMI ) , television viewing , energy intake , and physical activity were monitored every 6 months during 2 years . RESULTS Children r and omized to the intervention group showed greater reductions in targeted sedentary behavior ( P < .001 ) , z BMI ( P < .05 ) , and energy intake ( P < .05 ) compared with the monitoring control group . Socioeconomic status moderated z BMI change ( P = .01 ) , with the experimental intervention working better among families of low socioeconomic status . Changes in targeted sedentary behavior mediated changes in z BMI ( P < .05 ) . The change in television viewing was related to the change in energy intake ( P < .001 ) but not to the change in physical activity ( P = .37 ) . CONCLUSIONS Reducing television viewing and computer use may have an important role in preventing obesity and in lowering  BMI in young children , and these changes may be related more to changes in energy intake than to changes in physical activity BACKGROUND Overweight and obesity as well as weight dissatisfaction have been increasing in prevalence worldwide . Body weight dissatisfaction and fear of fatness are potential contributors to disordered eating . The present study aim ed to investigate the prevalence of self-reported overweight and weight dissatisfaction along with associations with socio-demographic characteristics , body image , health complaints , risk behaviours , physical activity and television viewing in adolescents in Palestine . METHODS The 2003/04 Palestinian Health Behaviour in School-aged Children ( HBSC ) is a cross-sectional survey of 17,817 adolescents from 405 r and omly selected schools . Students from a representative sample of grade s 6 , 8 , 10 and 12 ( aged 12 - 18 years ) self-completed a modified version of the international World Health Organization collaborative Health Behaviour in School-aged Children ( HBSC-2002 ) question naire . RESULTS Although 16.5 % of the adolescents were overweight , almost twice that number ( 32.1 % ) were dissatisfied with their weight ( i.e. dieting or perceiving a need to diet ) . Of those adolescents , two-thirds were not actually overweight ( 56.4 % boys ; 73.5 % girls ) . One-fifth of the total number of adolescents ( 16.0 % boys ; 24.0 % girls ) were not overweight but were dissatisfied with their weight . Boys reporting overweight or weight dissatisfaction were more likely to have mothers with higher education or to be from more affluent families . Among both genders , but especially among girls , weight dissatisfaction was positively associated with most of the outcome variables ( body image , health complaints , risk behaviours , and television viewing ) regardless of weight status , whereas weight status was associated with only a few of the outcome variables . CONCLUSIONS Weight dissatisfaction , independent of weight status , is associated with body image , health complaints , risk behaviours and television viewing , and represents a potential health risk factor for adolescents . Preventive interventions should focus not only on weight status , but also on body weight dissatisfaction Background : Disruption of circadian rhythms has been associated with obesity in children and adolescents , and with hypertension in adults , in industrialized population s. Objective : We examined cross-sectional associations between sleep duration or television viewing and  obesity and blood pressure in Brazilian adolescents . Design : The sample consisted of 4452 adolescents aged 10–12 years participating in a prospect i ve birth cohort study in Pelotas , Brazil .  Sleep duration and television viewing were determined through question naires . Obesity was assessed using international cut-offs for body mass index ( BMI ) , and body fatness by skinfold thicknesses . Blood pressure was measured using a vali date d monitor . Results : Short sleep duration was associated with increased BMI , skinfolds , systolic blood pressure , activity levels and television viewing . Each hour of sleep reduced BMI by 0.16 kg/m2 ( s.e . 0.04 ) , and was associated with odds ratio for obesity of 0.86 ( s.e . 0.04 ) , both P<0.001 . Television viewing was associated with increased BMI and skinfolds , and increased blood pressure . The effects of sleep duration and television viewing on obesity were independent of one another . Their associations with blood pressure were mediated by body fatness . Conclusions : Both short sleep duration and increased television viewing were associated with greater body fatness , obesity and higher blood pressure , independently of physical activity level . These associations were independent of maternal BMI , identified in other studies as the strongest predictor of childhood obesity . Our study shows that behavioural factors associated with metabolic risk in industrialized population s exert similar deleterious effects in a population undergoing nutritional transition and suggest options for public health interventions OBJECTIVE To describe the patterns ( specifically comparing weekdays and weekends classified by intensities ) of  physical activity ( PA ) measured by accelerometry in adolescent girls . RESEARCH METHODS AND PROCEDURES Healthy sixth grade girls ( n=1603 ) , 11 to 12 years old , were r and omly recruited from 36 schools participating in the Trial of Activity in Adolescent Girls . Age , ethnicity , socioeconomic status , weight , and height were taken .  PA patterns were measured for 6 days using accelerometry . RESULTS Adolescent girls spend most of their time in  sedentary  ( 52 % to 57 % of the day ) and  light activity ( 40 % to 45 % of the day ) on weekdays and weekends . In all girls , total PA  comprised 44.5 % of the day ( 41.7 % light , 2.2 % moderate , and 0.7 % vigorous ) with sedentary activity comprising 55.4 % .  Moderate-to-vigorous PA ( MVPA )  was higher ( p<0.001 ) on weekdays than weekends in all girls , but  MVPA  was lower in at-risk of overweight+overweight girls ( p<0.001 ) on both weekdays and weekends compared with normal-weight girls . DISCUSSION Adolescent girls are more active at moderate and vigorous intensities on weekdays than on weekends , and at-risk of overweight and those overweight spend less time engaging in  MVPA  than normal-weight girls OBJECTIVE : To assess the relationships between diet , body composition , physical activity , parents ’ obesity and adiposity in children at the age of 8 y and four years later . STUDY DESIGN : Prospect i ve observational study of anthropometric measures initiated in 1992 , follow-up examination in 1996 . METHODS : 112 prepubertal ( age : 8.6±1.0 y ) children were studied .  Energy and nutrient intakes were assessed by diet history , body composition by anthropometry and physical activity , by a question naire . Obesity was defined as relative body mass index ( BMI ) ( rel BMI ) > 120 % , where rel BMI =( BMI / BMI at 50th centile for age and gender) × 100 . RESULTS : Prevalence of obesity was not statistically different at baseline ( 22.3 % ) than four years later ( 19.8 % ) : rel BMI at the age of 8 y was positively self-related with rel BMI at the age of 12 y ( r=0.73 , P<0.001 ) . After four years , eight ( 32 % ) obese children became non obese and five ( 6 % ) non obese children became obese . Multiple regression analysis ( stepwise procedure ) revealed that , in the final equation , the mother ’s BMI and TV viewing ( independent variables ) accounted for 17 % of the children ’s rel BMI variance at the age of 8 y ( R=0.42 , P<0.001 ) while the parents ’ BMI s accounted for 13.5 % of the children ’s rel BMI variance at the age of 12 y ( r=0.37 , P<0.001 ) . Other variables such as total energy intake , nutrient intake percentage and amount of physical activity , were all rejected . An autoregressive unbalanced measures model regression analysis recognised the mother ’s and father ’s BMI s as the only variables able to predict rel BMI in the children ( mother ’s BMI coeff . 2.53 ( s.e.m . 0.26 ) , P<0.0001 ; father ’s BMI coeff . 2.07 ( s.e.m . 0.23 ) , P<0.0001 ) . A multivariate logistic regression analysis was also performed . The children who participated in the follow-up , were divided into two groups based on the positive or negative change in the rel BMI between final and baseline measurements . Of all the variables considered , only rel BMI at baseline was selected in the final equation . Other variables such as age , gender , energy and nutrient intake , TV viewing and amount of physical activity  , as well as the parents ’ BMI , were all removed . CONCLUSIONS : The parents ’ obesity was the main risk factor for obesity in this group of children .  Sedentary behaviour ( TV viewing ) was independently associated with overweight at the age of 8 y. Physical activity and energy and nutrient intakes did not significantly affect the change in rel BMI over the four-year period when the parents ’ obesity was taken into account The aim of this study is to examine  sedentary and light activity  in relation to overweight in adolescent girls . Adolescent girls were r and omly recruited from 36 schools participating in the Trial of Activity for Adolescent Girls ( TAAG ) . Assessment s included age , ethnicity , socioeconomic status , and body composition estimated from weight , height , and triceps skinfold .  Sedentary and light activity  was measured for 6 days using accelerometry in 6th and in 8th grade among two r and omly sample d cross-sections of girls .  Sedentary activity  increased from the 6th to 8th grade by 51.5 min/day . In the 8th grade , a significantly higher number of hours in sedentary activity for each of the 6-days of measurement were evident with higher tertiles of percent body fat ( 30 - 35 % , > 35 % fat ) ( P < 0.05 ) , but not across all increasing tertiles of BMI ( 5th to 85th , 85th to 95th , and > 95th percentiles ) . The increase in sedentary activity was observed on weekdays , but not on weekends for percent body fat tertiles . In the cohort of girls measured in both 6th and 8th grade s , the mean cross-sectional coefficient estimates were significant for percent body fat , but not BMI for sedentary and light activities . Adolescent girls from the 6th to 8th grade are shifting their time from light to more  sedentary activity as measured by accelerometers . In addition , the increase in sedentary activity is not associated with an adverse effect on BMI or percent body fat . The eventual impact of this shift to a more sedentary lifestyle on body composition and other outcomes needs to be evaluated further Childhood obesity incidence has increased substantially and it has been argued that decreasing physical activity levels , coinciding with an increase in sedentary behaviours , are responsible . Australian guidelines were published in 2004 , recommending that children participate in a minimum of 60 min of physical activity daily and spend no more than 2h a day using electronic media for entertainment . We aim ed to compare compliance with these guidelines amongst children of differing weight status . The Childhood Injury Prevention Study ( CHIPS ) collected data from a r and omly selected sample of Brisbane primary and preschool children aged 5 - 12 years . The following data were available for 518 participants : age , gender , measured height and weight and estimated time per week from a parent-completed 7 days diary in physical activity out of school and sedentary leisure activities including television viewing and computer use . Using age st and ardised body mass index estimates , approximately 20 % of the cohort were overweight . Non-compliance with guidelines was 14.7 % for out of school physical activity participation , and 30.9 % for excess electronic media entertainment use . There was a 63 % increase in the odds of overweight status amongst children who were non-compliant with the electronic entertainment recommendations than those who were compliant ( adjusted odds ratio=1.63 ; 95 % CI=1.05 - 2.54 ) . Female gender and school level socioeconomic category were also independently associated with overweight status . Non-compliance with the minimal physical activity guideline increased the odds of being overweight by 28 % , however this difference was not statistically significant . One in seven children from the Greater Brisbane area are at risk for being insufficiently active whilst a third overuse electronic media . Given that overuse of electronic entertainment was positively associated with childhood obesity , these children should be the target of public health campaigns to promote alternative leisure time activities Background Previous studies examining the relationship between physical activity levels and broad-based measures of psychological wellbeing in adolescents have been limited by not controlling for potentially confounding variables . The present study examined the relationship between adolescents ’ self-reported physical activity level , sedentary behaviour and psychological wellbeing ; while controlling for a broad range of sociodemographic , health and developmental factors . Methods The study entailed a  cross-sectional school-based survey in ten British towns . Two thous and six hundred and twenty three adolescents ( aged 13–16 years ) reported physical activity levels , patterns of sedentary behaviour  ( TV/computer/video usage )  and completed the strengths and difficulties question naire ( SDQ ) .  Results Lower levels of self-reported physical activity and higher levels of sedentary behaviour showed grade d associations with higher SDQ total difficulties scores , both for boys ( P < 0.001 ) and girls ( P < 0.02 ) after adjustment for age and town . Additional adjustment for social class , number of parents , predicted school examination results , body mass index , ethnicity , alcohol intake and smoking status had little effect on these findings . Conclusions Low levels of self-reported physical activity are independently associated with diminished psychological wellbeing  among adolescents . Longitudinal studies may provide further insights into the relationship between wellbeing and activity levels in this population . Ultimately , r and omised controlled trials are needed to evaluate the effects of increasing physical activity on psychological wellbeing among adolescents OBJECTIVE To examine the relation between baseline fat mass and gain in bone area and bone mass in preschoolers studied prospect ively for 4 years , with a focus on the role of physical activity and TV viewing . STUDY DESIGN Children were part of a longitudinal study in which measures of fat , lean and bone mass , height , weight , activity , and diet were taken every 4 months from ages 3 to 7 years . Activity was measured by accelerometer and TV viewing by parent checklist . We included 214 children with total body dual energy x-ray absorptiometry ( Hologic 4500A ) scans at ages 3.5 and 7 years . RESULTS Higher baseline fat mass was associated with smaller increases in bone area and bone mass over the next 3.5 years ( P < .001 ) . More TV viewing was related to smaller gains in bone area and bone mass accounting for race , sex , and height . Activity by accelerometer was not associated with bone gains . CONCLUSIONS Adiposity and TV viewing are related to less bone accrual in preschoolers BACKGROUND There are concerns that sedentariness among young people has increased and that this may be detrimental to their health . The purpose of this study was to examine the association between sedentary activities , including  small-screen recreation ( SSR : watching TV/DVDs/videos , recreational computer use ) and cardiorespiratory endurance ( CRE ) in children aged 11 - 15 years . METHODS A cross-sectional representative population survey was taken of New South Wales ( Australia ) school students in Grade s 6 , 8 , and 10 ( N=2750 ) in 2004 .  Sedentary activities and SSR were measured by a self-report question naire .  CRE was determined by the 20-meter multi-stage shuttle run test . The optimal cut point for time spent on SSR was determined by receiver operating characteristic analysis . RESULTS Time spent in sedentary activities was inversely associated with CRE among Grade 8 students ( p=0.01 ) and Grade 10 girls ( p=0.03 ) . CRE was lower among Grade 8 students ( p<0.001 ) and Grade 10 girls ( p<0.001 ) who spent > or=2 hours/day on SSR compared with students who spent < 2 hours/day . The 2-hour/day cut point for SSR had high sensitivity ( boys : 84 % , [ 95 % CI=79 % , 87 % ] ; girls : 79 % [ 95 % CI=74 % , 84 % ] ) and low specificity ( boys : 28 % [ 95 % CI=24 % , 32 % ] ; girls : 42 % [ 95 % CI=38 % , 46 % ] ) . CONCLUSIONS Cardiorespiratory endurance did not differ consistently across quintiles of sedentariness and SSR among boys ; however , among girls there was a consistent inverse association . If confirmed in prospect i ve studies , these findings have important implication s for risk of chronic disease Obese children 8 - 12 years old from 61 families were r and omized to treatment groups that targeted increased exercise , decreased sedentary behaviors , or both ( combined group ) to test the influence of reinforcing children to be more active or less sedentary on child weight change . Significant decreases in percentage overweight were observed after 4 months between the sedentary and the exercise groups ( -19.9 vs. -13.2 ) . At 1 year , the sedentary group had a greater decrease in percentage overweight than did the combined and the exercise groups ( -18.7 vs. -10.3 and -8.7 ) and greater decrease in percentage of body fat ( -4.7 vs. -1.3 ) . All groups improved fitness during treatment and follow-up . Children in the sedentary group increased their liking for high-intensity activity and reported lower caloric intake than did children in the exercise group . These results support the goal of reducing time spent in sedentary activities to improve weight loss Obese children were r and omly assigned to a family-based behavioral treatment that included either stimulus control or reinforcement to reduce sedentary behaviors . Significant and equivalent decreases in sedentary behavior and high energy density foods , increases in physical activity and fruits and vegetables , and decreases in st and ardized body mass index ( z- BMI ) were observed . Children who substituted active for sedentary behaviors had significantly greater z- BMI changes at 6 ( -1.21 vs. -0.76 ) and 12 ( -1.05 vs. -0.51 ) months , respectively . Substitution of physically active for sedentary behaviors and changes in activity level predicted 6- and 12-month z- BMI changes . Results suggest stimulus control and reinforcing reduced sedentary behaviors are equivalent ways to decrease sedentary behaviors , and behavioral economic relationships in eating and activity may mediate the effects of treatment BACKGROUND . The American Academy of Pediatrics recommends children ≥2 years of age limit daily media exposure to ≤1 to 2 hours and not have a television set in children 's bedrooms . However , there are limited prospect i ve studies to address how timing of media exposure influences  children 's health . OBJECTIVE . Our goal was to examine relations among children 's early , concurrent , and sustained  television exposure  and behavioral and social skills outcomes at 5.5 years . METHODS . We analyzed data collected prospect ively from the Healthy Steps for Young Children national evaluation . Television exposure was defined as > 2 hours of daily use ( at 30–33 months and 5.5 years ) and television in child 's bedroom ( at 5.5 years ) . At 5.5 years , outcomes were assessed by using the Child Behavior Checklist and social skills using the Social Skills Rating System . Linear regression was used to estimate the effect of television exposure on behavioral and social skills outcomes . RESULTS . Sixteen percent of parents reported that their child watched > 2 hours of television daily at 30 to 33 months only , 15 % reported > 2 hours of television daily at 5.5 years only , and 20 % reported > 2 hours of television daily at both times . Forty-one percent of the children had televisions in their bedrooms at 5.5 years . In adjusted analyses , sustained television viewing was associated with behavioral outcomes . Concurrent television exposure was associated with fewer social skills . For children with heavy television viewing only in early childhood , there was no consistent relation with behavioral or social skills outcomes . Having a television in the bedroom was associated with sleep problems and less emotional reactivity at 5.5 years but was not associated with social skills . CONCLUSIONS . Sustained exposure is a risk factor for behavioral problems , whereas early exposure that is subsequently reduced presents no additional risk . For social skills , concurrent exposure was more important than sustained or early exposure . Considering the timing of media exposure is vital for underst and ing the consequences of early experiences and informing prevention strategies BACKGROUND The purpose of the study was to explore the association among the following variables : physical activity , TV , videogames , and obesity . The study included a Portuguese r and om nationally representative sample of 3365 children ( 1610 girls and 1755 boys ) 7 - 9 year olds . METHODS A general question naire was completed by the parents of participating children to provide information about the hours spent per week watching television , computer use and electronic games , and the participation in physical education .  Overweight and obesity were calculated by using the body mass index ( BMI ) assessment and the cut-off points for overweight ( 25 kg/m(2 ) ) and obesity ( 30 kg/m(2 ) ) . RESULTS The data from the association between BMI and the independent variables ( analysis of variance ) were only significant for time playing electronic games for boys and girls ( P < 0.001 ; P < 0.029 ) . The association between hours of watching TV and BMI was significant only for boys ( P < 0.016 ) . The results from the logistic regression were only significant for electronic games both for boys and girls ( P < 0.000 ; P < 0.000 ) . CONCLUSIONS The results of this study suggest that the time spent playing electronic games is associated with obesity . Reducing childhood obesity calls for the reduction in sedentary behaviours , and the promotion of a more active lifestyle OBJECTIVES To assess how trial information reported in conference abstract s differs to their subsequent full publication . METHODS R and omized trials reported at the American Society of Clinical Oncology conference ( 1992 ) were identified . CENTRAL and PubMed ( December 2002 ) were search ed to identify corresponding full publications . A checklist ( based on CONSORT ) was used to compare abstract s for 37 trials with their full publication . RESULTS Some aspects were well reported . Ninety-five percent of study objectives , 92 % of participant eligibility , 100 % of trial interventions , and 84 % of primary outcomes were the same in both abstract and full publication . Other areas were more discrepant . Forty-six percent reported the same number of participants r and omized in the abstract and full publication ; only 22 % reported the same number analyzed ( median number analyzed per trial was 96 for abstract s and 117 for full publications ) . Eighty-two percent of trials were closed to follow-up in the full publication compared to 19 % of abstract s. Lack of information was a major problem in assessing trial quality : no abstract s reported on allocation concealment , 16 % reported on blinding and 14 % reported intention to treat analysis . These figures were 49 , 19 , and 46 % , respectively , for full publications . CONCLUSION The information given for trials in conference proceedings can be unstable , especially for trials presenting early or preliminary results , and needs to be improved OBJECTIVE To investigate the association of  television viewing  with educational and intellectual outcomes during adolescence and early adulthood . DESIGN Prospect i ve epidemiological study . SETTING Families participating in the Children in the Community Study , a prospect i ve longitudinal investigation , were interviewed at mean offspring ages 14 , 16 , and 22 years . PARTICIPANTS A community-based sample of 678 families from upstate New York . MAIN EXPOSURES Television viewing , attention difficulties , learning difficulties , and educational achievement during adolescence and early adulthood . MAIN OUTCOME MEASURES The Disorganizing Poverty Interview and age-appropriate versions of the Diagnostic Interview Schedule for Children . RESULTS Frequent television viewing during adolescence was associated with elevated risk for subsequent attention and learning difficulties after family characteristics and prior cognitive difficulties were controlled . Youths who watched 1 or more hours of television per day at mean age 14 years were at elevated risk for poor homework completion , negative attitudes toward school , poor grade s , and long-term academic failure . Youths who watched 3 or more hours of television per day were the most likely to experience these outcomes . In addition , youths who watched 3 or more hours of television per day were at elevated risk for subsequent attention problems and were the least likely to receive post secondary education . There was little evidence of bidirectionality in the association of television viewing with attention and learning difficulties . CONCLUSION Frequent television viewing during adolescence may be associated with risk for development of attention problems , learning difficulties , and adverse long-term educational outcomes
target: There is a large body of evidence from all study design s which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5 - 17 years .
  In particular , the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health , and that lowering sedentary time leads to reductions in BMI
background: Accumulating evidence suggests that , independent of physical activity levels , sedentary behaviours are associated with increased risk of cardio-metabolic disease , all-cause mortality , and a variety of physiological and psychological problems .
  Therefore , the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5 - 17 years .