ABSTRACTPurposeTo examine the associations between participation frequency in Physical Education (PE) classes and objective measures of physical activity (PA) and sedentary behavior (SB) in children from 12 countries at different levels of development.MethodsThis multinational, cross-sectional study included 5,874 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom and the United States. PA and SB were monitored over 7 consecutive days using a waist-worn accelerometer. PA and SB data were presented for weekdays (times in- and out-of-school) and weekend days. Participation frequency in PE classes was determined by questionnaire. Multilevel modeling analyses stratified by sex were used.ResultsOverall, 24.8% of children self-reported participation in PE classes ≥ 3 times/week (25.3% in high-income countries [HIC], and 24.3% in low- and middle-income countries [LMIC]). After adjusting for age, sex, parental education and body mass index z-score, results showed that children from LMIC who took PE classes 1-2 times/week were more likely to present better indicators of PA and shorter time in SB in- and out-of-school. In HIC, boys that participated in PE classes were more likely to meet the moderate-to-vigorous PA (MVPA) recommendations and to present better indicators of PA (in school) and shorter time in SB in- and out-of-school. For girls in HIC, attending PE classes increased the likelihood of spending more time in MVPA, especially if they attended ≥ 3 times/week.ConclusionAttending PE classes is associated with a higher level of PA and lower level of SB in- and out-of-school during weekdays in children from countries at various levels of development. Purpose To examine the associations between participation frequency in Physical Education (PE) classes and objective measures of physical activity (PA) and sedentary behavior (SB) in children from 12 countries at different levels of development. Methods This multinational, cross-sectional study included 5,874 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom and the United States. PA and SB were monitored over 7 consecutive days using a waist-worn accelerometer. PA and SB data were presented for weekdays (times in- and out-of-school) and weekend days. Participation frequency in PE classes was determined by questionnaire. Multilevel modeling analyses stratified by sex were used. Results Overall, 24.8% of children self-reported participation in PE classes ≥ 3 times/week (25.3% in high-income countries [HIC], and 24.3% in low- and middle-income countries [LMIC]). After adjusting for age, sex, parental education and body mass index z-score, results showed that children from LMIC who took PE classes 1-2 times/week were more likely to present better indicators of PA and shorter time in SB in- and out-of-school. In HIC, boys that participated in PE classes were more likely to meet the moderate-to-vigorous PA (MVPA) recommendations and to present better indicators of PA (in school) and shorter time in SB in- and out-of-school. For girls in HIC, attending PE classes increased the likelihood of spending more time in MVPA, especially if they attended ≥ 3 times/week. Conclusion Attending PE classes is associated with a higher level of PA and lower level of SB in- and out-of-school during weekdays in children from countries at various levels of development. *Corresponding Author: Mark S. Tremblay, Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada, K1H 8L1. Phone: +1 613 737 7600 ext. 4114. Fax: +1 613 738 4800. E-mail: mtremblay@cheo.on.ca The International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE) was funded by The Coca-Cola Company. GH was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R01DK100790. The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the manuscript. The authors declare no conflicts of interest.The results of the present study do not constitute endorsement by the American College of Sports Medicine. The authors declare that the results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Accepted for Publication: 8 December 2017 © 2017 American College of Sports Medicine
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