An integrated curriculum approach to increasing habitual physical activity in deprived South Asian children.

Integrating physical activity (PA) within a school curriculum is a promising approach for increasing PA in children. To date, no research has examined its effectiveness in increasing the low levels of PA witnessed in deprived South Asian (SA) children. The study aims to ascertain whether an integrated school-based curriculum and pedometer intervention could increase PA in children from deprived SA backgrounds. Following ethical approval and informed consent, 134 deprived SA children (63 boys, 71 girls, control (n = 40, mean age = 11.12 years, SD = 0.32 years) and intervention (n = 94, mean age = 9.48 years, SD = 0.62 years)) from a primary school in England, UK, completed a 6-week integrated PA intervention based on virtually walking from their school (middle of the country) to the coast and back (March-July 2013). Habitual PA was determined at baseline and post 6 weeks intervention for both groups, and determined weekly during the intervention in the experimental group. The results indicated that average daily steps were significantly higher at post 6 weeks compared to baseline for the intervention group (intervention mean change = 8694 steps/day, SD = 7428 steps/day vs. control mean change = -1121 steps/day, SD = 5592 steps/day, 95% CI of difference, 6726-7428 steps/day, P = .001, d = 1.76). In addition, significant decreases in BF% and waist circumference were observed in the intervention group post 6 weeks (mean change for BF% = -4.5%, mean change for WC = -1.7 cm, P = .001). School-based integrated curriculum and pedometer interventions provide a feasible and effective mechanism for increasing habitual PA in primary school children from deprived SA backgrounds.

The influence of age and weight status on cardiac autonomic control in healthy children: a review.

Heart rate variability (HRV) analyses can provide a non-invasive evaluation of cardiac autonomic activity. How autonomic control normally develops in childhood and how this is affected by obesity remain incompletely understood. In this review we examine the evidence that childhood age and weight status influence autonomic control of the heart as assessed using HRV. Electronic databases (Pubmed, EMBASE and Cochrane Library) were searched for studies examining HRV in healthy children from birth to 18 years who adhered to the Task Force (1996) guidelines. Twenty-four studies met our inclusion criteria. Seven examined childhood age and HRV. A reduction in 24-hour LF:HF was reported from birth to infancy (1 year), while overall HRV (SDNN) showed a marked and progressive increase. From infancy to early-to-late childhood (from 12 months to 15 years) LF:HF ratio was reported to decline further albeit at a slower rate, while RMSSD and SDNN increased. Twenty studies examined the effects of weight status and body composition on HRV. In a majority of studies, obese children exhibited reductions in RMSSD (n = 8/13), pNN50% (n = 7/9) and HF power (n = 14/18), no difference was reported for LF (n = 10/18), while LF:HF ratio was elevated (n = 10/15). HRV changes during childhood are consistent with a marked and progressive increase in cardiac parasympathetic activity relative to sympathetic activity. Obesity disrupts the normal maturation of cardiac autonomic control.

Low socio-economic environmental determinants of children's physical activity in Coventry, UK: A Qualitative study in parents.

BACKGROUND: Children's physical activity (PA) is affected by socio-economic status (SES) and the environment. Children are not fully autonomous in their decision making; parental decisions thus affect how children utilise their surrounding environments for PA. The aim was to examine environmental influences on children's PA from a qualitative perspective in parents from low SES wards in Coventry, UK. METHOD: 59 parents of children in year 4 (aged 8-9years) completed the ALPHA environmental questionnaire. 16 of these parents took part in focus group discussions examining environmental facilitators and barriers to their child's PA (March-April, 2013). RESULTS: Emerging themes related to physical (i.e. poor access, safety and quality of the neighbourhood) and social environment (i.e. 'rough' neighbourhood due to crime and anti-social behaviour) influences on the PA behaviour of children. The parents believed these environmental factors resulted in the children engaging in greater sedentary activity (watching TV) indoors. The school environment was perceived as a supportive physical environment for children's PA behaviour. CONCLUSION: Parent's perceptions of an unsupportive physical and social environment restrict children's opportunities to play outside and be physically active and may lead to increased body fat (BF). Schools provide a supportive environment for children from low SES to be physically active in.

Objectively measured patterns of physical activity in primary school children in Coventry: the influence of ethnicity.

AIMS: The aetiology of increased metabolic risk in South Asians is incompletely understood, but may include modifiable factors such as physical activity. This study assessed patterns of physical activity in UK primary school children and examined the influence of ethnicity. METHODS: We studied a community sample of children aged 8-9 years attending primary schools in Coventry, UK. One hundred and sixty-one children wore combined physical activity and heart rate monitors for 7 days. Levels of activity and energy expenditure were compared between White European (n = 96) and South Asian children (n = 65). Patterns of physical activity during the school week were also described. RESULTS: Seventy-three per cent of White Europeans compared with only 35% of South Asians achieved international recommendations of 60 minutes of moderate to vigorous physical activity daily (P < 0.0000). South Asians were less active during the week (106 ± 28 vs. 120 ± 32 counts/min, respectively, P = 0.0054) and at weekends (92 ± 34 vs. 108 ± 54 counts/min, P = 0.0118) compared with White Europeans. There were differences in energy expenditure with lower physical activity levels in South Asians (daily average 1.68 ± 0.13 vs. 1.76 ± 0.17, P < 0.0001). Differences were attributable to less activity after school in South Asians (97 ± 29 vs. 120 ± 43 counts/min, P < 0.0000) as daytime activity was comparable between groups (120 ± 41 vs. 124 ± 39 counts/min, P > 0.05). CONCLUSION: South Asian children in Coventry do significantly less physical activity than White Europeans, mainly attributable to differences in after-school activity. Ethnically tailored interventions should explore whether physical activity can be increased in South Asian children and, if so, whether this increased physical activity improves metabolic health.