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Miguel-Berges ML, Larruy-García A, De Miguel-Etayo P, Jimeno-Martinez A, Torres A, Moreno LA. Weight Status Determines the Impact of a School-Based Nutrition Education Intervention on Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1093. [PMID: 39334625 PMCID: PMC11430318 DOI: 10.3390/children11091093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND/OBJECTIVES This study investigated the impact of the FLUYE school-based intervention on children's lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. METHODS A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. RESULTS Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program's effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. CONCLUSIONS The FLUYE program effectively improved various aspects of children's lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity.
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Affiliation(s)
- María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Andrea Jimeno-Martinez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Antonio Torres
- School of Health Sciences Blanquerna, University Ramon Llull, 08022 Barcelona, Spain;
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Adamou H, Robitaille É, Paquette MC, Lebel A. Food environment trajectories: a sequence analysis from the CARTaGENE cohort. Public Health Nutr 2024; 27:e90. [PMID: 38250947 DOI: 10.1017/s1368980024000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE The purpose of this study was to create a typology of longitudinal exposure to food environment based on socio-economic context. DESIGN Food environment trajectories were modelled using a sequence analysis method, followed by a logistic regression to describe those trajectories. SETTING The study took place in Quebec, Canada, using food environment data from 2009, 2011 and 2018 merged with participants' demographic and socio-economic characteristics. PARTICIPANT At recruitment, 38 627 participants between the ages of 40 and 69 years from six urban areas in Quebec were included in the CARTaGENE cohort study. The cohort was representative of the Quebec urban population within this age range. RESULTS Our study revealed five trajectories of food access over time: (1) limited access to food stores throughout the study period, (2) limited access improving, (3) good access diminishing, (4) good access throughout the period and (5) low access throughout the period. Logistic regression analysis showed that participants who were unable to work (OR = 1·42, CI = 1·08-1·86), lived in households with five or more persons (OR = 1·69, CI = 1·17-2·42) and those living in low-income households (OR = 1·32, CI = 1·03-1·71) had higher odds of experiencing a disadvantaged food environment trajectory. Additionally, the level of education and age of participants were associated with the odds of experiencing a disadvantaged food environment trajectory. CONCLUSIONS The study demonstrates that people facing socio-economic disadvantage are more likely to experience a disadvantaged food environment trajectory over time.
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Affiliation(s)
- Habila Adamou
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Éric Robitaille
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- ESPUM, Université de Montréal, Montréal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- Département de nutrition, Université de Montréal, Montréal, Canada
| | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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Liu CH, Chang FC, Niu YZ, Liao LL, Chang YJ, Liao Y, Shih SF. Students' perceptions of school sugar-free, food and exercise environments enhance healthy eating and physical activity. Public Health Nutr 2021; 25:1-9. [PMID: 34933694 PMCID: PMC9991674 DOI: 10.1017/s1368980021004961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 11/16/2021] [Accepted: 12/13/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationships between students' perceptions of their school policies and environments (i.e. sugar-sweetened beverages (SSB) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 programme (exercise 150 min/week at school)) and their dietary behaviours and physical activity. DESIGN Cross-sectional study. SETTING Primary, middle and high schools in Taiwan. PARTICIPANTS A nationally representative sample of 2433 primary school (5th-6th grade) students, 3212 middle school students and 2829 high school students completed the online survey in 2018. RESULTS Multivariate analysis results showed that after controlling for school level, gender and age, the students' perceptions of school sugar-free policies were negatively associated with the consumption of SSB and positively associated with consumption of plain water. Schools' campaigns promoting the eating of vegetables and fruit were positively associated with students' consumption of vegetables. In addition, schools' initiatives promoting outdoor physical activity and the SH150 programme were positively associated with students' engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. CONCLUSIONS Students' perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.
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Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yu-Zhen Niu
- Office of Student Affairs, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung City, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Shu-Fang Shih
- Department of Health Administration, Virginia Commonwealth University, Richmond, USA
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Smirk E, Mazahery H, Conlon CA, Beck KL, Gammon C, Mugridge O, von Hurst PR. Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption. BMC Public Health 2021; 21:2277. [PMID: 34903202 PMCID: PMC8670206 DOI: 10.1186/s12889-021-12345-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children. Methods A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA). Results Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 servings reported by 62% of children. Of all SSBs assessed, consumption of ≥1 serving of sugar sweetened milk-based beverages (85%, mainly milk drinks made from powder) was most prevalent, followed by fruit juice (46%) and sugar-containing carbonated drinks (39%, mainly soft/fizzy drinks). Among unsweetened beverages, plain water was reported to be consumed < 2 times a day by 22% of children, and plain milk < 1 serving a day by 53%. Higher consumption of SSBs was associated with socio-economic disadvantage, non-NZ European ethnicities (Māori, Pacific, Asian, others), availability of SSBs in the home, frequent takeaway/convenience shop visits, children’s incorrect perception of adequate SSBs consumption frequency, and higher BF% (females only). School health policy and encouragement of children to consume un-sweetened beverages was not associated with SSBs consumption. Conclusions The consumption of SSBs is prevalent in NZ school age children, with higher consumption rates observed among those from socially disadvantaged areas. This high consumption is associated with higher BF% in females. Multi-contextual interventions to decrease SSBs should target children, and their families/environment, particularly those from socially disadvantaged areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12345-9.
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Affiliation(s)
- Emma Smirk
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Hajar Mazahery
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cheryl Gammon
- School of Health Sciences, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Owen Mugridge
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand.
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Wang Z, Jansen EC, Miller AL, Peterson KE, Téllez-Rojo MM, Watkins D, Schnaas L, Chavez MDCH, Cantoral A. Childhood emotional and behavioral characteristics are associated with soda intake: A prospective study in Mexico City. Pediatr Obes 2020; 15:e12682. [PMID: 32558284 PMCID: PMC8570088 DOI: 10.1111/ijpo.12682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 04/18/2020] [Accepted: 05/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether childhood emotional and behavioral characteristics are associated with soda intake. METHODS The study population included 391 Mexico City adolescents enrolled in a birth cohort study. When children were between 6 and 12 years of age, the Behavioral Assessment System for Children (BASC)-2 was administered. Nondiet soda intake was measured concurrently and again when participants were of peripubertal ages via food frequency questionnaire. Linear regression models were run with soda mL/day (cross-sectional and change in soda over time) as the outcome and BASC composite scores as predictors (in separate models), adjusting for confounders. RESULTS At baseline, children were 8.3 (SD 1.3) years (49% males). Three scales out of 18 examined had statistically significant associations. Parent-reported adaptive skills were inversely associated with concurrent soda intake (β = -2.29 with 95% CI -4.27 to -0.31). Parent-reported internalizing problems (higher = more problems) were related to higher change in soda intake from childhood to adolescence (β = 5.83 with 95% CI 0.98-10.68; N = 191). Self-reported school problems were associated with a higher change in soda intake over time (β = 9.46 with 95% CI 2.10-16.82; N = 122). CONCLUSIONS Parent- and self-reported emotional and behavioral difficulties in childhood were associated with soda consumption and changes in soda consumption over time.
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Affiliation(s)
- Zeyuan Wang
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA,Contributed equally to this work
| | - Erica C. Jansen
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA,Contributed equally to this work
| | - Alison L. Miller
- Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E. Peterson
- Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Deborah Watkins
- Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lourdes Schnaas
- Institute of Perinatology, ABC Hospital, Mexico City, Mexico
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Godin KM, Hammond D, Chaurasia A, Leatherdale ST. Examining changes in school vending machine beverage availability and sugar-sweetened beverage intake among Canadian adolescents participating in the COMPASS study: a longitudinal assessment of provincial school nutrition policy compliance and effectiveness. Int J Behav Nutr Phys Act 2018; 15:121. [PMID: 30482211 PMCID: PMC6257956 DOI: 10.1186/s12966-018-0754-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 11/19/2018] [Indexed: 02/06/2023] Open
Abstract
Background School nutrition policies can encourage restrictions in sugar-sweetened beverage (SSB) availability in school food outlets in order to discourage students’ SSB intake. The main objective was to examine how beverage availability in school vending machines changes over three school years across schools in distinct school nutrition policy contexts. Secondary objectives were to examine how students’ weekday SSB intake varies with time and identify longitudinal associations between beverage availability and SSB intake. Methods This longitudinal study used data from the COMPASS study (2013/14–2015/16), representing 7679 students from 78 Canadian secondary schools and three provincial school nutrition policy contexts (Alberta – voluntary guidelines, Ontario public – mandatory guidelines, and Ontario private schools – no guidelines). We assessed availability of 10 beverage categories in schools’ vending machines via the COMPASS School Environment Application and participants’ intake of three SSB varieties (soft drinks, sweetened coffees/teas, and energy drinks) via a questionnaire. Hierarchical regression models were used to examine whether: i) progression of time and policy group were associated with beverage availability; and, ii) beverage availability was associated with students’ SSB intake. Results Ontario public schools were significantly less likely than the other policy groups to serve SSBs in their vending machines, with the exception of flavoured milks. Vending machine beverage availability was consistent over time. Participants’ overall SSB intake remained relatively stable; reductions in soft drink intake were partially offset by increased sweetened coffee/tea consumption. Relative to Ontario public schools, attending school in Alberta was associated with more frequent energy drink intake and overall SSB intake whereas attending an Ontario private school was associated with less frequent soft drink intake, with no differences in overall SSB intake. Few beverage availability variables were significantly associated with participants’ SSB intake. Conclusions Mandatory provincial school nutrition policies were predictive of more limited SSB availability in school vending machines. SSB intake was significantly lower in Ontario public and private schools, although we did not detect a direct association between SSB consumption and availability. The findings provide support for mandatory school nutrition policies, as well as the need for comprehensive school- and broader population-level efforts to reduce SSB intake. Electronic supplementary material The online version of this article (10.1186/s12966-018-0754-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katelyn M Godin
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ashok Chaurasia
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Examining associations between school food environment characteristics and sugar-sweetened beverage consumption among Canadian secondary-school students in the COMPASS study. Public Health Nutr 2018; 22:1928-1940. [DOI: 10.1017/s1368980018001246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo examine associations between Canadian adolescents’ sugar-sweetened beverage (SSB) consumption and several school food environment characteristics, and to investigate differences in these characteristics between schools in provinces with voluntary (Alberta) v. mandatory (Ontario) provincial school nutrition policies.DesignWe used a questionnaire to assess the number of weekdays participants consumed three SSB categories (soft drinks, sweetened coffees/teas, energy drinks) and various sociodemographic and behavioural characteristics. We examined the in-school water fountain accessibility, vending machines’ contents and presence of various food outlets within schools’ 1 km buffer. We developed hierarchical Poisson regression models to identify associations between student- and school-level characteristics and students’ SSB outcomes.SettingAlberta and Ontario, Canada.SubjectsAdolescents (n 41 829) from eighty-nine secondary schools.ResultsCompared with their Ontarian counterparts, Albertan participants had a significantly higher rate of SSB intake across all drink categories and SSB availability was significantly greater in Albertan schools’ vending machines. Availability of sweetened coffees/teas in school vending machines and access to restaurants within the school’s 1 km buffer were associated with increased SSB intake in three of the final models. Overall, the school food environment-level characteristics examined had a modest to negligible impact on student days of SSB intake.ConclusionsWe identified that the school food environment characteristics examined here had little impact on adolescents’ days of SSB consumption. While schools should adopt or maintain a comprehensive policy approach to discourage students’ SSB intake, population-level interventions focusing on other contexts (e.g. home and community) are needed to complement existing school-based interventions.
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Individual and School Correlates of Adolescent Leisure Time Physical Activity in Quebec, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030412. [PMID: 29495509 PMCID: PMC5876957 DOI: 10.3390/ijerph15030412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 11/27/2022]
Abstract
Background: Leisure time physical activity (LTPA) correlates have been mostly studied in relation to adolescents’ home neighbourhoods, but not so much in relation to the environment of their schools’ neighbourhoods. We sought to investigate how objective environmental measures of the schools’ vicinity are related to adolescents’ self-reported LTPA. Methods: Individual data from the Quebec High School Students Health Survey (QHSSHS) were matched with schools’ socioeconomic indicators, as well as geographic information system-based indicators of their built environments. Self-reported levels of LTPA during the school year were assessed according to intensity, frequency and index of energy expenditure. Associations per gender between covariates and LTPA were estimated using ordinal multilevel regression with multiple imputations. Results: Boys (21% of which were highly active) were more active than girls (16% of which were highly active) (p ≤ 0.01). The incremental variance between schools explained by the contextual variables in the final models was higher among girls (7.8%) than boys (2.8%). The number of parks or green spaces within 750 m around their schools was positively associated with student LTPA in both genders. Conclusions: The promotion of parks around schools seems to be an avenue to be strengthened.
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