Age- and sex-specific reference percentile curves for accelerometry-measured physical activity in healthy European children and adolescents

Mark-Jan Ploegstra^{1

2}, Annika Swenne³, Christoph Buck³, Luis A Moreno^{4

5}, Lauren Lissner⁶, Fabio Lauria⁷, Stefaan de Henauw⁸, Dénes Molnár⁹, Michael Tornaritis¹⁰, Kenn Konstabel^{11

12}, Mark Rayson¹³, Yannis Pitsiladis¹⁴, Yannis Manios^{15

16}, Laurent Béghin¹⁷, Kurt Widhalm¹⁸, Angela Polito¹⁹, Kathrin Sinningen²⁰, Anthony Kafatos²¹, Sonia Gomez-Martinez²², Marcela González-Gross^{5

23}, José Antonio Casajús^{4

5}, Artur Mazur²⁴, Francisco B Ortega^{25

26}, Wolfgang Ahrens³, Rolf M F Berger²⁷, Timm Intemann³

Affiliations

¹ Department of Pediatrics, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands. m.ploegstra@umcg.nl.
² Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.ploegstra@umcg.nl.
³ Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
⁴ Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Saragossa, Spain.
⁵ Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
⁶ School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
⁷ Institute of Food Sciences, National Research Council, Avellino, Italy.
⁸ Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium.
⁹ Department of Pediatrics, Medical School, and , National Laboratory On Human Reproduction, University of Pécs, RRF-2.3.1-21, 2022-00012, Pécs, Hungary.
¹⁰ Research and Education Institute of Child Health, Strovolos, Cyprus.
¹¹ National Institute for Health Development, Tallinn, Estonia.
¹² Department of Psychology, University of Tartu, Tartu, Estonia.
¹³ Mark Rayson Consulting Ltd, Bristol, UK.
¹⁴ Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
¹⁵ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
¹⁶ Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410, Heraklion, Greece.
¹⁷ Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, and CIC, 1403-Clinical Investigation Center, 59000, Lille, France.
¹⁸ Academic Institute for Clinical Nutrition, Medical University of Vienna, Vienna, Austria.
¹⁹ Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, Rome, Italy.
²⁰ Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
²¹ University of Crete, Heraklion, Greece.
²² Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain.
²³ ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain.
²⁴ Institute of Medical Sciences, Medical College, Rzeszów University, Rzeszow, Poland.
²⁵ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, CIBEROBN Physiopathology of Obesity and Nutrition, Granada, Spain.
²⁶ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
²⁷ Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 39636324
DOI: 10.1007/s00431-024-05902-y

Multicenter Study

Age- and sex-specific reference percentile curves for accelerometry-measured physical activity in healthy European children and adolescents

Mark-Jan Ploegstra et al. Eur J Pediatr. 2024.

. 2024 Dec 5;184(1):65.

doi: 10.1007/s00431-024-05902-y.

Authors

Affiliations

¹ Department of Pediatrics, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands. m.ploegstra@umcg.nl.
² Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.ploegstra@umcg.nl.
³ Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
⁴ Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Saragossa, Spain.
⁵ Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
⁶ School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
⁷ Institute of Food Sciences, National Research Council, Avellino, Italy.
⁸ Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium.
⁹ Department of Pediatrics, Medical School, and , National Laboratory On Human Reproduction, University of Pécs, RRF-2.3.1-21, 2022-00012, Pécs, Hungary.
¹⁰ Research and Education Institute of Child Health, Strovolos, Cyprus.
¹¹ National Institute for Health Development, Tallinn, Estonia.
¹² Department of Psychology, University of Tartu, Tartu, Estonia.
¹³ Mark Rayson Consulting Ltd, Bristol, UK.
¹⁴ Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
¹⁵ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
¹⁶ Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410, Heraklion, Greece.
¹⁷ Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, and CIC, 1403-Clinical Investigation Center, 59000, Lille, France.
¹⁸ Academic Institute for Clinical Nutrition, Medical University of Vienna, Vienna, Austria.
¹⁹ Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, Rome, Italy.
²⁰ Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
²¹ University of Crete, Heraklion, Greece.
²² Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain.
²³ ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain.
²⁴ Institute of Medical Sciences, Medical College, Rzeszów University, Rzeszow, Poland.
²⁵ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, CIBEROBN Physiopathology of Obesity and Nutrition, Granada, Spain.
²⁶ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
²⁷ Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 39636324
DOI: 10.1007/s00431-024-05902-y

Abstract

Physical activity measured by accelerometry (PA-accelerometry) is used as an indicator of physical capacity in chronic diseases. Currently, only fragmented age ranges of reference percentile curves are available for European children and adolescents. This study aimed to provide age- and sex-specific percentiles for physical activity measured by hip-worn accelerometry derived throughout the full age range of European children and adolescents. Individual-level population-based PA data measured by accelerometry from HELENA and IDEFICS/I.Family studies were pooled and harmonized. Together these studies involved children and adolescents aged 2-18 years from 12 European countries. Primary outcomes included averaged counts per minute (CPM), sedentary time (SED), light PA (LPA) and moderate-to-vigorous PA (MVPA). Generalized Additive Models for Location, Scale and Shape were used to derive age- and sex-specific reference percentile curves for these outcomes. The combined cohort consisted of 11,645 children and adolescents aged 2 to 18 years who contributed 14,610 valid accelerometry recordings, with a median accelerometer wear time of 6 days. This dataset allowed for the construction of age- and sex-specific reference percentile curves for CPM, SED, LPA, and MVPA. The curves demonstrated varying trends and variability across age groups.

Conclusions: This study provides age- and sex-specific percentile curves for PA-accelerometry in European children and adolescents, addressing a current gap in the availability of full-age range reference data. These curves based on healthy children and adolescents can be used by clinicians, researchers, and policymakers to interpret PA-accelerometry measurements, track physical activity trends, and evaluate treatment responses and health interventions.

What is known: • Daily physical activity (PA) is considered an important measure in various paediatric conditions. Existing reference data for PA in European children based on hip-worn accelerometers are limited to specific age ranges, and comprehensive data covering the full age range are lacking.

What is new: • The study provides age- and sex-specific reference curves for PA derived by hip-worn accelerometers in European children and adolescents. These curves aid clinicians, researchers, and policymakers in interpreting PA measurements and tracking trends over time in European children.

Keywords: Accelerometer; Adolescents; Children; Percentile curves; Physical activity.

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Conflict of interest statement

Declarations. Ethics approval: All contributing studies have been approved by the appropriate ethics committees and have been performed in accordance with the ethical standards of the Declaration of Helsinki. The names of the approval committees/institutional review boards of HELENA were as follows: (1) Austria: Ethics Committee of the Medicine's University from Vienne; (2) Belgium: Ethics Committee of the Gent University Hospital; (3) France: Protection committees people from Lille; (4) Germany: Ethics Committee of the Medicine's University from Dortmund; (5) Greece: Ethics Committees of the Harokopio University from Athens and University of Crete School of Medicine from Heraklion; (6) Hungary: A Pecsi Orvostudomanyi és Egészségtudomanyi Központ Regionalis Kutatas-Etikai Bizottsaga from Pècs; (7) Italy: Ethics Committee of Medical Activities of the University of Naples Federico II; (8) Spain: Ethics Committee for Clinical Research of Aragon; (9) Sweden: Regional Ethics Committee from Stockholm. The names of the approval committees/institutional review boards of IDEFICS/I.Family were as follows: (1) Belgium: Ethics Committee of the Gent University Hospital; (2) Cyprus: Cyprus National Bioethics Committee; (3) Estonia: Tallinn Medical Research Ethics Committee; (4) Germany: Ethic Commission of the University of Bremen; (5) Hungary: Medical Research Council; (6) Italy: Ethics Committee of the Local Health Authority in Avellino; (7) Poland: Bioethical Committee of the University of Rzeszów; (8) Spain: Ethics Committee for Clinical Research of Aragon; (9) Sweden: Regional Ethics Research Board in Gothenburg. Consent to participate: All participants and/or their legal guardians have given informed consent prior to inclusion in the contributing studies. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

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Age- and sex-specific reference percentile curves for accelerometry-measured physical activity in healthy European children and adolescents

Affiliations

Age- and sex-specific reference percentile curves for accelerometry-measured physical activity in healthy European children and adolescents

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous