Systematic review of sedentary behaviour and health indicators in school-aged children and youth

Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review

INTRODUCTION

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected children and adolescents' movement behaviours, but there is a need to synthesise these findings. Therefore, we conducted this systematic review to examine the impact of COVID-19 lockdown on children and adolescents' movement behaviours.

METHODS

We searched eight databases and grey literature for relevant studies of all study designs; and conducted a narrative analysis of the results following synthesis without meta-analysis guidelines. We used appropriate tools to assess the risk of bias in quantitative and qualitative studies. We compared changes in physical activity, screen time and sleep duration and quality from before to during the COVID-19 lockdown.

RESULTS

This review included 71 studies reporting data from 35 countries and territories, mostly from high-income economies. A majority of the studies used a cross-sectional design and had fair to poor-quality ratings. Most studies reported reduced physical activity, increased screen time and longer sleep hours among children and adolescents. Children and adolescents facing strict lockdowns saw a larger decline in physical activity and a sharper increase in screen time than those under mild restrictions.

CONCLUSION

COVID-19-related lockdowns were detrimental to children and adolescents' movement behaviours, with stricter lockdowns tending to have a bigger impact. Children and adolescents under COVID-19 restrictions are likely to be less active, spend more time on screen, and sleep longer hours than before the lockdown. More studies from low-income and middle-income countries could provide a clearer picture of the impact.

PROSPERO REGISTRATION NUMBER

CRD42021245924.

The after-school sedentary behavior status among children and adolescents with intellectual disabilities

BACKGROUND

There is evidence that the after-school period plays an essential role in accumulating sedentary behavior (SB) among children and adolescents, as well as implementing potential interventions. However, relatively little is known regarding SB status of children and adolescents with intellectual disabilities (ID) during the after-school period. The purpose of this study was to investigate the total level and specific pattern of the after-school SB among children and adolescents with ID.

METHODS

The after-school SB status among 325 children and adolescents with ID was evaluated by the parent-reported Children's Leisure Activities Study Survey-Chinese edition questionnaire.

RESULTS

Parents of children and adolescents with ID reported approximately 204 min/day of after-school SB. Specifically, the longest time of the after-school period was spent performing the screen-based SB (84 mins/d). This was followed by recreational SB and educational SB (50 and 30 mins/d, respectively). The children aged 6-12 years old engaged more time in recreational SB than adolescents aged 16-18 years old (p < 0.05) during the after-school period. Further, the data indicated that 37.5% of children and adolescents with ID achieved the guideline limitation of 2-h-maximum screen-based SB during the after-school hour.

CONCLUSION

Children and adolescents with ID spent a large portion of the after-school period in SB, particularly engaged in more time on after-school screen-based SB. Future efforts should focus on developing and implementing period-specific interventions designed to reduce after-school SB in the segment of this population.

Screen time and depression risk: A meta-analysis of cohort studies

BACKGROUND

The impact of screen time on mental health, including depression, has attracted increasing attention from not only children and adolescents but also the elderly. Thus, we conducted a meta-analysis of cohort studies to evaluate the association between screen time and depression risk.

METHODS

The PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases were searched for cohort studies up to May 2022, and the reference lists of the included studies were also retrieved. A random-effect model was used to estimate the combined effect size. Heterogeneity was assessed with the I ² statistic. Potential publication bias was evaluated using a funnel plot and Begg's and Egger's tests.

RESULTS

The final analysis included 18 cohort studies with a combined total of 241,398 participants. The pooled risk ratio (RR) was 1.10 (95% confidence interval: 1.05-1.14), with significant heterogeneity (I ² = 82.7%, P < 0.001). The results of subgroup analyses showed that the pooled RRs varied according to geographic locations, gender, age group, screen time in the control group, depression at the baseline, and whether the study was conducted during the COVID-19 pandemic. No obvious evidence of publication bias was found.

CONCLUSION

This study indicates that screen time is a predictor of depressive symptoms. The effects of screen time on depression risk may vary based on the participant's age, gender, location, and screen time duration. The findings could have important implications for the prevention of depression.

Association between Metabolic Syndrome Diagnosis and the Physical Activity-Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study

Metabolic syndrome (MetS) is highly prevalent in children and adolescents with obesity and places them at an increased risk of cardiovascular-related diseases. However, the associations between objectively measured movement-related behaviors and MetS diagnosis remain unexplored in youths with obesity. The aim was to compare profiles of sedentary (SED) time (more sedentary, SED+ vs. less sedentary, SED−), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA−) and combinations of behaviors (SED−/MVPA+, SED−/MVPA−, SED+/MVPA+, SED+/MVPA−) regarding the MetS diagnosis. One hundred and thirty-four adolescents with obesity (13.4 ± 2.2 years) underwent 24 h/7 day accelerometry, waist circumference (WC), blood pressure (BP), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG) and insulin-resistance (IR) assessments. Cumulative cardiometabolic risk was assessed by using (i) MetS status (usual dichotomic definition) and (ii) cardiometabolic risk z-score (MetScore, mean of standardized WC, BP, IR, TG and inverted HDL-c). SED− vs. SED+ and MVPA+ vs. MVPA− had lower MetS (p < 0.01 and p < 0.001) and MetScore (p < 0.001). SED−/MVPA+ had the lowest risk. While SED and MVPA times were lower in SED−/MVPA− vs. SED+/MVPA+ (p < 0.001), MetScore was lower in SED−/MVPA− independently of body mass index (BMI) (p < 0.05). MVPA, but not SED, time was independently associated with MetS diagnosis (p < 0.05). Both MVPA (p < 0.01) and SED times (p < 0.05) were associated with MetScore independently of each other. A higher MVPA and lower SED time are associated with lower cumulative cardiometabolic risk.

Promoting physical activity and health in Hong Kong primary school children through a blended physical literacy intervention: protocol and baseline characteristics of the "Stand+Move" randomized controlled trial

BACKGROUND

Children predominantly remain sedentary in a traditional classroom. This study aimed to demonstrate the design and baseline characteristics of a three-armed intervention program that targeted enhancements in children's physical literacy (PL), physical activity (PA), sleep, and executive functions by constructing an active classroom environment in primary schools. The blended approach involved organized PA participation during recess combined with changes to the classroom environment in response to the emphasis on nurturing children's PL in Hong Kong.

METHODS

This blended "Stand + Move" intervention adopted a randomized controlled trial design to investigate its effectiveness in improving health-related aspects. Three groups were compared: (1) PA recess intervention, (2) blended (sit-stand desks and PA recess) experimental, and (3) control groups. In this 13-week intervention (from March to September 2019), 76 students (59.2% girls) were recruited and randomly assigned to the three groups. The primary outcomes were children's PL and PA. The secondary outcomes were children's sleep and executive functions.

RESULTS

Baseline data were evaluated. The mean age was 9.6 years [standard deviation = 0.61, range 9.0-12.0]. There were no significant differences between trial arms at baseline concerning any of the outcomes (all P = 0.06-0.89). Overall, 22.4% met the recommended PA guidelines, 36.8% met the sleep guidelines, and 10.5% met both guidelines. Three aspects of executive functions were evaluated: inhibition, executive control, and planning. Over half of the participants reported satisfaction with their perceived sleep quality.

CONCLUSIONS

The designed intervention is regarded as an innovative strategy that incorporates sit-stand desks and PA breaks to reconstruct children's traditional classroom environment. The baseline results suggest that intervention was satisfactory in reducing students' sitting time and increasing their PA engagement. We demonstrated the benefits of this intervention on children's PL, various sleep patterns, and executive functions. As expected, the designed intervention changes made to the classroom improved children's health behaviors, as well as the support from stakeholders at schools and the children's families. Our results also provided the desired evidence for policy reforms in teaching and learning strategies.

TRIAL REGISTRATION

ChiCTR ChiCTR2000035038 . Registered on July 29, 2020-retrospectively registered.

School Bag-Related Factors and Their Implications for Walking and Cycling to School among New Zealand Adolescents

Excessive school bag weight may be a modifiable barrier to active transport to school. This study examined correlates of school bag weight and adolescents’ perceptions of excessive school bag weight for walking and cycling to school among New Zealand adolescents living in diverse settlement types. Adolescents (n = 1512; 15.0 ± 1.3 years) completed a questionnaire and had their bag weight (n = 1190) and body weight (n = 1038) measured. Adolescents using active transport and rural adolescents had lighter school bags compared to their counterparts. One-third of adolescents reported excessive school bag weight for walking (31.2%) and cycling (37.2%) to school. Positive correlates of relative school bag weight were female gender (regression coefficient (95% CI): 0.53 (0.13, 0.93)), and underweight (2.21 (1.39, 3.02)), whereas negative correlates were Māori ethnicity (−0.87 (−1.41, −0.32)), overweight (−1.84 (−2.35, −1.34)) and obesity (−3.57 (−4.26, −2.87)), and school location in small urban areas (−2.10 (−4.19, −0.01)), and rural settlements (−3.58 (−5.66, −1.49)). Older adolescents, females, those with greater relative school bag weight, and those experiencing school bag-related pain symptoms and/or fatigue were more likely to report excessive school bag weight for both walking and cycling to school. Future initiatives should target reducing excessive school bag weight, particularly in female and urban adolescents.

Physical Activity and Screen Time among Hungarian High School Students during the COVID-19 Pandemic Caused Distance Education Period

Background: High school education took place in the form of distance learning during SARS-CoV-2 pandemic worldwide, including Hungary. Decreased physical activity and an increase in inactive behaviours may lead to an increased risk of obesity, diabetes, and cardiovascular disease. Aim: Our study targeted changes in physical activity (aerobic exercise, muscle strengthening) and screen time in adolescents and young adults during the pandemic. Methods: High school students were interviewed in 66 public schools in 37 Hungarian cities (N = 2508). Survey items on physical activity and screen time were derived from the WHO Health Behaviour of School-aged Children Survey and the Centers for Disease Control Youth Risk Behavior Survey. A 2 × 2 factorial ANCOVA was used to test the effects of gender (male vs. female) and/or age (adolescents vs. young adults) on the reported changes in physical activity and screen time before and during lockdown (covariate: BMI Z-score). Results: The majority of the cohort indicated less physical activity. Aerobic and muscle-strengthening type of exercises significantly decreased, and screen time increased during distance education. Male individuals showed a higher decrease in the level of aerobic exercise, and young adults reported a higher increase in the time spent in front of the screen.

Influence of socioeconomic variables on physical activity and screen time of children and adolescents during the COVID‑19 lockdown in Germany: the MoMo study

The COVID‑19 (coronavirus disease 2019) pandemic created a multitude of natural experiments about the change of human behavior in a widely unfamiliar situation. Besides physical and mental health, physical activity (PA) and people’s movement behaviors were of particular interest to researchers all over the world. In a recent study, we found that among youth in Germany, sports activity declined, whereas recreational screen time and habitual activity increased during the first COVID‑19 lockdown. In the present study, we analyze the influence of the socioeconomic status and the housing situation on the changes in PA behavior and recreational screen-time before and during the first COVID‑19 lockdown among children and adolescents living in Germany. We found an alignment of PA behavior among youth from families with different socioeconomic backgrounds during the first lockdown and identified the housing situation to be a meaningful predictor of the increase in habitual activity. We conclude that restriction policies, communities, and in the last instance parents need to enable access to nonorganized PA to all children and adolescents every day and especially during potential future lockdowns.

Sedentary behaviour in non-ambulant children and young people with physical disabilities: a systematic search and review protocol

INTRODUCTION

Non-ambulant children and young people with physical disabilities are at high risk of experiencing negative health outcomes associated with sedentary time. A previous scoping review summarising evidence relating to sedentary behaviours of children with physical disabilities identified the need for validated methods of measuring physical activity of children who use wheelchairs and evaluation of interventions to reduce sedentary time. The scoping review did not assess the quality of evidence relating to this topic, therefore its validity remains unclear. No reviews focussing on non-ambulant children and young people up to the age of 25 years have been undertaken.The objectives of this systematic search and review are to:Identify all peer-reviewed articles relating to sedentary behaviour of non-ambulant children and young people.Categorise the articles according to study design and four subquestions relating to (i) measurement, (ii) patterns, (iii) associated risks and (iv) interventions to reduce sedentary time or behaviour.Critically appraise quality of the articles using established critical appraisal tools.Summarise the evidence for each subquestion. Describe its cumulative strength and identify knowledge gaps.

METHODS AND ANALYSIS

This protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The research questions, inclusion/exclusion criteria and search terms have been developed a priori using the 'Population, Concept and Context' framework. Online databases will be systematically searched to identify peer-reviewed articles published between 1996 and 2021. Two reviewers will screen, categorise and critically appraise the articles. Data extraction and analysis will be verified by the second reviewer.Results will be reported as a best evidence synthesis, with reference to the PRISMA checklist.

ETHICS AND DISSEMINATION

Ethical approval is not required. The review will be submitted to an appropriate peer-reviewed journal.

REGISTRATION

The review is registered on the Open Science Framework database. DOI: https://doi.org/10.17605/OSF.IO/SQXJB. Any protocol amendments will be recorded in the Open Science Framework database.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

PURPOSE

The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019 (COVID-19) pandemic and movement behaviors (physical activity, sedentary behavior, and sleep) of school-aged children (aged 5-11 years) and youth (aged 12-17 years) in the first year of the COVID-19 outbreak.

METHODS

Searches for published literature were conducted across 6 databases on 2 separate search dates (November 25, 2020, and January 27, 2021). Results were screened and extracted by 2 reviewers (DCP and KR) independently, using Covidence. Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.

RESULTS

A total of 1486 records were extracted from database searches; of those, 150 met inclusion criteria and were included for analysis. Of 150 articles, 110 were empirical studies examining physical activity (n = 77), sedentary behavior/screen time (n = 58), and sleep (n = 55). Results consistently reported declines in physical-activity time, increases in screen time and total sedentary behavior, shifts to later bed and wake times, and increases in sleep duration. The reported impacts on movement behaviors were greater for youth than for children.

CONCLUSION

The COVID-19 pandemic is related to changes in the quantity and nature of physical activity, sedentary behavior, and sleep among children and youth. There is an urgent need for policy makers, practitioners, and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.

Identifying risk profiles for excess sedentary behaviour in youth using individual, family and neighbourhood characteristics

There are few known determinants of sedentary behaviour (SB) in children. We generated and compared profiles associated with risk of excess SB among children (n = 294) both at 8-10 and 10-12 years of age (Visits 1 and 2, respectively), using data from the QUebec Adipose and Lifestyle InvesTigation in Youth. Excess SB was measured by accelerometry and defined as >50% of total wear time at <100 counts/minutes. Recursive partitioning analyses were performed with candidate individual-, family-, and neighbourhood-level factors assessed at Visit 1, and distinct groups at varying risk of excess SB were identified for both timepoints. From the ages of 8-10 to 10-12 years, the prevalence of excess SB more than doubled (24.5% to 57.1%). At Visit 1, excess SB was greatest (73%) among children simultaneously not meeting physical activity guidelines, reporting >2 h/day of weekday non-academic screen time, living in low-dwelling density neighbourhoods, having poor park access, and living in neighbourhoods with greater disadvantage. At Visit 2, the high-risk group (70%) was described by children simultaneously not meeting physical activity guidelines, reporting >2 h/day of non-academic screen time on weekends, and living in neighbourhoods with low disadvantage. Risk factors related to individual lifestyle behaviours are generally consistent, and neighbourhood factors generally inconsistent, as children age from late childhood to pre-adolescence. Multiple factors from developmental, behavioural and contextual domains increase risk for excess sedentary behaviour; these warrant consideration to devise effective prevention or management strategies.

The Specific Impact of Nutrition and Physical Activity on Adolescents' Body Composition and Energy Balance

Purpose: The aim of the present study was to identify the contribution of nutrition, physical activity (PA), and total energy intake and expenditure on body weight and composition in adolescents. Methods: Body composition, PA, and dietary intakes from 904 Greek adolescents (446 boys and 458 girls; Age: 14.6 ± 1.5 yrs), were evaluated. All participants were assigned into three groups according to their age-sex adjusted Fat Mass Index: (A) Normal weight (N; N = 503), (B) Overweight (OW; N = 253), and (C) Obese (O; N = 148). Results: Significant differences were found for body weight and composition, basal metabolic rate (BMR) expressed per kg of body mass (normal weight children exhibited the highest values), physical-total energy expenditure, and energy balances between the groups (η²: 0.138 to 0.657; p < .05). In contrast, no differences were found for macronutrients' and total energy intakes, food consumption and quality (η²: 0.002 to 0.099; p > .05) between the three examined groups. Strong, negative correlations were observed between body weight, body fat percentage, PA, and total energy expenditure (r: -0.311 to -0.810; p < .001). Lower, negative correlations were found between body weight, body fat percentage, and macronutrients' daily intakes (r:-0.235 to -0.432; p < .05). BMR and total energy expenditure had strong, negative relative strengths for the determination of body weight and fat percentage. Conclusions: In conclusion, it seems that BMR, PA, and total daily energy expenditure expressed per body weight and not the nutritional and total energy intakes, were the primary determinant parameters of body composition and weight in adolescents.

Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents

BACKGROUND

Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes.

METHODS

Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex.

RESULTS

The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes.

CONCLUSIONS

The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.

The Association between Physical Activity, Motor Skills and School Readiness in 4-5-Year-Old Children in the Northeast of England

The benefits of being physically active, possessing good motor skills and being school-ready are well documented in early years. Nevertheless, the association between physical activity and motor skills with school readiness remains unknown. Therefore, the aim of this cross-sectional study was to explore the relationship between these variables. We collected data on 326 four to five-year-old children from the northeast of England. Children's PA (ActiGraph GT1M accelerometers), motor skills (MABC-2 and the locomotor section of the TGMD-2) and school readiness (EYFSP) were measured, and associations between these variables were examined. This study found that, on average, children engaged in more MVPA (99.6 min/day) and less sedentary behaviour (261 min/day) than documented in previous research. Motor-skill scores were consistent with existing literature in early years. A higher percentage of children in the sample (79.6%) achieved school readiness than the average for England. Regression analyses found that motor-skill variables and sedentary behaviour were significantly predictive of school readiness, whereas physical activity was not. Motor skills and sedentary behaviour significantly predict school readiness. Therefore, promoting motor skills and developmentally appropriate sedentary behaviour activities may increase the number of children achieving school readiness.

Associations between Physical Activity and Mental Health in Iranian Adolescents during the COVID-19 Pandemic: An Accelerometer-Based Study

Using self-reported questionnaires, several studies found that social isolation during the COVID-19 pandemic has significantly changed the level of physical activity (PA) in children and adolescents. Since the objectivity of self-reported PA is limited in several ways, we used modern accelerometers in this study to assess the PA levels of male and female adolescents during the pandemic-related lockdown. Moreover, the association of PA with mental health of the adolescents were analyzed. A total of 136 students (76 girls, mean age of 16.28 ± 0.97 years) from various schools in Iran wore the accelerometer (ActiGraph GT3X-BT) for seven consecutive days. Mental health was measured through the Depression, Anxiety, Stress Scale-21 of Lovibond and Lovibond (1995). Descriptive statistics and independent t-tests were used to analyze the PA levels of male and female students, and linear regressions were computed to examine whether PA predicts mental health status. On average, the daily time spent in moderate-to-vigorous PA (MVPA) was 18.47 min, which is clearly below the WHO guideline of at least 60 min of MVPA per day. Only 4% of adolescents showed MVPA for more than 30 min per day. Male students were significantly more active than their female peers (p = 0.015). As expected, MVPA was negatively associated with mental health issues such as depression, anxiety, and stress. However, the majority of adolescents reported symptoms of mild-to-moderate mental health disorders. These results emphasize the need for targeted strategies and offerings geared to young people's needs and preferences to promote an adequate level of PA and good mental health during and after the ongoing pandemic.

Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students

BACKGROUND

The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.

METHODS

The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.

RESULTS

The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences.

CONCLUSIONS

Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.

Most People Hate Physical Education and Most Drop Out of Physical Activity: In Search of Credible Curriculum Alternatives

High quality Physical Education should instigate and support all learners to develop into a lifelong participant in a way which upkeeps their own health, fitness, and well-being. There are, however, an ever-increasing number of children who drop out of participating in physical activities at the earliest opportunity, leading to an increase in sedentary lifestyles and a rise in childhood obesity. It is evidence such as this which indicates Physical Education, specifically in England, is not currently appropriate for all and requires change. To attempt to make the subject a more positive experience for all and to inspire lifelong involvement, varying the curriculum and including alternative activities for pupils might tap into useful wider cultures. This paper discusses the emergence of alternative sports, the challenges and synergies of implementation, and focuses on what could work and why.

The effect of resistance training programs on lean body mass in postmenopausal and elderly women: a meta-analysis of observational studies

Aging and menopause are associated with morphological and functional changes which may lead to loss of muscle mass and therefore quality of life. Resistance training (RT) is an effective training mode to increase muscle mass. We reviewed the existing literature to identify studies implementing RT protocols and evaluating muscle hypertrophy exclusively in healthy, postmenopausal and elderly women. Participants’ age range was comprised between 50 and 80 years. The primary outcome observed was muscle hypertrophy. Fat mass was also evaluated, if available. PubMed and Web of Science were the screened database, and original articles written in English and published from 2000 up to 2020 were included. 26 articles were considered eligible and included. Quality assessment revealed a “moderate quality” of the included studies, however the majority of studies was able to reach level 4 of evidence and on overall grade of recommendation C. In total, data from 745 female participants subjected to different forms of resistance training were considered. Heterogeneity across studies was present regarding study design, intervention length (mean 16 weeks), training frequency (3 d/w), no. of exercises (n = 7.4) and participants’ age (65.8 ± 4.9 years). Small-to-moderate significant increases (k = 43; SMD = 0.44; 95% CI 0.28; 0.60; p < 0.0001) of lean body mass were observed in post-menopausal and elderly women, regardless of age, intervention period, weekly training frequency and no. of exercises. No effects were noted for fat mass (k = 17; SMD = 0.27; 95% CI − 0.02; 0.55; p = 0.07). Studies need to concentrate on providing information regarding training parameters to more effectively counteract the effects of aging and menopause on skeletal muscle mass.

Impact of Body Mass Index, Socioeconomic Status, and Bedtime Technology Use on Sleep Duration in Adolescents

Factors related to adolescents and sleep are understudied. We evaluate the relationship between bedtime technology use (TU), TV in bedroom, weight, and socioeconomic status in seventh graders (N = 3956) enrolled in a school-based wellness intervention. Sleep quantity was dichotomized to insufficient (<8 hours) or sufficient (≥8 hours); high TU before sleep was defined by use "a few nights each week" or "every, or almost every night." Insufficient sleep (38.7%), having TV in bedroom (72.9%), and high TU (83.1%) were commonly reported. The likelihood of sufficient sleep was lower for those with high TU (odds ratio [OR] = 0.529 [0.463-0.605]), obese students (OR = 0.815 [0.700-0.949]), and those with a TV in the bedroom (OR = 0.817 [0.703-0.950]). Also, attending a school with higher percent low socioeconomic status students was also associated with insufficient sleep (P = .026). Interventions to reduce TU may be important for improving sleep quantity, especially for some vulnerable populations.

Sedentary behavior and motor competence in children and adolescents: a review

OBJECTIVE

To synthesize evidence from studies that analyzed the associations between sedentary behavior and motor competence in children and adolescents.

METHODS

Systematic review of original articles that analyzed possible associations between sedentary behavior and motor competence in children and adolescents (3-18 years of age), without restrictions on study design, instruments and analysis protocols. The articles were identified through searches in the PubMed, Web of Science, Academic Search Premier, Cinahl, Medline and SPORTDiscus databases, as well as in reference lists. The level of evidence was evaluated according to the amount of studies that reported statistical significance in the associations between the variables and the quality of the articles (risk of bias).

RESULTS

Of 2,462 initial studies, 22 composed the synthesis (two interventions, nine longitudinal and eleven cross-sectional studies). Of these, in 13, we observed negative associations between the variables, more often in the age group of seven to fourteen years. In the analysis of risk of bias, the main limitations of the studies were "convenience sampling" and "no description of sample sizing".

CONCLUSIONS

The available evidence suggests that sedentary behavior is negatively associated with motor competence in elementary school children, although the evidence is uncertain in the preschool years; the synthesis of results from longitudinal studies suggests that sedentary behavior negatively affects the development of motor competence. It is important that future studies have greater control over sociocultural determinants and deepen knowledge regarding sex and age, as well as the methods and indicators used to evaluate the two variables.

Subjective Health, Physical Activity, Body Image and School Wellbeing among Adolescents in South of Sweden

This study aimed to investigate subjective health and its associations with perceived body image (body appearance and body functioning), physical activity, perceived wellbeing in school, perceived family financial situation, and body mass index among 13- to 15-year-old boys and girls. The study was a cross-sectional study performed in four municipalities in Southern Sweden. Data were obtained from questionnaires completed by adolescents (median age 14; range: 13–15) in Sweden (n = 1518, 51% girls), with a participation rate of 73%. Body weight and body height were measured by school nurses and body mass index was calculated. Logistic regression analyses were carried out with subjective health as the dependent variable. Independent variables included in the model were perceived wellbeing in school, perceived family financial situation, perceived body image, physical activity, body mass index, sex, and residency. Variables significantly associated with good subjective health were good wellbeing in school, a perceived good family financial situation, perceived positive body appearance, perceived positive body functioning, being a boy, and high physical activity. Residency and body mass index were not associated with subjective health. Good subjective health is associated with good wellbeing in school, good family financial situation, positive body image, and high physical activity levels. The results highlight the importance of good school climates, the promotion of positive body image, and increased physical activity for adolescents.

Physical Activity through a Classroom-Based Intervention: A Pragmatic Non-Randomized Trial among Swedish Adolescents in an Upper Secondary School

Schools are an important arena to curb the decline in physical activity (PA) in youth. School-based interventions with accelerometer-measured PA are warranted. This study aimed to increase accelerometer-measured PA in adolescents following a 12-month school-based intervention. Two school-classes of 16–18-year-old Swedish students were allocated to intervention group and control group. Accelerometer-measured PA was gathered at baseline, 6- and 12-month follow-up. Mixed-effects linear regression was used to investigate between-group and within-group differences in mean minutes per day (min/day) of moderate to vigorous PA (MVPA), light PA (LPA) and sedentary time (ST). Fifty-seven students participated (intervention group = 31, control group = 26). At 12-month follow-up, the intervention group performed 5.9 (95% CI: −4.3, 16.2) min/day more in MVPA, 1.8 (95% CI: −17.9, 14.2) min/day less in LPA, and 4.1 (95% CI: −27.3, 19.2) min/day less in ST compared to the control group. Within the intervention group, there was no significant change in PA. Within the control group, LPA decreased (95% CI: −19.6, −0.2; p = 0.044) and ST increased (95% CI: 1.8, 30.8; p = 0.028). Although no between-group differences in PA were statistically significant, the within-group changes may suggest a preventive impact on the decline in PA during adolescence.

Adolescents' physical activity and sedentary behaviour in Indonesia during the COVID-19 pandemic: a qualitative study of mothers' perspectives

BACKGROUND

Socio-behavioural adaptations during the COVID-19 pandemic may have significantly affected adolescents' lifestyle. This study aimed to explore possible reasons affecting changes in physical activity and sedentary behaviour in Indonesian adolescents during the pandemic based on mothers' perspectives.

METHODS

We recruited parents (n = 20) from the Yogyakarta region of Indonesia (July-August 2020) using purposive and snowball sampling. Individual interviews were audio-recorded, transcribed verbatim and anonymised. Data were imported into NVivo software for a reflexive thematic analysis.

RESULTS

The interviews lasted between 38 and 113 min (M = 65 min). Participants' age ranged between 36 and 54 years (M = 42.6 years). Participants' children ranged in age from 12 to 15 years (M = 13.7 years, female: 9, male: 11). Themes related to changes in physical activity during the pandemic were 1) self-determination and enjoyment, 2) supports from others, and 3) physical activity facilities and equipment. Themes related to changes in sedentary behaviour during the pandemic included 1) educational demands, 2) psychological effects due to the pandemic, 3) devices and internet availability, 4) parental control, and 5) social facilitators.

CONCLUSIONS

During the pandemic, mothers perceived their children to be less active and using more screen-based devices, either for educational or recreational purposes, compared to before. The present themes might be useful when developing interventions and policies promoting physical activity and reducing sedentary behaviour in adolescents. Interventions could, for example, consider increasing parents' and adolescents' awareness on current activity guidelines, providing education on healthier recreational screen time, and involving parents, peers, and teachers. Increasing the accessibility of physical activity facilities and equipment, making use of adolescents' favourite program and social media for interventions, and providing activities that are fun and enjoyable may also important.

Indicators to Assess Physical Health of Children and Adolescents in Activity Research-A Scoping Review

Sufficient physical activity can help promote and maintain health, while its lack can jeopardize it. Since health and physical activity lay their foundation for later life in childhood and adolescence, it is important to examine this relationship from the beginning. Therefore, this scoping review aims to provide an overview of physical health indicators in children and adolescents in research on the effects of physical activity and sedentary behavior. We identified the indicators used to quantify or assess physical health and summarized the methods used to measure these indicators. We systematically searched Scopus, Pubmed, and Web of Science databases for systematic reviews. The search yielded 4595 records from which 32 records were included in the review. The measurements for physical health reported in the reviews contained measures of body composition, cardiometabolic biomarkers, physical fitness, harm/injury, or bone health. Body composition was the most used indicator to assess and evaluate physical health in children, whereas information on harm and injury was barely available. In future research longitudinal studies are mandatory to focus on the prospective relationships between physical activity or sedentary behavior, and physical health.

Overweight and obesity by school socioeconomic composition and adolescent socioeconomic status: a school-based study

BACKGROUND

The main objective of this study was to investigate the interaction effect of school socioeconomic composition (SEC) and adolescent socioeconomic status (SES) in the prevalence of overweight and obesity among a representative sample of French adolescents of the third most populous département of France.

METHODS

1038 adolescents agreed to participate (response rate: 91.4%). They self-reported anthropomorphic variables, SES, school lunch and physical activity. The body mass index was divided into six categories according to the Center for Disease Control. Multivariable binary logistic regressions analysis without and with interaction term were performed on overweight or obesity. Models fit was compared using the Aikaike Information Criterion. Odds-ratios (OR) and their 95% accelerated-bootstrap confidence interval (95%BCa CI) were computed to estimate overweight or obesity risk.

RESULTS

8.9% of the adolescents were overweight. 3.4% were obese. No school-SEC effect was observed among low-SES adolescents. Medium-SES adolescents were at greater risk in low-SEC (OR = 10.75, 95%BCa CI = 2.67-64.57) and medium-SEC (OR = 5.08, 95%BCa CI = 1.55-24.84) compared with high-SEC schools. High-SES adolescents in low-SEC schools were at greater risk compared with those in medium-SEC (OR = 5.94, 95%BCa CI = 1.94-17.29) and high-SEC schools (OR = 4.99, 95%BCa CI = 1.71-13.14). A social gradient was observed in medium-SEC (OR_low/high = 2.79, 95%BCa CI = 1.22-7.41) and high-SEC (OR_low/medium = 6.86, 95%BCa CI = 1.06-5.22*10⁶) schools.

CONCLUSIONS

Physical activity and lunch at and outside school help to understand these differences. Implications for obesity prevention initiatives are discussed.

A Qualitative Study on Children's Digital Media Use and Parents' Self-interest

This qualitative study provides insight into the role of parents' self-interest in digital media use of children in different age groups. We conducted 31 semi-structured interviews with fathers/mothers of children aged 3-16 years who were recruited via targeted sampling. A deductive and inductive content analysis was applied. Results show that parents' self-interest in letting children use digital media includes being able to do other tasks without being bothered, having some me-time, managing children's behavior, avoiding discussions, having moments to use digital media themselves and spending quality-time together. In addition, we found that the manner in which parents let children use digital media out of self-interest seems to depend on age. With younger children, parents initiate digital media use or set times at which children are allowed to use digital media. With older children, parents use a passive manner by omitting restrictive responses to their children's media use. Current findings can be used to inform interventions aimed at reducing children's screen time.

An Exploration of Domain-Specific Sedentary Behaviors in College Students by Lifestyle Factors and Sociodemographics

College students exhibit high levels of sedentary time and/or poor lifestyle factors (e.g., poor sleep, stress, physical inactivity). It is unknown; however, in what domains college students spend their sedentary time and whether there are associations between sedentary time and these lifestyle factors. This study examined sedentary behavior of college students by domains, current lifestyle factors and sociodemographics. Undergraduates (n = 272, M age = 20 years, 79% female) self-reported their sedentary behavior, sleep, stress, physical activity, anthropometrics and sociodemographics. Sedentary time was categorized as: total, recreational screen, education and social. Students reported spending > 12 h of their day sedentary on average, with over a third of this time spent in recreational screen time. All categories of sedentary time were significantly correlated with body mass index, and both total sedentary time and screen time were significantly correlated with sleep score, with poorer sleep quality associated with greater sedentary time. Physical activity was negatively correlated with social sedentary time only. Subgroups with elevated sedentary time included minority students, those with low parental education and students with overweight/obesity. Given the negative health impacts of sedentary behavior, college students would likely benefit from interventions tailored to this population which target reducing sedentary time, particularly recreational screen time.

Relating outdoor play to sedentary behavior and physical activity in youth - results from a cohort study

BACKGROUND

Outdoor play, sedentary behavior (SB), and moderate-to-vigorous physical activity (MVPA) are related to youth's health, however, there are research gaps regarding 1) associations between outdoor play, SB, and MVPA across a broad pediatric age range (6-17 years), and 2) longitudinal associations between outdoor play, SB, and MVPA across childhood and adolescence. Two studies were conducted to address those research gaps: Study 1 aimed to investigate relationships between outdoor play and accelerometer-assessed SB and MVPA in a cross-sectional nationwide sample of children and adolescents in Germany. Study 2 aimed to investigate prospective associations between outdoor play and self-reported screen-time SB and MVPA and in a sample of children with three measurement timepoints across 11 years.

METHODS

Data were obtained of the German national representative Motorik-Modul (MoMo) Study and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). In Study 1, N = 2278 participants (6-17 years) were included with self-reported outdoor play and accelerometer-assessed SB and MVPA. Associations were examined via multiple linear regressions. In Study 2, N = 570 participants (baseline: 4-7 years) were included in the longitudinal analysis with follow-ups six and 11 years later. Screen-time SB (TV watching and PC/Gaming), MVPA, and outdoor play were self-reported. Associations were investigated through a path prediction model.

RESULTS

Study 1 showed that compared to <1 h outdoor play, higher engagement in daily outdoor play was related to lower SB (1-2 h: - 9.75 min/day, P = 0.017; ≥2 h: - 17.78 min/day, P < 0.001) and higher MVPA (≥2 h: + 3.87 min/day, P = 0.001). The cross-sectional relationship between MVPA and outdoor play was moderated by sex (in favor of males) and age (in favor of younger children). Study 2 showed that outdoor play in early childhood negatively predicted PC use/Gaming in later childhood, but was unrelated to MVPA.

CONCLUSION

In Study 1, outdoor play was negatively related to SB cross-sectionally. In Study 2, outdoor play in early childhood was negatively related to PC and Gaming time in later childhood. Thus, providing outdoor play opportunities, especially during early childhood, has potential to prevent SB. Future research should investigate longitudinal relationships using device-based assessments for SB and MVPA.

Influence of Parenting Style on Body Mass Index, Physical Activity, and Sedentary Time

The purpose of the current study was to determine the influence of parenting style on body mass index (BMI) percentile, physical activity (PA), and sedentary time (ST) in children. Accelerometers were used to assess PA and ST in 152 fifth-grade children. Parenting style was assessed by the child participants’ responses to modified questions from the Parenting Style Inventory II and dichotomized as authoritative or non-authoritative. Multiple linear regression analyses were utilized to identify significant predictors of outcomes of interest. Parenting style did not predict ST or any intensity of PA; however, BMI percentile and gender were significant predictors of moderate-intensity PA, vigorous-intensity PA, and moderate-to-vigorous intensity PA (P < .01). BMI percentile was predicted to be lower in females with authoritative mothers (P < .01). While authoritative and non-authoritative parenting style did not predict objectively measured PA or ST in early adolescents, authoritative parenting style did predict BMI percentile in female participants.

Improved Self-Organizing Map-Based Unsupervised Learning Algorithm for Sitting Posture Recognition System

As the intensity of work increases, many of us sit for long hours while working in the office. It is not easy to sit properly at work all the time and sitting for a long time with wrong postures may cause a series of health problems as time goes by. In addition, monitoring the sitting posture of patients with spinal disease would be beneficial for their recovery. Accordingly, this paper designs and implements a sitting posture recognition system from a flexible array pressure sensor, which is used to acquire pressure distribution map of sitting hips in a real-time manner. Moreover, an improved self-organizing map-based classification algorithm for six kinds of sitting posture recognition is proposed to identify whether the current sitting posture is appropriate. The extensive experimental results verify that the performance of ISOM-based sitting posture recognition algorithm (ISOM-SPR) in short outperforms that of four kinds of traditional algorithms including decision tree-based (DT), K-means-based (KM), back propagation neural network-based (BP), self-organizing map-based (SOM) sitting posture recognition algorithms. Finally, it is proven that the proposed system based on ISOM-SPR algorithm has good robustness and high accuracy.

Breaks in Sedentary Time and Cardiometabolic Markers in Adolescents

BACKGROUND

The interruption of the time spent in sedentary behavior (breaks) has been associated with better levels of cardiometabolic indicators in the adult population, but in adolescents, further investigations are still needed to confirm these findings.

OBJECTIVES

To analyze the association of the number of breaks per day in sedentary behaviors with cardiometabolic markers and whether it was moderated by nutritional status and excessive time on sedentary behavior in adolescents.

METHODS

This is a cross-sectional study of 537 adolescents (52.3% girls), aged between 10 and 14 years, enrolled in public schools in the city of João Pessoa, Paraíba state, Brazil. The number of daily breaks (>100 counts/minutes) in sedentary time was measured by Actigraph GT3X+ accelerometers. The following cardiometabolic markers were analyzed: systolic and diastolic blood pressure (mmHg), fasting blood glucose levels, total cholesterol, triglycerides, HDL-c, LDL-c (all in mg/dL) and body mass index (BMI) (kg/m2). Linear regression was used to analyze the association between the number of breaks and cardiometabolic markers and whether this association was moderated by nutritional status and excessive time in sedentary behavior. The significance level of p<0.05 was adopted for all analyses.

RESULTS

The number of daily breaks was negatively associated with BMI (boys - ß = -0.083; 95%CI: -0.132; -0.034 and girls - ß = -0.115; 95%CI: -0.169; -0.061), but not with the remaining cardiometabolic markers. The number of breaks per day was negatively associated with BMI (ß = -0.069; 95% CI: -0.102; -0.035), but not with the other cardiometabolic markers and this association was not moderated by the adolescents' nutritional status (p=0.221), or by excessive time in sedentary behavior (p=0.176).

CONCLUSIONS

Including breaks in sedentary time seems to contribute to lower BMI values in adolescents.

Associations between Movement Behaviours and Obesity Markers among Preschoolers Compliant and Non-Compliant with Sleep Duration: A Latent Profile Analysis

This study identifies physical activity (PA) and sedentary behaviour (SB) clusters in preschoolers compliant (C) or non-compliant (NC) with sleep recommendations; and associates these clusters with obesity markers. PA and SB were objectively assessed (Actigraph WGT3-X) in 272 preschoolers (4.4 ± 0.7 years old). Sleep duration was parent-reported, and preschoolers were classified as C (3-4 years old: 600-780 min/day; 5 years old: 540-660 min/day) or NC with sleep recommendations. Body mass index (BMI) and waist circumference (WC) were assessed according to international protocols. Moderate to vigorous physical activity (MVPA) and light physical activity (LPA) were categorized as low/high (<60 min/>60 min/day or <180 min/180 min/day, respectively). SB was defined according to mean values between clusters. Latent profile analysis was performed. Associations between the observed clusters and obesity markers were determined using linear regression (RStudio; 1.3.1073). Four cluster solutions for C and NC preschoolers were identified. A negative association between C/Low MVPA cluster and BMI, and a positive association between NC/Low MVPA and BMI (β = -0.8, 95%CI = -1.6;-0.1, and β = 0.9, 95%CI = 0.1;1.7, respectively) were observed. No association was seen for SB clusters. Adequate sleep duration may have a protective role for preschoolers' BMI, even if the children do not comply with MVPA recommendations.

Physical Activity, Physical Well-Being, and Psychological Well-Being: Associations with Life Satisfaction during the COVID-19 Pandemic among Early Childhood Educators

Seeking personal well-being and life satisfaction during a global pandemic can be daunting, such is the case for early care and education teachers who were considered non-health care essential workers during the COVID-19 pandemic. The potential changes in their physical activity, along with their overall physical and psychological well-being, may have ultimately influenced their life satisfaction. These changes included the potential for increased sedentary behaviors. Despite the high health risks associated with these factors during the pandemic, the role of physical activity in early care and education teachers' well-being and life satisfaction remains largely unknown. The purpose of this study is to examine the associations of physical activity and sedentary behaviors with teacher well-being and life satisfaction during the COVID-19 pandemic. In doing so, we explored two competing models of the relationship between the teachers' physical activity, well-being, and life satisfaction, one with physical activity as a mediator and the other with teachers' well-being as a mediator. An online survey, that collected information on physical, psychological, and professional well-being, job demands, and life satisfaction, was completed by 1434 US ECE teachers in 46 states. To test our hypothesized models, we conducted confirmatory factor analyses, followed by structural equation modeling. Of the respondents, 77% were overweight or obese and only 39% met the recommended 150 min of moderate physical activity per week. They had a mean life satisfaction score that qualifies as slight satisfaction, they experience moderate stress, and, collectively, are approaching the threshold for depression yet still reflect moderate-to-high work commitment. The empirical test of our competing mediation models found the model where teacher well-being mediated the association between physical activity, sedentary behavior, and life satisfaction was the superior model. The relationships between physical activity, sedentary behavior, and overall well-being suggest that these modifiable risk factors can be addressed such that early care and education teachers can improve their overall physical and psychological well-being, along with their life satisfaction.

Health-Related Quality of Life and Frequency of Physical Activity in Spanish Students Aged 8-14

The study of health-related quality of life (HRQoL) in children and adolescents has important implications in terms of policy, education, and health. Data on the time spent in physical activity (PA) and in sedentary activities in this population are worrying. We aim to analyze possible differences in HRQoL and PA levels between sexes and age groups in Spanish students aged between 8 and 14 years, as well as to assess the relationship between HRQoL and the frequency of PA in this population. A total of 3197 participants (1610 boys and 1587 girls) from 8 to 14 years old were recruited. Mquality and Mapping Child Health Utility instrument (Chu9d) were used as HRQoL indicators. A medium positive association between PA and HRQoL concerning the Spanish school population was found. HRQoL was higher among students aged 8 to 12 than 13 to 14. Moreover, when children start secondary education, both sexes seem to lose the quality of life. Similarly, PA decreases among girls over the years, although it seems to increase among boys. Thus, PA levels and HRQoL are directly associated in Spanish schoolchildren aged between 8 and 14 years. However, this HRQoL decreases in children over the years. Practical implications include the need to support education and physical activity programs to improve HRQoL in children and adolescents.

The behavioral, psychological, and social impacts of team sports: a systematic review and meta-analysis

Objectives: To assess the association between team sport participation and behavioral, psychological, and social health outcomes in young athletes.Methods: A systematic review and meta-analysis were undertaken to identify studies published between 01/01/1950-05/01/2020 investigating the association between team sport participation and health outcomes in young athletes (<25 years). Included studies compared team sport participants to controls or themselves, assessed health outcomes, and had a sample size >50. Prospective and retrospective studies were included; non-primary literature was excluded. Health outcomes were categorized as: 1) behavioral, 2) psychological, or 3) social. Data were extracted to form 2 × 2 tables for each study to calculate odds ratios (OR) and 95% confidence intervals (CI).Results: Of 371 queried articles, 34 studies from 10 countries across 4 continents were included, with 9 reporting homogenous outcomes for meta-analysis.Behavioral: Fifteen studies evaluated behavioral health outcomes of alcohol and/or drug use, fitness, and diet. Quantitatively, team sport participation was found to decrease rates of cigarette/tobacco use across 5 studies (OR 0.72, 95% CI 0.69-0.76) and alcohol/drug use across 7 studies (OR 0.73, 95% CI 0.69-0.77). Qualitatively, 12/15 (80%) of studies confirmed improved behavioral health outcomes with team sport participation.Psychological: Nineteen studies evaluated psychological health outcomes including anorexia, anxiety, depression, self-esteem, and suicidal ideation. Quantitatively, team sport participation was associated with decreased depression/anxiety rates across 5 studies (OR 0.59, 95%CI 0.54-0.64). Qualitatively, 14/19 (74%) of studies confirmed improved psychological health.Social: Ten studies evaluated social health outcomes including academic performance, commitment, psychosocial health, social behavior/identity, and delinquency/high-risk activity. Qualitatively, 7/10 (70%) of studies confirmed improved social health outcomes with team sport participation.Conclusion: Team sport participation was associated with decreased odds of smoking/tobacco use, alcohol/drug use, and depression/anxiety. Though few studies mentioned potential negative effects of team sport participation, the majority reported improved behavioral, psychological, and social health outcomes in youth athletes worldwide.

The relationship between white matter microstructure, cardiovascular fitness, gross motor skills, and neurocognitive functioning in children

Recent evidence indicates that both cardiovascular fitness and gross motor skill performance are related to enhanced neurocognitive functioning in children by influencing brain structure and functioning. This study investigates the role of white matter microstructure in the relationship of both cardiovascular fitness and gross motor skills with neurocognitive functioning in healthy children. In total 92 children (mean age 9.1 years, range 8.0-10.7) were included in this study. Cardiovascular fitness and gross motor skill performance were assessed using performance-based tests. Neurocognitive functioning was assessed using computerized tests (working memory, inhibition, interference control, information processing, and attention). Diffusion tensor imaging was used in combination with tract-based spatial statistics to assess white matter microstructure as defined by fractional anisotropy (FA), axial and radial diffusivity (AD, RD). The results revealed positive associations of both cardiovascular fitness and gross motor skills with neurocognitive functioning. Information processing and motor response inhibition were associated with FA in a cluster located in the corpus callosum. Within this cluster, higher cardiovascular fitness and better gross motor skills were both associated with greater FA, greater AD, and lower RD. No mediating role was found for FA in the relationship of both cardiovascular fitness and gross motor skills with neurocognitive functioning. The results indicate that cardiovascular fitness and gross motor skills are related to neurocognitive functioning as well as white matter microstructure in children. However, this study provides no evidence for a mediating role of white matter microstructure in these relationships.

Parental perception and guideline awareness of children's lifestyle behaviours at ages 5 to 14 in Singapore

INTRODUCTION

There are limited data on the descriptive lifestyle behaviour of school-age children in Singapore.

METHODS

A total of 100 parents of children ages 5 to 14 participated in a parents' proxy-reported survey. Frequency of moderate physical activity (PA) and vigorous PA was assessed, while t-tests or chi-square test was used to examine differences between weekdays and weekends for sleep, screen viewing time (SVT) and sedentary behaviour (SB).

RESULTS

Of the 100 children (68% of Chinese ethnicity, 59% boys, mean age 9.1±2.9 years), 31% were overweight or obese, with body mass index z-score of >1. For moderate and vigorous PA participation in a typical week, 32.0% and 43.0%, respectively, did not participate, while median (interquartile range) days of participation were 3 (2-3) days/week and 2 (1-3) days/week for a duration of 60 (interquartile range 30-120) minutes/session. When comparing weekends with weekdays, the means (standard deviation) of both SVT and sleep duration were higher on weekends (SVT: 4.1 [2.9] versus 3.3 [3.1] hours/day, P=0.07; sleep: 8.8 [1.5] vs 8.3 [1.3] hours/day, P=0.02), while there were no significant differences for SB. A higher proportion of children had SB of ≥10 hours/day and slept <8 hours/day on weekdays compared with on weekends (SB: 23.5% vs 20.6%, P>0.05; sleep:18.8% vs 2.1%, P<0.05), while the proportion exceeding SVT of 2 hours/day were higher on weekends than on weekdays (63.8% vs 45.4%, P=0.03). Overall, there was higher parental awareness of sleep guidelines (80.0%), but lower awareness of PA (51.0%) and SVT (59.0%) guidelines.

CONCLUSION

Lifestyle behaviours were suboptimal in Singapore children compared with existing overseas guidelines, indicating a need for an integrated guideline with greater dissemination.

Age-related change in sedentary behavior during childhood and adolescence: A systematic review and meta-analysis

Sedentary behaviors are highly prevalent in youth and may be associated with markers of physical and mental health. This systematic review and meta-analysis aimed to quantify the age-related change in sedentary behavior during childhood and adolescence. Ten electronic databases were searched. Inclusion criteria specified longitudinal observational studies or control group from an intervention; participants aged ≥5 and ≤18 years; a quantitative estimate of the duration of SB; and English language, peer-reviewed publication. Meta-analyses summarized weighted mean differences (WMD) in device-assessed sedentary time and questionnaire-assessed screen-behaviors over 1-, 2-, 3-, or more than 4-year follow-up. Effect modification was explored using meta-regression. Eighty-five studies met inclusion criteria. Device-assessed sedentary time increased by (WMD 95% confidence interval [CI]) 27.9 (23.2, 32.7), 61.0 (50.7, 71.4), 63.7 (53.3, 74.0), and 140.7 (105.1, 176.4) min/day over 1-, 2-, 3-, and more than 4-year follow-up. We observed no effect modification by gender, baseline age, study location, attrition, or quality. Questionnaire-assessed time spent playing video games, computer use, and a composite measure of sedentary behavior increased over follow-up duration. Evidence is consistent in showing an age-related increase in various forms of sedentary behavior; evidence pertaining to variability across socio-demographic subgroups and contemporary sedentary behaviors are avenues for future research.

Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan

Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.

Youth Perceptions of Sport-Confidence

ABSTRACT

Zuk, EF, Maksymiw, K, Evanovich, J, McGarry, JE, Root, HJ, and Distefano, LJ. Youth perceptions in sport-confidence. J Strength Cond Res XX(X): 000-000, 2021-Sport-confidence is an important construct that is often missed during physical activity interventions in youth. Male and female children might display differences in sport-confidence that influences their activity levels. The purpose of this study is to assess any association between sport-confidence and gender in elementary school and middle-school children. All 286 children {(boys [ES: n = 71, age = 8±1 years; MS: n = 63, 11±1 years]; girls [ES: n = 67, 7±1 years; MS: n = 85, 11±1 years])} completed the Physical Literacy Assessment for Youth-Self Questionnaire. Separate chi-square tests of the association were used to evaluate the association between gender and sport-confidence among elementary (grades K-4) and middle-school (grades 5-8) children because of varying injury and participation rates for these groups, for each relevant question with a significance set at p ≤ 0.05. For elementary school children, there were no significant associations between genders and sport-confidence (p > 0.05). In middle-school children, there were significant associations detected for learning new skills (ϕ = 0.12; p = 0.031), perception of skill (ϕ = 0.12; p = 0.054), confidence in activity (ϕ = 0.17; p = 0.035), and being the best in the class (ϕ = 0.15; p = 0.048) between genders and sport-confidence. For all results, boys displayed more sport-confidence than girls. Education for key stakeholders about the importance of including sport-confidence in physical activity interventions is integral in promoting life-long activity, specifically in middle-school girls.

Adherence to 24-h movement behavior guidelines and psychosocial functioning in young children: a longitudinal analysis

BACKGROUND

A recent paradigm shift has highlighted the importance of considering how sleep, physical activity and sedentary behaviour work together to influence health, rather than examining each behaviour individually. We aimed to determine how adherence to 24-h movement behavior guidelines from infancy to the preschool years influences mental health and self-regulation at 5 years of age.

METHODS

Twenty-four hour movement behaviors were measured by 7-day actigraphy (physical activity, sleep) or questionnaires (screen time) in 528 children at 1, 2, 3.5, and 5 years of age and compared to mental health (anxiety, depression), adaptive skills (resilience), self-regulation (attentional problems, hyperactivity, emotional self-control, executive functioning), and inhibitory control (Statue, Head-Toes-Knees-Shoulders task) outcomes at 5 years of age. Adjusted standardised mean differences (95% CI) were determined between those who did and did not achieve guidelines at each age.

RESULTS

Children who met physical activity guidelines at 1 year of age (38.7%) had lower depression (mean difference [MD]: -0.28; 95% CI: -0.51, -0.06) and anxiety (MD: -0.23; 95% CI: -0.47, 0.00) scores than those who did not. At the same age, sleeping for 11-14 h or having consistent wake and sleep times was associated with lower anxiety (MD: -0.34; 95% CI: -0.66, -0.02) and higher resilience (MD: 0.35; 95% CI: 0.03, 0.68) scores respectively. No significant relationships were observed at any other age or for any measure of self-regulation. Children who consistently met screen time guidelines had lower anxiety (MD: -0.43; 95% CI: -0.68, -0.18) and depression (MD: -0.36; 95% CI: -0.62, -0.09) scores at 5. However, few significant relationships were observed for adherence to all three guidelines; anxiety scores were lower (MD: -0.42; 95% CI: -0.72, -0.12) in the 20.2% who adhered at 1 year of age, and depression scores were lower (MD: -0.25; 95% CI: -0.48, -0.02) in the 36.7% who adhered at 5 years of age compared with children who did not meet all three guidelines.

CONCLUSIONS

Although adherence to some individual movement guidelines at certain ages throughout early childhood was associated with improved mental health and wellbeing at 5 years of age, particularly reduced anxiety and depression scores, there was little consistency in these relationships. Future work should consider a compositional approach to 24-h time use and how it may influence mental wellbeing.

TRIAL REGISTRATION

ClinicalTrials.gov number NCT00892983.

The effects of standing in tutorial group meetings on learning: A randomized controlled trial

BACKGROUND

Standing desks have been brought into the education environment to reduce sedentary behavior among students. The current study explored the effects of standing in tutorial group meetings on learning among undergraduate students.

METHODS

Ninety-six participants were randomly allocated to a Sit or Stand group, with 2 h tutorial group meetings scheduled, once or twice per week, for nine weeks. Learning was analyzed using exam grades, concept maps, and tutorial interactions.

RESULTS

Overall, the Sit and Stand groups did not differ from each other in terms of learning, measured through their exam, concept map, and the use of learning-oriented interactions.

CONCLUSION

Standing in tutorial group meetings neither enhanced nor compromised learning. Considering the health risks associated with prolonged sedentary behavior, offering standing tutorial group meetings to undergraduate students is a recommended solution to break up prolonged sedentary behavior and encourage more physical activity, while maintaining the learning performance of students.

Characterizing Changes in Screen Time During the COVID-19 Pandemic School Closures in Canada and Its Perceived Impact on Children With Autism Spectrum Disorder

The COVID-19 pandemic has led to an increase in screen time for children and families. Traditionally, screen time has been associated with negative physical and mental health outcomes, and children with autism spectrum disorder (ASD) are at increased risk of these outcomes. The primary objectives of this study were to (1) characterize the change in screen time during COVID-19 school closures for children with ASD, and (2) examine the parent perceived impact of screen time on mental health and quality of life of children and their families. Canadian parents and caregivers of children 19 years of age and younger were eligible to participate in an anonymous, online survey study. This survey was available in English, consisted of 28 questions, took ~10-min to complete, and was available for 6 weeks (May 22 through July 6, 2020). The total sample consisted of 414 responses (ASD: n = 127, mean age = 11.7 ± 4.06 years; community sample: n = 287, mean age = 9.4 ± 4.26 years). Seventy-one respondents were missing responses to our primary question and removed from the analyses (final sample n = 344). Compared to the community sample, the ASD group had a significantly higher screen time use before and during the COVID-19 pandemic school closures [weekdays: difference = 1.14 (SE = 0.18), t = 6.56, p < 0.0001; weekends: difference = 1.41 (SE = 0.20), t = 6.93, p < 0.0001]. Mean total screen time during the pandemic was 6.9 h (95% CI 6.49, 7.21) on weekdays and 6.3 h (95% CI 5.91, 6.63) on weekends for the ASD group, and 5.6 h (95% CI 5.28, 5.92) on weekdays and 5.0 h (95% CI 4.70, 5.34) on weekends for the community sample. There was a significant increase in screen time during the COVID-19 pandemic as compared to before the pandemic period in the ASD group [weekdays: mean difference = 3.8 h (95% CI 3.35-4.25), p < 0.0001; weekends: mean difference = 1.5 h (95% CI 1.17-1.92), p < 0.0001]. Gender was a significant predictor of parent perceived mental health and quality of life, with male gender associated with a higher likelihood of negative impact [quality of life (child/family) OR = 1.8 (95% CI 1.1-2.9), corrected p = 0.040; mental health OR = 1.9 (95% CI 1.1-3.1), corrected p = 0.0028]. Parents' most frequently endorsed emotions toward screen time were guilt, frustration, and worry. Results of this survey study revealed that children with ASD were less likely to benefit from screen time to cope with social isolation, and screen time resulted in significantly more lost time on social interactions than the community sample, which may exacerbate difficulties in social domains. Given the unprecedented circumstances of the COVID-19 pandemic and the novel context of technology use, the findings of this study highlight the need for revision of screen time recommendations to reflect the current needs of children and families.

Recent Trends in Sedentary Time: A Systematic Literature Review

This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research.

Associations Between Adolescent Depression and Self-Harm Behaviors and Screen Media Use in a Nationally Representative Time-Diary Study

Screen media use is associated with mental health problems among adolescents. However, few studies have examined screen media use using contemporaneous time diaries (rather than retrospective reports), compared associations across specific screen media activities or by gender, or examined associations with self-harm behaviors. Participants were 13- to 15-year-old adolescents completing time diaries (n = 4,252) for one weekday and one weekend day in the 2015 administration of the Millennium Cohort Study, a nationally representative birth cohort study of UK adolescents. Participants also completed a measure of depressive symptoms and reported whether they had engaged in self-harm in the last year. Girls who spent 2 + hrs/day, compared to < 2 h/day, on digital media were more likely to self-harm (for social media use, adjusted relative risk [ARR] for self-harm = 1.46, 95% CI = 1.17, 1.82; for internet use, ARR = 1.80 [1.20, 2.70]). Girls spending more time on digital media were also more likely to be depressed (for social media, ARR = 1.29 [1.03, 1.63]; for internet use, ARR = 1.75 [1.19, 2.59]). Associations with gaming, texting/e-mailing, and TV/video watching among girls were mostly not significant. Associations for boys were mostly not significant. Girls who use digital media (especially social media and the internet) more hrs/day are more likely to have clinically significant levels of depressive symptoms and prior history of self-harm, though gaming, texting/e-mailing, and TV/video watching showed few associations. Screen media use was mostly not significantly associated with self-harm or depression among boys.

Screen-based media and young children: Review and recommendations

Early childhood development is influenced by a child's environmental experiences. The qualities of surrounding in which a child lives, grows up and learns are key for attaining their milestones. Increased availability of screen-based media in families leads to excessive screen time among young children, resulting in high chances of displacing parent-child interaction which is fundamental in a thriving child's process of learning and development. Numerous publications have investigated the potential health impacts of early exposure and excessive usage of screen-based media among children, with literature suggesting links between excessive screen time and behavioural difficulties, developmental delay and increased risk of obesity, among other issues. Existing guidelines from international bodies call for limiting screen time to an hour per day for children aged two to five years old and urge that children below the age of two should not be exposed to any screen time. To spark awareness among parents and caregivers concerning the potential health impacts of screen-based media usage among young children, child media habits are recommended to be incorporated as part of toddlers' developmental assessment in health clinics. A guideline for mindful usage of screen-based media focusing on children below the age of five tailored to a Malaysian context ought to be developed based on current evidence from research, theory and practice. A collaborative effort between concerned agencies is essential to ensuring a developmentally stimulating environment in which young children may grow up.

The Relationship between Students' Physical Self-Concept and Their Physical Activity Levels and Sedentary Behavior: The Role of Students' Motivation

This study aimed to analyze the association between specific dimension (i.e., fitness, appearance, physical competence, physical strength, and self-esteem) of students’ physical self-concept (PSC) and their physical activity (PA) levels (i.e., intentions to be physically active and out-of-school PA levels perceived by students) and sedentary behavior (SB) (i.e., total sitting and screen time perceived by students). We also tested the role of students’ motivation (i.e., intrinsic motivation and amotivation) towards PA in these relationships. A total of 1998 Spanish male (n = 1003) and female (n = 995) secondary students, aged between 13 and 17 years (M = 14.92, SD = 0.87) from 22 schools, enrolled in third grade (n = 1081) and fourth grade (n = 917), completed the self-reported questionnaires. Five independent structural equation modeling (SEM) adjusted by students’ sex was used to examine the association between specific dimension of students’ PSC (i.e., fitness, appearance, physical competence, physical strength, and self-esteem) and self-reported PA and SB variables, and to test the role of students’ motivation in these relationships. Overall, most of students’ PSC dimension positively predicted students’ PA outcomes, and were negatively associated with SB. In addition, most of students’ PSC dimension were positively associated with intrinsic motivation, and negatively predicted amotivation. In turn, intrinsic motivation was a positive predictor of PA outcomes, and a negative predictor of SB, whereas amotivation was a negative predictor of PA outcomes and sitting time, and a positive predictor of screen time. Finally, from PSC dimensions, sex as a covariate was a positive predictor of intrinsic motivation and PA outcomes, and was a negative predictor of amotivation and sitting time. These findings suggest the importance of the specific dimensions of PSC perceived by adolescents on their motivational processes, and in turn, on their PA and SB outcomes.