Relationships between outdoor time, physical activity, sedentary time, and body mass index in children : a 12-country study

Larouche, Richard and Barreira, Tiago V. and Hu, Gang and Maia, José and Sarmiento, Olga L. and Katzmarzyk, Peter T. and Mire, Emily F. and Chaput, Jean Philippe and Lambert, Estelle V. and Olds, Tim and Standage, Martyn and Belanger, Kevin and Fogelholm, Mikael and Maher, Carol and Onywera, Vincent and Tudor-Locke, Catrine and Tremblay, Mark S. and Church, Timothy S. and Lambert, Denise G. and Broyles, Stephanie and Butitta, Ben and Champagne, Catherine and Cocreham, Shannon and Dentro, Kara and Drazba, Katy and Harrington, Deirdre and Johnson, William and Milauskas, Dione and Tohme, Allison and Rodarte, Ruben and Amoroso, Bobby and Luopa, John and Neiberg, Rebecca and Rushing, Scott and Olds, Timothy and Lewis, Lucy and Ferrar, Katia and Georgiadis, Effie and Stanley, Rebecca and Matsudo, Victor Keihan Rodrigues and Matsudo, Sandra and Araujo, Timoteo and De Oliveira, Luis Carlos and Rezende, Leandro and Fabiano, Luis and Bezerra, Diogo and Ferrari, Gerson and Bélanger, Priscilla and Borghese, Mike and Wang, Yue (2019) Relationships between outdoor time, physical activity, sedentary time, and body mass index in children : a 12-country study. Pediatric Exercise Science, 31 (1). pp. 118-129. ISSN 1543-2920 (https://doi.org/10.1123/pes.2018-0055)

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Abstract

Purpose: This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. Methods: In total, 6478 children (54.4% girls) aged 9-11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. Results: Each additional hour per day spent outdoors was associated with higher moderate-to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: -6.3 min/d; girls: -5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. Conclusions: Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low-and middle-income countries.

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