A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study Decreasing sedentary behaviors in treating pediatric obesity. Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Behavioral engineering of activity choice in obese children The effect of reinforcement or stimulus control to reduce sedentary behavior in the treatment of pediatric obesity. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. Changes in physical activity and sedentary behavior in a randomized trial of an internet-based versus workbook-based family intervention study. The effect of the UP4FUN pilot intervention on objectively measured sedentary time and physical activity in 10–12 year old children in Belgium: the ENERGY-project Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years Longitudinal sedentary behavior changes in adolescents in Ho Chi Minh City. A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes) Research priorities for child and adolescent physical activity and sedentary behaviours: an international perspective using a twin-panel Delphi procedure A cluster randomized trial to evaluate the efficacy of a school-based behavioral intervention for health promotion among children aged 3 to 5 The effect of a cluster randomised control trial on objectively measured sedentary time and parental reports of time spent in sedentary activities in Belgian preschoolers: the ToyBox-study Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH): A randomized controlled trial study protocol Psychosocial correlates of physical activity in healthy children.
Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT 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 Objective . To assess the effectiveness of interventions that focus on reducing  sedentary behavior ( SB ) among school-age youth and to identify elements associated with interventions ' potential for translation into practice setting s. Methods . A comprehensive literature search was conducted using 4 data bases for peer- review ed studies published between 1980 and April 2011 . R and omized trials , which lasted at least 12 weeks , aim ed at decreasing  SB among children aged 6 to 19 years were identified . Results . Twelve studies were included ; 3 focused only on SB , 1 focused on  physical activity ( PA )  , 6 were combined SB and PA interventions , and 2 studies targeted SB , PA , and diet .  The majority of the studies were conducted in a school setting , while others were conducted in such setting s as clinics , community centers , and libraries . Conclusions . Overall , interventions that focused on decreasing SB were associated with reduction in time spent on SB and /or improvements in anthropometric measurements related to childhood obesity . Several of the studies did consider elements related to the intervention 's potential for translation into practice setting Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : This laboratory study examined whether making sedentary activities contingent upon being physically active would increase  obese children 's physical activity . Fourteen obese children aged 8–12 y participated in a baseline session in which they had free choice among a variety of sedentary activities and riding a stationary bicycle . Children were then r and omized to either a contingent group in which watching video cassette recorder ( VCR ) movies and playing video games were contingent upon riding the bicycle or a control group in which all physical and sedentary activities remained freely available . Contingent group children increased physical activity and decreased television activities in comparison to the control , even though other sedentary activities remained freely available . Findings suggest that highly valued sedentary activities can reinforce physical activities and that sedentary activities do not completely substitute amongst themselves . The automated system used to make television activities contingent upon physical activity has potential for modifying activity in the treatment of obesity 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 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 BACKGROUND The America on the Move ( AOM ) Family Intervention Program has been shown to prevent excess weight gain in overweight children . Providing intervention material s via the internet would have the potential to reach more families but may increase sedentary behavior . The purpose was to evaluate whether delivering the AOM Family Intervention via the internet versus printed workbook would have a similar impact on sedentary behaviors in children . METHODS 131 children ( age 8 - 12 ) were r and omized to receive the AOM Family Intervention via the internet or workbook for 12 weeks . Changes in objective ly measured sedentary time and moderate-to vigorous physical activity ( MVPA ) as well as self-reported screen time were compared between groups . RESULTS There were no significant differences between groups in screen time , sedentary time , or MVPA at the end of the 12 week intervention . Families receiving the intervention via the internet were more likely to remain in the study ( 98 % vs. 82 % , P = .016 ) . CONCLUSIONS Using the internet to deliver the lifestyle intervention did not increase  sedentary behavior in children . Attrition rates were lower when the program was delivered by internet versus via printed material s. These results provide support for using the internet to deliver healthy lifestyle programs for children BakckgroundThe first aim was to examine the effect of the UP4FUN pilot intervention on children ’s total sedentary time . The second aim was to investigate if the intervention had an effect on  children ’s physical activity ( PA ) level . Finally , we aim ed to investigate demographic differences ( i.e. age , gender , ethnicity , living status and having siblings ) between children in the intervention group who improved in sedentary time and PA at post-test and children in the intervention group who worsened in sedentary time and PA at post-test . Methods The six weeks UP4FUN intervention was tested in a r and omized controlled trial with pre-test post-test design with five intervention and five control schools in Belgium and included children of the 5th and 6th grade . The children wore accelerometers for seven days at pre- and post-test . Analyses included children with valid accelerometer data for at least two weekdays with minimum 10h-wearing time and one weekend day with 8h-wearing time . Result Final analyses included 372 children ( 60 % girls , mean age = 10.9 ± 0.7 years ) . There were no significant differences in the change in sedentary time or light PA between intervention and control schools for the total sample or for the subgroup analyses by gender . However , children ( specifically girls ) in the intervention group had a higher decrease in moderate-to-vigorous PA than children in the control group . In the intervention group , children who lived with both parents and children with one or more siblings were less likely to reduce sedentary time after exposure to the intervention . Older children , girls and children who lived with both parents were less likely to increase light PA after the intervention . Conclusion The UP4FUN intervention did not result in an effect on children ’s sedentary time . Based on the high amounts of accelerometer-derived sedentary time in this age group , more efforts are needed to develop strategies to reduce children ’s sedentary time Objective : To determine if time spent in objective ly measured sedentary behavior is associated with a change in body mass index ( BMI ) between ages 9 and 15 years , adjusting for moderate-to-vigorous physical activity ( MVPA ) . Design : Prospect i ve observational study of children at ages 9 ( 2000 ) , 11 ( 2002 ) , 12 ( 2003 ) and 15 years ( 2006 ) .  Longitudinal quantile regression was used to model the influence of predictors on changes at the 10th , 25th , 50th , 75th and 90th BMI percentiles over time . Subjects : Participants were enrolled in the National Institute of Child Health and Human Development ( NICHD ) Study of Early Child Care and Youth Development and include both boys and girls ( n=789 ) . Measurements : Objective ly measured BMI ( kg m–2 ) was the outcome variable and objective ly measured sedentary behavior was the main predictor . Adjustment was also made for MVPA , gender , race , maternal education , hours of sleep and healthy eating index . Results : Increases in BMI were observed at all percentiles , with the greatest increase observed at the 90th BMI percentile . Spending more time in sedentary behavior  ( h per day ) was associated with additional increases in BMI at the 90th , 75th and 50th BMI percentiles , independent of MVPA and the other covariates ( 90th percentile=0.59 , 95 % confidence interval ( 95 % CI ) : 0.19–0.98 kg m–2 ; 75th percentile=0.48 , 95 % CI : 0.25–0.72 kg m–2 ; and 50th percentile=0.19 , 95 % CI : 0.05–0.33 kg m–2 ) . No associations were observed between sedentary behavior and changes at the 25th and 10th BMI percentiles . Conclusion : Sedentary behavior was associated with greater increases in BMI at the 90th , 75th and 50th BMI percentiles between ages 9 and 15 years , independent of MVPA . Preventing an increase in sedentary behavior from childhood to adolescence may contribute to reducing the number of children classified as obese BACKGROUND Sedentary behavior is associated with increased risk of chronic disease and sedentary behavior is increasing among adolescents . Data on changes in sedentary behavior in developing countries are limited . PURPOSE To describe 5-year longitudinal changes in nonschool sedentary hours among urban adolescents in Ho Chi Minh City , and to identify correlates with this change . METHODS This is a 5-year longitudinal cohort with systematic r and om sampling of 759 students from 18 junior high schools . All measures were taken annually between 2004 and 2009 .  Sedentary behavior  was assessed by self-report and accelerometry . Generalized linear latent and mixed models were used to analyze the data in 2011 . RESULTS Between 2004 and 2009 , self-reported time spent in nonschool sedentary behavior  increased from 498 to 603 minutes/day . In the 5th survey year , boys and girls ( aged 16 years ) were , respectively , 3.6 times ( 95 % CI=2.3 , 6.0 ) and 3.1 times ( 95 % CI= 1.8 , 5.0 ) more likely to spend ≥2 hours/day on screen time compared with baseline ( aged 12 years ) . Accelerometer data adjusted for wearing time revealed that boys and girls aged 16 years had , respectively , 78 minutes/day ( 95 % CI=48 , 104 ) and 69 minutes/day ( 95 % CI=34 , 95 ) more nonschool sedentary time than those at the first accelerometer assessment ( at age 13 years ) . Girls in the highest socioeconomic quartile spent an additional 90 minutes/day in sedentary behavior compared with girls in the lowest quartile ( 95 % CI=52 , 128 ) .  CONCLUSIONS Nonschool sedentary behavior  increased among Vietnamese adolescents with age . The largest increase was in recreational screen time ( 28 % ) , which would be the most obvious target for preventive health strategies Aims Type 2 diabetes mellitus ( T2DM ) , a serious and prevalent chronic disease , is traditionally associated with older age . However , due to the rising rates of obesity and sedentary lifestyles , it is increasingly being diagnosed in the younger population . Sedentary ( sitting ) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes , including T2DM . Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM . We aim ed to investigate , through a r and omised controlled trial ( RCT ) design , whether a group-based structured education workshop focused on sitting reduction , with self-monitoring , reduced sitting time . Methods Adults aged 18–40 years who were either overweight ( with an additional risk factor for T2DM ) or obese were recruited for the Sedentary Time ANd Diabetes ( ST AND ) RCT . The intervention programme comprised of a 3-hour group-based structured education workshop , use of a self-monitoring tool , and follow-up motivational phone call . Data were collected at three time points : baseline , 3 and 12 months after baseline . The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months . Secondary outcomes included other objective ( activPAL ) and self-reported measures of sedentary behaviour and physical activity , and biochemical , anthropometric , and psycho-social variables . Results 187 individuals ( 69 % female ; mean age 33 years ; mean BMI 35 kg/m2 ) were r and omised to intervention and control groups . 12 month data , when analysed using intention-to-treat analysis ( ITT ) and per- protocol analyses , showed no significant difference in the primary outcome variable , nor in the majority of the secondary outcome measures . Conclusions A structured education intervention design ed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months . Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change . Moreover , some participants reported a focus on physical activity rather than reductions in sitting per se . The habitual nature of sedentary behaviour means that behaviour change is challenging . Trial Registration Controlled-Trials.com IS RCT Background The quantity and quality of studies in child and adolescent physical activity and sedentary behaviour have rapidly increased , but research directions are often pursued in a reactive and uncoordinated manner . Aim To arrive at an international consensus on research priorities in the area of child and adolescent physical activity and sedentary behaviour . Methods Two independent panels , each consisting of 12 experts , undertook three rounds of a Delphi methodology . The Delphi methodology required experts to anonymously answer questions put forward by the research ers with feedback provided between each round . Results The primary outcome of the study was a ranked set of 29 research priorities that aim ed to be applicable for the next 10 years . The top three ranked priorities were : developing effective and sustainable interventions to increase children ’s physical activity long-term ; policy and /or environmental change and their influence on children ’s physical activity and sedentary behaviour ; and prospect i ve , longitudinal studies of the independent effects of physical activity and sedentary behaviour on health . Conclusions These research priorities can help to guide decisions on future research directions Background The onset of inadequate behaviors leading to the development of risk factors for chronic diseases is known to occur early in life . An effective program for health promotion should therefore focus on children and their environment , as the starting point for behavior development . The overarching objective of the Program SI ! ( Salud Integral - Comprehensive Health ) is to intervene at the school level , to establish and develop life-lasting habits that will help preserving health during adulthood . The Program SI ! comprises five consecutive subprograms according to the five stages of education in Spain , the first being in preschoolers . This study aims to evaluate the efficacy of Program SI ! to establish and improve lifestyle behaviors in children ( preschoolers aged 3–5 years ) , their parents , and teachers , and also improving the school environment . A secondary objective is to evaluate improvements in cardiovascular health-related markers ( anthropometric parameters , blood pressure , and dietary and physical activity patterns ) in these same children . Methods / design 24 public schools from the city of Madrid ( Spain ) were allocated through stratified r and omization to intervention or control . The intervention schools follow the Program SI ! , which provides didactic units , emotions cards , healthy tips , and online re sources . The intervention schools integrate the Program SI ! into their scholar curriculum organized in four complete weeks during each academic year during the 3 years of preschool education . Control schools follow their normal curriculum . Primary outcomes are 1-year , and 3-year changes from baseline of scores for knowledge , attitudes , and habits ( KAH ) of children , their parents and teachers in regards to a healthy lifestyle . Secondary outcomes are 1-year , and 3-year changes from baseline in clinical and anthropometric parameters of children . Discussion The Program SI ! is a long-term health promotion program starting in 3 years old . It incorporates the traditional areas of intervention ( diet and physical activity ) , introducing additional components such as knowledge of the human body and management of emotions to achieve a comprehensive intervention . The Program SI ! is design ed to be an effective , sustainable health promotion program for the adoption of healthy behaviors from early in life . Trial registration Trial registration number : Background In preschoolers , high levels of sedentary behaviour are associated with several adverse health outcomes . The purpose of this study is to report the effects of the ToyBox-intervention ( a European 24-week cluster r and omised controlled trial ) on sedentary behaviour  in preschoolers . Methods In Belgium , 859 preschoolers from 27 kindergartens ( 15 intervention and 12 control ) wore an accelerometer  to objective ly measure  their  sedentary time  and 1715 parents/caregivers completed a question naire to assess sedentary activities in which preschoolers participate at home . Main outcomes were objective ly measured sedentary time , time spent watching TV , using the computer and time spent in quiet play . Multilevel repeated measures analyses were conducted to take clustering into account . Intention to treat analysis was used to h and le missing data . Results A sample of 859 ( 29.5 % of all contacted children ) preschoolers ( 4.4 ± 0.6 years , 54.4 % boys ) provided valid accelerometer data at either baseline or follow-up and parents of 1715 ( 58.9 % of all contacted children ) preschoolers ( 4.4 ± 0.5 years , 52.5 % boys ) completed a question naire at either baseline or follow-up . No intervention effects were found on objective ly and subjectively measured total sedentary time in the total sample . However , some effects on objective ly and subjectively measured sedentary time were found in specific subgroups . Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time , while preschoolers from the control group increased their sedentary time . Girls in the intervention group decreased their TV viewing time during weekend days ( -5.83 min/day ) , while girls ’ & TV viewing in the control group increased ( + 4.15 min/day ) . In low SES kindergartens , a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens ( + 6.06 min/day ) than in control kindergartens ( + 12.49 min/day ) . Conclusion While some small positive effects were found in some sub-groups , the ToyBox-intervention had no effect on objective ly and subjectively measured sedentary time in the total sample . A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects . The ToyBox- study is registered with the clinical trials registry clinical trials.gov , ID : NCT02116296 Background Approximately one third of New Zeal and children and young people are overweight or obese . A similar proportion ( 33 % ) do not meet recommendations for physical activity , and 70 % do not meet recommendations for screen time . Increased time being sedentary is positively associated with being overweight . There are few family-based interventions aim ed at reducing sedentary behavior in children . The aim of this trial is to determine the effects of a 24 week home-based , family oriented intervention to reduce sedentary screen time  on children 's body composition , sedentary behavior , physical activity , and diet . Methods / Design The study design is a pragmatic two-arm parallel r and omized controlled trial . Two hundred and seventy overweight children aged 9 - 12 years and primary caregivers are being recruited . Participants are r and omized to intervention ( family-based screen time intervention ) or control ( no change ) . At the end of the study , the control group is offered the intervention content . Data collection is undertaken at baseline and 24 weeks . The primary trial outcome is child body mass index ( BMI ) and st and ardized body mass index ( z BMI ) . Secondary outcomes are change from baseline to 24 weeks in child percentage body fat ; waist circumference ; self-reported average daily time spent in physical and sedentary activities ; dietary intake ; and enjoyment of physical activity and sedentary behavior . Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity . Discussion This study provides an excellent example of a theory-based , pragmatic , community-based trial targeting sedentary behavior in overweight children . The study has been specifically design ed to allow for estimation of the consistency of effects on body composition for Māori ( indigenous ) , Pacific and non-Māori/non-Pacific ethnic groups . If effective , this intervention is imminently scalable and could be integrated within existing weight management programs . Trial Registration BACKGROUND Underst and ing the determinants of physical activity in children is critical for the treatment and prevention of childhood obesity . Social-cognitive theory has been used to underst and behavioral patterns in children . OBJECTIVES To explore the relationship between health beliefs , self-efficacy , social support , and sedentary activities and physical  activity levels in children and to examine the relationship between physical activity and  children 's  self-esteem . METHODS Ninety-two children aged 10 to 16 years completed the study .  Physical activity was monitored for 1 week with a motion detector ( Actitrac ; IM Systems , Baltimore , Md ) . Moderate-level activity and high-level activity were defined based on the results of treadmill testing . Health beliefs , self-efficacy , social influences , and time spent in sedentary behaviors were determined through question naires . Self-esteem was measured using the Piers-Harris Children 's Self-Concept Scale . Chronic anxiety was measured with the Revised Children 's Manifest Anxiety Scale . RESULTS There was a significant decline in physical activity levels between ages 10 and 16 years , particularly in girls . Preteen girls spent approximately 35 % more time in low- and high-level activity than did teenage girls ( P<.001 ) . Overall , children spent 75.5 % of the day inactive , with a mean + /- SD of 5.2 + /- 1.8 hours watching television , sitting at the computer , and doing homework . In contrast , only 1.4 % of the day ( 12.6 + /- 12.2 minutes ) was spent in vigorous activity . Time spent in sedentary behaviors was inversely correlated with the amount of moderate-level activity ( P<.001 ) but not high-level activity . In contrast , time spent in high-level activity correlated with self-efficacy scores ( P<.001 ) and social influences scores ( P<.005 ) . High-level physical activity was also associated with improved self-esteem ( P<.05 ) . Higher health beliefs scores were not correlated with physical activity levels . CONCLUSIONS Children and adolescents are largely sedentary . Correlates of high- and low-level physical activity are different . Time spent on sedentary activities is inversely correlated with moderate-level activity , while self-efficacy and social influences are positively correlated with more intense physical activity . In addition , increased high-level physical activity is an important component in the development of self-esteem in children
In conclusion , very little is known about sedentary behaviors other than screen time in this age group .
Although highly variable , findings suggest that children are already engaging in high levels of screen time by age 2 and the majority exceed current recommendations
Sedentary behavior has negative health outcomes , evident even in young children .
Identifying the prevalence of sedentary behavior in children < 2years is important for determining the necessity for intervention strategies .
The aim of this systematic review was to determine the prevalence of sedentary behavior in children < 2years .