Physical activity profiles of attention-deficit/hyperactivity disorder symptoms among preschool children.

Childhood overweight and obesity are major global public health concerns [, ] caused by a complex interplay of various determinants. Individual determinants encompass a range of biological, behavioural and psychosocial factors, such as genetic predisposition, sleep, stress, diet, physical activity (PA) and knowledge []. Furthermore, there is the structure of and interaction with living environments, including the physical environment, social environment and economic and policy environments [–]. Unhealthy living environments, with a focus in this study on the food and PA environment, are environments which prohibit healthy behaviour owing to the lack of resources and thus encourage unhealthy behaviours []. Unhealthy food environments drive overconsumption of foods high in saturated fats, salt and sugar. Children are especially vulnerable owing to high accessibility and aggressive marketing []. Unhealthy PA environments lack layout and street design that encourage walking and cycling (freely or as means of active transportation to local destinations) and suitable spaces such as parks and sports fields for outdoor activities []. In addition, modern school environments, where children spend most of their time, often stimulate prolonged sedentary behaviour, leading towards decreased physical activity [, ]. These features are collectively described as the obesogenicity of the living environment []. Children from lower socio-economic groups experience a greater exposure to obesogenic environments [, ], as they generally have higher rates of access and exposure to unhealthy foods [, ], resulting in unhealthy dietary behaviour, and are generally exposed to less stimulating PA environments, with fewer quality parks, recreational facilities and walkable streets [, ], resulting in less PA []. With these health inequities in mind, there is a need to effectively target obesogenic living environments.