Variation in population levels of physical activity in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC

Abstract

Background: Regular physical activity is associated with physical, social and mental health benefits, whilst insufficient physical activity is associated with several negative health outcomes (e.g. metabolic problems). Population monitoring of physical activity is important to gain insight into prevalence of compliance to physical activity recommendations, groups at risk and changes in physical activity patterns. This review aims to provide an overview of all existing studies that measure physical activity in youth, in cross-European studies, to describe the variation in population levels of physical activity and to describe and define challenges regarding assessment methods that are used.

Methods: A systematic search was performed on six databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), supplemental forward- and backward tracking was done and authors' and experts' literature databases were searched to identify relevant articles. Journal articles or reports that reported levels of physical activity in the general population of youth from cross-European studies were included. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol of this review is published under registration number CRD42014010684 in the PROSPERO database.

Results: The search resulted in 9756 identified records of which 30 articles were included in the current review. This review revealed large differences between countries in prevalence of compliance to physical activity recommendations (i.e. 60 min of daily moderate- to vigorous-intensity physical activity (MVPA)) measured subjectively (5-47%) and accelerometer measured minutes of MVPA (23-200 min). Overall boys and children were more active than girls and adolescents. Different measurement methods (subjective n = 12, objective n = 18) and reported outcome variables (n = 17) were used in the included articles. Different accelerometer intensity thresholds used to define MVPA resulted in substantial differences in MVPA between studies conducted in the same countries when assessed objectively.

Conclusions: Reported levels of physical activity and prevalence of compliance to physical activity recommendations in youth showed large variation across European countries. This may reflect true variation in physical activity as well as variation in assessment methods and reported outcome variables. Standardization across Europe, of methods to assess physical activity in youth and reported outcome variables is warranted, preferably moving towards a pan-European surveillance system combining objective and self-report methods.

Keywords: Activity level; Assessment method; Childhood; Health behaviour; Prevalence; Youth.

Fig. 1

Flowchart of the combined review process

Fig. 2

Average daily counts per minute in children across countries based on different articles. When data were reported separately for boys and girls [30, 38], the mean was reported. Ekelund et al. [47] reported on pooled data from different studies and cleaned and processed the data together. In the Figure the original study is mentioned in the legend: ENERGY = European energy balance research to prevent excessive weight gain among youth; EYHS = European Youth Heart Study; ICAD = International Children’s Accelerometry Database; CSCIS = Copenhagen School Child Intervention Study; ALSPAC = Avon Longitudinal Study of Parents and Children; PEACH = Personal and Environmental Associations with Children’s Health; SPEEDY = Sport, Physical activity and Eating behaviour, Environmental Determinants in Young People; MAGIC = Movement and Activity Glasgow Intervention in Children; KISS = Kindersportstudie; Verloigne et al. [30] reported counts per 15 s, to harmonize results, this was multiplied by four to obtain counts per minute

Fig. 3

Average daily counts per minute in adolescents across countries based on different articles. When data were reported separately for boys and girls [37, 38], the mean was reported. Ekelund et al. [47] reported on pooled data from different studies and cleaned and processed the data together. In the Figure the original study is mentioned in the legend: EYHS = European Youth Heart Study; ICAD = International Children’s Accelerometry Database; ALSPAC = Avon Longitudinal Study of Parents and Children; PEACH = Personal and Environmental Associations with Children’s Health; KISS = Kindersportstudie

Fig. 4

Minutes per day of accelerometer based MVPA in children across countries based on different articles. When data were reported separately for boys and girls [30, 38] or week and weekend day [36], the mean was reported. Ekelund et al. [47] reported on pooled data from different studies and cleaned and processed the data together. In the Figure the original study is mentioned in the legend. ENERGY = European energy balance research to prevent excessive weight gain among youth, EYHS = European Youth Heart Study; ICAD = International Children’s Accelerometry Database; CSCIS = Copenhagen School Child Intervention Study; ALSPAC = Avon Longitudinal Study of Parents and Children; PEACH = Personal and Environmental Associations with Children’s Health, SPEEDY = Sport, Physical activity and Eating behaviour, Environmental Determinants in Young People, KISS = Kindersportstudie; ISCOLE = The international study of childhood obesity, lifestyle and the environment

Fig. 5

Minutes per day of accelerometer based MVPA in adolescents across countries based on different articles. When data were reported separately for boys and girls [37, 38] or week and weekend day [36], the mean was reported. Ekelund et al. [47] reported on pooled data from different studies and cleaned and processed the data together. In the Figure the original study is mentioned in the legend. EYHS = European Youth Heart Study; ICAD = International Children’s Accelerometry Database; ALSPAC = Avon Longitudinal Study of Parents and Children; PEACH = Personal and Environmental Associations with Children’s Health

Fig. 6

Questionnaire based percentage of boys and girls engaging in MVPA for ≥ 60 min daily in 8 countries across Europe. ENERGY = European energy balance research to prevent excessive weight gain among youth; HBSC = health behaviour in school-aged children