Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.


Collaborators: Anderssen S


Collaborators: Anderssen S, Cardon G, Davey R, Hallal P, Janz KF, Kriemler S, Møller N, Northstone K, Page A, Pate R, Puder JJ, Reilly J, Salmon J, Sardinha LB, van Sluijs EMF.
Author information:
(1)Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, 4364 Scorpius Street, Orlando, FL, 32816, USA. [Email]
(2)Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
(3)Department of Health & Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA.
(4)Department of Psychology, Loyola University Chicago, College of Arts and Sciences, Chicago, IL, USA.
(5)Alliance for Research in Exercise, Nutrition and Activity
(ARENA), University of South Australia, Adelaide, Australia.
(6)Department of Physical Education, Federal Rural University of Pernambuco, Recife, PE, Brazil.
(7)Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, 4364 Scorpius Street, Orlando, FL, 32816, USA.
(8)Department of Teacher Education and Sport, Western Norwegian University of Applied Sciences, Sogndal, Norway.
(9)Health Research Institute, University of Canberra, Canberra, Australia.
(10)Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
(11)Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK.
(12)Norwegian School of Sport Sciences, Oslo, Norway.
(13)Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.
(14)University of Southern Denmark, Odense, Denmark.
(15)Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.
(16)Service of Obstetrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
(17)Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, ZDeakin University, Geelong, Australia.
(18)Exercise and Health Laboratory, CIPER, Faculty of Human Movement, Universidade de Lisboa, Lisbon, Portugal.
(19)MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK.


PURPOSE: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. METHODS: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. RESULTS/FINDINGS: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. CONCLUSIONS: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.