Physical Education Classes, Physical Activity, and Sedentary Behavior in Children

Race, Ethnicity, and Geography as Determinants of Excessive Weight and Low Physical Activity in Pediatric Population: Protocol for Systematic Review and Meta-Analysis

The rationale for the current study is the sparsity of data on the combined effect of the environmental and individual risks of obesity and sedentary lifestyle in children of different races/ethnicities from different regions. An effective weight management strategy is hard to design due to insufficient evidence. This work was initiated to study race, ethnicity, and geography as determinants of excessive weight and low physical activity in the pediatric population. To achieve this aim, we systematically review publications on daily length of physical activity of light, moderate, and vigorous intensity, as well as sedentary time and BMI and its dynamics in children of different races/ethnicities and geographies. The extracted data are stratified into six major geographic regions and six races/ethnicities. Then, a random-effects meta-analysis is used to calculate the pooled mean of each outcome measure. A ridge regression is constructed to explore age-related change in BMI. A Kruskal-Wallis H test is applied to compare the pooled duration of physical activity and sedentary time in the subgroups. Finally, we calculate paired correlation coefficients between BMI and physical activity/inactivity for each group. The findings can be further used in public health surveillance to clarify the epidemiology of obesity, to guide priority setting and planning, and to develop and evaluate public health policy and strategy.

Determinants of Change in Physical Activity in Children during the Transition from Elementary to High School

INTRODUCTION

Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school.

METHODS

Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th to 11th grades in 2010-2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age.

RESULTS

As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years.

CONCLUSIONS

Interventions should target multiple domains of influences that may vary by age.

Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems

This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Effects of a physical education intervention on children's physical activity and fitness: the PROFIT pilot study

BACKGROUND

Physical education classes are widely accepted as one of the most effective settings for promoting physical activity and health and have often been used to implement physical activity interventions. The aim of this pilot study was to test a physical education intervention program on physical activity levels and physical fitness in a sample of school-age children.

METHODS

Participants were a convenience sample of 50 children (34 experimental group and 16 in the comparative group) aged between 6 and 11 years old (Mean = 8.28 years). A 21-week intervention was implemented, consisting of high-intensity and physical fitness-focused exercises, in addition to a once-a-month extra class nutritional education. The following variables were evaluated before and post-intervention: physical fitness, sedentary behavior (SB), light physical activity (LPA), moderate physical activity (MVA), and vigorous physical activity (VPA). Propensity score analyses calculated the average treatment effect on the treated (ATET) within a quasi-experimental framework.

RESULTS

Physical fitness variables showed improvements after the intervention, specifically for agility (ATET = -0.67 s; p < 0.001), cardiorespiratory fitness (ATET = 89.27 m; p = 0.045), lower limbs power (ATET = 4.47 centimeters; p = 0.025), and speed (ATET = -1.06 s; p < 0.001). For physical activity and SB levels, there were no improvements after intervention implementation.

CONCLUSION

The intervention program showed preliminary effectiveness to improve physical fitness of children, but not SB nor physical activity.

Individual, family, and environmental correlates of fundamental motor skills among school-aged children: a cross-sectional study in China

OBJECTIVE

This cross-sectional study examined the socio-ecological factors influencing fundamental motor skills (FMS) in Chinese school-aged children.

METHODS

A total of 1012 parent-child pairs were randomly sampled between March-1st and April-15th, 2022. Based on the socio-ecological model of Children's FMS, three levels of factors: individual-level (e.g., demographic, physical, psychological, and behavioral characteristics of children), family-level (e.g., caregiver demographics, parental support, and socioeconomic status), and environmental factors (e.g., availability of physical activity equipment) were assessed using self-reported scales (e.g., the Self-perception Profile for Children, the Physical Activity Enjoyment Scale, and the 12-item Psychological Well-Being Scale for Children) and objective measures (e.g., ActiGraph GT3X, the Chinese National Student Physical Fitness Standard, and the Test of Gross Motor Development-Third Edition). Multi-level regression models were employed using SPSS.

RESULTS

The results demonstrated that children's age, sex, physical fitness, parental support, and the quality of home and community physical activity environments consistently influenced all three types of FMS, including locomotor, ball, and composite skills. Additionally, seven individual-level factors (children's age, sex, body mass index, light physical activity, sleep duration, perceived motor competence, and physical fitness) were associated with different types of FMS.

CONCLUSIONS

The findings underscore the multidimensional and complex nature of FMS development, with individual-level factors playing a particularly significant role. Future research should adopt rigorous longitudinal designs, comprehensive assessment tools covering various FMS skills, and objective measurement of parents' movement behaviors to better understand the strength and direction of the relationship between socio-ecological factors and children's FMS.

Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews

BACKGROUND

Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents.

METHODS

We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary.

RESULTS

An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted.

CONCLUSIONS

These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.

Association between Sedentary Behavior during Leisure Time and Excessive Weight in Chinese Children, Adolescents, and Adults

(1) Background: Sedentary behavior is increasing in all age groups and is one of the most common lifestyles that is a risk factor for overweight and obesity; however, few studies have evaluated the impact of leisure-time sedentary behavior on overweight and obesity. This study aims to examine the distribution characteristics of different leisure-time sedentary behaviors and their effects on excessive weight in different age groups in the Chinese population to provide evidence for the development of behavioral interventions. (2) Methods: This study utilizes data from the 2004 to 2011 China Health and Nutrition Survey (CHNS). Participants ranged in age from 6 to 18 years or older and were from China. Weight and height were measured in the physical examination, and the sedentary behavior times during leisure periods were collected by using a questionnaire. Logistic regression models were performed for association analyses. (3) Results: A total of 36,169 participants were included in this study. The impact of screen-based sedentary leisure time on excessive weight is greater in middle-aged and older adults. For middle-aged adults, sedentary time periods spent on the Internet or video games were found to be significantly and positively associated with excessive weight (OR, 1.122, 95% CI, 1.005-1.253). In addition, for older adults, sedentary time periods spent watching television or videos were found to be significantly and positively associated with excessive weight (OR, 1.065, 95% CI, 1.035-1.095). (4) Conclusions: This study helps grasp the target population and provide evidence for the development of behavioral intervention guidelines.

Assessment of a Novel Instrument Measuring Perceived Physical Education Teachers' In-Class Skills

Physical Education (PE) teachers' professional and personal skills may not only affect the quality of the teaching-learning processes in PE, but also individuals' future active/inactive behaviors. The aim of this study is to examine the structure of a pool of items developed for measuring individuals' perception of such skills in PE teachers. Exploratory Factorial Analysis and a following structural modeling test on data collected from 660 participants suggest a two-factor structural model for the 10 items considered (χ² = 191.155; df = 34; CFI = 0.953, and SRMR = 0.0529), with good internal consistency for both factors (factor 1: alpha = 0.879; omega = 0.878; factor 2: alpha = 0.850, and omega = 0.858) and the overall instrument (alpha = 0.892; omega = 0.895). The final "Teachers' Personal and Professional Skills Questionnaire" is a valid instrument that may be used alone or in combination with other instruments for the analysis of the quality of teaching-learning processes in PE environments and its impact on individuals' behaviors regarding physical activity in their adult life.

Is Participation in Physical Education Classes Related to Physical Activity and Sedentary Behavior? A Systematic Review

Background: The aim of this systematic review was to summarize the results and assess the methodological quality of studies that analyzed the relation between physical education participation, physical activity, and sedentary behavior in schoolchildren. Methods: Searches were conducted for original cross-sectional and longitudinal observational studies published in Portuguese, English, and Spanish between January 2007 and August 2020, on the PubMed, Web of Science, Scientific Electronic Library Online, Education Resources Information Center, and Scopus databases. Results: A total of 60 articles (68 independent samples) were included in the revision (58 cross-sectional and 2 longitudinal observational studies). With regard to methodological quality, 27%, 52%, and 21% of the studies were classified as high, moderate, and low methodological quality, respectively. Physical activity was analyzed in 93% of the studies (n = 56) and sedentary behavior in 33% (n = 20). The higher frequency of physical education participation was associated with higher physical activity levels (56 of 68 results – 54/65 cross-sectional and 2/3 longitudinal studies) and less sedentary behavior (14 of 24 results), even after stratifying analyses by type and methodological quality. Conclusion: Physical education class participation may contribute to students being physically more active and less likely to engage in sedentary behavior.

Compared with dietary behavior and physical activity risk, sedentary behavior risk is an important factor in overweight and obesity: evidence from a study of children and adolescents aged 13-18 years in Xinjiang, China

BACKGROUND

Malnutrition or insufficient physical activity (PA) is a risk factor for obesity and chronic disease in children and adolescents. Affected by different economic circumstance, ethnic, dietary behavior, physical activity and other factors, children and adolescents in Xinjiang, China are facing a severe situation of overweight and obesity prevention and control. It is necessary to analyze the dietary behavior and physical activity of children and adolescents with different nutritional status and the relationship between them.

METHODS

Using a stratified cluster sampling method in Xinjiang, China, 4833 middle school students aged 13-18 were selected., and tests for height and weight were conducted. Self-assessment questionnaires were completed for Dietary Behaviors, Physical Activity, and Sedentary Behaviors as well. Chi-square test, Logistic regression analysis and other methods were used to analyze the relationship between Dietary Behaviors, Physical Activity, Sedentary Behaviors and other health behavior risk factors and Weight and BMI.

RESULTS

Children and adolescents aged 13-18 in Xinjiang, China, girls had a lower BMI compared with boys(19.49 VS. 20.41). The proportions of Underweight, Overweight and Obese among girls were lower (Underweight: 11.8 VS. 14.5; Overweight: 7.6 VS. 12.7; Obese 2.3 VS. 7.0).Boys with higher risk of sedentary had a 1.46-fold higher risk of developing Overweight/Obese than those with lower risk of sedentary (95%CI: 1.07-2.01).Girls with higher risky diet had a 1.56-fold higher risk of developing Underweight than those with lower risky diet (95%CI: 1.11-2.19). For all participants, the risk of Overweight/Obese in children and adolescents with higher risk of sedentary was 1.45 times more than that of children and adolescents with lower Risk sedentary (95%CI: 1.12 ~ 1.88). Overall, Weight had a significant correlation with PA risk (r = 0.076, P < 0.01) and sedentary behavior risk (r = 0.035, P < 0.05). BMI had a key correlation with PA risk (r = 0.064, P < 0.01) and sedentary behavior risk (r = 0.037, P < 0.05).

CONCLUSIONS

The detection rate of Underweight among children and adolescents aged 13-18 in Xinjiang, China is higher, while the detection rate of Overweight and Obese is lower than that of the whole country. Static behavior was an important factor affecting the occurrence of Overweight and Obese in children and adolescents, and the performance of boys was more obvious than that of girls.The results further improve the data on the weight status of Chinese children and adolescents and their influencing factors, and call on Chinese society and schools to continue their efforts to prevent and reduce malnutrition and obesity among children and adolescents in Xinjiang.

The Barriers to and Facilitators of Physical Activity and Sport for Oceania with Non-European, Non-Asian (ONENA) Ancestry Children and Adolescents: A Mixed Studies Systematic Review

BACKGROUND

Participation in sport and physical activity (PA) leads to better overall health, increased life expectancy, and decreased mortality rates across the lifespan; however, there may be a range of individual, family, and community factors that influence PA participation among ONENA children and adolescents residing in the 22 Pacific Island Countries and Territories (PICT) and Australia. This review aimed to synthesise existing quantitative and qualitative literature regarding barriers to and facilitators of PA and sport among ONENA youth.

METHODS

The literature was systematically searched to include studies reporting barriers to and facilitators of PA and sports participation among ONENA children and adolescents aged 0-18 years residing in the 22 PICT and Australia. Using a pre-established taxonomy based on the social-ecological model, a deductive analysis was performed. Quality appraisal was performed using the mixed methods appraisal tool.

RESULTS

Of 1388 articles, 14 studies were included, with 128 ONENA children and adolescent participants across the four qualitative studies; 156,581 ONENA children and adolescents across the seven quantitative studies; 801 parents, children, and adolescents in one quantitative study; and 642 parents in two quantitative studies. Of the 14 included studies, none were based in Australia and only 10 of the 22 PICT were reported as the participants' residence: Palau, New Zealand, Tonga, Cook Islands, Kiribati, Samoa, Solomon Islands, Tuvalu, Vanuatu, and Fiji. Four studies reported barriers, and another four studies reported facilitators of PA and sport, with the remaining studies reporting both barriers and facilitators. Overall, there were more barriers reported (30 in total) than facilitators (27 in total).

CONCLUSIONS

Research in this area is lacking, with ONENA youth living in Australia and 12 PICT not represented. Overall, there were a larger number of facilitators experienced at individual and interpersonal levels, while barriers were highest at the community level, with the policy level having facilitators and barriers equally represented. Programs that offer PA and sport participation options with embedded SDT-informed strategies for all family members; that are accessible through existing transport and related social, cultural, and physical infrastructure; and that are committed to communities through formal co-design partnerships are needed, to enhance the PA and sport participation of ONENA youth residing in PICT.

Attendance in physical education classes, sedentary behavior, and different forms of physical activity among schoolchildren: a cross-sectional study

Background

Attendance in physical education classes (PE) helps young people to achieve the physical activity recommendations and to reduce their exposure to sedentary behavior. However, the association between PE attendance and the daily frequency of specific forms of physical activity is less known. The current study analyzed the association between weekly attendance in PE and daily frequencies of different forms of physical activity (active play, non-active play, structured physical activity), and overall daily frequencies of physical activity (PA) and sedentary behaviors (SB) among schoolchildren.

Methods

Cross-sectional study with schoolchildren from second to fifth grade of 11 public schools (n = 2,477; 9.1 ± 1.38-y-old; 53.2% girls; 17.5 ± 3.5 kg/m²) in Feira de Santana (Northeast Brazil). PA, SB, and attendance in PE were self-reported using a previously validated on-line questionnaire based on the previous day's recall (Web-CAAFE). Multiple Binomial Negative regression modeling was carried out to analyze the association (Prevalence Rate: PR) between weekly attendance in PE (0/week, 1/week, ≥ 2/week) and frequencies of active play, non-active play, and structured physical activity, with adjustments by age, school shift, and BMI z-scores. Regression models analyzing overall PA also included adjustments by household chores.

Results

Attendance in PE ≥ 2/week was associated with higher frequencies of active play (girls: PR = 1.40, 95%CI = 1.11–1.78; boys: PR = 1.49, 95%CI = 1.15–1.94) and structured physical activity (girls: PR = 2.11, 95%CI = 1.31–3.40; boys: PR = 4.33, 95%CI = 1.63–11.52). Higher attendance in PE (≥ 2/week) was associated with high overall PA (girls: PR = 1.31, 95%CI = 1.06–1.62; boys: PR = 1.42, 95%CI = 1.14–1.77) and low SB (girls: PR = 0.80, 95%CI = 0.71–0.90; boys: PR = 0.81, 95%CI = 0.68–0.97). Attendance in PE 1/week was also associated with a lower frequency of daily SB among girls (PR = 0.73, 95%IC = 0.64–0.84)

Conclusion

Higher weekly attendance in PE was associated with higher frequencies of active play, structured physical activity, higher overall PA, and lower SB among both girls and boys.

Analysis of the Factors That Influence a Quality Physical Education in Mexico: School Supervision's Perspective

Different international organizations have spoken out in favor of the value of physical activity in the integral development of children and adolescents, which is why different guidelines have been established for governments to facilitate quality Physical Education. In this sense, the objective of this study was to analyze the factors that influence the performance of PE teachers, from the perspective of pedagogical technical advisors and school district supervisors from various school zones from the State of Chihuahua. This was a transversal study, with a qualitative approach and phenomenological focus, which was chosen because it allows the understanding of these aspects from a unique and unrepeatable process; data collection was carried out through focus groups in which PE ATP supervisors participated and data were collaboratively analyzed. The main results indicated that Physical Education does not have the same importance as other subjects, a situation that is reflected in: constant curricular reforms, administrative inconsistencies, dependence on the school organization, and being seldom taken into account in decision-making. It was concluded that strict public policies are required to be applied uniformly throughout the country, as well as privilege Physical Education within the Basic Education curriculum in Mexico.

Physical (in)activity, and its predictors, among Brazilian adolescents: a multilevel analysis

Background

Physical activity is a multifactorial trait, determined by both individual and environmental characteristics, it seems relevant to understand the determinants related to youth guidelines accomplishment. The present study aimed to verify the differences between the Brazilian federative units regarding to the prevalence of youth physical activity guidelines accomplishment and to investigate the determinants related to the inter-individual differences in this accomplishment.

Methods

Sample comes from the 2015 Brazilian National School Health Survey (PeNSE), comprising 99,570 adolescents (51,527 girls, 13-17y), enrolled in 3039 schools. Adolescents reported the time they spend in moderate-to-vigorous physical activity daily, and they were categorized as active or inactive, if the guidelines were achieved, or not, respectively, and multilevel statistical analyses were used, including both child and school-level variables. Multilevel Binomial model was computed in the SuperMix software.

Results

The majority of the adolescents did not comply with the physical activity guidelines daily, where Bahian children complied the least, while those from Amazonas, Tocantins, and Mato Grosso do Sul complied the most. Boys (OR: 2.305; 95%CI: 2.277-2.334), older adolescents (OR: 1.044; 95%CI: 1.036-1.051), and those who spent more time in active travelling to/from school (OR: 1.001; 95%CI: 1.001-1.001) complied more the physical activity guidelines. At the school level, adolescents from larger schools (OR: 0.957; 95%CI: 0.928-0.986) tended to comply less with the guidelines.

Conclusion

Significant differences between Brazilian federative units in youth daily physical activity guidelines compliance were observed, highlighting the role of individual but also environmental constraints in the Brazilian adolescents’ engagement in physical activity.

Participation in Physical Education Classes and Health-Related Behaviours among Adolescents from 67 Countries

The present study sought to examine the associations between participation in physical education (PE) classes and a range of health-related behaviours among adolescents. Secondary analysis of self-reported data from the Global Student Health Survey, collected between 2010 and 2017 from 222,121 adolescents (N = 117,914 girls; 49.0%; aged 13–17 years) from 67 countries and five world regions, was carried out. Participation in PE classes (0, 1–2, ≥3 days/week) was the independent variable. Physical activity (PA); sedentary behaviour (SB); active travel to school; fruit, vegetables, and alcohol consumption; and smoking; as well as adopting ≥5 of these healthy behaviours; were the dependent variables. Complex samples logistic regressions were performed to explore the associations between participation in PE classes and health-related behaviours. The results revealed that 18.2% of adolescents did not take part in PE classes. A total of 56.7% and 25.1% of adolescents reported participating in PE classes on 1–2 and ≥3 days/week, respectively. Only 26.8% of adolescents adopted ≥5 healthy behaviours. Participation in PE classes was positively associated with PA, active travel, fruit consumption, and vegetable consumption (only for ≥3 days/week), but was negatively associated with meeting SB recommendations, and with not smoking (only for girls and ≥3 days/week). Overall, PE participation was positively associated with adopting ≥5 healthy behaviours, with favourable results found for those who attended more PE classes. The findings revealed a positive association between participation in PE classes and a range of health-related behaviours among adolescents. This suggests that, worldwide, quality PE should be delivered at least 3 days per week up to daily to promote healthy lifestyles among adolescents.

Cross-Sectional Study of Headache in Flemish Children and Adolescents

Background: Although headache is common in pediatrics, data for the Flemish population are missing. We explored headache-prevalence, and its association with communication-technology (CT) and physical activity (PA) in Flemish children and adolescents. Methods: A cross-sectional exploratory school-based questionnaire study was designed. Flemish boys and girls (5–18 years) completed a symptom-questionnaire. Primary outcomes: sociodemographic background, headache-prevalence, headache-characteristics, CT-use and PA characteristics (self-report). Secondary outcomes: associations between headache-characteristics, age, gender, and CT-use and PA-characteristics. Results: Four hundred twenty-four questionnaires were analysed: 5–7-years: n = 58; 8–11-years: n = 84; 12–15-years: n = 137; 16–18-years: n = 145. Fifty-five percent suffered from headache. Prevalence increased with age. More 16–18-year girls versus boys had headache. CT-use was the main headache-provocateur. Headache prevalence was significantly higher in a frequently physical active population. Conclusion: Our results suggest presence of headache in Flemish children and adolescents. PA-level associates with headache prevalence. However, children and adolescents with headache did not report more CT-use compared to controls.

Bikes for Life: Measuring the effects of a bicycle distribution program on 6 to 12-year-old children's BMI and health behaviors

Treating pediatric obesity is challenging. The objective was to evaluate effect of receiving a bicycle on (a) physical activity, (b) sedentary activity, (c) Body Mass Index (BMI), and (d) eating habits. A stepped-wedge randomized controlled trial of 6- to 12-year-old patients with overweight/obesity was conducted April 2012-2018. Participants were randomized to wait 0, 2, 4, or 6 months for a bicycle. Outcomes on activity, BMI and eating were collected at 3, 6, 9- and 12-months after children received a bicycle. A total of 525 participants with 387 (74%) completed 3-month follow-up questionnaire, and 346 (66%) completed 12-month follow-up visit. Participants were mostly Latino/a (71%) and low income (58%), and 31% had never ridden a bicycle. Median baseline BMI was 98th percentile. At 3 months, 62% reported bicycle use last week, on average 3.6 days. Time spent on sedentary activities decreased by 48 min/day (p = 0.04), and time spent playing sports increased by 1.7 h/week (p < 0.01). No reduction in BMI was seen. Consumption of sugary drinks decreased (by 0.59 servings/week, p < 0.01), and consumption of vegetables increased (0.71 servings/week, p = 0.04). At 12 months, sedentary time, sugary drink and vegetable consumption remained significantly more favorable than at enrollment (p < 0.01, p < 0.01, p = 0.04 respectively), but not significantly different (p = 0.47 for sedentary, p = 0.73 for sugary drink) and significantly less favorable (p < 0.01 for vegetables) than at the time of intervention. Participants reported riding bicycle, improved activity and dietary habits, though reversion towards baseline behavior was seen by one year and no change in BMI from enrollment.

School environment and physical activity in adolescents from São Paulo city

We examined the association of physical activity (PA) facilities and access to school with total PA and domain-specific PA in adolescents. We enrolled 2610 adolescents (mean: 14.9 years) from Sao Paulo city. The number and presence of sports courts, swimming pools, locker rooms, running/athletics tracks, entrance accessible for student cyclists, bike racks, speed limit signal around the school, and pedestrian crossing were assessed in each school. All participants responded to a questionnaire about frequency and duration of physical education classes, leisure time, and active commuting. Total PA was obtained by adding up all PA domains. Presence of three or more (OR: 1.62; 95% CI: 1.15 to 2.30) sports courts, swimming pool available in usable conditions (OR: 1.45; 95% CI: 1.01 to 2.10), running/athletics tracks (OR: 2.35; 95% CI: 1.07 to 5.18), and bike racks (OR: 1.38; 95% CI: 1.07 to 1.78) were positively associated with total PA. Number of sports courts, swimming pool available in usable conditions, speed limit signals around the school, and pedestrian crossings were positively associated with physical education classes. The bike racks, speed limit signs around the school, and pedestrian crossings were positively associated with active commuting. School environment was associated with increased PA. Our findings should be considered in future epidemiologic studies and for educational and health policy makers.

Association between physical education classes and physical activity among 187,386 adolescents aged 13-17 years from 50 low- and middle-income countries

OBJECTIVE

This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs).

METHODS

A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences.

RESULTS

Included adolescents aged from 13 to 17 years (n=187,386, %boys=51.7; mean age=14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day=1.34, 2 days=1.66, 3 days=1.67, 4 days=1.79, 5 days or more=2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I²=53%, p<0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65).

CONCLUSIONS

Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

Daily Physical Education Linked to Higher Youth Aerobic Fitness Levels: A 4-Year Longitudinal Study

PURPOSE

Physical education (PE) provides opportunities for youth physical activity during the school day, yet daily PE policies remain low. This study investigated whether daily PE was linked to youth aerobic capacity across a 4-year period in Greenville (South Carolina).

METHODS

Youth in grade levels second to eighth at 2 schools providing daily PE and 2 schools that did not provide daily PE participated in the study (N = 466). The 2 schools used as comparisons provided standard PE outlined by South Carolina, which included one 50-minute session per week (elementary) and daily PE for one semester (middle school). Aerobic fitness was measured using the FITNESSGRAM® Progressive Aerobic Cardiovascular Endurance Run test (May 2011-2015). Number of Progressive Aerobic Cardiovascular Endurance Run laps completed, age, gender, ethnicity, body composition, and school attended were included in multilevel linear regression analyses.

RESULTS

Across the sample, aerobic fitness increased with age. Throughout the study, males demonstrated growth in aerobic fitness compared with a slight decline for females (P < .001). Youth participation in daily PE was linked to increases in aerobic fitness compared with youth who did not receive daily PE (P < .001).

CONCLUSIONS

Findings suggest that exposure to daily PE may contribute to increased aerobic fitness in youth.

Are Self-Efficacy and Perceived Environmental Characteristics Determinants of Decline in Physical Activity Time?

CONTEXT

This study analyzed whether self-efficacy (SE) and perceived environmental characteristics (EC) are determinants of the decline in physical activity (PA) time in adolescents.

METHODS

This used longitudinal observational approach, with 4 years of data collection, involving 355 adolescents (57.7% girls and 42.3% boys), average age of 11.8 years (0.1 y), from João Pessoa, Paraiba, Brazil. SE and EC were measured by scales and PA by a questionnaire. Ordinal logistic regression was used to associate SE and EC with a decline in PA.

RESULTS

There was a linear trend toward a decrease in average PA duration (58.3 [13.7] min/wk/y) and a rise in average access to places for PA (point per year) (0.6 [0.1]), urban safety (0.2 [0.1]), and traffic safety scores (0.5 [0.1]). The results of multivariable analysis indicated that SE and EC were not associated with the decline in PA.

CONCLUSION

There was a decline in PA time, and SE and perceived EC were not determinants of this decline.

Playing traditional games vs. free-play during physical education lesson to improve physical activity: a comparison study

Background and Study Aim. Non-sport activities like traditional games can be a practical way to promote physical activity (PA) during physical education (PE) lessons, especially among those who are less inclined towards sports. The purpose of this study is to compare the PA variables and acceptance between playing traditional games and free-play during physical education lessons among secondary school students. Material and Methods. Fifty-six (n = 56) subjects participated in this study wore accelerometers for a total of 40 minutes during each PE lesson to record PA. In the first week, a 40-min free-play PE lesson was done while in the second week, a 40-min PE lesson incorporated with traditional games (TG-PE lesson) was done. After following both lessons, subjects filled up a questionnaire on acceptance of TG-PE and free-play PE lessons. Results. The mean total activity count (p < 0.05) and time spent in moderate-to-vigorous physical activity (MVPA) (p < 0.05) were 20% and 19% greater respectively during TG-PE lesson compared to free-play PE lesson. The mean acceptance scores showed students preferred playing TG (19.29 ± 4.21; p < 0.00) over free-play PE lesson (17.59 ± 3.13). Conclusions. In conclusion, incorporating fun and meaningful activities such as TG during PE lessons can serve as an alternative strategy to promote PA during school hours. Further studies are warranted to determine other types of TG that may promote PA among secondary school students.

Physical education class participation is associated with physical activity among adolescents in 65 countries

In this study we examined the associations of physical education class participation with physical activity among adolescents. We analysed the Global School-based Student Health Survey data from 65 countries (N = 206,417; 11-17 years; 49% girls) collected between 2007 and 2016. We defined sufficient physical activity as achieving physical activities ≥ 60 min/day, and grouped physical education classes as '0 day/week', '1-2 days/week', and ' ≥ 3 days/week' participation. We used multivariable logistic regression to obtain country-level estimates, and meta-analysis to obtain pooled estimates. Compared to those who did not take any physical education classes, those who took classes ≥ 3 days/week had double the odds of being sufficiently active (OR 2.05, 95% CI 1.84-2.28) with no apparent gender/age group differences. The association estimates decreased with higher levels of country's income with OR 2.37 (1.51-3.73) for low-income and OR 1.85 (1.52-2.37) for high-income countries. Adolescents who participated in physical education classes 1-2 days/week had 26% higher odds of being sufficiently active with relatively higher odds for boys (30%) than girls (15%). Attending physical education classes was positively associated with physical activity among adolescents regardless of sex or age group. Quality physical education should be encouraged to promote physical activity of children and adolescents.

Physical Activity Recommendations for Segments of School Days in Adolescents: Support for Health Behavior in Secondary Schools

School physical activity (PA) is an indispensable part of daily PA, the foundation for developing lifelong PA and fitness, and an easy way to gain physical and health literacy. School PA is equally important for understanding the continuity of physical and mental health, even in broader psychosocial aspects. Regarding long-term outcomes, significant attention has been paid to the determination of daily and weekly recommendations for adolescent PA. However, comprehensive approaches suggesting recommendations for PA in segments of the school day are rare. This study aimed to (a) provide a rationale for PA recommendations in segments of school days and incorporate it into generally accepted PA recommendations, and (b) promote radical changes in the educational process toward a healthy school lifestyle through PA recommendations in segments of school days. The results of research conducted in 98 secondary schools in the Czech Republic and 104 secondary schools in Poland from 2009 to 2017 were used in this study. In total, 3,860 boys and 5,237 girls from the Czech Republic and 3,052 boys and 3,329 girls from Poland, all aged 15-19, participated. We recommended at least 2,000 steps (or 10 min of moderate-to-vigorous PA) for the before school segment and at least 6,000 steps (or 30 min of moderate-to-vigorous PA) for the after-school segment. For the time spent at school, we further recommended at least 500 steps/h (alternatively, at least 3,000 steps/school time), 20 min of moderate-to-vigorous PA (≥3METs or 60% HRmax), and at least one HRsubmax/max response to significant stress during PA to mitigate educational stress and high levels of sedentary behavior in schools. PA should account for at least 25% of school time, even on days with no scheduled physical education lessons. We propose using PA recommendations in segments of school days to achieve positive changes in the educational process and school lifestyle. Acceptance of PA recommendations in segments of school days theories on physical education could help refine and concretize demands for changes in PA and lifestyle in secondary schools. In practice, it could support the creation of innovative and comprehensive school PA programs. Future research should focus on obtaining evidence in support for adolescent PA by applying PA recommendations in segments of school days.

Changes in Self-Reported Physical Activity Predict Health-Related Quality of Life Among South African Schoolchildren: Findings From the DASH Intervention Trial

Introduction: Regular physical activity is associated with multiple health benefits for children. Evidence from cross-sectional studies suggests that physical activity is positively associated with health-related quality of life (HRQoL). The promotion of physical activity, and hence HRQoL, through a school-based intervention is therefore an important endeavor, particularly in disadvantaged areas of low- and middle-income countries, including South Africa.

Methods: We designed a multicomponent physical activity intervention that was implemented over a 20-week period in 2015 in eight disadvantaged primary schools of Port Elizabeth, South Africa. Overall, 758 children aged 8–13 years participated. HRQoL was measured with the 27-item KIDSCREEN questionnaire. Self-reported physical activity was assessed with a single item of the Health-Behavior of School-Aged Children test, and cardiorespiratory fitness with the 20-m shuttle run test. Post-intervention scores were predicted with mixed linear regression models, taking into consideration the clustered nature of the data.

Results: Higher baseline levels as well as increasing levels of self-reported physical activity predicted all dimensions of children's HRQoL. Baseline levels and increases in cardiorespiratory fitness predicted children's self-perceived physical well-being (one of the HRQoL subscales). Participation in the multicomponent physical activity intervention did not affect children's HRQoL.

Conclusion: Higher and increasing self-reported physical activity predict all assessed HRQoL dimensions, which underlines that the promotion of regular physical activity among children living in disadvantaged settings is an important public health measure. Policy makers should encourage schools to create physical activity friendly environments, while schools should implement regular physical education as proposed by the school curriculum.

Effects of a Physical Activity Program Potentiated with ICTs on the Formation and Dissolution of Friendship Networks of Children in a Middle-Income Country

This paper assesses the potential cohesion effect of a physical activity (PA) school-based intervention potentiated using text messages (SMS) through analyzing longitudinally the friendship network structure and the mechanisms of the formation and dissolution of friendships. Three schools (n = 125 participants) in Bogotá, Colombia, were randomly assigned into three groups: Modulo Activo Recreo Activo (MARA) + SMS (networks 1 and 2), MARA (networks 3 and 4), and control (no intervention: networks 5–7). We collected socio-economic, health-related, network structure, and intervention satisfaction variables in the baseline and after 10 weeks on July–November 2013. For each classroom network, we conducted four models using a temporal and static network approach to assess (1) temporal social network changes, (2) friendship homophily, (3) friendship formation and dissolution mechanisms, and (4) effect of SMS on the networks’ cohesion. We found that (1) social cohesion emerged in the four intervened networks that were measured over time with transitivity and homophily driven by clustering, (2) the intervention affected the mechanisms of friendship formation and dissolution, and (3) MARA + SMS on average created more social cohesion and 3.8 more friendships than the program alone. Potentially, school-based interventions with information and communication technologies (ICT) such as MARA + SMS could encourage social cohesion among children. The particular characteristics of each school network need to be considered when developing school-based interventions.

Accelerometer-measured physical activity and sedentary behavior in Chinese children and adolescents: a systematic review and meta-analysis

OBJECTIVE

To synthesize evidence on accelerometer-measured moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) levels of Chinese children and adolescents.

STUDY DESIGN

This is both a systematic review and meta-analysis study.

METHODS

Online databases were searched for studies published from January 2009 up to February 2019. These studies reported accelerometer-measured daily minutes of MVPA and/or SB among Chinese children and adolescents. Random-effects meta-analysis was used to separately pool the time spent in MVPA and SB.

RESULTS

Of 4754 records, 20 studies were included in the meta-analysis. Sample sizes ranged from 96 to 2163. The meta-analysis showed that Chinese children and adolescents spent 41.11 min/day in MVPA and 529.83 min/day in SB averagely. Boys spent more time in MVPA compared with girls (P = 0.01). Children accumulated more MVPA time than adolescents (P = 0.05), and children spent less time in SB than adolescents (P = 0.05). Unlike weekdays, SB was lower on weekends (P = 0.02). There were significant differences in children and adolescents' MVPA time in regions (P < 0.001).

CONCLUSIONS

MVPA level in Chinese children and adolescents is well below international recommendations, and their SB level is very high.

A Comparative Study of Participation in Physical Education Classes among 170,347 Adolescents from 54 Low-, Middle-, and High-Income Countries

Given the need for comparative research on the participation of adolescents in physical education (PE) classes as a privileged space for physical activity (PA) promotion, this study sought to estimate, analyse and compare the prevalence of participation in PE classes among adolescents from 54 countries and to examine sex, age, country income and world regions disparities. Data from the Global Students Health Survey (2010–2015) were used, comprising 170,347 adolescents (90,305 girls, aged 13–17 years) from nationally representative samples of 54 countries—of which 7 are low-income, 23 lower-middle-income, 14 upper-middle-income and 10 high-income—and six world regions. The weighted percentages of adolescents participating in PE classes (never, 1–2 days/week, 3–4 days/week, 5 or more days/week) were estimated along 95% confidence intervals and compared across sex, age, country income, region, and country. Most adolescents reported to participate in PE on 1–2 days/week (55.2%), but almost 20% of adolescents reported never participating in PE. Girls, compared to boys, presented a lower prevalence for participating ≥5 days/week (girls 16.8%, boys 20.0%). The prevalence of participating in PE on ≥3 days/week was higher among adolescents aged 13–14 years when compared to adolescents aged 15–17 years (boys: 30.9% vs. 24.6%; girls: 26.1% vs. 18.2%). Concerning the countries’ income, the prevalence of never participating in PE was higher in high-income countries, and participating on ≥3 days/week was higher in low-income countries, but further research is recommended. The findings suggest that national, regional and worldwide data highlight the importance of improving participation in PE, particularly for girls and older adolescents. An improved and continued monitoring of PE policies and their actual implementation is needed worldwide.

Associations of Heart Rate Measures during Physical Education with Academic Performance and Executive Function in Children: A Cross-Sectional Study

The current evidence for a relation between children’s heart rate measures and their academic performance and executive functioning is infancy. Despite several studies observing dose-response effects of physical activity on academic performance and executive function in children, further research using objective measures of the relative intensity of physical activity (e.g., heart rate) is warranted. The present study aimed to inspect associations between heart rate response and various academic performance indicators and executive function domains. A total of 130 schoolchildren between the ages of 9 and 13 years (M = 10.69, SD 0.96 years old; 56.9% boys) participated in a cross-sectional study. Children’s heart rate data were collected through participation in physical education classes using the polar Team^TM hardware and software. One week before heart rate measures, academic performance was obtained from the school records in maths, Spanish language, Catalan language, physical education, and Grade point average. Executive function was measured by two domains, cognitive flexibility with the Trail Making Test and inhibition with the Stroop test. Associations between children’s heart rate data and academic performance and executive function were analyzed using regression models. Academic performance was found to be positively related to four heart rate measures (β range, 0.191 to 0.275; all p < 0.040). Additionally, the hard heart rate intensity level was positively related to two academic indicators (β range, 0.183 to 0.192; all p < 0.044). Three heart rate measures were associated with two cognitive flexibility subdomains (β range, −0.248 to 0.195; all p < 0.043), and three heart rate measures were related to one inhibition subdomain (β range, 0.198 to 0.278; all p < 0.028). The results showed slight associations of heart rate responses during physical education lessons with academic performance but did not clearly indicate associations with executive function. Future experimental studies testing associations between different bouts of intensity levels are needed to disentangle the relationship with brain function during childhood.

Prevalence of low physical activity, its predictors and knowledge regarding being overweight/obesity: A community-based study from urban South India

INTRODUCTION

Physical inactivity is the fourth leading risk factor for mortality and morbidity as per the World Health Organisation (WHO). The current study was conducted in the city of Erode, Tamil Nadu, South India, to estimate the prevalence and predictors of low physical activity (LPA) and assess their knowledge with regards to being overweight/obesity.

METHODS

It was a cross-sectional study conducted over 24 months from July 2015 to June 2017. Multi-stage random sampling was done in 12 randomly chosen corporation wards. All consenting individuals above 18 years of age were included. Data were collected using a semi-structured questionnaire incorporating the validated International Physical Activity Questionnaire (IPAQ).

RESULTS

For the study, 489 individuals were screened and 461 were included. Prevalence of LPA was 49.9% (95% confidence interval [CI]:45.34%, 54.46%). The significant predictors (adjusted odds ratio [OR] [95% CI]) of LPA were patient education 1.129 (1.006, 1.2670); unemployment (2.418 [1.610, 3.631]) and knowledge score (5.172 [1.314, 9.423] 27). In the knowledge assessment, 60.3% of the participants scored less than 50%. The significant predictors of poor knowledge were marital status (unmarried) (3.857 [1.341, 11.091]), lower educational status (1.191 [1.009, 1.362]) and low socioeconomic status (SES) (1.050 [1.005, 1.121]).

CONCLUSION

Prevalence of LPA in our population is fairly high and there is gross knowledge inadequacy.

Correlates of physical activity among 142,118 adolescents aged 12-15 years from 48 low- and middle-income countries

Physical inactivity is a serious public health concern in adolescents from low- and middle-income countries (LMICs). Despite this, only a few multinational studies has investigated correlates of physical activity (PA) in young adolescents in this part of the world. In this study, we identified physical activity correlates using data from the Global school-based Student Health Survey. In total, 142,118 adolescents from 48 LMICs (age 13.8 ± 1.0 years; 49% girls) were included in the analyses. PA was assessed by the PACE+ Adolescent Physical Activity Measure and participants were dichotomised into those who do (60 min of moderate-vigorous PA every day of the week) and do not comply with the World Health Organization recommendations. We used multivariable logistic regression in order to assess the correlates. The prevalence of low PA was 15.3% (95%CI = 14.5%-16.1%). Boys (OR = 1.64; 95%CI = 1.47-1.83) and those who participated in physical education for ≥5 days/week (OR = 1.12; 95%CI = 1.10-1.15) were more likely to meet PA guidelines, while adolescents with food insecurity (OR = 0.85; 95%CI = 0.80-0.90), low fruit and vegetable intake (OR = 0.68; 95%CI = 0.63-0.74), low parental support/monitoring (OR = 0.68; 95%CI = 0.62-0.74), no friends (OR = 0.80; 95%CI = 0.72-0.88), and who experienced bullying (OR = 0.93; 95%CI = 0.86-0.99) were less likely to have adequate levels of PA. There were a few variations in the correlates depending on country-income level. Our data indicate that in adolescents aged 12 to 15 years living in LMICs physical activity participation is a complex and multi-dimensional behavior determined by sociocultural, socio-economic, and policy-related factors. Longitudinal research is needed to confirm/refute the present findings.

Influence of Emotional Intelligence, Motivation and Resilience on Academic Performance and the Adoption of Healthy Lifestyle Habits among Adolescents

Included among the basic objectives of Physical Education (PE) classes is the consolidation of habits of a healthy lifestyle among adolescents. However, the main studies in this field have focused on cognitive aspects related to students during these classes, yet they ignore the role that emotions can play in the adoption of future habits. Objectives: To analyze how emotions (emotional intelligence and emotional state) can influence the resilience and motivation of adolescents, as well as academic performance and adoption of healthy lifestyle habits. Methodology: 615 secondary school students between the ages of 14 and 19 participated (M = 16.02; SD = 1.57) in the study. A structural equations model was developed using the main variables and by applying some of the principles of Self-Determination Theory. The results show that emotional intelligence is positively related to positive emotions and negatively related to negative emotions. Positive emotions positively predict both self-motivation towards physical education classes and resilience. Resilience positively predicts self-motivation. Finally, self-motivation acts as a predictor of both academic performance and regular participation in physical activity. Conclusions: This study successfully shows the importance of focusing on emotions in PE classes inasmuch as emotion increases the tendency to get good grades and maintain active lifestyle habits. In this sense, focusing on the emotions of students in PE could prove quite beneficial.

Influence of Physical Education Teachers on Motivation, Embarrassment and the Intention of Being Physically Active During Adolescence

According to a WHO report (2018), more than 80% of adolescents do not do enough physical activity. Physical Education (PE) classes should be aimed at solving this problem. The present study aims to analyze the influence teachers have on motivation, embarrassment and intention to be physically active among their students. A total of 604 secondary school students participated in the study. Various statistical analyses were carried out to explain the causal relationships between the variables. The results revealed a positive relation between the autonomy support and the satisfaction of basic psychological needs (BPN), and a negative relation with the frustration of BPN. In contrast, perceived control revealed a positive relation with frustration of BPN, and a negative relation with the satisfaction of BPN. Satisfaction of BPN was negatively related to embarrassment and positively related to self-determined motivation. On the other hand, frustration of BPN was positively related to embarrassment and negatively with self-determined motivation. Embarrassment was negatively related to self-determined motivation, and the latter was positively related to intention to be physically active. Indeed, the study demonstrates the influence and the importance of PE teachers and of the motivational and emotional processes of adolescents during PE classes and the role they play in acquiring the habits of an active lifestyle.

Associations Among Physical Education, Activity-Related Healthy Lifestyle Practices, and Cardiorespiratory Fitness of Chinese Youth

PURPOSE

Physical education (PE) in school provides opportunities for physical activity (PA) engagement and reportedly results in improved health-related fitness. This study explored the underlying correlations between PE and activity-related healthy lifestyle practices with current level of cardiorespiratory fitness.

METHODS

A total of 13,138 students age 14 (boys = 7,094, 54.0%) in Grade 8 from the China National Assessment of Educational Quality - Physical Education & Health 2015 were included in this study. Two independent structural equation modeling (SEM) analyses were conducted to obtained sex-specific results. Data included the results of the 15-m progressive aerobic cardiovascular endurance run (PACER) and questionnaire data regarding PE curriculum implementation, learning and practice, perceived support from PE teachers, PE facilities, PE equipment, activity-related healthy lifestyle practices, habitual physical fitness, appropriate method of physical fitness, and breakfast eating habits. Structural equation modeling was applied to examine the associations between variables, controlling for socioeconomic status, the location of schools, and Body Mass Index.

RESULTS

There was a statistically significant relationship between cardiorespiratory fitness and activity-related healthy lifestyle practices, which was somewhat positively impacted by skill learning and practice and perceived support from PE teachers. Together, the boy's model explained 21.8% of the variance in cardiorespiratory fitness, whereas the girl's model explained 15.9%.

CONCLUSIONS

A well-organized PE program is related to students' activity-related healthy lifestyle practices, and consequently provides an improvement to cardiorespiratory fitness.

International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): Contributions to Understanding the Global Obesity Epidemic

The purpose of this review is to summarize the scientific contributions of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) in extending our understanding about obesity in children from around the world. ISCOLE was a multi-national study of 9 to 11 year-old children from sites in 12 countries from all inhabited continents. The primary purpose was to investigate relationships between lifestyle behaviors and obesity, and the influence of higher-order characteristics such as behavioral settings, and physical, social and policy environments. ISCOLE has made several advances in scientific methodology related to the assessment of physical activity, dietary behavior, sleep and the neighborhood and school environments. Furthermore, ISCOLE has provided important evidence on (1) epidemiological transitions in obesity and related behaviors, (2) correlates of obesity and lifestyle behaviors at the individual, neighborhood and school levels, and (3) 24-h movement behaviors in relation to novel analytical techniques. A key feature of ISCOLE was the development of a platform for international training, data entry, and data quality for multi-country studies. Finally, ISCOLE represents a transparent model for future public-private research partnerships across low, middle and high-income countries.

Participation frequency in physical education classes and physical activity and sitting time in Brazilian adolescents

Introduction

To examine the association between participation frequency per week in physical education (PE) classes and physical activity (PA) and sitting time levels in adolescents according to the economic development level of the region of residence.

Methods

A cross-sectional study with a sample representative of Brazil was carried out with 12,220 students aged 11–19 years. Participation frequency per week in PE classes, moderate-to-vigorous PA (MVPA), PA during PE classes, active commuting, PA outside of school hours, total accumulated PA, time sitting in front of the TV and total sitting time were assessed by using a self-administered questionnaire.

Results

Adolescents who reported having PE classes were more likely to meet MVPA recommendations (1–2 PE class/week–OR: 1.3, 95%CI: 1.1–1.5; ≥3 PE class/week–OR: 2.0, 95%CI: 1.7–2.5), spent more time in PA outside of school hours (1–2 PE class/week–OR: 1.6, 95%CI: 1.4–1.9; ≥3 PE class/week–OR: 2.0, 95%CI: 1.5–2.6), and accumulated more PA (1–2 PE class/week–OR: 1.9, 95%CI: 1.6–2.2; ≥3 PE class/week–OR: 6.0, 95%CI: 4.0–8.9) than students who reported not taking PE classes. Boys from regions with higher Human Development Index (HDI) who took ≥3 PE classes/week were more likely to have higher levels of active commuting (OR: 1.4, 95%CI: 1.1–1.9) and less likely of getting in front of TV (OR: 0.7, 95%CI: 0.5–0.9). Adolescents from regions with higher HDI were more likely to have more time spent in PA during PE classes (Male–OR: 2.7, 95%CI: 2.4–3.1; Female–OR = 3.2, 95%CI: 2.8–3.7).

Conclusions

Having PE classes is associated with a higher level of PA in both sexes and in both regions and lower level of sitting time in boys from regions with higher HDI.