Physical activity change during adolescence: a systematic review and a pooled analysis

Psychometric property and measurement invariance of perceived benefits and barriers of physical activity in Chinese adolescents

Background

The perceived benefits and barriers to physical activity play crucial roles in determining daily physical activity levels. However, previous studies have employed tools lacking adequate validation, leading to inconsistent conclusions about the impact of these two factors. Therefore, this national, population-based study was conducted to assess the psychometric properties, measurement invariance, and predictive validity of the Chinese versions of the perceived benefits (C-PBEPA) and barriers to physical activity (C-PBAPA) scales.

Methods

The final sample (N = 2942, 49.3 % for boys) was randomly split into two subsamples. The first subsample was used for exploratory factor analysis and the second subsample was used for confirmatory factor analysis. Measurement invariance across gender and age groups were examined. Structural equation models were developed to examine the predictive validity of the revised C-PBEPA and C-PBAPA on moderate to vigorous PA.

Results

The results showed that both scales were unidimensional, had excellent model fit (e.g., X 2/df < 3, CFI >0.9, RMSEA <0.06) and demonstrated convergent validity. Findings also revealed lack of scalar invariance for C-PBAPA between preadolescents and adolescents' groups (ΔCFI >0.01) and supported the predictive validity of both scales (p < 0.001).

Conclusion

The study demonstrated that the revised C-PBEPA and C-PBAPA are valid scales for measuring Chinese adolescents' perceived benefits and barriers to PA.

Lost in research translation: Female athletes are not male athletes, especially at the hip

Altered shape of the proximal femur (cam morphology) or acetabulum (pincer morphology) is indicative of femoroacetabular impingement, which can result in hip pain and osteoarthritis of the hip. As mechanical load during growth affects the resulting bone shape, there is strong evidence in males that cam morphology develops during skeletal growth while physes are open, rather than as an adaptation after growth plates are closed (skeletal maturity). This adaptation is particularly evident in athletes who participate at elite levels prior to skeletal maturity. The research providing this evidence, however, has primarily focused on male athletes. Despite the lack of inclusion in the research, females consistently comprise two thirds of the clinical and surgical populations with structural hip pain or pathology. Knowledge gained from male-dominated cohorts may not appropriately transfer to female athletes, especially at the hip. This perspectives article briefly reviews differences between females and males in femoral and acetabular structure, hormones, timing of puberty/maturation, hypermobility, activity level and movement control-factors which affect hip structure development and loading. Without female-focused research, the application of research findings from male athletes to female athletes may lead to ineffective or even inappropriate recommendations and treatments. Thus, there is a critical need for investment in research to promote life-long hip health for females.

Participation in physical activity and sport in adolescent girls from Middle Eastern backgrounds

OBJECTIVES

This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia.

DESIGN

A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis.

RESULTS

Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology.

CONCLUSION

The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds.

Longitudinal effects of basic psychological need support on the development of intrinsic motivation and perceived competence in physical education. A multilevel study

Background

Grounded in self-determination theory, this article deals with a multidimensional measurement of the support of the basic psychological needs and the individual and combined effects on the development of intrinsic motivation and perceived competence in physical education. In addition to the supportive teacher behaviors of autonomy support, competence support and relatedness support, peer relatedness support is examined as an additional factor.

Methods

A total of 1,047 students from 72 classes from various German-speaking Swiss cantons took part in the study. The hypothesized four factorial structure was analyzed using multilevel confirmatory factor analyses. Longitudinal measurement invariance testing of intrinsic motivation and perceived competence indicates scalar measurement invariance. Multilevel regression analyses were specified to analysis the longitudinal effects on the development of intrinsic motivation and perceived competence, whereby both the effects of the individual factors as well as the adjusted effects under the inclusion of all predictors were examined.

Results

Results of multilevel confirmatory factor analysis indicate that the hypothesized four-factor model (e.g., CFI = 0.97; TLI = 0.96; RMSEA = 0.04; SRMR between = 0.11) is to be favored over alternative models at both levels. Regarding the prediction of the development of intrinsic motivation and perceived competence our study underlines the predictive value of basic psychological need support. The models that examine the effects of the individual predictors indicate that the effects are largely consistent with expectations at both the class and individual level. At class level, however, autonomy support appears to be no significant predictor for the development of intrinsic motivation (p < 0.10), but for perceived competence (p < 0.05). Peer relatedness support is a significant predictor for both outcome variables at both levels of analysis. Regarding the simultaneous integration of all predictors, only the effects of peer relatedness support remain significant for both outcome variables.

Discussion

The empirical support of the multidimensionality of the instrument is particularly interesting in the context of the common conceptualization of a unidimensional measurement of autonomy support or a composite factor of psychological need support, whereby only few studies have adequately tested the factorial validity. Although significant effects of supportive teacher behaviors can be demonstrated in the multilevel regression analyses, it is also indicated that the different dimensions lack of incremental predictive validity. Particularly noteworthy is the rarely investigated role of peer relatedness support, which has been shown to be a meaningful predictor, even when supportive teacher behaviors are taken into account.

Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults

Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.

Factors that influence participation in physical activity for people with bipolar disorder: a synthesis of qualitative evidence

BACKGROUND

Mental health problems contribute significantly to the overall disease burden worldwide and are major causes of disability, suicide, and ischaemic heart disease. People with bipolar disorder report lower levels of physical activity than the general population, and are at greater risk of chronic health conditions including cardiovascular disease and obesity. These contribute to poor health outcomes. Physical activity has the potential to improve quality of life and physical and mental well-being.

OBJECTIVES

To identify the factors that influence participation in physical activity for people diagnosed with bipolar disorder from the perspectives of service users, carers, service providers, and practitioners to help inform the design and implementation of interventions that promote physical activity.

SEARCH METHODS

We searched MEDLINE, PsycINFO, and eight other databases to March 2021. We also contacted experts in the field, searched the grey literature, and carried out reference checking and citation searching to identify additional studies. There were no language restrictions.

SELECTION CRITERIA

We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that focused on the experiences and attitudes of service users, carers, service providers, and healthcare professionals towards physical activity for bipolar disorder.

DATA COLLECTION AND ANALYSIS

We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined questions. We used the "best fit" framework synthesis based on a revised version of the Health Belief Model to analyse and present the evidence. We assessed methodological limitations using the CASP Qualitative Checklist. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) guidance to assess our confidence in each finding. We examined each finding to identify factors to inform the practice of health and care professionals and the design and development of physical activity interventions for people with bipolar disorder.

MAIN RESULTS

We included 12 studies involving a total of 592 participants (422 participants who contributed qualitative data to an online survey, 170 participants in qualitative research studies). Most studies explored the views and experiences of physical activity of people with experience of bipolar disorder. A number of studies also reported on personal experiences of physical activity components of lifestyle interventions. One study included views from family carers and clinicians. The majority of studies were from high-income countries, with only one study conducted in a middle-income country. Most participants were described as stable and had been living with a diagnosis of bipolar disorder for a number of years. We downgraded our confidence in several of the findings from high confidence to moderate or low confidence, as some findings were based on only small amounts of data, and the findings were based on studies from only a few countries, questioning the relevance of these findings to other settings. We also had very few perspectives of family members, other carers, or health professionals supporting people with bipolar disorder. The studies did not include any findings from service providers about their perspectives on supporting this aspect of care. There were a number of factors that limited people's ability to undertake physical activity. Shame and stigma about one's physical appearance and mental health diagnosis were discussed. Some people felt their sporting skills/competencies had been lost when they left school. Those who had been able to maintain exercise through the transition into adulthood appeared to be more likely to include physical activity in their regular routine. Physical health limits and comorbid health conditions limited activity. This included bipolar medication, being overweight, smoking, alcohol use, poor diet and sleep, and these barriers were linked to negative coping skills. Practical problems included affordability, accessibility, transport links, and the weather. Workplace or health schemes that offered discounts were viewed positively. The lack of opportunity for exercise within inpatient mental health settings was a problem. Facilitating factors included being psychologically stable and ready to adopt new lifestyle behaviours. There were positive benefits of being active outdoors and connecting with nature. Achieving balance, rhythm, and routine helped to support mood management. Fitting physical activity into a regular routine despite fluctuating mood or motivation appeared to be beneficial if practised at the right intensity and pace. Over- or under-exercising could be counterproductive and accelerate depressive or manic moods. Physical activity also helped to provide a structure to people's daily routines and could lead to other positive lifestyle benefits. Monitoring physical or other activities could be an effective way to identify potential triggers or early warning signs. Technology was helpful for some. People who had researched bipolar disorder and had developed a better understanding of the condition showed greater confidence in managing their care or providing care to others. Social support from friends/family or health professionals was an enabling factor, as was finding the right type of exercise, which for many people was walking. Other benefits included making social connections, weight loss, improved quality of life, and better mood regulation. Few people had been told of the benefits of physical activity. Better education and training of health professionals could support a more holistic approach to physical and mental well-being. Involving mental health professionals in the multidisciplinary delivery of physical activity interventions could be beneficial and improve care. Clear guidelines could help people to initiate and incorporate lifestyle changes.

AUTHORS' CONCLUSIONS

There is very little research focusing on factors that influence participation in physical activity in bipolar disorder. The studies we identified suggest that men and women with bipolar disorder face a range of obstacles and challenges to being active. The evidence also suggests that there are effective ways to promote managed physical activity. The research highlighted the important role that health and care settings, and professionals, can play in assessing individuals' physical health needs and how healthy lifestyles may be promoted. Based on these findings, we have provided a summary of key elements to consider for developing physical activity interventions for bipolar disorder.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Trends of physical activity and recreational screen time among Chinese children and adolescents: a national study from 2017 to 2019

BACKGROUND

The prevalence of physical inactivity and sedentary behavior among children and adolescents is a growing public health concern. This study aims to examine the trends in Physical Activity (PA) and Recreational Screen Time (RST) amongst children and adolescents in China, considering variations in genders, school levels, areas (urban versus rural), and regions (north versus south). The findings provide a foundation to guide policy and strategy making for future health promotion and development.

METHODS

An annual national cross-sectional survey was conducted in China from 2017 to 2019 cumulatively involving 52,503 (48% female) children and adolescents from grades 4 to 12 (aged 12.72 ± 2.12). Data on PA and RST were collected through self-administered questionnaires. Weighted least squares regression was used to analyze the trends and differences in PA and RST among the participants' profiles.

RESULTS

There was an annual decreased in PA compliance rate of approximately 3.43% (95% CI: 0.79-6.08%) for primary school students, primarily among males residing in rural areas, and in northern regions. Middle school students experienced a yearly decrease of about 5.23% (95% CI: 2.55-7.92%) in PA compliance across all genders, regions, and urban areas. Similarly, the RST compliance rates for primary school students declined by approximately 3.18% (95% CI: 1.57-4.78%) annually for all genders and areas, but only in the northern regions.

CONCLUSIONS

This research highlights a downward trend in PA and RST compliance amongst Chinese children and adolescents, with variations based on school level, gender, area, and region. Urgent policies and interventions are imperative to promote PA while mitigating excessive RST within these populations.

Physical activity moderates the association between school start time and sleep duration in a cross-sectional national sample of adolescents

Background

Adolescent insufficient sleep is an endemic issue that may result in compromised functioning throughout the course of the day and is associated with increased risk for a variety of adverse outcomes. Early school start time (SST) has been consistently found to be detrimental to adolescents' sleep achievement on school nights. However, there are logistical barriers to changing SST. Evidence supports daily engagement in moderate-to-vigorous intensity physical activity (MVPA) to enhance adolescents' nightly sleep achievement. However, the role of MVPA in the association between SST and sleep duration is unknown. This study examines the potential moderating effect of MVPA in the association between SST and sleep duration on a typical school day among adolescents.

Methods

This study examined data (collected in April and October 2014) from a national sample of 1132 adolescents (m age = 14.5 years) living in the United States from the Family Life, Activity, Sun, Health, and Eating study, a cross-sectional, internet-based survey. First, three linear regressions were computed to examine bivariate associations between SST, MVPA, and sleep duration while controlling for participant sex, race and ethnicity, household income, school level, and the presence of a TV in the bedroom. Next, a three-step multiple regression was computed with sleep duration as the dependent variable, and the final step included an interaction term between SST and MVPA.

Results

Later SST (b 1 = 0.41, p < 0.001) and increased MVPA (b 1 = 0.39, p < 0.001) were both associated with increased sleep duration, while SST and MVPA were not significantly associated. In the final multiple regression model, which included the interaction term, school day MVPA moderated the positive association between SST and school night sleep duration (b 1 = - 3.7, p < 0.05), such that the greater the MVPA on a typical school day, the weaker the positive association between early SST and sleep duration. In post-hoc analysis, the interaction effect was only significant for females and not males.

Conclusions

The significant buffering effect of MVPA on the association between SST and sleep duration suggests that in the absence of SST changes, promoting MVPA among adolescents may be a promising strategy to mitigate insufficient sleep among US adolescents.

Sports participation in childhood and adolescence and physical activity intensity in adulthood

OBJECTIVES

The aim of the present study was to analyze the association between sports participation in childhood and adolescence and the practice of physical activity at different intensities in adulthood, and to verify if some sports participation characteristics such as number of sports; type of sport (individual, collective or a combination of both) and total estimated sports participation time are associated with the different physical activity intensities in adulthood.

DESIGN

This is a cross-sectional study.

METHODS

This study included 129 young adults of both sexes aged 18-25 years. Sports participation in childhood (7-10 years) and adolescence (11-17 years) was retrospectively estimated through specific questionnaire. Light, moderate, vigorous and moderate to vigorous intensity physical activity was objectively estimated by accelerometers. To verify the association between SP in childhood and adolescence and BP intensities in adults, multiple linear regression was adopted, with 5% significance.

RESULTS

Analyses showed that, in females, sports participation in childhood (β = 0.315; R2 = 0.14; P = 0.020) and persistence in sports participation (β = 0.364; R2 = 0.18; P = 0.007) were positive predictors of vigorous physical activity in adulthood. In addition, the comparison according to the specificities of the sport practice, indicated that participation in two or more sports in childhood, one sport and collective sports in adolescence and at least one year of sports participation throughout childhood and adolescence were associated with longer time in vigorous physical activity intensity and MVPA (minutes/day) in adult females (P < 0.05).

CONCLUSIONS

It could be concluded that sports participation indicators in childhood and adolescence were considered predictors of vigorous physical activity in adult females. In addition, number of sports, type of sport and practice time in childhood and adolescence seem to predict vigorous and moderate to vigorous levels of physical activity for adult females.

Cardiovascular Health Trajectories in Adolescence and Their Association With Sociodemographic and Cardiometabolic Outcomes in Spain

PURPOSE

To determine cardiovascular health (CVH) trajectories and their association with sociodemographic and cardiometabolic outcomes in adolescence.

METHODS

One thousand eighty adolescents attending 24 secondary schools enrolled in the SI! Program for Secondary Schools trial in Spain were assessed at approximately 12, 14, and 16 years of age. CVH was assessed according to American Heart Association criteria based on seven metrics (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and blood glucose), and CVH trajectories were identified by latent class trajectory modeling. Associations between CVH trajectories, sociodemographic characteristics, and cardiometabolic outcomes were analyzed using generalized linear and Poisson models.

RESULTS

Five CVH trajectory groups were identified: poor-stable (27 adolescents [2.5%]), intermediate-substantial rise (79 [7.3%]), intermediate-substantial decline (63 [5.8%]), intermediate-mild decline (403 [37.3%]), and intermediate-mild rise (508 [47.1%]). Boys and adolescents from families with low-average income, low-intermediate educational attainment, and a migrant background more frequently belonged to groups with lower baseline CVH and poor or declining trajectories. The intermediate-substantial decline group had the highest prevalence ratio for overweight/obesity (3.84; 95% confidence interval: 2.86-5.16) and metabolic syndrome (4.93; 95% confidence interval: 1.21-20.04) at age 16, whereas prevalence was lowest in the intermediate-mild rise group.

DISCUSSION

Adolescent CVH trajectories differ according to socioeconomic characteristics and are associated with cardiometabolic outcomes. Primordial prevention interventions should be implemented early in life, taking into account CVH trajectories and with a particular focus on vulnerable populations.

Physical activity levels before and after the COVID-19 restrictions among Danish adolescents: a retrospective cohort study

AIMS

It has been suggested that the COVID-19 restrictions may have negatively impacted physical activity (PA) levels, especially among adolescents, who often use organised sports to support their intrinsic motivation for staying active. This study aimed to investigate whether adolescents were less physically active after the COVID-19 restrictions compared with before and examine whether participation in organised sports has changed since the COVID-19 restrictions.

METHODS

This was a retrospective cohort study of Danish adolescents aged 15 to 19 years. Data was collected using a questionnaire in SurveyXact. The primary variable of interest was moderate or high-intensity PA frequency before and after COVID-19 restrictions (from March 11, 2020, to September 10, 2021). Secondary variables of interest included whether the PA was self-organised (e.g. running, hiking, going to a gym or cycling) or part of an organised sport delivered by a club or other association, before versus after the restrictions.

RESULTS

A total of 324 participants responded to the questionnaire. The relative risk of not performing PA at least twice per week after COVID-19 restrictions compared with before was significantly larger (1.44; 95%CI: 1.19 to 1.85, p = 0.005). Before the lockdowns, 190 (59%) were engaged in organised sports compared with 152 (47%) after the restrictions (relative risk: 1.51, 95%CI: 1.19 to 1.92, p < 0.001).

CONCLUSIONS

Compared with activity levels before the pandemic, adolescents became significantly less physically active following the COVID-19 restrictions, beyond what is typically observed during adolescence. These results emphasise a need for strategies to increase PA levels among adolescents to minimise the long-term negative effects of physical inactivity during adolescence.

Children's Independent Mobility, School Travel, and the Surrounding Neighborhood

INTRODUCTION

Children's active travel to and from school (AST) and children's independent mobility (CIM) are consistently positively associated with physical activity (PA); however, few researchers have investigated associations between objective measures of the environment and indicators of AST and CIM in national samples.

METHODS

A national sample of 2,067 Canadian parents of 7- to 12-year-old children was recruited in December 2020. Regression analyses were used in 2023 to assess the association between geographic information system measures of park density, blue space, population density, greenspace, intersection density, and CIM and AST to and from school.

RESULTS

Children in areas with high versus low park density (>0.025 vs. ≤0.025) had higher odds of travel to school via active modes (OR: 1.47 [1.14, 1.91], p=0.003). Children in neighborhoods in the highest quartile for neighborhood greenspace (Normalized Difference Vegetation Index) were more likely to travel to home actively than those in areas of lower greenspace (OR: 1.70 [1.18, 2.45], p=0.004). On average, children living in areas in the highest versus the lowest quartile for intersection density were more likely to engage in AST to (OR: 2.43 [1.58, 3.75], p<0.001) and from (OR: 2.77 [1.80, 4.29], p<0.001) school.

CONCLUSIONS

The observed associations underscore a need for city planners and policymakers to ensure sufficient access to parks and neighborhood greenspace, especially if findings are confirmed in longitudinal studies. More research is needed to investigate the role of intersection density in supporting AST and CIM.

Change in general and domain-specific physical activity during the transition from primary to secondary education: a systematic review

BACKGROUND

Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes.

METHODS

Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA.

RESULTS

Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition.

CONCLUSIONS

For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future.

TRIAL REGISTRATION

PROSPERO CRD42020190204.

Investigating the impact of developmental coordination difficulties across home, school, and community settings: Findings from the Australian Impact for DCD survey

AIM

To evaluate the participation difficulties experienced by children with developmental coordination disorder (DCD) in home, school, and community environments.

METHODS

The Impact for DCD survey was completed by primary caregivers of 4-18-year-old children with DCD (or synonymous diagnosis) (n = 429).

OUTCOMES AND RESULTS

The greatest participation difficulties experienced at home included dressing, eating with utensils, self-care tasks and drawing/writing reported by over 70% of families. At school, fine motor difficulties were also frequently reported, with additional difficulties keeping up or completing tasks, and not feeling supported at school. Socialisation challenges and bullying were also commonly reported (34.9%). As a result of participation difficulties at school, 5.4% were home schooled. Many children engaged in community activity, with 72.0% currently engaged in at least one organised sports-based activity.

CONCLUSIONS AND IMPLICATIONS

Increased recognition of the widespread impact of DCD in a child's life is crucial at an individual and societal level. Parents reported their children experiencing significant participation restrictions and difficulties. The findings of this large-scale study have revealed that most children with DCD are not receiving the support they need to thrive, especially at school. This largely reflects a lack of understanding and recognition of the condition and its associated challenges.

The importance of family support to engage and retain girls in male dominated action sports. A qualitative study of young people's perspectives

ISSUE ADDRESSED

Social support is positively correlated with physical activity (PA), especially amongst girls, but is underexplored in male-dominated action sports (e.g., mountain biking, skateboarding and surfing). This study explored family level social support needs and experiences of girls and boys in three action sports.

METHOD

Aspiring, current or former Australian adolescent (12-18 years; girls n = 25; boys n = 17) mountain bikers, skateboarders and/or surfers were individually interviewed (telephone/Skype) in 2018/2020. A socio-ecological framework guided the semi-structured interview schedule. Audio-recordings were transcribed verbatim and data analysed thematically using a constant comparative approach.

RESULTS

Family level social support was highly influential in young people's participation in action sports, with its absence a common reason for no or discontinued engagement amongst girls. Parents and siblings were the main social support providers with extended family (e.g., grandparents, aunts/uncles, cousins) also notable. Participation (current/past/co-) was the main social support type followed by emotional (e.g., encouragement), instrumental (e.g., transport, equipment/funding) and informational (e.g., coaching) support. Girls were inspired/encouraged by brothers but boys were not inspired/encouraged by sisters; boys and girls co-participated with both parents but co-participating and being inspired by fathers was most common, especially amongst girls; fathers were more commonly the main transport provider if they co-participated with their child; fathers mostly provided initial coaching; only boys were taught equipment maintenance by parents.

CONCLUSIONS AND SO WHAT

Sport-related organisations/groups have numerous opportunities to improve girls' representation in action sports by fostering family level social support through various means. Intervention strategies should be tailored to account for gendered participation differences.

Longitudinal development and tracking of cardiorespiratory fitness from childhood to adolescence

BACKGROUND

Cardiorespiratory fitness (CRF) is an important indicator of health in childhood and adolescence but longitudinal studies on the development and tracking of CRF from childhood to adolescence are scarce.

OBJECTIVES

The objectives of this study were (1) to assess longitudinal development and track CRF over 10 years from childhood to adolescence, and (2) to examine potential sex differences in the development and tracking of CRF during this period.

METHODS

Participants were Icelandic children born in 1999, measured at the age of 7 (n = 190, 106 girls), 9 (n = 163, 95 girls), 15 (n = 239, 134 girls), and 17 (n = 202, 119 girls). CRF was assessed with a maximal cycle ergometer test and expressed as maximal power output (Max W) and maximal power output relative to lean mass (W/kgLM). Multilevel regression models were used to study the longitudinal development of CRF, and tracking was assessed with Spearman's rank correlation, logistic regression, and the percentage of participants remaining in low, moderate, or high CRF categories between measurements.

RESULTS

Max W and W/kgLM increased for both boys and girls up to age 15. Max W plateaued for both boys and girls while W/kgLM plateaued for girls but declined for boys from age 15 to 17. Boys had higher Max W than girls from age 15 and higher W/kgLM from age 9. CRF tracked at low to moderate levels from childhood to adolescence and at high levels in adolescence, with higher values observed for boys than girls.

CONCLUSIONS

Age 15 was a critical time point in the development of CRF, with values starting to plateau for girls and decline for boys. The results support early intervention for improved CRF in later years, with interventions targeting all children, regardless of their CRF level.

Comparative Analysis of Physical Activity, Performance-Related Health, and Academic Achievements in 11-to-13-Year-Old Schoolchildren in Qatar

Age-related differences in physical activity (PA), maturity status (PHV), physical performance (PP), and academic achievement (AA) among schoolchildren in Qatar were examined. Sixty-nine students from a school in Doha were categorized into three equal (n = 23) groups: 11-year-old students (U11; male: n = 14), 12-year-old students (U12: male: n = 7), and 13-year-old students (U13: male: n = 11). The testing process comprised a medicine ball throw, Stork balance test, hand grip strength test, the T-half test (PP), GPA in Arabic, mathematics, science (AA), International Physical Activity Questionnaire Short Form (PA), and Moore's equations (PHV). Relevant age-related differences (p < 0.001) were identified in mathematics, science, the T-half test, maturity, and arm span. Notably, differences between adjacent age groups were evident between U11 and U12, concerning arm span, maturity, mathematics, and science, and between U12 and U13 (the T-half test, mathematics, science). Concerning AP, the performance maxima were calculated for U12 (mathematics, science) and U11 (Arabic). Regarding PP, performance maxima were only observed for U13. Except for the moderate level, the highest levels of PA were detected in U13. Maturity status and anthropometric parameters did not differ significantly between age groups. However, AA demonstrated the most notable age-related differences. Specifically, mathematics showed substantial differences between adjacent age groups.

Before-school physical activity patterns among adolescents using accelerometer and GPS data

Most adolescents do not meet physical activity (PA) guidelines. The before-school segment has been identified as one promising opportunity for intervention; however, there is a need for contextual understanding of PA in this segment. This study aimed to examine: a) adolescents' PA levels across various locations before school (6:00am - school start), b) contributions of before-school PA to daily PA and PA guidelines, and c) correlates of location-specific before-school PA. A cross-sectional analysis was conducted using adolescents' (n = 148, mean age 14.7) accelerometer and GPS data. Adolescents averaged 9.7 min in before-school moderate-to-vigorous PA (MVPA), representing substantial contributions to daily activity. Most MVPA occurred away from home and school. Significant correlates included segment duration, age, socio-economic status, and PA self-efficacy. Future work should consider these patterns and correlates to support adolescents' PA through targeted interventions.

Exergaming in augmented reality is tailor-made for aerobic training and enjoyment among healthy young adults

In recent years, the use of exergaming for physical activity practice has gain in popularity but few is known about the use of augmented reality for physical activity, particularly at moderate to vigorous intensities. The present study examined the use of an exergame in augmented reality for aerobic training in healthy young adults. In a within-subject design, 18 participants (19.8 ± 1.4 years of age) have performed two physical activity sessions playing dodgeball. Indeed, they realized a classical dodgeball session and an exergaming session with an augmented reality version of dodgeball game. Physical loads and intensities were measured with accelerometers, RPE and heart sensors. Enjoyment experienced during the sessions was measured with the short version of the physical activity enjoyment scale questionnaire. Results revealed that both physical load and intensity were appropriate for aerobic training in the two conditions (i.e., classical and exergame in augmented reality) although values were significantly higher in the classical condition. Enjoyment was high in the two conditions with a higher significant value in the classical condition compared to the exergame in augmented reality condition. Put together, these results indicate that an aerobic state can be attained through both physical gameplay and its augmented reality equivalent and was associated to a high level of enjoyment among healthy young adults.

A school-based physical activity intervention in primary school: effects on physical activity, sleep, aerobic fitness, and motor competence

Objective

The "Super Quinas" project evaluated the effectiveness of an intervention program to improve physical activity, aerobic fitness, sleep, and motor competence on children in primary school.

Methods

The experimental group (n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG (n = 19), all aged 9-10 years. Physical activity (PA) and sleep were measured by accelerometry, and aerobic fitness was measured by Children's Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. Motor Competence in PRE and POST intervention was also assessed by the Motor Competence Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes. A linear mixed model analysis (i.e., within-subject analyses) was performed.

Results

Comparing the EG and CG in DUR and POST, the EG spent ~18 min and ~ 34 min more time in moderate to vigorous physical activity (MVPA) per day (p < 0.001); had ~44 min and ~ 203 min less sedentary time per day (p < 0.001); performed more 44 and 128 m in the Children's Yo-Yo test compared to CG (p < 0.001) and slept more 17 and 114 min per night (p < 0.001). In POST motor competence was significantly better (27%) in the EG compared to CG (p < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun.

Conclusion

Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of physical activity, aerobic fitness, sleep duration, and motor competence in children aged 9-10 years.

Effectiveness of the Walking in ScHools (WISH) Study, a peer-led walking intervention for adolescent girls: results of a cluster randomised controlled trial

BACKGROUND

Most adolescent girls fail to meet current physical activity guidelines. Physical activity behaviours track from childhood into adulthood and providing adolescent girls with opportunities to be physically active may have health benefits beyond childhood. The effects of walking interventions on adult cardiometabolic health are known, however less is understood about the potential of walking to promote physical activity in adolescents. Following the Walking In ScHools (WISH) feasibility study, this definitive trial aimed to evaluate the effectiveness of a novel, low-cost, school-based walking intervention at increasing physical activity levels of adolescent girls (aged 12-14 years).

METHODS

Female pupils were recruited from eighteen schools across the border region of Ireland and in Northern Ireland. In intervention schools (n = 9), girls aged 15-18 years, were trained as walk leaders, and led the younger pupils in 10-15 min walks before school, at break and lunch recess. All walks took place in school grounds and pupils were encouraged to participate in as many walks as possible each week. The primary outcome measure was accelerometer determined total physical activity (counts per minutes, cpm).

RESULTS

In total, 589 pupils were recruited to the study. At baseline, pupils engaged in a median (interquartile range (IQR)) 35.7 (21.2) mins moderate-vigorous physical activity (MVPA) per day and only 12% (n = 66) of participants met physical activity guidelines (60 min MVPA per day). The intervention was delivered for a mean (standard deviation (SD)) 19.9 ± 0.97 weeks. The mean post-intervention total physical activity for the intervention group was 676 cpm and 710 cpm in the control group. Post-intervention total physical activity did not statistically differ between groups when adjusted for age, body mass index z-scores and baseline physical activity (mean difference, -33.5, 95% CI = -21.2 to 88.1; p = 0.213).

CONCLUSIONS

'Scaling-up' physical activity interventions is challenging and despite a promising feasibility study, the results of this fully powered trial suggest that in this context, the WISH intervention did not increase device measured physical activity. Since the COVID-19 pandemic, school environments have changed and although pupils enjoyed the programme, attendance at walks was low, indicating that there is a need to better understand how to implement interventions within schools.

TRIAL REGISTRATION

ISRCTN; ISRCTN12847782; Registered 2nd July 2019.

Capturing children's play behaviours in outdoor environments: A comparative analysis of play in early adolescence at primary school versus high school

INTRODUCTION

Transition from primary school to high school can be a time of significant stress for young people. Social connection may mitigate the stress experienced by young people, yet their play activities, which are a key source of connection and friendship, have not been examined. The aim of the study was to capture the play behaviours of children in outdoor school environments.

METHODS

Children's play behaviours in their final year of primary school and those in their first year of high school were captured using a standardised tool (Tool for Observing Play Outdoors). Observations occurred in school outdoor environments during break times in the South Australian autumn of 2021. Frequencies and types of play were compared between year levels using descriptive statistics and contingency tables. Data were collected from four schools (two metropolitan and two regional), which were all from a similar level on the Index of Educational Disadvantage. Four observation sessions were held at each school.

RESULTS

Parents of 42 (16 girls) primary school students and 85 (33 girls) high school students gave permission for their children to participate. Physical play was the most frequent activity observed in both primary school and high school followed by expressive play. Year level was significantly associated with the type of play engaged in.

CONCLUSION

Findings demonstrate children in the first year of high school continue to engage in physical and social play albeit less than those in the final year of primary school. Further research is needed to determine whether the physical and social environment or onset of puberty is more influential on changes in children's play.

Prospective Teachers' Knowledge of Physical Activity in Children and Adolescents

Over the past few years, organizations around the world have tried to reach different populations with recommendations about physical activity (PA), due to this subject playing an important role in the phases of intention development and in preparation for it. Thus, the knowledge of future educators in the fields of health and PA is of vital importance when improving the levels of the latter in students. The objective of this research is to determine what knowledge future teachers have about health and PA, examining possible disparities according to the gender, age, and level of physical exercise of the participants. In addition, the psychometric properties of the instrument used were explored. A total of 321 Colombian university students from the Faculty of Education between the ages of sixteen and thirty-five participated in this study, providing sociodemographic information by filling out the CUAFYS-A questionnaire. Significant differences were found in the scale items according to sex and self-perception of being physically active. Also, the findings revealed a single-factor structure with nine items that had satisfactory reliability (α = 0.71; CR = 0.72) and excellent goodness-of-fit indices (RMSEA = 0.055 (90% CI (0.3, 0.8), RMSR = 0.02, CFI = 0.935, NNFI = 0.912, CMIN/DF = 1.97). Therefore, strategies and campaigns to promote PA knowledge in prospective teachers should be tailored according to gender and PA levels. Similarly, the CUAFYS-A questionnaire can be considered a valid and reliable instrument to identify the PA knowledge of future educators.

Impact of Seated Movement Incorporation on Middle School Classroom Physical Activity Levels and Academic Engagement

Purpose: Physical inactivity is linked with several chronic diseases and poor academic outcomes. This study aimed to examine the effect an under-the-desk band would have on middle school students' physical activity level, and academic engagement. Methods: Two local middle school classrooms (n = 42, M = 20, F = 22) participated in the study, which was conducted over 14 weeks. Physical activity was measured with accelerometry, and academic engagement was assessed using momentary time sampling. Enrolled participants were provided an accelerometer to wear upon entering the classroom. The baseline period lasted for 36 days. During the intervention period, which lasted for the next 30 days, an under-the-desk band was provided to students to freely fidget at their desks. After the study, 13 participants (M = 5, F = 8) in Class A were included in final physical activity analysis, and the 6 participants (M = 3, F = 3) in Class B were included in the academic engagement analysis. Results: Class A had significant increases in percentage of sedentary time (MD = -12.91%, ES = .88) in addition to significant decreases in the percentage of light (MD = 8.82%, ES = .67), moderate (MD = 3.08%, ES = .84), and vigorous (MD = -.04%, ES = .63) physical activity time during the intervention period compared to the baseline period. No significant or meaningful changes occurred in academic engagement with the use of the under-the-desk band. Conclusions: This study high- lights the importance of finding appropriate methods to increase physical activity for adolescents.

Organized Physical Activity Program Participation, Physical Activity, and Related Psychosocial Factors Among Urban Adolescents

The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th-7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p < .001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p = .016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p = .009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p = .035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior.

The Longitudinal Mediating Effect of Smartphone Dependency on the Relationship between Exercise Time and Subjective Happiness in Adolescents

The phenomenon of adolescents engaging in less physical activity as they age raises several concerns. Among these, we hypothesized that this trend may negatively impact their mental health and smartphone dependency. Thus, the aim of this study was to longitudinally examine the mediating effect of smartphone dependency in the relationship between adolescents' exercise time and subjective well-being. For analysis, publicly available data from the 2018 Korean Children and Youth Panel Survey were utilized, with a total of 2,242 participants' data included in the analysis. Latent growth modeling results revealed a significant linear decrease in adolescents' exercise time and subjective well-being each year, while smartphone dependency exhibited an increasing trend. Furthermore, the significance tests of indirect effects indicated that the mediating effect of the changing trend in smartphone dependency between the changing trends in exercise time and subjective happiness in adolescents was statistically significant. These findings suggest that as grade levels increase, reducing exercise time can lead to higher smartphone dependency among adolescents, ultimately resulting in decreased subjective well-being.

Adolescence is characterized by more sedentary behaviour and less physical activity even among highly active forager-farmers

Over 80% of adolescents worldwide are insufficiently active, posing massive public health and economic challenges. Declining physical activity (PA) and sex differences in PA consistently accompany transitions from childhood to adulthood in post-industrialized populations and are attributed to psychosocial and environmental factors. An overarching evolutionary theoretical framework and data from pre-industrialized populations are lacking. This cross-sectional study tests hypotheses from life history theory, that adolescent PA is inversely related to age, but this association is mediated by Tanner stage, reflecting higher and sex-specific energetic demands for growth and reproductive maturation. Detailed measures of PA and pubertal maturation are assessed among Tsimane forager-farmers (age: 7-22 years; 50% female, n = 110). Most Tsimane sampled (71%) meet World Health Organization PA guidelines (greater than or equal to 60 min/day of moderate-to-vigorous PA). Like post-industrialized populations, sex differences and inverse age-activity associations were observed. Tanner stage significantly mediated age-activity associations. Adolescence presents difficulties to PA engagement that warrant further consideration in PA intervention approaches to improve public health.

Moving beyond moderate-to-vigorous physical activity: the role of light physical activity during adolescence

Regular physical activity is an important component of a healthy lifestyle for young people. However, an estimated 80% of adolescents globally are insufficiently active. Traditionally, health benefits were attributed only to physical activity of at least moderate intensity, and recommendations focused on achieving a threshold of moderate-to-vigorous physical activity, without consideration of other aspects of movement within the 24 h cycle. Recently, the overall daily balance of active and sedentary behaviours has gained recognition as an important determinant of health. However, the relationship between light intensity physical activity and health has not been fully explored. In this perspective paper, we discuss key challenges in defining, measuring and analysing light physical activity which have hindered the advancement of knowledge in this area. Next, we suggest three ways in which light physical activity may enhance adolescent wellbeing: firstly, by replacing sedentary behaviours to increase daily movement; secondly, by supporting the accumulation of higher intensities of physical activity; and thirdly, by providing positive experiences to facilitate lifelong engagement with physical activity. In highlighting the importance of light physical activity during adolescence, we aim to encourage critical reflection and the exploration of new approaches towards physical activity within public health and beyond.

Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit)

Background

COVID-19 public health crisis has exerted immediate negative impacts on children's physical fitness, but the longer-term effects are not clear, and the impact on children with excess weight is yet unknown. We examined changes in multiple components of physical fitness in response to COVID-19 imposed restrictions, but also a year after the restrictions were terminated, and compared these trends in groups of boys and girls with normal weight, overweight, or obesity before the pandemic.

Methods

Information was gathered through Slovenia's national fitness surveillance system, and included 41,330 children (19,890 girls), aged 5-17, who had their fitness levels measured yearly from 2019 to 2022. Multilevel linear mixed models, fitted separately for boys and girls, were used to model the individual-level trends over time in centile score for each fitness test across 3 weight groups.

Findings

Overall fitness levels decreased markedly across all weight categories between 2019 and 2020, with the largest decreases in Total Fitness Index observed in children with normal weight and overweight (-8.4 and -7.7 centiles for boys and -8.3 and -8.8 for girls, respectively, p < 0.001). While there was some recovery in the overall fitness level between 2020 and 2022, it remained much lower in 2022 compared to 2019 across most groups, apart from boys with obesity. Fitness components that had the largest impact on general fitness trends were cardiorespiratory fitness, lower body power, body core, and upper body strength.

Interpretation

A severe decline in fitness that has not come close to returning to pre-pandemic levels in most population groups of youth begs for urgent population-wide initiatives that will provide additional opportunities for physical activity to youth. Among vulnerable groups, girls with overweight and obesity deserve a special focus of these policies.

Funding

Horizon 2020 (Grant no. 774548), Slovenian National Research Agency (Grant no. P5-0142), Croatian Science Foundation (Grant no. DOK-2020-01-3728).

Physical activity in childhood and later risk of inflammatory bowel disease: A Scandinavian birth cohort study

BACKGROUND AND OBJECTIVE

Retrospective data have linked adult physical activity (PA) to reduced risk of inflammatory bowel disease (IBD). We aimed to prospectively examine the association of PA and screen time (ST) in childhood with later risk of IBD, for which data are scarce.

METHODS

Using two population-based birth cohorts (All Babies in Southeast Sweden [ABIS] and Norwegian Mother, Father, and Child Cohort Study [MoBa]), we retrieved parent-reported data on PA and ST degree at ages 3 and 8 years. Data were modelled as binary (high vs. low) and numerical (hours/day) exposures. Inflammatory bowel disease was defined as ≥2 diagnostic records in national health registers. Cox regression estimated hazard ratios adjusted for potential confounding from parental IBD, country of origin, education, and smoking habits (Adjusted hazard ratio (aHR)). Our 8-year analyses included a 2-year lag period to reduce the risk of reverse causation. Cohort-specific estimates were pooled using random-effects model.

RESULT

Among 65,978 participants from ABIS (n = 8810) and MoBa (n = 57,168) with available data, 266 developed IBD. At 3 years, children with high versus low PA had an aHR of 1.12 for IBD (95%CI = 0.87-1.43); high versus low ST showed an aHR of 0.91 (95%CI = 0.71-1.17). Conversely, at 8 years, high versus low ST was associated with increased risk of later IBD (aHR = 1.51; 95%CI = 1.02-2.25), but PA at 8 years, was not linked to IBD (aHR = 1.19; 95%CI = 0.80-1.76). Subtype-specific analyses for Crohn's disease and ulcerative colitis did not differ appreciably.

CONCLUSION

Acknowledging possible confounding variables, children with high versus low ST at 8 years were at increased risk of IBD. In contrast, PA degree was not linked to IBD at any age category.

Feasibility and Utility of a Fitbit Tracker Among Ambulatory Children and Youth With Disabilities

PURPOSE

To examine the feasibility and utility of the Fitbit Charge HR to estimate physical activity among ambulatory children and youth with disabilities.

METHOD

Participants (4-17 y old) with disabilities were recruited and asked to wear a Fitbit for 28 days. Feasibility was assessed as the number of participants who adhered to the 28-day protocol. Heat maps were generated to visually examine variability in step count by age, gender, and disability group. Between-group differences for wear time and step counts by age, gender, and disability type were assessed by independent sample t tests for gender and disability group, and a 1-way analysis of variance for age group.

RESULTS

Participants (N = 157; median age = 10 y; 71% boys; 71% nonphysical disabilities) averaged 21 valid days of wear time. Wear time was higher in girls than boys (mean difference = 18.0; 95% confidence interval [CI], 6.8 to 29.1), and in preadolescents (mean difference = 27.6; 95% CI, 15.5 to 39.7) and adolescents (mean difference = -21.2; 95% CI, -33.6 to -8.7) than children. More daily steps were taken by boys than girls (mean difference = -1040; 95% CI, -1465 to -615) and individuals with a nonphysical disability than a physical disability (mean difference = -1120; 95% CI, -1474 to -765). The heat maps showed peaks in physical activity on weekdays before school, at recess, lunchtime, and after school.

CONCLUSION

The Fitbit is a feasible tool for monitoring physical activity among ambulatory children and youth with disabilities and may be useful for population-level surveillance and intervention.

The mediating role of social support in promoting physical activity among children in South Africa

Background

Low physical activity (PA) participation levels and increasing non-communicable diseases in children are concerning in South Africa and globally.

Objectives

We sought to assess the mediating role of perceived social support factors on the relationship between PA enjoyment and PA levels among rural, peri-urban and urban school children.

Method

A cross-sectional study was adopted to assess peer, family and teacher encouragement as mediators on the relationship between perceived PA enjoyment and perceived physical activity participation among children, using the Physical Activity Questionnaire for Older Children (PAQ-C). The sample comprised a random sample of primary school learners aged 9-14 years.

Results

The sample consisted of 870 primary school learners with a mean age of 11.0 ± 1.49 years. Most participants were girls (n = 519; 59.7%). The findings suggest low levels of perceived PA participation (mean = 2.33, standard deviation [s.d.]: 0.43). Peer (β = 0.0187, 95% confidence interval [CI]: 0.0088, 0.0307), family (β = 0.0280, 95% CI: 0.0155, 0.0425) and teacher (β = 0.0242, 95% CI: 0.0127, 0.0378) encouragement partially mediates the relationship between perceived PA enjoyment and perceived PA participation. Family encouragement (β = 0.0158, 95% CI: 0.0017, 0.0311) has the most considerable mediating effect, followed by teacher encouragement (β = 0.0125, 95% CI: 0.0010, 0.0269).

Conclusion

The findings demonstrated low levels of perceived PA participation in school learners. Therefore, we recommends including social factors as mediators in PA intervention programmes in primary schools.

Clinical implications

Social support factors as mediators on the relationship between PA enjoyment and PA participation among children may improve children's PA participation levels and help prevent non-communicable diseases in future.

Evaluation of Physical Literacy in 9- to 11-Year-Old Children: Reliability and Validity of Two Measurement Tools in Three Southeastern European Countries

The awareness of the importance of physical literacy (PL) is globally increasing; however, knowledge of the applicability of PL measurement tools in southeastern Europe is limited. The aim of this study was to evaluate the reliability and validity of translated versions of the CAPL-2 and PLAYself questionnaires in 9- to 11-year-old elementary school children from Croatia, Bosnia and Herzegovina, and Montenegro. The participants were 303 children (141 girls; all 9 to 11 years of age) from Croatia (n = 71), Bosnia and Herzegovina (n = 162), and Montenegro (n = 70), enrolled in regular elementary school. The participants were tested throughout a test-retest procedure using two PL evaluation tools, i.e., the Canadian Assessment of Physical Literacy (shorter version, CAPL-2) and the Physical Literacy Assessment of Youth (PLAYself) questionnaires. With an intraclass correlation (ICC) of 0.70-0.80 for specific questionnaire subscales and 0.84 for the total score, PLAYself was found to be reliable. With Kappa values of 0.11-0.23 and a percentage of absolute agreement of less than 62%, CAPL-2 appeared to be less reliable. Factors related to sport participation were significantly positively associated with the PLAYself score, indicating its proper validity. In conclusion, we suggest the usage of the PLAYself questionnaire in further studies examining PL in children of a similar age in the region. Future studies in other age groups and languages are also warranted.

U.S. Adolescent Rest-Activity patterns: insights from functional principal component analysis (NHANES 2011-2014)

BACKGROUND

Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents.

METHODS

Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011-2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend specific analyses were performed in addition to the overall analysis.

RESULTS

Four rest-activity rhythm profiles were identified, which explained a total of 82.7% of variance in the study sample, including (1) High amplitude profile; (2) Early activity window profile; (3) Early activity peak profile; and (4) Prolonged activity/reduced rest window profile. The rest-activity profiles were associated with subgroups of age, sex, race/ethnicity, and household income. On average, older age was associated with a lower value for the high amplitude and early activity window profiles, but a higher value for the early activity peak and prolonged activity/reduced rest window profiles. Compared to boys, girls had a higher value for the prolonged activity/reduced rest window profiles. When compared to Non-Hispanic White adolescents, Asian showed a lower value for the high amplitude profile, Mexican American group showed a higher value for the early activity window profile, and the Non-Hispanic Black group showed a higher value for the prolonged activity/reduced rest window profiles. Adolescents reported the lowest household income had the lowest average value for the early activity window profile.

CONCLUSIONS

This study characterized main rest-activity profiles among the US adolescents, and demonstrated that demographic and socioeconomic status factors may shape rest-activity behaviors in this population.

A research synthesis on successful educational practices and student outcomes for physical education in schools

Although successful educational practices (SEPs) in higher education institutions have well-established student outcomes, the vast majority do not meet physical education standards in schools. Despite the promising nature of policy initiatives supporting schools, there is scant evidence of how these SEPs affect student outcomes. This review aimed to determine the status of the literature and the type of evidence regarding school SEPs. Several studies have demonstrated that these SEPs contribute directly or indirectly to improving student outcomes. Three objectives were examined and synthesized in our review of SEP research findings. The first goal is to identify different types of impacts on students in schools. The second goal is to provide educators, principals, and policymakers with a unified and comprehensive framework. Lastly, we provide suggestions for future SEP research. The review identified 45 studies that met our inclusion criteria. Our reviewed studies documented impacts on the individual level. It encompasses both students' instrumental abilities and their sense of self-esteem and motivation. Secondly, improving interpersonal relationships, reducing conflict, and increasing group cohesion are important components at the group level. Finally, there are factors at the community level, including absenteeism reduction, parental involvement, and changes in attitudes toward school. Current research supports the effectiveness of successful school practices. It stresses the importance of implementing policies to maximize student outcomes. Finally, the review concludes by discussing findings implications and future research directions.

Minimal Detectable Change in Resting Blood Pressure and Cardiorespiratory Fitness: A Secondary Analysis of a Study on School-Based High-Intensity Interval Training Intervention

High-intensity interval training (HIIT) effects on resting blood pressure (BP) and cardiorespiratory fitness (CRF) have already been studied. Furthermore, the responses of responders and non-responders to HIIT in terms of these physiological outcomes have also been examined. However, the minimal detectable change (MDC) in BP and CRF has not been addressed yet. Therefore, the current study aimed to compare the MDC90 of BP (systolic and diastolic) and CRF (fitness index (FI) results) in the context of a school-based HIIT program for adolescents. Participants were adolescents, with an average age of 16.16 years (n = 141; 36.6% males). A preplanned secondary analysis was conducted using pre-post data from the control group to estimate MDC90. The MDC90 of SBP, DBP, and FI were 7.82 mm HG, 12.45 mm HG, and 5.39 points, respectively. However, taking into account the relative values of these changes, MDC90 required a greater change in DBP (17.27%) than FI (12.15%) and SBP (6.68%). Any training-induced physiological changes in the average values of the outcomes did not exceed MDC90. However, a comparison of the participants who exceeded and did not exceed MDC90 showed statistically significant differences. These findings reveal the huge variability in and insensitivity to the intervention effect for all measurements. This is likely because of the large subgroup of participants with low sensitivity to the physiological stimulus. As such, there is a considerable need to create individually tailored intervention programs.

Is the transition from primary to secondary school a risk factor for energy balance-related behaviours? A systematic review

OBJECTIVE

The substantial changes in the physical and social environment during the transition from primary to secondary school may significantly impact adolescents' energy balance-related behaviours (i.e. dietary behaviour, sedentary behaviour, sleep behaviour and physical activity (PA)). This is the first review systematically summarising evidence on changes in four energy balance-related behaviours of adolescents across the school transition from primary to secondary school.

DESIGN

For this systematic review, the electronic databases Embase, PsycINFO and SPORTDiscus were searched for relevant studies from inception to August 2021. PubMed was searched for relevant studies from inception to September 2022. Inclusion criteria were: (i) longitudinal studies reporting; (ii) one or more energy balance-related behaviours; and (iii) across the school transition, that is, with measurement(s) during both primary and secondary school.

SETTING

Transition from primary to secondary school.

PARTICIPANTS

Adolescents across the transition from primary to secondary school.

RESULTS

Thirty-four studies were eligible. We found strong evidence for an increase in sedentary time, moderate evidence for a decrease in fruit and vegetable consumption, and inconclusive evidence for a change in total, light, and moderate-to-vigorous PA, active transport, screen time, unhealthy snack consumption, and sugar-sweetened beverages consumption among adolescents across the school transition.

CONCLUSIONS

During the transition from primary to secondary school, sedentary time and fruit and vegetable consumption tend to change unfavourably. More high-quality, longitudinal research is needed specifically on changes in energy balance-related behaviour across the school transition, especially regarding sleep behaviour. (Prospero registration: CRD42018084799).

Puberty timing and relative age as predictors of physical activity discontinuation during adolescence

Among same-age adolescents, those who enter puberty relatively later and those who are relatively younger (e.g., born later in the year) might be at greater risk of physical activity discontinuation. This study aimed to (1) describe gender-specific discontinuation, re-engagement, and uptake rates in various types of physical activities from the age of 11 to 17 years, and (2) assess puberty timing and relative age as predictors of discontinuation from organized, unorganized, individual, and group-based physical activities. Longitudinal data from 781 (56% girls, age 10-13 years at study baseline) Canadian participants who self-reported puberty status, birthdate, and involvement in 36 physical activities every four months from 2011 to 2018 was analyzed. The incidence of discontinuation, re-engagement, and uptake in organized/unorganized and individual/group activities from grade 6 until grade 12 was described and Cox proportional hazard models were used to estimate associations of puberty timing and relative age with organized/unorganized and individual/group activity discontinuation. Results demonstrate that individual and unorganized activities are maintained longer than group-based and organized activities. Girls who started puberty earlier were more likely to discontinue organized activities than girls with average-puberty timing [Hazard ratio (HR) (95% confidence interval (CI)) 1.68 (1.05-2.69)]. Compared to boys born in the 4th quarter of the year, boys born in the 2nd quarter of the year were less likely to discontinue organized [HR (95% CI) 0.41 (0.23-0.74)], unorganized [HR (95% CI) 0.33 (0.16-0.70)], group [HR (95% CI) 0.58 (0.34-0.98)], and individual activities[HR (95% CI) 0.46 (0.23-0.91)], and boys born in the 3rd quarter were less likely to discontinue unorganized activities[HR (95% CI) 0.41 (0.19-0.88)]. This study illustrates the patterns of physical activity participation throughout adolescence. However, the generalizability of findings may be limited due to participant representation.

Relationships between grit, physical activity, and academic success in university students: Domains of physical activity matter

ObjectiveTo examine the relationships between contexts of physical activity, grit, and GPA in a college population.Participants:875 Undergraduate students from a large, southern university participated between October 2018 and March 2020.Methods:Participants completed an electronic survey evaluating physical activity and grit. The university provided official GPAs. Multiple linear regression models evaluated the correlations between grit, the different physical activity domains, and GPA.Results:Grit was positively associated with domestic physical activity, leisure time physical activity, and GPA. Consistency of interest had no associations with the domains of physical activity or GPA. Perseverance of effort was positively associated with walking, active transport physical activity, domestic physical activity, leisure physical activity, and GPA.Conclusion:Perseverance of effort is related to different domains of physical activity and GPA. Future studies should investigate if increasing leisure time physical activity causes increases in perseverance of effort.

Physical Activity in Youth with Down Syndrome and Its Relationship with Adiposity

PURPOSE

The aims of this study are to (1) compare physical activity (PA) and sedentary activity (SA) in youth with and without Down syndrome (DS and non-DS) and examine the relationships of PA and SA with their traditional risk factors (age, sex, race, and body mass index Z score [BMI-Z]) and (2) explore the relationship of PA with visceral fat (VFAT) in both groups.

METHODS

SenseWear accelerometry data from at least 2 weekdays and 1 weekend day were collected from youth with DS (N = 77) and non-DS (N = 57) youth. VFAT was measured by dual x-ray absorptiometry.

RESULTS

In age-, sex-, race-, and BMI-Z-adjusted models, those with DS engaged in more minutes of light PA (LPA) ( p < 0.0001) and less SA ( p = 0.003) and trended toward fewer minutes of moderate-to-vigorous PA (MVPA) ( p = 0.08) than non-DS youth. No race or sex differences in MVPA were detected in those with DS, unlike non-DS. After additional adjustment for pubertal status, the relationship between MVPA and VFAT approached significance ( p = 0.06), whereas the relationships of LPA and SA with VFAT were maintained ( p ≤ 0.0001 for both).

CONCLUSION

Youth with DS engage in more LPA compared with non-DS, which, in typically developing populations, can confer a more favorable weight status. Increasing the opportunity for youth with DS to engage in LPA as part of their activities of daily living may offer a viable strategy for achieving healthy weight when barriers restrict pursuit of more vigorous PA.

Strategies to Improve Physical Activity and Nutrition Behaviours in Children and Adolescents: A Review

Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.

Effects of Pubertal Timing and Pubertal Tempo on Social Physique Anxiety, Self-determined Motivation, and Exercise in Early Adolescent Girls

PURPOSE

Research has shown that there is a decrease in physical activity levels during early adolescence, especially for girls. Previous studies have shown that the social physique anxiety (SPA) may be a controlling factor influencing exercise motivation and engagement in this behavior; however, the potential role that puberty plays in this decrease has not been considered until now. The objective of the present study was to examine the impact of pubertal timing and pubertal tempo on SPA and exercise motivation and behavior.

METHODS

Data from 328 early adolescent girls, aged between 9 and 12 at the time of joining the study, were collected in 3 waves over a 2-year period. Using structural equation modeling techniques, different 3-time-point growth models were estimated to examine if earlier maturing and compressed maturing in girls had differential effects on SPA and exercise motivation and behavior.

RESULTS

The results from growth analyses suggest that early maturing (according to all the pubertal indicators considered, except menstruation) tends to translate into (1) an increase in SPA levels and (2) a decrease in exercise - in the latter case, by reducing self-determined motivation. However, no differential effects from any of the pubertal indicators were found for compressed maturing in girls.

DISCUSSION

These results highlight the need for increased efforts toward developing programs aimed at helping early maturing girls to cope with the challenges of puberty with a particular focus on SPA experiences and exercise motivation and behavior.

Global Accelerometer-derived Physical Activity Levels from Preschoolers to Adolescents: A Multilevel Meta-analysis and Meta-regression

BACKGROUND

Global level physical activity surveillance studies were primarily based on self-report data that could generate inaccurate results.

PURPOSE

To investigate global accelerometer-measured daily moderate to vigorous physical activity (MVPA) changes from preschool age to adolescence as well as gender differences in MVPA while adjusting for the geographic regions and major MVPA cut points.

METHODS

A comprehensive search was conducted through August 2020 that includes 30 databases such as Academic Search Ultimate, Child Development & Adolescent Studies, Education Full Text, ERIC, General Science, PsycINFO, ScienceDirect, and SPORTDiscuss. We included both cross-sectional and longitudinal MVPA tracking studies with daily MVPA being measured by waist-worn accelerometers and determined by either Freedson 3 METs, 4 METs, or Evenson cut points for preschoolers, children, and adolescents.

RESULTS

Researchers analyzed 84 studies reporting on 124 effect sizes with a total of 57,587 participants. The combined data showed significant MVPA differences among various continents of participants (p < .001) or cut points (p < .05-.001) for both preschoolers, children, and adolescents. Globally, when continents and cut points were controlled, individuals' daily MVPA time decreased every year by an average of 7.88, 10.37, and 6.68 min from preschool age to adolescence, preschool age to children, and children to adolescence, respectively. When cut points and continents were controlled, boys had significantly higher daily MVPA than girls for all three age groups (p < .001).

CONCLUSIONS

Globally, individuals' daily MVPA starts to decline dramatically as early as the beginning of preschool age. Early intervention is needed to counteract the high decline rate in MVPA.

Physical Literacy for Communities (PL4C): physical literacy, physical activity and associations with wellbeing

BACKGROUND

Physical literacy (PL) is considered an important determinant of children's physical activity through which health benefits may be derived. The purpose of this study is to describe a sample of Canadian children's baseline levels of PL and movement behaviors, and explore whether the associations between PL and their mental wellbeing, if any, are mediated by moderate-to-vigorous physical activity (MVPA).

METHODS

All grade two children in 14 elementary schools in the West Vancouver School District, Canada were invited to participate in a two-year longitudinal project. PL was assessed through PLAYfun and PLAYself tools. Physical activity was measured by wrist-worn accelerometers (GT3X + BT) for seven days. Children's mental well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ). A score of total difficulties was aggregated for internalizing and externalizing problems.

RESULTS

A total of 355 children aged 7-9 (183 boys, 166 girls, 6 non-binary) participated with 258 children providing valid accelerometer data. Children exhibited an average of 111.1 min of MVPA per day, with 97.3% meeting the physical activity guidelines. Approximately 43% (108/250) of participants were meeting the Canadian 24-h movement guidelines. Children were at an 'emerging' level of overall physical competence (45.8 ± 5.6) and reported a mean score of 68.9 (SD = 12.3) for self-perceived PL, with no significant differences between boys and girls. PL was significantly associated with MVPA (r = .27) and all SDQ variables (rs = -.26-.13) except for externalizing problems. Mediation analyses showed PL was negatively associated with internalizing problems and total difficulties when the association with MVPA was considered. However, the mediating role of MVPA was found only between PL and internalizing problems, β = -.06, 95%CI [-.12, -.01].

CONCLUSIONS

Although most of our sample was physically active and showed higher adherence to 24-H movement guidelines than comparable population data, the motor competence and self-perceived PL of our sample were similar to those of previous studies. PL has an independent association with children's internalizing problems and total difficulties. Ongoing assessment will investigate the relationships between PL and children's mental health from a longitudinal perspective.

The Impact of Physical Activity and Inactivity on Cardiovascular Risk across Women's Lifespan: An Updated Review

Physical inactivity (PI) represents a significant, modifiable risk factor that is more frequent and severe in the female population worldwide for all age groups. The physical activity (PA) gender gap begins early in life and leads to considerable short-term and long-term adverse effects on health outcomes, especially cardiovascular (CV) health. Our review aims to highlight the prevalence and mechanisms of PI across women's lifespan, describing the beneficial effects of PA in many physiological and pathological clinical scenarios and underlining the need for more awareness and global commitment to promote strategies to bridge the PA gender gap and limit PI in current and future female generations.

Bidirectional associations between adiposity and physical activity: a longitudinal study from pre-puberty to early adulthood

Objective

This study aimed to investigate directional influences in the association between adiposity and physical activity (PA) from pre-puberty to early adulthood.

Methods

In the Calex-study, height, weight, body fat and leisure-time physical activity (LTPA) were measured at age11.2-years, 13.2-years and 18.3-years in 396 Finnish girls. Body fat was measured by dual-energy X-ray absorptiometry, calculating fat mass index (FMI) as total fat mass in kilograms divided by height in meters squared. LTPA level was evaluated using a physical activity questionnaire. In the European Youth Heart Study (EYHS), height, weight and habitual PA were measured at age 9.6-years, 15.7-years and 21.8-years in 399 Danish boys and girls. Habitual PA and sedentary behaviour were assessed with an accelerometer. Directional influences of adiposity and PA were examined using a bivariate cross-lagged path panel model.

Results

The temporal stability of BMI from pre-puberty to early adulthood was higher than the temporal stability of PA or physical inactivity over the same time period both in girls and boys. In the Calex-study, BMI and FMI at age 11.2-years were both directly associated with LTPA at age 13.2-years (β = 0.167, p = 0.005 and β = 0.167, p = 0.005, respectively), whereas FMI at age 13.2-years showed an inverse association with LTPA at age 18.3-years (β = - 0.187, p = 0.048). However, earlier LTPA level was not associated with subsequent BMI or FMI. In the EYHS, no directional association was found for physical inactivity, light-, moderate-, and vigorous-PA with BMI during the follow-up in girls. In boys, BMI at age 15.7-years was directly associated with moderate PA (β = 0.301, p = 0.017) at age 21.8-years, while vigorous PA at age 15.7-years showed inverse associations with BMI at age 21.8-years (β = - 0.185, p = 0.023).

Conclusion

Our study indicates that previous fatness level is a much stronger predictor of future fatness than level of leisure-time or habitual physical activity during adolescence. The directional associations between adiposity and physical activity are not clear during adolescence, and may differ between boys and girls depending on pubertal status.

Gene-environment interaction in the association of residential greenness and 25(OH) vitamin D

There is increasing awareness for beneficial health effects of green space surrounding the home, but the underlying mechanisms are not yet fully understood and challenging to study given the correlation with other exposures. Here, the association of residential greenness and vitamin D including a gene-environment interaction is investigated. 25-hydroxyvitamin D (25(OH)D) was measured by electrochemiluminescence at ages 10 and 15 years in participants of two German birth cohorts GINIplus and LISA. Greenness was measured using the Landsat-derived Normalized Difference Vegetation Index (NDVI) in a 500 m buffer surrounding the home. Linear and logistic regression models were applied at both time points adjusted for several covariates (N_10Y = 2,504, N_15Y = 2,613). In additional analyses vitamin D-related genes, physical activity, time spent outdoors, supplements, and measurement season were investigated as potential confounders or effect modifiers. A 1.5-SD increase in NDVI was significantly associated with increased 25(OH)D values at ages 10 and 15 years (β_10y = 2.41 nmol/l, p=<0.01; β_15y = 2.03 nmol/l, p = 0.02). In stratified analyses, the associations were not seen in participants spending more than 5 h/day outside in summer, having a high physical activity level, taking supplements, or being examined during the winter season. In a subset (n = 1,732) with genetic data, a significant gene-environment interaction of NDVI with CYP2R1, an upstream gene in 25(OH)D synthesis, was observed at age 10 years. When investigating 25(OH)D sufficiency, defined as values above 50 nmol/l, a 1.5-SD increase in NDVI was associated with significantly higher odds of having sufficient 25 (OH)D levels at age 10 years (OR = 1.48, 1.19-1.83). In conclusion, robust associations between residential greenness and 25 (OH)D levels were observed in children and adolescents independent of other confounders and additionally supported by the presence of a gene-environment interaction. Effects of NDVI were stronger in those having lower vitamin D levels at age 10 years due to their covariate profile or genetically lower 25(OH)D synthesis.

Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study

Objective

Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences.

Method

This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire.

Results

2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%).

Conclusions

High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.

Changes in physical activity patterns from adolescence to young adulthood: the BELINDA study

Physical activity (PA) is recognized as a marker of health. The aim was to investigate PA differences from adolescence to young adulthood. European adolescents included in the HELENA study were invited to participate in a follow-up study, 10 years later. The present study included 141 adults (25.0 ± 1.4 years) for whom valid accelerometer data were available in adolescence and adulthood. Changes in PA by sex, weight and maternal education level were explored with interactions. Time spent in sedentary activity, light PA (LPA) and moderate PA (MPA) increased by 39.1, 59.6 and 6.6 min/day, respectively, whereas the time spent in vigorous PA (VPA) decreased by 11.3 min/day compared with adolescent VPA (p < 0.05). Increases in MPA were greater on weekends compared with weekdays, but we found a greater decrease in VPA on weekdays compared with weekends. Moderate-to-vigorous PA (MVPA) decreased significantly on weekdays (-9.6 min/day; 95%CI, -15.9 to -3.4), while it increased on weekends (8.4 min/day; 95%CI, 1.9 to 14.8). Significant heterogeneity was found across sexes for VPA and MVPA, with a stronger decrease in VPA in males compared with females and a significant decrease in MVPA (-12.5 min/day; 95%CI, -20.4 to -4.5) in males but not in females (1.9 min/day; 95%CI, -5.5 to 9.2). No significant heterogeneity was found to be linked to maternal education level or weight, irrespective of PA level.  Conclusion: Our data suggest that the transition from adolescence to young adulthood is a critical period for lifestyle PA habits. A decline in VPA and an increasingly sedentary time were observed. The observed changes are worrying and may increase the risk of developing adverse health consequences later in life. What is Known: • The transition from adolescence to adulthood is marked by many life changes affecting lifestyle habits. Most studies tracking physical activity from adolescence to adulthood were done using PA questionnaires, which is a subjective method. What is New: • Our study bring first data on objective changes in PA patterns between adolescence and young adulthood, taking account of BMI, sex and maternal educational level. Our results suggest that the transition from adolescence to young adulthood is a critical period for lifestyle PA habits, especially for time spent on sedentary activities.