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Pediatrics International (2014) 56, 651–653
doi: 10.1111/ped.12436
Brief Report
Physical activity and movement skills proficiency of young Filipino children Catherine M Capio,1 Cindy HP Sit,1,2 Kathlynne F Eguia2 and Bruce Abernethy1,3 Institute of Human Performance, University of Hong Kong, 2Department of Sports Science and Physical Education, Chinese University of Hong Kong, Hong Kong and 3Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
1
Abstract
Recent reports indicate an increasing prevalence of overweight among Filipino children. Considering the known association of physical activity (PA) with obesity, this study reports the findings of an objective monitoring of PA in a sample of Filipino children. The study also explores the relationship of PA with fundamental movement skills (FMS) proficiency. Thirty-two children (6.54 ± 2.45 years old) wore an accelerometer for 7 days of PA monitoring and were assessed on five FMS (throw, catch, kick, run, jump). The children met the World Health Organization’s recommendation of 60 min of PA per day, with more active time being accrued during weekdays than weekends. Children with greater FMS proficiency were found to spend more time in PA than those who were less skillful during weekends. Further research is recommended to examine PA and FMS proficiency associations, exploring the role of social interactions on weekends and weekdays.
Key words children, movement skills, Philippines, physical activity.
The prevalence of childhood overweight and obesity has increased over recent decades. The World Health Organization reports that as of 2010, an estimated 43 million children were overweight or obese, with a worldwide prevalence of 6.7%.1 Trends indicate that this is expected to increase to 9.1% by 2020, which translates to approximately 60 million affected children. Although the prevalence is relatively lower in Asia (4.9%), this translates to approximately 18 million affected children. Moreover, the majority of affected children worldwide – approximately 35 million – are reported to be in developing countries. An increase in obesity prevalence among children in developing Asian countries has been suggested to be related to declining levels of physical activity (PA), as modernization tends to result in decreased engagement in many primary sources of daily PA including household chores and active commuting.2 The Philippines is one such Asian country that appears to be experiencing the shift in PA pattern. Previous studies have reported that although prepubescent Filipino children are physically inactive during school days,2 adolescents are generally active through non-sport/exercise activities.3 The most recently reported national nutrition survey found that 4.3% of children were overweight for their age.4 While this figure is still lower than those reported in most developed countries, a trend toward increasing prevalence of overweight and obesity has been Correspondence: Catherine M Capio, PhD PT, Institute of Human Performance, University of Hong Kong, Pokfulam Road, Hong Kong. Email: [email protected] Received 12 March 2014; revised 25 May 2014; accepted 2 June 2014.
© 2014 Japan Pediatric Society
observed and this could signal an emerging, and much bigger, future public health problem. It is well-established that engaging in 60 min of moderate– vigorous physical activity (MVPA) daily contributes to combating the problem of unhealthy weight gain.5 Unfortunately, it has also been reported that children and adolescents worldwide do not accumulate sufficient amounts of active time. In aiming to facilitate PA in children, relevant correlate factors need to be considered. One such factor is fundamental movement skills (FMS) proficiency, which had been shown to influence PA in children, such that more skillful children tend to be more active.6 Moreover, lower FMS proficiency has also been reported in children who are overweight or obese.7 In the Philippines, given the increasing trend of overweight and obesity in children, studies that would examine PA and relevant correlates such as FMS are warranted. There has been very limited research done in this area among Filipino children, and this is the first study that objectively monitored the PA level of a sample of typically developing children and their FMS proficiency. The aim of this study was to provide preliminary data that could provide objective justification for further research and program development.
Methods Participants consisted of 32 primary school students (17 girls, 15 boys), with a mean age of 6.54 ± 2.45 years and body mass index (BMI) of 16.98 ± 1.88 kg/m2 (Table 1). Participants’ families were reportedly of middle socioeconomic status, above the current national poverty index. Written informed consent was provided by parents, while participants gave verbal assent.
652
CM Capio et al.
Table 1 Participant characteristics Male (n = 15) Age (years) Mean 95%CI BMI (kg/m2) Mean 95%CI
Female (n = 17)
6.78 ± 2.79 5.29–8.26
6.44 ± 2.19 5.27–7.60
17.13 ± 1.76 16.20–18.07
16.82 ± 2.04 15.74–17.91
BMI, body mass index; CI, confidence interval.
All participants wore an accelerometer (Actigraph 7164; MTI, Pensacola, FL, USA) on their hip for 1 week for objective PA monitoring. Each participant completed a minimum monitoring duration of 3 weekdays and 2 weekend days. Days during which the total monitoring time was 18 h were excluded.8 Continuous accelerometer counts of zero for ≥20 min were considered non-wear times. Cut-points recommended by Freedson et al.9 were used to calculate time spent in sedentary, MVPA, and vigorous physical activity (VPA). Percentage of the time spent in each PA category was calculated by dividing the participant’s minutes of activity per day by the total monitoring time.8 Using components of the Test of Gross Motor Development (2nd edition),10 process-oriented assessment of five FMS was completed (object-control: throw, catch, kick; locomotor: run, jump). Two licensed physiotherapists conducted individual testing sessions (10 min per session) during school hours. Posthoc video analyses by the first author were found to have >90% agreement with the testers’ scores. All procedures were approved by the institutional review board of the university.
Results The overall average monitored time of the participants was 11.29 ± 2.04 h. Paired samples t-tests showed significant differences between weekday and weekend observations of PA (all P < 0.05), with the children spending more active time during weekdays than weekends (Table 2). Multivariate analysis of variance (MANOVA) showed that age (F(2,27) = 30.27, P < 0.001, η2 = 0.692) was a significant predictor of aggregate locomotor and object control skills. BMI (F(2,27) = 0.019, P = 0.981, η2 = 0.001) and gender (F(2,27) = 2.537, P = 0.098, η2 = 0.158) were not significant predictors.
Boys tended to score better than girls in FMS components, but the differences were not significant. Similarly, MANOVA also showed that age (F(3,26) = 8.166, P = 0.001, η2 = 0.485) was a significant predictor of PA measures (percentage of time spent in sedentary, light, moderate and vigorous PA). BMI (F(3,26) = 1.783, P = 0.175, η2 = 0.171) and gender (F(3,26) = 1.595, P = 0.215, η2 = 0.155) were not significant predictors. The same results were found for weekend PA measures, where age (F(3,26) = 6.747, P = 0.002, η2 = 0.438) but not BMI (F(3,26) = 2.359, P = 0.095, η2 = 0.214) nor gender (F(3,26) = 0.801, P = 0.505, η2 = 0.085) was a significant predictor. Because age was found to be a significant predictor of the examined variables, partial correlation, accounting for age as a covariate, was performed. The aggregate scores for object control and locomotor skills, and the total score for all five skills had significant positive correlations with the percentage of active time (MVPA+VPA) during weekends (all P < 0.05). Only locomotor skills were found to have a significant association with percentage of active time during weekdays (Table 3). The correlations, although significant, were relatively modest in magnitude and the FMS proficiency scores accounted for >20% of the observed variance in PA.
Discussion This study offers preliminary information on objectively monitored PA of young Filipino children. We build on previous findings that have indicated inadequate PA participation among prepubescent youth, which had shown that children in this developing country may be tracking toward decreasing PA.2 Based on the monitored hours (Table 1), the children spent an average of 92.7 ± 17.03 min in active time (MVPA+VPA) on a weekday and 65.18 ± 19.90 min on a weekend day. Both figures meet the World Health Organization’s recommendation that children and youth should accumulate at least 60 min of daily activity.10 The accrued active time appeared to be different between weekdays and weekend days. Filipino children aged ≥5 years typically spend at least 5 h per day in school on weekdays,3 during which activities may be influenced by school programs. Weekends are potentially less structured with greater variability in activities. The finding that children tend to be less active on days outside of school suggests that there is a need to support PA engagement in less structured environments.
Table 2 Percentage of active time
Average monitored time (h) % time sedentary % time in LPA % time in MVPA % time in VPA Average min in active time (MVPA+VPA)
Overall Mean ± SD 11.29 ± 2.04 56.80 ± 2.45 31.60 ± 2.37 7.90 ± 1.02 3.69 ± 0.85 78.32 ± 17.27
Weekday Mean ± SD 12.41 ± 1.77 55.23 ± 2.16 32.28 ± 2.57 8.51 ± 0.99 3.99 ± 0.96 92.7 ± 17.03
Weekend Mean ± SD 10.18 ± 2.69 58.38 ± 3.52 30.92 ± 3.36 7.30 ± 1.20 3.40 ± 0.88 65.18 ± 19.90
Significance†
0.000** 0.023* 0.000** 0.000** 0.000**
*P < 0.05; **P < 0.01. †Paired samples t-tests to compare the weekday and weekend data. LPA, light physical activity; MVPA, moderate– vigorous physical activity; VPA, vigorous physical activity.
© 2014 Japan Pediatric Society
Physical activity in Filipino children
653
Table 3 FMS and percentage of active time (MVPA+VPA) FMS (maximum score)†
Object control Throwing (8.00) Catching (6.00) Kicking (8.00) Locomotor Jumping (8.00) Running (8.00) Total of five skills
Mean ± SD 95%CI
4.38 ± 2.01 3.65–5.10 3.94 ± 1.63 3.35–4.52 4.94 ± 1.34 4.45–5.42 4.88 ± 1.86 4.20–5.55 5.56 ± 1.52 5.01–6.11
Correlation coefficient (r)‡ MVPA Weekday 0.12 0.13
VPA Weekend 0.37* 0.37*
Total PA
Weekday 32 0.25
Weekend 0.19 0.17
Weekday 0.23 0.20
Weekend 0.38* 0.37*
−0.01
0.15
0.04
0.07
0.02
0.15
0.10
0.21
0.33
0.13
0.22
0.23
0.16 0.18
0.41* 0.44**
0.43* 0.40*
0.23 0.12
0.38* 0.30
0.43* 0.39*
0.07
0.22
0.33
0.31
0.20
0.34
0.16
0.44**
0.42*
0.24
0.32
0.46**
*P < 0.05; **P < 0.01. †FMS scores based on components of the Test of Gross Motor Development (2nd edition).10 ‡Pearson’s product moment correlation coefficient between FMS performance and % time in MVPA, VPA, and total PA (MVPA + VPA) measured using Actigraph model 7164 (MTI, Pensacola, FL, USA). FMS, fundamental movement skills; MVPA, moderate–vigorous physical activity; PA, physical activity; VPA, vigorous physical activity.
It is interesting that FMS proficiency was found to have a stronger association with PA participation during weekends. More skillful children tended to be more active on weekends than those who were less proficient in FMS, accounting for approximately 21% of the variability in PA scores, with other factors also being clearly important. Although this finding is consistent with earlier research that has shown positive associations of FMS with PA participation in children,8 the distinction of the weekend association generates further implications. The significant association between PA and FMS proficiency on weekends may be reflective of children’s spontaneous play patterns that are likely to be influenced by their proficiency in movement skills. In other words, in less structured environments, children who have better movement skills are more likely to be active. Nevertheless, it must also be considered that family dynamics might be a factor influencing children’s PA outside the school environment, and future research should examine this, as well as other potential factors. For instance, this study found that gender was not associated with any of the measured variables. Future research with bigger samples could verify this. More than a decade ago, it was suggested that lifestyle changes in the Philippines, as a consequence of modernization, might lead to PA changes that are associated with higher risks of overweight and obesity.3 Recently, a rising prevalence of overweight among Filipino children has been noted.4 Although the present findings cannot be generalized due to the limited sample size, the study provides a methodological approach that could be implemented in bigger samples. It appears that the children in this sample are sufficiently active, but the marked difference between weekday and weekend PA signals an issue that needs to be addressed by subsequent research. There is a clear need for future research to further explore movement skills of Filipino children and examine family factors and play patterns during weekends.
Acknowledgments The authors wish to thank Jean Guadana, PT for her assistance during data collection and participants from the UP Integrated School.
References 1 de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am. J. Clin. Nutr. 2010; 92: 1257–64. 2 Gonzalez-Suarez CB, Grimmer-Somers K. Physical activity pattern of prepubescent Filipino school children during school days. J. Sch. Health 2009; 79: 304–11. 3 Tudor-Locke C, Ainsworth BE, Adair LS, Popkin BM. Physical activity in Filipino youth: The Cebu Longitudinal Health and Nutrition Survey. Int. J. Obes. Relat. Metab. Disord. 2003; 27: 181–90. 4 Philippine Information Agency. Overweight Children Steadily Increasing: Food and Nutrition Research Institute, Department of Science and Technology. 2012. [Cited 20 February 2013.] Available from URL: http://www.pia.gov.ph/news/index.php?article =1701338514946. 5 World Health Organization. Global Strategy on Diet, Physical Activity and Health. 2013. [Cited 8 April 2013.] Available from URL: http://www.who.int/dietphysicalactivity/factsheet_young _people/en/index.html. 6 Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills in children and adolescents: Review of associated health benefits. Sports Med. 2010; 40: 1019–35. 7 Cliff DP, Okely AD, Magarey AM. Movement skill mastery in a clinical sample of overweight and obese children. Int. J. Pediatr. Obes. 2011; 6: 473–5. 8 Williams HG, Pfeiffer KA, O’Neill JR et al. Motor skill performance and physical activity in preschool children. Obesity (Silver Spring) 2008; 16: 1421–6. 9 Freedson P, Pober D, Janz KF. Calibration of accelerometer output for children. Med. Sci. Sports Exerc. 2005; 37: S523–30. 10 Ulrich D. Test of Gross Motor Development, 2nd edn. Pro-Ed, Texas, TX, 2000.
© 2014 Japan Pediatric Society
Pediatrics International (2014) 56, 651–653
doi: 10.1111/ped.12436
Brief Report
Physical activity and movement skills proficiency of young Filipino children Catherine M Capio,1 Cindy HP Sit,1,2 Kathlynne F Eguia2 and Bruce Abernethy1,3 Institute of Human Performance, University of Hong Kong, 2Department of Sports Science and Physical Education, Chinese University of Hong Kong, Hong Kong and 3Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
1
Abstract
Recent reports indicate an increasing prevalence of overweight among Filipino children. Considering the known association of physical activity (PA) with obesity, this study reports the findings of an objective monitoring of PA in a sample of Filipino children. The study also explores the relationship of PA with fundamental movement skills (FMS) proficiency. Thirty-two children (6.54 ± 2.45 years old) wore an accelerometer for 7 days of PA monitoring and were assessed on five FMS (throw, catch, kick, run, jump). The children met the World Health Organization’s recommendation of 60 min of PA per day, with more active time being accrued during weekdays than weekends. Children with greater FMS proficiency were found to spend more time in PA than those who were less skillful during weekends. Further research is recommended to examine PA and FMS proficiency associations, exploring the role of social interactions on weekends and weekdays.
Key words children, movement skills, Philippines, physical activity.
The prevalence of childhood overweight and obesity has increased over recent decades. The World Health Organization reports that as of 2010, an estimated 43 million children were overweight or obese, with a worldwide prevalence of 6.7%.1 Trends indicate that this is expected to increase to 9.1% by 2020, which translates to approximately 60 million affected children. Although the prevalence is relatively lower in Asia (4.9%), this translates to approximately 18 million affected children. Moreover, the majority of affected children worldwide – approximately 35 million – are reported to be in developing countries. An increase in obesity prevalence among children in developing Asian countries has been suggested to be related to declining levels of physical activity (PA), as modernization tends to result in decreased engagement in many primary sources of daily PA including household chores and active commuting.2 The Philippines is one such Asian country that appears to be experiencing the shift in PA pattern. Previous studies have reported that although prepubescent Filipino children are physically inactive during school days,2 adolescents are generally active through non-sport/exercise activities.3 The most recently reported national nutrition survey found that 4.3% of children were overweight for their age.4 While this figure is still lower than those reported in most developed countries, a trend toward increasing prevalence of overweight and obesity has been Correspondence: Catherine M Capio, PhD PT, Institute of Human Performance, University of Hong Kong, Pokfulam Road, Hong Kong. Email: [email protected] Received 12 March 2014; revised 25 May 2014; accepted 2 June 2014.
© 2014 Japan Pediatric Society
observed and this could signal an emerging, and much bigger, future public health problem. It is well-established that engaging in 60 min of moderate– vigorous physical activity (MVPA) daily contributes to combating the problem of unhealthy weight gain.5 Unfortunately, it has also been reported that children and adolescents worldwide do not accumulate sufficient amounts of active time. In aiming to facilitate PA in children, relevant correlate factors need to be considered. One such factor is fundamental movement skills (FMS) proficiency, which had been shown to influence PA in children, such that more skillful children tend to be more active.6 Moreover, lower FMS proficiency has also been reported in children who are overweight or obese.7 In the Philippines, given the increasing trend of overweight and obesity in children, studies that would examine PA and relevant correlates such as FMS are warranted. There has been very limited research done in this area among Filipino children, and this is the first study that objectively monitored the PA level of a sample of typically developing children and their FMS proficiency. The aim of this study was to provide preliminary data that could provide objective justification for further research and program development.
Methods Participants consisted of 32 primary school students (17 girls, 15 boys), with a mean age of 6.54 ± 2.45 years and body mass index (BMI) of 16.98 ± 1.88 kg/m2 (Table 1). Participants’ families were reportedly of middle socioeconomic status, above the current national poverty index. Written informed consent was provided by parents, while participants gave verbal assent.
652
CM Capio et al.
Table 1 Participant characteristics Male (n = 15) Age (years) Mean 95%CI BMI (kg/m2) Mean 95%CI
Female (n = 17)
6.78 ± 2.79 5.29–8.26
6.44 ± 2.19 5.27–7.60
17.13 ± 1.76 16.20–18.07
16.82 ± 2.04 15.74–17.91
BMI, body mass index; CI, confidence interval.
All participants wore an accelerometer (Actigraph 7164; MTI, Pensacola, FL, USA) on their hip for 1 week for objective PA monitoring. Each participant completed a minimum monitoring duration of 3 weekdays and 2 weekend days. Days during which the total monitoring time was 18 h were excluded.8 Continuous accelerometer counts of zero for ≥20 min were considered non-wear times. Cut-points recommended by Freedson et al.9 were used to calculate time spent in sedentary, MVPA, and vigorous physical activity (VPA). Percentage of the time spent in each PA category was calculated by dividing the participant’s minutes of activity per day by the total monitoring time.8 Using components of the Test of Gross Motor Development (2nd edition),10 process-oriented assessment of five FMS was completed (object-control: throw, catch, kick; locomotor: run, jump). Two licensed physiotherapists conducted individual testing sessions (10 min per session) during school hours. Posthoc video analyses by the first author were found to have >90% agreement with the testers’ scores. All procedures were approved by the institutional review board of the university.
Results The overall average monitored time of the participants was 11.29 ± 2.04 h. Paired samples t-tests showed significant differences between weekday and weekend observations of PA (all P < 0.05), with the children spending more active time during weekdays than weekends (Table 2). Multivariate analysis of variance (MANOVA) showed that age (F(2,27) = 30.27, P < 0.001, η2 = 0.692) was a significant predictor of aggregate locomotor and object control skills. BMI (F(2,27) = 0.019, P = 0.981, η2 = 0.001) and gender (F(2,27) = 2.537, P = 0.098, η2 = 0.158) were not significant predictors.
Boys tended to score better than girls in FMS components, but the differences were not significant. Similarly, MANOVA also showed that age (F(3,26) = 8.166, P = 0.001, η2 = 0.485) was a significant predictor of PA measures (percentage of time spent in sedentary, light, moderate and vigorous PA). BMI (F(3,26) = 1.783, P = 0.175, η2 = 0.171) and gender (F(3,26) = 1.595, P = 0.215, η2 = 0.155) were not significant predictors. The same results were found for weekend PA measures, where age (F(3,26) = 6.747, P = 0.002, η2 = 0.438) but not BMI (F(3,26) = 2.359, P = 0.095, η2 = 0.214) nor gender (F(3,26) = 0.801, P = 0.505, η2 = 0.085) was a significant predictor. Because age was found to be a significant predictor of the examined variables, partial correlation, accounting for age as a covariate, was performed. The aggregate scores for object control and locomotor skills, and the total score for all five skills had significant positive correlations with the percentage of active time (MVPA+VPA) during weekends (all P < 0.05). Only locomotor skills were found to have a significant association with percentage of active time during weekdays (Table 3). The correlations, although significant, were relatively modest in magnitude and the FMS proficiency scores accounted for >20% of the observed variance in PA.
Discussion This study offers preliminary information on objectively monitored PA of young Filipino children. We build on previous findings that have indicated inadequate PA participation among prepubescent youth, which had shown that children in this developing country may be tracking toward decreasing PA.2 Based on the monitored hours (Table 1), the children spent an average of 92.7 ± 17.03 min in active time (MVPA+VPA) on a weekday and 65.18 ± 19.90 min on a weekend day. Both figures meet the World Health Organization’s recommendation that children and youth should accumulate at least 60 min of daily activity.10 The accrued active time appeared to be different between weekdays and weekend days. Filipino children aged ≥5 years typically spend at least 5 h per day in school on weekdays,3 during which activities may be influenced by school programs. Weekends are potentially less structured with greater variability in activities. The finding that children tend to be less active on days outside of school suggests that there is a need to support PA engagement in less structured environments.
Table 2 Percentage of active time
Average monitored time (h) % time sedentary % time in LPA % time in MVPA % time in VPA Average min in active time (MVPA+VPA)
Overall Mean ± SD 11.29 ± 2.04 56.80 ± 2.45 31.60 ± 2.37 7.90 ± 1.02 3.69 ± 0.85 78.32 ± 17.27
Weekday Mean ± SD 12.41 ± 1.77 55.23 ± 2.16 32.28 ± 2.57 8.51 ± 0.99 3.99 ± 0.96 92.7 ± 17.03
Weekend Mean ± SD 10.18 ± 2.69 58.38 ± 3.52 30.92 ± 3.36 7.30 ± 1.20 3.40 ± 0.88 65.18 ± 19.90
Significance†
0.000** 0.023* 0.000** 0.000** 0.000**
*P < 0.05; **P < 0.01. †Paired samples t-tests to compare the weekday and weekend data. LPA, light physical activity; MVPA, moderate– vigorous physical activity; VPA, vigorous physical activity.
© 2014 Japan Pediatric Society
Physical activity in Filipino children
653
Table 3 FMS and percentage of active time (MVPA+VPA) FMS (maximum score)†
Object control Throwing (8.00) Catching (6.00) Kicking (8.00) Locomotor Jumping (8.00) Running (8.00) Total of five skills
Mean ± SD 95%CI
4.38 ± 2.01 3.65–5.10 3.94 ± 1.63 3.35–4.52 4.94 ± 1.34 4.45–5.42 4.88 ± 1.86 4.20–5.55 5.56 ± 1.52 5.01–6.11
Correlation coefficient (r)‡ MVPA Weekday 0.12 0.13
VPA Weekend 0.37* 0.37*
Total PA
Weekday 32 0.25
Weekend 0.19 0.17
Weekday 0.23 0.20
Weekend 0.38* 0.37*
−0.01
0.15
0.04
0.07
0.02
0.15
0.10
0.21
0.33
0.13
0.22
0.23
0.16 0.18
0.41* 0.44**
0.43* 0.40*
0.23 0.12
0.38* 0.30
0.43* 0.39*
0.07
0.22
0.33
0.31
0.20
0.34
0.16
0.44**
0.42*
0.24
0.32
0.46**
*P < 0.05; **P < 0.01. †FMS scores based on components of the Test of Gross Motor Development (2nd edition).10 ‡Pearson’s product moment correlation coefficient between FMS performance and % time in MVPA, VPA, and total PA (MVPA + VPA) measured using Actigraph model 7164 (MTI, Pensacola, FL, USA). FMS, fundamental movement skills; MVPA, moderate–vigorous physical activity; PA, physical activity; VPA, vigorous physical activity.
It is interesting that FMS proficiency was found to have a stronger association with PA participation during weekends. More skillful children tended to be more active on weekends than those who were less proficient in FMS, accounting for approximately 21% of the variability in PA scores, with other factors also being clearly important. Although this finding is consistent with earlier research that has shown positive associations of FMS with PA participation in children,8 the distinction of the weekend association generates further implications. The significant association between PA and FMS proficiency on weekends may be reflective of children’s spontaneous play patterns that are likely to be influenced by their proficiency in movement skills. In other words, in less structured environments, children who have better movement skills are more likely to be active. Nevertheless, it must also be considered that family dynamics might be a factor influencing children’s PA outside the school environment, and future research should examine this, as well as other potential factors. For instance, this study found that gender was not associated with any of the measured variables. Future research with bigger samples could verify this. More than a decade ago, it was suggested that lifestyle changes in the Philippines, as a consequence of modernization, might lead to PA changes that are associated with higher risks of overweight and obesity.3 Recently, a rising prevalence of overweight among Filipino children has been noted.4 Although the present findings cannot be generalized due to the limited sample size, the study provides a methodological approach that could be implemented in bigger samples. It appears that the children in this sample are sufficiently active, but the marked difference between weekday and weekend PA signals an issue that needs to be addressed by subsequent research. There is a clear need for future research to further explore movement skills of Filipino children and examine family factors and play patterns during weekends.
Acknowledgments The authors wish to thank Jean Guadana, PT for her assistance during data collection and participants from the UP Integrated School.
References 1 de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am. J. Clin. Nutr. 2010; 92: 1257–64. 2 Gonzalez-Suarez CB, Grimmer-Somers K. Physical activity pattern of prepubescent Filipino school children during school days. J. Sch. Health 2009; 79: 304–11. 3 Tudor-Locke C, Ainsworth BE, Adair LS, Popkin BM. Physical activity in Filipino youth: The Cebu Longitudinal Health and Nutrition Survey. Int. J. Obes. Relat. Metab. Disord. 2003; 27: 181–90. 4 Philippine Information Agency. Overweight Children Steadily Increasing: Food and Nutrition Research Institute, Department of Science and Technology. 2012. [Cited 20 February 2013.] Available from URL: http://www.pia.gov.ph/news/index.php?article =1701338514946. 5 World Health Organization. Global Strategy on Diet, Physical Activity and Health. 2013. [Cited 8 April 2013.] Available from URL: http://www.who.int/dietphysicalactivity/factsheet_young _people/en/index.html. 6 Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills in children and adolescents: Review of associated health benefits. Sports Med. 2010; 40: 1019–35. 7 Cliff DP, Okely AD, Magarey AM. Movement skill mastery in a clinical sample of overweight and obese children. Int. J. Pediatr. Obes. 2011; 6: 473–5. 8 Williams HG, Pfeiffer KA, O’Neill JR et al. Motor skill performance and physical activity in preschool children. Obesity (Silver Spring) 2008; 16: 1421–6. 9 Freedson P, Pober D, Janz KF. Calibration of accelerometer output for children. Med. Sci. Sports Exerc. 2005; 37: S523–30. 10 Ulrich D. Test of Gross Motor Development, 2nd edn. Pro-Ed, Texas, TX, 2000.
© 2014 Japan Pediatric Society
