Outdoor physical activity and its relation with self-reported health in Japanese children: results from the Toyama birth cohort study

Familial and lifestyle factors related to physical activity in elementary school students: a cross-sectional study based on a nationally representative survey in Japan

PURPOSE

The decrease in physical activity (PA) among children has become a global concern. Since the analysis of sociodemographic factors as determinants of exercise habits has been inconclusive, this study investigated the factors related to participation in organized sports and moderate-to-vigorous PA (MVPA) levels.

METHODS

Cross-sectional data from the Sports-Life Survey conducted in 2019 by the Sasagawa Sports Foundation were used. Data on the gender, age, grade, annual household income, family members, and lifestyle habits of elementary school children as well as information on participation in organized sports and MVPA were collected by written questionnaires. Multiple logistic regression models were applied to calculate the adjusted odds ratio and 95% confidence interval for the association of each variable with participation in organized sports and frequent MVPA (≥ 60 min/day for ≥ 5 days/week).

RESULTS

A total of 1,197 participants were included in the analysis. Whereas 1,053 (88.2%) students expressed a like for PA, only 725 students (60.8%) actually took part in organized sports. Organized sports participation was significantly associated with gender, grade, population density, household income, daily breakfast, lower screen time, and frequent exercise with parents (all P < 0.05). We observed that 12.3% of participants met the frequent MVPA level, which was significantly related to lower screen time and exercise habits with parents (both P < 0.05).

CONCLUSIONS

Social and family factors may be strong determinants of engagement in PA among Japanese elementary school-aged children. Parental involvement appears particularly important for promoting PA among youths.

Social and family factors as determinants of exercise habits in Japanese elementary school children: a cross-sectional study from the Super Shokuiku School Project

BACKGROUND

Many studies have already reported on the relationship between exercise habits and health among schoolchildren. However, few have examined social and/or family factors as determinants of exercise habits.

METHODS

This study's participants included 1721 schoolchildren aged between 6 and 13 who were involved in the Super Shokuiku School Project in January 2016. A survey was conducted to assess gender, grade level, physical activity, lifestyle, overall health, enrichment of school life, social background, and parental lifestyles. Both dislike and lack of physical activity were used to measure poor exercise habits; correlates were analyzed using logistic regression.

RESULTS

"Lack of close friends" had the strongest links with both dislike (adjusted odds ratio [OR] 5.30; 95% confidence interval [CI], 2.78-10.1) and lack of (adjusted OR 5.40; 95% CI, 2.81-10.4) physical activity. Further, children who engaged in long periods of screen time and lacked parental communication also tended to dislike and lack physical activity. Children with mothers who were unemployed (housewives) and had unhealthy lifestyles, as well as those with poor health, were also more likely to lack physical activity.

CONCLUSION

Social and family factors (e.g., having close friends) may be determinants of exercise habits among schoolchildren, independent of their own lifestyle factors. Although a longitudinal study is needed to determine causality, substantial attention may thus be required to these factors when promoting physical activity in children.

Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis

Background

Self-rated health (SRH) is an indicator that captures a person’s perception of their overall health status. The relationship between physical activity (PA), sedentary behaviour (SB) and SRH has been investigated in systematic reviews among adult and elderly populations. No systematic review to date has synthesized the relationship between PA, SB and SRH among children and adolescents. The purpose of this systematic review and meta-analysis was to synthesize the associations between PA, SB and SRH in the general population of children and adolescents and to investigate the dose-response relationship between PA, SB and SRH.

Methods

We conducted a computer search for English language studies in the databases of MEDLINE, EMBASE and PSYCINFO that were published between 1946 and 2019. We searched PubMed, Google Scholar, and the references of the identified publications for additional studies. A meta-analysis was employed to synthesize the associations between PA, SB respectively and SRH. The dose-response association was tested using a random effects meta-regression model. The review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results

Sixty-eight published articles were included in the final review, including 59 cross-sectional and nine longitudinal studies. We found evidence that PA was associated with better SRH, and SB was associated with lower SRH among children and adolescents. A dose-response relationship between PA and SRH was observed, where a higher level of PA was associated with better SRH than a lower level of PA. The relationship between PA, SB and SRH was observed in both boys and girls, and did not show a significant gender difference.

Conclusions

The findings in the systematic review suggest that health intervention programmes targeting promoting PA and reducing SB among children and adolescents may enhance their overall health status. Future research is needed to expand prospective cohort and intervention studies to address directionality and causality in the relationships between PA, SB and SRH among children and youth.

Trial registration

PROSPERO - CRD42019142244. Registered on October 18, 2019.

Association Between Outdoor Activity and Insufficient Sleep in Chinese School-Aged Children

Background

The aim of this study was to explore the relationship between outdoor activity (OA) and insufficient sleep duration (ISD) among Chinese children and to assess the potential age- and gender-specific effects.

Material/Methods

A national sample of 62 517 children aged 6–17 years were recruited from 7 provinces of China in the autumn of 2013. Children and their caregivers reported daily sleep duration (<7 h, 7–9 h and ≥9 h), daily OA time (<1 h, 1–2 h, and ≥2 h), and other behavior and demographic information by standardized questionnaire. ISD was defined as <9 h/day. Logistic regression analysis was used to evaluate the relationship between ISD and OA.

Results

In total, 46 639 children (50.9% boys) completed this survey. The prevalence of ISD was 74.9% (73.7% in boys and 76.1% in girls). Stratified by age, compared with <1 h OA, the odds ratios for ISD were 0.67 (95% confidence interval: 0.62–0.72, aged 6–13 years) and 0.69 (0.49–0.98, 14–17 years) in the ≥2 h OA group; 0.91 (0.85–0.97, 6–13 years) and 0.73 (0.54–0.97, 14–17 years) in the 1–2 h OA group. Further stratified by gender, we found similar trends for both boys and girls in each age group, although some results became non-significant.

Conclusions

Adequate OA time per day is associated with decreased risks for ISD among children aged 6–17 years, but age and gender can modify the association.

Psychosocial and Physiological Health Outcomes of Green Exercise in Children and Adolescents-A Systematic Review

Both physical activity (PA) and nature exposure are associated with several youth health benefits. However, the health outcomes when being physically active in nature, called Green Exercise (GE), are less clear. Thus, the purpose of this systematic review was to provide an overview of the psychosocial and physiological outcomes of GE in children and adolescents and to outline future GE research directions. The PRISMA statement guided the review. Web of Science, PubMed, ERIC, and APA PsychNET were systematically searched in February 2019, including studies between 2000 and 2019. Fourteen of 1175 identified publications were included, which reported 15 different psychosocial and six different physiological outcomes, with some studies reporting more than one outcome. For 16 outcomes, studies reported either similar or no effects for both GE and comparison groups. For six outcomes, studies reported stronger effects for GE, for three outcomes, studies reported stronger effects in the comparison group. Evidence was rated as weak, using the EPHPP tool. Thus, GE does not have deleterious effects for children and adolescents compared to PA in other settings. GE might be beneficial; however, due to the study's heterogeneity and quality, it is premature to make definite conclusions. Future research should build the quality of evidence for GE, use more rigorous research designs, and investigate the underlying effects and mechanisms of GE.

Health self-perception and its association with physical activity and nutritional status in adolescents

OBJECTIVE

To evaluate the association between total physical activities, physical activity in free time and nutritional status with self-perceived health in adolescents of both genders.

METHODS

This is a quantitative study that integrates the school-based, cross-sectional epidemiological survey with statewide coverage, whose sample consisted of 6261 adolescents (14-19 years old) selected by random conglomerate sampling. Data were collected using the Global School-based Student Health Survey. The chi-squared test (χ²) and the Poisson regression model with robust variance were used in the data analyses.

RESULTS

It was observed that 27.3% of the adolescents had a negative health self-perception, which was higher among girls (33.0% vs. 19.0%, p<0.001). After adjusting for potential confounding factors, it was observed that boys who did not practice physical activity during free time (PR=1.44, 95% CI: 1.15-1.81) and were classified as insufficiently active (PR=1.27, 95% CI: 1.04-1.56), as well as girls who did not practice physical activity during free time (PR=1.15, 95% CI: 1.02-1.29) and were classified as overweight (PR=1.27, 95% CI: 1.01-1.29) had a greater chance of negative health self-perception.

CONCLUSION

Behavioral issues may have different effects on health self-perception when comparing boys with girls. Negative health self-perception was associated with nutritional status in girls and a lower level of physical activity in boys, and the practice of physical activity in the free time was considered a protective factor against a negative health self-perception for adolescents of both genders.

Environmental correlates of physical activity among children 10 to 13 years old in Wallonia (Belgium)

Background

In Belgium, as in many other countries, the juvenile practice of physical activity is insufficient. A growing attention has been paid to environmental factors that may influence physical activity but with inconsistent findings. This study aims to estimate the association between daily life environment characteristics and physical activity among children 10 to 13 years old in Wallonia (Belgium).

Methods

Data were collected using a self-administered questionnaire among 1940 children (HBSC survey). Associations between factors related to the children’s living environment and physical activity (vigorous physical activity (VPA) ≥ twice a week; global physical activity (GPA) defined as VPA ≥ twice a week and moderate-to-vigorous physical activity ≥1 h/day) were estimated using logistic regressions adjusted for potential confounders.

Results

Nearly three-quarters of the children practiced VPA ≥ twice a week, but only one in five practiced GPA consistent with recommendations. After adjustment, children living in a neighborhood with playgrounds or parks were more likely to achieve a recommended level of GPA (OR: 1.34 [1.04–1.73]), as were children who reported that other youngsters were present in their neighborhood with whom they could play outside (OR: 1.50 [1.12–1.99]). The presence of neighborhood children was also positively associated with VPA (OR: 1.80 [1.42–2.29]); in stratified analyses, the association was significant only among boys (OR: 1.95 [1.34–2.82]). Moreover, and only in girls (OR: 1.66 [1.10–2.49]), a feeling of safety in one’s neighborhood was positively associated with VPA. No association was found between VPA and the existence of a yard or a garden at home to go playing outside.

Conclusion

Our results argue for developing actions aimed at creating living environments more favorable to children’s daily physical activity. More specifically, they help better understand the environment of Belgian children and thus contribute to better identify their needs.

Prevention of Progression in Myopia: A Systematic Review

The prevalence of myopia has increased worldwide in recent decades and now is endemic over the entire industrial world. This increase is mainly caused by changes in lifestyle and behavior. In particular, the amount of outdoor activities and near work would display an important role in the pathogenesis of the disease. Several strategies have been reported as effective. Spectacles and contact lenses have shown only slight results in the prevention of myopia and similarly ortokerathology should not be considered as a first-line strategy, given the high risk of infectious keratitis and the relatively low compliance for the patients. Thus, to date, atropine ophthalmic drops seem to be the most effective treatment for slowing the progression of myopia, although the exact mechanism of the effect of treatment is still uncertain. In particular, low-dose atropine (0.01%) was proven to be an effective and safe treatment in the long term due to the lowest rebound effect with negligible side effects.

The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review

BACKGROUND

The association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents.

METHODS

We conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3-18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time.

RESULTS

In total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life.

CONCLUSIONS

The findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.

Use of time and adolescent health-related quality of life/well-being: a scoping review

Time use could profoundly affect adolescents' health-related quality of life (HRQL). Ideally, overall time use patterns would be considered, because activities within a 24-hour day are inherently correlated (more in one activity means less in another). This review focused on the associations of (i) overall time use patterns and (ii) components of time use patterns with HRQL in adolescents.

CONCLUSION

More physical activity, less screen time and more/adequate sleep, in isolation, are associated with better profile-based HRQL subscales. Greater understanding of adolescents' overall time use patterns and HRQL is, therefore, a priority for policy development.

In 6- to 8-year-old children, cardiorespiratory fitness moderates the relationship between severity of life events and health-related quality of life

PURPOSE

In children, the pathways by which physical activity and fitness are associated with physical and psychological wellbeing are still not fully understood. The present study examines for the first time in young children whether high levels of cardiorespiratory fitness and physical activity moderate the relationship between severity of life events and health-related quality of life.

METHODS

Three hundred and seventy-eight children (188 girls, 190 boys, M _age = 7.27 years) participated in this cross-sectional study. Parental education, gender, age, severity of life events, health-related quality of life and physical activity were assessed via parental questionnaires. Cardiorespiratory fitness was assessed with the 20 m shuttle run test. Hierarchical regression analyses were used to test whether physical activity and fitness interacted with critical life events to explain health-related quality of life.

RESULTS

When exposed to critical life events, children with higher fitness levels experienced higher levels of psychological wellbeing, relative to their less fit peers. On the other hand, children with higher fitness levels experienced higher physical wellbeing and more positive friendship relationships when severity of life events was low. A similar moderation effect was found for physical activity with overall quality of life as outcome.

CONCLUSIONS

Recent stressful experiences alone were not sufficient to explain negative health outcomes in young children. Children with low cardiorespiratory fitness levels experienced lower psychological wellbeing when they were exposed to critical life events. More research is needed to find out whether similar findings emerge with objective physical activity measurements and when critical life events are assessed over longer periods of time.