Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

BACKGROUND

Obesity in childhood has deleterious consequences for health while improving physical fitness can significantly reduce health risks related to high body mass index. We aimed to examine the evolution of disparities in physical fitness based on weight status among 7-15-year-olds in Slovenia between 1989 and 2019 and compare these trends across sex, age and socioeconomic status.

METHODS

We used annual data collected within the SLOfit monitoring system in the period between 1989 and 2019, totalling 4,256,930 participants (about 137 000 per year). We examined cardiorespiratory fitness (600-m run test), muscular fitness (60-s sit-ups, bent arm hang, and standing broad jump test) and skill-related fitness (backwards obstacle course, 60-m dash, arm plate tapping). We grouped children according to the IOTF cut-offs for BMI to those living with normal weight or excess weight and estimated changes in physical fitness over time by fitting quantile regression models separately by sex and age group, and then using segmented regression to identify the patterns of trends over time.

RESULTS

Weight-based disparities in physical fitness were large in 1989 and have further increased by 2019. The increase in disparities was generally around 5 percentiles larger in boys, and 10-15-year-olds compared to younger children. It was particularly pronounced for body core strength and speed in boys (up to 15 and 19 percentiles, respectively) and upper body strength and speed among girls (up to 13 percentiles). Most of the increase in disparities in health-related fitness accumulated during the 2010s, when the fitness of children generally improved, but much less so in children living with excess weight.

CONCLUSIONS

Despite recent improvements in population fitness levels, children with excess weight seem to be left behind, which adds to existing health inequalities. Our results should encourage policymakers to redesign policies aimed at promoting physical activity and enhancing physical fitness to make them more equitable and ultimately lead to reducing inequalities in fitness.

Assessment of Motor Performance and Self-Perceived Psychophysical Well-Being in Relation to Body Mass Index in Italian Adolescents

BACKGROUND/OBJECTIVES

The relationship between psychophysical self-perception (PSP), body mass index (BMI) and motor performance (MP) levels, in quantitative and qualitative terms, can be a very interesting connection to investigate. This study aimed to assess MP and PSP according to gender and weight differences (normal weight-Nw/overweight-obese-Ov-Ob) and their relationship to BMI in Italian adolescents.

METHODS

In total, 144 students (F = 72; M = 72) aged between 11 and 13 y.o. participated in this study. They were divided into two groups by gender and into two subgroups based on weight (Nw/Ov-Ob). Standing long jump, sit-and-reach, 10 × 5 m shuttle and sit-up tests to assess MP were carried out, and an ad hoc questionnaire to evaluate PSP was administrated.

RESULTS

In comparing the Nw and Ov-Ob subgroups on the basis of BMI for each gender, statistically significant differences emerged in all motor skill tests administered. Regarding PSP, the Nw subgroup showed high and positive levels, while Ov-Ob showed low and negative levels, highlighting a relationship between high BMI and poor motor performance as well as negative psychophysical perception in the Ov-Ob subgroup.

CONCLUSIONS

this study supports the importance of physical sport activity to regulate excess weight but also contribute to better psychophysical well-being.

Effect of eight-week high-intensity interval training versus moderate-intensity continuous training programme on body composition, cardiometabolic risk factors in sedentary adolescents

Objectives

This study aimed to assess and compare the effect of an 8-week high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) programme on body composition and cardiovascular metabolic outcomes of sedentary adolescents in China.

Methods

Eighteen sedentary normal-weight adolescents (age: 18.5 ± 0.3 years, 11 females) were randomized into three groups. HIIT group protocol consisted of three sessions/week for 8-week of "all out" sprints to reach 85%-95% of HRmax, and MICT group protocol undertook three sessions/week for 8-week of continuous running to reach 65%-75% of HRmax. The control group resumed normal daily activities without any intervention. Blood pressure and body composition were measured, and fasting blood samples were obtained at baseline and 48 h post-trial. Mixed-design ANOVA analysis was employed followed by post hoc t-tests and Bonferroni alpha-correction was used to evaluate interaction, between-group, and within-group differences, respectively.

Results

Results indicated that HIIT and MICT similarly affected body fat mass (p = 0.021, ES = 0.19; p = 0.016, ES = 0.30, respectively), body fat percentage (p = 0.037, ES = 0.17; p = 0.041, ES = 0.28, respectively), visceral fat area (p = 0.001, ES = 0.35; p = 0.003, ES = 0.49, respectively) of body composition. A positive outcome was observed for waist/hip ratio (p = 0.033, ES = 0.43) in HIIT, but not MICT (p = 0.163, ES = 0.33). No significant differences were found between groups for any clinical biomarkers. However, pairwise comparison within the group showed a significant decrease in systolic blood pressure (p = 0.018, ES = 0.84), diastolic blood pressure (p = 0.008, ES = 1.76), and triglyceride (p = 0.004, ES = 1.33) in HIIT, but no significant differences were found in the MICT and Control group.

Conclusion

Both 8-week HIIT and MICT programmes have similar positive effects on reducing body fat mass, fat percentage, and visceral fat area. However, sedentary adolescents may have limited scope to decrease insulin resistance after these 8-week interventions. Notably, the 8-week HIIT intervention was highly effective in increasing cardiometabolic health compared to the MICT. The exercise intensity threshold value and metabolic outcomes of high-intensity interval sprints should be explored further to extend the long-term benefit in this cohort.

Are school uniforms associated with gender inequalities in physical activity? A pooled analysis of population-level data from 135 countries/regions

PURPOSE

It is aimed to assess whether school uniforms are associated with population-level gender inequalities in physical activity, and whether associations differ by school level, country/region income, and assessment method.

METHODS

An ecological study design was employed. We collected data about global uniform practices using an online survey. We searched for country/region-level estimates of school-aged youth meeting physical activity guidelines from international surveillance studies. Study selection was conducted in duplicate using a systematic process, and a random sample of all data was checked to ensure extraction and pooling processes were accurate. We calculated absolute and relative gender inequalities in physical activity for each country. Linear regression examined associations between country/region-level uniform practices (binary yes/no exposure variable) and country/region-level gender inequalities in physical activity guideline compliance (absolute and relative inequalities). We investigated moderation by school level, stratified analyses by income group, and repeated primary analyses using device-measured data.

RESULTS

Pooling data from 135 countries/regions (n = 1,089,852), we found no association between population-level uniform practices and gender inequalities in physical activity across all ages (absolute: β = -0.2; 95% confidence interval (95%CI): -1.7 to 1.3, p = 0.74; relative: β = 0.1; 95%CI: -0.1 to 0.2, p = 0.51). Subgroup analysis suggested a positive association in primary school settings (absolute: β = 4.3; 95%CI: -0.0 to 8.6, p = 0.05). Among high-income countries, absolute inequalities were significantly greater in countries/regions with uniform practices (N = 37) compared to those without (N = 48) (9.1 (SD = 3.6) vs. 7.8 percentage points (SD = 4.3)). Repeating analyses using device-measured data (n = 32,130; N = 24) did not alter our primary finding. From initial descriptive statistics, we found that in countries/regions where a majority of schools (>50%) reportedly use uniforms, there was lower compliance with physical activity guidelines among all genders (median: 16.0%, interquartile range: 13.2%-19.9%, N = 103) compared to generally non-uniform countries/regions (median: 19.5%, interquartile range: 16.4%-23.5%, N = 32) (z = 3.04, p = 0.002). (N = countries, regions and studies represented; n = sample size or participants included).

CONCLUSION

School uniforms are associated with greater gender inequalities in physical activity in primary school settings and in high-income countries. Our population-level findings warrant testing using individual-level data across contexts.

Perceived Barriers to Physical Activity Among Youth Living in Rural and Urban Canadian Communities: A Nationally Representative Cross-Sectional Study

BACKGROUND

We used nationally representative data to explore associations among location of residence (rural/urban) and perceived barriers to physical activity (PA) in Canadian youth.

METHODS

We analyzed the 2017 Canadian Community Health Survey, Barriers to Physical Activity Rapid Response data for 12- to 17-year-old youth. Nine items from the survey assessing perceived barriers to PA were combined into 3 barrier domains: resources, motivational, and socioenvironmental. The likelihood of reporting barriers to PA based on rural-urban location was examined using survey-weighted binary logistic regression following a model fitting approach. Sociodemographic factors were modeled as covariates and tested in interaction with location. For each barrier domain, we derived the best-fitting model with fewest terms.

RESULTS

There were no location-specific effects related to reporting any barrier or motivation-related PA barriers. We found a sex by location interaction predicting the likelihood of reporting resource-related barriers. Rural boys were less likely to report resource-related barriers compared with urban boys (odds ratio [OR] = 0.42 [0.20, 0.88]). Rural girls were more likely to report resource-related barriers compared with boys (OR = 3.72 [1.66, 8.30]). Regarding socioenvironmental barriers, we observed a significant body mass index by location interaction demonstrating that rural youth with body mass index outside the "normal range" showed a higher likelihood of reporting socioenvironmental barriers compared with urban youth (OR = 2.38 [1.32, 4.30]). For urban youth, body mass index was unrelated to reporting socioenvironmental barriers (OR = 1.07 [0.67, 1.71]).

CONCLUSION

PA barriers are not universal among Canadian youth. Our analyses highlight the importance of testing interactions in similar studies as well as considering key sociodemographic characteristics when designing interventions.

Tracking of MVPA across childhood and adolescence

OBJECTIVES

Tracking of physical activity from childhood onwards is an important public health issue, but evidence on tracking is limited. This study quantified the tracking of Moderate-Vigorous Physical Activity (MVPA) across childhood and adolescence in a recent cohort from England.

DESIGN

Longitudinal, with a socio-economically representative sample from North-East England, over an 8-year period.

METHODS

Measures of time spent in MVPA, with an Actigraph GT1M accelerometer, were made at age 7-8y (n = 622, T1), age 9-10y (n = 585, T2), age 12-13y (n = 525, T3) and age 14-16y (n = 361, T4). Tracking of MVPA was assessed using rank order correlations between time spent in MVPA T1-T2, T1-T3, and T1-T4, and by using Cohen's kappa to examine tracking of meeting the MVPA guideline (mean of 60 min/d). We examined whether tracking varied by sex, socio-economic status (SES), initial MVPA, or initial body fatness.

RESULTS

Rank order correlations were all statistically significant at p < 0.01 and moderate: 0.58 between T1 and T2; 0.42 between T1 and T3; 0.41 between T1 and T4. Cohen's kappas for meeting the global MVPA guideline were all significant, weakening from moderate to low over the 8 years. Tracking was stronger in higher SES compared to lower SES groups, and there was some evidence that it was stronger in girls than boys, but the other explanatory variables had little influence on tracking.

CONCLUSIONS

Tracking of MVPA from mid-childhood to mid-adolescence in this cohort was moderate. This study suggests there is a need to establish high MVPA by mid-childhood, and to mitigate the age-related reduction in MVPA which occurs from mid-childhood.

[Temporal trend of physical activity in Brazilian adolescents: analysis of the Brazilian National Survey of School Health from 2009 to 2019]

This study aimed to analyze the physical activity trend of Brazilian schoolchildren and the associations with demographic, socioeconomic, and behavioral variables by using the Brazilian National Survey of School Health (PeNSE) in its four editions - 2009, 2012, 2015, and 2019. Data from students (13-17 years old) participating in the four editions of the PeNSE (n = 392,922) were used. We describe the percentage of active, mean, and percentile values of moderate to vigorous intensity physical activity in minutes/week. Poisson's regression was adjusted for gender, age, skin color, goods score, and sedentary behavior (≥ 2 hours/day watching TV and ≥ 3 hours/day sitting time). As a limitation, the PeNSE/2009 sample refers only to the Brazilian capital cities. The percentage of active students decreased from 43.1% in 2009 to 18.2% in 2019. The mean moderate to vigorous intensity physical activity of PeNSE/2009 (mean = 318.4 minutes/week; 95%CI: 313.4-323.4) decreased 50% in 2019. In physical education, the weekly average in moderate to vigorous intensity physical activity of girls is less than 50 minutes and boys is greater than 60 minutes in the four editions of PeNSE, also 22.7% of girls reported (PeNSE/2019) not having taken physical education classes whereas the same thing is reported by 19.7% of boys. Sedentary behavior reduced regarding time watching TV, but sitting time increased by 50.1% (95%CI: 48.9-51.3) and 54% (95%CI: 53.1-54.9) between PeNSE/2009 and PeNSE/2019. As a consequence of the drop in physical activity levels, public policies that promote physical activity are necessary, including increasing physical education classes at school to at least three times a week.

Are there differences between Mediterranean diet and the consumption of harmful substances on quality of life?-an explanatory model in secondary education regarding gender

Background

Adolescence is a key life stage in human development. It is during this stage of development that healthy and physical behaviors are acquired that will last into adulthood. Gender differences in the acquisition of these behaviors have been observed. This research aims to (a) study the levels of Mediterranean diet adherence, quality of life and alcohol and tobacco consumption as regarding the gender of the participants and (b) study the effects of the variable adherence to the Mediterranean diet, alcohol consumption and tobacco consumption on quality of life as a function of the gender of the participants.

Methods

A non-experimental, cross-sectional, exploratory study was carried out in a sample of 1,057 Spanish adolescents (Average Age = 14.19; Standard Deviation = 2.87).

Results

The comparative analysis shows that the male teenagers shows a higher Mediterranean diet adherence compared to the male adolescents (p ≤ 0.05) and a higher consumption of alcoholic beverages (p ≤ 0.05). On the contrary, adolescent girls show a higher consumption of alcoholic beverages than male participants (p ≤ 0.05). The exploratory analysis indicates that for boys, alcohol consumption has a beneficial effect on the quality of life of adolescents (β = 0.904; p ≤ 0.001).

Conclusion

In this case, participants show differences in the levels of Mediterranean diet adherence, consumption of harmful substances and quality of life according to gender. Likewise, there are different effects between the variables according to gender. Therefore, gender is a key factor to consider during adolescence.

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

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

Scoping Review of Population-Based Physical Activity and Sedentary Behavior in Saudi Arabia

BACKGROUND

Saudi Arabia is experiencing rapid development of the built environment and implementing policy changes to promote physical activity (PA) and reduce sedentary behavior (SB) among its population. In light of these developments, this scoping review systematically summarized population levels of PA/SB in Saudi Arabia.

METHODS

The authors searched 6 databases on December 13, 2021, for articles published in English or Arabic from 2018 to the search date. Studies using population-based sampling in Saudi Arabia and measuring PA/SB were included.

RESULTS

Of the 1272 records found, 797 were screened, and 19 studies (9 on children/adolescents age 6-19 y and 10 on adults age 15-75 y) were included. All studies were cross-sectional in design, and 18 studies collected data at only one point in time, ranging from 2009 to 2020. A total of 18 studies relied on self-reporting to assess PA/SB using a variety of questionnaires. Among children/adolescents, approximately 80% to 90% did not attain at least 60 minutes per day of moderate to vigorous PA and 50% to 80% engaged in ≥2 hours per day of screen time or SB. Among adults, approximately 50% to 95% had low or insufficient PA (eg, less than meeting PA guidelines) and about half had a sitting time of ≥5 hours per day. Population-based studies were not found among children <10 years and adults >75 years.

CONCLUSIONS

A high proportion of participants in the reviewed studies did not meet PA recommendations and spent excessive time in SB. Ongoing surveillance efforts for all ages may help identify target populations for interventions and prioritize the national strategy on PA/SB in Saudi Arabia.

Indicators of physical activity and nutritional status among children and adolescents in Zimbabwe: Findings from three global matrix initiatives

Background

Regular physical activity is associated with several benefits among children and adolescents. Globally, only limited surveillance data, collected using harmonized approaches to accurately compare levels of physical activity among children and adolescents are available. Through its Global Matrix initiatives, Active Health Kids Global Alliance provides an opportunity for participating countries/jurisdictions to compare physical activity levels of children and adolescents based on ten common indicators. The 2022 Zimbabwe Report Card summarizes the best available evidence and assigns grades on these ten indicators of physical activity for children and adolescents.

Methods

Through an iterative process, a team of national experts working in various sectors of physical activity used Active Healthy Kids Global Alliance's Global Matrix benchmarks and grading rubric, to assign Report Card grades on 10 indicators of physical activity (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviours, Physical Fitness, School, Family and Peers, Community Environment, and Government) among 5-17-year-old children and adolescents in Zimbabwe. Published and unpublished data as well as policy documents informing grades for each indicator were summarized. An unweighted average of all studies with data for an indicator was used to inform the grade assignment. Where data were unavailable or insufficient to provide accurate estimates, an incomplete grade was assigned. The primary purpose of the present study was to synthesize and summarize the best available data and assign grades on 10 common indicators of physical activity for children and adolescents. The secondary objective was to compare Report Grades across three Global Matrix initiatives.

Results

Grades for the ten common indicators for Global Matrix 4.0 plus Nutritional Status (B+) were assigned as follows: Overall Physical Activity (C+), Organized Sport and Physical Activity (B-), Active Play (C+), Active Transportation (B), Sedentary Behaviours (C), Physical Fitness (Incomplete), Family and Peers (Incomplete), School (C), Community and Environment (C-), Government (D). Generally, grades for individual behaviours (Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviours) were higher than for sources of influence (Family and Peers, School, Community and Environment, Government). Across 3 Global Matrices, the grade for Overall Physical activity (C+) did not change, Community and Environment (F, D, C-) steadily improved over time; while those for Active Transportation, Sedentary Behaviours and Sports were unchanged for Global Matrix 2.0 and 3.0, but declined for Global Matrix 4.0.

Conclusion

Although grades for individual behaviours were higher than those for sources of influence, overall, our findings show that the levels of physical activity among children and adolescents in Zimbabwe were lower than recommended. Robust surveillance data with large and representative samples are required to provide accurate estimates of physical activity participation among children and adolescents in Zimbabwe. Furthermore, policies and initiatives that promote equitable physical activity participation among children and adolescents are urgently needed in Zimbabwe.

A scoping review on the impact of the COVID-19 pandemic on physical activity and sedentary behavior in Saudi Arabia

BACKGROUND

In Saudi Arabia, stay-at-home orders to address the coronavirus disease 2019 (COVID-19) pandemic between March 15 and 23, 2020 and eased on May 28, 2020. We conducted a scoping review to systematically describe physical activity and sedentary behavior in Saudi Arabia associated with the timing of the lockdown.

METHODS

We searched six databases on December 13, 2021 for articles published in English or Arabic from 2018 to the search date. Studies must have reported data from Saudi Arabia for any age and measured physical activity or sedentary behavior.

RESULTS

Overall, 286 records were found; after excluding duplicates, 209 records were screened, and 19 studies were included in the review. Overall, 15 studies were cross-sectional, and 4 studies were prospective cohorts. Three studies included children and adolescents (age: 2-18 years), and 16 studies included adults (age: 15-99 years). Data collection periods were <  = 5 months, with 17 studies collecting data in 2020 only, one study in 2020-2021, and one study in 2021. The median analytic sample size was 363 (interquartile range 262-640). Three studies of children/adolescents collected behaviors online at one time using parental reporting, with one also allowing self-reporting. All three studies found that physical activity was lower during and/or following the lockdown than before the lockdown. Two studies found screen time, television watching, and playing video games were higher during or following the lockdown than before the lockdown. Sixteen adult studies assessed physical activity, with 15 utilizing self-reporting and one using accelerometry. Physical activity, exercise, walking, and park visits were all lower during or following the lockdown than before the lockdown. Six adult studies assessed sedentary behavior using self-report. Sitting time (4 studies) and screen time (2 studies) were higher during or following the lockdown than before the lockdown.

CONCLUSIONS

Among children, adolescents, and adults, studies consistently indicated that in the short-term, physical activity decreased and sedentary behavior increased in conjunction with the movement restrictions. Given the widespread impact of the pandemic on other health behaviors, it would be important to continue tracking behaviors post-lockdown and identify subpopulations that may not have returned to their physical activity and sedentary behavior to pre-pandemic levels to focus on intervention efforts.

Sibling Resemblance in Physical Activity Levels: The Peruvian Sibling Study on Growth and Health

Physical activity is associated with a host of positive health outcomes and is shaped by both genetic and environmental factors. We aim to: (1) estimate sibling resemblance in two physical activity phenotypes [total number of steps∙day^-1 and minutes for moderate steps per day (min∙day^-1)]; and (2) investigate the joint associations of individual characteristics and shared natural environment with intra-pair sibling similarities in each phenotype. We sampled 247 biological siblings from 110 nuclear families, aged 6-17 years, from three Peruvian regions. Physical activity was measured using pedometers and body mass index was calculated. In general, non-significant variations in the intraclass correlation coefficients were found after adjustment for individual characteristics and geographical area for both phenotypes. Further, no significant differences were found between the three sib-ship types. Sister-sister pairs tended to take fewer steps than brother-brother (β = -2908.75 ± 954.31). Older siblings tended to walk fewer steps (β = -81.26 ± 19.83), whereas body mass index was not associated with physical activity. Siblings living at high-altitude and in the Amazon region had higher steps/day (β = 2508.92 ± 737.94; β = 2213.11 ± 776.63, respectively) compared with their peers living at sea-level. In general, we found no influence of sib-types, body mass index, and/or environment on the two physical activity phenotypes.

Physical Inactivity Levels of European Adolescents in 2002, 2005, 2013, and 2017

Sport and Physical Activity (PA) Special Eurobarometer surveys may inform of the physical inactivity (PIA) levels in the European Union (EU). This study aimed to analyse the PIA levels of EU adolescents (15-17 years) in four time points, according to gender. The data were from 2002, 2005, 20013, and 2017 Special Eurobarometers. Adolescents were categorised as "Inactive" when performing less than 60 min/day of moderate to vigorous PA on average. A χ2 test was used to compare the levels of PIA between survey years. PIA levels between gender were analysed using a Z-score test for two population proportions. PIA levels ranged from 67.2% for boys (59.4% to 71.5%;) to 76.8% for girls (76.0% to 83.4) across the time points. Adjusted standardised residuals revealed a decrease in the observed levels versus the expected for 2005 (whole sample: -4.2; boys: -3.3) and an increase for 2013 (whole sample: +2.9; boys: +2.5). Boys presented lower PIA levels than girls in all years (p ≤ 0.003), but descriptively, the difference progressively decreased (from 18.4% to 11.8%). No significant reductions in PIA levels were observed between 2002 and 2017, and girls reported consistently higher levels of PIA than boys.