Association of sports club participation with fitness and fatness in children

Sport participation, weight status, and physical fitness in French adolescents

The primary objective of this study was to investigate the associations between sport participation and weight status with physical fitness among French adolescents. The secondary aim was to establish sex- and age-specific physical fitness percentiles for French adolescents. The sample comprised 8084 adolescents (4126 boys, 3958 girls), aged 10-14 years. Participants were tested on cardiorespiratory fitness and muscular strength using the following tests: 20-m shuttle run test and handgrip strength test. A questionnaire on organized sport participation was completed. Physical fitness levels were better in boys (P < 0.005). Handgrip strength increased with age whereas 20-m shuttle run performance decreased with age. Overweight and obese adolescents had significantly lower cardiorespiratory fitness levels than their normal-weight peers (P < 0.005), whereas normal-weight adolescents had lower cardiorespiratory fitness than thin adolescents (P < 0.005). Sport participation was higher for boys (57.2% boys vs. 52.8% girls) (P < 0.001). Adolescents who participated in at least one organized sport (either through a club or at school) were fitter than those who did not participate in organized sports (P < 0.005). Adolescents who engaged in organized sports were more active and physically fit than those who did not participate. The fitness benefits of club sports are greater than those provided by school-based sports, highlighting the potential of sports clubs as a key setting for promoting health. What is Known: • Physical fitness is a strong marker of health in children and adolescents. • The last French Report Card highlighted the lack of fitness data and the need for nationwide programs, while showing a significant decline in cardiorespiratory fitness among youth in recent decades.. What is New: • This study reveals that adolescents participating in organized sports have better physical fitness compared to their peers who do not, emphasizing the potential advantages of club sports over school-based activities. • We highlight the need for targeted strategies, particularly for overweight or obese adolescents and girls, to increase participation in organized sports and enhance health outcomes. • The study emphasizes the need to develop policies that improve access to organized sports clubs and expand physical education in schools, aiming to improve CRF in adolescents.

Association between sports participation and overall health in children and adolescents

Emerging evidence revealed that participating in sports may have benefits for health, but the association between sports participation and self-rated overall health has not been clearly established in children and adolescents. The present study aimed to examine the cross-sectional relationships between sports participation and self-rated overall health. A national sample of 42,777 (mean age = 9.4 ± 5.2, 48.3% girls) United States children and adolescents completed self-administered questionnaires and were included in the final analysis. The crude and adjusted odds ratio (ORs) and 95% CI were used to analyze the association between sports participation and self-rated overall health. Results indicated that children and adolescents participated in sports were more likely to report better overall health (OR = 1.92, 95%CI: 1.83, 2.02) compared to those not participating in sports. This study found that sport participation was positively associated with self-rated overall health in children and adolescents. This study offers evidence concerning adolescents' health literacy promotion.

Relationship between Type and Intensity of Sports Activities and the Prevalence of Overweight in Serbian School Children

This study aimed to explore the relationship between different forms and intensities of sports activities and the prevalence of overweight in primary school children. Using International Obesity Task Force BMI criteria, we have identified body weight status in a group of 2893 children aged 9–15 years participating in 27 different sports and within a group of 4987 non-active children of the same age. We have compared the prevalence of overweight and obesity between these groups, as well as between genders and different forms and intensities of sports, within the group of active children. We have found lower prevalence of overweight (Χ2 = 41.689, DF = 1, p < 0.001), as well as prevalence of obesity (Χ2 = 175.184, DF = 1, p < 0.001) in physically active children compared with their non-active counterparts, as expected. Overweight (including obesity) had the highest prevalence in mixed sports of the Classification of Sports of the European Association of Preventive Cardiology, in boys (p = 0.003), as well as in girls (p = 0.043). A lower prevalence of overweight was noted in boys (p = 0.001), as well as in girls (p = 0.025) with more than 7 years of training. Regarding the number of hours of training per week, a lower prevalence of overweight was noted only in girls with 4 and more hours of training per week (p = 0.025). Concerning intensity, we have found a significant drop in the prevalence of overweight in children with sports activities whose intensity is more than 60 MET-hours per week. We conclude that a significant relationship between sports and the prevalence of overweight is found in children with more than 60 MET-hours of sports activities per week, as well as among children involved in mixed sports, and after more than 7 years spent in regular sports training.

Development of Cardiorespiratory Fitness in Children in the Transition From Kindergarten to Basic School According to Participation in Organized Sports

Purpose: This study examined the development of cardiorespiratory fitness (CRF) in children in the transition from kindergarten to basic school according to participation in organized sports and estimated the associations of CRF and body composition indices during the transition from childhood to preadolescence.

Methods: Children participated in the three-staged study (kindergarten, 6.6 years, n = 212; 1st grade, 7.6 years, n = 136; and 5th grade, 11.5 years, n = 142) for 5 years and were categorized into three groups according to their participation in organized sports in the study period (whole period, episodically, and never). Cardiorespiratory fitness was assessed by performing a 20-m shuttle run test, while body composition was measured by skinfold thicknesses, and physical activity was registered with an accelerometer. International gender- and age-specific CRF reference normativities were also used to characterize the participants.

Results: Children who participated consistently in organized sports had significantly higher CRF levels and lower body fatness (31.3 ± 13.5 laps in 20 m shuttle run; 21.1% ± 6.3% body fat) in 11.5 years than in children who had never participated in sports clubs (20.7 ± 12.0 laps in 20-m shuttle run; 26.1% ± 6.8% body fat). Body composition and CRF did not associate in consistently trained children. The proportion of 5th grade children demonstrating age-appropriate healthy CRF was almost threefold higher in the group of consistent sports training among both boys and girls than among non-members of sports clubs.

Conclusion: Consistent attendance in organized sports in childhood and early preadolescence ensures higher CRF and healthier body composition than in children who had no experience of organized sports.

Influencing factors of children's physical activity in family

BACKGROUND

Children's physical activity (PA) is an important guarantee for children's physical and mental health. Influencing factors of children's PA in family is related to the healthy growth of children and the happy life of families.

METHODS

This is a cross-sectional study of influencing factors of children's PA in family. Parents whose children in 15 kindergartens(i.e., children are aged from 3 to 6 years) were sampled.

RESULTS

Government had a significant negative impact on parents' perceived risks. Community has a significant positive effect on parents' perceived benefits and a significant negative effect on parents' perceived risks. Kindergarten has a significant positive effect on parents' perceived benefits, but has no significant effect on the parents' perceived risks. Children sports club has a significant positive effect on parents' perceived benefits. Parents' perceived benefits has a significant positive impact on children's PA in family, while perceived risks has a significant negative impact.

CONCLUSION

Government should play a leading role in the development of children's PA in family. Community provides supplementary support. Kindergarten is the key point of developing children's PA in family. Children sports club is the auxiliary force of children's PA in family.

Profiles of Physical Fitness and Fitness Enjoyment Among Children: Associations With Sports Participation

Purpose: The present study examined whether groups of children with different physical fitness and fitness enjoyment profiles could be identified and, if so, whether the different groups varied from one another in terms of organized sports participation. Method: Five hundred and fifty-eight 8-11-year-olds (56.99% boys) participated in this cross-sectional study. Physical fitness and fitness enjoyment were assessed with seven items from a standardized test battery and a pictorial scale containing pictures referring to the enjoyment in those seven physical fitness tests, respectively. To examine whether groups with different fitness and enjoyment profiles could be identified, we conducted cluster analyses based on children's standardized physical fitness and fitness enjoyment scores. A two-way ANCOVA (sex*cluster) was conducted to investigate differences in weekly organized sports participation among each of the identified groups while controlling for age. Results: Cluster analyses revealed two groups with aligned levels of physical fitness and fitness enjoyment (i.e., relatively low-low and relatively high-high) and two groups with unaligned levels (i.e., relatively low-moderate and relatively high-moderate), respectively. Both groups with relatively high fitness scores were found to spend significantly more time in organized sports (M = 2.01 h and 2.29 h, respectively) than the two groups with relatively low fitness scores (M = 1.08 h and 0.98 h, respectively), irrespective of their enjoyment levels. Conclusion: Increasing physical fitness levels (especially among those children with suboptimal enjoyment levels) may lead to increased organized sports participation, while increased organized sports participation in its turn may lead to higher fitness levels. As such, participation in sports programs should be promoted in children of all age groups.

Well-being, physical fitness and health profile of 10-12 years old boys in relation to leisure-time sports club activities: a cross-sectional study

OBJECTIVES

This study investigated the correlation between sports club activities and well-being and physical health parameters in 10-12 years old boys.

DESIGN

Cross sectional.

SETTING

Danish schools.

PARTICIPANTS

2293 boys took part in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Questionnaires on participation in sports clubs and well-being and testing of physical health profile through measurement of body composition, resting heart rate (RHR), blood pressure and postural balance, jump and Yo-Yo IR1C performance. Data were analysed by participation in sport and according to the five most frequently reported sports.

RESULTS

Boys enrolled in sports clubs had higher physical well-being (51.7±9.7 vs 45.9±8.7) and psychological well-being (53.3±9.6 vs 51.4±10.0), experienced more peers and social support (50.9±9.9 vs 48.0±11.6), and had a more positive perception of the school environment (48.6±7.5 vs 45.9±8.1) than boys not involved in sports clubs. In addition, they showed better Yo-Yo IR1C (+46%), long jump (9%) and balance test performance (+20%). The boys active in sports clubs had higher relative muscle mass (+6%) and lower fat percentage (-3%), body mass index (-6%) and RHR (-5%) compared with boys not involved in sports clubs (p<0.05). Boys enrolled in football clubs had higher aerobic fitness compared with boys not active in clubs (+11%), handball players (+5%), swimmers (+8%) and badminton players (+7%). Moreover, the boys enrolled in football clubs had lower fat percentage (-17%) and higher relative muscle mass (+4%) than swimmers.

CONCLUSION

Boys participating in club-based sports showed markedly higher levels of well-being and better physical health profiles than boys not involved in sports club activities. Footballers had superior aerobic fitness and body composition compared with those active in other sports. Results suggest that sports club activities seem to be beneficial for young boys' well-being, fitness and physical health profile, with the greatest benefits achieved by boys involved in football.

Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile

In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.

Physical Fitness and Motor Competence in Chinese and German Elementary School Children in Relation to Different Physical Activity Settings

(1) Background: Children with greater physical activity (PA) may show a higher physical fitness (PF) and motor competence (MC) compared to peers with less PA. The purpose of this study was to examine the relationship between moderate-to-vigorous physical activity (MVPA), PF, and MC in 8- to 9-year old children in Germany and China. MVPA was differentiated into five PA settings: family sport, club training, school sport, leisure sport, and outside play. (2) Methods: This longitudinal study comprised N = 577 children (n = 311 girls, n = 266 boys) who were studied over a one-year period. Each child's PF and MC was determined using sports motor tests. The children's PAs were measured using a questionnaire. (3) Results: The children's PA was positively associated with PF and MC. The MVPA-settings: family sport, leisure sport, outside play, school, and club sport, explained between 18 and 23 percent of the variance in selected PF and MC characteristics in a multivariate linear regression analysis. (4) Conclusions: An increase in the children's MVPA might be an appropriate aim in the school sport in Germany as well as in the club sport system in China. Furthermore, family sport should be enhanced in Germany and outside play activities in China, respectively.

'One hundred dollars is a big help, but to continue, it's a challenge': A qualitative study exploring correlates and barriers to Active Kids voucher uptake in western Sydney

INTRODUCTION

The Active Kids voucher is a universal, state-wide voucher program, provided by the New South Wales (NSW) Government, Office of Sport. All school-aged children in NSW are eligible to receive a voucher to reduce registration costs of structured physical activity programs. This study explores reasons behind lower uptake among children who are overweight or obese, from cultural and linguistically diverse families and those living in low socio-economic areas.

METHODS

Participants were recruited through a convenience sample of parent/carers who participated in the NSW Health Go4Fun program. Qualitative data were collected using focus groups. The Framework method was adapted for the analysis, taking an interpretive phenomenological approach.

RESULTS

Study participants (n = 54) were all parents of children who were overweight or obese from both low and high socio-economic status (SES). Most reported speaking a primary language other than English at home (65%). Parents were mostly aware of the Active Kids program (91%) and reported that the voucher had a positive impact on their children's participation in structured physical activity. A range of socio-ecological factors, in addition to activity cost, influenced whether parents were able to use an Active Kids voucher and participate in structured physical activity.

CONCLUSIONS

The Active Kids voucher does not alleviate all barriers, particularly for families living in low socio-economic areas. Engagement of this population in structured physical activities using the Active Kids vouchers could be strengthened through the implementation of effective interventions which comprehensively address the remaining barriers, such as access and flexibility of programs with local stakeholders and activity providers.

Effect of practice on learning to maintain balance under dynamic conditions in children: are there sex differences?

Background

In youth, sex-related differences in balance performances have been reported with girls usually outperforming same-aged boys. However, it is not known whether sex also has an influence on learning of a new balance task in primary school-aged children. Therefore, the present study investigated sex-related differences in children learning to maintain balance under dynamic conditions.

Methods

Thirty-two children (16 girls, 16 boys) aged 8.5 ± 0.5 years practiced balancing on a stabilometer (i.e., to keep it as horizontal as possible) for seven trials (90 s each) on two consecutive days. Knowledge of results (KR) (i.e., time in balance) was provided after each trial. On day three learning was assessed using a retention test (i.e., balance task only) and a test of automation (i.e., balance plus concurrent motor interference task). Root-mean-square-error (RMSE) was recorded for all trials and used for further analysis.

Results

During practicing (Day 1, Day 2) RMSE values significantly decreased over the days (p = 0.019, d = 0.92) and trials (p = 0.003, d = 0.70) in boys and girls. Further, the main effect of sex showed a tendency toward significance (p = 0.082, d = 0.67). On day 3, the girls showed significantly smaller RMSE values compared to boys in the retention (p = 0.012, d = 1.00) and transfer test (p = 0.045, d = 0.74).

Conclusions

Performance increases during the acquisition phase tended to be larger in girls than in boys. Further, learning (i.e., retention and automation) was significantly larger in girls compared to boys. Therefore, practitioners (e.g., teachers, coaches) should supply boys and grils with balance exercises of various task difficulties and complexities to address their diverse learning progress.

Reducing financial barriers through the implementation of voucher incentives to promote children's participation in community sport in Australia

BACKGROUND

Participation in organised sport and physical activity contributes to health-enhancing levels of leisure time physical activity. In Australia, 58% of children aged 0-14 years participated at least once a week in October 2015 - December 2017. To overcome the frequently cited cost barrier, sports voucher incentives have been widely implemented across Australia.

METHOD

The financial value of jurisdictional vouchers and the National median financial value were used to calculate the proportion of total annual expenditure on children's participation in sport supported by sports vouchers. Participation rates using AusPlay data were estimated by age, sex and socio-economic index (SEIFA) at state and national level for children aged 0-14 years.

RESULTS

Five States and Territories implemented sports vouchers from 2011 to 2018, with a median value of AU$150. Nationally, median annual expenditure for children's sport participation was AU$447 (IQR $194.2-936), with 27% reported expenditure supported by a sports voucher. The proportion of financial support from sports vouchers increased considerably with social disadvantage, rising to over 60% of total expenditure in the most disadvantaged populations.

CONCLUSIONS

Socio-economic status was associated with sports-related expenditure and sports participation amongst children. Sport vouchers should target children in the most disadvantaged areas to promote participation in organised sport and physical activity.

Association between Club Sports Participation and Physical Fitness across 6- to 14-Year-Old Austrian Youth

Changes in social and built environments most likely contribute to a decline in physical activity (PA) and physical fitness in children and adolescents. Organized sports may be an important component in ensuring adequate fitness, which is an important aspect in general health and well-being. The present study examines differences by club sports participation in cardiorespiratory endurance, muscular strength, power, speed, agility, flexibility and balance in 3293 (55.1% male) Austrian children and adolescents between 6 and 14 years of age. Anthropometric measurements (height and weight) were taken and participants completed the German motor test during regular class time. Even though there was no significant difference in body weight between club sports participants and non-club sports participants, club sports participation was associated with higher physical fitness, particularly regarding endurance, strength, power, and agility. Differences by club sports participation, however, declined during the elementary school years (6-10 years of age), while they became more pronounced during middle school years (10-14 years of age). Club sports participation, therefore, may be a viable option in the promotion of physical fitness, particularly during adolescence. At younger ages, other sources of PA, such as physical education and free play, however, should be considered to ensure sufficient fitness levels that contribute to a healthy and active lifestyle.

Physical fitness and physical activity of 6-7-year-old children according to weight status and sports participation

BACKGROUND

The aim of this study was to investigate physical fitness and physical activity (PA) of 6-7-year-old children just before entering school according to their sports club (SC) participation and weight status, and to examine possible associations of their body mass index, fat mass and fat-free mass with physical fitness and PA.

METHODS

A total of 256 preschoolers aged 6 to 7 years participated in the study. Physical fitness was assessed using PREFIT test battery and objective PA by 7 day accelerometry. Body composition was estimated using two skinfold thickness parameters. SC participation and parental data were assessed by questionnaires.

RESULTS

Children participating in SC had higher moderate-to-vigorous PA, vigorous PA and cardiorespiratory fitness than children not participating in SC. Overweight children had lower results in cardiorespiratory fitness and all weight-bearing fitness tests, and better results in handgrip strength test in comparison with normal weight children. Significant associations were found between body composition indices and physical fitness tests. PA level was associated with fat-free mass and physical fitness but not with fatness indices.

CONCLUSIONS

Weight-status and body composition together with PA level were associated with physical fitness level. The differences in physical fitness based more upon weight status than SC participation among 6-7-years old children.

Objectively assessed vigorous physical activity and motor coordination are associated in 11-year old children

This cross-sectional study examined the associations between gender, sports club (SC) participation, physical activity (PA), motor coordination (MQ) and object control skill (TC). 11 year-old children (n = 477) wore accelerometers during seven consecutive days for the analysis of moderate PA (MPA) and vigorous PA (VPA). To detect motor competence (MC), children's motor coordination was measured using the KTK (MQ), and object control skill with throw-and-catch task (TC). Sports club (SC) status was obtained by a questionnaire. Boys had higher levels of MPA (F = 50.45, P<0.001) and VPA (F = 11.13, P = 0.001), and were better in TC (F = 39.83, P < 0.001) than girls. SC participants outperformed non-participants in MPA (F = 5.45, P = 0.020) and VPA (F = 11.71, P = 0.001), MQ (F = 31.56, P < 0.001), and TC (F = 15.60, P < 0.001). Moreover, better TC was associated with higher MPA (β = 0.88, t = 2.16, P = 0.031), and higher MQ was associated with higher VPA (β = 0.21, t = 3.87, P < 0.001). The association between PA and MC was found showing that different intensities of PA were associated with different aspects of MC. SC participation may be one important factor promoting PA and MC in children. Therefore, all children, especially girls, should be encouraged to participate in various practices to ensure the development of adequate level of motor competence to be physically active.

Organized Sports for Children, Preadolescents, and Adolescents

Interest and participation in organized sports for children, preadolescents, and adolescents continue to grow. Because of increased participation, and younger entry age, in organized sports, appropriate practice, game schedules, and content become more important, taking into account athlete developmental stage and skills. Parental support for organized sports in general, with focus on development and fun instead of winning, has emerged as a key factor in the athlete's enjoyment of sports. Schools and community sports organizations who support multiple levels of sport (eg, recreational, competitive, elite) can include more youth who want to play sports and combat sport dropout. This report reviews the benefits and risks of organized sports as well as the roles of schools, community organizations, parents, and coaches in organized sports. It is designed to complement the American Academy of Pediatrics clinical reports "Physical Activity Assessment and Counseling in Pediatric Clinical Settings" and "Sports Specialization and Intensive Training in Young Athletes" by reviewing relevant literature on healthy organized sports for youth and providing guidance on organized sport readiness and entry. The report also provides guidance for pediatricians on counseling parents and advocating for healthy organized sports participation.

Are there disparities in different domains of physical activity between school-aged migrant and non-migrant children and adolescents? Insights from Germany

Background

Large proportions of the populations in many European countries, including Germany, are migrants. Migrant children and adolescents tend to be less physically active than their non-migrant peers. However, current research is limited as it does not sufficiently consider different domains of physical activity. Using a representative dataset, the present study examines the patterns of sports participation and other domains of physical activity among migrant and non-migrant children and adolescents residing in Germany.

Methods

Nationwide data from the Motorik-Modul (MoMo) Study is used. Five different domains of physical activity participation (sports clubs, outside of sports clubs, extra-curricular physical activity, physical activity, outdoor play and active commuting to school) were compared between children and adolescents with no, one-sided and two-sided migration background using logistic regression adjusted for demographic factors. Interaction terms were included in order to examine whether difference between the three groups differ by age and gender.

Results

Information on n = 3,323 children and adolescents was available. As compared to non-migrants, children and adolescents with a two-sided migration background had a 40% (adjusted odds ratio [aOR] = 0.60, 95%-CI: 0.44–0.81), those with a one-sided migration background a 26% (aOR = 0.74, 95%-CI: 0.55-<1.00) lower chance of participating in sport club activities. In contrast, children and adolescents with a two-sided migration background were at 65% higher chance of participating in extra-curricular physical activity than non-migrants (OR = 1.65, 95%-CI: 1.15–2.36).

Conclusion

The study shows that differences in levels of physical activity between migrant and non-migrant children and adolescents are less pronounced than previous research has suggested. In particular, it reveals that migrants are only disadvantaged regarding participation in sports clubs whereas they fare better with respect to extra-curricular physical activity. Interventions should therefore address barriers migrant children and adolescents encounter in the access to sport clubs while maintaining their high level of extra-curricular physical activity.

The Role of Youth Sports in Promoting Children's Physical Activity and Preventing Pediatric Obesity: A Systematic Review

Youth sport participation plays an important role in promoting physical activity among children and may be a possible venue for the prevention of pediatric obesity. To design effective physical activity interventions, it is imperative to understand how different aspects of sport participation influence physical activity (PA). The purpose of this article is to present a comprehensive review of the impact of youth sport participation on children's PA and obesity status. A total of 44 studies published up to January 2014 concerning youth sport participation, PA, and obesity status were identified. Inclusion criteria were studies comparing PA levels of sport participants to nonparticipants or those comparing PA levels in different sport types and settings. Studies with the outcome variables of obesity status (e.g., body mass index, fat percentage, waist circumference) were also included. Participation in youth sport was positively associated with children's PA levels, and youth participating in sports were more likely to persist in their PA. However, the relationship between youth sport participation and obesity status was inconclusive. Educators and sports professionals should find ways to involve children in various sports settings and policies and help obese children engage more in sports.

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

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

Organized Sport Trajectories from Childhood to Adolescence and Health Associations

INTRODUCTION

The purpose of this study was to identify unique organized sport trajectories from early childhood to late adolescence in an Australian pregnancy cohort, the Raine Study.

METHODS

Participation in organized sport was assessed at ages 5, 8, 10, 14, and 17 yr. Physical activity, body composition, and self-rated physical and mental health were assessed at the age of 20 yr. Latent class analysis was used to identify patterns of sport participation. To assess the internal validity of the trajectory classes, differences in health characteristics between trajectories were analyzed using generalized linear models.

RESULTS

For girls, three trajectory classes were identified: consistent sport participators (47.5%), sport dropouts (34.3%), and sport nonparticipators (18.1%). For boys, three trajectory classes were identified: consistent sport participators (55.2%), sport dropouts (36.9%), and sport joiners (8.1%). For girls, there were overall differences across trajectory classes in lean body mass (P = 0.003), lean mass index (P = 0.06), and physical health (P = 0.004). For boys, there were differences across classes in physical activity (P = 0.018), percent body fat (P = 0.002), lean body mass (P < 0.001), lean mass index (P < 0.001), physical health (P = 0.06), and depression scores (P = 0.27).

CONCLUSION

This study identified unique, sex-specific trajectories of organized sport participation. The differences in health outcomes between trajectory classes, such as participants with consistent sport participation having more preferable health outcomes at the age of 20 yr, support the internal validity of the trajectories. Strategies are needed to identify and encourage those in the dropout trajectory to maintain their participation and those in the nonparticipator or joiner trajectories to join sport earlier. Specifically, interventions to encourage early sport participation in girls and help nonparticipating boys to join sport during adolescence may help more children receive the benefits of sport participation.

Participation in sports, body composition, and fitness characteristics in children according to ethnic background

Participation in sports has important implications, being associated with health and social features. The objectives of this study were to verify whether there were any differences in sport participation between immigrant and Italian children and whether there was any relation with their body composition and fitness characteristics. A survey was conducted on 1432 children attending primary school in the Emilia-Romagna (northern Italy). Anthropometric measurements, fitness characteristics, and data about participation in sports were considered. Italian children were more likely to participate in sports than immigrants and boys than girls. Among immigrants, the lowest values were observed in Asians. Eastern European males and Latin American females displayed the widest dimensions. Eastern Europeans generally showed the highest values of strength, while Latin Americans had the highest values of flexibility. Asian children showed the highest values of centripetal fat, and a high percentage of them exceeded the %F reference. These aspects, together with the low frequency of practicing sports, place Asians at greater risks for health. Sex and ethnic group are the most informative variables associated with participation in sports by children. Interventions including health education lessons and promoting the participation in sports for immigrant children attending schools need to be encouraged.

Active children through incentive vouchers - evaluation (ACTIVE): a mixed-method feasibility study

Background

Adolescents face many barriers to physical activity, demonstrated by the decline in physical activity levels in teenage populations. This study aimed to assess the feasibility of overcoming such barriers via the implementation of an activity-promoting voucher scheme to teenagers in deprived areas.

Methods

All Year 9 pupils (n = 115; 13.3 ± 0.48 years; 51 % boys) from one secondary school in Wales (UK) participated. Participants received £25 of activity vouchers every month for six months for physical activity or sporting equipment. Focus groups (n = 7), with 43 pupils, and qualitative interviews with teachers (n = 2) were conducted to assess feasibility, in addition to a process evaluation utilising the RE-AIM framework. Quantitative outcomes at baseline, five months (during intervention) and twelve months (follow-up) included: physical activity (accelerometer), aerobic fitness (12 min Cooper run) and self-reported activity (PAQ-A). Motivation to exercise (BREQ-2) was measured three months post-baseline and at follow-up.

Results

Qualitative findings showed that vouchers encouraged friends to socialise through activity, provided opportunities to access local activities that pupils normally could not afford, and engaged both those interested and disinterested in physical education. Improvements in weekend moderate-to-vigorous physical activity and reductions in sedentary behaviour were observed in both sexes. Boys’ fitness significantly improved during the voucher scheme. ‘Non-active’ pupils (those not meeting recommended guidelines of 60 mins∙day⁻¹) and those with higher motivation to exercise had higher voucher use.

Conclusions

Adolescents, teachers and activity providers supported the voucher scheme and felt the vouchers enabled deprived adolescents to access more physical activity opportunities. Voucher usage was associated with improved attitudes to physical activity, increased socialisation with friends and improved fitness and physical activity; presenting interesting avenues for further exploration in a larger intervention trial.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3381-6) contains supplementary material, which is available to authorized users.

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

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

Contribution of organized and nonorganized activity to children's motor skills and fitness

BACKGROUND

To examine the associations between children's organized physical activity (OPA), nonorganized physical activity (NOPA), and health-related outcomes (fundamental movement skill [FMS] fitness).

METHODS

Cross-sectional survey of children aged 10-16 years (N = 4273). Organized physical activity and NOPA were assessed by self-report, FMS by process-orientated criteria, and fitness by 20-m shuttle run test.

RESULTS

Boys spent 97.5 minutes and girls 86.6 minutes in daily physical activity with the majority spent in OPA (boys, 56.3%; girls 60.5%). Organized physical activity increased with grade, whereas NOPA decreased. Organized physical activity and NOPA were associated with fitness, and OPA was consistently associated with FMS competency. Boys' fitness was associated with OPA and NOPA (adjusted odds ratio [AOR] 1.42, 95% confidence interval [CI]: 1.04, 1.94; AOR 1.26, 95% CI: 1.03, 1.54, respectively), FMS competency (side gallop leap, kick) with OPA and catch, and over-arm throw with both OPA and NOPA. Girls' fitness (AOR 2.62, 95% CI: 1.88, 3.66) and FMS competency were consistently associated with OPA.

CONCLUSIONS

Both OPA and NOPA are important contributors to children's physical activity; however, for girls, OPA was more strongly associated with fitness and FMS competency. Our findings support the importance of providing children with opportunities to engage in daily OPA. School physical education programs are an ideal delivery vehicle for OPA and need to be central to education policy.

Effect of living area and sports club participation on physical fitness in children: a 4 year longitudinal study

Background

Cross-sectional studies detected associations between physical fitness, living area, and sports participation in children. Yet, their scientific value is limited because the identification of cause-and-effect relationships is not possible. In a longitudinal approach, we examined the effects of living area and sports club participation on physical fitness development in primary school children from classes 3 to 6.

Methods

One-hundred and seventy-two children (age: 9–12 years; sex: 69 girls, 103 boys) were tested for their physical fitness (i.e., endurance [9-min run], speed [50-m sprint], lower- [triple hop] and upper-extremity muscle strength [1-kg ball push], flexibility [stand-and-reach], and coordination [star coordination run]). Living area (i.e., urban or rural) and sports club participation were assessed using parent questionnaire.

Results

Over the 4 year study period, urban compared to rural children showed significantly better performance development for upper- (p = 0.009, ES = 0.16) and lower-extremity strength (p < 0.001, ES = 0.22). Further, significantly better performance development were found for endurance (p = 0.08, ES = 0.19) and lower-extremity strength (p = 0.024, ES = 0.23) for children continuously participating in sports clubs compared to their non-participating peers.

Conclusions

Our findings suggest that sport club programs with appealing arrangements appear to represent a good means to promote physical fitness in children living in rural areas.

Parental characteristics have a larger effect on children's health behaviour than their body weight

OBJECTIVE

Parents take an important role in a child's development, but there is currently limited information on parental correlates with children's health behaviour. The purpose of this study, therefore, was to examine whether parental characteristics, such as body weight, TV consumption and sport participation, affect children's body weight and health behaviour.

METHODS

To examine the effects of parental characteristics on children's body weight and health behaviour, baseline data of 1,118 elementary school children (7.6 ± 0.4 years) participating in a school-based intervention in southwest Germany was used. Children's height and weight were measured and parent as well as child behaviour was assessed via questionnaire.

RESULTS

BMI percentiles of children were positively associated with parental BMI (r = 0.2, p <0.01). Further, high parental TV time increased the odds for high TV time in children (OR mother= 2.2, OR father = 2.3) and parental club sport participation increased the odds for club sport participation in children (OR mother = 1.9, OR father = 1.7). The relationship between parental and child behaviour was stronger than the relationship between parental BMI and BMI percentiles of the child.

CONCLUSION

These results suggest that parental behaviour and role modeling provide an important contribution to childrens' health behaviour, especially at younger ages.

The effects of out-of-school time on changes in youth risk of obesity across the adolescent years

This study examined the longitudinal effects of out-of-school time (OST) activities on youth weight-status through mid-to-late adolescence. First, using pattern-centered methods, we identified the prominent ways in which youth allocate their OST across 12 common active and sedentary activities available to them. Second, through multi-level modeling procedures we examined the relation of OST activity patterns to: 1) BMI-status during the 11th grade, and; 2) within-person change in BMI-status across the adolescent years. After accounting for race, gender, SES, pubertal-status, and gaming, youth who participated in a sports-dominant activity pattern for 2 or more years had significantly lower 11th grade odds of being at-risk for overweight/obesity compared to youth in all other activity patterns. Youth of all other activity patterns had similar odds of being at-risk as Low-Activity youth and each other. Understanding the relations of OST to youth healthy weight is a critical first step in developing healthy OST settings.

Correlates of weight gain in German children attending elementary school

OBJECTIVE

To examine the association of physical fitness, sports participation, physical activity and sedentary behavior as well as dietary patterns and family background with weight gain in non-overweight elementary school children, independent of absolute body weight.

METHODS

Height, weight, and physical fitness were assessed in 1249 (51% male) children in south-west Germany during the fall of 2010 and 2011 (age at baseline: 7.0±0.6years). Based on changes in body mass index percentiles children were classified into a weight loss, constant weight, or weight gain group. Health behavior and family background were assessed via parent questionnaire. Group differences were examined via analysis of variance and multinomial logistic regression.

RESULTS

Weight gain was associated with low physical activity, lack of active transport, and lack of regular breakfast at follow-up. Children in the weight gain category also displayed lower fitness during baseline and follow-up, but differences were more pronounced during follow-up. TV time, migration background or parental education was not associated with weight gain.

CONCLUSION

Ensuring adequate physical activity and high fitness is an important aspect in the prevention of excessive weight gain during childhood. In addition to sports participation active transport should be emphasized in future weight management programs in children.

Exercise deficit disorder in youth: a paradigm shift toward disease prevention and comprehensive care

Despite the widely recognized benefits of daily play, recreation, sports, and physical education on the physical and psychosocial well-being of children and adolescents, many contemporary children and adolescents worldwide do not meet the recommendations for daily physical activity (PA). The decline in PA seems to start early in life, which leads to conditions characterized by reduced levels of PA in the pediatric population that are inconsistent with current public health recommendations. Unlike many other diseases and disorders in pediatrics, physical inactivity in youth is unique in that it currently lacks a clinical gold standard for diagnosis. This makes the diagnosis and treatment medically challenging, though no less important, as the resultant ramifications of a missed diagnosis are of significant detriment. Exercise-deficient children need to be identified early in life and treated with developmentally appropriate exercise programs designed to target movement deficiencies and physical weaknesses in a supportive environment. Without such interventions early in life, children are more likely to become resistant to our interventions later in life and consequently experience adverse health consequences. Integrative approaches that link health care professionals, pediatric exercise specialists, school administrators, community leaders, and policy makers may provide the best opportunity to promote daily PA, reinforce desirable behaviors, and educate parents about the exercise-health link.

Injury initiates unfavourable weight gain and obesity markers in youth

OBJECTIVE

The purpose of this study was to examine the association of knee injuries with subsequent changes in body mass index and body composition during maturation in young females.

METHODS

A prospective longitudinal study design was employed to evaluate young females active in soccer or basketball (N=862). Participants who completed at least 1-year follow-up to provide consecutive annual measures of BMIZ and %fat were included in the study analysis to determine the effect of knee injuries on the trajectory of these obesity markers in youth.

RESULTS

Of the 71 reported knee injuries, 12 (17%) occurred in athletes at the prepubertal stage, 24 (34%) in athletes at the pubertal stage, and 35 (49%) in postpubertal athletes. Controlling for the effects of maturation, female athletes who reported knee injury demonstrated a greater yearly increase in BMIZ (LS means and 95% CI for the injured group=0.039 (-0.012 to 0.089), for the non-injured group=-0.019 (-0.066 to 0.029), and group difference=0.057 (0.005 to 0.11), p=0.03) and in %body fat (LS means and 95% CI for the injured group=1.05 (0.45 to 1.65), for the non-injured group=0.22 (-0.21 to 0.064), and group difference=0.83 (0.21 to 1.45), p=0.009), compared to those without knee injuries. This indicates that the athletes with knee injuries will increase their body mass index percentile by up to 5 units more than someone of the same age without an injury, and in body fat by up to 1.5%, compared to their non-injured peers.

CONCLUSIONS

The present findings indicate that knee injury during the growing years may be associated with unfavourable changes in body composition.

Motor and Cognitive Performance of Overweight Preschool Children

Gross and fine motor skills and cognitive performance in obese and overweight children were compared to healthy weight children. Participants were 1,543 children (797 boys and 746 girls) ages 43 to 84 months, attending child-care centers in Munich, Germany. According to German Body Mass Index (BMI) standards for age and sex, 4.6% of the children were classified as obese (percentile greater or equal 97), 6.8% as overweight (percentile greater or equal 90 and less than 97), 5.9% as underweight (percentile less than 10), and 83.1% as being of healthy weight. Dependent variables were physical characteristics (height, weight, skinfold thickness), physical fitness (standing broad jump, shuttle run, hanging), body coordination (balancing forward, balancing backward, lateral jump, hopping), manual dexterity (right and left hand), and cognitive performance (intelligence, verbal ability, concentration). Higher proportions of children from lower socioeconomic and immigrant backgrounds were overweight. There was no association between weight and sex. Overweight children showed lower performance on gross motor skills (coordination and fitness), manual dexterity, and intelligence compared to healthy weight children, even after controlling for the effects of social class and immigration status.

Relationship between participation in leisure time physical activities and aerobic fitness in children with DCD

PURPOSE

(1) To explore participation in leisure time physical activities (LTPAs) in children with developmental coordination disorder (DCD) compared with children developing typically. (2) To examine the association between participation in LTPA and aerobic fitness.

METHODS

Thirty-eight children with DCD (aged 7-12 years) were age and gender matched with 38 children developing typically. Participation in LTPA was self-administered by using an activity questionnaire, and aerobic fitness was estimated using a Shuttle Run Test.

RESULTS

Children with DCD spent significantly less time in overall, nonorganized, and vigorous LTPA compared with children developing typically. Aerobic fitness was significantly lower for children with DCD. The best model, including age, group, and overall LTPA, explained 46.2% of the variance in aerobic fitness.

CONCLUSIONS

Suitable physical activities should be fostered in children with DCD, who have a low participation rate and aerobic fitness level.

Organized sports, overweight, and physical fitness in primary school children in Germany

Physical inactivity is associated with poor physical fitness and increased body weight. This study examined the relationship between participation in organized sports and overweight as well as physical fitness in primary school children in southern Germany. Height, weight, and various components of physical fitness were measured in 995 children (7.6 ± 0.4 years). Sports participation and confounding variables such as migration background, parental education, parental body weight, and parental sports participation were assessed via parent questionnaire. Multiple logistic regression as well as multivariate analysis of covariance (MANCOVA) was used to determine associations between physical fitness, participation in organized sports, and body weight. Participation in organized sports less than once a week was prevalent in 29.2%, once or twice in 60.2%, and more often in 10.6% of the children. Overweight was found in 12.4% of the children. Children participating in organized sports more than once per week displayed higher physical fitness and were less likely to be overweight (OR  =  0.52, P < 0.01). Even though causality cannot be established, the facilitation of participation in organized sports may be a crucial aspect in public health efforts addressing the growing problems associated with overweight and obesity.

Relationship of hyperactivity/inattention with adiposity and lifestyle characteristics in preschool children

We performed a cross-sectional study in 450 nonreferred preschool children aged 4 to 6 years to assess the association between hyperactivity/inattention with adiposity and lifestyle characteristics. Measurements included scores of hyperactivity/inattention, adiposity, objectively measured physical activity, television viewing, and eating habits. Higher scores of hyperactivity/inattention were associated with lower percentage body fat, higher levels of physical activity, and less time spent in sedentary activity (all P ≤ .01). However, higher scores of hyperactivity/inattention were also associated with more television viewing and less healthy eating habits (all P ≤ .04). Except for some selected eating habits (P ≥ .07), those relationships remained significant after adjustment for age, sex, and sociodemographic confounders. To conclude, higher scores of hyperactivity/inattention are linked to different lifestyle characteristics that may in part contribute to a future development of overweight/obesity. Precise mechanisms explaining these associations and possible preventive approaches should be further investigated.

Effect of a lifestyle intervention on adiposity and fitness in socially disadvantaged subgroups of preschoolers: a cluster-randomized trial (Ballabeina)

OBJECTIVE

A multidimensional lifestyle intervention performed in 652 preschoolers (72% of migrant, 38% of low educational level (EL) parents) reduced body fat, but not BMI and improved fitness. The objective of this study is to examine whether the intervention was equally effective in children of migrant and/or low EL parents.

METHODS

Cluster-randomized controlled single blinded trial, conducted in 2008/09 in 40 randomly selected preschools in Switzerland. The culturally tailored intervention consisted of a physical activity program and lessons on nutrition, media use and sleep. Primary outcomes included BMI and aerobic fitness. Secondary outcomes included %body fat, waist circumference and motor agility.

RESULTS

Children of migrant parents benefitted similarly from the intervention compared to their counterparts (p for interaction≥ 0.09). However, children of low EL parents benefitted less, although these differences did not reach statistical significance (p for interaction≥ 0.06). Average intervention effect sizes for BMI were -0.10, -0.05, -0.11 and 0.04 kg/m(2) and for aerobic fitness were 0.55, 0.20, 0.37 and -0.05 stages for children of non-migrant, migrant, middle/high EL and low EL parents, respectively.

CONCLUSIONS

This intervention was similarly effective among preschoolers of migrant parents compared to their counterparts, while children of low EL parents benefitted less.

Differences in aerobic fitness and lifestyle characteristics in preschoolers according to their weight status and sports club participation

OBJECTIVE

This study assesses differences in adiposity, aerobic fitness, and lifestyle characteristics in preschoolers according to their weight status and sports club (SC) participation.

METHOD

As part of the Ballabeina study, 600 randomly selected preschoolers (mean age 5.1 ± 0.6 years; 50.2% girls) were analyzed. Body composition was measured by bioelectrical impedance, aerobic fitness by the 20-meter shuttle run test, and physical activity by accelerometers. Eating habits, media use, and SC participation were assessed by questionnaires.

RESULTS

Overweight children (Swiss national percentiles) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts (all p ≤ 0.028). In addition, children not participating in SC were less physically active, had more media use, and ate less healthy compared to children participating in SC (all p ≤ 0.023). Controlling for parental sociocultural determinants attenuated differences in % body fat, in physical activity, and in eating habits.

CONCLUSION

Aerobic fitness differs both according to weight status and SC participation in preschoolers. Furthermore, in view of the many differences in lifestyle behaviors, SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status.

Do youth sports prevent pediatric obesity? A systematic review and commentary

Sport is a promising setting for obesity prevention among youth, but little is known about whether it prevents obesity. We reviewed research comparing sport participants with nonparticipants on weight status, physical activity, and diet. Among 19 studies, we found no clear pattern of association between body weight and sport participation. Among 17 studies, we found that sport participants are more physically active than those who do not participate. We found seven studies that compared the diet of sport participants with non-participants. These studies reported that youth involved in sport were more likely to consume fruits, vegetables, and milk, and also more likely to eat fast food and drink sugar-sweetened beverages and consume more calories overall. It is unclear from these results whether sports programs, as currently offered, protect youth from becoming overweight or obese. Additional research may foster understanding about how sport, and youth sport settings, can help promote energy balance and healthy body weight.

Children's weight and participation in organized sports

AIMS

Literature dealing with the impact of organized sports on children's weight has been marked by a lack of consensus. A major weakness characterizing most of this research is a lack of proper measurement methods. This paper seeks to fill an important knowledge gap through careful application of econometric methods.

METHODS

Estimations are carried out using data on 1,400 children attending 6th grade in 2008 in the municipality of Aalborg, Denmark. We use standard ordinary least squares (OLS) and class fixed effects to explore the effect of sports participation on body mass index (BMI) as well as underweight, overweight and obesity.

RESULTS

Results indicate that participation in organized sports reduced BMI by 2.1%. Likewise it reduced the likelihood of being overweight by 8.2 percentage points and obese by 3.1 percentage points.

CONCLUSIONS

It is the unique dataset combined with econometric methods that distinguishes our contribution from that of others in the field, thereby offering new insight. Results using statistically sound methods suggest that participation in organized sports has a beneficial effect on children's weight.

Rate of muscle activation in power- and endurance-trained boys

Previous studies in adults have demonstrated power athletes as having greater muscle force and muscle activation than nonathletes. Findings on endurance athletes are scarce and inconsistent. No comparable data on child athletes exist.

PURPOSE

This study compared peak torque (Tq), peak rate of torque development (RTD), and rate of muscle activation (EMG rise, Q30), in isometric knee extension (KE) and flexion (KF), in pre- and early-pubertal power- and endurance-trained boys vs minimally active nonathletes.

METHODS

Nine gymnasts, 12 swimmers, and 18 nonathletes (7-12 y), performed fast, maximal isometric KE and KF. Values for Tq, RTD, electromechanical delay (EMD), and Q30 were calculated from averaged torque and surface EMG traces.

RESULTS

No group differences were observed in Tq, normalized for muscle cross-sectional area. The Tq-normalized KE RTD was highest in power athletes (6.2 ± 1.9, 4.7 ± 1.2, 5.0 ± 1.5 N·m·s-1, for power, endurance, and nonathletes, respectively), whereas no group differences were observed for KF. The KE Q30 was significantly greater in power athletes, both in absolute terms and relative to peak EMG amplitude (9.8 ± 7.0, 5.9 ± 4.2, 4.4 ± 2.2 mV·ms and 1.7 ± 0.8, 1.1 ± 0.6, 0.9 ± 0.5 (mV·ms)/(mV) for power, endurance, and nonathletes, respectively), with no group differences in KF. The KE EMD tended to be shorter (P = .07) in power athletes during KE (71.0 ± 24.1, 87.8 ± 18.0, 88.4 ± 27.8 ms, for power, endurance, and nonathletes), with no group differences in KF.

CONCLUSIONS

Pre- and early-pubertal power athletes have enhanced rate of muscle activation in specifically trained muscles compared with controls or endurance athletes, suggesting that specific training can result in muscle activation-pattern changes before the onset of puberty.

Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial

BACKGROUND

Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups.

METHODS/DESIGN

This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation.

DISCUSSION

The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population.

TRIAL REGISTRATION

Trial Registration: (clinicaltrials.gov) NCT00674544.