Active lifestyle in childhood and adolescence prevents obesity development in young adulthood

Associations Between Youth Sport Participation and Bone, Muscle, and Fat in Adulthood: Iowa Bone Development Study

The objective of this study was to characterize bone, muscle, and fat measurements in early adulthood by youth sport participation. The study sample included 328 Iowa Bone Development Study participants (184 females). Organized sport participation was longitudinally assessed (14 times on average) using a physical activity questionnaire from age 6 to 17 years. At age 23 years, bone, lean mass (a proxy measure of muscle mass), and fat mass were assessed using dual-energy X-ray absorptiometry (DXA). Tibial bone stiffness, a bone strength indicator, was determined using high-resolution multi-row detector computed tomography (CT) and Finite Element Analysis. Longitudinal youth sport participation patterns were categorized into consistent participation, drop-out, and no participation. Sex-specific multivariable linear regression analyses were conducted to examine the associations between youth sport participation patterns and bone mineral content (BMC), lean mass index (LMI), fat mass index (FMI), BMC-to-lean ratio, lean-to-fat ratio, and tibial bone stiffness at age 23 years. After adjusting for covariates, males in the consistent youth sport participation and drop-out groups had 377 g and 192 g higher BMC, 1.6 kg/m2 and 1.5 kg/m2 higher LMI, and 112 kN/mm and 76 kN/mm higher bone stiffness at age 23, compared to males in the no-participation group (p < 0.01). Females in the consistent youth sport participation group had 1.4 kg/m2 lower FMI at age 23, compared to females in the no-participation group (p = 0.04). The BMC-to-lean ratio was higher among males (p = 0.02) and females (p < 0.01) in the consistent participation group, compared to their counterparts in the no-participation group; the lean-to-fat ratio also tended to be higher in males (p = 0.06) and females (p = 0.11). This study suggests sex differences in the benefits of youth sport participation on adulthood body compartments: healthier bone and muscle for males and healthier body fat for females. This study provides evidence to support the promotion of youth sport participation for healthy body composition later in life.

Moderate to Vigorous Physical Activity Patterns and Cardiometabolic Risk Factors in Urban Indian Children

OBJECTIVE

To determine the duration of moderate to vigorous physical activity (MVPA), perceived barriers to physicaly activity and examine its association with cardiometabolic risk factors in Indian children.

METHODS

Sociodemographic data, physical activity patterns and the barriers to physical activity were collected using questionnaires, from urban children aged 6-19 years residing in Bengaluru, Karnataka. Anthropometry, body composition, blood pressure, glycated hemoglobin, and lipid profile were measured.

RESULTS

The mean (SD) age of a total of 4004 enrolled children was 13.1 (2.5) years; 17.8% were overweight/obese. The median (IQR) duration of MVPA was 7.7 (0.0, 44.1) minutes/day, with 81% (n = 3252) not meeting the MVPA recommendation, particularly girls (88.6%; n = 1980/2234). In adjusted analysis, children who did not engage in MVPA had elevated systolic blood pressure (mm Hg) [1.07 (95% CI 0.40, 1.35)] and diastolic blood pressure (mm Hg) [1.09 (95% CI 0.40, 1.77)]. Significant barriers to engaging in physical activity included time constraints due to academic work and lack of space/facilities.

CONCLUSION

Indian children do not meet the required daily MVPA recommendations; academic demands and limited access to space/facilities were significant barriers to physical activity. Children who did not engage in any form of MVPA had significantly higher blood pressure.

Comparing and intervening on behavioral demand for snack foods among justice-involved adolescents: A preliminary translational analysis

Obesity may be more prevalent among populations who are of low socioeconomic status, have limited access to nutrient-dense foods, or both. One such population is justice-involved youth. This series of translational experiments builds on previous research on food reinforcement and behavioral demand by (a) assaying demand for snack foods among justice-involved adolescents and (b) evaluating the effect of a nutrition intervention on justice-involved adolescents' demand for healthier alternatives. In Experiment 1, participants completed preference assessments for high- and low-energy-density snack foods and corresponding commodity purchasing tasks. The results indicated significant differences in demand based on energy density and preference. In Experiment 2, justice-involved adolescents received a nutrition intervention. Following intervention, participants repeated preference assessments and commodity purchasing tasks. The researchers used mixed-effects modeling to evaluate the effect of (a) the intervention, (b) participant age, and (c) the amount of intervention received on pre-post differences in demand for healthier alternatives. Results and implications are discussed along with future directions for improving conditions of confinement for justice-involved adolescents.

The Overflow Effects of Movement Behaviour Change Interventions for Children and Adolescents: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

BACKGROUND

Considering the finite time within a 24-h day, the distribution of time spent on movement behaviours has been found to be associated with health outcomes.

OBJECTIVES

This systematic review and meta-analysis aimed to summarise and evaluate the overflow effects of interventions targeting a single behaviour (physical activity, sedentary behaviour/screen time, or sleep) on other non-targeted behaviours among children and adolescents.

METHODS

Six databases (MEDLINE [Ovid], PsycINFO [ProQuest], EMBASE [Ovid], PubMed, Web of Science and SPORTDiscus [EBSCO]) were searched for relevant studies published before 13 May, 2024. Randomised controlled trials and clustered randomised controlled trials that targeted a single behaviour and also assessed the effects on non-targeted behaviours, comprised of healthy children under the age of 18 years, were included. Movement behaviours can be measured either objectively or subjectively. The revised Cochrane risk-of-bias tool for randomised trials was adopted to evaluate the risk of bias.

RESULTS

A total of 102 studies with 45,998 participants from 21 countries were identified, and 60 of them with 26,183 participants were incorporated into the meta-analysis. The meta-analysis demonstrated that physical activity interventions led to a reduction in the proportion of each day spent in sedentary behaviour (mean difference =  - 0.95% of wear time, 95% confidence interval - 1.44, - 0.45, I2 = 39%). Sedentary behaviour interventions resulted in increased standing time (mean difference = 3.87%, 95% confidence interval 1.99, 5.75, I2 = 0%). Interventions targeting screen time did not yield changes in physical activity or sleep. The findings on the effectiveness of sleep interventions on non-targeted behaviours and of physical activity interventions on sleep were inconclusive.

CONCLUSIONS

Overall, the findings suggested that interventions aimed at increasing physical activity or reducing sedentary behaviour had overflow effects on non-targeted behaviours, but the effect sizes were small. Additional evidence is needed to reach definitive conclusions regarding the impact of behaviour change interventions on sleep and of the overflow effects of sleep interventions.

Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students

BACKGROUND/OBJECTIVES

This study aimed to investigate the association of body mass index (BMI) with the weekly frequency of moderate-intensity physical activity, eating behavior, and the use of the Internet or games among Korean middle school students.

METHODS

The data of 23,583 Korean middle school students were collected from the 2023 Korean Student Health Examination. The collected data were analyzed using frequency, chi-square, and multivariate logistic regression analyses.

RESULTS

The results also showed that the higher the BMI, the greater the likelihood of moderate-intensity physical activity. The likelihood of breakfast intake reduced as the BMI increased. However, the likelihood of using the Internet or games increased with an increase in BMI. The results revealed that 28% (6594 of 23,583) of middle school students rarely participate in moderate-intensity physical activity, while 32% (7553 of 23,583) participate only once or twice a week. The results also showed that the higher the BMI, the higher the likelihood of moderate-intensity physical activity. Among those who were underweight, the odds ratio (OR) of 3-4 days of participation in moderate-intensity physical activity was 0.764 (95% confidence interval [CI]: 0.664-0.880; p < 0.001). Among those who were healthy, the OR of more than 5 days of participation was 1.279 (95% CI: 1.131-1.446; p < 0.001). Among those who were overweight, the OR of 3-4 days and more than 5 days of participation was 1.172 (95% CI: 1.019-1.348; p = 0.026) and 1.181 (95% CI: 1.011-1.380; p = 0.036), respectively. The likelihood of the use of the Internet or games increased with an increase in BMI. The OR of the use of the Internet or games was 0.876 (95% CI: 0.806-0.952; p = 0.002) and 0.824 (95% CI: 0.743-0.913; p < 0.001) among those who were healthy and those who were overweight, respectively. However, the likelihood of breakfast intake reduced as the BMI increased. Among those who were underweight, the OR of always eating breakfast and mostly eating breakfast was 1.299 (95% CI: 1.114-1.515; p < 0.001) and 1.236 (95% CI: 1.045-1.461; p = 0.013), respectively. Among those who were healthy, the OR of always eating breakfast was 1.157 (95% CI: 1.026-1.305; p = 0.018). Among those who were overweight, the OR of mostly eating breakfast was 1.215 (95% CI: 1.030-1.433; p = 0.021).

CONCLUSIONS

Given this, outdoor sports may increase adolescents' participation in physical activities by helping them break away from repetitive ball games and increasing their overall interest and participation in physical activities. Overall, our results suggest the need to move away from traditional physical education and develop engaging physical activity programs that motivate students to participate in moderate-intensity physical activities.

Longitudinal physical activity patterns and the development of cardiometabolic risk factors during adolescence

PURPOSE

To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood.

METHODS

This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (via a data-driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear-time.

RESULTS

Insulin and BMI increased among decreasers from moderate to low PA (β for insulin 0.23, 95% CI 0.03-0.46; β for BMI 0.90; CI 0.02-1.78). The concentration of HDL cholesterol decreased (β -0.18, CI -0.31 to -0.05) and that of glucose increased (β 0.18, CI 0.02-0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic β -6.43, CI -12.16 to -0.70; diastolic β -6.72, CI -11.03 to -2.41).

CONCLUSIONS

Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline.

Leisure-time physical activity trajectories from adolescence to adulthood in relation to several activity domains: a 27-year longitudinal study

BACKGROUND

Insufficient physical activity (PA) levels among adolescents and adults make promoting PA a public health priority. Although most people exhibit low or decreasing levels of PA, other groups increase or maintain high levels of activity. These different groups may engage differently in activity domains during their leisure time. This study aimed to identify distinct trajectories of leisure-time vigorous physical activity (LVPA) and to explore whether these trajectories are characterised by differences in four activity domains (participation in organised sports clubs, diversity in leisure-time activities, outdoor recreation, and peer PA) over the life course.

METHODS

Data were drawn from the Norwegian Longitudinal Health Behaviour Study. The sample of participants (n = 1103, 45.5% female) was surveyed 10 times from age 13 years in 1990 to age 40 years in 2017. LVPA trajectories were identified using latent class growth analysis, and mean differences in activity domains were studied using the one-step BCH approach.

RESULTS

Four trajectories were identified: active (9%), increasingly active (12%), decreasingly active (25%), and low active (54%). Overall, this analysis showed a declining tendency in LVPA from age 13 to 40 years except for the increasingly active trajectory. Belonging to a trajectory with a higher LVPA level was related to higher mean levels of the included activity domains. Compared with those in the increasing trajectory, people belonging to the decreasing trajectory reported higher mean participation levels in and age at becoming a member of sports clubs, diversity in leisure-time activities, and best friend's activity level during adolescence. However, in young adulthood, people in the increasingly active trajectory reported significantly higher mean levels for the same variables.

CONCLUSIONS

The development of LVPA from adolescence to adulthood is heterogeneous, suggesting the need for targeted health promotion initiatives. The largest trajectory group included more than 50 percent and was characterized by low levels of LVPA, less engagement in PA domains and fewer active friends. There seems to be little carry-over effect of engagement in organised sports in adolescence regarding level of LVPA later in life. Changes in social surroundings throughout the life span, such as having friends who are more or less engaged in PA, may assist or hinder health enhancing engagement in LVPA.

Association between genetic risk score and tri-ponderal mass index growth trajectories among different dietary consumption adolescents in a prospective Taiwanese cohort

BACKGROUND

Single-nucleotide polymorphisms (SNPs) in various genetic loci are associated with childhood obesity; however, their influence on adolescent growth patterns has rarely been explored. This study investigated whether genetic variants could predict tri-ponderal mass index (TMI)-derived growth trajectories and the interaction between genetic and dietary factors.

METHODS

We conducted Taiwan Puberty Longitudinal Study, a prospective cohort that recruited 1,135 children since 2018. Anthropometric measurements were recorded every three months, while dietary nutrition assessment and biological sampling for genotyping were collected during the first visit. TMI growth trajectory groups were identified using growth mixture modeling. A multinomial logistic regression model for different growth trajectories was used to examine the effect of candidate SNPs, and the most related SNPs were used to establish the genetic risk score. We then explored the effect of the genetic risk score in subgroup analysis according to dietary calories and different dietary consumption patterns.

RESULTS

Three TMI-based growth trajectory groups were identified among adolescents. The "increased weight" trajectory group accounted for approximately 9.7% of the participants. FTO/rs7206790 was associated with the increased weight growth trajectory after adjusting for the baseline TMI and other correlated covariates (OR: 2.13, 95% CI: 1.08-4.21). We generated the genetic risk score using 4 SNPs (FTO/rs7206790, ADCY9/rs2531995, TFAP2B/rs4715210, and TMEM18/rs6548238) and selected the threshold of 10 points to define risk categories. There were 11.66% and 3.24% of participants belonged to the increased weight trajectory in high- and low-risk groups, respectively; and the predictive ability of the genetic risk score was notable among low calories intake participants (OR: 1.90, 95% CI: 1.18-3.05 vs. OR: 1.17, 95% CI: 0.78-1.75 in high calories intake group).

CONCLUSION

Our results offer a new perspective on the genetic and dietary basis of changes in adolescent obesity status. Individualized interventions for obesity prevention may be considered among high-risk children.

Correlation between Language Development and Motor Skills, Physical Activity, and Leisure Time Behaviour in Preschool-Aged Children

Sedentary behaviour has a negative impact on children’s physical and mental health. However, limited data are available on language development. Therefore, this pilot study aimed to analyse the associations between language development and possible predictors such as motor skills and leisure time behaviour in preschool-aged children. Methods: In this cross-sectional analysis, motor skills and speech development status were assessed in 49 healthy preschool children. Physical activity and screen time were assessed via a parental questionnaire. Results: On average, physical activity was 8.2 ± 6.5 h/week; mean screen time was 154.2 ± 136.2 min/week. A positive relationship between the results in the item ‘One-leg stand’ and ‘Phonological working memory for nonwords’ (β-coefficient −0.513; p < 0.001) resp. ‘Formation of morphological rules’ (β-coefficient −0.626; p = 0.004) was shown within backward stepwise regression. ‘Lateral jumping’, resp. ‘Sit and Reach’ were positively associated with ‘Understanding sentences’ (β-coefficient 0.519; p = 0.001 resp. β-coefficient 0.735; p = 0.002). ‘Physical inactivity’ correlated negatively with all language development subtests (each p < 0.05). Media consumption had a negative predictive effect on the subdomain ‘Understanding Sentences’ (β-coefficient −0.530, p = 0.003). Conclusions: An inactive lifestyle correlated negatively with selected subtests of language development in early childhood. These results should be verified in larger groups and longitudinally but support the need for early health promotion.

Health-Related Fitness in Slovak High School Students in Prešov Region

The purpose of this study was to examine the physical characteristics, body composition, and health-related fitness components in Slovak high school students. Data on body composition and health-related fitness were obtained from 848 students attending 14 high schools in the Prešov self-governing region. Health-related fitness levels were determined using the FITNESSGRAM test battery. Body composition was measured using a direct segmental multifrequency bioelectric impedance analyzer InBody 230. The results of the study showed gender differences in anthropometric measures, body composition parameters, and health-related fitness components. Analysis of variance among subgroups with different performance levels in particular tests showed an effect on anthropometric measures and body composition, especially on abdominal strength and endurance and upper body strength and endurance. Regarding gender differences, boys were found to be taller and heavier in all age groups. The BMI values showed a normal rate of physical development in all age groups and both genders. Overall, body composition was more optimal for boys than for girls. Girls were found to have a higher degree of abdominal fat and visceral adiposity. Boys were found to have higher levels of upper body strength and endurance and abdominal strength and endurance. The difference in flexibility level was statistically significant between 16 year-olds.

Failure to Launch: Predictors of Unfavourable Physical Activity and Sedentary Behaviour Trajectories from Childhood to Adolescence: The Gateshead Millennium Study

In a previous study based on this cohort, only 15% of the participants belonged to a favourable physical activity/sedentary behaviour trajectory group (characterised by relatively high moderate–vigorous intensity physical activity and relatively low sedentary behaviour across childhood and adolescence). Since this favourable trajectory is protective against obesity, we aimed to identify factors associated with membership of this group. In this longitudinal study, 671 participants were assessed at ages 7, 9, 12 and 15 years. Participants’ demographics, socio-economic status (SES) and physical activity environment such as, sports club participation and commuting school were assessed at ages 7, 9 and 12 and analysed with favourable trajectory membership as an outcome using multinomial logistic regression. Sex (male) and SES (higher) were the non-modifiable factors associated with favourable trajectory group. Of the modifiable factors, commuting to school at age 7, a safe environment to play at age 7 and sports club participation at age 12 were all associated with more than 2.0 times increased probability of being in the most favourable trajectory. Future interventions to promote a favourable trajectory could focus on girls and participants with low SES. Promoting active commuting, safe local spaces to play and sports participation should also help lead to a favourable trajectory for physical activity and sedentary behaviour across childhood and adolescence.

Impact of Exercise and Detraining during Childhood on Brown Adipose Tissue Whitening in Obesity

This study aimed to investigate the influence of childhood exercise and detraining on brown adipose tissue (BAT) whitening in obesity. Four-week-old male Long-Evans Tokushima Otsuka (LETO) rats (n = 9) and Otsuka Long-Evans Tokushima Fatty (OLETF) rats (n = 24) were used as non-obese and obese animals, respectively. OLETF rats were divided into non-exercise sedentary (n = 9) and exercise groups. OLETF rats in the exercise group were further divided into subgroups according to the exercise period—exercise from 10- to 12-weeks-old (n = 6); and exercise from 4- to 6-weeks-old, and detraining from 6- to 12-weeks-old (n = 9). At 12-weeks-old, immediately after exercise period, BAT whitening in OLETF rats was inhibited by exercise despite the fact that hypertrophy was not caused in the plantaris muscle. However, the effectiveness was attenuated during the detraining period. Histological BAT whitening and downregulation of uncoupling protein-1 (UCP-1) were found in non-exercise sedentary OLETF rats at 12-weeks-old. The downregulation was not inhibited, even though exercise histologically inhibited BAT whitening in OLETF rats. Childhood exercise decreased BAT whitening in obesity. Detraining attenuated the inhibition of BAT whitening. These results suggest that regular exercise is needed to improve BAT whitening and downregulation of UCP-1 in obesity.

Moderate-To-Vigorous Intensity Physical Activity and Sedentary Behaviour across Childhood and Adolescence, and Their Combined Relationship with Obesity Risk: A Multi-Trajectory Analysis

The combined role of objectively assessed moderate-vigorous intensity physical activity (MVPA) and sedentary behaviour (SB) is unclear in obesity prevention. This study aimed to identify latent groups for MVPA and SB trajectories from childhood to adolescence and examine their relationship with obesity risk at adolescence. From the Gateshead Millennium Study, accelerometer-based trajectories of time spent in MVPA and SB at ages 7, 9, 12, and 15 were derived as assigned as the predictor variable. Fat mass index (FMI), using bioelectrical impedance at age 15, was the outcome variable. From 672 children recruited, we identified three distinct multiple trajectory groups for time spent in MVPA and SB. The group with majority membership (54% of the cohort) had high MVPA and low SB at childhood, but MVPA declined and SB increased by age 15. One third of the cohort (31%) belonged to the trajectory with low MVPA and high time spent sedentary throughout. The third trajectory group (15% of the cohort) that had relatively high MVPA and relatively low SB throughout had lower FMI (-1.7, 95% CI (-3.4 to -1.0) kg/m2, p = 0.034) at age 15 compared to the inactive throughout group. High MVPA and low SB trajectories when combined are protective against obesity.

Physical activity from adolescence to young adulthood: patterns of change, and their associations with activity domains and sedentary time

BACKGROUND

Longitudinal studies demonstrate an average decline in physical activity (PA) from adolescence to young adulthood. However, while some subgroups of adolescents decrease activity, others increase or maintain high or low activity. Activity domains may differ between subgroups (exhibiting different PA patterns), and they offer valuable information for targeted health promotion. Hence, the aim of this study was to identify PA patterns from adolescence to young adulthood; also to explore the associations of (i) changes in PA domains and in sedentary time, (ii) sociodemographic factors, and (iii) self-rated health with diverging PA patterns.

METHODS

The observational cohort study data encompassed 254 adolescents at age 15 and age 19. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Logistic regressions were applied in further analysis.

RESULTS

Five PA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, participation in sports clubs (SC, 41-97%) and active commuting (AC, 47-75%) was common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Inactivity maintainers reported the lowest amount of weekly school physical education. Dropout from SC - in contrast to non-participation in SC - was associated with higher odds of being a decreaser from high PA, and with lower odds of being an inactivity maintainer. Maintained SC participation was associated with higher odds of belonging to the decreasers from high PA, and to the combined group of activity maintainers and increasers; also with lower odds of being an inactivity maintainer. Maintenance/adoption of AC was associated with decreased odds of being an inactivity maintainer. Self-reported health at age 19 was associated with the patterns of maintained activity and inactivity.

CONCLUSIONS

PA patterns diverge over the transition to adulthood. Changes in SC participation and AC show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.

Association between Tobacco Consumption and Problematic Internet Use and the Practice of Physical Activity in Spanish Adolescents

The practice of physical activity (PA) is a healthy habit that offers health benefits. In contrast, the lack thereof may be associated with an increase in diseases, even at an early age. The objective of this study was to analyze the association between unhealthy behaviors, such as tobacco consumption and problematic internet use, and the practice of PA in adolescents. Protective factors (physical activity and sport) and risk factors (leading a sedentary life, tobacco use, and problematic internet use) were evaluated. Other variables such as sex, the intensity of physical activity, and being a member of a sports federation were also evaluated. The sample consisted of a total of 1222 Spanish adolescents. Univariate descriptive analysis and multiple linear regression were used, and confirmatory factor analyses and structural models were also estimated. The results confirm a significant positive association between physical activity, intensity, and being a member of a sports federation, as well as between cigarette consumption and internet use. It is advisable to implement public policies that promote the practice of sports as a direct investment in health, preventing the consumption of tobacco and other habits that are harmful to the health of adolescents.

Investigation of the associations between physical activity, self-regulation and educational outcomes in childhood

It is common knowledge that physical activity leads to physiological and psychological benefits. The current study explored the association between physical activity and self-regulation longitudinally and the indirect relationship this may have on academic achievement, using secondary data on primary and secondary school children from the Millennium Cohort Study, a cohort of infants born in 2000–2001 in the United Kingdom. There are two main findings. First, there is a positive link between physical activity and emotional (not behavioural) regulation both concurrently and longitudinally across all three time points, 7-years-old, 11-years-old and 14-years-old. The relationship was negative for emotional regulation and negligible for behavioural regulation when controlling for socioeconomic status. Second, across two time points (due to data availability), physical activity positively predicted academic achievement through emotional regulation for 7-year-olds and behavioural regulation in 11-year-olds. The impact of this relationship was more pronounced when controlling for socioeconomic status. Together these findings indicate that emotional regulation is linked to physical activity in early childhood. Subsequently, emotion regulation predicts academic attainment, suggesting that early interventions might focus on attention rather than behaviour.

Brief Report: Youth Living With Perinatally Acquired HIV Have Lower Physical Activity Levels as They Age Compared With HIV-Exposed Uninfected Youth

BACKGROUND

Few studies have evaluated physical activity patterns or their association with vascular inflammation among youth living with perinatally acquired HIV (YPHIV).

METHODS

We assessed YPHIV and youth perinatally HIV-exposed but uninfected (YPHEU) in the PHACS Adolescent Master Protocol with at least one Block physical activity questionnaire (PAQ) completed between ages 7-19 years. Physical activity metrics were as follows: (1) daily total energy expenditure (TEE) and (2) physical activity duration (PAD) defined as the minutes of daily moderate and vigorous activities. In a subgroup, we measured serum biomarkers of coagulation (fibrinogen and P-selectin) and endothelial dysfunction (soluble intracellular cell adhesion molecule-1, soluble vascular cell adhesion molecule-1, and E-selectin) obtained within 3 months of a single PAQ. Repeated measures linear regression models were used to compare the trajectories of log-transformed TEE and PAD by HIV status, adjusting for confounders. Spearman correlations were calculated to assess the relationship of TEE and PAD with vascular biomarkers.

RESULTS

Five hundred ninety-six youth (387 YPHIV and 209 YPHEU) completed 1552 PAQs (median PAQs completed = 3). The median age at enrollment (Q1, Q3) was 11 (9, 13) years. TEE and PAD increased with age in both YPHIV and YPHEU. However, even after adjusting for confounders, YPHIV had significantly less increase per year than YPHEU for TEE (5.7% [95% confidence interval (CI): -9.9% to -1.4%, P = 0.010] less) and PAD (5.2% [95% CI: -9.2% to -1.1%, P = 0.016] less). Among 302 youth with biomarker measures (187 YPHIV and 114 YPHEU), we observed little correlation with TEE or PAD.

CONCLUSIONS

Both groups had increases in physical activity levels as they aged, but YPHIV had smaller increases throughout adolescence compared with YPHEU, which may impact long-term health.

Moderate-to-vigorous intensity physical activity trajectories during adolescence and young adulthood predict adiposity in young adulthood: The Iowa Bone Development Study

This study examined the associations of moderate-to-vigorous intensity physical activity (MVPA) trajectories in adolescence through young adulthood with adiposity in young adults. Participants from The Iowa Bone Development Study cohort were longitudinally assessed (N = 297; 57% female). Accelerometry-measured MVPA (min/day) at ages 15 through 23 years, and fat mass and visceral adipose tissue mass indices (kg/m2, g/m2) derived from dual-energy X-ray absorptiometry scans at age 23 years were analyzed. Latent trajectory analyses classified MVPA into two patterns. Multivariable linear regression analyses showed that being in the high MVPA trajectory group was associated with lower fat mass index z-scores. Individuals who were consistently active with high MVPA (vs. moderately active with decreasing MVPA) during adolescence up until early young adulthood had less accumulation of total body adiposity in young adulthood. This study suggests that adopting a consistently active lifestyle throughout adolescence can result in healthier body composition in young adulthood.

Youth Sports Participation Is More Important among Females than Males for Predicting Physical Activity in Early Adulthood: Iowa Bone Development Study

A gender difference in youth sports and physical activity participation is well documented. However, research is limited to understand potential gender difference in the long-term effects of youth sports participation. The study aim was to compare the likelihood of meeting the aerobic Physical Activity Guidelines (PAG) in early adulthood by youth sports participation patterns among females and males. The study sample included 582 Iowa Bone Development Study participants (Iowa, USA). Participation in organized sports was assessed using a physical activity questionnaire 19 times on average between age 6 and 17 years. Accelerometer and dual-energy X-ray absorptiometry assessments were conducted at an average age of 23 years. Group-based trajectory analysis was conducted to identify youth sports participation trajectory patterns. Multivariable logistic regression analysis was conducted to examine the association between youth sports participation patterns and meeting the PAG in adulthood. We identified three youth sports participation patterns: "continuous participation," "drop-out," and "no participation." Females in the continuous participation group were more likely to meet the aerobic PAG at age 23 years, compared to females in the no-participation group (OR = 2.63; 95% CI = 1.05, 6.55) or the drop-out group (OR = 2.55; 95% CI = 1.38, 4.69). However, among males, youth sports participation patterns were not significantly associated with meeting the aerobic PAG at age 23 years. In conclusion, this study suggests that youth sports participation could be more important among females than males for predicting physical activity in early adulthood.

Adolescent physical activity, sedentary behavior and sleep in relation to body composition at age 18 years in urban South Africa, Birth-to-Twenty+ Cohort

BACKGROUND

Adolescence is marked by a decline in physical activity, rapid physical growth and changes in body composition, which have been linked to body composition. Prospective data on these associations are rare, particularly in Africa.

AIM

The aim of this study was to examine the association of longitudinal patterns across adolescent in physical activity, sedentary behavior and sleep, with anthropometry and body composition at age 18 years in urban South Africa.

METHODS

We analyzed data from the Birth-to-Twenty Plus Cohort (Bt20+), a longitudinal study of children born in 1990 in Soweto-Johannesburg, South Africa. We used general linear models to investigate the association of adolescent (ages 12 to 18 years) longitudinal trends in physical activity, sedentary behavior and schoolnight sleep and overall physical activity patterns, with body mass index (BMI), waist circumference, fat mass index (FMI), lean mass index (LMI) and percent body fat at age 18 years.

RESULTS

The final study sample included 1337 participants with anthropometric measurements (52% female) and 958 participants with body composition measurements (53% female). Males who were consistently more active and consistently walked to school over adolescence had lower waist circumference (B = - 2.0, 95% CI: - 3.9 to - 0.2), FMI (B = - 0.8, 95%: CI: - 1.2 to - 0.1) and percent body fat (B = -2.9, 95% CI: - 4.9 to - 0.9) at age 18 years than those who decreased activity and did not walk to school. Consistently-sedentary females had higher waist circumference than those whose sedentary behavior increased over adolescence (B = 5.4, 95% CI: 0.2 to 10.6). Males who reported sleeping 9 h or more per night on schoolnights had significantly lower BMI (B = -1.0, 95% CI: - 1.4 to- 0.5), and percent body fat (B = -1.5, 95%CI - 2.8 to - 0.1) than those who reported sleeping 8 h or less per night.

CONCLUSION

Patterns of adolescent physical activity, sedentary behavior and sleep are related to young-adult body composition in urban South Africa. These modifiable behaviors may be paths for public health interventions to curb overweight and obesity in many low- or middle-income countries.

Associations of Physical Activity and Sedentary Behaviour Assessed by Accelerometer with Body Composition among Children and Adolescents: A Scoping Review

The possible adverse health effects of reduced physical activity (PA) on children and adolescents have been extensively documented as a result of the global obesity epidemic. However, the research has sometimes led to controversial results, due to the different methods used for the assessment of PA. The main aim of this review was to evaluate the association between PA and body composition parameters based on quantitative PA studies using the same equipment (Actigraph accelerometer) and cutoffs (Evenson’s). A literature review was undertaken using PUBMED and Scopus databases. Subjects aged 6–15 were considered separately by sex. Weighted multiple regression analyses were conducted. From the analysis of fourteen selected articles, it emerged that 35.7% did not evaluate the association of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with body composition, while the remaining 64.3% found a negative association of MVPA with BMI and fat mass with different trends according to sex. Furthermore, only 7.1% of these studies identified a positive association between ST and fat percentage. Based on the regression analyses conducted on the literature data, ST and MVPA were found to be significant predictors of body composition parameters, in addition to age and sex. Further studies using standardized methodologies to assess PA and body composition are needed. The inclusion of sex-disaggregated data may also be crucial to understand this phenomenon and to provide stronger evidence of the determinants of body composition in order to prevent the risk of obesity.

The Relation between Levels of Media Literacy and Attitudes and Beliefs Concerning Obesity in University Students

The prevalence of obesity in young people around the world. The written and visual media have an important role to play in increasing student awareness in the prevention of obesity. This study was planned with the aim of determining the effect on attitudes and beliefs concerning obesity of the levels of media literacy of university students. This cross-sectional descriptive study was conducted with 300 obese students. The Media Literacy Scale, and the Obesity Health Belief Model Scale were used in the collection of data for the study. The Student t test and the one-way ANOVA test were used in the analysis of the data. A weak, positive statistically significant correlation was found between media literacy and the subscales of perceived severity, perceived barriers, and perceived benefit (p < .05). A weak positive correlation was found between the subscales of possessing knowledge, the ability to analyze and form a response, and the ability to judge and see hidden messages, and the sub-scales of perceived severity, perceived barriers, and perceived benefit (p < .05). It was found in this study that the media literacy of obese students was at a medium level, and that media literacy affected their attitudes and beliefs regarding obesity. It is recommended that the visual media should broadcast short audiovisual educational films at regular intervals on the prevention of obesity.

Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthood

Physical activity has been associated with physical and mental health across the life course, yet few studies have used group-based trajectory modeling to examine the effect of longitudinal patterns of physical activity during childhood and adolescence on adult health outcomes. The Raine Study data from Gen2 follow-ups at 8, 10, 14, 17, 20, and 22 years collected between 1998 and 2014 were used. Latent class analysis identified trajectories using parent-reported physical activity for ages 8 to 17. Associations between trajectories and physical and mental health outcomes at ages 20 and 22 were explored, adjusting for current physical activity and considering sex interactions. Analysis in 2019 identified three trajectories: low (13%), mid (65%) and high (22%) physical activity (n = 1628). Compared to the low-activity trajectory, those in the high-activity trajectory had lower adiposity, insulin, HOMA-IR and fewer diagnosed disorders, higher HDL-cholesterol, and faster cognitive processing. For example, those in the high-activity trajectory had lower percent body fat at age 20 compared to those in the mid-activity (-4.2%, 95%CI: -5.8, -2.7) and low-activity (-9.5%, 95%CI: -11.7, -7.2) trajectories. Physical activity trajectories showed different associations between sexes for self-reported physical and mental health, BMI, systolic blood pressure, and depression symptoms. Being in the high- or mid-activity trajectory was associated with a more favorable cardiometabolic and mental health profile in young adulthood. Strategies are needed to help less active children to increase physical activity throughout childhood and adolescence to improve young adult health outcomes.

Group‐based trajectory modeling of body mass index and body size over the life course: A scoping review

Background

Group‐based trajectory modeling has been applied to identify distinct trajectories of growth across the life course. Objectives of this study were to describe the methodological approaches for group‐based modeling of growth across the life course and to summarize outcomes across studies.

Methods

A scoping review with a systematic search of Medline, EMBASE, CINAL, and Web of Science was conducted. Studies that used a group‐based procedure to identify trajectories on any statistical software were included. Data were extracted on trajectory methodology, measures of growth, and association with outcomes.

Results

A total of 59 studies were included, and most were published from 2013 to 2020. Body mass index was the most common measure of growth (n = 43). The median number of identified trajectories was 4 (range: 2–9). PROC TRAJ in SAS was used by 33 studies, other procedures used include TRAJ in STATA, lcmm in R, and Mplus. Most studies evaluated associations between growth trajectories and chronic disease outcomes (n = 22).

Conclusions

Group‐based trajectory modeling of growth in adults is emerging in epidemiologic research, with four distinct trajectories observed somewhat consistently from all studies. Understanding life course growth trajectories may provide further insight for population health interventions.

Association between Physical Activity and Age among Children with Overweight and Obesity: Evidence from the 2016-2017 National Survey of Children's Health

Physical activity participation in children declines with age. It is not clear yet whether the age-related trends vary by weight status. This study is aimed at investigating the association between physical activity participation and age among children with healthy weight, overweight, or obesity, using data from the 2016-2017 National Survey of Children's Health (NSCH). Physical activity participation was evaluated by days participated in physical activity for at least 60 minutes out of 7 days. Weight status was categorized from body mass index (BMI) percentiles. Data were analyzed on 33,056 US children age 10-17 years. The percentages of been active 0 day out of 7 days in BMI5th < 85th (healthy weight), 85th < 95th (overweight), and ≥95th percentile (obese) groups were 8.9%, 11.5%, and 18.2%, respectively. Among all groups, been active 0 day out of 7 days was positively associated with age, while the strongest associations were observed in the BMI85th < 95th group (age 17 years vs. age 10 years: OR = 7.48, p < 0.0001). Older age was significantly associated with been active less than 4 days out of 7 days in the BMI5th < 85th and 85th < 95th groups, but those associations were attenuated in the BMI ≥ 95th group. This study found that physical activity participation was inversely associated with age among children with healthy weight, overweight, or obese, and the association was strongest among children with overweight and weakest among children with obesity. Interventions aimed at promoting physical activity among children should take these patterns of association into account.

Prevalence and Correlates of Physical Activity Among Children and Adolescents: A Cross-Sectional Population-Based Study of a Rural City in Japan

BACKGROUND

Although moderate-to-vigorous physical activity (MVPA) has multiple health benefits, current participation in recommended MVPA level and its determinants among Japanese children and adolescents remain unclear. Therefore, this cross-sectional study investigated the prevalence of meeting recommended MVPA level and its correlates among Japanese children and adolescents.

METHODS

Using the Japanese version of the World Health Organization (WHO) Health Behaviour in School-aged Children survey questionnaire, we confirmed the prevalence of meeting recommended MVPA level in all primary schools (PS) and junior high schools (JHS) in Unnan City, Japan. We evaluated its association with school grade, gender, body weight status, screen time, consumption of breakfast, physical activity (PA) preference, and population density using Poisson regression.

RESULTS

We found that 20.1% of the 1,794 students (9-15 years old) met the WHO recommendation. Meeting recommended MVPA level was significantly associated with being in the sixth grade of PS (prevalence ratio [PR] 0.57; 95% confidence interval [CI], 0.39-0.84) and first (PR 1.52; 95% CI, 1.16-1.99), second (PR 1.45; 95% CI, 1.10-1.90), and third grade of JHS (PR 0.40; 95% CI, 0.26-0.62) (vs fourth grade of PS); being a boy (PR 1.33; 95% CI, 1.12-1.59) (vs girl); liking PA (PR 3.72; 95% CI, 2.22-6.22) (vs dislike); and belonging to a medium-population-density (PR 0.73; 95% CI, 0.61-0.88) or low-population-density area (PR 0.67; 95% CI, 0.48-0.94) (vs high-population-density area).

CONCLUSIONS

About 20% of Japanese children and adolescents engaged in the recommended MVPA level. MVPA was associated with grade, gender, preference for PA, and population density.

Validation of the Activity Preference Assessment: a tool for quantifying children's implicit preferences for sedentary and physical activities

BACKGROUND

High levels of sedentary behavior and low physical activity are associated with poor health, and the cognitive determinants of these behaviors in children and adolescents are not well understood. To address this gap, we developed a novel, non-verbal, computer-based assessment to quantify the degree to which youth prefer to be sedentary relative to physically active in their leisure time.

METHODS

The Activity Preference Assessment (APA) uses a forced-choice paradigm to understand implicit decision-making processes when presented with common sedentary and physical activities. The APA bias score ranges from - 100 to + 100, with positive scores indicating a relative preference for sedentary activities, and negative scores representing a preference for physical activities. In 60 children ages 8-17 years, we assessed the validity of this behavioral task against a free-choice play observation, accelerometry-measured activity, anthropometrics and body composition, and cardiorespiratory fitness. We explored neighborhood, family, and individual-level factors that may influence implicit activity preferences. Test-retest reliability was assessed over one week.

RESULTS

The majority of children (67%) preferred sedentary relative to physical activities. APA bias scores were positively associated with sedentary time during free-choice play. In girls, bias scores were negatively associated with average daily MVPA. APA bias scores were positively associated with body fat and negatively associated with cardiorespiratory fitness. These findings were independent of age, sex, and race/ethnicity. Neighborhood access to physical activity spaces, the number of people in the home, perceived physical self-competence (e.g., coordination, strength), and self-reported depressive symptoms were associated with activity preferences. The intra-class correlation for test-retest reliability was r = 0.59.

CONCLUSIONS

The APA shows promise as a novel tool for quantifying children's relative preference for sedentary versus physical activities. Implicit bias scores from the APA are clinically meaningful, as shown by significant associations with adiposity and cardiorespiratory fitness. Future longitudinal studies should examine the directionality of the association between preferences and health markers, and the degree to which implicit activity preferences are modifiable. Importantly, the task only takes an average of 10 min to complete, highlighting a potential role as an efficient screening tool for the propensity to be sedentary versus physically active.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03624582 .

Intervention Effects of a Kindergarten-Based Health Promotion Programme on Motor Abilities in Early Childhood

Background: Physical activity is positively related to motor abilities. Especially in childhood, an active lifestyle is important to support healthy motor development. The low-threshold health promotion programme "Join the Healthy Boat" in kindergartens promotes physical activity in order to also improve motor abilities. Here, effects of the programme on children's motor abilities after 1 year were investigated. Materials and Methods: The longitudinal study included 419 children (3.7 ± 0.6 years) from 58 kindergartens throughout south-west Germany (intervention: 254, control: 165). Children in the intervention group received physical activity promotion with a focus on motor ability development, led by teachers, through one kindergarten year; children in the control group followed the normal kindergarten routine. At baseline and follow-up, motor tests (3-min-run, one-leg-stand, standing long jump, sit-and-reach-test) were performed, anthropometric measures (body weight and height) were taken and a parental questionnaire was issued. Intervention effects were assessed using differential measures (follow-up - baseline) adjusted for gender, age, socioeconomic status (SES) and baseline values, with covariance analyses. Results: Children in the intervention group showed a significant improvement in endurance performance ( F ( 1 . 329 ) = 20 . 95 ,   p < 0 . 000 ,   η P 2 = 0 . 060 ) , which applies to boys ( F ( 1 , 172 ) = 13 , 66 ,   p ≤ 0 . 000 ,   η P 2 = 0 , 074 )   and girls ( F ( 1 , 152 ) = 7 , 48 ,   p ≤ 0 . 007 , η P 2 = 0 , 047 ) . No significant intervention effects on endurance performance were found for children with low baseline values, children with a low SES, and children aged 5 years, nor for any other assessed motor ability. Conclusions: The theory-based, teacher-centered intervention promoting physical activity in order to also improve motor abilities has shown a positive effect on endurance performance in kindergarten children, but no other motor ability. Future interventions should therefore be either longer, more intense and take into account children's age, initial level of performance and their SES. In addition, the influence of teachers should be considered more closely in future research.

A Pilot Study of Cardiorespiratory Fitness, Adiposity, and Cardiometabolic Health in Youth With Overweight and Obesity

OBJECTIVE

To conduct a preliminary assessment of the relationships between cardiorespiratory fitness, adiposity, and cardiometabolic health using gold standard measures in diverse youth ranging from overweight to severe obesity.

METHODS

Twenty of 30 participants (mean [SD]; age 13.2 [1.8] y, 55% female, 45% African American) met the criteria for VO2peak during a graded cycle ergometer test to volitional fatigue. The body composition was measured by dual-energy X-ray absorptiometry (percentage of body fat, fat mass index, and fat-free mass) and magnetic resonance imaging (abdominal visceral and subcutaneous [SAT] adipose tissue). The VO2peak was expressed relative to fat-free mass. Fasting lipid levels, glycemic biomarkers, and vital signs were examined individually and used in a composite cardiometabolic risk score. Accelerometer-measured physical activity and sedentary time were included as covariates.

RESULTS

VO2peak was negatively associated with abdominal SAT (r = -.49, P < .05), but not visceral adipose tissue or markers of cardiometabolic health. The association between SAT and VO2peak was partly explained by habitual sedentary time.

CONCLUSIONS

We demonstrated a significant negative association between cardiorespiratory fitness and SAT in a diverse group of high-risk youth. The inclusion of rigorous, laboratory-based measures and youth with severe obesity extends the previous work in pediatric populations.

Obesogenic Lifestyle and Its Influence on Adiposity in Children and Adolescents, Evidence from Mexico

Overweight (OW) and obesity (OB) during childhood/adolescence are major public health problems in Mexico. Several obesogenic lifestyle (OL) risk factors have been identified, but the burden and consequences of them in Mexican children/adolescents remain unclear. The objective of this study was to estimate the prevalence of OL components and describe their relationships with adiposity, and OW/OB. A population-based cross-sectional study of Mexican children/adolescents with nutritional assessment, data collection on daily habits and adiposity as fat-mass index (FMI) by dual-energy X-ray absorptiometry was performed. Individual OL-components: “inactivity,” “excessive screen time,” “insufficient sleep,” “unhealthy-diet”, were defined according to non-adherence to previously published healthy recommendations. Results: 1449 subjects were assessed between March 2015 to April 2018. Sixteen percent of subjects had all four OL-components, 40% had three, 35% had two, 9% had one, and 0.5% had none. A cumulative OL score showed a significant dose–response effect with FMI. The combination of inactivity, excessive screen time, and insufficient sleep showed the highest risk association to OW/OB and higher values of FMI. Conclusions: The prevalence of OL-components was extremely high and associated with increased adiposity and OW/OB. Several interventions are needed to revert this major public health threat.

Hidden Markov model-based activity recognition for toddlers

OBJECTIVE

Physical activity has been shown to impact future health outcomes in adults, but little is known about the long-term impact of physical activity in toddlers. Accurately measuring the specific types and amounts of physical activity in toddlers will help us to understand, predict, and better affect their future health outcomes. Although activity recognition has been extensively developed for adults as well as older children, toddlers move in ways that are significantly different from older children, indicating the need for a more tailored approach.

APPROACH

In this study, 22 toddlers wore Actigraph waist-worn accelerometers which recorded their movements during guided play. The toddlers were videotaped and their activities were later annotated for the following eight distinct activity classes: lying down, being carried, riding in a stroller, sitting, standing, running/walking, crawling, and climbing up/down. Accelerometer data were extracted in 2 s signal windows and paired with the activities the toddlers were performing during that time interval.

MAIN RESULTS

A variety of classifiers were tuned to a validation set. A random forest classifier was found to achieve the highest accuracy of 63.8% in a test set. To improve the accuracy, a hidden Markov model (HMM) was applied by providing the predictions of the static classifiers as observations. The HMM was able to improve the accuracy to 64.8% with all five classifiers increasing the accuracy an average of 1.3% points (95% confidence interval  =  0.7-1.9, p   <  0.01). When the three most misclassified activities (sitting, standing, and riding in a stroller) were collapsed together, the accuracy increased to 79.3%.

SIGNIFICANCE

Further refinement of the toddler activity recognition classifier will enable more accurate measurements of toddler activity and improve future health outcomes of toddlers.

Longitudinal changes in moderate-to-vigorous-intensity physical activity in children and adolescents: A systematic review and meta-analysis

Moderate-to-vigorous-intensity physical activity (MVPA) is important for childhood obesity prevention and treatment, yet declines with age. Timing and magnitude of the decline in MVPA in children and adolescents are unclear but important for informing effective obesity intervention development. This systematic review aimed to determine and compare the year-to-year changes in MVPA among children and adolescents. Longitudinal studies were identified by searching 10 relevant databases up to December 2018. Studies were eligible for inclusion if they reported accelerometer-assessed MVPA (min day^-1 ) separately for boys and girls and had follow-up duration of at least 1 year. After screening 9,232 studies, 52 were included representing 22,091 aged 3 to 18 year olds (boys=8,857; girls=13,234). Pooled-analysis of the relative change in MVPA per year showed a decline of -3.4% (95% CI, -5.9 to -0.9) in boys and -5.3% (95% CI, -7.6 to -3.1) in girls, across all age groups. There were notable declines in MVPA at age 9 for both boys (-7.8%, 95% CI, -11.2 to -4.4) and girls (-10.2%, 95% CI, -14.2 to -6.3). The relative decline in MVPA affects both sexes from an early age; however, it is greater among girls. Interventions to promote MVPA should start before adolescence.

Cardiometabolic Risk Factors and Physical Activity Patterns Maximizing Fitness and Minimizing Fatness Variation in Malaysian Adolescents: A Novel Application of Reduced Rank Regression

Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13–17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health.

Associations of Leisure-Time Physical Activity Trajectories with Fruit and Vegetable Consumption from Childhood to Adulthood: The Cardiovascular Risk in Young Finns Study

A physically active lifestyle and a diet rich in vegetables and fruits have a central role in promoting health. This study examined the associations between leisure-time physical activity (LTPA) trajectories and fruit and vegetable consumption (FVC) from childhood to middle age. The data were drawn from the Cardiovascular Risk in Young Finns Study with six age cohorts. Participants were 9 to 18 years (n = 3536; 51% females) at baseline in 1980 and 33 to 48 years at the last follow-up in 2011. LTPA and FVC were self-reported. LTPA trajectories were identified using latent profile analyses, after which the mean differences in FVC across the trajectories were studied. Active, low-active, decreasingly and increasingly active trajectories were identified for both genders. An additional trajectory describing inactivity was identified for females. Those who were persistently active or increased their LTPA had higher FVC at many ages when compared to their inactive or low-active counterparts (p < 0.05). In females prior to age 42 and in males prior to age 24, FVC was higher at many ages in those with decreasing activity than in their inactive or low-active counterparts (p < 0.05). The development of LTPA and FVC from childhood to middle age seem to occur in tandem.

Tracking of Physical Activity and Sedentary Behavior From Adolescence to Young Adulthood: A Systematic Literature Review

PURPOSE

The transition from adolescence to young adulthood is categorized by substantial changes in one's activity behaviors, which may have important implications for health. To date, no reviews have systematically investigated the evidence of tracking for both physical activity (PA) and sedentary behavior (SB) specifically during this transition period.

METHODS

Web of Science, PubMed, SPORTDiscus, PsycINFO, and CINAHL were searched for articles that examined the tracking of PA and SB in adolescents (aged 9-18 years) through young adulthood (aged 19-25 years) published between the years of 2000 and 2018. Studies were also compared on methodologic quality.

RESULTS

Sixteen studies met the inclusion criteria. The tracking correlations for both the frequency and duration of PA were low-to-moderate. Gender differences were observed in the tracking of PA frequency and duration. Studies that examined the tracking of SB were less frequent, making it difficult to determine how SB tracks from adolescence to young adulthood.

CONCLUSIONS

Generally, PA was shown to track moderately from adolescence through young adulthood. The lack of studies reporting on the tracking of SB indicates that this area should be a target for future research. Future tracking studies should consider appropriate gold-standard objective methodologies and statistical analysis techniques that report fixed outcomes.

Incorporating Technology Into the iCook 4-H Program, a Cooking Intervention for Adults and Children: Randomized Controlled Trial

BACKGROUND

Families who cook, eat, and play together have been found to have more positive health outcomes. Interventions are needed that effectively increase these health-related behaviors. Technology is often incorporated in health-related interventions but is not always independently assessed.

OBJECTIVE

The objective of this study was to describe challenges and facilitators to incorporating technology into the iCook 4-H intervention program.

METHODS

Dyads (n=228) composed of children (mean 9.4, SD 0.7 years old) and an adult primary meal preparer (mean 39.0, SD 8 years) were randomly assigned to a control (n=77) or treatment group (n=151). All treatment group dyads participated in 6 in-person sessions designed to increase families cooking, eating, and playing together. We incorporated Web-based between-session technological components related to the curriculum content throughout the intervention. Assessments were completed by both groups at baseline and at 4, 12, and 24 months; they included measured anthropometrics for children, and online surveys about camera and website skill and use for dyads. Session leaders and participants completed open-ended process evaluations after each session about technological components. We computed chi-square analysis for sex differences in technological variables. We tested relationships between video posting frequency and outcomes of interest (cooking frequency, self-efficacy, and skills; dietary intake; and body mass index) with Spearman correlations. Process evaluations and open-ended survey responses were thematically analyzed for beneficial and inhibiting factors, including technological components in the curriculum.

RESULTS

Only 78.6% (81/103) of children and 68.3% (71/104) of adults reported always being comfortable accessing the internet postintervention. Boys reported being more comfortable than girls with technological tasks (P<.05). Children who posted more videos had a higher level of cooking skills at 4 months postintervention (r=.189, P=.05). Barriers to website usage reported most frequently by children were lack of accessibility, remembering, interactivity, motivation, time, and lack of parental encouragement.

CONCLUSIONS

Incorporating technological supports, such as cameras and websites, into children's programs may help produce improved outcomes. Identifying barriers to and patterns of technology usage need to be considered when developing future child health promotion interventions.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN54135351; https://www.isrctn.com/ISRCTN54135351.

Does optimal parenting style help offspring maintain healthy weight into mid-life?

An authoritative parenting style is generally associated with healthier body weight in children and adolescents. However, whether the protective effect of an authoritative style on offspring body weight may persist into adulthood has seldom been investigated. In this study we examined the longitudinal association between parenting style and body mass index (BMI) change in mid-life. Longitudinal data from the Midlife in the United States Study (N = 3929) were analyzed using generalized estimating equations, adjusting for a range of relevant covariates. Parenting styles were assessed at phase I (1995-1996) using items measuring parental warmth and control, while BMI was assessed at phases I and II (2004-2006). Four parenting styles were derived following prior research: authoritative, authoritarian, permissive, and uninvolved styles. Compared to an authoritative style, an authoritarian style was associated with 14% higher increase in the standardized BMI change score (β = 0.14, 95% confidence interval: 0.03, 0.26). While there was suggestive evidence that an uninvolved versus authoritative style might also be associated with greater BMI increase, we found no differences between a permissive and authoritative style. This study suggested that the protective effect of an authoritative parenting style on offspring body weight may persist well into mid-life, particularly as compared to the authoritarian style and possibly the uninvolved style. Such work may reinforce the importance of a public health focus on improving parenting practices and suggest the value of implementing parenting programs, as one strategy for increasing the likelihood that individuals can maintain healthy weight well into adulthood.

Non-linear longitudinal associations between moderate-to-vigorous physical activity and adiposity across the adiposity distribution during childhood and adolescence: Gateshead Millennium Study

OBJECTIVE

Insufficient moderate-to-vigorous intensity physical activity (MVPA) is harmful for youth; however, the evidence for differential effects by weight status is limited. The study aimed to examine associations between MVPA and adiposity by weight status across childhood and adolescence.

METHODS

Participants were from the Gateshead Millennium Study. Physical activity and body composition measures were taken at age 7 y (n = 502; measures taken between October 2006 and December 2007), 9 y (n = 506; October 2008-September 2009), 12 y (n = 420; October 2011-September 2012), and 15 y (n = 306; September 2014-September 2015). Participants wore an ActiGraph GT1M and epochs were classified as MVPA when accelerometer counts were ≥574 counts/15 s. Weight and height were measured using standardized methods and fat mass using bioelectrical impedance. Associations between MVPA and changes in BMI and FMI were examined by weight status using quantile regression.

RESULTS

Higher MVPA was associated with lower FMI for the 25th, 50th, 75th, and 90th percentile and lower BMI at the 50th, 75th, and 90th percentile, independent of accelerometer wear time, sex, and sedentary time. The association between MVPA and change in adiposity was stronger in the higher than lower FMI and BMI percentiles (e.g., 1 h/day more MVPA was associated with a 1.5 kg/m2 and 2.7 kg/m2 lower FMI at the 50th and 90th FMI percentiles, respectively).

CONCLUSIONS

The effect of MVPA on adiposity in the higher adiposity percentiles is stronger than reported to date. Given overweight and obese children are the highest risk group for later obesity, targeting MVPA might be a particularly effective obesity prevention strategy.

Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review

BACKGROUND

In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases.

METHODS

The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations.

RESULTS

Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA.

CONCLUSIONS

The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions.

TRIAL REGISTRATION

PROSPERO registration number: CRD42018088120 .

Gender influences physical activity changes during adolescence: The HELENA study

BACKGROUND

We compared differences in physical activity (PA) between pre/mid-pubertal and post-pubertal participants according to gender.

METHODS

The study included a total of 1842 healthy participants aged 12.5-17.4 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Participants wore a uniaxial accelerometer (ActiGraph© GT1M, Pensacola, FL, USA) attached to their lower back for seven consecutive days to measure PA. Pubertal status was assessed by physical examination and the population was classified as pre/mid-pubertal (Tanner stages 1-3) or post-pubertal (Tanner stages 4-5). PA was compared between these groups according to gender during the whole week, on school-free days and on school days, before and after school, and during lessons and recesses.

RESULTS

When comparing the pre/mid-pubertal group with the post-pubertal group, girls' total PA did not differ between groups. However, a slight difference was observed in boys, among whom PA on school-free days showed a difference of 17.6% between the pre/mid-pubertal group and the post-pubertal group (679 kcounts vs 564 kcounts, respectively; P = 0.0007) and 20% (162 kcount vs 135 kcounts; P = 0.006) for school recess. There was no difference among girls.

CONCLUSIONS

A reduced level of PA in the post-pubertal groups was only observed in boys during non-organized times such as on school-free days and during school recesses, with a moderate impact on total PA.

Social Status and Adolescent Physical Activity: Expanding the Insurance Hypothesis to Incorporate Energy Expenditure

Low social status (SS) is a determinant of poor health status and is associated with increased disease burden. Obesity affects 20.6% of American adolescents, most of whom are from low-SS families. Contributors to the development of obesity among adolescents include sedentary behavior and low levels of physical activity. Environmental determinants-infrastructure, policy, and social relationships-influence engagement in physical activity and are affected by SS. Significant declines in physical activity have been documented during adolescence, and adolescents of low SS engage in significantly less physical activity per week than those with high SS. This article briefly reviews the literature on the relationship between SS and physical activity in adolescents and introduces a proposed biological mechanism that may explain that relationship. Characterizing the effects that SS can have on physical activity may help tailor clinical interventions and public health campaigns seeking to improve adolescent physical activity and weight management, thus increasing their effectiveness. This may be particularly beneficial for underserved populations.

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.

Health-related parental indicators and their association with healthy weight and overweight/obese children's physical activity

Background

Although it is accepted that parents play a key role in forming children’s health behaviours, differences in parent-child physical activity (PA) have not previously been analysed simultaneously in random samples of families with non-overweight and overweight to obese preschool and school-aged children. This study answers the question which of the health-related parental indicators (daily step count (SC), screen time (ST), and weight status and participation in organized leisure-time PA) help their children achieve the step count recommendations.

Methods

A nationally representative sample comprising 834 families including 1564 parent-child dyads who wore the Yamax Digiwalker SW-200 pedometer for at least 8 h a day on at least four weekdays and both weekend days and completed a family log book (anthropometric parameters, SC, and ST). Logistic regression analyses were used to investigate whether parental achievement of the daily SC recommendation (10,000 SC/day), non-excessive ST (< 2 h/day), weight status, and active participation in organized PA were associated with children’s achievement of their daily SC (11,500 SC/day for pre-schoolers and 13,000/11,000 SC/day for school-aged boys/girls).

Results

While living in a family with non-overweight parents helps children achieve the daily SC recommendation (mothers in the model: OR = 3.50, 95% CI = 2.29–5.34, p < 0.001; fathers in the model: OR = 2.41, 95% CI = 1.37–4.26, p < 0.01) regardless of their age category, gender, or ST, for families with overweight/obese children, only the mother’s achievement of the SC recommendations and non-excessive ST significantly (p < 0.05) increase the odds of their children reaching the daily SC recommendation. The active participation of children in organized leisure-time PA increases the odds of all children achieving the daily SC recommendations (OR = 1.80–2.85); however, for overweight/obese children this remains non-significant. The participation of parents in organized leisure-time PA does not have a significant relationship to the odds of their overweight/obese or non-overweight children achieving the daily SC recommendations.

Conclusions

The mother’s health-related behaviours (PA and ST) significantly affect the level of PA of overweight/obese preschool and school-aged children. PA enhancement programmes for overweight/obese children cannot rely solely on the active participation of children in organized leisure-time PA; they also need to take other family-based PA, especially at weekends, into account.

Physical activity among children and adolescents in Germany. Results of the cross-sectional KiGGS Wave 2 study and trends

Self-reported data from wave 2 of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) provides the basis for assessing whether the levels of physical activity of children and adolescents in Germany meet the levels recommended by the World Health Organization (WHO). Merely 22.4% of girls and 29.4% of boys in the 3-17 age group are physically active for at least 60 minutes per day and therefore meet the WHO recommendations. Prevalence of recommended levels of physical activity decreases continuously with age, both for girls and boys. In KiGGS Wave 2, girls in the 3-10 age group met the levels of physical activity recommended by the World Health Organization significantly less often than in KiGGS Wave 1. Low levels of physical activity were highest amongst adolescent age girls, as well as among boys and girls of low socioeconomic status. The results indicate a great potential to promote physical activity.

Sex Differences in Birth Weight and Physical Activity in Japanese Schoolchildren

BACKGROUND

Lower birth weight (BW) is associated with increased chronic disease risk later in life. Previous studies suggest that this may be mediated principally via physical activity (PA). However, the association between BW and PA in children has not been clarified. The purpose of this study was to examine the association between BW and PA in school-aged children in Japan.

METHODS

Participants were children from a prospective birth cohort study (Project Koshu) who were born from 1996 through 2002 in rural Japan. BWs were obtained from the Maternal and Child Health Handbook. Data on PA during childhood were collected using a self-reported questionnaire when participants were 9-15 years of age in July 2011. Analysis of covariance was used to evaluate exercise duration; Poisson regression analysis was used to evaluate if the recommended PA amount was met.

RESULTS

Data from 657 children (boys: 54.8%, follow-up rate: 77.6%) were analyzed. Compared with the normal BW group, only girls in the low-BW group had significantly lower PA level (normal BW, 11.4 [standard error, 1.0] hours/week; low BW, 5.8 [standard error, 3.6] hours/week, P = 0.010), and were more likely to not meet the recommended PA level (prevalence ratio 1.57; 95% CI, 1.14-2.16).

CONCLUSION

Low BW was associated with a lower PA level in school-aged girls but not boys. Earlier consideration of BW may be an important public health strategy to prevent physical inactivity in school-aged girls.

Trajectories of self-reported physical activity and predictors during the transition to old age: a 20-year cohort study of British men

BACKGROUND

Maintenance of physical activity (PA) during later life is associated with optimal health; however, the long-term trajectories of PA into old age and their predictors have not been extensively researched using latent class methods. This study aimed to identify trajectories of self-reported PA and their predictors in men transitioning from midlife to old age.

METHODS

7735 men (aged 40-59 years) recruited in 1978-80 were followed up after 12, 16 and 20 years, reporting PA, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling identified the trajectories of PA and associations with time-stable and time-varying covariates. We considered a range of sociodemographic and health and lifestyle factors as potential covariates.

RESULTS

4952 men (mean baseline age 49.1 ± 5.6 years) providing PA data at ≥3 time points were included in analyses. Three distinct 20-year trajectories were identified: low decreasing (24.6%, n = 1218), light stable (51.1%, n = 2530) and moderate increasing (24.3%, n = 1204). Being older, having a manual occupation, having never married or had children, residing in the midlands or North of England, suffering from a range of health conditions, being a smoker/ex-smoker and never consuming breakfast cereal or alcohol were independently associated with reduced odds of belonging to the moderate increasing trajectory group compared to the low decreasing group. Of the time-varying covariates considered, leaving employment was associated with a decrease in PA in the low decreasing group (β -0.306, p < 0.001) but an increase in the light stable (β 0.324, p < 0.001) and moderate increasing groups (β 0.847, p < 0.001). Developing cardiovascular-related conditions was associated with a decrease in PA in the low decreasing (β -0.408, p < 0.001) and light stable groups (β -0.118, p < 0.001) but no association was observed in the moderate increasing group (β -0.060, p = 0.313).

CONCLUSIONS

Three distinct trajectories of PA were identified in men transitioning from midlife to old age, of which nearly a quarter had persistently low levels of PA. Promotion efforts may need to focus attention prior to middle age and consider a number of sociodemographic, health and lifestyle factors to sustain PA into old age. The effects of retirement and development of cardiovascular disease may vary according to PA trajectories.

Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms

This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.

Organized Sport Trajectories from Childhood to Adolescence and Health Associations

INTRODUCTION

The purpose of this study was to identify unique organized sport trajectories from early childhood to late adolescence in an Australian pregnancy cohort, the Raine Study.

METHODS

Participation in organized sport was assessed at ages 5, 8, 10, 14, and 17 yr. Physical activity, body composition, and self-rated physical and mental health were assessed at the age of 20 yr. Latent class analysis was used to identify patterns of sport participation. To assess the internal validity of the trajectory classes, differences in health characteristics between trajectories were analyzed using generalized linear models.

RESULTS

For girls, three trajectory classes were identified: consistent sport participators (47.5%), sport dropouts (34.3%), and sport nonparticipators (18.1%). For boys, three trajectory classes were identified: consistent sport participators (55.2%), sport dropouts (36.9%), and sport joiners (8.1%). For girls, there were overall differences across trajectory classes in lean body mass (P = 0.003), lean mass index (P = 0.06), and physical health (P = 0.004). For boys, there were differences across classes in physical activity (P = 0.018), percent body fat (P = 0.002), lean body mass (P < 0.001), lean mass index (P < 0.001), physical health (P = 0.06), and depression scores (P = 0.27).

CONCLUSION

This study identified unique, sex-specific trajectories of organized sport participation. The differences in health outcomes between trajectory classes, such as participants with consistent sport participation having more preferable health outcomes at the age of 20 yr, support the internal validity of the trajectories. Strategies are needed to identify and encourage those in the dropout trajectory to maintain their participation and those in the nonparticipator or joiner trajectories to join sport earlier. Specifically, interventions to encourage early sport participation in girls and help nonparticipating boys to join sport during adolescence may help more children receive the benefits of sport participation.