Is physical activity maintenance from adolescence to young adulthood associated with reduced CVD risk factors, improved mental health and satisfaction with life: the HUNT Study, Norway

Incorporating Cardiovascular Risk Assessment into Adolescent Reproductive Health and Primary Care Visits

STUDY OBJECTIVE

This study aimed to evaluate the usability and feasibility of incorporating a cardiovascular risk assessment tool into adolescent reproductive health and primary care visits.

DESIGN, SETTING, AND PARTICIPANTS

We recruited 60 young women ages 13-21 years to complete the HerHeart web-tool in 2 adolescent clinics in Atlanta, GA.

MAIN OUTCOME MEASURES

Participants rated the tool's usability via the Website Analysis and Measurement Inventory (WAMMI, range 0-95) and their perceived 10-year and lifetime risk of cardiovascular disease (CVD) on a visual analog scale (range 0-10). Participants' perceived risk, blood pressure, and body mass index were measured at baseline and 3 months after enrollment. Health care providers (HCP, n = 5) completed the WAMMI to determine the usability and feasibility of incorporating the HerHeart tool into clinical practice.

RESULTS

Adolescent participants and HCPs rated the tool's usability highly on the WAMMI with a median of 79 (interquartile range [IQR] 65, 84) and 76 (IQR 71, 84). At the baseline visit, participants' median perceived 10-year risk of a heart attack was 1 (IQR 0, 3), and perceived lifetime risk was 2 (IQR 0, 4). Immediately after engaging with the tool, participants' median perceived 10-year risk was 2 (IQR 1, 4.3), and perceived lifetime risk was 3 (IQR 1.8, 6). Thirty-one participants chose to set a behavior change goal, and 12 participants returned for follow-up. Clinical metrics were similar at the baseline and follow-up visits.

CONCLUSION

HerHeart is acceptable to young women and demonstrates potential for changing risk perception and improving health habits to reduce risk of CVD. Future research should focus on improving retention in studies to promote cardiovascular health within reproductive health clinics.

Comparing the Use and Effectiveness of In-Person and Remote Physical Education Delivery During the COVID-19 Pandemic

BACKGROUND

Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats.

PURPOSE

We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio.

METHODS

We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram® Project (n=216) schools in multiple US cities. Questionnaires entailed learning format, weekly PE minutes, perceived effectiveness, and student-to-teacher ratio. We used linear mixed models to compare PE formats across evaluation variables.

RESULTS

Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more effective in-person PE (4.0) than remote PE (2.8, p<0.001). In-person PE also had significantly smaller reported student-to-teacher ratio (16.7) compared to remote PE (23.7, p<0.001).

DISCUSSION

Findings indicate PE was offered during the pandemic, but remote learning appeared less effective than in-person PE.

TRANSLATION to HEALTH EDUCATION PRACTICE

Efforts are needed to improve remote PE to reinforce high-quality PE in the future.

Longitudinal physical activity patterns and the development of cardiometabolic risk factors during adolescence

PURPOSE

To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood.

METHODS

This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (via a data-driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear-time.

RESULTS

Insulin and BMI increased among decreasers from moderate to low PA (β for insulin 0.23, 95% CI 0.03-0.46; β for BMI 0.90; CI 0.02-1.78). The concentration of HDL cholesterol decreased (β -0.18, CI -0.31 to -0.05) and that of glucose increased (β 0.18, CI 0.02-0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic β -6.43, CI -12.16 to -0.70; diastolic β -6.72, CI -11.03 to -2.41).

CONCLUSIONS

Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline.

Physical activity maintenance and increase in Chinese children and adolescents: the role of intrinsic motivation and parental support

Objective

This longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents.

Methods

A sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents' physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change.

Results

Most children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173-1.533)] and parental concern [OR = 1.922 (95%CI: 1.204-3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046-1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095-3.633]).

Conclusion

This study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents' physical activity.

Education Level and Self-Reported Cardiovascular Disease in Norway-The Tromsø Study, 1994-2016

BACKGROUND

Cardiovascular disease (CVD) is a leading source of morbidity and mortality, and research has shown education level to be a risk factor for the disease. The aim of this study was to investigate the association between education level and self-reported CVD in Tromsø, Norway.

METHODS

This prospective cohort study included 12,400 participants enrolled in the fourth and seventh surveys of the Tromsø Study (Tromsø4 and Tromsø7) in 1994-1995 and 2015-2016, respectively. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

For every 1-level increase in education, the age-adjusted risk of self-reported CVD decreased by 9% (OR = 0.91, 95% CI: 0.87-0.96), but after adjustment for covariates, the association was weaker (OR = 0.96, 95% CI: 0.92-1.01). The association was stronger for women (OR = 0.86, 95% CI: 0.79-0.94) than men (OR = 0.91, 95% CI: 0.86-0.97) in age-adjusted models. After adjustment for covariates, the associations for women and men were similarly weak (women: OR = 0.95, 95% CI: 0.87-1.04; men: OR = 0.97, 95% CI: 0.91-1.03). In age-adjusted-models, higher education level was associated with a lower risk of self-reported heart attack (OR = 0.90, 95% CI: 0.84-0.96), but not stroke (OR = 0.97, 95% CI: 0.90-1.05) or angina (OR = 0.98, 95% CI: 0.90-1.07). There were no clear associations observed in the multivariable models for CVD components (heart attack: OR = 0.97, 95% CI: 0.91-1.05; stroke: OR = 1.01, 95% CI: 0.93-1.09; angina: OR = 1.04, 95% CI: 0.95-1.14).

CONCLUSIONS

Norwegian adults with a higher education level were at lower risk of self-reported CVD. The association was present in both genders, with a lower risk observed in women than men. After accounting for lifestyle factors, there was no clear association between education level and self-reported CVD, likely due to covariates acting as mediators.

Associations Between Moderate to Vigorous Physical Activity, Sedentary Behavior, and Depressive Symptomatology in Adolescents: A Prospective Observational Cohort Study

BACKGROUND

More moderate to vigorous physical activity (MVPA) and less time in sedentary behavior (SB) may protect against poor mental health in adolescence. Depressive symptomatology may also influence adolescents' own MVPA and SB. The aim of this study was to examine the bidirectional relationship between adolescent MVPA, SB, and depressive symptomatology using a longitudinal approach.

METHODS

Adolescents (10-16 y) were recruited for a prospective observational cohort. Depressive symptomatology was measured using the Short Mood and Feelings Questionnaire. Accelerometry was used to measure MVPA and SB. Adolescents were classified by meeting the MVPA guideline (≥60 min/d) and quartiles of SB time, with the lowest amount of time in SB compared to others. Bidirectional associations between MVPA, SB, and depressive symptomatology were assessed using mixed-effects regression models.

RESULTS

At baseline, adolescents (n = 205) were 12.5 (2.0) years, 54.6% women, 59.1% White, and 34.6% African American. In unadjusted models, adolescents with less baseline time in SB had lower follow-up Short Mood and Feelings Questionnaire scores, and fewer were classified as depressed at follow-up compared to others. After adjustment, adolescents with less baseline time in SB had lower depressive symptomatology at follow-up.

CONCLUSIONS

Limiting time spent in SB in adolescence may improve future mental health.

Physical fitness changes in adolescents due to social distancing during the coronavirus disease pandemic in Korea

Background

At least 60 min of moderate-intensity physical activity per day is recommended for physical and mental health of adolescents. Schools are one of the most suitable places for promoting students' health as it is a place where vigorous physical activity occurs. However, the physical activity of students is threatened because schools are closed worldwide owing to the coronavirus disease (COVID-19) outbreak in 2019. Therefore, this study aimed to analyze the physical fitness changes in 27,782 Korean adolescents during the pandemic and present alternative education and health policies to the school.

Methods

We included 29,882 middle school students (age: 13-15 years; males: 14,941, females: 12,841) in Korea from 2019 to 2021 . Participants' physical fitness at school was measured using the physical activity promotion system (PAPS) manual developed to measure students' physical fitness. Physical fitness variables included body mass index (BMI), 20 m shuttle run, handgrip strength, sit-and-reach, and 50 m run.

Results

The COVID-19 pandemic has had a negative impact on the BMI and cardiorespiratory endurance of Korean middle school students. Specifically, male students' BMI increased, while body composition, cardiorespiratory endurance, and grip strength decreased significantly. Female students showed significant decreases in BMI and sit-and-reach test scores. It is clear that the physical fitness level of adolescents decreased by a greater degree after the COVID-19 pandemic than before, and the decrease in the physical fitness level of male students was noticeable. Therefore, a lesson strategy should be prepared that considers the contents and methods of physical education classes to improve the physical fitness level of male and female adolescents.

Conclusions

Fitness-based classes suitable for online methods should be urgently added as alternative physical education classes to prepare for the second COVID-19 outbreak. In addition, it is necessary to create an environment in which physical activity is a possibility in physical education classes, in any situation using artificial intelligence and virtual reality.

Ideal Cardiovascular Health in adolescents: Findings from Study of Cardiovascular Risks in Adolescents

BACKGROUND AND AIM

We assessed the Ideal Cardiovascular Health (CVH) in Brazilian adolescents according to demographics and socioeconomic characteristics.

METHODS AND RESULTS

This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationwide representative sample of 36,956 Brazilian adolescents, aged 12-17 years, enrolled in public and private schools. The CVH metrics considered were body mass index (BMI), physical activity, smoking, healthy diet score, blood pressure, fasting plasma glucose, and total cholesterol. The demographics and socioeconomic characteristics analyzed were sex, age, race/skin color, and type of school attended. The study design was considered, and the significant difference determined by the non-overlapping of 95% Confidence Interval. The mean ideal CVH score was 4.0, higher for females, adolescents aged 15-17 years, and students from private schools. The prevalence of ideal fasting plasma glucose was 96%, of non-smoking 95.6%, of ideal blood pressure 75.5%, of ideal BMI 73.2%, of ideal total cholesterol 55.4%, of ideal physical activity 45.2%, and only 0.5% had an ideal diet. The prevalence of ideal CVH metrics varied according to demographics and socioeconomic characteristics.

CONCLUSION

Females, older adolescents, and students who attended private school had a better CVH. Demographics and socioeconomic characteristics were associated with CVH metrics. The low ideal proportions found for diet and physical activity are of concern and reinforce the need for food and nutritional educational actions designed to promote healthy behaviors in adolescence to prevent the development of cardiovascular diseases.

Enjoyment Mediates Associations of the Physical and Family Environment With Adolescent Physical Activity: A Structural Equation Modeling Approach

PURPOSE

The purpose of this study was to examine the direct effects and mediating effect of physical activity (PA) enjoyment on the associations of the physical environment and family environment with adolescent PA behavior.

METHODS

Participants were US high school students who participated in the National Youth Physical Activity and Nutrition Study (N = 11,429; 49.4% female). The dependent variable was a latent variable from 3 survey items indicating adolescent PA behavior. One set of independent variables were items of the physical environment and a second set of independent variables were items of the family environment. A latent PA enjoyment mediating variable was constructed within a weighted structural equation model to examine the standardized direct and indirect effects (IEs) of the physical and family environment variables with adolescent PA controlling for demographic covariates.

RESULTS

Significant PA enjoyment mediating effects on adolescent PA were observed for the physical environment variables (IE range = 0.015-0.040) and adult transportation (IE = 0.013, 95% confidence interval [CI]: 0.006-0.020). The strongest direct effects were the associations between the family environment variables of adult PA encouragement (β = 0.11, 95% CI: 0.08-0.14), transportation (β = 0.14, 95% CI: 0.10-0.17), and watching (β = 0.12, 95% CI: 0.09-0.15) with adolescent PA.

DISCUSSION

Stronger PA enjoyment mediating effects on adolescent PA were observed for variables of the physical environment compared to the family environment but the strongest direct effects on adolescent PA were observed for family environment variables. Interventions that provide equipment, improve neighborhood safety, and educate parents on how to support PA may both indirectly and directly improve adolescent PA.

Effects of the COVID-19 Pandemic on the Perception of Inclusion in School Education and Physical Activity Among Polish Students

The coronavirus disease-2019 (COVID-19) pandemic impacted the lives of children and adolescents, leading to many changes in their routines, especially in education. Face-to-face physical education (PE) classes during COVID-19 were affected in organization, possibly conditioning students' participation, motivation, and learning. In the extreme conditions of the coronavirus, it may be assumed that daily physical activity became much less than before, partly because students are learning outside the school environment and PE lessons taught using remote forms do not fulfill their purpose. The aim of the study was to assess the pupil's perception of inclusion in school education during the remote learning caused by the COVID-19 pandemic and to compare the results with the control group. Moreover, the physical activity of respondents during social isolation due to the coronavirus was examined. The sample consisted of 111 pupils of both genders, aged 14–21 years. The Perceptions of Inclusion Questionnaire (PIQ) was used to measure the perception of inclusion in school education. The structure of the participants' physical activity was examined using the International Physical Activity Questionnaire-Long Form (IPAQ-LF) for adolescents. It was observed that the pupils' gender did not differentiate their perception of inclusion in school education. It was proved that respondents participating in research during the COVID-19 pandemic obtained statistically significantly lower results in the case of “emotional wellbeing in school” (p &lt; 0.001; η2 = 0.07) but a higher mean was observed in relation to “social relationships with other pupils” (p = 0.04; η2 = 0.02) than the control group. Girls achieved a higher mean in the case of walk Metabolic Equivalent of Task (MET) (p = 0.02; η2 = 0.06) than boys. In addition, it was observed that the recommendation of vigorous physical activities was achieved by 37.78% of boys and 34.85% of girls. In turn, 69.70% of female pupils and 77.78% of male respondents met the recommendations for medium physical activities. It was also noted that 87.88% of girls and 86.67% of boys participating in the research achieved the recommendation for total physical activities. The analysis showed negligible and low positive correlations between examined variables.

Identification of Lifestyle Risk Factors in Adolescence Influencing Cardiovascular Health in Young Adults: The BELINDA Study

Cardiovascular diseases are the leading cause of mortality worldwide. These diseases originate in childhood, and a better understanding of their early determinants and risk factors would allow better prevention. The BELINDA (BEtter LIfe by Nutrition During Adulthood) study is a 10−14-year follow-up of the HEalthy Lifestyle in Europe by Nutrition in Adolescence study (the HELENA study, a European cross-sectional study in adolescents). The study aims to evaluate cardiovascular risk using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score during young adulthood (21−32 years), and to examine the impact of risk factors identified during adolescence (12.5−17.5 years). Our secondary objective is to compare the characteristics of the BELINDA study population with the HELENA population not participating in the follow-up study. The HELENA study recruited 3528 adolescents during 2006−2007 and reassessed 232 of them 10−14 years later as young adults. We assessed clinical status, anthropometry, nutrition, physical activity (including sedentary behavior), physical fitness, and mental health parameters, and collected biological samples (blood, stool, and hair). Dietary intake, and physical activity and fitness data were also collected. A multivariable linear regression model will be used for the analysis of the primary outcome. A Chi-square and T-test were conducted for the comparison of the descriptive data (gender, age, weight, height, body mass index (BMI), and maternal school level) between participating and non-participating BELINDA adolescents. When comparing the 1327 eligible subjects with the 232 included in the BELINDA study, no significant differences regarding gender (p = 0.72), age (p = 0.60), height (p = 0.11), and weight (p = 0.083) at adolescence were found. However, the participating population had a lower BMI (20.4 ± 3.1 kg/m2 versus 21.2 ± 3.6 kg/m2; p < 0.001) and a higher maternal educational level (46.8% high school or university level versus 38.6%; p = 0.027) than the HELENA population who did not participate in the BELINDA study. The complete phenotyping obtained at adolescence through the HELENA study is a unique opportunity to identify adolescent risk factors for cardiovascular diseases. This paper will serve as a methodological basis for future analysis of this study.

Association Between Concussions and Suicidality in High School Students in the United States

Importance

Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.

Objective

To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.

Design

This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender.

Setting

A national sampling of U.S. high school students.

Participants

Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls.

Exposure(s)

Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality.

Main Outcomes and Measures

The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis.

Results

The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)].

Conclusions and Relevance

There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.

Factors associated with changes in physical activity and sedentary behaviour during one year among university-based young adults

The purpose of this study was to identify correlates of changes in physical activity (PA) and sedentary behaviour (SB) among university-based young adults in Bangladesh. Data were from a 1-year prospective study with 2 assessment points (baseline n ​= ​573, 20.7 ​± ​1.35 years, 45% female; retention rate 69%, analytical sample ​= ​395). Participants completed a self-administered written survey on PA, SB, health and lifestyle behaviours, and sociodemographics. Changes in PA were categorised as: negligible (± < 60 ​min/week), > 60 ​min/week decrease, or > 60 ​min/week increase. Changes in SB were categorised as negligible (± < 120 ​min/week), > 120 ​min/week decrease, and > 120 ​min/week increase. Multinomial logistic regression analysis was used to identify the correlates. About quarters (72%) of participants had insufficient PA at both assessment points. Of those who were sufficiently active at Wave 1, 5% became insufficiently active at Wave 2. One quarter of participants (23%) had high SB at Wave 1 and Wave 2. Of those who had low SB at Wave 1, 16% had high SB at Wave 2. Being male [OR ​= ​2.04 (95% CI: 1.06–3.93)], baseline phone time of > 2 h/day [OR ​= ​3.14 (95% CI: 1.04–7.04)] and not participating in organised sports at baseline [OR ​= ​2.56 (95% CI: 1.24–5.29) were associated with a decrease in PA by ​> ​60 ​min/week. Participants who frequently experienced stress at baseline had higher odds of increasing SB by ​> ​120 min/day [OR ​= ​1.83 (95% CI: 1.04–3.23)]. SB is more variable than PA over 1 year in university-based young adults in Bangladesh. Males, those with high phone time, those not engaging with organised sports, and those with frequent stress may change to a more inactive lifestyle.

Mental distress among young adults - gender differences in the role of social support

Background

The aim of the present study was to examine to what extent observed gender differences in mental health are associated with the protective factors social support, sense of coherence and participation in regular physical activity and more generally, engagement in organized or unorganized activity with other people.

Methods

This study was based upon a cross-sectional regional health survey in Norway, conducted during the winter of 2015–2016, in three southern counties; Aust-Agder, Vest-Agder and Vestfold. The study focused on young adults, comparing three age groups; 18–24 years old (n = 624), 25–31 (n = 582), and 32–38 years old (n = 795).

Results

Sense of coherence was strongly associated with low mental distress in all age groups and for both genders, while the association between low social support and mental distress was significant for young women only. Regular physical activity was not positively associated with low mental distress when sense of coherence and social support were included in the analysis.

Conclusion

Social support appears to have a stronger role as a protective factor for mental distress among young women, compared to young men and older persons. This has implications for health promoting activities that target young women. Sense of coherence showed a strong association with low mental distress scores for all ages studied.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12109-5.

Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood

OBJECTIVE

To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years.

DESIGN

Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort study sampled nationally representative US participants at 4 time points from 1994 to 2008.

SETTING

In-home assessment.

PARTICIPANTS

There were 3147 boys (age: median = 14.9, SD = 1.8) who participated during adolescence in 1994 to 1995 (wave I), of whom 2353 were reinterviewed in 2008 (wave IV, age: median = 29.1, SD = 1.8).

ASSESSMENT OF RISK FACTORS

Football participation, history of psychological counseling, suicide ideation, and a suicide attempt in the past year during high school.

MAIN OUTCOME MEASURES

Lifetime history of depression, suicide ideation within the past year, and feeling depressed in the past 7 days at wave IV.

RESULTS

Men who played high school football, compared with those who did not, reported similar rates of lifetime diagnosis of depression, suicide ideation in the past year, and feeling depressed in the past 7 days. Those who played football reported similar rates of suicide ideation in the past year when they were in their early 20s. Individuals who underwent psychological counseling during adolescence were more likely to report a lifetime history of depression and suicide ideation in the past year.

CONCLUSIONS

Young men who played high school football are not at an increased risk for suicide ideation during both their early 20s and late 20s. By contrast, those who experienced mental health problems in high school were much more likely to experience suicide ideation during their 20s.

Impact of COVID-19 Pandemic on Behavioral and Emotional Aspects and Daily Routines of Arab Israeli Children

Negative psychological effects of the coronavirus disease (COVID-19) have been identified in adults and children, such as anxiety and sleep disorders. However, research about the impact of this pandemic on children from ethnical minorities is scarce. We tested the effects of COVID-19 outbreak on psychological aspects and daily routines among Arab Israeli Children. An online cross-sectional survey was conducted among Arab Israeli parents, including behavioral and emotional aspects questionnaire and questions addressing using of screens, sleep, and physical activities. The results showed that, during the COVID-19 outbreak, 55.8% of the children asked to sleep in their parents' bed and 45% expressed fears they did not have before. Most of the children showed increased irritability, constant mood swings and nervousness about limits and messages, and 41.4% showed sleep difficulties. Concerning adaptive behaviors, more than 50% of the parents reported that their child became wiser, lazier, and was able to adapt the limits and restriction of the COVID-19 outbreak. Moreover, the children tended to increase their use of screens, used to sleep more time, and were less active physically. The results suggest that children are vulnerable to the COVID-19 outbreak psychological effects and highlight the need to reduce the psychological burden of this pandemic and the necessity of immediate intervention.

Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

In children, arterial alterations occur with increased intima-media thickness as well as vascular diameter enlargement. Both conditions correlate with higher cardiovascular risk in adults, and both the array and proportion of these alterations are important hemodynamic parameters. In terms of functional adaptation processes, they influence several arterial wall properties as for example the shear and tensile stress of the vessel. There are no reference values for the vascular diameter and intima-media thickness/diameter ratio of the carotid artery in children. Therefore, this study aimed to assess vascular diameter, intima-media thickness/diameter ratio and related tensile stress values in children and to further investigate the influence of sex, age, body mass index, and blood pressure. The parameters were measured with high-resolution semi-automated ultrasound. Sex- and age-dependent values were calculated with the LMS method for a cross-sectional sample of 642 healthy, non-obese children aged 8-17 years. The mean vascular diameter was 5.45 ± 0.46 mm; the median intima-media thickness/diameter ratio was 0.085 (0.079-0.092); the median tensile stress was 105.4 (95.2-116.4) kPa. The vascular diameter and the tensile stress were higher, and the intima-media thickness/diameter ratio was lower in boys than in girls. In comparison to the normal weight study population the excludedobese children had a significantly higher diameter, a lower intima-media thickness/diameter ratio, and a higher tensile stress. In multiple regression analyses of diameter, intima-media thickness/diameter ratio, and tensile stress, all parameters were influenced by sex and body mass index. Furthermore, systolic and diastolic blood pressure significantly influenced the vascular diameter, and systolic blood pressure significantly influenced the intima-media thickness/diameter ratio. Conclusion: This study is the first to report values for the diameter, the intima-media thickness/diameter ratio of the carotid artery, and the related tensile stress allowing a more differentiated view of cardiovascular adaptations as it combines structural and functional vascular parameters. What is known: • Intima-media thickness and vascular diameter are related to a higher cardiovascular risk in adults • The intima-media thickness/diameter ratio gives information about hemodynamic and functional vessel adaptation What is new: • Values for vascular diameter, intima-media thickness/diameter ratio, and tensile stress of the carotid artery in children are presented in this study • Intima-media thickness as a surrogate marker for arterial health in children should be complemented by intima-media thickness/diameter ratio measurement.

Clustering effects of health risk behavior on mental health and physical activity in Chinese adolescents

PURPOSE

Risk behaviors are significantly impacting physical and psychological health among adolescents, resulting in a tremendous public health issue. The aim of this study is to examine the association of clustered risk behaviors with mental health and physical activity, and identify to what extent the clustering of various risk behaviors is associated with psychological health and physical activity in Chinese adolescents.

METHODS

Students aged 16-18 years, male 16.2 ± 1.03, female 16.3 ± 1.56, were recruited from 30 high schools to complete an online questionnaire in fall semester 2017. A structured questionnaire, 2017 state and local youth risk behavior survey was revised, modified, and translated into Chinese. Five questions were designed to assess physical activity times of the last 7 days. Symptom checklist 90 (SCL-90) was used to investigate the mental health status of the participants. Statistical analyses were done employing chi-square tests, two step cluster analysis, logistic regression.

RESULT

Results illustrate that girls report a significantly higher mean of being bullied in school, electronically bullied, feeling sad or hopeless, and trying cigarette smoking. Two-step cluster analysis and regression analysis find that alcohol use, smoking and sedentary behavior have significant effect on adolescent health. Logic regression demonstrated that risk behaviors have significantly associated with mental health and physical activity in specific cluster.

CONCLUSION

This study finds that a specific behavior cluster has significant impact on mental health and physical activity among adolescents. Integrating risk behaviors cluster with factors can be employed to target high-risk adolescents who have poor physical and psychosocial health. The research suggest that more effective and feasible school intervention programs can be designed to promote adolescent health-related behavior in terms of those pathways.

Age at puberty and accelerometer-measured physical activity: Findings from two independent UK cohorts

BACKGROUND

It is unclear if puberty timing influences future physical activity (PA).

AIM

To investigate the association of puberty timing with PA across adolescence and adulthood.

SUBJECTS AND METHODS

Data were from two British cohorts. Participants from an adolescent birth cohort (females = 2349, males = 1720) prospectively reported age at menarche and voice break and had PA recorded by Actigraph accelerometers at ages 14 years and 16 years. A cohort of middle-aged and older adults (40-70 years; females = 48,282; males = 36,112) recalled their age at puberty and had PA (mean acceleration; mg) measured by AxivityAX3 accelerometers.

RESULTS

After adjustment for age, education, smoking and BMI, per 1-year older age at menarche was associated with higher mean counts/minute at age 14 years (0.07 SD counts/minute; 95% CI = 0.04-0.11) with associations attenuated at age 16 years (0.02; -0.03-0.07). Differences in mean acceleration per older year at menarche were close to the null in women aged 40-49 years (0.02 mg; 0.01-0.03), 50-59 years (0.01; 0.00-0.02) and 60-70 years (0.01; 0.00-0.01). Age at voice break and PA associations were close to the null in both cohorts.

CONCLUSION

We found a positive association between puberty timing and PA in females which weakened at older ages and limited evidence of an association at any age in males.

The impact of physical activity on psychological health during Covid-19 pandemic in Italy

The worldwide spread of COVID-19 has upset the normality of Italian daily life, forcing population to social distancing and self-isolation. Since the containment precautions also concern sport-related activities, home workout remained the only possibility to play sports and stay active during the pandemic. The present study aimed to examine changes in the physical activity levels during self-quarantine in Italy, and the impact of exercise on psychological health. A total of 2974 Italian subjects has completed an online survey, but only 2524 subjects resulted eligible for this study. The questionnaire measured the total weekly physical activity energy expenditure before and during quarantine (i.e. the sum of walking, moderate-intensity physical activities, and vigorous-intensity physical activities) in Metabolic Equivalent Task minutes per week (MET-min/wk) using an adapted version of International Physical Activity Questionnaire and their psychological well-being using the Psychological General Well Being Index. Of the 2524 Italian subjects included in the study, 1426 were females (56.4%) and 1098 males (43.6%). Total physical activity significantly decreased between before and during COVID-19 pandemic (Mean: 2429 vs. 1577 MET-min/wk, ∗∗∗∗p < 0.0001), in all age groups and especially in men (Female, mean: 1994 vs. 1443 MET-min/wk, ∗∗∗∗p < 0.0001; Male, mean: 2998 vs. 1754 MET-min/wk, ∗∗∗∗p < 0.0001). Furthermore, a significant positive correlation was found between the variation of physical activity and mental well-being (r = 0.07541, ∗∗∗p = 0.0002), suggesting that the reduction of total physical activity had a profoundly negative impact on psychological health and well-being of population. Based on this scientific evidence, maintaining a regular exercise routine is a key strategy for physical and mental health during a forced rest period like the current coronavirus emergency.

Composition of weekly physical activity in adolescents by level of physical activity

Background

Physical activity (PA) in adolescence is crucial for lifelong healthy lifestyle, and attention is needed to adolescents at health risk due to insufficient PA. This study investigates the composition of weekly PA in adolescents by PA level and provides a rationale for change in their lifestyles.

Methods

The research was conducted at 66 schools in Poland between 2009 and 2016, among 949 girls and 650 boys aged 15–18 years. We used pedometers to monitor weekly PA with data assessed using the Indares web app. The participants were split into three groups by mean daily step count (lower, < 9000; middle, 9000–12,999; and higher, ≥ 13,000 steps/day), as a reliable and non-expensive indicator of PA.

Results

We did not observe statistically significant differences in composition of 7-day PA between participants with varying levels of PA, regardless of their gender (F_(12,9558) = 0.60; p = 0.841; η_p² > 0.000). The smallest differences in daily step counts by PA level were found on Mondays and the biggest on Fridays and Saturdays, in boys and girls; the differences between average school and average weekend days were most pronounced in less active girls (1677 steps/day) and boys (1886 steps/day). During the school week, the highest proportion of less active girls met the 11,000 steps/day recommendation on Fridays (21.9%), statistically significantly less than on other school days (p < 0.001). Similarly, less active boys (22.2%) had significantly less activity on Fridays than on other school days, except for Mondays (p = 0.143) Analogous pattern was apparent also in more active adolescents.

Conclusions

Less active adolescents have comparable composition of weekly PA to the more active ones but they can hardly meet the generally accepted PA recommendations. Better understanding of weekly PA composition and rates of meeting PA recommendations by day of the week can lead to more efficient interventions improving lifestyles. The recommendation of 9000 steps/day most days of the week, thus, appears appropriate for less active adolescents, as a motivating achievable goal.

Combined Effects of Physical Inactivity and Sedentary Behaviour on Psychological Distress Among University-Based Young Adults: a One-Year Prospective Study

Insufficient physical activity (PA) and prolonged sedentary behaviour (SB) may have deleterious psychological health consequences. Using one-year prospective data, this study examined the combined effects of PA and SB on psychological distress among university-based young adults in Dhaka, Bangladesh. During Wave 1 (September-December 2015), total 573 undergraduate students (mean age: 20.7 ± 1.35 years; 45% females) completed a self-administered survey on PA, SB, psychological distress, health and lifestyle factors and sociodemographics. During Wave 2 (October-November 2016), 395 students (retention rate = 69%) completed a sub-set of Wave 2 survey with items on PA, SB and psychological distress. PA and SB were assessed using the Global Physical Activity Questionnaire and distress with the Kessler 6 Psychological Distress scale. Generalized Estimating Equations with Gaussian family and identity link under exchangeable correlation structure was used to examine the relationships. Multivariable modeling showed that participants with insufficient PA (<150 min/week) and high SB (≥480 min/day) or insufficient PA + low SB had more distress [ß: 3.07 (95% CI: 2.12-4.01) and 2.77 (1.86-3.67), respectively] than those who had sufficient PA + low SB, after controlling for gender, sleep difficulties, perceived health, fast food and fresh fruit intake. There was no statistically significant difference for the level of distress between other PA and SB groups. In this one-year prospective study, irrespective of SB, insufficient PA was associated with high psychological distress in university-based young adults in Bangladesh. The protective role of PA should be considered in intervention programs to improve psychological health of young adults.

Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders

BACKGROUND

Most Finnish adolescents are not sufficiently physically active. Health education (HE) provides beneficial starting point for physical activity (PA) promotion in schools. This study evaluates an intervention integrated into three HE lessons to increase PA and reduce sedentary behavior (SB) among eighth graders.

METHODS

All public secondary schools in Tampere, Finland participated and were randomized to intervention (INT, n = 7) and comparison group (COM, n = 7). In INT (690 students, 36 classes) the teachers (n = 14) implemented behavioral theory-driven content during three HE lessons. In COM (860 students, 41 classes) the teachers (n = 14) carried out standard lessons. The evaluation was based on RE-AIM: Effectiveness was assessed from baseline to 4 weeks (Follow-up 1) and Maintenance from 4 weeks to 7 months (Follow-up 2) with change in students' PA and SB and related psychosocial and parental factors. Methods included questionnaire, accelerometer and activity diary. Linear mixed models with baseline adjustments and random effect correction were used to compare the difference in change between INT and COM. Data on Reach, Adoption and Implementation were collected during the process.

RESULTS

Intervention effects were only seen in the self-reported data favoring INT in the weekly number of days with at least 1 h of brisk leisure PA (0.3 [95%CI 0.1 to 0.6]), proportion of students meeting PA recommendations (4.1 [95%CI 2.5 to 5.7]), proportion of students reporting that their family sets limitations for screen time (5.4 [95%CI 3.3 to 7.4]) and in the number of days on which the students intended to do leisure PA in the following week (0.3 [95%CI 0.1 to 0.6]). The effects on PA were still beneficial for INT at Follow-up 2. The intervention reached 96% of the students, was adopted in all 7 schools and was implemented by 13/14 teachers in 35/36 classes.

CONCLUSIONS

The intervention was feasible and had small favorable effects on students' self-reported PA, intention to do PA and family norm in screen time. The effects on PA persisted until Follow-up 2. It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility.

TRIAL REGISTRATION

NCT01633918 (June 27th, 2012).

The Role of Family of Origin in Current Lifestyle Choices: A Qualitative Secondary Data Analysis of Interracial and Same-Race Couples

Many Americans are in poor health. This is acute for racial/ethnic minorities compared with the Non-Hispanic white population. A grounded theory approach was used to analyze semistructured qualitative interviews to identify perceptions of family-of-origin lifestyle choices in same-race and interracial couples. Several central themes emerged from the data including influence of family-of-origin eating patterns, lack of family-of-origin importance for physical activity, and romantic partner influence in eating and exercise. Findings provide evidence for the socialization of family of origin on lifestyle choices into adulthood and also suggest promising changes due to romantic partner.

Competence and Satisfaction in Occupational Performance Among a Sample of University Students: An Exploratory Study

Success at university may be influenced by concerns with occupation and occupational performance. To understand occupations of concern and occupational performance among a sample (N = 144) of university students in the Midwest United States, the Canadian Occupational Performance Measure was administered. Socially related (n = 103), academic-related (n = 75), and work-related (n = 64) occupations were the three most frequently reported occupational concerns. Time management (n = 79) was the most frequent person-level concern. Mean self-perceived competence in occupations was 29.83 (SD = 7.18) out of 50 and mean performance satisfaction was 26.80 (SD = 8.01) out of 50. There were no differences in occupational performance across gender, race/ethnicity, class standing, living environment, or work status. However, within participants, there was a significant and clinically relevant difference between performance satisfaction and self-perceived competence in occupation, t(143) = 7.052, p < .0005, d = 0.58. Students have varied occupations that they find important, and future research should explore how occupational performance and performance satisfaction influence university success.

Depressive symptom trajectories and physical health: Persistence of problems from adolescence to young adulthood

BACKGROUND

We examine how depressive symptom trajectories are related to adolescent and young adult subjective health, health-promoting, health-risk, and sexual risk behaviors, as well as cardiometabolic risks.

METHOD

Data came from a community-based sample of youth (N = 662; 52% female) followed biannually, six times across 10 years. Latent class growth analysis identified four depressive symptom trajectories which were compared on adolescent (T1; ages 12-18) and young adult (T6; ages 22-29) health indicators.

RESULTS

The Low stable trajectory (49%) showed the fewest health risks. The Persistent high trajectory (9%) reported higher physical symptoms, lower physical self-concept, less physical activity and sleep, and higher rates of smoking and sexual risk behaviors than the Low stable trajectory and risks for physical symptoms, physical self-concept, and physical activity worsened in young adulthood. Increasers (21%) showed risks for physical symptoms, physical activity, and sleep in adolescence and problems for physical symptoms and physical self-concept persisted in young adulthood. Decreasers (22%) showed risks for physical symptoms, physical self-concept, physical activity, and sleep in adolescence but these risks resolved into young adulthood.

LIMITATIONS

Findings may not generalize to ethnic minorities. Sex differences were not examined due to sample size limitations and most variables, except cardiometabolic risks, were self-reported.

CONCLUSIONS

Findings suggest early treatment of depressive symptoms that includes strategies addressing physical symptoms, physical self-concept, and physical activity may prove beneficial. Screening youth for physical symptoms and declines in health-promoting behaviors may also identify youth at risk of depression onset and progression.

Perceived environmental barriers to physical activity in young adults in Dhaka City, Bangladesh-does gender matter?

Background

Physical activity (PA) has demonstrated health benefits, but participation is low in many countries. Little is known about environmental barriers to PA among young Asian adults. The purpose of this study was to identify common perceived environmental barriers to PA in young adults in Dhaka, Bangladesh and to examine if these barriers differed by gender.

Methods

This was a cross-sectional study with a self-administered survey and data collected from a convenience sample of 573 students aged 20.71±1.35 years (female 45%) in Dhaka. Binary logistic regression analysis was used to examine the association between environmental barriers and gender, adjusting for potential confounders.

Results

Poor street lighting at night (62%) and a lack of convenient places to do PA (56%) were the most frequently reported environmental barriers to PA. Females were more likely than males to identify a lack of neighbourhood safety (OR 4.65 [95% CI 3.09-7.00]), poor street lighting (OR 2.82 [95% CI 1.95-4.11]), lack of convenient places (OR 2.04 [95% CI 1.39-3.00]), unclean and untidy neighbourhood (OR 1.84 [95% CI 1.25-2.72]) and poor weather (OR 1.61 [95% CI 1.11-2.33]) as barriers to PA, after adjusting for a set of confounders.

Conclusions

Findings suggest that environmental barriers to PA are particularly salient to young females in urban Bangladesh. This study underscores the need for safe and convenient options for PA that are also female friendly.

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

BACKGROUND

The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated.

METHODS

A total of 258,146 participants (49% women), aged 19-70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO_2max) were obtained.

RESULTS

Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81-0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17-1.23) for exercising regularly and a normal/high VO_2max in adulthood. For men, the ORs were significantly lower (range: 0.66-0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood.

CONCLUSIONS

Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO_2max, and metabolic health in adulthood up to 70 years.

Active Learning Increases Children's Physical Activity across Demographic Subgroups

Purpose

Given the need to find more opportunities for physical activity within the elementary school day, this study was designed to asses the impact of I-CAN!, active lessons on: 1) student physical activity (PA) outcomes via accelerometry; and 2) socioeconomic status (SES), race, sex, body mass index (BMI), or fitness as moderators of this impact.

Methods

Participants were 2,493 fourth grade students (45.9% male, 45.8% white, 21.7% low SES) from 28 central Texas elementary schools randomly assigned to intervention (n=19) or control (n=9). Multilevel regression models evaluated the effect of I-CAN! on PA and effect sizes were calculated. The moderating effects of SES, race, sex, BMI, and fitness were examined in separate models.

Results

Students in treatment schools took significantly more steps than those in control schools (β = 125.267, SE = 41.327, p = .002, d = .44). I-CAN! had a significant effect on MVPA with treatment schools realizing 80% (β = 0.796, SE =0.251, p = .001; d = .38) more MVPA than the control schools. There were no significant school-level differences on sedentary behavior (β = -0.177, SE = 0.824, p = .83). SES, race, sex, BMI, and fitness level did not moderate the impact of active learning on step count and MVPA.

Conclusion

Active learning increases PA within elementary students, and does so consistently across demographic sub-groups. This is important as these sub-groups represent harder to reach populations for PA interventions. While these lessons may not be enough to help children reach daily recommendations of PA, they can supplement other opportunities for PA. This speaks to the potential of schools to adopt policy change to require active learning.

Diversity of leisure-time sport activities in adolescence as a predictor of leisure-time physical activity in adulthood

Because sustained physical activity is important for a healthy life, this paper examined whether a greater diversity of sport activities during adolescence predicts higher levels of leisure-time physical activity (LTPA) in adulthood. From sport activity participation reported by 17-year-old twins, we formed five groups: 1, 2, 3, 4, and 5+ different sport activities. At follow-up in their mid-thirties, twins were divided into four activity classes based on LTPA, including active commuting. Multinomial regression analyses, adjusted for several confounders, were conducted separately for male (N=1288) and female (N=1770) participants. Further, conditional logistic regression analysis included 23 twin pairs discordant for both diversity of sport activities in adolescence and LTPA in adulthood. The diversity of leisure-time sport activities in adolescence had a significant positive association with adulthood LTPA among females. Membership in the most active adult quartile, compared to the least active quartile, was predicted by participation in 2, 3, 4, and 5+ sport activities in adolescence with odds ratios: 1.52 (P=.11), 1.86 (P=.02), 1.29 (P=.39), and 3.12 (P=5.4e-05), respectively. Within-pair analyses, limited by the small sample of twins discordant for both adolescent activities and adult outcomes, did not replicate the association. A greater diversity of leisure-time sport activities in adolescence predicts higher levels of LTPA in adulthood in females, but the causal nature of this association remains unresolved.

Effects of Adolescent Sport Practice on Health Outcomes of Adult Amateur Endurance Cyclists: Adulthood Is Not Too Late to Start

Background: We investigated the effects of adolescent sport practice on the training, performance, and health outcomes of adult amateur endurance cyclists and compared health outcomes of 3 adult groups: amateur endurance cyclists who practiced sports during adolescence, amateur endurance cyclists who did not practice sports during adolescence, and inactive individuals. Methods: In 859 (751 men and 108 women) adult cyclists and 718 inactive subjects (307 men and 411 women), we examined adolescent sport practice, current training status, quality of life, quality of sleep, anxiety and depression, and cardiometabolic risk: body mass index, physical activity, physical fitness, adherence to Mediterranean diet, and alcohol and tobacco consumption. Results: Independent of gender, no significant differences in training, performance, or health outcomes were observed between amateur endurance cyclists who practiced sports during adolescence and those who did not. Independent of gender, cyclists reported significantly better health outcomes than inactive individuals in all variables, except depression. Conclusions: Training, performance, and health outcomes did not differ between adult amateur endurance cyclists who practiced sports during adolescence and those who did not, but their health outcomes were significantly improved compared with inactive individuals, except for depression.

Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations?

Background

Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether ‘PA patterns’ (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality outcomes, compared to single time-point measure of PA.

Methods

Data were the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study over three waves 1982–3 (time 1), 1987–8 (time 2) and 1993–4 (time 3). Associations between leisure time single time-point PA levels at time 1 and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to ‘PA patterns’ spanning multiple time points. PA pattern classified participants’ PA as either 1) inactive or low PA at both time points; 2) moderate level PA at time 1 and high activity at time 3; or 3) a ‘mixed PA pattern’ indicating a varying levels of activity over time. Similarly, sport and active travel were also classified as indicating stable low, stable high and mixed patterns.

Results

The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across ‘PA patterns’, ‘active maintainers’ had a 2.0 cm lower waist circumference than ‘inactive/low maintainers’. Waist circumference was inversely related to sport but not active travel. CHD risk did not vary by activity levels at time 1, but was reduced significantly by 43% for high PA at time 3 (vs ‘inactive’ group) and among ‘active maintainers’ (vs ‘inactive/low maintainers’) by 62%. ‘Sport pattern’ showed stronger reductions in mortality for cardiovascular disease and CHD deaths among sport maintainers, than the single time point measures.

Conclusions

PA patterns demonstrated a stronger association with a number of anthropometric and mortality outcomes than the single time-point measures. Operationalising PA as a sustained behavioural pattern may address some of the known under-estimation of risk for poor health in PA self-report measurements and better reflect exposure for epidemiological analysis of risk of health outcomes.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4806-6) contains supplementary material, which is available to authorized users.

Associations between social control, motivation, and exercise: How romantic partners influence exercise during young adulthood

This study investigated whether positive and negative romantic partner social control attempts (persuasion and pressure, respectively) were related to approach-avoidance motives and exercise among young adults (N = 98), using daily reports. Daily persuasion was linked to higher daily approach motives. At the person level, persuasion was associated with higher approach and avoidance motives in addition to more frequent, longer exercise. Pressure was associated with higher daily relationship stress, which was associated with higher daily avoidance motives. At the person level, pressure was related to less frequent, shorter exercise. Thus, romantic partners' social control use correlates with exercise motives and behavior.

Prevalence and sociodemographic patterns of physical activity among Bangladeshi young adults

BACKGROUND

Physical activity offers physical and psychosocial health benefits that are important during young adulthood and later in life. However, little is known about the physical activity of young adults in low- and middle-income countries. The purpose of this study was to estimate the participation of physical activity in Bangladeshi young adults and to assess differences by gender, age and family income.

METHODS

This cross-sectional study with a self-administered survey used a convenience sample of 573 young adults aged 18-24 years from six purposively selected universities in Dhaka City, Bangladesh. Data were collected during September-November 2015. Medians and their interquartile ranges of weekly time spent in total physical activity, and in different domains of physical activity, were computed. Non-parametric equality of medians test was used to examine gender differences in the median values. Chi-square test and Fisher's exact test were used to examine gender differences in the prevalence of meeting physical activity recommendations and frequency of participation in different leisure-time physical activities, and differences in meeting the activity recommendations by age and family income.

RESULTS

Seventeen percent of the participants were meeting moderate-to-vigorous physical activity (MVPA) recommendations with a significantly higher proportion of males than females (27 vs. 6%, p < .0001). Median duration of MVPA was significantly higher (p < .0001) for males [120 min/week (80, 190)] than females [90 min/week (50, 120)]. Jogging/running was the most commonly reported leisure-time physical activity, with 20% of males and 12% of females doing this at least once a week. Age and family income were not significantly associated with meeting MVPA recommendations.

CONCLUSIONS

Four out of five young adults in Dhaka City did not meet the physical activity recommendations. Additional population-based studies, including regional and metropolitan areas, and using objective measurement, are needed to understand the physical activity patterns of Bangladeshi young adults.

Addressing mental health through sport: a review of sporting organizations' websites

AIM

Mental health is a major concern among adolescents. Most mental illnesses have their onset during this period, and around 14% of all young people aged 12 to 17 years experience a mental illness in a 12-month period. However, only 65% of these adolescents access health services to address their mental health problems. Approximately 70% of all Australian adolescents participate in sport, and this presents an opportunity for mental health promotion.

METHODS

This paper reviewed current approaches by sporting organizations to mental health promotion, prevention and early intervention by searching peak body websites, as well as the wider Internet.

RESULTS

Findings revealed many of the sport organizations reviewed acknowledged the importance of mental components of their sport to increase competitiveness, but few explicitly noted mental health problems or the potential of their sport to promote good mental health. Although some had participated in mental health promotion campaigns, there was no evaluation or reference to the evidence base for these campaigns.

CONCLUSIONS

We describe a framework for integrating mental health promotion into sports organizations based on the MindMatters programme for schools.

A Summer Health Program for African-American High School Students in Baltimore, Maryland: Community Partnership for Integrative Health

CONTEXT

Physical inactivity, poor nutrition, and chronic stress threaten the health of African-American youth in urban environments. Conditions often worsen in summer with diminished access to healthy foods and safe venues for physical activity.

OBJECTIVE

A public-private partnership was formed to develop and evaluate an integrative health intervention entitled "Mission Thrive Summer" (MTS).

METHODS

The MTS setting was an urban farm and adjacent school in a low-income community in Baltimore, Maryland. The intervention included farming, nutrition education, cooking, physical activity, yoga, mindfulness, and employment. Mixed-methods outcomes evaluation was conducted. Quantitative measures included accelerometry and self-reported health behaviors, using the Child and Adolescent Mindfulness Measure, Perceived Stress Scale, Physical Activity Questionnaire for Adolescents (PAQA), CDC Youth Risk Behavior Survey, and Block Kids Food Screener (BKFS). Outcomes were compared pre- and post-intervention using paired t-tests. Qualitative evaluation was based on participant and parent interviews.

PARTICIPANTS

In total, 36 African-American 9th- and 10th-grade students joined MTS (17 in 2013, 26 in 2014, and 7 participating both years).

RESULTS

In total, 88% of participants completed MTS. Accelerometry revealed that participants took 7158 steps and burned 544 calories per day during MTS. Participants experienced statistically significant improvements in self-reported physical activity (PAQA) and dietary habits (BKFS). Surveys did not detect changes in stress or mindfulness (P > .05). Qualitative data demonstrated new knowledge and skills, increased self-efficacy, health behavior change, and program enjoyment.

CONCLUSIONS

MTS was feasible among African-American high school students in Baltimore. Mixed-methods outcomes evaluation provided preliminary evidence of health behavior change during the summer and at follow-up.

Framework for the design and delivery of organized physical activity sessions for children and adolescents: rationale and description of the 'SAAFE' teaching principles

The economic burden of inactivity is substantial, with conservative estimates suggesting the global cost to health care systems is more than US$50 billion. School-based programs, including physical education and school sport, have been recommended as important components of a multi-sector, multi-system approach to address physical inactivity. Additionally, community sporting clubs and after-school programs (ASPs) offer further opportunities for young people to be physically active outside of school. Despite demonstrating promise, current evidence suggests school-based physical activity programs, community sporting clubs and ASPs are not achieving their full potential. For example, physical activity levels in physical education (PE) and ASP sessions are typically much lower than recommended. For these sessions to have the strongest effects on young people's physical activity levels and their on-going physical literacy, they need to improve in quality and should be highly active and engaging. This paper presents the Supportive, Active, Autonomous, Fair, Enjoyable (SAAFE) principles, which represent an evidence-based framework designed to guide the planning, delivery and evaluation of organized physical activity sessions in school, community sport and ASPs. In this paper we provide a narrative and integrative review of the conceptual and empirical bases that underpin this framework and highlight implications for knowledge translation and application.

Protective lifestyle behaviours and depression in middle-aged Irish men and women: a secondary analysis

Objective

To examine the association between protective lifestyle behaviours (PLB) and depression in middle-aged Irish adults.

Design

Secondary analysis of a cross-sectional study. PLB (non-smoker, moderate alcohol, physical activity, adequate fruit and vegetable intake) were assessed using a general health and lifestyle questionnaire and a validated FFQ. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. A score of 15–21 indicates mild/moderate depression and a score of 22 or more indicates a possibility of major depression. Binary logistic regression was used to examine the association between PLB and depression.

Setting

Livinghealth Clinic, Mitchelstown, North Cork, Republic of Ireland.

Subjects

Men and women aged 50–69 years were selected at random from a list of patients registered at the clinic (n 2047, 67 % response rate).

Results

Over 8 % of participants engaged in zero or one PLB, 24 % and 39 % had two and three PLB respectively, while 28 % had four PLB. Those who practised three/four PLB were significantly more likely to be female, have a higher level of education and were categorised as having no depressive symptoms. Engaging in zero or one PLB was significantly associated with an increased odds of depression compared with four PLB. Results remained significant after adjusting for several confounders, including age, gender, education and BMI (OR=2·2; 95 % CI 1·2, 4·0; P for trend=0·001).

Conclusions

While causal inference cannot be established in a cross-sectional study, the findings suggest that healthy behaviours may play a vital role in the promotion of positive mental health or, at a minimum, are associated with lower levels of depression.

Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study

Background

The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation.

Methods

Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (<2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (>3840 kcal/week).

Results

At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 ± 1.0 mg/L), oxidized-LDL (68.35 ± 67.7 ng/mL), leptin (4.71 ± 3.07 ng/mL) and irisin (0.47 ± 0.13 μmol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups (p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 ± 1.4 mg/L), oxidized-LDL (249.8 ± 129 ng/ml), Interleukine-6 (3.74 ± 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT (r = 0.301; p < 0.01), and irisin and IMT (r = 0.223; p < 0.05).

Conclusions

The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.

Impact of exercise changes on body composition during the college years--a five year randomized controlled study

Background

Observational studies have consistently reported severe weight gains during the college years; information about the effect on body composition is scarce, however. Thus, the aim of the study was to determine the effect of exercise changes on body composition during 5 years at university.

Methods

Sixty-one randomly selected male and female dental (DES; 21 ± 3 years., 22 ± 2 kg/m²) and 53 sport (physical education) students (SPS; 20 ± 2 years., 22 ± 3 kg/m²) were accompanied over their 5-year study program. Body mass and body composition as determined via Dual-Energy x-ray-absorptiometry (DXA) at baseline and follow-up were selected as primary study endpoints. Confounding parameters (i.e., nutritional intake, diseases, medication) that may affect study endpoints were determined every two years. Endpoints were log-transformed to stabilize variance and achieve normal distributed values. Paired t-tests and unpaired Welch-t-tests were used to check intra and inter-group differences.

Results

Exercise volume decreased significantly by 33 % (p < .001) in the DES and increased significantly (p < .001) in the SPS group. Both cohorts comparably (p = .214) gained body mass (SPS: 1.9 %, 95 %-CI: 0.3−3.5 %, p = .019 vs. DES: 3.4 %, 1.4−5.5 %, p = .001). However, the increase in the SPS group can be completely attributed to changes in LBM (2.3 %, 1.1−3.5 %, p < 0.001) with no changes of total fat mass (0.6 %, −5.0−6.5 %, p = 0.823), while DES gained total FM and LBM in a proportion of 2:1. Corresponding changes were determined for appendicular skeletal muscle mass and abdominal body-fat. Maximum aerobic capacity increased (p = .076) in the SPS (1.6 %, −0.2−3.3 %) and significantly decreased (p = .004) in the DES (−3.3 %, −5.4 to −1.2 %). Group differences were significant (p < .001). With respect to nutritional intake or physical activity, no relevant changes or group differences were observed.

Conclusion

We conclude that the most deleterious effect on fatness and fitness in young college students was the pronounced decreases in exercise volume and particularly exercise intensity.

Trial registration

NCT00521235; “Effect of Different Working Conditions on Risk Factors in Dentists Versus Trainers. A Combined Cross sectional and Longitudinal Trial with Student and Senior Employees.”; August 24, 2007.

Physical activity in adolescents who later developed schizophrenia: A prospective case-control study from the Young-HUNT

BACKGROUND

Adults suffering from schizophrenia and other psychiatric disorders report low levels of physical activity. In addition, these patients have an increased risk of overweight and poor nutritional habits. Less is known about patterns and levels of physical activity before the onset of disease.

AIMS

The purpose of the study was to investigate whether there were specific patterns of physical activity in the premorbid phase of schizophrenia and whether these participants differed from those with bipolar disorder (BD). A group of healthy controls (HC) was also included.

METHODS

The study was a prospective, longitudinal, comparative cohort design in which 15 adolescents who later developed schizophrenia and 18 with later BD were compared with HC. Data were analysed using non-parametric statistical tests.

RESULTS

Patients with a diagnosis of schizophrenia were less physically active with fewer days per week (p < 0.05) and fewer hours per week (p < 0.05) in the premorbid phase than both BD and HC. They also participated less in team sports than HC (p < 0.05).

CONCLUSION

Our results suggest that individuals who develop schizophrenia in their teens may be at risk of establishing a lifestyle harmful to health. From a preventive perspective it is important to gain more knowledge about the connections between health habits and later development of disease.

Temporal Trends in Overweight and Obesity, Physical Activity and Screen Time among Czech Adolescents from 2002 to 2014: A National Health Behaviour in School-Aged Children Study

This study examines trends in overweight and obesity, physical activity (PA) and screen time (ST) among Czech adolescents over a recent 12-year study period. Nationally representative samples consisted of 19,940 adolescents (9760 boys and 10,180 girls) aged 10.5-16.5 years from the Czech Health Behaviour in School-aged Children (HBSC) questionnaire-based surveys conducted in 2002, 2006, 2010 and 2014. Trends in the prevalence of overweight/obesity, meeting the recommendations for moderate-to-vigorous PA (MVPA) (≥60 min per day of MVPA) and excessive ST (>2 h per day) were estimated using logistic regression. Significant increases (p < 0.001) in the prevalence of overweight/obesity between the years 2002 and 2014 were evident for both adolescent boys (18.3%(2002)-24.8%(2014)) and girls (8.3%(2002)-11.9%(2014)). Compared to 2002, in 2014 significant decreases (p < 0.001) in meeting MVPA recommendations were observed among boys (32.2%(2002)-25.6%(2014)) and girls (23.2%(2002)-19.2%(2014)). Moreover, in boys we observed significant increases (p < 0.001) in excessive ST on weekdays (75.1%(2002)-88.8%(2014)), as well as on weekends (78.3%(2002)-91.9%(2014)) between the years 2002 and 2014. Increases in overweight/obesity with concomitant decreases in PA provide evidence in support of the current and upcoming efforts of government and commercial organizations in implementing interventions aimed at reducing excessive body weight among Czech adolescents.

Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway

BACKGROUND

Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed.

METHODS

This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires.

RESULTS

Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents.

CONCLUSIONS

The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.

[Overweight and obesity in young adults: relevance of job-related changes of exercise on fat, lean body and body mass in students]

Early adulthood is related to changes in lifestyle that negatively affect body weight and health. The aim of the study was to determine the effect of exercise changes on the development of weight and body composition in college students.Sixty-one randomly selected dental (ZMS) and 53 sport students (SLS) were accompanied over 5 years. Body mass, fat and lean body mass (LBM) were determined via DXA-technique. Exercise and physical activity were assessed by questionnaires and interviews.All exercise indices significantly increased in the SLS and significantly decreased in the ZMS. Physical activity slightly increased in both groups. Both cohorts comparably gained body mass, however, the increase in the SLS group can be attributed to LBM-changes with minor changes of fat-mass (2.4 % ± 3.3 % vs. 0.1 ± 1.0 %) whereas ZMS gained fat and LBM in a proportion of 2:1.Maintenance/increase of exercise compensate the negative effects of lifestyle changes on body composition during young adulthood.

Are total, intensity- and domain-specific physical activity levels associated with life satisfaction among university students?

Background

Thorough information about the relationship between physical activity (PA) and life satisfaction is still lacking. Therefore, this study examined the cross-sectional relationships between life satisfaction and meeting the World Health Organization (WHO) moderate to vigorous-intensity PA recommendations, total volume and duration of PA, intensity-specific PA (walking, moderate- and vigorous-intensity), domain-specific PA (work, transport-related, domestic, and leisure-time), and 11 domain and intensity-specific PA types among university students. Additionally, we examined the associations between life satisfaction and gender, age, disposable income, community size, smoking, alcohol intake, body mass index (BMI), and self-rated health.

Methods

The study included a random sample of 1750 university students in Zagreb, Croatia (response rate = 71.7%; 62.4% females; mean age 21.5 ± 1.8 years), using the International Physical Activity Questionnaire — long form and the Satisfaction with Life Scale.

Results

Higher life satisfaction was associated with female gender (β = 0.13; p = <0.001), younger age (β = -0.07; p = 0.024), higher disposable income (β = 0.10; p = 0.001), and better self-rated health (β = 0.30; p = <0.001). No significant association was found between life satisfaction and size of community (p = 0.567), smoking status (p = 0.056), alcohol consumption (p = 0.058), or BMI (p = 0.508). Among all PA variables, only leisure-time vigorous-intensity PA was significantly associated with life satisfaction after adjustments for socio-demographic characteristics, lifestyle and self-rated general health (β = 0.06; p = 0.045).

Conclusions

This study indicated a weak positive relationship between leisure-time vigorous-intensity PA and life satisfaction, whilst no such association was found for other PA variables. These findings underscore the importance of analyzing domain and intensity-specific PA levels in future studies among university students, as drawing conclusions about the relationship between PA and life satisfaction based on total PA levels only may be misleading.

Health impact of sport and exercise in emerging adult men: a prospective study

PURPOSE

Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life.

METHODS

The analysis used baseline and 15-month follow-up data (N = 4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis.

RESULTS

At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life.

CONCLUSIONS

From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Motivation for physical activity in children: a moving matter in need for study

Motivation for physical activity in children below the age of 12 years is a largely underrepresented issue in contemporary research. Although engagement in sufficient physical activity is highly important for children's current and later health, relatively little is known of the factors that motivate children to be physically active. Various theories have been developed in an attempt to explain motivation toward physical activity in adults. Recent developments have focussed on integrating constructs of these theories in order to attain a comprehensive account of motivated behavior. The relationships between different motivational constructs have generally been investigated in healthy adolescents and adults. This manuscript outlines why more theoretically driven research into children's motivation toward physical activity is needed. Constructs stemming from various motivational theories and their interrelationship as evidenced in youth and adults will be summarized. The current state of research on the applicability of these motivational constructs to children, and the generalizability of the interrelationship between the constructs to child samples will be outlined. A deeper insight into the motivational determinants of physical activity participation in children could inform the design of interventions to facilitate the development of physically active lifestyles that persist at older ages.