Does a pre-school day with less sitting result in acute health benefits in 4-5 year old children?

This study is Phase III of a proposed five-phase study. This phase will test the differences in energy expenditure between the typical and “Stand more-Sit less” day at childcare using the UOW Whole Room Calorimeter. This information will then be used to examine the feasibility, acceptability, and potential efficacy of a 6-month pilot intervention to promote less total and prolonged sitting in childcare services (Phase IV). This study plans to address the high levels of sitting found among pre-schoolers during their time at child care, which has the potential to substantially improve the health and developmental outcomes of the children. Assuming energy intake remains constant, this increase would be enough to alter energy balance and potentially prevent unhealthy weight gain. This project will also provide important feasibility data for another follow-up study which has the potential to improve musculoskeletal outcomes – an important outcome that has not yet been examined in any age group - and behavioural self-regulation skills, which are better predictors of school readiness than IQ or entry-level literacy or numeracy skills. Details of Visits: Visit 1 – Initial familiarisation with calorimeter room and a discussion with parents and children to start the process of consent. The child will take home an information book which parents will read to them several times to familiarise them both with the study. After given consent height/weight and musculoskeletal assessments and posture analysis will be conducted. Visit 2 – (typical pre-school day-50% of time sitting). Participants will arrive 20 mins prior to entering the calorimeter at 9am after having eaten a standardised breakfast at 7am. Executive function assessments will be conducted prior to entering and immediately upon leaving the calorimeter. A standard morning tea will be consumed around 1.5 hrs after entering the calorimeter and lunch will be provided at the completion of the protocol (after 2.5 hrs in the calorimeter). Participants will then spend 50% of their time in the calorimeter sitting, undertaking tasks that they normally would as part of a typical day at pre-school. After this visit, children will do the muskuloskeletal and executive function tests again. After this visit children will wear a Sensewear and actigraph for 48 hours. Visit 3 – (modified pre-school day-25% of time sitting). This will be identical to Visit 2 except that participants will sit for 50% less time and replace this with 50% more time spent in light-intensity activity (such as standing) based on the modifications suggested by staff in Phase 2 of the preliminary study, and confirmed by the researchers listed in this application as developmentally appropriate. Musculoskeletal and executive function assessments will be conducted prior to entering and immediately upon leaving the calorimeter at both Visits 2 and 3. The child’s parent will be able to view their child in the Calorimeter through a window and communicate with them via intercom if necessary. The child will be constantly supervised and in contact with a trained qualified Childcare educator, and a research student from the University of Wollongong. Before entering the calorimeter on Visits 2 and 3, children will be fitted with an Actigraph and Geneactiv accelerometer on the wrist and hip and an activPal on their leg. Participants will be free to leave the calorimeter at any time. They will be shown how they can open the door by themselves, and all measurements will be in the presence of a research assistant (an early childhood trainer educator who can observe and communicate with the participant at all times via an external window and intercom). Visits 2 and 3 will each last 2.5 hours – the equivalent of half a day in childcare. Each visit is seperated by 1 week. As there is a possibility that participants may compensate for sitting less and engaging in more light-intensity PA by being less active afterwards, we will ask participants to wear an Actigraph and a Sensewear mini arm band for 48 hours after Visit 2 and 3. The Sensewear Mini combines accelerometry with four additional physiological sensors (heat flux sensor, galvanic skin response, skin temperature, and a near-body ambient temperature) and will be used to assess Energy Expenditure over the 48 hour period immediately following Visit 3. To measure if participants compensate for less sitting by increasing their energy intake, we will ask parents of the participants to complete 2 x 24hr dietary recalls over the same 48 hr period. We will use the same instrument as used in the Australian Health Survey 2011-2013. Parents will be asked to list all the food and drink their child has consumed in each of the 24 hour periods, from midnight to midnight on each of the days after their child’s visit to the calorimeter. This will allow the estimation of total intake of food, beverages, food energy, nutrients and non-nutrient food components consumed by their child. Parents will also be asked to fill in a one page log that indicates when the accelerometer was worn or not worn (eg removed for bathing). See Appendix D Activity monitor log ver1 3-09-13 . An information sheet about the accelerometers will be given to the parent. See Appendix C Activity monitor info sheet ver1 3-09-13 . Appendices D and C are available in the 'Attachments' section of ANZCTR registration form.