Age and gender differences in objectively measured physical activity in youth

Associations Between Parent's and Child's Total Physical Activity and Sedentary Behavior among Hispanic/Latino Families

Parents play a critical role in supporting their children's physical activity (PA) and sedentary behavior (SB). However, less is known about parents' support for child PA and SB in underserved populations. In this study, we examined the associations between parent and child total PA (TPA), SB, and moderators of these associations in a primarily Hispanic/Latino sample. This cross-sectional study used baseline data from 68 parent-child dyads who participated in a two-group randomized controlled trial. TPA and SB were measured for seven consecutive days using GeneActiv wrist-worn accelerometers. Multivariable linear regression was used to evaluate the parent-child TPA and SB associations [betas (ß) and 95% confidence intervals (CIs)]. We examined child sex (girl versus boy), child age (6-10 versus 11-12 years), and day of week (weekday versus weekend) as moderators of these associations. In covariate-adjusted models, there were no statistically significant associations between parent-child TPA (ß = - 0.04, 95%CI = - 0.20, 0.13) or SB (ß = 0.05, 95%CI = - 0.13, 0.22), and child sex and child age did not modify these associations (Pinteraction > 0.05). Parent-child TPA were not associated on weekdays (ß = - 0.07, 95%CI = - 0.22, 0.09) or weekends (ß = - 0.05, 95%CI = - 0.21, 0.12); however, parent-child SB were significantly associated on weekends (ß = 0.67, 95%CI = 0.38, 0.96), but not weekdays (ß = 0.04, 95%CI = - 0.12, 0.21). In this study of primarily Hispanic/Latino parent-child dyads, parent and child TPA and SB were not associated, except for SB on the weekends. Interventions aimed at supporting Hispanic/Latino parents to promote PA and limit SB in their children may be important for promoting a healthy lifestyle.

Effect of physical activity on mental toughness and quality of life in gender-specific participants: a cross-sectional examination

Background and aims

Mental toughness is a psychological construct related to resilience and perseverance, and quality of life encompasses physical, emotional, and social wellbeing, which are critical indicators of overall health and wellbeing. This study aims to investigate the effects of different levels of physical activity on mental toughness and quality of life in both male and female participants.

Methods

This cross-sectional study consists of 220 participants with the age range of 18-31 years. The data were collected using the International Physical Activity Questionnaire, the Mental Toughness Questionnaire, and the World Health Organization Quality of Life. Gender specific differences were determined using an independent t-test (two-tailed). The effect of varying levels of physical activity in male and female participants was determined by analysis of variance.

Results

Significant differences were found between male and female participants for physical activity levels as high (t = 4.21, p ≤ 0.001, d = 871.80), moderate (t = 3.72, p ≤ 0.001, d = 1309.59), and low (t = 3.21, p = 0.002, d = 520.91) physical activity participants. Statistically significant differences were also found between gender for mental toughness parameters [handling pressure (t = 17.96, p ≤ 0.001, d = 1.25), concentration (t = 16.07, p ≤ 0.001, d = 1.22), mental rebounding (t = 13.34, p ≤ 0.001, d = 1.45), winning attitude (t = 12.01, p ≤ 0.001, d = 1.17)] and quality of life parameters [physical (t = 13.16, p ≤ 0.001, d = 1.58), mental (t = 6.17, p ≤ 0.001, d = 1.69), social (t = 4.58, p ≤ 0.001, d = 2.05), environmental (t = 8.35, p ≤ 0.001, d = 4.95)].

Conclusion

Statistically significant differences were found between genders in levels of physical activity, mental toughness, and quality of life. Future research should aim to unravel the complex interlink between physical activity, mental toughness, and quality of life, using longitudinal designs and diverse populations to validate the findings and explore the underlying mechanisms further.

The Importance of Physical Activity Variability and Its Relation with Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children

OBJECTIVES

There is a need to examine the utility of objective measures of attention-deficit/hyperactivity disorder (ADHD) symptoms in children. Objective measures of ADHD symptoms, such as physical activity, may provide a more nuanced assessment of behavior that can be used to augment traditional cross-informant ratings of ADHD symptoms by parents and teachers. The most widely used and researched technique for objectively capturing children's physical activity is accelerometry (i.e., the use of small devices that measure gravitational acceleration). The current study examined the unique and interactive effects of mean levels of physical activity (physical activity volume) and intra-individual variability in physical activity (physical activity variability), as measured by accelerometry, on teacher-reported ADHD symptoms (hyperactivity/impulsivity and inattention examined separately).

METHOD

One hundred seventy-six early elementary school students (Mage = 6.83, SD = 0.96, 53% male) from four midwestern schools and four northeastern schools were included. All were participants in a before-school intervention study involving physical activity or a sedentary classroom program. Data were collected using accelerometry during the intervention period and ADHD symptoms were reported by teachers following the intervention. Multiple regression models were used to examine the unique and interactive effects of physical activity volume and physical activity variability on ADHD symptoms.

RESULTS

Results demonstrated that physical activity volume was positively associated with hyperactive/impulsive symptoms, whereas physical activity variability was negatively associated with hyperactive/impulsive and inattentive symptoms. Additionally, when both physical activity variables were in the same model, only physical activity variability uniquely predicted ADHD symptoms after accounting for physical activity volume. Specifically, higher physical activity variability was linked with lower hyperactive/impulsive and inattentive symptoms.

CONCLUSION

Objective measures of physical activity volume and physical activity variability may enhance our understanding of physical activity patterns as they relate to ADHD symptoms. Future research should continue to investigate the usability of objective measures of physical activity, and especially physical activity variability, as a screener to identify children at risk for ADHD.

Cannabis use is not associated with altered levels of physical activity: evidence from the repeated cross-sectional Belgian Health Interview Survey

BACKGROUND

Several studies have suggested a positive effect of occasional cannabis consumption on the frequency of leisure-time physical activity, possibly due to more motivation before, more enjoyment during, and better recovery after engaging in leisure-time physical exercise. While such an effect would contradict the stereotypical image of lower physical activity levels in cannabis users as compared to non-users, evidence has been mixed at best. The current study investigated this proposed association in a representative sample of the Belgian population.

METHODS

Data from four waves of the Belgian Health Interview Survey (HIS; repeated cross-sectional survey; 2001 - 2018) were used in a regression and propensity matching analysis to examine the association between past-month cannabis use and physical activity levels, while controlling for potentially confounding variables. A total of n = 19,936 individuals (48.9% female) aged 15-64 years were included in the analysis. We modelled physical activity in function of past-month cannabis use while adjusting for potential confounders.

RESULTS

Both the regression analysis and the propensity-matching analysis revealed no evidence in favor of a positive effect of past-month cannabis use on physical activity level (estimated OR = 0.97, 95% CI = [0.74, 1.28] and estimated RR = 0.90, 95% CI = [0.70; 1.16] respectively). Descriptive analyses of baseline characteristics suggested some clear differences between users and non-users that were in line with previous studies.

CONCLUSIONS

There was no evidence suggesting that past-month cannabis users have better or worse physical activity levels compared to non-users in the Belgian population aged 15-64 years.

Leveraging agent-based modeling and a randomized intervention to advance childhood physical activity: A study protocol

This study (1R01HD107002-01A1) protocol describes the planned creation and use of an agent-based model (ABM) of early childhood physical activity (PA). Successful early childhood PA interventions can potentially play an important role in both increasing overall population health as well as closing health disparities across subpopulations. At present, effective strategies for doing so are currently unknown. In large part, this is because PA determinants operate across levels dynamically, interact with one another, and can differ substantially across children. A complex systems approach-specifically, ABM-can be used to provide important insights about effect pathways driving child PA. Design of the proposed ABM will be based on high-quality extant research on childhood physical activity while allowing for the testing of hypotheses that extend beyond this body of literature. Its primary source of input data will be participants in GROW (NCT01316653), a completed cohort-based randomized controlled trial (RCT) that includes extensive longitudinal PA data collected from accelerometer observations of children from ages 3-9. We will iteratively test and improve upon an etiologic ABM of childhood PA, ensuring that it can satisfactorily reproduce micro- and macro-level influences and trends comparable to those seen in GROW. The tested ABM will then be used to extrapolate beyond the context of the GROW RCT, experimentally identifying potentially efficacious intervention strategies to improve childhood physical activity through program implementation or changes in policies and practices. We will use expert input to identify promising intervention approaches. We will use the model to systematically experiment with a wide array of different hypothetical combinations of intervention specifications and combinations. At the end of the model experimentation step, we expect to generate insights of broad applicability to the field of PA science regarding what might work, and for whom, in promoting PA and reducing disparities in these behaviors.

A graded personalized exercise program's effect on muscle and body fat: randomized controlled trial

OBJECTIVES

With population aging, personalized exercise programs considering clinical and demographic factors like sex, age, and physical activity level are essential; however, research on their effects remains limited. We aimed to evaluate the effectiveness of a Global Physical Activity Questionnaire-based graded personalized exercise program tailored for middle-aged adults aged 40-69 years.

PARTICIPANTS

We enrolled 71 middle-aged adults in their 40s, 50s, and 60s (approximately 20 participants per age group) in a parallel-group randomized controlled trial.

INTERVENTION

Participants were assigned using age-stratified randomization to a treatment or control group. Participants were categorized into three levels according to weekly physical activity measured by the Global Physical Activity Questionnaire and physical activity guidelines for adults. Each participant's grade was determined by applying equal weight adjustments for sex, age, and physical activity level, and the participants were assigned an exercise program corresponding to their grade. The exercise intervention consisted of a circuit training program alternating between aerobic and anaerobic exercises. The control group was instructed to maintain their usual physical activity levels.

MAIN OUTCOME MEASURES

Changes from before to after exercise in clinical results (body composition, physical fitness, ultrasound-measured muscle/fat thickness, and biochemical data) were recorded during the 8-week exercise program and differences between pre- and post-exercise values of the groups were analyzed using the t-test and Wilcoxon rank-sum test.

RESULTS

Among 64 participants who had completed the program, 33 (51.5%) participated in the exercise program. The exercise program significantly increased abdominal muscle thickness (p < 0.01), reduced body fat percentage (p = 0.02) and waist circumference (p = 0.01), and positively affected various physical fitness indicators.

CONCLUSIONS

This study demonstrated the beneficial effects of a graded personalized exercise program on muscle thickness, body fat, and physical fitness and offers key data to support early preventive exercise programs in middle-aged adults to mitigate the risk of sarcopenia in later life.

TRIAL REGISTRATION

Registered on November, 29, 2024 at cris.nih.go.kr identifier KCT0009970.

Identity, Rurality, and Gender: A Phenomenological Exploration of Rural Nova Scotian Girls' Physical Activity Experiences

BACKGROUND/OBJECTIVES

Adolescent girls' physical activity levels are well below the minimum recommended levels for health and wellbeing. Rural-dwelling adolescents may also experience decreased physical activity levels than their urban counterparts, placing rural adolescent girls at a greater disadvantage. The reasons for these low levels are multifactorial, including, but not limited to, age, geographical locations, and gendered stereotypes surrounding activities. Qualitative investigations into adolescent girls' physical activity can provide deeper understandings on the key barriers and supports that specific populations experience and have been limited in the current literature. This study explores the physical activity experiences of adolescent girls living in rural Nova Scotia to provide deeper understandings of the needs of this population to inform physical activity policy and programming.

METHODS

Heideggerian hermeneutic phenomenology and feminist post-structuralism were used in a bricolage fashion to analyze six semi-structured interviews from adolescent girls between 11-13 years old living in rural eastern Nova Scotia.

RESULTS

Three major themes were identified from the interviews: (1) what physical activity looks like depends on your definition; (2) "What do you do when the boys take over the gym?"; and (3) "It's really nice to have space…but there's a lot less options out here". The themes were not independent, but rather all were linked by the threads of gendered sociocultural expectations and hegemonic femininity.

CONCLUSIONS

Distinct physical activity identities were exposed within the stories, shaped by parental and peer supports, personal ideals, sociocultural gender roles, and individual sense of agency surrounding physical activity engagement. Rural adolescent girls need both increased social and parental support to better navigate barriers of location and gender stereotypes that may be limiting their physical activity.

Changes in physical fitness in transgender adolescents receiving gender-affirming hormone therapy: protocol for a prospective cohort pilot study

There is very little data about the physical fitness of transgender and gender-diverse (TGD) youth. This protocol paper describes the methods for a pilot study that aims to measure changes in fitness levels in TGD adolescents undergoing gender-affirming hormone therapy (GAHT) using FitnessGram, a reliable, validated tool used to measure physical fitness. A secondary aim of the study is to compare the physical fitness of TGD adolescents with normative data for cisgender individuals. This will be a prospective cohort study. We will recruit 25 TGD participants who are 13-18 years old and patients in our organisation's Gender Development Clinic, planning to initiate GAHT. Participants will complete FitnessGram before starting GAHT and undergo repeat assessments 6 months and 12 months after GAHT initiation. Participants will also complete the Physical Activity Questionnaire for Adolescents. We plan to report changes in the participant's ability to achieve the FitnessGram standards over 12 months. Secondary outcomes will include a comparison of the achievement of the FitnessGram standards in the cohort with the reported achievement of standards for cisgender adolescents.

Factors influencing regular exercise in young women: a survey study assessing the preferences and motivators for aerobic and muscle-strengthening exercise

Young adult women have unique barriers to exercise, but assessing the psychological and behavioral strategies of women who overcome these barriers may be beneficial for informing future exercise programs. This study assessed differences in motives and self-regulation by type (aerobic or muscle-strengthening) and frequency of exercise, along with preferences for exercise amongst young adult women who exercise regularly.

Methods

A survey assessed exercise frequency (International Physical Activity Questionnaire), intensity (Borg's scale), type, and social and physical preferences. The Exercise Motivations Inventory-2 measured motivators for exercise and the Physical Activity Self-Regulation Scale measured self-regulation. Characteristics and preferences for exercise were examined using descriptives and frequencies. MANOVAs assessed differences in motivators and self-regulation by frequency of exercise, and regression analyses assessed differences in exercise predictors by type.

Results

The sample consisted of 269 women ages 18-34 (66.5% White), of whom 80.3% met the national guidelines for aerobic exercise, 78.4% met the guidelines for muscle-strengthening exercise, and 32.3% identified resistance exercise as their preferred type of exercise. Weight management and self-regulation (p = .021, R2 = .073) were the strongest predictors of aerobic exercise. Positive health, strength and endurance, and self-regulation (p = .023, R2 = .161) were predictors of muscle-strengthening exercise. Women who participated in high amounts of aerobic exercise were motivated by interpersonal factors while psychological factors motivated high frequency of muscle-strengthening exercise.

Conclusions

Programs for young adult women should consider incorporating resistance exercise as this study shows it may evoke motivation that could lead to regular participation. Self-regulation strategies were associated with adherence to both aerobic and muscle-strengthening exercises, highlighting the potential importance for inclusion in future interventions.

Tracking and changes in the clustering of physical activity, sedentary behavior, diet, and sleep across childhood and adolescence: A systematic review

INTRODUCTION

Clusters of health behaviors (e.g. physical activity/sedentary behavior/diet/sleep) can exert synergistic influences on health outcomes, such as obesity. Understanding how clusters of health behaviors change throughout childhood and adolescence is essential for developing interventions aimed at uncoupling unhealthy behaviors. This review synthesizes prospective studies examining changes in clusters of physical activity, sedentary behavior, diet, and sleep through childhood and adolescence.

METHODS

Electronic searches (PubMed, Embase, Web of Science, Scopus) identified prospective studies, published in English up to/including January 2024, of children/adolescents (0-19 years) which used data-driven methods to identify clusters of 2/more behaviors (physical activity, sedentary behaviors, diet, sleep) at multiple timepoints. A narrative synthesis was conducted due to methodological heterogeneity.

RESULTS

Eighteen studies reporting data from 26,772 individual participants were included. Eleven studies determined clusters at each timepoint (i.e. identified clusters at T1 and T2, respectively), while seven determined clusters longitudinally using behavioral data across multiple timepoints. Among studies that identified clusters at each timepoint, participants commonly transitioned to similarly characterized clusters between timepoints. Where cluster tracking was examined, 64% of clusters had stable transition probabilities of 60-100%. The most prevalent longitudinal cluster trajectories were characterized by co-occurring healthy behaviors which remained stable. Remaining within unhealthy clusters at multiple timepoints was associated with higher markers of adiposity.

CONCLUSION

'Healthy' and 'unhealthy' clusters remained highly stable over time, suggesting behavioral patterns developed early can become entrenched and resistant to change. Interventions focused on instilling healthy behaviors early are required to provide a strong foundation for behavioral stability throughout life.

Use of Accelerometry and Global Positioning System (GPS) to Describe Children's Park-Based Physical Activity Among Racial and Ethnic Minority Youth

Parks are one component of the built environment to promote regular physical activity (PA) among youth. This study investigated differences in park-based PA among youth based on demographics and park features in racially or ethnically diverse communities. In 2017-2018, parks were selected in majority Asian (n = 3), Latino (n = 5), and Black (n = 4) neighborhoods in North Carolina (n = 6) and New York (n = 6). Researchers recruited parents/caregivers of 5-10-year-olds to participate. Children wore an Actigraph GT3 + waist accelerometer and a QStarz GPS unit and were instructed to play normally for at least 15 min. Evenson cut-points were used to classify PA levels as sedentary, light, moderate, and vigorous. Chi-squared tests and non-parametric Kruskal-Wallis tests were used to examine differences in PA intensity minutes (sedentary, light, moderate-to-vigorous) across study location and demographic variables. Youth participated from NY (n = 200) and NC (n = 157). Overall, most park-based PA was spent in light intensity (59.9%), followed by moderate-to-vigorous intensity (32.4%). Females, compared to male participants, spent more time in sedentary behavior (9.0%, 6.1%) and less time in moderate-to-vigorous PA (26.6%, 38.1%). Participants who identified as Black (32.9% MVPA), Latino (35.8%), and Other (39.8%) spent higher percentages of time in moderate-to-vigorous PA than Asian (26.6%) and non-Hispanic White (21.3%) participants. The highest proportion of moderate-to-vigorous PA occurred on swing sets (46%) and basketball courts (45%). Racial and ethnic, sex, and activity area differences in park-based PA indicate that diverse youth use parks uniquely; these factors should be considered in designing parks for various ages and backgrounds.

Patterns of physical activity in hunter-gatherer children compared with US and UK children

Contemporary hunter-gatherers are highly active, but little is known about physical activity levels in hunter-gatherer children. We analysed 150 days of accelerometer data from 51 BaYaka hunter-gatherer children (aged 3-18) in the Republic of Congo, comparing it with British and American children using samples from Millennium Cohort Study (MCS) and National Health and Nutrition Examination Survey (NHANES). BaYaka children were highly active, engaging in over 3 h of moderate-to-vigorous physical activity (MVPA) daily, surpassing British adolescents by over 70 min. Unlike US children, whose activity diminished with age, BaYaka children's activity levels increased, irrespective of gender. This trend suggests that formal education may suppress activity among American children, a pattern not seen in the BaYaka community. Reflecting their foraging lifestyle, activity patterns varied within and between days in BaYaka children, a contrast to the more uniform daily activity observed in American children. Furthermore, our data challenges the concept of 'teenage chronotypes' prevalent in post-industrial societies, with adolescent BaYaka maintaining shorter sleep phases and later bedtimes, synchronized with sunrise. These findings highlight the impact of a foraging upbringing on children's activity levels, providing a benchmark for understanding childhood physical activity and wellbeing.

The global, regional, and national disease burden of colorectal cancer attributable to low physical activity from 1990 to 2021: an analysis of the Global Burden of Disease Study 2021

OBJECTIVES

This study aims to estimate the spatiotemporal variation in the burden of colorectal cancer (CRC) attributable to low physical activity (LPA) at global, regional, and national levels from 1990 to 2021.

STUDY DESIGN

Cross-sectional study.

METHODS

Annual data on deaths of CRC related to LPA, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), and the age-standardized DALYs rate (ASDR) for 204 countries and territories from 1990 to 2021 was extracted from the Global Health Data Exchange website. They were retrieved by age (5-year age groups from 25 to 94 years, and 95+ years), gender (male and female), and Socio-demographic Index (SDI). The association between age-standardized rates and SDI values was assessed by Spearman's correlation.

RESULTS

Between 1990 and 2021, there was nearly a twofold increase in DALYs and mortality globally for CRC related to LPA, despite decreases in ASMR and ASDR (EAPC: -0.82% and -0.83%, respectively). However, on a national scale, ASMR and ASDR increased in more than half of the world's countries and territories. Moreover, a greater burden of CRC related to LPA was observed in older populations, females, and those residing in regions with an SDI near 0.77.

CONCLUSION

These findings indicate the critical need to raise awareness about the preventive role of physical activity in CRC. Policymakers should prioritize developing and implementing strategies that ensure equitable access to sports resources, enabling more people to meet the World Health Organization guidelines.

Engagement in Sedentary and Physically Active After-School Programs Among African American Children with ADHD and Disruptive Behavior Disorders

CONTEXT

Sport and physical activity (PA) programs are an important developmental resource for youth with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders. The purpose of this study is to assess sport participation rates, PA participation, and after-school supervision rates among African American children with ADHD and/or Disruptive Behavior Disorders.

DESIGN

In this cross-sectional study, parents of African American children with elevated symptoms of ADHD, oppositional defiant disorder, and/or conduct disorder (N = 175, 6- to 12-y-old, 31% female) reported after-school program participation over the past year.

METHODS

Logistic regression analyses tested relationships between ADHD symptoms, oppositional defiant disorder symptoms, and conduct disorder symptoms, likelihood of regular participation (≥2 d/wk) in sport, PA, and sedentary after-school programs, and likelihood of being supervised and unsupervised after school. All regressions controlled for age, sex, income, and medication status. Sample participation rates were descriptively compared with participation rates of same-aged peers regionally, and nationally, reported in 3 national surveys.

RESULTS

Parents in the local sample reported higher rates of sedentary after-school program participation (54%) but lower rates of PA program participation (31%), and sport participation (12%) compared with same-aged peers. The local sample was less likely to be unsupervised after-school compared with same-aged peers with only 27% of parents reporting that their child was unsupervised ≥ 2 days per week. Children endorsing oppositional defiant disorder (odds ratio = 2.05; P < .05) and conduct disorder (odds ratio = 5.74; P < .05) were more likely to be unsupervised more frequently after-school as compared with those not meeting endorsement.

CONCLUSIONS

Given demonstrated benefits of youth sport programming and observed inequities in participation, there is a need to develop support models that connect parents, coaches, and social services agencies to facilitate inclusion. Sports medicine professionals are uniquely positioned to contribute to these efforts, as they are often key opinion leaders in both the youth sport and health care contexts.

Physical fitness levels among children in northeast Italy by sex and age group: a comparison with teachers' assessments and children in other European countries

Introduction

Physical fitness is associated with health-related quality of life, especially among youth. Although schools play an important role in promoting children's physical activity, in Italy the lack of qualified physical education teachers in primary schools may be compromising children's achievement of recommended levels of physical activity.

Methods

To test that possibility, we measured the physical fitness of 170 children (i.e., 79 boys and 91 girls) 6-10 years old in two schools in Cadore, Veneto, in northeast Italy, using the Physical Fitness Test, a tool developed in Norway and previously used among children there and in Lithuania. Teachers in Italy also assessed their students' physical fitness, and their rankings were correlated with the children's test results. The test battery included nine elements: a standing broad jump, hopping 7 m on both feet, hopping 7 m on one foot, throwing a tennis ball, pushing a medicine ball, climbing wall bars, a 10 × 5 m shuttle run, a 20 m run, and a 6 min Cooper test.

Results

Test scores generally increased with age and more steeply among boys than girls, and boys outperformed girls on most items. Children in Italy performed similarly to children in Norway but outperformed ones in Lithuania on nearly every item across sex and age groups. The correlation between teachers' predictions and the actual test results was rather low for boys (.538, p < .001) and even lower for girls (.360, p < .001).

Discussion

Data revealed similar results in physical fitness between the three countries, albeit with some differences for individual items. However, primary school teachers in Italy assessed physical fitness rather poorly, possibly due to their lack of specific academic training in physical education and thus limited perception of physical fitness compared with academically trained physical education teachers. Last, because the procedure for categorizing children by age may significantly affect the results and subsequent between-group comparisons, researchers comparing children in different age groups should report their procedures for categorizing age.

Reduced multiscale complexity of daily behavioral dynamics in autism spectrum disorder

Aim

Autism spectrum disorder (ASD) is difficult to diagnose objectively due to its heterogeneous and complex manifestations. This study aimed to objectively characterize the behavioral phenotypes of ASD children by exploring the multiscale behavioral dynamics.

Methods

We applied behavioral organization (BO) and multiscale sample entropy (MSE) analyses to physical activity data collected from ASD and typically developing children, using wearable monitors in their daily life. We also examined their correlation with auditory startle response measures and clinical questionnaires, including the Social Responsiveness Scale (SRS) and the Strengths and Difficulties Questionnaire (SDQ).

Results

A significant decrease in MSE at timescales longer than 6 min was observed in ASD children, suggesting decreased irregularity or unpredictability, potentially linked to repetitive behaviors or stereotyped patterns commonly observed in ASD. Additionally, an increase in MSE positively correlated with prepulse inhibition levels, indicating its relationship with sensorimotor gating. Moreover, the observed significant negative correlation with the total difficulty score of SDQ substantiates MSE's potential as an objective metric for assessing general mental health problems associated with ASD.

Conclusion

Multiscale analysis enhances the understanding of ASD's behavioral dynamics, providing valuable metrics for real-world assessments.

Relationship Between Physical Activity and Subjective Well-Being Among College Students: The Mediating Role of Social Support

Subjective well-being is a key concept in positive psychology and is associated with a variety of physical and mental health outcomes. Physical activity (PA) is a modifiable health behavior that has been identified as a potential correlate of subjective well-being. However, the underlying mechanisms that connect PA to subjective well-being are not well-understood. This study aimed to examine the association between the PA and various components of subjective well-being in college students, and to determine if social support mediated this association. A total of 1158 college students (46.3% female, mean age = 19.75 years) voluntarily completed a set of questionnaires measuring PA, life satisfaction, positive affect, negative affect, and social support in a single-wave assessment. Three sets of mediation analyses were conducted (employing bootstrapping techniques with 10,000 samples), with life satisfaction, positive affect, and negative affect serving as the dependent variables, PA as the independent variable, and social support as the mediator. The findings revealed that the relationships between PA, subjective well-being, and social support differ by the component of subjective well-being. While no association was detected between PA and negative affect, increased PA led to enhanced social support, which in turn contributed to higher levels of life satisfaction and positive affect. As social support was found to mediate the relationship between PA and subjective well-being, future interventions are suggested to foster supportive social environments and develop effective strategies to modify the social experience of PA to maximize their benefits in enhancing subjective well-being.

Recent trends and disparities in screen-based sedentary behavior and physical activity among U.S. overweight youth, 2018-2022

BACKGROUND

Sedentary behavior (SB) and physical activity (PA) are crucial factors influencing health outcomes in overweight children and adolescents. However, recent changes in SB and PA trends among U.S. overweight youth have not been well described, limiting the development of evidence-based clinical and public health interventions.

METHODS

Serial, cross-sectional analyses were conducted using data from the National Survey of Children's Health (NSCH) on U.S. overweight youth aged 6-17 years, spanning from 2018 to 2022. Linear regression models were employed to analyze time trends, with survey year as the exposure and recreational screen time (ST), adherence to the ≤2 h/day ST guideline, and adherence to the ≥1 h/day PA guideline as the outcomes. Multivariable-adjusted logistic and linear regressions were used to evaluate trends, adjusting for age group, sex, race/ethnicity, household income, and the highest education level of primary caregivers.

RESULTS

Data from 11,865 individuals (mean age 12.3 years [SD 2.9]; 6417 [52.3 %] girls) were analyzed. From 2018 to 2022, the average ST duration among overweight youth increased from 3.7 h to 4.1 h per day, a statistically significant increase (p = 0.07). The estimated prevalence of overweight youth meeting the ≤2 h/day ST guideline decreased from 44.6 % to 30.0 % (p = 0.007). Additionally, the prevalence of meeting the ≥1 h/day PA guideline remained low and stable, ranging from 8.4 % to 12.3 % during the analysis period (p = 0.6).

DISCUSSION

In this nationally representative sample of U.S. overweight youth, ST increased by nearly 0.4 h/day over the five-year observation period, while adherence to the ≤2 h/day ST guideline decreased. Adherence to the ≥1 h/day PA guideline remained consistently low. These patterns were consistent across sociodemographic subgroups (age group, sex, ethnicity, and household income). These findings underscore the need for enhanced public health initiatives targeting U.S. youth to reduce recreational screen time and promote a physically active lifestyle.

Design of a Temporally Augmented Text Messaging Bot to Improve Adolescents' Physical Activity and Engagement: Proof-of-Concept Study

BACKGROUND

Digital interventions hold promise for improving physical activity in adolescents. However, a lack of empirical decision points (eg, timing of intervention prompts) is an evidence gap in the optimization of digital physical activity interventions.

OBJECTIVE

The study examined the feasibility and acceptability, as well as the technical and functional reliability, of and participant engagement with a digital intervention that aligned its decision points to occur during times when adolescents typically exercise. This study also explored the impact of the intervention on adolescents' moderate to vigorous physical activity (MVPA) levels. Consistent with the Obesity-Related Behavioral Interventions Trials (ORBIT) model, the primary goal of the study was to identify opportunities to refine the intervention for preparation for future trials.

METHODS

Ten adolescents completed a 7-day baseline monitoring period and Temporally Augmented Goal Setting (TAGS), a 20-day digital physical activity intervention that included a midday self-monitoring message that occurred when adolescents typically start to exercise (3 PM). Participants wore an accelerometer to measure their MVPA during the intervention. Participants completed questionnaires about the acceptability of the platform. Rates of recruitment and attrition (feasibility), user and technological errors (reliability), and engagement (average number of text message responses to the midday self-monitoring message) were calculated. The investigation team performed multilevel models to explore the effect of TAGS on MVPA levels from preintervention to intervention. In addition, as exploratory analyses, participants were matched to adolescents who previously completed a similar intervention, Network Underwritten Dynamic Goals Engine (NUDGE), without the midday self-monitoring message, to explore differences in MVPA between interventions.

RESULTS

The TAGS intervention was mostly feasible, acceptable, and technically and functionally reliable. Adolescents showed adequate levels of engagement. Preintervention to intervention changes in MVPA were small (approximately a 2-minute change). Exploratory analyses revealed no greater benefit of TAGS on MVPA compared with NUDGE.

CONCLUSIONS

TAGS shows promise for future trials with additional refinements given its feasibility, acceptability, technical and functional reliability, participants' rates of engagement, and the relative MVPA improvements. Opportunities to strengthen TAGS include reducing the burden of wearing devices and incorporating of other strategies at the 3 PM decision point. Further optimization of TAGS will inform the design of a Just-in-Time Adaptive Intervention for adolescent physical activity and prepare the intervention for more rigorous testing.

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.

Perceptions Matter! Active Physical Recreation Participation of Children with High and Low Actual and Perceived Physical Competence

Emerging evidence suggests that the accuracy of a child's perceived physical competence (PPC) impacts participation in physical activity. We examined differences in active physical recreation (APR) participation based on clusters of high and low motor competence and perceptions from grades 3-5. Participants were a longitudinal sample (n = 155; 85 girls) of grade three, four, and five children. Fundamental motor skills (FMSs) were assessed using the TGMD-2, perceptions were assessed using the Self-Perception Profile for Children, and APR was measured using the Children's Assessment of Participation and Enjoyment. K-means cluster analysis was used to create four clusters per grade based on participants' FMSs and PPC z-scores. Differences in FMSs, PPC, and APR with cluster group as a factor were examined using a series of factorial ANOVAs. In each grade, participants in the high-high cluster participated in significantly more APR than those in the low-low cluster (p = 0.002 in grades three and four; p < 0.001 in grade five). Among the less accurate clusters (e.g., low FMSs with high PPC) was a trend toward positive FMSs growth among the children with higher perceptions. Results show that combinations of FMSs and PPC influence patterns of engagement or disengagement in active physical recreation persistently across middle childhood.

Associations of family socioeconomic indicators and physical activity of primary school-aged children: a systematic review

BACKGROUND

Family socioeconomic indicators (education, occupation, and household income) are key determinants influencing children's physical activity (PA). This study aims to systematically review the current research about the association between family socioeconomic indicators and PA among primary school-aged children and to quantify the distribution of reported associations by childs' and parents' sex and according to analysis and assessment methods.

METHODS

A systematic literature research in multiple scientific databases (MEDLINE via PubMed, Web of Science, ScienceDirect, SPORTDiscus and ERIC) was performed for literature published between 1st January 2010 and 31st March 2022. Only studies reporting statistical associations between an SES indicator of at least one parent (education, occupation, income, or an SES index) and different types and intensities of PA in primary school-aged children (6 to 12 years) were included in the analysis. The distributions of the reported associations were evaluated across and differentiated by sub-group analysis of assessment methods (objectively measured vs. self-reported PA) and analysis methods (univariate vs. multivariate models).

RESULTS

Overall, 93 studies reported in 77 publications were included in this review. Most of the studies were conducted in Europe and used self-reports (questionnaires) to assess PA. Most studies used only a single SES indicator (commonly maternal education), and only two studies calculated an SES index. The majority of the studies focused on moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and organized physical activity (OPA). Results showed predominantly positive associations between SES indicators and OPA. In contrast, results regarding different intensities of daily PA (TPA, LPA, MPA, MVPA, VPA, LTPA) were heterogeneous, with overwhelmingly no associations.

CONCLUSION

Overall, the results expand the knowledge about the association between family socioeconomic indicators and children's PA and disprove the hypothesis of a clear positive association. However, large multicenter studies are lacking using a real SES index as a predictor and analyzing gender-specific multivariate models.

School-aged children's movement behaviours and subjective health complaints in Japan: a cross-sectional study during COVID-19 pandemic-related school closures and after school reopenings

BACKGROUND

Social restrictions associated with the COVID-19 pandemic have altered children's movement behaviours and impacted their mental health. However, the influence of social restrictions on subjective health complaints remains inadequately understood. This study compared adherence to 24-hour movement behaviour guidelines and the prevalence of subjective health complaints during school closure and one year after reopening. We also examined how combinations of adherence to movement behaviour recommendations relate to subjective health complaints.

METHODS

A repeated cross-sectional survey was conducted at two points. The first survey in May 2020 included 1535 (766 boys and 769 girls) participants during school closures, while the second survey from May to July 2021 involved 1125 (583 boys and 542 girls) participants one year after school reopening. The questionnaire covered socio-demographics, physical activity, screen time, sleep, and subjective health complaints. Differences between periods were analysed using chi-square tests. Logistic regression models assessed the association between adherence to guidelines and subjective health complaints.

RESULTS

During school closure, children were more likely to meet 'only sleep' recommendations and have irritability and lethargy symptoms. Irrespective of sex, those adhering to two or all three recommendations (excluding physical activity and screen time) had a lower risk of symptoms related to physical and mental pain, fatigue, irritability, and lethargy as compared to those who met none of the recommendations.

CONCLUSIONS

Children should meet at least one physical activity or screen time recommendation in addition to sleep recommendations for subjective health. Strategies considering the priority of each movement behaviour are crucial, even during abnormal situations, such as pandemic-related social restrictions. This study offers insightful findings concerning children's mental health issues during unprecedented and massive disasters or crises.

Physical activity level correlates with obesity-related factors, but not with fundamental movement skills in preschool children: a cross-sectional study

This study aimed to examine the differences in physical activity (PA) level, fundamental movement skill (FMS), and obesity-related factors in preschoolers. A cross-sectional study was conducted in 426 preschool children aged 3-5 years. Participants were assigned to the low PA group (LPAG), moderate PA group (MPAG), and high PA group (HPAG) according to the total score obtained in the PA questionnaire for young children. FMS and obesity-related factors were also analyzed. PA was compared by age and sex, and FMS and obesity-related factors were compared between groups. Significant differences were found according to sex. Boys were more active than girls in the 3-4 years age group, but no significant differences were observed at the age of 5 years. LPAG showed lower FMS than MPAG and HPAG, although this was not statistically significant. However, body mass index (BMI), BMI z-score, body fat, and muscle mass showed significant differences in terms of PA levels. Consideration of age and sex is crucial in promoting PA among preschoolers. Additionally, better obesity-related factors are associated with higher PA levels, and FMS may be a useful tool in evaluating health and fitness.

Systematic review and meta-analysis of physical activity interventions to increase elementary children's motor competence: a comprehensive school physical activity program perspective

BACKGROUND

Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in children's PA participation is their motor competence (MC). The comprehensive school physical activity program (CSPAP) framework offers a way to classify existing PA interventions that have included children's MC development and understand the potential avenues for supporting children's MC. However, there have been no systematic reviews or meta-analyses of PA interventions and their effects on the MC of elementary school children (aged 5-12 years) from a CSPAP perspective.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched seven electronic databases (PubMed/Medline, Embase, ERIC, SPORTDiscus, CINAHL, Web of Science, and PsycINFO) for articles on 29 November 2021. The CSPAP framework was used to categorize the different intervention approaches. This review was registered with PROSPERO (CRD42020179866).

RESULTS

Twenty-seven studies were included in the review, and twenty-six studies were included in the meta-analysis. A wide range of PA intervention approaches (e.g., single component or multicomponent) within the context of the CSPAP framework appear to be promising pathways in enhancing children's MC. The results of the aggregate meta-analysis presented that effect sizes for the development of MC from pre-and post- intervention ranged from moderate to large (Hedges' g = 0.41-0.79). The analysis revealed that the predicted moderators, including study length, delivery agent, and study design, did not result in statistically significant moderate variations in MC outcomes. There was, however, considerable heterogeneity in study design, instruments, and study context, and studies were implemented in over 11 countries across diverse settings.

CONCLUSIONS

This study uniquely contributes to the literature through its primary focus on the effectiveness of PA interventions on elementary children's MC. This review emphasizes the importance of customizing CSPAP to fit the specific characteristics of each school setting, including its environmental, demographic, and resource attributes. The effectiveness of CSPAP, particularly its physical education (PE) component, is significantly enhanced when these programs are adapted to address the unique needs of each school. This adaptation can be effectively achieved through targeted professional teacher training, ensuring that PE programs are not only contextually relevant but also optimized for maximum impact in diverse educational environments. Researchers and practitioners should pursue how to effectively translate the evidence into practice to better conceptualize CSPAPs designed for children's MC development.

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.

Gastrocnemius medialis and Achilles tendon properties do not differ between children with unilateral or bilateral spastic cerebral palsy

Spastic cerebral palsy (SCP) is a common neurodevelopmental disorder in children, which can be categorized into unilateral and bilateral subtypes. Most studies examining the muscle-tendon properties of the lower extremities in individuals with SCP do not distinguish between subtypes. However, spastic muscle morphology is an important determinant for its function. Therefore, differences in muscle-tendon pathology might lead to different treatment strategies. The aim of this retrospective study was to investigate the muscle-tendon properties between children with unilateral SCP and those with bilateral SCP. Overall, 33 ambulatory children (15 with unilateral SCP and 18 with bilateral SCP, Gross Motor Function Classification System Level I-III) were included. Ankle joint range of motion, isometric muscle strength, and muscle-tendon properties of the gastrocnemius medialis (GM) muscle-tendon unit (MTU) (e.g., muscle volume, tissue lengthening behavior) were assessed with isokinetic dynamometry, 3D motion capture, and ultrasound, respectively. Independent t-tests or Mann-Whitney tests were used to test for group differences (α = 0.05). Effect sizes (Cohen's d) were also calculated. No significant differences in any assessed parameter were found between children with unilateral SCP and children with bilateral SCP (p > 0.05, d < 0.57). Our findings suggest that the functional and morphological properties of the GM MTU are similarly developed in children with unilateral SCP and children with bilateral SCP. We assume that activity levels might be the decisive factor. Nonetheless, our investigations need be extended by including gait parameters and associated tissue dynamics.

Sociodemographic influences on youth sport participation and physical activity among children living within concentrated Hispanic/Latino rural communities

Introduction

Lack of physical activity (PA) among children living in rural communities is a documented public health problem. Although studies have examined community conditions defined by a rural-urban dichotomy, few have investigated rural community conditions with a concentration of Hispanic/Latino people. This cross-sectional study examined sociodemographic characteristics associated with youth sport (YS) participation and daily PA among children living within concentrated Hispanic/Latino rural U.S. Midwest communities.

Methods

During spring 2022, 97% of 3rd-6th grade children (n = 281, aged approximately 8-12 years) attending school in rural Midwestern communities (n = 2) with >50% concentration of Hispanic students participated in the Wellscapes Project, a community randomized trial. Participants completed the Youth Activity Profile and supplemental National Survey of Children's Health questions assessing PA behaviors and YS participation. Caregivers of a subsample of children (n = 215; males, n = 93; females, n = 122) consented to pair their child's survey results with school enrollment records (e.g., free/reduced lunch status and race and ethnicity). Mixed models with community as a random effect examined main and interaction effects of grade, sex, ethnoracial status, and family income on YS participation and these sociodemographic characteristics and YS participation on daily moderate-to-vigorous PA (MVPA).

Results

Approximately half of children participated in YS. Non-Hispanic White children (n = 82) were over five times more likely to participate in YS than Hispanic peers (n = 133) (OR = 5.54, 95% CI = 2.64-11.61, p < 0.001). YS participants accumulated 8.3 ± 2.3 more minutes of daily MVPA than non-participants (p < 0.001). Sixth graders, females, and Hispanic children reported lower daily MVPA than comparison groups (p < 0.05). Significant interaction effects on daily MVPA between grade and ethnoracial status (F(3, 204) = 3.04, p = 0.030) were also found.

Discussion

Disparities in sport participation and PA outcomes based on sociodemographic characteristics exist among children living in ethnoracially diverse rural communities. Strategies to promote YS participation, including community structural changes, may help reduce PA disparities. The research provides valuable insights for policymakers, public health professionals, and community members to address YS participation barriers, not limited to cost, while considering other PA-promotion efforts to improve child population health.

Worse becomes the worst: obesity inequality, its determinants and policy options in Iran

Background

This tracked obesity inequality and identified its determinants among the population of Iran. In addition, it examined the impact of implemented policies on these inequalities.

Methods

This study was performed in two phases. First, we conducted a rapid review of the disparity in obesity prevalence in Iran. Then we investigated the main determinants of this inequality in a qualitative study. In addition, we examined Iran's policies to deal with obesity from the perspective of equality. We conducted 30 Semi-structured interviews with various obesity stakeholders selected through a purposive snowball sampling method between November 25, 2019, and August 5, 2020. In the inductive approach, we used the content analysis method based on the Corbin and Status framework to analyze the data using MAXQDA-2020. The consolidating criteria for reporting a Qualitative Study (COREQ-32) were applied to conduct and report the study.

Results

Inequalities in the prevalence of obesity in terms of place of residence, gender, education, and other socioeconomic characteristics were identified in Iran. Participants believed that obesity and inequality are linked through immediate and intermediate causes. Inequality in access to healthy foods, physical activity facilities, and health care are the immediate causes of this inequality. Intermediate factors include inequality against women, children, and refugees, and inequality in access to information, education, and financial resources. Policymakers should implement equity-oriented obesity control policies such as taxing unhealthy foods, subsidizing healthy foods, providing healthy and free meals in schools, especially in disadvantaged areas, and providing nutrient-rich foods to low-income families. Also, environmental re-engineering to increase opportunities for physical activity should be considered. Of course, for the fundamental reduction of these inequalities, the comprehensive approach of all statesmen is necessary.

Conclusion

Obesity inequality is a health-threatening issue in Iran that can prevent achieving human development goals. Targeting the underlying causes of obesity, including inequalities, must be considered.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools

BACKGROUND

In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not.

METHODS

PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess.

RESULTS

Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one.

CONCLUSIONS

Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

Sex differences in frailty among older adults

By definition, aging is a natural, gradual and continuous process. On the other hand, frailty reflects the increase in vulnerability to stressors and shortens the time without disease (health span) while longevity refers to the length of life (lifespan). The average life expectancy has significantly increased during the last few decades. A longer lifespan has been accompanied by an increase in frailty and decreased independence in older adults, with major differences existing between men and women. For example, women tend to live longer than men but also experience higher rates of frailty and disability. Sex differences prevent optimization of lifestyle interventions and therapies to effectively prevent frailty. Sex differences in frailty and aging are rooted in a complex interplay between uncontrollable (genetic, epigenetic, physiological), and controllable factors (psychosocial and lifestyle factors). Thus, understanding the underlying causes of sex differences in frailty and aging is essential for developing personalized interventions to promote healthy aging and improve quality of life in older men and women. In this review, we have discussed the key contributors and knowledge gaps related to sex differences in aging and frailty.

Online exercise program for men living with obesity: Experiences, barriers, and enablers

The prevalence of obesity is increasing among men, and this population remains under-represented in lifestyle and weight management interventions. The current study aims to explore the experiences of men living with obesity (body fat ≥25 %) toward a 12-week supervised online exercise platform. Ten men were interviewed for this qualitative study. Semi-structured, open-ended phone interviews were conducted, and the transcripts were thematically coded using the qualitative data analysis Nvivo QSR software package. The research findings are illustrated using quotes from participants. The results were organized into two main themes: those that removed barriers to exercise and those that improved the enablers of exercise. Eliminating barriers included not purchasing specialized equipment or travelling to a gym facility. The enablers to their success with the program included the structured format of the circuit program and having supervised sessions. By removing barriers and enhancing enablers, the 12-week online exercise circuit program increased compliance to and success of the exercise program for men living with obesity. Future research should explore the long-term effects of an online program for men living with obesity and its appeal beyond COVID-19.

Lifestyle and patterns of physical activity in Hadza foragers

OBJECTIVES

Physically active lifestyles are associated with several health benefits. Physical activity (PA) levels are low in post-industrial populations, but generally high throughout life in subsistence populations. The Hadza are a subsistence-oriented foraging population in Tanzania known for being physically active, but it is unknown how recent increases in market integration may have altered their PA patterns. In this study, we examine PA patterns for Hadza women and men who engage in different amounts of traditional foraging.

MATERIALS AND METHODS

One hundred and seventy seven Hadza participants (51% female, 19-87 years) wore an Axivity accelerometer (dominant wrist) for ~6 days during dry season months. We evaluated the effects of age, sex, and lifestyle measures on four PA measures that capture different aspects of the PA profile.

RESULTS

Participants engaged in high levels of both moderate-intensity PA and inactivity. Although PA levels were negatively associated with age, older participants were still highly active. We found no differences in PA between participants living in more traditional "bush" camps and those living in more settled "village" camps. Mobility was positively associated with step counts for female participants, and schooling was positively associated with inactive time for male participants.

CONCLUSIONS

The similarity in PA patterns between Hadza participants in different camp types suggests that high PA levels characterize subsistence lifestyles generally. The sex-based difference in the effects of mobility and schooling on PA could be a reflection of the Hadza's gender-based division of labor, or indicate that changes to subsistence-oriented lifestyles impact women and men in different ways.

Sex differences and athletic performance. Where do trans individuals fit into sports and athletics based on current research?

There are well known sex differences in parameters of physical fitness/performance due to changes occurring during sexual development. Thus, many sport and athletic events have regulations separating male and female participants. However, the inclusion or exclusion of transgender individuals in athletics has recently received outsized attention despite relatively few cases of transgender athletes. When determining which athletic gender category trans individuals should be permitted to compete in, it is important to understand the level of physical fitness/performance these individuals possess relative to their cisgender counterparts. Unfortunately, there are few studies investigating this topic, and several complications that confound this research. The current review seeks to discuss sex and gender as concepts, review sex differences in fitness/performance and how they develop, and then, consider how current evidence suggests that trans individuals compare to cis individuals. Finally, this review seeks to offer considerations for whether trans individuals should be excluded from sports and athletics, and how future research should proceed to better understand this marginalized population.

Hand grip strength, vitamin D status, and diets as predictors of bone health in 6-12 years old school children

BACKGROUND

Vitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children.

PURPOSE

This study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6-12 years old schoolchildren.

METHODS

This study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6-12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.

Multidimensional school features associated with physical activity among youth at risk of obesity: an exploratory principal component and generalized estimating equation analysis

BACKGROUND

Schools may be high-leverage points for the promotion of physical activity (PA), yet little is known about school built and social environments among youth at high risk of obesity.

PURPOSE

To characterise school built and social environments that may be salient for PA and to examine associations between school PA environments and PA in youth at risk of obesity.

METHODS

Data from youth attending 206 schools (314 youth in 2005-2008, and 129 youth in 2008-2010) within the QUALITY cohort study, a longitudinal investigation of youth at high risk of obesity were used. Features of schools, based on built, policy/programming and social environments were identified using principal components (PC) analysis. Gender-stratified generalized estimating equation (GEE) models were used to explore associations between school features and accelerometer measured mean counts per minute (MCPM), mean daily moderate-to-vigorous physical activity (MVPA) and the odds of meeting MVPA guidelines cross-sectionally and prospectively using 90% confidence intervals.

RESULTS

Nine PCs were identified. Associations were observed between PA and 7 of the 9 PCs. The social environment seemed to be particularly important. Social Norms to Promote PA was associated with an increase in girls' baseline MCPM and MVPA. High Willingness to Promote PA was associated with boys' MCPM, MVPA, and odds of meeting MVPA guidelines, at both baseline and follow-up.

CONCLUSION

School built and social contexts may be associated with PA cross-sectionally and over time. Further studies are necessary to confirm the direction and magnitude of effects and to establish their relevance to school-based health promotion efforts.

Mediating Effects of the COVID-19 Pandemic on the Associations between Physical Activity and Physical Fitness; Cross-Sectional Study among High School Adolescents

The COVID-19 pandemic and the imposed social distancing measures caused negative changes in physical activity levels (PALs) and physical fitness (PF) among adolescents, but the potential mediating effect of the pandemic on the association between PAL and PF is unknown. This study aimed to evaluate gender-specific associations between objectively measured PAL and indices of PF among high school adolescents during the period of the COVID-19 pandemic. The participants were 150 adolescents (101 females) aged 14-18 years; their anthropometrics were evaluated, and they were tested on PF (cardiorespiratory fitness (CRF; beep test), power (broad jump), flexibility (sit-and-reach test), and abdominal strength (sit-ups)) and PAL (using a pedometer for 7 days) during the pandemic period. A T-test was calculated to determine differences between genders. Associations between variables were evaluated using Pearson correlations. Additionally, multivariate taxonomic classification was used to sort participants into homogenous groups (clusters) according to their PF, and then analysis of variance (ANOVA) was performed to differentiate them according to PAL. For the total sample, PAL was correlated with CRF only (R = 0.25, p < 0.05), while gender-stratified correlations showed that PAL was significantly associated with CRF among girls only (R = 0.29, p < 0.05), which was additionally confirmed with multivariate cluster analysis and subsequent ANOVA. No association between PAL and PF was found for boys. The relatively low association between PAL and PF is most likely related to the mediating effect of the change in life circumstances during the COVID-19 pandemic, and limited applicability of pedometers in evaluating high-intensity PAL. Further studies in other age groups and environments are warranted.

Gender differences in the distribution of children's physical activity: evidence from nine countries

BACKGROUND

Physical activity in childhood is thought to influences health and development. Previous studies have found that boys are typically more active than girls, yet the focus has largely been on differences in average levels or proportions above a threshold rather than the full distribution of activity across all intensities. We thus examined differences in the distribution of physical activity between girls and boys in a multi-national sample of children.

METHODS

We used the harmonised International Children Accelerometry Database (ICAD), including waist-worn accelerometry data from 15,461 individuals (Boys: 48.3%) from 9 countries. Employing Generalised Additive Models of Location, Shape, and Scale (GAMLSS) we investigated gender differences in the distribution of individuals, including comparisons of variability (SD) and average physical activity levels (mean and median) and skewness. We conducted this analysis for each activity intensity (Sedentary, Light, and Moderate-to-Vigorous (MVPA)) and a summary measure (counts per minute (CPM)).

RESULTS

Sizable gender differences in the distribution of activity were found for moderate to vigorous activity and counts per minute, with boys having higher average levels (38% higher mean volumes of MVPA, 20% higher CPM), yet substantially more between-person variability (30% higher standard deviation (SD) for MVPA, 17% higher SD for CPM); boys' distributions were less positively skewed than girls. Conversely, there was little to no difference between girls and boys in the distribution of sedentary or light-intensity activity.

CONCLUSIONS

Inequality in activity between girls and boys was driven by MVPA. The higher mean volumes of MVPA in boys occurred alongside greater variability. This suggests a need to consider the underlying distribution of activity in future research; for example, interventions which target gender inequality in MVPA may inadvertently lead to increased inequality within girls.

Data Informing Governing Body Resistance-Training Guidelines Exhibit Sex Bias: An Audit-Based Review

The objective of this review was to examine the ratio of female and male participants utilised in data informing consensus statements and position stands in the field of resistance training (RT). In order to achieve this objective, we conducted an 'audit' style review. We accessed three databases: SPORTDiscus, MEDLINE and Google Scholar utilising the following search terms: resistance or strength training AND consensus statements or position statements/stands. Eligibility criteria included consensus statements and position stands for RT in youth, adults and older adults. In this paper we have used the term 'female' to describe biological sex. Gender is a social construct and often describes roles and behaviours that society assigns to men or women. In this paper we have used the term 'women' to describe gender. Reference lists from each guideline were screened with the number of male and female participants extracted from each study. We also extracted data on the gender of the authors of the statements. We located 11 guidelines encompassing a total of 104,251,363 participants. Youth guidelines were comprised of 69% male participants. There were 287 studies that included both sexes, 205 male-only and 92 female-only studies. Adult guidelines were comprised of 70% male participants. There were 104 studies that included both sexes, 240 male-only and 44 female-only studies. Older adult guidelines were comprised of 54% female participants. There were 395 studies that included both sexes, 112 male-only and 83 female-only studies. Women authors comprised 13% of all authors of position stands and consensus statements. These results demonstrate an under-representation of females and women as both participants and as authors. It is imperative to ensure that data informing governing body guidelines and consensus statements are representative of the population they aim to inform. If this is not possible, guidelines should clearly state when their data and recommendations are based primarily upon one sex.

Prevalence and socio-demographic distributions of meeting RMI Guidelines for Healthy Living among elementary school children in Majuro, Republic of Marshall Islands: a cross-sectional population-based survey

Background

Childhood obesity is high in Republic of Marshall Islands (RMI). We report the prevalence and socio-demographic distribution of selected obesity-related risk factors among children in Majuro, RMI.

Methods

Sixteen elementary schools were approached and students and parents in Grades 1, 3, and 5 invited to participate in this cross-sectional population-based survey. Accelerometry and a questionnaire were used to collect data on children's physical activity (PA), sleep, screen time and dietary behaviours. Descriptive statistics and mixed-effects logistic regression were used to examine differences in the proportions of children meeting selected RMI Healthy Living Guidelines by sex, school grade and school sector.

Findings

Thirteen schools and 958 children were recruited, of which 892 (52.2% girls; mean age 9.3 ± 1.8 years) provided useable data. Around 90% met the PA, 29% screen time, 13% sleep, 69% sugar-sweetened beverage and 56% highly processed food guidelines. The proportion meeting individual guidelines was higher among children in Grade 1 compared with Grade 5. Being a girl (0.27; 95% CI 0.16, 0.46) was associated with lower odds of meeting the PA recommendation. Compared with children from Grade 1, those in Grade 5 had lower odds of meeting the PA (0.28; 95% CI 0.15, 0.55), screen time (0.60; 95% CI 0.40, 0.89), sleep duration (0.33; 95% CI 0.18, 0.59), sugar-sweetened beverage (0.35; 95% CI 0.23, 0.53), and consumption of highly processed foods recommendations (0.49; 95% CI 0.33, 0.72).

Interpretation

While most children in RMI are adequately active, resources are needed to promote healthier levels of screen time, sleep, sugar-sweetened beverage and highly processed food consumption, especially among older children.

Funding

This study was funded by World Diabetes Foundation; Canvasback Missions, RMI; NHMRC Australia (APP1176858); Pacific Community.

Daily step counts before, during, and after COVID-19 pandemic: a smartphone-tracking study of university students in Egypt and Saudi Arabia

BACKGROUND

COVID-19 pandemic has drastically changed people's lifestyles and daily routines around the world. This study aimed to investigate changes in daily step counts - as an indicator of physical activity - before, during, and after the pandemic among university students in Egypt and Saudi Arabia and to identify regional and gender factors that may have influenced physical activity during these periods.

METHODS

A total of 1273 university students from Egypt (Assiut University and Zagazig University) and Saudi Arabia (Taif University, King Faisal University, and Imam AbdulRahman Bin Faisal University) provided valid data on their daily step counts recorded by a smartphone application (iPhone Health App) from January 2019 to December 2021. The data was divided and averaged based on three periods: the pre-pandemic year (January to December 2019), the first pandemic year (January to December 2020), and the second pandemic year (January to December 2021).

RESULTS

The results showed a significant decrease in daily steps from pre-pandemic to the first pandemic year, followed by an increase in the second pandemic year. However, daily step counts did not fully recover to pre-pandemic levels in male Egyptian and marginally in male Saudi participants. In both nationalities, female participants did not show a significant difference in daily steps between the pre-pandemic and second-pandemic years. Female Egyptian participants had significantly lower daily step counts than male Egyptian participants, and a gender difference in daily steps was also observed in Saudi female participants in the pre-pandemic and the second pandemic year but not during the first pandemic year.

CONCLUSION

These findings outline the need for strategies in Egypt and Saudi Arabia to promote physical activity and reduce sedentary behavior, especially among young women, to mitigate the negative consequences of COVID-19 and meet physical activity guidelines.

Physical Activity and the Development of Islet Autoimmunity and Type 1 Diabetes in 5- to 15-Year-Old Children Followed in the TEDDY Study

OBJECTIVE

This study investigated physical activity and its association with the development of islet autoimmunity and type 1 diabetes in genetically at-risk children aged 5-15 years.

RESEARCH DESIGN AND METHODS

As part of the longitudinal Environmental Determinants of Diabetes in the Young (TEDDY) study, annual assessment of activity using accelerometry was conducted from age 5 years. Time-to-event analyses using Cox proportional hazard models were used to assess the association between time spent in moderate to vigorous physical activity per day and the appearance of one or several autoantibodies and progression to type 1 diabetes in three risk groups: 1) 3,869 islet autoantibody (IA)-negative children, of whom 157 became single IA positive; 2) 302 single IA-positive children, of whom 73 became multiple IA positive; and 3) 294 multiple IA-positive children, of whom 148 developed type 1 diabetes.

RESULTS

No significant association was found in risk group 1 or risk group 2. A significant association was seen in risk group 3 (hazard ratio 0.920 [95% CI 0.856, 0.988] per 10-min increase; P = 0.021), particularly when glutamate decarboxylase autoantibody was the first autoantibody (hazard ratio 0.883 [95% CI 0.783, 0.996] per 10-min increase; P = 0.043).

CONCLUSIONS

More daily minutes spent in moderate to vigorous physical activity was associated with a reduced risk of progression to type 1 diabetes in children aged 5-15 years who had developed multiple IAs.

The Impact of Peripheral Vision on Manual Reaction Time Using Fitlight Technology for Handball, Basketball and Volleyball Players

The purpose of the research was to identify the impact of peripheral (unilateral and bilateral) vision on manual reaction time to visual stimuli in handball, basketball and volleyball players by implementing a 6-week experimental program of specific exercises and some adapted tests using Fitlight technology. The research included 412 players (212 male-51.5%; 200 female-48.5%) from three team sports: basketball-146 (35.4%), handball-140 (40%) and volleyball-126 (30.6%). The experimental program carried out over 6 weeks was identical for all handball, basketball and volleyball players participating in the study; two training sessions per week were performed, with each session lasting 30 min; 15 exercises were used for the improvement of manual reaction time to visual stimuli involving peripheral vision. Through the Analysis of Variance (ANOVA), we identified statistically significant differences between the arithmetic means of the samples of handball, basketball and volleyball players, as well as according to general samples also of gender (male and female), p = 0.000. Male and female handball samples achieved the greatest progress in manual reaction time to visual stimuli involving peripheral vision for the Reaction time test with a unilateral right visual stimulus (30 s) and the Reaction time test with a unilateral left visual stimulus (30 s), while general sample also of male and female basketball samples, for the Reaction time test with bilateral visual stimuli (30 s) and the Reaction time test with six Fitlights (1 min); male and female volleyball samples recorded the lowest progress in all tests compared to handball and basketball groups. According to our results, female samples made greater progress in reaction time than male groups for all four tests of the present study. The implemented experimental program led to an improvement in manual reaction time to visual stimuli due to the use of Fitlight technology and the involvement of peripheral vision for all research samples.

Gardening in Childcare Centers: A Randomized Controlled Trial Examining the Effects of a Garden Intervention on Physical Activity among Children Aged 3-5 Years in North Carolina

This study examined the effects of a childcare gardening intervention on children's physical activity (PA). Eligible childcare centers were randomly assigned to: (1) garden intervention (n = 5; year 1); (2) waitlist control (n = 5; control year 1, intervention year 2); or (3) control (n = 5; year 2 only) groups. Across the two-year study, PA was measured for 3 days at four data collection periods using Actigraph GT3X+ accelerometers. The intervention comprised 6 raised fruit and vegetable garden beds and a gardening guide with age-appropriate learning activities. The sample included a total of 321 3-5-year-olds enrolled in childcare centers in Wake County, North Carolina, with n = 293 possessing PA data for at least one time point. The analyses employed repeated measures linear mixed models (SAS v 9.4 PROC MIXED), accounting for clustering of the children within the center and relevant covariates (e.g., cohort, weather, outside days, accelerometer wear). A significant intervention effect was found for MVPA (p < 0.0001) and SED minutes (p = 0.0004), with children at intervention centers acquiring approximately 6 min more MVPA and 14 min less sedentary time each day. The effects were moderated by sex and age, with a stronger impact for boys and the youngest children. The results suggest that childcare gardening has potential as a PA intervention.

Relationship between Skeletal Muscle Thickness and Physical Activity in 4- to 6-Year-Olds in Japan

Purpose: Physical activity (PA) is widely recognized as a key factor in promoting skeletal muscle growth, though little is known about the specific impact of PA on the skeletal muscle development of preschool children. The purpose of this study is to investigate whether there is a relationship between PA levels and skeletal muscle thickness in preschoolers. By exploring this relationship, we hope to gain a better understanding of how PA can be used to promote healthy skeletal muscle development in preschoolers. Methods: In this study, a total of 275 healthy Japanese preschoolers, aged 4–6 years, from seven nursery schools in the town of Togo were recruited. Participants were asked to wear an accelerometer for four consecutive days to record their daily steps and the amount of time spent in moderate-to-vigorous PA and t total physical activity. Muscle thickness (MTs) was measured using B-mode ultrasonography at four sites: the anterior and posterior thigh (AT and PT, respectively) and the anterior and posterior lower leg (AL and PL, respectively). Results: On weekdays, boys were found to be more physically active and engaged in significantly higher levels of total physical activity and moderate-to-vigorous PA than girls. Both boys and girls recorded more physical activity, daily steps, and higher levels of total physical activity and MVPA on weekdays compared to weekends. After adjusting for daylight duration, multivariable regression analyses revealed that increased total physical activity and moderate-to-vigorous PA were positively associated with greater muscle thickness size in the anterior tibialis (AT) and posterior lower leg (PL) muscles (β = 1.11 and β = 1.37 for AT, β = 1.18 and β = 0.94 for PL, p < 0.05) in Japanese preschoolers. Conclusions: The time spent involved in most of the different categories of moderate-to-vigorous PA was significantly higher for boys than for girls on the weekdays and weekends. Additionally, there was a positive correlation between time spent in moderate-to-vigorous PA and greater development of skeletal muscle in the lower body.

Comparing Post-Exercise Hypotension after Different Sprint Interval Training Protocols in a Matched Sample of Younger and Older Adults

This study assessed the post-exercise hypotension (PEH) effect in a sample of matched young and older adults after different sprint interval training (SIT) protocols. From forty-three participants enrolled in this study, twelve younger (24 ± 3 years) and 12 older (50 ± 7 years) participants, matched for the body mass index, systolic blood pressure, and VO₂max-percentiles, were selected. The participants completed two SIT protocols consisting of 4 × 30 s exercise bouts interspersed by either one (SIT1) or three minutes (SIT3) of active rest. The peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), and heart rate (HR) were obtained before and at different measurement time points (t5, t15, t30, t45) after the exercise. No significant time × group interactions were detected in pSBP (p = 0.242, η² = 0.060), pDBP (p = 0.379, η² = 0.046), cSBP (p = 0.091, η² = 0.861), cDBP (p = 0.625, η² = 0.033), PWV (p = 0.133, η² = 0.076), and HR (p = 0.190, η² = 0.123) after SIT1. For SIT3 no significant time × group interactions could be detected for pSBP (p = 0.773, η² = 0.020), pDBP (p = 0.972, η² = 0.006), cSBP (p = 0.239, η² = 0.060), cDBP (p = 0.535, η² = 0.036), PWV (p = 0.402, η² = 0.044), and HR (p = 0.933, η² = 0.009). Matched samples of young and older adults reveal similar PEH effects after HIIT. Accordingly, age does not seem to affect PEH after SIT. These results show that rest interval length and age modulate the PEH effect after SIT.

Evaluating Changes in Perceived Enjoyment throughout a 12-Week School-Based Exergaming Intervention

This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate perceived enjoyment during the 12-week intervention. Thirty fifth- and sixth-grade students (10.5 ± 0.7 years; 50% girls) participated in this study. During baseline assessments, anthropometric measurements and a shuttle run test were conducted. Throughout the intervention period, the students participated in 15−20-min exergaming sessions (ES) in the ExerCube twice a week during school hours. Enjoyment was assessed after an ES in weeks 2 and 12. Additionally, enjoyment was evaluated after a physical education (PE) class in week 2. The results reveal no significant changes in enjoyment (p = 0.164) over time. The modest changes over time were significantly affected by BMI (p = 0.027), WHtR (p = 0.007), and weekly activity level (p = 0.016). Compared to the PE class, enjoyment was significantly higher during the ES (p < 0.001). None of the covariates showed a significant effect. Mean HR during the ES reached 87.1 ± 1.9% of students’ individual maximum HR. In conclusion, the ExerCube provides a promising tool for schools to promote enjoyable moderate-to-vigorous physical activity.

Relationship Between Mindfulness and Physical Activity in College Students: The Mediating Effect of Eudaimonic Well-Being

Previous research has shown many benefits of mindfulness for physical and psychological health, including its link to such health behaviors as increased physical activity (PA). We re-examined the association between mindfulness and PA to better understand a possible mediating role of eudaimonic well-being in this association, while controlling for participants' age, gender, and affect. We had 738 undergraduate student participants (45.0% females; M age = 19.58 years) complete measures of trait mindfulness, eudaimonic well-being, and PA, and we used age, gender, and affect as covariates in a single-wave assessment. We conducted this mediation analysis with a bootstrapping technique to produce 10,000 resamples. We replicated findings of a significant relationship between mindfulness and enhanced eudaimonic well-being (β = 0.474, p < 0.001), which in turn contributed to increased PA (β = 0.193, p < 0.001). The bootstrapping method indicated a significant indirect effect of eudaimonic well-being (β = 0.092, 95% CI = [0.043, 0.142]) in the relationship between mindfulness and PA through eudaimonic well-being. Thus, eudaimonic well-being may mediate the connection between mindfulness and PA. College administrators should consider incorporating mindfulness into health promotion programs as a means of enhancing college students' well-being and health behaviors.

Addressing sex and gender to improve asthma management

Sex (whether one is 'male' or 'female', based on biological characteristics) and gender (defined by socially constructed roles and behaviors) influence asthma diagnosis and management. For example, women generally report more severe asthma symptoms than men; men and women are exposed to different asthma-causing triggers; men tend to be more physically active than women. Furthermore, implicit, often unintended gender bias by healthcare professionals (HCPs) is widespread, and may result in delayed asthma diagnosis, which can be greater in women than men. The sex and gender of the HCP can also impact asthma management. Pregnancy, menstruation, and menopause can all affect asthma in several ways and may be associated with poor asthma control. This review provides guidance for considering sex- and gender-associated impacts on asthma diagnosis and management and offers possible approaches to support HCPs in providing personalized asthma care for all patients, regardless of their sex or gender.

A Feasibility Study of Bilateral Wrist Sensors for Measuring Motor Traits in Children With Autism

Direct, quantitative measures of hyperactivity and motor coordination, two motor characteristics associated with impairment in autism, are limited. Wearable sensors can objectively index real-world movement variables that may relate to these behaviors. Here, we explored the feasibility of bilateral wrist accelerometers for measuring upper limb activity in 3-10-year-olds with autism (n = 22; 19 boys, 3 girls; M age = 5.64, SD = 2.73 years) and without autism (n = 26; 15 boys, 11 girls; M age = 6.26, SD = 2.47 years). We investigated the relationships between movement characteristics related to duration, intensity, complexity, and symmetry on the one hand and parent-reported hyperactivity and motor coordination on the other. Participants with and without autism wore the sensors for 12-hour periods. Sensor variables varied by age but not sex, with movement intensity and complexity moderately related to motor coordination. These findings lend preliminary support to wearable sensors as a means of providing ecologically-valid metrics of motor characteristics that impact adaptive function in children with autism.