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Zhao H, Wu N, Haapala EA, Gao Y. Association between meeting 24-h movement guidelines and health in children and adolescents aged 5-17 years: a systematic review and meta-analysis. Front Public Health 2024; 12:1351972. [PMID: 38774055 PMCID: PMC11106490 DOI: 10.3389/fpubh.2024.1351972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/09/2024] [Indexed: 05/24/2024] Open
Abstract
Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines. Systematic review registration https://www.crd.york.ac.uk/prospero/, CRD42023481230.
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Affiliation(s)
- HanHua Zhao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Na Wu
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Eero A. Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ying Gao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
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Brady SM, Salway R, Mariapun J, Millard L, Ramadas A, Rizal H, Skinner A, Stone C, Johnson L, Su TT, Armstrong MEG. Accelerometer-measured 24-hour movement behaviours over 7 days in Malaysian children and adolescents: A cross-sectional study. PLoS One 2024; 19:e0297102. [PMID: 38377079 PMCID: PMC10878504 DOI: 10.1371/journal.pone.0297102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions. METHODS Data came from the South-East Asia Community Observatory health surveillance cohort, 2021-2022. Children aged 7-18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity. RESULTS The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9-8.4) hours/day asleep, 12.4 (95% CI = 12.2-12.7) hours/day inactive, 2.8 (95% CI = 2.7-2.9) hours/day in LPA, and 33.0 (95% CI = 31.0-35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics. CONCLUSIONS Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia.
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Affiliation(s)
- Sophia M. Brady
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jeevitha Mariapun
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Louise Millard
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Hussein Rizal
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Andy Skinner
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chris Stone
- Integrative Cancer Epidemiology Programme, MRC Integrative Epidemiology Unit, and School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Laura Johnson
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia, Malaysia
| | - Miranda E. G. Armstrong
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
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Zink J, Liu B, Yang CH, Herrick KA, Berrigan D. Differential associations between television viewing, computer use, and adiposity by age, gender, and race/ethnicity in United States youth: A cross-sectional NHANES analysis. Pediatr Obes 2023; 18:e13070. [PMID: 37580912 DOI: 10.1111/ijpo.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Time spent on screens and adiposity change rapidly from childhood to adolescence, with differences by gender and race/ethnicity. OBJECTIVE Apply time-varying effect models (TVEMs) to a nationally representative sample of youth to identify the age ranges when the cross-sectional associations between television viewing, computer use, and adiposity are significant. METHODS Data from 8 to 15-year-olds (n = 3593) from the National Health and Nutrition Examination Survey (2011-2018) were extracted. TVEMs estimated the associations between television viewing, computer use, and fat mass index as dynamic functions of the participants' age, stratified by gender and race/ethnicity. RESULTS TVEMs revealed age-specific statistically significant associations that differed by gender and race/ethnicity. Notably, computer use was related to higher adiposity in non-Hispanic White females aged 9.3-11.4 years (slope β-range: 0.1-0.2) and in non-Hispanic Black females older than 14.8 years (β-range: 0.1-0.5). In males, these age windows were 13.5-15.0 years (non-Hispanic White, β-range: 0.1-0.2), 11.4-13.0 years (non-Hispanic Black, β-range: 0.1-0.14), and older than 13.0 years (Hispanic, β-range: 0.1-0.4). CONCLUSIONS More research during the specific age ranges in the demographic subgroups identified here could increase our understanding of tailored interventions in youth.
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Affiliation(s)
- Jennifer Zink
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Benmei Liu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kirsten A Herrick
- Risk Factors Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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Lund Rasmussen C, Gába A, Stanford T, Dygrýn J, Dumuid D, Janda D, Hron K. The Goldilocks Day for healthy adiposity measures among children and adolescents. Front Public Health 2023; 11:1158634. [PMID: 37841713 PMCID: PMC10569221 DOI: 10.3389/fpubh.2023.1158634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background The optimal balance of time spent on daily movement behaviors ("The Goldilocks Day") associated with childhood obesity remains unknown. Objective To estimate the optimal durations of sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MPVA) associated with excess adiposity in a paediatric population. Methods Accelerometer-measured 24-h movement behaviors were obtained from 659 Czech children and adolescents (8-18-year-olds). Adiposity indicators were body mass index z-score, fat mass percentage, fat-free mass index, and visceral adipose tissue. Excess adiposity was defined as exceeding the 85th percentile for an adiposity indicator. Compositional regression analyses were used investigate the associations between movement behaviors and adiposity indicators and estimating "The Goldilocks Day." Results The movement behavior composition was associated with visceral adipose tissue (Fdf1 = 3,df2 = 317 = 3.672, p = 0.013) and fat mass percentage (Fdf1 = 3,df2 = 289 = 2.733, p = 0.044) among children and adolescents. The Goldilocks Day consisted of 8.5 h of sleep, 10.8 h of SB, 3.9 h of LPA, and 0.8 h of MVPA among children and 7.5 h of sleep, 12.4 h of SB, 3.6 h of LPA, and 0.5 h of MVPA among adolescents. Conclusion Optimizing the time spent sleeping, and in sedentary and physical activities appears to be important in the prevention of excess adiposity.
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Affiliation(s)
- Charlotte Lund Rasmussen
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Tyman Stanford
- Alliance for Research in Exercise, Nutrition, and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition, and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David Janda
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Karel Hron
- Department of Mathematical Analysis and Applications of Mathematics, Palacký University Olomouc, Olomouc, Czechia
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Marques A, Ramirez-Campillo R, Gouveia ÉR, Ferrari G, Tesler R, Marconcin P, Loureiro V, Peralta M, Sarmento H. 24-h Movement Guidelines and Overweight and Obesity Indicators in Toddlers, Children and Adolescents: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2023; 9:30. [PMID: 37184735 DOI: 10.1186/s40798-023-00569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 04/13/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Engaging in physical activity increases energy expenditure, reducing total body fat. Time spent in sedentary behaviours is associated with overweight and obesity, and adequate sleep duration is associated with improved body composition. This systematic review aimed to analyse the relationship between compliance with the 24-h movement guidelines and obesity indicators in toddlers, children and adolescents. METHODS A systematic review and meta-analysis was conducted. PubMed, Web of Science and Scopus were searched from inception to December 2021. Cross-sectional and prospective studies that analysed the relationship between 24-h movement guidelines and overweight and obesity written in English, French, Portuguese or Spanish were included. PROSPERO registration number is CRD42022298316. RESULTS The associations between meeting the 24-h movement guidelines and standardised body mass index were null in the two studies for toddlers. Seven studies analysed the relationship between compliance with the 24-h movement guidelines and overweight and obesity among preschool children. Of these seven studies, six found no association between compliance with 24-h movement guidelines and body composition. Among children and adolescents, 15 articles were analysed. Of these 15 studies, in seven, it was found that children and adolescents who meet the 24-h movement guidelines were more likely to have lower risks of overweight and obesity. The meta-analysis yielded a pooled OR = 0.80 (95% CI = 0.68 to 0.95, p = 0.012, I2 = 70.5%) in favour of compliant participants. Regarding participants' age groups, compliance with 24-h movement guidelines seems to exert greater benefits on overweight and obesity indicators among children-adolescents (OR = 0.62, p = 0.008) compared to participants at preschool (OR = 1.00, p = 0.931) and toddlers (OR = 0.91, p = 0.853). CONCLUSION Most included studies have not observed a significant relationship between compliance with the 24-h movement guidelines and overweight and obesity in toddlers, children and adolescents.
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Affiliation(s)
- Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Lisbon, Portugal.
- ISAMB, Universidade de Lisboa, Lisbon, Portugal.
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Élvio R Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal
- LARSYS, Interactive Technologies Institute, Funchal, Portugal
| | - Gérson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Riki Tesler
- School of Health Sciences, Ariel University, Ariel, Israel
| | - Priscila Marconcin
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Lisbon, Portugal
- KinesioLab Research Unit in Human Movement Analysis, Instituto Piaget, Almada, Portugal
| | - Vânia Loureiro
- ISAMB, Universidade de Lisboa, Lisbon, Portugal
- Department of Arts, Humanities and Sports, School of Education, Polytechnic Institute of Beja, Beja, Portugal
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Lisbon, Portugal
- ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Hugo Sarmento
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
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Liu Y, Sun X, Zhang E, Li H, Ge X, Hu F, Cai Y, Xiang M. Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents. Nutrients 2023; 15:2055. [PMID: 37432199 DOI: 10.3390/nu15092055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. METHODS A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. RESULTS The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. CONCLUSIONS Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.
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Affiliation(s)
- Yujie Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Huilun Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
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Sun Y, Liu Y, Yin X, Li M, Zhang T, Zhang F, Guo Y, Sun P. Proportion of Chinese Children and Adolescents Meeting 24-Hour Movement Guidelines and Associations with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1408. [PMID: 36674163 PMCID: PMC9859181 DOI: 10.3390/ijerph20021408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Background: Since there is little knowledge about the 24-hour movement behaviors of Chinese children and adolescents, the purposes of this study were to investigate the proportion of Chinese children and adolescents meeting the 24-Hour Movement Guidelines and to further evaluate its relationship with overweight and obesity. Methods: A total of 440 children and adolescents aged 7−18 years from 7 cities in China were selected to measure physical activity using accelerometers, and sleep (SLP) and screen time (ST) using questionnaires. The data were analyzed with the independent T-test, Mann−Whitney U test, Cox−Stuart test, chi-square test, and logistic regression. Results: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was 7.3%. Boys (11.8%) were higher than girls (3.4%) (p < 0.001) and showed a downward trend with age (Ptrend = 0.03). The rates of overweight and obesity among children and adolescents who met the ST, MVPA + ST, ST + SLP, and MVPA + SLP + ST guidelines were 39%, 15%, and 36%, and 25% did not meet any guidelines. The rates of overweight and obesity among those who met 1, 2, and 3 guidelines were lower than the rate among those who did not meet any guidelines (odds ratio (OR) = 0.51, 95% confidence interval (CI): 0.22−1.17; OR = 0.32, 95% CI: 0.13−0.77; OR = 0.23, 95% CI: 0.07−0.81) and showed a decreasing trend (Ptrend = 0.006). Conclusions: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was low. The rate of overweight and obesity among children and adolescents who met the overall 24-Hour Movement Guidelines was the lowest compared with the rates among those who met any one or two. There was a dose−response relationship between the number of guidelines met and the overweight and obesity rate.
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Affiliation(s)
- Yi Sun
- College of Physical Education, Ludong University, Yantai 264025, China
| | - Yuan Liu
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Xiaojian Yin
- College of Economics and Management, Shanghai Institute of Technology, Shanghai 201418, China
| | - Ming Li
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Ting Zhang
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Feng Zhang
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Yaru Guo
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Pengwei Sun
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
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Kozioł-Kozakowska A, Wójcik M, Januś D, Starzyk J. The positive impact of lifestyle intervention on selected mio- and chemokines levels in prepubertal children with obesity. Pediatr Endocrinol Diabetes Metab 2023; 29:83-90. [PMID: 37728459 PMCID: PMC10411087 DOI: 10.5114/pedm.2023.127273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/08/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION It is proven that life style modification (diet and physical exercises) have positive effect on the metabolic functions in pa-tients with obesity, even without significant weight reduction. AIM OF THE STUDY The objective of the present study was to check whether the intensive controlled lifestyle intervention (personalized diet modification and monitored, regular physical activity) may have positive impact on the concentration of irisin and chemerin in children with obesity. MATERIAL AND METHODS Twenty children (mean age 8.9) were included in the prospective, cross-over study. They were randomly assigned to group A (with three months intensive intervention), and B (standard intervention). After three months, the groups were switched. RESULTS Mean irisin level increased significantly after the phase of intensive intervention (4.8 to 5.1 µg/ml; p = 0.03), regardless of whether the intervention was applied from the beginning (Group A) or after 3 months from the advice of healthy-lifestyle (Group B). A period without intensive monitoring was associated with a significant reduction of irisin level. For chemerin in the group A (starting from intensive intervention) mean level decreased after the phase of intensive intervention (65.8 to 57.0 ng/ml), and then increased to 67 ng/ml during the standard intervention. In the group B after the standard intervention period chemerin level increased 67.5 to 68.8 ng/ml (p = 0.03), and then after introduction the intensive intervention de-creased to 63.7 ng/ml. CONCLUSIONS Personalized diet modification and regular, daily exercises may positively influence on the levels of irisin and chemerin.
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Affiliation(s)
- Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Institute of Pediatrics, Jagiellonian University Medical College, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University, Medical College, Poland
| | - Dominika Januś
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University, Medical College, Poland
| | - Jerzy Starzyk
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University, Medical College, Poland
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Janda D, Gába A, Vencálek O, Fairclough SJ, Dygrýn J, Jakubec L, Rubín L. A 24-h activity profile and adiposity among children and adolescents: Does the difference between school and weekend days matter? PLoS One 2023; 18:e0285952. [PMID: 37200304 DOI: 10.1371/journal.pone.0285952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/05/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Twenty-four-hour movement behaviours are gaining attention in the research community. However, no study has addressed how 24-h activity profiles vary between structured and less structured days and whether an unfavourable activity profile is associated with childhood obesity. We aimed to analyse differences between school day and weekend day 24-h activity profiles and their associations with adiposity indicators among children and adolescents. METHODS Participants were 382 children and 338 adolescents who wore wrist accelerometers for 24 hours a day for seven consecutive days. The 24-h activity profile expressed by the average acceleration (AvAcc) and intensity gradient (IG) were estimated from multi-day raw accelerometer data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Multiple linear regression of activity profile metrics and adiposity indicators was performed separately for school and weekend days. RESULTS Weekend days AvAcc and IG were lower compared to school days in both age groups (p <0.001 for all). Specifically, AvAcc was lower by 9.4% and 11.3% in children and adolescents, respectively. IG on weekend days was lower (more negative) by 3.4% in children and 3.1% in adolescents. Among children, on school days AvAcc and IG were negatively associated with FM%, FMI, and VAT, whilst on weekend days AvAcc was positively associated with BMI z-score, FMI, and VAT (p < 0.05 for all). Among adolescents, negative associations were found between weekend day AvAcc and IG and FM% and FMI (p < 0.05 for all), respectively. CONCLUSIONS This study confirms the importance of 24-h activity profile as a potentially protective factor against excess adiposity. The variability of movement behaviours during structured and less structured days should be considered when optimizing the 24-h movement behaviours to prevent childhood obesity.
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Affiliation(s)
- David Janda
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Ondřej Vencálek
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Stuart J Fairclough
- Health Research Institute and Movement Behaviours, Health, and Wellbeing Research Group, Department Sport and Physical Activity, Edge Hill University, Ormskirk, United Kingdom
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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Fillon A, Pereira B, Vanhelst J, Baran J, Masurier J, Guirado T, Boirie Y, Duclos M, Julian V, Thivel D. Development of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q): Psychometric Validity and Clinical Interpretation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13782. [PMID: 36360664 PMCID: PMC9655272 DOI: 10.3390/ijerph192113782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pediatricians' clinical practice and health interventions in youths require instruments with adequate psychometric properties to assess physical activity (PA), sedentary behaviors (SB), and their subdomains. OBJECTIVE To assess the psychometric properties of the Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) in healthy French children and adolescents. METHODS The CAPAS-Q has been developed through a rigorous collective procedure and consists of a 31 items self-administered questionnaire evaluating children's 7-day PA and SB dimensions and subdomains. Participants (n = 103, aged 8-18 years old) completed the questionnaire twice (7 days apart) and wore an ActiGraph GT3X + accelerometer for 7 days. Anthropometric measurements and body composition were assessed. RESULTS Cronbach alpha for PA and SB dimensions were 0.71 and 0.68, respectively. Reproducibility was found moderate to good, with Lin's coefficients of 0.69 and 0.68 for PA and SB dimensions, respectively. Reproducibility was higher for adolescents compared to children. PA dimension was positively correlated with moderate PA, vigorous PA, moderate to vigorous PA, and total PA times and negatively correlated with SB time (p < 0.05). SB dimension and screen time were positively correlated with SB time and negatively correlated with LPA, MPA, MVPA, and total PA times (p < 0.05). Spearman correlation coefficients were fair to moderate, ranging between 0.23-0.45. CONCLUSION The CAPAS-Q proposes a reliable and valid evaluation of French children and adolescents' PA and SB, providing clinicians with potential intervention levels to improve youth movement behaviors.
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Affiliation(s)
- Alicia Fillon
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Jérémy Vanhelst
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics—University of Paris Cité (CRESS), 93017 Bobigny, France
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Julie Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital,13 Rue Molière, 63000 Clermont-Ferrand, France
| | - Terry Guirado
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
| | - Yves Boirie
- CRNH-Auvergne, 63178 Clermont-Ferrand, France
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
- UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Martine Duclos
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
- UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied, 63000 Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont Auvergne University, CRNH Auvergne, 63178 Clermont-Ferrand, France
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), UFR Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63000 Clermont-Ferrand, France
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Gába A, Baďura P, Vorlíček M, Dygrýn J, Hamřík Z, Kudláček M, Rubín L, Sigmund E, Sigmundová D, Vašíčková J. The Czech Republic's 2022 Report Card on Physical Activity for Children and Youth: A rationale and comprehensive analysis. J Exerc Sci Fit 2022; 20:340-348. [PMID: 36128039 PMCID: PMC9450136 DOI: 10.1016/j.jesf.2022.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 10/26/2022] Open
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Julian V, Bergsten P, Ennequin G, Forslund A, Ahlstrom H, Ciba I, Dahlbom M, Furthner D, Gomahr J, Kullberg J, Maruszczak K, Morwald K, Olsson R, Pixner T, Schneider A, Pereira B, Ring-Dimitriou S, Thivel D, Weghuber D. Association between alanine aminotransferase as surrogate of fatty liver disease and physical activity and sedentary time in adolescents with obesity. Eur J Pediatr 2022; 181:3119-3129. [PMID: 35771354 DOI: 10.1007/s00431-022-04539-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/26/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 ± 2.2 years, body mass index (BMI) 98.9 ± 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time. CONCLUSION Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible. WHAT IS KNOWN • MVPA and SED times are associated with cardiometabolic risks in youths with obesity. • The relationships between NAFLD markers and concomitant MVPA and SED times have not been studied in this population. WHAT IS NEW • Low SED time is associated with healthier liver enzyme profiles and LFC independent of MVPA. • While low SED/high MVPA is the more desirable pattern, low SED/low MVPA pattern would have healthier liver enzyme profile compared with high MVPA/high SED, independent of BMI, suggesting that reducing SED time irrespective of MVPA is needed to optimize liver health.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, Human Nutrition Research Center (CRNH), University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, INRA, University of Clermont Auvergne, Clermont-Ferrand, Europe, France. .,Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.,Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gael Ennequin
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Clermont-Ferrand, France
| | - Anders Forslund
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Hakan Ahlstrom
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, 431 53, Mölndal, Sweden
| | - Iris Ciba
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Dahlbom
- Children Obesity Clinic, Uppsala University Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Dieter Furthner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Julian Gomahr
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Antaros Medical AB, BioVenture Hub, 431 53, Mölndal, Sweden
| | - Katharina Maruszczak
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Katharina Morwald
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Roger Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Thomas Pixner
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Anna Schneider
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Bruno Pereira
- Department of Biostatistics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Clermont-Ferrand, France
| | - Daniel Weghuber
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148798. [PMID: 35886650 PMCID: PMC9319843 DOI: 10.3390/ijerph19148798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023]
Abstract
Background: The combined movement behavior guidelines for adolescents recommend ≥60 min of moderate to vigorous physical activity, ≤2 h of screen time, and 8–10 h of sleep. Considering that the information available on this topic in the young Latin American population is rare, this study aimed to identify the proportion of a sample of Brazilian adolescents meeting individual guidelines as well as the combination of the three healthy movement behavior guidelines. In addition, another objective of the study was to examine the effects of compliance with these guidelines on cardiometabolic health markers. Methods: This is a cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire with structured questions was applied to collect data on physical activity, screen time, and sleep duration. Cardiometabolic health was assessed by the calculation of a continuous risk score, including twelve markers related to body fat, blood pressure, plasma lipids and lipoproteins, glycemia, and insulin. Results: Only 4.8% (4.3–5.4) of the adolescents met the three healthy movement behavior guidelines, while 9.3% (8.4–10.4) of the sample did not meet any of the guidelines. No significant difference between sexes was found in the simultaneous compliance of the three movement guidelines. Adolescents who did not meet any of the movement guidelines were twice as likely to have higher cardiometabolic risk (OR = 2.05 (1.41–3.17)) than their peers who met all three guidelines. Conclusions: Considering the high proportion of adolescents who did not meet the movement behavior guidelines and the negative effects on cardiometabolic health, it is suggested that future policies and interventions should consider an integrated and holistic approach aimed at simultaneous actions of maximizing physical activity, minimizing screen time, and ensuring sufficient sleep duration.
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Hansen J, Hanewinkel R, Galimov A. Physical activity, screen time, and sleep: do German children and adolescents meet the movement guidelines? Eur J Pediatr 2022; 181:1985-1995. [PMID: 35113254 PMCID: PMC8811591 DOI: 10.1007/s00431-022-04401-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/13/2022]
Abstract
UNLABELLED The interactions between physical activity (PA), screen time, and sleep affect the health of children and adolescents. This study described the national prevalence estimates of German youth aged 9 to 18 years who meet PA, screen time, and sleep guidelines alone and in combination and examined the associations of demographic and personal characteristics with adherence to guidelines. Data from a 2019-2020 German student survey were used (n = 15,786). The target population consisted of children and adolescents enrolled in grades 5-10, with a mean age of 13.0 years (SD = 1.8) and an equal gender distribution (male: 50%). The levels of PA, screen time, and sleep were assessed by self-reports (online questionnaires). The prevalence rates of meeting each guideline individually and in different combinations were calculated, and multilevel logistic regression models were used to examine the associations of demographic and personal characteristics with meeting versus not meeting guidelines. Overall, 9.7% of the respondents met all three guidelines combined, and approximately 25% did not meet any of the guidelines. Half of the participants (50%) met the sleep guidelines, and approximately one third met the screen time (35%) and PA (37%) guidelines alone. Demographic characteristics associated with adherence to meeting all three movement guidelines included younger age, male gender, higher self-reported socioeconomic status, and school type. Personal characteristics related to adherence to meeting all three movement guidelines included better subjective school performance, less frequent attention deficit hyperactivity disorder (ADHD), lower levels of depressive symptoms, lower body mass index (BMI), and not using substances in the past 30 days. CONCLUSION A low percentage of German children and adolescents met the movement guidelines. With increasing age, the proportion of young people who follow the recommendations decreases. There is an urgent need for health interventions devoted to youth behavior as a whole. WHAT IS KNOWN • High levels of PA, low levels of screen time, and optimal sleep duration provide enhanced health benefits in comparison to the adoption of just one of these behaviors. • Evidence shows that movement behaviors interact throughout the day and should be studied concurrently. WHAT IS NEW • Approximately 10% of German children and adolescents met the recommendations on PA, screen time, and sleep, while 25% did not meet any guidelines. • Meeting all guidelines was associated with less frequent ADHD and depressive symptoms, lower BMI, and less frequent substance use in the past 30 days.
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Affiliation(s)
- Julia Hansen
- Institute for Therapy and Health Research, IFT-Nord, Harmsstrasse 2, 24114 Kiel, Germany
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, IFT-Nord, Harmsstrasse 2, 24114 Kiel, Germany
| | - Artur Galimov
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Institute for Health Promotion and Disease Prevention Research, Los Angeles, USA
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Materová E, Pelclová J, Gába A, Frömel K. Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades. BMC Public Health 2022; 22:363. [PMID: 35189870 PMCID: PMC8859875 DOI: 10.1186/s12889-022-12766-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic. METHODS The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". RESULTS Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively. CONCLUSIONS Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.
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Affiliation(s)
- Eliška Materová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Jana Pelclová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Aleš Gába
- Department of Natural Sciences in Kinathropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Karel Frömel
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
- Institute of Sport Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Moitra P, Madan J, Verma P. Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents. BMC Public Health 2021; 21:2093. [PMID: 34781921 PMCID: PMC8591930 DOI: 10.1186/s12889-021-12183-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. METHODS Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. RESULTS The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. CONCLUSIONS The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.
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Affiliation(s)
- Panchali Moitra
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Jagmeet Madan
- Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
| | - Preeti Verma
- Department of Special Education, Department of Interdisciplinary Studies, SNDT Women’s University, Santacruz West, Mumbai, Maharashtra 400049 India
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Hossain MS, Deeba IM, Hasan M, Kariippanon KE, Chong KH, Cross PL, Ferdous S, Okely AD. International study of 24-h movement behaviors of early years (SUNRISE): a pilot study from Bangladesh. Pilot Feasibility Stud 2021; 7:176. [PMID: 34526148 PMCID: PMC8440144 DOI: 10.1186/s40814-021-00912-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/02/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) released guidelines for physical activity, sedentary behavior, and sleep for children under 5 years of age in 2019. In response to these guidelines, this pilot study aimed to (i) determine the proportion of preschool children (ages 3-4 years) who met the WHO guidelines; (ii) examine the feasibility of the proposed protocol for the SUNRISE study; and (iii) assess the impact of the COVID-19 pandemic on movement behaviors of preschool children in Bangladesh. METHODS Time spent in physical activity, sedentary behavior and sleep were objectively measured using two types of accelerometers (ActiGraph wGT3x-BT and ActivPAL4). Screen time and sleep quality were assessed via parent questionnaire. Fine and gross motor skills were measured using the Ages and Stages Questionnaire (3rd edition). Three executive functions were assessed using the Early Years Toolbox. Focus groups were conducted with parents and childcare staff to determine the feasibility of the protocol. Follow-up data during COVID-19 pandemic was collected from parents over phone. RESULTS Data from 63 preschool-aged children and their parents was analyzed in this pilot study. Only three children (4.7%) met all components of the WHO guidelines. Separately, children meeting physical activity, sedentary screen time and sleep guidelines were 71.9%, 17.5%, and 59.7% respectively. The proportion of all children who were developmentally on-track for the gross and fine motor skills was 58.7% and 50.8%, respectively. Parents and educators reported that the protocol was feasible except for the activPAL-4 accelerometer. Approximately, 39% of children (14 out of 37) who wore this device developed itchy skin and rashes resulting in the suspension of using this device mid-way through data collection. During COVID-19, there was a significant decrease in children's total physical activity (- 193 min/day), and time spent outside on weekdays (- 75 min/day) and weekend days (- 131 min/day) and a significant increase in sedentary screen time (+85 min/day). CONCLUSION Only a low proportion of children met the WHO guidelines. Methods and devices (except ActivPAL4) used in this pilot study proved to be feasible and this has paved the way to conduct the main SUNRISE study in Bangladesh. Future measures should be taken to address the issue of movement behaviors of children during the time of pandemics like COVID-19.
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Affiliation(s)
- Mohammad Sorowar Hossain
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh.
| | - Iztiba M Deeba
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Mahmudul Hasan
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Katharina E Kariippanon
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Kar Hau Chong
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Penny L Cross
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Shameema Ferdous
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Anthony D Okely
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
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Dygrýn J, Medrano M, Molina-Garcia P, Rubín L, Jakubec L, Janda D, Gába A. Associations of novel 24-h accelerometer-derived metrics with adiposity in children and adolescents. Environ Health Prev Med 2021; 26:66. [PMID: 34118885 PMCID: PMC8199825 DOI: 10.1186/s12199-021-00987-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/01/2021] [Indexed: 12/14/2022] Open
Abstract
Background Further research is required to explore the associations between 24-h movement behaviours and health outcomes in the paediatric population. Therefore, this study aimed to examine the associations between novel data-driven 24-h activity metrics and adiposity among children and adolescents. Methods The sample included 382 children (8–13 years) and 338 adolescents (14–18 years). The average acceleration (AvAcc) of activity, intensity gradient (IG), and metrics representing the initial acceleration for the most active time periods of the 24-h cycle were calculated from raw acceleration data. Adiposity measures included body mass index z-score, fat mass percentage (FM%), and visceral adipose tissue (VAT). Data analysis was performed using multiple linear regression adjusted for wear time, sex, maternal education level, and maternal overweight and obesity. Results Children demonstrated higher values in all 24-h activity metrics than did adolescents (p < 0.001 for all). For children, the initial acceleration for the most active 2, 5, 15, and 30 min of the 24-h cycle were negatively associated with FM% (p ≤ 0.043 for all) and VAT (p <0.001 for all), respectively. For adolescents, the IG was negatively associated with FM% (p = 0.002) and VAT (p = 0.007). Moreover, initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min were associated with FM% (p ≤ 0.007 for all) and with VAT (p ≤ 0.023 for all). Conclusions The intensity distribution of activity and initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min within the 24-h cycle are beneficial for the prevention of excess adiposity in the paediatric population.
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Affiliation(s)
- Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - María Medrano
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Pablo Molina-Garcia
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.,Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - David Janda
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.
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Sigmundová D, Sigmund E. Weekday-Weekend Sedentary Behavior and Recreational Screen Time Patterns in Families with Preschoolers, Schoolchildren, and Adolescents: Cross-Sectional Three Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094532. [PMID: 33923313 PMCID: PMC8123206 DOI: 10.3390/ijerph18094532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/13/2022]
Abstract
Background: Excessive recreational screen time (RST) has been associated with negative health consequences already being apparent in preschoolers. Therefore, the aim of this study was to reveal parent-child sedentary behavior, and RST patterns and associations with respect to the gender, age category of children, and days of the week. Methods: Our cross-sectional survey included 1175 parent-child dyads with proxy-reported RST data collected during a regular school week during the spring and fall between 2013 and 2019. The parent-child RST (age and RST) relationship was quantified using Pearson’s (rP) correlation coefficient. Results: Weekends were characterized by longer RST for all family members (daughters/sons: +34/+33 min/day, mothers/fathers: +43/+14 min/day) and closer parent-child RST associations than on weekdays. The increasing age of children was positively associated with an increase in RST on weekdays (+6.4/+7.2 min per year of age of the daughter/son) and weekends (+5.8/+7.5 min per year of age of the daughter/son). Conclusions: Weekends provide a suitable target for implementation of programs aimed at reducing excessive RST involving not only children, but preferably parent-child dyads.
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Adherence to 24-Hour Movement Guidelines among Spanish Adolescents: Differences between Boys and Girls. CHILDREN-BASEL 2021; 8:children8020095. [PMID: 33535696 PMCID: PMC7912944 DOI: 10.3390/children8020095] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 12/22/2022]
Abstract
Background: The 24-Hour Movement Guidelines for adolescents recommend ≥60 min/day of moderate-to-vigorous physical activity (PA), ≤ 2 h/day of screen time, and 8–10 h/day of sleep. Since little information is available on the 24-Hour Movement Guidelines in Spanish adolescents, this study aims to estimate the proportion of Spanish adolescents meeting individual and combinations of these 24-Hour Movement Guidelines. Moreover, another aim of this study is to examine gender differences in compliance with 24-Hour Movement Guidelines. Methods: A final sample of 1465 Spanish adolescents (44.50% girls; 13.08 ± 0.86) participated in this cross-sectional study. The 24-Hour Movement Guidelines were measured during weekdays and the weekend days by self-reported questionnaires. Results: Although most adolescents met sleep duration guidelines (81.3%), only 38% and 15.8% met physical activity and screen time guidelines, respectively. Only 5.4% of these adolescents met all three 24-Hour Movement Guidelines, whereas 10.2% of this sample did not meet any of these guidelines. Although boys reported greater compliance with physical activity recommendations and girls with screen time recommendations, no significant gender differences were found in the compliance of all three 24-Hour Movement Guidelines. Conclusion: Given that 94.4% of Spanish adolescents did not meet 24-Hour Movement Guidelines, promoting all these three movement behaviours in both boys and girls is an urgent public health priority.
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Replacing school and out-of-school sedentary behaviors with physical activity and its associations with adiposity in children and adolescents: a compositional isotemporal substitution analysis. Environ Health Prev Med 2021; 26:16. [PMID: 33504330 PMCID: PMC7842010 DOI: 10.1186/s12199-021-00932-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/07/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Little is known on how context-specific sedentary behaviors (SB) affect adiposity. This study aimed to investigate compositional associations between context-specific SB and adiposity and estimate the differences in adiposity associated with replacing school and out-of-school SB with physical activity (PA). METHODS This study included 336 children and adolescents. Time spent in SB and PA was estimated using multi-day 24-hour raw accelerometer data. SB and PA were specified for school and out-of-school times. Fat mass percentage (FM%) and fat mass index (FMI) were used as adiposity indicators. A compositional isotemporal substitution model was used to estimate differences in adiposity associated with one-to-one reallocations of time from context-specific SB to PA. RESULTS Participants spent approximately two thirds of their school and out-of-school time being sedentary. Relative to the remaining 24-h movement behaviors, significant associations between out-of-school SB and adiposity were found in both boys (βilr1 = 0.63, 95% confidence interval [CI] = 0.03-1.22 for FM%; βilr1 = 0.76, 95% CI = 0.03-1.49 for FMI) and girls (βilr1 = 0.62, 95% CI = 0.25-0.98 for FM%; βilr1 = 0.80, 95% CI = 0.28-1.32 for FMI). Replacing 30 min/day of out-of-school SB with out-of-school light PA decreased FM% by 10.1% (95% CI = 3.3-17.9) and FMI by 14% (95% CI = 2.7-24) in girls. No significant associations were found for school SB. CONCLUSIONS A reduction of out-of-school SB in favor of light PA should be advocated as an appropriate target for interventions and strategies to prevent childhood obesity.
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Rubín L, Gába A, Dygrýn J, Jakubec L, Materová E, Vencálek O. Prevalence and correlates of adherence to the combined movement guidelines among Czech children and adolescents. BMC Public Health 2020; 20:1692. [PMID: 33176735 PMCID: PMC7661270 DOI: 10.1186/s12889-020-09802-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background There are limited studies on the prevalence of adherence to the combined guidelines for physical activity (PA), sedentary behavior, and sleep in children and adolescents. Moreover, little is known about correlates of adherence to the guidelines. Therefore, the main aim of this study is to examine the prevalence and identify the correlates of adherence to the combined movement guidelines among children and adolescents. Methods A total of 355 children aged 8–13 years (44% boys) and 324 adolescents aged 14–18 years (43% boys) from the Czech Republic participated in this study. PA and sleep duration were estimated using multi-day 24-h raw data from wrist-worn accelerometers. Recreational screen time was parent proxy-reported in children and self-reported in adolescents. Seventeen potential correlates were grouped into three homogenous categories for biological and cognitive, behavioral, and family correlates. The multi-level multivariable logistic regression was applied to identify correlates of adherence to combined movement guidelines and to specific combinations of any of two recommendations. Results Approximately 6.5% of children and 2.2% of adolescents met all recommendations of the combined movement guidelines. In children, girls (OR = 0.4; 95% CI = 0.1–0.9) and participants with overweight or obese fathers (OR = 0.3; 95% CI = 0.1–0.7) had significantly lower odds of adherence to the combined movement guidelines. Additionally, children had higher odds of meeting specific combinations of two recommendations if they reported regular fruit and vegetable intake, participated in organized PA, or if their fathers had a university degree. Meanwhile, paternal overweight and obesity, and high sleep efficiency were associated with lower odds of meeting specific combinations of recommendations. In adolescents, sex, fruit and vegetable intake, organized PA, and active play were correlates of meeting specific combinations of any two recommendations. Conclusions A low proportion of children and adolescents met the combined movement guidelines and several correlates related to family were identified. Family is a key source of influence for healthy movement behaviors during childhood and adolescence.
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Affiliation(s)
- Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.,Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Eliška Materová
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Ondřej Vencálek
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
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23
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Gába A, Dygrýn J, Štefelová N, Rubín L, Hron K, Jakubec L, Pedišić Ž. How do short sleepers use extra waking hours? A compositional analysis of 24-h time-use patterns among children and adolescents. Int J Behav Nutr Phys Act 2020; 17:104. [PMID: 32795287 PMCID: PMC7427741 DOI: 10.1186/s12966-020-01004-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To examine compositional associations between short sleep duration and sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) among children and adolescents. METHODS Multi-day 24-h data on sleep, SB, LPA and MVPA were collected using accelerometers among 343 children (8-13 years old) and 316 adolescents (14-18 years old). Children and adolescents with sleep duration of < 9 and < 8 h, respectively, were classified as short sleepers. Robust compositional regression analysis was used to examine the associations between short sleep duration and the waking-time composition. RESULTS Seventy-one percent of children and 75.3% of adolescents were classified as short sleepers. In children, being a short sleeper was associated with higher SB by 95 min/day (p < 0.001) and lower MVPA by 16 min/day (p = 0.002). Specifically, it was associated with a higher amount of time spent in long sedentary bouts (βilr1 = 0.46, 95% confidence interval [CI] = 0.29 to 0.62) and lower amounts of time spent in sporadic SB (βilr1 = - 0.17, 95% CI = -0.24 to - 0.10), sporadic LPA (βilr1 = - 0.09, 95% CI = -0.14 to - 0.04) and sporadic MVPA (βilr1 = - 0.17, 95% CI = -0.25 to - 0.10, p < 0.001 for all), relative to the remaining behaviours. In adolescents, being a short sleeper was associated with a higher amount of time spent in SB by 67 min/day (p = 0.001) and lower LPA by 2 min/day (p = 0.035). Specifically, it was associated with more time spent in sedentary bouts of 1-9 min (βilr1 = 0.08, 95% CI = 0.02 to 0.14, p = 0.007) and 10-29 min (βilr1 = 0.10, 95% CI = 0.02 to 0.18, p = 0.015), relative to the remaining behaviours. CONCLUSIONS Among children and adolescents, short sleep duration seems to be highly prevalent and associated with less healthy waking time. Public health interventions and strategies to tackle the high prevalence of short sleep duration among children and adolescents are warranted.
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Affiliation(s)
- Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Nikola Štefelová
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.,Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Karel Hron
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Željko Pedišić
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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