Abstract

Daily adherence to WHO recommended physical activity guidelines has multiple health benefits in children and adolescents. Limited data from low and middle-income countries are available regarding adherence to WHO physical activity recommendations. This study aims to objectively measure physical activity intensities and explore associations with sociodemographic and anthropometric factors related to nonadherence to the WHO minimum physical activity recommendations. Two cross-sectional studies were conducted between 2014 and 2019 in two distinct populations of Ecuador in terms of poverty and residency (Cuenca: 66% live in urban areas, and 38.2% have unsatisfied basic needs; Quininde, 76.4% live in rural areas and 91% have unsatisfied basic needs). Waist-worn accelerometers were used to measure daily physical activity, standardized questionnaires were used to assess sociodemographic variables (age, sex, ethnicity, and socioeconomic status), and anthropometric (weight, height, waist circumference) measurements were taken. Multivariable regression was used to assess the relationship between sociodemographic and anthropometric factors with physical activity in each study population. The study involved 650 participants in Cuenca, with a mean age of 9.1 years (SD 2.9), and 985 children and adolescents in Quinindé, with a mean age of 8.3 years (SD 0.4). In both settings, boys were more likely than girls (Cuenca: adj. OR 3.09, 95% CI 2.17-4.39; Quinindé adj. OR 5.63, 95% CI 4.03-7.85) to achieve the WHO physical activity guidelines. More affluent participants were much less likely to meet this recommendation than their poorer counterparts in both settings. In Cuenca, a higher waist circumference was inversely associated with meeting WHO daily physical activity recommendation (adj. OR 0.96, 95% CI 0.94-0.98), whereas in Quinindé, adherence to WHO guidelines was more likely in non-Mestizo than Mestizo children (adj. OR 1.45, 95% CI 1.02-2.07). The findings suggest that anthropometric differences and sociodemographic disparities influence the attainment of WHO physical activity recommendations in Ecuadorian children.