Physical activity, screen time and obesity status in a nationally representative sample of Maltese youth with international comparisons

Background: There is some evidence that physical activity (PA), sedentary time and screen time (ST) are associated with childhood obesity, but research is inconclusive and studies are mainly based on self-reported data. The literature is dominated by data from North American countries and there is a shortage of objective data from Malta which has one of the highest prevalences of childhood obesity in the world. The aims of this study were to assess the PA levels and ST patterns of Maltese boys and girls and how they compared with children in other countries while also examining differences in PA and ST by weight status. Methods: A nationally representative sample of 1126 Maltese boys and girls aged 10-11 years, of which 811 provided complete data. Physical activity was assessed using accelerometry, and ST by questionnaire. Body mass index (BMI) was computed from measured height and weight. Results: Only 39% of boys and 10% of girls met the recommendation of one hour of daily MVPA. Comparison with international data indicated that mean MVPA (58.1 min for boys; 41.7 min for girls) was higher than in North America and Australia, but lower than in England. Girls were less active than boys at all measured times and spent less time in ST. A quarter of the children exceeded guidelines of two hours of TV on weekends, and double the amount on weekdays. Obese children were less active than normal weight children on weekdays and on weekends, reaching significance during the period after school, and they spent more time in ST than their normal weight counterparts. Conclusions: A low percentage of Maltese 10-11 year olds, particularly girls, reached the recommended levels of daily MVPA and spent large amounts of time engaged in screen time. Obese children were less active than non-obese children. As children spend most of their waking time at school and that activity during this time is less than one third of the daily requirements, aiming to increase MVPA at school for all Maltese children is likely to be an important strategy to promote MVPA. Targeting less active and obese children is important.