Relationship of blood cholesterol to body composition, physical fitness, and dietary intake measures in third-grade children and their parents

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

BACKGROUND

The World Health Organization (WHO) estimates that 1.9 million deaths worldwide are attributable to physical inactivity and at least 2.6 million deaths are a result of being overweight or obese. In addition, WHO estimates that physical inactivity causes 10% to 16% of cases each of breast cancer, colon, and rectal cancers as well as type 2 diabetes, and 22% of coronary heart disease and the burden of these and other chronic diseases has rapidly increased in recent decades.

OBJECTIVES

The purpose of this systematic review was to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents.

SEARCH METHODS

The search strategy included searching several databases to October 2011. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information.

SELECTION CRITERIA

To be included, the intervention had to be relevant to public health practice (focused on health promotion activities), not conducted by physicians, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, included all school-attending children, and be implemented for a minimum of 12 weeks. In addition, the review was limited to randomized controlled trials and those that reported on outcomes for children and adolescents (aged 6 to 18 years). Primary outcomes included: rates of moderate to vigorous physical activity during the school day, time engaged in moderate to vigorous physical activity during the school day, and time spent watching television. Secondary outcomes related to physical health status measures including: systolic and diastolic blood pressure, blood cholesterol, body mass index (BMI), maximal oxygen uptake (VO2max), and pulse rate.

DATA COLLECTION AND ANALYSIS

Standardized tools were used by two independent reviewers to assess each study for relevance and for data extraction. In addition, each study was assessed for risk of bias as specified in the Cochrane Handbook for Systematic Reviews of Interventions. Where discrepancies existed, discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated, and outcomes measured.

MAIN RESULTS

In the original review, 13,841 records were identified and screened, 302 studies were assessed for eligibility, and 26 studies were included in the review. There was some evidence that school-based physical activity interventions had a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally, school-based interventions had little effect on physical activity rates, systolic and diastolic blood pressure, BMI, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity resulted in positive effects.In this update, given the addition of three new inclusion criteria (randomized design, all school-attending children invited to participate, minimum 12-week intervention) 12 of the original 26 studies were excluded. In addition, studies published between July 2007 and October 2011 evaluating the effectiveness of school-based physical interventions were identified and if relevant included. In total an additional 2378 titles were screened of which 285 unique studies were deemed potentially relevant. Of those 30 met all relevance criteria and have been included in this update. This update includes 44 studies and represents complete data for 36,593 study participants. Duration of interventions ranged from 12 weeks to six years.Generally, the majority of studies included in this update, despite being randomized controlled trials, are, at a minimum, at moderate risk of bias. The results therefore must be interpreted with caution. Few changes in outcomes were observed in this update with the exception of blood cholesterol and physical activity rates. For example blood cholesterol was no longer positively impacted upon by school-based physical activity interventions. However, there was some evidence to suggest that school-based physical activity interventions led to an improvement in the proportion of children who engaged in moderate to vigorous physical activity during school hours (odds ratio (OR) 2.74, 95% confidence interval (CI), 2.01 to 3.75). Improvements in physical activity rates were not observed in the original review. Children and adolescents exposed to the intervention also spent more time engaged in moderate to vigorous physical activity (with results across studies ranging from five to 45 min more), spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min). However, the overall conclusions of this update do not differ significantly from those reported in the original review.

AUTHORS' CONCLUSIONS

The evidence suggests the ongoing implementation of school-based physical activity interventions at this time, given the positive effects on behavior and one physical health status measure. However, given these studies are at a minimum of moderate risk of bias, and the magnitude of effect is generally small, these results should be interpreted cautiously. Additional research on the long-term impact of these interventions is needed.

[Body mass index to the cardiovascular disease risk screening in infancy]

OBJECTIVE

To purpose news body mass index (BMI) cut offs to 7 to 12 years old scholars.

SUBJECTS AND METHODS

1.413 scholars of 7 to 12 years old selected of aleatory way. Were measured the BMI, total cholesterol (TC), and systolic (SBP) and diastolic blood pressure (DBP). To the date analyze were used the receiver operating characteristic curve (ROC curve) and the bivariate analyze.

RESULTS

The BMI cut offs proposed at this study show adequate capacity to identify true positive and negative to the cardiovascular diseases (CVD) risk factors presence. Besides, these cut offs show higher and more balanced sensibility and specificity values than other cut offs proposals.

CONCLUSIONS

The BMI proposed at this study configure with as the more adequate alternative to the screening for the scholars with increased chances to carry DCV risk factors.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18

BACKGROUND

The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity. Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease.

OBJECTIVES

The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents.

SEARCH STRATEGY

The search strategy included searching several databases. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information.

SELECTION CRITERIA

To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group.

DATA COLLECTION AND ANALYSIS

Standardized tools were used by two independent reviewers to rate each study's methodological quality and for data extraction. Where discrepancies existed discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured.

MAIN RESULTS

13,841 titles were identified and screened and 482 articles were retrieved. Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies). Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak. In total 26 studies were included in the review. There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects.

AUTHORS' CONCLUSIONS

Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time.

Aptidão física relacionada à saúde em escolares de Jequié, BA, Brasil

O objetivo deste estudo foi analisar a aptidão física relacionada à saúde (AFRS) em escolares de Jequié, BA, Brasil. Para tanto, a AFRS de 182 meninos e 160 meninas (sete a 12 anos), escolares da rede pública de ensino, foi avaliada mediante a aplicação dos testes motores corrida/caminhada de nove minutos (indicador de resistência cardiorrespiratória), abdominal modificado em um minuto (indicador de força e resistência abdominal), sentar-e-alcançar (indicador de flexibilidade). O somatório das espessuras das dobras cutâneas tricipital e subescapular foi utilizado como indicador de gordura corporal. Os resultados encontrados indicaram maior prevalência de meninos e meninas abaixo (19% e 49%, respectivamente) do que acima (3% e 1%, respectivamente) dos critérios estabelecidos pela AAHPERD (1988) para indicadores de gordura corporal. Por outro lado, somente 51% dos meninos e 58% das meninas no sentar-e-alcançar; 11% e 7%, respectivamente, no abdominal modificado em um minuto, e 15% e 14%, respectivamente, na corrida/caminhada de nove minutos alcançaram os critérios estabelecidos. Portanto, os resultados sugerem que programas efetivos de intervenção parecem necessários para a promoção de mudanças no estado nutricional e na atividade física habitual de escolares de Jequié.

Composição corporal em crianças de sete a 10 anos de idade, de alto nível socioeconômico

O objetivo deste estudo foi analisar a composição corporal de crianças de sete a 10 anos de idade, de alto nível socioeconômico. Para tanto, 511 crianças (274 meninos e 237 meninas) foram submetidas a medidas antropométricas de massa corporal, estatura e espessuras de dobras cutâneas tricipital (TR) e subescapular (SE). Com base nessas informações, foram determinados: gordura corporal relativa (% Gordura), massa corporal magra (MCM), distribuição da gordura corporal (DGC) e o somatório da espessura das dobras cutâneas TR e SE (ΣEDC). Anova two-way foi utilizada para as comparações entre os sexos e os diferentes grupos etários, seguida pelo teste post hoc de Scheffé quando P < 0,05. Para a classificação das crianças, de acordo com as categorias de adiposidade corporal, foi utilizada distribuição de freqüência. O teste de comparação entre proporções foi adotado para verificar as diferenças entre os sexos, em cada categoria (P < 0,05). Diferenças significantes entre os sexos (P < 0,05) foram verificadas na dobra TR (meninas > meninos) e na MCM (meninos > meninas). Efeito significante da idade foi identificado em todas as variáveis analisadas, exceto na DGC, com os valores mais elevados sendo encontrados no grupo etário de 10 anos. Um percentual elevado, tanto de meninos quanto de meninas, apresentou índice de adiposidade alto, com superioridade para os meninos (28% vs. 14%, P < 0,01). Por outro lado, um contingente maior de meninas apresentou concentrações de gordura corporal relativa abaixo dos pontos de corte desejáveis (15% vs. 3%, P < 0,01). Os valores de adiposidade corporal encontrados no presente estudo sugerem que um percentual elevado de crianças, de ambos os sexos, já apresenta importantes fatores de risco à saúde, em idades precoces.

Diagnóstico da aptidão física em escolares de alto nível socioeconômico: avaliação referenciada por critérios de saúde

A prática regular de atividades físicas sistematizadas na infância e na adolescência pode favorecer sobremaneira o desenvolvimento ou a manutenção de níveis adequados de aptidão física, reduzindo o risco de incidência de inúmeras disfunções crônico-degenerativas em idades precoces. Assim, o propósito deste estudo foi analisar a adiposidade corporal e o desempenho motor em crianças de alto nível socioeconômico, de acordo com uma avaliação referenciada por critérios de saúde. Para tanto, 511 escolares (274 meninos e 237 meninas) de sete a 10 anos, foram submetidos a medidas antropométricas de massa corporal, estatura e espessuras de dobras cutâneas (tricipital e subescapular) e aos seguintes testes motores: sentar e alcançar (SA), abdominal modificado (ABD) e corrida/caminhada de nove minutos (9MIN). As informações foram analisadas de acordo com os pontos de corte sugeridos pelo Physical Best (1988). Com relação à adiposidade corporal, verificou-se maior contingente de escolares acima (33% dos meninos e 15% das meninas, P < 0,01) do que abaixo (7% dos meninos e 15% das meninas, P < 0,01) dos critérios preestabelecidos. O comportamento observado nos diferentes testes motores empregados foi bastante semelhante em ambos os sexos, com exceção do SA, no qual uma proporção maior de meninas atendeu ao critério adotado (76% vs. 58%, P < 0,01). Por outro lado, o desempenho motor mais fraco foi identificado no teste 9MIN, no qual somente 27% dos meninos e 32% das meninas (P > 0,05) alcançaram os pontos de corte adotados. Quando analisados conjuntamente, constatou-se que somente 15% dos meninos e 21% das meninas (P > 0,05) apresentaram resultados satisfatórios nos três testes motores utilizados. A alta prevalência de crianças que se situaram acima do critério de saúde para quantidade de gordura corporal, associada à baixa proporção de sujeitos que atenderam aos critérios estabelecidos no conjunto dos testes motores utilizados, indica que o nível de aptidão física encontrado nos escolares investigados está bastante aquém do desejável. Os resultados sugerem a necessidade do desenvolvimento de programas de educação para a saúde que estimulem a participação mais efetiva de jovens em programas de exercícios físicos e esportes de diferentes naturezas, sobretudo no segmento escolar, no qual grande parte dos hábitos de vida são estabelecidos.

Prevalência de sobrepeso e obesidade em escolares de alto nível socioeconômico em Londrina, Paraná, Brasil

OBJETIVO: Verificar a prevalência de sobrepeso e obesidade em escolares na faixa etária entre sete e dez anos, de ambos os sexos e de alto nível socioeconômico. MÉTODOS: Quinhentos e onze escolares (274 meninos e 237 meninas) foram submetidos a medidas antropométricas de massa corporal, estatura e espessuras de dobras cutâneas (tricipital e subescapular). Valores de índice de massa corporal maiores ou iguais ao percentil 85 e menores do que percentil 95 foram utilizados para a determinação de sobrepeso, ao passo que valores de índice de massa corporal maior ou igual ao percentil 95 foram adotados como indicadores de obesidade. O nível socioeconômico foi estabelecido a partir de informações produzidas por um questionário, de acordo com o grau de instrução dos pais e os bens de consumo familiar. RESULTADOS: A prevalência total de sobrepeso foi de 19,7% nos meninos e 17,3% nas meninas, sem diferenças significantes entre sexo e faixa etária (p>0,05). Por outro lado, a prevalência de obesidade em meninos e meninas foi de 17,5% e 9,3%, respectivamente, com diferenças significantes entre os sexos aos nove (p<0,01) e dez anos (p<0,05), bem como no conjunto de todas as idades (p<0,01). CONCLUSÃO: Os resultados indicam taxas de prevalência de sobrepeso (~19%) e de obesidade (~14%) bastante superiores à média da população brasileira na faixa etária entre os sete e dez anos. Portanto, diferentemente do observado em países desenvolvidos, o alto nível socioeconômico parece afetar negativamente a prevalência de sobrepeso e obesidade, aumentando os riscos para o desenvolvimento de disfunções metabólicas em idades precoces.

Health and physical activity research as represented in RQES

In the past 75 years, articles in Research Quarterly for Exercise and Sport (RQES) have contributed to the understanding of the role physical activity plays in the health of individuals and populations. Articles have described laboratory and community research studies in humans and animals, presented reviews of topics and conference proceedings, and presented forums for discussion about current topics in physical activity and health. The articles reflect the growth of the profession from basic inquiry, about physiological responses to exercise (and the development of physical fitness methods and standards), to studies of the effects of exercise on physical fitness and health in various population subgroups. This evolution in RQES reflects the well recognized paradigm shift toward public health concerns for physical activity and health outcomes.

The relationship between physical activity and cholesterol levels in children and adolescents

OBJECTIVES: to describe total cholesterol (TC) plasma levels according to age and sex; to determine the contribution of sex, age, body mass index and physical activity (PA) to TC variation; to determine the odds ratio for high total cholesterol (HTC) plasma levels of the subjects in the first PA quartile (lower PA) in comparison to the fourth PA quartile. METHODS: the sample comprised 799 white children and adolescents, 353 males and 446 females. Body height and body weight were determined by standard anthropometric methods. Subject's capillary blood samples were taken from the earlobe after at least 12 hours fasting in order to obtain values of plasmatic TC. To calculate physical activity index (PAI) a PA questionnaire was used. RESULTS: the logistic regression of HTC for males and females showed that girls in the lower quartile of PAI, are 3.0 times (p <0.05; 95%CI: 1.3-6.8) as likely to belong at HTC group in relation to girls in the fourth PAI quartile. No significant influence was found in boys. CONCLUSIONS: the results of the present study suggested that the higher TC values could be found even in early ages.

Factors affecting levels of physical activity in adults

A large proportion of adults in Western cultures are physically inactive, despite several decades of warnings about the potentially negative health consequences of a sedentary lifestyle. Efforts to promote physical activity have focused on identifying its determinants and designing interventions that might effectively promote regular physical activity. The multitude of factors that induce adults to initiate and maintain programmes of physical activity have been divided into those that are invariable (age, gender, race, ethnicity) and those that are presumed to be modifiable (behavioural and personality characteristics, environmental circumstances and community settings). The lack of consistency in the design, analysis and reporting of interventions in the lives of inactive or sedentary individuals has produced equivocal results. However, several social and environmental factors have systematically emerged as determinants of physical activity in adults. In ethnic minorities, the removal of barriers such as unaffordable facilities and unavailable childcare, high crime rates, fear for personal safety and culturally inappropriate activities are of primary importance. Social support from family, peers, communities and healthcare providers has resulted in modest improvements across cultures, ages and genders in selected settings, but the definition of specific interventions and their outcomes deserve additional attention. Longitudinal studies indicate that components of physical fitness are relatively transitory, with low to modest correlations between physical activity and measures of physical fitness in childhood and adolescence and in adulthood. Attempts to explain the activity behaviour of adults by applying various theories in programmes of intervention have also produced mixed results. Successful interventions tailor programmes to individual needs, account for personal levels of fitness, allow for personal control of the activity and its outcomes, and provide for social support by family, peers and communities. The initiation and maintenance of regular physical activity in adults depends on a multitude of biological and sociocultural variables that demand attention across the lifespan.