Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health

Association Between Daily Physical Education Attendance and Meeting 24-Hour Movement Guidelines in Adolescence and Adulthood

PURPOSE

To investigate the relationship between participation in physical education lessons (PELs), i.e., minutes or frequency per week, and meeting the 24-hour movement guidelines (i.e., physical activity, screen time, and sleep duration) during adolescence (12-17 years old) and adulthood (33-39 years old).

METHODS

We analyzed data from individuals who participated in Waves I (1994-1995) and V (2016-2018) of the National Longitudinal Study of Adolescent Health. We determined total weekly minutes of PELs and PELs participation by asking how many days adolescents attended PELs in an average week at school, with three possible responses as follows: 0, 1-4, or 5 days/week. Movement behaviors were assessed through self-completed questionnaires in both waves.

RESULTS

Daily PELs participation during adolescence was related to higher odds of meeting five of more weekly sessions of moderate-to-vigorous physical activity and all three guidelines in both sexes compared with adolescents who reported no days of PELs per week (men: incidence rate ratio [IRR] = 1.70, 95% CI 1.02-3.12; women: IRR = 3.81, 95% CI 1.65-8.77). Additionally, each additional weekly hour of PELs increased the likelihood of meeting all three recommendations (men: IRR = 1.11, 95% CI 1.05-1.35; women: IRR = 1.67, 95% CI 1.27-2.24). During adulthood, daily PELs was also related to a higher likelihood of meeting all three recommendations in both sexes (men: IRR = 1.04, 95% CI 1.01-1.07; women: IRR = 1.07, 95% CI 1.00-1.11). Each additional weekly hour of PELs increased the odds of meeting all three recommendations (men: IRR = 1.02, 95% CI 1.01-1.05; women: IRR = 1.03, 95% CI 1.01-1.06).

DISCUSSION

Daily PELs attendance was linked to healthy movement behaviors during adolescence, and these benefits could extend into adulthood.

An Evaluation of Policies Promoting Physical Activity among Filipino Youth

Government is key to promoting physical activity at the population level through policy. The government was one of the physical activity indicators graded for the 2022 Philippine Physical Activity Report Card based on ten physical activity-related policies. This study aimed to evaluate the scope of the policies and to update these policies. Philippine government databases were searched for policies using physical activity-related key terms. Policies found were evaluated using the Wales Active Healthy Kids scoring rubric. The overall grade was converted to a letter grade based on the Global Matrix 4.0 grading system. The authors analyzed the policies' scope and implications to practice and policy. Seven additional policies were found. Considering all 17 policies, the government indicator grade is now A- from the preliminary grade of B. The scope covers promoting physical activity mainly through sports participation and active transport among students, student-athletes, persons with disabilities, and the general population in school and community settings. The gap between government and overall physical activity (F) scores suggests the need for a comprehensive physical activity plan promoting various forms of physical activity and reducing sedentary behavior among all Filipino youth and across various settings. Crucial to achieving change is a well-coordinated, whole-of-systems approach to promoting active healthy lifestyles.

Assessment of a Novel Instrument Measuring Perceived Physical Education Teachers' In-Class Skills

Physical Education (PE) teachers' professional and personal skills may not only affect the quality of the teaching-learning processes in PE, but also individuals' future active/inactive behaviors. The aim of this study is to examine the structure of a pool of items developed for measuring individuals' perception of such skills in PE teachers. Exploratory Factorial Analysis and a following structural modeling test on data collected from 660 participants suggest a two-factor structural model for the 10 items considered (χ² = 191.155; df = 34; CFI = 0.953, and SRMR = 0.0529), with good internal consistency for both factors (factor 1: alpha = 0.879; omega = 0.878; factor 2: alpha = 0.850, and omega = 0.858) and the overall instrument (alpha = 0.892; omega = 0.895). The final "Teachers' Personal and Professional Skills Questionnaire" is a valid instrument that may be used alone or in combination with other instruments for the analysis of the quality of teaching-learning processes in PE environments and its impact on individuals' behaviors regarding physical activity in their adult life.

Global Matrix 4.0 physical activity report cards grades for children and adolescents: A comparison among 15 Asian countries and regions

Background

/Objective: This paper aimed to compare the report card grades among 15 Asian jurisdictions participating in the Global Matrix 4.0, and to explore differences in regional cultural and policy factors related to physical activity behaviors.

Methods

All participating jurisdictions followed a harmonized process to develop a country report card. Ten required common indicators were assessed, including five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behavior), four sources of influence indicators (Family and Peers, School, Community and Environment, and Government), and an outcome indicator (Physical Fitness). Letter grades, ranging from A+ to F or incomplete (INC), were assigned to the indicators based on the predefined benchmarks and grading rubric, and were converted to numerical scale for analyses.

Results

The country average scores ranged from F (Indonesia) to B- (Japan), with C+/C/C- the most prevalent grades. The mean behavioral score (D+) was lower than sources of influence score (C+). Poor grades (D or F) were observed for Overall Physical Activity among 73.3% (11/15) of the jurisdictions. Government was the indicator with the highest proportion of A or B grades (66.7%), followed by School (53.3%). Physical Fitness (n = 10) and Active Play (n = 8) were two indicators with the largest number of INC grades.

Conclusions

Poor grades for physical activity and sedentary behavior were generally found in Asian jurisdictions. The better, though modest, grades on the sources of influence have not been translated into favorable behaviors among children and adolescents. The findings also suggested surveillance gaps for physical fitness, active play, and organized sport participation. National-level investments and action plans are needed to ensure physical activity interventions are developed, effectively implemented, and regularly evaluated in multiple settings.

Trends in Morphological Characteristics among 7- and 11-Year-Old Serbian Children: A Comparison between 1990 and 2020

Since knowledge possession about the morphological characteristics trend is important to understand, it is necessary to monitor the physical growth and children’s development. We have aimed to examine the current state, dynamics, and direction of changes in morphological characteristics, over a 30-year period in Serbian children and adolescents. Morphological characteristics measured in 2020 ( $n=304$ ; age $7\pm 6$ and $11\pm 6$ ) were compared with the results of same-age children and adolescents from 1990 ( $n=1789$ ). The following characteristics were measured: body height, body mass, body mass index, forearm circumference, and upper arm skinfold. The average height (95% IP) of 7-year-old boys was significantly lower in all morphological variables in 1990, compared to their 2020 peers, while in forearm circumference was opposite. As for the 11-year-old boys, body mass ( $p=0.02$ ) and BMI ( $p=0.009$ ) had significantly better average values in 2020 than 1990, whereas forearm circumference (1.6-2.5 cm) and upper arm skinfold (2.7-4.9 cm) results were opposite. Seven-year-old girls from a 1990 sample also had significantly lower average values for morphological characteristics, compared to their 2020 peers. All morphological characteristic variables of 11-year-old girls have significantly better average values in 1990 sample than in 2020, except for body mass ( $p=0.47$ ) and BMI ( $p=0.55$ ). The current results have presented a true “picture” of the trends in morphological characteristics status among 7- and 11-year-old Serbian children by comparing them with the already obtained results 30 years ago.

Physical activity and academic achievement: an analysis of potential student- and school-level moderators

BACKGROUND

Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement.

METHODS

In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship.

RESULTS

Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (β = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (β = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities.

CONCLUSIONS

Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics.

TRIAL REGISTRATION

This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

Attendance in physical education classes, sedentary behavior, and different forms of physical activity among schoolchildren: a cross-sectional study

Background

Attendance in physical education classes (PE) helps young people to achieve the physical activity recommendations and to reduce their exposure to sedentary behavior. However, the association between PE attendance and the daily frequency of specific forms of physical activity is less known. The current study analyzed the association between weekly attendance in PE and daily frequencies of different forms of physical activity (active play, non-active play, structured physical activity), and overall daily frequencies of physical activity (PA) and sedentary behaviors (SB) among schoolchildren.

Methods

Cross-sectional study with schoolchildren from second to fifth grade of 11 public schools (n = 2,477; 9.1 ± 1.38-y-old; 53.2% girls; 17.5 ± 3.5 kg/m²) in Feira de Santana (Northeast Brazil). PA, SB, and attendance in PE were self-reported using a previously validated on-line questionnaire based on the previous day's recall (Web-CAAFE). Multiple Binomial Negative regression modeling was carried out to analyze the association (Prevalence Rate: PR) between weekly attendance in PE (0/week, 1/week, ≥ 2/week) and frequencies of active play, non-active play, and structured physical activity, with adjustments by age, school shift, and BMI z-scores. Regression models analyzing overall PA also included adjustments by household chores.

Results

Attendance in PE ≥ 2/week was associated with higher frequencies of active play (girls: PR = 1.40, 95%CI = 1.11–1.78; boys: PR = 1.49, 95%CI = 1.15–1.94) and structured physical activity (girls: PR = 2.11, 95%CI = 1.31–3.40; boys: PR = 4.33, 95%CI = 1.63–11.52). Higher attendance in PE (≥ 2/week) was associated with high overall PA (girls: PR = 1.31, 95%CI = 1.06–1.62; boys: PR = 1.42, 95%CI = 1.14–1.77) and low SB (girls: PR = 0.80, 95%CI = 0.71–0.90; boys: PR = 0.81, 95%CI = 0.68–0.97). Attendance in PE 1/week was also associated with a lower frequency of daily SB among girls (PR = 0.73, 95%IC = 0.64–0.84)

Conclusion

Higher weekly attendance in PE was associated with higher frequencies of active play, structured physical activity, higher overall PA, and lower SB among both girls and boys.

The Perception of Teaching, Learning Styles and Commitment to Learning and Their Influence on the Practice of Physical Activity and Eating Habits Related to the Mediterranean Diet in Physical Education Students

Childhood obesity, linked to a sedentary lifestyle and an unbalanced diet, is one of the main problems in today's Western societies. In this sense, the aim of the study was to analyze students' perceived satisfaction in physical education classes with learning strategies and engagement in learning and critical thinking as determinants of healthy lifestyle habits. The study involved 2,439 high school students aged 12-18 years (M = 14.66, SD = 1.78). Structural equation modeling was conducted to analyze the predictive relationships between the study variables. The results showed that teaching, teaching mastery, and cognitive development are precursors to deep thinking on the part of students, indicators of the adoption of healthy lifestyle habits. These results reflect the importance of the methodology adopted by the teacher in order to positively influence the students' habits.

Physical Education and Physical Activity Promotion: Lifestyle Sports as Meaningful Experiences

The value of embracing a physically active lifestyle has been well documented in recent times. However, despite this knowledge, physical activity levels in many western societies remain worryingly low in both adult and youth populations. Habit formation in youth is a key indicator of engagement in physical activity as an adult; therefore, maximising opportunities to develop motivation in young people is vitally important to increase the likelihood of maintaining physical activity habits as an adult. A key factor for the development of motivation is school-based physical education. This review considers the current landscape of physical education as a vehicle for physical activity promotion, and suggests that a change of approach that moves away from physical education focusing solely on sport techniques is long overdue. A culturally relevant curriculum that includes lifestyle sports, with a focus on mastery and enjoyment through a meaningful experiences approach, is proposed as a viable update to current practice.

Health Behaviors of Austrian Secondary Level Pupils at a Glance: First Results of the From Science 2 School Study Focusing on Sports Linked to Mixed, Vegetarian, and Vegan Diets

Attaining healthy behaviors is essential at any life stage, particularly childhood, due to the strong link between children’s lifestyle and the subsequent adult state of health. This multidisciplinary study aimed to assess lifestyle behaviors of Austrian pupils of secondary schools I and II, with a specific focus on PA habits and diet types based on a large sample. In total, 8845 children/adolescents participated in the short standardized online survey on relevant health-related aspects nationwide. Valid and complete data was provided by 8799 pupils, including 1.14% of the eligible 771,525; 63% girls, 76% having a normal body weight, 70% attending secondary schools II, and more pupils/students living in rural vs. urban areas (3:1 ratio). Across the total sample, 11.8% were considered overweight/obese with a higher prevalence of overweight/obesity in boys than girls (15.5% vs. 9.6%) and urban vs. rural participants (13.9% vs. 10.8%; p < 0.05). The majority of participants (84.5%) reported a mixed diet, while 7.2% and 8.5% reported a vegan and vegetarian diet, respectively. Vegans reported a lesser alcohol intake (p < 0.05) compared to non-vegan pupils (no difference in dietary subgroups for smoking). Although overall PA and dietary behaviors suggest an appropriate health status among Austrian youth, attention should be focused on policies to increase healthy lifestyle habits at best through a dual approach to health permanently combining regular PA, sports, and exercise with a healthy diet, which would contribute to matching the current recommendations for improving individual and public health.

Subjective Health, Physical Activity, Body Image and School Wellbeing among Adolescents in South of Sweden

This study aimed to investigate subjective health and its associations with perceived body image (body appearance and body functioning), physical activity, perceived wellbeing in school, perceived family financial situation, and body mass index among 13- to 15-year-old boys and girls. The study was a cross-sectional study performed in four municipalities in Southern Sweden. Data were obtained from questionnaires completed by adolescents (median age 14; range: 13–15) in Sweden (n = 1518, 51% girls), with a participation rate of 73%. Body weight and body height were measured by school nurses and body mass index was calculated. Logistic regression analyses were carried out with subjective health as the dependent variable. Independent variables included in the model were perceived wellbeing in school, perceived family financial situation, perceived body image, physical activity, body mass index, sex, and residency. Variables significantly associated with good subjective health were good wellbeing in school, a perceived good family financial situation, perceived positive body appearance, perceived positive body functioning, being a boy, and high physical activity. Residency and body mass index were not associated with subjective health. Good subjective health is associated with good wellbeing in school, good family financial situation, positive body image, and high physical activity levels. The results highlight the importance of good school climates, the promotion of positive body image, and increased physical activity for adolescents.

Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults

Aim: To study how change in cardiorespiratory fitness over time is associated with the development of poor self-rated health in healthy Swedish adults, and whether this association varies with sex, age, body mass index and cardiorespiratory fitness at baseline. A secondary aim was to study the influence of other predictors of self-rated health. Methods: A total of 98,718 participants (45% women, mean age 42.2 years) with two assessments from occupational health service screenings between 1988 and 2019 (mean duration 4.3 years), with good self-rated health at baseline were included. Cardiorespiratory fitness was assessed as estimated maximal oxygen consumption using submaximal cycle testing. Change in cardiorespiratory fitness was expressed as percentage annual change. Poor self-rated health at follow-up was defined as percieving self-rated health as 'poor' or 'very poor'. Results: A large decrease in cardiorespiratory fitness (⩾-3%) was associated with a 34% higher risk of poor self-rated health compared to maintainers (-1 to +1%) after multi-adjustment including change in body mass index, back/neck pain, stress, exercise habits and sleep quality or sleep problems. The associations for decreasers were stronger with longer follow-up time (>10 years). Preserving, or changing to, risk level for body mass index, back/neck pain, stress, exercise and sleep quality/problems were associated with a higher risk of poor self-rated health. Conclusions: Preserving or increasing cardiorespiratory fitness is associated with a lower risk of poor self-rated health, independently of change in other health-related variables, which may act as a protection against future poor self-rated health. This is of high clinical value, and strategies for maintaining or improving cardiorespiratory fitness have the potential to influence both disease and mortality.

Associations between the School Environment and Physical Activity Pattern during School Time in Swedish Adolescents

Knowledge about associations between school-based initiatives and physical activity patterns is limited. The purpose of this paper was to examine associations between factors in the school environment, physical activity and sedentary time during school time. The cross-sectional study included 1139 adolescents aged 13–14 from 34 schools. Physical activity and sedentary time were measured using hip-worn accelerometers. Factors in the school environment included health policy, a mobile phone ban during breaks, organized physical activities during breaks and activity breaks during lessons reported by teachers. The frequency and duration of breaks and physical education (PE) lessons were collected from school schedules. The results showed significant associations between health policy (β = 3.87, 95% confidence interval (CI): 2.37, 5.23), the mobile phone ban (β = 2.51, 95% CI: 1.29, 3.94) and PE; total duration (β = 0.08, 95% CI: 0.05, 0.11), average duration (β = 0.08, 95% CI: 0.01, 0.13) and frequency (β = 1.73, 95% CI: 0.50, 3.04) and moderate-vigorous physical activity. There were negative associations between health policy (β = −6.41, 95% CI: −10.24, −2.67), the mobile phone ban (β = −3.75, 95% CI: −7.25, −0.77) and PE; total duration (β = −0.15, 95% CI: −0.23, −0.08) and average duration (β = −0.14, 95% CI: −0.27, −0.03) and time spent sedentary. Adolescents attending schools with health policies, mobile phone bans and more time for PE showed higher levels of physical activity and lower sedentary time.

Biological and socioeconomic factors as moderator in relationship between leisure-time physical activity and cardiometabolic risk in adolescents from southern Brazil

BACKGROUND

Given the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil.

METHODS

Cross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant's age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models.

RESULTS

It was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools.

CONCLUSIONS

The association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.

Effect of Physical Activity on Adolescent Obesity Status over Time: A Latent Growth Modeling Approach

This study aims to examine the longitudinal influence of physical activity (PA) on obesity among normal-weight adolescents in South Korea. A total of 1347 data samples from the Korean Children and Youth Panel Survey from 2011 to 2014 were used. Latent growth modeling was applied. PA was assessed by the hours spent on PA during physical education (PE) classes in the last week. Body mass index for age was considered to determine obesity status. PA during PE positively predicted the intercept of obesity status, but it was not associated with the slope of obesity status. Although a longitudinal effect of PA was not identified, PA could influence the initial status of obesity. Because obesity in early years could steadily influence future obesity status, early detection and intervention for adolescent obesity are necessary. Moreover, more studies examining the effect of PA during PE on obesity status among adolescents should be conducted to identify the association between PA during PE and obesity status over time.

Objective Assessment of Physical Activity and Associated Contexts During High School Sport Practices

Background: Organized sports provide children and adolescents with opportunities to achieve recommended amounts of moderate to vigorous physical activity (MVPA), and schools are a primary setting for sports programs. The main aims of this study were to examine participant physical activity (PA) levels during the most popular high school sports in the United States and to assess the influences of practice contextual factors on PA levels. Methods: Participant PA and its contexts were assessed during practices for the 10 most popular girls' and boys' high school sports in the United States. Data were obtained during 598 practice sessions in 12 schools in North Carolina using a validated direct observation instrument (System for Observing Fitness Instruction Time (SOFIT). A regression model was applied to understand the association between sport context and athletes' PA. Results: Overall, athletes were observed engaging in MVPA 60% of practice time. MVPA varied among sports and levels were highly influenced by practice contexts. Among girls' sports, cross country and soccer practices provided the highest proportion of MVPA and MVPA percent during boys' practice sessions was highest during cross country and track and field. Practice contexts were associated with MVPA accrual with time allocated for gameplay and fitness activities associated with the highest levels of PA. Conclusions: The results contribute to an understanding of which sports and how their practices are conducted facilitate increased PA. Findings indicate athletes accrue substantial amounts of PA during high school practices, but that it varies from sport to sport. As well, the context that characterizes sport practices is a significant determinant in how much PA occurs. Most sports that emphasized game simulation, fitness, and skill development drills had higher levels of MVPA. Given the length and frequency of practices and how the content is delivered, we can accurately predict how much PA athletes are likely to achieve during a given sport season. The findings from this study demonstrate that sport can make a useful, if not sufficient role in helping high school athletes reach recommended PA levels. PA engagement can be optimized by attending to the management of contexts surrounding the sports.

Physical Activity, Sedentary Behavior, and Cardiorespiratory Fitness in Hazardous and Non-Hazardous Alcohol Consumers

Purpose:

To describe physical activity habits, sedentary behavior, and cardiorespiratory fitness levels among alcohol abstainers, hazardous and non-hazardous drinkers.

Design:

Cross-sectional study with data collected between 2017-19.

Setting:

Sweden.

Subjects:

Adults aged 18-65 years (n = 47,559; 59.4% male).

Measures:

During a routine health assessment, participants answered validated single-item questions regarding: habitual physical activity, structured exercise, and the percentage of time spent sedentary during leisure-time (past 30 days), and completed a 6-minute cycle ergometer test (V02max) to determine cardiorespiratory fitness (CRF). Participants were categorized as alcohol abstainers, non-hazardous drinkers or hazardous drinkers (low/high) based on the Alcohol Use Disorders Identification Test (AUDIT-C) cut-points for men and women.

Analysis:

Logistic regression models stratified by sex and age.

Results:

Compared to non-hazardous drinkers, the heaviest drinkers were less physically active (males: OR = 1.38, CI = 1.13-1.67, p = .001; females: OR = 1.41, CI = 1.01-1.97, p = .040) and more sedentary during leisure time (males: OR = 1.94, CI = 1.62-2.32, p = .000; females: OR = 1.62, CI = 1.21-2.16, p = .001). Apart from young females, the heaviest drinkers also did less structured exercise than non-hazardous drinkers (males: OR = 1.22, CI = 1.15-1.51, p = .000; females: OR = 1.43, CI = 1.15-1.78, p = .001). The strongest associations were seen among adults aged 40-65 years (shown here). High-hazardous drinking was associated with low CRF among older males only (OR = 1.19, CI = 1.00-1.41).

Conclusion:

Middle-aged adults with AUDIT-C scores of ≥6 (women) and ≥7 (men) were less physically active and more sedentary during leisure time and may be appropriate targets for physical activity interventions.

Dimensions of Leisure and Perceived Health in Young University Students

The aim of this study was to analyze the main leisure habits of students at the University of Huelva and the relationship with perceived health by grouping the various activities into components whilst also evaluating possible gender differences. The sample was selected through random cluster sampling and was composed of 903 students from various courses and degrees. Of the sample, 73.8% were female and 26.2% were male, with a mean age of 20.82 years. The participants responded to items measuring perceived health and the inventory of leisure activities extracted from the INJUVE (Spanish Youth Observatory) survey. The results obtained offered a solution of four components, grouping the activities into passive leisure, festive leisure, sports-competitive leisure and cultural leisure. Passive leisure was the most practiced and cultural leisure the least practiced. Statistically significant differences were observed between men and women in terms of the sports-competitive component and in the perception of health. In addition, a direct relationship was found between the sports-competitive dimension and health perception. These results support the existence of a "techno-active" profile in males and should be considered in the creation of university policies linked to health promotion or the prevention of risk behaviors.

Individual, Social and Environmental Correlates of Active School Travel among Adolescents in India

Active School Travel (AST) is an important domain for physical activity among adolescents; however, few studies in India have explored barriers or correlates of AST. This was a cross-sectional study of 324 adolescents aged 12-17 years recruited via households and schools from diverse areas of Chennai, India. Adolescents reported their mode of travel to school, neighbourhood correlates, and the barriers for AST. Adolescents were considered to be using AST to/from school if they walked/cycled ≥once/week during an average week. Half the adolescents usually performed AST (≥1 trip/week). School being too far was associated with 75% lower odds and parents not allowing their child to walk or cycle was associated with 82% lower odds of the adolescent performing AST to or from school at least once/week. AST among adolescents should be encouraged and there is considerable scope for improvement. Parental restriction and distance to school were the two strongest barriers for AST.

Effect of a Game-Based Physical Education Program on Physical Fitness and Mental Health in Elementary School Children

Promotion of healthy active behaviors should start from early ages, as behaviors learned in youth are more likely to endure. A fundamental body of research in this field focuses on the implementation of programs within physical education (PE), thanks to its favorable characteristics. However, traditional PE based on exercise training and controlling styles seems to have weaker association with students' health benefits. For this reason, the aim of this study was to assess the effects of a game-based PE program on physical fitness and psychological health in schoolchildren aged 10 to 12 years old. A total of 252 students were distributed in experimental (EG, games-centered activities) and control (CG, traditional exercise training activities) groups. The program lasted 6 months. Health-related physical fitness components, psychological wellbeing, self-esteem, stress, and anxiety were assessed before and after the treatment. Both groups increased physical fitness at post-test; however, cardiorespiratory fitness did not improve. No differences were found between the groups at post-test. Our results show that games may be as effective as traditional training methods; yet, they suggest that PE alone may be insufficient for obtaining substantive benefits in cardiorespiratory fitness, regardless of the type of task presented.

Effectiveness of a Family Intervention to Increase Physical Activity in Disadvantaged Areas-A Healthy Generation, a Controlled Pilot Study

There are large social inequalities in health. The purpose of this study was to evaluate the effects of a family intervention on physical activity (PA) and sedentary time (ST) in children and their parents. In this controlled pilot study, all 8–9-year-old children from four schools from a socioeconomically disadvantaged area in Sweden were invited and 67 children and 94 parents were included. The intervention was run by a foundation in co-operation with the municipality. The 9-month program included: (1) activity sessions, (2) healthy meals, (3) health information and (4) parental support groups. PA was primary outcome and ST was secondary outcome, measured by accelerometry. In total, 40 of the children (60%) and 45 of the adults (50%) had at least one day of valid accelerometer data at both baseline and follow-up. Significant intervention effects for the whole group were found in total PA (p = 0.048, mean difference (MD) intervention/control 150 counts per minute) and in vigorous PA (p = 0.02, MD 8 min/day) during the weekends. There were no differences between groups in the other PA variables or ST. This pilot study shows that it is possible to influence PA in families from a disadvantaged area through a family program.

Prevalence and time trends of overweight, obesity and severe obesity in 447,925 Swedish adults, 1995-2017

Aims: The purpose of this research was to describe the current prevalence and historic trends in overweight, obesity and severe obesity in Sweden. Methods: Data on BMI, age, gender, education and geographic region were obtained in n=447,925 Swedish adults through a nationwide screening test (1995–2017). To account for sampling variations, we quantified prevalence estimates and time trends using standardized values (direct method) to all 18–74-year-old Swedes, using nationwide databases. Rates of overweight (BMI ⩾25 kg/m²), obesity (BMI ⩾30 kg/m²) and severe obesity (BMI ⩾35 kg/m²) were calculated across gender, age, education and geographic categories. Years were grouped into two-year sampling periods (except the first period where we used three years) for increased power. We used multivariable logistic regression to quantify independent associations between age, gender, education and region with obesity development and current prevalence rates. Results: In 2016/17 the unstandardized prevalence of overweight, obesity and severe obesity were 55.1%, 16.6% and 4.2%, respectively. Factors associated with a higher obesity prevalence were male gender, older age, lower education and residing in a rural region (all P<0.001). Between 1995 and 2017 the prevalence of severe obesity increased by 153%, compared to obesity (+86%) and overweight (+23%). While there were similar increases in obesity across gender and age groups, people with low education (vs high) and rural areas (vs urban) had a higher prevalence increase (both P<0.001). Conclusions: Rates of overweight, obesity and severe obesity have increased markedly in Swedish adults since 1995. Priority groups for prevention efforts include individuals with low education and those living in rural areas.

Latent profile analysis patterns of exercise, sitting and fitness in adults - Associations with metabolic risk factors, perceived health, and perceived symptoms

Aim

To identify and describe the characteristics of naturally occurring patterns of exercise, sitting in leisure time and at work and cardiorespiratory fitness, and the association of such profiles with metabolic risk factors, perceived health, and perceived symptoms.

Methods

64,970 participants (42% women, 18–75 years) participating in an occupational health service screening in 2014–2018 were included. Exercise and sitting were self-reported. Cardiorespiratory fitness was estimated using a submaximal cycle test. Latent profile analysis was used to identify profiles. BMI and blood pressure were assessed through physical examination. Perceived back/neck pain, overall stress, global health, and sleeping problems were self-reported.

Results

Six profiles based on exercise, sitting in leisure time and at work and cardiorespiratory fitness were identified and labelled; Profile 1 “Inactive, low fit and average sitting in leisure, with less sitting at work”; Profile 2 “Inactive, low fit and sedentary”; Profile 3 “Active and average fit, with less sitting at work”; Profile 4 “Active, average fit and sedentary in leisure, with a sedentary work” (the most common profile, 35% of the population); Profile 5 “Active and fit, with a sedentary work”; Profile 6 “Active and fit, with less sitting at work”. Some pairwise similarities were found between profiles (1 and 2, 3 and 4, 5 and 6), mainly based on similar levels of exercise, leisure time sitting and fitness, which translated into similar dose-response associations with the outcomes. In general, profile 1 and 2 demonstrated most adverse metabolic and perceived health, profile 4 had a more beneficial health than profile 3, as did profile 6 compared to profile 5.

Conclusions

The present results implies a large variation in exercise, sitting, and fitness when studying naturally occurring patterns, and emphasize the possibility to target exercise, sitting time, and/or fitness in health enhancing promotion intervention and strategies.

Associations of sedentary behavior in leisure and occupational contexts with symptoms of depression and anxiety

Sedentary behaviors (SB) can be associated with poorer mental health, but it remains unclear whether contexts for these behaviors may be important. We assessed relationships of SB in leisure-time and occupational contexts with frequent symptoms of depression and anxiety. Data originate from the Swedish Health Profile Assessment (HPA) database, a health assessment offered to employees working for companies or organizations connected to healthcare services. Analyses are based on data from 2017 onwards (N = 23,644; 57% male, mean age = 42 years). Two self-report questions assessed proportions of time spent in SB in leisure contexts and in the occupational setting. Logistic regressions examined relationships of SB in each context with the self-reporting of frequent symptoms of depression/anxiety. A separate model for the leisure plus occupational SB was also generated. Fully-adjusted models included exercise frequency. Compared to those reporting that they were 'almost never' sedentary in leisure-time contexts, a detrimental dose-response with frequent depression/anxiety symptoms was observed with increasing proportions of sedentary time: 50% of the time (OR = 1.44; 1.23-1.70), 75% (OR = 2.95; 2.45-3.54), almost always (OR = 3.85; 2.84-5.22). For occupational SB, the only associations were among those who reported being sedentary almost always, compared to almost never (OR = 1.47; 1.25-1.73). Associations of 'overall' SB with depression/anxiety symptoms mirrored the dose-response relationship for leisure-time SB. Exercise frequency attenuated the association for leisure-time SB only, but it remained statistically significant. Adults who spend ≥50% of their leisure-time in sedentary pursuits experience more frequent symptoms of depression and anxiety, compared to those who are less sedentary in that context.