Long-term effects of 4-year longitudinal school-based physical activity intervention on the physical fitness of children and youth during 7-year followup assessment

The long-term effects of primary school-based obesity prevention interventions in children: A systematic review and meta-analysis

INTRODUCTION

This systematic review and meta-analysis investigate the long-term effects of primary school-based obesity prevention interventions on body-mass index (and z-scores), waist circumference (and z-scores) and weight status.

METHODS

Four databases were searched for studies from date of inception until June 8th, 2021. We included randomized controlled trials (RCT) and non-RCTs investigating effects ≥12 months post-intervention of primary school-based interventions with intervention duration ≥6 months and containing a diet and/or physical activity component on outcomes of interest. Articles were assessed on risk of bias and methodological quality by RoB2 and ROBINS-I. Meta-analysis was performed and results were narratively summarized. Evidence quality was assessed with GRADE.

RESULTS

Nineteen studies were included, 9 were pooled in a meta-analysis. No long-term effects were found on body-mass index (+0.06 kg/m² ; CI95% = -0.38, 0.50; I²  = 66%), body-mass index z-scores (-0.08; CI95% = -0.20, 0.04; I²  = 36%), and waist circumference (+0.57 cm; CI95% = -0.62, 1.75; I²  = 13%). Non-pooled studies reported mixed findings regarding long-term effects on body-mass index, body-mass index z-scores and weight status, and no effects on waist circumference and waist circumference z-scores. Evidence certainty was moderate to very low.

DISCUSSION

No clear evidence regarding long-term effects of primary school-based interventions on obesity-related outcomes was found. Recommendations for further research and policy are discussed. Prospero registration ID: CRD42021240446.

Effectiveness of a population-scaled, school-based physical activity intervention for the prevention of childhood obesity

OBJECTIVE

The aim of this study was to examine the effectiveness of a real-world, population-scaled, school-based physical activity (PA) intervention that provided two to three additional physical education lessons per week to children aged 6 to 14 years in Slovenia.

METHODS

More than 34,000 participants from over 200 schools were compared with a similar number of nonparticipants from the same schools. Generalized estimating equations were used to estimate the effects of differing levels of exposure to the intervention (i.e., from 1-5 years) on BMI in children with normal weight, overweight, or obesity at baseline.

RESULTS

BMI was lower in the intervention group, irrespective of participation duration or baseline weight status. The difference in BMI increased with the program duration, with maximal effects being seen after 3 to 4 years of participation, and was consistently larger for children with obesity (peaking at 1.4 kg/m² [95% CI: 1.0-1.9] for girls with obesity and peaking at 0.9 kg/m² [95% CI: 0.6-1.3] for boys with obesity). The program started to become effective at reversing obesity after 3 years, whereas the lowest numbers needed to treat (NNTs) were observed after 5 years (NNTs = 17 for girls and 12 for boys).

CONCLUSIONS

The population-scaled, school-based PA intervention was effective in preventing and treating obesity. The effects were the greatest in children initially presenting with obesity, such that the program was able to benefit children needing support the most.

Motor competence interventions in children and adolescents - theoretical and atheoretical approaches: A systematic review

This study aimed to compare for the first time the immediate and retention effects of theory-based and atheoretical motor competence (MC) interventions, by conducting a systematic review to determine which intervention approach resulted in the most improvements for motor outcomes. In accordance with PRISMA guidelines, studies were identified from searches across seven databases, for articles relating to theory-based (Achievement Goal Theory, Dynamic Systems Theory, and Social-Cognitive Theory) and atheoretically-derived MC interventions in typically developing children and adolescents. Publication bias was assessed using an adapted form of Consolidated Standards of Reporting Trials statement. Of the thirty two included studies, seventeen utilized theory-based intervention approaches. The majority of studies were grounded in Achievement Goal Theory. Also, the majority of MC interventions elicited immediate (short) and/or long-term effects for children and adolescents. Studies varied with regards to intervention components and MC assessment. Many studies scored poorly for risk of bias items. Overall, the levels of success for theoretical and atheoretical intervention programmes were not distinguishable. Findings open up new horizons for motor skills instruction to be taught using developmentally appropriate pedagogy, a research field which has gained significant traction among stakeholders in recent years.

Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review

BACKGROUND

Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions.

METHOD

A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom.

RESULTS

A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%).

CONCLUSIONS

This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.

Sports activity and changes in physical fitness of Polish children and adolescents: OSF study

BACKGROUND

Physical activity promotion programs for children and adolescents should constitute the basis of any national health policy aiming to improve physical fitness, which is a significant health indicator in children, adolescents, adults as well as elderly persons.

METHODS

The study included 1,230 children and adolescents aged 8-16 years (60.1% of girls) from Poland. Five hundred and twenty-seven persons covered by the survey (42.8%) participated in physical activity promotion called "Athletics for All!" (AFA) as an experimental group and 703 peers not participating in any forms of physical extra-curricular activities as a control group. Participants were measured for basic anthropometric parameters and body mass indices were calculated: Body Mass Index (BMI) and Ponderal Index (PI). Evaluation of physical fitness was made using the OSF Test (3 × 10 m shuttle run, standing broad jump, 1 kg medicine ball overhead throw, 4-min run). Comparative analysis between the experimental and control groups was carried out using the T-test for independent samples. Analysis of correlations between quantitative variables was performed with Pearson's r coefficient.

RESULTS

Statistically significant differences in all the tests were noted between the experimental group (AFA) and the control group in favor of the former one. Taking into account reference ranges of BMI created according to the latest Polish norms, statistically significant differences were noted between the subgroups in all physical fitness tests. As far as PI is concerned, in the AFA group significant differences were noted in all physical fitness tests between subgroups created in accordance with the aforementioned norms.

CONCLUSION

The findings of our study show that it is necessary to introduce physical activity promotion programs for children and adolescents. Such programs should constitute the basis of national health policy aiming at improving physical fitness among young people.

Associations Between Physical Fitness, Objectively Measured Physical Activity and Academic Performance

There is evidence that physical activity (PA) can improve the academic performance. We recruited healthy adolescent girls, aged 11–12 years, and measured their PA with the accelerometer ActiGraph GT3X for the consecutive 5 days. Physical fitness (PF) was measured with eight motoric tests and three anthropometry measures. Academic performance (AP) was assessed for the six academic narrated school subjects. The results revealed that the girls were more physically active during the week days and less active at weekend (557 vs. 516 counts/min). Physical education grade shows the highest overall correlations with the results of the PF test battery (r = 0.53–0.95, p < 0.01). Nevertheless, correlations surprisingly decrease for the combined daily PA (r = 0.45), especially the weekend PA (r = 0.28). Grade point average and PF correlated moderately (r = 0.43-0.64), while they were moderate to high for PA (r = 0.59–0.87). Many questions arose after the completion of the present study and several new topics opened up, such as the question of how parental education affects the duration of PA and AP of the children and the influence of the place of residence AP of the children.

A staged approach to address youth unresponsive to initial obesity intervention: a randomized clinical trial

BACKGROUND/OBJECTIVE

Maintenance interventions inherently require BMI improvement to maintain. This overlooks individuals initially unresponsive to obesity interventions. Staged pediatric clinical treatment guidelines were adapted to the school setting to develop an escalated treatment option for individuals initially unresponsive. This staged randomized controlled trial examined differences between escalated treatment (Take CHARGE!) and a maintenance program (PE Planners). Take CHARGE was hypothesized to have greater improvements in BMI as a percentage of the 95th BMI Percentile (%BMIp95) than PE Planners.

SUBJECTS/METHODS

From 2018 to 2020, 171 middle and high schoolers (BMI Percentile ≥ 85) were recruited from a Houston school district to participate in a staged obesity intervention in their physical education (PE) class. After receiving a semester-long intensive lifestyle intervention (ILI) with established efficacy, all participants were randomized to Take CHARGE (n = 85) or PE Planners (n = 86). Take CHARGE escalated the behavioral treatment of obesity received in ILI with more frequent individual sessions, additional opportunities for parental and school staff involvement, and increased mentorship from trained college students. PE Planners allowed participants to decide how they wanted to be active in PE class. Mixed linear modeling examined %BMIp95 overtime between groups. This trial was registered at ClinicalTrials.gov (#NCT04362280).

RESULTS

Participants were 13.63 ± 1.32 years old; 59% were female, and 85% were Hispanic. Among those initially unresponsive to ILI, Take CHARGE had significantly greater decreases in %BMIp95 than PE Planners (β = -0.01, p < 0.01). Conversely, among those initially responsive, Take CHARGE had significantly smaller decreases in %BMIp95 than PE Planners (β = 0.02, p < 0.05). Intention-to-treat analysis had similar results.

CONCLUSIONS

Participant outcomes in semester two differed based on initial response. Individuals responsive to initial intervention were most likely to benefit from a maintenance intervention and those initially unresponsive benefited more from escalated treatment. This indicates the need for staged intervention protocols to better address obesity in the school setting.

Influence of an increased number of physical education lessons on the motor performance of adolescents-A non-interventional cohort study

Increasing the amount of regular physical education lessons in school is currently discussed in many countries in order to increase physical activity in youth. The purpose of this study was to compare the motor performance of pupils from an observation group participating in a school trial of two additional physical education lessons (5 lessons of each 50 min/week) without a specific intervention program to a control group with a regular amount of three physical education lessons (3 lessons of each 50 min/week) as indicated by the standard Austrian school curriculum. In this cohort study motor performance of 140 adolescents (12.7±0.5 years) was assessed by means of the German Motor Performance Test 6–18 over a period of 1.5 years with measurement time points before (T1), after eight months (T2) and at the end of the observation period (T3). Two- and three-way mixed analysis of variance were used to detect time, group and interaction effects. Although the observation group demonstrated a higher total motor performance score at all time points (P = 0.005), the improvement over time in total motor performance (P < 0.001) was more pronounced in the control group. Girls and boys developed differently over time (time*gender interaction: P = 0.001), whereby group allocation did not affect this interaction (time*gender*group: P = 0.167). Anyway, girls of control group tend to benefit most of additional physical education lessons. Sports club members scored significantly higher in motor performance across the observation period (P = 0.018) irrespective of group allocation. These findings indicate that there could be a ceiling effect in what the pupils could achieve in terms of motor performance as the pupils of the observation group might have reached this point earlier than their counterparts in the control group. Nevertheless, sports club membership seems to reveal some benefits. Whether improving quality and specificity of the single physical lessons might be superior to merely adding additional ones needs to be confirmed in future studies.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

BACKGROUND

Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school.

OBJECTIVES

The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information.

SELECTION CRITERIA

Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update.  DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type.

MAIN RESULTS

Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias.  Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events.

AUTHORS' CONCLUSIONS

Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.

IMPLEMENTATION OF THE GYMNASTICS CURRICULUM IN THE FIRST THREE-YEAR CYCLE OF THE PRIMARY SCHOOL IN SLOVENIA

Throughout the world, gymnastics is an essential part of physical education (PE) curricula, especially in the first years of schooling. In this period, PE is taught by the general teachers (GTs) with low levels of experience about how to teach gymnastics. Our study aimed to find out how GTs complied with the prescribed gymnastics curriculum contents. The sample included 90 GTs from 21 primary schools from Ljubljana, the capital of Slovenia. A self-administered questionnaire was designed to examine the opinions of GTs about some factors of importance and implementation of gymnastics contents on a five-level Likert scale. A one-way ANOVA, Tukey post hoc test, and Mann-Whitney U test were used in the data processing. GTs allocated more time to those contents of the PE curriculum that rank higher regarding the importance of child development and are easier to teach. They spent only 16.93 lessons on gymnastics per academic year, ranked gymnastics at fourth place (out of 7) regarding its importance for children's development, and gymnastics seemed to be the most challenging content to teach. Within gymnastic content, the least implemented elements were those mentioned as the most difficult to learn for children (acrobatics, hang and support, and vaults). GTs believed that teaching methods (4.29) were less important for successful gymnastics performance than children’s motor efficiency (4.73) and self-activity (4.57). The outcomes of this study may aid in the future updating of GT education study programmes and designing a creative system of continuous professional development.

Children's Physical Activity, Academic Performance, and Cognitive Functioning: A Systematic Review and Meta-Analysis

Researching the relationship between physical activity and academic performance is becoming an important research topic due to increasing evidence about the positive effect of physical activity on cognitive functioning. The present systematic review and meta-analysis (PROSPERO registration number: CDR132118) is a unique contribution to the recently published reviews since it only includes interventions longer than 6 weeks and acknowledges the influence of the qualifications of practitioners who deliver interventions. After identifying 14,245 records in five databases and selecting 247 full-text articles assessed for eligibility, 44 interventions passed all eligibility criteria. This meta-analysis uses validity generalization in a random effects model, which shows that academic performance itself is not solely caused by increased physical activity. The weighted mean population effect of all included interventions was r_w = 0.181. Most of the studies had serious limitations since they did not report physical activity intensity, which is an essential component to achieving positive exercise effects on cognition. In addition, the qualifications of the staff who administer the interventions were largely ignored in existing literature. It was found that 13 out of 20 physical activity interventions with significant positive effects on academic performance were performed by practitioners who held higher qualifications in the field of physical education and exercise science, who could mediate higher physical activity intensities of the given interventions. The population effect in studies where interventions were administered by practitioners with lower qualifications in the field (r_w = 0.14) was lower compared to interventions performed by staff with higher qualifications (r_w = 0.22). There was also a significant difference in academic performance with regard to staff qualification level (χ = 4.464; p = 0.035). In addition to activity duration, future physical activity intervention studies including those investigating academic performance should focus on the importance of physical activity intensity and include measures of physical fitness as objective indicators to enable more reliable analyses to establish physical activity influence on academic performance.

Decline of physical activity in early adolescence: A 3-year cohort study

This study analyses the changes of moderate-to-vigorous physical activity (MVPA) in a cohort of boys and girls aged 11 (n = 50) and 14 (n = 50). Physical activity was assessed with Bodymedia SenseWear Pro Armband monitor for 6 days in October 2013 and October 2016, considering 90% of daily wear time (21h and 40min). The initial sample (n = 160) included the children who wore the monitors at age 11 but the final analyzed sample included only those children from the initial sample (n = 50), whose data fulfilled the inclusion criteria at age 11 and 14. Physical fitness and somatic characteristics of the final sample (n = 50) were compared to a representative sample of Slovenian schoolchildren at ages 11 (n = 385) and 14 (n = 236) to detect possible bias. Changes in MVPA were controlled for maturity using the timing of adolescent growth spurt as its indicator. The average MVPA decreased more than one quarter (34.96 min) from age 11 to age 14. Children were significantly more active at age 11 than at age 14 (p < 0.01, d = 0.39). The timing of puberty onset in girls was significantly earlier (12.01 ± 1.0 years) (p < 0.01) than in boys (13.2 ± 0.75 years) (p < 0.01, d = 1.35). There was a significant gender difference in moderate-to vigorous physical activity at age 14 (p < 0.05, η2 = 0.12) and between moderate-to vigorous physical activity at age 11 and 14 (η2 = 0.11). After controlling for the timing of adolescent growth spurt the girls at age 11 showed significantly higher level of physical activity than at age 14 (p < 0.01, η2 = 0.17). Early adolescence is crucial for the development of physical activity behaviours, which is especially pronounced in girls. The significant decline of MVPA between ages 11 and 14 in Slovenia are likely influenced by environmental changes since the timing of adolescent growth spurt did not prove as a factor underlying the decline of MVPA.

Motor tests for primary school aged children: A systematic review

Motor testing in education has gained in relevance in light of recent developments in educational systems (Köller & Baumert, 2012). The purpose of this systematic review was to identify studies using motor tests in primary school children aged 4 to 12 years and to synthetize information about the quality and application of the test instruments used. A systematic review of 910 records identified by a search of nine databases yielded 144 papers reporting motor testing in primary school age children, including 25 articles reporting on the quality of 20 test instruments. In the selected articles, tests grounded on the constructs of "motor abilities" and/or "motor skills" are the most frequent and are mostly used for monitoring purposes or for impact research. Tests based on the construct "motor competencies" have become popular only recently, being relevant for educational motor testing due to their curricular validity. The test instruments have been investigated towards their validity and reliability to different extents. However, for several test instruments factorial validity has not been established and more validation studies are needed to improve their psychometric quality especially if used in educational contexts.

Pedagogical Approaches to and Effects of Fundamental Movement Skill Interventions on Health Outcomes: A Systematic Review

BACKGROUND

Fundamental movement skills (FMS) are assumed to be the basic prerequisite motor movements underpinning coordination of more integrated and advanced movement capabilities. FMS development and interventions have been associated with several beneficial health outcomes in individual studies.

OBJECTIVE

The primary aim of this review was to identify FMS intervention characteristics that could be optimised to attain beneficial outcomes in children and adolescents, while the secondary aim was to update the evidence as to the efficacy of FMS interventions on physiological, psychological and behavioural health outcomes.

METHODS

A systematic search [adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines] was conducted in seven databases. Studies were included if they conducted an FMS intervention and targeted at least one physiological, behavioural or psychological outcome in school-aged children (5-18 years).

RESULTS

Twenty-nine studies examining the effect of FMS interventions relative to controls were identified. Specialist-led interventions, taught in conjunction with at-home practice and parent involvement, appeared more efficacious in enhancing FMS proficiency than school physical education alone. Intervention environments encouraging psychological autonomy were likely to enhance perceived and actual competence in FMS alongside physical activity. FMS interventions had little influence on overweight/obesity reduction, strength or flexibility. In 93% of studies, evidence indicated interventions improved FMS motor proficiency. Favourable specific physiological, psychological and behavioural outcomes were also identified across a variety of interventions.

CONCLUSION

With reference to clinical and normative school-age populations, future studies should be directed toward determining validated standard FMS assessments to enable accurate effect estimates, permit intervention comparisons and improve the efficacy of FMS development.

Long-term effects of daily physical education throughout compulsory school on duration of physical activity in young adulthood: an 11-year prospective controlled study

Objectives

We examined whether daily physical activity (PA) during compulsory school encourages children to be more physically active during the intervention and 4 years after termination of the programme.

Methods

This prospective controlled intervention study followed the same 124 children (81 children in an intervention group and 43 controls) aged 7.7±0.6 (mean±SD) during a 7-year PA intervention and 4 years after the intervention when the children were 18.7±0.3 years old. The intervention included daily school physical education (PE) (200 min/week), whereas the controls continued with the Swedish standard of 60 min/week. Using a questionnaire, we gathered data about total PA, leisure time PA and sedentary activities (SA). Group comparisons are adjusted for age and gender, and data are provided as means with 95% CIs.

Results

At baseline, we found similar duration of PA and SA between groups. After a mean of 7 years with intervention, the intervention group was more physically active than the controls (+4.5 (2.9 to 6.0) hours/week), whereas SA was similar (+0.6 (−2.5 to 3.9) hours/week). Four years beyond the intervention, the intervention group was still more physically active than the controls (2.7 (0.8 to 4.7) hours/week), and SA was still similar (−3.9 (−9.7 to 1.7) hours/week).

Conclusions

Intervention with daily school PE throughout compulsory school is associated with higher duration of PA not only during the intervention but also 4 years after termination of the programme.

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.

HOW IS CLASSMATE AND PE TEACHER SUPPORT ASSOCIATED WITH THE LEVEL OF PHYSICAL ACTIVITY IN YOUNG ADOLESCENTS FROM KOSOVO? THE ROLE OF GENDER AND AGE

AIM

This study aimed to investigate how were the peer and physical education (PE) teacher variables associated with moderate-to-vigorous physical activity (MVPA) among Kosovar teenagers (13-15 years of age), and the role of age and gender in these associations.

METHODS

Cross-sectional data was gathered through a study conducted in seven major municipalities of Kosovo. 632 girls (aged 14.3 ± 0.8) and 664 boys (aged 14.2 ± 0.8) were examined using the adjusted Classmate and Teacher Support Scale and the Physical Activity Screening measure. A three-way (support*age*gender) ANOVA was used to compare the individuals' MVPA level with the different levels of support they received, with different age in groups of girls and boys.

RESULTS

Boys reported higher levels of MVPA than girls in all age categories. A higher level of MVPA was reported by boys receiving high or medium support from classmates. In case of PE teacher support, high, medium and even low support correlated with high MVPA in all age categories. In girls only 13 year olds reported receiving high levels of both classmate and PE teachers support which correlated with a higher level of MVPA.

CONCLUSIONS

It appears that engagement in MVPA among young Kosovar adolescents is relatively high in boys, regardless of the level of classmate or PE teacher support, whereas in girls the level of MVPA decreased over their time at school. Support from both classmates and PE teachers turned out to be the most significant factor in 13 years old girls, before they moved from primary to secondary school. This issue requires more detailed insight, considering traditional ethnical and religious barriers to engagement of young female adolescents in physical activity.