Association between maternal education and objectively measured physical activity and sedentary time in adolescents

Childhood Listening and Associated Cognitive Difficulties Persist Into Adolescence

OBJECTIVE

Listening difficulty (LiD) refers to the challenges individuals face when trying to hear and comprehend speech and other sounds. LiD can arise from various sources, such as hearing sensitivity, language comprehension, cognitive function, or auditory processing. Although some children with LiD have hearing loss, many have clinically normal audiometric thresholds. To determine the impact of hearing and cognitive factors on LiD in children with a clinically normal audiogram, we conducted a longitudinal study. The Evaluation of Children's Listening & Processing Skills (ECLiPS), a validated and standardized caregiver evaluation tool, was used to group participants as either LiD or typically developing (TD). Our previous study aimed to characterize LiD in 6- to 13-year-old children during the project's baseline, cross-sectional phase. We found that children with LiD needed a higher signal-to-noise ratio during speech-in-speech tests and scored lower on all assessed components of the NIH Cognition Toolbox than TD children. The primary goal of this study was to examine if the differences between LiD and TD groups are temporary or enduring throughout childhood.

DESIGN

This longitudinal study had three data collection waves for children with LiD and TD aged 6 to 13 years at Wave 1, followed by assessments at 2-year (Wave 2) and 4-year (Wave 3) intervals. Primary analysis focused on data from Waves 1 and 2. Secondary analysis encompassed all three waves despite high attrition at Wave 3. Caregivers completed the ECLiPS, while participants completed the Listening in Spatialized Noise-Sentences (LiSN-S) test and the NIH-Toolbox Cognition Battery during each wave. The analysis consisted of (1) examining longitudinal differences between TD and LiD groups in demographics, listening, auditory, and cognitive function; (2) identifying functional domains contributing to LiD; and (3) test-retest reliability of measures across waves. Mixed-effect models were employed to analyze longitudinal data.

RESULTS

The study enrolled 169 participants, with 147, 100, and 31 children completing the required testing during Waves 1, 2, and 3, respectively. The mean ages at these waves were 9.5, 12.0, and 14.0 years. On average, children with LiD consistently underperformed TD children in auditory and cognitive tasks across all waves. Maternal education, auditory, and cognitive abilities independently predicted caregiver-reported listening skills. Significant correlations between Waves 1 and 2 confirmed high, long-term reliability. Secondary analysis of Wave 3 was consistent with the primary analyses of Waves 1 and 2, reinforcing the enduring nature of listening difficulties.

CONCLUSION

Children with LiD and clinically normal audiograms experience persistent auditory, listening, and cognitive challenges through at least adolescence. The degree of LiD can be independently predicted by maternal education, cognitive processing, and spatial listening skills. This study underscores the importance of early detection and intervention for childhood LiD and highlights the role of socioeconomic factors as contributors to these challenges.

Factors associated with walking performance among adolescents undergoing cancer treatment: A correlational study

This study aimed to describe and compare the differences in walking performance between adolescent patients in inpatient wards and outpatient units, and to identify factors that influence walking performance among adolescents receiving cancer treatment. The cross-sectional study with correlational research design recruited 32 adolescents with cancer between February 2015 and March 2017 in two teaching hospitals in Taiwan. Descriptive, bivariate, and multivariate regression analyses were used. Participants' age, treatment setting, and symptom distress were significantly associated with number of walking steps. All independent variables in the model together accounted for 82.1% of variance. This study addresses a gap in the existing literature to identify associated factors that affected walking performance among adolescents undergoing cancer treatment. Our findings represent a pathway toward generating knowledge to enhance well-being for this unique population.

Associations between socioeconomic status and risk of obesity and overweight among Chinese children and adolescents

BACKGROUND

In China, the threat of obesity and overweight in children and adolescents is developing quickly. It may be possible to lower the risk of obesity and overweight in children and adolescents by understanding the factors that drive these conditions. Therefore, this study aimed to investigate the association between SES and risk of obesity and overweight among children and adolesecnts in China's provinces of Jiangsu, Anhui, Zhejiang, and Shanghai.

METHODS

Chinese children and adolescents (n = 2,746; 46.3% boys) were recruited using multistage sampling. SES was measured using self-reported questionnaires, the specific indicators were parental education, perceived family wealth, and Family Affluence Scale II. Height and weight were measured and used to calculate body mass index (BMI, categorized into obesity or overweight). The definition of obesity or overweight was based on the Chinese standard "Screening for obesity and overweight among school-age children and adolescents". Descriptive statistics, independent sample t-tests, and a Chi-square test were used to report the sample characteristics and analyse BMI differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with BMI in children and adolescents.

RESULTS

Overall, 22.5% of children and adolescents were obese or overweight. Participants with medium and high maternal education levels were 1.48 [95% CI 1.15-1.91] and 1.47 [95% CI 1.03-2.11] times more likely to be obese/overweight. Girls with medium maternal education levels were 1.70[95% CI 1.21-2.40] times more likely to be obese/overweight. For boys, no association was observed. Junior middle school students with medium maternal education levels were 1.51[95% CI 1.10-2.07] times more likely to be obese/overweight. Participants with medium or high FAS, perceived family wealth, or paternal education levels were not associated with obesity/overweight.

CONCLUSIONS

The findings of this study indicated a positive association between SES and risk of overweight/obesity in girls, suggesting that maternal education level may have a substantial impact on future prevention efforts for these conditions in girls. To increase the effectiveness of interventions, longitudinal studies are necessary to better understand the causal association between SES and obesity/overweight.

Correlates of Sedentary Time Among Children and Adolescents in Ethiopia: A Cross-Sectional Study

PURPOSE

To assess the correlates of sedentary time among children and adolescents in Ethiopia.

METHODS

The study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models were used to determine associations of sedentary time and predictor variables.

RESULTS

The mean sedentary time was 4.61 (95% confidence interval [CI], 4.35-4.86) hours per day. Overall, the prevalence of high sedentary time (>3 h/d) was 68.2% (95% CI, 64.2-72.2). Results of multivariable logistic regression analyses showed a statistically significant association between high sedentary time and female household head (adjusted odds ratio [AOR] = 0.50; 95% CI, 0.32-0.80), literate mothers (AOR = 1.98; 95% CI, 1.26-3.11), child attending public school (AOR = 1.79; 95% CI, 1.12-2.85), children who belonged to the poor and rich household wealth tertiles compared with medium wealth tertile (AOR = 2.30; 95% CI, 1.42-3.72 and AOR = 2.04; 95% CI, 1.14-3.65, respectively), and those families that did not have adequate indoor play space for children (AOR = 0.45; 95% CI, 0.29-0.72).

CONCLUSION

The study found that time spent sedentary was high in the study area as compared with other studies of similar settings. Several modifiable factors were identified that can be targeted in interventions to reduce sedentary time in the study setting.

Accumulation of Black Carbon Particles in Placenta, Cord Blood, and Childhood Urine in Association with the Intestinal Microbiome Diversity and Composition in Four- to Six-Year-Old Children in the ENVIRONAGE Birth Cohort

BACKGROUND

The gut microbiome plays an essential role in human health. Despite the link between air pollution exposure and various diseases, its association with the gut microbiome during susceptible life periods remains scarce.

OBJECTIVES

In this study, we examined the association between black carbon particles quantified in prenatal and postnatal biological matrices and bacterial richness and diversity measures, and bacterial families.

METHODS

A total of 85 stool samples were collected from 4- to 6-y-old children enrolled in the ENVIRonmental influence ON early AGEing birth cohort. We performed 16S rRNA gene sequencing to calculate bacterial richness and diversity indices (Chao1 richness, Shannon diversity, and Simpson diversity) and the relative abundance of bacterial families. Black carbon particles were quantified via white light generation under femtosecond pulsed laser illumination in placental tissue and cord blood, employed as prenatal exposure biomarkers, and in urine, used as a post-natal exposure biomarker. We used robust multivariable-adjusted linear models to examine the associations between quantified black carbon loads and measures of richness (Chao1 index) and diversity (Shannon and Simpson indices), adjusting for parity, season of delivery, sequencing batch, age, sex, weight and height of the child, and maternal education. Additionally, we performed a differential relative abundance analysis of bacterial families with a correction for sampling fraction bias. Results are expressed as percentage difference for a doubling in black carbon loads with 95% confidence interval (CI).

RESULTS

Two diversity indices were negatively associated with placental black carbon [Shannon: -4.38% (95% CI: -8.31%, -0.28%); Simpson: -0.90% (95% CI: -1.76%, -0.04%)], cord blood black carbon [Shannon: -3.38% (95% CI: -5.66%, -0.84%); Simpson: -0.91 (95% CI: -1.66%, -0.16%)], and urinary black carbon [Shannon: -3.39% (95% CI: -5.77%, -0.94%); Simpson: -0.89% (95% CI: -1.37%, -0.40%)]. The explained variance of black carbon on the above indices varied from 6.1% to 16.6%. No statistically significant associations were found between black carbon load and the Chao1 richness index. After multiple testing correction, placental black carbon was negatively associated with relative abundance of the bacterial families Defluviitaleaceae and Marinifilaceae, and urinary black carbon with Christensenellaceae and Coriobacteriaceae; associations with cord blood black carbon were not statistically significant after correction.

CONCLUSION

Black carbon particles quantified in prenatal and postnatal biological matrices were associated with the composition and diversity of the childhood intestinal microbiome. These findings address the influential role of exposure to air pollution during pregnancy and early life in human health. https://doi.org/10.1289/EHP11257.

Associations between socioeconomic position and young people's physical activity and sedentary behaviour in the UK: a scoping review

OBJECTIVE

To examine the evidence on the associations between socioeconomic position and young people's physical activity and sedentary behaviours in the UK.

DESIGN

Scoping review.

DATA SOURCES

PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Observational studies in children and adolescents (aged 5-18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour.

RESULTS

Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents.

CONCLUSION

Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.

Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination

BACKGROUND

Conditional cash transfer (CCT) programmes are one of the strategies to increase vaccination coverage among underprivileged families by conditioning cash transfer to the up-to-date immunisation of children. However, there are gaps in knowledge of its impact on vaccination at the recommended age (timely).

METHODS

We performed two cross-sectional analyses of secondary data from a retrospective cohort, at the landmark ages of 12 and 24 months, to assess the effect of the Brazilian CCT on the up-to-date and timely vaccination in children born between 2014 and 2016 and resident in the city of Araraquara, São Paulo (Southeast Brazil). The Propensity Score Matching (PSM) was used to balance two pre-defined groups (beneficiaries and non-beneficiaries) according to the profile of socioeconomic and demographic characteristics.

RESULTS

From a total of 7386 children within the cohort, 22.2% (1636) were from beneficiary families of the CCT. After the pairing by PSM, the final sample size included in the analyses was 1440 for each group. We found higher up-to-date vaccination coverage, at 12 (92.1%, 95% CI=90.6% to 93.5%) and 24 months (83.8%, 95% CI=81.8% to 85.7%), among the CCT beneficiaries compared with the non-beneficiaries (85.1%, 95% CI=83.2% to 86.9% at 12 months and 73.6%, 95% CI=71.2% to 75.8% at 24 months). The coverage of timely vaccination did not statistically differ between beneficiaries (41.5%, 95% CI=38.9% to 44.1% and 17.4%, 95% CI=15.4% to 19.4%) and non-beneficiaries (40.7%, 95% CI=38.1% to 43.3% and 17.1%, 95% CI=15.2% to 19.1%) at 12 and 24 months, respectively.

CONCLUSION

The study highlights a positive effect of the CCT on vaccination coverage of the up-to-date infant vaccination schedule. However, there was no difference in timely vaccination.

Do adolescents' experiences of the barriers to and facilitators of physical activity differ by socioeconomic position? A systematic review of qualitative evidence

This review aims to systematically identify and synthesize qualitative data on adolescents' experiences of the barriers to and facilitators of physical activity to understand whether these differ by socioeconomic position. Multiple databases (MEDLINE, Web of Science Core Collection, PsycINFO, and ERIC) were searched in August 2020. Duplicate title/abstract and full text screening was conducted. Studies were included if they reported qualitative data collected from adolescents (aged 10-19), a measure of socioeconomic position and focused on physical activity. Studies not published in English or published before 2000 were excluded. Relevant data were extracted and methodological quality assessed (in duplicate). Data were analyzed using Thomas and Harden's methods for the thematic synthesis. Four analytical themes emerged from the 25 included studies: (1) social support, (2) accessibility and the environment, (3) other behaviors and health, and (4) gendered experiences. These themes appeared across socioeconomic groups; however, their narratives varied significantly. For example, provision and access to local facilities was discussed as a facilitator to middle and high socioeconomic adolescents, but was a barrier to low socioeconomic adolescents. These findings can be used to inform how different socioeconomic groups may benefit from, or be disadvantaged by, current interventions.

Effect of Childhood Developmental Coordination Disorder on Adulthood Physical Activity; Arvo Ylppö Longitudinal Study

Individuals at risk of Developmental Coordination Disorder (DCD) have low levels of physical activity in childhood due to impaired motor competence; however, physical activity levels in adulthood have not been established. This study sought to determine the impact of DCD risk on physical activity levels in adults using accelerometry measurement. Participants (n = 656) from the Arvo Ylppö Longitudinal Study cohort had their motor competence assessed at the age of five years, and their physical activity quantified via device assessment at the age of 25 years. Between group differences were assessed to differentiate physical activity measures for individuals based on DCD risk status, with general linear modeling performed to control for the effects of sex, body mass index (BMI), and maternal education. Participants at risk of DCD were found to have a lower total number of steps (d = 0.3, p = 0.022) than those not at risk. Statistical modeling indicated that DCD risk status increased time spent in sedentary light activity (β = 0.1, 95% CI 0.02 to 0.3, p = 0.026) and decreased time spent in vigorous physical activity via interaction with BMI (β = 0.04, 95% CI 0.001 to 0.1, p = 0.025). Sensitivity analysis found that visuomotor impairment did not significantly impact physical activity but did increase the role of DCD risk status in some models. This 20‐year‐longitudinal study indicated that DCD risk status continues to negatively impact on levels of physical activity into early adulthood.

Prospective Association of Maternal Educational Level with Child's Physical Activity, Screen Time, and Diet Quality

Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children’s lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child’s physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child’s socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child’s screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.

Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

Physical activity behaviours in adolescence: current evidence and opportunities for intervention

Young people aged 10-24 years constitute 24% of the world's population; investing in their health could yield a triple benefit-eg, today, into adulthood, and for the next generation. However, in physical activity research, this life stage is poorly understood, with the evidence dominated by research in younger adolescents (aged 10-14 years), school settings, and high-income countries. Globally, 80% of adolescents are insufficiently active, and many adolescents engage in 2 h or more daily recreational screen time. In this Series paper, we present the most up-to-date global evidence on adolescent physical activity and discuss directions for identifying potential solutions to enhance physical activity in the adolescent population. Adolescent physical inactivity probably contributes to key global health problems, including cardiometabolic and mental health disorders, but the evidence is methodologically weak. Evidence-based solutions focus on three key components of the adolescent physical activity system: supportive schools, the social and digital environment, and multipurpose urban environments. Despite an increasing volume of research focused on adolescents, there are still important knowledge gaps, and efforts to improve adolescent physical activity surveillance, research, intervention implementation, and policy development are urgently needed.

Associations Between Household Socioeconomic Status, Car Ownership, Physical Activity, and Cardiorespiratory Fitness in South African Primary Schoolchildren Living in Marginalized Communities

BACKGROUND

Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness.

METHODS

Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test.

RESULTS

Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA.

CONCLUSIONS

A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.

Sociodemographic Predictors of Adherence to National Diet and Physical Activity Guidelines at Age 5 Years: The Healthy Start Study

PURPOSE

To assess adherence to the 2015-2020 Dietary Guidelines for Americans and 2018 Physical Activity Guidelines, and identify sociodemographic predictors of adherence among children.

DESIGN

Cross sectional.

SETTING

Colorado, United States.

PARTICIPANTS

Children aged 5 (n = 482).

MEASURES

Sex, race/ethnicity, maternal education, maternal employment, maternal subjective social status and household income were assessed via questionnaires. Diet was assessed via 2 interviewer-administered 24-hour dietary recalls. Physical activity was objectively-measured with accelerometry for 7 days. Adherence was defined as a Healthy Eating Index-2015 score of ≥70 and/or ≥6 hours/day of light, moderate and vigorous activity.

ANALYSIS

For each predictor, logistic regression was used to estimate odds ratios for adherence to the diet guidelines only, the activity guidelines only or both guidelines.

RESULTS

In the full sample, 29% of children were non-adherent to both guidelines, 6% adhered to the dietary guidelines only, 50% adhered to the activity guidelines only and 14% adhered to both. Girls had a 41% lower odds of adhering to the physical activity guidelines than boys (p = 0.01), after adjustment for race/ethnicity, household income and maternal education level, perceived social status and employment status.

CONCLUSION

Efforts to improve the health of young children should promote adherence to the Dietary Guidelines for Americans among all children. Targeted interventions that increase physical activity among girls may help to mitigate health disparities.

Family Influence on Children's Nutrition and Physical Activity Patterns in Oman

PURPOSE

The objective of this study is to expand the understanding of the family influence on children's nutrition and physical activity patterns in Oman.

DESIGN AND METHODS

A cross-sectional research design was used in this study. We recruited 204 dyads (a mother with a child) conveniently. Research data were collected in public cycle one schools, nongovernmental community centers, and home visits from five provinces in Oman. Study measures included a general information survey, anthropometric measurements, electronic children and family nutrition and physical activity questionnaires, and a single-day dietary recall for children. Univariate, bivariate, and multivariate analyses were used.

RESULTS

Children's nutrition intake was significantly associated with parental education level, family income, and family nutrition and physical activity patterns, while children's physical activity patterns were significantly associated with maternal BMI and parental education level.

CONCLUSIONS

Children's nutrition and physical activity patterns are associated with maternal BMI, family's sociodemographic characteristics, and family's nutrition and physical activity pattern.

PRACTICE IMPLICATIONS

Family is a key element in shaping and influencing children's lifestyle-related behaviors. School-health programs that actively involve the families hold promise in promoting children's nutrition and physical activity pattern. Future research should be directed toward understanding the moderating and mediating factors.

A national survey showed low levels of physical activity in a representative sample of Swedish adolescents

AIM

This study investigated objectively measured physical activity and sedentary time by sex, age and socioeconomic status in a large representative sample of Swedish adolescents.

METHODS

In this cross-sectional national survey between 2016 and 2017, students aged 11-12, 14-15 and 17-18 years from 131 schools were invited to participate. Physical activity and sedentary time were measured objectively with accelerometers for seven consecutive days. Socioeconomic status (parental education) and country of birth were self-reported in a questionnaire. Weight and height were measured by trained staff.

RESULTS

A total of 3477 adolescents participated in the study, and 2419 (73%) had at least 3 days of valid accelerometer data. The results showed that 43% of boys and 23% of girls reached the recommendation of 60 minutes of daily moderate-to-vigorous physical activity. Boys were more physically active than girls in all age groups. Girls with high socioeconomic status were more physically active than girls with low socioeconomic status (P < .001), and this difference was not found in boys.

CONCLUSION

The majority of Swedish adolescents did not reach the physical activity recommendation, and boys were more active than girls. Effective strategies to increase physical activity, especially among girls with low socioeconomic status, are urgently needed.

The prevalence of physical inactivity in Iranian adolescents and the impact of economic and social inequalities on it: results of a National Study in 2018

BACKGROUND

This study aims to determine the prevalence of physical inactivity in Iranian adolescents aged 10-12 years and the impact of socioeconomic inequality on it.

METHODS

In this descriptive study, the study population consisted of 10-12 years old adolescents from an Iranian population from Kurdistan, Fars and Markazi provinces in 2018. The sample size was 1590 individuals. The sampling method was cluster sampling. Data was collected using demographic questionnaire, modifiable activity questionnaire (MAQ) and socioeconomic questionnaire. Cut points on the MAQ for light activity, moderate activity and heavy activity were MET< 3, MET = 3-6 and MET> 6, respectively. Linear and logistic regression were used to estimate the final model and the Oaxaca analysis method was applied. All analyses were performed in Stata/SE 14.0.

RESULTS

Of the 1590 participants, 52.82% were male. The results showed that 25.79% of the subjects were physically inactive and 7.30% engaged in moderate physical activity during the week. The average physical activity during 1 week was more in boys than in girls (P-value< 0.05). Adolescents of mothers with secondary and high school education were more likely to have physical inactivity than mothers with a high school diploma or higher (AOR: 1.35, 95% CI: 1.02-1.77). The concentration index was -.11, indicating a greater concentration of physical inactivity in adolescents with low socioeconomic levels.

CONCLUSION

One-fourth of the study population had physical inactivity in this age group. Socioeconomic levels, parental literacy, and sex of adolescents were associated with the level of physical activity.

Examining weather-related factors on physical activity levels of children from rural communities

OBJECTIVE

The objective was to examine the influence of weather on moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) levels of children aged 8-14 years from rural communities, an understudied Canadian population.

METHODS

Children (n = 90) from four communities in rural Northwestern Ontario participated in this study between September and December 2016. Children's MVPA and LPA were measured using an Actical accelerometer and demographic data were gathered from surveys of children and their parents. Weather data were collected from the closest weather station. Cross-classified regression models were used to assess the relationship between weather and children's MVPA and LPA.

RESULTS

Boys accumulated more MVPA than girls (b = 26.38, p < 0.01), children were more active on weekdays as compared with weekends (b = - 16.23, p < 0.01), children were less active on days with precipitation (b = - 22.88, p < 0.01), and higher temperature led to a significant increase in MVPA (b = 1.33, p  < 0.01). As children aged, they accumulated less LPA (b = - 9.36, p < 0.01) and children who perceived they had higher levels of physical functioning got more LPA (b = 25.18, p = 0.02). Similar to MVPA, children had higher levels of LPA on weekdays (b = - 37.24, p < 0.01) as compared to weekend days and children accumulated less LPA (b = -50.01, p < 0.01) on days with rain.

CONCLUSION

The study findings indicate that weather influences rural children's MVPA and LPA. Future research is necessary to incorporate these findings into interventions to increase rural children's overall PA levels and improve their overall health.

Prevalence and socio-demographic correlates of accelerometer measured physical activity levels of school-going children in Kampala city, Uganda

Background

The current international physical activity guidelines for health recommend children to engage in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Yet, accurate prevalence estimates of physical activity levels of children are unavailable in many African countries due to the dearth of accelerometer-measured physical activity data. The aim of this study was to describe the prevalence and examine the socio-demographic correlates of accelerometer-measured physical activity among school-going children in Kampala city, Uganda.

Methods

A cross-sectional study design was used to recruit a sample of 10–12 years old school-going children (n = 256) from 7 primary schools (3 public schools and 4 private schools) in Kampala city, Uganda. Sedentary time, light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) were measured by accelerometers (ActiGraph GT3X+ [Pensacola, Florida, USA]) over a seven-day period. Socio-demographic factors were assessed by a parent/guardian questionnaire. Weight status was generated from objectively measured height and weight and computed as body mass index (BMI). Multi-level logistic regressions identified socio-demographic factors that were associated with meeting physical activity guidelines.

Results

Children’s sedentary time was 9.8±2.1 hours/day and MVPA was 56±25.7 minutes/day. Only 36.3% of the children (38.9% boys, 34.3% girls) met the physical activity guidelines. Boys, thin/normal weight and public school children had significantly higher mean daily MVPA levels. Socio-demographic factors associated with odds of meeting physical activity guidelines were younger age (OR = 0.68; 95% CI = 0.55–0.84), thin/normal weight status (OR = 4.08; 95% CI = 1.42–11.76), and socioeconomic status (SES) indicators such as lower maternal level of education (OR = 2.43; 95% CI = 1.84–3.21) and no family car (OR = 0.31; 95% CI = 0.17–0.55).

Conclusion

Children spent a substantial amount of time sedentary and in LPA and less time in MVPA. Few children met the physical activity guidelines. Lower weight status, lower maternal education level and no family car were associated with meeting physical activity guidelines. Effective interventions and policies to increase physical activity among school-going children in Kampala, are urgently needed.

Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial

BACKGROUND

Less than 20% of adolescents globally meet recommended levels of physical activity, and not meeting these recommended levels is associated with social disadvantage and rising disease risk. The determinants of physical activity in adolescents are multilevel and poorly understood, but the school's social environment likely plays an important role. We conducted a cluster randomised controlled trial to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) among adolescents.

METHODS AND FINDINGS

Non-fee-paying, co-educational schools including Year 9 students in the UK counties of Cambridgeshire and Essex were eligible for inclusion. Within participating schools (n = 16), all Year 9 students were eligible and invited to participate. Participants were 2,862 13- to 14-year-olds (84% of eligible students). After baseline assessment, schools were computer-randomised, stratified by school-level pupil premium funding (below/above county-specific median) and county (control: 8 schools, 1,319 participants, mean [SD] participants per school n = 165 [62]; intervention: 8 schools, 1,543 participants, n = 193 [43]). Measurement staff were blinded to allocation. The iteratively developed, feasibility-tested 12-week intervention, aligned with self-determination theory, trained older adolescent mentors and in-class peer-leaders to encourage classes to conduct 2 new weekly activities. Students and classes gained points and rewards for engaging in any activity in or out of school. The primary outcome was average daily minutes of accelerometer-assessed MVPA at 10-month follow-up; a mixed-methods process evaluation evaluated implementation. Of 2,862 recruited participants (52.1% male), 2,167 (76%) attended 10-month follow-up measurements; we analysed the primary outcome for 1,874 participants (65.5%). At 10 months, there was a mean (SD) decrease in MVPA of 8.3 (19.3) minutes in the control group and 10.4 (22.7) minutes in the intervention group (baseline-adjusted difference [95% confidence interval] -1.91 minutes [-5.53 to 1.70], p = 0.316). The programme cost £13 per student compared with control; it was not cost-effective. Overall, 62.9% of students and 87.3% of mentors reported that GoActive was fun. Teachers and mentors commented that their roles in programme delivery were unclear. Implementation fidelity was low. The main methodological limitation of this study was the relatively affluent and ethnically homogeneous sample.

CONCLUSIONS

In this study, we observed that a rigorously developed school-based intervention was no more effective than standard school practice at preventing declines in adolescent physical activity. Interdisciplinary research is required to understand educational-setting-specific implementation challenges. School leaders and authorities should be realistic about expectations of the effect of school-based physical activity promotion strategies implemented at scale.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN31583496.

Temporal Trends of Compliance With School-Based Physical Activity Recommendations Among Spanish Children, 2011-2018

BACKGROUND

According to the current physical activity (PA) recommendations, children should accumulate 60 minutes of moderate to vigorous PA (MVPA) throughout the day, 30 minutes of MVPA during the school hours, and 50% of the recess time in MVPA. Our aim was to examine the temporal trends of accelerometer-based PA during the previously mentioned day segments and the proportion of children who met the PA recommendations.

METHODS

This was a cross-sectional study with 2 independent samples: 499 fourth graders (49.2% females) in 2011-2012 and 364 fourth graders (46.9% females) in 2017-2018. Hip-worn accelerometers were used to assess PA.

RESULTS

A decline in light PA, moderate PA, vigorous PA, MVPA, and total PA during whole day, and in the rate of compliance with daily MVPA recommendations in males (P < .01) was observed from 2011-2012 to 2017-2018. Females decreased their daily light PA and moderate PA (P < .05). A decline in all PA variables during school hours in both sexes (P < .05) and in the rate of compliance with the 30 minutes of MVPA recommended during school hours in males (P < .001) were observed. There were no differences in PA during recesses.

CONCLUSIONS

Interventions are needed to attenuate the temporal decrease in PA levels in children.

Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents

Objectives Body image is widely related to behavioral factors in adolescents and negative levels has been associated to poor physical and mental health. This study analyzed the association of physical activity and sedentary behavior with body dissatisfaction in adolescents. Methods Data from 15,632 adolescents between 11 and 17 years from the Brazilian National Scholar Health Survey - PeNSE 2015 were analyzed. Body dissatisfaction was self-reported. Sedentary behavior was assessed by hours in television (TV) viewing and in overall sitting behaviors. Physical activity was assessed by amount of time in domains of active commuting, physical education classes at school, and physical activities outside the school. Analyses were adjusted by age, ethnicity, body mass index, and scholarity of mother. Results Body dissatisfaction prevalence was 18.5%, being higher in girls than boys (24.2 vs. 12.7%, p < 0.001). Female gender (OR = 2.35), higher age-group (OR = 1.64), high scholarity of mother (OR = 1.43), and had overweight/obesity (OR = 2.38/4.81) were positively related to body dissatisfaction. Higher sedentary time was associated with body dissatisfaction in adolescents when compared to less than 2 h/day of sedentary time (OR varying from 1.45 to 2.14). Physical activity was negatively associated with adolescent body dissatisfaction in all assessed domains, with odds ratio varying from 0.66 to 0.89. Conclusions Body dissatisfaction showed an independent association of with total sedentary behavior (positively) and with different domains of physical activity (negatively) in a large scholar sample of Brazilian adolescents.

Physical activity rather than sedentary behaviour is socially determined in French adolescents with overweight and obesity

Social differences in prevalence of overweight and obesity among adolescents, known as the weight social gradient, could be explained by differences in behaviours between social classes. This study examined the respective association of physical activity (PA), sedentary behaviour (SB) and weight status with adolescents' socioeconomic status. We used cross-sectional data for 1935 adolescents (13-18 years old) with overweight or obesity who participated in the PRALIMAP-INÉS (PRomotion de l'ALImentation et de l'Activité Physique - INÉgalités de Santé) trial conducted in northeastern France between 2012 and 2015. Adolescents completed the International Physical Activity Questionnaire for PA and SB and the Family Affluence Scale for socioeconomic status. Weight status was assessed by the body mass index (BMI) and BMI z-score. Social gradient of weight status, PA and SB were described according to the Family Affluence Scale (slopes) and evidenced by the linear trend test (p). Adolescents' socioeconomic status was positively associated with PA practice (frequency, vigorous PA and leisure-time PA), but there was no association with their SB. The results confirmed a significant weight social gradient: BMI (β = 0.37, p < .0001) and BMI z-score (β = 0.07, p = .0001). The weight social gradient in adolescents was mostly associated with PA (5.7% to 8.1%) rather than SB (2.7% to 5.7%). Nearly 14% of BMI z-scores could be related to a combined PA and SB effect. PA was found an important factor of weight social gradient in adolescence. Actions aimed at preventing weight social inequalities among adolescents could include PA promotion as lever. CLINICAL TRIALS REGISTRY AND NUMBER: ClinicalTrials.gov (NCT01688453).

Specific Features of the Ukrainian Urban Adolescents' Physical Activity: A Cross-Sectional Study

Background

An increase in the proportion of physically active peoples is one of the public health priorities. Particular attention should be addressed to the adolescent group with regard to their sensitivity. The purpose of our study is to determine the overall level of physical activity (PA) of urban adolescents and to evaluate its components.

Methods

The study included the results of a survey of 415 children aged 11–15 years from public schools in Ukraine. We have adapted the standardized questionnaire QAPACE, which allows characterizing the level of adolescent's PA by indicators: type, duration, and intensity.

Results

A sedentary lifestyle is typical for most Ukrainian urban adolescents. Only 30.8% of Ukrainian urban adolescents (45.4% of boys and 21.4% of girls; p < 0.001) meet the recommended level of moderate-to-vigorous PA (at least 60 minutes per day). The chances to follow the recommended moderate-to-vigorous PA are almost 5 times higher in the group of adolescents exercising at their own wish and not by parents' direction (OR = 4.96; 95% CI: 2.77–8.90; p < 0.001). Girls have a 3.0 higher chance of not adhering to recommendations for duration of PA (OR = 3.01; 95% CI: 1.95–4.63). They are 2.5 times more likely to lead a sedentary lifestyle (OR = 2.48; 95% CI: 1.54–3.98) than boys.

Conclusion

The obtained results are indicative of a lack of implementation of measures to increase physical activity, which requires public attention to this problem. A search for ways to improve public policy towards optimizing adolescents' PA is still an urgent goal for scholars and practitioners. PA-promoting measures should be developed taking into account the impact of family traditions, accessibility of sports facilities, leisure, advertising, and other factors. The obtained results are the initial stage for developing the program of physical inactivity prevention.

Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood

BACKGROUND

Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts.

METHODS

Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test.

RESULTS

General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results.

LIMITATIONS

We lacked data on physical activity and only studied males at three time-points.

CONCLUSIONS

Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.

Changes in the school and non-school sedentary time in youth: The UP&DOWN longitudinal study

The aims of this study were (i) to examine the sedentary time (ST) during different time periods [i.e., weekend, out-of-school weekdays hours, school hours, recess, physical education classes (PEC)] in children and adolescents; (ii) to identify 2-year longitudinal changes in the ST for these periods; and (iii) to examine if ST at baseline is associated with ST 2 years later. This was a 2-year follow-up study with 826 (51.9% boys) children and 678 (50.7% boys) adolescents. Accelerometers were used to assess ST. Students spent more than 60% of their weekend, out-of-school hours and school hours in ST. During these periods, girls and adolescents were more sedentary than boys and children, respectively (p < 0.05). Over 2-year follow-up, ST increased during the weekend, out-of-school hours, school hours and recess in all subgroups studied (p < 0.001). ST during PEC declined 2% per year in children (p < 0.001) but it increased in adolescents (p < 0.05). ST during the periods analysed at baseline was lowly associated with ST during these periods 2 years later (intraclass correlations from <0.001 to 0.364). Interventions in these settings may be adequate if the intention is to avoid ST increase in students.

Manual Dexterity is not Related to Media Viewing but is Related to Perceptual Bias in School-Age Children

Although the media can have both negative and positive effects on children’s cognitive and motor functions, its influence on their perceptual bias and manual dexterity is unclear. Thus, we investigated the association between media viewing time, media preference level, perceptual bias, and manual dexterity in 100 school-aged children. Questionnaires completed by children and their parents were used to ascertain media viewing time and preference levels. Perceptual bias and manual dexterity were measured using the visual-tactile temporal order judgment task and Movement Assessment Battery for Children—2nd edition, respectively. There were significant positive correlations between age and media viewing time and between media viewing time and media preference level. There was also a significant negative correlation between visual bias and manual dexterity. Hierarchical multiple regression analysis revealed that increasing visual bias was a significant predictor of decreasing manual dexterity. Further, children with low manual dexterity showed significant visual bias compared to those with high manual dexterity, when matched for age and gender. The present results demonstrated that, in school-aged children, although viewing media was not associated with perceptual bias and manual dexterity, there was a significant association between perceptual bias and manual dexterity.

Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia

BACKGROUND

Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior.

METHODS

School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis.

RESULT

A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18-18.78), maternal education (AOR: 5.12, 95%CI = 1.09-23.83), access to TV (AOR: 4.87, 95%CI = 1.99-11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14-4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43-6.17) were positively associated with adolescent sedentary behavior.

CONCLUSION

The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.

Associations between socioeconomic position and changes in children's screen-viewing between ages 6 and 9: a longitudinal study

OBJECTIVES

To explore socioeconomic differences in screen-viewing at ages 6 and 9, and how these are related to different media uses.

DESIGN

Longitudinal cohort study.

SETTING

Children recruited from 57 state-funded primary schools in Southwest England, UK.

PARTICIPANTS

1299 children at ages 5-6, 1223 children at ages 8-9, including 685 children at both time points.

OUTCOME MEASURES

Children's total screen-viewing time (parent-reported) and time spent using multiple screen devices simultaneously (multiscreen viewing), for weekdays and weekends.

METHODS

Negative binomial regression was used to model associations between socioeconomic variables (highest household education and area deprivation) and total screen-viewing at age 6 and the change from age 6 to 9. We additionally adjusted for child characteristics, parental influences and media devices in the home. Multiscreen viewing was analysed separately.

RESULTS

Household education was associated with children's screen-viewing at age 6 with lower screen-viewing in higher socioeconomic groups (21%-27% less in households with a Degree or Higher Degree, compared with General Certificate of Secondary Education: GCSE). These differences were explained by the presence of games consoles, parental limits on screen-viewing and average parent screen-viewing. Between ages 6 and 9, there were larger increases in screen-viewing for children from A level and Degree households (13% and 6%, respectively, in the week) and a decrease in Higher Degree households (16%), compared with GCSE households. Differences by household education remained when adjusting for media devices and parental factors.

CONCLUSIONS

Children's screen-viewing patterns differ by parental education with higher levels of viewing among children living in households with lower educational qualifications. These differences are already present at age 6, and continue at age 9. Strategies to manage child sedentary time, and particularly screen-viewing, may need to take account of the socioeconomic differences and target strategies to specific groups.

Economic Growth and Cardiorespiratory Fitness of Children and Adolescents in Urban Areas: A Panel Data Analysis of 27 Provinces in China, 1985-2014

With rapid economic development in China, cardiorespiratory fitness (CRF) of children and adolescents is on a decline. However, this appears to have slowed down, reaching stagnation in certain areas. However, it is unclear if the change in CRF is related to economic growth and development or not. This study describes trends in CRF of Chinese children and adolescents, and empirically tests the relationships between China's macro-economic developments and cardiorespiratory fitness of children and adolescents over the past 30 years using provincial panel data collected from one million samples. We used per capita disposable income as the economic indicator. CRF was assessed by using running tests: 50 m × 8 for boys and girls (7-12 years), 1000 m for boys (13-22 years), and 800 m for girls (13-22 years). The results show that economic growth has a U-shaped relationship with CRF of children and adolescents (both boys and girls). It appears that as incomes increased, CRF of urban male and female students in China gradually decreased to its lowest point, after which it showed an upward trend. From a horizontal perspective, it can be inferred that for low-developed provinces, increases in incomes cause a decrease in CRF levels. In contrast, for highly developed provinces, as incomes increase, CRF levels increase. This study provides the first empirical evidence of the relationship between macro-economy and CRF of youth, based on provincial panel data. The results presented here can be used to formulate health policies targeting the cardiorespiratory fitness of children and adolescents from middle-income provinces in China. This study also provides a reference for developing countries.

Associations between objectively assessed and questionnaire-based sedentary behaviour with body mass index and systolic blood pressure in Kuwaiti adolescents

Objective

Kuwait has one of the highest obesity rates in the world. This study examined the associations between sedentary behaviour (objectively measured and self-reported), adiposity and systolic blood pressure in a sample of adolescents residing in Kuwait. Data was obtained from the Study of Health and Activity among adolescents in Kuwait (2012–2013). The sample included a total of 435 adolescents (201 boys). Outcomes were age- and sex specific body mass index Z-scores and systolic blood pressure. Exposures were total sedentary behaviour measured by accelerometry and time spent in some sedentary behaviours (television viewing, video games, computer use and total screen-time). We used multiple linear regression analyses, adjusted for age, governorate, maternal education and physical activity, to examine associations between sedentary behaviour and adiposity and systolic blood pressure.

Results

Only 2 statistically significant associations were found between sedentary behaviour and the study outcomes: body mass in boys was directly associated with higher sedentary time [β (95% CIs) 0.003 (0.00 to 0.06)]; body mass index was inversely associated with videogames in both sexes [girls: β (95% CIs) − 0.17 (− 0.48 to − 0.04); boys: − 0.24 (− 0.57 to − 0.12)]. In this sample of Kuwaiti adolescents, sedentary behaviour showed limited deleterious associations with adiposity and systolic blood pressure.

The Role of School in Helping Children and Adolescents Reach the Physical Activity Recommendations: The UP&DOWN Study

BACKGROUND

The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods.

METHODS

The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods.

RESULTS

Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC.

CONCLUSIONS

Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents.

Association between Maternal Education and School-Age Children Weight Status: A Study from the China Health Nutrition Survey, 2011

Childhood abnormal weight status is a global public health issue. This study aims to explore the association between maternal education and weight status of school-age children using the data from the China Health Nutrition Survey (CHNS), wave 2011. Body Mass Index (BMI) is calculated based on children's weight and height and is divided into three levels (normal, underweight, overweight/obesity). Logistic regression is used to assess the relationship of maternal education and children weight status. The prevalence of childhood underweight and overweight/obesity are 5.9% and 21.7%, respectively. Children with high maternal education are found less likely to be underweight (technical college: Odds Ratio (OR) = 0.223, 95% Confidence Interval (CI) = 0.052-0.956, above college: OR = 0.182, 95% CI = 0.041-0.812). Children with maternal education at junior high school are of 2.170 greater odds to be overweight/obese than those with maternal education at junior high school and below (OR = 2.170, 95% CI = 1.398-3.370), and children with maternal education at technical college are of 2.397 greater odds to be overweight/obese than those with lower education level (OR = 2.397, 95% CI = 1.478-3.887), and children with maternal education at above college are of 2.146 greater odds to be overweight/obese than those with lower education level (OR = 2.146, 95% CI = 1.293-3.560). A significant association between maternal education and children's weight status is found. Targeted interventions for mothers with different education levels should be carried out to effectively manage the children's weight status.

Associations of subjective social status with accelerometer-based physical activity and sedentary time among adolescents

This study examined the associations of subjective social status (SSS) with physical activity (PA) and sedentary time (ST) among adolescents. The study population consisted of 420 Finnish adolescents aged 13 to 14 years. The adolescents reported their own SSS within their school (school SSS) and their family's social position within society (society SSS) based on the youth version of the Subjective Social Status Scale. Adolescents' moderate- to vigorous-intensity physical activity (MVPA) and ST were measured objectively by accelerometers and analyzed separately for the whole day and the school day. The associations between SSS and MVPA and ST outcomes were analyzed using multilevel modeling. School SSS was positively associated with whole-day MVPA and negatively associated with school-time ST. Society SSS was not significantly associated with objectively measured MVPA or ST. Both MVPA and ST are important behavioral determinants of health. As an important correlate of MVPA and ST, school SSS should be addressed by providers when discussing obesity risk and healthy behaviors with adolescents.

Objectively assessed moderate-to-vigorous physical activity levels among primary school children in Norway: The Health Oriented Pedagogical Project (HOPP)

AIMS

The objective was to investigate moderate-to-vigorous physical activity levels (MVPA) of primary school children at baseline of the Health Oriented Pedagogical Project (HOPP), Norway.

METHODS

Data on 2123 children aged 6-12 years were included for analysis (75% participation rate). Average minutes per day in MVPA was objectively measured using accelerometry based on seven-day averages. The sample was analysed for age-, sex-, socioeconomic-, and season-related patterns. A linear regression investigated the moderating effect of these factors as well as body mass index and waist circumference.

RESULTS

Some 86.5% of the sample had at least 60 min/day MVPA, averaging 90.7 min/day. The main differences in daily averages were between age groups 6½-9 and 10-12 ( p < .05). Boys (95.8 min/day, 95% CI: 94.1-97.5) were more active than girls (85.6 min/day, 95% CI: 83.9-87.2) in all age groups ( p < .0001). MVPA was lower by 3.5 min ( p < .0001) per additional year of age in the linear regression (R² = 0.176) and was reduced by 20 min less per day in MVPA in the winter months compared with the summer months ( p < .0001).

CONCLUSIONS

Physical activity levels are already in decline from 6-7 years old and are likely to continue to decline into adolescence. Interventions must therefore focus on primary school children.

Socioeconomic position and sedentary behavior in Brazilian adolescents: A life-course approach

Socioeconomic position (SEP) is a potential correlate of sedentary behavior in adolescents. The aim of this study was to examine the associations between SEP and self-reported and objective measures of sedentary behavior in adolescents, using a life-course approach. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N=5249). Cross-sectional and longitudinal associations between multiple SEP indicators (maternal education, family income, SEP composite, cumulative family income) at birth, 11, 15 and 18years, and five sedentary behavior outcomes (≥4h/day screen time; ≥4h/day TV; ≥2h/day computer; ≥2h/day video game; ≥12.7h/day objectively measured sedentary time) at 11, 15 and 18years, were examined. In cross-sectional analyses, higher SEP was positively associated with more screen time at ages 11 and 15years. There was a consistent and positive association between higher SEP with time spent using a computer, and with sedentary time assessed through accelerometry. SEP at birth had a positive and direct effect on screen, computer and total sedentary time at 18years. Participants in the highest cumulative income group had higher odds of high sedentary behavior in screen (OR: 2.40; 95% CI: 1.50-3.54), computer (OR: 7.35; 95% CI: 4.19-12.89) and total sedentary time (OR: 5.40; 95% CI: 3.53-10.35), respectively, compared with their counterparts with lower cumulative income. Our findings showed that SEP is an early determinant of sedentary behavior in adolescents.

How does the activity level of the parents influence their children's activity? The contemporary life in a world ruled by electronic devices

INTRODUCTION

Apart from many positive changes associated with technical civilization, there are also - from the health point of view - some threats. The reduction in the level of physical activity is one of them. The aim of the study was to investigate whether there are any relationships between children's physical activity and behaviors, and to assess the impact of the adults' activity on their children's habits.

MATERIAL AND METHODS

The study involved a group of 340 children aged 7-12 years (mean age: 9.81 ±1.7) and their parents. In order to evaluate children's physical activity and the amount of time that they spend with electronic devices, an original questionnaire and the IPAQ questionnaire were used.

RESULTS

Children usually use electronic devices between 2 and 7 days per week (mean: 4.74 ±0.86), regardless of sex (p > 0.09) and spend between 5 and 1620 min per week (mean: 459.46 ±308.1) with their mobile phone, tablet, PCs and TVs. 67.92% of boys and 69.61% of girls lead an active lifestyle. The children's activity level depends on their parents' level of activity (p < 0.000001). Parents of semi-active children lead a lifestyle with a moderate level of physical activity.

CONCLUSIONS

The level of physical activity in younger children depends on the children's relationship with their parents and their level of activity. Children spend a lot of free time with their electronic devices. It is necessary to develop and implement activities intended to raise awareness of children and their families about the effects of hypokinesis.

Cluster of risk and protective factors for obesity among Brazilian adolescents

OBJECTIVES

This study aims to identify and analyze clusters formed by risk and protective factors for obesity among Brazilian adolescents.

METHODS

Cross-sectional data collected in a national representative sample of adolescents by the Brazilian National School Health Survey of 2012 were used (n = 109,104). Cluster analysis was applied to identify clusters involving dietary intake, eating behavior, physical activity and sedentary behaviors. Logistic regression was employed to contextualize the clusters according to students' sociodemographics and schools' characteristics.

RESULTS

Two clusters were identified. Cluster 1 was predominantly characterized by the low frequency of both risk and protective factors for obesity; Cluster 2 was characterized by high frequency of both of these factors. None was essentially healthy or unhealthy. Adolescents from less developed regions and with mothers with lower education level were associated to Cluster 1.

CONCLUSIONS

The identification of two mixed clusters indicate wide spread obesity risk among scholars in the country. The association between the clusters and sociodemographic characteristics of the population allows a greater refinement of health promotion and obesity prevention and combat actions in Brazil.

Physical Activity and Sedentary Time Associations with Metabolic Health Across Weight Statuses in Children and Adolescents

OBJECTIVE

The aim of this study was to examine the prevalence of metabolic health across weight statuses and the associations of physical activity and sedentary time within and across metabolic health-weight status groups.

METHODS

Six studies (n = 4,581) from the International Children's Accelerometry Database were used. Sedentary time, light physical activity, and moderate to vigorous physical activity (MVPA) were accelerometer derived. Individuals were classified with normal weight (NW), overweight, or obesity. Strict and lenient composite definitions of metabolic health were created. Binomial and multinomial logistic regressions controlling for age, sex, study, and accelerometer wear time were conducted.

RESULTS

The metabolically unhealthy (MU) prevalence was 26.4% and 45.6% based on two definitions. Across definitions, more sedentary time was associated with higher odds of MU classification compared with metabolically healthy (MH) classification for the NW group. More MVPA was associated with lower odds of MU classification than MH classification for NW and overweight groups. For multinomial logistic regressions, more MVPA was associated with lower odds of MH-obesity classification, as well as MU-NW, -overweight, and -obesity classifications, compared with the MH-NW group. Furthermore, more sedentary time was associated with higher odds of MU-NW classification compared with the MH-NW group.

CONCLUSIONS

More MVPA was beneficial for metabolic health and weight status, whereas lower sedentary time was beneficial for metabolic health alone, although associations were weak.

The weight of pupils' schoolbags in early school age and its influence on body posture

BACKGROUND

Postural development progresses through a series of stages (growth spurts, development of balance and coordination, postural stability) which occur when children are at school age. The reduction in the level of physical activity, increased body weight, overloaded school bags, asymmetry of the backpack straps, the method of putting on and taking off the backpacks and increased usage of electronic devices have negative side effects such as bad body posture habits.

METHODS

A prospective cohort study in the group of 155 pupils at early school age 7-9 years old has been conducted. Examinations have been conducted twice: first, at the beginning of the school year (initial examination) and second - after 10-11 months (final examination). Age, gender, BMI, weight of school bag carried to school and the length of straps have been assessed. Body posture measurement (using Adams' test), the evaluation of the plumb line deflection from the gluteal cleft, the angle values of kyphosis and lordosis (according to Dobosiewicz methodology) and the pelvis and shoulder blades position (using a ruler and pediscoliometer) have been also measured.

RESULTS

The mean weight of a school bag in the initial study was 6.3 ± 0.8 (range between 4,7 and 9 kg). A tendency to carry slightly heavier school bags was noted in boys (6.7 vs. 5.9 kg; p = 0,00001). This tendency has linearly changed with age (R = 0.68; p < 0,001). In 3.2% of all school bags of children, weights exceeded norms with regard to the weight of the pupil. The increase of torso rotation exceeding norms was observed in 35.3% of girls (mean 2.7 ± 1.2) and in 60.9% of boys (mean 2.3 ± 1.3). The increase of kyphosis angle was noted in 48.5% of girls and in 36.8% of boys. The difference of straps length had a significant influence on the increase of rotation in upper thoracic spine, thoracolumbar junction and it also had influence on the decrease of lumbar lordosis in the group of girls.

CONCLUSIONS

Differences in the weight of school bags after one school year have influenced changes in body posture abnormalities, especially in rotation parameters. Backpack straps asymmetry was noticeably stronger in the group of girls and the difference between braces may have an impact on some posturometric parameters. Lack of proper backpack lifting skills tends to create programs and training systems in this regard.

Association of socioeconomic, school-related and family factors and physical activity and sedentary behaviour among adolescents: multilevel analysis of the PRALIMAP trial inclusion data

BACKGROUND

Social differences among adolescents in physical activity and sedentary behaviour have been identified but are not well explained. The current study aimed to identify socioeconomic, family and school-related associated factors with physical activity and sedentary behaviour among high-school adolescents.

METHODS

This was a cross-sectional analysis of T0 physical activity and sedentary behaviour of 2523 students 14 - 18 years old recruited for the PRALIMAP trial from 24 French state-run high schools. Data were collected by self-administered questionnaire at the start of grade 10. Adolescents completed the International Physical Activity Questionnaire for physical activity and sedentary behaviour and an ad hoc questionnaire for active commuting and sport participation. Statistical analyses involved linear and logistic regressions.

RESULTS

Socioeconomic, family or school variables were associated with levels of physical activity and sedentary behaviour for both boys and girls, but no factor, except perceived parental physical activity level, was associated with total energy expenditure (total physical activity) for either gender. Adolescents with privileged and less privileged socioeconomic status reported the same total amount of energy expenditure.

CONCLUSIONS

Total physical activity score alone is not sufficient to assess the physical activity of adolescents. These findings may have implications for better understanding of social inequalities in this context and recommendations to prevent overweight.

TRIAL REGISTRATION

This trial is registered at ClinicalTrials.gov ( NCT00814554 ). The date of registration: 23 December 2008. Registration was not required at the time of the start of PRALIMAP for public health and prevention programmes and trials.

Correlation of Body Mass Index and Physical Activity Among 7- to 11-Year Children at Zahedan, Iran

Background:

Childhood obesity is currently one of the major concerns in pediatric field. In recent literature, correlation of obesity with some behavioral factors such as physical activity (PA) received attention.

Objective:

The purpose of this study was to determine the relationship between body mass index (BMI) and PA.

Materials and Methods:

This cross-sectional study was carried out in 2012 on 548 randomly selected 7- to 11-year schoolchildren from Zahedan, Iran. The underweight, normal weight, overweight, and obesity status were all based on BMI percentiles for age and sex. Moderate to vigorous PA during the previous 7 days was assessed by a modified version of the Physical Activity Questionnaire for Children.

Results:

The prevalence of underweight, normal weight, overweight, and obesity among the participants was 18.3%, 47.9%, 11.8%, and 22.1%, respectively. Overweight and obesity were significantly higher among girls than boys. Mean PA score in participants was 2.4 ± 0.5. The results showed the PA score was significantly higher among boys than girls. The PA score had a significant association with BMI ( P = .018), and it was greater in normal participants than in obese participants.

Conclusion:

On the basis of observed data and due to the impact of PA on BMI as an indicator of nutritional status and health, teaching children to have better nutrition and lifestyle changes is very important. Therefore, more studies should focus on childhood obesity prevention programs to prevent nonoverweight children from becoming overweight or obese in the future.