2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years: summary of the evidence

Adherence to the Canadian 24-hour movement guidelines and vision impairment in children and adolescents: a cross-sectional study

Objectives

To investigate the associations between adherence to the Canadian 24-hour movement guidelines-covering physical activity (PA), screen time (ST), and sleep duration (SD)-and vision impairment, specifically myopia and myopic anisometropia, among children and adolescents in Shenzhen, China.

Methods

A cross-sectional study was conducted in 2022 with 4,649 participants. Adherence to the guidelines was assessed using self-reported PA, ST, and SD measures, while vision impairment was clinically evaluated. Logistic regression models were used to analyze the associations, adjusting for sociodemographic factors.

Results

Among the participants, 48.63% were diagnosed with myopia and 11.01% had myopic anisometropia. Meeting the ST guideline was associated with a reduced risk of myopia (aOR = 0.86, 95% CI = 0.76-0.98) and myopic anisometropia (aOR = 0.78, 95% CI = 0.64-0.95). Meeting both PA and ST guidelines further reduced the odds of myopia (aOR = 0.73, 95% CI = 0.56-0.97) and myopic anisometropia (aOR = 0.60, 95% CI = 0.41-0.89). Meeting all three guidelines (PA, ST, and SD) significantly reduced the odds of myopia (aOR = 0.71, 95% CI: 0.53-0.93) and showed a trend toward reduced risk of anisometropia (aOR = 0.69, 95% CI: 0.47-1.02), compared to those who met none. Meeting two guidelines also significantly reduced the risk of myopia (aOR = 0.76, 95% CI: 0.59-0.97) and anisometropia (aOR = 0.71, 95% CI: 0.51-1.00).

Conclusion

Adherence to the 24-hour movement guidelines, particularly meeting the ST and PA recommendations, was associated with a lower risk of myopia and myopic anisometropia. These findings highlight the importance of promoting balanced lifestyle behaviors, such as limiting screen time and encouraging physical activity, to mitigate vision impairment among children and adolescents.

The open health-promoting activities programme: redefining health promotion and family dynamics by engaging parents in socioeconomically deprived Swedish communities

BACKGROUND

Current evidence suggests that even in high-income countries such as Sweden, there are socioeconomic differences in children's participation in physical activity. While family-based programmes appear promising to encourage physical activity, there is a lack of knowledge on how to engage families in such programmes, particularly in socioeconomically disadvantaged areas. The Open Health-Promoting Activities programme was launched to promote physical activity outdoors and health equity for children and their families in these areas. This study aims to explore parents' experiences with the Open Health-Promoting Activities programme in socioeconomically disadvantaged areas, focusing on family engagement in physical activity and perceived changes in family dynamics.

METHODS

A qualitative design with an ethnographic approach was employed. In line with an ethnographic approach, the research team conducted 15 participant observations of the programme sessions on Saturdays during Spring 2022. Field notes were compiled during the observations, which provided contextual information for individual interviews with 12 programme participants. These interviews were conducted after the researchers attended the programme. The participants were adults/parents who participated in the programme with one or more of their children. An inductive reflexive thematic analysis was used to analyse the field notes and interviews.

RESULTS

The analysis identified three main themes: (1) prioritising children's equal engagement in physical activity, (2) helping parents promote children's healthy lifestyles, and (3) improving family dynamics through engagement in physical activity. Each theme captures an aspect of the programme that parents perceived as essential to facilitating their family's engagement in the programme. All the themes are interconnected and form the basis for improving family dynamics.

CONCLUSION

To develop tailored family-based programmes in socioeconomically deprived communities, it is crucial to understand parents' experiences and perceptions of aspects that facilitate their children's engagement in physical activity. The findings suggest that emphasising equal opportunities, a safe space approach and participation are essential for increasing family engagement in physical activity. These elements also supported increasing parents' awareness of their children's need to be active and have fun together.

Effects of a 7-week active breaks intervention program on physical literacy and body mass index

Introduction

Physical literacy (PL) emerges as a highly effective resource for creating lasting physical activity habits at a time when physical inactivity has become one of the main risk factors in our population. Thus, active breaks (AB) could be an ideal option for increasing physical activity time in schoolchildren.

Methods

A cross-sectional quasi-experimental study was conducted, involving 89 participants aged 8-12 years from Extremadura. The Canadian assessment of physical literacy (CAPL-2) was administered to assess the participants' physical literacy level. The BMI was also measured.

Results

Higher scores were obtained in all domains and subdomains of the CAPL in the experimental group. Significant differences were found both in total physical literacy score (p < 0.001) and in all domains and subdomains, except for the subdomains self-reported question, intrinsic motivation and knowledge and understanding domain (p = 0.344).

Conclusion

The results of the study support the positive effects of an AB program of PL and its domains. The development of active break programs could help to increase the PL level of schoolchildren.

Comparative effects of moderate-intensity continuous training and high-intensity interval training on ADHD symptoms and behavioral inhibition in children

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition in children, characterized by inattention, hyperactivity, and impulsivity. Recent studies have investigated the potential role of physical exercise as a complementary intervention to traditional ADHD treatments. This study aimed to compare the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on ADHD symptoms and behavioral inhibition in children diagnosed with ADHD. In a randomized controlled trial, 60 male participants aged 7-10 years were allocated into three groups: control, MICT, and HIIT. The intervention lasted 12 weeks, with the MICT group performing 20 min of running at 70-75% of their individual VO2 max and the HIIT group performing alternating intervals of running at 100% and 50% of their VO2 max for 1 min each. The control group received no exercise intervention. Cognitive and symptomatic assessments were conducted using the Children's Symptom Questionnaire (CIS-4) and go/no-go tasks before and 48 h post-intervention. Both MICT and HIIT demonstrated significant improvements in behavioral components, including attention deficit, hyperactivity, and impulsivity (all P < 0.0001). HIIT showed superior effects on attention deficit compared to MICT (P = 0.008). Both HIIT (P < 0.0001) and MICT (P = 0.028) improved correct responses (CR) in the Go task compared to the control group. HIIT also outperformed the control group in erroneous responses (ER) (P = 0.022) and correct reaction time (P = 0.027) in the Go task. In the No-Go task, HIIT showed superiority over the control group in both CR (P = 0.013) and ER components.

CONCLUSION

This study highlights the comparative efficacy of MICT and HIIT as nonpharmacological interventions for children with ADHD. HIIT, in particular, demonstrated superior benefits for attention deficits, suggesting its potential as a targeted adjunctive treatment. These findings may inform the development of exercise programs to enhance the quality of life and daily functioning of children with ADHD.

WHAT IS KNOWN

• Physical exercise has been explored as a complementary intervention for ADHD, with evidence suggesting its potential to improve symptoms such as inattention, hyperactivity, and impulsivity. • Moderate-intensity continuous training (MICT) has shown positive effects on cognitive and behavioral outcomes in children with ADHD.

WHAT IS NEW

• High-intensity interval training (HIIT) demonstrated superior benefits over MICT in improving attention deficits in children with ADHD. • Both HIIT and MICT significantly improved behavioral inhibition, with HIIT showing additional advantages in reducing erroneous responses and enhancing reaction times in cognitive tasks.

Raising active children: how family and school shape health-promoting physical activity-findings from the FAMIPASS study

This study investigated the combined impact of family dynamics and school environments on physical activity levels in children aged 3-9 years across distinct segments of the school day. Conducted as part of the FAMIPASS project in the Czech Republic, the study collected data in 2022 and 2023 from 502 families affiliated with 36 preschools and primary schools. The device-based monitoring of movement behaviors in children and their parents was conducted over a one-week period using ActiGraph accelerometers, complemented by detailed family questionnaires. Regression analysis revealed that parental physical activity, BMI, and education level significantly influenced children's moderate-to-vigorous physical activity, with educated parents more likely to raise active children. Active transport to school emerged as a key factor associated with higher child activity levels specifically in the time segment before school. This research underscores the role of family and school as critical arenas for promoting health and physical activity. These insights highlight the need for integrated family-school strategies to foster healthy activity habits in children, thereby laying the groundwork for a more active generation.

Impact and perceptions of Active Learning Classrooms on reducing sedentary behaviour and improving physical and mental health and academic indicators in children and adolescents: A scoping review

Prolonged sitting in school harms children's physical and mental health and reduces the ability to focus on classroom tasks. 'Active Learning Classrooms' (ALCs) aim to decrease sitting time, following current pedagogical trends, though research on the effects of ALCs on these aspects is still an emerging field. The aims of this review were to: (i) synthesise the available literature on the impact of ALCs on reducing sedentary behaviour, increasing physical activity (PA), physical and mental health, and academic indicators in children and adolescents; and (ii) describe the educational community's perceptions and teaching practices used in ALCs. This scoping review followed Joanna Briggs Methods and PRISMA guidelines for scoping reviews. We searched for peer-reviewed quantitative and qualitative studies published in English that examined the impact of ALCs on movement patterns, physical or mental health, and academic indicators in children and adolescents, as well as those that explored the perceptions of members of the educational community and the teaching practices used in ALCs. Databases research included MEDLINE (PubMed), ERIC, SCOPUS and ProQuest Education. Nineteen studies were included, of which 11 were experimental, 4 were cross-sectional, and 4 were qualitative. The analysis revealed a predominantly positive influence of ALCs on children's sedentary behaviour, learning engagement and psychological well-being; and mixed results on PA, physical health and academic performance. Our results also suggest that learning spaces are positively perceived and well accepted by the entire educational community, and that teachers teaching in ALCs are more prone to use student-centered and collaborative pedagogies than in traditional classrooms. Although this review shows a positive impact on key health and education variables, the evidence is limited and lacks depth. In addition, the small number of studies and their methodological weaknesses prevent robust conclusions, but the results still help to guide future decisions.

Gamification to Promote Physical Activity in Youth and Mothers With Obesity

PURPOSE

Physical inactivity and sugar-sweetened beverage (SSB) consumption are associated with obesity. Gamification and self-monitoring to promote physical activity in youth is unknown, but evidence of effectiveness is present in adults. This study examined the effects of a gamification intervention on increased steps per day among parent-adolescent dyads with obesity compared with digital self-monitoring and if self-monitored SSB intake differed between these arms.

METHODS

Youth ages 10-16 years and their mothers (N = 39 pairs), both with obesity, were randomized to a self-monitoring (N = 18) or a self-monitoring plus gamification arm (N = 21) for 9 weeks. The step goal was set and incrementally increased each week and was measured with Fitbit devices. Mixed effects linear regression examined changes in steps and SSB consumption per day, per week by study arm.

RESULTS

During run-in, mothers averaged 8317 and youth 7508 steps per day. Compared with self-monitoring alone, gamification did not increase daily steps in mothers or youth beyond baseline levels. On average, SSB intake decreased in mothers by approximately 0.5 servings per day; occurred in both arms and persisted throughout the intervention.

CONCLUSION

Gamification did not promote physical activity levels in mother-youth dyads with obesity. SSB intake declined in mothers with obesity in both study arms.

The moderating effect of maternal modeling on age-related decline in children's physical activity

Maintaining adequate levels of physical activity is challenging for many children. Parents, particularly mothers, play a pivotal role in children's engagement in health behaviors. This longitudinal study investigated the moderating role of maternal physical activity-related modeling behaviors on the typical age-related decline in children's physical activity. A total of six waves of 1-week ecological momentary assessments were conducted with mother-child dyads (N = 202) of 8- to 12-year-old children. The results indicated that both maternal physical activity and physical activity in the presence of their child attenuated the typical decline in the children's physical activity over time. These findings underscore the importance of maternal physical activity-related behaviors in shaping children's physical activity habits over time. The discussion centers on the need to further explore the mechanisms underlying these moderation effects and outlines implications for interventions targeting children's physical activity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Moving beyond moderate-to-vigorous physical activity: A longitudinal study on adherence to 24-hour Movement Guidelines in adolescents

OBJECTIVES

Low adherence to 24-hour Movement Guidelines for moderate-to-vigorous physical activity, screen time and sleep during adolescence is well documented, yet recommendations regarding light physical activity, vigorous physical activity and muscle and bone strengthening activities have received less attention. This study comprehensively examined adherence to seven components of the movement guidelines in adolescents and analysed disparities by age and gender.

DESIGN

Longitudinal study with two assessment time points, separated by one year.

METHODS

Data were collected in 216 New Zealand adolescents aged 12-17 years, and at 1-year follow-up in 167 participants (77 %), using thigh-worn accelerometers and a self-reported diary.

RESULTS

Adherence rates were 3.7 % for moderate-to-vigorous physical activity, 13.0 % for screen time, 44.0 % for sleep, 14.4 % for light physical activity, 36.1 % for vigorous physical activity, 30.6 % for bone and muscle strengthening activities, and 4.6 % for consistent bedtimes. Less than 1 % of participants met all seven recommendations. Adherence was disproportionately low amongst older adolescents for light physical activity, screen time and consistent bedtimes, and amongst girls for vigorous physical activity and muscle and bone strengthening activities. Over one year, adherence declined for light physical activity (15.0 %-7.2 %) and screen time (15.6 %-6.0 %).

CONCLUSIONS

New Zealand adolescents are not adhering to recommendations for a healthy balance of time use outlined in the 24-h Movement Guidelines. These findings highlight the need for adolescents to increase their daily movement, with a particular focus on light physical activity amongst older adolescents and muscle and bone strengthening activities amongst girls.

Associations of Physical Activity and Sedentary Behavior With Self-Rated Health Status in Brazilian Older Adults

In a longevity society, as we live longer, adopting healthy lifestyles is essential to develop and maintain functional ability, which enables well-being in older adults. We aim to examine the associations of physical activity (PA) and sedentary behaviors (SBs) with self-rated health (SRH) status in older Brazilian adults. We analyzed 21,701 persons aged 60 or older from the Brazilian National Health Survey. A partial proportional odds model for SRH adjusted by sociodemographic confounders was estimated. The marginal effects of PA and SB on SRH status were expressed in terms of the average-adjusted probabilities. In addition, average-adjusted probabilities for the better and worse SRH status among representative cases of Brazilian socioeconomic inequalities were calculated. The main findings of the study indicate: (a) a significant positive association exists between PA and SRH status and, conversely, a negative association exists between SB and SRH; (b) the PA effect across daily sitting time watching TV attenuated and improved the probability of declaring a worse and better SRH status, respectively; and (c) the SRH status differences associated with PA and SB represent the socioeconomic inequalities in the older Brazilian population. Beyond some methodological limitations, we conclude that increasing PA and SB in older persons is significantly associated with better and worse SRH status, respectively. In addition, the results suggest that SRH status is a consistent health inequality measurement. In societies moving on longevity transition, substantial efforts are required in individuals' behavior across the life courses and public policies to promote healthy aging.

Geographic and Grade-Level Disparities in Student Access to School-Based Physical Education and Physical Activity Opportunities Across 25 US States

BACKGROUND

Most US children and adolescents do not meet recommended daily physical activity (PA) guidelines. Determinants of PA are complex; however, access to opportunities precedes actual PA engagement. Schools are well positioned to support student PA through the provision of physical education (PE) and before, during, and after school PA opportunities through comprehensive (ie, expanded) school PA programming. Monitoring access to school PE and PA opportunities is an essential function of public health. However, there are limited comprehensive data across K-12 settings. Therefore, the purpose of this study was to evaluate students' access to PE and expanded recreation time before, during, and after school PA opportunities in K-12 schools across 25 US states.

METHODS

The US Physical Education and Physical Activity Policy questionnaire was completed by 4845 K-12 PE teachers across 25 states, representing diverse geographical regions, with responses standardized across varying academic calendars. Descriptive statistics were used to illustrate access to PE and PA opportunities.

RESULTS

Access to PE and PA varied, with elementary schools generally providing more opportunities than middle and high schools. There was an overall misalignment with national PE and recess recommendations. Limited before and after school PA opportunities were also reported.

DISCUSSION

The relative dearth of access to PE and expanded PA opportunities currently available to students in relation to national guidelines shows a need for states to prioritize expanding access to PE and recreational PA to reduce disparities. To ensure more equitable student access, collaborative efforts among educators, policymakers, and stakeholders are essential.

Association between physical activity, smartphone usage, and obesity risk among Korean adolescents: A cross-sectional study based on 2021 Korean adolescent health behavior survey

BACKGROUND

With adolescent obesity rates steadily rising, it has become crucial to identify modifiable risk factors to develop effective interventions. This study explores the associations between physical activity (PA) levels, smartphone usage, and obesity risk among Korean adolescents, aiming to inform the design of targeted health promotion programs to mitigate obesity rates in this demographic.

METHODS

This cross-sectional analysis used data from 50,407 Korean adolescents who participated in the 2021 Adolescent Health Behavior Online Survey. Descriptive statistics and chi-square tests compared PA patterns, sedentary behavior, and smartphone usage between adolescents with obesity and those without obesity. To examine the impact of key exposure factors-including PA, muscle strengthening exercises (MSE), sedentary behavior, and smartphone usage-on obesity risk, binary logistic regression models were used, adjusting for grade level, economic status, and other potential confounders.

RESULTS

Male adolescents exercising "3-4 times/week" had a significantly higher obesity risk compared to those with no PA (OR = 1.144, 95 % CI: 1.032-1.267, p < 0.01). Similarly, females exercising "3-4 times/week" (OR = 1.208, 95 % CI: 1.048-1.393, p < 0.01) or "≥ 5 times/week" (OR = 1.333, 95 % CI: 1.087-1.636, p < 0.01) also showed increased risk. Both males and females participating in high-intensity PA (HIPA) "1-2 times/week" were at higher risk (males: OR = 1.110, 95 % CI: 1.011-1.219, p < 0.01; females: OR = 1.427, 95 % CI: 1.283-1.587, p < 0.001). Conversely, MSE was linked to a significant reduction in obesity risk across most frequency groups, especially in males (OR = 0.450, 95 % CI: 0.399-0.508, p < 0.001). For sedentary behavior, females with ≥6 h of weekday non-learning sedentary time (SWD-N) had increased obesity risk (OR = 1.210, 95 % CI: 1.002-1.462, p < 0.01), as did males with ≥6 h of weekend sedentary time (SWK-N) (OR = 1.334, 95 % CI: 1.154-1.542, p < 0.001) and females with ≥6 h of weekend smartphone usage (SPWK_TM) (OR = 1.567, 95 % CI: 1.066-2.303, p < 0.01).

CONCLUSIONS

The findings reveal complex relationships between PA, MSE, sedentary behavior, and smartphone usage in the context of adolescent obesity. Certain PA levels, particularly 3-4 times/week and ≥ 5 times/week for females, and HIPA frequency were associated with increased obesity risk. In contrast, MSE significantly reduced obesity risk across genders, with the most substantial effects observed in males engaging in MSE ≥ 5 times/week. Only associations meeting the p < 0.01 threshold were interpreted in this study to ensure robust conclusions. These results emphasize the importance of promoting MSE and balanced sedentary behavior patterns to reduce adolescent obesity risk, suggesting health policies should address these factors with a focus on gender-specific and age-specific strategies. However, limitations such as the lack of nutrition data, unassessed PA intensity, and HIPA duration should be addressed in future research.

Effectiveness of school-based active breaks on classroom behavior, executive functions and physical fitness in children and adolescent: a systematic review

Introduction

The classroom environment is ideal for promoting physical activity interventions since children spend most of their day there but often engage in sedentary behavior. Given this context, an emerging trend to promote physical activity is active breaks at school. This systematic review evaluated the effects of school-based physical activity interventions involving active breaks on children and adolescents' classroom behavior, executive functions, and physical fitness.

Methods

This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost. Studies published between January 2010 and August 31, 2023, including participants aged 5 to 18, were included. Interventions involving active breaks and outcomes related to classroom behavior, executive functions, and physical fitness were considered.

Results

Initially, 145 studies were identified, with 22 duplicates excluded. After screening 123 articles by title and abstract, 86 were excluded. Subsequently, 37 articles underwent full-text screening, resulting in 22 included studies. Six studies showed positive effects on classroom behavior; five studies showed improvements in executive functions, and only two studies indicated increases in physical fitness.

Discussion

This review suggests incorporating active breaks during school hours can improve classroom behavior in children and adolescents. However, the effects of active breaks on executive functions and physical fitness are unclear. More research is needed to fully understand the benefits of implementing active break programs in the classroom.

Systematic review registration

PROSPERO, CRD42023448267, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023448267.

Association between moderate-to-vigorous physical activity trajectories and academic achievement in Chinese primary school children: a 3-year longitudinal study

BACKGROUND

Past cross-sectional studies have reported a positive association between moderate-to-vigorous physical activity (MVPA) and academic achievement in children and adolescents. Despite this, the influence of variations in MVPA over time on academic achievement remains yet to be definitively understood. Therefore, this study aims to track the patterns of MVPA and examine how they are associated with academic achievement over a three-year period among Chinese primary school students.

METHODS

The longitudinal study examined the MVPA and academic achievement of a cohort of 202 primary school children over a three-year period. MVPA was assessed via accelerometers and analysed using Compositional Data Analysis (CoDA). Academic achievement was quantified using standardised test scores in reading, mathematics, and language. Group-Based Trajectory Models (GBTMs) were used to identify patterns of MVPA. Covariates such as demographics, sleep duration, and attitudes towards sports were adjusted in the Generalized Estimating Equations (GEEs) used to examine associations with academic achievement. All statistical analyses were conducted using R and SAS 9.4 software.

RESULTS

This study identified three distinct MVPA trajectories: Low (74.8%), Decline (13.2%), and High (12.0%). At baseline, the High MVPA group had better academic achievement with mean scores of 89.8 in reading, 94.5 in mathematics, and 94.7 in language, compared to the Low MVPA group with mean scores of 80.4, 83.0, and 84.9, respectively. After adjustment for confounders, GEE models showed significant associations between MVPA trajectories and improved academic achievement. Compared to the Low MVPA group, the Decline MVPA group exhibited significant score increases in reading (β = 4.11, 95% CI: 1-7.21) and mathematics (β = 2.79, 95% CI: 0.09-5.5). The High MVPA group exhibited significant score increases in reading (β = 11.3, 95% CI: 7.93-14.67), mathematics (β = 12.32, 95% CI: 9.61-15.02), and language (β = 11.53, 95% CI: 8.99-14.06). Additionally, notable gender differences in MVPA trajectories were observed, and a positive association was found between favorable sports attitudes and improved academic achievement.

CONCLUSIONS

This study reveals three distinct MVPA trajectories among Chinese primary school children and demonstrates that those with high MVPA trajectories showcase superior academic achievements, particularly in reading, mathematics, and language. This highlights the vital role of MVPA in supporting academic excellence.

Healthier Diet and Diet-Related Behaviors Are Associated with Increased Physical Activity and Reduced Sedentary Behavior Among Adolescents in Greece

BACKGROUND/OBJECTIVES

Healthy diet, regular physical activity (PA), and minimizing sedentary behavior (SB) are crucial in promoting adolescents' health and well-being. We assessed adherence to PA and SB recommendations among a representative sample of adolescents and explored their relationship with diet and diet-related behaviors.

METHODS

Data from the Greek arm of the 2017/2018 international Health Behavior in School-Aged Children (HBSC) cross-sectional study were used, including a probability sample of 3357 students (47.6% boys) who were 11, 13, and 15 years old. PA, SB, consumption of food groups/beverages, and diet-related behaviors were self-reported. Multiple logistic regression was used to identify potential associations.

RESULTS

Most students failed to meet PA (83.9%) (i.e., ≥1 h of moderate-to-vigorous physical activity/day) and SB (90.2%) (i.e., ≤2 h of screen time/day) recommendations. Daily consumption of fruit and vegetables compared to consumption at ≤1 day/week was associated with increased adherence to PA recommendations (adjusted Odds Ratio (aOR) = 2.26, 95% Confidence Intervals (CI): 1.62-3.17 for fruit; aOR = 1.35, 95%CI: 1.00-1.82 for vegetables). Eating sweets ≤1 day/week vs. every day was associated with higher adherence to SB recommendations (aOR = 2.41, 95%CI: 1.43-4.04). Poor diet quality was related to lower adherence to PA and SB recommendations. Daily breakfast consumption vs. never and abstaining from eating at fast-food restaurants were associated with better adherence to PA and SB recommendations. Rarely eating in front of screens was associated with substantially higher odds of adhering to SB recommendations (aOR = 5.79, 95%CI: 3.67-9.14).

CONCLUSIONS

Healthier diet/diet-related behaviors were associated with increased PA and reduced SB in this sample of adolescents.

Role of physical activity in cardiovascular disease prevention: impact of epigenetic modifications

Cardiovascular disease (CVD) remains the leading cause of death worldwide, imposing a major burden on morbidity, quality of life, and societal costs, making prevention of CVD a top public health priority. Extensive research has pointed out that lack of adequate physical activity in life is one of the key risk factors for heart disease. Indeed, moderate exercise is not only beneficial to the heart in healthy populations, but also exerts a protective effect in pathological states. However, the molecular mechanisms underlying the cardioprotective effects of exercise are still not fully understood. An increasing body of research indicates that variations in the epigenetic system-such as DNA methylation, histone modifications, and production of non-coding RNA-are essential for maintaining heart health and preventing heart disease. Exercise is a potent epigenetic modulator that induces direct and long-lasting genetic changes and activates biological signals associated with cardiovascular health. These changes can be influenced by external stimuli such as physical activity and may even be passed on to offspring, thus providing a mechanism for generating genetic effects through behavioral interventions. Therefore, understanding this relationship can help identify potential biomarkers and therapeutic targets associated with CVD. This study aims to provide an overview of the beneficial effects of exercise on heart health. This information may help guide future research efforts and improve our understanding of epigenetics as a therapeutic, prognostic, and diagnostic biomarker for CVD.

Short bouts and long-term exercise reduce sedentary-induced bone loss and microstructural changes by modulating bone formation and resorption in healthy young male rats

Although the toxic effect of Sedentary behavior (SED) on bone health has been demonstrated in the previous study, the underlying mechanisms of SED, or break SED to bone health remain unclear. In this study, we aim to investigate the effects of sedentary behavior (SED) on bone health, as well as the potential favor effects of moderate to vigorous physical activity (MVPA) and periodic interruptions of SED. To simulate SED, we used small Plexiglas cages (20.0 × 9.0 × 10.0 cm) to restrict animal movement. Short bursts of exercise to break SED and continuous long-term exercise were also designed. After an 8-weeks period of SED, we observed decreased bone mass and bone microstructure. Specifically, there was a notable decrease in the bone mineral density (BMD), bone surface (BS) and cortical thickness (Ct.Th) significantly reduced in cortical bone. In the trabecular bone, parameters such as trabecular separation (Tb.Sp), trabecular number (Tb.N), BS, connectivity density (Conn.D), BS/BV, bone volume/tissue volume (BV/TV), degree of anisotropy (DA), and structural model index (SMI) were also significantly reduced. In addition, we detected an increase in serum tartrate-resistant acid phosphatase (TRAP) levels in SED rats at both 4 and 8 weeks. At 8 weeks, the osteoclast number and surface with TRAP-staining were significantly increased, however, the OPG mRNA and proteins level were significantly decreased. After daily short bouts exercise and long-term exercise, we observed improvements in bone mass and microstructure. These improvements included increasing BMD and BV/TV of cortical bone, and improving Conn.D, BV/TV, DA and SMI of trabecular. Meanwhile, we found that, at 4 and 8 weeks, there was an increase in serum ALP. At 8 weeks, the mineralized nodules surface with Alizarin Red S-staining, and OPG mRNA and proteins level in bone tissue were significantly increased. Our findings suggest that SED leads to alterations in the bone mass and microstructure, which are associated with the changes in the OPG protein and bone remodeling. Exercise, whether in short daily bouts or continuous long-term sessions, can ameliorate the harmful effects of SED. Similarly, the changes in bone mass and microstructure from exercise are also associated with the changes in the OPG protein and bone remodeling by upregulated osteoblast activity to bone formation. Overall, our findings indicate the importance of physical activity in maintaining bone health and preventing the negative impacts of prolonged SED.

Physical Literacy, According to the World Health Organization (WHO), in an Italian Preschool and Education for a Daily Movement Routine

BACKGROUND AND OBJECTIVES

The preschool context produces excessive sedentary behavior in children. The systematic fulfillment of structured physical activities during school time, namely a daily movement routine (DMR), can contribute to increasing the quantity of physical activity (PA) and to improving physical literacy (PL), reaching the WHO's recommendations.

AIM

The present study aims to quantify the sedentary time spent by 4- and 5-year-old preschool children and to verify the effects that a DMR could have on sedentary habits in preschool children.

METHOD

An experimental observational study was carried out. Ad hoc questionnaires were administered to parents, teachers, and children, and an observation checklist was used to quantify the time spent in sedentary activities at school. Descriptive statistics and t-tests were applied for data analysis.

RESULTS

Thirty-two children attending Italian preschool participated in this study. The implementation of a DMR significantly reduced the sedentary time in preschool, decreasing the time spent sitting by 45.69% and increasing the time spent standing by 185%.

CONCLUSIONS

This study confirms the hypothesis that children move for less time than recommended by the WHO and highlights the importance of making the experiences of the DMR structural, as this could be an opportunity for educational processes to enhance active lifestyles in promoting the development of physical literacy.

Exercise improves body composition, physical fitness, and blood levels of C-peptide and IGF-1 in 11- to 12-year-old boys with obesity

Introduction

Exercise is vital in preventing and treating obesity. Despite its importance, the understanding of how exercise influences childhood obesity at the biochemical level is limited. In this study, we explore the effects of a 16-week exercise program (EP) on body composition, physical fitness, and the blood levels of hormones related to obesity.

Methods

Sixteen boys with obesity (n = 16) and seventeen boys without obesity (n = 17) took part in an EP comprising sports games and aerobic and resistance exercises. We examined alterations in body composition and physical fitness. In addition, we measured circulating hormone levels, including C-peptide, resistin, insulin-like growth factor 1 (IGF-1), and growth hormone (GH), in the blood.

Results

Body fat percentage (BFP) decreased from 37.61% at pre-EP to 29.16% at post-EP in the obese group, but not in the non-obese group. The EP decreased C-peptide (4.58 ng/mL vs. 2.96 ng/mL, p < 0.001) and resistin levels (14.05 ng/mL vs. 11.06 ng/mL, p < 0.001) in the obese group. After the EP, significant improvement in IGF-1 (non-obese: 265.56 ng/mL vs. 311.81 ng/mL, p < 0.001; obese: 224.74 ng/mL vs. 272.89 ng/mL, p < 0.001) and GH levels (non-obese: 3.91 ng/mL vs. 4.80 ng/mL, p < 0.05; obese: 1.76 ng/mL vs. 2.51 ng/mL, p < 0.05) were observed in both groups. Lower C-peptide levels were associated with BFP (r = 0.447, p = 0.009) and muscle mass (r = -0.385, p = 0.02), whereas enhanced IGF-1 levels correlated with increased muscle strength (r = 0.343, p = 0.05) and cardiovascular fitness (r = 0.347, p = 0.04). Multiple linear regression analysis revealed that cardiovascular fitness variability and BFP in the obese group were determined by C-peptide (β = -0.054, p < 0.001) and IGF-1 levels (β = -2.936, p < 0.05), respectively.

Discussion

Exercise may induce positive effects on improvements in body composition and physical fitness, as well as on blood levels of metabolic biochemicals such as C-peptide and IGF-1, in adolescent boys with obesity.

Parenting Practices and Well-Being and Health Behaviors Among Young Asian American Children

Importance

Literature suggests that well-being and health status differ by generational status among Asian American individuals.

Objective

To compare young children's well-being and health behaviors and their parents' parenting practices among families of second-generation Asian American, third- or later-generation Asian American, and third- or later-generation non-Hispanic White children in the US.

Design, Setting, and Participants

For this survey study, secondary data analysis was conducted from September 2, 2023, to June 19, 2024, using data from the 2018 to 2022 National Survey of Children's Health participants aged 6 months to 5 years. Parents completed a survey about their positive parenting practices and their child's psychological well-being and health behaviors via mail or online. Multivariable logistic and linear regression analyses were conducted to compare psychological well-being and health behaviors by study groups and positive parenting practices, adjusting for sociodemographic variables.

Main Outcomes and Measures

Positive parenting practices (ie, reading, storytelling or singing, and family meals), psychological well-being (ie, flourishing, social-emotional development, and self-regulation), and health behaviors.

Results

The analysis included 42 846 participants (5456 in 2018, 5140 in 2019, 7494 in 2020, 12 817 in 2021, and 11 939 in 2022; 46.6% female and 53.4% male). Participants were categorized into 3 groups: 2881 (6.7%) were second-generation Asian American children aged 0 to 5 years, 570 (1.3%) third- or later-generation Asian American children aged 0 to 5 years, and 39 395 (92.0%) third- or later-generation non-Hispanic White children aged 0 to 5 years. Compared with White children, Asian American children were less likely to flourish (odds ratio [OR], 0.57 [95% CI, 0.52-0.63] for second-generation Asian American; OR, 0.82 [95% CI, 0.65-1.03] for third- or later-generation Asian American), have regular bedtimes (OR, 0.80 [95% CI, 0.69-0.92] for second-generation Asian American; OR, 0.66 [95% CI, 0.49-0.88] for third- or later-generation Asian American), and have moderate screen time (OR, 0.92 [95% CI, 0.84-1.00] for second-generation Asian American; OR, 0.82 [95% CI, 0.69-0.97] for third- or later-generation Asian American). Results for regular reading and storytelling or singing were the lowest among second-generation Asian American children (1430 [49.6%] for reading and 1629 [56.5%] for storytelling or singing), followed by the third- or later-generation Asian American children (376 [66.0%] for reading and 412 [72.3%] for storytelling or singing) and than White children (28 628 [72.7%] for reading and 30 375 [77.1%] for storytelling or singing) (P < .001). Results for family meals were similar between second-generation (2356 [81.8%]) and third- or later-generation (467 [81.9%]) Asian American children; however, both were significantly lower than for White children (33 928 [86.1%]) (P < .001). All 3 positive parenting practices were positively associated with children's psychological well-being and health behaviors.

Conclusions and Relevance

This survey study of young children found lower likelihoods of flourishing, regular bedtimes, and moderate screen time among Asian American children compared with non-Hispanic White children in the US. Reading and storytelling or singing parenting practices, which were associated with children's well-being and health behaviors, were particularly less frequent among parents of second-generation Asian American children than those of third- or later-generation Asian American children. Promotion of these practices among Asian immigrant parents may help improve the psychological well-being and health behaviors of their young Asian American children.

Physical health in young males and risk of chronic musculoskeletal, cardiovascular, and respiratory diseases by middle age: A population-based cohort study

BACKGROUND

Cardiovascular, respiratory, and musculoskeletal disease are among the leading causes of disability in middle-aged and older people. Health and lifestyle factors in youth have known associations with cardiovascular or respiratory disease in adulthood, but largely unknown associations with musculoskeletal disease.

METHODS AND FINDINGS

We included approximately 40,000 18-year-old Swedish males, who completed their conscription examination in 1969 to 1970, followed up until age of 60 years. Exposures of interest were physical health: body mass and height, blood pressure, pulse at rest, muscle strength, cardiorespiratory fitness, and hematocrit; self-reported lifestyle: smoking, alcohol, and drug use; self-reported health: overall, headache and gastrointestinal. We followed the participants through the Swedish National Patient Register for incidence of common musculoskeletal (osteoarthritis, back pain, shoulder lesions, joint pain, myalgia), cardiovascular (ischemic heart disease, atrial fibrillation), and respiratory diseases (asthma, chronic obstructive pulmonary disease, bronchitis). We analyzed the associations using general estimating equations Poisson regression with all exposures included in one model and adjusted for parental education and occupation. We found that higher body mass was associated with higher risk of musculoskeletal (risk ratio [RR] per 1 standard deviation [SD] 1.12 [95% confidence interval, CI 1.09, 1.16]), cardiovascular (RR 1.22 [95% CI 1.17, 1.27] per 1 SD) and respiratory diseases (RR 1.14 [95% CI 1.05, 1.23] per 1 SD). Notably, higher muscle strength and cardiorespiratory fitness were associated with higher risk of musculoskeletal disease (RRs 1.08 [95% CI 1.05, 1.11] and 1.06 [95% CI 1.01, 1.12] per 1 SD difference in exposure), while higher cardiorespiratory fitness was protective against both cardiovascular and respiratory diseases (RRs 0.91 [95% CI 0.85, 0.98] and 0.85 [95% CI 0.73, 0.97] per 1 SD exposure, respectively). We confirmed the adverse effects of smoking, with risk ratios when comparing 11+ cigarettes per day to non-smoking of 1.14 (95% CI 1.06, 1.22) for musculoskeletal, 1.58 (95% CI 1.44, 1.74) for cardiovascular, and 1.93 (95% CI 1.60, 2.32) for respiratory diseases. Self-reported headache (category "often" compared to "never") was associated with musculoskeletal diseases (RR 1.38 [95% CI 1.21, 1.58]) and cardiovascular diseases (RR 1.29 [95% CI 1.07, 1.56]), but had an inconclusive association with respiratory diseases (RR 1.13 [95% CI 0.79, 1.60]). No large consistent associations were found for other exposures. The most notable associations with specific musculoskeletal conditions were for cardiorespiratory fitness and osteoarthritis (RR 1.23 [95% CI 1.15, 1.32] per 1 SD) and for muscle strength and back pain (RR 1.18 [95% CI 1.12, 1.24] per 1 SD) or shoulder diseases (RR 1.27 [95% CI 1.19, 1.36] per 1 SD). The main limitations include lack of adjustment for genetic factors and environmental exposures from childhood, and that the register data were available for males only.

CONCLUSIONS

While high body mass was a risk factor for all 3 studied groups of diseases, high cardiorespiratory fitness and high muscle strength in youth were associated with increased risk of musculoskeletal disease in middle age. We speculate that these associations are mediated by chronic overload or acute trauma.

Moderate-to-vigorous physical activity modulates the association between serum 25-hydroxyvitamin D and bone stiffness in European children and adolescents

It remains unclear how serum 25-hydroxyvitamin D (25(OH)D) concentrations relate to childhood bone health. We hypothesized that 25(OH)D was inversely associated with bone turnover biomarkers and positively associated with bone stiffness. Cross-sectional analyses were performed using data from participants (2-15-year-old, 51% boys) from the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants Study (IDEFICS)/I.Family cohort, comprising 3,638 serum 25(OH)D measurements collected in 2007-2008 and 2012-2013 across eight European countries. A biomarker of bone formation (serum osteocalcin), a biomarker of bone resorption (serum C-terminal telopeptides of type I collagen [CTx]), and stiffness index measured using calcaneal quantitative ultrasound were considered outcomes. Linear mixed-effects models were used to adjust for confounders (i.e., age, sex, parental education, time spent in sports club, dairy products consumption, sedentary behavior, height and weight z-scores), the cluster effect of country and repeated measurements. Interactions of calcium intake, moderate-to-vigorous physical activity (MVPA) and weight status with 25(OH)D on outcomes were tested. Only 1 in 3 participants reached the sufficient 25(OH) D concentration of 20 ng/mL. Sufficient 25(OH)D was associated with higher stiffness index if participants had MVPA ≥60 min/day (β = 12.14, P < .05). Moreover, 25(OH)D was inversely associated with CTx (β = -7.09, P < .05); this association was positive but not statistically significant among primary school children living with overweight/obesity. No interaction was observed for calcium intake. In conclusion, serum 25(OH)D and CTx were inversely associated. MVPA interacted with the positive association between 25(OH)D and bone stiffness, highlighting the importance of promoting MVPA guidelines in future vitamin D and bone health interventions.

Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea

Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised 3 phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides 3 priorities for pediatric health promotion policy and practice and 3 recommendations for future research.

Possible determinants of physical fitness in Japanese school children: A cross-sectional study

BACKGROUND

Physical fitness is one of the most important health indicators in children. Although appropriate body composition or certain lifestyle factors such as frequent physical activity are thought to improve physical fitness, results of previous studies are inconsistent, and most studies were from Western countries.

OBJECTIVES

We investigated associations of body composition and modifiable lifestyle factors such as physical activity, screen time, diet and sleep duration with physical fitness in Japanese primary school children.

METHODS

2308 children (age 10-12 years old) in 12 primary schools were analysed in this cross-sectional study. Physical fitness was evaluated by sports battery tests conducted routinely and annually at schools. The total score of sports battery tests, 20-m shuttle run (laps) and grip strength (kg) were selected as outcomes. Information about lifestyle factors was collected by two questionnaires. Associations between lifestyle factors and physical fitness were assessed by multivariable linear mixed models by sex.

RESULTS

Frequent exercise was related to better overall physical fitness. Regarding the 20-m shuttle run, many unfavourable lifestyle factors such as higher BMI in boys (β -7.37, 95% confidence interval [CI] -8.39, -6.35) and girls (β -3.54, 95% CI -4.50, -2.58), longer screen time (β -4.31, 95% CI -7.29, -1.34) in boys and girls (β -5.65, 95% CI -9.01, -2.30); shortest (reference) versus longest, breakfast skipping in boys (β -5.24, 95% CI -8.71, -1.77) and girls (β -3.57, 95% CI -6.84, -0.30); consumers (reference) versus skippers were associated with worse performance. Better quality of diet was associated with better results in the 20-m shuttle run only in girls (β 2.58, 95% CI 0.24, 4.93); lowest (reference) versus highest.

CONCLUSIONS

Frequent exercise was related to better physical fitness. Higher BMI and unfavourable lifestyle factors such as longer screen time and breakfast skipping were associated with worse results of the 20-m shuttle run.

Dimensions of well-being and social harmony of older persons in Ghana: A secondary analysis of longitudinal survey data of the 2014/15 Study on Global Ageing and Adult Health (SAGE Wave 2)

OBJECTIVES

A crucial factor in healthy ageing is age-friendly environments for older persons. The opportunities that come with getting older as well as the safety of older persons are influenced by their social surroundings and overall well-being, yet, there is a dearth of research focus on this subject. This study examined the association between dimensions of well-being and the social harmony of older persons in Ghana.

METHODS

A secondary analysis of longitudinal survey data of the 2014/15 Study on Global Ageing and Adult Health (SAGE Wave 2) conducted by the World Health Organization was used. Only older adults 60 years and older were included in this study. Multilevel logistic regression techniques were used to examine dimensions of well-being as predictors of social harmony of older persons. The output was reported as odds ratios (OR).

RESULTS

Results show that high levels of emotional and physical well-being were 13.5% and 14.3% more likely to be associated with a high level of social harmony (OR = 1.35, 95% CI = 1.35,1.35), (OR = 1.43, 95% CI = 1.43,1.43). However, older persons with high levels of psychological and spiritual well-being were 7% and 3% less likely to experience a high level of social harmony (OR = 0.73, 95% CI = 0.63,0.93), (OR = 0.39, 95% CI = 0.39,0.40).

CONCLUSION

This study shows a multifarious association between dimensions of well-being and the social harmony of older persons. A positive association is found between high levels of emotional and physical well-being and social harmony in older persons. However, older persons with high levels of psychological and spiritual well-being showed less experience of social harmony. This has implications for policy for improving older persons' well-being and social harmony. Policies and social interventions should consider the various needs and situations of older persons to establish an environment of safety and opportunities concerning higher social harmony in Ghanaian society.

Improving Physical Activity, Athletic Performance, and School Climate in Disadvantaged Schools

BACKGROUND

Children are encouraged to spend 60 min each day performing moderate-to-vigorous physical activity. In this study, we assessed the impact of an intervention throughout the school year on physical activity, sports performance, and school climate in fifth-sixth-grade children from schools in a disadvantaged neighborhood.

METHODS

The intervention group (n = 44) participated in six weekly 45 min physical education classes; an athletic subgroup of these students participated in two additional weekly athletic classes. The control group (n = 73) participated in two standard weekly physical education classes. Pre- and post-intervention Eurofit Physical Fitness Tests were conducted.

RESULTS

Significant improvements were seen in the stand-and-reach test among girls in the intervention group [M = -0.47(7.71)-1.26(8.02) cm] compared to the control group [F(1,54) = 14.86, p < 0.01, η2 = 0.22]. No differences were seen between the groups in their daily physical activity, screen time, or school climate (p = 0.13, p = 0.17, and p = 0.35, respectively). Improvements were seen in the shuttle-run beep test, yet only in the athletic subgroup [F(1,93) = 60.38, p < 0.001, η2 = 0.39]. A trend towards significance for the largest improvement was seen in the athletic subgroup, who participated in eight weekly physical activity classes [F(2,93) = 3.75, p = 0.027, η2 = 0.07).

CONCLUSIONS

Physical education curricula should enhance their focus on athletic performance, while increasing the number of weekly physical education classes in schools, to include daily lessons throughout the school week, each lasting at least 45 min.

Autonomy support, basic needs satisfaction, and involvement in physical education among Norwegian secondary school students

Purpose

This study investigated the relationship between teacher autonomy support, students' basic psychological needs satisfaction, and involvement in physical education (PE) with gender specific analyses. Additionally, the study examined the validity of a Norwegian version of the Basic Psychological Needs in PE (BPN-PE) scale.

Method

Survey data from the Norwegian 2017/2018 Health Behaviour in School-aged Children study.

Results

A structural equation model showed that perceived autonomy support from teacher predicted students' basic needs satisfaction of competence, autonomy and relatedness. Furthermore, satisfaction of competence predicted weekly PE participation and physical activity during PE among boys. The analyses revealed mean level differences with boys scoring higher than girls on all the investigated variables. The findings also supported the validity and reliability of the BPN-PE scale across genders.

Discussion/conclusion

The study adds knowledge to the understanding of the relationship between autonomy support from teachers, students basic need satisfaction and students' involvement in PE.

Daily Physical Activity, Sports Participation, and Executive Function in Children

Importance

It is unclear whether daily physical activity and sports participation relate to executive function (EF) in children.

Objective

To explore associations between early-life physical activity, sports participation, and executive function in primary school children.

Design, Setting, and Participants

Data for this cohort study were collected from April 2006 to December 2017 from the Groningen Expert Center for Kids with Obesity (GECKO) Drenthe birth cohort, which includes Northern Dutch children. Preschool children aged 5 to 6 years and primary school children aged 10 to 11 years with valid EF, daily physical activity, and sports participation data were included in the analysis. Data were analyzed from May 2023 to February 2024.

Exposures

At ages 5 to 6 years, daily physical activity was measured with accelerometry. At ages 10 to 11 years, sports participation data were collected using the Short Questionnaire to Assess Health-Enhancing Physical Activity.

Main Outcomes and Measures

Executive function was assessed using the Behavior Rating Inventory of Executive Function at ages 10 to 11 years.

Results

A total of 880 children (470 female [53.4%]; mean [SD] age at EF measurement, 11.1 [0.4] years) were included. Moderate to vigorous physical activity at ages 5 to 6 years did not correlate with EF at ages 10 to 11 years (eg, Global Executive Composite [GEC]: β, 0.16; 95% CI, -0.21 to 0.53). Higher levels of light physical activity at ages 5 to 6 years were associated with poorer inhibitory control (β, 0.86; 95% CI, 0.24-1.47) and self-monitoring (β, 0.79; 95% CI, 0.09-1.48) at ages 10 to 11 years, while greater sedentary time was associated with better inhibitory control (β, -0.62; 95% CI, -1.08 to -0.16) and self-monitoring (β, -0.57; 95% CI, -1.09 to -0.06). Compared with children engaged in individual sports, team sports participants exhibited better overall EF (mean difference [SE], -3.03 [0.81]), behavior regulation (mean difference [SE], -3.39 [0.77]), and metacognition (mean difference [SE], -2.55 [0.81]). Children involved in both types of sports vs only individual sports had better EF (GEC: mean difference [SE], -2.66 [0.93]).

Conclusions and Relevance

In this cohort study of Dutch children, early-life moderate to vigorous physical activity was not associated with EF in middle childhood. Children participating in team sports at ages 10 to 11 years consistently exhibited superior EF compared with participants in individual sports.

Effects of Physical Activity and Inactivity on Microvasculature in Children: The Hong Kong Children Eye Study

Purpose

The purpose of this study was to investigate the effects of physical activity and inactivity on the microvasculature in children, as measured from retinal photographs.

Methods

All participants were from the Hong Kong Children Eye Study, a population-based cross-sectional study of children aged 6 to 8 years. They received comprehensive ophthalmic examinations and retinal photography. Their demographics and involvement in physical activity and inactivity were obtained from validated questionnaires. A validated Deep Learning System was used to measure, from retinal photographs, central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE).

Results

In the final analysis of 11,959 participants, 6244 (52.2%) were boys and the mean age was 7.55 (1.05) years. Increased ratio of physical activity to inactivity was associated with wider CRAE (β = 1.033, P = 0.007) and narrower CRVE (β = -2.079, P < 0.001). In the subgroup analysis of boys, increased ratio of physical activity to inactivity was associated with wider CRAE (β = 1.364, P = 0.013) and narrower CRVE (β = -2.563, P = 0.001). The subgroup analysis of girls also showed increased ratio of physical activity to inactivity was associated with narrower CRVE (β = -1.759, P = 0.020), but not CRAE.

Conclusions

Increased activity in children is associated with healthier microvasculature, as shown in the retina. Our study contributes to the growing evidence that physical activity positively influences vascular health from a young age. Therefore, this study also underscores the potential of using the retinal vasculature as a biomarker of cardiovascular health.

Barriers to Physical Activity Participation in Children and Adolescents with Autism Spectrum Disorder

BACKGROUND

Children and adolescents with autism spectrum disorders tend to participate in less physical activity. The purpose of this study was to identify barriers to physical activity participation in children and adolescents with autism spectrum disorder (ASD) based on parental reports.

METHODS

The sample comprised 370 children and adolescents with ASD, aged 8-20 years. Simple random sampling was selected. We designed a questionnaire and used the survey method for data collection. Data were analyzed using descriptive and inferential statistics.

RESULTS

The results revealed several barriers to physical activity participation: interpersonal barriers were the top priority, followed by friends and peers as well as psychological factors as the second and third priorities. Additionally, family, cognition, management and planning, social and cultural factors, and skills were identified as the fourth through eighth barriers, respectively.

CONCLUSIONS

Understanding these barriers is crucial for developing effective school- and community-based strategies to promote physical activity participation.

Should organized sport characteristics be considered as a strategy for meeting physical activity guidelines in children?

BACKGROUND

A clearer understanding of the relationships between specific sport context with overall physical activity (PA) and sedentary time (ST) may contribute to the development of more accurate preventive strategies to increase children's engagement in PA.

PURPOSE

This study aimed to examine how different organized sports contributed to children's daily PA and ST.

METHODS

PA was measured for seven days via accelerometers, in 410 children aged 6-10 years (49.8% boys). Of those, 332 (53.0% boys) were engaged in an organized sport and were further considered for statistical analyses. Parents reported children's sport participation (e.g. which sport, number of times per week, duration). The sports were classified into: indoor vs. outdoor; individuals vs. team; combat vs. individual aesthetic vs. racing vs. invasion. Children's height and weight were objectively collected. Multiple one-way analyses of covariance were used to examine the effects of sport characteristics on PA and ST. A linear regression, adjusted for children's sex, age, body mass index and father's educational level, determined the relationship between being involved in multiple PA and sedentary behaviours with Moderate to Vigorous PA (MVPA) levels.

RESULTS

Although engaged in an organized sport, only 30% of the children achieved the PA recommendations. Sport (compared with active commute and active play) was the best contributor to daily MVPA. Outdoor sports (vs. indoor) contributed the most to vigorous PA (VPA) and MVPA. Team sports (vs. individual) were significantly associated with lower ST. Children in combat sports accumulated more VPA and MVPA, while those in racing sports showed a higher ST.

CONCLUSIONS

Sport participation alone does not guarantee children will reach the PA guidelines, and the type of sport can influence children's PA levels. Gender-stereotypes in sports may prevent girls from achieving their 60 minutes of MVPA daily.

Physical Activity Report Card Indicators and the United Nations Sustainable Development Goals: Insights From Global Matrix 4.0

BACKGROUND

The World Health Organization recognizes that physical activity (PA) during childhood is crucial for healthy development, aligning well with the achievement of several United Nations (UN) Sustainable Development Goals (SDGs). This study aimed to explore the associations between 10 key indicators of PA for children and adolescents assessed in the Global Matrix 4.0 project, and the UN SDGs.

METHODS

Data from 57 countries/jurisdictions of the Global Matrix 4.0 project were used. The UN SDG indicators were sourced from the SDG Transformation Center, which publishes each country's performance on each of the 17 SDGs. Given the robust evidence supporting plausible links between PA and SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions), these SDGs were investigated.

RESULTS

Countries/jurisdictions with good and moderate performance in achieving SDG 3, SDG 9, SDG 11, and SDG 16 had higher grades than countries/jurisdictions with fair performance in achieving these SDGs for the following indicators: Organized Sports and PA, Community and Environment, and Government Investments and Strategies. However, countries/jurisdictions with good performance in achieving SDG 13 had lower grades than countries/jurisdictions with fair performance in achieving SDG 13 for the following indicators: Organized Sports and PA, Community and Environment, and Government Investments and Strategies.

CONCLUSIONS

Organized Sports and PA, Community and Environment, and Government Investments and Strategies were the indicators that demonstrated differences between countries/jurisdictions with good and poor performance in achieving the SDGs.

The impact of COVID-19-induced distance learning on physical activity and dietary habits of female students in the Qassim Region

Background

The COVID-19 pandemic has profoundly affected the physical activity (PA) levels and dietary habits of individuals, particularly children and adolescents in Saudi Arabia, owing to widespread closures and social distancing measures, including school closures.

Methods

A cross-sectional study was conducted to assess the impact of distance learning (DL) on PA and dietary habits among public middle school girls during the pandemic. The Arab Teens Lifestyle Questionnaire (ATLS) was used to assess habitual PA, sedentary behavior, and dietary habits.

Results

A total of 300 middle school female students, with an average age of 14 years, participated in the study. The results indicated a generally low level of PA among students during DL and after school reopening, with a significant decrease in specific types of PA, such as walking and stair climbing during DL. However, after schools reopened, there was a significant increase in students' participation in activities such as swimming, dancing, and housework (P < 0.05). Moreover, sleep hours and TV-watching time increased compared to the DL period. Despite the prevalence of students frequently consuming soft drinks, sugary treats, fried and fast foods, as well as sweets and chocolates during the lockdown, middle school girls also consumed a lot of fruits and vegetables.

Conclusion

Assessing students' habitual PA and dietary habits during the lockdown may provide insights into their future health and well-being post-pandemic. This assessment can help in identifying strategies to redirect current PA levels to maintain health and prevent potential long-term health implications.

Are school settings restricting access to daily physical activity for children with cystic fibrosis? Parents' perspectives and recommendations for practice

BACKGROUND

Cystic Fibrosis (CF) is a genetic life limiting disease that impacts upon quality of life. An aim of CF care is to preserve lung function, with physical activity (PA) being an important part of daily airway clearance. Ensuring children have opportunities to engage in PA at school should be an important part of their daily routine. It is important to gain parental perspectives on this, as they manage the daily care for their children. This study aims to explore parents' perceptions of school-based PA for their children with CF.

METHODS

Parents of children with CF (n = 10), from three regions of the UK (England, Wales and Northern Ireland) took part in online semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

Although parents recognized the benefits of school-based PA for their children, systemic barriers in the school setting often inhibit daily PA for children with CF, including teachers' misconceptions, emotional and physical barriers, and PA not being a priority.

CONCLUSION

Recommendations for practice have been developed to help engage children with CF in daily school-based PA in an inclusive way, with the hope of maintaining health outcomes for children with CF.

Eating in the Absence of Hunger Is a Stable Predictor of Adiposity Gains in Middle Childhood

BACKGROUND

Eating in the absence of hunger (EAH) is a behavioral phenotype of pediatric obesity characterized by the consumption of palatable foods beyond hunger. Studies in children have identified EAH to be stable over time, but findings are unclear on whether it predicts the development of adiposity, particularly in middle childhood, a period of increased autonomy over food choices.

OBJECTIVES

We hypothesized that EAH would remain stable and be associated with increased adiposity over a ≥1-y prospective study in 7-8-y old children without obesity. Secondary hypotheses tested whether physical activity moderated the impact of EAH on adiposity.

METHODS

Children (n =72, age 7.8 ± 0.6 y; BMI% <90th), in a 7-visit longitudinal study, had EAH, adiposity, and physical activity assessed at baseline (time 1 - T1) and follow-up (time 2 - T2). EAH was determined by measuring children's intake from 9 energy-dense (>3.9 kcal/g) sweet and savory foods during a 10-min access period after intake of a standard meal eaten to satiation. Adiposity was measured by dual-energy X-ray absorptiometry (DXA), with an outcome of fat mass index (FMI; fat mass/height in m2). Seven days of wrist-worn Actigraphy quantified moderate-to-vigorous-physical activity (MVPA) and sedentary time.

RESULTS

EAH had moderate stability across time points (ICC = 0.54). ICCs were stronger for sweet (ICC = 0.53) than savory (ICC = 0.38) foods. Linear regression predicting 1-y change in FMI (adjusted for income, parent education, sex, time to follow-up, T2 Tanner stage, maternal weight status, and baseline adiposity) found that both total and sweet food EAH at baseline predicted increases in adiposity (P < 0.05 for both). EAH and adiposity were negatively correlated among children with high MVPA and low sedentary time.

CONCLUSIONS

These findings show that EAH is a stable predictive phenotype of increases in adiposity over 1 y among youth in middle childhood, although activity-related behaviors may moderate this effect. If replicated, targeting EAH as part of interventions may prevent excess adiposity gain.

TRIAL REGISTRATION NUMBER

The data was obtained from the Food and Brain study with registration number: NCT03341247.

Associations of perceived neighbourhood and home environments with sedentary behaviour among adolescents in 14 countries: the IPEN adolescent cross sectional observational study

BACKGROUND

Understanding environmental correlates of sedentary behaviour (SB) among young people is important as such data can identify approaches to limit sedentary time. This paper estimates associations of parent-reported neighbourhood and adolescent-reported home environments with SB among adolescents aged 11-19 years from 14 countries.

METHODS

In the International Physical activity and the Environment Network (IPEN) Adolescent Study (an observational, cross-sectional multi-country study), adolescents wore a triaxial accelerometer for seven days that assessed sedentary time (ST). Adolescents completed survey measures of sedentary behaviour (SB) related to recreational screen time and sitting time in motor vehicles. Parents and adolescents completed surveys assessing neighbourhood and home environments. Accelerometer based ST was available in 3,982 adolescents while survey data were available for 6,302 dyads. We estimated the total and direct effects of each environmental attribute on ST and SB. Sex of the adolescent and city/country were examined as moderators.

RESULTS

The average ST in adolescents from 14 countries ranged from 7.8 to 10.5 h/day. Personal social media was the only significant correlate of total ST across both sexes. With respect to self-reported SB, adolescents accumulated an average of 3.8 h of non-school screen time per day and nearly 40 min of transport-related sitting time. Screen time was associated with all home environment variables, including social media account, as well as land use mix-diversity, traffic safety, and crime safety. Transport-related sitting time was related to land use mix-diversity, recreation facilities, walking facilities, and pedestrian infrastructure, but no home environment variables. City/country and sex were significant moderators of several associations.

CONCLUSIONS

Both home and neighbourhood environment features were related to ST and SB. Having social media accounts emerged as a major contributor towards sedentarism in adolescents.

Relative age effect on the physical activity and sedentary behavior in children and adolescents aged 10 to 18 years old: a cross-sectional study in Japan

BACKGROUND

Few studies have shown that relatively younger children and adolescents (those born later in the same school year) were less likely to engage in physical activity in a phenomenon termed the relative age effect. Although these studies mainly targeted elementary and middle school students, no study has reported on the relative age effect on physical activity in ordinary high school students. Moreover, the relative age effect on sedentary behavior might show an opposite association with physical activity. Therefore, we aimed to clarify the relative age effects on physical activity and sedentary behavior across different school stages in Japanese children and adolescents.

METHODS

A cross-sectional questionnaire survey was conducted with 21,491 children and adolescents (elementary, middle, and high school students aged 10-18 years) in various Japanese regions from January 2018 to July 2019. Overall, 18,281 children and adolescents (10,299 boys and 7,982 girls) were finally included in our analysis. Data on the birth month, frequency and duration of their physical activity (vigorous, moderate, and moderate-to-vigorous intensity), and sedentary behavior (weekday and weekend total sedentary time, television viewing, playing video games, and Internet use) were obtained. We utilized two-part model regression analyses. Statistically significant association with birth month indicated that a relative age effect was observed.

RESULTS

The relatively younger individuals were less likely to engage in physical activity (especially vigorous physical activity (VPA)); this association was observed in middle and high school students. Conversely, the relatively younger boys spent more time during weekends with sedentary behaviors and Internet use. Based on school stage, the relative age effect on VPA time was observed in middle school boys (average margin effect (AME) = -0.74, p < 0.01) and high school students (boys: AME = -0.69, p < 0.01; girls: AME = -0.53, p < 0.05). The relative age effect on sedentary behavior was observed during weekends with sedentary behaviors (AME = 3.55, p < 0.01), playing video games (AME = 0.72, p < 0.05) and Internet use (AME = 2.46, p < 0.01) for male high school students and on television viewing (AME = 1.12, p < 0.05) for female middle school students.

CONCLUSION

The relative age effect on physical activity can persist after middle school, and the relatively younger individuals are more likely to replace physical activity with sedentary behavior.

Intervention Mapping for Refining a Sport-Based Public Health Intervention in Rural Schools

Sport-based youth development programs, delivered through campus-community partnerships, can create impactful experiences for college students, meet university objectives, and improve the health of children in under-resourced rural communities. This study aimed to pilot test intervention mapping (IM), a systematic approach to intervention development and implementation, to refine the Hoosier Sport intervention, which is a local public health initiative that utilizes the Obesity-Related Behavioral Intervention Trials (ORBITs) model to improve physical activity in middle school children. The IM process, which included a diverse IM planning and advisory group of university representatives and local schools, was guided by self-determination theory (SDT) and social cognitive theory (SCT) and followed four steps: Logic Model of the Problem, Logic Model of Change, Program Design, and Program Production. Using SDT and SCT, we identified our personal determinants as autonomy, competence, and relatedness, while our environmental determinants were role-modeling and sports equipment access. We then created change methods and practical applications for refining and implementing our intervention and gathered pilot test data to assess the feasibility of the intervention. The IM process provided a more robust and evidence-based approach to intervention design and production, while involving stakeholders to foster meaningful collaboration and increase program success. By using IM in program development, public health interventions that promote youth development through sport will likely be more easily scaled up.

Getting up for brain health: Association of sedentary behavior breaks with cognition and mental health in children

Children spend most of their waking hours sedentary and reducing this behavior has been challenging. Interrupting prolonged episodes of sedentary behavior with active breaks can provide mental and cognitive health benefits. Considering the multifactorial nature of these health aspects, this study aimed to verify the role of body mass index (BMI), cardiorespiratory fitness (CRF), and moderate to vigorous physical activity (MVPA) in the relationship between the break in sedentary time with cognitive and mental health in children. This is a cross-sectional study with 129 children (62 boys), aged between 6 and 11 years (mean 8.73 ± 1.53) from a public school in southern Brazil. For the assessment of fluid intelligence, psychologists applied Raven's Colored Progressive Matrices test. Mental health was measured using the Strengths and Difficulties Questionnaire. Sedentary breaks were measured using accelerometers, and CRF was determined using the 6-min walk test. Generalized linear regression analyses were used to verify associations of sedentary breaks with fluid intelligence and mental health, according to children's BMI, CRF, and MVPA. All models were adjusted for sex, age, somatic maturation, and total time of accelerometer use. Our results indicated that sedentary breaks were associated with fluid intelligence in overweight/obese (β = 0.108; p = 0.021) and physically inactive children (β = 0.083; p = 0.010). Regarding mental health, no association was identified with sedentary breaks. In conclusion, sedentary breaks should be encouraged for the benefits of fluid intelligence, especially in children who do not meet physical activity recommendations and are overweight.

Exercise Mediates Noncoding RNAs in Cardiovascular Diseases: Pathophysiological Roles and Clinical Application

Exercise-based cardiac rehabilitation is effective in improving cardiovascular disease risk factor management, cardiopulmonary function, and quality of life. However, the precise mechanisms underlying exercise-induced cardioprotection remain elusive. Recent studies have shed light on the beneficial functions of noncoding RNAs in either exercise or illness models, but only a limited number of noncoding RNAs have been studied in both contexts. Hence, the present study aimed to elucidate the pathophysiological implications and molecular mechanisms underlying the association among exercise, noncoding RNAs, and cardiovascular diseases. Additionally, the present study analysed the most effective and personalized exercise prescription, serving as a valuable reference for guiding the clinical implementation of cardiac rehabilitation in patients with cardiovascular diseases.

Differences in physical activity, sedentary time, and anthropometric variables among children and adolescents: The TUBON project

BACKGROUND

Although physical inactivity may lead to increasing obesity prevalence, research on anthropometric variables changes based on physical activity (PA) in children and adolescents is limited. PA decreases with age, while sedentary behavior increases. The study aimed to examine differences in objectively measured sedentary time, light-intensity physical activity (LPA), and moderate-to-vigorous intensity physical activity (MVPA) between children and adolescents, and the differences in the percentiles of anthropometric variables between physically active and inactive groups according to World Health Organization PA recommendations.

METHODS

A total of 759 participants aged 6-17 years (boys, n=358; girls, n=401) were included in the study. The ActiGraph wGT3x-BT accelerometer was used to measure sedentary time, LPA, and MVPA. Height, weight, waist circumference (WC), triceps skinfold thickness (T-SFT), and medial-calf skinfold thickness (M-SFT) were measured. Body fat percentage (BF%) and body mass index (BMI) were calculated, and the percentiles of anthropometric variables were categorized.

RESULTS

The findings showed that children had less sedentary time and a higher LPA than adolescents for both genders (p<0.05). Children had a higher MVPA than adolescents in girls (p<0.05), but the difference was insignificant in boys (p>0.05). In boys, physically active children were in lower percentiles for T-SFT and BF% than those who did not (p<0.05). In boys, adolescents who were physically inactive were in higher percentiles for BMI, T-SFT, M-SFT, and BF% (p<0.05). In addition, in girls, adolescents who were physically active were in lower percentiles of BMI, M-SFT, and BF%, whereas children who were physically active were in lower percentiles of M-SFT and BF% (p<0.05).

CONCLUSION

Sedentary time increases while PA decreases with age. Children and adolescents who met the WHO PA recommendation had lower percentiles of anthropometric variables, indicating the importance of PA in preventing obesity in these age groups.

Cross-sectional survey of gender differences in gross motor skills among preschool children in Jinhua City, China

Background

While gender differences in ball skills are widely recognized, the differences in locomotor skills remain unclear. This study aims to explore these gender differences among preschool children in Jinhua City, China, and to examine the influence of evolutionary factors and local cultural activities on these skills.

Methods

A cluster random sampling method was employed to select 777 preschool children aged 5.1-6.7 years from seven kindergartens in Jinhua, Zhejiang Province, Eastern China. The Test of Gross Motor Development-Third Edition (TGMD-3) was used to assess GMS, including locomotor and ball skills.

Results

Boys outperformed girls in ball skills, such as underhand throwing, catching, two-handed striking, and kicking. However, no significant overall gender differences were found in locomotor skills. A deeper analysis revealed that boys excelled in running-related tasks, whereas girls performed better in skipping-related tasks. These findings suggest that TGMD-3 locomotor skills should be divided into running-related and jumping-related categories. The results also show that not all ball skills are dominated by boys, indicating the impact of environmental factors. The findings highlight the role of both evolutionary factors and local cultural activities in shaping these specific gender differences.

Conclusion

The study's cross-sectional design provides a snapshot of existing gender differences in motor skills among preschool children. The results suggest the need for gender-sensitive physical education programs to address these disparities early on. Future research should utilize longitudinal methods and objective measures to further understand the development of these skills over time and the underlying factors contributing to these differences.

The Mediating Role of Physical Activity and Self-Rated Health in the Association Between Depression and Quality of Life in Older Europeans: An Analysis Differentiated by Sex

Objectives: This study investigates the mediating role of moderate physical activity (MPA), vigorous physical activity (VPA), and self-rated health (SRH) in the association between depression and quality of life (QoL) in a large sample of Europeans aged 50 and over, differentiated by sex. Methods: Data from the 2017 Survey of Health, Ageing and Retirement in Europe were analyzed, including 11,986 individuals (6843 women) aged 50 and older. All information was collected through face-to-face interviews: sociodemographic data, SRH, physical activity levels, depression (EURO-D scale), and QoL (CASP-12). Results: Comparatively, women reported a higher prevalence of depression, a lower perception of QoL, and slightly lower levels of SRH, MPA, and VPA. Parallel mediation models revealed, for both sexes, that an increase in VPA levels was more effective in benefiting SRH; and MPA proved to be a better promoter of QoL. When comparing sexes, only the path depression → VPA → QoL showed a significant difference (p < 0.001). Conclusions: These results provide valuable insights for developing physical activity interventions capable of improving mental health and promoting QoL in older European adults.

Parental obesity, health determinants, and cardiometabolic risk according to sleep duration in schoolchildren: analysis through structural equations

BACKGROUND

the independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time.

METHODS

This cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis.

RESULTS

The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model.

CONCLUSION

Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents.

Systematic review and meta-analysis of combined cognitive-behavioral therapy and physical activity and exercise interventions for pediatric chronic disease

OBJECTIVE

Cognitive-behavioral (CBT) interventions combined with either a physical activity (CBT+PA) or exercise intervention (CBT+Ex) are becoming more common in pediatric populations. Considering the independent effects of PA and exercise on health and psychological outcomes, it is unclear whether CBT alone differs from CBT+PA or CBT+Ex in efficacy. The main objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to assess the efficacy of CBT+PA and CBT+Ex interventions in pediatric chronic disease.

METHOD

This review included RCTs in children (≤18 years) with a chronic condition, a CBT+Ex or CBT+PA intervention, and an objective measure of PA&Ex. Seven databases were searched using MeSH terms and key terms and included studies published before July 1, 2023. Abstracts were reviewed for inclusion by two independent reviewers, data was extracted by three independent reviewers. Risk of bias (RoB 2) and study quality were coded. Random effect meta-analyses of differences in between-group change in PA&Ex were conducted.

RESULTS

Eligible studies (k = 5) reported outcomes for a combined 446 children. A small, nonsignificant overall effect was found (d = 0.10, 95% CI -0.16, 0.35) indicating intervention groups (CBT+PA or CBT+Ex) increased engagement in PA&Ex more than comparator groups (CBT). Additional analyses were inconclusive due to the small number of eligible studies.

DISCUSSION

Additional RCTs are needed with integrated PA&Ex interventions targeting pediatric chronic disease. Future trials should report more detailed PA&Ex data. The full protocol for this analysis was prospectively registered in Open Science Framework (project ID: osf.io/m4wtc).

Mediators of the association between physical activity and executive functions in primary school children

There is growing interest in identifying the mechanisms underpinning the effects of physical activity on executive functions (e.g. inhibitory control, cognitive flexibility) in children. Our study examined cardiorespiratory fitness, muscular fitness, and motor competence as potential mediators of this relationship. The study used baseline data from the Learning to Lead (L2L) cluster randomised controlled trial. In total, 675 children (7-11 years, 49.5% girls) completed measures of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness, muscular fitness, motor competence, and executive functions. Structural equation modelling was used to examine the potential mediating roles of cardiorespiratory fitness, muscular fitness, and motor competence in the cross-sectional association between MVPA and executive functions. Cardiorespiratory fitness (β = 0.06, SE = 0.021, p = 0.004) partially mediated the association between MVPA and cognitive flexibility. Muscular fitness was a significant mediator of the association between MVPA and both inhibitory control (β = 0.03, SE = 0.014, p = 0.027) and cognitive flexibility (β = 0.06, SE = 0.021, p = 0.005). No significant mediated effects were found for motor competence. Our findings suggest cardiorespiratory and muscular fitness (but not motor competence) mediate the association between physical activity and executive functions in children.

How can digital citizen science approaches improve ethical smartphone use surveillance among youth: Traditional surveys versus ecological momentary assessments

Ubiquitous use of smartphones among youth poses significant challenges related to non-communicable diseases, including poor mental health. Although traditional survey measures can be used to assess smartphone use among youth, they are subject to recall bias. This study aims to compare self-reported smartphone use via retrospective modified traditional recall survey and prospective Ecological Momentary Assessments (EMAs) among youth. This study uses data from the Smart Platform, which engages with youth as citizen scientists. Youth (N = 77) aged 13-21 years in two urban jurisdictions in Canada (Regina and Saskatoon) engaged with our research team using a custom-built application via their own smartphones to report on a range of behaviours and outcomes on eight consecutive days. Youth reported smartphone use utilizing a traditional validated measure, which was modified to capture retrospective smartphone use on both weekdays and weekend days. In addition, daily EMAs were also time-triggered over a period of eight days to capture prospective smartphone use. Demographic, behavioural, and contextual factors were also collected. Data analyses included t-test and linear regression using Python statistical software. There was a significant difference between weekdays, weekends and overall smartphone use reported retrospectively and prospectively (p-value = <0.001), with youth reporting less smartphone use via EMAs. Overall retrospective smartphone use was significantly associated with not having a part-time job (β = 139.64, 95% confidence interval [CI] = 34.759, 244.519, p-value = 0.010) and having more than two friends who are physically active (β = -114.72, 95%[CI] = -208.872, -20.569, p-value = 0.018). However, prospective smartphone use reported via EMAs was not associated with any behavioural and contextual factors. The findings of this study have implications for appropriately understanding and monitoring smartphone use in the digital age among youth. EMAs can potentially minimize recall bias of smartphone use among youth, and other behaviours such as physical activity. More importantly, digital citizen science approaches that engage large populations of youth using their own smartphones can transform how we ethically monitor and mitigate the impact of excessive smartphone use.

Secular trends in risk factors for adolescent anxiety and depression symptoms: the Young-HUNT studies 1995-2019, Norway

In recent decades, increases in mental health problems in adolescents have been reported from several large population-based surveys. This raises questions about changes in underlying risk and protective factors that can inform future intervention strategies. Population data were collected from 1995 to 2019 in three waves of the Young-HUNT studies in Norway to map decennial trends in the prevalence of established risk factors for, and their associations with, adolescent mental health problems. All adolescents (aged 13-19 years) attending lower and upper secondary school in the county of Trøndelag were invited, representing three historical cohorts of 25,245 unique adolescents. Mental health problems (HSCL-5) and established mental health risk factors were self-reported. Using a generalized linear model and linear regression, we calculated changes in relative and absolute differences between risk factors and mental health problems. Overall, the prevalence of established risk factors for mental health problems in adolescence increased markedly between 1995 and 2019, especially in girls. Prominent increases were observed for fatigue, bullying, musculoskeletal pain and migraine, loneliness, and overweight. Furthermore, with the exception of excess alcohol use and family economy, associations between each risk factor and adolescent mental health problems strengthened over the same time span in girls, but less among boys. Our findings suggest that several modifiable risk factors for poor mental health in adolescence are increasing, especially among girls, and should be targeted in community, school, and in clinical settings.