Factors associated with participation in physical activity among adolescents in Malaysia

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.

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.

The longitudinal relationship between dietary intake, physical activity and muscle strength among adolescents

The longitudinal relationship between muscle strength, dietary intake and physical activity among adolescents is not well understood. We investigated the trend and longitudinal effects of dietary intakes and physical activity scores on muscle strength in adolescents. This prospective cohort study consisted of 436 adolescents (134 males; 302 females) aged 13 years at baseline (2012) who were followed up at the ages of 15 (2014) and 17 (2016) years, respectively. We measured muscle strength using a calibrated hand dynamometer, estimated dietary intake with a 7-d dietary history and physical activity scores with a validated physical activity questionnaire for older children. A generalised estimating equation was used to examine the effect of dietary intakes and physical activity on muscle strength changes. The analysis was performed separately by sex. The muscle strength for males and females had increased within the 5-year period. The dietary intakes (energy and macronutrients) also increased initially but plateaued after the age of 15 years for both sexes. Females recorded a significant declining trend in physical activity scores compared with males as they grew older. A significant positive longitudinal relationship was found between protein (β = 0·035; P = 0·016), carbohydrate intake (β = 0·002; P = 0·013) and muscle strength among males. However, no longitudinal relationship was found between dietary intake, physical activity and muscle strength among females. Higher protein and carbohydrate intake among males was associated with higher muscle strength but was not observed in females. Nutrition and physical activity focusing on strength building are required in early adolescence and need to be tailored to males and females accordingly.

Personal and Family Factors Associated With High-risk Behaviours Among Adolescents in Malaysia

PURPOSE

The objective of this study was to investigate the relationships between high-risk behaviours and personal and family factors among adolescents in Malaysia.

METHODS

A nationwide data set was examined for this secondary data analysis. The dependent variable was the degree of risk, which was measured based on the number of high-risk behaviours in which adolescents participated. Age, gender, ethnicity, self-rated academic performance, family size, parental marital status and parental academic attainment were included as independent variables. Analyses stratified by educational level were conducted. Odds ratios (ORs) were calculated using ordered logit.

RESULTS

The most common high-risk behaviour among Malaysian adolescents was physical inactivity (35.97%), followed by smoking (13.27%) and alcohol consumption (4.45%). The majority of adolescents had low risks (52.93%), while only a small proportion had high risks (6.08%). Older age was associated with increased odds of having high risks (OR: 1.26). Male adolescents had higher odds of being in a high-risk category compared to female adolescents (OR: 1.28). Compared to Malays, Chinese adolescents had higher odds of being in a high-risk category (OR: 1.71), whereas Indian adolescents had lower odds (OR: 0.65). Excellent academic performance was associated with reduced odds of participating in high-risk behaviours (OR: 0.41).

CONCLUSION

Personal factors are important determinants of high-risk behaviours. This study provides a better understanding of those adolescent groups that are at greater risk.

PRACTICAL IMPLICATIONS

An intervention directed towards reducing participation in high-risk behaviours among adolescents who have both poor academic performance and less-educated parents may yield promising outcomes.

Determinants of Diet and Physical Activity in Malaysian Adolescents: A Systematic Review

The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adolescents has become a public health concern. The aim of this systematic review was to summarize evidence from observational studies related to diet and physical activity (PA) among Malaysian adolescents (13–18 years) and to recognize the associations between determinants of diet and PA and diet and PA behaviours. A systematic search for observational studies published from August 1990 through August 2017 was conducted via PubMed, Science Direct, Cochrane and Web of Science. A total of 18 studies met the inclusion criteria; these were independently extracted by two reviewers. Gender and ethnicity were the most commonly studied correlates of diet and PA; males were more physically active and they tended to have poorer diet quality and higher energy and macronutrient intakes in comparison to females; Malay adolescents had a lower diet quality and Chinese adolescents spent less time in PA compared to other ethnicities. However, the significance of these associations was often small or inconsistent. This review highlights the lack of longitudinal observational studies but summarizes the best available evidence for policymakers and public health practitioners to improve the diet and the level of PA in Malaysian adolescents.

Demographic and lifestyle determinants of time spent in physical activity among Malaysian adolescents

BACKGROUND AND OBJECTIVES

The objective of the present study is to examine factors affecting time spent in physical activity among adolescents in Malaysia.

PATIENTS AND METHODS

A nationally representative data of adolescents that consists of 25399 respondents is used. The demographic (age, gender, education) and lifestyle (fruits and vegetables consumption, carbonated soft drink consumption, cigarette smoking, alcohol drinking, sex behaviour, participation in physical education class, obesity) determinants of physical activity are assessed using binomial regression.

RESULTS

The results show that age is negatively associated with time spent in physical activity. However, being male and education levels are positively related to time spent in physical activity. Having unhealthy lifestyle and being obese are associated with low levels of physical activity. Physical education seems to promote participation in physical activity.

CONCLUSION

In conclusion, demographic and lifestyle factors play an important role in determining levels of physical activity among adolescents. In order to reduce the prevalence of physically inactive adolescents, policy makers should focus primarily on late adolescents, females, adolescents who engage in unhealthy lifestyle and seldom attend physical education classes, as well as obese adolescents.

Leisure Time Physical Inactivity and Sedentary Behaviour and Lifestyle Correlates among Students Aged 13-15 in the Association of Southeast Asian Nations (ASEAN) Member States, 2007-2013

The aim of this study was to examine the relationship between self-reported leisure time physical inactivity frequency and sedentary behaviour and lifestyle correlates among school children in the Association of Southeast Asian Nations (ASEAN) region. The analysis included 30,284 school children aged 13–15 years from seven ASEAN countries that participated in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The measure asked about overall physical activity, walking or biking to school, and on time spent sitting. Overall, the prevalence of physical inactivity was 80.4%, ranging from 74.8% in Myanmar to 90.7% in Cambodia and sedentary behaviour 33.0%, ranging from 10.5% in Cambodia and Myanmar to 42.7% in Malaysia. In multivariate logistic regression, not walking or biking to school, not attending physical education classes, inadequate vegetable consumption and lack of protective factors (peer and parental or guardian support) were associated with physical inactivity, and older age (14 and 15 years old), coming from an upper middle income country, being overweight or obese, attending physical education classes, alcohol use, loneliness, peer support and lack of parental or guardian supervision were associated with sedentary behaviour. In boys, lower socioeconomic status (in the form of having experienced hunger) and coming from a low income or lower middle income country were additionally associated with physical inactivity, and in girls, higher socioeconomic status, not walking or biking to school and being bullied were additionally associated with sedentary behaviour. In conclusion, a very high prevalence of leisure physical inactivity and sedentary behaviour among school going adolescents in ASEAN was found and several factors identified that may inform physical activity promotion programmes in school-going adolescents in ASEAN.