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Socioeconomic Patterning of Children's Accelerometer-Assessed Physical Activity Intensities and Adiposity: A Pooled Analysis of Individual-Level Data for 26,915 Children and Adolescents from 36 European Cohorts

43 Pages Posted: 21 Apr 2020

See all articles by Agnes Luzak

Agnes Luzak

German Research Center for Environmental Health

Amelia Guadalupe Grau

Institute of Development and Peace (INEF)

Anders Mikael Sjödin

University of Copenhagen

Andrew Decelis

University of Malta

Angela Polito

Council for Agricultural Research and Agricultural Economics-CREA

Angie Page

University of Bristol

Christopher G. Owen

University of London - Population Health Research Institute

Claire Nightingale

University of London - Population Health Research Institute

Claudia Flexeder

Helmholtz Association of German Research Centres - German Research Centre for Environmental Health

Esther MF van Sluijs

University of Cambridge

Greet Cardon

Ghent University

Holger Schulz

Helmholtz Association of German Research Centres - German Research Centre for Environmental Health

Inge Huybrechts

World Health Organization (WHO) - International Agency for Research on Cancer (IARC)

Jardena J. Puder

University of Lausanne - Lausanne University Hospital

Jean Adams

University of Cambridge - MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR)

Jorge Mota

Universidade do Porto

José Antonio Casajús

Carlos III Institute of Health - CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Red española de Investigación en Ejercicio Físico y Salud (EXERNET)

Jostein Steene-Johannessen

Norwegian School of Sport Sciences

Kate Northstone

University of Bristol

Kenn Konstabel

National Institute for Health Development (Tallinn)

Lars Bo Andersen

Norwegian School of Sport Sciences

Lars B. Christiansen

University of Southern Denmark

Laura Basterfield

University of Newcastle

Lauren Lissner

University of Gothenburg

Laurent Beghin

Hôpital Jeanne de Flandre CHRU

Line G. Olesen

University of Southern Denmark

Luis A. Moreno

Carlos III Institute of Health - CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN)

Luis B. Sardinha

University of Lisbon

Mads F. Hjorth

University of Copenhagen

Marie Standl

German Research Center for Environmental Health

Mette Togtager

University of Southern Denmark

Nathalie Michels

Ghent University

Ole Sprengeler

Leibniz Institute for Prevention Research and Epidemiology - BIPS

Paola Russo

National Research Council (CNR)

Peter Lund Kristensen

University of Southern Denmark

Rebecca Love

University of Cambridge - MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR)

Russell Jago

University of Bristol

Stefaan De Henauw

Ghent University

Susana Vale

Polytechnic Institute of Porto (IPP)

Susi Kriemler

University of Zurich

Ulf Ekelund

Norwegian School of Sport Sciences

Wolfgang Ahrens

Leibniz Institute for Prevention Research and Epidemiology - BIPS

More...

Abstract

Background: Childhood obesity is increasing globally with widening socioeconomic inequalities. It is unclear if differences in the accumulation and intensity distribution of children’s physical activity is contributing to these rising disparities. We investigated if the intensity patterning of physical activity differs between socioeconomic groups across Europe and if this relationship differs by national level income inequality and age to help explain obesity disparities.

Methods: We pooled and harmonised individual-participant accelerometer-assessed activity and socioeconomic position (SEP) data from 36 European child studies. Included participants were between 5 to 16 years of age with valid accelerometer data (≥480 minutes of daily wear time on 3 days), parental education and anthropometric measurements. Study-level multivariable linear regression models were run to assess differences in moderate-vigorous physical activity (MVPA), vigorous physical activity (VPA) and adiposity by socioeconomic position (by parental education). Effects were pooled in random effect meta-analyses.

Findings: 26,915 participants (mean age: 10·1y [SD:1.2]; 51·7% female) from 16 European countries met the inclusion criteria. Meta-analyses revealed proportionally more average daily minutes of VPA were performed by children from a higher socioeconomic position (High vs low SEP, b: 0·57, 95%CI: 0·28, 0·85 mins), despite lower overall levels of physical activity (MVPA; b: -1·51, 95%CI: -2·36, -0·67 mins). Higher intensity activity in children from a higher socioeconomic position was paralleled by lower levels of adiposity measured by BMI z-score (b: -0·20, 95%CI: -0·24, -0·16). Stepwise differences were apparent moving from low to medium to high socioeconomic position [e.g. BMI z-score: (Low vs Med SEP; b: -0·10, 95%CI: -0·14, -0·07) (Low vs High SEP; b: -0·20, 95%CI: -0·24, -0·16)]. Inequalities in VPA and BMI z-score widened with age and were not affected by national level income inequality.

Interpretation: Lower levels of adiposity in children from a higher socioeconomic position are paralleled by relatively higher amounts of VPA despite overall lower levels of MVPA. Physical activity promotion efforts should focus on providing opportunities for less affluent children to be vigorously active.

Funding Statement: BHF, CRUK, ESCR, MRC, Wellcome Trust, Research Council of Norway

Declaration of Interests: All authors declare that they have no conflicts of interest.

Ethics Approval Statement: The authors declared not applicable.

Keywords: Physical activity; Obesity; children; Adolescents; Inequalities; ICAD; ALSPAC

Suggested Citation

Luzak, Agnes and Guadalupe Grau, Amelia and Sjödin, Anders Mikael and Decelis, Andrew and Polito, Angela and Page, Angie and Owen, Christopher G. and Nightingale, Claire and Flexeder, Claudia and van Sluijs, Esther MF and Cardon, Greet and Schulz, Holger and Huybrechts, Inge and Puder, Jardena J. and Adams, Jean and Mota, Jorge and Casajús, José Antonio and Steene-Johannessen, Jostein and Northstone, Kate and Konstabel, Kenn and Andersen, Lars Bo and Christiansen, Lars B. and Basterfield, Laura and Lissner, Lauren and Beghin, Laurent and Olesen, Line G. and Moreno, Luis A. and Sardinha, Luis B. and Hjorth, Mads F. and Standl, Marie and Togtager, Mette and Michels, Nathalie and Sprengeler, Ole and Russo, Paola and Kristensen, Peter Lund and Love, Rebecca and Jago, Russell and De Henauw, Stefaan and Vale, Susana and Kriemler, Susi and Ekelund, Ulf and Ahrens, Wolfgang, Socioeconomic Patterning of Children's Accelerometer-Assessed Physical Activity Intensities and Adiposity: A Pooled Analysis of Individual-Level Data for 26,915 Children and Adolescents from 36 European Cohorts (3/7/2020). Available at SSRN: https://ssrn.com/abstract=3551423 or http://dx.doi.org/10.2139/ssrn.3551423

Agnes Luzak

German Research Center for Environmental Health ( email )

Neuherberg, 85764
Germany

Amelia Guadalupe Grau

Institute of Development and Peace (INEF) ( email )

University Duisburg-Essen
Geibelstr.41
Duisburg, 47057
Germany

Anders Mikael Sjödin

University of Copenhagen ( email )

Nørregade 10
Copenhagen, København DK-1165
Denmark

Andrew Decelis

University of Malta ( email )

Msida MSD 2080
Msida MSD 06
Malta

Angela Polito

Council for Agricultural Research and Agricultural Economics-CREA ( email )

Italy

Angie Page

University of Bristol ( email )

University of Bristol,
Senate House, Tyndall Avenue
Bristol, Avon BS8 ITH
United Kingdom

Christopher G. Owen

University of London - Population Health Research Institute ( email )

Claire Nightingale

University of London - Population Health Research Institute ( email )

London
United Kingdom

Claudia Flexeder

Helmholtz Association of German Research Centres - German Research Centre for Environmental Health ( email )

Neuherberg, 85764
Germany

Esther MF Van Sluijs

University of Cambridge ( email )

Trinity Ln
Cambridge, CB2 1TN
United Kingdom

Greet Cardon

Ghent University ( email )

Coupure Links 653
Ghent, 9000
Belgium

Holger Schulz

Helmholtz Association of German Research Centres - German Research Centre for Environmental Health ( email )

Neuherberg, 85764
Germany

Inge Huybrechts

World Health Organization (WHO) - International Agency for Research on Cancer (IARC) ( email )

150 Cours Albert Thomas
Lyon, 69372
France

Jardena J. Puder

University of Lausanne - Lausanne University Hospital ( email )

Rue du Bugnon 46
Lausanne, 1011
Switzerland

Jean Adams

University of Cambridge - MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR) ( email )

Cambridge, CB2 0QQ
United Kingdom

Jorge Mota

Universidade do Porto ( email )

Rua Dr. Roberto Frias
4200-464 Porto
Portugal

José Antonio Casajús

Carlos III Institute of Health - CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) ( email )

Madrid
Spain

Red española de Investigación en Ejercicio Físico y Salud (EXERNET) ( email )

Spain

Jostein Steene-Johannessen

Norwegian School of Sport Sciences ( email )

P.o. box 4014 Ullevål Stadion
Oslo, 0806
Norway

Kate Northstone

University of Bristol ( email )

University of Bristol,
Senate House, Tyndall Avenue
Bristol, Avon BS8 ITH
United Kingdom

Kenn Konstabel

National Institute for Health Development (Tallinn) ( email )

Hiiu 42
Tallinn, EE-11619
Estonia

Lars Bo Andersen

Norwegian School of Sport Sciences ( email )

P.o. box 4014 Ullevål Stadion
Oslo, 0806
Norway

Lars B. Christiansen

University of Southern Denmark ( email )

Campusvej 55
DK-5230 Odense, 5000
Denmark

Laura Basterfield

University of Newcastle ( email )

5 Barrack Road
Devonshire Building
NEWCASTLE UPON TYNE, 2308 NE1 7RU
United Kingdom

Lauren Lissner

University of Gothenburg ( email )

Gothenburg
Sweden

Laurent Beghin

Hôpital Jeanne de Flandre CHRU ( email )

France

Line G. Olesen

University of Southern Denmark ( email )

Campusvej 55
DK-5230 Odense, 5000
Denmark

Luis A. Moreno

Carlos III Institute of Health - CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) ( email )

Madrid
Spain

Luis B. Sardinha

University of Lisbon ( email )

R. Branca Edmée Marques
Dept. Plant Biology
Lisboa, 1600-276
Portugal

Mads F. Hjorth

University of Copenhagen ( email )

Nørregade 10
Copenhagen, København DK-1165
Denmark

Marie Standl

German Research Center for Environmental Health ( email )

Neuherberg, 85764
Germany

Mette Togtager

University of Southern Denmark ( email )

Campusvej 55
DK-5230 Odense, 5000
Denmark

Nathalie Michels

Ghent University ( email )

Coupure Links 653
Ghent, 9000
Belgium

Ole Sprengeler

Leibniz Institute for Prevention Research and Epidemiology - BIPS ( email )

Achterstraße 30
Bremen, 28359
Germany

Paola Russo

National Research Council (CNR) ( email )

Via San Martino della battaglia, 44
Roma, 00185
Italy

Peter Lund Kristensen

University of Southern Denmark ( email )

Campusvej 55
DK-5230 Odense, 5000
Denmark

Rebecca Love (Contact Author)

University of Cambridge - MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR) ( email )

Cambridge, CB2 0QQ
United Kingdom

Russell Jago

University of Bristol ( email )

University of Bristol,
Senate House, Tyndall Avenue
Bristol, Avon BS8 ITH
United Kingdom

Stefaan De Henauw

Ghent University ( email )

Coupure Links 653
Ghent, 9000
Belgium

Susana Vale

Polytechnic Institute of Porto (IPP) ( email )

Portugal

Susi Kriemler

University of Zurich ( email )

Rämistrasse 71
Zürich, CH-8006
Switzerland

Ulf Ekelund

Norwegian School of Sport Sciences ( email )

P.o. box 4014 Ullevål Stadion
Oslo, 0806
Norway

Wolfgang Ahrens

Leibniz Institute for Prevention Research and Epidemiology - BIPS ( email )

Achterstraße 30
Bremen, 28359
Germany