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Rev Bras Cineantropom Hum
DOI: http://dx.doi.org/10.5007/1980-0037.2018v20n4p532
review article
Physical activity of parents and of their
children: a systematic review of Brazilian
sample studies – Report Card Brazil
Atividade física de pais e filhos: uma revisão sistemática
de estudos com amostras brasileiras – Report Card
Brazil
William R. Tebar1
Crystian B.S. Oliveira2
Fernanda C.S. Gil2
Bruna T.C. Saraiva1
Vinicius Y.B. Suetake1
Catarina C. Scarabottolo1
Leandro D. Delfino2
Romulo A. Fernandes1,2
Diego G.D. Christofaro1,2
Abstract – The aim of this study was systematically review the researches in regard the
association of PA of parents and the PA of their children. A literature search was performed
in five databases (Medline, Embase, Cinahl, Lilacs and SciELO) using combined terms
about youth, PA and social support, with restriction to publications with Brazilian sample
and to English and Portuguese language. Thirteen studies were included in this review and
was observed a positive association of parental PA and the PA of their children for the
majority of the studies (n=11). Only two studies did not observed significant association
between PA of parents and their children and, otherwise, it was not observed negative
associations in the review. It was observed different associations according to the gender
of both parents and children. This findings support the importance for the practice of
PA by parents as encouragement for the practice of PA by their children among Brazil-
ians. The strategies to promote the increase in practice of physical activity of children
and adolescents of both genders may consider the social support as an important factor,
especially in relation to the practice of PA of their parents.
Key words: Adolescent; Child; Parents; Physical activity; Social support.
Resumo – O objetivo do presente estudo foi revisar sistematicamente estudos que analisaram
a associação da prática de atividade física de pais e filhos. Foi realizada uma busca sistemática
em cinco bases de dados (Medline, Embase, Cinahl, Lilacs e SciELO), por meio da combinação
de termos sobre crianças e adolescentes, atividade física e suporte social, sendo restrita a estudos
contendo amostras brasileiras e escritos em Inglês e/ou Português. Foram incluídos treze estudos
na presente revisão e foi observada associação positiva da prática de atividade física de pais e
filhos na maioria dos estudos (n=11). Somente dois estudos não observaram associação signifi-
cativa da atividade física de pais e filhos, contudo não foram observadas associações negativas.
Foram observadas diferentes associações de acordo com o gênero tanto dos pais quanto dos filhos.
Estes achados ressaltam a importância da prática de atividade física dos pais como incentivo à
prática de atividade física dos filhos em amostras brasileiras. Estratégias de promoção da prá-
tica de atividade física em crianças e adolescentes de ambos os sexos devem considerar o suporte
social como um fator importante, especialmente a respeito da prática de atividade física dos pais.
Palavras-chave: Adolescente; Apoio social; Atividade física; Criança; Pais.
1 Sao Paulo State University. Post-
-Graduation Program in Movement
Sciences. Presidente Prudente, SP.
Brazil.
2 Sao Paulo State University. Post-
-Graduation Program in Physiothera-
py. Presidente Prudente, SP. Brazil.
Received: April 22, 2017
Accepted: July 10, 2018
Rev Bras Cineantropom Desempenho Hum 2018, 20(4):532-542 533
INTRODUCTION
A worldwide prevalence of 81% of school-aged population did not reach
recommended levels of physical activity in the last decade1. Surveys have
shown a decrease in prevalence of physical activity practice over the years
and according to the increase of age2,3. Moreover, obesity affects 3 times
more people aged 6-19 years during the last three decades and faced with
this alarming condition, the practice of physical activity among children
and adolescents is widely considered to be an important factor in the pre-
vention of these problems in adult life, besides promoting better health
conditions in short-middle term since early ages4.
However, youth is a period characterized by large biological and
psychological developments, which can also result in social, cultural
and educational implications5. In this sense, the social support has been
investigated for decades as a predictor of health outcomes in clinical and
epidemiological approaches6 and consists of indirect support in a verbal
and nonverbal way (e.g., encouragement, information, examples of life
habits and health conditions), besides the direct help, such as transporta-
tion and encouragement from parents, have been consistently associated
with the practice of adolescent’s physical activity7. In addition, children
and adolescents present limitations of autonomy for daily activities that
may compromise physical activity, and it may be attenuated by family
actions, such as spending time together, communicating with each other
and strengthening family ties8.
Although fathers and mothers may encourage the practice of physical
activity of boys and girls in different forms, it was observed that children
were more active if both parents share the responsibility of support their
practice of physical activity9. Social support was associated with adoles-
cents who dedicated more days to physical activity in the week compared
to those who did not receive this incentive10.
In the social support context, the parental practice of physical activ-
ity has been considered as an important determinant for physical activity
of children and adolescents11. However, in a country with continental
dimensions such as Brazil, which has a wide diversity of climate, cultures
and income distribution12, it becomes necessary a systematic approach of
findings involving physical activity of parents and their children, aiming
to guide effective strategies of health promotion in country-wide spectrum.
Therefore, the objective of this study was systemically review the find-
ings of studies investigating the relationship between parents’ and youth’s
physical activity among Brazilians.
METHODOLOGICAL PROCEDURES
Literature searches were performed from February to April 2018, in the
following electronic databases: Medline, Embase, Cinahl, Lilacs and
SciELO. We combined search terms regarding youth (e.g. children and
Physical activity of parents and their children Tebar et al.
534
adolescents), physical activity (e.g. exercise, motor activity, sport practice),
and social support (e.g. encouragement, incentive). Our searches were
restricted to publications in English and Portuguese.
Two independent reviewers performed the titles and abstracts screening of
the records retrieved from the search. Then, two independent reviewers evalu-
ated the full-texts of the potentially eligible articles following the inclusion cri-
teria. In any case of disagreement, a third reviewer would cast the deciding vote.
We included studies investigating the association between parents’and
youth’s physical activity among Brazilians, regardless of the study design.
Therefore, cross-sectional, longitudinal, and clinical trials were included
in this review. In addition, studies were considered eligible if they had
included participants until 18 years in the sample, with their respective
parents, or at least provide information about them, reported by parents
or children’s part. Finally, physical activity assessed by subjective (e.g.
questionnaires and physical activity diary) and objective methods (e.g.
accelerometer, pedometer) were considered eligible.
Two independent authors extracted the following information using
a standardized form: region; sample characteristics (i.e. number of par-
ticipants, sex, age); study design (i.e. cross-sectional, longitudinal study);
physical activity assessment (i.e. objective or subjective methods); and main
results. The results of the included studies were described in narrative form
and displayed in tables.
RESULTS
Our searches retrieved a total of 3,033 articles, which 210 were excluded
as being duplicated and 2788 were excluded after assessment by titles and
abstracts. Then, a total of 35 articles were selected to full-text review, of
which 22 articles were excluded for not meet the review criteria for inclu-
sion. Finally, 13 articles remained selected for been considered eligible in
proposed inclusion criteria. Figure 1 shows the processes of this review.
The publication date of the selected studies ranged from 2008 to
2018. Seven of the included studies were conducted in the South region
of Brazil11,13-18, three studies in the Southeast region19-21 and three studies
in the Northeast region22-24.
Regarding the methodology of the studies, only two studies showed
a longitudinal design13,17 and the others were cross-sectional11,14-16,18-24,
all studies were observational researches. Eleven studies showed a sample
of adolescents at a range of age from 10 to 18 years11,13-16,18,19,21-24 and only
two studies were composed by children with 6 years old and below17,20.
Physical activity was differently measured across the selected studies.
One study measured objectively using accelerometers17 and the remain-
ing included articles measured using self-report questionnaires11,13-16,18-24.
However, it was observed different instruments across the studies and the
most used questionnaire were International Physical Activity Question-
naire – IPAQ15,18,23 and Baecke’s questionnaire11,19. The methodological
Rev Bras Cineantropom Desempenho Hum 2018, 20(4):532-542 535
characteristics of the included studies are summarized in Table 1.
The Table 2 shows the main findings of selected studies. A positive
association between physical activity of parents and their children was
observed by eleven studies. Christofaro et al.11 observed that parents who
practice physical activity during their childhood or adolescence increase
the chance of their children practice physical activity, besides the emotional
and financial incentive. Fernandes et al.19 showed a positive association of
sports practice of parents and their children, with a determinant factor for
the gender. This gender difference was also observed in a study by Ramos
et al.20, where boys were more likely to be physically active if having an
adult at home who practice physical activity. It was also observed that the
sports practice among boys was associated with having physically active
mothers13. Prado et al.14 observed in both genders that the practice of physi-
cal activity was positively associated with the frequent company of family
and friends. Cheng et al.22 showed that physical activity was differently
associated according to gender, being the physical activity of the father
associated with physical activity of their sons and the physical activity of
the mother associated with physical activity of their daughters. Loch et
al.15 observed that the association between physical activity of children and
their parents remained significant in older adolescents regard the age, and
among sons and fathers regard the gender.
Figure 1. Flowchart of the articles selection process.
Physical activity of parents and their children Tebar et al.
536
Raphaelli et al.16 observed that of physical activity of daughters was
positively associated with physical activity of their fathers. It was observed
by Wanderley Júnior et al.23 a smaller prevalence of low physical activity
level among children whose parents reported to practice physical activity.
Lemos et al.21 observed that the association of physical activity of parents
and their children was positively significant if both fathers and mothers
reported to practice physical activity. Mendonça et al.24 observed association
of physical activity in adolescents with different kinds of social support by
their parents, with increase in chance of adolescents be physically active
according to accumulation of sources from parental support, such as joint
participation, encouragement, transportation, watching and comments.
Two studies did not observed significant association between physical
activity of children with physical activity of their parents17,18, although one
of them presented a borderline significance level for positive association18.
Table 1.Methodological characteristics of included studies.
Author Publication
Year City, State Sample Study design PA Assessment
Christofaro et al.11 2018
Londrina,
Parana
1231 adolescents between 14-17
years (716 girls) and 2073 parents
(1202 mothers and 871 fathers).
Cross-sectional Questionnaire
Ramos et al.20 2017 Belo Horizonte,
Minas Gerais
1015 adolescents between 11-17
years (484 girls) and respective
parents at home.
Cross-sectional Questionnaire
Knuth et al.17 2016 Pelotas, Rio
Grande do Sul
2604 children at 4 years of age
(1262 girls) and 2524 mothers Cohort Acelerometer
Mendonça et al.24 2015 João Pessoa,
Paraiba
2859 adolescents between 14-19
years (1653girls) and their parents. Cross-sectional Questionnaire
Loch et al.15 2015 Londrina,
Parana
224 adolescents between 12-18
years (124 girls) and 406 parents
(222 mothers and 184 fathers).
Cross-sectional Questionnaire
Prado et al.14 2014 Curitiba, Parana 1469 adolescents between 14-18
years (869 girls) and questions
about their parents.
Cross-sectional Questionnaire
Cheng et al.22 2013 João Pessoa,
Paraiba
2361 adolescents between 14-19
years (1336 girls) and questions
about their parents.
Cross-sectional Questionnaire
Wanderley Júnior et al.23 2013 Recife, Pernam-
buco
1042 children between 3-5 years
(476 girls) and their parents. Cross-sectional Questionnaire
Fernandes et al.19 2011
Presidente
Prudente, Sao
Paulo
1111 adolescents between 11-17
years (692 girls) and their parents. Cross-sectional Questionnaire
Raphaelli et al.16 2011 Rio Grande do
Sul (área rural)
377 adolescents between 10-18
years (177 girls) and 338 par-
ents(173 mothers and 165 fathers).
Cross-sectional Questionnaire
Lemos et al.21 2010 Rio Claro, Sao
Paulo
467 adolescents between 14-17
years (254 girls) and 660parents
(395 mothers and 265 fathers).
Cross-sectional Questionnaire
Silva et al.13 2009 Pelotas, Rio
Grande do Sul
4350 adolescents with 11 years of
age (2283 girls) and their mothers.
Cohort Questionnaire
Silva et al.18 2008 Pelotas, Rio
Grande do Sul
384 parents who reported to have at
least one children between 6-18 years
and questions about them (total sam-
ple of 972 adults, with 554 women).
Cross-sectional Questionnaire
Note. PA Assessment=Physical activity assessment.
Rev Bras Cineantropom Desempenho Hum 2018, 20(4):532-542 537
DISCUSSION
The practice of physical activity of parents and the physical activity of their
children was positively associated in the majority of the selected studies.
However, it was not found a large amount of evidence among Brazilian
sample studies in literature.
This review found studies with samples from different regions of
the country, but not from all of them. In this sense, it is important to
highlight that Brazil has a wide racial miscegenation and a continental
dimension, with great socioeconomic disparities in an estimated popula-
tion of more than 200 million inhabitants25. Nonetheless, the majority of
Table 2. Main findings of included studies in regard the practice of physical activity of parents and their children.
Author, year Direction of
association Main results
Christofaro
et al.11
Positive Adolescents whose parents were physically active in the past and in currently have six times
more chance to be physically active compared with those who parents were not physically active
(OR=6.67[95%CI=1,94; 22,79]).
Ramos et
al.20
Positive Boys were more likely to be physically active among those who have an adult at home who practice PA
when compared with boys who have no adult at home who practice PA (PR=1,26[95%CI=1,02; 1,55]).
Knuth et
al.17
Null No significant association between PA of children at 4 years of age with PA of their mothers (OR=
-0,48[95%CI= -2,32; 1,36]; p-value=0,61).
Mendonça
et al.24
Positive The cluster of social support by parents (joint participation, encouragement, transportation, watch-
ing and comments) increased the chance of adolescents be physically active when compared to
those with no social support (One type of social support: OR=1,47[95%CI=1,16;1,86]; Two types:
OR=1,92[95%CI=1,47;2,51]; Three or more types: OR=2,54[95%CI=1,96; 3.30]).
Loch et al.15 Positive Positive association between Leisure PA of fathers and Leisure PA of their children (p-value=0,04).
Older adolescents were more likely to be physically active in leisure time if fathers were physically
active (p-value=0,02) and if both father and mother were physically actives (p-value= 0,01), not been
observed in younger adolescents.
Prado et
al.14
Positive Adolescents who reported always practice PA with their family were more likely to be physically active
when compared with those who reported never practice PA with their family in both genders (Boys:
PR=2.88 [95%CI=2,00;4,13]; Girls: PR=3,39 [95%CI=1,49; 7,69]).
Cheng et
al.22
Positive PA of fathers was associated with PA of their sons (β=0,10; p-value <0,001) and PA of mothers was
associated with PA of their daughters (β=0,08; p-value <0,05). In addition, providing social support by
parents was directly associated with PA of adolescents in both genders (Boys: β=0,14; p-value <0,01
and Girls: β=0,17; p-value <0,01).
Wanderley
Júnior et
al.23
Positive The parental participation in PA of their children was inversely associated with low levels of PA
(OR=0,54 [95%CI=0,40; 0,73]). It was not observed significant association between physically active
parents and children with low level of PA (OR=0,84 [95%CI=0,59; 1,19).
Fernandes
et al.19
Positive Adolescents were 60% more likely to practice sports if the mother practice sports (OR=1,6 [95%CI=1,1;
2,2]) and 2,5 times more likely to practice sports if both parents also practice (OR=2,5 [95%CI=1,5;
4,1]). Among girls, this observation was the same (Mothers who practice sports: OR=2,4 [95%CI=1,4;
3,8] and Both parents: OR=2,7 [95%CI=1,3; 5,1]), but in boys was only significant in sports practice by
both parents (OR=2,3 [95%CI=1,0; 5,3]).
Raphaelli et
al.16
Positive PA of daughters was positively associated with have father who were physically active (OR=1,4
[95%CI=1,1; 1,8]. It was not observed significant association among mothers who were physically
actives and the PA of their children.
Lemos et
al.21
Positive The PA level of parents influenced the PA level of their children (Parents who were physically actives
[45%] vs parents who were physically inactive [22%] among physically actives adolescents, p<0,05).
It was not observed significant results if only one of parents was physically active (p>0,05).
Silva et al.13 Positive The practice in individual sports of boys was associated with have mothers who were physically
actives (OR=1,28 [95%CI=1,04; 1,58]). This association was not observed in girls and either in regard
collective sports in both genders.
Silva et al.18 Null It was not observed a significant association between the PA practice of children and the PA level of
parents. Although, the p-value has been borderline in general analysis (p=0,053).
Note. PA=Physical activity; OR=Odds ratio; PR=Prevalence ratio; 95%CI= 95% Confidence Interval
Physical activity of parents and their children Tebar et al.
538
included studies from different regions observed similar results about the
practice of physical activity of parents and their children, where children
and adolescents whose parents practice physical activity are more likely
to also practice. These findings are convergent with observations of other
studies across the world26.
Some studies of this review observed differences between gender in
regard to the association of physical activity of children and the physical
activity of their parents13,15,16,19,20. This observation is similar to findings
involving other adolescent sample, where the physical activity of girls was
more strongly related with the practice of physical activity of the mothers,
and in boys was related with physical activity of their fathers9. One possible
hypothesis is that boys present higher practice of physical activity than girls,
besides the fact that girls are less favored in socioecological aspects, such
as individuality, family and scholar environment for practice of physical
activity28. Another possibility is that males adult present higher practice of
physical activity in leisure time than women29 and this can reflect a more
strongly association of physical activity of children and adolescents with
their fathers than their mothers.
The assessment of physical activity by questionnaire for majority of
the selected studies corresponds to a methodological limitation of the evi-
dences. A previous systematic review observed that self-reported measures
of physical activity can present results below or above from the objective
measurements, that can importantly compromises the confiability of
information30. Therefore, although the evaluation of physical activity by
accelerometry promote slightly consistent results, the questionnaires pro-
vide complementary information such as the domains of physical activity
andthe use of both instruments can provide more complete informations31.
Only two studies observed no significant association between physical
activity of parents and their children in this review17,18. One possible hy-
pothesis is that the study of Silva et al.18 does not have a design performed
specifically to assess this outcome, since it was analyzed the data from 972
participants from 20 to 69 years, of which 384 adults reported to have at
least a children with age between 6 to 18 years (~40% of the sample). The
other study17, that report no significant association, has a sample with
age lower than all the others included studies, with the exception of only
one23. In this sense, there is limited evidence in literature that parental
physicalactivity is a predictor of physical activity of children with 6 years
or less32 and this relation is still dependent on the type of physical activity
and on the age group33 although the participation of parents has been the
preferredcondition reported by children of 3-6 years for the practice of
physical activity34. Another possible hypothesis for the divergent results
between the two studies was the use of different methods of physical activity
assessmentand were conducted in different regions of the country, where
one study from South region used accelerometer and assessed only the
mothers17 and the other study from Northeast region used a questionnaire
for physical activity assessment and evaluated both fathers and mothers23.
Rev Bras Cineantropom Desempenho Hum 2018, 20(4):532-542 539
Only one included study evaluated a sample residing in rural area16.
Previous study observed that the level of physical activity of children and
adolescents from rural areas was significantly lower than those who re-
siding in urban areas35. Raphaelli et al.16 observed significant association
between the practice of physical activity of parents and the physical activ-
ity of their children. These findings are convergent with observed in the
study of Larsen et al.36, that evaluated a sample between 8 and 11 years
from a rural community in Midwest region of United States. One possible
hypothesis is that even the practice of physical activity is lower in rural
areas, the family environment may exert similar influence when analyzed
the parental physical activity.
In accordance to the findings of Mendonça et al.24, Pyper et al.37
showed that besides the parental practice of physical activity, the social
support of parents are predictors significantly related with sufficient levels
of physical activity of their children, such as taking the children to places
where they can be physically actives. Thus, the parents have a fundamental
role in the consolidation of physically active lifestyle in early ages, which
contributes to the increase of chance to become physically active adults
and consequently have a lower incidence of morbidities due to sedentary
lifestyle, such as obesity38. Despite this, it was observed that the level of
physical activity of parents is lower than their nonparents counterparts and
the mothers presented larger inadequate eating habits and higher body
mass index when compared to women with no children39.
An important limitation of this review is the cut point used to identify
sufficient engagement in physical activity, that is widely problematic in the
literature, mainly because the studies that have composed this systematic
review use a large variety of cut points and different domains (e.g., sports
practice, time reported in moderate-to-vigorous physical activity, physi-
cal activity level by quartiles of dimensionless score) for both parents and
children, such as the lack of specific social support definition, limiting
comparisons among them. Otherwise, as practical application, this review
highlight the important role of familiar environment for promote healthy
habits in early ages, with the practice of physical activity by parents as
encouragement of the practice of physical activity by their children.
In this sense, the education of parents contributes to higher probability
of adequate growth of their children, in part for the increase of the pos-
sibility for getting more resources, been highlighted that educate parents
residing in low and middle-income countries it is an investment in health40.
CONCLUSION
The practice of physical activity of parents was associated with physical
activity engagement of their children in the most of studies. Two studies
did not observed significant relationship, but otherwise, no study observed
negative associations. Strategies to encourage the practice of physical ac-
tivity aimed at children and adolescents might to consider the important
Physical activity of parents and their children Tebar et al.
540
role of family environment, with emphasis in practice of physical activity
of parents, that may also differently associated with physical activity of
boys and girls.
COMPLIANCE WITH ETHICAL STANDARDS
Funding
This research did not receive any specific grant from funding agencies in
the public, commercial, or not-for-profit sectors. This study was funded
by the authors.
Conflict of interest statement
The authors have no conflict of interests to declare.
Author Contributions
Conceived and designed the experiments: DGDC, RAF, and CBSO.
Performed the experiments: CBSO, BTCS, and VYBS. Analyzed the
data: BTCS, VYBS, CCS, LDD, FCSG, and WRT. Contributed rea-
gents/materials/analysis tools: CBSO, DGDC, RAF, and WRT. Wrote
the paper: WRT, FCSG, and CBSO.
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CORRESPONDING AUTHOR
Diego Giuliano Destro Christofaro
Roberto Simonsen St., 305.
Postal Code:19060-900, Presidente
Prudente-SP, Brazil.
Email: diegochristofaro@yahoo.
com.br
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