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Open AccessArticle

Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study

Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
GENUD (Growth, Exercise, Drinking Behaviour and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
Children’s Memorial Health Institute, 04730 Warsaw, Poland
Clinic of Paediatric Endocrinology, Medical University Varna, 9000 Varna, Bulgaria
University of Munich Medical Centre, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany
Department of Nutrition and Dietetics, Harokopio University, 80337 Athens, Greece
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(2), 291;
Received: 10 November 2017 / Revised: 15 January 2018 / Accepted: 23 January 2018 / Published: 7 February 2018
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers’ step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01) and clearly reflected the kindergartens’ daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers. View Full-Text
Keywords: preschool; children; physical activity; patterns; hour-by-hour preschool; children; physical activity; patterns; hour-by-hour
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Van Stappen, V.; Van Dyck, D.; Latomme, J.; De Bourdeaudhuij, I.; Moreno, L.; Socha, P.; Iotova, V.; Koletzko, B.; Manios, Y.; Androutsos, O.; Cardon, G.; De Craemer, M. Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study. Int. J. Environ. Res. Public Health 2018, 15, 291.

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