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Compliance with national guidelines for physical activity in U.S. preschoolers: measurement and interpretation
Michael W Beets1, Daniel Bornstein, Marsha Dowda
1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Room 131, Columbia, SC 29208, USA. beets@mailbox.sc.edu
Insights
Estimating preschoolers' physical activity is challenging due to varied National Association for Sport and Physical Education (NASPE) guidelines and accelerometer cut points. This leads to wide prevalence rate differences, impacting public health policy.
Area of Science:
- Pediatric physical activity research
- Public health policy implications
- Objective measurement techniques
Background:
- National Association for Sport and Physical Education (NASPE) guidelines recommend 120 minutes of daily physical activity for preschoolers.
- Inconsistent interpretations of NASPE guidelines and varying accelerometer cut points lead to significant discrepancies in reported physical activity prevalence rates.
- Objective monitoring using accelerometry is standard, but different analytical approaches yield diverse outcomes.
Purpose of the Study:
- To estimate the prevalence of preschoolers meeting NASPE physical activity guidelines.
- To highlight the variability in prevalence estimates based on different guideline interpretations and accelerometer cut points.
- To inform future standardization efforts in measuring preschooler physical activity.
Main Methods:
- Utilized ActiGraph accelerometers to monitor physical activity in 3- to 5-year-old children (n=397) for an average of 5.9 days.
- Applied three interpretations of NASPE guidelines: 120 minutes of light-to-vigorous physical activity (LVPA), 120 minutes of moderate-to-vigorous physical activity (MVPA), and 60 minutes of MVPA daily.
- Calculated prevalence estimates using four distinct accelerometer cut points: Pate, Reilly and Puyau, Sirard, and Freedson.
Main Results:
- Prevalence estimates for 120 minutes of daily LVPA ranged widely from 13.5% to 99.5%.
- Estimates for 120 minutes of daily MVPA varied dramatically, from 0.0% to 95.7%.
- Prevalence for 60 minutes of daily MVPA showed a broad range of 0.5% to 99.5%.
Conclusions:
- Discrepancies in NASPE guideline interpretations and accelerometer cut points create substantial variation in estimating preschooler physical activity levels.
- This variability hinders accurate population prevalence assessments, limiting their utility for guiding public health policy.
- Standardization of physical activity measurement and clearer guideline definitions are crucial for future research and policy development.
Objective:
The National Association for Sport and Physical Education (NASPE) guidelines for preschoolers recommend 120 minutes of physical activity daily. Two issues, however, create a situation whereby substantial variation in estimated prevalence rates of (in)active preschoolers are reported. First, NASPE guidelines have been interpreted in multiple ways. Second, objective monitoring via accelerometry is the most widely accepted measure of preschoolers' physical activity, yet multiple cut points provide vastly different estimates of physical activity. This study aimed to estimate the prevalence of preschoolers meeting NASPE guidelines and illustrate the differences among rates, given guideline interpretations, and cut points.
Patients And Methods:
Three- to 5-year-old children (n = 397) wore ActiGraph accelerometers for an average of 5.9 days. NASPE guidelines were expressed in 3 ways: 120 minutes daily of light-to-vigorous physical activity; 120 minutes daily of moderate-to-vigorous physical activity; and 60 minutes daily of moderate-to-vigorous physical activity. Estimates of 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity were calculated on the basis of 4 common accelerometer cut points for preschoolers: Pate, Reilly and Puyau, Sirard, and Freedson.
Results:
Prevalence rates varied considerably, with estimates ranging from 13.5% to 99.5%, 0.0% to 95.7%, and 0.5% to 99.5% for 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity, respectively.
Conclusions:
The variation in NASPE guidelines, coupled with different accelerometer cut points, results in disparate estimates of (in)active preschoolers. This limits the ability to estimate population prevalence levels of physical activity that can be used to guide public health policy. Development of new guidelines should focus on an explicit delineation of physical activity and attempt to standardize the measurement of preschoolers' physical activity.
