Longitudinal predictors of preschool and adolescent physical activity and sedentary behavior in Ghanaian youth: findings from the iLiNS-DYAD Ghana study cohort

Background Early life factors including nutrition, motor development, and the home environment may influence life-long physical activity (PA) patterns. We examined which biological and socio-environmental factors from gestation to adolescence were associated with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) at preschool (4–6 y) and adolescence (11–13 y), in a cohort of Ghanaian children. Methods This observational cohort analysis included participants from the International Lipid-Based Nutrient Supplements (iLINS)-DYAD Ghana trial, which enrolled 1320 pregnant women. Data were available for 1228 infants at birth. Subsequent assessments occurred at 6mo, 12mo, 18mo, 4–6 y, 9–11 y, and 11–13 y. Accelerometers (Actigraph wGT3X-BT; right hip) (4–6 y) and non-dominant wrist (11–13 y) measured MVPA and SB at 4–6 y and 11–13 y for 353 and 305 randomly selected children, respectively. Bivariate and multivariable regression models examined biological (child sex, age, anthropometrics, motor and pubertal development) and socio-environmental (maternal age, maternal depression symptoms, food security, household assets, and home environment) predictors of PA and SB. Results Thirty-seven key predictors at different ages, associated at p < 0.1 in bivariate analyses, were included in multivariable models. At preschool age, male sex (β = 1.7, 95% CI 1.2, 2.3) and child age (β = 0.6/year, 95% CI 0.02, 1.1) were positively associated with higher MVPA; higher motor scores at 18 mo were associated with lower SB (β=-1.3/SD, 95% CI -2.5, -0.1), while a more stimulating home environment at 18 mo (β = 0.6, 95% CI 0.00, 0.1) was associated with higher SB. In adolescence, male sex (β = 1.0, 95% CI 0.4, 1.7) was associated with higher MVPA, while higher maternal age (β = 0.5/year, 95% CI 0.1, 0.4), maternal depression scores at 11–13 y (β = 0.1, 95% CI 0.01, 0.2), a more stimulating home environment at 9–11 y (β = 0.2/SD, 95% CI 0.03, 0.3), and more advanced pubertal development (β = 0.8/SD, 95% CI 0.01, 1.5) were associated with higher SB. Conclusions Early life factors such as child sex and motor development may shape PA while maternal characteristics and home environments are related to SB patterns. Interventions emphasizing parental support, early motor development and gender-sensitive programs to increase PA among girls may help promote PA among Ghanaian children. Trial registration This trial was registered at clinicaltrials.gov as NCT00970866 ( https://clinicaltrials.gov/ct2/show/record/NCT00970866 ).