Developmental trajectories of physical activity and television viewing during adolescence among girls: National Growth and Health Cohort Study

Long-term recreational exercise patterns in adolescents and young adults: Trajectory predictors and associations with health, mental-health, and educational outcomes

Individual and societal factors influencing the formation of long-term recreational exercise habits during the transition from adolescence to young adulthood are not well explored. Using data from the Longitudinal Survey of Australian Youth (LSAY), a population-representative cohort study of Young People followed from age 15 to 25, we aimed to (1) model longitudinal recreational exercise trajectories from age 16 to 24, (2) examine predictors at age 15 of entering these trajectories, and (3) explore the association between the trajectories and health, mental health and educational achievement outcomes measured at the final study wave (age 25). Self-reported recreational exercise frequency data from 9353 LSAY participants were analysed using group-based trajectory modelling. We modelled the evolution of two patterns of recreational exercise behaviour: daily exercise, as per public health guidelines (Model 1); and at least once weekly exercise (Model 2). Model 1 trajectories were guideline-adherent exercisers (17.9% of the sample), never guideline exercisers (27.5%), guideline drop-outs (15.2%) and towards guideline (39.4%); Model 2 trajectories were weekly exercise (69.5% of the sample), decreasing (17.4%), increasing (4.8%), and infrequent (8.3%). For both models, at age 15, trajectory membership was predicted by gender, self-efficacy, time spent participating in sport, time spent watching TV, parental socioeconomic status, and academic literacy. At age 25, people in the guideline-adherent exerciser trajectory (model 1) reported better general health relative to other trajectories, Those in the weekly exerciser trajectory (model 2) had better general health and reduced rates of psychological distress, were happier with life and were more optimistic for the future relative to participants in less than weekly trajectory groups. Exercise-promoting interventions for Young People should specifically address the needs of females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage.

Subjective Cognitive Decline and Frailty Trajectories and Influencing Factors in Japanese Community-Dwelling Older Adults: A Longitudinal Study

We studied frailty and subjective cognitive decline (SCD) trajectories in older Japanese adults and evaluated the influence of various factors on these trajectories. We analyzed data from 1157 non-demented adults aged 70 and above from 2013 to 2019. Frailty was assessed using the self-administered Kihon Checklist (KCL), a Japanese frailty index. SCD was evaluated using the questionnaire of the Subjective Memory Complaints scale. Through group-based joint trajectory models, we discerned three frailty trajectories: non-progressive (n = 775), moderate progressive (n = 312), and rapid progressive (n = 70); and three SCD trajectories: non-progressive (n = 302), moderate progressive (n = 625), and rapid progressive (n = 230). Individuals in the rapid progressive SCD trajectory had a 32.2% probability of also being in the rapid progressive frailty trajectory. In contrast, those in the non-progressive SCD trajectory had zero probability of being in the rapid progressive frailty trajectory. Both the rapid progressive frailty and SCD groups combined had a higher incidence of depressive symptoms and slow gait speed. Our results have found that frailty and SCD share a similar trajectory in Japanese older adults. Additionally, rapid progressive frailty and SCD were associated with the highest risk of depressive symptoms and slow gait speed. Thus, interventions targeting both frailty and cognitive decline should prioritize mental health enhancement and gait speed improvement.

Caregiver perceptions of neighbourhood green space quality, heavy traffic conditions, and asthma symptoms: Group-based trajectory modelling and multilevel longitudinal analysis of 9,589 Australian children

BACKGROUND

This study assessed the associations between changes in exposure to green space quality, heavy traffic conditions, and asthma symptoms among children.

METHODS

10-year cohort data of 9589 children, retrieved from the Longitudinal Study of Australian Children, were analysed. Caregiver-reported neighbourhood green space quality, heavy traffic conditions, and asthma symptoms were measured biennially. Group-based trajectory mixture models were used to develop trajectory groups, denoting different patterns of, or changes in, exposure to green space quality, heavy traffic conditions, and asthma symptoms across childhood. Multilevel multinomial logistic regression was used to identify factors associated with trajectory group membership and examine the confounders-adjusted associations between trajectory groups of green space quality, heavy traffic conditions, and asthma symptoms.

RESULTS

Four trajectory groups for each green space quality and heavy traffic conditions, and five trajectory groups for asthma symptoms were developed. Children in less disadvantaged areas were more likely to be in trajectory groups with exposure to quality green space, but less likely to be exposed to heavy neighbourhood traffic. Living in more remote areas was associated with the decreased likelihood to be in groups with exposure to both quality green space and heavy traffic conditions over time. Accumulation of exposure to quality green space across childhood was not found to be protective against asthma symptoms. However, children whose caregiver perceptions of heavy traffic conditions trended from low to moderate levels; or were consistently in high levels across childhood had a higher likelihood to be in trajectory groups with a higher risk of asthma symptoms.

CONCLUSION

Exposure to quality green space was not associated with the reduced risk of asthma symptoms. The accumulation of exposure to heavy traffic conditions increased the likelihood of asthma symptoms among children. Reducing the presence of heavy traffic in neighbourhoods might reduce the risk of childhood asthma.

Perceived green space quality, child biomarkers and health-related outcomes: A longitudinal study

Accumulating exposure to quality green space over time is posited to influence child health, yet longitudinal studies are scarce. This study aimed to examine the associations between trajectories of perceived green space quality and child health-related outcomes. We used data from 1874 childrenin the B-cohort of the Longitudinal Study of Australian Children who participated in the Child Health Checkpoint module at 11-12 years. Data on caregiver perceived green space quality measured biennially was assessed using discrete trajectory mixture models to group children by contrasting distributions in green space quality over time. Examination of associations between trajectory groups of perceived green space quality and child biomarkers (i.e., albumin-to-creatinine ratio, total, cholesterol, total triglycerides, and glucose), physical health and behavioural assessments (i.e., anthropometric measurements, blood pressure, sedentary behaviour, physical activity, sleep, aerobic work capacity, and general wellbeing), and health care use were assessed using multilevel models, adjusted for sociodemographic variables. Four perceived green space quality trajectories were identified: "decreasing quality from high to moderate"; "increasing quality from low to high"; "consistently high quality"; "consistently low quality". Compared with consistently low levels of quality green space, adjusted models indicated consistently high-quality green space was associated with lower total triglycerides (β -0.13; 95%CI -0.25, -0.01). Lower odds of hospital admission was observed among children who accumulated quality green space over time (OR 0.45; 95%CI 0.23, 0.87). These associations were observed in boys only in sex-stratified analyses. Moreover, boys accumulating quality green space through time tended to have lower diastolic blood pressure (β -2.76; 95%CI -5.17, -0.35) and girls who experienced loss in quality green space tended to have a higher percentage of body fat (β 2.81; 95%CI 0.43, 5.20). Accumulating quality green space over time is important for various aspects of child health, with contrasting benefits by sex.

24-Hour Movement Behaviors in Children with Chronic Disease and Their Healthy Peers: A Case-Control Study

Background: Time spent in 24-h movement behaviors is important to health and wellbeing in childhood, but levels of these behaviors in children with chronic disease are unknown. Methods: A case-control-study included 80 children with chronic disease; 20 with type 1 diabetes mellitus (T1DM), 20 with juvenile idiopathic arthritis (JIA), 20 with congenital heart disease (CHD), 20 with cystic fibrosis (CF); pair-matched individually for age, sex, and timing of measures with 80 healthy children. Habitual time spent in movement behaviors and step counts were all measured with an activPAL accelerometer over 7 days. Comparisons against recommendations and differences between the groups were made. Results: Time spent in physical activity and step counts/day were significantly lower in T1DM and CHD groups compared to controls. Only 20/80 children with chronic disease and 29/80 controls met step count recommendations. Sedentary time was significantly higher in children with CF compared to controls. Time spent asleep was slightly greater in children with chronic disease, significant only for the JIA group. Sleep disruption was consistently greater in those with chronic disease, reaching significance for T1DM, CHD, and CF groups. Conclusions: For some groups of children with chronic disease, 24-h movement behaviors may differ substantially from recommendations, and slightly but systematically from their healthy peers. Optimizing levels of 24-h movement behaviors should confer a number of benefits for child health, development, and wellbeing.

Moderate-To-Vigorous Intensity Physical Activity and Sedentary Behaviour across Childhood and Adolescence, and Their Combined Relationship with Obesity Risk: A Multi-Trajectory Analysis

The combined role of objectively assessed moderate-vigorous intensity physical activity (MVPA) and sedentary behaviour (SB) is unclear in obesity prevention. This study aimed to identify latent groups for MVPA and SB trajectories from childhood to adolescence and examine their relationship with obesity risk at adolescence. From the Gateshead Millennium Study, accelerometer-based trajectories of time spent in MVPA and SB at ages 7, 9, 12, and 15 were derived as assigned as the predictor variable. Fat mass index (FMI), using bioelectrical impedance at age 15, was the outcome variable. From 672 children recruited, we identified three distinct multiple trajectory groups for time spent in MVPA and SB. The group with majority membership (54% of the cohort) had high MVPA and low SB at childhood, but MVPA declined and SB increased by age 15. One third of the cohort (31%) belonged to the trajectory with low MVPA and high time spent sedentary throughout. The third trajectory group (15% of the cohort) that had relatively high MVPA and relatively low SB throughout had lower FMI (-1.7, 95% CI (-3.4 to -1.0) kg/m2, p = 0.034) at age 15 compared to the inactive throughout group. High MVPA and low SB trajectories when combined are protective against obesity.

Correlates of dual trajectories of physical activity and sedentary time in youth: The UP & DOWN longitudinal study

Trajectories of physical activity and sedentary time (SED) may differ between subgroups of youth. The aim of this study was to identify group-based dual trajectories of physical activity and SED and explore individual, social, and environmental correlates of these trajectories. Longitudinal data (three time points, baseline 2011-2012) of Spanish youth (n = 1597, mean age = 11.94 ± 2.52, 50.9% boys) were used. Moderate-to-vigorous physical activity (MVPA) and SED were assessed objectively at each time point, and 21 potential correlates were self-reported at baseline. Parallel process growth mixture models identified shared categorical latent groups, adjusting for school and age. Multinomial logistic regression models identified baseline correlates of a given trajectory. Four shared categorical latent groups were identified: (1) stable MVPA and decreasing SED (4%); (2) stable MVPA and increasing SED (3%); (3) consistently higher MVPA (18%); and (4) stable low MVPA and slight increase in SED (75%). Multinomial logistic regression models with group 3 as reference found: negative affect (RRR = 0.90, 95% CI 0.84-0.97), parental screen-time rules (RRR = 1.15, 95% CI 1.00-1.33), and household media equipment (RRR = 1.17, 95% CI 1.05-1.30) predicted likelihood of group 1 membership; cons of reducing SED (RRR = 2.70, 95% CI 1.77-4.10) predicted likelihood of group 2 membership; and co-participation in physical activity with friends (RRR = 0.80, 95% CI 0.69-0.94), fathers' modeling of TV viewing (RRR = 1.22, 95% CI 1.02-1.47), and household media equipment (RRR = 1.16, 95% CI 1.02-1.31) predicted likelihood of group 4 membership. Results suggest that strategies to improve MVPA and SED behaviors among youth may need to be multifaceted, targeting all levels of influence.

Contemporaneous trajectories of physical activity and screen time in adolescents

Adolescents often report low moderate-to-vigorous physical activity (MVPA) and high screen time. We modeled sex-specific MVPA and screen time trajectories during adolescence and identified contemporaneous patterns of evolution. Data were drawn from 2 longitudinal investigations. The Nicotine Dependence in Teens (NDIT) study included 1294 adolescents recruited at age 12-13 years who completed questionnaires every 3 months for 5 years. The Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study included 937 participants recruited at age 9-12 years who completed questionnaires every 4 months for 7 years. MVPA was measured as the number of days per week of being active for at least 5 min (NDIT) or 60 min (MATCH). In both studies, screen time was measured as the number of hours spent weekly in screen activities. In each study, sex-specific group-based trajectories were modeled separately for MVPA and screen time from grade 7 to 11. Contemporaneous patterns of evolution were examined in mosaic plots. In both studies, 5 MVPA trajectories were identified in both sexes, and 4 and 5 screen time trajectories were identified in boys and girls, respectively. All combinations of MVPA and screen time trajectories were observed. However, the contemporaneous patterns of evolution were favourable in 14%-31% of participants (i.e., they were members of the stable high MVPA and the lower screen time trajectories). Novelty: MVPA and screen time trajectories during adolescence and their combinations showed wide variability in 2 Canadian studies. Up to 31% of participants showed favourable contemporaneous patterns of evolution in MVPA and screen time. Using uniform methods for trajectory modeling may increase the potential for replication across studies.

The Classification of the Persistent Infection Risk for Human Papillomavirus among HIV-Negative Men Who Have Sex with Men: Trajectory Model Analysis

Objective. To classify the infection risk of human papillomavirus (HPV) among human immunodeficiency virus- (HIV-) negative men who have sex with men (MSM) using group-based trajectory modeling (GBTM). Methods. This study collected data on demographic and sexual behavior characteristics by questionnaires at semiannual visits from March 1st, 2016 to December 31th, 2017. Researchers collected anal exfoliated cells to finish HPV testing and blood samples to finish HIV testing at baseline and follow-up visits. Accumulative infection numbers of different types of HPV as the primary outcome and the follow-up visits as the independent predicator to build a GBTM model. Results. There were 500 potentially eligible HIV-negative participants at baseline, 361 (72.2%) of whom were included in this study after screening. Three trajectory groups were identified as the best-fitted GBTM model. Trajectory 1, defined as decreased group (DG) accounted for 44.6% (161/361) of the sample, showed a declining pattern with visits. Trajectory 2, defined as flat group (FG) accounted for 49.6% (179/361) of the sample, showed a flat pattern with visits. Trajectory 3, regarded as the increased group (IG) accounted for 5.8% (21/361) of the sample, showed an uptrend. Compared to the DG, risk factors for the FG included receptive anal intercourse (AOR, 2.24; 95% CI, 1.36-3.71), occasional condom use in anal sex during the past six months (AOR, 1.90; 95% CI, 1.16-3.14), experience of transactional sex with males in the past year (AOR, 3.60; 95% CI, 1.12-11.54), and substance use (AOR, 1.81; 95% CI, 1.08-3.04). Risk factors for the IG included receptive anal intercourse (AOR, 2.81; 95% CI, 1.04-7.70), occasional condom use in anal sex during the past six months (AOR, 3.93; 95% CI, 1.40-11.01), and history of other STIs (AOR, 5.72; 95% CI, 1.40-23.46). Conclusion. The MSM data in this study showed three distinct developmental trajectories (DG, FG, and IG) of HPV infection among HIV-negative MSM, with receptive anal intercourse and occasional condom use in anal sex during the past six months being the risk factors associated with FG and IG.

Exploring the relationship between adolescent biological maturation, physical activity, and sedentary behaviour: a systematic review and narrative synthesis

CONTEXT

Across adolescence, there is a notable decline in physical activity in boys and girls. Maturational timing may be a risk factor for disengagement from physical activity and increased sedentary behaviours during adolescence.

OBJECTIVE

This systematic review aimed to summarise literature that examined the relationship between maturational timing, physical activity and sedentary behaviour in adolescents.

METHODS

Six electronic databases were searched for articles that assessed biological maturation and physical activity (including sports participation and active transportation) or sedentary behaviours in adolescents. Two reviewers conducted title, abstract, and full-text screening, reference and forward citation searches. Included articles were evaluated for quality using a standardised tool. A narrative synthesis was used to analyse the findings due to the heterogeneity of the studies.

RESULTS

Searches yielded 78 articles (64 unique studies) that met the inclusion criteria, representing 242,316 participants (153,179 unique). Studies ranged from 30.0% (low) to 91.7% (high) in quality. An inverse relationship between maturational timing and physical activity (in 50 and 60% of studies in boys and girls, respectively) and a positive relationship between maturational timing and sedentary behaviour (in 100% and 53% of studies in boys and girls, respectively) was most commonly reported. Evidence supporting an association between maturational timing, sports participation, and active transportation was inconsistent.

CONCLUSIONS

While this review demonstrates some evidence for early maturational timing as a risk factor for disengagement from physical activity and increase in sedentary behaviours, the reviewed literature also demonstrates that this relationship is complex. Future research that tracks maturity-related variations in physical activity and sedentary behaviours over adolescence is warranted.

One size does not fit all: identifying clusters of physical activity, screen time, and sleep behaviour co-development from childhood to adolescence

Purpose

Canada was the first to adopt comprehensive 24-h movement guidelines that include recommendations for physical activity, screen time and sleep to promote health benefits. No studies have investigated the concurrent development of these behaviours in youth. The objectives were to assess adherence to the Canadian 24-h movement guidelines for children and youth and estimate co-development of self-reported moderate-to-vigorous intensity physical activity (MVPA), screen time and sleep during 8-years from childhood to adolescence.

Methods

Nine hundred and twenty three participants of the MATCH study self-reported their MVPA, screen time and sleep duration at least twice over 8 years. MVPA and screen time were measured three times per year (24 cycles), and sleep was measured once per year (8 cycles). Guideline adherence was dichotomised as meeting each specific health behaviour recommendation or not. Multi-group trajectory modeling was used to identify unique trajectories of behavioural co-development. Analyses were stratified by sex.

Results

Between 10 and 39% of youth did not meet any recommendation at the various cycles of data collection. More than half of youth met only one or two recommendation, and roughly 5% of participants met all three recommendations at one or more study cycle throughout the 8 years of follow-up. Four different trajectories of behavioural co-development were identified for boys and for girls. For boys and girls, a complier (good adherence to the guideline recommendations; 12% boys and 9% girls), a decliner (decreasing adherence to the guideline recommendations; 23% boys and 18% girls) and a non-complier group (low adherence to the guideline recommendations; 42% boys and 42% girls) were identified. In boys, a MVPA-complier group (high MVPA-low screen time; 23%) was identified, whereas in girls a screen-complier group (moderate screen time-low MVPA; 30%) was identified.

Conclusions

There is a need to recognise that variations from general trends of decreasing MVPA, increasing screen time and decreasing sleep exist. Specifically, we found that although it is uncommon for youth to adhere to the Canadian 24-h movement guidelines, some youth displayed a high likelihood of attaining one or multiple of the behavioural recommendations. Further, patterns of adherence to the guidelines can differ across different sub-groups of youth.

Determinants of Physical Activity and Screen Time Trajectories in 7th to 9th Grade Adolescents-A Longitudinal Study

Physical activity (PA) in youth tends to decline with increasing age, while sedentary behaviour including screen time (ST) increases. There are adolescents, however, whose PA and ST do not follow this pattern. The aim of this study is (i) to examine trajectories in PA and ST from grade 7-9 among students in Berlin, and (ii) to investigate the relationship of these trajectories with individual factors and school type. For the present analyses, changes in students' PA and ST across three time points from 7th to 9th grade were assessed via self-report questionnaires. Positive and negative trajectories were defined for both PA (positive: increasing or consistently high, negative: decreasing or consistently low) and ST (vice versa). Multivariable logistic regression analyses were performed to identify possible predictors of PA and ST trajectories. In total, 2122 students were included (50.2% girls, mean age 12.5 (standard deviation 0.7) years). Compared to grade 7, less students of grade 9 fulfilled PA and ST recommendations (PA: 9.4% vs. 13.2%; ST: 19.4% vs. 25.0%). The positive PA trajectory included 44% of all students (63% boys), while the positive ST trajectory included 21% of all students (30% boys). Being a boy was significantly associated with a positive PA trajectory, while being a girl, having a high socioeconomic status, and attending a high school, were significantly associated with a positive ST trajectory. Different PA and ST trajectories among adolescents should be taken into account when implementing prevention programs for this target group.

Intensity and frequency of physical activity and high blood pressure in adolescents: A longitudinal study

Despite limited evidence on the association between physical activity (PA) and blood pressure (BP) in youth, experts recommend that adolescents engage regularly in moderate-to-vigorous PA. We examined the relationships between PA intensity and frequency and the likelihood of having high BP in a population-based cohort of adolescents from Montréal, Canada. PA was self-reported every 3 months from grade 7 to 11, and BP was measured at ages 12.8, 15.2, and 17.0 years on average. We analyzed data from 993 participants (mean [SD] age = 16.0 [1.0], 51.6% female) with BP data at ages 15.2 and/or 17.0 years, using pooled ordinal logistic regression. BP (normal/elevated/hypertensive range) was the outcome, and past-year PA intensity and frequency were potential predictors. Eight percent of participants had elevated BP (120-129/<80), and 3.2% had BP in the hypertensive range (≥130/≥80). Participants engaged in a median (interquartile range) of 7.0 (4.5, 9.3) and 5.5 (2, 10.8) moderate and vigorous PA sessions/week, respectively. After adjusting for age, sex, mother's education, use of alcohol and cigarette consumption, engaging in PA more intense than light during the previous year was associated with a lower odds of having BP in the hypertensive range (ORs [95% CIs] = 0.93 [0.88, 0.97] to 0.97 [0.94, 0.99]). The relationships were not altered by adjusting for BMI. Our findings support recommendations that adolescents engage in at least moderate PA on a regular basis to prevent development of BP in the hypertensive range.

Associations Between Trajectories of Leisure-Time Physical Activity and Television Viewing Time Across Adulthood: The Cardiovascular Risk in Young Finns Study

BACKGROUND

The purpose of this study was to examine trajectories of leisure-time physical activity (LTPA) and television-viewing (TV) time and their associations in adults over 10 years.

METHODS

The sample comprised 2934 participants (men, 46.0%) aged 24-39 years in 2001 and they were followed up for 10 years. LTPA and TV time were assessed using self-report questionnaires in 2001, 2007, and 2011. Longitudinal LTPA and TV-time trajectories and their interactions were analyzed with mixture modeling.

RESULTS

Three LTPA (persistently highly active, 15.8%; persistently moderately active, 60.8%; and persistently low active, 23.5%) and 4 TV time (consistently low, 38.6%; consistently moderate, 48.2%; consistently high, 11.7%; and consistently very high, 1.5%) trajectory classes were identified. Persistently highly active women had a lower probability of consistently high TV time than persistently low-active women (P = .02), whereas men who were persistently highly active had a higher probability of consistently moderate TV time and a lower probability of consistently low TV time than their persistently low-active counterparts (P = .03 and P = .01, respectively).

CONCLUSIONS

Maintaining high LTPA levels were accompanied by less TV over time in women, but not in men. The associations were partially explained by education, body mass index, and smoking.

Identifying County-Level All-Cause Mortality Rate Trajectories and Their Spatial Distribution Across the United States

INTRODUCTION

All-cause mortality in the United States declined from 1935 through 2014, with a recent uptick in 2015. This national trend is composed of disparate local trends. We identified distinct groups of all-cause mortality rate trajectories by grouping US counties with similar temporal trajectories.

METHODS

We used all-cause mortality rates in all US counties for 1999 through 2016 and estimated discrete mixture models by using county level mortality rates. Proc Traj in SAS was used to detect how county trajectories clustered into groups on the basis of similar intercepts, slopes, and higher order terms. Models with increasing numbers of groups were assessed on the basis of model fit. We created county-level maps of mortality trajectory groups by using ArcGIS.

RESULTS

Eight unique trajectory groups were detected among 3,091 counties. The average mortality rate in the most favorable trajectory group declined 29.4%, from 592.3 deaths per 100,000 in 1999 to 418.2 in 2016. The least favorable mortality trajectory group declined 3.4% over the period, from 1,280.3 deaths per 100,000 to 1,236.9. We saw significant differences in the demographic and socioeconomic profiles and geographic patterns across the trajectory categories, with favorable mortality trajectories in the Northeast, Midwest, and on the West Coast and unfavorable trajectories concentrated in the Southeast.

CONCLUSIONS

County-level disparities in all-cause mortality rates widened over the past 18 years. Further investigation of the determinants of the trajectory groupings and the geographic outliers identified by our research could inform interventions to achieve equitable distribution of county mortality rates.

Group-based physical activity trajectories in children transitioning from elementary to high school

Background

Physical activity has been observed repeatedly to decline as children transition into adolescence; however, few studies have explored the possibility that sub-groups of children experience unique patterns of change during this transition. The purpose of this longitudinal study was to examine the physical activity trajectories in clusters of youth transitioning from 5th to 11th grade.

Methods

Participants (n = 652) were recruited as 5th graders (ages 10–12 years) from elementary schools (n = 21) in two school districts. Demographic, anthropometric, and physical activity data were collected once per year when children were in 5th, 6th, 7th, 9th, and 11th grades. Children wore accelerometers for 7 consecutive days. Group-based trajectory modeling statistical techniques were applied to identify patterns of physical activity trajectories. Posterior probabilities confirmed participants’ membership in their respective group.

Results

Three distinct physical activity trajectories were identified. Group 1 (n = 27) remained highly active over time, and physical activity increased from ages 14 to 16 years. Group 2 (n = 365) was active at baseline, but activity declined and remained low as group members aged. Group 3 (n = 260) had the lowest levels of physical activity at all ages, and activity declined from ages 10 to 16 years.

Conclusions

While most children experienced a decline in physical activity as they transitioned into high school, some remained highly active and increased their level of physical activity. Future studies should test physical activity interventions for youth that are tailored for age-related trajectory groups.

Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review

BACKGROUND

In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases.

METHODS

The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations.

RESULTS

Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA.

CONCLUSIONS

The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions.

TRIAL REGISTRATION

PROSPERO registration number: CRD42018088120 .

Trajectories of self-reported physical activity and predictors during the transition to old age: a 20-year cohort study of British men

BACKGROUND

Maintenance of physical activity (PA) during later life is associated with optimal health; however, the long-term trajectories of PA into old age and their predictors have not been extensively researched using latent class methods. This study aimed to identify trajectories of self-reported PA and their predictors in men transitioning from midlife to old age.

METHODS

7735 men (aged 40-59 years) recruited in 1978-80 were followed up after 12, 16 and 20 years, reporting PA, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling identified the trajectories of PA and associations with time-stable and time-varying covariates. We considered a range of sociodemographic and health and lifestyle factors as potential covariates.

RESULTS

4952 men (mean baseline age 49.1 ± 5.6 years) providing PA data at ≥3 time points were included in analyses. Three distinct 20-year trajectories were identified: low decreasing (24.6%, n = 1218), light stable (51.1%, n = 2530) and moderate increasing (24.3%, n = 1204). Being older, having a manual occupation, having never married or had children, residing in the midlands or North of England, suffering from a range of health conditions, being a smoker/ex-smoker and never consuming breakfast cereal or alcohol were independently associated with reduced odds of belonging to the moderate increasing trajectory group compared to the low decreasing group. Of the time-varying covariates considered, leaving employment was associated with a decrease in PA in the low decreasing group (β -0.306, p < 0.001) but an increase in the light stable (β 0.324, p < 0.001) and moderate increasing groups (β 0.847, p < 0.001). Developing cardiovascular-related conditions was associated with a decrease in PA in the low decreasing (β -0.408, p < 0.001) and light stable groups (β -0.118, p < 0.001) but no association was observed in the moderate increasing group (β -0.060, p = 0.313).

CONCLUSIONS

Three distinct trajectories of PA were identified in men transitioning from midlife to old age, of which nearly a quarter had persistently low levels of PA. Promotion efforts may need to focus attention prior to middle age and consider a number of sociodemographic, health and lifestyle factors to sustain PA into old age. The effects of retirement and development of cardiovascular disease may vary according to PA trajectories.

Perceived Impairment in Sports Participation in Adolescents With Inflammatory Bowel Diseases: A Preliminary Examination

OBJECTIVE

Physical activity (PA) is important for adolescents with inflammatory bowel diseases (IBDs) given the increased risk of developing osteoporosis and the increased risk of IBD-related complications among those with IBD and obesity. Symptoms such as fatigue, abdominal pain, nausea, and frequent bowel movements can interfere with PA. Sports participation is an important source of PA for adolescents; however, the extent to which IBD interferes with sports participation is unstudied. The present study aimed to examine demographic, health-related, physical, and psychosocial correlates of perceived impairment in sports participation.

METHOD

Seventy-six adolescents (M[SD] = 14.5 [1.8] years, 45% girls) completed surveys of perceived impairment in sports participation, demographics, physical health, and psychosocial health. Physicians rated disease activity at enrolment. All participants were diagnosed with IBD for at least a year and prescribed a daily oral medication.

RESULTS

Nearly half of participants reported at least occasional interference in sports participation because of their IBD. Active disease (P = 0.014), older age (P = 0.006), and poorer disease-specific quality of life, and quality of life in physical health and psychosocial domains were associated with greater impairment in sports participation in bivariate analyses (P < 0.001). In regression analyses, systemic disease-related symptoms, body image concerns, and older age emerged as the strongest predictors of impairment in sports participation (P < 0.05).

CONCLUSIONS

Older adolescents, those with greater systemic symptoms, and those with poorer body image may be particularly at risk for impairment in sports participation. Addressing barriers to sports participation may be a useful strategy in enhancing PA in this patient group.

Active lifestyle in childhood and adolescence prevents obesity development in young adulthood

OBJECTIVE

To test the hypothesis that individuals who are active but who decrease physical activity (PA) over time have a higher risk of becoming obese in young adulthood, when compared to individuals who are consistently active throughout childhood and adolescence.

METHODS

Iowa Bone Development Study cohort members (242 males and 251 females) participated in accelerometry assessments, dual-energy X-ray absorptiometry scans, and dietary questionnaire surveys at ages 5, 8, 11, 13, 15, 17, and 19 years. Group-based trajectory analyses identified distinct trajectory patterns of moderate- to vigorous-intensity PA (MVPA), percentage of body fat, and energy intake. A multivariable logistic regression model was fit to estimate the odds of "becoming obese" based on the MVPA trajectories, adjusted for mother's education, somatic maturation, and energy intake.

RESULTS

Among males, 74.7% had a "normal" body fat pattern, 14.6% had a "becoming obese" pattern, and 10.7% had a "consistently obese" pattern, while among females, the percentages were 58.6%, 28.6%, and 12.8%, respectively. Participants who were active (≥45 min MVPA) as children but decreased MVPA with age were more likely to become obese, compared to consistently active participants (adjusted OR = 2.77; 95% CI = 1.16, 6.58).

CONCLUSIONS

An active lifestyle throughout childhood and adolescence could prevent obesity development in young adulthood.