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Yang H, Chang Q, Ji C, Zheng G, Ma Z, Chen L, Xia Y, Zhao Y. Life's essential 8, genetic susceptibility, and risk of inflammatory bowel diseases: a population-based cohort study. Int J Behav Nutr Phys Act 2024; 21:66. [PMID: 38956566 PMCID: PMC11221134 DOI: 10.1186/s12966-024-01617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/16/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Evidence has shown that the individual metrics in Life's Essential 8 (LE8), an updated cardiovascular health (CVH) concept proposed by the American Heart Association, play a role in the development of inflammatory bowel disease (IBD). However, epidemiological evidence on the overall LE8 on IBD risk remains limited. We aimed to assess the longitudinal associations of LE8-defined CVH and the risks of IBD and its subtypes, ulcerative colitis (UC) and Crohn's disease (CD). We also tested whether genetic susceptibility could modify these associations. METHODS A total of 260,836 participants from the UK Biobank were included. LE8 scores were determined by 8 metrics (physical activity, diet, nicotine exposure, sleep, body mass index, blood pressure, blood glucose, and blood lipids), and were divided into three levels: low CVH (0-49), moderate CVH (50-79), and high CVH (80-100). Cox proportional hazards models were used to calculate the hazard ratios (HRs) and confidence intervals (CIs) of the risk of IBD in relation to CVH status. RESULTS Over a median follow-up 12.3 years, we documented 1,500 IBD cases (including 1,070 UC and 502 CD). Compared to participants with low CVH, the HRs (95% CIs) of those with high CVH for IBD, UC, and CD were 0.67 (0.52, 0.83), 0.70 (0.52, 0.93), and 0.55 (0.38, 0.80), respectively. These associations were not modified by genetic susceptibility (all P for interactions > 0.05). The lowest HR (UC: 0.30, 95% CI: 0.20-0.45; CD: 0.33, 95% CI: 0.20-0.57) was observed in participants with both high CVH and low genetic risk. CONCLUSIONS Better CVH, defined by LE8, was associated with significantly lower risks of IBD, UC, and CD, irrespective of genetic predisposition. Our results underscore the importance of adherence to LE8 guidelines for maintaining CVH as a potential strategy in the prevention of IBD.
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Affiliation(s)
- Honghao Yang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Gang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zheng Ma
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning Province, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
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Womack SR, Beam CR, Giangrande EJ, Tong X, Scharf RJ, Finkel D, Davis DW, Turkheimer E. Co-recovery of physical size and cognitive ability from infancy to adolescence: A twin study. Child Dev 2024; 95:1367-1383. [PMID: 38303087 PMCID: PMC11223985 DOI: 10.1111/cdev.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
This study tested phenotypic and biometric associations between physical and cognitive catch-up growth in a community sample of twins (n = 1285, 51.8% female, 89.3% White). Height and weight were measured at up to 17 time points between birth and 15 years, and cognitive ability was assessed at up to 16 time points between 3 months and 15 years. Weight and length at birth were positively associated with cognitive abilities in infancy and adolescence (r's = .16-.51). More rapid weight catch-up growth was associated with slower, steadier cognitive catch-up growth. Shared and nonshared environmental factors accounted for positive associations between physical size at birth and cognitive outcomes. Findings highlight the role of prenatal environmental experiences in physical and cognitive co-development.
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Affiliation(s)
- Sean R. Womack
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Christopher R. Beam
- Department of Psychology, University of Southern California, Los Angeles, California
| | - Evan J. Giangrande
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
- Analytic & Translational Genetics Unit, Massachusetts General Hospital
- Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard
| | - Xin Tong
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Rebecca J. Scharf
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Deborah Finkel
- Center for Economic and Social Research, University of Southern California
- Institute for Gerontology, Jönköping University
| | - Deborah W. Davis
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
- Norton Children’s Research Institute affiliated with the University of Louisville School of Medicine, Louisville, Kentucky
| | - Eric Turkheimer
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
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Kiyohara K, Matsui S, Ayusawa M, Sudo T, Nitta M, Iwami T, Nakata K, Kitamura Y, Sobue T, Kitamura T. Basic life support for non-traumatic out-of-hospital cardiac arrests during school-supervised sports activities in children: A nationwide observational study in Japan. Resusc Plus 2024; 17:100531. [PMID: 38155977 PMCID: PMC10753082 DOI: 10.1016/j.resplu.2023.100531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 12/30/2023] Open
Abstract
Objective To investigate the prognostic impact of bystander-initiated cardiopulmonary resuscitation (CPR) and public-access automated external defibrillator (AED) use on non-traumatic out-of-hospital cardiac arrest (OHCA) occurring during school-supervised sports activities in children. Methods From a nationwide database of pediatric OHCAs occurring under school supervision in Japan, data between April 2008 and December 2020 were obtained. We analyzed non-traumatic OHCAs that occurred during school-supervised sports activities among schoolchildren from elementary, junior high, high, and technical colleges. A multivariable logistic regression model was used to evaluate the effect of basic life support (BLS) on 1-month survival with favorable neurological outcomes after OHCA. Results In total, 318 OHCA cases were analyzed. The 1-month survival with favorable neurological outcomes was 64.8% (164/253) in cases receiving both bystander-CPR and AED application, 40.7% (11/27) in cases receiving CPR only, 38.5% (5/13) in patients receiving AED application only, and 28.0% (7/25) in cases receiving no bystander intervention. Compared with cases receiving no BLS, cases receiving both CPR and AED had a significantly higher proportion of 1-month survival with favorable neurological outcomes (adjusted odds ratio [AOR]: 3.97, 95% confidence interval [CI]: 1.32-11.90, p = 0.014). However, compared to cases receiving no BLS, there was no significant difference in the outcome in the cases receiving CPR only (AOR: 1.35, 95% CI: 0.34-5.29, p = 0.671) and the cases receiving AED application only (AOR: 1.26, 95% CI: 0.25-6.38, p = 0.778). Conclusion The combination of CPR and AED as BLS performed by bystanders for non-traumatic OHCA during school-supervised sports activities improved the outcomes.
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Affiliation(s)
- Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women’s University, Tokyo, Japan
| | - Satoshi Matsui
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Mamoru Ayusawa
- Department of Nutrition and Health Science, Faculty of Health and Medical Science, Kanagawa Institute of Technology, Atsugi, Japan
| | - Takeichiro Sudo
- Institute of Human Culture Studies, Otsuma Women’s University, Tokyo, Japan
| | - Masahiko Nitta
- Department of Emergency Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Division of Patient Safety, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Ken Nakata
- Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuri Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - the SPIRITS investigators
- Department of Food Science, Faculty of Home Economics, Otsuma Women’s University, Tokyo, Japan
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
- Department of Nutrition and Health Science, Faculty of Health and Medical Science, Kanagawa Institute of Technology, Atsugi, Japan
- Institute of Human Culture Studies, Otsuma Women’s University, Tokyo, Japan
- Department of Emergency Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Division of Patient Safety, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
- Kyoto University Health Service, Kyoto, Japan
- Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
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Brady SM, Salway R, Mariapun J, Millard L, Ramadas A, Rizal H, Skinner A, Stone C, Johnson L, Su TT, Armstrong MEG. Accelerometer-measured 24-hour movement behaviours over 7 days in Malaysian children and adolescents: A cross-sectional study. PLoS One 2024; 19:e0297102. [PMID: 38377079 PMCID: PMC10878504 DOI: 10.1371/journal.pone.0297102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions. METHODS Data came from the South-East Asia Community Observatory health surveillance cohort, 2021-2022. Children aged 7-18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity. RESULTS The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9-8.4) hours/day asleep, 12.4 (95% CI = 12.2-12.7) hours/day inactive, 2.8 (95% CI = 2.7-2.9) hours/day in LPA, and 33.0 (95% CI = 31.0-35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics. CONCLUSIONS Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia.
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Affiliation(s)
- Sophia M. Brady
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jeevitha Mariapun
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Louise Millard
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Hussein Rizal
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Andy Skinner
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chris Stone
- Integrative Cancer Epidemiology Programme, MRC Integrative Epidemiology Unit, and School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Laura Johnson
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Miranda E. G. Armstrong
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
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Waterworth SP, Kerr CJ, McManus CJ, Chung HC, Shaw BS, Shaw I, Sandercock GR. Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents. Pediatr Res 2024; 95:736-743. [PMID: 37833532 PMCID: PMC10899106 DOI: 10.1038/s41390-023-02837-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. METHODS Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. RESULTS Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (β = 0.084, p = 0.002). Baseline PAQ-A score (β = -0.822, p = 0.020) and changes in PAQ-A score (β = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. CONCLUSIONS Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. IMPACT Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.
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Affiliation(s)
- Sally P Waterworth
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK.
| | - Catherine J Kerr
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Christopher J McManus
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Henry C Chung
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Brandon S Shaw
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Ina Shaw
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Gavin R Sandercock
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
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Onadeko K, Walker TJ, Craig DW, Szeszulski J, Pavlovic A, DeFina LF, Kohl HW. Comparing the Use and Effectiveness of In-Person and Remote Physical Education Delivery During the COVID-19 Pandemic. AMERICAN JOURNAL OF HEALTH EDUCATION 2024; 55:24-32. [PMID: 38264143 PMCID: PMC10803051 DOI: 10.1080/19325037.2023.2277945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/29/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats. PURPOSE We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio. METHODS We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram® Project (n=216) schools in multiple US cities. Questionnaires entailed learning format, weekly PE minutes, perceived effectiveness, and student-to-teacher ratio. We used linear mixed models to compare PE formats across evaluation variables. RESULTS Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more effective in-person PE (4.0) than remote PE (2.8, p<0.001). In-person PE also had significantly smaller reported student-to-teacher ratio (16.7) compared to remote PE (23.7, p<0.001). DISCUSSION Findings indicate PE was offered during the pandemic, but remote learning appeared less effective than in-person PE. TRANSLATION to HEALTH EDUCATION PRACTICE Efforts are needed to improve remote PE to reinforce high-quality PE in the future.
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Affiliation(s)
- Kempson Onadeko
- The University of Texas Health Science Center at Houston School of Public Health
| | - Timothy J Walker
- The University of Texas Health Science Center at Houston School of Public Health
| | - Derek W Craig
- The University of Texas Health Science Center at Houston School of Public Health
| | | | | | | | - Harold W Kohl
- The University of Texas Health Science Center at Houston School of Public Health
- The University of Texas at Austin
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Bezerra TA, Souza Filho AND, Pessoa MLF, Ribeiro Bandeira PF, Cabral LGA, Moraes JFVND, Martins CMDL, Carvalho FO. Effects of a multicomponent intervention on cardiovascular risk factors in overweight children: a randomized clinical trial in light of complex systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1368-1378. [PMID: 35699999 DOI: 10.1080/09603123.2022.2088704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Analyzing the effects of interventions from a theoretical and statistical perspective that allows understanding these dynamic relationships of obesity etiology can be a more efficient and innovative way of understanding the phenomenon's complexity. Thus, we aimed to analyze the pattern of cardiovascular risk factors between-participants, and the effects within-participants of a multidisciplinary intervention on cardiovascular risk factors in overweight children. This is a randomized clinical trial, and 41 participated in this study. A multicomponent intervention (physical activities, nutritional and psychological counseling) was performed for 10 weeks. Anthropometric and hemodynamics measurements, lipid and glucose profile, cardiorespiratory fitness, and left ventricular mass were evaluated. A network analysis was done. Considering patterns in the network at baseline, WC, WHR, BMI, and Fat were the main variables for cardiovascular risks. Group was the most critical variable in the within-participant network. Participating in a multicomponent intervention and decreasing body fat promoted beneficial cardiovascular factors.
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Affiliation(s)
- Thaynã Alves Bezerra
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | | | | | | | - Clarice Maria de Lucena Martins
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Brazil
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, University of Porto, Portugal
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Morgado MC, Sousa M, Coelho AB, Vale S, Costa JA, Seabra A. Effects of "Football and Nutrition for Health" program on body composition, physical fitness, eating behaviours, nutritional knowledge, and psychological status among 7 to 10 years school children. Front Pediatr 2023; 11:1251053. [PMID: 38027281 PMCID: PMC10663241 DOI: 10.3389/fped.2023.1251053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Noncommunicable diseases and obesity are between the major health threat due to consumption of unhealthy foods and limited time spent on physical activities, a situation of particular concern among children. Since children spend most of their time at school, this study intends to investigate the effect of a school intervention program, which combines recreational football and nutrition education, on body composition, physical fitness, physical activity, blood pressure and heart rate, eating behaviours, nutritional knowledge, and psychological status in elementary school children. Methods A total of 67 children, between 7 and 10 years old, were allocated into three groups: the Football Group (FG) which held 2 weekly sessions of 60 min of recreational football, the Nutrition and Football Group (NFG) which held 2 sessions per week of 60 min of recreational football plus 60 min of nutritional education and the Control Group (CG) which maintained its usual curriculum. The intervention lasted 12 weeks. All measurements were collected before and after the intervention. Results Intervention groups significantly (p < 0.05) improved BMI Z-score, rest heart rate, horizontal jump and shuttle test, physical activity level, and psychosocial health. The NFG group significantly decreased (p < 0.05) waist-to-height ratio and blood pressure, and significantly increased (p < 0.05) nutritional knowledge, fruit, and fish consumption. While FG significantly decreased (p < 0.05) the percentage of fat mass and significantly increased (p < 0.05) muscle mass and performance in the 20 m sprint. Discussion The results have shown to improve nutritional status, explosive strength, aerobic and neuromuscular fitness, as well as increase the level of physical activity. The nutritional education sessions contributed to increase nutritional knowledge and to improve the consumption of healthy food groups in a ludic-educational way. The "Football and Nutrition for Health" program was able to induce short-term improvements in several health markers, highlighting the role of the school curriculum in children's health.
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Affiliation(s)
- Micaela C. Morgado
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - Mónica Sousa
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CINTESIS@RISE, NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisboa, Portugal
| | - André B. Coelho
- Research Center for Sport and Physical Activity (CIDAF), Faculty of Sports Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Susana Vale
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Porto School of Education, Polytechnic Institute of Porto, Porto, Portugal
| | - Júlio A. Costa
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
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Vanluyten K, Cheng S, Roure C, Seghers J, Ward P, Iserbyt P. Participation and physical activity in organized recess tied to physical education in elementary schools: An interventional study. Prev Med Rep 2023; 35:102355. [PMID: 37584060 PMCID: PMC10424207 DOI: 10.1016/j.pmedr.2023.102355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/17/2023] Open
Abstract
Maintaining physical activity habits is important for long-term health benefits. Many children do not achieve the World Health Organization (WHO) benchmark of 60 min Moderate-to-Vigorous Physical Activity (MVPA) daily. Comprehensive school physical activity programs (CSPAP) target all opportunities at school for children to be physically active. The purpose of this intervention study was to investigate boys' and girls' voluntary participation and MVPA in physical activity recess sessions during and after these were connected with the content of physical education. 147 (55 girls, 92 boys; mean age = 8 years) second grade children from seven different schools received a 10-lesson parkour unit in physical education and were concurrently offered five parkour recess sessions. After the parkour unit in physical education (i.e., maintenance) another five parkour sessions in which children could voluntarily participate were organized. Systematic observation tools were used to assess children's MVPA. Overall participation in parkour recess was 64% for both boys and girls. Participation decreased from intervention to maintenance phase for both boys (75% vs 54%; p < .001) and girls (80% vs 49%; p < .001). MVPA was higher for boys compared to girls in parkour recess (64% vs 58%; p = .002) and traditional recess (49% vs 39%; p = .006), but not in physical education (40% vs 37%). One aspect of physical activity promotion is to connect recess activities with the content taught in physical education, which could contribute up to 20% of the daily recommended MVPA. Positive effects maintained when the connection between physical education and recess stopped.
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Affiliation(s)
- Kian Vanluyten
- Department of Movement Sciences, KU Leuven, Leuven Belgium
| | - Shu Cheng
- Department of Movement Sciences, KU Leuven, Leuven Belgium
| | - Cédric Roure
- University of Teacher Education, Vaud, Lausanne, Switzerland
| | - Jan Seghers
- Department of Movement Sciences, KU Leuven, Leuven Belgium
| | - Phillip Ward
- Department of Human Sciences, The Ohio State University, OH, USA
| | - Peter Iserbyt
- Department of Movement Sciences, KU Leuven, Leuven Belgium
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10
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da Silva BGC, Menezes AMB, Gonçalves H, Alves CPDL, Delpino FM, Martins RC, Wehrmeister FC. Physical Activity During Adolescence and Mental Health in Early Adulthood: Findings From the 1993 Pelotas Birth Cohort Study. J Phys Act Health 2023; 20:860-867. [PMID: 37558222 DOI: 10.1123/jpah.2022-0658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Low prevalence of physical activity (PA) and a high prevalence of mental health problems are common among youth. The aim of this study was to evaluate the association between PA during adolescence and depression and anxiety disorders in young adulthood. METHODS Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed. Leisure-time PA and total PA (leisure plus commuting) were evaluated at 11, 15, and 18 years using self-reported data. PA was evaluated at each age separately and during adolescence, considering the number of times participants reached PA recommendations. Depression and anxiety were assessed through Mini International Neuropsychiatric Interview at 22 years. Crude and adjusted association analyses were performed using Poisson regression with robust error variance, providing prevalence ratios and 95% confidence intervals. RESULTS Three thousand two hundred and forty-seven participants were included in the study. In the adjusted analyses, active participants in leisure-time PA (≥300 min/wk) and total PA at 11 years were less likely to be depressed at age 22 (prevalence ratios: 0.54; 95% confidence interval, 0.33-0.89; prevalence ratios: 0.63; 95% confidence interval, 0.41-0.97). For leisure-time PA, the more PA recommendations were met during adolescence, the lower the prevalence of depression. There was no association when PA variables were evaluated separately at 15 and 18 years and between PA and anxiety after controlling for potential confounders. CONCLUSIONS Early adolescence appears to be a sensitive period for PA benefits on depression in early adulthood. The more timepoints reaching PA recommendations during adolescence, the lower the risk of depression. On the other hand, PA during adolescence was not associated with anxiety in young adults.
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Affiliation(s)
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | | | | | - Rafaela Costa Martins
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
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11
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Valmorbida JL, Baratto PS, Leffa PS, Sangalli CN, Silva JA, Vitolo MR. Consumption of ultraprocessed food is associated with higher blood pressure among 6-year-old children from southern Brazil. Nutr Res 2023; 116:60-68. [PMID: 37354762 DOI: 10.1016/j.nutres.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/26/2023]
Abstract
Ultraprocessed foods (UPF) consumption plays a critical role in the development of chronic diseases, but evidence of their effect on children's health is limited. We hypothesized that the consumption of UPF can influence blood pressure levels in 6-year-old children. This study is a secondary analysis of a randomized field trial in Brazil that is registered at clinicaltrial.gov (NCT00635453). Dietary intake was obtained using 2 multiple-pass 24-hour recalls when 305 children were 3 and 6 years old. We classified foods according to the NOVA system and determined the percentage of total energy intake derived from ultraprocessed foods. We collected anthropometric measures from and evaluated systolic and diastolic blood pressures of 6-year-old children. Linear regression analysis was used to assess the association between UPF consumption and blood pressure levels. UPF represented 40.3% (interquartile range, 34.1-48.5) of the total energy intake at 3 years and 45.2% (interquartile range, 41.5-53.2) at 6 years. The adjusted linear regression analyses showed that systolic blood pressure was associated with UPF consumption at 6 years (P = .05), birth weight (P = .02), waist circumference (P < .01), and physical activity (P = .04), whereas diastolic blood pressure was associated with UPF consumption at 3 and 6 years (P = .01 and P < .01, respectively), birth weight (P = .05), and waist circumference (P < .01). Our data suggest that UPF consumption played a role in increasing 6-year-old children's blood pressure. These results reinforce the importance of effective strategies to prevent the excessive consumption of UPF in childhood.
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Affiliation(s)
- Julia L Valmorbida
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil.
| | - Paola S Baratto
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Paula S Leffa
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Caroline N Sangalli
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Janilson A Silva
- Nutrition Department, University Center of João Pessoa, João Pessoa/PB, 58053-000, Brazil
| | - Marcia R Vitolo
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
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12
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Amine I, Guillien A, Philippat C, Anguita-Ruiz A, Casas M, de Castro M, Dedele A, Garcia-Aymerich J, Granum B, Grazuleviciene R, Heude B, Haug LS, Julvez J, López-Vicente M, Maitre L, McEachan R, Nieuwenhuijsen M, Stratakis N, Vafeiadi M, Wright J, Yang T, Yuan WL, Basagaña X, Slama R, Vrijheid M, Siroux V. Environmental exposures in early-life and general health in childhood. Environ Health 2023; 22:53. [PMID: 37480033 PMCID: PMC10360263 DOI: 10.1186/s12940-023-01001-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Early-life environmental exposures are suspected to be involved in the development of chronic diseases later in life. Most studies conducted so far considered single or few exposures and single-health parameter. Our study aimed to identify a childhood general health score and assess its association with a wide range of pre- and post-natal environmental exposures. METHODS The analysis is based on 870 children (6-12 years) from six European birth cohorts participating in the Human Early-Life Exposome project. A total of 53 prenatal and 105 childhood environmental factors were considered, including lifestyle, social, urban and chemical exposures. We built a general health score by averaging three sub-scores (cardiometabolic, respiratory/allergy and mental) built from 15 health parameters. By construct, a child with a low score has a low general health status. Penalized multivariable regression through Least Absolute Shrinkage and Selection Operator (LASSO) was fitted in order to identify exposures associated with the general health score. FINDINGS The results of LASSO show that a lower general health score was associated with maternal passive and active smoking during pregnancy and postnatal exposure to methylparaben, copper, indoor air pollutants, high intake of caffeinated drinks and few contacts with friends and family. Higher child's general health score was associated with prenatal exposure to a bluespace near residency and postnatal exposures to pets, cobalt, high intakes of vegetables and more physical activity. Against our hypotheses, postnatal exposure to organochlorine compounds and perfluorooctanoate were associated with a higher child's general health score. CONCLUSION By using a general health score summarizing the child cardiometabolic, respiratory/allergy and mental health, this study reinforced previously suspected environmental factors associated with various child health parameters (e.g. tobacco, air pollutants) and identified new factors (e.g. pets, bluespace) warranting further investigations.
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Affiliation(s)
- Ines Amine
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France.
| | - Alicia Guillien
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Augusto Anguita-Ruiz
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
| | - Maribel Casas
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Montserrat de Castro
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - Audrius Dedele
- Department of Environmental Science, Vytautas Magnus University, 44248, Kaunas, Lithuania
| | - Judith Garcia-Aymerich
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Berit Granum
- Division for Climate and Environmental Health, Norwegian Institute of Public Health, 0213, Oslo, Norway
| | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, 44248, Kaunas, Lithuania
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
| | - Line Småstuen Haug
- Division for Climate and Environmental Health, Norwegian Institute of Public Health, 0213, Oslo, Norway
| | - Jordi Julvez
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Clinical and Epidemiological Neuroscience (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
| | - Mónica López-Vicente
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
| | - Léa Maitre
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark Nieuwenhuijsen
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Nikos Stratakis
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Wen Lun Yuan
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
- Singapore Institute for Clinical Science, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Xavier Basagaña
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Martine Vrijheid
- Parc de Recerca Biomèdica de Barcelona (PRBB), ISGlobal-Instituto de Salud Global de Barcelona Campus MAR, 08003, Barcelona, Spain
- Pompeu Fabra University (UPF), 08002, Barcelona, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Valérie Siroux
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
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13
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Herouvi D, Paltoglou G, Soldatou A, Kalpia C, Karanasios S, Karavanaki K. Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1230. [PMID: 37508727 PMCID: PMC10378563 DOI: 10.3390/children10071230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.
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Affiliation(s)
- Despina Herouvi
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Christina Kalpia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
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Dahlstrand J, Fridolfsson J, Arvidsson D, Börjesson M, Friberg P, Chen Y. Move for Your Heart, Break a Sweat for Your Mind: Providing Precision in Adolescent Health and Physical Activity Behaviour Pattern. J Adolesc Health 2023; 73:29-36. [PMID: 37162429 DOI: 10.1016/j.jadohealth.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 01/31/2023] [Accepted: 03/11/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Adolescent health benefits of different physical activity (PA) intensities, especially of lower intensities, are debated due to challenges in accelerometer data processing and analyses. Using a new accelerometer data processing method and multivariate pattern analysis, this study investigated the association of PA intensities with indicators of cardiovascular and mental health. METHODS Adolescents (n = 1,235, mean age 13.6 years, 41% males) were examined for cardiovascular health: body mass index (BMI) z-score, waist circumference (WC), resting heart rate and blood pressure, white blood cell count (WBC), pulse wave velocity (PWV), and answered questionnaires assessing stress and psychosomatic symptoms. Sex, age, and socioeconomic status were confounders. Hip-worn accelerometer data were processed with 10 Hz frequency extended method and a spectrum of 22 PA intensity categories was analyzed for association with health using partial least squares regression. RESULTS Total explained variances for BMI z-score, WC, resting heart rate, stress, and psychosomatic symptoms were higher (3.3%-8.7%) compared to diastolic blood pressure, WBC, and PWV (0.9%-1.4%). We found positive associations of high-end moderate PA and vigorous PA with cardiovascular and mental health indicators. More sedentary time and lower level of light PA were associated with higher BMI z-score, WC, resting heart rate, diastolic blood pressure, WBC, and PWV, but not with mental health indicators. Very vigorous PA was negatively associated with resting heart rate, stress, and psychosomatic symptoms. DISCUSSION In adolescents, PA of varying intensities were generally found to be positively associated with better cardiovascular health, but only higher intensity PA was associated with better mental health.
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Affiliation(s)
- Johan Dahlstrand
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Jonatan Fridolfsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Arvidsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of MGA, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Peter Friberg
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Yun Chen
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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15
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Nowaczyk M, Cieślik K, Waszak M. Assessment of the Impact of Increased Physical Activity on Body Mass and Adipose Tissue Reduction in Overweight and Obese Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050764. [PMID: 37238312 DOI: 10.3390/children10050764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Within the last 30 years, growing rates of child overweight and obesity have been observed as a very concerning phenomenon in most countries worldwide. The research aim was to assess what effect increased physical activity has on reducing body mass and adipose tissue in children between 10 and 11 years of age as well as to answer the question of whether physical activity could be considered as a factor in preventing child overweight and obesity when maintaining their existing diet and lifestyle. (2) Material and methods: There were 419 sports class primary school pupils in the experimental group who, in addition to four obligatory weekly physical education hours, attended six training hours. The control group comprised 485 children from parallel non-sports classes. In all pupils, height and weight measurements as well as physical fitness measurements were taken twice, at the beginning and end of the school year. Cole's method was used to assess the children's normal body weight. With the help of this method, children with excessive body weight were selected from the entire study group (N = 904), who additionally had skinfolds and adipose tissue measured using the BIA electrical bioimpedance method. The obtained results were interpreted using the variance analysis for repeated measurements and LSD test. (3) Results: The number of children with excessive body mass after 10 months of increased physical activity decreased (in the case of overweight: p = 0.0014, obesity: p = 0.0022), as did their skinfolds (p ≤ 0.001) and body fat (p ≤ 0.001), while their physical fitness considerably improved compared to the control group. (4) Conclusions: The introduction of increased physical activity in the experimental group children when maintaining their existing diet and lifestyle contributed to reducing their obesity and overweight and, at the same time, proved to be an effective factor in the process of decreasing their excessive body mass.
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Affiliation(s)
- Marta Nowaczyk
- Institute of Health and Physical Education, Jan Amos Komenski University of Applied Sciences in Leszno, 64-100 Leszno, Poland
| | - Krystyna Cieślik
- Institute of Health and Physical Education, Jan Amos Komenski University of Applied Sciences in Leszno, 64-100 Leszno, Poland
| | - Małgorzata Waszak
- Department of Biology and Anatomy, Poznan University of Physical Education, 61-871 Poznań, Poland
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16
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Močnik M, Marčun Varda N. Lipid Biomarkers and Atherosclerosis-Old and New in Cardiovascular Risk in Childhood. Int J Mol Sci 2023; 24:ijms24032237. [PMID: 36768558 PMCID: PMC9916711 DOI: 10.3390/ijms24032237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Lipids are a complex group of molecules in the body, essential as structural, functional and metabolic components. When disbalanced, they are regarded as a cardiovascular risk factor, traditionally in cholesterol level evaluation. However, due to their complex nature, much research is still needed for a comprehensive understanding of their role in atherosclerosis, especially in the young. Several new lipid biomarkers are emerging, some already researched to a point, such as lipoproteins and apolipoproteins. Other lipid molecules are also being increasingly researched, including oxidized forms due to oxidative inflammation in atherosclerosis, and sphingolipids. For many, even those less new, the atherogenic potential is not clear and no clinical recommendations are in place to aid the clinician in using them in everyday clinical practice. Moreover, lipids' involvement in atherogenesis in children has yet to be elucidated. This review summarizes the current knowledge on lipids as biomarkers of cardiovascular risk in the paediatric population.
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Affiliation(s)
- Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska Cesta 2, 2000 Maribor, Slovenia
- Correspondence:
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska Cesta 2, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
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Fillon A, Pereira B, Vanhelst J, Baran J, Masurier J, Guirado T, Boirie Y, Duclos M, Julian V, Thivel D. Development of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q): Psychometric Validity and Clinical Interpretation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13782. [PMID: 36360664 PMCID: PMC9655272 DOI: 10.3390/ijerph192113782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pediatricians' clinical practice and health interventions in youths require instruments with adequate psychometric properties to assess physical activity (PA), sedentary behaviors (SB), and their subdomains. OBJECTIVE To assess the psychometric properties of the Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) in healthy French children and adolescents. METHODS The CAPAS-Q has been developed through a rigorous collective procedure and consists of a 31 items self-administered questionnaire evaluating children's 7-day PA and SB dimensions and subdomains. Participants (n = 103, aged 8-18 years old) completed the questionnaire twice (7 days apart) and wore an ActiGraph GT3X + accelerometer for 7 days. Anthropometric measurements and body composition were assessed. RESULTS Cronbach alpha for PA and SB dimensions were 0.71 and 0.68, respectively. Reproducibility was found moderate to good, with Lin's coefficients of 0.69 and 0.68 for PA and SB dimensions, respectively. Reproducibility was higher for adolescents compared to children. PA dimension was positively correlated with moderate PA, vigorous PA, moderate to vigorous PA, and total PA times and negatively correlated with SB time (p < 0.05). SB dimension and screen time were positively correlated with SB time and negatively correlated with LPA, MPA, MVPA, and total PA times (p < 0.05). Spearman correlation coefficients were fair to moderate, ranging between 0.23-0.45. CONCLUSION The CAPAS-Q proposes a reliable and valid evaluation of French children and adolescents' PA and SB, providing clinicians with potential intervention levels to improve youth movement behaviors.
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Affiliation(s)
- Alicia Fillon
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Jérémy Vanhelst
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics—University of Paris Cité (CRESS), 93017 Bobigny, France
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Julie Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital,13 Rue Molière, 63000 Clermont-Ferrand, France
| | - Terry Guirado
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
| | - Yves Boirie
- CRNH-Auvergne, 63178 Clermont-Ferrand, France
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
- UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Martine Duclos
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
- UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
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18
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Nathan N, McCarthy N, Hall A, Shoesmith A, Lane C, Jackson R, Sutherland R, Groombridge D, Reeves P, Boyer J, Duggan B, Wolfenden L. Cluster randomised controlled trial to determine the impact of an activity enabling uniform on primary school student's fitness and physical activity: study protocol for the Active WeAR Everyday (AWARE) study. BMJ Open 2022; 12:e064692. [PMID: 36137630 PMCID: PMC9511594 DOI: 10.1136/bmjopen-2022-064692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED IntroductionMulticomponent school-based physical activity (PA) interventions can improve students' cardiorespiratory fitness (CRF) and PA. Due to the complex nature of such interventions when delivered at scale their effect sizes markedly reduce. Modifying student school uniforms, so that they are more PA enabling, may be a simple intervention that could enhance student health. The primary aim of this trial is to assess the effectiveness of an activity enabling uniform intervention (shorts, polo shirt and sports shoes) in improving children's CRF. METHODS AND ANALYSIS A cluster randomised controlled trial will be conducted in 24 primary schools in New South Wales (NSW), Australia. Schools will be randomly allocated to either intervention or usual practice following baseline data collection. Active WeAR Everyday intervention schools will allow students in grades 4-6 (aged approx. 9-12 years) to wear their existing sports uniform (shorts, polo shirt and sports shoes) every day. To avoid any financial cost to students they will be provided with two additional sports shirts and one pair of shorts. Study outcomes will be assessed at baseline and 9 months postbaseline. The primary outcome is students' CRF measured using the 20 m multistage fitness test. Secondary outcomes include students': mean daily steps and steps/minute measured via accelerometer, quality of life, mental well-being and perceived PA self-efficacy. The acceptability, feasibility and cost of the intervention will be assessed. Analyses will be performed using an intention-to-treat framework. Linear mixed effects regression models will be used to assess intervention effects on the primary outcome at follow-up. Planned exploratory analyses will examine effects by subgroups (eg, gender). ETHICS AND DISSEMINATION This study has received approval from Hunter New England Local Health District Human Ethics Committee (2020/ETHO2602) the University of Newcastle, Human Research Ethics Committee (H-2021-0013), NSW Department of Education (SERAP: 2020387) and Catholic School Offices. TRIAL REGISTRATION NUMBER ACTRN12621000201875.
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Affiliation(s)
- Nicole Nathan
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Nicole McCarthy
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Alix Hall
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Adam Shoesmith
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Rebecca Jackson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Daniel Groombridge
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Penny Reeves
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Health Research Economics, University of Newcastle Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - James Boyer
- School Sport Unit, NSW Department of Education, Sydney, New South Wales, Australia
| | - Bernadette Duggan
- Education Office (Sport/PDHPE), Catholic Schools Office Diocese of Maitland-Newcastle, Newcastle, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
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19
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Julian V, Bergsten P, Forslund A, Ahlstrom H, Ciba I, Dahlbom M, Furthner D, Gomahr J, Kullberg J, Maruszczak K, Morwald K, Olsson R, Pixner T, Schneider A, Pereira B, Thivel D, Weghuber D. Sedentary time has a stronger impact on metabolic health than moderate to vigorous physical activity in adolescents with obesity: a cross-sectional analysis of the Beta-JUDO study. Pediatr Obes 2022; 17:e12897. [PMID: 35083885 DOI: 10.1111/ijpo.12897] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/18/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Relationships between movement-related behaviours and metabolic health remain underexplored in adolescents with obesity. OBJECTIVES To compare profiles of sedentary time (more sedentary, SED+ vs. less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA-) and combinations of behaviours (SED-/MVPA+, SED-/MVPA-, SED+/MVPA+, SED+/MVPA-) in regard to metabolic health. METHODS One hundred and thirty-four subjects (mean age 13.4 ± 2.2 yrs, mean body mass index [BMI] 98.9 ± 0.7 percentile, 48.5% females) underwent 24 h/7 day accelerometry, anthropometric, body composition, blood pressure (BP), lipid profile and insulin resistance (IR) assessments. RESULTS Metabolic health was better in SED- [lower fat mass (FM) percentage (p < 0.05), blood pressure (BP) (p < 0.05), homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and metabolic syndrome risk score (MetScore) (p < 0.001), higher high-density lipoprotein-cholesterol (HDL-c) (p = 0.001)] vs. SED+ group and in MVPA+ [lower triglyceridemia (TG), (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.001), higher HDL-c (p < 0.01)] vs. MVPA- group after adjustment with age, gender, maturation and BMI. SED-/MVPA+ group had the best metabolic health. While sedentary (p < 0.001) but also MVPA times (p < 0.001) were lower in SED-/MVPA- vs. SED+/MVPA+, SED-/MVPA- had lower FM percentage (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.05) and higher HDL-c (p < 0.05), independently of BMI. Sedentary time was positively correlated with HOMA-IR and Metscore and negatively correlated with HDL-c after adjustment with MVPA (p < 0.05). MVPA was negatively correlated with HOMA-IR, BP and MetScore and positively correlated with HDL-c after adjustment with sedentary time (p < 0.05). CONCLUSION Lower sedentary time is associated with a better metabolic health independently of MVPA and might be a first step in the management of pediatric obesity when increasing MVPA is not possible.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France.,Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Hakan Ahlstrom
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, Mölndal, Sweden
| | - Iris Ciba
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Dahlbom
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Dieter Furthner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Julian Gomahr
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, Mölndal, Sweden
| | - Katharina Maruszczak
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Katharina Morwald
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Roger Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Thomas Pixner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Anna Schneider
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Bruno Pereira
- Department of Biostatistics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Clermont-Ferrand, France
| | - Daniel Weghuber
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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20
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Su Y, Zhang Y, Chen ST, Hong JT, Wang H. Is the Health Behavior in School-Aged Survey Questionnaire Reliable and Valid in Assessing Physical Activity and Sedentary Behavior in Young Populations? A Systematic Review. Front Public Health 2022; 10:729641. [PMID: 35419332 PMCID: PMC8995780 DOI: 10.3389/fpubh.2022.729641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 02/14/2022] [Indexed: 12/30/2022] Open
Abstract
Backgrounds Using the self-reported questionnaire to assess the levels of physical activity (PA) and sedentary behavior (SB) has been a widely recognized method in public health and epidemiology research fields. The selected items of the Health Behavior in School-aged (HBSC) Survey Questionnaire have been used globally for measurements and assessments in PA and SB of children and adolescents. However, there are no comprehensive and critical reviews to assess the quality of studies on reliability and validity of selected items for PA and SB measurement and assessment derived from the HBSC. Thus, this review aimed to critically assess the quality of those studies and summary evidence for future recommendations. Methods A systematic review protocol was used to search potentially eligible studies on assessing reliability and validity of PA and SB measures of the HBSC questionnaire. electronically academic databases were used. The information on the reliability and validity of the PA and SB measures were extracted and evaluated with well-recognized criteria or assessment tools. Results After a literature search, six studies were included in this review. The reliability of PA measures of the HBSC questionnaire showed a moderate agreement while the reliability of SB measures showed a great variation across the different items in the different subgroups. The validity of the PA measures had acceptable performance, whereas no studies assess the validity of the SB measures. The included studies all had quality weaknesses on reliability or validity analysis. Conclusions The PA and SB measures of the HBSC questionnaires were reliable in assessing PA and SB among adolescents. However, a little evidence showed that PA measures are partially valid in assessing PA, but no evidence confirmed the validity of SB measures. The included studies all had methodological weaknesses in examining the reliability and validity of the PA and SB measures, which should be addressed in the future. Further studies are encouraged to use a more standardized study design to examine the reliability and validity of the PA and SB measures in more young populations.
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Affiliation(s)
- Yang Su
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China.,School of Physical Education and Humanity, Nanjing Sport Institute, Nanjing, China
| | - Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen, China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Jin-Tao Hong
- Center of Physical Fitness Research and Health Guidance, Shanghai Research Institute of Sports Science (Shanghai Anti-doping Agency), Shanghai, China
| | - Hongying Wang
- School of Leisure Sport, Shanghai University of Sport, Shanghai, China
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21
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Schaan CW, Schaan BD, Cureau FV. Prevalence and correlates of meeting physical activity, screen time and sleep duration guidelines among Brazilian adolescents: findings from ERICA. Appl Physiol Nutr Metab 2022; 47:690-698. [PMID: 35395163 DOI: 10.1139/apnm-2021-0447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The prevalence of meeting movement guidelines is low in developed countries; however there is a lack of data among medium-income countries, including Brazil. We evaluated the prevalence and correlates of meeting physical activity, screen time, and sleep guidelines in Brazilian adolescents. Employing a cross-sectional design, Brazilian adolescents (aged 12-17) were surveyed about their physical activity levels, sleep, and screen time. The data was collected at schools through a self-administered questionnaire using a Personal Digital Assistant for entering the data. Poisson regression models were used to examine the associations between correlates (sex, age, socioeconomic status, region, skin colour and shift of school) and meeting movement guidelines. A total of 58,535 adolescents were included. Although only 8.7% of adolescents met all three movement guidelines, the prevalence of those who met physical activity, screen time and sleep duration guidelines was 46.4%, 42.5% and 40%, respectively. Moreover, male sex, age 14-15 years old, non-white skin colour, afternoon shift of school and living in the Northern and Northeastern regions were associated with a higher prevalence of meeting all movement guidelines. The prevalence of adolescents who met all three movement guidelines was low among Brazilian adolescents. Adolescents living in less developed regions show greater adherence to movement guidelines, suggesting a possible impact of the urbanization process on these behaviours. Novelty bullets: - The prevalence of Brazilian adolescents whom met all three movement behaviours guidelines was around 9%. - Among all adolescents, 40% met only one movement guideline.
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Affiliation(s)
- Camila Wohlgemuth Schaan
- Universidade Federal do Rio Grande do Sul, Graduate Program in Endocrinology, Porto Alegre, Brazil;
| | - Beatriz D Schaan
- HCPA, 37895, Endocrine Division, Porto Alegre, RS, Brazil.,UFRGS, 28124, Graduate Program in Endocrinology, Porto Alegre, RS, Brazil;
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul, 28124, Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Porto Alegre, RS, Brazil;
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22
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Julian V, Haschke F, Fearnbach N, Gomahr J, Pixner T, Furthner D, Weghuber D, Thivel D. Effects of Movement Behaviors on Overall Health and Appetite Control: Current Evidence and Perspectives in Children and Adolescents. Curr Obes Rep 2022; 11:10-22. [PMID: 35020189 PMCID: PMC9165266 DOI: 10.1007/s13679-021-00467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To present the definitions and recommendations for movement behaviors in children and adolescents, including physical activity (PA), sedentary behaviors (SB), and sleep, and to provide an overview regarding their impact on health and obesity outcomes from childhood to adulthood, as well as interactions with appetite control. RECENT FINDINGS PA represents a variable proportion of daily energy expenditure and one can be active with high SB or vice versa. Studies have described movements across the whole day on a continuum from sleep to SB to varying intensities of PA. More PA, less SB (e.g., less screen time) and longer sleep are positively associated with indicators of physical health (e.g., lower BMI, adiposity, cardiometabolic risk) and cognitive development (e.g., motor skills, academic achievement). However, less than 10% of children currently meet recommendations for all three movement behaviors. Movement behaviors, adiposity, and related cardiometabolic diseases in childhood track into adolescence and adulthood. Furthermore, low PA/high SB profiles are associated with increased energy intake. Recent studies investigating energy balance regulation showed that desirable movement behavior profiles are associated with better appetite control and improved eating habits. Early identification of behavioral phenotypes and a comprehensive approach addressing all key behaviors that directly affect energy balance will allow for individual strategies to prevent or treat obesity and its comorbidities. Investigating exercise as a potential "corrector" of impaired appetite control offers a promising weight management approach.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Research Center in Human Nutrition, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Ferdinand Haschke
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicole Fearnbach
- Pediatric Energy Balance Laboratory, Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, LA USA
| | - Julian Gomahr
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Pixner
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Dieter Furthner
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - David Thivel
- Laboratory AME2P, Research Center in Human Nutrition, University of Clermont Auvergne, Aubière, France
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23
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Clevenger KA, Belcher BR, Berrigan D. Associations between Amount of Recess, Physical Activity, and Cardiometabolic Traits in U.S. Children. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7. [DOI: 10.1249/tjx.0000000000000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Climie RE, Tafflet M, van Sloten T, de Lauzon-Guillain B, Bernard JY, Dargent-Molina P, Plancoulaine S, Lioret S, Jouven X, Charles MA, Heude B, Empana JP. Cardiovascular Health at Age 5 Years: Distribution, Determinants, and Association With Neurodevelopment. Front Pediatr 2022; 10:827525. [PMID: 35479759 PMCID: PMC9035843 DOI: 10.3389/fped.2022.827525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Early childhood may represent an opportune time to commence primordial prevention of cardiovascular disease (CVD, i.e., prevention of risk factors onset), but epidemiological evidence is scarce. We aimed to examine the distribution and parental and early life determinants of ideal cardiovascular health (CVH) in children up to 5 years and to compare the level of cognitive development between children with and without ideal CVH at age 5 years. METHODS Using data from the Etude sur les déterminants pré et post natals précoces du Développement psychomoteur et de la santé de l'Enfant (EDEN) study, a French population-based mother-child cohort study, CVH was examined in children at 5 years of age based on the American Heart Association CVH metrics (ideal body mass index, physical activity, diet, blood pressure, cholesterol and glucose levels, and passive smoking, considered in sensitivity analysis only). Children were categorized as having ideal (five to six ideal metrics) or non-ideal CVH (<5 ideal metrics). Intelligence quotient (IQ) at age 5 years was assessed using the French version of the Wechsler Preschool and Primary Scale of Intelligence. RESULTS Among the 566 children (55% boys), only 34% had ideal CVH. In fully adjusted logistic regression, boys compared to girls (OR = 1.77, 95% CI 1.13-2.78), children with intermediate (1.77, 1.05-2.98) or ideal (2.58, 1.38-4.82) behavioral CVH at age 3 years and children who spent < 30 min/day watching television (1.91, 1.09-3.34) at age 3 years were more likely to have ideal CVH at age 5 years. At age 5 years, there was a significant 2.98-point difference (95% CI 0.64-5.32) in IQ between children with and without ideal biological CVH after adjusting for confounders. CONCLUSION This study highlights that only a third of children aged 5 years had ideal CVH and identified modifiable determinants of ideal CVH and is suggestive of an association between CVH and neurodevelopment at a young age.
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Affiliation(s)
- Rachel E Climie
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Menzies Institute for Medical Research, University of Tasmanian, Hobart, TAS, Australia.,Sports Cardiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Muriel Tafflet
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Thomas van Sloten
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Blandine de Lauzon-Guillain
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Patricia Dargent-Molina
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sabine Plancoulaine
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Xavier Jouven
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Marie-Alines Charles
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Jean-Philippe Empana
- Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France
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Association between Metabolic Syndrome Diagnosis and the Physical Activity-Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study. Nutrients 2021; 14:nu14010060. [PMID: 35010936 PMCID: PMC8746544 DOI: 10.3390/nu14010060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 01/09/2023] Open
Abstract
Metabolic syndrome (MetS) is highly prevalent in children and adolescents with obesity and places them at an increased risk of cardiovascular-related diseases. However, the associations between objectively measured movement-related behaviors and MetS diagnosis remain unexplored in youths with obesity. The aim was to compare profiles of sedentary (SED) time (more sedentary, SED+ vs. less sedentary, SED−), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA−) and combinations of behaviors (SED−/MVPA+, SED−/MVPA−, SED+/MVPA+, SED+/MVPA−) regarding the MetS diagnosis. One hundred and thirty-four adolescents with obesity (13.4 ± 2.2 years) underwent 24 h/7 day accelerometry, waist circumference (WC), blood pressure (BP), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG) and insulin-resistance (IR) assessments. Cumulative cardiometabolic risk was assessed by using (i) MetS status (usual dichotomic definition) and (ii) cardiometabolic risk z-score (MetScore, mean of standardized WC, BP, IR, TG and inverted HDL-c). SED− vs. SED+ and MVPA+ vs. MVPA− had lower MetS (p < 0.01 and p < 0.001) and MetScore (p < 0.001). SED−/MVPA+ had the lowest risk. While SED and MVPA times were lower in SED−/MVPA− vs. SED+/MVPA+ (p < 0.001), MetScore was lower in SED−/MVPA− independently of body mass index (BMI) (p < 0.05). MVPA, but not SED, time was independently associated with MetS diagnosis (p < 0.05). Both MVPA (p < 0.01) and SED times (p < 0.05) were associated with MetScore independently of each other. A higher MVPA and lower SED time are associated with lower cumulative cardiometabolic risk.
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Cesa CC, Molino GOG, Lima J, Pereira RB, Eibel B, Barbiero SM, Schaan BD, Pellanda LC. Physical Activity and Cardiovascular Risk Factors in Children: a Meta-Analysis Update. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Handgrip strength cut-off points for early detection of cardiometabolic risk in Chilean children. Eur J Pediatr 2021; 180:3483-3489. [PMID: 34105001 DOI: 10.1007/s00431-021-04142-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
The aim of this study was to determine whether handgrip strength is associated with cardiometabolic risk in children. The secondary aim was to establish sex-specific handgrip strength cut-off points for early detection of cardiometabolic risk. A total sample of 452 Chilean children (267 girls and 185 boys) aged 7-9 years old was analyzed. Muscle fitness was measured by an adjustable dynamometer and normalized by body mass (i.e., handgrip strength/body mass). Sex-specific cardiometabolic risk scores were computed as the sum of the waist-to-height ratio (Equation 1) or waist circumference (Equation 2) and insulin, triglycerides, high-density lipoproteins, and glycemia levels. Receiver operating curve (ROC) analyses were performed to identify those with cardiometabolic risk scores > 1 standard deviation above the mean. ROC analyses showed a significant discriminating accuracy of normalized handgrip strength in identifying cardiometabolic risk in boys (≤ 0.33) and girls (≤ 0.40) using both equations. The highest sensitivity was offered by Equation 2 for boys [46%; 95% CI (32-59%)] and for girls [71%; 95% CI (60-80)]. The greatest specificity was also offered by Equation 2 for boys [82%; 95% CI (74-88)] and girls [63%; 95% CI (55-70)]. Since the values obtained by ROC analyses are low (especially in boys), caution is warranted regarding the strength of the existing evidence base.Conclusion: These specific cut-off points according to sex for possible cardiometabolic risk could be used by Chilean health professionals and school staff as an initial assessment in the field setting. What is known • There is strong evidence for the importance of muscular fitness during childhood and adolescence for cardiometabolic risk. • There has been no research to establish minimum handgrip strength capacity levels to predict cardiometabolic risk among Chilean children. What is new • Cut-off points for handgrip strength relative to body mass to identify cardiometabolic risk in Chilean children are 0.33 in boys and 0.40 in girls. • The early use of these cut-off points and its appropriate identification could have benefits of preventive and diagnostic therapeutic intervention and as a starting point to define adequate levels of handgrip strength.
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Woodforde J, Alsop T, Salmon J, Gomersall S, Stylianou M. Effects of school-based before-school physical activity programmes on children's physical activity levels, health and learning-related outcomes: a systematic review. Br J Sports Med 2021; 56:740-754. [PMID: 34815223 DOI: 10.1136/bjsports-2021-104470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To review and evaluate the impact of school-based, before-school physical activity (PA) programmes on children's PA levels, health and learning-related outcomes. DESIGN Systematic review. DATA SOURCES PubMed, PsycINFO, Scopus, Embase and ERIC were searched in January 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: (1) Original research published in English, (2) sample included typically developing school-age children and/or adolescents, (3) examined school-based PA programmes delivered before school, (4) included a comparator and (5) reported associations with PA, physical health, learning-related and/or psychosocial outcomes. Studies examining before-school active transport or sport were excluded. RESULTS Thirteen articles representing 10 studies were included (published 2012-2020); seven conducted in primary schools. Programmes ranged between 3 weeks and 6 months, primarily operating daily and for 25-40 min. One study examined a programme informed by theory; six incorporated fidelity measures. Data synthesis, considering consistency of findings, showed indeterminate associations for the domains of physical health, learning-related and psychosocial outcomes. Among subdomains, synthesis showed positive associations with before-school and daily PA, cardiorespiratory and muscular fitness, readiness to learn and an inverse association with adiposity. Risk of bias was high/serious or insufficiently detailed across studies and outcome domains, except PA, which included moderate-risk studies. CONCLUSION There is limited available evidence on school-based, before-school PA programmes, with some positive associations at domain and subdomain levels. Continued research is justified to understand the role of before-school programmes for facilitating PA. Future research should follow recommended practice for intervention design and process evaluation, and address under-represented contexts, including secondary schools. PROSPERO REGISTRATION NUMBER CRD42020181108.
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Affiliation(s)
- James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sjaan Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Comeras-Chueca C, Marin-Puyalto J, Matute-Llorente A, Vicente-Rodriguez G, Casajus JA, Gonzalez-Aguero A. Effects of Active Video Games on Health-Related Physical Fitness and Motor Competence in Children and Adolescents With Overweight or Obesity: Systematic Review and Meta-Analysis. JMIR Serious Games 2021; 9:e29981. [PMID: 34661549 PMCID: PMC8561411 DOI: 10.2196/29981] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/11/2021] [Accepted: 08/02/2021] [Indexed: 01/31/2023] Open
Abstract
Background Childhood obesity is one of the most important public health problems. Active video games (AVGs) have been proposed as an attractive alternative to increase energy expenditure and are being investigated to determine their effectiveness against childhood obesity. Objective The aim of this study is to summarize the existing research and draw conclusions about the effects of AVGs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. Methods The search strategy was applied to PubMed, MEDLINE, Web of Science, and SPORTDiscus, including randomized and nonrandomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. To measure the risk of bias in randomized and nonrandomized controlled trials, 2 different quality assessment tools were used. In total, 15 articles met the inclusion criteria, and the variables of interest were BMI, body fat percentage, cardiorespiratory fitness (CRF), waist circumference, fat-free mass, muscular fitness, and motor competence. A meta-analysis was performed. Results Positive effects were found for BMI and body fat percentage, favoring the AVG group compared with a control group with no intervention (mean difference −0.209; 95% CI −0.388 to −0.031 vs mean difference −0.879; 95% CI −1.138 to −0.602). Positive effects seem to be observed for CRF. The effects of AVG interventions on muscular fitness, fat-free mass, waist circumference, and motor competence are unclear. Conclusions AVG programs showed positive effects on BMI, body fat percentage, and CRF. AVG could be a good strategy to combat childhood obesity.
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Affiliation(s)
- Cristina Comeras-Chueca
- Department of Physiatry and Nursing, Faculty of Health Science, University of Zaragoza, Zaragoza, Spain.,GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain
| | - Jorge Marin-Puyalto
- GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain.,Instituto Agroalimentario de Aragón -IA2-, CITA, Universidad de Zaragoza, Zaragoza, Spain
| | - Angel Matute-Llorente
- GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain.,Instituto Agroalimentario de Aragón -IA2-, CITA, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - German Vicente-Rodriguez
- GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain.,Instituto Agroalimentario de Aragón -IA2-, CITA, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Jose Antonio Casajus
- Department of Physiatry and Nursing, Faculty of Health Science, University of Zaragoza, Zaragoza, Spain.,GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain.,Instituto Agroalimentario de Aragón -IA2-, CITA, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Alex Gonzalez-Aguero
- GENUD Research Group (Growth, Exercise, NUtrition and Development), University of Zaragoza, Zaragoza, Spain.,EXERNET, Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain.,Instituto Agroalimentario de Aragón -IA2-, CITA, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
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Solera-Martínez M, Herraiz-Adillo Á, Manzanares-Domínguez I, De La Cruz LL, Martínez-Vizcaíno V, Pozuelo-Carrascosa DP. High-Intensity Interval Training and Cardiometabolic Risk Factors in Children: A Meta-analysis. Pediatrics 2021; 148:peds.2021-050810. [PMID: 34497117 DOI: 10.1542/peds.2021-050810] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT High-intensity interval training (HIIT) has been widely used to prevent and treat cardiovascular risk factors in adolescents and adults; nevertheless, the available evidence in children is scarce. OBJECTIVE To synthesize evidence regarding the effectiveness of HIIT interventions on improving cardiovascular risk factors and cardiorespiratory fitness (CRF) in children from 5 to 12 years old. DATA SOURCES We searched 5 databases, Medline, Embase, SPORTDiscus, the Cochrane Library, and Web of Science. STUDY SELECTION Randomized controlled trials (RCTs) evaluating the effectiveness of HIIT interventions on cardiometabolic risk factors and CRF in children were included. DATA EXTRACTION Meta-analyses were conducted to determine the effect of HIIT on body composition, cardiometabolic and CRF variables in comparison with nontraining control groups. RESULTS A total of 11 RCTs and 512 participants were included. The results of the meta-analysis revealed a significant improvement in peak oxygen uptake (standardized mean difference [SMD] = 0.70, 95% confidence interval [CI] = 0.28 to 1.12; P = 0.001], in total cholesterol [SMD = -1.09, 95% CI = -1.88 to -0.30; P = 0.007], in low-density lipoprotein cholesterol [SMD = -1.28, 95% CI = -2.34 to -0.23; P = 0.017] and triglycerides [SMD = -0.71, 95% CI = -1.15 to -0.28; P = 0.001) levels. LIMITATIONS Because of the small number of available RCTs, it was not possible to conduct a subgroup analysis or a linear meta-regression analysis. CONCLUSIONS HIIT is a feasible and time-efficient approach for improving CRF, total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels in children.
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Affiliation(s)
- Monserrat Solera-Martínez
- Health and Social Research Center.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Ángel Herraiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain
| | | | - Lidia Lucas De La Cruz
- Health and Social Research Center.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center.,Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile
| | - Diana P Pozuelo-Carrascosa
- Health and Social Research Center.,Faculty of Nursing.,Multidisciplinary Research Group in Care, Universidad of Castilla-La Mancha, Toledo, Spain
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Arlinghaus KR, Ledoux TA, Johnston CA. Randomized Controlled Trial to Increase Physical Activity Among Hispanic-American Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2021; 91:307-317. [PMID: 33655526 DOI: 10.1111/josh.13004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/03/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Moderate-to-vigorous physical activity (MVPA) declines during adolescence, particularly among girls. In this randomized control trial, we examined MVPA in a physical activity intervention compared to physical education (PE) class as usual (TAU), stratified by sex and weight classification. Standardized BMI (zBMI) overtime was also examined. METHODS Hispanic-American middle school students (N = 193) were recruited from a school district in Houston, Texas. Participants were randomized to either a circuit-based physical activity intervention or TAU (PE class as usual). MVPA was assessed using accelerometry at baseline and 6 months. Repeated measures ANCOVA were conducted to examine changes in MVPA, overall and stratified by sex and weight classification. This procedure was repeated for zBMI. RESULTS Participants were 12.10 ± 0.63 years old and 53% were girls. Overall those in intervention increased weekday MVPA more than TAU (F(1,190) = 7.03, p < .01). Intervention girls increased weekday MVPA; whereas TAU girls decreased weekday MVPA (F(1,99) = 7.36, p < .01). Among those with obesity, there was no difference in MVPA between conditions (F(1, 56) = 0.33, p = .57), but Intervention decreased zBMI significantly more than TAU (F(1, 56) = 6.16, p < .05). CONCLUSIONS Structured PE classes grounded in behavioral theory may be an important strategy to prevent typical decreases in MVPA during adolescence, particularly among girls and for youth with obesity.
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Affiliation(s)
- Katherine R Arlinghaus
- Assistant Professor, , Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street Suite 300, Minneapolis, MN, 55454., USA
| | - Tracey A Ledoux
- Associate Professor, , Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015., USA
| | - Craig A Johnston
- Associate Professor, , Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015., USA
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Matłosz P, Wyszyńska J, Asif M, Szybisty A, Aslam M, Mazur A, Herbert J. Prevalence of Overweight, Obesity, Abdominal Obesity, and Obesity-Related Risk Factors in Polish Preschool Children: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10040790. [PMID: 33669323 PMCID: PMC7920301 DOI: 10.3390/jcm10040790] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the prevalence of overweight, obesity, abdominal obesity (AO), and obesity-related risk factors in children aged 5–6 years from Poland. The study was conducted at 22 randomly selected kindergartens representing each city district. A cross-sectional study of 1172 children aged 5–6 years was conducted using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), and body fat percentage (BFP). A univariate and multivariate logistic regressions were performed to evaluate the risk factors for excess weight, excess adiposity, and abdominal obesity (AO). The prevalence of excess weight (BMI ≥ 85th percentile) was 11.0%. The prevalence of excess adiposity (BFP ≥ 85th percentile) was 42.3%. Prevalence of AO (WC ≥ 90th percentile) was higher in girls compared to boys (14.9% vs. 10.7%, respectively). Multivariate logistic regression analysis indicated that children whose both parents were obese had significantly higher risk of excess weight, excess adiposity, and AO. Lower education level of fathers was associated with higher risk of excess weight and excess adiposity in children, while a lower level of maternal education was associated with higher risk of AO in children. Screen time over 120 min per day, participating less than once a week in at least 60 min of moderate-to-vigorous physical activity (MVPA) and birth weight over 4000 g were associated with excess weight, excess adiposity and AO. Moreover, cesarean delivery was associated with higher risk of excess weight and excess adiposity, and lower socio-economic status with higher risk of AO. This study revealed that excess adiposity and AO differed by gender. Parental obesity, screen time, MVPA, and birth weight could be significant determinants of excess weight, excess adiposity and AO in Polish preschool children.
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Affiliation(s)
- Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, ul. Cicha 2a, 35-326 Rzeszów, Poland; (A.S.); (J.H.)
- Correspondence: ; Tel.: +48-784-120-686
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Muhammad Asif
- Department of Statistics, Govt. Degree College, Qadir Pur Raan, 60000 Multan, Pakistan;
| | - Agnieszka Szybisty
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, ul. Cicha 2a, 35-326 Rzeszów, Poland; (A.S.); (J.H.)
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, 60000 Multan, Pakistan;
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Jarosław Herbert
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, ul. Cicha 2a, 35-326 Rzeszów, Poland; (A.S.); (J.H.)
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Life-Course Implications of Pediatric Risk Factors for Cardiovascular Disease. Can J Cardiol 2021; 37:766-775. [PMID: 33581191 DOI: 10.1016/j.cjca.2021.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022] Open
Abstract
The concept that origins of cardiovascular disease (CVD) begin in childhood is supported by substantial evidence. Prospective studies beginning in childhood report associations of childhood obesity, abnormal blood pressure (BP), dyslipidemia, diabetes, and tobacco use with intermediate CVD markers, including left ventricular hypertrophy and vascular stiffness in young adulthood. Trajectory analyses from longitudinal studies describe discrete BP pathways from childhood to young adult status of hypertension and prehypertension. Among individuals with familial hypercholesterolemia, abnormal low-density lipoprotein cholesterol levels are present in childhood. Some children are at risk for future CVD owing to hereditary factors, psychosocial stress, race, low birth weight, or other nonmodifiable exposures. Behavioural factors, including suboptimal diet, sedentary activity, and tobacco use, in childhood augment risk and can be modified to reduce risk. Pharmacologic treatments are reserved for those at high levels of the BP and cholesterol distributions and for those with diabetes and additional risk factors.
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Costa R, Barroso B, Reichert T, Vieira A, Kruel L. Effects of supervised exercise training on lipid profile of children and adolescents: Systematic review, meta-analysis and meta-regression. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dos Santos GC, Queiroz JDN, Reischak-Oliveira Á, Rodrigues-Krause J. Effects of dancing on physical activity levels of children and adolescents: a systematic review. Complement Ther Med 2020; 56:102586. [PMID: 33197661 DOI: 10.1016/j.ctim.2020.102586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dancing has been suggested to increase the levels of physical activity of the youth. However, it is not clear what are the physiological characteristics of the dance classes for young people, mainly regarding the levels of moderate to vigorous physical activity (MVPA) during classes. It is also unclear if regular engagement in dance practices can contribute with increases in the amounts of daily/weekly MVPA, recommended by health organizations. OBJECTIVES To conduct a systematic review verifying the amount of time spent at MVPA (primary outcome), by children and adolescents in the following situations: i) During dance classes, and ii) Before and after dance interventions. Secondary outcomes included: markers of exercise intensity during class, such as oxygen consumption (VO2) and heart rate (HR); VO2peak and lipid profile before and after dance interventions. METHODS Six data sources were accessed (MEDLINE, EMBASE, Cochrane Wiley, PEDRO and SCOPUS). Study selection included different designs (acute, cohort, randomized controlled trials and others). Participants were from 6 to 19 years old, regularly engaged in dance practices. Methodological quality was assessed using the Downs and Black checklist. Two independent reviewers extracted characteristics and results of each study. RESULTS 3216 articles were retrieved, and 37 included. Studies indicated that dance classes do not achieve 50% of total class time at MVPA. However, there are peaks of HR and VO2 during dance classes, which reach moderate and vigorous intensities. MVPA/daily/weekly did not improve before and after dance interventions for most of the studies, also VO2peak did not. The few results on lipid profile showed improvements only in overweight and obese participants. LIMITATIONS Lack of meta-analysis, because there were not enough articles to be analyzed on any given outcome of interest, neither under the same study design. CONCLUSIONS Results of individual studies indicated that dance classes did not active 50% of the total time at MVPA levels. This may be related to the absence of improvements in daily/weekly MVPA before and after dance interventions. VO2 and HR attained peaks of moderateto vigorous intensity during dance classes, suggesting that the structure of the classes may be manipulated to maintain longer periods at MVPA levels. Lack of data on cardiorespiratory fitness and metabolic outcomes limit conclusions on these parameters. IMPLICATIONS OF KEYS FINDS Considering there are peaks of HR and VO2 during dance classes, we suggest that the structure of a dance class can be manipulate in order to induce cardiorespiratory and metabolic adaptations. Thus, dancing is a potential strategy to contribute with a healthy life style since the earliest ages. Prospero registration: CRD42020144609.
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Affiliation(s)
- Gabriela Cristina Dos Santos
- Universidade Federal do Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Jéssica do Nascimento Queiroz
- Universidade Federal do Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Álvaro Reischak-Oliveira
- Universidade Federal do Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil
| | - Josianne Rodrigues-Krause
- Universidade Federal do Rio Grande do Sul, School of Physical Education, Physiotherapy and Dance, Porto Alegre, RS, Brazil.
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Whooten RC, Horan C, Cordes J, Dartley AN, Aguirre A, Taveras EM. Evaluating the Implementation of a Before-School Physical Activity Program: A Mixed-Methods Approach in Massachusetts, 2018. Prev Chronic Dis 2020; 17:E116. [PMID: 33006544 PMCID: PMC7553220 DOI: 10.5888/pcd17.190445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose and Objectives Our aim was to evaluate the implementation of a widely available, before-school, physical activity program in a low-resource, racially/ethnically and socioeconomically diverse, urban school setting to identify adaptations needed for successful implementation. Intervention Approach We used a collaborative effort with stakeholders to implement the Build Our Kids’ Success (BOKS) program in 3 schools in Revere, Massachusetts. Program structure followed a preexisting curriculum, including 60-minute sessions, 3 mornings per week, over 2 sessions (spring and fall 2018). Programs had a capacity of 40 students per school per session and the ability to adapt as needed. Evaluation Methods We used a mixed-methods approach, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. RE-AIM domains were assessed by use of baseline and follow-up student measures, parent interviews, and program administrative records. Results From a district of 11 schools, 3 schools (2 elementary, 1 middle) implemented the BOKS program. Program enrollment reached 82% capacity (188 of 230 potential participants). Of the 188 enrolled students, 128 (68%) had parental consent for study participation. Among the 128 study participants, 61 (48%) were male, 52 (41%) identified as Hispanic/Latino, and mean age was 9.3 years (SD, 2.2). Program duration varied by school (25–60 minutes), with a mean of 33% (SD, 16%) of the session spent in actigraphy-measured moderate-to-vigorous physical activity (MVPA), or mean 16.3 (SD, 9.3) minutes of MVPA. Participants attended a median 90% (interquartile range [IQR], 56%–97%) of sessions. We observed no change in body mass index (BMI) z score or self-reported quality of life from baseline to follow-up assessment. Parents reported positive program effects. Enrollment was sustained in elementary schools and decreased in the middle school during the study period, expanding to 3 additional schools for spring 2019. Implications for Public Health Implementation and evaluation of an evidence-based physical activity program, in a low-resource setting, are feasible and yield relevant information about program adaptations and future dissemination of similar programs.
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Affiliation(s)
- Rachel C Whooten
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114. .,Division of Endocrinology, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Christine Horan
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Jack Cordes
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Anna Nicole Dartley
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Annabelle Aguirre
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.,Kraft Center for Community Health, Massachusetts General Hospital, Boston, Massachusetts.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
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38
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Specific Features of the Ukrainian Urban Adolescents' Physical Activity: A Cross-Sectional Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:3404285. [PMID: 32351581 PMCID: PMC7171637 DOI: 10.1155/2020/3404285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 12/05/2022]
Abstract
Background An increase in the proportion of physically active peoples is one of the public health priorities. Particular attention should be addressed to the adolescent group with regard to their sensitivity. The purpose of our study is to determine the overall level of physical activity (PA) of urban adolescents and to evaluate its components. Methods The study included the results of a survey of 415 children aged 11–15 years from public schools in Ukraine. We have adapted the standardized questionnaire QAPACE, which allows characterizing the level of adolescent's PA by indicators: type, duration, and intensity. Results A sedentary lifestyle is typical for most Ukrainian urban adolescents. Only 30.8% of Ukrainian urban adolescents (45.4% of boys and 21.4% of girls; p < 0.001) meet the recommended level of moderate-to-vigorous PA (at least 60 minutes per day). The chances to follow the recommended moderate-to-vigorous PA are almost 5 times higher in the group of adolescents exercising at their own wish and not by parents' direction (OR = 4.96; 95% CI: 2.77–8.90; p < 0.001). Girls have a 3.0 higher chance of not adhering to recommendations for duration of PA (OR = 3.01; 95% CI: 1.95–4.63). They are 2.5 times more likely to lead a sedentary lifestyle (OR = 2.48; 95% CI: 1.54–3.98) than boys. Conclusion The obtained results are indicative of a lack of implementation of measures to increase physical activity, which requires public attention to this problem. A search for ways to improve public policy towards optimizing adolescents' PA is still an urgent goal for scholars and practitioners. PA-promoting measures should be developed taking into account the impact of family traditions, accessibility of sports facilities, leisure, advertising, and other factors. The obtained results are the initial stage for developing the program of physical inactivity prevention.
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39
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Solomon-Moore E, Salway R, Emm-Collison L, Thompson JL, Sebire SJ, Lawlor DA, Jago R. Associations of body mass index, physical activity and sedentary time with blood pressure in primary school children from south-west England: A prospective study. PLoS One 2020; 15:e0232333. [PMID: 32348363 PMCID: PMC7190166 DOI: 10.1371/journal.pone.0232333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/13/2020] [Indexed: 12/13/2022] Open
Abstract
Elevated blood pressure in children is a significant risk factor for the development of cardiovascular disease in adulthood. We examined how children’s body mass index (BMI), physical activity and sedentary time at ages 9 and 11 are associated with blood pressure at age 11. Data were from 1283 children from Bristol, UK, who participated in the study aged 11 years, 797 of whom also participated in the study aged 9 years. Child height, weight and blood pressure were measured, and children wore accelerometers for five days, from which moderate-to-vigorous-intensity physical activity and sedentary minutes per day were derived. Multiple imputation of missing data and adjusted linear and logistic regression models were used to examine associations. Child BMI at 11 years was cross-sectionally associated with higher systolic and diastolic blood pressure (mean difference [95% confidence interval]: 0.91 [0.32 to 1.50] mm Hg and 1.08 [0.54 to 1.62] mm Hg, respectively, per standard deviation (SD) of BMI). BMI at age 9 was also positively associated with diastolic blood pressure at age 11 (1.16 mmHg per two years [0.49 to 1.84], per SD of BMI). For girls, sedentary time at age 9 years was associated with increased odds of having high systolic blood pressure at age 11 (odds ratio: 1.08 [1.01 to 1.16], per 10 minutes per day). There was no evidence of associations between sedentary time and blood pressure among boys. Similarly, there was little evidence that physical activity was associated with blood pressure in either cross-sectional or prospective analyses. Effective strategies are needed to prevent excess bodyweight among children in order to reduce cardiovascular disease risk.
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Affiliation(s)
- Emma Solomon-Moore
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Lydia Emm-Collison
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Janice L. Thompson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Simon J. Sebire
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
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40
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Falkner B, Lurbe E. Primordial Prevention of High Blood Pressure in Childhood: An Opportunity Not to be Missed. Hypertension 2020; 75:1142-1150. [PMID: 32223379 DOI: 10.1161/hypertensionaha.119.14059] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hypertension is a condition with increased risk for subsequent adverse events, and treatment of hypertension is prescribed for primary prevention of adverse events. Primordial prevention is a concept that precedes primary prevention and focuses on risk factor prevention. Primordial prevention of hypertension consists of strategies to maintain blood pressure in a normal range and prevent development of elevated blood pressure or hypertension. Childhood is a period in which primordial prevention could be effective and if sustained throughout childhood could contribute to a healthier young adulthood. Targets for primordial prevention in childhood include preventing and reducing childhood obesity, achieving an optimal diet that includes avoiding excessive salt consumption, and removing barriers to physical activity and healthy sleep throughout childhood. Primordial prevention also includes the prenatal period wherein some maternal conditions and exposures are associated with higher blood pressure in child offspring.
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Affiliation(s)
- Bonita Falkner
- From the Departments of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA (B.F.)
| | - Empar Lurbe
- Pediatric Department, Hospital General, University of Valencia, Spain (E.L.)
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41
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Nasi M, Patrizi G, Pizzi C, Landolfo M, Boriani G, Dei Cas A, Cicero AFG, Fogacci F, Rapezzi C, Sisca G, Capucci A, Vitolo M, Galiè N, Borghi C, Berrettini U, Piepoli M, Mattioli AV. The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. J Cardiovasc Med (Hagerstown) 2020; 20:631-639. [PMID: 31436678 DOI: 10.2459/jcm.0000000000000855] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
: Regular physical activity is a cornerstone in the prevention and treatment of atherosclerotic cardiovascular disease (CVD) due to its positive effects in reducing several cardiovascular risk factors. Current guidelines on CVD suggest for healthy adults to perform at least 150 min/week of moderate intensity or 75 min/week of vigorous intensity aerobic physical activity. The current review explores the effects of physical activity on some risk factors, specifically: diabetes, dyslipidemia, hypertension and hyperuricemia. Physical activity induces an improvement in insulin sensitivity and in glucose control independently of weight loss, which may further contribute to ameliorate both diabetes-associated defects. The benefits of adherence to physical activity have recently proven to extend beyond surrogate markers of metabolic syndrome and diabetes by reducing hard endpoints such as mortality. In recent years, obesity has greatly increased in all countries. Weight losses in these patients have been associated with improvements in many cardiometabolic risk factors. Strategies against obesity included caloric restriction, however greater results have been obtained with association of diet and physical activity. Similarly, the beneficial effect of training on blood pressure via its action on sympathetic activity and on other factors such as improvement of endothelial function and reduction of oxidative stress can have played a role in preventing hypertension development in active subjects. The main international guidelines on prevention of CVD suggest to encourage and to increase physical activity to improve lipid pattern, hypertension and others cardiovascular risk factor. An active action is required to the National Society of Cardiology together with the Italian Society of Sports Cardiology to improve the prescription of organized physical activity in patients with CVD and/or cardiovascular risk factors.
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Affiliation(s)
- Milena Nasi
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Carmine Pizzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Matteo Landolfo
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Giuseppe Boriani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Alessandra Dei Cas
- Endocrinology and Metabolism, Department of Clinical and Experimental Medicine, University of Parma, Parma
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Claudio Rapezzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Giovanbattista Sisca
- Bologna F.C.,FIFA Medical Centre of Excellence, Isokinetic Medical Group, Bologna
| | | | - Marco Vitolo
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Nazzareno Galiè
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Claudio Borghi
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | | | - Massimo Piepoli
- Heart Failure Unit, Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
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42
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Wyszyńska J, Ring-Dimitriou S, Thivel D, Weghuber D, Hadjipanayis A, Grossman Z, Ross-Russell R, Dereń K, Mazur A. Physical Activity in the Prevention of Childhood Obesity: The Position of the European Childhood Obesity Group and the European Academy of Pediatrics. Front Pediatr 2020; 8:535705. [PMID: 33224905 PMCID: PMC7674497 DOI: 10.3389/fped.2020.535705] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 09/07/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity affects an increasing number of children and adolescents. Physical activity (PA) is a significant factor in the prevention of excessive body mass in the pediatric population. A significant percentage of pediatric population do not attain the public health recommendation for PA, and typically, those with higher levels of PA have lower content of body fat than less active peers. Although the development of childhood obesity is multifactorial, the decline in energy expenditure is considered as one of the most important determinants of excessive body weight. The lack of intervention causes that excess body weight to remain stable from birth through childhood and adolescence to adulthood. Accordingly, public health interventions are needed to increase the level of PA in the pediatric population. The task force from the European Childhood Obesity Group and the European Academy of Pediatrics reviewed English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from 2018 to August 2020, and developed a consensus statement. This statement presents the role of PA in the prevention of excessive body weight and gives age-appropriate recommendations for PA and recommendations for school-based interventions, parents, and guardians.
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Affiliation(s)
- Justyna Wyszyńska
- Medical College of Rzeszów University, Rzeszów, Poland.,European Childhood Obesity Group, Brussels, Belgium
| | - Susanne Ring-Dimitriou
- European Childhood Obesity Group, Brussels, Belgium.,Department of Sport and Exercise Science, Paris Lodron-University, Salzburg, Austria
| | - David Thivel
- European Childhood Obesity Group, Brussels, Belgium.,Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions, Clermont Auvergne University, Clermont Ferrand, France
| | - Daniel Weghuber
- European Childhood Obesity Group, Brussels, Belgium.,Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Adamos Hadjipanayis
- Medical School, European University Cyprus, Nicosia, Cyprus.,European Academy of Paediatrics, Brussels, Belgium
| | - Zachi Grossman
- Adelson School of Medicine, Ariel University, Ariel, Israel.,Maccabi Health Services, Tel Aviv, Israel
| | - Robert Ross-Russell
- European Academy of Paediatrics, Brussels, Belgium.,Department of Paediatric Respiratory Medicine, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom
| | - Katarzyna Dereń
- Medical College of Rzeszów University, Rzeszów, Poland.,European Childhood Obesity Group, Brussels, Belgium
| | - Artur Mazur
- Medical College of Rzeszów University, Rzeszów, Poland.,European Childhood Obesity Group, Brussels, Belgium.,European Academy of Paediatrics, Brussels, Belgium
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43
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Norris E, van Steen T, Direito A, Stamatakis E. Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: a systematic review and meta-analysis. Br J Sports Med 2019; 54:826-838. [PMID: 31619381 DOI: 10.1136/bjsports-2018-100502] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. DESIGN Systematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. DATA SOURCES PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. STUDIES ELIGIBILITY CRITERIA Physically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations. RESULTS 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95% CI 1.42 to 3.25: k=16) and small, increases on overall PA (d=0.32; 95% CI 0.18 to 0.46: k=8), large, improvement in lesson-time educational outcomes (d=0.81; 95% CI 0.47 to 1.14: k=7) and a small improvement in overall educational outcomes (d=0.36; 95% CI 0.09 to 0.63: k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains. CONCLUSION In elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting. TRIAL REGISTRATION NUMBER CRD42017076933.
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Affiliation(s)
- Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Tommy van Steen
- Institute of Security and Global Affairs, Leiden University, Leiden, The Netherlands
| | - Artur Direito
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emmanuel Stamatakis
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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44
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Critical Hours and Important Environments: Relationships between Afterschool Physical Activity and the Physical Environment Using GPS, GIS and Accelerometers in 10-12-Year-Old Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173116. [PMID: 31461924 PMCID: PMC6747485 DOI: 10.3390/ijerph16173116] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/06/2019] [Accepted: 08/17/2019] [Indexed: 11/23/2022]
Abstract
Introduction: The objective of this study was to assess relationships between children’s physical environment and afterschool leisure time physical activity (PA) and active transport. Methods: Children aged 10–12 years participated in a 7-day accelerometer and Global Positioning Systems (GPS) protocol. Afterschool leisure time PA and active transport were identified based on location- and speed-algorithms based on accelerometer, GPS and Geospatial Information Systems (GIS) data. We operationalized children’s exposure to the environment by combining home, school and the daily transport environment in individualized daily activity-spaces. Results: In total, 255 children from 20 Dutch primary schools from suburban areas provided valid data. This study showed that greenspaces and smaller distances from the children’s home to school were associated with afterschool leisure time PA and walking. Greater distances between home and school, as well as pedestrian infrastructure were associated with increased cycling. Conclusion: We demonstrated associations between environments and afterschool PA within several behavioral contexts. Future studies are encouraged to target specific behavioral domains and to develop natural experiments based on interactions between several types of the environment, child characteristics and potential socio-cognitive processes.
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45
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Psaltopoulou T, Tzanninis S, Ntanasis-Stathopoulos I, Panotopoulos G, Kostopoulou M, Tzanninis IG, Tsagianni A, Sergentanis TN. Prevention and treatment of childhood and adolescent obesity: a systematic review of meta-analyses. World J Pediatr 2019; 15:350-381. [PMID: 31313240 DOI: 10.1007/s12519-019-00266-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/03/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The goal of this systematic review is to synthesize the published meta-analyses assessing the role of nutritional, behavioral and physical activity factors/interventions on the prevention or treatment of pediatric and adolescent obesity. METHODS An online search was conducted in PubMed (end-of-search: September 30, 2015); English-language meta-analyses pooling observational and/or interventional studies examining weight-related indices on children and adolescents were included. RESULTS Sixty-six meta-analyses corresponding to more than 900,000 children and adolescents were retrieved. The majority of meta-analyses included interventional studies most of which referred to mixed or combined interventions, including components such as diet, physical activity and sedentary behavior reduction. Discrepancies between meta-analyses on observational and interventional studies were noted. Combined interventions including physical activity and nutritional modifications seemed to represent the most effective means for tackling childhood obesity. CONCLUSIONS Synthesis of interventional or observational evidence may yield discrepant results. The combination of enhanced physical activity and improved nutrition emerged as a promising intervention in the fight against childhood/adolescent obesity. However, further research is needed about the most effective multidimensional prevention strategy.
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Affiliation(s)
- Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75, M. Asias Str, 115 27, Athens, Greece.
| | - Stamatios Tzanninis
- Department of Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George Panotopoulos
- Hellenic Association for the Study of Obesity, Metabolism and Eating Disorders (HASOMED), Athens, Greece
| | - Myrto Kostopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75, M. Asias Str, 115 27, Athens, Greece
| | | | - Anastasia Tsagianni
- Division of Internal Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
| | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75, M. Asias Str, 115 27, Athens, Greece
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46
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Spiegler J, Eves R, Mendonça M, Wolke D. Association of physical activity and cardiorespiratory function or BMI and body composition in preterm-born individuals: a systematic review. Acta Paediatr 2019; 108:1205-1214. [PMID: 30664798 DOI: 10.1111/apa.14726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the association of physical activity (PA) and forced expiratory volume in one second (FEV1), peak oxygen consumption (pVO2), body mass index (BMI) and body composition in preterm-born individuals. METHODS Cochrane Library, EMBASE, MEDLINE, AMED, ERIC, Web of Science and PsycInfo were searched with no restriction on language and date of publication from inception to January 2018. Data were extracted comparing preterm-born individuals with different frequencies of PA and the outcome of interest. RESULTS One randomized controlled, two longitudinal and thirteen cross-sectional studies comprising 1922 preterm-born individuals aged 5-25 were included. Assessment varied from a PA program to accelerometer data, interviews and self-report questionnaires. In preterm-born children, more PA was associated with better cardiorespiratory function in those groups with impaired lung function or with lower BMI in those groups with increased risk factors, but no association was found in unimpaired children. In preterm-born adults, more PA was associated with higher pVO2 and lower BMI. CONCLUSION Only tentative conclusions can be drawn, especially regarding differences of the association of PA between preterm- and term-born populations. Further studies are needed to analyse the association of PA in preterm-born individuals with reduced cardiorespiratory function.
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Affiliation(s)
- Juliane Spiegler
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
- Department of Paediatrics University of Lübeck Lübeck Germany
| | - Robert Eves
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Marina Mendonça
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
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47
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Proudfoot NA, King-Dowling S, Cairney J, Bray SR, MacDonald MJ, Timmons BW. Physical Activity and Trajectories of Cardiovascular Health Indicators During Early Childhood. Pediatrics 2019; 144:peds.2018-2242. [PMID: 31186368 DOI: 10.1542/peds.2018-2242] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Cardiovascular disease prevention should begin in childhood. However, the influence of physical activity on cardiovascular health in early childhood is unknown. Our purpose in this study was to determine the effect of physical activity on trajectories of cardiovascular health indicators during early childhood. METHODS This prospective, observational cohort study (Health Outcomes and Physical Activity in Preschoolers) enrolled 418 3- to 5-year-olds with annual assessments for 3 years. Total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) were measured over 7 days via accelerometry. Cardiovascular health indicators included cardiovascular fitness (exercise time on a maximal treadmill test [treadmill time] and 1-minute heart rate recovery), resting arterial stiffness (whole-body pulse wave velocity and carotid β stiffness index), and seated systolic blood pressure. Data were analyzed by using linear mixed-effects modeling; effects are reported as unstandardized estimates (Est). RESULTS There were main effects of TPA and MVPA on treadmill time (Est = 0.004 [P = .005] and 0.008 [P = .001], respectively) and heart rate recovery (Est = 0.05 [P < .001] and 0.08 [P < .001], respectively). There was a main effect of TPA on pulse wave velocity (Est = -0.001; P = .02) and an MVPA × time interaction (Est = -0.002; P = .01). For carotid β stiffness index, the effect of a TPA × time interaction was not significant (Est = -0.002; P = .051); however, there was a significant MVPA × time interaction (Est = -0.003; P = .03). MVPA was associated with a slower rate of change in systolic blood pressure for girls (Est = 0.06; P = .009). CONCLUSIONS Children who engage in higher levels of physical activity during early childhood have better cardiovascular health indicators, with more intense physical activity (ie, MVPA) attenuating the stiffening of arteries.
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Affiliation(s)
- Nicole A Proudfoot
- Child Health and Exercise Medicine Program, Department of Pediatrics and.,Department of Kinesiology, and
| | - Sara King-Dowling
- Child Health and Exercise Medicine Program, Department of Pediatrics and.,Department of Kinesiology, and.,Infant and Child Health Laboratory, Department of Family Medicine, McMaster University, Hamilton, Canada; and
| | - John Cairney
- Infant and Child Health Laboratory, Department of Family Medicine, McMaster University, Hamilton, Canada; and.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | | | | | - Brian W Timmons
- Child Health and Exercise Medicine Program, Department of Pediatrics and
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48
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Martínez-Vizcaíno V, Álvarez-Bueno C, Cavero-Redondo I, Pozuelo-Carrascosa DP, Garrido-Miguel M, Martínez-Hortelano JA, Martínez-Madrid V, de Medio EP, Sánchez-López M. MOVI-daFIT! Intervention: Rationale and design of a cluster randomized controlled trial testing the effects on improving adiposity, cognition, and subclinical atherosclerosis by increasing cardiorespiratory fitness in children. Medicine (Baltimore) 2019; 98:e14737. [PMID: 30817628 PMCID: PMC6831241 DOI: 10.1097/md.0000000000014737] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION High-intensity interval training (HIIT) programs have demonstrated positive effects on cardiorespiratory fitness and cardiometabolic parameters, but their impact on other health parameters (such as body mass and fat) and cognition remains unclear. This paper presents the rationale and methods of a HIIT after-school physical activity (PA) intervention (MOVI-daFIT!) on reducing fat mass and cardiovascular risk, and improving physical fitness, executive function, and academic achievement among children aged 9 to 11 years old. METHODS A cluster randomized controlled trial (RCT), including 10 schools from Cuenca province, Spain, was designed. Schools were randomly assigned to the MOVI-daFIT! intervention and to the control group. Children were evaluated at the beginning (September 2017) and at the end (June 2018) of the school year. Children in the intervention group were involved in 60-minute after-school sessions 4 days per week developed in the school setting. Each session consisted of 15 minutes of set-up and warm-up games, 28 minutes of games using the HIIT protocol, and 10 minutes of cool down. In addition, children in the intervention and control groups received 2 regular 50-minute physical education sessions per week, as it is compulsory by law in Spanish schools. CONCLUSION This study will determine the effect of an after-school physical activity intervention (MOVI-daFIT!), designed as a HIIT program, on reducing fat mass and cardiovascular risk, and improving fitness and cognition, including executive function and academic achievement.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
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49
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Skrede T, Steene-Johannessen J, Anderssen SA, Resaland GK, Ekelund U. The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis. Obes Rev 2019; 20:55-74. [PMID: 30270500 DOI: 10.1111/obr.12758] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 01/03/2023]
Abstract
Sedentary time and moderate-to-vigorous physical activity (MVPA) may be uniquely related to cardiometabolic health. Excessive sedentary time is suggested as an independent cardiometabolic risk factor, while MVPA is favourably associated with cardiometabolic health. This systematic review and meta-analysis summarizes the evidence on a prospective relationship between objectively measured sedentary time, MVPA and cardiometabolic health indicators in youth. PubMed, Embase, CINAHL, PhyscINFO and SPORTDiscus were systematically searched from January 2000 until April 2018. Studies were included if sedentary time and physical activity were measured objectively and examined associations with body mass index, waist circumference, triglycerides, high-density lipoprotein, insulin, blood pressure or the clustering of these cardiometabolic risk factors. We identified 30 studies, of which 21 were of high quality. No evidence was found for an association between sedentary time and cardiometabolic outcomes. The association between MVPA and individual cardiometabolic risk factors was inconsistent. The meta-analysis for prospective studies found a small but significant effect size between MVPA at baseline and clustered cardiometabolic risk at follow-up (ES -0.014 [95% CI, -0.024 to -0.004]). We conclude that there is no prospective association between sedentary time and cardiometabolic health, while MVPA is beneficially associated with cardiometabolic health in youth.
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Affiliation(s)
- T Skrede
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - S A Anderssen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - G K Resaland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - U Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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50
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Pozuelo-Carrascosa DP, Cavero-Redondo I, Herráiz-Adillo Á, Díez-Fernández A, Sánchez-López M, Martínez-Vizcaíno V. School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis. Pediatrics 2018; 142:peds.2018-1033. [PMID: 30337478 DOI: 10.1542/peds.2018-1033] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES We identified studies from database inception to February 22, 2018. STUDY SELECTION We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
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Affiliation(s)
| | | | - Ángel Herráiz-Adillo
- Social and Health Care Research Center and.,Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain
| | - Ana Díez-Fernández
- Social and Health Care Research Center and.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center and.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain; and
| | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center and.,Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile
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