The association between physical activity, fitness and body mass index on mental well-being and quality of life in adolescents

The effect of electronic health (eHealth) interventions for promoting physical activity self-efficacy in children: A systematic review and meta-analysis

Background/objective

Physical activity (PA) self-efficacy plays a crucial role in maintaining and enhancing PA behaviors in children. However, the effectiveness of eHealth interventions in boosting PA self-efficacy among children remains uncertain. Furthermore, which behavior change techniques (BCTs) used in eHealth interventions can positively influence children's PA self-efficacy needs further exploration for designing tailored eHealth interventions. Therefore, this systematic review and meta-analysis aimed to identify the effectiveness of eHealth interventions and BCTs in promoting children's PA self-efficacy.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted across six databases (PubMed, Web of Science, EBSCOhost, Ovid, SPORTDiscus, PsycINFO) up to January 8, 2024. Inclusion criteria included randomized controlled trials (RCT), quasi-experimental, and two-group experiments that examined the effect of eHealth interventions on PA self-efficacy among healthy children aged 0-18 years. The Physiotherapy Evidence Database (PEDro) scale was utilized to assess the risk of bias. Random effects meta-analysis was performed to determine the effectiveness of eHealth interventions and BCTs in selected studies.

Results

Sixteen studies were screened, including 6020 participants with an average age of 11.58 years (SD = 2.87). The result showed small but significant intervention effects with high heterogeneity (I2 = 92.34 %) for postintervention PA self-efficacy (Hedges' g = 0.315; 95 % CI = 0.069, 0.562, p = .012). Two BCTs were significantly associated with enhanced PA self-efficacy: instruction on performing the behavior (p = .003) and behavior demonstration (p = .036). Additionally, studies that adopted social support (unspecified) a nd prompt/cues were significantly less effective than studies that did not use these BCTs (p = .001).

Conclusions

The findings showed that eHealth interventions positively affect children's PA self-efficacy. This review is the pioneer in focusing on BCTs in eHealth interventions for children. The insights gained provide valuable knowledge about tailored BCTs incorporated into eHealth interventions that promote children's PA self-efficacy.

Trial registration

International Prospective Register of Systematic Review (PROSPERO): CRD42024512058.

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors

This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.

The benefit and limitations of an online physical activity program in response to the COVID-19 pandemic: A quantitative analysis of the virtual Latrobe Streetgames program

ISSUE ADDRESSED

The COVID-19 pandemic led to the closure of many physical activity programs, with many online programs being created in place to maintain physical activity engagement. This study explored the outcomes of an online physical program on its participants.

METHOD

A validated survey was used to explore Virtual Streetgames (VSG) participants' perceptions about their physical, mental, and social health while participating in VGS. Descriptive and inferential statistics were used to evaluate the impact of the online format.

RESULTS

Many VSG participants were not achieving their daily physical activity recommendations, with a considerable portion of individuals feeling frustrated at not being able to socialise. A substantial difference was seen between adults and adolescents, with increased adult activity rates for those adults participating in VSG. Despite this influence on physical well-being, VSG did not seem to influence mental or social wellbeing.

CONCLUSIONS

The results give detail into how the COVID-19 pandemic has influenced adolescent and young adult physical, mental, and social health, noting that the reduction of in-person contact influenced motivation for exercise. Online physical activity programs may have some positive impact in improving adult physical activity rates, but they are not as effective as face-to-face programs in improving overall well-being. SO WHAT?: The findings of this study suggest that online physical activity programs may not be as effective as face-to-face programs in improving overall well-being. Future research should explore ways to improve the social and motivational aspects of online physical activity programs to maximise their benefits for participants.

Weekend physical activity profiles and their relationship with quality of life: The SOPHYA cohort of Swiss children and adolescents

INTRODUCTION

Quality of life (QoL) is an important health indicator among children and adolescents. Evidence on the effect of physical activity (PA)-related behaviors on QoL among youth remains inconsistent. Conventional accelerometer-derived PA metrics and guidelines with a focus on whole weeks may not adequately characterize QoL relevant PA behavior.

OBJECTIVE

This study aims to a) identify clusters of accelerometer-derived PA profiles during weekend days among children and adolescents living in Switzerland, b) assess their cross-sectional and predictive association with overall QoL and its dimensions, and c) investigate whether the associations of QoL with the newly identified clusters persist upon adjustment for the commonly used PA metrics moderate-to-vigorous physical activity (MVPA) and time spent in sedentary behavior (SB).

METHODS

The population-based Swiss children's Objectively measured PHYsical Activity (SOPHYA) cohort among children and adolescents aged 6 to 16 years was initiated at baseline in 2013. PA and QoL information was obtained twice over a five-year follow-up period. The primary endpoint is the overall QoL score and its six dimension scores obtained by KINDL® questionnaire. The primary predictor is the cluster membership of accelerometer-derived weekend PA profile. Clusters were obtained by applying the k-medoid algorithm to the distance matrix of profiles obtained by pairwise alignments of PA time series using the Dynamic Time Warping (DTW) algorithm. Secondary predictors are accelerometer-derived conventional PA metrics MVPA and SB from two combined weekend days. Linear regression models were applied to assess a) the cross-sectional association between PA cluster membership and QoL at baseline and b) the predictive association between PA cluster membership at baseline and QoL at follow-up, adjusting for baseline QoL.

RESULTS

The study sample for deriving PA profile clusters consisted of 51.4% girls and had an average age of 10.9 [SD 2.5] years). The elbow and silhouette methods indicated that weekend PA profiles are best classified in two or four clusters. The most differentiating characteristic for the two-clusters classification ("lower activity" and "high activity"), and the four-clusters classification ("inactive", "low activity", "medium activity", and "high activity"), respectively was the participant's mean counts per 15-seconds epoch. Participants assigned to high activity clusters were younger and more often male. Neither the clustered PA profiles nor MVPA or SB were cross-sectionally or predictively associated with overall QoL. The only association of a conventional PA metrics with QoL while adjusting for cluster membership was observed between MVPA during the weekend days and social well-being with a mean score difference of 2.4 (95%CI: 0.3 to 4.5; p = 0.025).

CONCLUSION

The absence of strong associations of PA metrics for the weekend with QoL, except for the positive association between MVPA during the weekend days and social well-being, is in line with results from two randomized studies not showing efficacy of PA interventions on youth QoL. But because PA decreases with age, its promotion and relevance to QoL remain important research topics. Larger longitudinal study samples with more than two follow-up time points of children and adolescents are needed to derive new novel accelerometer-derived PA profiles and to associate them with QoL dimensions.

Sequential mediation analysis of physical activity, healthy diet, BMI, and academic burnout in the Pakistani educational landscape

Research has indicated a negative impact of physical activity on academic burnout among students, however, there is a paucity of evidence about the underlying mechanism of this association in Pakistani students. The present research seeks to investigate the relationship between physical activity and academic burnout by investigating the potential mediating effects of adherence to the Mediterranean diet (MD) and body mass index (BMI). A sample of 596 students using a cross-sectional survey design was gathered from two public universities (Riphah International University and Mohammed Ali Jinnah University) in Rawalpindi, Pakistan from June to July 2022. The study participants were asked to fill out the Physical Activity Rating Scale-3, the Learning Burnout Scale, and the Test of Adherence to MD questionnaires. The study employed descriptive, bivariate, and path analysis through regression utilizing the SPSS software version 27. The findings demonstrated a negative correlation between academic burnout and BMI, physical activity, and adherence to the MD. The relationship between physical activity and academic burnout was mediated by BMI. Physical activity and academic burnout were inversely correlated, with adherence to the MD and BMI interacting as sequential mediators. The outcomes of this research have expanded our knowledge of the association between physical activity and academic burnout and have suggested crucial and appropriate strategies for addressing student academic burnout.

Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

Introduction

The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic.

Methods

An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health.

Results

The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated.

Conclusion

These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies.

The Relationship between Self-Rated Health and Physical Fitness in Polish Youth

Self-rated health (SRH) is a tool for assessing a population's health across the lifetime, and seems to be a dynamic assessment of current health status and a strong predictor of cardiovascular disease and mortality, whereas insufficient levels of physical fitness in adolescence are a significant health problem and may contribute to the development of many disorders in adulthood. In this cross-sectional study, we attempted to assess the relationship between SRH and the physical fitness of adolescents. Two hundred and thirty-five adolescents (eighty-five boys and one hundred and fifty girls) aged 16-17 were recruited for this study. The study procedures included a short author questionnaire and physical fitness assessment (Zuchora's Physical Fitness Index). Boys declared better health states and reported less frequent morbidity of seasonal diseases (p < 0.05). No differences were found in physical fitness, the incidence of postural disorders, lower limb malalignments, foot deformities, sleep duration, and perception of physical activity on physical condition and well-being in boys and girls (p > 0.05). The comparison of physical fitness levels in adolescents with different SRH, sleep duration, perceptions of physical activity on physical condition and well-being also showed significant differences (p < 0.05). Positive SRH and perception of physical activity on physical condition and well-being, proper sleep duration (7-8 h/night), and a lack of foot deformities are associated with a better physical fitness in adolescents. Physical fitness seems to be a good predictor of SRH only in Polish boys, but not girls and the entire population. The lack of significance in the entire population could be attributed to the substantial number of girls in the study group. Despite that, it is recommended to encourage adolescents to engage in regular exercises, sleep routines and healthy lifestyles. Further research should be based on a more representative group, with a comparable number of girls and boys in the study group and potential confounders, but also they should be focused on SRH predictors to improve SRH in Polish girls.

Health-related quality of life of children from low-income families: the new patterns study

BACKGROUND

Child poverty has been gradually rising, and about 12% of all Norwegian children are living in a state of relative poverty. This study was part of the New Patterns project, which recruits low-income families requiring long-term welfare services. Included families receive integrated welfare services, with the help of a family coordinator. The current study objectives were to explore the associations between HRQoL, demographic variables (age, gender, immigration status) and leisure activities in children and adolescents in low-income families.

METHODS

A cross-sectional survey was conducted among low-income families. Participating families had children (N = 214) aged 8-18 years.The family had a household income below 60% of the equivalized median population income for three consecutive years and needed long-term welfare services. HRQoL was measured using the KIDSCREEN-27 self-report instrument. Descriptive statistics, including means, standard deviations, and proportions, were calculated, and ordinary least squares regressions were performed, clustering standard errors at the family level.

RESULTS

Compared with boys, girls reported lower HRQoL on only one out of five dimensions, physical wellbeing. In the regression analysis we found statistically significant positive associations between migrant status and HRQoL on all five dimensions: physical wellbeing, psychological wellbeing, parents and autonomy, peers and social support, and school environment. In addition, age was associated with school environment, and age, gender and participation in leisure activities was associated with better physical wellbeing.

CONCLUSIONS

Baseline results regarding HRQoL among children and adolescents in low-income families indicate that they have overall good HRQoL, though some participants had low HRQoL scores, especially on the physical and social support dimensions. Children with an immigrant background report higher HRQoL than do children without an immigrant background.

Long-term function, body composition and cardiometabolic health in midlife former athletes: a scoping review

While sports medicine has traditionally focused on recovering from injury and returning athletes to sport safely after injury, there is a growing interest in the long-term health of athletes. The purpose of this scoping review was to (1) summarise the literature (methodologies and findings) on physical function, body composition and cardiometabolic health in midlife (age 40-65 years) former competitive athletes compared with non-athlete controls, (2) identify areas for future study in long-term health in athletes and (3) determine outcomes that could be evaluated in a future systematic review(s). We searched PubMed, CINAHL, Web of Science and SPORTDiscus for studies published between 2000 and 2022 evaluating former athletes and controls on physical function, body composition and/or cardiometabolic measures using MeSH terms. We identified 20 articles that met our criteria. Outcomes varied considerably across studies, most of which were cross-sectional and evaluated only males. Limited data suggest that former endurance athletes have leaner body compositions, higher aerobic capacity and better cardiometabolic indicators than controls; former athletes who maintain higher physical activity (ie, self-reported exercise) are healthier than those who do not; and former team sport athletes, who have higher injury prevalence, may have poorer functional performance than controls who were recreationally active in college. Studies rarely evaluated functional performance, did not control for prior injury or diet and seldom assessed current physical activity levels. Future research should include females and evaluate sex differences, control for prior sports-related injury(ies), quantify physical activity, use standardised outcome measures including performance-based functional assessments and incorporate longitudinal designs.

Parent-reported child's close contact with non-household family members and their well-being during the COVID-19 pandemic: A cross-sectional survey

In England (UK), at the start of the COVID-19 pandemic the public were required to reduce their physical contacts to slow the spread of COVID-19. We investigated the factors associated with children having: 1) close contact with family members from outside their household ('non-adherent behaviour'); and 2) low well-being (Revised Child Anxiety and Depression Scale). We conducted an online cross-sectional survey, completed at any location of the participant's choice between 8 and 11 June 2020 in parents (n = 2,010) who were aged eighteen years or over and had a school-aged child (4-18 years old). Parents reported that 15% (n = 309) of children had non-adherent contact and that 26% (n = 519) had low well-being. We used a series of binary logistic regressions to investigate associations between outcomes and child and parent characteristics. Children had higher odds of having non-household contact when they had special educational needs [adjusted odds ratio, 2.19 (95% CI, 1.47 to 3.27)], lower well-being [2.65 (95% CI, 2.03 to 3.46)], were vulnerable to COVID-19 [2.17 (95% CI, 1.45 to 3.25)], lived with someone who was over 70 years old [2.56 (95% CI, 1.55 to 4.24)] and their parent had low well-being [1.94 (95% CI, 1.45 to 2.58)]. Children had higher odds of lower well-being when they had special educational needs [4.13 (95% CI, 2.90 to 5.87)], were vulnerable to COVID-19 [3.06 (95% CI, 2.15 to 4.36)], lived with someone else who was vulnerable to COVID-19 [2.08 (95% CI, 1.64 to 2.64)], or lived with someone who was over 70 years old [2.41 (95% CI, 1.51 to 3.83)]. Many children came into contact with non-household family members, mainly for childcare. Factors relating to COVID-19, children's well-being and education were also important. If school closures are needed in future, addressing these issues may help reduce contact.

Role of physical activity and health-related fitness on self-confidence and interpersonal relations in 14-year-old adolescents from secondary school settings: DADOS study

BACKGROUND

The effect of physical activity (PA) and physical fitness (PF) on self-confidence and interpersonal relations in adolescents is uncertain.

AIM

To analyzed the associations of PA and PF with self-confidence and interpersonal relations in adolescents.

SAMPLE

A total of 268 (138 boys) adolescents (13.9 ± 0.3 years) from the DADOS study were included in the analysis.

METHODS

PA was evaluated using GENEActiv accelerometers and the health-related PF components by the ALPHA health-related fitness test battery. The levels of self-confidence and interpersonal relations were determined by the Behavior Assessment System for Children Level 3.

RESULTS

The associations of PA levels and PF components with self-confidence reported positive associations of moderate-vigorous PA (MVPA), standing long jump, and 20-m shuttle run (shuttle run test) tests (all p < 0.05), and negative association of 4 × 10-m shuttle run test (4 × 10-m test), but only the 4 × 10-m test remained significant in the adjusted model for the whole sample and only in boys (p ≤ 0.01) when analyzed by sex. Regarding interpersonal relations, positive associations of standing long jump and shuttle run test (all p < 0.05), and negative association of 4 × 10-m test were found in all the adolescents. The shuttle run test was associated with interpersonal relations in boys independently of confounders. PA levels were not associated with interpersonal relations.

CONCLUSION

A higher level of lower-limb muscle strength, speed-agility, and cardiorespiratory fitness might improve self-confidence and interpersonal relations in adolescents, but these relationships seem to be influenced by sex, body mass index, and pubertal status. Speed-agility and cardiorespiratory fitness seem to have a stronger impact on boys. MVPA may improve self-confidence in adolescents.

Associations between physical activity, screen time, sleep time and selected academic skills in 8/9-year-old children

BACKGROUND

High levels of physical activity (PA), low levels of screen time, combined with sufficient sleep time, provide better health benefits. However, few studies have examined the association of these behaviours with academic skills. Therefore, this study aims to determine how PA, screen time, and sleep time are related to selected academic skills of 8/9-year-old children while examining compliance with the guidelines on PA, sedentary behaviour, and sleep among this population group.

METHODS

This cross-sectional study included 114 primary school children (50% girls) aged 8-9years old from 2nd grade. The levels of PA, screen time, and sleep were assessed using self-reported questionnaires. The selected academic skills (based on reading and writing) were assessed by a battery of methods designed to diagnose the causes of school failure in students aged 7-9. Non-linear regression was applied to build multivariate models aimed at finding the most significant predictors for the selected academic skills separately.

RESULTS

Sixty-seven percent of children met the sleep guidelines, 22% met the screen time guidelines, and only 8% met PA guidelines. In terms of screen time, boys spent more time playing games than girls (p = .008). Moderate to vigorous intensity physical activity (MVPA) was associated with higher/better scores of the visual-auditory integration (B = -0.07, p = .040). Not meeting the sleep guidelines was associated with lower scores in visual-auditory integration among children (B = 0.12, p = .042). Children who did not meet the screen time guidelines had lower scores in perceptual-motor integration (B = -0.09, p = .040).

CONCLUSIONS

Participating in PA, limiting screen time and sufficient sleep time may benefit/support academic skills in children.

Assessment of physical activity among adolescents: a guide to the literature

Purpose

The aim of this article is to systematically review articles and annual reports concerning young peoples' physical activity (PA) and linking this to considerations of the state and national defense.

Method

A systematic search of the literature included an analysis of publications accessible in global databases and other available books, student papers, and projects. The articles and reports were categorized based on year of publication, methods used, age of respondents, sample size, country, and digital object identifier (DOI).

Results

The result of this search is an overview of the extent and manner in which the worldwide scientific community is addressing the current situation and the long-term development of the physical fitness of adolescents. This publication also maps to what extent professional publications and articles are addressing PA from the perspective of the needs of armies and armed forces of various countries around the world.

Conclusions

The article provides a systematic overview of methods used to measure PA, and an overview of articles dealing with assessing PA. The examined articles indicate that from the perspective of not only national defense, but also health and overall quality of life, in particular, we need initiatives to encourage and motivate young people to increase their everyday PA. The research therefore also includes an overview of factors that may considerably influence PA. The results ascertained in this publication will be used, i.a. for investigating a longitudinal defense research project of the Ministry of Defense of the Czech Republic in which the authors are participating.

Evaluation of Nursing Students' Sleep Patterns, Social Jet Lag, and Quality of Life*,*

AIM

The aim of this study is to evaluate the relationship between the chronotypes of nursing students, social jet lag, and quality of life.

METHOD

This study was planned and performed in a descriptive, method. Research data were collected in the 2019-2020 fall semester. The research population consisted of nursing students working at the nursing departments of state and private universities in Istanbul. The study sample included 1152 nursing students who agreed to participate in the study after obtaining informed consent. Data were collected using the "Student Information Form," "Morningness- Eveningness Scale," and "Short Form of the Turkish WHO Quality of Life Scale."

RESULTS

Of the nursing students, 81.2% (n = 935) were women, 26.5% (n = 305) were first-year students, 86.5% (n = 997) were non-smoker, and 92.4% (n = 1065) not consumed alcohol. Most of the nursing students in this study were intermediate chronotypes (80.2%). Students' social-jet lag mean value was 1.36±0.73 hours (min:0-max:4.8). Multiple regression analysis showed that an increase in social jetlag decreases the average scores of the physical and environmental subdimension and an increase in the morning chronotype increases the average scores of the physical, mental, and social subdimension.

CONCLUSION

High social jet lag reduced the quality of life and a morning chronotype improved the quality of life.

Cardiovascular endurance and psychosocial health predict short- and long-term BMI-SDS reduction: results from the CHILT III program

This longitudinal study analyzes data from the Children's Health Interventional Trial (CHILT) III, an 11-month juvenile multicomponent weight management program. The objective is to identify predictors of changes in body mass index standard deviation scores (BMI-SDS), so as to further enable the advancement of existing interventions with sustained impact. This study's sample consists of 237 children and adolescents with obesity (8-17 years, 54% girls) participating in the CHILT III program between 2003 and 2021. Anthropometrics, demographics, relative cardiovascular endurance (W/kg), and psychosocial health (i.e., physical self-concept and self-worth) were assessed at program entry ([Formula: see text]), end ([Formula: see text]), and one-year follow-up ([Formula: see text]; n = 83). From [Formula: see text] to [Formula: see text], the mean BMI-SDS was reduced by -0.16 ± 0.26 units (p < 0.001). Media use and cardiovascular endurance at baseline and improvements in endurance and self-worth over the course of the program predicted changes in BMI-SDS (adj. R² = 0.22, p < 0.001). From [Formula: see text] to [Formula: see text], mean BMI-SDS increased ([Formula: see text], p = 0.005). Changes in BMI-SDS from [Formula: see text] to [Formula: see text] were associated with parental education, improvements in cardiovascular endurance and physical self-concept, and BMI-SDS, media use, physical self-concept, and endurance level at program end (adj. R² = 0.39, p < 0.001).  Conclusions: This study highlights the need for comprehensive, sustainable weight management approaches, in order to sustain the initial treatment benefits. In this context, improvements in cardiovascular endurance and psychosocial health could be essential strategies to pursue in practice, as they significantly predicted reductions in BMI-SDS - both pre- to post-intervention and at follow-up.

TRIAL REGISTRATION

DRKS00026785; date of registration: 13.10.202, retrospectively registered.

WHAT IS KNOWN

• Childhood obesity is associated with the onset of noncommunicable diseases, many of which are likely to carry into adulthood. Thus, effective weight management strategies for affected children and their families are vital. However, achieving lasting positive health outcomes with multidisciplinary weight management programs remains challenging.

WHAT IS NEW

• According to this study, short- and longer-term BMI-SDS reductions are associated to cardiovascular endurance and psychosocial health. These factors should therefore be given even greater consideration in weight management strategies, as they may be important not only in themselves but also for long-term weight loss (maintenance).

Independent and joint associations of cardiorespiratory fitness and weight status with health-related quality of life among Brazilian adolescents

PURPOSE

To investigate the independent and joint associations of cardiorespiratory fitness and body mass index (BMI) with five dimensions of Health-Related Quality of Life (HRQoL) in a cross-sectional sample of Brazilian adolescents.

METHODS

619 Brazilian schoolchildren answered a survey, BMI categories (healthy weight and overweight/obesity) were assessed by their weight and height, and they participated in a 20-m shuttle run test. HRQoL was measured using the KIDSCREEN-27 across five dimensions: Physical Well-Being, Psychological Well-Being, Autonomy and Parent Relation, Peers and Social Support, and School Environment. Sex, age, maternal education, physical activity level, and habitual sedentary behaviour were assessed and used as adjusting variables. Cardiorespiratory fitness was categorized in tertiles and independent and joint associations were tested using mixed-effects linear regressions.

RESULTS

Higher levels of cardiorespiratory fitness were favourably associated with the physical well-being, psychological well-being, and peer and social support dimensions of HRQoL. Adolescents with overweight/obesity presented higher scores on peer and social support dimensions when compared to healthy-weight adolescents. Independent of the adolescents' BMI categories, better cardiorespiratory fitness was positively associated with physical and psychological well-being when compared with the category of overweight/obesity and low cardiorespiratory fitness. In addition, adolescents with overweight/obesity combined with intermediate cardiorespiratory fitness or high cardiorespiratory fitness had higher scores on the peer and social support dimension.

CONCLUSION

Cardiorespiratory fitness is a strong correlate of HRQoL across most of the dimensions measured, while BMI was a correlate of one dimension of HRQoL. Future studies should evaluate these relationships prospectively and experimentally.

The Relationship between Physical Fitness and Perceived Well-Being, Motivation, and Enjoyment in Chinese Adolescents during Physical Education: A Preliminary Cross-Sectional Study

Purpose: The purpose of this study is to investigate the relationship between physical fitness (PF) level and Chinese middle-school students’ perceived well-being, motivation, and enjoyment. Method: In this study, the participants were randomly selected from 16 Beijing-based middle schools in China. In addition to the collection of demographic data (i.e., gender, age, and parental education), tools including the Warwick-Edinburgh Mental Well-Being Scale, the Behavioural Regulation in Sport Questionnaire, and the Physical Activity Children’s Enjoyment Scale were employed for collecting data on other variables of well-being, motivation, and enjoyment, respectively. Results: A total of 1678 adolescents (M age = 14.66 years, SD = 1.80) participated in this study. According to the results, significant gender differences could be observed in the PF categories of mean age, BMI, vital capacity, 50-m sprint, muscular strength, and flexibility (all p < 0.05). In contrast, there was no significant gender difference in the levels of well-being, motivation, and enjoyment observed, with similar scores for boys and girls (p > 0.05). Indeed, adolescents with low BMI scores and high levels of vital capacity, muscular strength, and flexibility showed better well-being, motivation, and enjoyment. However, no association was observed between timed sit-ups and pull-ups and well-being, motivation, and enjoyment. Conclusions: This study produced preliminary findings on the relationship between PF and Chinese adolescents’ perceived well-being, motivation, and enjoyment. To improve the health of adolescents, it is necessary to adopt prospective and experimental research designs for advocating for fitness education in school-based programs in future research.

Effectiveness of an adapted physical activity intervention on health-related physical fitness in adolescents with intellectual disability: a randomized controlled trial

This study aimed to examine the effects of an adapted physical activity (APA) intervention on health-related physical fitness (HRPF) in adolescents with intellectual disability (ID). With a randomized controlled trial design, adolescents aged 12-18 years, with mild and moderate ID, and being overweight and obese were recruited and randomly assigned to either an intervention or a control group. The APA intervention consisted of overall moderate intensity aerobic and resistance exercise, with a duration of 45 min/session, a frequency of 2 sessions/week, and lasting for 9 months. A negative control was involved, in which participants received no treatment. Changes in four fitness tests, including the 9-min run/walk, handgrip strength, 30-s sit-ups, and sit-and-reach tests, were assessed between the groups using general linear models. A total of 57 participants (39 in the intervention group and 18 in the control group) completed the study. Significant mean differences in changes in the 9-min run/walk test (413.6 m [95% CI 146.72 m, 680.41 m], p = 0.003) and the right-side sit-and-reach test (2.2 cm [95% CI 0.37 cm, 4.09 cm], p = 0.020) respectively were observed in the intervention group, compared to the control group. No significant between-group improvement was observed for the handgrip strength and the 30-s sit-ups tests. The APA intervention induced beneficial effects on cardiorespiratory fitness and potential beneficial effects on flexibility for adolescents with ID. However, no significant effects of this intervention on muscular strength and endurance were observed in this study. Future studies should consider involving effective exercises in interventions to improve muscular strength and endurance.

Cardiovascular health behavior and cardiorespiratory fitness in adolescents: a longitudinal study

Cardiorespiratory fitness has been substantially associated with health status. However, longitudinal studies on cardiorespiratory fitness and ideal cardiovascular health behavior (ICHB) in adolescents are scarce. The aim of this study was to evaluate the longitudinal association between ICHB (at baseline) and cardiorespiratory fitness (at follow-up). This is a 2-year prospective analysis of 445 adolescents (232 girls) aged 12-18 years. The ICHB was developed by the American Heart Association as meeting the ideal health behaviors for a healthy diet, physical activity, smoking status, and body mass index. ANCOVAS adjusted by age, sex, pubertal stage, socioeconomic status, and cardiorespiratory fitness showed that the higher the number of ICHB metrics accumulated at baseline (from 1 to 4), the higher the cardiorespiratory fitness levels over a 2-year period (p = 0.038). In logistic regressions, after adjusting for potential confounders, the odds ratios for having high cardiorespiratory fitness at follow-up was 4.9 (95% CI, 1.2-20.1, p = 0.02) for those who accumulated all four metrics of ICHB, when compared to those with 1 or less metrics of ICHB. In addition, the higher the number of ICHB metrics accumulated, the higher the likelihood of having a high cardiorespiratory fitness level over a 2-year period (p for trend = 0.01).

CONCLUSION

 We identified a significant association between ICBH and cardiorespiratory fitness in adolescents. Therefore, improving ICBH in adolescence is likely to benefit the cardiorespiratory fitness.

WHAT IS KNOWN

• Smoking status, body mass index, physical activity, and diet are associated to cardiorespiratory fitness in adulthood. • Lifestyle behaviors such as physical activity, smoking, body weight, and healthy diet are individually linked with cardiorespiratory fitness and, however, have not been examined jointly, as combined health behaviors.

WHAT IS NEW

• Accumulation of cardiovascular health behavior metrics was positively associated with cardiorespiratory fitness at a 2-year follow-up, in adolescents. • Meeting all the four metrics of ideal cardiovascular health behavior seems important for healthy cardiorespiratory fitness during adolescence.

Guidelines for treating child and adolescent obesity: A systematic review

Obesity is a chronic disease that compromises the physical and mental health of an increasing proportion of children globally. In high-income countries, prevalence of paediatric obesity is increasing faster in those from marginalised populations such as low-income households, suggesting the disease as one that is largely systemic. Appropriate treatment should be prioritised in these settings to prevent the development of complications and co-morbidities and manage those that already exist. An array of clinical practice guidelines are available for managing overweight and obesity in children and adolescents, but no systematic review has yet compared their quality or synthesised their recommendations. We aimed to narratively review clinical practice guidelines published in English for treating child and adolescent obesity, to identify the highest quality guidelines, and assess similarities, conflicts, and gaps in recommendations. We systematically searched academic databases and grey literature for guidelines published. We used the AGREE II tool to assess the quality, and identified nine high quality guidelines for inclusion in a narrative review of recommendations. Guidelines predominantly recommended the delivery of multi-component behaviour-change interventions aimed at improving nutrition and physical activity. Treatment outcomes were generally focussed on weight, with less emphasis on managing complications or improving quality-of-life. There was no evidence-based consensus on the best mode of delivery, setting, or treatment format. The guidelines rarely included recommendations for addressing the practical or social barriers to behaviour change, such as cooking skills or supervised physical activity. There is insufficient evidence to evaluate pharmaceutical and surgical interventions in children, and these were generally not recommended. It should be noted that this review addressed documents published in English only, and therefore the included guidelines were applicable predominantly to high-resource settings.

Relationship between Moderate-to-Vigorous Physical Activity with Health-Related Physical Fitness Indicators among Pakistani School Adolescents: Yaali-Pak Study

Background

The current study is the foremost study exploring the relationships between moderate-to-vigorous physical activity and health-related physical fitness indicators among 12-16-year-old adolescents of the South Punjab region of Pakistan.

Methods

The researcher adopted the cross-sectional research design for the study. A total of 2970 participants (1477 boys and 1493 girls) aged adolescents from South Punjab, Pakistan, completed health-related physical fitness indicators measuring strength, endurance, and aerobic capacity through a hand-grip strength test, modified pull-up test, plank test, and 20-m shuttle run test, and physical activity were subjectively assessed by International Physical Activity Questionnaire Short Form (IPAQ-SF). Linear regression models were used to explore the between moderate-to-vigorous physical activity (MVPA) with health-related physical fitness indicators.

Results

Positive associations were observed between hand-grip strength (p < 0.001), modified pull-up (p < 0.001), plank exercise (p < 0.001), and 20-m shuttle run test (p < 0.001), with MVPA. The gender-specific comparison also indicated a significant (p < 0.001) and positive relationship. The results revealed that as MVPA increases, body composition, muscular strength, core muscular endurance, and aerobic capacity could improve in both genders.

Conclusions

MVPA appears to be an effective and reliable predictor of health-related physical fitness among school adolescents.

Physical Activity and Well-being Status among Employees of University of Medical Sciences

Background: Workplace physical activity plays an important role in employees' health. As university employees are a population at risk for a sedentary working pattern, this study aimed to investigate the physical activity status of employees of Iran University of Medical Sciences (IUMS) and its subsequent effects on their well-being. Methods: This cross-sectional study included 472 employees from different units of IUMS in Tehran. The participants were selected by a multistage sampling method. Interviews were conducted by using an international physical activity questionnaire, a questionnaire for stages of behavioral change, the World Health Organization Well-being Questionnaire, and a demographic checklist from July to October 2019. Analysis of variance, t test, and logistic regression analysis were used. Data were analyzed using IBM SPSS (Version 21.0). Results: Total physical activity in the study population was 6216.58 ± 5886.09 MET-minutes/week. The mean score of the well-being index was 54.72 ± 22.4; there was an association between sex and location of work with physical activity in domains (p<0.05). The highest prevalence rates for change of stage of physical activity were found in the maintenance stage for men and the contemplation stage for women. There was a significant difference between men and women's well-being index-men reported being more active and energetic than women (p<0.001). Results also revealed that having vigorous physical activity compared with a moderate level could increase the well-being index. Conclusion: Physical activity behavior at the workplace was associated with well-being level. It could, therefore, be postulated that enhancing physical activity may be beneficial to improving well-being in an academic environment.

Associations between Demographic Characteristics, Lifestyle Factors and School-Related Conditions and Symptoms of Mental Health Problems in Norwegian Upper Secondary School Students

Background: The purpose of this study was to evaluate the associations between demographic characteristics, lifestyle factors and school-related conditions, and symptoms of mental health problems in Norwegian upper secondary school students following the COVID-19 pandemic. Methods: In this cross-sectional study design we used a binary logistic regression model to evaluate potential associations between the predictors and dependent variable. Results: The following six predictors had a statistically significant impact on symptoms of mental health problems; gender effect of being a girl (p < 0.001), self-perceived body image (p < 0.001), sleep problems (p < 0.001), dietary habits (p = 0.033), school satisfaction (p = 0.013), and satisfaction with physical education (PE) class participation (p = 0.025). Conclusions: Being a girl was associated with a 315% higher probability of reporting symptoms of mental health problems than boys, whereas one unit increase in sleep problems showed a 192% higher probability of symptoms of mental health problems. Furthermore, a one unit increase on the respective beneficial predictors’ scales was associated with the following percentage having a lower probability of reporting symptoms of mental health problems; self-perceived body image (59%), dietary habits (58%), school satisfaction (82%), and satisfaction with PE class participation (68%).

Associations of sport participation, muscle-strengthening exercise and active commuting with self-reported physical fitness in school-aged children

Background

Numerous studies suggest a positive association between physical activity and physical fitness in schoolchildren. However, little is known about some neglected forms of physical activity and their associations with physical fitness. This study was conducted via a self-reported questionnaire, owing to the COVID-19 pandemic in many regions in China.

Purpose

This study explores the associations between participating in sports, muscle-strengthening exercises, and active commuting with self-reported physical fitness assessed by the International Fitness Scale (IFIS).

Methods

A total of 3,807 study participants (ages 11–17) from 12 public schools in South-eastern China were recruited, with 2,407 providing valid data on variables for analysis. Study participants were asked to self-report their sociodemographic factors (i.e., sex, grade, age), participation in sports (never, 1–3 times per month, 1–2 times per week, and 3 or more times per week), muscle-strengthening exercise (0–7 days) and active commuting (0–5 days). Generalized linear models were used to explore the associations between sports participation, muscle-strengthening exercise, and active commuting with self-reported physical fitness (comprising general physical fitness, cardiorespiratory fitness, muscular strength, speed and agility, and flexibility). A total of 2,407 children and adolescents with a mean age of 13.82 (±2.1) years were included in the study's final analysis.

Results

The study found no significant association between active commuting and physical fitness. Regarding participating in sports and muscle-strengthening exercises, positive, significant associations were found, which showed that a higher frequency of participating in sports and more participation in muscle-strengthening exercises are associated with improved physical fitness.

Conclusion

This study offered evidence on the roles of some aspects of physical activity in physical fitness. To promote health in children and adolescents, they should be encouraged to participate in more sports and engage in muscle-strengthening exercises.

WALES 2021 Active Healthy Kids (AHK) Report Card: The Fourth Pandemic of Childhood Inactivity

This is the fourth Active Healthy Kids (AHK) Wales Report Card. The 2021 card produced grades on children and young people's physical activity (PA) using pre-COVID-19 data that were not used in previous versions. Eleven quality indicators of PA were graded through expert consensus and synthesis of the best available evidence. Grades were assigned as follows: Overall PA-F; Organised Sport and PA-C; Active Play-C+; Active Transportation-C-; Sedentary Behaviours-F; Physical Fitness-C-; Family and Peer Influences-D+; School-B-; Community and the Built Environment-C; National Government and Policy-C; and Physical Literacy-C-. All but three grades remained the same or decreased from the 2018 AHK-Wales Report Card (Active Play increased from C- to C+; Active Transportation, D+ to C-; Family and Peers, D to D+). This is concerning for children's health and well-being in Wales, particularly given recent evidence that PA has further decreased during the COVID-19 pandemic. The results from the Report Card should be used to inform the decision making of policy makers, practitioners and educators to improve children and young people's PA levels and opportunities and decrease PA inequalities.

Exploring the Relationship between Physical Activities and Health-Related Factors in the Health-Related Quality of Life among People with Disability in Korea

The purpose of this study is to explore the relationship between modes (e.g., frequency and total time) of physical activity and health-related conditions of disabled people on their health-related quality of life (HRQoL) in Korea. This study is a cross-sectional research funded by the Ministry of Health and Welfare. Data was obtained from the 2017 disability survey. A total of 6549 people with disabilities (Mage = 61.92, SD = 17.36; Male = 55.98%) were analyzed in this study. The higher the frequency of physical activity for the disabled in Korea, the more positive the HRQoL (p < 0.001). Among the elderly disabled, the higher the severity of disability and educational degree, the lower the HRQoL (all p < 0.05). Disabled people who had fewer diseases and lived an independent socio-economic and cultural life had a higher HRQoL (all p < 0.001). This study revealed different dimensions of how health-related factors influence the quality of life of people with disabilities. More attention should be paid to supporting people in being independent and active, in order to help them maintain a healthy life. Especially, the barriers to physical activity faced by disabled people are multi-layered and multifaceted. Increasing the frequency of physical activity for disabled people is not only beneficial for their physical function, but also for their HRQoL. This study enables welfare promotion for disabled people through various policies and incentives. Further, this will be an opportunity to reduce the socio-economic burden on medical and health-related services related to the disabled population.

Sports- and physical activity-related concussion and mental health among adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey

This study examined the association between self-reported sports- or physical activity-related concussion and symptoms of depression and suicidal behaviors (suicidal ideation, having a suicide plan, and suicide attempts). This study used data from the 2017 and 2019 Youth Risk Behavior Survey (YRBS), a biennial, school-based, nationally representative survey of U.S. students in grade levels 9 to 12 (N = 14,496). Multivariate logistical regression models assessed the association between self-reported sports-or physical activity-related concussions and suicidal behaviors among students, controlling for a range of demographic and psychosocial variables. Altogether, 13.6% of students reported a sports-or physical activity related concussion in the past 12 months. Among youth, sports-or physical activity related concussions were significantly associated with greater odds of symptoms of depression, suicidal ideation, making a suicide plan, and suicide attempts compared to other youth who did not experience sports- or physical activity-related concussion. Findings highlight increased risk for adverse mental health outcomes among students with sports-or physical activity related concussions. Providing resources for students to engage in physical activity and sports teams may help prevent the onset of depression and suicidal behaviors; however, resources must also be available to monitor any concussions related to these activities to provide support for student emotional well-being.

The Combinations of Physical Activity, Screen Time, and Sleep, and Their Associations with Self-Reported Physical Fitness in Children and Adolescents

Much evidence has indicated that adherence to the 24 h movement guidelines (physical activity, screen time and sleep) is associated with physical health, while little is known about the adherence to the 24 h movement guidelines and self-reported physical fitness in adolescents. This study, therefore, aims to explore the association between the 24 h movement guidelines (in isolation or combination) and self-reported physical fitness in a sample of Chinese adolescents in an age range of 10-17.

METHODS

A convenient sample of 3807 children and adolescents from 12 schools was adopted in the present study. A questionnaire based on the Health Behaviour in School-aged Children was used to assess physical activity and screen time, and the Pittsburgh Sleep Scale was utilized to measure sleep duration. The International Fitness Scale was used to assess physical fitness in study participants. Ordinal logistic regression was performed to estimate the association between adherence to the 24 h movement guidelines and self-reported physical fitness.

RESULTS

Of all study participants, 0.9% of them met the 24 h movement guidelines, and meeting the guidelines was significantly associated with higher levels of self-reported physical fitness. The analysis for the association between specific combinations of 24 h movement guidelines and self-reported physical fitness underscored the importance of meeting the physical activity recommendations.

CONCLUSION

Adherence to more recommendations contained in the 24 h movement guidelines was associated with higher self-reported physical fitness, especially cardiorespiratory fitness and muscular strength. Our study also stressed the importance of promoting moderate to vigorous physical activity in children and adolescents. Further works should focus on the association of a recommendation of adherence with other health indicators and replicate this study on larger samples among Chinese children and adolescents. Additionally, longitudinal or interventional studies that include more socio-demographic factors are needed to explore the association between 24 h movement guidelines and self-reported physical fitness, and the 24 h movement guidelines also should be promoted on a large scale in Chinese children and adolescents. Moreover, it is also needed to gain better insights into the directionality of the relationship between compliance with 24 h movement guidelines and self-reported physical fitness, as well as the mechanisms underlying the associations in Chinese children and adolescents.

COVID-19 Quarantine Impact on Wellbeing and Cognitive Functioning During a 10-Week High-Intensity Functional Training Program in Young University Students

Physical exercise can improve cognitive functioning and wellbeing; however, the degree of change in either of these two variables seems to be related to the exercise intensity or type. Therefore, new physical training (PT) programs have been developed to increase exercise efficiency. One such example is high-intensity functional training (HIFT), which has proven to be a time-efficient and highly effective strategy to improve physical fitness. This study analyzed whether HIFT can affect reaction time (RT) and vitality, as well as positive and negative affect. Forty-two college students participated in the study, 21 in the experimental group and 21 in the control group. The experimental group completed 10 weeks of training, five of which were supervised, and the remainder consisted of online training during the COVID-19 quarantine. Participants were evaluated at the beginning, at the end of the 5 weeks of supervised training, and after the 5 weeks of online training. HIFT improved RT without changes in psychological wellbeing during the entire period of training supervised and online. Therefore, during the HIFT program, the quarantine situation did not adversely affect this population’s wellbeing, but it did negatively affect adherence to the training program.

Depressive Symptoms and Their Associated Factors in Vocational-Technical School Students during the COVID-19 Pandemic

The objectives of this study were to compare the prevalence of depressive symptoms, behavioral habits, and QoL in students from two vocational-technical schools, and to determine the association of depressive symptoms with behavioral habits and quality of life (QoL) in these students during the COVID-19 pandemic. A cross-sectional survey was conducted with students attending the institution of the Brazilian Federal Network of Professional, Scientific and Technological Education. The students answered a questionnaire on sociodemographic variables, situations related to the COVID-19 pandemic, behavioral habits, QoL, and depressive symptoms. The outcome variable was the presence of depressive symptoms, assessed using the Children's Depression Inventory (CDI). Poisson regression analysis with robust variance was performed. A total of 343 students participated in this study (women, 55.7%; mean age of 16.1 ± 0.93 years). The prevalence of depressive symptoms among students was 43.4% (95% confidence interval [CI]: 38.0-49.0), and these symptoms were significantly associated with being female (prevalence ratio [PR] 1.72; 95% CI: 1.31-2.27); being in the 10th grade (PR: 1.80; 95% CI: 1.18-2.76) and 9th grade (PR 2.08; 95% CI: 1.37-3.18); social isolation (PR: 2.04; 95% CI: 1.00-4.14); hunger due to a lack of food at home (PR: 1.78; 95% CI: 1.33-2.39); low physical activity levels (PR: 1.68; 95% CI: 1.09-2.59); and moderate (PR: 2.87, 95% CI: 1.68-4.89) and low QoL (PR: 5.66; 95% CI: 3.48-9.19). The results emphasize the importance of interventions aimed mainly at female students and those in the initial years of high school, in addition to the importance of physical activity, food safety, and QoL to improve the mental health of students.

The Impact of COVID-19-Related Mitigation Measures on the Health and Fitness Status of Primary School Children in Austria: A Longitudinal Study with Data from 708 Children Measured before and during the Ongoing COVID-19 Pandemic

The COVID-19-related closing of schools and sport facilities resulted in major changes to daily routines worldwide. It was the aim of this study to investigate the impact of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. Seven hundred and eight primary school children (7–10 years old) participated in the longitudinal study. Data on height, weight, waist circumference, and fitness were collected before (September 2019) and during the course of the COVID-19 pandemic (June 20, September 20, March 21, June 21). A significant increase in EQUI BMI_AUT (η_p² = 0.087) and significant changes (η_p² = 0.355) in waist circumference were found. Cardiorespiratory endurance (η_p² = 0.440) and action speed (η_p² = 0.221) decreased dramatically following lockdowns/school closures. In contrast, muscle strength showed no significant changes. The COVID-19-related mitigation measures intended to contain a communicable disease resulted in an acceleration of the pre-existing pandemic of overweight and obesity. The adverse combination of increasing BMI and the loss of physical fitness is likely to result in long-term negative effects on the health status of growing and developing individuals. Health professionals should therefore not only support further longitudinal observations of this “non-communicable disease” but also support intervention programs to reverse this worrying side-effect of COVID-19-associated containment policies.

A Better Cardiopulmonary Fitness Is Associated with Improved Concentration Level and Health-Related Quality of Life in Primary School Children

This study aimed to examine the physical fitness (PF) levels of primary school children and to determine the associations among PF, concentration, and health-related quality of life (HRQOL) in a subcohort. PF was assessed in 6533 healthy primary school-age children (aged 6−10 years, 3248 boys and 3285 girls) via standardized test batteries. Concentration was measured with the d2-R test, and KINDL questionnaires were used to determine HRQOL. Analysis of variance showed an increase in PF with age in all PF dimensions (all p < 0.001), except cardiopulmonary fitness (estimated VO2max) in girls (p = 0.129). Boys performed better in nearly all PF dimensions, except curl-ups, in all children aged ≥7 years (p < 0.05). Concentration levels increased in boys and girls aged 7−9 years (p < 0.001), whereas HRQOL did not (p = 0.179). The estimated VO2max had a strong impact on concentration (β = 0.16, p < 0.001) and HRQOL (β = 0.21, p < 0.001) in 9- to 10-year-olds. Cardiopulmonary fitness is important for improved concentration and better HRQOL in primary school-age children. However, longitudinal data are needed to provide further insight into the intraindividual relationships of PF and concentration over the course of child development and set up targeted prevention programs.

The association between physical fitness, sports club participation and body mass index on health-related quality of life in primary school children from a socioeconomically deprived area of England

We examined associations between physical fitness components, body mass index (BMI) and sports club participation on health-related quality of life (HRQoL) in 8- to 11-year-old children from a socioeconomically deprived region of England. From May-October 2019, 432 children completed the HRQoL questionnaire Kidscreen-27 and Leisure Time Physical Activity Survey, and a physical fitness testing battery of 20 m shuttle run test (20mSRT), handgrip strength (Handgrip), standing broad jump (Broad Jump), and sit-and-reach. Height, body mass, BMI and somatic maturity data were collected. Comparisons with reference populations were undertaken using a quintile framework. Linear and quantile regression assessed associations between physical fitness components and HRQoL variables. Using English Indices of Multiple Deprivation, 90% of children were from the most deprived quintile and 39% were overweight or obese. More children scored poorly on the Physical Wellbeing (40%) and Psychological Wellbeing (45%) HRQoL domains than the reference population (31%). Physical fitness scores were generally classed as 'low'-'very low' (42-58%). 20mSRT and Broad Jump performance explained an additional 10.7% of variance in Physical Wellbeing after adjusting for BMI z-score, sex and age (total R² 21.2%). Quantile regression identified a subset of children who rated Physical Wellbeing as high regardless of 20mSRT performance. Sports club participation was associated with better 20mSRT and Broad Jump performance, and all domains of HRQoL. Our data indicate that some physical fitness components and sports club participation are positively associated with HRQoL of children from socioeconomically deprived areas, irrespective of BMI z-score. Interventions to improve HRQoL should consider both aspects.

Improving youth physical, mental and social health through physical activity: A Systematic literature review

BACKGROUND

Across various parts of the world there is an increasing trend in adolescent and young adult physical inactivity, which has been linked to a multitude of illnesses throughout the lifespan. To further understand the link between physical inactivity and illness, it is important to determine the effect that physical activity has various components of wellbeing. The primary aim of this review was to compile and synthesise the recent evidence on physical activity and its effect on physical, mental and social wellbeing across younger populations. The secondary aim was to determine whether there is relationship between the amount, type and intensity of exercise, and changes in wellbeing outcomes.

METHODS

Main databases were searched using MeSH terms for the population of interest (young adult, adolescent), intervention (physical activity) and outcome (wellbeing). Upon screening papers of eligibility, quality appraisal was completed through the Critical Appraisals Skills Programme (CASP).

RESULTS

Nineteen studies were included in this review. The majority of studies found an associated link between the participation of physical activity and improvements in physical, mental and social wellbeing outcomes. There was evidence to suggest that lower levels of physical intensity produced similar results in mental and social outcomes when compared to higher levels of physical intensity.

CONCLUSION

This review supports the encouragement of adolescent and young adult physical activity, noting the improvements seen across the physical, mental and social wellbeing outcomes. Future research is still required to further understand the benefits of lower intensity exercise within the adolescent and young adult population.

Predicting Psychosocial Health of Children and Adolescents with Obesity in Germany: The Underappreciated Role of Physical Fitness

Background: The aim of this study was to analyze the inhibitory and promotive factors of psychosocial health in the context of childhood obesity, incorporating physical fitness as an additional, potentially relevant predictor. Methods: The sample comprised cross-sectional data of 241 children and adolescents with obesity and overweight from the German Children's Health InterventionaL TriaL III program (12.5 ± 2.1 years; 51.9% girls). Demographics and lifestyle patterns were assessed via parent reports. Anthropometric data and physical fitness in relation to body weight (W/kg) were measured. Children and adolescents completed standardized questionnaires (GW-LQ-KJ, FSK-K) to assess health-related quality of life (HRQOL) and five dimensions of self-concept (scholastic, social, physical, behavioral, and self-worth). Results: Multiple linear regression analysis showed that HRQOL was significantly related to relative physical fitness (W/kg; β = 0.216, p = 0.011) as were scholastic (β = 0.228, p = 0.008) and social self-concept (β = 0.197, p = 0.023). Increasing body mass index (BMI) Z-scores, age, physical activity (hours/day), low parental educational levels, and/or migration background were negatively associated with three subdomains of self-concept (physical, behavioral, self-worth; all p < 0.05). Conclusion: The results emphasize BMI Z-scores, age, physical activity, migration background, and parents' educational level as relevant predictors of psychosocial health in the context of childhood obesity. Additionally, this study adds physical fitness as a key determinant of HRQOL and self-concept. To enable the development of more effective weight management, therapeutic strategies should therefore consider addressing these aspects and improving physical fitness in particular not only for weight loss but also to strengthen psychosocial health.

Exploring the Association Between Electronic Wearable Device Use and Levels of Physical Activity Among Individuals With Depression and Anxiety: A Population Level Study

Aim: The present study aimed to investigate the cross-sectional association between self-reported use of electronic wearable devices (EWDs) and the levels of physical activity among a representative sample of adults with depression and anxiety in the United States. Methods: For this cross-sectional study, data were pooled from the Health Information National Trends Survey 2019. A sample of 1,139 adults with self-reported depression and anxiety (60.9% women; mean age of 52.5 years) was analyzed. The levels of physical activity and prevalence of EWD utilization were self-reported. The chi-square tests were used to compare individual characteristics through the use of EWDs. Multivariable logistic regression was employed to investigate the association between EWDs and physical activity levels while adjusting for sociodemographic and health-related factors. Results: From the 1,139 adults with self-reported depression and anxiety, 261 (weighted percentage 28.1%) endorsed using EWD in the last year. After adjusting for covariates, the use of EWDs was only significantly associated with a higher odds of reporting intention to lose weight (OR 2.12; 95% CI 1.04, 4.35; p = 0.04). We found no association between the use of EWDs and meeting the national weekly recommendation for physical activity or resistance/strength exercise training. Conclusion: About three in 10 adults suffering from depression and anxiety in the United States reported using EWDs in the last year. The current study findings indicate that among people living with mental illness, EWD use is associated with higher odds of weight loss intent suggesting that EWDs may serve as an opening for the clinical interactions around physical health through identifying patients primed for behavior change. Further large-scale studies using randomized trial designs are needed to examine the causal relationships between EWDs and the physical activity of people with mental health conditions.

Potential Predictors of Psychological Wellbeing in Elementary School Students

BACKGROUND

This study aimed to investigate the association of elementary school students' manipulative skill competency, cardiorespiratory fitness, and cognitive function with psychological wellbeing (PWB), as well as whether the association had gender differences.

METHODS

Participants were 291 fourth-grade students (166 boys vs. 125 girls; mean age = 9.770 years old; SD = 0.584) at two elementary schools from the province of Henan in China. The students' soccer skills in manipulative skill competency were assessed using the PE Metric Assessment Rubric, cardiorespiratory fitness was assessed by means of the PACER 15 m test, and cognitive function and PWB were assessed using the d2 test of attention and Warwick-Edinburgh Mental Wellbeing Scale, respectively. Data were analyzed with descriptive statistics and multiple linear regression models.

RESULTS

The result of linear regression models showed that soccer skills, cardiorespiratory fitness, and cognitive function were collectively associated with PWB for the total sample (F (5, 285) = 3.097, p < 0.01), boys (F (5, 160) = 1.355, p < 0.01), and girls (F (5, 119) = 2.132, p < 0.01). Furthermore, the standardized regression coefficients (β) indicated that cardiorespiratory fitness was the only significant contributor to PWB for the total sample (β = 0.119, t = 2.021, p < 0.05), but not for boys and girls. Soccer skills and cognitive function were not individual significant contributors to PWB for the total sample, boys, and girls.

CONCLUSIONS

Cardiorespiratory fitness was significantly associated with PWB, and there were no gender differences in the relationship of manipulative skill competency, cardiorespiratory fitness, and cognitive function with PWB in elementary school students. This study provides empirical evidence that improving cardiorespiratory fitness is an important intervention strategy to promote elementary school students' PWB.

Health Promotion through Movement Behaviors and Its Relationship with Quality of Life in Spanish High School Adolescents: A Predictive Study

A growing number of studies have highlighted the health benefits of high physical activity, low screen time, and optimal sleep duration among school-age children and adolescents. Objective: The present study proposes to examine the individual and combined association between movement behaviors (physical activity, screen time, and sleep time) and quality of life in boys and girls. Method: A total of 319 Spanish primary and secondary school students participated in the study. Physical activity, screen time, sleep duration, and quality of life were evaluated. Results: Descriptive, correlation, and regression analyses were carried out in order to improve knowledge about health-related behaviors for all participants. The results found significant positive associations between physical activities and sleep time with quality of life. Finally, the regression models showed that physical activity scores predict quality of life, especially in children. It is concluded that movement behaviors are important in association with quality of life. Likewise, the impact of physical activity on the quality of life is highlighted as the main behavior in the prediction of the quality of life for a population of school adolescents.

Physical Activity and Quality of Life in High School Students: Proposals for Improving the Self-Concept in Physical Education

Adolescence is a critical period for the acquisition of health-related behaviors that will transcend later psychological well-being in adulthood. The present study presents a theoretical model whose objective is to analyze how physical activity predicts an adequate quality of life through self-concept and subjective happiness among adolescents. A total of 452 students aged 12 to 15 (M = 13.8; SD = 0.77) from four Compulsory Secondary Education institutes of the Autonomous Community of Extremadura participated, including boys (n = 258) and girls (n = 194). The students reported information on the following variables: physical activity, body mass index, self-concept, subjective happiness, and quality of life. The results show acceptable fit indices for the proposed theoretical model, which showed the importance of physical activity through self-concept and subjective happiness in quality of life: MRLχ2 = 67.533, p < 0.05, CFI = 0.93, TLI = 0.90, SRMR = 0.05, and RMSA = 0.07. Likewise, the model presented a better fit index for males than females. This study draws conclusions on the importance of physical activity as a predictor of quality of life mediated by the perception of self-concept and mood in adolescents.

Psychological Effects of Whole-body Electromyostimulation Training: a Controlled Pilot Study in Healthy Volunteers

BACKGROUND

Whole-body electromyostimulation (WB-EMS) training is used in popular and health sports to improve muscular performance. Little is known about the possible psychological effects of WB-EMS training. The aim of the study is therefore to investigate the possible psychological effects of WB-EMS training on subjective well-being, relaxation, mood, and perceived stress.

MATERIALS AND METHODS

Twenty-five healthy subjects underwent conventional WB-EMS training and Sham training (without the application of electrical stimulation) as part of a randomized, controlled pilot study in a crossover design. Subjective well-being and subjective relaxation were assessed using visual analog scales, the current state of mood was assessed with Multidimensional Mood State Questionnaires (MDBF), and the current level of stress was assessed with Recovery-Stress Questionnaires/Erholungs-Belastungs-Fragebögen (RESTQEBF) before and after training.

RESULTS

WB-EMS training has a statistically significant positive effect on subjective well-being and subjective relaxation, as well as on the awake subscale of the MDBF. No significant main effect of sequence and no interaction effects were found. Also, compared to a Sham training session, a single WB-EMS training session had no significant effect on mood, nervousness, or the current level of stress.

CONCLUSION

Besides physiological effects, WB-EMS might also have a strong psychological impact. WB-EMS could be beneficial for people who, due to their limitations, have problems training on a regular basis and with adequate training intensity.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00012583 , 22 June 2017.

Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies

Background

No review to date has evaluated the association between physical fitness and health-related quality of life (HRQoL) in healthy children and adolescents. The aims of this systematic review and meta-analysis were to examine the relationship between both cardiorespiratory fitness (CRF) and muscular fitness (MF) and HRQoL in healthy subjects under 18 years of age and to describe the dimensions of HRQoL in which these relationships are more robust.

Methods

The Medline, Embase, Cochrane Library, SCIELO, SPORTDiscus and PEDro databases were systematically searched to collect observational studies that examined the relationship between CRF and HRQoL and between MF and HRQoL in participants under 18 years of age without any diagnosed medical condition. Pooled effect sizes (ES) were estimated for the associations between both CRF and MF and the various HRQoL dimensions.

Results

The pooled ES (95% CI) estimates for the relationship between CRF and HRQoL were as follows: 0.19 (0.10 to 0.27) for physical well-being, 0.19 (0.07 to 0.32) for psychological well-being, 0.20 (− 0.14 to 0.55) for perceived health status, 0.10 (0.00 to 0.20) for self-perception/self-esteem, 0.07 (− 0.05 to 0.19) for quality of family relationship, 0.14 (0.04 to 0.25) for quality of peer relationship, 0.17 (0.04 to 0.29) for everyday functioning at school and 0.20 (0.12 to 0.28) for total HRQoL score. The pooled ES (95% CI) estimates for the relationship between MF and HRQoL were: 0.25 (0.12 to 0.37) for physical well-being, 0.11 (0.04 to 0.17) for psychological well-being, 0.08 (0.01 to 0.15) for quality of family relationship, 0.14 (0.03 to 0.25) for quality of peer relationship, and 0.09 (0.03 to 0.14) for total HRQoL score.

Conclusions

Our data suggest that both CRF and MF are positively associated with HRQoL, mainly in physical, psychological and peer relationships. Moreover, CRF is positively associated with school dimensions and MF is positively associated with family relationships.

Trail registration Protocol PROSPERO registration number: CRD42015025823.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01766-0.

Mental Health Problems and the Associated Family and School Factors in Adolescents: A Multilevel Analysis

Objective: Mental health is one of the most important issues in adolescents’ life. Adolescents’ health is highly important, because of their role in the future. This study was conducted using multilevel analysis to investigate the risk factors at student and school levels.

Method: This was a cross sectional study for which 1740 students and 53 schools were selected between February and March 2018 in Qazvin, Iran. Multistage stratified cluster sampling was used for data collection. Mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Emotional symptom, conduct problem, hyperactivity, peer relationship problem, and prosocial behavior were the subscales. This study used multilevel analysis to determine the association between each of the questionnaire scales and students and schools variables. Results: The prevalence of the mental health problems was 16.2%. Conduct problem was more prevalent than others (21.1%). Overall, the score of mental health problems was significantly lower in boys’ schools, in adolescents with physical activity, and in families with high socioeconomic status. Hyperactivity and emotional symptoms were significantly higher in girls’ schools. While prosocial behavior and peer relationship problems were significantly higher in boys’ schools. The association between variables and the scales of mental health problems was different.Conclusion: Results indicated desirable physical activity and socioeconomic status are effective components in the adolescents’ mental health, and, mostly girls’ schools were more vulnerable than boys’ schools. Therefore, the educational authorities and health policymakers should consider this diversity to design interventional programs and pay more attention to the high-risk adolescents in different schools.

A study of quality of life among hemodialysis patients and its associated factors using kidney disease quality of life instrument-SF36 in Riyadh, Saudi Arabia

We aimed in this study to assess the quality of life for kidney-ill patients using Kidney Disease Quality of Life Instrument-SF36 (KDQOL-SF36) and the impact of other demographic, clinical, and social factors on patients' QOL. The quality of life was assessed using an Arabic version of KDQOL-36. The KDQOL-36 subscales Physical Component Summary (PCS), Mental Component Summary (MCS), Burden of Kidney Disease, and Effects of Kidney Disease were calculated. The effect of sex, diabetic status, diabetes mellitus, marital and status employment status, etc. on these subscales was evaluated. Reliability was determined by calculating Cronbach's alpha. A total of 254 patients were enrolled. The mean age was 58.2 (standard deviation 18.2) years; 61% were male, 56.7% diabetic and 20.1% were employed. The mean domain scores on the PCS, MCS, burden of kidney disease, and effects of kidney disease subscales were 49.4, 38.7, 52.6, and 37.2, respectively. Afternoon shift patients score highest among all shifts in MCS and PCS (P = 0.0001). The MCS score (38.7 ± 28.7) was significantly lower than PCS (49.4 ± 16.5) (P = 0.0001). The "effect of kidney disease" subscale was higher in males (P = 0.02), employed patients (P = 0.02), in the afternoon dialysis shift (0.0001). For PCS higher scores were seen in males (P = 0.0001), in non-diabetics (compared to diabetics) (P = 0,006), in the employed patients (P = 0.02). The highest score was seen in the "burden of kidney disease" subscale and the lowest in the "effects of kidney disease" subscale. Higher scores were seen in males, in nondiabetics, in the employed patients.

Examining social-cognitive theory constructs as mediators of behaviour change in the active team smartphone physical activity program: a mediation analysis

Background

Regular engagement in physical activity has well-established physical and psychological health benefits. Despite this, over a quarter of the global adult population is insufficiently physically active. Physical activity interventions grounded in behaviour change theory, such as the social-cognitive theory, are widely considered to be more effective than non-theoretical approaches. Such interventions set out to intervene on the ultimate outcome (physical activity), but also influence intermediate factors (social-cognitive theory constructs) which in turn, are believed to influence physical activity behaviour. The primary aim of the study was to use mediation analysis to examine whether changes in the social-cognitive theory and related constructs, in particular self-efficacy, outcome expectations, intentions, barriers and goal setting, mediated the effects of a smartphone-based social networking physical activity intervention.

Methods

Mediation analyses were conducted using the PROCESS Macro in SPSS to (i) calculate the regression coefficients for the effect of the independent variable (group allocation) on the hypothesised mediators (social-cognitive theory constructs), (ii) calculate the regression coefficient for the effect of the hypothesised mediators (social-cognitive theory constructs) on the dependent variable (objectively measured physical activity or self-report physical activity), independent of group assignment and (iii) determine the total, direct and indirect intervention effects.

Results

Data from 243 participants were included in the mediation analysis. There was no evidence of mediation for change in objectively measured MVPA or self-reported MVPA.

Conclusions

There was no conclusive evidence that any of the social-cognitive theory constructs mediated the relationship between an app-based intervention and change in physical activity. Ongoing efforts to develop and understand components that make physical activity app-based interventions effective are recommended.

Trial registration

This trial was registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12617000113358, date of registration 23 January, 2017).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-10100-0.

Association of Physical Fitness Performance Tests and Anthropometric Indices in Taiwanese Adults

Background

The association between physical fitness performance tests and anthropometric indices is not clear. The study aims to explore the association between physical fitness performance and anthropometric indices in Taiwanese community-dwelling adults. This may help in monitoring anthropometric indices to improve physical fitness.

Methods

We recruited 2216 participants aged 23–64 years between 2014 and 2017. Physical fitness performance, including abdominal muscular endurance (60-s sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (3-min step test), was evaluated in all participants. The association of the physical fitness performance and anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), was analyzed using linear regression, with adjustments for age and gender.

Results

Body mass index was negatively associated with abdominal muscular endurance (p < 0.001) and cardiorespiratory endurance (p < 0.001). Neither BMI, WC, WHR, nor WHtR were significantly associated with flexibility. Abdominal muscle endurance, flexibility, and cardiorespiratory endurance were significantly lower in obese participants when obesity was defined using a BMI of ≥27, 30, and 35 kg/m². Participants with central obesity that was defined as WC ≥ 90 cm in men and 80 cm in women and WHtR ≥ 0.6 had lower abdominal muscular endurance than those without central obesity.

Conclusion

Body mass index is associated with abdominal muscular endurance and cardiorespiratory endurance in a reverse J-shaped manner. None of the anthropometric indices are significantly associated with flexibility. Obesity defined by BMI is linked to worse physical fitness performance and obesity defined using WHtR is linked to lower abdominal muscular endurance in Taiwanese community-dwelling adults.

Relationship between Smoking, Physical Activity, Screen Time, and Quality of Life among Adolescents

Background: Quality of life (QOL) is a crucial part of evaluating health conditions IN adolescents. The purposes of this study were to (1) examine the relationship of QOL and smoking, physical activity (PA) and screen time (ST) among Chinese adolescents, (2) explore the relationship between PA-ST combination and QOL of adolescents, and (3) investigate the dose-response relationship between PA-ST and QOL. Methods: This study randomly selected 12,900 adolescents (11–18 years) from 13 administrative regions in Shandong Province, China. The data gathering tools for Smoking (tobacco), PA (PAQ-A) and ST (average daily time for ST) and QOL questionnaire (child and adolescent quality of life scale) were completed among all adolescents. Statistical analysis was performed by T test, chi-square test and multiple linear regression. Results: 12,641 adolescents (aged 12–18) completed the study. In multiple linear regression models, the result demonstrated that the adolescents from rural areas, with high ST, low PA, and smoking, with older age and low socioeconomic status, showed a lower QOL score. First-time smokers under 10 years revealed the lowest QOL, and PA > 30 min five days per week have the highest QOL. In addition, boys and girls with PA > 30 min three to four days per week in high ST group obtain the higher scores (boys β = 5.951, girls β = 3.699) than low PA-low ST groups. Conclusions: Adolescents from rural areas suffer from a relatively poorer QOL. More than 30 min of PA five or more days for boys and three or four days per week for girls could decrease negative effects of ST and improve QOL.

Relación entre nivel de condición física y percepción de la calidad de vida relacionada con la salud en adolescentes del sureste español

Introducción. La condición física relacionada con la salud (CFS) es considerada como uno de los factores que determinan el concepto de calidad de vida relacionada con la salud (CVS).Objetivo. Analizar la relación entre el nivel de CFS y la percepción de la CVS en adolescentes españoles.Materiales y métodos. Estudio multicéntrico realizado en una población de 1 037 adolescentes (15.52±1.11 años) del sureste de España (Región de Murcia). La CFS y la CVS se evaluaron mediante la batería COFISA y el Cuestionario de Salud SF-36, respectivamente.Resultados. La prueba MANOVA mostró que los varones tuvieron un mejor rendimiento físico global (p<0.001). Respecto a la CVS, las mujeres tuvieron una mejor percepción en la dimensión salud general (p=0.011), mientras que la percepción de los varones fue mejor en las dimensiones rol emocional (p=0.010) y salud mental (p<0.001). Los adolescentes con mayor nivel CFS tuvieron valores superiores en la percepción global de la CVS (p<0.001 en todas las variables).Conclusión. La asociación entre niveles altos de CFS y puntajes superiores de percepción de la CVS hace necesario establecer estrategias y acciones que busquen aumentar los niveles de participación de los jóvenes en actividades físicas y deportivas.

Recognition of 16-18-Year-Old Adolescents for Guiding Physical Activity Interventions: A Cross-Sectional Study

Adolescence is a rapid life stage requiring special attention wherein personal autonomy is developed to govern independent lifestyles. Unhealthy lifestyles are integral to prevailing adolescent physical inactivity patterns. Understudied 16-18-year-olds were investigated to establish physical activity prevalences and influencing health-related lifestyle factors. Adolescents were recruited randomly across 2017-2019 from Farnborough College of Technology and North Kent College, UK. Demographic and health-related lifestyle information were gathered anonymously and analysed using SAS® 9.4 software. Among the 414 adolescents included (48.3% male and 51.7% female), the mean (standard deviation (SD)) age was 16.9 (0.77). Approximately 15.2% smoked and 20.8% were overweight/obese. There were 54.8% perceiving themselves unfit and 33.3% spent >4 h/day on leisure-time screen-based activity. Around 80.4% failed to meet the recommended fruit/vegetable daily intake and 90.1% failed to satisfy UK National Physical Activity Guidelines, particularly females (p = 0.0202). Physical activity levels were significantly associated with gender, body mass index, smoking status, leisure sedentary screen-time, fruit/vegetable consumption and fitness perceptions. Those who were female, overweight/obese, non-smoking, having poor fitness perceptions, consuming low fruit/vegetables and engaging in excess screen-based sedentariness were the groups with lowest physical activity levels. Steering physical activity-oriented health interventions toward these at-risk groups in colleges may reduce the UK's burden of adolescent obesity.

The association between physical fitness and mental health in Norwegian adolescents

BACKGROUND

Studies indicate that health-related components of physical fitness are associated with mental health outcomes. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine whether body composition, muscular strength and cardiorespiratory fitness were associated with self-reported mental health in Norwegian adolescents.

METHODS

Adolescents from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) participated. Self-reported mental health (psychological difficulties) was measured by completing the Strengths and Difficulties Questionnaire. Cardiorespiratory fitness was assessed with an intermittent running test; muscular strength was assessed by measuring handgrip strength, standing broad jump and sit-ups; and body composition was assessed by calculating body mass index from weight and height. Linear mixed effects models were conducted to assess the associations between the health-related components of physical fitness and psychological difficulties. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign).

RESULTS

Body composition was not associated with psychological difficulties. Muscular strength was independently associated with psychological difficulties, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with psychological difficulties.

CONCLUSIONS

There was a small but significant inverse association between cardiorespiratory fitness and levels of psychological difficulties in Norwegian adolescents. The results suggest that muscular strength is not associated with psychological difficulties in adolescents, when controlling for cardiorespiratory fitness. Future research should focus on the prospective association between physical fitness components and mental health outcomes in adolescents.

TRIAL REGISTRATION

The study is registered in ClinicalTrials.gov ID nr: NCT03817047. Retrospectively registered January 25, 2019.