Assessing physical activity in adolescents: common activities of children in 6th-8th grades

Movement Behaviour and Health Outcomes in Rural Children: A Systematic Review

BACKGROUND

Studies with rural children are limited, and results are divergent regarding the information on movement behaviours.

PURPOSE

to (i) describe the physical activity and sedentary behaviour in children; (ii) synthetize the year and place of publication, methodological quality, and instruments used to measure physical activity and sedentary behaviour; and (iii) to analyse the relationship between physical activity, sedentary behaviour, and health outcomes in these children.

METHODS

We use the databases PubMed, Web of Science, SPORTDiscus, Scopus, Virtual Health Library, and SciELO, considering papers published until October 2021. A total of 12,196 studies were identified, and after the exclusion of duplicate, title and abstract screening, and the full-text assessment, a total of 68 were included in the study.

RESULTS

A cross-sectional design was dominant among the studies, with sample sizes ranging from 23 to 44,631 children of both sexes. One-third of the studies were conducted in North America and Europe, and most of them used device-based measurements. Inequalities were observed regarding sex, age, economic level, race, and physical activity domains within and between the places of residence. Sociodemographic characteristics were also related to health outcomes for children living in rural and urban areas.

CONCLUSION

It is necessary to increase the evidence on movement behaviours among children living in the countries of South America and Oceania, as well as to increase the level of evidence on the role of school for physical activity in children in rural areas, given the inconsistent findings.

Evaluation of two different 1-year training programs among prepuberal female children

The aim of this study was to analyse and compare the effects of two different dance training concepts in terms of anthropometric indices and supervised motor test performance between two groups of 56 prepuberal girls. The first group, composed of 29 girls, performed a typical classical dance training program (D group), while the second one, composed of 27 girls, followed a mixed training (D&R group) workout, with classical dance exercises alternated to rhythmic gymnastics. Anthropometric and exercise performance data were collected and assessed initially (T1) and after a 1-year (T2) training program. Data collected were firstly tested for collinearity using Belsley’s test and, after their normality was tested through the Shapiro–Wilk test, analysis of variance (ANOVA) tests were performed on a subset of noncollinear variables. The two groups showed improvements in both anthropometric parameters and exercise performance; however, no differences arose between the variation of anthropometric parameters between the two groups. On the other hand, exercise performance was improved in some fields of the D&R group, particularly in exercises regarding the upper body, such as pull-ups, chin-ups and sit-ups. In conclusion, our data provide evidence that a specific training program consisting of classic dance plus rhythmic gymnastics exercises (D&R) has a greater impact compared to a program of simple classic dance, in terms of skill performance without impairment of anthropometric parameters.

U.S. Children and Youth's Physical Activities Inside and Outside of School PE: 1985 vs. 2012

The purpose of this study was, by taking advantage of the rich data from two U.S. national fitness surveys, to examine the physical activity (PA) students engaged in, both inside and outside school physical education (PE), determine if there are differences by grade, sex, and weight status, and if there was a change between 1985 and 2012. The data from the 1985 National Children and Youth Fitness Study (NCYFS) and the 2012 NHANES National Youth Fitness Survey (NNYFS) were matched, merged (N = 6178, 3107 boys and 3071 girls), and analyzed. It was found that basketball remained the most popular PA inside school PE across both surveys. Swimming was the most popular PA outside of school PE in 1985, but was replaced by running in 2012. Although PA taught and promoted inside of school PE and that such PA practiced outside were moderately correlated across the surveys, some disconnections were noticed. The impact of grade, sex, and weight status on PA preference and participation was also confirmed. What is needed is to the design and integration of more lifelong and individual PAs in future school PE curricula and school and community children and youth sport and PA programs.

Effects of dancing on physical activity levels of children and adolescents: a systematic review

BACKGROUND

Dancing has been suggested to increase the levels of physical activity of the youth. However, it is not clear what are the physiological characteristics of the dance classes for young people, mainly regarding the levels of moderate to vigorous physical activity (MVPA) during classes. It is also unclear if regular engagement in dance practices can contribute with increases in the amounts of daily/weekly MVPA, recommended by health organizations.

OBJECTIVES

To conduct a systematic review verifying the amount of time spent at MVPA (primary outcome), by children and adolescents in the following situations: i) During dance classes, and ii) Before and after dance interventions. Secondary outcomes included: markers of exercise intensity during class, such as oxygen consumption (VO₂) and heart rate (HR); VO₂peak and lipid profile before and after dance interventions.

METHODS

Six data sources were accessed (MEDLINE, EMBASE, Cochrane Wiley, PEDRO and SCOPUS). Study selection included different designs (acute, cohort, randomized controlled trials and others). Participants were from 6 to 19 years old, regularly engaged in dance practices. Methodological quality was assessed using the Downs and Black checklist. Two independent reviewers extracted characteristics and results of each study.

RESULTS

3216 articles were retrieved, and 37 included. Studies indicated that dance classes do not achieve 50% of total class time at MVPA. However, there are peaks of HR and VO₂ during dance classes, which reach moderate and vigorous intensities. MVPA/daily/weekly did not improve before and after dance interventions for most of the studies, also VO₂peak did not. The few results on lipid profile showed improvements only in overweight and obese participants.

LIMITATIONS

Lack of meta-analysis, because there were not enough articles to be analyzed on any given outcome of interest, neither under the same study design.

CONCLUSIONS

Results of individual studies indicated that dance classes did not active 50% of the total time at MVPA levels. This may be related to the absence of improvements in daily/weekly MVPA before and after dance interventions. VO₂ and HR attained peaks of moderateto vigorous intensity during dance classes, suggesting that the structure of the classes may be manipulated to maintain longer periods at MVPA levels. Lack of data on cardiorespiratory fitness and metabolic outcomes limit conclusions on these parameters.

IMPLICATIONS OF KEYS FINDS

Considering there are peaks of HR and VO₂ during dance classes, we suggest that the structure of a dance class can be manipulate in order to induce cardiorespiratory and metabolic adaptations. Thus, dancing is a potential strategy to contribute with a healthy life style since the earliest ages. Prospero registration: CRD42020144609.

Physical Activity and Sedentary Behavior Among U.S. Children With and Without Down Syndrome: The National Survey of Children's Health

It is unclear whether children with Down syndrome have differing physical activity and sedentary behavior levels compared to typical children. This study addressed this evidence gap in a national sample. Physical activity/sedentary behavior were ascertained by parental report. Findings highlighted that children with Down syndrome were less likely to engage in regular physical activity compared to typical children and had the lowest likelihood of regular physical activity among all subgroups with developmental disabilities/special healthcare needs. Children with Down syndrome were also more likely to watch high volumes of television compared to typical children, although this was nonsignificant upon adjustment for general health. It was concluded that children with Down syndrome are in urgent need for interventions/programs that promote physical activity.

Physical activity, sedentary behaviour, and socioeconomic status among Finnish girls and boys aged 6-8 years

We studied differences in physical activity (PA), sedentary behaviour (SB), and the types of PA and SB between Finnish girls and boys and children from different socioeconomic backgrounds (SES). We assessed PA, SB, parental education, and household income using detailed questionnaires in a representative population sample of 486 children (238 girls, 248 boys) aged 6-8 years. Girls spent on average 1.7 h/day and boys 2.0 h/day in total PA (p = 0.002). Altogether 66% of girls and 54% of boys had less than 2 h of total PA per day (p = 0.012). Girls had lower levels of unsupervised PA (45 vs. 54 min/day, p = 0.001), supervised PA (1.5 vs. 1.9 h/week, p = 0.009), and PA during school recess (1.8 vs. 1.9 h/week, p = 0.032) than boys. Girls had higher levels of total SB (3.8 vs. 3.4 h/day, p = 0.015) but lower levels of screen-based SB (1.5 vs. 1.9 h/day, p < 0.001) than boys. Lower parental education and household income were associated with lower levels of supervised PA in girls (p = 0.011 and p = 0.008, respectively) and in boys (p = 0.006 and p = 0.003, respectively). Lower parental education and household income were also related to higher levels of screen-based SB in boys (p = 0.005 and p < 0.001, respectively) but not in girls. Girls have lower levels of total, unsupervised, and supervised PA, PA during recess, and screen-based SB but higher levels of total SB than boys. Lower parental education and household income are associated with lower levels of supervised PA in both genders and higher levels of screen-based SB in boys.

Gender Differences in Health Risk Behaviors and Physical Activity Among Middle School Students

Adolescence is a period of accelerated growth and change, bridging the complex transition from childhood to adulthood. This period offers adolescents an opportunity to begin planning for their futures and to adopt healthy attitudes about risk behaviors that can continue into adulthood, thus setting the stage for a lifetime of desirable health behaviors. This study used the Youth Risk Behavior Survey on middle school students and examined the gender differences of health risk behaviors among 674 8th-graders from an urban setting. The results showed that males were more likely to be involved in fights, to initiate alcohol use, and to participate in physical activity; whereas females were more likely to try to lose weight with unhealthy practices, such as fasting and laxatives. School nurses are in a prime position to promote adolescent health in the school setting by providing health-related services and teaching to help students initiate and maintain healthy lifestyles.

Promoting healthy lifestyles in high school adolescents: a randomized controlled trial

BACKGROUND

Although obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed experimental studies have been conducted in high schools.

PURPOSE

The goal of the study was to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and at 6 months post-intervention.

DESIGN

A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013.

SETTING/PARTICIPANTS

A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial.

INTERVENTION

COPE was a cognitive-behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics.

MAIN OUTCOME MEASURES

Primary outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental health, alcohol and drug use, social skills, and academic performance.

RESULTS

Post-intervention, COPE teens had a greater number of steps per day (p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values <0.05). Teens in the COPE group with extremely elevated depression scores at pre-intervention had significantly lower depression scores than the Healthy Teens group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group (p=0.04). COPE teens had higher health course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy Teens=25.05, adjusted M=-0.34, 95% CI=-0.56, -0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month follow-up (chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control adolescents. There also was a trend for COPE Teens to report less alcohol use at 6 months (p=0.06).

CONCLUSIONS

COPE can improve short- and more long-term outcomes in high school teens.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT01704768.

The COPE healthy lifestyles TEEN randomized controlled trial with culturally diverse high school adolescents: baseline characteristics and methods

Obesity and mental health disorders remain significant public health problems in adolescents. Substantial health disparities exist with minority youth experiencing higher rates of these problems. Schools are an outstanding venue to provide teens with skills needed to improve their physical and mental health, and academic performance. In this paper, the authors describe the design, intervention, methods and baseline data for a randomized controlled trial with 779 culturally diverse high-school adolescents in the southwest United States. Aims for this prevention study include testing the efficacy of the COPE TEEN program versus an attention control program on the adolescents' healthy lifestyle behaviors, Body Mass Index (BMI) and BMI%, mental health, social skills and academic performance immediately following the intervention programs, and at six and 12 months post interventions. Baseline findings indicate that greater than 40% of the sample is either overweight (n = 148, 19.00%) or obese (n = 182, 23.36%). The predominant ethnicity represented is Hispanic (n = 526, 67.52%). At baseline, 15.79% (n = 123) of the students had above average scores on the Beck Youth Inventory Depression subscale indicating mildly (n = 52, 6.68%), moderately (n = 47, 6.03%), or extremely (n = 24, 3.08%) elevated scores (see Table 1). Anxiety scores were slightly higher with 21.56% (n = 168) reporting responses suggesting mildly (n = 81, 10.40%), moderately (n = 58, 7.45%) or extremely (n = 29, 3.72%) elevated scores. If the efficacy of the COPE TEEN program is supported, it will offer schools a curriculum that can be easily incorporated into high school health courses to improve adolescent healthy lifestyle behaviors, psychosocial outcomes and academic performance.

Translating policies into practice: a framework to prevent childhood obesity in afterschool programs

Afterschool programs (3-6 p.m.) are positioned to play a critical role in combating childhood obesity. To this end, state and national organizations have developed policies related to promoting physical activity and guiding the nutritional quality of snacks served in afterschool programs. No conceptual frameworks, however, are available that describe the process of how afterschool programs will translate such policies into daily practice to reach eventual outcomes. Drawing from complex systems theory, this article describes the development of a framework that identifies critical modifiable levers within afterschool programs that can be altered and/or strengthened to reach policy goals. These include the policy environment at the national, state, and local levels; individual site, afterschool program leader, staff, and child characteristics; and existing outside organizational partnerships. Use of this framework and recognition of its constituent elements have the potential to lead to the successful and sustainable adoption and implementation of physical activity and nutrition policies in afterschool programs nationwide.

Time perspective and physical activity among central Appalachian adolescents

Time perspective is a cultural behavioral concept that reflects individuals' orientations or attitudes toward the past, present, or future. Individuals' time perspectives influence their choices regarding daily activities. Time perspective is an important consideration when teaching adolescents about the importance of being physically active. However, little is known about the relationship between time perspective and physical activity among adolescents. The purpose of this study was to determine the time perspective of central Appalachian adolescents and explore the relationship between time perspective and physical activity. This study was guided by The theory of planned behavior (TPB). One hundred and ninety-three students completed surveys to examine time perspective and physical activity behaviors. Data were collected in one school. Results of this study can inform school nurses and high school guidance counselors about the importance of promoting a future-oriented time perspective to improve physical activity and educational outcomes.

Organized physical activity in young school children and subsequent 4-year change in body mass index

OBJECTIVE

To determine whether participation in organized outdoor team sports and structured indoor nonschool activity programs in kindergarten and first grade predicted subsequent 4-year change in body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) during the adiposity rebound period of childhood.

DESIGN

Longitudinal cohort study.

SETTING

Forty-five schools in 13 communities across Southern California.

PARTICIPANTS

Largely Hispanic and non-Hispanic white children (N = 4550) with a mean (SD) age at study entry of 6.60 (0.65) years.

MAIN EXPOSURES

Parents completed questionnaires assessing physical activity, demographic characteristics, and other relevant covariates at baseline. Data on built and social environmental variables were linked to the neighborhood around children's homes using geographical information systems.

MAIN OUTCOME MEASURES

Each child's height and weight were measured annually during 4 years of follow-up.

RESULTS

After adjusting for several confounders, BMI increased at a rate 0.05 unit/year slower for children who participated in outdoor organized team sports at least twice per week compared with children who did not. For participation in each additional indoor nonschool structured activity class, lesson, and program, BMI increased at a rate 0.05 unit/year slower, and the attained BMI level at age 10 years was 0.48 units lower.

CONCLUSION

Engagement in organized sports and activity programs as early as kindergarten and the first grade may result in smaller increases in BMI during the adiposity rebound period of childhood.

The development of a unique physical activity self-report for young children: challenges and lessons learned

The number of overweight and obese children in the Western world is alarming. Efforts to impact this problem at an individual level have had little effect. Interventions that focus on the whole population may prove more successful. This study reports the development of a unique self-report picture questionnaire designed to assess playground physical activity preferences in young children (4-9 years, N = 1,881) at 14 regional Australian primary schools. Children's picture preferences were compared with observational data using the Children's Activity Scanning tool (CAST2). Results indicate that 62% to 89% of children preferred activities that were moderate or highly active; however, CAST2 data indicated that children spent only 50% to 70% of play time being active. The findings confirm that young children are able to indicate their preferences for physical activity. Important considerations in future attempts to develop a measure of physical activity in young children are discussed.

Improving the mental health, healthy lifestyle choices, and physical health of Hispanic adolescents: a randomized controlled pilot study

BACKGROUND

Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to improve both their healthy lifestyles and mental health outcomes. Even fewer studies have been conducted with Hispanic youth. The purpose of this study was to evaluate the preliminary efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, and Nutrition) program, a manualized educational and cognitive behavioral skills-building program, on Hispanic adolescents' healthy lifestyle choices as well as mental and physical health outcomes.

METHODS

A cluster randomized controlled pilot study was conducted with 19 Hispanic adolescents enrolled in 2 health classes in a southwestern high school. One class received COPE and the other received an attention control program.

RESULTS

Adolescents in the COPE program increased their healthy lifestyle choices and reported a decrease in depressive and anxiety symptoms from baseline to postintervention follow-up. A subset of 7 overweight adolescents in the COPE program had a decrease in triglycerides and an increase in high-density lipoproteins. In addition, these overweight adolescents reported increases in healthy lifestyle beliefs and nutrition knowledge along with a decrease in depressive symptoms.

CONCLUSION

The COPE TEEN program is a promising school-based strategy for improving both physical and mental health outcomes in adolescents.

Determinantes biológicos e sócio-culturais associados à prática de atividade física de adolescentes

A atividade física é um comportamento importante na promoção de saúde e na prevenção de doenças. Para que se desenvolvam programas eficazes no incentivo à prática de atividade física em adolescentes, torna-se necessário que se identifiquem os fatores que a determinam. Este estudo pretende rever alguns dos aspectos do estado atual do conhecimento acerca da influência de determinantes demográfico-biológicos (idade, sexo, estatuto sócio-econômico) e sócio-culturais (família, pares e professor de educação física) na atividade física de adolescentes. Nesta revisão apenas foram incluídos estudos efetuados com amostras superiores a 100 adolescentes com idades entre os 10 e os 18 anos, que tenham adotado delineamentos de pesquisa transversal e que tenham utilizado questionários. Os principais resultados e conclusões foram que: a idade parece estar negativamente associada à atividade física; o sexo masculino tende a estar mais envolvido nessas atividades; o estatuto sócio-econômico elevado parece ser um fator protetor do risco de inatividade física; a participação da família e dos pares em atividades físicas parece estar positivamente associada às atividades por parte dos adolescentes; o professor de educação física parece não representar um fator propiciador da atividade física.

Age and sex differences in physical activity of Portuguese adolescents

PURPOSE

This study sought to examine sex- and age-associated variations in physical activity (PA) among Portuguese adolescents aged 10-18 yr.

METHODS

A total of 12,577 males and females at the primary or secondary education level were sampled across four regions of Portugal. PA was assessed by a questionnaire, producing four different indexes: work/school (WSI), sport (SI), leisure time (LI), and total physical activity index (PAI). We examined sex and age differences by using two-way analysis of variance.

RESULTS

Males had higher mean values of PA than did females. In both sexes, mean values for all four PA indexes increased from ages 10 to 16 yr. After age 16, females decreased their mean values, whereas males continued to increase their values (except for LI). In both sexes, the average annual rate of change for the mean values of all four PA indexes correspond to three sensitive age periods (10-13, 13-16, and 16-18 yr). Until age 16, average mean changes for females ranged from +0.7 to +1.6% per year, except for SI in the youngest group (a modest decrease). For males under 16 yr, the pattern was similar, with increases ranging from 0.4 to 1.9% per year. After age 16, females experienced decreases of 1-2.1% per year for the four PA indexes, whereas males showed an increase for three indexes and an average decrease of 1.3% per year for LI.

CONCLUSIONS

These results suggest that it is important to consider sex differences in PA levels among Portuguese adolescents. Unlike their male counterparts, Portuguese females may reduce much of their PA during late adolescence.

Social inequalities in changes in health-related behaviour among Slovak adolescents aged between 15 and 19: a longitudinal study

Background

Lower socioeconomic position is generally associated with higher rates of smoking and alcohol consumption and lower levels of physical activity. Health-related behaviour is usually established during late childhood and adolescence. The aim of this study is to explore changes in health-related behaviour in a cohort of adolescents aged between 15 and 19, overall and by socioeconomic position.

Methods

The sample consisted of 844 first-year students (42.8% males, baseline in 1998 – mean age 14.9, follow-up in 2002 – mean age 18.8) from 31 secondary schools located in Kosice, Slovakia. This study focuses on changes in adolescents' smoking, alcohol use, experience with marijuana and lack of physical exercise with regard to their socioeconomic position. Four indicators of socioeconomic position were used – adolescents' current education level and employment status, and the highest education level and highest occupational status of their parents. We first made cross tabulations of HRB with these four indicators, using McNemar's test to assess differences. Next, we used logistic regression to assess adjusted associations, using likelihood ratio tests to assess statistical significance.

Results

Statistically significant increases were found in all health-related behaviours. Among males, the most obvious socioeconomic gradient was found in smoking, both at age 15 and at 19. Variations in socioeconomic differences in health-related behaviour were more apparent among females. Although at age 15, almost no socioeconomic differences in health-related behaviour were found, at age 19 differences were found for almost all socioeconomic indicators. Among males, only traditional socioeconomic gradients were found (the lower the socioeconomic position, the higher the prevalence of potentially harmful health-related behaviour), while among females reverse socioeconomic gradients were also found.

Conclusion

We confirmed an increase in unhealthy health-related behaviour during adolescence. This increase was related to socioeconomic position, and was more apparent in females.

The COPE Healthy Lifestyles TEEN program: feasibility, preliminary efficacy, & lessons learned from an after school group intervention with overweight adolescents

INTRODUCTION

There has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents. Therefore, two intervention studies were conducted to: (a) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, and Nutrition (TEEN) program with overweight adolescents; (b) obtain feedback that could be used to refine the program; and (c) examine the preliminary efficacy of the COPE program on the adolescents' weight and body mass index (BMI).

METHOD

Phase I and Phase II clinical trials were conducted with 23 overweight teens. The Phase 1 trial used a pre-experimental design with one group of 11 urban adolescents. The Phase 2 trial was conducted with 12 suburban teens using a randomized controlled pilot study. COPE teens received a 15-session cognitive-behavioral skills building program that included physical activity, while the control group received an attention control program. Weight change and BMI were the key outcomes.

RESULTS

COPE teens experienced a significantly greater reduction in weight and BMI than did teens in the control group, who gained weight over time. Although the COPE program was well received by all of the teens, retention of subjects across time and parent involvement in the program were challenges in the urban high school.

DISCUSSION

These studies provide preliminary data to indicate that the implementation of COPE is feasible and may lead to a reduction in weight and BMI in overweight teens. Implementing COPE within the context of the school day may be more successful in sustaining adolescent involvement in the program versus using an after-school format.

Training programs for children: literature review

INTRODUCTION

Training programs are increasingly being prescribed for occupational therapy for adults affected by chronic illness and/or handicap, but their use is more recent for children and teenagers.

OBJECTIVE

A review of the literature to synthesize information concerning training programs for children, whether healthy or with disease or handicap, considering the target population, methodology, the results and limitations.

METHODS

We searched the Medline database with use of the key words retraining, training, training programs, physical activity, physical training, fitness program, sport, children, disability, and handicap. We also searched references of the selected articles for appropriate studies.

DISCUSSION/CONCLUSION

Physical activity seems to be a good means of primary preventing adverse health in the healthy child and secondary prevention in children with chronic disease or handicap. Thus, training programs could be adapted and integrated into the global treatment of sick or handicapped children in the health care situation or in the home. These programs are feasible and do not undermine children's health, but few studies have shown clear data on the methods of the programs. The suggested training programs, not always validated, included two to five sessions from 30 to 60 min/week, for 6-16 weeks, of variable activity and intensity, adapted to the condition and the objectives of therapy. Training programs adapted to children should be validated to allow their accessibility by health care professionals dealing with children with chronic disease and/or handicap.

Associations between sport participation, demographic and socio-cultural factors in Portuguese children and adolescents

BACKGROUND

The number of studies that focus on factors influencing the sport participation (SP) of children and adolescents is limited. The present study examines the associations between demographic [age, gender and socio-economic status (SES)] and socio-cultural factors (SP of family, and peers and physical educator influences) and the SP of children and adolescents.

METHODS

A random sample of 3352 Portuguese children/adolescents, 10-18 years, their parents and siblings was surveyed. The assessment of SP was based on a psychometrically established questionnaire. Multivariable logistic regression was used in data analysis.

RESULTS

(i) age was not related to children/adolescent's SP; (ii) children/adolescents with high SES (OR:1.7, 95%CI:1.4-2.2) and medium SES (OR:1.4, 95%CI:1.1-1.7) were more involved in sports; (iii) children/adolescents were more likely to participate in sports when their family also participate; (iv) boys were more likely to participate in sports than girls (adjusted OR:3.3, 95%CI:2.8-3.9 from a main effects model), but mother's SP influenced their daughters and sons differently. Daughters showed a greater propensity for practising sports when their mothers did (OR:2.5; 95%CI:1.7-3.6). For sons, sports involvement was similar whether or not their mothers participated (OR:1.1; 95%CI:0.7-1.7); (v) peers had a positive influence on the participants' SP (OR:2.2, 95%CI:1.9-2.7); (vi) after adjusting for other factors, the influence of a physical education teacher was not found to affect the SP of the children/adolescents.

CONCLUSION

There are important demographic and socio-cultural influences on the SP of children/adolescents-in particular, gender, SES, family members' SP and peer influence.

The relationship between motor proficiency and physical activity in children

OBJECTIVES

Youth with better motor abilities may find it easier to be physically active and may be more likely to engage in physical activity compared with peers with poorer motor competence. The purpose of this study was to examine the relationship between motor proficiency and physical activity in 8- to 10-year-old children. Self-efficacy toward physical activity was also assessed.

METHODS

Sixty-five children (34 girls and 31 boys) were studied. Children's physical activity was assessed by the Manufacturing Technologies Incorporated/Computer Science and Applications Incorporated model 7164 accelerometer, and their motor proficiency was determined by the Bruininks-Oseretsky Test of Motor Proficiency. The Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scale measured children's self-perceptions of adequacy in performing and desire to participate in physical activities.

RESULTS

Children's motor proficiency was positively associated with activity counts and percentage of time in moderate and moderate-to-vigorous intensity physical activity and inversely related to percentage of time in sedentary activity. Children in the greatest quartile of motor proficiency were the most physically active compared with children with lower levels of motor proficiency who had similar levels of physical activity. Children with greater standardized BMI were less physically active, more sedentary, and had poorer motor proficiency compared with children with a lower standardized BMI. Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scores were positively associated with Bruininks-Oseretsky Test of Motor Proficiency standard score for boys. Children's motor proficiency explained an additional 8.7% of the variance in physical activity in multiple linear regression after controlling for factors that may influence physical activity.

CONCLUSIONS

Motor proficiency is positively associated with physical activity and inversely associated with sedentary activity in children, but there may be a threshold of motor proficiency above which children may be the most physically active. Children's motor proficiency may be an appropriate target for increasing physical activity in youth.

Physical Activity Patterns in Youth with Autism Spectrum Disorders

The purpose of this study was to examine age-related physical activity patterns in youth with autism spectrum disorders (ASD). Thirty youth, aged 10-19 years, were divided into three groups: elementary (n=9), middle (n=9) and high (n=12) school. Participants wore an accelerometer and completed an activity questionnaire for seven consecutive days. The main findings were that (a) elementary youth are more active than the other groups, regardless type of day or time period, and (b) there are no consistent patterns in physical activity of youth with ASD according to day or time period. Findings emphasize that interventions for this population should address increasing extracurricular physical activity options during adolescence.

Effective weight loss for overweight children: a meta-analysis of intervention studies

Childhood overweight has increased in the United States. Success of weight-loss programs has been limited (Barlow, S.E., & Dietz, W.H. (1998). Obesity evaluation and treatment: Expert committee recomendations. Pediatrics, 102, e29.). The purpose of this investigation was to systematically examine the effectiveness of weight-loss interventions for children. For this meta-analysis, seven weight-loss intervention studies were coded and quality index scores calculated. The interventions had a significant positive effect on weight-loss average d = 0.95, with a 95% confidence interval of 0.79 to 1.11. Limited interventional studies with effective long-term maintenance of weight loss in children are available in the literature. However, there are effective methods for weight loss in children.

Dairy intake is associated with lower body fat and soda intake with greater weight in adolescent girls

Body fat and weight of 9- to 14-y-old girls (n = 323) from Kaiser Permanente were studied in relation to age, ethnicity, and physical activity. Mean age, calcium intake, weight, and iliac skinfold thickness were 11.5 +/- 1.4 y, 736.5 +/- 370.7 mg/d, 44.6 +/- 13.0 kg, and 12.4 +/- 6.1 mm, respectively. Multiple regression with age, ethnicity, height, Tanner breast stage, physical activity, energy, soda, and calcium intake explained 17% of the variation in iliac skinfold thickness. Calcium intake, age, and physical activity were significantly negatively associated with iliac skinfold thickness whereas height, Tanner breast stage, and Pacific Islander ethnicity were significantly positively associated (P < 0.0001, R(2) = 0.165). Substituting total calcium with dairy and nondairy calcium in separate models accounted for 16 and 15% of the variance, respectively (P < 0.0001, both models); 1 mg of total and dairy calcium was significantly associated with 0.0025 mm (P = 0.01) and 0.0026 mm (P = 0.02) lower iliac skinfold thickness. Thus, 1 milk serving was associated with 0.78 mm iliac skinfold thickness. The interaction of Asian ethnicity and dairy intake was significant (P = 0.027). Nondairy calcium was not associated with weight or iliac skinfold thickness. Soda intake was significantly positively associated with weight in both models (P = 0.01, both models). Decreasing soda and increasing dairy consumption among Asians may help maintain body fat and weight during adolescence.