Association between Family Structure and Physical Activity of Chinese Adolescents

Nutritional status, food consumption, lifestyle, and physical fitness in rural and urban elementary school children in Northeast China

Childhood obesity is observed not only in developed countries but also in some developing countries in Asia, where low physical activity and poor physical fitness have been reported. The primary goal of weight loss is to reduce body fat mass, thereby reducing the risk of metabolic syndrome. Unfortunately, a concomitant decrease in lean mass, including muscle mass, is often observed when weight is lost. This study aimed to clarify the nutritional status and physical fitness of local elementary school children and to investigate the factors associated with nutritional status. This study evaluated measures that can reduce the tendency toward obesity and recommends exercise that can reduce weight while maintaining or increasing muscle strength. A total of 911 elementary school children were recruited for this study. All the participants completed anthropometric measurements, dietary surveys, and physical fitness tests. Compared with the Chinese obesity criteria, the proportions of obese and overweight subjects were generally high [22 (rural girls) to 47% (urban boys)], and urban children had a higher obesity rate than rural children. Overall, rural children had better physical fitness test results than urban children did. Skipping rope was correlated with muscle mass. Exercise time (β = −0.31, p < 0.01), skipping rope (β = −0.25, p < 0.01), screen time (β= 0.23, p < 0.01); sit-ups (β = −0.20, p < 0.01); 400-m run (β = −0.19, p < 0.01); urban or rural area (β = 0.18, p < 0.01); oil intake (β = 0.15, p < 0.01), family income (β = 0.11, p < 0.05); and sex (β = −0.10, p < 0.05) were significant predictive factors for overweight and obesity, respectively. The diet of schoolchildren can be improved by reducing the intake of grain and edible oils. Physical fitness of schoolchildren can be improved by increasing exercise time and selecting exercises with higher metabolic equivalents. Rope skipping appears to be the best option because it can ameliorate obesity by increasing muscle strength. The results of this study can provide a reference for the development of obesity intervention methods for children in China and worldwide.

Acculturation and leisure-time physical activity among Asian American adults in the United States

ABSTRACTObjectives: To examine the association between acculturation and leisure-time physical activity among Asian Americans.Design: Data came from the 2011-2016 National Health and Nutrition Examination Survey, restricting to non-Hispanic Asian adults aged 20 years and older (n = 1989). Acculturation was assessed by language preference at home, birth locations, and length of residency in the United States (US). Self-reported physical activity was used to estimate leisure-time moderate-to-vigorous physical activity (MVPA) in MET-minutes/week and meeting the World Health Organization's physical activity guidelines. Multiple linear and logistic regression models were used to model MVPA as continuous and categorical variables, respectively.Results: A quarter of Asian Americans spoke only English and 47.8% spoke only non-English at home; 13.0% were born in the US. Asians who spoke only English (adjusted prevalence ratio [aPR]:1.5) and Asians who spoke both English and non-English at home (aPR: 1.4) had greater proportions of meeting physical activity guidelines compared to those who spoke only non-English at home. The US-born Asians had higher a proportion of meeting the physical activity guidelines (aPR:1.4) and performed 547.6 more MET-minutes of MVPA each week than foreign-born Asians; they also had a higher proportion of meeting the physical activity guidelines than foreign-born Asians who stayed in US for ≤10 years (aPR:1.5). Length of time staying in the US was associated with a higher proportion of meeting physical activity guidelines. Among foreign-born Asian Americans, higher acculturation measures were also positively associated with meeting physical activity guidelines.Conclusions: Acculturation was positively associated with physical activity levels among Asian Americans. More acculturated Asian Americans such as those who spoke more English at home and US-born Asians, performed more MVPA than less acculturated Asian Americans. Interventions are needed to promote physical activity among non-English speaking Asian immigrants and recent immigrants.

Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study

OBJECTIVE

This cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.

METHODS

Data were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3-6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.

RESULTS

Multiple linear regression analysis showed that "having grandparents as primary caregivers" (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1-57.2); LTSB (ln): 0.19 (0.11-0.28)) and "having a television (for LTSB (ln): 0.13 (0.00-0.25)) or computer (for LTSB (ln): 0.13 (0.03-0.23)) in the child's bedroom" were both associated with higher SB. Furthermore, "having grandparents as primary caregivers" was associated with less MVPA (β (95%CI): -7.6 (-14.1 to -1.2)), and "active commuting to school by walking" correlated with more MVPA (β (95%CI): 9.8 (2.2-17.4)). The path model showed that "more neighborhood PA facilities close to home" was indirectly related to higher LTPA (ln), which was partly mediated by "outdoor play" (path coefficients (95%CI): 0.005 (0.002-0.008)) and "going to these facilities more often" (path coefficients (95%CI): 0.013 (0.008-0.018)). Traffic safety was not a correlate.

CONCLUSION

Family structure and media exposure in the home maybe important factors in shaping preschoolers' PA patterns. Built environmental correlates could indirectly influence preschoolers' LTPA through parental help with engaging in active behaviors.

Family Related Variables' Influences on Adolescents' Health Based on Health Behaviour in School-Aged Children Database, an AI-Assisted Scoping Review, and Narrative Synthesis

Objects

Health Behaviours in School-aged Children (HBSC) is an international survey programme aiming to investigate adolescents' health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents' health-related outcomes.

Methods

We searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included if they were based on HBSC data and investigated the effects of family environment on adolescents' health outcomes. Researches addressed family-related factors as mediators or moderators were also included.

Results

A total of 241 articles were included. Family environmental contributors could be mapped into six categories: (1) Demographic backgrounds (N = 177); (2) General family's psycho-socio functions (N = 44); (3) Parenting behaviours (N = 100); (4) Parental health behaviours (N = 7); (5) Family activities (N = 24); and (6) Siblings (N = 7). Except for 75 papers that assessed family variables as moderators (N = 70) and mediators (N = 7), the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.

Conclusion

Our results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents' health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family's impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data.

Physical Activity and Quality of Life of University Students, Their Parents, and Grandparents in Poland-Selected Determinants

Physical activity is one of the factors conditioning human health. Research shows a positive impact of regular physical activity on the quality of human life. The aim of the study was to determine the relationship between the physical activity of university students, their parents, and their grandparents, and the overall quality of their lives in individual domains (physical, mental, social, environmental), as well as the perceived state of health in relation to selected determinants. The research included 1001 participants, including 253 students related to physical culture and health promotion studying at the University of Szczecin (faculties: physical education, tourism and recreation, public health, sports diagnostics), and their 336 parents and 412 grandparents. Purposive sampling was used to outline the determinants of quality of life and family factors in physical activity. The diagnostic survey was carried out based on the standardized WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Statistically significant differences were shown in the studied generations regarding the assessment of quality of life and satisfaction with health in the physical, psychological, social, and environmental domains. The oldest generation gave the lowest assessment of quality of life and was the least satisfied with their health regarding particular domains. Female students were more satisfied with their health compared to grandmothers and grandfathers, whereas male students compared to mothers and fathers. Fathers achieved the highest scores in the psychological and social domains, but, in case of the latter, differences were found between mothers’ and fathers’ assessments. Intergenerational differences were found in quality of life and the assessment of health status. Current participation in broadly understood physical culture was often a result of positive attitudes towards physical education and doing sport in the past, which meant higher scores in the physical domain each time. The study demonstrated that taking up physical activity impacted the quality of life and assessment of health in the past and currently.

Associations between Sociodemographic, Dietary, and Substance Use Factors with Self-Reported 24-Hour Movement Behaviors in a Sample of Brazilian Adolescents

We aimed to identify sociodemographic, dietary, and substance use factors associated with self-reported sleep duration, physical activity (PA), and sedentary behavior (SB) indicators in a sample of Brazilian adolescents. Adolescents (n = 731, 51% female, mean age: 16.4 years) answered a questionnaire. The volume of total PA, sports, non-sports, total SB, leisure-time SB, involuntary SB, sleep duration, dietary behaviors, sociodemographic, and substance use indicators were self-reported. Multilevel linear models were fitted. Females engaged in less total PA, sports, total SB, and leisure-time SB, but in more involuntary SB than males. Age was positively associated with non-sports and involuntary SB. Socioeconomic status was positively associated with total PA. Adolescents who lived with the mother only practiced more sports compared to those living with two parents. Unprocessed food was positively associated with total PA and sports. Processed food was inversely associated with total PA and non-sports, and positively associated with total SB and leisure-time SB. Alcohol use was positively associated with total PA, and tobacco smoking was negatively associated with total PA. No associations were observed for sleep duration. In conclusion, sociodemographic, dietary, and substance use factors are associated with the 24 h movement behaviors among Brazilian adolescents, and some associations are type specific.

Association Between Sedentary Behavior and Obesity in School-age Children in China: A Systematic Review of Evidence

Background and Objective:

China has experienced a rapid increase in the number of obese and overweight children, and sedentary behavior has been recognized as an important factor. The purpose of this review is to summarize studies on the relationship between sedentary behavior and obesity in school-age children in China.

Methods:

A systematic search was conducted to identify studies that investigate the relationship between sedentary behavior and obesity in children between the ages of 6 and 18 years in China. Two researchers independently screened studies, assessed their methodological quality, and extracted relevant data. Findings on the relationship between sedentary behavior and obesity in children were synthesized and analyzed.

Results:

A total of 17 studies were included in the review. Fifteen out of 17 studies indicated that spending too much time engaged in sedentary behavior, especially screen-based sedentary behavior, was associated with obesity in children and adolescents in China. Possible reasons for this association are less energy expenditure, increased energy intake, and insufficient sleep owing to overtime sedentary behavior. Moreover, seven, six, and three studies justified children’s physical activity, dietary intake, or sleep, and most of the studies (five, three, and two) indicated that association between sedentary behavior and obesity is independent of these justified variables. Although differences in gender and area of residence in the association between sedentary behavior and obesity were examined in five studies, definite conclusions could not be drawn because of inconsistent findings or limited research.

Conclusion:

Future research is necessary to enhance understanding of demographic differences in the association between sedentary behavior and obesity in children as well as on the contributions of different types of sedentary behavior to child obesity in China.

How Does the Family Influence the Physical Condition and Health of Children in a Rural Environment?

The aim of this cross-sectional study was to assess physical conditions related to health status and establish relationships with influencing factors such as family structure, educational level, and parental professional occupation in the infant stage of three to five years in a rural setting. The sample included 205 children between 3 and 5 years of age from rural areas (<10,000 inhabitants) from the region of Castilla-La Mancha (Spain). Fitness level was measured using the PREFIT battery; influencing factors were assessed with a family information questionnaire. The results showed significant differences in all the analyzed variables of physical condition and between genders at each of the educational levels except for body mass index. Boys performed better than girls on cardio-respiratory fitness tests, muscle strength in both hands, speed-agility, and longitudinal jump tests for boys aged three, while girls performed the test better at four years. The type of family structure was not correlated with any of the variables of physical condition; a lower level of education of the father and mother and the professional occupation of the mother were correlated with a higher body mass index. As a main conclusion, physical condition related to health seems to be affected by influencing factors such as educational level and family professional occupation, especially of the mother, but the type of family structure does not have as much influence. There are few studies in children from three to five years of age in exclusively rural areas, so the data in this study provides relevant and innovative information, while opening research to cater to this population group.

A Longitudinal Study of the Associations of Family Structure with Physical Activity across the Week in Boys and Girls

The aim of this study was to examine how family structure is associated with moderate-to-vigorous-intensity physical activity (MVPA) for children aged between 6 and 11. At 6, 9 and 11 years, children wore an accelerometer and parents/carers completed questionnaires on demographics and family structure. Linear regression models examined cross-sectional associations between family structure and MVPA at age 9 and 11. Linear multilevel models examined longitudinal associations between age 6 and 11, differences in change over time were examined using interaction terms. No associations between exposures and MVPA were evident at age 9. Compared to boys living in one home, eleven-year-old boys who lived in multiple homes performed 15.99 (2.46-29.52) fewer minutes of MVPA on weekend days. In longitudinal analyses, the evidence was unclear whether the association with family structure changed over time. Models that assumed associations with family structure remained constant over time, found that boys who lived in multiple homes performed 11.02 (0.76-21.28) fewer minutes of MVPA per weekend day, while for each additional sibling, girls performed an extra 1.89 (0.25-3.53) minutes of MVPA per weekend day. Findings indicate a small number of associations, varying in magnitude, between family structure and children's MVPA. Therefore, families of all structures should be supported to help their children meet MVPA recommendations.

Associations between family structure and young people's physical activity and screen time behaviors

Background

Identifying factors that can influence young peoples’ physical activity and sedentary behaviors is important for the development of effective interventions. The family structure in which children grow up may be one such factor. As the prevalence of single parent and reconstituted families have increased substantially over the last decades, the objective of this study was to examine whether these family structures are differentially associated with young people’s MVPA, participation in organized sports and screen-time activities (screen-based passive entertainment, gaming, other screen-based activities) as compared to traditional nuclear families.

Methods

The data stem from the 2013/2014 “Health Behaviour in School- aged Children (HBSC) study”. A large Norwegian sample of 11–16 years old students (n = 4509) participated. Cluster-adjusted regression models were estimated using full information maximum likelihood with robust standard errors (MLR).

Results

After adjusting for covariates, living with a single parent was negatively associated with days/week with 60 min MVPA (b = −.39, 95%CI: −.58, −.20), and positively associated with hours/weekday of total screen time (b = .50, 95%CI: .08, .93). Young people living with a single parent were also more likely to report no participation in organized sports (OR = 1.40, 95%CI: 1.09, 1.79). Living in a reconstituted family was negatively associated with days/week with 60 min MVPA (b = −.31, 95%CI: −.53, −.08), and positively associated with hours/weekday of total screen time (b = .85, 95%CI: .37, 1.33). For all outcomes, the interaction effects of family structure with sex, and with having siblings were not statistically significant. For material affluence, a significant interaction effect was found for participation in organized sports (χ² [4] =13.9, p = .008). Those living in a reconstituted family with low or high material affluence had an increased risk for not participating in organized sports whereas those with medium material affluence did not.

Conclusion

This study suggests that living with a single parent or in reconstituted families was unfavorably associated with physical activity, sport participation and screen-based behaviors among Norwegian youth. The findings indicate that family structure could be an important factor to take into account in the development and testing of interventions. More in-depth research is needed to identify the mechanisms involved.

Sibling influence on children's objectively measured physical activity: a meta-analysis and systematic review

Abstract

Children without siblings (only children) have higher rates of obesity than children with siblings. Childhood obesity may be prevented by minimising sedentary behaviour and accumulating sufficient physical activity in young children. A growing number of articles have examined the influence of siblings on physical activity and sedentary behaviour, yet these articles have not been synthesised.

Objective

To synthesise literature and describe the influence of siblings on objectively measured physical activity and sedentary behaviour of children (ages 2–18 years).

Design

Outcomes were analysed in a systematic review and meta-analysis.

Data sources

PubMed, EMBASE, Web of Science and Medline OVID were searched for articles related to siblings, physical activity, sedentary behaviour and obesity outcomes from 1947 to March 2018.

Eligibility criteria

Articles that evaluated sibling status on physical activity objectively measured by accelerometer or pedometer were included.

Results

Nineteen articles, representing 17 independent datasets, were included in the review. Nine were included in the quantitative analysis. Pooled data from nine articles indicated children with siblings had higher moderate-to-vigorous physical activity (MVPA) relative to only children, with a potential dose response for higher number of children in household and higher MVPA (Mean Difference=3.13, 95% CI 1.90 to 4.35, p=0.001). Findings were mixed for the influence of siblings on sedentary behaviour and light physical activity.

Summary/Conclusion

Children with siblings had healthier physical activity patterns, as measured by accelerometer or pedometer, than did only children. Suggested mechanisms include peer modelling, encouraging active transport and sports participation, opportunity for playmate and serving as additional caregivers.

Trial registration number

CRD42017055463.

Associations between parental support for physical activity and moderate-to-vigorous physical activity among Chinese school children: A cross-sectional study

PURPOSE

The objective of this study was to examine the associations between parental support for physical activity (PA) and levels of moderate-to-vigorous physical activity (MVPA) among Chinese school children.

METHODS

Study participants were 81,857 school-aged children (aged 9-17 years; mean age = 13 years; 49.0% boys) and their parents or guardians who took part in the 2016 Physical Activity and Fitness in China-The Youth Study project. The independent variables included various forms of parental support for PA ascertained through a survey completed by parents or guardians. The dependent variable was the children's average MVPA in minutes per day by self-report. Structure equation modeling was used to examine the associations between parental support for PA and children's MVPA minutes.

RESULTS

The overall mean for MVPA participation time for the child participants was 48.82 ± 28.71 min/day. Significant associations between various forms of parental support and MVPA among children were found. Parental encouragement, accompanying, financial support, involvement, and role modeling for PA were positively associated with a high level of student MVPA participation. Parental PA knowledge-sharing was not associated with MVPA. The patterns of the associations were similar across sex, residence locale (i.e., urban and rural), and school grades (primary, junior middle, and junior high schools).

CONCLUSION

Findings from this study suggest that, among Chinese school children, parental support for PA is important in promoting and facilitating children's participation in MVPA.

Insignificant Correlation between Thyroid Hormone and Antithyroid Peroxidase Antibodies in Alopecia Areata Patients in Northern Rajasthan

Background

Alopecia areata (AA) is a common, recurrent form of nonscarring alopecia which often presents as circumscribed patches of spontaneous hair loss. The global prevalence of this disease varies from 0.1% to 0.2% in general population and 7-30 cases per 1000 dermatological patients. The etiology of AA still remains uncertain; however, genetic or environmental factor and autoimmunity are claimed responsible for it. Various autoimmune diseases, such as Hashimoto's thyroiditis, diabetes mellitus, vitiligo, and lupus erythematosus, have been reported in association with AA.

Aim

The index study was aimed at estimation of serum T3, T4, thyroid-stimulating hormone, and antithyroid peroxidase (TPO) antibodies.

Material and Methods

Similar age/sex-matched AA patients and controls (110 in each group). Enhanced chemiluminescence immunoassay for thyroid profile and anti-TPO antibody level estimation in veinous blood sample.

Observations

The mean/standard deviation (SD) of T3 was 3.30 ± 0.84 pg/ml in AA while 3.27 ± 0.67 pg/ml in controls (P = 0.302). Serum mean/SD of T4 level was1.23 ± 0.76 ng/dl in AA patients while 1.17 ± 0.34 ng/dl in controls (P = 0.522). The mean/SD of anti-TPO levels in AA patients was 21.52 ± 35.09 while 56.43 ± 140.72 in controls (P = 0.136).

Limitation

The limitation of this study was moderate number of AA patients and different genotype of study population.

Conclusion

Occurrence of thyroid dysfunction and evidence of anti-TPO antibodies in AA is rare event in this study population.

Factors of physical activity among Chinese children and adolescents: a systematic review

Background

Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development.

Methods

A systematic search was finished on Jan 10^th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method.

Results

Forty two papers (published 2002–2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents’ physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents.

Conclusions

The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0486-y) contains supplementary material, which is available to authorized users.