The LOOK study has four main phases:
The Primary School Phase (2005 - 2009)
The Adolescent Phase (2009 - 2016)
The Young Adult Phase (2022 - 2040)
The Middle and Old Age Phase (2040 - )
Our cohort is 850 boys and girls who we studied longitudinally from ages 8 through to 16 years, and who we will study into later life.
The aim of the Primary School phase was to investigate relationships between physical activity and physical education on physiological and psychological health and development in young children. We also investigated the influence of primary school physical education on academic achievement and the role of the family and environment in creating opportunities for physical activity.
Many contributions to the medical science literature have been made in areas of psychology, pathology, bone health, cardiovascular and metabolic health, nutrition, obesity control, and motor learning.
Several methodological contributions have been made, especially in areas of measurement of body composition and weight status. Although measurements for the Primary and Adolescent phase have been completed there is still ongoing work examining these research questions. Indeed these measures will form the basis for investigations of the effect of early lifestyle on physical and psychological well-being in adulthood.
The immediate focus of LOOK work is to investigate the effect of lifestyle during childhood and adolescence on the health and wellbeing of the now young Australian adults
Accurately measuring physical activity is a challenging task, particularly in a large group of people. To assist in our estimation of physical activity, partcipants wear an accelerometer (no GPS) for a period of 7 days. Questionnaires are also used to gain information such as sports club participation and screen time.
The results of any fitness test have to be carefully administered and interpreted in children and adolescence whose fitness test performances are more likely to be influenced by external factors, including their peers. The 20 m shuttle run is used to estimate the aerobic fitness of the children, well established as a field test and used with children in many studies. Single effort lower body power is measured by a vertical jump, and trunk (core) strength is measured using the duration the child can hold a self-supported prone position, in preference to the commonly used “sit-up” test.
We are investigating the influence of psychological factors on children’s engagement in a structured movement education program and the interactive effect of both psychological factors and engagement in structured physical activities on the overall development of health facilitative or health risk behaviors and attitudes. Various questionnaire instruments are involved in the assessment.
Endothelial dysfunction is an early event that predisposes individuals to formation of atherogenic plaques and increased stiffness of the carotid artery, and has already been found in children. Two sets of measures are used to characterize the vascular structure and function of the children using cardiac and carotid echo measures, as well as pulse wave analysis measures.
Total body and regional areal bone mineral density is measured using dual energy x-ray absorptiometry. Bone geometry and volumetric BMD was assessed at the tibia and radius using peripheral quantitative computed tomography (pQCT),
Movement and Coordination
Motor control was assessed during the Primary school phase of the LOOK study. Balance control was determined by children holding five different postures on a large rocker board, of similar shape and size to a surf board. The amount of board deviation is detected by a fine wire sensor and is stored in a laptop computer. Children who have poor balance skills show a higher level of deviation on the board. Fine motor control was assessed using the nut and bolt test. Handedness and eye dominance are also noted during this procedure. Hand-eye coordination is measured with an indoor throw-catch procedure developed for this study.
A questionnaire for parents has been devised to gather information on child and family medical history, ethnicity, weight and height at birth, We also provide questions relating to parents’ involvement and attitudes toward physical activity, sport and active leisure pursuits for both themselves and children. A series of questions aims to estimate the amount of television and video game involvement, the family meal patterns, beverage consumption and sleep patterns of the child.
Nutritional intake is examined using 24-hour recall surveys and dietary record and administered by qualified nutritionists. Values of energy, macronutrients and micronutrients are measured.
Early research findings
In brief, strong evidence has emerged of a negative impact on the health and well-being of children of the 21st century when they are insufficiently physically active. To this end we demonstrated the importance of well-designed physical education in primary schools, unfortunately found wanting in public primary schools, and participation in organised sport.
Some key findings: (extracted from our publications)
Effects of Physical Education:
Reduced the prevalence of overweight and obesity between grades 3 and 5
Reduced the prevalence of “at-risk” levels o LDL cholesterol between grades 2 and 6
Reduced the prevalence of insulin resistance (a risk factor of Type II diabetes) between grades 2 and 6
Improved scores in national numeracy and literacy (NAPLAN tests) between grades 3 and 5
Effects and Relationships of Physical Activity and obesity
Physical inactivity and overweight/obesity during childhood and adolescence increased prevalence of risk factors for Type II diabetes
Physical inactivity and overweight/obesity during childhood and adolescence increased prevalence of risk factors for cardiovascular disease
Physical inactivity and overweight/obesity during childhood and adolescence impedes optimal development of bone health, especially in girls.
In general, the main driver of overweight and obesity during childhood and adolescence is physical inactivity; intake of dietary kilojoule intake, sugar and fat intake was not related to overweight and obesity. Fatter children did not consume more kilojoules, sugar or fat; the difference was that they were less physically active and more sedentary.
Body Mass Index is a misleading proxy for percent body fat in longitudinal studies of children and adolescents. In some age groups, increased BMI can actually coincide with decreased percentage of body fat.
Children who develop good eye hand coordination measured by ball handling skill are more likely to be physically active, participate in sport and to have a leaner body composition.
The higher the average fitness level of children in a particular school, the higher their average academic achievement (NAPLAN national assessments) of that school.
Extensive studies have also been carried out investigating the relationships between stress and depressive symptoms and early life cardiovascular function in our LOOK children and adolescents, these studies providing the basis for areas to be pursued in our adult phase.