Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight

Effects of different types of exercise intensity on improving health-related physical fitness in children and adolescents: a systematic review

A substantial body of empirical evidence reveals that physical activity is associated with a wide range of positive physical and mental health outcomes. However, an absence of comprehensive syntheses is observed concerning the varying effects of different exercise intensities on the improvement of physical health among children and adolescents. The aim of this review is to systematically investigate the effects of different exercise intensities on the physical fitness of children and adolescents, to analyses the optimal exercise intensities for improving physical fitness, and to provide a relevant theoretical basis for optimizing school physical education curricula. A systematic search strategy was used in this study in four online databases (PubMed, Scopus, EBSCO and Web of Science). Intervention studies that met the inclusion criteria underwent a thorough screening process, and their methodological quality was assessed utilizing the PEDro scale. The selected literature was systematically analyzed and evaluated through induction, summary, analysis, and evaluation. These findings indicate that high-intensity exercise training exerts significant positive effects on body composition, cardiopulmonary function and muscle fitness in children and adolescents. Therefore, we suggest that schools should focus on high-intensity sports in their physical education curriculum, which can further improve the student's PHYSICAL FITNESS.

Exploring the mediating role of promoting school physical activity on the relationship between low socioeconomic status and academic achievement and school climate: evidence from 4,990 Chilean schools

There is evidence that promoting school physical activity (PSPA) benefits children and adolescents, but little is understood about how this promotion may relate to academic achievement and school climate across varying levels of socioeconomic status (SES). Hence, the study aimed to address this knowledge gap by examining two main objectives: (1) determining the association between PSPA and academic achievement and school climate according to schools' SES and (2) exploring the potential mediating role of PSPA in the relationship between schools' SES and academic achievement and school climate. This cross-sectional study at the school level focused on 4,990 schools (including public, subsidized, and private schools) that participated in the National Educational Study 2018 (Chile), which was applied to primary schoolchildren (4th grade, aged 8-10 years). Schools were divided into non-PSPA (n = 4,280) and PSPA (n = 710) during the year 2018. Changes in academic achievement from 2017 to 2018 and school climate were considered. PSPA was associated with improvements in maths (low-SES OR: 1.80, p < 0.001) and reading (middle-SES OR: 1.45, p = 0.029; low-SES OR: 1.47, p < 0.001). The indirect effect (IE) showed that PSPA partially mediated the relationship between SES and academic achievement in reading (IE = 1.017; SE = 0.12; 95%CI, -1.27, -0.77), maths (IE = -1.019; SE = 0.12; 95%CI, -1.25, -0.78), and school climate (IE = -0.46; SE = 0.52; 95%CI, -0.56, -0.35). In conclusion, PSPA was linked to positive changes in academic achievement, especially among low SES, and PSPA presented a potential mediating role in the relationship between SES of schools and academic achievement and school climate.

Lifestyle interventions in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a dynamic chronic liver disease that develops in close association with metabolic irregularities. Between 2016 and 2019, the global prevalence among adults was reported as 38% and among children and adolescents it was about 10%. NAFLD can be progressive and is associated with increased mortality from cardiovascular disease, extrahepatic cancers and liver complications. Despite these numerous adverse outcomes, no pharmacological treatments currently exist to treat nonalcoholic steatohepatitis, the progressive form of NAFLD. Therefore, the main treatment is the pursuit of a healthy lifestyle for both children and adults, which includes a diet rich in fruits, nuts, seeds, whole grains, fish and chicken and avoiding overconsumption of ultra-processed food, red meat, sugar-sweetened beverages and foods cooked at high heat. Physical activity at a level where one can talk but not sing is also recommended, including leisure-time activities and structured exercise. Avoidance of smoking and alcohol is also recommended. Policy-makers, community and school leaders need to work together to make their environments healthy by developing walkable and safe spaces with food stores stocked with culturally appropriate and healthy food items at affordable prices as well as providing age-appropriate and safe play areas in both schools and neighbourhoods.

Effect of exercise interventions on brain-derived neurotrophic factor expression in people with overweight and obesity: protocol for a systematic review and meta-analysis

INTRODUCTION

Epidemic obesity ('globobesity') has led to a considerable rise in the prevalence and incidence of many disabling conditions, including cognitive dysfunction. Recent evidence has suggested that habitual exercise can alleviate the deleterious effects of obesity on cognitive functioning across the lifespan. Given that there is a potential link among obesity, exercise, cognitive health and brain-derived neurotrophic factor (BDNF), this systematic review aims to critically appraise interventional trials on exercise and BDNF and to estimate the pooled effect of exercise training on BDNF levels among healthy individuals with overweight and obesity.

METHODS AND ANALYSIS

Six electronic databases-PubMed, MEDLINE, EMBASE, Web of Science, Ovid Nursing Database and SPORTDiscus-will be searched from their inception through December 2022. Only interventional studies, including randomised controlled trials and quasi-experimental studies, with full text available and reported in English will be included. The primary outcomes will be changes in BDNF levels among healthy subjects with overweight and obesity following either acute or chronic bouts of exercise interventions. Two reviewers will independently conduct data extraction and risk of bias assessment for included trials using the Physiotherapy Evidence Database Scale. We will produce a narrative synthesis, with findings categorised by sex, age groups and types of exercise training. Data will be extracted and pooled for meta-analyses using random-effects models.

ETHICS AND DISSEMINATION

No formal ethical approval is required for this systematic review. The findings of this review will be disseminated through peer-reviewed publications.

PROSPERO REGISTRATION NUMBER

CRD42023414868.

Effects of combined training or moderate intensity continuous training during a 3-week multidisciplinary body weight reduction program on cardiorespiratory fitness, body composition, and substrate oxidation rate in adolescents with obesity

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m-2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V'O2 peak (e.g., MICT ≥ 80%). Body composition, V'O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: - 5.0 ± 1.2 vs. - 8.4 ± 1.5, P < 0.05; FM: - 4.3 ± 3.0 vs. - 4.2 ± 1.9 kg, P < 0.05). V'O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min-1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min-1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP.

Physical activity and physical fitness among children and adolescents after the onset of the COVID-19 pandemic in the WHO European Region: a systematic review protocol

INTRODUCTION

The implementation of COVID-19 pandemic-related restrictions resulted in limitations for physical activity (PA) opportunities, which may have initiated a longer-term behavioural change. The protocol describes the methodology for a planned systematic review that aims to summarise changes in PA and physical fitness (PF) in children and adolescents in the WHO European Region after the onset of the COVID-19 pandemic.

METHODS AND ANALYSIS

The protocol adheres to the 'Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols' (PRISMA-P) statement. Using a peer-reviewed search strategy according to the evidence-based checklist 'Peer Review of Electronic Search Strategies' (PRESS), we will perform a systematic literature search in seven databases. Inclusion criteria are all primary studies that gathered data on children and adolescents ≤19 years living in the WHO European Region and made a comparison to pre-pandemic data. Primary outcomes are PA and PF. We will assess the risk of bias with the 'Risk of Bias Instrument for Non-Randomized Studies of Exposures' (ROBINS-E). The 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) approach will be used for the evaluation of the certainty of evidence. Also, subgroup analyses will be performed (eg, for gender, age, stringency of pandemic restrictions).

ETHICS AND DISSEMINATION

Ethical approval is not required, as primary data will not be collected in this study. The results will be presented in a peer-reviewed publication and at congresses relevant to the research field.

PROSPERO REGISTRATION NUMBER

CRD42023395871.

Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents

BACKGROUND

Increasingly, parents use child health promotion apps to find health information. An overview of child health promotion apps for parents currently does not exist. The scope of child health topics addressed by parent apps is thus needed, including how they are evaluated.

OBJECTIVE

This scoping review aims to describe existing reported mobile health (mHealth) parent apps of middle- to high-income countries that promote child health. The focus centers on apps developed in the last 5 years, showing how the reported apps are evaluated, and listing reported outcomes found.

METHODS

A scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines to identify parent apps or web-based programs on child health promotion published between January 2016 and June 2021 in 5 databases: PubMed, ERIC, IEEE Xplore, Web of Science, and Google Scholar. Separate sources were sought through an expert network. Included studies were summarized and analyzed through a systematic and descriptive content analysis, including keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, and study outcomes.

RESULTS

In total, 39 studies met the inclusion criteria from 1040 database and 60 expert-identified studies. Keywords reflected the health topics and app foci. About 64% (25/39) of included studies were published after 2019 and most stemmed from the United States, Australian, and European-based research. Studies aimed to review or evaluate apps or conducted app-based study interventions. The number of participants ranged from 7 to 1200. Quantitative and qualitative methods were used. Interventions included 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Study intervention evaluations cited behavior change theories in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. To evaluate apps, user input and qualitative evaluations were often combined with surveys and frequently rated with the Mobile App Rating Scale. Outcomes reported some positive effects, while several intervention studies saw no effect at all. Effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement were challenges cited.

CONCLUSIONS

New parents are a key target group for child health apps, but evaluating child health promotion apps remains a challenge. Whether tailored to parent needs or adapted to the specific topic, apps should be rooted in a transparent theoretical groundwork. Applicable lessons for parent apps from existing research are to tailor app content, include intuitive and adaptive features, and embed well-founded parameters for long-term effect evaluation on child health promotion.

The effect of exercise on cerebral blood flow and executive function among young adults: a double-blinded randomized controlled trial

Studies have demonstrated that exercise benefits executive function. However, it remains unclear which type of exercise is optimal for preserving executive function among young adults and the cerebral blood flow (CBF) mechanisms that underlie exercise-induced cognitive benefits. Therefore, this study aims to compare the intervention effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on executive function and the CBF mechanism. This was a double-blinded, randomized, controlled trial study conducted between October 2020 and January 2021 (ClinicalTrials.gov identifier: NCT04830059). Ninety-three healthy young adults (25.23 ± 2.18 years old; 49.82% male) were randomized into the HIIT (N = 33), MICT (N = 32), and control (N = 28) groups. Participants in exercise groups were guided to perform 40 min of HIIT and MICT three times a week for 12 weeks, while the control group received health education for the same period. The primary outcomes, changes in executive function assessed by the trail-making test (TMT), and CBF measured by transcranial Doppler flow analyzer (EMS-9WA), were evaluated before and after the interventions. The time taken to complete the TMT task improved significantly in the MICT group compared to the control group [β = -10.175, 95%, confidence interval (CI) =  -20.320, -0.031]. Additionally, the MICT group showed significant improvements in the pulsatility index (PI) (β = 0.120, 95% CI = 0.018, 0.222), resistance index (RI) (β = 0.043, 95% CI = 0.005, 0.082), and peak-systolic/end-diastolic velocity (S/D) (β = 0.277, 95% CI = 0.048, 0.507) of CBF compared to the control group. The time taken to complete the TMT was associated with the velocity of peak-systolic (F = 5.414, P = 0.022), PI (F = 4.973, P = 0.012), and RI (F = 5.845, P = 0.006). Furthermore, the accuracy of TMT was associated with PI (F = 4.797, P = 0.036), RI (F = 5.394, P = 0.024), and S/D (F = 4.312, P = 0.05) of CBF. A 12-week MICT intervention improved CBF and executive function more effectively than HIIT among young adults. Furthermore, the findings suggest that CBF was one of the potential mechanisms underlying the cognitive benefits of exercise in young people. These results provide practical evidence supporting the promotion of regular exercise to maintain executive function and improve brain health.

Evaluation of community-based health promotion interventions in children and adolescents in high-income countries: a scoping review on strategies and methods used

BACKGROUND

In recent decades, community-based interventions have been increasingly adopted in the field of health promotion and prevention. While their evaluation is relevant for health researchers, stakeholders and practitioners, conducting these evaluations is also challenging and there are no existing standards yet. The objective of this review is to scope peer-reviewed scientific publications on evaluation approaches used for community-based health promotion interventions. A special focus lies on children and adolescents' prevention.

METHODS

A scoping review of the scientific literature was conducted by searching three bibliographic databases (Medline, EMBASE, PsycINFO). The search strategy encompassed search terms based on the PCC (Population, Concept, Context) scheme. Out of 6,402 identified hits, 44 articles were included in this review.

RESULTS

Out of the 44 articles eligible for this scoping review, the majority reported on studies conducted in the USA (n = 28), the UK (n = 6), Canada (n = 4) and Australia (n = 2). One study each was reported from Belgium, Denmark, Germany and Scotland, respectively. The included studies described interventions that mostly focused on obesity prevention, healthy nutrition promotion or well-being of children and adolescents. Nineteen articles included more than one evaluation design (e.g., process or outcome evaluation). Therefore, in total we identified 65 study designs within the scope of this review. Outcome evaluations often included randomized controlled trials (RCTs; 34.2%) or specific forms of RCTs (cluster RCTs; 9.8%) or quasi-experimental designs (26.8%). Process evaluation was mainly used in cohort (54.2%) and cross-sectional studies (33.3%). Only few articles used established evaluation frameworks or research concepts as a basis for the evaluation.

CONCLUSION

Few studies presented comprehensive evaluation study protocols or approaches with different study designs in one paper. Therefore, holistic evaluation approaches were difficult to retrieve from the classical publication formats. However, these publications would be helpful to further guide public health evaluators, contribute to methodological discussions and to inform stakeholders in research and practice to make decisions based on evaluation results.

Do psychological distress and digital sports influence the willingness to take the vaccine and precautionary saving? Empirical evidence from Shanghai

Aim

The COVID-19 epidemic has caused risk and uncertainty. This study answers whether and how psychological distress and digital sports influence willingness to take the vaccine and precautionary savings.

Subject and methods

We conducted a cross-sectional study with an online survey sample of 1016 Shanghai residents who live and work there and are aged between 16-60. All of them experienced the COVID-19 lockdown in Shanghai. We used logistic regressions to examine the relationships between the variables of interest.

Results

Three findings were demonstrated. First, psychologically distressed individuals are less inclined to take the vaccine. Second, those engaged in fitness activities via digital media platforms are more willing to get vaccinated. Third, psychologically distressed individuals and digital video-based physical exercisers are more likely to precautionary save.

Conclusions

This study contributes to the literature by documenting how people changed their life from the perspective of finance and health during the lockdown and providing practical implications.

Effect of school-based nutrition interventions among primary school children in sub-Saharan Africa: a systematic review protocol

INTRODUCTION

Preadolescents are passing through an intensive growth and development period that will benefit from healthy eating practices. For those attending school, school environments offer several potential benefits and have been demonstrated to influence the quality of dietary intakes and consequentially, nutritional status of school-aged children (SAC). Considering the amount of time children spend in school and the enormous potential of evidence-based interventions, the purpose of this review is to critically appraise peer-reviewed literature addressing the impact of school-based interventions on the nutritional status of SAC aged 6-12 years in sub-Saharan Africa.

METHODS AND ANALYSIS

A systematic search will be conducted in the following databases and online search records: Medline, CINAHL, Web of Science, Embase, Global health, Global Index Medicus, Cochrane library, Hinari and Google Scholar using search terms and keywords codeveloped with two librarians. An additional search will also be conducted from the reference list of identified literature. Search results of titles and abstracts will be initially screened for eligibility criteria by two independent reviewers and where there is disagreement, a third reviewer will be consulted. Articles meeting these criteria will then undergo a full-text review for the eligibility and exclusion criteria. The Joanna Briggs Institute critical appraisal tool will be used to assess the risk of bias. Data from articles meeting all study criteria will be extracted, analysed and synthesised. A meta-analysis will also be conducted if sufficient data are available.

ETHICS AND DISSEMINATION

This systematic review is limited to publicly accessible data bases not requiring prior ethical approval to access. The results of the systematic review will be disseminated through publications in peer-reviewed journals as well as conference and stakeholder presentations.

PROSPERO REGISTRATION NUMBER

CRD42022334829.

FAMILY INFLUENCE ON THE FORMATION OF CHILDREN'S MOTIVATION FOR A HEALTHY LIFESTYLE

OBJECTIVE

The aim: To study the family influence on the formation of children's motivation for a healthy lifestyle.

PATIENTS AND METHODS

Materials and methods: The medical and sociological study among parents was conducted to assess their children's adherence to the principles of a healthy lifestyle and the influence of the family on the formation of children's motivation for a healthy lifestyle. The survey was conducted using a specially designed questionnaire using Google Forms. The design of the questionnaire was typical and contained the following structural components: addressing the respondent, obtaining informed consent to participate in the survey, and blocks with targeted questions (25 questions in total). The research involved 150 parents (including 54.7 % (82 people) of women and 45.3 % (68 people) of men). Methods: bibliosemantic, system-oriented analysis and logical generalization, medical and sociological (questionnaire), statistical data processing.

RESULTS

Results: It has been found that positive attitudes towards a healthy lifestyle prevail in the families of the respondents (44.0 %), 42.0 % of parents indicated that their family members regularly adhere to a healthy lifestyle. Herewith, 48.0 % are interested in teaching their children about a healthy lifestyle. The main motives that most parents form in their children regarding a healthy lifestyle are maintaining and promoting health (38.0 %), improving physical condition (16.0 %), and creating a healthy family (10.0 %). However, almost a third of parents do not instill responsibility for their children's life and health due to a lack of time and knowledge about a healthy lifestyle.

CONCLUSION

Conclusions: To foster a positive attitude toward a healthy lifestyle in children, parents should set their example, create favorable conditions for a healthy lifestyle, and follow traditions related to active recreation, sensible nutrition, and the absence of bad habits. Children's motivation for a healthy lifestyle is the main responsibility of the family.

Association between dietary knowledge and overweight and obesity in Chinese children and adolescents: Evidence from the China Health and Nutrition Survey in 2004-2015

OBJECTIVE

To assess whether dietary knowledge of Chinese children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity.

METHODS

This cross-sectional study obtained data from the China Health and Nutrition Survey (CHNS) between 2004 and 2015. Dietary knowledge of children and adolescents and their mothers was assessed by asking questions and statements on diets, and clustered by K-means clustering. Body mass index (BMI) and waist circumference (WC) were used to evaluate overweight and obesity among children and adolescents. The association of dietary knowledge with childhood and adolescent overweight and obesity was evaluated by multivariate regression analysis, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated.

RESULTS

A total of 2,338 children and adolescents were included. Children and adolescents with low dietary knowledge were demonstrated to have significantly higher risks of BMI-defined overweight or obesity (OR = 1.66, 95%CI = 1.21-2.28, P = 0.002), and WC-defined obesity (OR = 1.52, 95%CI = 1.12-2.06, P = 0.007) than those with high dietary knowledge. Compared with high dietary knowledge in mothers, low dietary knowledge was associated with significantly elevated risks of BMI-defined overweight or obesity (OR = 1.48, 95%CI = 1.08-2.02, P = 0.014), and WC-defined obesity (OR = 1.59, 95%CI = 1.18-2.16, P = 0.003). Furthermore, significantly increased odds of BMI-defined overweight or obesity and WC-defined non-obesity in children and adolescents were related to low dietary knowledge versus high dietary knowledge of children and adolescents (OR = 1.72, 95%CI = 1.08-2.74, P = 0.023), while there was no association of BMI-defined non-overweight and non-obesity and WC-defined obesity with dietary knowledge among children and adolescents (OR = 1.35, 95%CI = 0.89-2.04, P = 0.161). Additionally, no association was found between dietary knowledge of mothers and BMI-defined overweight or obesity and WC-defined non-obesity among children and adolescents (OR = 1.39, 95%CI = 0.89-2.17, P = 0.155), while low dietary knowledge of mothers was associated with increased odds of BMI-defined non-overweight and non-obesity and WC-defined obesity in children and adolescents (OR = 1.58, 95%CI = 1.03-2.43, P = 0.036).

CONCLUSION

Dietary knowledge of children and adolescents and their mothers was associated with childhood and adolescent overweight and obesity. Dietary knowledge of children and adolescents negatively related to the risk of BMI-defined overweight or obesity, and dietary knowledge of mothers to odds of WC-defined obesity.

Association Between Physical Activity and Sedentary Behavior With Depressive Symptoms Among US High School Students, 2019

INTRODUCTION

The prevalence of depression among US adolescents has increased during the past decade. Previous studies found relationships among physical activity, sedentary behavior, and depression, but more recent information is needed to inform research and practice. We used national surveillance data to assess the association of physical activity and sedentary behavior with depressive symptoms among US high school students.

METHODS

This study included 13,526 high school students from the 2019 Youth Risk Behavior Survey. The dependent variable was the presence of depressive symptoms in the past year that lasted almost every day for at least 2 weeks in a row and interfered with usual activities. The independent variables were physical activity (overall activity, muscle-strengthening exercises, participation on sports teams) and sedentary behavior (watching television, using a computer or digital device). We used weighted multivariable logistic regression to evaluate the association of physical activity and sedentary behavior variables with depressive symptoms, while controlling for demographic characteristics and other health behaviors.

RESULTS

The prevalence of depressive symptoms was 36.7%. Participating in physical activity 5 or more days in the past 7 days (adjusted odds ratio [aOR], 0.81; 95% CI, 0.68-0.97) and participating on 1 or more sports teams in the past year (aOR, 0.66; 95% CI, 0.55-0.78) were associated with reduced odds of depressive symptoms. Using a computer or digital device for 3 or more hours per school night was associated with higher odds of reporting depressive symptoms (aOR, 1.61; 95% CI, 1.41-1.85).

CONCLUSION

Inadequate physical activity and excessive sedentary behavior are associated with depressive symptoms among US high school students. Interventions targeting physical activity and sedentary behavior may be a public health strategy to reduce depressive symptoms in this population.

Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana

Objetivo.

Identificar e compilar os achados de estudos observacionais que analisaram a relação de fatores do ambiente alimentar escolar e individuais de consumo na escola com excesso de peso em escolares da América do Sul no período de 2011 a 2021.

Métodos.

A pesquisa foi realizada em cinco bases de dados (PubMed, Web of Science, SciELO, Scopus e LILACS) e no Google Scholar, além de consulta a especialistas. Foram selecionados estudos observacionais com escolares de 5 a 19 anos, realizados na América do Sul, que usaram medidas objetivas para avaliar excesso de peso, como o índice de massa corporal (Organização Mundial da Saúde e/ou International Obesity Task Force), em associação a fatores do ambiente alimentar escolar e individuais de consumo na escola. O protocolo foi registrado na plataforma PROSPERO (CRD42020212383).

Resultados.

Dos 906 registros identificados, 13 estudos transversais (um da Argentina, um do Equador e 11 do Brasil) foram incluídos na revisão. As prevalências variaram de 7,5% a 32,5% para sobrepeso e 1,7% a 28,0% para obesidade. Fatores do ambiente alimentar escolar, dos domínios político e físico (como educação alimentar e nutricional insatisfatória e indisponibilidade de refeições preparadas na escola) se associaram com maiores prevalências de excesso de peso. Fatores individuais relacionados à adesão ao programa de alimentação escolar (como consumo da alimentação oferecida pela escola ao invés de lanche trazido de casa) se associaram a menores prevalências de excesso de peso.

Conclusões.

São escassos os estudos sul-americanos enfocando a associação entre fatores do ambiente alimentar escolar e/ou individuais e excesso de peso em escolares. As evidências restritas a contextos locais ou regionais incentivam novos estudos de abrangência nacional.

The effectiveness of web-based interventions on non-alcoholic fatty liver disease (NAFLD) in obese children: A study protocol for a randomized controlled trial

Aim

Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent liver disease in the world, increasing the risk of cirrhosis and hepatocellular carcinoma, and contributing to the development of type 2 diabetes, cardiovascular disease, and chronic kidney disease. This study aims to carry out a web-based continuum of a care intervention model to provide comprehensive care interventions for obese children with NAFLD, to improve the effectiveness of treatment of children with NAFLD.

Design

A 1-year single-blinded randomized clinical trial in hospital in Zhejiang Province.

Methods

Eighty subjects will implement the program in a randomized order. The interventions for the control group mainly consisted of the routine distribution of health education materials and health education by holding health-themed lectures, and the preliminary proposed interventions including establishing management teams, regularly delivering related health knowledge, daily uploading of health intervention records, regular supervision and mutual encouragement, home visiting and psychological guidance. The primary outcomes are serum biomarkers such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), aspartate aminotransferase, and imaging (liver ultrasound and magnetic resonance imaging). Second outcomes are: BMI, waist-to-hip ratio and quality of life. In addition, socio-demographic characteristics such as age, gender and ethnicity will be recorded. Children aged 7-18 years old and diagnosed with NAFLD will be included, patients will be not eligible if they do not agree to participate or are participating in other health intervention programs. This study was registered on ClinicalTrials.gov (NCT05527938).

Results

Over the past 30 years, NAFLD has been recognized as one of the most common liver diseases in adults and children. The current studies have focused on promoting lifestyle changes in children with NASH by providing some education and advice to children and their families to improve the histological features of NASH and lose weight. Because of the convenience and efficiency of the internet can provide some new strategies and ways for lifestyle interventions for children with NAFLD. In addition, we have designed a high-quality RCT based on the SPIRIT guidelines, which also provides strong evidence in this area.

Assessment of executive functions and physical activity in girls and boys with normal weight, overweight and obesity

OBJECTIVE

To evaluate the association between body mass index (BMI) and performance of executive functions (EFs) in girls and boys with 9- and 10-year-old schoolchildren with moderate- to vigorous-intensity physical activity (MVPA) and sedentary behaviour.

METHODS

A total of 120 schoolchildren (61 girls and 59 boys) were evaluated anthropometrically. The MVPA was evaluated with a self-report questionnaire. EFs were measured using a neuropsychological battery of Executive Functions and Frontal Lobes-2 (BANFE-2).

RESULTS

A high BMI was associated with longer delay in completing inhibitory control tests (p = 0.00, r_p  = 0.32) and working memory (p = 0.00, r_p  = 0.26). We observed correlations in time (p = 0.00, r_p  = -0.43) and hits (p = 0.04, r_p  = -0.27) of self-directed signalling test in boys; and girls in alphabetical words order (p = 0.00, r_p  = -0.39). Active normal weight schoolchildren (ANw) performed better by successfully completed the working memory tasks (H = 26.97, p = 0.00) than sedentary schoolchildren with overweight and obesity. In addition, overweight-active schoolchildren (AOw) showed better performance on working memory tests in time (p = 0.00) and hits (p = 0.01) than their sedentary peers. Multiple linear regression analysis revealed a significant association between BMI and EFs scores (F = 2.41, df = 98, p = 0.001).

CONCLUSIONS

EFs are affected by a high BMI and sedentary behaviour in school children. Boys and girls reflected differences to solve the same challenges. The MVPA has a positive effect on executive control skills mainly in overweight children.

Sociodemographic and Socioeconomic Factors Influencing the Body Mass Composition of School-Age Children

The purpose of the study was to evaluate the components of overweight, obesity, and body mass components among children aged 7 to 13 years against important sociodemographic factors. The analyses considered 315 school-age children from 7 to 13 years of age (164 boys and 151 girls). Each subject was assessed for body weight and height, body weight category, and main sociodemographic factors. Body mass components of body mass (body-fat percentage (BFP), muscle tissue, fat-free mass (FFM), and total body water (TBW) levels) were evaluated using the electrical bioimpedance method (BIA) and the TANITA 780 MC analyzer. A statistical analysis showed significant differences between the body composition of children living in cities in relation to children living in small towns and villages, and no significant differences were found between the results of children living in small towns and children living in villages. The presence of statistically significant differences between the values of the parameters of body composition of the studied children was demonstrated depending on the level of education of their fathers. The presence of statistically significant relationships between BMI of mothers and BFP of their children (p = 0.003), FFM (p = 0.003), muscle tissue (p = 0.001), and TBW (p = 0.001) has been demonstrated. The higher content of adipose tissue in children is strongly dependent on the higher BMI and body mass category of the mother, as well as the lower level of education of the father. The place of residence also significantly affects both the body fat content and the total body water content of body hydration. Living in the city is associated with better body composition.

Physical activity and academic achievement: an analysis of potential student- and school-level moderators

BACKGROUND

Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement.

METHODS

In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship.

RESULTS

Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (β = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (β = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities.

CONCLUSIONS

Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics.

TRIAL REGISTRATION

This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

Effectiveness of Physical-Activity-Based Interventions Targeting Overweight and Obesity among University Students—A Systematic Review

Overweight and obesity, including their prevalence and consequences, reflect a leading public health problem. Studies have already shown that physical activity leads to a reduction in body weight in children and adults. However, the university setting has rarely been investigated. The aim of this review is, therefore, to examine and summarize the effectiveness of physical-activity-based interventions to reduce obesity and overweight in university students. Three databases (PubMed, Scopus, and Web of Science) were searched for relevant studies published in English between January 2010 and February 2022. Quantitative studies conducting a physical-activity-based intervention with overweight or obese university students and reporting changes in BMI were included. Data were described in a narrative synthesis. Out of 16 included studies, 11 reported a significant reduction in BMI. However, all studies except one were able to demonstrate some BMI improvements, whereas all studies reported significant changes in at least one health-related indicator. Aerobic exercises were able to demonstrate the greatest reductions in BMI. This review is the first systematic presentation on the effectiveness of physical-activity-based interventions in overweight and obese university students. Future work should reconsider BMI as the primary outcome if appropriate within the respective study design (i.e., to measure long-term effects). More interventions are needed to improve strategies.

Gender Differences in Fundamental Motor Skills Proficiency in Children Aged 3-6 Years: A Systematic Review and Meta-Analysis

The age range of 3−6 years is considered as a critical period in developing and learning fundamental motor skills (FMS). To make the formulation of future FMS guidance programs more targeted, we examined gender differences in children’s FMS proficiency using a meta-analysis. Structured electronic databases including PubMed, Scopus and Web of Science were systematically searched using key terms, and the Joanna Briggs Institute (JBI) was used to assess the quality of included literature. Finally, 38 articles (39 studies) met the pre-specified inclusion criteria. The results showed that boys had higher proficiency in total FMS and object control skills than girls (SMD = 0.17 (95% CI 0.03, 0.31), p = 0.02; SMD = 0.48 (95% CI 0.38, 0.58), p < 0.00001), and gender differences in locomotor skill proficiency approached significance, trending in favor of girls (SMD = −0.07 (95 % CI −0.15, 0.01), p = 0.09, I2 = 66%). Meta-regression shows that age is associated with gender differences in object control skills (p < 0.05). In addition, through subgroup analysis, we found that boys’ advantage in object control skills increased with age (3 years: SMD = 0.27 (95% CI 0.00, 0.54), p < 0.00001; 4 years: SMD = 0.58 (95% CI 0.38, 0.77), p < 0.00001; 5 years: SMD = 0.59 (95% CI 0.31, 0.88), p < 0.00001; 6 years: SMD = 0.81 (95% CI 0.61, 1.01), p < 0.00001). In this meta-analysis, we found gender differences in FMS levels in children aged 3−6 years. Notably, gender differences in skill proficiency in object control were influenced by age. We recommend focusing on and developing girls’ object control skills starting at age 3.

Outcome Evaluation on Impact of the Nutrition Intervention among Adolescents: A Feasibility, Randomised Control Study from Myheart Beat (Malaysian Health and Adolescents Longitudinal Research Team—Behavioural Epidemiology and Trial)

A healthy eating environment in the school setting is crucial to nurture the healthy eating pattern for youth. Thus, it helps to combat the obesity issue. However, the impact of healthy school environment on healthy eating habits among Asian adolescents is scarce and less clear. This clustered randomised-control study has two objectives. The first objective was to evaluate the changes in adolescents’ dietary intake after the interventions for all arms (control; healthy cooking training only; subsidization with healthy cooking training). The second objective was to compare the effect of subsidization with healthy cooking training and healthy cooking training only with the control arm on adolescents’ dietary intakes. This study consisted of 340 secondary school students aged 14 years in rural and urban Malaysia. A total of two arms of intervention and one arm of control were included. Intervention one focused on healthy cooking preparation for the canteen and convenience shop operators. Intervention two included subsidization for fruits and vegetables with a healthy cooking preparation training for the canteen and suggestions on providing healthy options to the convenience shop operators. The outcome measured was changes to dietary intake. It was measured using a three-day dietary history pre- and post-intervention. A paired-t test was used to evaluate the outcome of intervention programmes on dietary changes for all arms (control, intervention one and two). An ANCOVA test was used to investigate the effect of providing subsidization and healthy cooking preparation training to the canteen and convenience shop operators on adolescents’ dietary intakes as compared to the control arm. Overall, the reduction in energy and carbohydrates for all arms were observed. Interestingly, fat intake was significantly increased after the four-week intervention programme under healthy cooking intervention but not in the food subsidization group. When comparing between control, healthy cooking training only and subsidization with the healthy cooking training arm, there was no significant changes between arms. A robust intervention to include subsidization of healthy foods for intervention programmes at schools in a larger scale study is needed to confirm this finding.

The Association between Greenness and Urbanization Level with Weight Status among Adolescents: New Evidence from the HBSC 2018 Italian Survey

Recent studies have examined how the environment can influence obesity in young people. The research findings are conflicting: in some studies, green spaces have shown a protective association with obesity and urbanization has turned out to worsen this condition, while other studies contradicted these results. The aim of the study was to examine the relationships between greenness, urbanization, and weight status among Italian adolescents. Student data (11-13 years old) on weight and height, physical activity (PA), and demographic characteristics were extracted from the 2018 Health Behaviour in School-aged Children (HBSC) survey in Piedmont, Northwest of Italy. Data on Normalized Difference Vegetation Index (NDVI) and urbanization were obtained from satellite images and the National Institute of Statistics (ISTAT). A multilevel regression model was used to assess the association between NDVI, urbanization, and obesity, controlling for PA. Students living in greener areas reported a lower likelihood of being obese [OR = 0.11, 95% CI 0.02-0.56, p = 0.007], while students living in areas with a higher level of urbanization showed a significantly increased risk of obesity [OR = 2.3, 95% CI:1.14-4.6, p = 0.02]. Living surrounded by higher amounts of greenness and lower levels of urbanization may positively influence health status through lower risk of obesity among youth.

Differences in Health-Related Physical Fitness and Academic School Performance in Male Middle-School Students in Qatar: A Preliminary Study

This study examined the differences in the level of physical fitness and academic performance among male middle-school children based on different body status categories. A total of 69 male children [age: 12.4 ± 0.7 years; body mass: 58.5 ± 7.2 kg; height: 1.62 ± 0.09 m; and body mass index (BMI): 22.4 ± 3.3 kg/m²] participated and were divided into BMI age-adjusted groups (i.e., lowest, middle, and highest BMI). Height, mass, BMI, stork test of static balance, 10 and 15 m sprint as an indicator for speed, hand-grip strength test, agility T-half test, medicine ball throw (MBT), and the Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1) were assessed. School records were retrieved for grade point averages (GPA) of mathematics, science, and Arabic. We found significant group differences regarding anthropometric (height: ηp2 = 0.24, mass: ηp2 = 0.33, and BMI: ηp2 = 0.66), physical (sprint 10 m: ηp2 = 0.26), and academic (mathematics: ηp2 = 0.19 and science: ηp2 = 0.15) performance parameters. The largest difference (p < 0.001) was observed between the lowest and highest group for the 10 m sprint. All pairwise differences were between the lowest and highest BMI group or the lowest and middle BMI group. No relevant (r > 0.5) correlation between parameters of different dimensions (e.g., anthropometric vs. physical performance parameters) was found. In conclusion, the highest BMI group exhibited similar physical and academic performances than the lowest group. Thus, these data emphasize the importance and appropriateness to engage young Qatari schoolchildren in physical activity as it associates with superior academic performance.

The Effectiveness of Wearable Devices as Physical Activity Interventions for Preventing and Treating Obesity in Children and Adolescents: Systematic Review and Meta-analysis

Background

The prevalence of obesity in children and adolescents remains a global public health issue. Wearable devices may offer new opportunities for prevention and intervention in obesity. Previous systematic reviews have only examined the effect of the wearable device interventions on preventing and treating obesity in adults. However, no systematic review has provided an evaluation of wearable devices as physical activity interventions for preventing and treating obesity in children and adolescents.

Objective

The purpose of this review and meta-analysis was to evaluate the effectiveness of wearable devices as physical activity interventions on obesity-related anthropometric outcomes in children and adolescents.

Methods

Research articles retrieved from PubMed, EMBASE, Cochrane Library, Scopus, and EBSCO from inception to February 1, 2021, were reviewed. The search was designed to identify studies utilizing wearable devices for preventing and treating obesity in children and adolescents. The included studies were evaluated for risk of bias following the Cochrane recommendation. Meta-analyses were conducted to evaluate the effectiveness of wearable devices as physical activity interventions on body weight, body fat, BMI z-score (BMI-Z), BMI, and waist circumference. Subgroup analyses were performed to determine whether the characteristics of the interventions had an impact on the effect size.

Results

A total of 12 randomized controlled trials (3227 participants) were selected for meta-analysis. Compared with the control group, wearable device interventions had statistically significant beneficial effects on BMI (mean difference [MD] –0.23; 95% CI –0.43 to –0.03; P=.03; I²=2%), BMI-Z (MD –0.07; 95% CI –0.13 to –0.01; P=.01; I²=81%), body weight (MD –1.08; 95% CI –2.16 to –0.00; P=.05; I²=58%), and body fat (MD –0.72; 95% CI –1.19 to –0.25; P=.003; I²=5%). However, no statistically significant effect was found on waist circumference (MD 0.55; 95% CI –0.21 to 1.32; P=.16; I²=0%). The subgroup analysis showed that for participants with overweight or obesity (MD –0.75; 95% CI –1.18 to –0.31; P<.01; I²=0%), in the short-term (MD –0.62; 95% CI –1.03 to –0.21; P<.01; I²=0%), wearable-based interventions (MD –0.56; 95% CI –0.95 to –0.18; P<.01; I²=0%) generally resulted in greater intervention effect size on BMI.

Conclusions

Evidence from this meta-analysis shows that wearable devices as physical activity interventions may be useful for preventing and treating obesity in children and adolescents. Future research is needed to identify the most effective physical activity indicators of wearable devices to prevent and treat obesity in children and adolescents.

The Role of Chronic Physical Activity in Alleviating the Detrimental Relationship of Childhood Obesity on Brain and Cognition

Childhood obesity and its negative relation with children’s brain health has become a growing health concern. Over the last decade, literature has indicated that physical activity attenuates cognitive impairment associated with obesity and excess adiposity in children. However, there is no comprehensive review that considers the extent to which these factors affect different domains of cognition. This narrative review comprehensively summarizes behavioral, neuroimaging, and neuroelectric findings associated with chronic physical activity and fitness on brain and cognition in childhood obesity. Based on the literature reviewed, increased adiposity has a demonstrated relationship with neurocognitive health via mechanisms triggered by central inflammation and insulin resistance, with the most pronounced decrements observed for cognitive domains that are prefrontal- and hippocampal-dependent. Fortunately, physical activity, especially interventions enhancing aerobic fitness and motor coordination, have demonstrated efficacy for attenuating the negative effects of obesity across different subdomains of structural and functional brain imaging, cognition, and multiple academic outcomes in children with overweight or obesity. Such mitigating effects may be accounted for by attenuated central inflammation, improved insulin sensitivity, and increased expression of neurotrophic factors. Lastly, individual differences appear to play a role in this relationship, as the manipulation of physical activity characteristics, the employment of a wide array of cognitive and academic measures, the inclusion of different adiposity measures that are sensitive to neurocognitive function, and the utilization of an inter-disciplinary approach have been found to influence the relationship between physical activity and excess adiposity on brain and cognition.

Physical Activity, Fitness, and Executive Functions in Youth: Effects, Moderators, and Mechanisms

Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.

Australian School Stakeholders' Perceived Strategies for Preventing Adolescent Obesity

Adolescent obesity is a complex multifactorial disease with a combination of environmental, behavioral, psychosocial, biological, cultural and genetic determinants. It remains a global public health issue that presents a major challenge to chronic disease prevention and health into adulthood. Schools have a rich opportunity to improve youth health and tackle obesity, yet they face barriers in fulfilling this function. This study investigated school stakeholders' beliefs and perceptions of the barriers and enablers currently experienced by schools, as well as their recommendations towards preventing adolescent obesity. A sequential explanatory mixed-methods study design was utilised with surveys administered for the quantitative phase and individual interviews for the qualitative phase. Descriptive statistics and inductive thematic analyses were utilised for the survey and interview data, respectively. Triangulation of findings from the quantitative and qualitative phases aided in the better understanding and integration of the overall results. In total, 60 school stakeholders (52 subject teachers, 3 senior teachers and 5 heads of department) from both independent and public high schools in Queensland, Australia responded to the survey, while 14 respondents participated in the interviews. The main perceived causes of obesity were poor eating habits and sedentary lifestyle. Highlighted barriers were busy timetables, shortage of trained staff and funding, lack of robustness in the introduction and implementation of school interventions and insufficient motivation of learners to participate in obesity prevention programs. Enabling factors included parental support, easy access to fitness equipment during recess, supportive government policies, provision of healthier school tuck shop menu options and elimination of sugary drinks from vending machines. A model for the prevention of adolescent obesity was developed based on participants' perceptions. Tripartite collaboration between the school, government and parents was perceived as fundamental to preventing adolescent obesity. Strategies targeting nutrition, physical activity and overall health, including parental education on health, formal health talks in schools by health professionals and better-targeted advertisement encouraging healthy lifestyle choices, were identified as essential for improved adolescent health outcomes.

Objectively measured physical activity and academic performance in school-aged youth: The UP&DOWN longitudinal study

To examine the longitudinal relationships between objectively measured total volume and specific intensities of physical activity (PA) with academic performance in a large sample of youth aged 6-18 years. A longitudinal study of 1046 youth (10.04 ± 3.10 years) from Spain was followed over 2 years. PA (volume and intensity) was measured by accelerometry. Academic performance was assessed through grades reported on the transcript at the end of the academic year (Mathematics, Language, an average of these two core subjects, and grade point average [GPA]). Longitudinal relationships between PA and four indicators of academic performance were examined using covariance and regression analyses, adjusted for a variety of confounders. Youth Quartile 2 for PA volume at baseline obtained better scores than those who participated in Quartiles 1 or 4 volumes of PA in GPA 2 years later (p = 0.006). There were generally no longitudinal associations between specific PA intensities and any of the academic performance indicators (all p > 0.170). However, a change in light PA over 2 years was inversely associated with three academic indicators in youth (β_range , -.103 to - 090; all P < 040). Findings suggest that participants in Quartile 2 volume of PA had a better GPA in comparison with Quartiles 1 and 4 volumes of PA during youth, but there was no association with changes in PA volume over time. PA intensity was generally unrelated to academic performance during youth. However, there was an inverted u-shape relationship between light PA changes and GPA.

Universal School Meals in the US: What Can We Learn from the Community Eligibility Provision?

Changes in school meal programs can affect well-being of millions of American children. Since 2014, high-poverty schools and districts nationwide had an option to provide universal free meals (UFM) through the Community Eligibility Provision (CEP). The COVID-19 pandemic expanded UFM to all schools in 2020–2022. Using nationally representative data from the Early Childhood Longitudinal Study: Kindergarten Class of 2010–2011, we measured CEP effects on school meal participation, attendance, academic achievement, children’s body weight, and household food security. To provide plausibly causal estimates, we leveraged the exogenous variation in the timing of CEP implementation across states and estimated a difference-in-difference model with child random effects, school and year fixed effects. On average, CEP participation increased the probability of children’s eating free school lunch by 9.3% and daily school attendance by 0.24 percentage points (p < 0.01). We find no evidence that, overall, CEP affected body weight, test scores and household food security among elementary schoolchildren. However, CEP benefited children in low-income families by decreasing the probability of being overweight by 3.1% (p < 0.05) and improving reading scores of Hispanic children by 0.055 standard deviations. UFM expansion can particularly benefit at-risk children and help improve equity in educational and health outcomes.

Differences between Active and Semi-Active Students Regarding the Parameters of Body Composition Using Bioimpedance and Magnetic Bioresonance Technologies

The aim of the study was to identify differences in obesity-related parameters between active sports students and semi-active or sedentary students, differentiated by sex, in order to optimize health. The study sample included 286 students, of which the male experimental sample consisted of 86 active sports students, age X ± SD 21.25 ± 0.32 years; height X ± SD 181.08 ± 3.52 cm; control group consisting of 89 semi-active students aged X ± SD 21.07 ± 0.1.13 years; height X ± SD 182.11 ± 1.32. The female experimental sample includes 57 active sports students, age X ± SD 21.02 ± 0.92 years; height X ± SD 167.48 ± 1.34 cm; the control group includes 54 semi-active students aged X ± SD 21.57 ± 0.1.98 years; height X ± SD 168.42 ± 1.76. The study used a thalliometer, Tanita Health Ware software and Quantum Resonance Magnetic Analyzer equipment to investigate height (cm), Body Mass Index (BMI), muscle mass (kg, %), as well as the obesity analysis report, and componential analysis of body and nourishment. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The most important parameters regarding obesity and body composition that registered significant differences between the two male groups were in favor of the group of active athletes: triglyceride content of abnormal coefficient 0.844 (CI95% 0.590–1.099), abnormal lipid metabolism coefficient 0.798 (CI95% 1.091–0.504), obesity degree of body (ODB %) 10.290 (CI95% 6.610–13.970), BMI 2.326 (CI95% 1.527–3.126), body fat (kg) 2.042 (CI95% 0.918–3.166), muscle volume (kg) 2.565 (CI95% 1.100–4.031), Lean body weight (kg) 2.841 (CI95% 5.265–0.418). In the case of female samples, the group of active sportswomen registered the biggest differences compared to the group of students who were significantly active in the parameters: abnormal lipid metabolism coefficient 1.063 (CI95% 1.380–0.746), triglyceride content of abnormal coefficient 0.807 (CI95% 0.437–1.178), obesity degree of body (ODB%) 8.082 (CI95% 2.983–13.181), BMI 2.285 (CI95% 1.247–3.324), body fat (kg) 2.586 (CI95% 0.905–4.267), muscle volume (kg) 2.570 (CI95% 0.154–4.985), lean body weight (kg) 4.118 (CI95% 1.160–7.077). The results of the study directly facilitate the understanding of the complexity of the impact of obesity on multiple parameters of body composition and health.

Social Inequalities in Breakfast Consumption among Adolescents in Spain: The DESKcohort Project

Breakfast has a critical role in energy balance and dietary regulation. Consequently, it is considered an important component of a healthy diet, especially in adolescence, when there are great opportunities to consolidate habits and establish future patterns of healthiness in adulthood. Socioeconomic position (SEP) causes inequalities that are reflected in health behaviors, physical activity, mental health, and diet. Therefore, we conducted a cross-sectional study using data from the 2019-2020 DESKcohort project (Spain) to explore the relationships between breakfast and sociodemographic characteristics, health-related behaviors, and school performance of 7319 adolescents. Our findings showed that the prevalence of skipping breakfast every day was 19.4% in girls and 13.7% in boys and was related to students' SEP. The risk of skipping breakfast was 30% higher in girls from the most disadvantaged SEP, in comparison to those in the most advanced SEP (prevalence ratio (PR) = 1.30; 95% confidence interval (CI) = 1.11-1.54). Also, boys from the most disadvantaged SEP showed 28% higher risk of skipping breakfast than those in the most advanced SEP (PR = 1.28; 95% CI = 1.04-1.59). In conclusion, future public policies should be adapted considering a SEP and gender perspective to avoid increasing nutritional and health inequalities.

Effects of a Physical Education Program on Physical Activity and Emotional Well-Being among Primary School Children

(1) Background: It has been identified that schools that adopt at least two hours a week of physical education and plan specific contents and activities can achieve development goals related to physical level, such as promoting health, well-being, and healthy lifestyles, on a personal level, including bodily awareness and confidence in physical skills, as well as a general sense of well-being, greater security and self-esteem, sense of responsibility, patience, courage, and mental balance. The purpose of this study was to establish the effect of physical education programs on the physical activity and emotional well-being of primary school children. (2) Methods: The experimental group comprised 45 girls and 44 boys aged 6–7 years (First Grade) and 48 girls and 46 boys aged 8–9 years (Second Grade), while the control group comprised 43 girls and 46 boys aged 6–7 years (First Grade) and 47 girls and 45 boys aged 8–9 years (Second Grade). All children attended the same school. The Children’s Physical Activity Questionnaire was used, which is based on the Children’s Leisure Activities Study Survey questionnaire, which includes activities specific to young children (e.g., “playing in a playhouse”). Emotional well-being status was explored by estimating three main dimensions: somatic anxiety, personality anxiety, and social anxiety. The Revised Children’s Manifest Anxiety Scale (RCMAS) was used. (3) Results: When analysing the pre-test results of physical activity of the 6–7- and 8–9-year-old children, it turned out that both the First Grade (92.15 MET, min/week) and Second Grade (97.50 MET, min/week) participants in the experimental group were physically active during physical education lessons. When exploring the results of somatic anxiety in EG (4.95 ± 1.10 points), both before and after the experiment, we established that somatic anxiety in EG was 4.55 ± 1.00 points after the intervention program, demonstrating lower levels of depression, seclusion, somatic complaints, aggression, and delinquent behaviours (F = 4.785, p < 0.05, P = 0.540). (4) Conclusions: We established that the properly constructed and purposefully applied eight-month physical education program had positive effects on the physical activity and emotional well-being of primary school children (6–7 and 8–9 years) in three main dimensions: somatic anxiety, personality anxiety, and social anxiety. Our findings suggest that the eight-month physical education program intervention was effective at increasing levels of physical activity. Changes in these activities may require more intensive behavioural interventions with children or upstream interventions at the family and societal levels, as well as at the school environment level. These findings have relevance for researchers, policy makers, public health practitioners, and doctors who are involved in health promotion, policy making, and commissioning services.

Influence of eating habits and alcohol consumption on the academic performance among a university population in the community of Madrid: A pilot study

OBJECTIVE

To evaluate the association between dietary habits and alcohol consumption on academic performance among university students.

DESIGN

Cross-sectional study.

SETTING

University located in Madrid, Spain.

PARTICIPANTS

56 university students of nursing (45 women and 11 men). The study complies with the Helsinki Declaration and was approved by the University Ethics Committee (36/2018).

MAIN OUTCOME MEASURE

Dietary intake and habits assessed with validated survey, alcohol consumption and academic performance.

ANALYSIS

Chi-square test, Student's t-test, ANOVA analysis, Mann-Whitney test, Kruskal-Wallis analysis and Shapiro-Wilk test.

RESULTS

The average daily energy intake of the students was 1918 ± 725 kcal and, on average, alcohol accounted for 6%. The increased energy contribution from alcohol was negatively correlated with body mass index (BMI). Moreover, an inverse association was also found in alcohol intake according to Body Mass Index (BMI) (p < 0.02). Students with failing grades (53.6%) reported a higher daily alcohol intake than those who passed (42.2 %) (32 g/day versus 24 g/day) (p = 0.043).

CONCLUSIONS

Alcohol consumption is related to both poor academic performance as well as diminished quality of life. Thus, it is of vital importance to undertake awareness campaigns at various levels to dissuade alcohol consumption especially at early ages.

Psychosocial Factors and Obesity in Adolescence: A Case-Control Study

INTRODUCTION

The continuously increasing prevalence of childhood obesity is reaching epidemic proportions. Greece is among the countries with the highest childhood obesity prevalence rates. The present study aims to identify psychosocial factors associated with excess body weight of adolescents.

METHODS

This case-control study was conducted in Athens, Greece, and included 414 adolescents aged 11-18 years. Anthropometric measurements were recorded, and an anonymous self-completed questionnaire captured the psychosocial background, family environment, peer relations, and school environment.

RESULTS

Of the total sample of adolescents, 54.6% had normal body weight and 45.4% were overweight or obese. A multivariate logistic regression analysis showed that the factors related to the presence of overweight/obesity were adolescents' age (OR = 0.416, p < 0.001), area of residence, presence of anxiety (OR = 4.661, p = 0.001), presence of melancholia (OR = 2.723, p = 0.016), participation in sports (OR = 0.088, p <0.001), smoking (OR = 0.185, p = 0.005), and mother's occupation (OR = 0.065, p < 0.001).

CONCLUSION

Psychological problems, maternal occupation, the absence of physical activity, and poor school performance were associated with adolescent overweight/obesity. It is important that screening for the presence of psychosocial issues is included in childhood obesity policies and treatment.

Does Physical Activity Predict Obesity-A Machine Learning and Statistical Method-Based Analysis

Background: Obesity prevalence has become one of the most prominent issues in global public health. Physical activity has been recognized as a key player in the obesity epidemic. Objectives: The objectives of this study are to (1) examine the relationship between physical activity and weight status and (2) assess the performance and predictive power of a set of popular machine learning and traditional statistical methods. Methods: National Health and Nutrition Examination Survey (NHANES, 2003 to 2006) data were used. A total of 7162 participants met our inclusion criteria (3682 males and 3480 females), with average age ranging from 48.6 (normal weight) to 52.1 years old (overweight). Eleven classifying algorithms—including logistic regression, naïve Bayes, Radial Basis Function (RBF), local k-nearest neighbors (k-NN), classification via regression (CVR), random subspace, decision table, multiobjective evolutionary fuzzy classifier, random tree, J48, and multilayer perceptron—were implemented and evaluated, and they were compared with traditional logistic regression model estimates. Results: With physical activity and basic demographic status, of all methods analyzed, the random subspace classifier algorithm achieved the highest overall accuracy and area under the receiver operating characteristic (ROC) curve (AUC). The duration of vigorous-intensity activity in one week and the duration of moderate-intensity activity in one week were important attributes. In general, most algorithms showed similar performance. Logistic regression was middle-ranking in terms of overall accuracy, sensitivity, specificity, and AUC among all methods. Conclusions: Physical activity was an important factor in predicting weight status, with gender, age, and race/ethnicity being less but still essential factors associated with weight outcomes. Tailored intervention policies and programs should target the differences rooted in these demographic factors to curb the increase in the prevalence of obesity and reduce disparities among sub-demographic populations.

Three-Year Follow-Up of the POIBA Intervention on Childhood Obesity: A Quasi-Experimental Study

Childhood obesity has increased worldwide over the past four decades. This quasi-experimental study aimed to assess the effectiveness of a multicomponent and multilevel school-based intervention (POIBA) at 3 years of follow-up. The nutrition intervention focused on food groups, food pyramid, nutrients, portions, and balanced menus. In total, 3624 children participated in the study. Anthropometric measurements and information on food frequency and behavior, physical activity, and daily screen use were collected in the intervention (IG) and comparison group (CG). Positive unadjusted changes toward adherence to recommendations were found for water, meat, sweets, and fried potato consumption, proper breakfast, not having dinner in front of the TV, out-of-school physical activity, and daily screen use. Three scores were used to calculate the proportion of children making more than one change to improve healthy habits regarding physical activity (global Activity score), nutrition (global Nutrition score), and both (global score). Students exposed to the intervention had a significantly better global Activity score (16.2% IG vs. 11.9% CG; p = 0.012) and Global score (63.9% IG vs. 58.5% CG; p = 0.025). Intervention effects on obesity incidence at 3-year follow-up lost significance but maintained the positive trend. In conclusion, school-based interventions including a family component could be useful to address the childhood obesity problem.

Sex-Specific Temporal Trends in Overweight and Obese Among Schoolchildren From 2009 to 2018: An Age Period Cohort Analysis

Background: Our study examined the age, period, and cohort effects on overweight and obesity in children using a 10-year dataset collected from schoolchildren in Hualien, Taiwan. Methods: We used data from the annual health checkup of a total of 94,661 schoolchildren in primary schools and junior high schools in Hualien from 2009 to 2018. Children were defined as overweight or obese by the gender- and age-specific norm of the body mass index. We conducted the age-period-cohort (APC) analysis in boys and girls separately. Results: From 2009 to 2018, the rates of children overweight and obese were 12.78 and 14.23%, respectively. Boys had higher rates of overweight and obesity than girls (29.73 vs. 24.03%, P < 0.001). Based on APC analysis results, positive age effect existed regardless of gender. The risk of overweight or obesity of children aged 9 or 12 years was significantly higher compared to the average rate. As for period effect, a fluctuating downward trend in overweight was evident in 2016, and a similar trend in obesity was seen in 2017 across gender groups. The birth cohort of 2007 to 2009 had a significant higher proportion of overweight and obese than other birth cohorts. This indicated that the proportion of children overweight and obese in the young generation is higher than that in the old generation. Conclusion: An increased risk of children overweight or obese was associated with age and later birth cohort. For the period effect, the trend in the prevalence of overweight and obesity fluctuated downward slowly from 2016 to 2017.

Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews

BACKGROUND

Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes.

METHODS

Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised.

RESULTS

Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions.

CONCLUSION

There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns.

TRIAL REGISTRATION

Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.

Interventions for Children with Neurocognitive Impairments in Resource-Limited Settings: A Systematic Review

Many children and adolescents around the world suffer from neurocognitive deficits due to chronic disorders, such as Human Immunodeficiency Virus (HIV) and malaria. Resource-limited settings exacerbate the risk of negative cognitive outcomes due to high prevalence of associated disorders, poverty, and limited access to interventions. Current literature does not provide consensus regarding the efficacy of interventions to support children with cognitive impairments in low-resource settings. This research aimed to identify and evaluate interventions for youth with neurocognitive deficits in resource-limited settings. A systematic review of peer-reviewed literature was conducted within five databases (PubMed, Web of Science, CINAHL, PsycInfo, and WHO Index Medicus). Cognitive impairment was broadly defined to be inclusive of aspects of intellectual and cognitive functioning (e.g., working memory, attention, executive function). The income status of the country or countries in which each study was located was determined according to World Bank Income Status. Studies conducted in countries classified as low- or middle-income were included. Since low-resource areas exist within high-income countries, the resource availability within study settings in high-income countries was systematically evaluated for inclusion. The search yielded 19 articles that met all inclusion criteria. Interventions included strategies involving caregiver training, computerized and non-computerized cognitive training, physical activity, and nutritional supplementation. Interventions were administered in medical facilities, educational facilities, or the home. The majority of the interventions targeted the domains of memory and attention. Overall, the efficacy of interventions was inconsistent. Further, results indicated that the relationship between cognitive improvement and intervention types was not consistent across cognitive domains. However, when evaluating studies on an individual basis, some strategies demonstrated clinically- and statistically-significant improvement in cognitive function among specific groups of children. The low article yield highlights that few researchers have evaluated pediatric cognitive support interventions in low-resource contexts. This review suggests support strategies that should be considered for future studies as neurocognitive screening capacity improves in resource-limited settings.

Effectiveness of healthy eating interventions among children: A quantitative systematic review

AIMS

This review aimed to evaluate the effectiveness of healthy eating interventions among normal-weight children.

DESIGN

A systematic review of randomized controlled trials.

DATA SOURCES

Seven databases were searched from the inception of each database until September 2019.

REVIEW METHODS

A systematic review of quantitative studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA extension for reporting a synthesis without a meta-analysis.

RESULTS

Fifteen studies were included in this review. A meta-analysis could not be conducted because of the observed heterogeneity across studies. There were mixed effects of the included interventions on healthy eating habits, ranging from effective to not effective. Only a few studies found behavioural determinants effective in enhancing healthy eating.

CONCLUSION

Because of the observed heterogeneity and varied outcome variables, a meta-analysis could not be conducted, and the overall effectiveness of the included interventions could not be verified. Interventions that were theory based, parent focused, and delivered through the multimodal interactive approach were found to be effective in enhancing healthy eating habits among children. More studies involving peers that are institution based need to be conducted.

European Countries Ranking and Clustering Solution by Children’s Physical Activity and Human Development Index Using Entropy-Based Methods

The aim of the present study is to propose a new approach for evaluating and comparing European countries using indicators of the children physical activity and the human development index. The Global Matrix 3.0 on physical activity for children and youth and human development index data on the 18 European countries were used. MADM (multi-attribute decision making) approach was applied for this task. The criteria weights calculated by applying the weight balancing method—weight balancing indicator ranks accordance (WEBIRA). New methodology of interval entropy is proposed for determining the priority of criteria separately in each group. The novel approach of α-cuts for recursive procedure of ranking the alternatives was used. For comparison, three alternative entropy-based methods—entropy method for determining the criterion weight (EMDCW), method of criteria impact LOSs and determination of objective weights (CILOS) and integrated determination of objective criteria weights (IDOCRIW) were applied to address this MADM problem. Cluster analysis of European countries carried out using results obtained by all above methods. Comparison of the MADM methods revealed that three alternative methods assigned negligible values to whole group of criteria. Meanwhile, WEBIRA family methods performed the ranking of European countries according to the interrelation of the two groups of criteria in a balanced way. Thus, when addressing MADM tasks with two or more naturally related sets of criteria, it is appropriate to apply criteria adapted for that purpose, such as WEBIRA.

Differences in educational attainment between obese and non-obese Kuwaiti female university students

Individuals with obesity tend to perform less well than their non-obese peers in tertiary education, but there is little evidence from non-Western countries and recent studies. The present study aimed to test whether academic attainment differed between female undergraduates with obesity (defined by body mass index (BMI)), and those who were non-obese in Kuwait, a country with very high obesity prevalence. In 400 female Kuwaiti first- and second-year Social Science students (mean age 18⋅0, sd 0⋅6 years), educational attainment was defined as the Grade Point Average (GPA) across all subjects (from 1⋅00 to 4⋅00). The mean GPA (2⋅51, sd 0⋅53) among students defined as obese by the BMI (n 163) was significantly lower than among the students defined as non-obese by the BMI (n 237; 2⋅80, sd 0⋅63; P < 0⋅001), and those defined as obese were more likely to be in the lowest quartile for the GPA (OR 3⋅03; 95% CI 1⋅90, 4⋅85), independent of socio-economic status. Similar differences were observed between students defined as having high versus normal body fatness. Female undergraduates in Kuwait with obesity have lower academic attainment than their non-obese peers, and universities should consider measures to mitigate reduced attainment among their female undergraduates.

Physical Activity and Academic Achievement: An Umbrella Review

Background: This umbrella review aimed to summarise the evidence presented in systematic reviews and meta-analyses regarding the effect of physical activity on academic achievement of school-age children and adolescents. Methods: A comprehensive electronic search for relevant systematic reviews and meta-analyses were performed in Pubmed, Cochrane Library, Web of Science, Scopus, and Latin American and Caribbean of Health Sciences Information System, and reference lists of the included studies, from inception to May 2020. Studies were included if they were systematic reviews or meta-analyses, included school-age children or adolescents, the intervention included physical activity, and the outcome was the academic achievement. Two independent authors screened the text of potentially eligible studies and assessed the methodological quality of the studies using the AMSTAR 2 tool. Results: Forty-one systematic reviews and meta-analyses that examined the effects of physical activity on children and adolescents’ academic achievement were identified. Overall, the systematic reviews reported small positive or mixed associations between physical activity and academic achievement. From meta-analyses, it was observed that physical activity had null or small-to-medium positive effects on academic achievement. Chronic physical activity showed a medium positive effect on academic achievement, and acute physical activity did not demonstrate benefits. Conclusions: Physical activity seems not to be detrimental to school-age children and adolescents’ academic achievement, and may, in fact, be beneficial.

Dietary patterns of patients with psoriasis at a public healthcare institution in Brazil

BACKGROUND

Psoriasis is a chronic inflammatory disease with systemic repercussions and an association with comorbidities such as metabolic syndrome, cardiovascular diseases, and obesity. Psoriasis patients have a higher prevalence of obesity compared to the general population. Diet is a relevant environmental factor, since malnutrition, inadequate body weight, and metabolic diseases, in addition to the direct health risk, impair the treatment of psoriasis.

OBJECTIVES

To evaluate food intake patterns, anthropometric, and metabolic syndrome-related aspects in psoriasis patients.

METHODS

Cross-sectional study through anthropometric assessment and food frequency questionnaire. Food frequency questionnaire items were evaluated by exploratory factor analysis and identified dietary patterns were analyzed by multivariate methods.

RESULTS

This study evaluated 94 patients, 57% female, with a mean age of 54.9 years; the prevalence of obesity was 48% and of metabolic syndrome, 50%. Factor analysis of the food frequency questionnaire identified two dietary patterns: Pattern 1 - predominance of processed foods; Pattern 2 - predominance of fresh foods. Multivariate analysis revealed that Patterns 1 and 2 showed inverse behaviors, and greater adherence to Pattern 2 was associated with females, eutrophic individuals, absence of lipid and blood pressure alterations, and lower waist-to-hip ratio and skin disease activity.

STUDY LIMITATIONS

Monocentric study conducted at a public institution, dependent on dietary memory.

CONCLUSION

Two dietary patterns were identified in a Brazilian sample of psoriasis patients. The prevalence of obesity and metabolic syndrome were greater than in the adult Brazilian population. The fresh diet was associated with lower indicators of metabolic syndrome in this sample.

Associations between parent and child physical activity and eating behaviours in a diverse sample: an ecological momentary assessment study

OBJECTIVE

This study is a secondary data analysis that examines the association between parent modelling of dietary intake and physical activity and the same child behaviours among different races/ethnicities using innovative, rigorous and objective measures.

DESIGN

Ecological momentary assessment surveys were sent to parents to assess whether their child had seen them exercise or consume food. Dietary recall data and accelerometry were used to determine dietary intake and physical activity behaviours of children.

SETTING

Participants were randomly selected from primary care clinics, serving low-income and racially/ethnically diverse families in Minnesota, USA.

PARTICIPANTS

Participants were families with children aged 5-7 years old who lived with parents 50 % of the time and shared at least one meal together.

RESULTS

A 10 percentage point higher prevalence in parent modelling of fruit and vegetable intake was associated with 0·12 higher serving intake of those same foods in children. The prevalence of parent modelling of eating energy dense foods (10 % prevalence units) was associated with 0·09 higher serving intake of sugar-sweetened beverages. Furthermore, accelerometry-measured parent sedentary hours was strongly correlated with child sedentary time (0·37 child sedentary hours per parent sedentary hours). An exploratory interaction analysis did not reveal any statistical evidence that these relationships depended on the child's race/ethnic background.

CONCLUSIONS

Interventions that increase parent modelling of healthy eating and minimise modelling of energy dense foods may have favourable effects on child dietary quality. Additionally, future research is needed to clarify the associations of parent modelling of physical activity and children's physical activity levels.

Season of birth and sugary beverages are predictors of Raven's Standard Progressive Matrices Scores in adolescents

To investigate factors associated with cognitive functioning in healthy adolescents, a school-based cross-sectional study was conducted on 1370 adolescents aged 11–16 years that were randomly selected from all governorates of Kuwait. Raven’s Standard Progressive Matrices (SPM), a non-verbal test of intelligence, was used to measure cognitive functioning of the study participants. Data on predictors of cognitive functioning were collected from parents and adolescents. Weight and height of the participants were measured in a standardized manner and blood samples were tested in an accredited laboratory under strict measures of quality control. In multivariable linear regression analysis, factors that showed significant association with the SPM score were gender (p = 0.002), season of birth (p = 0.009), place of residence (p < 0.001), father’s (p < 0.001) and mother’s (p = 0.025) educational level, type of housing (p < 0.001), passive smoking at home (p = 0.031), sleeping hours during weekends (p = 0.017), students’ educational level (p < 0.001) and the frequency of consumption of sugary drinks (p < 0.001). The link between cognitive functioning and season of birth seems to be robust in various geographical locations including the Middle East. The association between sugary drinks and cognitive functioning highlights the importance of diet independently of obesity and support efforts to reduce consumption of sugary drinks among children.

The role of age, sex, anthropometry, and body composition as determinants of physical fitness in nonobese children aged 6-12

Purpose

The determinants of physical fitness in children have been given limited attention. In particular, the relative role of chronological age, sex, anthropometry, and body composition in physical fitness of children has been barely investigated. This cross-sectional study investigated determinants of physical fitness using a set of predictive variables including, in addition to chronological age and sex, a large panel of anthropometric measurements as well as body composition. The study was carried out in a convenience sample of children aged 6–12 participating in a summer camp.

Methods

One-hundred-ninety-three children (128 males) fulfilled all requirements and entered analysis. Health-related physical fitness components (speed, muscular power and balance) were explored by means of field tests, namely the 30-m dash test for running speed, the standing long jump and the seated chest pass test for lower limbs and upper body muscular power, respectively, and the flamingo balance test for static balance. Determinants of physical fitness were investigated by regression analysis using chronological age, sex, anthropometry, and body composition in a hierarchical approach. To minimize the expected effect of collinearity in predictor variables, an original statistical approach using Random Forests analysis was adopted.

Results

Age predicted 45.2%, 43.6%, 35.6% and 25.6%; and sex 9.5%, 10.7%, 6.3% and 2.0% of variance in the 30-m dash, seated chest pass, standing long jump, and flamingo balance test, respectively. Anthropometry and body composition explained a limited or no percentage of variance. The adjusted R² (root mean square error) was 0.61 (0.31 s), 0.45 (0.32 m), 0.58 (0.15 m) and 0.41 (0.75 logs) for the 30-m dash, seated chest pass, standing long jump, and flamingo balance test, respectively making these models useful when physical fitness tests are not feasible.

Conclusions

We highlighted the respective role of chronological age, sex, anthropometry, and body composition in physical fitness of children in the wide age range 6–12 years. Data confirm and expand on previous literature by showing with a strictly conservative statistical approach that chronological age is a main determinant of physical fitness of both boys and girls, sex playing a limited role. The role of anthropometry was even less important, and no role was found for body composition. These findings should be considered when planning/implementing motor development or physical education programs.

The Effect of Eating Habits' Quality on Scholastic Performance in Turkish Adolescents

Evidence associates scholastic performance to quality of eating habits. However, there is limited information on this topic in Turkey, an emerging economy with notable disparities. Our work aimed to evaluate the effect of eating habits quality of high-school students in Turkey, on the Scholastic Aptitude Standardized Examination (TEOG) scores. The study was conducted in 29 different cities in Turkey during the academic year 2016–2017, involving students of ages 14–17 years (up to senior-high school). A dietary habits survey developed and validated for this population was distributed over the internet in February 2017. Apart from students’ TEOG scores, Family Affluence Score (FAS) was used to categorize the students into low, medium, and high financial standing. Eating Habits Score (EHS) was calculated by using a validated scoring system. A working sample of 298 participants was used. Based on our results, we observed that there is a significant positive correlation between EHS, FAS and success rate of students as assessed by TEOG scores. Further research on this subject should be conducted in combination with intervention studies to reveal potential strategies and policies that would enhance positive behavior change as it relates to nutritional habits, aiming at improved scholastic performance and overall health throughout lifespan.

Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines

PURPOSE

Physical activity (PA) is known to improve cognitive and brain function, but debate continues regarding the consistency and magnitude of its effects, populations and cognitive domains most affected, and parameters necessary to achieve the greatest improvements (e.g., dose).

METHODS

In this umbrella review conducted in part for the 2018 Health and Human Services Physical Activity Guidelines for Americans Advisory Committee, we examined whether PA interventions enhance cognitive and brain outcomes across the life span, as well as in populations experiencing cognitive dysfunction (e.g., schizophrenia). Systematic reviews, meta-analyses, and pooled analyses were used. We further examined whether engaging in greater amounts of PA is associated with a reduced risk of developing cognitive impairment and dementia in late adulthood.

RESULTS

Moderate evidence from randomized controlled trials indicates an association between moderate- to vigorous-intensity PA and improvements in cognition, including performance on academic achievement and neuropsychological tests, such as those measuring processing speed, memory, and executive function. Strong evidence demonstrates that acute bouts of moderate- to vigorous-intensity PA have transient benefits for cognition during the postrecovery period after exercise. Strong evidence demonstrates that greater amounts of PA are associated with a reduced risk of developing cognitive impairment, including Alzheimer's disease. The strength of the findings varies across the life span and in individuals with medical conditions influencing cognition.

CONCLUSIONS

There is moderate-to-strong support that PA benefits cognitive functioning during early and late periods of the life span and in certain populations characterized by cognitive deficits.