Physical activity and associated socio-demographic factors among school adolescents in Jiangsu Province, China

Chinese physical fitness standard for campus football players: A pilot study of 765 children aged 9 to 11

Objectives: In 2022, 55 million Chinese children participate in campus football; however, there is no physical fitness standard, making it a priority task to enhance the current national program. This study aimed to explore a pilot method for the development of a reliable physical fitness standard. Methods: This study examined 765 male football players aged 9 to 11 in 2020 and 2022. The anthropometric and physical fitness assessments were conducted in accordance with the Chinese Football Association's field manuel. Physical fitness tests include sit and reach test, t test, 30 m run test, and vertical jump test. Physical fitness standard was modeled using the generalized additive models for location, scale, and shape (GAMLSS). Data were fitted with appropriate GAMLSS distributions and smoothing term. P-splines were applied to smooth the model's parameters using the default local maximum likelihood method and link functions. Following diagnostics of fitted models, age-specific centile estimations were computed for physical fitness tests. In addition, players in each age group were categorized according to their body mass index as normal weight or overweight/obese. Welch's t-test was utilized to compare the group differences in physical fitness testing. The significance level was chosen at p < 0.05. Results: Sit and reach test, t test, 30 m run test, and vertical jump test data were fitted with original Sinh-Arcsinh, Box-Cox power exponential, Box-Cox power exponential, and Box-Cox Cole and Green, respectively. Physical fitness standard for each age group is presented as tabulated centiles (1p, 3p, 5p, 15p, 25p, 50p, 75p, 85p, 95p, 97p, 99p). Overweight/obese campus football players did significantly worse (p < 0.05) on the t test, 30 m run test, and vertical jump test than their normal-weight peers of the same age. Conclusion: This study developed the first physical fitness standard for 9 to 11-year-old campus football players in China. We made three recommendations to Chinese policymakers on sample size, data management, and field procedure for the creation of a national physical fitness standard.

Relationship between physical activity, screen-related sedentary behaviors and anxiety among adolescents in less developed areas of China

This study aimed to explore the association between physical activity, screen-related sedentary behaviors, and anxiety. The current study used latent profile analysis (LPA) to identify homogenous subtypes of anxiety among adolescents in less-developed areas of China. Data were aggregated from 6 schools in the less-developed areas of China in September 2018. In total, 900 students were evaluated using the 100-item Mental Health Test (MHT) and Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The LPA was conducted to explore the potential classification of anxiety, which makes full use of all the sample data and explore heterogeneous classifications within groups. Logistic regression was used for the multifactor analysis. A P value <.05 was considered statistically significant. The entropy value suggested that the model with 3 latent profile was the best choice. There were 223 adolescents in the severe anxiety group, accounting for 24.78%. Logistics regression analysis of anxiety revealed that the risk of severe anxiety in boys was lower (odds ratio [OR] = 0.317, P < .001) than in girls. Students had a significantly lower probability of suffering from severe anxiety in using cellphones or computers ≤ 2 hours/day than those used cellphones or computers＞2 hours/day (OR = 0.391, P = .004). Decreasing screen-related sedentary behaviors should be a target of community and school-based interventions, because high screen-related sedentary behaviors were associated with higher odds of anxiety among adolescents in less developed area of China.

Level of engagement of recreational physical activity of urban villagers in Luohu, Shenzhen, China

Physical activity is important for health. However, there is a lack of literature related to the physical activity levels of adults living in urban villagers, which is a vulnerable population in China. The aim of this study is to compare the physical activity and sedentary behavior engagements between urban villagers and non-urban villagers using the 2019 Luohu Shenzhen, China Community Diagnosis Questionnaire. A total of 1205 adults living in urban villages and non-urban villages were included in the analysis. Unadjusted and multiple multivariate logistic regression were conducted for the dependent variable of engagement in recreational physical activity, frequency of recreational physical activity per week, and hours spent in sedentary behaviors per day. Descriptive analysis was conducted to identify the reasons for not engaging in physical activity among urban villagers and non-urban villagers. Across the included sample, 29.05% were urban villagers and 70.95% were non-urban villagers. The results suggested that urban villagers are more likely to engage in physical activity than non-urban villager (OR = 1.90, 95% CI [1.40, 2.59], p < 0.001). However, it was also found that urban village status had no significant association for frequency in engaging in physical activity and average hours spent in sedentary behaviors. Both urban villagers and non-urban villages indicated that lack of time, lack of safe and appropriate environment, and working in labor intensive occupations as some of the reasons for not engaging in physical activity. There is a need for tailed interventions and policies for promoting physical activity among urban villagers and non-urban villagers. Additional studies are needed to further our understanding of the physical activity behaviors among urban villagers in China.

Urban-Rural Differences in Physical Fitness and Out-of-School Physical Activity for Primary School Students: A County-Level Comparison in Western China

Rapid urbanization of China has brought lifestyle changes resulting in a continuous decline in children's physical fitness (PF) and out-of-school physical activity (PA). To date, studies have been focused on correlates of PF and out-of-school PA, and patterns and trends based on geographic diversity and urban-rural contrasts. Western China, with a large rural population, has substantial urban-rural differences, but little work has been done to compare its children's physical fitness (PF) and out-of-school physical activity (PA) at a county level. A total of 715 primary school students (grades 3-6) were surveyed from one urban school (n = 438) and four rural schools (n = 277) in a county-level administrative unit, Yangling District, Shaanxi, in western China. Physical fitness index (PFI) was measured and calculated based on the revised Chinese Student Physical Fitness Standards. Out-of-school PA and other variables of demographics, behavior and perception were collected using questionnaires. Statistical analyses explored urban-rural differences and correlates of PFI and out-of-school PA. We found that the PFI (72.86 vs. 79.67) and weekly moderate-to-vigorous physical activity (MVPA) duration (167.57 vs. 220.08) of urban students were significantly lower than those of rural students. Weekly MVPA duration had the largest positive impact on PFI. Perceived availability of PA spaces was positively associated with both the urban and rural students' PF and PA, while screen time was negatively associated with PF and PA, especially for rural students. Facilitators of PA frequency include the perceived availability of PA time and parental educational level. Parents' PA habits had a positive impact on urban students' PA. No association between active school commuting and PF or PA was found. Our findings revealed that PF and out-of-school PA of urban students were clearly lower than among rural students. The health of rural children at the county level in western China should be paid much more attention during the process of rapid urbanization.

A GIS based approach to neighbourhood physical environment and walking among adults in Colombo municipal council area, Sri Lanka

BACKGROUND

Physical Activity (PA) promotes health and wellbeing and walking is one of the easiest and commonest way to incorporate activity into everyday life. This study examined the association between the objectively measured neighbourhood physical environment and walking among the adults in Colombo Municipal Council (CMC) area in Sri Lanka.

METHODS

A cross sectional study was carried out and primary data collection carried out to assess walking, socio-demographic characteristics and geo location of residence. Secondary data was obtained to assess neighbourhood environment from existing spatially referenced data from the survey department of Sri Lanka. Geographic Information Systems (GIS) was used to calculate density measures (residential density, land use, connectivity and access) and distance measures, which were then correlated with walking.

RESULTS

A sample consisted of 284 adults aged 29-59 years with a mean age of 40.6 (SD,10.9) years. The total mean minutes walked a week was 175.8 min with a standard deviation of 214.0. The mean and the standard deviations of walking per week for transportation and leisure were 158.4 (SD,196.6) and 17.5 (SD,70.1) respectively. Residential density measures, building foot print area, length of major roads, number of intersections, number of bus stops, and distance to nearest major roads showed significant moderate degree of correlations with total minutes of walked per week, (p < 0.001). These results were similar with walking for transportation.

CONCLUSION

There is indication that neighbourhood features are associated with walking among the adults in the CMC area using secondary data on physical environment. This paves way for further exploration to understand the relationship between neighbourhood physical environment and walking which could be used for effective interventions to promote walking.

The association between socioeconomic position and vigorous physical activity among adolescents: a cross-sectional study in six European cities

Background

The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European countries using a wide range of SEP indicators, including family-based (education, family affluence, perceived social standing, parents’ employment, housing tenure) and adolescent-based (academic performance and pocket money) ones.

Methods

We used data from a survey among 10,510 students aged 14–17 from 50 schools in six European cities: Namur (BE), Tampere (FI), Hannover (DE), Latina (IT), Amersfoort (NL), Coimbra (PT). The questionnaire included socio-demographic characteristics and the amount of time spent in VPA.

Results

The mean time spent practicing VPA was 60.4 min per day, with lower values for Namur (BE) and Latina (IT), and higher values for Amersfoort (NL). In the multivariable analysis, both categories of SEP indicators (family-based and adolescent based indicators) were independently associated with VPA. For each SEP indicator, lower levels of VPA were recorded in lower socioeconomic groups. In the total sample, each additional category of low SEP was associated with a decrease in mean VPA of about 4 min per day.

Conclusions

This study showed that across European cities adolescent VPA is positively related to both family-based SEP and adolescents’ own SEP. When analysing socioeconomic differences in adolescent VPA, one should consider the use of multiple indicators of SEP.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10791-z.

Impact of physical exercise intervention and PPARγ genetic polymorphisms on cardio-metabolic parameters among a Chinese youth population

Objective

Physical inactivity inChinese youth students particularly in senior high schools, who participate inthe National Higher Education Entrance Examination (NCEE) is very common. Inorder to explore the beneficial effects from physical exercise and education afterNCEE, we performed a Physicalexercise Intervention Program in the Youth (PiPy) to evaluate the interaction with PPARγ genetic variants on cardiovascular and metabolicparameters.

Methods

A total of 772 freshmen (males 610/females162) from high schools to university were recruited into the PiPy cohort, which was designedaccording to the National Student Health Standards in China. Anthropometric data were collected, whilephysical activities and body composition at the baseline of PiPy cohort weremeasured with SECAprotocols. Eighttagged single nucleotide polymorphisms (SNPs) in the PPARγ gene were genotyped with TaqMan allelicdiscrimination.

Results

After physical exercise intervention forthree months, in parallel with increased physical activities, BMI and skeletalmuscle content in all subjects was enhanced, while heart rate and bloodpressures were decreased. Furthermore, SNPs in 5’-UTR of the PPARγ gene, including rs2920502, rs9817428 and rs2972164, were found to be associated with the changes of BMI. Body weight in the subjects with BMI <18.5and 18.5-23.9 kg/m² were increased, while the obese subjects (BMI ≥24.0 kg/m²) decreased.

Conclusion

The present study for the first timedemonstrated that the PiPy could improve cardio-metabolic parameters such asheart rate, blood pressures and BMI for Chinese youth students after NCEE, inwhich the genetic interactive effects of PPARγ should be included into obesityintervention.

Gender and age differences in the association between living arrangement and physical activity levels among youth aged 9-19 years in Shanghai, China: a cross-sectional questionnaire study

BACKGROUND

We examined the correlations between living arrangement and the physical activity (PA) levels of youth aged 9-19 years while accounting for demographic factors such as age, sex, and socioeconomic status in Shanghai, China.

METHODS

Cross-sectional analyses of data from the 2014 Physical Activity and Fitness in Shanghai China-The Youth Study was conducted. Participants were 33,213 primary (9-11-year-olds; n = 13,237), junior middle (12-14-year-olds; n = 11,157), and junior high school students (15-19-year-olds; n = 8819). Youth (boys = 49%) and their guardians were randomly sampled from 17 districts in Shanghai, China. Youths' moderate-to-vigorous PA (MVPA) levels, information about living arrangement, and guardians' sociodemographic factors were collected via questionnaires.

RESULTS

Only 17.8% of school-aged youths in Shanghai met MVPA recommendations, with significantly more boys (20.6%) meeting recommendations than girls (p < .001). Youths living in rural areas showed an overall significantly higher percentage of meeting MVPA recommendations (20.3%) than those living in urban areas (p < .001). Youths who lived with single parents showed an overall significantly lower percentage of meeting MVPA recommendations (15.3%) than those living with their grandparent(s) or with both parents (p < .001). A logistic regression analysis revealed that, among 9-11-year-olds, children who live with their grandparent(s) were less likely to meet MVPA recommendations than those who lived with both parents (boys: adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.61-0.84; girls: aOR = 0.84, 95%CI = 0.72-0.98).

CONCLUSIONS

Type of living arrangement was associated with the PA of youth in Shanghai, with no significant gender difference. Youth aged 9-19 years who lived with single parents had the lowest percentage of meeting MVPA recommendations. The probability of achieving 60 min/day MVPA recommendations was significantly lower among 9-11-year-old children living with their grandparent(s) than children living with both parents; however, no such difference was observed among adolescents. Our findings suggest that living arrangement may be an important consideration for promotion of PA among youth in China.

Increasing socioeconomic disparities in sedentary behaviors in Chinese children

BACKGROUND

Sedentary behaviors are prevalent in Chinese children, however, the studies on their trends and socioeconomic disparities are scarce. We examined the time trends of daily television (TV) viewing and video game playing and the associated socioeconomic factors in Chinese children in Hong Kong, the most developed and westernized city in China.

METHODS

In a panel data study involving 538,300 primary four and 510,294 primary six students from 1999/2000 to 2008/09, data on socioeconomic status, sedentary behaviors (TV viewing and video game playing) and other lifestyle habits were collected using a self-administered questionnaire. Trends in sedentary behaviors over time were assessed. Their socioeconomic disparities were examined by interactions in generalized estimating equations with the adjustment for weight status and extracurricular physical activities.

RESULTS

The age and sex-standardized prevalence of ≥2 h daily TV viewing decreased from 51.4% (95% confidence interval [CI] 51.1-51.8%) in 1999/2000 to 43.8% (95% CI 43.4-44.2%) in 2008/09 (P for trend < 0.001), whereas that of ≥1 h daily video game playing increased from 8.2% (95% CI 7.9-8.4%) to 22.4% (95% CI 22.0-22.7%). Both sedentary behaviors were more prevalent in boys than girls, but the disparities decreased over time (Ratio of odds ratio [ROR] = 0.996 and 0.924 for TV viewing and video game playing, respectively). In contrast, both sedentary behaviors were increasingly more prevalent in children whose parents had lower education levels or non-managerial/professional occupations (ROR 1.006-1.082).

CONCLUSIONS

Children in lower socioeconomic families in Hong Kong were increasingly at risk of having sedentary behaviors over years and thus deserve more attention. Effective strategies targeting children and/or their parents of lower socioeconomic status are needed to reduce sedentary behaviors.

Short-Term and Long-Term Effects of a Combined Intervention of Rope Skipping and Nutrition Education for Overweight Children in Northeast China

The aim of the present study was to evaluate whether an exercise intervention, nutrition education, or the combination of both were effective in weight reduction and maintenance for rural school children. Two hundred twenty-nine primary school children aged 9 to 12 years determined as overweight/obese were randomly assigned to 1 of 4 groups: exercise intervention, nutrition education, combination of both, and control. Nutrition education and rope-skipping sessions were performed for 2 months. Anthropometric measurements were administered at baseline, after 2 months (postintervention), and 1 year later (follow-up). The order of change from high to low in the body mass index standard deviation scores (BMI-SDS) between postintervention and baseline was combined intervention, exercise intervention, and nutrition education. The BMI-SDS between following-up and baseline was for combined intervention, exercise intervention, and nutrition education. The combined intervention had the best short-term and long-term effects. The exercise intervention had a better short-term effect than nutrition education, while nutrition education had a better long-term effect than the exercise intervention.

Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

Background

The body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.

Objectives

The overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.

Methods

We performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10–19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).

Results

Data from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81–0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62–0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04–1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62–0.74) and television (TV) time (ES 0.58; 95 % CI 0.49–0.69), whereas in low-middle-income countries, the associations were strongest for ‘other’ screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07–1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.

Conclusion

The associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0555-4) contains supplementary material, which is available to authorized users.

Physical Environment Correlates of Physical Activity in Developing Countries: A Review

BACKGROUND

Noncommunicable diseases and obesity are considered problems of wealthy, developed countries. These conditions are rising dramatically in developing countries. Most existing research on the role of the physical environment to support physical activity examines developed countries only.

OBJECTIVES

This review identifies physical environment factors that are associated with physical activity in developing countries.

METHODS

This review is modeled on a highly cited review by Saelens and Handy in 2008. The current review analyzes findings from 159 empirical studies in the 138 developing countries.

RESULTS

Results discuss the association of physical environment features and physical activity for all developing countries and identify the patterns within regions. The review supports the association of traffic safety with physical activity for transportation. Rural (vs urban) residence, distance to nonresidential land uses, and "composite" features of the physical environment are associated with general physical activity. Rural (vs urban) residence is associated with physical activity for work.

CONCLUSIONS

More research is needed on associations between the physical environment and physical activity in developing countries. Research should identify specific physical environment features in urban areas that are associated with higher activity levels.

Physical activity and park use of youth in Nanchang, China

Physical inactivity is a growing issue in Chinese youth, but parks can facilitate traditional and non-traditional forms of physical activity for little to no cost. Despite this opportunity, very little is known regarding park use among Chinese youth. The purpose of this study was to conduct a cross-sectional observational study of park usage and physical activity of youth in municipal parks in Nanchang, China. Data were collected in June of 2014 in eight parks across Nanchang, Jiangxi a large city in southeast China. Physical activity was measured by a modified version of System for Observing Play and Recreation in Communities. Ordered hierarchic generalized linear models were estimated using a logit link function. The influence of the park was estimated using random effects, with fixed effects and park, environmental, and park user characteristics. Youth were most often seen active in the afternoon, on weekends, and during cooler times (≤ 29 °C). Paradoxically, more children were active when air quality was poorer. Older boys were more active than younger boys, but no differences were observed in girls. More children were seen active in unstructured play compared to structured activities. The results suggest parks are an important setting for physical activity among Chinese youth, and that unstructured activities can play an important role in promoting greater youth physical activity.

•

Chinese youth were most often seen engaging in physical activity in the afternoon, on weekends, and during cooler times (< 29 °C).

•

Paradoxically, more Chinese youth were physically active when air quality was poorer.

•

More Chinese youth were seen physically active in unstructured play compared to structured activities.

Trends in domain-specific physical activity and sedentary behaviors among Chinese school children, 2004-2011

Background

Dramatic increases in child overweight have occurred in China. A comprehensive look at trends in physical activity and sedentary behaviors among Chinese youth is needed. The study aimed to examine trends in domain-specific physical activity and sedentary behaviors, explore mean and distributional changes in predicted behaviors over time, and investigate how behaviors vary by residence.

Methods

Using 2004–2011 China Health and Nutrition Survey data, adjusted means for MET-hours/week from physical activity and hours/week from sedentary behaviors were determined for school children (6–18 years), stratifying by gender, age group, and residence. Physical activity domains included in-school physical activity, active leisure (out-of-school physical activity), active travel (walking or biking), and domestic activity (cooking, cleaning, and child care). For each physical activity domain, the MET-hours/week measure was determined from the total weekly time spent (hours) in domain-specific activities and corresponding MET-values using the Compendium of Energy Expenditures for Youth. Sedentary behaviors included television, computer use, homework, and other behaviors (board games, toys, extracurricular reading and writing). For each sedentary behavior, the hours/week measure was determined from total weekly time spent in specific sedentary behaviors. Residence groups included megacities (population ≥ 20million), cities/towns (300,000 ≤ population < 20million), and rural/suburban areas (population < 300,000). Repeated measure linear mixed and quantile regression models were used to predict adjusted means.

Results

Little change in physical activity behaviors occurred over time, with the exception of statistically significant trends toward increased domestic activity among male children (p < .05). Across all gender and age groups, statistically significant trends over time toward an average increase in computer use were seen (p < .01); these increases were largely driven by those ≥50th percentile on the distribution. Children living in megacities (versus rural areas) reported higher levels of physical activity, homework, and computer use.

Conclusions

Intensified, systematic intervention and policy efforts promoting physical activity and reducing sedentary behaviors among children are needed.

Electronic supplementary material

The online version of this article (10.1186/s12966-017-0598-4) contains supplementary material, which is available to authorized users.

Age, period and cohort effects and the predictors of physical activity and sedentary behaviour among Chinese children, from 2004 to 2011

BACKGROUND

Very few studies have explored the effects of age, time period, and cohort in association with biological, behavioral, economic, and environmental factors predictors on physical activity (PA) and sedentary behaviour (SB) among Chinese children.

METHODS

We used data from a cohort study of the China Health and Nutrition Survey (CHNS) between 2004 and 2011 (2004, 2006, 2009 and 2011). The outcomes of interest were metabolic equivalent of task (MET) hours per week from both active and sedentary activities. Age, gender, individual characteristics, household size, asset ownership, and urbanisation were included as covariates. Age, period and cohort effects analyses for PA and SB of children (6-17 y, n = 3528) was conducted to explicitly assess differences in PA and SB due to age vs. period effects, and implicitly assess differences by cohorts due to the period-specific experiences across individuals of varying ages.

RESULTS

The mean age of the sample in each time point fluctuated from 12.6 to 11.3 years and PA slightly decreased from 50.0 ± 63.2 MET hours per week (MET-hr./wk) in 2004 to 47.1 ± 54.9 MET-hr./wk. in 2011. However, SB increased from 31.8 ± 22.0 MET-hr./wk. to 37.6 ± 22.2 MET-hr./wk. Girls had lower PA and higher SB levels than boys. Controlling for age effects, marginal period effects on PA were observed in some survey years. Higher levels of urbanisation and number of household computers served as negative and positive predictors for PA and SB, respectively. Higher household income was a positive predictor of SB. Surprisingly, bigger household size was the only negative predictor of SB (P < 0.05).

CONCLUSIONS

This longitudinal study followed a large cohort of children over a significant period of their childhood. We observed potential age and secular trends in PA levels. Higher community urbanisation and number of home computers were associated with both PA and SB levels. Larger household size was the only factor that was negatively associated with SB. These findings shed light on health policy and preventative health strategies for China and other countries that are now facing similar public health challenges.

Factors of physical activity among Chinese children and adolescents: a systematic review

Background

Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development.

Methods

A systematic search was finished on Jan 10^th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method.

Results

Forty two papers (published 2002–2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents’ physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents.

Conclusions

The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0486-y) contains supplementary material, which is available to authorized users.

Using the self-determination theory to understand Chinese adolescent leisure-time physical activity

PURPOSES

This study applies the self-determination theory (SDT) to test the hypothesized relationships among perceived autonomy support from parents, physical education (PE) teachers, and peers, the fulfilment of psychological needs (i.e., autonomy, competence, and relatedness), autonomous motivation, and leisure-time physical activity of Chinese adolescents.

METHOD

There are 255 grade six to eight student participants from four middle schools around Shanghai, China included in this study. An accelerometer was used to measure the moderate-to-vigorous physical activity (MVPA). The participants completed the questionnaires regarding SDT variables. The structural equation modelling was applied to examine the hypothesized relationships among the study variables.

RESULTS

The model of hypothesized relationships demonstrated a good fit with the data [X² = 20.84, df = 9, P = .01; CFI = 0.98; IFI = 0.98; SRMR = 0.04; RMSEA = 0.05]. The findings revealed that autonomy support from parents, PE teachers, and peers foster social conditions in which the three basic psychological needs can be met. In turn, autonomy, competence, and relatedness are positively associated with autonomous motivation for MVPA. The autonomous motivation positively relates to the MVPA time of adolescents. The three psychological needs partially mediate the influence of autonomy support from parents (β = 0.18, P < .01; Bootstrap 95% CI = 0.06-0.33) and teachers (β = 0.17, P < .01; Bootstrap 95% CI = 0.03-0.26) in the autonomous motivation.

CONCLUSION

In conclusion, these findings support the applicability of SDT in understanding and promoting physical activity of Chinese adolescents.

Predicting Childhood Obesity Prevention Behaviors Using Social Cognitive Theory: Children in China

Four commonly suggested public health strategies to combat childhood obesity are limiting television viewing, encouraging daily physical activity, increasing fruit and vegetable intake, and increasing water consumption. This study examined the extent to which selected social cognitive theory constructs can predict these four behaviors in upper elementary Chinese children. A 55-item valid and reliable scale was administered to 282 fifth-graders. Minutes of physical activity was predicted by self-efficacy to exercise and number of times taught at school ( R2 = 0.198). Hours of TV watching was predicted by self-efficacy of watching less than two hours of TV ( R2 = 0.155). Glasses of water consumed was predicted by self-efficacy for drinking water, gender, and number of times taught about physical activity at school ( R2 = 0.100). Servings of fruits and vegetables consumed was predicted by self-efficacy of eating fruits and vegetables ( R2 = 0.197). Social cognitive theory offers a useful framework for designing primary prevention interventions to reduce childhood obesity.

Association between Family Structure and Physical Activity of Chinese Adolescents

Background. This study examines the association between family structure and moderate-to-vigorous physical activity (MVPA) of adolescents in China. Methods. The participants included 612 adolescents (317 boys and 295 girls) from Shanghai with ages ranging from 10 to 16 years. Accelerometers were used to measure the duration of MVPA of adolescents, and questionnaires on family structure were completed by the parents of these adolescents. Results. Findings suggested that family structure significantly increased the likelihood of adolescents engaging in physical activity (PA) and explained 6% of MPVA variance. Adolescents living in single-parent households and step families were more physically active than those living in two-parent homes and with biological parents, respectively. However, adolescents residing with grandparents were less active than those living with neither grandparent. No significant difference was found in MVPA time between adolescents living with one sibling and those without siblings. Conclusion. Family environment may be considered in the development of PA interventions and policies, and adolescents living with their grandparents may be targeted in PA promotion.

Built environmental correlates of physical activity in China: A review

Objective

China faces growing levels of physical inactivity and obesity, associated with increasing urbanization and changing lifestyles in recent years. China is expanding its cities to accommodate a growing urban population. This paper identifies built environment factors that are associated with physical activity in China. Findings can inform urban design and development in China to support increased physical activity.

Methods

This paper is modeled on a review of built environment correlates of walking by Saelens and Handy (2008). Saelens and Handy reviewed research in developed countries. The present paper reviews 42 empirical studies that were conducted in China and were published between 2006 and 2014.

Results

Results discuss the association of built environment features and physical activity for transportation, recreation and work. Studies focus on adults and on major cities. Data on the built environment is typically self-reported. Strongest evidence was found for the positive association of physical activity with proximal non-residential locations, pedestrian infrastructure, aesthetics, and non-park physical activity facilities, and for the negative association of physical activity with urban residence. In terms of physical activity for transportation, evidence is strongest for associations between physical activity for transportation and proximal non-residential locations.

Conclusion

More research is needed on the built environment and physical activity, especially including research on significant features of Chinese cities, such as air pollution, high density levels, traffic safety, and others. Research on associations between built environment features and physical activity should consider the specific social and built environment contexts of Chinese cities.

•

Research on the environment and physical activity is increasing in China.

•

Physical activity is linked to mixed land use, sidewalks, aesthetics, and facilities.

•

Future research should address environments and issues specific to China.

Using Theory of Planned Behavior to Predict the Physical Activity of Children: Probing Gender Differences

Objectives. The primary objective of this study was to use the theory of planned behavior (TPB) to examine the association between TPB variables and the moderate-to-vigorous physical activity (MVPA) of children in Shanghai, China. Gender differences were also explored. Methods. The participants were 353 children (180 boys and 173 girls) aged 9 to 13 years from three primary schools in Shanghai. Accelerometers were used to measure the MVPA duration of the children. Questionnaires that focused on attitude, subjective norms, and perceived behavioral control (PBC) related to MVPA engagement were completed by the participants. Results. Regression analyses revealed that intention, and not PBC, accounted for 9% of the variance in MVPA. Meanwhile, attitude and PBC explained 33% of the variance in intentions to engage in MVPA. In terms of gender differences, TPB performed better in the physical activity (PA) domain for boys than for girls. Furthermore, attitude and PBC were significantly associated with intention among boys, whereas only PBC was significantly related to intention among girls. Conclusion. Practitioners should consider tailoring intervention to address gender differences to increase leisure-time PA participation of children.

Physical activity level and associated factors among civil servants in Xi'an, China

OBJECTIVES

This study investigated physical activity levels and associated factors among civil servants in Xi'an, China, to provide reference data for the implementation of health improvement strategies among civil servants.

DESIGN

A cross-section study.

METHODS

A random sample of 1000 civil servants aged 18-60 years and employed by the Xi'an civic government was assessed by using the Chinese version of the International Physical Activity Questionnaire. Associations between physical activity and sociodemographic characteristics, family history of chronic disease, and existing disease were evaluated by the Mann-Whitney U-test, Kruskal-Wallis H-test, and binary logistic regression.

RESULTS

The response rate was 92.4%. The median physical activity score was 2227 metabolic equivalents of task (MET) minutes per week (interquartile range [IQR]: 1308-3802METmin/week). Among the 924 participants, 7.4% did not meet minimum recommendations for physical activity, 57.3% had moderate activity levels, and 35.4% had high activity levels. Participants spent most of their time on occupational activities (median: 869METmin/week, IQR: 228-1953METmin/week). Female sex (odds ratio [OR]:0.40, 95% confidence interval [CI]:0.29-0.55), age≥51 years (OR: 0.45, 95%CI: 0.27-0.75), and family history of chronic disease (OR: 0.67, 95%CI: 0.48-0.94) were associated with significantly lower odds of a high activity level.

CONCLUSIONS

Most civil servants in Xi'an, China, have moderate activity levels. Some have high activity levels, but few engage in vigorous-intensity physical activity. Interventions to encourage a high level of physical activity are needed, especially for women, older civil servants, and those with family histories of chronic disease.

Study on Current Levels of Physical Activity and Sedentary Behavior among Middle School Students in Beijing, China

Introduction

This study aimed to determine current levels of physical activity and sedentary behavior in middle school students on the basis of grade, sex, student attitudes toward physical education, and residence location.

Methods

In 2013, a cross-sectional study of 1793 students aged 12 to 15 years was conducted across eight middle schools in Beijing, China. Four schools were selected from an urban district and another four schools were from a suburban district. Physical activity and sedentary behavior data were collected using the commonly used school-based Chinese version of the China Health and Nutrition Survey.

Results

The mean age of sampled students was 13.3±1.0 years; 51.5% were boys. Approximately 76.6% of students reported having three 45-minute physical education classes every week. A total of 35.6% students spent ≥1 h/day performing moderate to vigorous physical activity (MVPA) during school, and 34.9% spent ≥1 h/day in MVPA outside school time. Approximately half (49.7%) of the students engaged in reading, writing, or drawing for ≥2 h/day, and 42.9% reported screen time for ≥2 h/day. Although boys spent more time engaged in physical activity than girls did, they also spent more time exhibiting sedentary behavior. Each 10-unit increase in attitudes toward physical education was associated with an increased odds of 1.15 (95%CI: 1.09–1.20) for spending more than 1 h/day on MVPA. Students in suburban schools reported engaging in physical activity less when compared with those in urban schools.

Conclusion

The majority of our students did not meet the current physical activity recommendations, and about half of the students spent excessive time engaging in sedentary behaviors. Findings from this study highlight a positive association between student attitudes toward physical education and physical activity. Studies are needed to further explore the role of student attitudes toward physical education in promoting physical activity among Chinese students.

An extended version of the theory of planned behaviour: the role of self-efficacy and past behaviour in predicting the physical activity of Chinese adolescents

This study aimed to use an extended theory of planned behaviour (TPB), which incorporated additional self-efficacy and past behaviour, to predict the intention to engage in moderate-to-vigorous physical activity (MVPA) and the MVPA level of Chinese adolescents. Questionnaires that focused on MVPA, attitude, subjective norm, perceived behavioural control (PBC), self-efficacy and past behaviour related to the MVPA engagement were administered to a sample of 488 young people. Multiple regression analyses provided moderate support for TPB. Three TPB constructs predicted 28.7% of the variance in intentions to engage in MVPA, and that PBC, but not intention, explained 3.4% of the variance in MVPA. Self-efficacy significantly affected intention and behaviour over and above the influence of TPB. Past behaviour had a small but significant improvement in the prediction of intention, but no improvement in the prediction of MVPA. Based on the results, interventions should target adolescent self-efficacy and PBC in physical activity participation.

Self-management training for Chinese obese children at risk for metabolic syndrome: Effectiveness and implications for school health

This article reviews the results of a school-based self-management intervention for Chinese obese children at risk for metabolic syndrome. Twenty-eight Chinese obese children ( M age = 10 years) and their parents participated in the study. Metabolic syndrome risk factors were measured pre- and post-intervention. The risk factors included Body Mass Index, waist circumstance, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, High-sensitivity C-reactive Protein, fasting plasma glucose, and fasting blood insulin. After 6 months of school-based self-management intervention, all risk factors with the exception of triglycerides and fasting plasma glucose changed significantly in the healthful direction ( p < 0.01). This pilot study offers promising implications for school interventions that are delivered by school-based practitioners collaborating with parents, teachers, and children. An individualized program based on a self-care and -management framework may have utility as a relatively cost-effective, school-based intervention to improve children’s health.

Socio-economic influence on weight status through time in schoolchildren

AIM

This paper describes the developmental trajectory of adiposity in relation to socio-demographic status in primary schoolchildren studying in local schools in Hong Kong.

METHODS

Body mass index (BMI) and prevalence of overweight and obesity were determined in a cohort of primary schoolchildren annually from 2001/2002 to 2005/2006. To study the associations between socio-demographic status and adiposity, repeated measures analysis of variance was used for the longitudinal change in BMI, while logistic regression was used with overweight and obesity development as outcomes.

RESULTS

Prevalence of overweight and obesity was 12.1% and 4.0%, respectively, at baseline, and 16.7% and 3.3%, respectively, at the end of the study period. Boys were more likely to be overweight and obese. Parents in the 'Professional' occupational group were less likely to have overweight and obese children. Among 32,781 children with normal weight at baseline, 2885 (8.8%) became overweight or obese after 4 years. Among 6286 children who were initially overweight or obese, 2079 (33.1%) returned to normal weight. Boys were more likely to move up from normal weight to overweight or obesity and less likely to move down the opposite direction during the study period. Parental education at degree level and the occupational group of 'Professionals' were, in general, associated with more favourable changes in weight status during follow-up.

CONCLUSION

Overweight and obesity were not firmly established during early primary school years. Interventions at the school level on students and their parents might help prevent and control the future development of the obesity epidemic in the population.

Prevalence of physical inactivity and associated factors among adolescents from public schools in Uruguaiana, Rio Grande do Sul State, Brazil

This study aimed to identify the prevalence of physical inactivity and associated factors in adolescents, using a cross-sectional design with a sample of 1,455 adolescents (741 females). Data were collected using a questionnaire consisting of socio-demographic, perceptual, and behavioral variables. Physical activity was estimated with the Physical Activity Questionnaire for Older Children and Adolescents. Prevalence of physical inactivity was 68% (95%CI: 65.6%-70.4%). The following variables remained associated with physical inactivity in the adjusted analysis (p < 0.05): living in an apartment, female gender, older adolescents, lower self-rated physical activity compared to peers, low perception of maternal physical activity, passive commuting to school, non-participation in physical education at school, non-enjoyment of physical education classes, and limited involvement in other types of physical exercise besides physical education at school. There were a high proportion of inactive adolescents. Strategies to prevent physical inactivity in adolescents should be elaborated with a central role for the school and family.

Distal and proximal factors of health behaviors and their associations with health in children and adolescents

OBJECTIVE

The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health.

METHODS

Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination.

RESULTS

Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown.

CONCLUSIONS

Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.

Longitudinal physical activity changes in adolescents: Ho Chi Minh City Youth Cohort

PURPOSE

This study aimed to describe the 5-yr longitudinal change in moderate-to-vigorous physical activity (MVPA) among urban adolescents in Ho Chi Minh City, Vietnam, and to identify individual, family, and environmental factors associated with changes in MVPA.

METHODS

The Ho Chi Minh City Youth Cohort is a 5-yr longitudinal cohort with systematic random sampling of 759 students (48% boys) from 18 junior high schools in Ho Chi Minh City, conducted from 2004 to 2009. All measures were taken on five separate occassions. MVPA was assessed by self-report and accelerometry. Data were analyzed using multilevel linear regression models with estimation by generalized linear latent and mixed models.

RESULTS

Overall, after adjusting for covariates, students' accelerometer-based MVPA reduced 38% per annum (rate ratio = 0.62, 95% confidence interval (CI) = 0.59-0.64). Boys spent 2.9 times more in MVPA (rate ratio = 2.94, 95% CI = 2.63-3.22) than their female peers. Compared with normal-weight adolescents, overweight and obese adolescents were doing 40% (rate ratio = 0.60, 95% CI = 0.53, 0.67) less MVPA.

CONCLUSIONS

MVPA significantly declined among Vietnamese adolescents with age. This finding is similar to those reported among Western adolescents and suggests that strategies to promote physical activity in adolescents are a priority in Vietnam because economic transitioning potentially increases the risk of adopting unhealthy lifestyle behaviors associated with obesity and chronic diseases.

Review of Physical Activity Prevalence of Asian School-Age Children and Adolescents

Overweight and obese populations in Asia are high and increasing rapidly. Physical activity prevalence studies have found low physical activity rates among Asian school-age children and adolescents. The purpose of this review is to establish a baseline for physical activity rates in Asian school-age children and adolescents and serve as a platform for additional research. Thirty articles published between 2000 and 2011 on physical activity prevalence of school-age children and adolescents were included in the review. Fourteen studies were conducted in East Asia, 10 in Southeast Asia, 2 in South Asia, and 2 in West Asia. Studies used subjective methods (questionnaires or diaries) and objective methods (accelerometers or heart rate monitors). Although nearly all studies found low physical activity levels, it was not possible to provide an accurate picture due to an absence of standardized, reliable, and economically viable measurement tools.

Prevalence and socio-demographic correlates of active commuting to school in a nationwide representative sample of German adolescents

OBJECTIVE

To assess the prevalence and socio-demographic correlates of walking and cycling to school in a nationwide representative cross-sectional sample of German adolescents.

METHODS

A sample of 1828 German adolescents aged 11-17 years were examined between 2003 and 2006. Mode of commuting to school was assessed using a reliable self-report measure. Socioeconomic status, migration background and residential area were assessed as socio-demographic variables using a parent-report questionnaire.

RESULTS

Overall, 19.4% of adolescents walked and 22.2% cycled to school. Compared to girls with high socioeconomic status, girls with low socioeconomic status were more likely to walk (OR = 1.89, 95% CI = 1.23-2.89). Migration background increased the chance of walking in girls (OR = 0.47, 95% CI = 0.32-0.70) and decreased the chance of cycling in boys (OR = 2.39, 95% CI = 1.35-4.24). Compared to living in cities, living in rural areas lowered the chance of walking (girls: OR = 0.29, 95% CI = 0.18-0.50; boys: OR = 0.54, 95% CI = 0.32-0.93) and cycling (girls: OR = 0.12, 95% CI = 0.06-0.24; boys: OR = 0.34, 95% CI = 0.21-0.56), and living in medium-sized towns increased the chance of cycling in girls (OR = 1.86, 95% CI = 1.24-2.78) and boys (OR = 1.75, 95% CI = 1.20-2.56), respectively.

CONCLUSIONS

In Germany many adolescents use motorised transportation. Socio-demographic variables were associated with mode of commuting.

Longitudinal, cross-cohort comparison of physical activity patterns in Chinese mothers and children

BACKGROUND

There is limited evidence comparing adult and child physical activity (PA) trends and examining parent-child PA associations within a newly industrialized country setting. PA research within a newly industrialized country setting is particularly important given the negative effects of rapid urbanization, socioeconomic growth, and technological advances on PA behaviors. The purpose of our study was to examine trends and associations in PA behaviors in Chinese mother-child pairs and to investigate relationships between PA behaviors and socioeconomic variables in this dyad.

METHODS

We studied PA behaviors in 2 separate cohorts of mother-child pairs (n = 353) followed over a 2-4 year time period using longitudinal data from the China Health and Nutrition Survey (2000 COHORT: 2000-2004; 2004 COHORT: 2004-2006). Comparable mother-child PA behaviors included total metabolic equivalent hours per week (MET-hrs/wk) from active commuting, leisure-time sports, and sedentary behaviors. Logistic regression models were used to examine associations between mother and child PA and relationships between PA behaviors and socioeconomic variables.

RESULTS

Children experienced increases in active commuting and leisure-time sports activities with increasing child age, whereas mothers experienced temporal declines in active commuting and minimal change in leisure-time sports activity. Sedentary behavior was high for children and mothers over time. Mother-child associations were positive for active commuting and leisure-time sports activities and negative for sedentary behavior (P < 0.05). Maternal education was associated with a greater likelihood of high leisure-time sports activity and high sedentary behavior in mothers but not in children (P < 0.05).

CONCLUSION

Efforts to reduce sedentary behavior in Chinese mothers and children are imperative. While increased leisure-time and active commuting activities in children is encouraging, continued PA promotion in children and more intensive efforts to promote leisure-time sports and active commuting in mothers is needed.

Active commuting to school among adolescents in Ho Chi Minh City, Vietnam: change and predictors in a longitudinal study, 2004 to 2009

BACKGROUND

Active commuting (walking or cycling) to/from school is an important part of the overall physical activity levels of children but is on the decline in many countries. Data for adolescents on mode of transportation to and from school are limited for low- and middle-income countries, including Vietnam.

PURPOSE

This paper aims to describe the changes in the prevalence of active commuting to and from school, and to examine prospectively the predictors of active commuting, among adolescents from Ho Chi Minh City (HCMC).

METHODS

The data are from a 5-year cohort study from 2004 of a representative sample of 759 adolescents from 18 schools in HCMC. Data were obtained at five annual assessments using validated questionnaires to capture commuting behaviors, socioeconomic and demographic factors, individual and family characteristics, and physical and social environmental factors. Height and weight were measured by trained staff using standardized guidelines. Generalized linear latent and mixed models with a hierarchic approach were used to analyze the data in 2011.

RESULTS

The results show a remarkable decrease in the prevalence of active commuting in adolescents from 27.8% in 2004 to 19.6% in 2009. Male students, from the least-wealthy families, living in suburban areas, close to school, studying at schools in less-wealthy districts, were more likely to actively commute.

CONCLUSIONS

In the context of an epidemic of childhood and adolescent obesity in urban Vietnam, the decline in active commuting over the 5 years of this study highlights the need for development of urban physical environments favorable for active commuting and education campaigns to promote active commuting in adolescents.

Longitudinal study of childhood adiposity and the risk of developing components of metabolic syndrome-the Da Qing children cohort study

Childhood adiposity is increasingly recognized as a significant predictor of cardiometabolic risks in later life. The aim of this study was to investigate factors associated with longitudinal changes in weight during childhood and the development of metabolic disease risk factors. Four hundred twenty-four children from DaQing city, China, were recruited at 5 y old and followed up for 5 y. Birth weight, television (TV) viewing time at 5 y old, blood pressure, anthropometric measurements, fasting plasma insulin (FI), and triglycerides (TG) levels were measured at 5 and 10 y old. Both birth weight and TV viewing time at 5 y old significantly correlated with percentage of ideal weight for height (WFH) at 5 y old (WFH5; p = 0.0032 and p = 0.01), but only TV time was significantly correlated with WFH at 10 y old (WFH10; p < 0.0001). Blood pressures, FI, homeostasis model assessment for insulin resistance (HOMA-IR), and TG at 10 y old were significantly greater in those children who had greater change in WFH from 5 to 10 y old (ΔWFH). We concluded that TV viewing time was the stronger determinant of later childhood adiposity. A greater ΔWFH was associated with increased cardiometabolic risk factors at 10 y old.

Active commuting to and from school among Swedish children--a national and regional study

BACKGROUND

Active commuting to school by walking or cycling can have positive impact on children's health and development. The study investigates the prevalence of active commuting to school in Sweden, a setting where it is facilitated and promoted; and how active commuting varies according to socio-demographic and socio-economic characteristics.

METHODS

Self-reports from a national sample of Swedish children (11- to 15-year-olds, n = 4415) and a regional one from Stockholm County (13-year-olds, n = 1008) on transport to school were compared. The association that active commuting has with socio-demographic (gender, school grade, Swedish origin, type of housing, urbanicity in the local area), and socio-economic characteristics (household socio-economic status, family car ownership) was studied using logistic regression, controlling for car ownership and urbanicity, respectively.

RESULTS

Active commuting was high (62.9% in the national sample) but decreased with age-76% at the age of 11 years, 62% at the age of 13 years and 50% at the age of 15 years-whereas public transport increased (19-43%). Living in an apartment or row-house (compared with detached house) and living in a medium-sized city (compared with a metropolitan area) was associated with active commuting. In urban areas, active commuting was more common in worker households compared with intermediate- to high-level salaried employees.

CONCLUSION

Active commuting is common but decreases with age. Active commuting differed based on housing and urbanicity but not based on gender or Swedish origin, and impact of socio-economic factors differed depending on level of urbanicity.

Prevalence and correlates of physical activity among adolescents from Southern Brazil

OBJECTIVE

To estimate the prevalence and identify correlates of physical activity among adolescents.

METHODS

Cross-sectional study nested within a cohort of 4,325 subjects from the city of Pelotas, Southern Brazil, aged 14-15 years in 2008. Physical activity was analyzed using three different approaches: (1) prevalence of any leisure-time physical activity; (2) prevalence of any active commuting to school; and (3) prevalence of engaging in at least 300 minutes per week of both (1) and (2) combined. Independent variables included sociodemographic, behavioral, social, and biological characteristics, and number of different leisure-time physical activities practiced. Statistical analyses were carried out using Poisson regression.

RESULTS

The proportion of adolescents involved in any type of leisure-time physical activity was 75.6%, while 73.4% displayed some form of active commuting to school. Prevalence of total physical activity score (>300 min/week) was 48.2%, being greater among boys (62.6%) than among girls (34.5%). Furthermore, prevalence increased along with the number of physical activity modalities practiced (p<0.001). Factors associated with greater physical activity (leisure+commuting) at the recommended levels were: nonwhite skin color, having failed at school, and playing videogames. Lower socioeconomic status, more time spent on the computer, and parental physical activity were associated with the outcome only among girls.

CONCLUSIONS

Less than half the adolescents reached recommended levels of physical activity, and this proportion tended to decrease among subjects with higher socioeconomic level. Associated factors were different for leisure-time and commuting. Engaging in a wide variety of physical activities should be encouraged already during childhood.

Active commuting to school in children and adolescents: an opportunity to increase physical activity and fitness

AIMS

The purpose was to describe the patterns of commuting to school in young people and to examine its associations with physical activity (PA) and cardiorespiratory fitness.

METHODS

The sample comprised 2271 Estonian and Swedish children and adolescents (1218 females) aged 9-10 years and 15-16 years. Data were collected in 1998/99. Mode of commuting to and from school was assessed by questionnaire. Time spent (min/day) in PA and average PA (counts/min) was measured by accelerometry. Cardiorespiratory fitness was assessed by means of a maximal cycle ergometer test.

RESULTS

Sixty-one percent of the participants reported active commuting to school (ACS). Estonian youth showed lower levels of ACS than Swedish (odds ratio, 0.64; 95% confidence interval, 0.53-0.76) and girls reported lower levels than boys (0.74; 0.62-0.88). ACS boys showed higher PA levels than non-ACS boys for moderate, vigorous, MVPA, and average PA levels (all p ≤ 0.01). Participants who cycled to school had higher cardiorespiratory fitness than walkers or passive travellers (p < 0.001).

CONCLUSIONS

Nearly two-thirds of the participants actively commuted to school. ACS may provide an opportunity to increase levels of daily PA, especially in boys, and cardiorespiratory fitness, especially if cycling. Public health strategies should develop and test ACS patterns to get more evidence and promote bike-friendly environments.

Sedentary patterns and media availability in European adolescents: The HELENA study

OBJECTIVE

To describe sedentary behaviors in adolescents and to examine the influence of media availability on TV viewing.

METHOD

The study assessed 3278 adolescents (1537 males and 1741 females, 12.5-17.5 years) involved in the HELENA study (2007). Adolescents reported hours of TV viewing, computer games, console, internet for study and non-study reasons, and study, as well as availability of TVs, computers and consoles.

RESULTS

Time spent in sedentary behaviors was higher during weekends (all p<0.001). Males spent more hours on TV viewing (for > or = 15 years at weekends), playing computer games and console games while females spent more time studying and surfing for non-study reasons. During weekdays, one third of adolescents exceeded the screen time guidelines (>2h/day) based solely on TV viewing, whereas around 60% exceeded it at weekends. Having a TV or a console in the bedroom was associated with higher TV viewing (OR=2.66; 95% CI 2.23-3.18; and OR=1.92; 95% CI 1.61-2.28, respectively) whereas the presence of computer reduced it (OR=0.57; 95% CI 0.48-0.68).

CONCLUSION

Adolescents living in Europe are not meeting media recommendations, especially during weekend. The absence of a TV in the adolescents' bedroom might reduce TV viewing. Further studies are needed to confirm or contrast our findings.

Sedentary behaviours and socio-economic status in Spanish adolescents: the AVENA study

BACKGROUND

This study aimed to describe the influence of socio-economic status (SES) on the prevalence sedentary behaviours among Spanish adolescents.

METHODS

Cross-sectional data from Spanish adolescents from the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) Study (2002). A national representative sample of 1776 adolescents aged 13-18.5 years provided information about time spent watching television (TV), playing with computer or videogames and studying. Parental education and occupation were assessed as SES. Participants were categorized by gender, age, parental education and occupation. Logistic regression models were used.

RESULTS

No gender differences were found for TV viewing. For computer and videogames use (weekdays), more boys played >3 h/day (P < 0.001), whereas a higher percentage of girls reported studying >3 h/day (P < 0.001). Among boys, parental education and occupation were inversely associated with TV viewing, parental occupation directly associated with study and maternal education inversely with computer and videogames use during weekdays (all P < 0.05). For girls, parental occupation was inversely associated with TV viewing.

CONCLUSION

Spanish adolescents presented different sedentary patterns according to age, gender and SES. Boys reported more time engaged in electronic games, whereas girls reported more time studying. Parental occupation had more influence than parental education on the time spent in sedentary behaviours.

Self-reported physical activity in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study

OBJECTIVE

To describe self-reported physical activity (PA) patterns in the various domains (school, home, transport, leisure time) and intensity categories (walking, moderate PA, vigorous PA) in European adolescents. Furthermore, self-reported PA patterns were evaluated in relation to gender, age category, weight status category and socio-economic status (SES).

DESIGN

Cross-sectional study.

SETTING

Ten European cities.

SUBJECTS

In total, 3051 adolescents (47·6 % boys, mean age 14·8 (sd 1·2) years) completed an adolescent-adapted version of the validated International Physical Activity Questionnaire.

RESULTS

The total sample reported most PA during leisure time (485 min/week) and least PA at home (140 min/week). Boys reported significantly more school-based PA (P < 0·001), leisure-time PA (P = 0·003), vigorous PA (P < 0·001) and total PA (P = 0·002) than girls, while girls reported more home-based PA (P < 0·001) and walking (P = 0·002) than boys. Self-reported PA at school (P < 0·001), moderate PA (P < 0·001), vigorous PA (P < 0·001) and total PA (P < 0·001) were significantly higher in younger age groups than in older groups. Groups based on weight status differed significantly only in leisure-time PA (P = 0·004) and total PA (P = 0·003), while groups based on SES differed in all PA domains and intensities except transport-related PA and total PA.

CONCLUSIONS

The total sample of adolescents reported different scores for the different PA domains and intensity categories. Furthermore, patterns were different according the adolescents' gender, age, weight status and SES.

Atividade física e comportamento sedentário em adolescentes estudantes do ensino médio

OBJETIVO: Identificar a prevalência e fatores associados a nível insuficiente de prática de atividades físicas e exposição a comportamento sedentário em adolescentes. MÉTODOS: Estudo transversal cuja amostra foi constituída por 4210 estudantes do ensino médio (14-19 anos), selecionados através de amostragem por conglomerados em dois estágios. Para coleta de dados foi utilizado o questionário "Global School-based Student Health Survey". Sujeitos que relataram participar de, pelo menos, 60 minutos diários de atividades físicas moderadas a vigorosas, durante cinco ou mais dias por semana, foram classificados como ativos, enquanto os demais foram denominados insuficientemente ativos. Foram considerados expostos a comportamento sedentário aqueles que referiram assistir televisão por três horas ou mais por dia. As análises foram realizadas através do teste de Qui-quadrado e de regressão logística binária. RESULTADOS: A prevalência de insuficientemente ativos foi 65,1% (IC95% 63,7-66,6). Identificou-se que sexo, local de residência (rural/urbano), turno de aulas, status ocupacional e participação nas aulas de educação física foram fatores associados a nível insuficiente de atividade física. Verificou-se prevalência de exposição a comportamento sedentário de 40,9% (IC95% 39,4-42,4) em dias de semana e de 49,9% (IC95% 48,4-51,4) em dias de final de semana. Local de residência, turno de aulas, status ocupacional e participação nas aulas de educação física foram fatores associados à exposição a comportamento sedentário em dias de semana; enquanto sexo, faixa etária e turno de aulas discriminaram a exposição nos dias de final de semana. CONCLUSÃO: Este estudo evidenciou elevada prevalência de níveis insuficientes de atividade física e de exposição a comportamento sedentário.