Current Government Actions and Potential Policy Options for Reducing Obesity in Queensland Schools

Age- and Sex-Specific Physical Fitness Reference and Association with Body Mass Index in Hong Kong Chinese Schoolchildren

There is lacking a population-based study on the fitness level of Hong Kong schoolchildren, and it seems that increasing childhood obesity prevalence has shifted the classification of healthy fitness, with 'underfit' as normal. This cross-sectional territory study aimed to develop an age- and sex-specific physical fitness reference using a representative sample of children aged 6-17 and to determine the associations with body mass index in schoolchildren. The study analyzed Hong Kong School Physical Fitness Award Scheme data covering grade 1 to grade 12 students' physical fitness and anthropometric measurements from 2017 to 2018. This reference was established without the impact due to COVID-19. Four aspects of physical fitness tests were measured using a standardized protocol, including (i) upper limb muscle strength, (ii) one-minute sit-up, (iii) sit-and-reach, and (iv) endurance run tests. The generalized additive model for location, scale, and shape was used to construct the reference charts. A Mann-Whitney U test was used to compare the mean differences in age, weight, and height, and a Pearson's chi-square test was used to examine the distributions of sex groups. A Kruskal-Wallis test was used to compare the group differences in BMI status, followed by the Dunn test for pairwise comparisons. A 5% level of significance was regarded as statistically significant. Data of 119,693 students before the COVID-19 pandemic were included in the analysis. The association between physical fitness level and BMI status varied depending on the test used, and there were significant differences in fitness test scores among BMI groups. The mean test scores of the obese group were lower in most of the tests for both boys and girls, except for handgrip strength. The underweight group outperformed the obese group in push-ups, one-minute sit-ups, and endurance run tests, but not in handgrip strength. In conclusion, a sex- and age-specific physical fitness reference value for Hong Kong Chinese children aged 6 to 17 years old is established, and this study demonstrated a nonlinear relationship between BMI status and physical fitness. The reference will help to identify children with poor physical fitness to offer support and guidance on exercise training. It also serves as a baseline for assessing the impact of the COVID-19 pandemic on Hong Kong students' physical fitness.

Healthy Eats-Evaluation of a Social Marketing Program Delivered in Primary School Settings in Queensland

One in four school children in Australia are overweight or obese. In response, the Healthy Eats program was developed, piloted, and delivered using a whole-of-school approach underpinned by the socio-ecological model to increase fruit and vegetable consumption among children aged 8-10 years in regional Queensland, Australia. This research presents an outcome evaluation of the Healthy Eats program using pre-post data collected throughout 2021 (cross-sectional for knowledge and longitudinal for behaviour) from 19 schools to assess whether changes occurred in students' nutritional knowledge (n = 1868 (pre = 933, post = 935)) and fruit and vegetable consumption (n = 1042 (pre = 521, post = 521)). Knowledge data was collected via self-reports two weeks prior and immediately after the Nutrition Module. Behavioural data on daily fruit and vegetable consumption was gathered via student passports (i.e., surveys) one week before and for four consecutive weeks after the Nutrition Module. Chi-Square Difference tests and t-Tests were conducted with a significance level set at p < 0.05. Across all 19 schools, knowledge of the daily recommended serves of fruit and vegetables improved significantly following participation in the program, aligning knowledge closer to the Australian dietary guidelines. Behavioural results for fruit consumption were favourable, with clear improvements reported. Increases in vegetable consumption were demonstrated in two of the eight schools. A discussion on the knowledge-action gap is provided, including recommendations for future iterations of the Healthy Eats program.

Physical Changes of Preschool Children during COVID-19 School Closures in Fujian, China

The COVID-19 pandemic may constitute an "obesogenic lifestyle" that results in exacerbating childhood obesity. However, studies investigating regional sociodemographic factors including different age groups or sexes in children with obesity are lacking. We aimed to clarify the high obesity prevalence populations of preschool children to provide a regional basis for children's health policy during the COVID-19 school closures. From May to September 2019, a total of 29,518 preschool children were included in a large sample, multicenter cross-sectional study to explore physical status in Fujian Province by stratified cluster random sampling. In October 2019 and October 2020, we also conducted a cross-sectional study exploring physical development including changes in height, weight, and BMI of 1688 preschool children in Fuzhou before and after the COVID-19 school closures. Student' s t-test, Mann-Whitney U test, or chi-square test was used to assess differences in physical development and overweight and obesity rates among preschool children before and after school closures. For regional factors, the weight of urban preschool children of all ages became higher after the outbreak (p (age 3-4) = 0.009; p (age 4-5) < 0.001; p (age 5-6) = 0.002). For sex factors, overweight and obesity in boys had a greater prevalence than in girls before and after the outbreak. In four age groups, overweight and obesity rates in the 5-year-old group (15.5% and 9.9%) were higher than before (11.4% and 6.0%). The weight and BMI of 4- to 5-year-old children also increased faster than before (p < 0.001). The COVID-19 pandemic has promoted the epidemic of childhood obesity. Living in urban/coastal (economically developed) areas, boys, and aged 4-6 years old may be a susceptible population to obesity development after the outbreak.

Development of Physical Activity Competence Test Battery and Evaluation Standards for Korean Children

The purpose of this study is to develop a comprehensive and systematic method and standard for evaluating children’s physical activity competency as a solution to the problem of increasing child obesity rates due to a decrease in physical activity among children. This study was used a cross-sectional study design. A literature review and Delphi survey were conducted to develop children’s physical activity competency evaluation. The evaluation criteria were presented based on the measurement data of metropolitan area kindergarten students (228 subjects) on the 2016 winter vacation. Items in the evaluation of children’s physical activity competency test battery include health physical strength, basic movement skills, physical activity habits, and physical activity attitudes. Physical fitness for health consisted of muscle strength and endurance (sit-up), flexibility (sit and reach, trunk lift) and body composition (BMI). Fundamental movement skills consisted of mobility (run, hop, jump), stability (static balance, dynamic balance), and control (throw kick). Physical activity habits consisted of the amount of daily steps (steps), exercise time, screen time, and sleep time. Physical activity attitudes consisted of preference, enjoyment, and confidence. The evaluation criteria for child physical activity competency test battery were presented in five stages, divided by age and gender. With the developed evaluation of children’s physical activity competency, the overall level of physical fitness for health, fundamental movement skills, physical activity habits, and physical activity attitudes of kindergarteners in the metropolitan area could be confirmed, and standards were presented.

Regional Adolescent Obesity and Overweight Status in Korea from 2018-2019: Comparison between Two Data Sources

Difference in the regional adolescent obesity level may cause a notable health inequality between regions since it significantly affects adulthood health status. This study examined 2018 and 2019 regional obesity and overweight status of adolescents aged 12 to 18 by comparing two cross sectional population-based data sources, the Korea Youth Risk Behavior Web-based Survey (KYRBS) and the National Student Health Examination (NSHE). Prevalence was estimated by calculating weighted percentages and 95% confidence intervals. Correlations in the relative rankings of each municipality were determined by computing Spearman correlation coefficients (r_s), and prevalence discrepancies between the data sources were visualized by simple correlation graphs. The geographical distributions of adolescent obesity and overweight status showed no perfect concordances between the data sources regardless of sexes and survey years. For adolescent obesity status, there were significant difference between the least and the most obese regions and r_s levels were fair to good with p-values less than 0.05, but the correlation graphs indicated body mass index (BMI) underreporting in the KYRBS. For adolescent overweight status, no significant similarities were defined between the data. These results can be used as a basis for the establishment of related policies.

Program Evaluation of Environmental and Policy Approaches to Physical Activity Promotion in a Lower Income Latinx School District in Southeast Los Angeles

There is alarming population wide prevalence of low adolescent physical activity as this represents a risk factor for later chronic disease development. There is evidence to suggest that schools with strong wellness policies have students that are more frequently active. We designed an intervention to enhance students' physical activity levels in five majority Latinx, underserved school districts. Evaluation consisted of assessment of written quality of school-district wellness policies; observation of student's physical activity during leisure times; and after-school program practices and policies. We examined one of these district's results more closely, the only participating district with a community coalition, and extracted lessons learned. On the physical activity section of the wellness policy, this district covered a moderate extent of recommended content areas using weak language. Compared to previous reports, we identified low vigorous activity levels for girls and boys at baseline (respectively, 12% and 18%). Finally, we identified that of four after school program sites assessed at baseline, no program reported the recommended 50% or more of program time dedicated to physical activity. Based on these evaluation findings, additional strategies are urgently needed to encourage all students and particularly more girls to be physically active throughout the school day.

First Physical Activity Report Card for Children and Youth in Lebanon

Background: Evidence on physical activity (PA) indicators for children and youth at a national level is necessary to improve multilevel support for PA behaviors. Lebanon's first Physical Activity Report Card for children and youth (2018) aimed to fill this gap. Methods: In line with the recommended methods of "Global Matrix 3.0," nationally representative data were retrieved from peer-reviewed manuscripts, national surveys, and government reports. In addition to adopting the 10 indicators of "Global Matrix 3.0," publications that discussed weight status were also retained. A grade was assigned for each indicator using a standard rubric: A = 80% to 100%, B = 60% to 79%, C = 40% to 59%, D = 20% to 39%, F = <20%, and INC = incomplete data. Results: Four indicators (active play, family and peers, community and environment, and physical fitness) received an "INC." Three indicators (overall PA, active transportation, and school) received a "D." Sedentary behaviors received a "C-." Weight status received a "C." Government received a "C+." Organized sport received an "F." Conclusions: PA participation among Lebanese children and youth is low. Stakeholders should aim to improve low PA indicators grades. Gaps in the literature also need to be filled to inform on the status of all indicators.