Objective: The purpose of the current study was to use latent profile analysis to identify family typologies characterized by parental acceptance, parental monitoring, and family conflict, and to examine whether such typologies were associated with the number of movement behavior recommendations (i.e., physical activity, screen time, and sleep) met by children. Methods: Data for this cross-sectional observational study were part of the baseline data from the Adolescent Brain Cognitive Development (ABCD) study. Data were collected from September 1, 2016 to September 15, 2018, across 21 study sites in the United States. Participants included 11,875 children aged 9 and 10 years. Results: Results from latent profile analysis showed that children were meaningfully classified into one of five family typologies, ranging from ideal (high acceptance, high monitoring, and low conflict) to poor (medium acceptance, low monitoring, and high conflict) functioning. Children from good (OR= 0.54; 95% CI, 0.39-0.76), average (OR=0.28; 95% CI, 0.20, 0.40), fair (OR=0.24; 95% CI, 0.16, 0.36), and poor (OR=0.19; 95% CI, 0.12-0.29) functioning families were less likely to meet all three movement behavior recommendations compared to children from ideal functioning families. The odds of meeting all recommendations progressively decreased as family functioning worsened. Similar findings and pattern of results were found for meeting ≥2 recommendations and ≥1 recommendation. Conclusions: These findings highlight the importance of the family environment for promoting healthy movement behaviors among children.
Purpose To identify criterion-referenced standards for cardiorespiratory fitness (CRF); to estimate the percentage of children and youth that met each standard; and to discuss strategies to help improve the utility of criterion-referenced standards for population health research. Methods A search of four databases was undertaken to identify papers that reported criterion-referenced CRF standards for children and youth generated using the receiver operating characteristic curve technique. A pseudo-dataset representing the 20-m shuttle run test performance of 1 142 026 children and youth aged 9–17 years from 50 countries was generated using Monte Carlo simulation. Pseudo-data were used to estimate the international percentage of children and youth that met published criterion-referenced standards for CRF. Results Ten studies reported criterion-referenced standards for healthy CRF in children and youth. The mean percentage (±95% CI) of children and youth that met the standards varied substantially across age groups from 36%±13% to 95%±4% among girls, and from 51%±7% to 96%±16% among boys. There was an age gradient across all criterion-referenced standards where younger children were more likely to meet the standards compared with older children, regardless of sex. Within age groups, mean percentages were more precise (smaller CI) for younger girls and older boys. Conclusion There are several CRF criterion-referenced standards for children and youth producing widely varying results. This study encourages using the interim international criterion-referenced standards of 35 and 42 mL/kg/min for girls and boys, respectively, to identify children and youth at risk of poor health—raising a clinical red flag.
Objective To estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of children and adolescents and to examine relationships between temporal trends in CRF and temporal trends in broad socioeconomic and health-related indicators across countries. Methods Data were obtained from a systematic search of studies that explicitly reported 20 m shuttle run test (a validated measure of CRF) descriptive data on apparently healthy individuals aged 9–17 years. Following the estimation of relative peak oxygen uptake (mL/kg/min) as a measure of CRF, sample-weighted temporal trends were estimated at the country–sex–age level using best-fitting linear or polynomial regression models relating the year of testing to mean CRF. Poststratified population-weighted mean changes in absolute and per cent CRF were estimated. Pearson’s correlations were used to describe the association between linear temporal trends in CRF and linear temporal trends in broad socioeconomic and health-related indicators. Results Temporal trends were estimated from 965 264 children and adolescents from 19 high-income and upper middle-income countries between 1981 and 2014, using data from 137 studies. Collectively, there was a moderate decline in CRF of 3.3 mL/kg/min (95% CI −3.5 to −3.1), equivalent to a decline of 7.3% (95% CI −7.8% to −6.7%) over the 33-year time period. This international decline diminished with each decade and stabilised near zero around 2000. The decline was larger for boys than girls and was similar for children and adolescents. Trends also differed in magnitude and direction between countries, with most showing declines. There was a strong negative association between country-specific trends in income inequality (Gini index) and trends in CRF across 18 countries; meaning, countries approaching income equality had more favourable trends in CRF. Conclusions There has been a substantial decline in CRF since 1981, which is suggestive of a meaningful decline in population health. However, the international trend in CRF has not followed the anticipated trajectory, diminishing and stabilising with negligible change since 2000. CRF data are needed from children in low-income and middle-income countries to more confidently determine true international trends and determine whether temporal trends are similar to those observed in high-income and upper middle-income countries.