Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017

Screen time exposure and academic performance, anxiety, and behavioral problems among school children

BACKGROUND

The growth of the digital landscape has surely outpaced research on the effects of screen media on the health, learning, and development of children. The potential risk-to-benefit ratio of screen media exposure for education and entertainment purposes warrants further exploration. Therefore, we aimed to investigate the relationships between screen time and academic performance, anxiety, and outdoor playing among school children in India.

METHODS

A total of 537 parents responded to this online survey and reported approximately 537 Indian school children (mean age 10.9 years) from five schools. Data was collected using an e-questionnaire which consisted of a socio-demographic domain, recreational activities, self-reported physical measures, academic performance, information related to children's screen time, the Spence Children Anxiety Scale (SCAS), and the Pediatric Symptom Checklist (parent version) instruments. We employed multivariate linear regression models to estimate the association between children's screen time and the predictor variables with 0.05 alpha as level of significance.

RESULTS

The mean screen time was 3.06 ± 1.22 h/day, the average duration of outdoor play per week was 11.23 ± 4.1 h, and the mean body mass index (BMI) was 18.2 ± 3.2. Screen time (h) in a typical week was positively correlated with BMI, the SCAS anxiety score, and behavioral problems and negatively correlated with academic performance. School children's screen time was a predictor of their BMI, behavioral symptoms, and academic performance according to the linear regression analysis.

CONCLUSION

Our findings pointed out that screen time was associated with increased BMI, behavioral problems and poor academic performance. These insights shall be used for development of targeted tailored interventions and strategies to reduce childhood obesity related to screen time. Further research is necessary to rule out the influence of other intricate factors, such as sleep, parental practices, family connectedness, and supervision of parents. The careful use of digital media must serve as a positive force in children's educational and developmental trajectories.

Influence of Screen Time on Physical Activity and Lifestyle Factors in German School Children: Interim Results from the Hand-on-Heart-Study ("Hand aufs Herz")

Background/Objectives: Today, digital technologies are integral to children's lives; their increasing use, however, may raise health concerns. This study aims to examine the effect of screen time on physical activity and lifestyle factors in German school children. Methods: As part of the prospective hand-on-heart-study ("Hand-aufs-Herz"), a comprehensive cardiovascular system check-up examination was conducted on 922 German schoolchildren. The pupils were asked for a self-report on their daily physical activities and club sports. The examinations on-site contained measurements of the pupils' weight and height as well as their physical fitness, which was assessed by a stair-climbing test. Results: A large proportion of pupils had a screen time of more than 2 h daily, regardless of the day of the week (63-76%). In fact, pupils with a screen time ≥ 2 h were more likely to achieve poor grades in school (weekday ORs 3.23, 95% CI 1.76, 5.95; weekend ORs 3.28, 95% CI 1.53, 7.00) and not be members of a sports club (weekday ORs 2.35, 95% CI 1.68, 3.29; weekend ORs 2.13, 95% CI 1.44, 3.14). Pupils who did not meet both recommendations for physical activity and screen time walked <5000 steps daily (60%), had a high proportion of overweight/obesity (40%), were non-swimmers (38.5%), spent ≥7 h sitting (35.8%), and slept fewer hours than recommended (30%). It has also been shown that longer screen time has a negative impact on the lifestyle of children and young people. Conclusions: Our results show that excessive screen time in children is linked to higher weight and an unhealthy lifestyle, increasing long-term cardiovascular risks. Public health initiatives aimed at reducing screen time, promoting physical activity, and encouraging healthier habits are essential to improve children's overall health and prevent future chronic diseases.

Understanding the impact of developmental coordination disorder on Belgian children and families: A national survey study

BACKGROUND

Developmental Coordination Disorder (DCD) is an under-recognized and often trivialized neurodevelopmental condition impacting five to six percent of children. This study aimed to map the impact of DCD on children and their families in Belgium.

METHODS

The Australian 'Impact for DCD' questionnaire was translated and adapted to suit the Belgian context. Parents of 4-to-18-year-old children living in Belgium with movement difficulties consistent with DCD were invited to complete the online survey covering diagnosis, activities, school, therapy, and social and emotional impact.

RESULTS

A total of 491 children were included in the analyses. First concerns emerged primarily at home (61.4%) at age 3.3 ± 2.25y, with help sought at age 4.7 ± 2.57y. Formal diagnosis occurred at age 6.9 ± 2.36y, with DCD (76.5%) and/or dyspraxia (38.4%) the most frequently received terms. DCD was generally unknown, especially within school settings. Nearly one in four children (23.2%) repeated a year of school. Reduced sleep quality (50.6%), fatigue after school (76.0%), difficulties with toilet training (47.9%) and speech articulation (52.3%), as well as elevated emotional problems (52.7%) and peer-related issues (46.4%), were prevalent. Most children received therapy (89.2%) but 59.1% of parents did not feel adequately supported to assist their child. Moreover, 37.5% of parents regularly took time off work to facilitate their child's therapy attendance, while 49.1% had reduced their working hours or were contemplating doing so (16.7%). Parents expressed concerns about their child's future and well-being, with a prominent plea for guidance on supporting their child and increased awareness. Parents reported important strengths in their children, including empathy, creativity, cognitive abilities, perseverance, and good social and/or language skills.

CONCLUSIONS

These results highlight the significant impact of DCD from parents' perspectives. The next step is to explore ways to empower and support parents, raise awareness, and collaborate with policymakers to address these challenges.

Socioeconomic inequalities in childhood and adolescent obesity in Australia: The role of behavioral and biological factors

BACKGROUND

Obesity among children and adolescents is a significant public health concern, influenced by a complex interplay of biological and behavioral factors. However, the extent to which these factors contribute to socioeconomic disparities in obesity remains inadequately understood. Therefore, this study aimed to elucidate the roles of behavioral factors -such as dietary habits, physical activity levels, and outdoor activities-alongside biological factors, including parental body weight, in shaping socioeconomic inequalities in obesity among Australian children and adolescents.

METHODS

This study utilized data from the Birth Cohort (n=5101) and Kindergarten Cohort (n=4983) of the Longitudinal Study of Australian Children (LSAC). LSAC data have been collected biannually since 2004 for the B cohort and since 2000 for the K cohort. The study employed Concentration Index and Decomposition Index analyses to assess the magnitude and to identify the relative contributions of socioeconomic inequalities in obesity, focusing on the contributions of behavioral and biological factors.

RESULTS

The analysis revealed that socioeconomic disparities in obesity among children and adolescents were significantly influenced by both biological and behavioral factors, as well as household income. Biological factors were found to account for 28.96% of these disparities, while household income contributed 49.17%, and behavioral factors explained 10.36% of the inequalities. Moreover, non-consumption of fatty foods and outdoor activities were found to be associated with a decrease in obesity by [Formula: see text] [Formula: see text] respectively. However, non-consumption of fruits and vegetables and maternal BMI were significantly correlated with an increased risk of obesity in children ([Formula: see text]) and adolescents ([Formula: see text]) respectively.

CONCLUSION

These findings provide critical insights into the distribution of obesity across different socioeconomic groups in Australia, highlighting the substantial role of household income and the combined impact of biological and behavioral factors. The results emphasize the importance of developing targeted public health interventions that support families from lower socioeconomic backgrounds to reduce obesity-related disparities.

How Screen Time Affects Greek Schoolchildren's Eating Habits and Functional Food Consumption?-A Cross-Sectional Study

BACKGROUND

Television (TV), video games, PC and devices such as tablets and smart phones have become part of everyday life at an ever-younger age. Increased screen time correlates with unhealthy eating habits among children.

METHODS

374 children aged 9-12 years and their parents (n = 159), from 3 schools in Lemnos and 5 schools in Thessaloniki, Greece, took part in this cross-sectional study. The children completed the KIDMED score and a questionnaire about their physical activity, time spent watching TV, PC and playing electronic games, the frequency of cooking or shopping with their parents, the frequency of eating fast food, soft drinks and Functional Foods (FFs). Statistical analysis was performed with SPSS-29.0, using One Way ANOVA and Pearson chi-square.

RESULTS

As the hours of TV viewing increased, so did the percentage of children who consumed soft drinks (p = 0.03). A statistically significant association detected between television (p = 0.024), video games (p = 0.028), all screen categories (p = 0.011) and fast-food consumption. Increased screen time is associated with a higher weekly consumption of fast food (p = 0.011). The more hours children spent in front of screens, the less adherence they had to the Mediterranean Diet (p = 0.001) and less natural FFs consumption (p = 0.001).

CONCLUSIONS

The results suggest that screen time seems to affect children's eating behaviors. The study concluded that the longer the screen time, the unhealthier the dietary habits of schoolchildren become. Future research should focus on reducing screen time, as a means of improving dietary patterns and potentially reducing childhood obesity.

Prevalence of Obesity Among Elementary School Children in Cyprus: The National COSI Program

Background/Objectives: A worldwide epidemic of overweight and obesity is an ongoing global health concern. This rise in overweight and obesity among children contributes to the increasing pattern of current and future physiological and psychological problems. Our study aimed at examining overweight and obesity among elementary school children in Cyprus. Methods: Data on children's age, sex, place of residence (urban/rural) and weight/height status were collected using the WHO Childhood Obesity Surveillance Initiative (COSI) in Cyprus, using standardized measurements of children aged 6-9 years enrolled in the first and fourth class of elementary schools during the academic year 2021-2022. We describe the prevalence and distribution of overweight and obesity, while we also compare the findings with previous rounds of the COSI program. Results: A total of 1662 children were evaluated (830 boys and 832 girls, 952 from the first and 710 from the fourth class, and 1303 from urban and 369 from rural areas). The study showed 335 children with overweight (20.1%) and 275 with obesity (16.5%). Both overweight [158 (22.2%, 95% CI: 19.2-25.5%)] and obesity [149 (21.0%, 95% CI: 18.1-24.2%)] was significantly higher in children aged 8-9 years of age compared to younger children (6-7 years) (p < 0.0001) and was also higher in boys compared to girls (p = 0.0007). No difference was seen by place of residence or round of examination. Conclusions: Our study confirmed that both overweight and obesity remain at high levels over the past decade in both boys and girls in Cyprus.

Associations Between Screen Time, Physical Activity, and Sleep Patterns in Children Aged 3-7 Years-A Multicentric Cohort Study in Urban Environment

In most developed countries, children's use of digital media has increased significantly. Concerns about how screen time (ST) affects physical activity (PA), sleep patterns (SL), and overall health habits have prompted further exploration of these associations. This study examined ST, PA, and SL patterns in children aged 3-7 years living in an urban environment. A multicenter prospective cohort study was conducted using the Surveillance of Digital Media Habits in Early Childhood Questionnaire (SMALLQ®). Parents of 243 children completed the questionnaire, providing data on their children's ST, SL, and PA habits during weekdays and weekends. A series of ANOVA tests were performed to assess differences in weekday and weekend ST, PA, and SL across age groups and sexes, as well as to compare these results with UN recommendations. The findings revealed a non-significant trend in ST and a significant effect of age group on PA during both weekdays and weekends, as well as on weekend SL. No significant differences based on sex were observed. Additionally, the comparison indicated that 3-5-year-old preschool children exceeded the recommended ST during weekends, while 6-7-year-old first-grade elementary children failed to meet the PA recommendations. These results highlight the critical role of age-related changes in shaping PA and SL behaviors in young children, emphasizing the importance of targeted interventions to foster healthy habits in early childhood.

Association between parental stress, coping, mood, and subsequent child physical activity and screen-time: an ecological momentary assessment study

BACKGROUND

Few children meet physical activity and screen-time guidelines. Parents play a key role in supporting children's physical activity and limiting child screen-time, but their own stress, management of stress (i.e., coping), and mood may impact their ability to do so. Ecological momentary assessment (EMA) is a methodology that can be used to assess the temporality of parental state (i.e., stress, mood) and subsequent child behavior. This study aimed to examine the relationship between parental stress, coping, and mood with child physical activity and screen-time, and whether there were differences by child sex.

METHODS

Parents and their children (n = 436, 5-9 y) participated in an EMA study that used signal-contingent and end-of-day surveys. Parents received three signal-contingent surveys during fixed 3-hour windows and one end-of-day survey over 7-days via smartphone notifications. Parents reported their current stress, ability to manage stress, and depressive mood at the first signal-contingent survey. Parents also reported the frequency of their child's physical activity and screen-time across the day during the end-of-day survey. Conditional fixed effects regression was fitted to examine current and lagged day stress, coping, and mood relationships on change in child physical activity and screen-time.

RESULTS

Children were girls (53.7%), mainly non-white (64.3%), and with a household income of less than $50,000 USD (54.1%). Overall, parent's current day stress was negatively related to the frequency of child physical activity (p = 0.001), but not screen-time. Among girls, higher parent current-day stress and lower coping were related to less frequent girl's physical activity (ps < 0.05). Parent's lagged day stress was then associated with more frequent girl physical activity the next day (p = 0.018). There were no associations among parent mood or in models with only boys.

CONCLUSIONS

This study found parent's stress may negatively impact child's physical activity that day, but may positively impact physical activity the next day, namely girls. Findings suggest that reducing parental stress and improving coping abilities may improve girl's physical activity, but other approaches are needed to reduce child screen-time at this age.

Stranger danger or good Samaritan? A cross-sectional study examining correlates of tolerance of risk in outdoor play among Canadian parents

BACKGROUND

Negative parental perceptions of risk may restrict children's opportunities for outdoor play. Excessively minimizing children's exposure to risks in their environment may have a range of developmental consequences. The purpose of this cross-sectional study was to assess correlates of parental tolerance of risk among a large sample of Canadian parents.

METHODS

In this cross-sectional study, a sample of 2,291 parents of 7-12 year olds completed online questionnaires assessing a range of potential individual (e.g., gender), social (e.g., neighbourhood cohesion), and environmental (e.g., walkability) correlates of parental tolerance of risk. Logistic regressions were created to examine associations between these factors and odds of being in the most risk averse quartile. The logistic regression was built in hierarchal steps relying on the Akaike information criterion (AIC) and pseudo R2 for model progression.

RESULTS

The final model had a pseudo R2 of 0.18. Five out of seventeen correlates were associated with risk aversion in parents. Concerns about stranger danger were associated with a higher odds of risk aversion (OR = 2.33, 95%CI[1.93, 2.82]). A higher number of children in the home was associated with lower odds of risk aversion in parents (OR = 0.80, 95%CI[0.69, 0.92], and parents of children born outside of Canada had higher odds of being risk adverse when compared to parents born in Canada (OR = 2.13, 95%CI[1.54, 2.94]). Finally, being very concerned with COVID-19 increased the odds of risk aversion (OR = 3.07, 95%CI[1.93, 5.04], while having a household income of > 100,000 lowered the odds of risk aversion (OR = 0.56, 95%CI[0.36, 0.87]).

CONCLUSIONS

Tailored interventions that reframe perceptions of risk for parents are needed. Such interventions could reframe concerns about stranger danger which persist despite occurrences of stranger abduction being extremely rare. Interventions could also be targeted to immigrant families and those with fewer children as they appear to be more averse to risk. A complementary focus on examining how cultural background influences risk perceptions is needed in future research.

Assessing physical literacy and establishing normative reference curves for 8-12-year-old children from South Punjab, Pakistan: The PAK-IPPL cross-sectional study

BACKGROUND

Physical literacy (PL) encompasses an individual's motivation, confidence, physical competence, and knowledge, all of which foster lifelong engagement in physical activities. In developing countries like Pakistan, there is a pressing need to assess PL status using culturally valid tools. This study aims to evaluate PL among children aged 8-12 in South Punjab, Pakistan while developing normative reference curves and exploring factors influencing PL.

METHODS

A cross-sectional study was conducted with 1,360 students (mean age = 10.00, SD = 1.41 years) from 85 schools, using a culturally adapted and validated version of the CAPL-2 tool. The CAPL-2 scoring system was validated to align with the population and cultural context. Statistical analyses, including t-tests, Chi-squared tests, Pearson's correlation, multivariate logistic regression, and Classification and regression tree methods, were performed to identify factors associated with PL classifications, with significance set at p < 0.05. The Generalized Additive Models for Location, Scale, and Shape were used to create age- and sex-specific PL normative reference curves.

RESULT

The study revealed significant influences of gender, socioeconomic status (SES), and locality on PL. Boys consistently scored higher in PL across all domains compared to girls, with significant differences (p < 0.001) in all but the knowledge and understanding domain (p = 0.160). Boys' PL scores were 6% higher overall, with a 7% and 5% advantage in the daily behavior and physical competence domains, respectively. Children from low SES and rural settings exhibited significantly higher PL scores than their middle/high SES and urban counterparts (p < 0.001). Walking to school was positively correlated with higher PL scores, while children traveling by car had the lowest scores (p < 0.001). Anthropometric differences between genders were noted, further emphasizing the disparities in physical competence. Most participants (71.6%) fell into the "Beginning" or "Progressing" PL categories, with females predominantly in these lower stages.

CONCLUSION

This study reveals that gender, SES, and locality significantly impact PL among children in South Punjab, Pakistan. Boys, lower SES groups, and rural children showed higher PL scores, with everyday activities like walking to school positively contributing to PL development. These findings emphasize the need for targeted, demographically sensitive interventions to enhance PL in the region.

Cross-Sectional Study on the Influence of Religion on the Consumption of Ultra-Processed Food in Spanish Schoolchildren in North Africa

(1) Background: The consumption of ultra-processed foods (UPFs) constitutes a public health problem given their high availability and easy accessibility among children and young people and their influence on the development of non-communicable diseases in the long term. In this context, culture and religion may be modulating factors for the consumption of processed food. The aim of this study is to assess the consumption of UPFs in Spanish schoolchildren living in Melilla (North Africa), together with the possible impact of religion on this. (2) Methods: A cross-sectional study of 590 Christian and Muslim schoolchildren aged 15-17 years was conducted. The NOVA food classification was used to identify UPFs. Associations between religion and daily consumption were identified using risk analysis (Odds Ratio). (3) Results: Muslim schoolchildren had a higher consumption of industrial juices [OR = 2.700, 95%CI = 1.830-4.037], milkshakes [OR = 2.925, 95% = 1.850-4.748], industrial pastries [OR = 2.217, 95% = 1.440-3.510], sweets [OR = 2.197, 95%CI = 1.437-3.541], chocolates [OR = 2.272, 95%CI = 1.482-3.606] and savory snacks [OR = 3.431, 95%CI = 1.844-6.579] compared to that observed among Christians. (4) Conclusions: Both Muslim and Christian schoolchildren had a high consumption of UPFs. Regarding the potential impact of religion on the consumption of UPF, we observed that Muslim schoolchildren consumed three to four times more UPF than Christian schoolchildren. These results show a shift away from a healthy eating pattern, especially among Muslim schoolchildren. Thus, it is necessary to implement nutritional education strategies in order to understand and control the consumption of UPF in adolescents, thereby reducing the occurrence of non-communicable diseases in the long term.

Exploring urban-rural differences in 24-h movement behaviours among tunisian preschoolers: Insights from the SUNRISE study

Little is known about differences in physical activity among children from urban and rural areas in low-to middle-income countries and some previous investigations revealed disparities in physical activity levels among children and adolescents residing in urban and rural environments. We aimed to: (i) assess the proportion of preschool-aged children (3.0-4.9 years) meeting the global movement guidelines, (ii) evaluate the feasibility of the methods for the SUNRISE study, (iii) examine gender- and urban-rural differences in health and behavior outcomes. Urban and rural location was based on national classifications. Physical activity (waist-worn ActiGraph); sleep duration, screen time and movement behaviors; Gross and fine motor skills (Lower body strength and mobility, Supine-Timed up and go [S-TUG], One-leg standing balance test, hand grip dynamometer, 9-hole peg-board test); and executive functions (visual-spatial working memory and inhibition) were assessed in 112 preschoolers (n ​= ​50 boys, 33 urban), (n ​= ​62 girls, 41 urban). The results showed that only 18% of children met all movement guidelines, with 53% and 41% meeting the recommendations for sedentary screen time and total physical activity, respectively. A large proportion of children (81%) met the recommended sleep duration of 10-13 ​hours (h) per day. There is a clear need to promote healthy movement behaviours among preschool-aged children through targeted interventions that address their unique challenges related to gender and urban/rural residence.

Should organized sport characteristics be considered as a strategy for meeting physical activity guidelines in children?

BACKGROUND

A clearer understanding of the relationships between specific sport context with overall physical activity (PA) and sedentary time (ST) may contribute to the development of more accurate preventive strategies to increase children's engagement in PA.

PURPOSE

This study aimed to examine how different organized sports contributed to children's daily PA and ST.

METHODS

PA was measured for seven days via accelerometers, in 410 children aged 6-10 years (49.8% boys). Of those, 332 (53.0% boys) were engaged in an organized sport and were further considered for statistical analyses. Parents reported children's sport participation (e.g. which sport, number of times per week, duration). The sports were classified into: indoor vs. outdoor; individuals vs. team; combat vs. individual aesthetic vs. racing vs. invasion. Children's height and weight were objectively collected. Multiple one-way analyses of covariance were used to examine the effects of sport characteristics on PA and ST. A linear regression, adjusted for children's sex, age, body mass index and father's educational level, determined the relationship between being involved in multiple PA and sedentary behaviours with Moderate to Vigorous PA (MVPA) levels.

RESULTS

Although engaged in an organized sport, only 30% of the children achieved the PA recommendations. Sport (compared with active commute and active play) was the best contributor to daily MVPA. Outdoor sports (vs. indoor) contributed the most to vigorous PA (VPA) and MVPA. Team sports (vs. individual) were significantly associated with lower ST. Children in combat sports accumulated more VPA and MVPA, while those in racing sports showed a higher ST.

CONCLUSIONS

Sport participation alone does not guarantee children will reach the PA guidelines, and the type of sport can influence children's PA levels. Gender-stereotypes in sports may prevent girls from achieving their 60 minutes of MVPA daily.

Pediatric Blood Pressure and Cardiovascular Health in Adulthood

PURPOSE OF REVIEW

This review summarizes current knowledge on blood pressure in children and adolescents (youth), with a focus on primary hypertension-the most common form of elevated blood pressure in this demographic. We examine its etiology, progression, and long-term cardiovascular implications. The review covers definitions and recommendations of blood pressure classifications, recent developments in measurement, epidemiological trends, findings from observational and clinical studies, and prevention and treatment, while identifying gaps in understanding and suggesting future research directions.

RECENT FINDINGS

Youth hypertension is an escalating global issue, with regional and national variations in prevalence. While the principles of blood pressure measurement have remained largely consistent, challenges in this age group include a scarcity of automated devices that have passed independent validation for accuracy and a generally limited tolerance for ambulatory blood pressure monitoring. A multifaceted interplay of factors contributes to youth hypertension, impacting long-term cardiovascular health. Recent studies, including meta-analysis and sophisticated life-course modelling, reveal an adverse link between youth and life-course blood pressure and subclinical cardiovascular outcomes later in life. New evidence now provides the strongest evidence yet linking youth blood pressure with clinical cardiovascular events in adulthood. Some clinical trials have expanded our understanding of the safety and efficacy of antihypertensive medications in youth, but this remains an area that requires additional attention, particularly regarding varied screening approaches. This review outlines the potential role of preventing and managing blood pressure in youth to reduce future cardiovascular risk. A global perspective is necessary in formulating blood pressure definitions and strategies, considering the specific needs and circumstances in low- and middle-income countries compared to high-income countries.

Mapping the research using 24-h movement guidelines in children and adolescents: A bibliometric analysis

BACKGROUND

There are limited comprehensive bibliometric analyses that have examined research articles using the 24-h movement guidelines, which are necessary to evaluate the impact of the research field, map the scientific structure of the research landscape, and identify knowledge gaps.

OBJECTIVES

The aim of this study was to analyse the published research articles using the 24-h movement guidelines and assess their bibliometric characteristics.

METHODS

The search was conducted across all databases indexed in the Web of Science on March 6, 2024, and the bibliometric characteristics of studies published from 2016 onwards were analysed. Descriptive statistics and visualisations by the VOSviewer were used for the presentation of bibliometric characteristics.

RESULTS

120 studies using the 24-h movement guidelines in children and adolescents were included for analysis in this study. In general, number of the related publications using the 24-h movement guidelines increased from 2016 until now. 16 distinct clusters of author networking were displayed, of which the Canadian team was the strongest cluster with the highest research impacts. Of the included studies, cross-sectional studies accounted for the majority. North America and Europe were the leading two study locations across the included studies. Highly varied adherence rate to the 24-h movement guidelines across the included studies were observed. In terms of correlates and health outcomes of meeting the 24-h movement guidelines, separately, sociodemographic and health functioning characteristics were the most examined aspects.

CONCLUSIONS

This study provides a comprehensive scientific overview for research using the 24-h movement guidelines in children and adolescents, which may help guide potential research directions to improve the low compliance rates in this population.

The Impact of Interactive Video Games Training on the Quality of Life of Children Treated for Leukemia

OBJECTIVES

The study aimed to assess the impact of interactive video games (IVGs) as a form of physical activity (PA) on the quality of life.

METHODS

The study used a quality-of-life questionnaire (KIDSCREEN-10) and the HBSC questionnaire. In order to determine individual IVGs training parameters, an initial assessment of cardiorespiratory fitness level was performed, using the Cardio Pulmonary Exercise Test-Godfrey's progressive protocol. Children in the intervention group participated in 12 interval training sessions using IVGs (Microsoft's Xbox 360 S console with Kinect,).

RESULTS

The study included 21 patients (7-13 years old; 12 boys and 9 girls) treated for acute lymphoblastic leukemia (n = 13) and acute myeloid leukemia (n = 8). Before the IVGs, all children had insufficient PA levels (90% of children in the intervention group and 90.91% of children in the control group did not engage in any PA during the last 7 days). After the intervention, 80% of the children in the IVGs group undertook PA lasting at least 60 min a day, three times a week. They exhibited better well-being, a subjective feeling of improved physical fitness (p < 0.0001), a greater subjective sense of strength and energy (p < 0.0001), and less feeling of sadness (p = 0.0016) than the children from the control group (p = 0.0205).

CONCLUSIONS

The results of our study confirmed that an attractive form of virtual game or sport is willingly undertaken by children undergoing cancer treatment, and has significant benefits in improving the quality-of-life parameters. There is a clear need to create specific recommendations and rehabilitation models for children with cancer.

Exploring the Link Between Early Technology Exposure and Developmental Milestones in Childhood

Background This study examined the relationship between touchscreen exposure and developmental outcomes in early childhood using the Ages and Stages Questionnaire, Third Edition (ASQ-3), a widely-used developmental screening tool. Methods During a well-child visit, parents of 51 children aged 18-36 months completed the ASQ-3 and a survey on their child's touchscreen habits (timing of introduction, daily usage duration, independent use, engagement in creative activities). Medical records were reviewed for developmental diagnoses and health conditions. Analysis One-way analysis of variances (ANOVAs) examined differences in ASQ-3 domain scores (problem-solving, personal-social, communication, gross motor, fine motor) based on the age of touchscreen introduction and average daily usage time. Independent t-tests compared scores between groups defined by independent touchscreen use and creative activity engagement. Effect sizes were calculated for significant differences. Results In the problem-solving domain, children introduced to touchscreens before 12 months of age scored significantly higher than those introduced later, with a statistical significance of p<0.05 and an effect size of d=0.45. However, there were no significant differences in scores based on the duration of daily touchscreen usage. In the personal-social domain, children introduced to touchscreens at 12 months or later scored significantly higher than those introduced before 12 months, with a significance of p<0.05 and an effect size of d=0.51. Moderate daily usage of 30-90 minutes was associated with higher scores compared to lower usage of less than 30 minutes or higher usage of more than 90 minutes (p<0.05). Additionally, children who used touchscreens independently had significantly higher scores, with a significance of p<0.01 and an effect size of d=0.76. Those who engaged in activities such as coloring or crafting also had significantly higher scores, with a significance of p<0.01 and an effect size of d=0.82. In other domains, such as communication, gross motor, and fine motor, no significant effects of touchscreen exposure were observed. Discussion Earlier touchscreen introduction may facilitate problem-solving skills like experimentation and cognitive flexibility through interactive digital play. However, excessive touchscreen use (greater than 90 minutes per day) before 12 months could interfere with pivotal social-emotional learning from real-world interactions, impeding personal-social development. Moderate, supervised touchscreen exposure combined with creative hands-on activities appears optimal for fostering strong personal-social competencies like cooperation and emotional understanding during the toddler years. Conclusion Timing, duration, context, and content of touchscreen experiences in early childhood relate differently to specific developmental domains. Guidelines should consider these nuances to support overall healthy child development in our digital world. Larger longitudinal studies using multi-method assessments are needed.

Sleep timing behaviour, sleep duration and adherence to obesogenic dietary patterns from pre-school to school age: results from the Portuguese birth cohort Generation XXI

In an obesogenic environment, short sleeping may increase opportunistic eating. The timing of sleep might also influence the drive to eat. This study investigated the prospective association of sleep timing and duration with diet in 5286 children from the Portuguese birth cohort Generation XXI, evaluated at 4 and 7 years of age. At 4 years, sleep duration was categorised into ≤10 and >10 h. Four sleep timing categories were generated based on the median split for sleep-onset and -offset times: 'Early Sleep-Early Wake'; 'Early Sleep-Late Wake'; 'Late Sleep-Early Wake'; 'Late Sleep-Late Wake'. At 7 years, diet was obtained by a food frequency questionnaire and three dietary patterns were included: 'Healthier', 'Energy-Dense Foods (EDF)' and 'Snacking'. The Healthy Eating Index was used to evaluate diet quality. Multinomial logistic regression models and generalised linear models were performed. Children who had a late sleep, independently of the time of waking up, had higher odds of following the 'EDF' pattern, compared with the 'Healthier'. Boys who had late sleep and/or late wake had also higher odds of following the 'Snacking' pattern and had poorer diet quality. In both sexes, a late sleep or late wake were associated with a lower diet quality, compared to the group 'Early Sleep-Early Wake', and independently of nap behaviour. In boys, shorter sleep duration was associated with a poorer diet. In conclusion, pre-schoolers with late bedtimes or wake-up times have worse dietary patterns and poorer diet quality at the age of 7 years, which seems to be independent of sleep duration.

Exposure to Smartphones and Tablets, Physical Activity and Sleep in Children From 5 to 10 Years Old: A Systematic Review and Meta-Analysis

OBJECTIVE

To conduct a systematic review and meta-analysis to verify the association between smartphone/tablet exposure and physical activity and sleep in children from 5 to 10 years old. Data Source: This study followed the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and included studies that met eligibility criteria based on the "PECO" strategy: participants (children from 5 to 10 years old), exposure (smartphone and tablet use), and outcome (physical activity and sleep).

STUDY INCLUSION AND EXCLUSION CRITERIA

The inclusion criteria were observational studies published in indexed scientific journals and written in Portuguese, English, and Spanish that verified the association of exposure to smartphones/tablets with physical activity and sleep in children aged 5 to 10 years of both sexes. Studies were considered eligible only if they met the previous criteria. Data Extraction: The search was conducted in January 2023 on databases from electronic journals without the restriction of the period. To meta-analyze were extracted and grouped using models of fixed and random effects, the coefficients Odds Ratio (OR), Beta (β), Standard Error (SE), and Confidence Intervals of 95% (95%CI). Data Synthesis: 2396 potentially relevant papers were identified, and 17 met the inclusion criteria.

RESULTS

It can be verified that there was an inverse association between smartphones with physical activity and sleep. Studies indicate that for every additional hour of smartphone and tablet use, sleep can be expected to decrease by an average of 11 minutes (β = - 0.11; 95%CI = -0.13; -0.09). Children using smartphones and tablets were 1.79 times (OR = 1.79; 95%CI = 1.72-1.86) more likely to have shorter sleep duration and 1.53 times (OR = 1.53; 95%CI = 1.41-1.65) more likely to have worse sleep quality. Children with shorter smartphone and tablet usage were 1.19 times more likely to be active (OR = 1.19; 95% CI = 1.03-1.37).

CONCLUSION

Children of 5 to 10 years who are more often exposed to smartphones and tablets are prone to have worse quality and quantity of sleep, as well as less practice of physical activity. Health promotion actions can be encouraged based on the results, aiming to reduce the use time of these devices and improve children's health and quality of life.

Sleep duration is associated with appetitive traits in school-age years - results from the Generation XXI birth cohort

Sleep may influence appetite regulation through physiological and neurocognitive pathways. However, the association between sleep and appetite in childhood has been scarcely reported, particularly using a prospective design. We aimed to test associations between sleep duration at 7 years of age (y) and appetitive traits at both 7 and 10 y. Participants are from the population-based birth cohort Generation XXI (Porto, Portugal), at 7 (n = 2437) and 10 y (n = 1938) follow-ups. Data on sleep was gathered at 7 y and, considering bedtime and get-up time, total mean sleep duration was calculated and further categorized according to the 10th and 90th percentiles. Appetitive traits were assessed at 7 and 10 y using the parent-reported Children's Eating Behaviour Questionnaire. Associations were tested through Generalized Linear Models (co-variates: child's sex; maternal age, education and pre-pregnancy body mass index at 7 y). At 10 y, associations were further adjusted for the respective appetitive trait at 7 y. Children slept a mean of 10.2 h/night, and 13% and 9% slept ≤9.5 and ≥ 11.0 h/night at 7 y, respectively. For each additional hour in sleep duration, children scored 0.078 (99%CI: -0.145; -0.011) lower on Food Responsiveness, 0.065 (99%CI: -0.129; -0.002) lower on Emotional Undereating and 0.096 (99%CI: -0.161; -0.032) lower on Food Fussiness. Lastly, children sleeping ≤9.5 h/night scored higher on Food Responsiveness (β = 0.145 99%CI: 0.020; 0.271); while those sleeping ≥11.0 h/night scored lower on Food Fussiness (β = -0.255 99%CI: -0.370; -0.079). No significant prospective associations were found. In conclusion, in 7 y children, sleep duration was cross-sectionally associated with lower scores on food approach (Food Responsiveness) and avoidant traits (Emotional Undereating and Food Fussiness). However, the magnitude of the associations was small and further studies are warranted.

Analysis of the associations between moderate-to-vigorous physical activity and screen time on psychological symptoms among university students: a cross-sectional survey based on six geographic regions in China

BACKGROUND

Declining physical activity and increasing screen time (ST) among Chinese adolescents have become major concerns shared by scholars, while mental health issues are also on the rise. Previous studies have confirmed the association between physical activity and screen time and psychological symptoms, but it is unclear how their psychological symptoms, especially for Chinese university students who have a high proportion of psychological symptoms, and no research evidence has been found.

METHODS

This study investigated physical activity, screen time, and psychological symptoms in 11,173 university students aged 19-22 years in six regions of China. A binary logistic regression analysis was used to analyze the association between moderate-to-vigorous physical activity (MVPA) and screen time and psychological symptoms. And the generalize linear model (GLM) analysis was used to further analyze the association between MVPA and screen time and psychological symptoms.

RESULTS

The detection rate of psychological symptoms among Chinese university students was 16.3%, with a higher percentage of female students (17.5%) than male students (14.7%). The proportion of male students (8.2%) with MVPA > 60 min/d was higher than that of female students (2.3%), and the proportion of male students (33.8%) and female students (34.5%) with screen time > 2 h/d was basically the same. The generalize linear model (GLM) analysis showed that university students with MVPA < 30 min/d and screen time > 2 h/d (OR = 1.59, 95% CI: 1.10-2.31) had the highest risk of psychological symptoms (OR = 1.59, 95% CI: 1.10-2.31) compared to university students with MVPA > 60 min/d and screen time < 1 h/d as the reference group. The risk of psychological symptoms was the highest among those with MVPA < 30 min/d and screen time > 2 h/d (OR = 1.59,95% CI: 1.10-2.31). In addition, university students with MVPA > 60 min/d and a screen time of 1-2 h/d (OR = 0.09, 95% CI: 0.03-0.25) had the lowest risk of psychological symptoms (P < 0.001). The same trend was observed for both male and female students.

CONCLUSION

Chinese university students have a certain proportion of psychological symptom problems, and there is a significant between MVPA and screen time and psychological symptoms, and the same trend exists for both male and female students. Chinese university students should perform MVPA for not less than 60 min a day, and at the same time control the duration of screen time, and screen time should be controlled between 1 and 2 h a day, which has a better promotion effect on psychological health.

Physical Activity Habits and Sleep Duration According to Gender: A Cross-Sectional Study of Elementary School Children

(1) Background: The main goals of this study were to describe the physical activity (PA) and sleep habits of 8-12-year-old children according to their gender and to evaluate the relationship between PA and sleep habits (i.e., duration and timing). (2) Methods: A total of 236 children (114 boys and 122 girls) completed the Physical Activity Questionnaire for Older Children (PAQ-C) and an ad hoc sleep habits questionnaire. (3) Results: Boys were more physically active than girls (2.62 ± 0.51 vs. 2.46 ± 0.48, p = 0.026) and enacted higher PA levels in school recess (3.82 ± 1.36 vs. 3.56 ± 1.38, p = 0.003), during the afternoon (3.37 ± 1.20 vs. 2.89 ± 1.12, p = 0.003), and during weekends (3.54 ± 1.20 vs. 3.18 ± 0.48, p = 0.009). Per sleep habits, boys had a significantly later bedtime (21:53 ± 2:08 vs. 21:34 ± 2:14, p = 0.009) and a significantly smaller total sleep duration (9.64 ± 0.86 vs. 9.89 ± 0.87 h, p = 0.023) than girls. No significant correlations between PA and sleep habits were found. (4) Conclusions: We found differences in the PA and sleep habits between school-age boys and girls. Institutions and entities should consider designing specific interventions to improve PA and sleep habits according to gender.

Occurrence of Body Posture Abnormalities in Overweight and Obese Children Aged 5-6 Years-Pilot Study

OBJECTIVES

The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight.

METHODS

In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture.

RESULTS

A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups.

CONCLUSIONS

There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5-6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity.

Exploring the world of active play: A comprehensive review of global surveillance and monitoring of active play based on the global matrix data

A valid assessment tool that measures active play is not yet available due to the sporadic and spontaneous nature of play, as well as the potential differences in how active play is understood and measured across different age groups, cultures, and contexts. The purpose of this review was to identify the scope and gaps in the measurement of active play based on data gathered from 68 countries that participated in the Global Matrix (GM) initiative, led by the Active Healthy Kids Global Alliance (AHKGA). GM is the global-level, biennial evaluation system of physical activity related behaviors among children and youth, including the Active Play indicator, and the sources of influence using letter grades (ranging between "A" and "F"). Based on the identified scope and gaps, this study offers recommendations for future research dedicated to the measurement/surveillance of active play. Out of the 68 countries involved in the previous GM (2014-22), 55% of the grades remained unassigned due to insufficient data on the Active Play indicator. The high number of unassigned grades, combined with the absence of valid measurement tool, highlight a need for a standardized measurement tool for improved global data generation of active play among children and youth. Our findings emphasize the need to address challenges in measuring active play. This review offers future considerations, research recommendations specific to the GM initiative, and two sets of age- and location-specific (indoor and outdoor settings) questionnaire items along with guidelines for its use. Together, these elements provide a roadmap for guiding future research and evaluation efforts on active play.

Patterns and trajectories of inequality in physical activity from childhood to adolescence in Kazakhstan

Objective

Sociodemographic differences in physical activity (PA) levels during the transition from childhood to adolescence, particularly in Central Asian countries, is lacking. In this study, we examine individual, family and environmental sociodemographic variables associated with PA among children and young adolescents in Kazakhstan.

Study design

Secondary data analyses of two nationally representative cross-sectional studies administered by parents of children (aged 7-9 y) and by self-report surveys (adolescents aged, 11-15 y) .

Methods

The 2020 Childhood Obesity Surveillance Initiative (COSI) and 2018 Health Behaviour in School-aged Children (HSBC) studies were used. Predictors of daily PA by individual (gender, grade, weight status), family (family composition, family employment, family wealth), and environment (school location) factors were analysed through binary logistic regressions after adjusting for screen time.

Results

Among both children and adolescents, males were more physically active than females. Daily PA among children was positively associated with high family employment (OR = 1.23, CI = 1.03-1.48) or living in an urban location (OR = 0.58, CI = 0.49-0.70). Daily PA was associated with low family wealth, two-parent families (OR = 1.25 CI = 1.08-1.44) or living in a rural location (OR = 1.18 CI = 1.04-1.34) among adolescents.

Conclusion

In Kazakhstan, the trajectory of children's and adolescent's PA levels, differed according to individual, family and environmental characteristics , suggesting a need for age-specific, targeted interventions to promote PA, appropriate policies that promote programs in schools, communities, and development of infrastructure for physically active lifestyles.

Co-construct, implement and evaluate a multi-level intervention to prevent a sedentary lifestyle in children-Study protocol of the CIPRES study

BACKGROUND

A sedentary lifestyle is commonly associated with a higher risk of chronic disease development. Among school-aged children from European countries, screen-time represents a significant portion of sedentary time with 39.8% of children spending more than 2h/day in front of a screen on average. Therefore, effective solutions to reduce sedentary behavior (SB) must be found. Multilevel interventions based on the socio-ecological model (SEM) are particularly relevant to take into account influences of the social environment on individuals' SB. Moreover, the trans-contextual model (TCM) can offer complementary levers for individuals' behavior change. The CIPRES study is a theory-based multilevel intervention designed to decrease the SB in French primary school children aged 8-10 years. The present paper describes the protocol of a randomized controlled study to evaluate the effectiveness of the CIPRES multilevel intervention on SB.

METHODS

The CIPRES study is a cluster-randomized controlled trial comparing intervention vs control groups. A total of 700 children are targeted for inclusion, distributed in four municipalities considered as clusters. The study consists of two successive phases: 1) co-building of a SB prevention intervention by using a participatory approach involving representatives of each level of the SEM (e.g., children, parents, staff from municipalities, teachers) and 2) implementation and evaluation of the intervention. The intervention will last for 6 weeks in each involved class. Primary outcome will be the sedentary time of children per week, assessed by accelerometry. In addition, children and their parents will be asked to fill out questionnaires concerning children's physical activity level, screen time, quality-of-life and variables of the TCM.

DISCUSSION

This study will give information on the effectiveness of a theory-based intervention, involving multiple levels of actors in the co-construction and the implementation of the intervention, that may interest schools and public health officers looking for innovative sedentary prevention programs.

Living with obesity in Ireland: determinants, policy and future perspectives

Globally, the prevalence of those living with obesity (≥30 kg/m2) is rising, with this trend expected to continue if firm and decisive policy interventions are not introduced. Across Europe, despite many consecutive policies aiming to reverse rising trends in weight status over recent decades, no country is currently on track to halt and reverse current trends in the coming years. This is evident in Ireland too, whereby the reporting of nationally representative weight status data show that targets have not been achieved since reporting began. The aim of this review is to critically appraise recent evidence relating to the key determinants of obesity including weight status, diet quality and physical activity with an emphasis on socioeconomic inequalities. And to consider these in the context of respective policy measures and propose future-focused recommendations. Furthermore, as with the complex nature of obesity, multifaceted approaches that shift the focus from the individual and place responsibility at a societal level will be reviewed.

Association between Screen Time and Sociodemographic Factors, Physical Activity, and BMI among Children in Six European Countries (Feel4Diabetes): A Cross-Sectional Study

Screen time among children in most European countries is notably high and is influenced by various sociodemographic and other factors. Our study aimed to explore the associations between parents' sociodemographic characteristics, socioeconomic status, body mass index (BMI), physical activity, risk status for type 2 diabetes, and their children's BMI, physical activity, and screen time. The data were sourced from the 2016 Feel4Diabetes study, involving 12,280 parents and 12,211 children aged 6-9 years (average age 8.21 years) in a cross-sectional study design. We used a logistic regression model to identify potential factors associated with children's screen time. The results showed that mothers with tertiary education (OR = 0.64; 95%CI = 0.49-0.82; p < 0.001), the middle age group (45-54 years) (OR = 0.81 95%CI = 0.66-0.98; p = 0.033), and families with higher incomes (middle-OR = 0.85; 95%CI = 0.75-0.97; p = 0.014; high-OR = 0.8; 95%CI = 0.69-0.93; p = 0.003) were associated with a decreased chance of children spending more than 2 h/day in front of the screen. In contrast, maternal overweight/obesity (OR = 1.15; 95%CI = 1.03-1.29; p = 0.013) and lower physical activity in children were linked to an increased likelihood of more than 2 h of screen time per day. Our findings suggest that targeted interventions should be developed to mitigate excessive screen time, particularly focusing on low-income families and mothers with low educational levels.

Association of sleep traits with myopia in children and adolescents: A meta-analysis and Mendelian randomization study

PURPOSE

The association between sleep and myopia in children and adolescents has been reported, yet it remains controversial and inconclusive. This study aimed to investigate the influence of different sleep traits on the risk of myopia using meta-analytical and Mendelian randomization (MR) techniques.

METHODS

The literature search was performed in August 31, 2023 based on PubMed, Embase, Web of Science, and Cochrane library. The meta-analysis of observational studies reporting the relationship between sleep and myopia was conducted. MR analyses were carried out to assess the causal impact of genetic pre-disposition for sleep traits on myopia.

RESULTS

The results of the meta-analysis indicated a significant association between the risk of myopia and both short sleep duration [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.08-1.42, P = 0.003] and long sleep duration (OR = 0.75, 95% CI = 0.66-0.86, P < 0.001). MR analyses revealed no significant causal associations of genetically determined sleep traits with myopia, including chronotype, sleep duration, short sleep duration and long sleep duration (all P > 0.05).

CONCLUSIONS

No evidence was found to support a causal relationship between sleep traits and myopia. While sleep may not independently predict the risk of myopia, the potential impact of sleep on the occurrence and development of myopia cannot be disregarded.

Relationship between accelerometer-measured sleep duration and Stroop performance: a functional near-infrared spectroscopy study among young adults

OBJECTIVES

Short sleep is becoming more common in modern society. This study aimed to explore the relationship between accelerometer-measured sleep duration and cognitive performance among young adults as well as the underlying hemodynamic mechanisms.

METHODS

A total of 58 participants were included in this study. Participants were asked to wear an ActiGraph GT3X+ accelerometer to identify their sleep duration for 7 consecutive days. Cognitive function was assessed by the Stroop test. Two conditions, including the congruent and incongruent Stroop, were set. In addition, stratified analyses were used to examine sensitivity. 24-channel functional near-infrared spectroscopy (fNIRS) equipment was applied to measure hemodynamic changes of the prefrontal cortex (PFC) during cognitive tasks.

RESULTS

Results showed that sleep duration was positively associated with accuracy of the incongruent Stroop test (0.001 (0.000, 0.002), p = 0.042). Compared with the regular sleep (≥7 h) group, lower accuracy of the incongruent Stroop test (-0.012 (-0.023, -0.002), p = 0.024) was observed in the severe short sleep (<6 h). Moreover, a stratified analysis was conducted to examining gender, age, BMI, birthplace, and education's impact on sleep duration and the incongruent Stroop test accuracy, confirming a consistent correlation across all demographics. In the severe short sleep group, the activation of left middle frontal gyri and right dorsolateral superior frontal gyri were negatively associated with the cognitive performance.

CONCLUSIONS

This study emphasized the importance of maintaining enough sleep schedules in young college students from a fNIRS perspective. The findings of this study could potentially be used to guide sleep time in young adults and help them make sleep schemes.

Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts

Background

The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation.

Objective

To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs.

Methods

A cross-sectional study of the habitual physical activity of 353 children (8-9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively).

Results

The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001).

Conclusion

One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation.

Childhood sound disturbance and sleep problems in Alpine valleys with high levels of traffic exposures and greenspace

Sound disturbance and sleep problems are regarded as the most common adverse effects of environmental noise but evidence of the role of air pollution and greenspace is scant. This is especially true for children who find themselves in a sensitive developmental period and experience their environment differently than adults. This study examined the joint effects of traffic exposures and residential greenspace on child sound disturbance and sleep problems via perceptions of neighborhood quality. We used cross-sectional data for 1251 schoolchildren (8-12 years) in the Tyrol region of Austria/Italy. Questionnaires provided information on sociodemographic and housing factors, perceived neighborhood quality, sound disturbance in different situations, and sleep problems. Modelled acoustic indicators included day-evening-night sound levels and the highest percentile level, and night-time sound level and a bespoke sleep disturbance index. Nitrogen dioxide served as a proxy for traffic-related air pollution. The normalized difference vegetation index was calculated as a measure of residential greenspace, and presence of a domestic garden was self-reported. Results showed that higher level of traffic-related exposures was positively associated with sound disturbance and sleep problems, while living in a greener area, especially in a house with a garden, was associated with lower sound disturbance and less sleep problems even in the presence of traffic. Traffic exposures contributed to more unfavorable, and greenspace to more positive perceptions in terms of traffic-related stressors, opportunities for outdoor recreation, and general satisfaction with the neighborhood. This indirect path seemed more important for greenspace than for traffic exposures. In conclusion, it seems advantageous to combine traffic-related mitigation with improving access to greenspace in interventions for supporting the acoustic comfort of children during day and nighttime. Even highly nature-dominated environments could still benefit from proximal green infrastructure, especially from domestic gardens.

Age-Specific Quantification of Overweight/Obesity Risk Factors From Infancy to Adolescence and Differences by Educational Level of Parents

Objectives: To explore the age-dependent associations between 26 risk factors and BMI in early life, and differences by parental educational level. Methods: Data of 10,310 children (24,155 measurements) aged 2-16 years participating in a multi-centre European cohort from 2007 to 2014 were utilized. Trajectories of overweight/obesity risk factors and their age-specific associations with BMI were estimated using polynomial mixed-effects models. Results: Exposure to most unfavourable factors was higher in the low/medium compared to the high education group, e.g., for PC/TV time (12.6 vs. 10.6 h/week). Trajectories of various risk factors markedly changed at an age of 9-11 years. Having a family history of obesity, maternal BMI, pregnancy weight gain and birth weight were positively associated with BMI trajectories throughout childhood/adolescence in both education groups; associations of behavioural factors with BMI were small. Parental unemployment and migrant background were positively associated with BMI in the low/medium education group. Conclusion: Associations of risk factors with BMI trajectories did not essentially differ by parental education except for social vulnerabilities. The age period of 9-11 years may be a sensitive period for adopting unfavourable behaviours.

Physical Activity Level and Quality of Life of Children Treated for Malignancy, Depending on Their Place of Residence: Poland vs. the Czech Republic: An Observational Study

This study aimed to assess the level of physical activity (PA) and quality of life of cancer-treated children, depending on their place of residence (Poland vs. the Czech Republic, where incidence and mortality rates of childhood malignancies are similar). A total of 68 school-age children (7-18 years) undergoing oncological treatment were included in this study. This study used the quality of life questionnaire (KIDSCREEN-10) and the HBSC questionnaire. This study showed statistically significant differences in the level of PA between Polish and Czech children. In Poland, 93.75% of children exhibited no weekly physical effort at the level of moderate to vigorous PA. In the Czech Republic, 69.44% of children engaged in PA lasting at least 60 min per day, or at least 1 day weekly. Physically active children engaging in more frequent effort, at least 60 min daily, reported higher physical performance (rho = 0.41), higher energy levels (rho = 0.41), and less mood disturbance (rho = -0.31). Children with good relationships with parents were more likely to engage in submaximal PA and spend less time on stationary games. Our study showed that an appropriate level of PA improves well-being and quality of life. It is crucial to promote attractive PA programs tailored for cancer-treated children.

The role of the cultural environment in the development of physical literacy and physical activity of Iranian children

BACKGROUND

The investigation of physical literacy (PL) and physical activity (PA) should be done in an ecological context because the socio-cultural situation can encourage or inhibit children's activity. The present study aimed to study the role of the cultural environment in the development of PL and PA in Iranian children.

METHODS

The statistical population consisted of Iranian children aged 8 to 12, of whom 270 students were recruited by cluster sampling from six provinces. They complete the Canadian Assessment of Physical Literacy 2 (CAPL-2) and the International Physical Activity Survey. To examine the cultural environment, the components of geographic location (west, south, central, east, and northwest), place of residence (downtown, suburban, and village), and gender (boys and girls) were used. A multivariate ANOVA analysis was used to analyze the data.

RESULTS

From the geographic location, the findings showed that students inhabit in the west and east of Iran have significantly higher scores than their counterparts living in the central, south, and northwest at PA and PL (P < 0.001). From the place of residence, we observed a higher level of PA and PL in children living in the village than in those living in the suburbs and downtown (P < 0.001). In terms of gender, boys have higher PL and PA scores (P < 0.001).

CONCLUSION

The findings demonstrate that socio-cultural factors, geographic location, place of residence, and gender have different impacts on children's PL and physical activity. Therefore, we suggest using ecologically appropriate decentralized planning in a physical education curriculum.

Protocol for a randomised controlled trial evaluating the effect of a CBT-I smartphone application (Sleep Ninja®) on insomnia symptoms in children

BACKGROUND

Sleep is necessary for healthy development and mental wellbeing. Despite this, many children do not get the recommended duration of sleep each night, and many experience sleep problems. Although treatable, existing interventions for sleep disturbance are time-consuming, burdensome for families, and focus on providing behavioural strategies to parents rather than upskilling children directly. To address this gap, we modified Sleep Ninja®, an evidence-based cognitive behavioural therapy for insomnia (CBT-I) smartphone app for adolescent sleep disturbance, to be appropriate for 10 to 12 year olds. Here, we describe the protocol for a randomised controlled trial to evaluate the effect of Sleep Ninja on insomnia and other outcomes, including depression, anxiety, sleep quality, and daytime sleepiness, and explore effects on the emergence of Major Depressive Disorder (MDD), compared to an active control group.

METHODS

We aim to recruit 214 children aged 10 to 12 years old experiencing disturbed sleep. Participants will be screened for inclusion, complete the baseline assessment, and then be randomly allocated to receive Sleep Ninja, or digital psychoeducation flyers (active control) for 6-weeks. The primary outcome, insomnia symptoms, along with depression, anxiety, sleep quality, and daytime sleepiness will be assessed at 6-weeks (primary endpoint), 3-months, and 9-months post-baseline (secondary and tertiary endpoints, respectively). A mixed model repeated measures analytic approach will be used to conduct intention-to-treat analyses to determine whether reductions in insomnia and secondary outcomes are greater for those receiving Sleep Ninja relative to the control condition at the primary and secondary endpoints. The difference in relative risk for MDD onset will be explored at 9-months and compared between conditions.

DISCUSSION

This is the first clinical trial examining the effects of a CBT-I smartphone app in children experiencing sleep disturbance. Results will provide empirical evidence about the effects of Sleep Ninja on insomnia and other mental health outcomes.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12623000587606).

UNIVERSAL TRIAL NUMBER

U1111-1294-4167.

The prevalence and associated factors of sleep deprivation among healthy college students in China: a cross-sectional survey

Background

The prevalence of sleep deprivation among college students is increasing and has a few associated factors.

Methods

The present study analyzed 2,142 college students from 28 provinces in China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Binary logistic regression was conducted to explore the sleep deprivation related factors. Age and gender were controlled as covariates.

Results

Among the 2,142 college students (27.7% male, 72.3% female), 1,620 (75.6%) reported the average sleep duration was below 7 h per day for one month, 49.3% (1,055/2,142) slept 6∼7 h (contains 6 h), 21.0% (449/2,142) slept 5∼6 h (contains 5 h), and 5.4% (116/2,142) slept <5 h. Age increased the risk of sleep deprivation, the adjusted odds ratio = 1.05 (95% CI [1.01∼1.10]). The adjusted odds ratio (A-OR) for sleep deprivation was higher for students of more than 60 min nap duration per day (A-OR = 2.35, 95% CI [1.45∼3.80]), and age growth (A-OR = 1.05, 95% CI [1.01∼1.10]). In contrast, A-ORs were lower among sleeping inconsistency between work and rest days (A-OR = 0.61, 95% CI [0.49∼0.75]), accustomed to staying up late (A-OR = 0.45, 95% CI [0.36∼0.57]), staying up late to work or study (A-OR = 0.62, 95% CI [0.49∼0.78]), stress (A-OR = 0.75, 95% CI [0.58∼0.98]), and repeated thoughts in bed had (A-OR = 0.79, 95% CI [0.62∼0.99]).

Conclusions

Sleep deprivation is extremely common among healthy college students in China. It is necessary to perform methods maintaining enough sleep due to the current high incidence of sleep deprivation. Controlling the nap duration and getting enough sleep on rest days to replace missing hours of sleep on workdays might improve college students' sleep.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study

Introduction

Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren.

Methods

A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses.

Results

The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]).

Conclusion

Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

Results from Portugal's 2022 report card on physical activity for children and youth

Background

The purpose of this study is to update results of Portuguese's Report Card on Physical activity (PA) for Children and Adolescents.

Methods

The grades were assigned by results derived from the PA and Fitness in Portugal 2021 Portuguese Report Card and corresponds to the third report for the Portuguese children and adolescents. It includes indicators of PA and sedentary behavior (SB) that are common to the GLOBAL matrix 4.0: Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviors, Family and Peers, School, Community and the Environment, Government and Physical Fitness. The search focused on published national evidence/data sources (academia, NGO, governmental) from end 2018 onwards excluding data obtained during the covid-19 pandemic.

Results

The grades were assigned as follows: Overall PA (D^-), Organized Sport Participation (C^-), Active Play (D⁺), Active Transportation (D^-), Sedentary behaviors (C⁺), Physical Fitness (C), Family and Peers (B), School (A), Community and Environment (B), and Government (B).

Conclusion

In line with previous Portuguese Report Cards, a large proportion of Portuguese children and adolescents are not sufficiently active nor fit enough setting urgency for effective strategies. Particular attention should be given to Active play, Active transport and Organized Sports Participation has their grades have decreased. Some actions in selected indicators as Governmental and policy seems promising however results weren't seen yet. Despite the strong support of schools with mandatory curricula in PE no correspondent change is observed in fitness or PA, so more research is needed to find why.

24-h Movement Guidelines and Overweight and Obesity Indicators in Toddlers, Children and Adolescents: A Systematic Review and Meta-Analysis

BACKGROUND

Engaging in physical activity increases energy expenditure, reducing total body fat. Time spent in sedentary behaviours is associated with overweight and obesity, and adequate sleep duration is associated with improved body composition. This systematic review aimed to analyse the relationship between compliance with the 24-h movement guidelines and obesity indicators in toddlers, children and adolescents.

METHODS

A systematic review and meta-analysis was conducted. PubMed, Web of Science and Scopus were searched from inception to December 2021. Cross-sectional and prospective studies that analysed the relationship between 24-h movement guidelines and overweight and obesity written in English, French, Portuguese or Spanish were included. PROSPERO registration number is CRD42022298316.

RESULTS

The associations between meeting the 24-h movement guidelines and standardised body mass index were null in the two studies for toddlers. Seven studies analysed the relationship between compliance with the 24-h movement guidelines and overweight and obesity among preschool children. Of these seven studies, six found no association between compliance with 24-h movement guidelines and body composition. Among children and adolescents, 15 articles were analysed. Of these 15 studies, in seven, it was found that children and adolescents who meet the 24-h movement guidelines were more likely to have lower risks of overweight and obesity. The meta-analysis yielded a pooled OR = 0.80 (95% CI = 0.68 to 0.95, p = 0.012, I² = 70.5%) in favour of compliant participants. Regarding participants' age groups, compliance with 24-h movement guidelines seems to exert greater benefits on overweight and obesity indicators among children-adolescents (OR = 0.62, p = 0.008) compared to participants at preschool (OR = 1.00, p = 0.931) and toddlers (OR = 0.91, p = 0.853).

CONCLUSION

Most included studies have not observed a significant relationship between compliance with the 24-h movement guidelines and overweight and obesity in toddlers, children and adolescents.

Executive function, behavioral problems, and insulin resistance in adolescents with obesity

OBJECTIVES

In this study, we examined executive function (EF) abilities, behavioral and emotional (BE) issues, and overall quality of life (QoL) of adolescents with obesity and compared them with a control group and also aimed to investigate whether the presence of insulin resistance (IR) is associated with these problems.

METHODS

This cross-sectional study included a sample of 50 adolescents aged 11-18 years with obesity and age- and gender-matched 50 normal weight adolescents who had attended and were treated at the pediatric outpatient clinic. Sociodemographic data were collected through personal interviews with the adolescents and their parents. Measurements of the height and weight, fasting blood glucose, and insulin levels of all adolescents were assessed. In addition, the participants and their parents completed the Kiddo-KINDL, the Strengths and Difficulties Questionnaire, and the Behavior Rating Inventory Scale from Executive Function.

RESULTS

Of the 50 adolescents with obesity, 27 (54.0 %) were girls, and 23 (46.0 %) were boys, with a mean age of 14.06 ± 1.83 years. Adolescents with obesity have more EF deficiencies, BE difficulties, more problems in peer relationships and lower QoL scores than those without obesity. The QoL was worse in girls, adolescents with obesity, and those with IR. Adolescents with obesity and those with and without IR did not differ about EF deficiencies and BE problems.

CONCLUSIONS

Addressing these EF deficits and BE problems in interventions for adolescents who have difficulty adapting to lifestyle changes, an essential part of obesity treatment in clinical practice, may contribute to treatment success.

A Meta-Analysis of Sampled Maximal Aerobic Capacity Data for Boys Aged 11 Years Old or Less Obtained by Cycle Ergometry

The aim of this study was to develop distributions of VO_2max based on measured values that exist in the literature in prepubertal boys using cycle ergometry. PRISMA guidelines were followed in conducting this research. One database was searched for peak and maximal VO₂ values in healthy boys with mean age under 11 years old. Data were split into articles reporting absolute and relative VO_2max values and analyzed accordingly. Multilevel models grounded in Bayesian principles were used. We investigated associations between VO_2max and body mass, year of the study, and country of origin. Differences in "peak" and "maximal" VO₂ were assessed. Absolute VO_2max (Lmin^-1) increases with age (P ~100%) but mean relative VO_2max does not change (P ~100%). Absolute VO_2max is higher in more recent studies (P = 95.7 ± 0.3%) and mean relative VO_2max is lower (P = 99.6 ± 0.1%). Relative VO_2max in the USA is lower compared with boys from other countries (P = 98.8 ± 0.2%), but there are no differences in absolute values. Mean aerobic capacity estimates presented as "peak" values are higher than "maximal" values on an absolute basis (P = 97.5 ± 0.3%) but not on a relative basis (P = 99.6 ± 0.1%). Heavier boys have lower cardiorespiratory fitness (P ≈ 100%), and body mass seems to be increasing faster with age in the USA compared with other countries (P = 92.3 ± 0.3%). New reference values for cardiorespiratory fitness are presented for prepubertal boys obtained with cycle ergometry. This is new, as no reference values have been determined so far based on actual measured values in prepubertal boys. Aerobic capacity normalized to body weight does not change with age. Cardiorespiratory fitness in prepubertal boys is declining, which is associated with increasing body mass over the last few decades. Lastly, this study did not find any statistically significant difference in the sample's mean aerobic capacity estimates using the "peak" and "maximum" distinctions identified in the literature.

The clinical implications of digital technology

The proliferation of digital technology within the lives of children and young people (CYP) provides arguably one of the most significant clinical and ethical paradigm shifts in Child and Adolescent Psychiatry. One can argue that mental health research has taken a myopic approach to understanding the interaction between young people's technology use and their mental health. Mental health clinicians also need a better understanding of the digital lives of CYP and how technology may be supporting or harming their mental health. Within this paper, we argue that greater longitudinal research is required, particularly in vulnerable groups, and that there is an essential need for a standardised digital use assessment (DUA) tool, which assimilates CYP use of technology and their vulnerabilities/resilience to online risks. We subsequently offer a series of questions clinicians can use to explore technology use by CYP. Such an aide memoire may empower clinicians to have wider discussions around digital technology use with CYP, while also helping to develop appropriate safety and management plans.

Exploring physical literacy in children aged 8 to 12 years old: a cross-cultural comparison between China and Greece

Background

The concept of physical literacy (PL) has been advocated as a crucial determinant for increasing the quality and quantity of movement and physical activity (PA). Children’s PL has been rarely compared across countries, although it has shown low levels in many countries. This study aimed to explore and compare children’s PL from China and Greece.

Methods

A total of 327 Chinese (47.1% boys) and 295 Greek children (48.1% boys) aged 8 to 12 years participated in this study. Children’s PL was objectively assessed by the Chinese and Greek version of the Canadian Assessment of Physical Literacy, 2nd edition, which consists of four domains: Daily Behavior, Physical Competence, Motivation and Confidence, and Knowledge.

and Understanding. Univariate analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) on total PL and domain scores were conducted in both countries, respectively.

Results

MANOVA revealed significant differences in total PL and distribution scores between two countries (Pillais’ trace = 0.260, F = 53.855, p < 0.001, η² = 0.260), with Greek children scoring better than Chinese. Nevertheless, most children failed to present an adequate PL level as they were mostly in the “progressing” stage. The chi-square denoted that the distribution of Chinese and Greek participants across the CAPL-2 interpretive categories was statistically different for total PL (χ² [3] = 18.726, p < 0.001, Cramer’s V = 0.174), with more Greek children being classified as “achieving” and “excelling”.

Conclusions

The variance between Chinese and Greek children may be attributed to cultural differences in the context of PA, such as PE policies and settings. The relatively low level of PL shown in both countries echoes the global trend of the declining PA among children, with an increasing amount of their time spent in a sedentary lifestyle. These findings highlight the need to consider children’s cultural factors and pedagogical strategies in terms of developing their PL. Future research is required to explore the impact of cultural background on PL development among children and appropriate strategies to migrate their influence.

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

İstanbul'da 6-15 Yaş Arası Çocuklarda Obezite Prevalansı

Amaç: Bu araştırma, İstanbul'un bir ilçesinde 6-15 yaş arası çocuklarda obezite prevalansını ve beslenme alışkanlıklarını değerlendirmeyi amaçlamaktadır.Yöntem: Bu araştırma, İstanbul'un Avcılar ilçesinde 19 ilköğretim okulunda 6-15 yaş arası 2452 öğrenci ile gerçekleştirilen kesitsel tipte bir araştırmadır. Çocukların beslenme alışkanlıkları ve besin tüketim sıklıkları hakkında yüz yüze anket uygulanmıştır. Çocukların boy uzunluğu, vücut ağırlığı, bel ve kalça çevresi ölçümleri alınmıştır. Çocuklar Z-skorlarına göre sınıflandırılmıştır. İstatistikler SPSS 21 programı kullanılarak yapılmıştır.Bulgular: Öğrencilerin toplam %47.8'i erkek, %52.2'si kızdır. Öğrencilerin yaşlarının ortalaması 9.47±2.21, ortalama BKİ ise 18.7±3.73 kg/m2’dir. Fazla kiloluluk ve obezite prevalansı sırasıyla %20.3 ve %13.2 bulunmuştur. 9 yaşındakilerin obezite prevalansı en yüksek düzeydedir ve erkeklerde kızlara göre daha fazla obezite görülmüştür (p&lt;0,001). Obez olan ve obez olmayan öğrenciler arasında ders çalışırken ve televizyon izlerken atıştırma ve bazı besinleri tüketme sıklığı açısından anlamlı fark bulunmuştur (p&lt;0.05).Sonuç: Her üç çocuktan birinin normalden fazla kilolu olduğu bulunmuştur. Ulusal ve uluslararası politikaların yanı sıra bölgesel ve yerel takipler ile gerekli önlemlerin alınması çocukluk çağı obezitesinin kontrolünde faydalı olabilir.

Association between Physical Fitness Index and Psychological Symptoms in Chinese Children and Adolescents

The aim of this study was to determine the relationship between different physical fitness indices (PFIs) and psychological symptoms and each dimension (emotional symptoms, behavioral symptoms, social adaptation difficulties) of Chinese children and adolescents. Methods: A total of 7199 children and adolescents aged 13−18 in Jiangxi Province, China, were tested for grip strength, standing long jump, sit-ups, sit and reach, repeated straddling, 50 m run, 20 m shuttle run test (20 m SRT) items. The physical fitness indicators were standardized, converted to Z score and added up to obtain the PFI, and the self-assessment of the psychological section of the multidimensional sub-health questionnaire of adolescents (MSQA) to test the psychological symptoms, using the chi-square test to determine the psychological symptoms of different types of children and adolescents and binary logistic regression analysis to determine the association between psychological symptoms and different PFI grades. Results: The higher the PFI of Chinese children and adolescents, the lower the detection rate of psychological symptoms, emotional symptoms and social adaptation difficulties, from 25.0% to 18.4%, 31.3% to 25.7% and 20.1% to 14.4%, respectively. These results were statistically significant (χ2 = 14.073, 9.332, 12.183, p < 0.05). Taking the high-grade PFI as a reference, binary logistic regression analysis was performed. Generally, compared with the high-grade PFI, children and adolescents with a low-grade PFI (OR = 1.476, 95% CI: 1.200−1.814) or medium-grade PFI (OR = 1.195, 95% CI: 1.010−1.413) had a higher risk of psychological symptoms (p < 0.05). Conclusions: The lower the PFI of Chinese children and adolescents, the higher the detection rate of psychological symptoms, showing a negative correlation. In the future, measures should be taken to improve the physical fitness level of children and adolescents in order to reduce the incidence of psychological symptoms and promote the healthy development of children and adolescents.

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.

The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents

Background: Over the last few decades, the time children spend using electronic devices has increased significantly. The aim of the study was to evaluate the impact of screen time on dietary behaviors and physical activity in children and adolescents. Methods: An online survey was conducted among parents of preschool and school-aged children during the COVID-19 lockdown in Poland. There were 3127 surveys used in the analysis. Results: Survey responses referred to 1662 (53%) boys and 1465 (47%) girls, with a mean age of 12.1 ± 3.4 years. During a routine weekday, most children (71%) spent >4 h on educational activities using electronic devices, and 43% of children spent 1−2 h using devices for recreational purposes. The majority of children (89%) were exposed to screens during meals, and ate snacks between main meals (77%). There was an association between screen time and the exposure to screens during meals, and between screen time and time spent performing physical activity. Conclusions: This study revealed that the majority of children were exposed to screens during meals, which is a risk factor of obesity. The promotion of the judicious use of digital devices and healthy dietary habits associated with the use of screens may be an important component of obesity prevention strategies.