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MacKay M, Mathis S. School-Based Versus Family-Based Interventions for the Reversal and Prevention of Obesity Among Hispanic Youth: a Review of the Literature. J Racial Ethn Health Disparities 2024; 11:2338-2345. [PMID: 37440109 DOI: 10.1007/s40615-023-01701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
Childhood obesity prevalence in the USA continues to rise and the Hispanic American population is disproportionately affected. Obesity prevalence among Hispanic youth is 26.2%, the highest prevalence of any minority or non-minority group of children. Prevalence of related conditions including type 2 diabetes, heart disease, and stroke also are increased among Hispanic Americans. Physicians and other providers commonly utilize body mass index (BMI) to estimate percentage of bodily fat and risk of adverse health outcomes. BMI has been shown to track from childhood to adulthood, demonstrating necessity for early intervention. Interventions targeting the prevention and reversal of obesity among children are categorized as school-based or family-based. Interventions vary but may involve strategies such as meetings to discuss health-related curriculum, augmentation of physical activity, and/or improvement of nutritional quality of food. The aim of this article is to review the current literature to determine whether family-based or school-based interventions are more successful in the prevention and reversal of obesity among Hispanic youth. We reviewed twenty-eight studies describing these interventions and included ten (four school-based and six family-based) in our in-depth analysis. Inclusion criteria required trials were conducted among adequate population sizes of Hispanic youth within the age range of interest, analyzed the primary outcome of interest, and took place after the year 2000. Family-based interventions typically involved small population sizes, were dependent upon parent adherence, and were rarely effective. School-based interventions were more commonly effective and involved larger population sizes, allowing for greater generalizability and greater impact of the intervention. Of five family or school-based interventions which successfully reduced BMI among this population, four included a component involving structured physical activity. School-based interventions involving augmentation of physical activity with minimal limitations of study execution demonstrated efficacy in the prevention and reversal of obesity among Hispanic children.
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Affiliation(s)
- Micaela MacKay
- The University of Texas Medical Branch, Galveston, TX, USA.
| | - Samuel Mathis
- The University of Texas Medical Branch, Galveston, TX, USA
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Souilla L, Amedro P, Morrison SA. Children With Cardiac Disease and Heat Exposure: Catastrophic Converging Consequences? Pediatr Exerc Sci 2024; 36:118-122. [PMID: 38171350 DOI: 10.1123/pes.2023-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 01/05/2024]
Abstract
The detrimental impact of extreme heat exposure on the health and well-being of children is widely acknowledged. The direct and indirect effects of climate change have led to an increased risk of certain cardiovascular events which may be particularly harmful to children who are born with, or develop, heart disease. PURPOSE To highlight the worrying paucity of investigative research aimed at differentiating how higher ambient temperatures further tax an already compromised cardiovascular system in children. METHODS This commentary describes basic thermoregulatory concepts relevant to the healthy pediatric population and summarizes common heart diseases observed in this population. RESULTS We describe how heat stress and exercise are important factors clinicians should more readily consider when treating children with heart disease. Countermeasures to physical inactivity are suggested for children, parents, clinicians, and policymakers to consider. CONCLUSIONS As sudden, excessive heat exposures continue to impact our rapidly warming world, vulnerable populations like children with underlying heart conditions are at greater heat health risk, especially when coupled with the negative physical activity and fitness trends observed worldwide.
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Affiliation(s)
- Luc Souilla
- PhyMedExp, Inserm U 1046, CNRS, University of Montpellier, Montpellier,France
- Department of Pediatric and Congenital Cardiology, M3C Regional Reference Centre, University Hospital, Montpellier,France
| | - Pascal Amedro
- Department of Pediatric and Adult Congenital Cardiology, M3C National Reference Center, Bordeaux University Hospital, Pessac,France
- Bordeaux Cardio-Thoracic Research Center, Electrophysiology and Heart Modeling Institute, Inserm U1045, IHU Liryc, University of Bordeaux, Pessac,France
| | - Shawnda A Morrison
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
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srivastav P, K V, Bhat HV, Broadbent S. Effect of a pragmatic lifestyle modification intervention on physical activity levels and body mass index among obese and overweight adolescents in Udupi, India: a cluster randomized trial. F1000Res 2024; 13:859. [PMID: 39113943 PMCID: PMC11303949 DOI: 10.12688/f1000research.153483.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
Background Determine the effects of a multifactorial lifestyle intervention on physical activity (PA), BMI and health-related quality of life (QoL) in obese and overweight adolescents. Methods Nine schools in India were clustered randomly in a 12-month study with students allocated to a multifactorial intervention (MFI), or exercise only (EX) or control (CON) group. Participants were adolescents aged 11-16 years (n=671). In the MFI group, adolescents and their parents received lifestyle education using a validated booklet combined with a PA intervention for school students. The EX group received school-based PA only; the CON group continued regular activities. Primary outcomes were PA levels measured with the PAQ-A, and BMI; the secondary outcome was health-related QoL. A linear regression statistical model was used to analyse time, group effects and interactions, with Bonferroni correction for within-group differences at baseline (T0) and at 12-weeks (T1) (post-intervention), 6-month (T2) and 12-month (T3) follow-ups. Results Significant time and group effects observed for all groups with PA scores (p<0.001), with MFI group having largest increase in PA; with BMI (p<0.001) and MFI showing the least gain in BMI; and HRQOL (p<0.001), with MFI group showing greatest improvement in scores. There were significant increases in PA at T1 and T3 time-points with the EX group, and at T3 time-point only for MFI and CON, with MFI group showing largest increase in HRQOL scores. BMI increased significantly for all groups at T2 (MFI p=0.001, EX p<0.001) and T3 (p<0.001), while HRQOL increased significantly for both MFI and EX at both follow-ups (p<0.001). Conclusions School-based lifestyle MFI was more effective for improving PA, lifestyle behaviours and HRQOL than exercise alone for adolescents, although BMI was not reduced. MFI with PA could be an effective school-based approach for behaviour modification but BMI has limitations for measuring body composition changes. Registration CTRI/2019/04/018834 (30/04/2019).
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Affiliation(s)
- prateek srivastav
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - H Vinod Bhat
- The Apollo University, Chittoor, Andhra Pradesh, 517127, India
| | - Suzanne Broadbent
- School of Health, University of Sunshine Coast, Sippy Downs, Queensland, 4556, Australia
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Abdelkarim O, El-Gyar N, Shalaby AM, Aly M. The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project. CHILDREN (BASEL, SWITZERLAND) 2024; 11:842. [PMID: 39062291 PMCID: PMC11276202 DOI: 10.3390/children11070842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the "Be Fit Program" aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. METHODS A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. RESULTS Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). CONCLUSIONS The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children's fitness in the Egyptian context.
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Affiliation(s)
- Osama Abdelkarim
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
| | - Noha El-Gyar
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Amira M. Shalaby
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed Aly
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
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García I, San-Millán M, Cazorla-González J, Román-Viñas B, Serrano-Ferrer J, Jòdar-Portas A, Prats-Puig A, Font-Lladó R. Association of Physical Fitness and Anthropometric Parameters With Lung Function in 7-Year-Old Children. Pediatr Exerc Sci 2024:1-7. [PMID: 38307007 DOI: 10.1123/pes.2023-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/20/2023] [Accepted: 12/06/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE Associations between health-related parameters and lung function remain unclear in childhood. The study aims to evaluate the relationship between physical fitness and anthropometric parameters with the lung function of healthy scholar-aged children. METHOD A total of 418 children aged 7 years old participated in this study. The associations of physical fitness (handgrip strength, standing broad jump, and 800-m run) and anthropometric (waist circumference and body mass index) parameters with lung function (forced vital capacity and forced expiratory volume in 1 s) were analyzed using a mixed-linear regression model. RESULTS Girls had significantly lower forced vital capacity values (P = .006) and physical fitness (P < .030) compared to boys. On mixed-linear regression analyses, waist circumference (P = .003) was independently associated with forced vital capacity, explaining 34.6% of its variance, while handgrip strength (P = .042) and waist circumference (P = .010) were independently associated with forced expiratory volume in 1 second, accounting together for 26.5% of its variance in 7-year-old healthy children. CONCLUSIONS Handgrip strength and waist circumference were associated with lung function in healthy children highlighting the influence of upper body muscular strength and trunk dimension on lung function. Our results corroborate the need to promote physical fitness during childhood to protect against lung complications in later on in life.
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Affiliation(s)
- Iker García
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
- Physiology Section, Department of Cell Biology, Physiology, and Immunology, Universitat de Barcelona, Barcelona,Spain
| | - Marta San-Millán
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
- Medical Sciences Department, Clinical Anatomy, Embriology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona,Spain
| | | | - Blanca Román-Viñas
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
| | - Juan Serrano-Ferrer
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
| | - Anna Jòdar-Portas
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
| | - Anna Prats-Puig
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
- Medical Sciences Department, Clinical Anatomy, Embriology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona,Spain
| | - Raquel Font-Lladó
- EUSES University School of Health and Sports, University of Girona, Salt,Spain
- Psychology Department, Culture, Education and Human Development Research Group (GRICEDH), University of Girona, Girona,Spain
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Martinko A, Sorić M, Jurak G, Starc G. Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit). THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100748. [PMID: 37927431 PMCID: PMC10624998 DOI: 10.1016/j.lanepe.2023.100748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
Background COVID-19 public health crisis has exerted immediate negative impacts on children's physical fitness, but the longer-term effects are not clear, and the impact on children with excess weight is yet unknown. We examined changes in multiple components of physical fitness in response to COVID-19 imposed restrictions, but also a year after the restrictions were terminated, and compared these trends in groups of boys and girls with normal weight, overweight, or obesity before the pandemic. Methods Information was gathered through Slovenia's national fitness surveillance system, and included 41,330 children (19,890 girls), aged 5-17, who had their fitness levels measured yearly from 2019 to 2022. Multilevel linear mixed models, fitted separately for boys and girls, were used to model the individual-level trends over time in centile score for each fitness test across 3 weight groups. Findings Overall fitness levels decreased markedly across all weight categories between 2019 and 2020, with the largest decreases in Total Fitness Index observed in children with normal weight and overweight (-8.4 and -7.7 centiles for boys and -8.3 and -8.8 for girls, respectively, p < 0.001). While there was some recovery in the overall fitness level between 2020 and 2022, it remained much lower in 2022 compared to 2019 across most groups, apart from boys with obesity. Fitness components that had the largest impact on general fitness trends were cardiorespiratory fitness, lower body power, body core, and upper body strength. Interpretation A severe decline in fitness that has not come close to returning to pre-pandemic levels in most population groups of youth begs for urgent population-wide initiatives that will provide additional opportunities for physical activity to youth. Among vulnerable groups, girls with overweight and obesity deserve a special focus of these policies. Funding Horizon 2020 (Grant no. 774548), Slovenian National Research Agency (Grant no. P5-0142), Croatian Science Foundation (Grant no. DOK-2020-01-3728).
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Affiliation(s)
| | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Jurak
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Morrison SA, Jurak G, Starc G, Kovač M, Golobič M, Pavletič Samardžija P, Gabrijelčič M, Kotnik P, Meh K, Primožič M, Sember V. Challenges of social change: The 2021 Republic of Slovenia report card on physical activity of children and adolescents. J Exerc Sci Fit 2023; 21:305-312. [PMID: 37520932 PMCID: PMC10372450 DOI: 10.1016/j.jesf.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/12/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023] Open
Abstract
Background Slovenian children are facing considerable health challenges from the rapid social changes that influence their opportunity to engage in daily physical activity. Objective To overlay the social changes to the established Report Card model as a means of contextualising the extreme changes in physical activity and fitness observed over several years. Methods Benchmarks were graded for 10 core indicators, plus two (Sleep, Seasonal Variations). Active Healthy Kids Slovenia members met (predominantly via zoom) liaising with team leader(s) on a flexible, individual basis, based on coronavirus disease 2019 (COVID-19) regulations, over the ∼2-year assessment period of the project. Data were separated to the years prior to, 'pre' 2018-2020, and 'during' the global pandemic (2020-2021). Where sufficient data existed for both timeframes, grades were averaged to produce an overall grade. Results Grade results are expressed as pre/during/final grade, where the final grade (bolded) is a straight average of the two preceding time epochs: Overall Physical Activity (A-/A-/A-), Organized Sport and Physical Activity (C+/C/C), Active Play (D/C+/C), Active Transport (C/INC/C), Sedentary Behaviour (B/C/C+), Physical Fitness (A+/A-/A), Family and Peers (B+/INC/B+), Schools (A/A/A), Community and Environment (A+/A+/A+), Government (A/F/D), Sleep (D-/INC/D-), Seasonal Variations (D/C-/D+). Conclusion Although Slovenia has some of the most consistently physically-active children in the world, the effects of the COVID-19 pandemic exerted significant reductions in physical activity opportunities, and especially when coupled with funding re-distributions, resulted in the steepest decline of child physical fitness observed within the >35-year history of Slovenia's well-established national fitness surveillance system.
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Affiliation(s)
- Shawnda A. Morrison
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gregor Jurak
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Marjeta Kovač
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mojca Golobič
- Biotechnical Faculty, University of Ljubljana, Slovenia
| | | | | | - Primož Kotnik
- Faculty of Medicine, University of Ljubljana, Slovenia
| | - Kaja Meh
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | | | - Vedrana Sember
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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