Physical Activity in the Prevention of Childhood Obesity: The Position of the European Childhood Obesity Group and the European Academy of Pediatrics

Children with obesity have poorer circadian health as assessed by a global circadian health score

BACKGROUND

Circadian health refers to individuals' well-being and balance in terms of their circadian rhythm. It is influenced by external cues. In adults, a close relationship between circadian-related alterations and obesity has been described. However, studies in children are scarce, and circadian health and its association with obesity have not been evaluated globally. We aimed to assess whether circadian health differed between children with and without obesity as determined by a global circadian score (GCS) in a school-age population.

METHODS

Four hundred and thirty-two children (7-12 years) were recruited in Spain. Non-invasive tools were used to calculate the GCS: (1) 7-day rhythm of wrist temperature (T), activity (A), position (P), an integrative variable that combines T, A, and P (TAP); (2) cortisol; and (3) 7-day food and sleep records. Body mass index, body fat percentage, waist circumference (WC), melatonin concentration, and cardiometabolic marker levels were determined.

RESULTS

Circadian health, as assessed by the GCS, differed among children with obesity, overweight, and normal weight, with poorer circadian health among children with obesity. Children with obesity and abdominal obesity had 3.54 and 2.39 greater odds of having poor circadian health, respectively, than did those with normal weight or low WC. The percentage of rhythmicity, a marker of the robustness of the TAP rhythm, and the amplitude, both components of the GCS, decreased with increasing obesity. Different lifestyle behaviors were involved in the association between circadian health and obesity, particularly protein intake (P = 0.024), physical activity level (P = 0.076) and chronotype (P = 0.029).

CONCLUSIONS

The GCS can capture the relationship between circadian health and obesity in school-age children. Protein intake, physical activity level, and chronotype were involved in this association. Early intervention based on improving circadian health may help to prevent childhood obesity.

Losing sleep influences dietary intake in children: a longitudinal compositional analysis of a randomised crossover trial

BACKGROUND

Although inadequate sleep increases the risk of obesity in children, the mechanisms remain unclear. The aims of this study were to assess how sleep loss influenced dietary intake in children while accounting for corresponding changes in sedentary time and physical activity; and to investigate how changes in time use related to dietary intake.

METHODS

A randomized crossover trial in 105 healthy children (8-12 years) with normal sleep (~ 8-11 h/night) compared sleep extension (asked to turn lights off one hour earlier than usual for one week) and sleep restriction (turn lights off one hour later) conditions, separated by a washout week. 24-h time-use behaviors (sleep, wake after sleep onset, physical activity, sedentary time) were assessed using waist-worn actigraphy and dietary intake using two multiple-pass diet recalls during each intervention week. Longitudinal compositional analysis was undertaken with mixed effects regression models using isometric log ratios of time use variables as exposures and dietary variables as outcomes, and participant as a random effect.

RESULTS

Eighty three children (10.2 years, 53% female, 62% healthy weight) had 47.9 (SD 30.1) minutes less sleep during the restriction week but were also awake for 8.5 (21.4) minutes less at night. They spent this extra time awake in the day being more sedentary (+ 31 min) and more active (+ 21 min light physical activity, + 4 min MVPA). After adjusting for all changes in 24-h time use, losing 48 min of sleep was associated with consuming significantly more energy (262 kJ, 95% CI:55,470), all of which was from non-core foods (314 kJ; 43, 638). Increases in sedentary time were related to increased energy intake from non-core foods (177 kJ; 25, 329) whereas increases in MVPA were associated with higher intake from core foods (72 kJ; 7,136). Changes in diet were greater in female participants.

CONCLUSION

Loss of sleep was associated with increased energy intake, especially of non-core foods, independent of changes in sedentary time and physical activity. Interventions focusing on improving sleep may be beneficial for improving dietary intake and weight status in children.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ANZCTR ACTRN12618001671257, Registered 10th Oct 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.

The Optimal Cut-Off Point of Physical Activity for the Prevention of Childhood Overweight and Obesity

Childhood obesity might threaten children's current and adulthood health outcomes. Previous studies have illustrated the positive effects of physical activity on weight control; however, there is a lack of evidence on the optimal dose of physical activity. Therefore, we aimed to explore the relationship between physical activity and overweight and obesity, as well as the optimal threshold for physical activity. The median (interquartile range) and number (proportion) were used to describe the statistics. The Mann-Whitney U test and chi-square test were used for an univariable analysis. The generalized additive model with a smooth function was used to depict the preliminary relationship between physical activity and overweight and obesity. The cut-off level of physical activity was identified using AddFor algorithms, and a logistic regression model was applied to explore the multivariable relationship between physical activity and overweight and obesity after adjusting for control variables. According to the statistical analyses, 24.3% of 842 children and adolescents had overweight and obesity. The average number of days that the participants engaged in more than one hour of physical activity was three days a week. The optimal cut-off level of physical activity for the prevention of childhood overweight and obesity was 4 times a week. The participants who exercised more than four times a week (AOR(95% CI) = 0.56(0.38, 0.83), p = 0.004) were less likely to be overweight and obese. In the context of the general lack of physical activity among children and adolescents, we recommend that children and adolescents engage in 60 min of physical activity more than four times a week for a healthy weight.

Mediating role of body mass index on the relationship between physical activity and physical fitness among junior high school students in Shanghai

Objectives: This study explored the relationship between physical activity (PA), body mass index (BMI), and physical fitness among junior high school students in Shanghai. Methods: A nationwide offline survey was conducted in Shanghai between August and December 2023, using a purposive sampling design. A total of 403 questionnaires were administered to 10 ninth-grade classes in 10 schools in Shanghai and 372 responses were included in the final analysis. Smart-PLS 4.0, structural equation modeling techniques were employed to analyze the collected data. Results: Light physical activity (LPA) had no influence on BMI, 800/1000 m (800/1000 M), sitting forward bend (FB), standing long jump (SLJ), 50 m (50 M), or vital capacity (VC). The results of part hypothesis supported the hypothetical model and explained that BMI had a negatively influence on 50 M, 800/1000 M and SLJ, BMI had a positively influence on VC. Moderate physical activity (MPA) had a negatively influence on BMI, but vigorous physical activity (VPA) had a positively influence on BMI, they both had influence on 50 M and FB, but had no influence on 800/1000 M, SLJ, and VC. Conclusions: BMI, MPA and VPA were found as pivotal factors influencing physical fitness, MPA and VPA were found to have divergent effects on BMI. This study highlighted the multifaceted nature of the relationship between PA, BMI, and physical fitness in junior high school students in Shanghai.

Sport Specialization and Sport Motivation in Middle School-Aged Athletes

CONTEXT

Sport specialization has been assumed to have psychosocial ramifications for athletes, especially autonomous motivation, which has been associated with continued sport participation. Sport dropout is common in youth athletes, yet it is unknown how sport specialization may affect this population psychosocially.

OBJECTIVE

To determine the association of sport specialization with autonomous and controlled motivation and amotivation in middle school-aged athletes.

DESIGN

Cross-sectional study.

SETTING

An anonymous online questionnaire was distributed to athletes via schools, club sports, and social media.

PATIENTS OR OTHER PARTICIPANTS

A total of 178 athletes (male = 59%; private school = 51%; grade: sixth = 20%, seventh = 32%, eighth = 48%) completed the questionnaire.

MAIN OUTCOME MEASURE(S)

The questionnaire assessed demographics, sport participation, and motivation using the Youth Behavioral Regulation in Sport Questionnaire. Sport specialization was defined using a modified 3-point scale (low, moderate, or high) and multisport versus single-sport athletes. Nonparametric tests were used to analyze the differences among the types of motivation and specialization levels and between multisport and single-sport athletes.

RESULTS

Sport specialization categories were not significantly associated with autonomous motivation, controlled motivation, or amotivation. No significant associations were present between multisport or single-sport athletes and any type of motivation. However, multisport athletes had higher scores for intrinsic motivation, a subscale of autonomous motivation, compared with single-sport athletes (single sport: median = 5.00, 25th-75th quartile = 4.50-5.00; multisport: median = 5.00, 25th-75th quartile = 5.00-5.00; P = .04).

CONCLUSIONS

Sport motivation did not differ between sport specialization groups in middle school athletes. Dropout from sport is common in this age group but is multifactorial in nature. A lack of sport motivation could be a factor for some athletes, but all specialization groups appeared to have similar outcomes. Our exploratory analysis suggests that clinicians may consider having an open dialogue with single-sport athletes, their parents or guardians, and coaches to ensure that athletes are enjoying their sport.

The Role of the Perceived Neighborhood Social Environment on Adolescent Sedentary Behavior and Physical Activity: Findings from Add Health

Few studies have examined the role of perceived neighborhood characteristics such as neighborhood safety, social cohesion, and contentedness on sedentary behavior (SB) and physical activity (PA) among adolescents. Furthermore, no studies have investigated how these associations are moderated by gender and race. This study aimed to examine the associations of the perceived neighborhood social environment with (SB) and moderate-to-vigorous physical activity (MVPA). Data from 6504 adolescents (aged 15.4 ± 0.03 years) who participated in the National Longitudinal Study of Adolescent Health was used. SB and PA were considered continuously and dichotomously. PNSE variables include safety, social cohesion, and contentedness, where higher values of PNSE indicate a more favorable neighborhood perception. Weighted linear and logistic regression models were used to examine the association of PNSE with continuous total SB (hours/week) and MVPA (bouts/week), and binary excessive SB (14 h/week) and meeting MVPA guidelines (≥ 5 bouts/week), respectively. Associations were stratified by gender and race to test moderation effects. Models were adjusted for demographic, health, parental, and neighborhood covariates. This study found that neighborhood safety and contentedness were negatively associated with SB, whereas neighborhood social cohesion and contentedness were positively associated with PA. Gender-specific and race-specific results remained somewhat consistent with overall findings; however, neighborhood safety was not associated with SB among female and non-White adolescents, respectively. Similarly, neighborhood safety and contentedness were not associated with MVPA for non-White adolescents. Findings suggest that an adolescent's neighborhood environment, gender, and race should be considered when implementing strategies to reduce SB and increase PA.

The availability between recreational facilities and physical activity of US adolescents

Determining the locations where adolescents tend to accumulate greater amounts of physical activity may assist policymakers to address the built environment design and promote PA. This study evaluated the association between the availability of recreational facilities and average minutes of moderate to vigorous physical activity (MVPA) per day of US adolescents in 2017 (n = 1,437). Data for this cross-sectional study were obtained from the 2017 Family Life, Activity, Sun, Health, and Eating study, an internet-based study collecting information on diet and PA of parent and adolescent dyads. Adolescents aged 12-17 from the US were included. Predicted daily minutes of MVPA were calculated. The exposure variables of interest were the availability of school recreational facilities, indoor recreational facilities, playing fields, bike/hiking/walking trails or paths or public parks. Participants were excluded if no information was provided for MVPA or availability of recreational facilities. Unadjusted and adjusted linear regression analysis was used to calculate mean daily minutes of MVPA and their corresponding 95 % confidence intervals. In fully adjusted models, we found statistically significant associations between the type of recreational facility and differences in daily minutes of MVPA for school (p-value < 0.001) and public parks p-value < 0.001), but not for the other recreational facilities. The average daily minutes of MVPA differed by 4.4 min (95 % CI 2.6, 6.2) if participants had school recreational facilities, respectively. School recreational facilities are important for engaging adolescents in PA objectives. Features within school recreational facilities should be studied to further investigate contributions to increased PA levels.

Obesity and Preventive Intervention Among Children: A Narrative Review

Childhood obesity has become a major public health concern around the world, with a rise in prevalence over the last few decades. This abstract provides an overview of pediatric obesity, including its causes, implications, and potential treatments. Childhood obesity is caused by a complex combination of environmental, genetic, and behavioral variables. A child's likelihood of developing obesity is influenced by factors, such as socioeconomic status, family dynamics, and cultural norms. Childhood obesity leads to extensive repercussions, elevating the risk of chronic conditions, such as diabetes, cardiovascular diseases, and mental health challenges. Furthermore, children dealing with obesity often face social stigmatization, diminished self-esteem, and academic struggles. Efforts to prevent and manage childhood obesity should employ a comprehensive and multi-tiered approach. This involves enacting policies geared toward enhancing nutrition in schools and communities, advocating for increased physical activity (PA), and curbing sedentary behaviors.

Effects of accelerometer-based sedentary time and physical activity on DEXA-measured fat mass in 6059 children

Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal mediation relationships of accelerometer-based sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with dual-energy X-ray absorptiometry-measured fat mass were examined in 6059 children aged 11 years followed-up until age 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort. Over 13-year follow-up, each minute/day of ST was associated with 1.3 g increase in fat mass. However, each minute/day of LPA was associated with 3.6 g decrease in fat mass and each minute/day of MVPA was associated with 1.3 g decrease in fat mass. Persistently accruing ≥60 min/day of MVPA was associated with 2.8 g decrease in fat mass per each minute/day of MVPA, partly mediated by decrease insulin and low-density lipoprotein cholesterol. LPA elicited similar and potentially stronger fat mass-lowering effect than MVPA and thus may be targeted in obesity and ST prevention in children and adolescents, who are unable or unwilling to exercise.

[Association between weight status and motor competence in schoolchildren from Chilean Patagonia]

BACKGROUND

the prevalence of overweight and obesity in the child population is a global public health problem, with measures such as the promotion of physical activity being necessary. One of the recognized factors for this is the development of motor competence, due to its dynamic interaction with physical activity, so it is necessary to understand its relationship with weight status.

OBJECTIVE

the aims of this study are to determine whether there are differences in the levels of motor competence of schoolchildren in Chilean Patagonia according to their nutritional status, as well as to determine the association between body mass index (BMI) and the levels of motor competence in these schoolchildren.

MATERIAL AND METHODS

we evaluated 295 boys and girls in 5th and 6th grade of primary school, from educational centres in Coyhaique and Punta Arenas. We used the MOBAK 5-6 test to assess their motor competence.

RESULTS

schoolchildren with normal weight status presented higher values of motor competence in self-movement (M = 3.1; SD = 1.84) compared to overweight (M = 2.7; SD = 1.68) and obese schoolchildren (M = 1.7; SD = 1.57), presenting significant differences between all groups (p < 0.001). In object control, no differences were found between the groups. In addition, there was an inverse association of object control with gender (β: 1.49; p < 0.001) and BMI (β: -0.05; p = 0.026), while self-movement had an inverse association with BMI (β: -0.11; 95 % CI: -0.15 -0.07; p < 0.001).

CONCLUSION

weight status and motor competence are associated. Schoolchildren with higher BMI values tend to perform lower in self-movement. These results underline the importance of addressing motor competence in efforts to combat overweight and obesity in children.

The impact of perceived school climate on exercise behavior engagement among obese adolescents: a dual mediation effect test of exercise benefits and perseverance qualities

Introduction

This study explores the relationship between perceived school climate and exercise behavior among obese adolescents, as well as the multiple mediating effects of perseverance qualities and exercise benefits.

Methods

A survey was conducted on 586 obese adolescents in Beijing, with an age range of 13-18 years old and an average age of 15.40 ± 1.824, among who 337 were male, 249 were female, 303 were high school students and 238 were middle school students. A standard scale was used to evaluate perceived school climate, exercise benefits, perseverance qualities, and exercise behaviors. The data was analyzed by independent samples t-test, bivariate correlation analysis, descriptive statistical analysis, and structural equation model (SEM).

Results

(1) Perceived school climate among obese adolescents positively predicted exercise behavior (Z = 2.870, p < 0.01), perseverance qualities (Z = 3.107, p < 0.01) and exercise benefits (Z = 4.290, p < 0.001); perseverance qualities positively predicted exercise behavior in obese adolescents (Z = 4.431, p < 0.001); exercise benefits positively predicted the obese adolescents' exercise behavior (Z = 4.267, p < 0.001). (2) Perseverance qualities (Z = 2.282, 95% CI [0.032, 0.191], [0.028, 0.179]) and exercise benefits (Z = 2.518, 95% CI [0.060, 0.287], [0.053, 0.271]) play a mediating role in the obese adolescents' perceived school climate and exercise behavior, respectively. These two factors have parallel multiple mediating effects between obese adolescents' perceived school climate and exercise behavior, with mediating effects accounting for 16 and 25%, respectively. The mediating effect of exercise benefits is greater than that of perseverance qualities. (3) There is no difference in the specific indirect effects of perseverance qualities and exercise benefits (Z = -0.800, 95% CI [- 0.198, 0.064], [-0.190, 0.068]).

Conclusion

Obese adolescents' perception of school climate can effectively enhance their motivation to participate in exercise behavior and indirectly influence exercise behavior through exercise benefits and perseverance qualities, cultivate good physical exercise behavior among obese adolescents, and effectively prevent and intervene in the occurrence of obesity.

Evaluation of Antioxidant Defence Systems and Inflammatory Status in Basketball Elite Athletes

Intense physical activity can induce metabolic changes that modify specific biochemical biomarkers. In this scenario, the purpose of our study was to evaluate how intense physical activity can affect oxidative metabolism. Following this, fifteen professional basketball players and fifteen sedentary controls were recruited and subjected to two samplings of serum and urine in the pre-season (September) and two months after the start of the competitive season (November). Our results have shown an increase in athletes compared to controls in CK and LDH in September (respectively, p-value 0.003 and p-value < 0.001) and in November (both p-value < 0.001), whereas ALT is increased only in November (p-value 0.09). GGT serum levels were decreased in athletes compared to controls in both months (in September p-value 0.001 and in November p-value < 0.001). A gene expression analysis, carried out using RT-PCR, has revealed that IL-2, IL-6, IL-8, xCT and GCLM are increased in athletes in both months (p-value < 0.0001), while IL-10 and CHAC1 are increased only in September if compared to the controls (respectively, p-value 0.040 and p-value < 0.001). In conclusion, physical activity creates an adaptation of the systems involved in oxidative metabolism but without causing damage to the liver or kidney. This information could be of help to sports doctors for the prevention of injuries and illnesses in professional athletes for the construction of the athlete's passport.

Associations between basic motor competencies and physical fitness in Spanish pre-schoolers: a cross-sectional study

BACKGROUND

Basic motor competencies (BMC) play a vital role in child development and are a primary focus of physical education. However, there is a lack of research on BMC in preschool-aged children, making this study particularly significant. The present study aims to examine the relationship between BMC and physical fitness components in Spanish preschool children.

METHODS

This cross-sectional study was conducted on 101 children (n = 52 boys, average age of 4.80 years) living in Pamplona, North Spain. Components of physical fitness (handgrip strength, standing long jump, speed-agility, and cardiorespiratory fitness) were assessed using the PREFIT Battery. Overall physical fitness was computed from the four selected fitness components separately for boys and girls. Higher z-scores values in physical fitness indicate better fitness performance. To assess BMC, the MOBAK KG test battery was applied (subscales of object control and self-movement). Sex, age, and body mass index were used as main confounders.

RESULTS

After adjustment for confounding factors, the BMC was positively associated with single (z-scores) components and overall physical fitness sum of z-scores (R2 from 0.178 to 0.469, all P-values < 0.05). Additional percentile scores weakened the associations, but they still remained significant (R2 from 0.146 to 0.337, all P-values < 0.05). Compared with participants in the lowest tertile, those in the highest tertile of the MOBAK KG sum score, and in both object movement and self-movement test subscales had significantly higher scores in single fitness component (z-scores or percentile) and overall physical fitness sum of z-scores (all P for trend < 0.001).

CONCLUSIONS

Our results revealed that higher BMC is associated with better physical fitness in Spanish preschool children. The findings emphasize the crucial role that basic motor competence plays in promoting physical activity in preschool children.

Obesity in Childhood and Adolescence: The Role of Motivation for Physical Activity, Self-Esteem, Implicit and Explicit Attitudes toward Obesity and Physical Activity

The purpose of the present study was to compare attitudes toward body weight and physical activity in both regular-weight and overweight/obese children and adolescents, and assessing relations between attitudes and self-esteem, motivation for physical activity, life satisfaction and level of physical activity. A total of 126 children (Mage = 12.2, SD = 3.4), divided into two subsamples (i.e., overweight/obese, N = 44, and regular-weight), voluntarily participated in the study. A series of univariate analyses of variance was conducted to examine the differences in the study variables across the subsamples. Correlational analyses were conducted to examine the relationships among the variables. The results indicated that obese/overweight participants expressed a more positive implicit attitude toward the thin category than regular-weight participants. Furthermore, among overweight/obese participants, implicit attitude toward physical activity was significantly negatively correlated with explicit attitude toward physical activity and general self-esteem. Significant differences between obese/overweight and regular-weight participants indicated that the status in terms of weight played a key role in attitudes toward the explored constructs.

Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes

The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.

The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery

This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.

The effects of adapted physical education sessions on the empathy of female students with overweight

The global prevalence of childhood and adolescent overweight and obesity increases rapidly. Physical activity plays a major role in the prevention of obesity. The present study aimed to analyze the effect of adapted basketball sessions according to the empathic capacity of adolescent girls with overweight. Forty-two girls with overweight (age: 16.09 ± 0.85; years; height: 1.64 ± 0.67 m: weight: 73.02 ± 0.61 kg; BMI: 27.15 ± 1.37) volunteered to participate in the study and were randomly assigned to the experimental group (EG, n = 21) and control group (CG, n = 21). EG was submitted to a basketball intervention adapted to students with obesity while the CG performed classic basketball exercises for 7 weeks. Each week girls had 2 basketball teaching-learning sessions, lasting 50 min. The participants' empathy was assessed before and after the intervention using the Favre CEC. The results showed that adaptation intervention was associated with a significant emotional contagion decrease (Δ% = 0.466) and splitting with emotions (Δ% = 0.375), and with an empathy increase (Δ% = 1.387), in EG compared to CG. No significant difference was assessed in the empathy CG, before and after the intervention. This study demonstrated that adapted physical education classes could be an effective strategy to improve empathetic skills and inclusion of overweight girls as well as a means to prevent obesity.

Centre-based childcare in early childhood and growth in later childhood: a prospective cohort study

BACKGROUND

Attending government-regulated centre-based childcare may influence important health behaviours including dietary quality, physical activity and routines related to child growth. However, the relationship between centre-based childcare and childhood obesity remains unclear.

OBJECTIVES

The primary objective was to evaluate the association between centre-based childcare attendance in early childhood and body mass index z-score (zBMI) in later childhood. Secondary objectives included exploring whether family income, child sex, or non-centre-based setting modified these relationships.

METHODS

A prospective cohort study of children aged 1 to 10 years who participated in the TARGet Kids! cohort was conducted. Linear mixed-effect modelling was used to evaluate the relationship between centre-based childcare attendance (in hours/week) compared to non-centre-based childcare between 1-4 years of age and zBMI between 4 and 10 years of age. Generalised estimating equation modelling was used to explore weight status categories. Models were adjusted for confounders and effect modification was explored.

RESULTS

A total of 3503 children were included. Children who attended centre-based childcare full-time (40 h/week) had 0.11 (95% CI: -0.19, -0.03; p = 0.01) lower zBMI at 4 and 7 years of age and lower odds of overweight and obesity at 4 years (OR 0.78; 95% CI: 0.62, 0.97; p = 0.03), but no evidence of an association was found at 10 years of age. Children from families with income < $50,000CDN who attended centre-based childcare full-time had 0.32 (95% CI: -0.50, -0.14; p = 0.001) lower zBMI and lower odds of overweight and obesity (OR 0.52; 95% CI: 0.28, 0.99; p = 0.05) at 10 years of age.

CONCLUSIONS

Attending centre-based childcare in early childhood was associated with a lower zBMI and odds of overweight and obesity in later childhood. These associations were stronger for children from lower income families. Centre-based childcare may be an early intervention for the prevention of childhood obesity.

CLINICAL TRIAL

Clinical Trial Registry Number: NCT01869530 (clinicaltrials.gov).

Assessment of the Impact of Increased Physical Activity on Body Mass and Adipose Tissue Reduction in Overweight and Obese Children

(1) Background: Within the last 30 years, growing rates of child overweight and obesity have been observed as a very concerning phenomenon in most countries worldwide. The research aim was to assess what effect increased physical activity has on reducing body mass and adipose tissue in children between 10 and 11 years of age as well as to answer the question of whether physical activity could be considered as a factor in preventing child overweight and obesity when maintaining their existing diet and lifestyle. (2) Material and methods: There were 419 sports class primary school pupils in the experimental group who, in addition to four obligatory weekly physical education hours, attended six training hours. The control group comprised 485 children from parallel non-sports classes. In all pupils, height and weight measurements as well as physical fitness measurements were taken twice, at the beginning and end of the school year. Cole's method was used to assess the children's normal body weight. With the help of this method, children with excessive body weight were selected from the entire study group (N = 904), who additionally had skinfolds and adipose tissue measured using the BIA electrical bioimpedance method. The obtained results were interpreted using the variance analysis for repeated measurements and LSD test. (3) Results: The number of children with excessive body mass after 10 months of increased physical activity decreased (in the case of overweight: p = 0.0014, obesity: p = 0.0022), as did their skinfolds (p ≤ 0.001) and body fat (p ≤ 0.001), while their physical fitness considerably improved compared to the control group. (4) Conclusions: The introduction of increased physical activity in the experimental group children when maintaining their existing diet and lifestyle contributed to reducing their obesity and overweight and, at the same time, proved to be an effective factor in the process of decreasing their excessive body mass.

Intensity matters: impact of physical activity energy expenditure at moderate and vigorous intensity on total and abdominal obesity in children

BACKGROUND/OBJECTIVES

Physical activity (PA) guidelines advocate that children should accumulate at least 60 min of moderate-to-vigorous PA daily. Still, it is not clear how body fat may differ if the same dose of PA is accumulated at different intensities. We aimed to determine the independent associations of energy expenditure (EE) at moderate (MPA) and vigorous (VPA) PA intensity on total and abdominal fat in children and if these associations were moderated by cardiorespiratory fitness (CRF).

SUBJECTS/METHODS

A total of 326 children (girls = 171, boys = 151) aged 10-12 years had PA assessed with accelerometers. Total fat mass index (FMI) and abdominal FMI were assessed with DXA. CRF was assessed by a cycle ergometer test. Linear regression models were used to model the outcomes with the inclusion of an interaction term to test for moderation effects.

RESULTS

An inverse association was found between VPA EE and FMI (β = -0.013, p < 0.001) and abdominal FMI (β = -0.0014, p < 0.001) independent of MPA EE. In contrast, MPA EE was not related to adiposity independent of VPA EE (p > 0.05). The relationships between the PA intensities and FMI and abdominal FMI were moderated by CRF. MPA EE was positively associated with adiposity in children with high levels of CRF, whereas VPA EE remained inversely associated with adiposity regardless of CRF level, although the strength of the association was lower in those with higher CRF levels.

CONCLUSION

PA programs should provide opportunities for children to perform VPA in order to achieve healthier body fat profiles and avoid excess adiposity.

The art of forming habits: applying habit theory in changing physical activity behaviour

Background

Habits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one’s life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits.

Methods

This study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported.

Results

Binary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05).

Conclusions

The emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary.

Assessment of executive functions and physical activity in girls and boys with normal weight, overweight and obesity

OBJECTIVE

To evaluate the association between body mass index (BMI) and performance of executive functions (EFs) in girls and boys with 9- and 10-year-old schoolchildren with moderate- to vigorous-intensity physical activity (MVPA) and sedentary behaviour.

METHODS

A total of 120 schoolchildren (61 girls and 59 boys) were evaluated anthropometrically. The MVPA was evaluated with a self-report questionnaire. EFs were measured using a neuropsychological battery of Executive Functions and Frontal Lobes-2 (BANFE-2).

RESULTS

A high BMI was associated with longer delay in completing inhibitory control tests (p = 0.00, r_p  = 0.32) and working memory (p = 0.00, r_p  = 0.26). We observed correlations in time (p = 0.00, r_p  = -0.43) and hits (p = 0.04, r_p  = -0.27) of self-directed signalling test in boys; and girls in alphabetical words order (p = 0.00, r_p  = -0.39). Active normal weight schoolchildren (ANw) performed better by successfully completed the working memory tasks (H = 26.97, p = 0.00) than sedentary schoolchildren with overweight and obesity. In addition, overweight-active schoolchildren (AOw) showed better performance on working memory tests in time (p = 0.00) and hits (p = 0.01) than their sedentary peers. Multiple linear regression analysis revealed a significant association between BMI and EFs scores (F = 2.41, df = 98, p = 0.001).

CONCLUSIONS

EFs are affected by a high BMI and sedentary behaviour in school children. Boys and girls reflected differences to solve the same challenges. The MVPA has a positive effect on executive control skills mainly in overweight children.

Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours

BACKGROUND

Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children.

METHODS

The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed.

RESULTS

BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group.

CONCLUSIONS

This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.

Levels and Patterns of Physical Activity and Sedentary Behaviour of Primary School Learners in Lagos State, Nigeria

BACKGROUND

Physical activity (PA) and sedentary behaviour (SB) assessment in children is critical for the prevention of noncommunicable diseases. African studies examining PA and SB of primary school-age children are few. This study investigated PA, SB levels and their correlates among primary school children in Lagos, Nigeria.

METHOD

In a cross-sectional study of 733 learners, their self-reported PA and SB were assessed using the Children PA Questionnaire (CPAQ) (6-9 years age category) and Youth Activity Profile (YAP) (10-12 years age category) while pedometers were used for objective PA and SB assessment, and socioeconomic status (SES) index were measured using a structured questionnaire. Standardised procedures were used for anthropometric and cardiovascular measures. Results Based on CPAQ, 87.5% and 100% of the learners aged 6-9 years met the recommended PA and SB guidelines, respectively which were lower with pedometers (72.8% and 87.3%). The proportion of boys aged 6-9 years who met the guidelines for PA and SB (using pedometer) was significantly higher than that of the girls(PA: 80.7% vs. 64%, p = 0.018; SB: 94% vs. 80%, p = 0.008). Self-reported PA was positively associated with age (CPAQ: B = 455.39, p < 0.001; YAP: B = 1.638, p = 0.009) and negatively with SES (CPAQ: B = -201.39, p < 0.001; YAP: B = -1.000, p < 0.001). Objective PA was positively associated with waist to hip ratio(WHR) (6-9 years: B = 66090.24, p = 0.032) and negatively with sex (6-9 years: B = -5533.41, p = 0.027) and hip circumference (10-12 years: B = -1269.13, p = 0.017). SB was associated with SES in learners aged 10-12 years (B = -0.282, p = 0.003).

CONCLUSION

High SES is a major predictor of reduced PA among these cohort of learners.

Effect of pre and post-transplant body mass index on pediatric kidney transplant outcomes

Introduction

Kidney transplantation (KT) has been established as an efficient treatment of end stage renal disease (ESRD) with the advantage of allowing the patient to live a nearly healthy life. We aimed to determine whether pre-transplant body mass index (BMI) affects renal allograft function and survival in pediatric KT recipients.

Methods

cross sectional cohort study included 50 post KT recipients (more than 3 years) with an age range of 10 to 15 years, regularly following at the Kidney Transplantation Outpatient Clinic, Cairo University Children’s Hospital, were subjected to a detailed history and physical examination, laboratory investigation in the form of fasting blood glucose (FBG),oral glucose tolerance test (OGTT), lipid profile, hemoglobin A1c (HbA1c) and microalbuminuria.

Results

Pre- post- kidney transplant BMI has significant positive correlation with graft rejection episodes, HbA1c, FBG, BMI post-KT, total cholesterol, triglycerides, and low-density lipoprotein (p < 0.01). There was a statistically significant negative correlation between the mean difference of BMI (post – pre) and graft survival in years (p = 0.036). Obese patients displayed lower survival compared with non-obese subjects at 5 years, but this was statistically not significant (p-value = 0.165).

Conclusion

obesity is an independent risk factor for graft loss and patient death in kidney transplantation. Careful patient selection with pre-transplantation weight reduction is mandatory to reduce the rate of early post-transplantation complications and to improve long-term outcomes.

Physical Exercise as a Non-Pharmacological Intervention for Attenuating Obesity-Related Complications in Children and Adolescents

Obesity is the most prevalent nutrition-related disorder among the pediatric population [...].

Prevalence of Obesity and Associated Risk Factors among Children and Adolescents in the Eastern Cape Province

Obesity is a global public health concern that begins in childhood and is on the rise among people aged 18 and up, with substantial health consequences that offer socioeconomic challenges at all levels, from households to governments. Obesity and associated risk factors were investigated in children and adolescents in the Eastern Cape Province of South Africa. A cross-sectional study was conducted at Mt Frere among 209 conveniently selected participants using anthropometric measurements and a structured questionnaire. Chi-squared statistics or Fisher's exact test were used to evaluate the risk factors predicting different outcomes such as hypertension or diabetes mellitus. A 5% level of significance was used for statistical significance (p-value 0.05). The prevalence of overweight or obesity among females when using waist circumference (2.7%), triceps skinfold (6.9%), and body mass index cut-offs (16.4%) were respectively higher when compared to those of males. About 89% engaged in physical activities. After school, 53% watched television. About 24.9% of participants did not eat breakfast. Most of overweight or obese participants (92.9%) brought pocket money to school. Use of single anthropometric measurements for assessing nutritional status indicated inconclusive results. Strengthening parental care, motivation for consumption of breakfast and limiting pocket money for children going to school are important steps to improve child health.

A Better Cardiopulmonary Fitness Is Associated with Improved Concentration Level and Health-Related Quality of Life in Primary School Children

This study aimed to examine the physical fitness (PF) levels of primary school children and to determine the associations among PF, concentration, and health-related quality of life (HRQOL) in a subcohort. PF was assessed in 6533 healthy primary school-age children (aged 6−10 years, 3248 boys and 3285 girls) via standardized test batteries. Concentration was measured with the d2-R test, and KINDL questionnaires were used to determine HRQOL. Analysis of variance showed an increase in PF with age in all PF dimensions (all p < 0.001), except cardiopulmonary fitness (estimated VO2max) in girls (p = 0.129). Boys performed better in nearly all PF dimensions, except curl-ups, in all children aged ≥7 years (p < 0.05). Concentration levels increased in boys and girls aged 7−9 years (p < 0.001), whereas HRQOL did not (p = 0.179). The estimated VO2max had a strong impact on concentration (β = 0.16, p < 0.001) and HRQOL (β = 0.21, p < 0.001) in 9- to 10-year-olds. Cardiopulmonary fitness is important for improved concentration and better HRQOL in primary school-age children. However, longitudinal data are needed to provide further insight into the intraindividual relationships of PF and concentration over the course of child development and set up targeted prevention programs.

Circadian Rhythm of Salivary Cortisol in Obese Adolescents With and Without Apnea: A Pilot Study

BACKGROUND AND OBJECTIVE

Obstructive sleep apnea (OSA) and obesity are associated with stress system activation involving the hypothalamic-pituitary-adrenal (HPA) axis in adults, but these effects in childhood and adolescence remain unclear. We examined diurnal salivary cortisol as a measurement of the HPA axis function in obese adolescents with and without OSA and the relationships between cortisol levels, body weight, and parameters of polysomnography (PSG).

METHODS

After PSG, saliva samples were collected from obese participants (with and without OSA) and lean participants four times over a 24-h period, namely, at 7:00 h (m-sCort), 13:00 h (a-sCort), 19:00 h (e-sCort), and 23:00 h (n-sCort). An enzyme-linked immunosorbent assay (ELISA) was used to measure salivary cortisol levels. The mean values of cortisol levels and fixed-time point diurnal cortisol slope (DCS) were calculated and compared among the three study groups. Correlations between parameters were analyzed using Spearman's correlation coefficients.

RESULTS

Obese OSA participants had significantly higher e-sCort and n-sCort levels than both obese non-OSA participants and lean controls. However, m-sCort and a-sCort in these patients had a pronounced upward trend. M-sCort was significantly correlated with both the lowest oxygen saturation (SpO₂) and time with SpO₂ <90%. Moreover, in the obese OSA group, DCS was significantly flatter than in the other two groups. The a-sCort in obese non-OSA participants was significantly higher than that in the lean control group and, surprisingly, was positively correlated with the apnea/hypopnea index. Additionally, m-sCort was related to body weight.

CONCLUSION

This study provided further evidence for alterations in diurnal cortisol production in obese adolescents, which may indicate a chronically stressed HPA axis. However, there were significant differences in salivary cortisol parameters between participants with and without OSA. Furthermore, patients with OSA had more associations between time-point cortisol levels and OSA-related indices. Nonetheless, this research is a pilot study, and further investigations are necessary.

Assessment of the influence of physical activity and screen time on somatic features and physical fitness in 6 to 7-year-old girls

Aim of the study is to assess the relationship between screen time, physical activity and physical fitness among girls 6–7 years-old.

21,528 girls aged 6 and 7 from Poland were assessed in terms of physical fitness. Arm strength, abdominal strength and explosive strength of the lower limbs were measured using the EUROFIT test. Basic somatic features were measured and BMI and WHtR indices were calculated. Spontaneous and organized physical activities as well screen time were assessed by the parents utilizing a questionnaire. The multiple logistic regression method was used to evaluate the influence of screen time and spontaneous physical activity on various components of physical fitness.

Physically active (PA) girls (≥1h/day) and those who participated in additional physical activities (APA) during the week had significantly higher height, weight, and BMI (p<0.001), but not WHtR. They had a higher level of flexibility, explosive strength of the lower limbs and arm strength (p<0.001). With an increase in screen time, the BMI, WHtR increased significantly and explosive strength of the lower limbs, abdominal strength and arm strength were lower. Regression analysis showed that more frequent participation in extracurricular activities increased the values of BMI and WHtR in quartile 4 (Q4), and strength components: Q2–Q4 (p<0.05). Spontaneous physical activity was positively related to the values of BMI, WHtR (both: Q4; p<0.05), explosive force of lower limbs (Q3–Q4; p=0.001), and negatively related to arm strength (Q2; p=0.001). Screen time (≥2hrs/day) increased odds for higher BMI values (p<0.05). Each screen time category decreased the odds of achieving abdominal muscle strength related to the quartiles: Q2–Q4 (p<0.05), arm strength (Q4: p<0.05). ST (1 <2hrs/day) decreased arm strength (Q3; p= 0.045). Our research has shown that screen time-related sedentary behavior and physical activity affect overweight and obesity indices (especially BMI) and strength abilities. The observed associations more often affected girls with a higher level of fitness The results observed in girls aged 6-7 indicate a need for early intervention aimed at limiting time spent watching TV and computer use, as well as to encourage both spontaneous and organized physical activities.

Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review

The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks.

Relationship between Objectively and Subjectively Measured Physical Activity in Adolescents during and after COVID-19 Restrictions

Background: Studying the relationship between subjectively and objectively measured physical activity (PA) can provide viable information on youths’ behaviors. However, the restrictions due to COVID-19 pandemic, which reduced children’s possibilities to be active, may negatively affect it. The aim of this study was to assess the relationship between subjectively and objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous) during COVID-19-based restrictions and after they were lifted, and to determine whether such relationships changed in these two periods. Methods: A total of 26 adolescents (58% girls; mean age = 12.4 ± 0.5) wore accelerometers during public restrictions and after they were removed. Participants also completed the International Physical Activity Questionnaire during the same periods. Results: High significant correlations were found at all levels of PA (r = 0.767–0.968) in both time periods, except for moderate PA during restrictions. Comparing the two periods, significantly higher correlations were found for moderate PA (p < 0.001) and moderate-to-vigorous PA (p = 0.003) after restrictions were lifted. Conclusions: In this highly active cohort of adolescents, results emphasize the potential threat of lockdown conditions for youths’ ability to accurately perceive their behaviors, with possible detrimental consequences on the short- and long-term health.

COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review

During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and "stay at home" orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents' wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection.

Nutrition, Physical Activity, and New Technology Programs on Obesity Prevention in Primary Education: A Systematic Review

Early acquisition of healthy lifestyle habits is crucial for good adult health. For this reason, the primary stage of education is a critical period to implement educational policies in this regard. The aim of this review is to compile the published evidence regarding school interventions at the primary stage aimed at preventing obesity, and which integrate as part of their action plan two features: an improvement in knowledge or nutrition habits and the promotion of physical activity (PA), and the use of new information and communications technologies (ICT) to do this. The method used for this review is the searching of different databases for publications that include these criteria. The results show beneficial effects of such interventions in improved eating habits and increased PA. The effect on BMI is limited, and the use of ICT can be of help at a motivational level for the maintenance and fulfilment of the health objectives. However, studies of this type in elementary school are very limited, so it would be necessary to continue researching on this line. In conclusion, this review demonstrates the suitability of carrying out mixed interventions (improved nutrition and PA) together with the use of new technologies to improve health and prevent obesity at an early age.

COVID-19 Risk in Youth Club Sports: A nationwide sample representing over 200,000 Athletes

CONTEXT

The COVID-19 pandemic has affected almost every aspect of life including youth sports. Little data exists on COVID-19 incidences and risk mitigation strategies in youth club sports.

OBJECTIVE

To determine the reported incidence of COVID-19 cases among youth club sport athletes and the information sources used to develop COVID-19 risk mitigation procedures.

DESIGN

Cross-sectional study.

SETTING

Online surveys.

PATIENTS

Soccer and volleyball youth club directors.

INTERVENTION

A survey was completed by directors of youth volleyball and soccer clubs across the country in October 2020. Surveys included self-reported date of re-initiation, number of players, player COVID-19 cases, sources of infection, COVID-19 mitigation strategies, and information sources for the development of COVID-19 mitigation strategies.

MAIN OUTCOME MEASURES

Total number of cases reported, number of players, and days since club re-initiation were used to calculate an incidence rate of cases per 100,000 player-days. To compare reported incidence rates between soccer and volleyball, a negative binomial model was developed to predict player cases with sport and state incidence as covariates and log(player-days) as an offset. Estimates were exponentiated to yield a reported incidence rate ratio (IRR) with Wald confidence intervals.

RESULTS

A total of 205,136 athletes (soccer=165,580; volleyball=39,556) were represented by 437 clubs (soccer=159; volleyball=278). Club organizers reported 673 COVID-19 cases (soccer=322; volleyball=351), for a reported incidence rate of 2.8 cases per 100,000 player-days (soccer=1.7, volleyball=7.9). Volleyball had a significantly higher reported COVID-19 incidence rate compared to soccer (reported IRR = 3.06 [2.0-4.6], p<0.001). Out of 11 possible mitigation strategies, the median number of strategies used by all clubs was 7 with an interquartile range of 2.

CONCLUSIONS

The incidence of self-reported cases of COVID-19 was lower in soccer clubs than volleyball clubs. Most clubs report using many COVID-19 mitigation strategies to reduce the risk of COVID-19.

Familial Correlates of Leisure Time Activities among Polish Early School-Age Children: A Cross-Sectional Study

The after-school period may play a critical role in the accumulation of children’s physical activity and sedentary time. The study aimed to characterize familial correlates of early school-age children’s leisure time activities. A cross-sectional study was conducted among a group of 223 children (mean age 8.7 ± 0.5) and their parents. The percentage of children with daily leisure time physical activity (LTPA) >1 h was 23.32%, and with daily screen time <2 h was 32.74%. The average children’s leisure time physical activity was significantly higher on weekend days than on weekdays (114.85 vs. 89.43 min, p = 0.005). Similarly, the average screen time was higher on weekend days than on weekdays (95.50 vs. 66.10 min, p < 0.001). The multivariate regression analysis revealed that independent predictors of children’s leisure time physical activity were the father’s education level and the father’s occupational status, whereas at least one parent with higher education correlated negatively with children’s longer screen time. The study showed that children’s leisure time activities are associated with parental education and differ significantly between weekdays and weekend days. These findings underline the need for screening for unfavorable health behaviors among early school-age children, and indicate that health promotion programs should be oriented on both parents and children aiming to improve parental health consciousness, reduce screen time and increase physical activity, especially during the weekend.

Prevalence of Overweight, Obesity, Abdominal Obesity, and Obesity-Related Risk Factors in Polish Preschool Children: A Cross-Sectional Study

The aim of this study was to assess the prevalence of overweight, obesity, abdominal obesity (AO), and obesity-related risk factors in children aged 5–6 years from Poland. The study was conducted at 22 randomly selected kindergartens representing each city district. A cross-sectional study of 1172 children aged 5–6 years was conducted using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), and body fat percentage (BFP). A univariate and multivariate logistic regressions were performed to evaluate the risk factors for excess weight, excess adiposity, and abdominal obesity (AO). The prevalence of excess weight (BMI ≥ 85th percentile) was 11.0%. The prevalence of excess adiposity (BFP ≥ 85th percentile) was 42.3%. Prevalence of AO (WC ≥ 90th percentile) was higher in girls compared to boys (14.9% vs. 10.7%, respectively). Multivariate logistic regression analysis indicated that children whose both parents were obese had significantly higher risk of excess weight, excess adiposity, and AO. Lower education level of fathers was associated with higher risk of excess weight and excess adiposity in children, while a lower level of maternal education was associated with higher risk of AO in children. Screen time over 120 min per day, participating less than once a week in at least 60 min of moderate-to-vigorous physical activity (MVPA) and birth weight over 4000 g were associated with excess weight, excess adiposity and AO. Moreover, cesarean delivery was associated with higher risk of excess weight and excess adiposity, and lower socio-economic status with higher risk of AO. This study revealed that excess adiposity and AO differed by gender. Parental obesity, screen time, MVPA, and birth weight could be significant determinants of excess weight, excess adiposity and AO in Polish preschool children.