Health behaviors, such as physical activity (PA), are important to the development and health outcomes of children, including those with chronic illnesses. Due to concerns related to growth and bone health, PA may be especially important in Pediatric Inflammatory Bowel Disease (Pedi IBD). Previous research examining PA and related factors (i.e., muscle mass) has demonstrated the potential for PA to have a positive impact on IBD health outcomes. However, studies have been limited and results have been inconsistent. It is important to examine PA and other health behaviors in Pedi IBD in order to maximize health promotion and IBD health outcomes. Objective: To examine PA rates and the relationship between PA and health outcomes in Pedi IBD.
Children diagnosed with IBD (8.0 to 17.5 years old) were recruited as part of a larger study examining biomedical, behavioral, and adherence factors associated with Pedi IBD health outcomes. All participants were also enrolled in the Pediatric IBD Collaborative Research Group Registry and biomedical data were derived from the registry data. Participants who had completed physical activity questionnaires (N = 51) were included in the analyses. PA questionnaire items were adapted from the Youth Risk Behavior Survey (YRBS) from the Center for Disease Control and Prevention and the International Physical Activity Questionnaire-short form (IPAQ-SF). Overall PA rates were calculated into days per week. Health outcomes were measured by physician global assessment (PGA), height z-scores, and erythrocyte sedimentation rate (ESR). Chi-square goodnessof-fit tests were conducted to examine PA rates compared to state-based proportions from the YRBS. Correlations were conducted to evaluate the relationship between PA and biomedical factors.
Average age was 15 years old and 63% were male. Sixty-nine% had Crohn's disease. Average PA rate was 3 days/week. Reported PA rates were not significantly different than state-based YRBS proportions (Table 1). Anthropometric and disease activity characteristics are presented in Table 2. A significant positive correlation was found between PGA and PA days/week (r(47) = .35, P = .02). Participation in organized sports was associated with lower ESR (r(30) = −.36, P = .04), even after accounting for PGA (partial r(28) = −.40, P = .03). Greater time engaged in sedentary behaviors (i.e., >3 hours of computer/video game time per day) was associated with higher ESR (r(39) = .32, P = .04). A significant positive association was found between height z-scores and number of PA days/week (r(35) = .38, P = .02).
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Rates of PA in Pedi IBD appear to be comparable to those without IBD. Results from the present study suggest that PA is associated with health outcomes in Pedi IBD, with greater PA rates associated with better health outcomes. Study limitations include cross-sectional design and correlational analyses which limit interpretation of directionality, as well as, moderate sample size, and reliance on self-reported activity rates. Given the potential impact PA may have on IBD health outcomes, including growth and development, it is important for future research to 1) continue to examine the relationship between PA and IBD health outcomes, including long-term trends and outcomes; 2) examine factors that promote healthy PA behaviors in Pedi IBD to develop interventions to maximize health outcomes.
