Time trends of physical activity among Brazilian adolescents over a 7-year period

The impact of sports participation on mental health and social outcomes in adults: a systematic review and the 'Mental Health through Sport' conceptual model

BACKGROUND

Sport is a subset of physical activity that can be particularly beneficial for short-and-long-term physical and mental health, and social outcomes in adults. This study presents the results of an updated systematic review of the mental health and social outcomes of community and elite-level sport participation for adults. The findings have informed the development of the 'Mental Health through Sport' conceptual model for adults.

METHODS

Nine electronic databases were searched, with studies published between 2012 and March 2020 screened for inclusion. Eligible qualitative and quantitative studies reported on the relationship between sport participation and mental health and/or social outcomes in adult populations. Risk of bias (ROB) was determined using the Quality Assessment Tool (quantitative studies) or Critical Appraisal Skills Programme (qualitative studies).

RESULTS

The search strategy located 8528 articles, of which, 29 involving adults 18-84 years were included for analysis. Data was extracted for demographics, methodology, and study outcomes, and results presented according to study design. The evidence indicates that participation in sport (community and elite) is related to better mental health, including improved psychological well-being (for example, higher self-esteem and life satisfaction) and lower psychological ill-being (for example, reduced levels of depression, anxiety, and stress), and improved social outcomes (for example, improved self-control, pro-social behavior, interpersonal communication, and fostering a sense of belonging). Overall, adults participating in team sport had more favorable health outcomes than those participating in individual sport, and those participating in sports more often generally report the greatest benefits; however, some evidence suggests that adults in elite sport may experience higher levels of psychological distress. Low ROB was observed for qualitative studies, but quantitative studies demonstrated inconsistencies in methodological quality.

CONCLUSIONS

The findings of this review confirm that participation in sport of any form (team or individual) is beneficial for improving mental health and social outcomes amongst adults. Team sports, however, may provide more potent and additional benefits for mental and social outcomes across adulthood. This review also provides preliminary evidence for the Mental Health through Sport model, though further experimental and longitudinal evidence is needed to establish the mechanisms responsible for sports effect on mental health and moderators of intervention effects. Additional qualitative work is also required to gain a better understanding of the relationship between specific elements of the sporting environment and mental health and social outcomes in adult participants.

Secular trends in physical activity in adolescents: A systematic review

Objective

One in five adolescents has been estimated to perform sufficient physical activity (PA), thus potentially indicating that PA among adolescents has declined. This systematic review was aimed at reporting and summarizing the available knowledge regarding PA secular trends in adolescents over time.

Methods

Seven databases were consulted (Web of Science, Scopus/Elsevier, Medline/PubMed, ScienceDirect, Lilacs, Physical Education Index, and SPORTDiscus), and 1809 studies were examined. According to the PRISMA guidelines, relevant research on secular PA trends in adolescents was screened for inclusion in a narrative synthesis. The risk of bias in the articles included was also assessed.

Results

Forty-three studies with data collected between 1969 and 2018 met the inclusion criteria, and data from high-income countries predominated. PA was estimated predominantly by self-reporting, except in seven studies, and diverse contexts and domains were analyzed. Increased PA was reported in 16 studies (from 2.9% to 43.5%), decreased PA was reported in 15 studies (-2.5% to -69.5%), and no change was reported in 22 studies (-12.0% to 14.4%).

Conclusions

Although PA has increased in some countries, very little information is available in low- and middle-income countries. Efforts should support studies on PA trends in adolescents from economically disadvantaged countries.

Active school commuting in adolescents from 28 countries across Africa, the Americas, and Asia: a temporal trends study

BACKGROUND

Evidence examining trends in active school commuting among adolescents are mainly single-country studies, and principally focused on high-income countries. Thus, the present study aims to examine temporal trends in adolescents' active school commuting and to examine if there are differences in such trends by sex. We used nationally representative samples of 28 countries, which were predominantly low- and middle-income countries (LMICs), covering 5 different WHO regions.

METHODS

Data from the Global School-based Student Health Survey 2004-2017 were analyzed in 177,616 adolescents [mean (SD) age: 13.7 (1.0) years; 50.7% girls]. Active school commuting was self-reported (frequency of walking or riding a bike to and from school in the past 7 days). The prevalence and 95%CI of active school commuting (i.e., ≥ 3 days/week) was calculated for the overall sample and by sex for each survey. Crude linear trends in active school commuting were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls.

RESULTS

Trends in active school commuting were heterogeneous across countries, with results showing stable patterns for the majority (16/28), decreasing trends for some (7/28) and increasing trends over time for a few (5/28). The majority of countries showed no differences in active school commuting trends between girls and boys.

CONCLUSIONS

The quantification of changes in adolescents' active school commuting over time, together with a deeper understanding of local determinants for such behaviors will provide valuable evidence to inform the development of tailored and context-specific actions.

Physical Activity Levels in Brazilian Adolescents: A Secular Trend Study (2007-2017/18)

Only a small proportion of Brazilian adolescents practice sufficient physical activity (PA). However, it is not clear whether this proportion has been decreasing over time. This study aimed to examine the 10-year trends of sufficient PA in adolescents and to investigate differences by sex and age. Using a standard protocol, we compared two cross-sectional cohorts of adolescents aged 15 to 18 years, recruited in 2007 (n = 1040) and in 2017/18 (n = 978). Using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the adolescents reported moderate-to-vigorous PA (MVPA) performed in the last seven days. Sufficient PA was defined as engaging in at least 60 min/day of MVPA. In the subgroups, investigated by sex or age, there was an increase in the prevalence of sufficient PA. Overall, sufficient PA declined by 28.1% from 2007 to 2017/18. Boys in 2007 were more active than their 2017/18 peers, and this was equally observed in girls in 2007 compared to those in 2017/18. The findings show decreasing secular trends in sufficient PA in the investigated adolescents. Not only are public health authorities in Brazil witnessing an escalation of insufficient PA, but they are also losing ground with the most active adolescents.

Moderating Influence of Home Location and School Type across Time on Cardiometabolic Risk and Active School Commuting: A Five-Year Longitudinal Study

Background: We examined the moderating influence of home location and school type across time on cardiometabolic risk and active school commuting over 5 years in a sample of children from southern Brazil. Methods: We recruited a sample of children (n = 154; baseline age = 9.6 ± 1.5 years old; 56.8% female) who were followed for 5 years from 2011/2012 to 2016/2017. We collected home location, school type, and school commute data using self-report methods and collected cardiometabolic risk measures to calculate a cardiometabolic composite risk score (cMetSyn). General and generalized linear mixed effects models were employed to examine the moderating influence of home location and school type across time on cardiometabolic risk and active school commuting. Results: We found a significant three-way home location × school type × time interaction on cMetSyn scores (b = 0.62, 95% confidence interval [CI]: 0.13-1.12, p = 0.014), indicating that children who were living within rural areas and enrolled in state schools during 2016/2017 had higher cardiometabolic risk compared with children enrolled in municipal schools and living in urban areas at the end of the study. Additionally, we found that children living in rural areas had an 86% lower rate of active school commuting compared with students living in urban areas (rate ratio = 0.14, 95% CI: 0.07-0.32, p < 0.001). Conclusions: The results suggest that Brazilian children enrolled in state schools and living in rural areas had higher cardiometabolic risk scores at the end of the study and that southern Brazilian children residing in rural areas had a much lower rate of actively commuting to school.

Assessing adolescent diet and physical activity behaviour, knowledge and awareness in low- and middle-income countries: a systematised review of quantitative epidemiological tools

PURPOSE

Quantitative epidemiological tools are routinely used to assess adolescent diet and physical activity (PA) constructs (behaviour, knowledge, and awareness) as risk factors for non-communicable diseases. This study sought to synthesize evidence on the quantitative epidemiological tools that have been used to assess adolescent diet and PA constructs in low to middle-income countries (LMIC).

METHODS

A systematised review was conducted using 3 databases (EbscoHost, Scopus and Web of Science).

RESULTS

We identified 292 LMIC studies assessing adolescent diet and PA. Identified studies predominantly explored behavioural (90%) constructs with a paucity of studies investigating knowledge and awareness. The majority of studies used subjective (94%) and self-administered (78%) tools. Only 39% of LMIC studies used tools validated for their contexts.

CONCLUSIONS

The findings highlight the need for more contextual tools for assessing adolescent diet and PA in LMICs. Diet and PA measurement tools used in future research will need to incorporate measures of knowledge and awareness for a more comprehensive understanding of the epidemiology of diet and PA in adolescents. Furthermore, there is a need for more evidence on the reliability and validity of these tools for use, in both cross sectional and longitudinal studies, in LMIC contexts.

Analysis of the profile of cardiovascular risk in Brazilian schoolchildren: metabolic and behavioral indicators

OBJECTIVE

There is evidence demonstrating that cardiovascular diseases (CVD) manifesting during adulthood result from an intense interaction among risk factors that may have originated during childhood and adolescence. To compare the prevalence and clustering of cardiovascular risk factors in Brazilian schoolchildren with a 15-year interval between samples.

METHODS

A cross-sectional analysis based on the scores for cardiovascular risk factors was used to investigate 1,232 Brazilian schoolchildren of both sexes aged 12 to 18 years. The data of 596 schoolchildren of the 2000 sample were compared to those of 636 schoolchildren of the 2015 sample.

RESULTS

The prevalence of physical inactivity and abdominal obesity increased exponentially in both sexes from 2000 to 2015. The score for the clustering of cardiovascular risk factors showed that in 2000 the adolescents were exposed to 1 cardiovascular risk factor (31.7%), while in 2015 the greatest percentage was assigned to the category of 3 or more cardiovascular risk factors (34.9%), p < 0.001.

CONCLUSION

The present results demonstrate a high prevalence of exposure to health risk behaviors of the adolescents studied over time. Considering the presence of modifiable risk factors, preventive measures regarding life style are essential.

Longitudinal Trends in Sport Participation and Retention of Women and Girls

Measurement and analysis of sport participation data is vital to understand trends, and therefore to make informed decisions relating to sport policy and strategies to get more people active through sport. This study identified patterns of club sport participation, retention and drop-out of women and girls over a 7 year period in a popular team sport in Australia. The study included registered women and girls of all ages (4–96 years at baseline) in an almost exclusively female sport, with a particular focus on the ages 4–14 years where most participation occurs. All commencing participants in the base year (2010) were tracked over the 7 year period. Participants were classified in two ways: the total number of years they played and their overall pattern of participation. Differences between age groups were analyzed using Kruskall Wallis and Mann Whitney tests. Registration records of 29,225 participants were analyzed in the study. Overall, there were considerable differences in the years participating in the sport. Almost one third (30%) of commencing 4–9 year olds played continuously for the 7 years. This proportion diminished through ages at commencement from 10 to 19, reaching a low point of 4% for ages 15–19, then rebounded slightly, reaching 7% for ages 30+. The proportion who dropped out during the 7 year period and did not return varied with age in the converse manner, as did the proportion of single-year players. The optimal age of entry to sport for retention in participation was 6–9 years. Consideration needs to be given to the age appropriateness of sports programs for very young participants. Strategies specifically relating to retention of girls and young women during adolescence should be developed.

[Standards of physical activity practices in adolescents in a city of Northeastern Brazil]

The scope of this study was to describe the standards of physical activity practices and analyze its variations as sociodemographic characteristics of adolescents in a city of Northeastern Brazil. The sample consisted of 2,350 adolescents in the city of João Pessoa in the Brazilian State of Paraíba. The prevalence of physical activity was determined and the practice scores (minutes/week) calculated: general and types (sports, exercise, active commuting and recreational activities). Multiple linear regression was used to estimate the relative contribution of the types of practice for the general score of physical activity. The physical activities most practiced were active commuting (55.2%) and sports (52.7%). The activities that presented the greatest explanatory capacity for the overall score of practice were: sports (38.1%) and exercises (21.8%). The explanatory capacity of sports was increased in all subgroups, except in female patients. The practice of exercise contributes to the major changes in the general score in female adolescents from private schools. Recreational activities and active commuting had the largest contribution for the female gender. Sports and exercise were the activities that contributed the most to explain the changes in the general practice score.

Temporal Trends of Physical Activity and Sedentary Behavior Simultaneity in Brazilian Students

OBJECTIVE

To evaluate trends in physical activity and sedentary behavior simultaneity among Brazilian students from 2009 to 2015 and its association with independent variables.

METHODS

This study presents a panel of 3 cross-sectional studies carried out in 2009, 2012, and 2015 (Pesquisa Nacional de Saúde do Escolar-PeNSE). The population was comprised of ninth-grade public and private schools students from Brazilian capitals. Physical activity and sedentary behavior variables were combined to create the outcome of simultaneity of these risk factors.

RESULTS

A large proportion of students were simultaneously inactive and sedentary in the 3 surveys. However, it was possible to observe a downward trend (2009: 56.4%; 95% confidence interval, 55.7-57.1; 2012: 53.7%; 95% confidence interval, 53.0-54.4; 2015: 51.9%; 95% confidence interval, 51.2-52.7). In 2015, estimates of physical inactivity and sedentary behavior simultaneity were greater than 48% for 20 out of 27 of the Brazilian states. Significant declining trends were observed among mideast residents, females, nonwhite, and those attending private schools. Only around 5%-7% of the adolescents were both active and nonsedentary in the 3 surveys.

CONCLUSION

Despite of a slight decreasing trend in the proportion of Brazilian students simultaneously inactive and sedentary throughout the period, the prevalence remained elevated across the surveys.

Changes in leisure-time physical activity among Brazilian pregnant women: comparison between two birth cohort studies (2004 - 2015)

BACKGROUND

Low levels of leisure-time physical activity (LTPA) during pregnancy have been shown in studies conducted worldwide. Surveillance is extremely important to monitor the progress of physical activity patterns over time and set goals for effective interventions to decrease inactivity among pregnant women. The aim of this study was to evaluate time changes in LTPA among Brazilian pregnant women in an 11-year period (2004-2015) by comparing data from two birth cohort studies.

METHODS

Two population-based birth cohort studies were carried out in the city of Pelotas, southern Brazil, in 2004 and 2015. A total of 4244 and 4271 mothers were interviewed after delivery. Weekly frequency and duration of each session of LTPA in a typical week were reported for the pre-pregnancy period and for each trimester of pregnancy. Trends in both recommended LTPA (≥150 min/week) and any LTPA (regardless of weekly amount) were analysed overtime. Changes were also calculated separately for subgroups of maternal age, schooling, family income, parity, pre-pregnancy body mass index and pre-pregnancy LTPA.

RESULTS

The proportion of women engaged in recommended levels of LTPA pre-pregnancy increased from 11.2% (95%CI 10.0-12.2) in 2004 to 15.8% (95%CI 14.6-16.9) in 2015. During pregnancy, no changes were observed over the period for the first (10.6 to 10.9%) and second (8.7 to 7.9%) trimesters, whereas there was a decrease from 3.4% (95%CI 2.9-4.0) to 2.4% (95%CI 1.9-2.8) in the last trimester. Major decreases in LTPA in the last trimester were observed among women who were younger, with intermediate to high income, high schooling, primiparous, pre-pregnancy obese and, engaged in LTPA before pregnancy. Changes in any LTPA practice followed the same patterns described for recommended LTPA.

CONCLUSIONS

Despite the increase in the proportion of women engaged in LTPA before pregnancy between 2004 and 2005, LTPA levels remained stable during the first and second trimesters of pregnancy and declined during the third gestational trimester over the period. Interventions to encourage the maintenance of LTPA practice throughout pregnancy are urgently needed.

Physical activity throughout adolescence and body composition at 18 years: 1993 Pelotas (Brazil) birth cohort study

Background

Adolescence is a period of accelerated development and increases in body composition. Physical activity (PA) practice has been associated with the development of major components of body composition (bone, muscle and fat). However, the longitudinal effects of PA of different intensities during adolescence are still not well understood. Thus, the main goal this study has investigate the association between practice of moderate- and vigorous-intensity physical activity throughout adolescence and body composition, specifically lean mass (LM) and fat mass (FM), at age 18.

Methods

In this cohort study, physical activity was measured at 11, 15 and 18 years, using questionnaires. Thresholds of 300, 150 and 75 min per week, were used for MVPA, moderate- and vigorous-intensity physical activity, respectively. Consistent physical activity was defined as reaching the thresholds at the three follow-ups. FM and LM at age 18 were assessed by DXA and expressed as fat mass (FMI) and lean mass (LMI) indexes. To verify the association between the trajectories of MVPA, moderate- and vigorous-intensity physical activity in adolescence and FM and LM at 18, multivariate analyses were performed through multiple linear regressions adjusted for co-variables.

Results

A total of 3,176 adolescents were evaluated. The consistent practice of moderate- and vigorous-intensity physical activity according to thresholds during adolescence were directly related to the LMI in boys (moderate-intensity - β = 0.40 and CI95 % 0.13; 0.68 and vigorous-intensity - β = 0.95 and CI95 % 0.69; 1.21) and girls (Moderate-intensity - β = 0.23 and CI95 % 0.02; 0.45 and vigorous-intensity - β = 0.80 and CI95 % 0.29; 1.32). Practice of vigorous-intensity physical activity alone showed to be inversely associated with the FMI in boys (β = -0.53 and CI95 % -0.96;–0.10).

Conclusion

Consistent physical activity practice during adolescence was associated with greater lean mass in both sexes. In boys, vigorous-intensity physical activity was associated with less fat mass.

Time trends: a ten-year comparison (2005-2015) of pedometer-determined physical activity and obesity in Czech preschool children

BACKGROUND

To explore the time trends (2005-2015) of pedometer-determined weekday and weekend physical activity (PA) and obesity prevalence in 4-7-year-old Czech preschool children and changes in proportion of kindergarten vs. leisure-time PA.

METHODS

The study compared data of two cross-sectional cohorts of preschool children (2005: 92 boys and 84 girls; 2015: 105 boys and 87 girls) in the Czech Republic, using the same measurements and procedures in both cases. PA was monitored by the Yamax Digiwalker SW-200 pedometer for at least eight continuous hours a day over seven consecutive days. Body weight and height were measured using calibrated Tanita scales and anthropometry. The analysis of variance was conducted to examine the gender and cohort effect on step counts. The t-test was used to examine the difference in step counts in kindergarten (or leisure-time) between non-obese and obese children, and the chi-square test compared the prevalence of obesity between 2005 and 2015.

RESULTS

The steps/day (mean ± standard deviation) of preschoolers was significantly higher (p < 0.05) in 2015 (11,739 ± 4,229 steps/day) than in 2005 (10,922 ± 3,181 steps/day); and (p < 0.001) in boys (11,939 ± 3,855 steps/day) than in girls (10,668 ± 3,587 steps/day). In 2015, girls, but not boys, had a significantly (p < 0.01) greater step count on weekdays than in 2005, but not at weekends. A decline of leisure-time step counts on weekdays between 2005 and 2015 in girls (6,8652005 vs. 6,0592015, p < 0.01) and boys (7,8612005 vs. 6,4362015, p < 0.001) is compensated for by the increase of step counts in kindergarten (girls: 3,0582005 vs. 5,3302015, and boys: 4,0032005 vs. 5,9992015, p < 0.001). The prevalence of obesity was not significantly different either in 2005 or 2015 among preschool girls (7.14 % 2005 vs. 9.20 % 2015) or boys (6.52 % 2005 vs. 9.52 % 2015).

CONCLUSION

The steps/day of preschoolers was higher in 2015 than in 2005; this higher level of PA was the result of increased PA in kindergartens over the last ten years, particularly among girls. Thus, the current PA program in kindergartens effectively compensates for the decline in PA in leisure-time of weekdays of non-obese and obese preschoolers compared to 2005 and 2015. Prevalence of obesity among Czech preschool children remains relatively stable between 2005 and 2015.

[Physical activity, screen time, and use of medicines among adolescents: the 1993 Pelotas (Brazil) birth cohort study]

This study aimed to evaluate cross-sectional and longitudinal associations between physical activity, screen time, and use of medicines among adolescents from the 1993 Pelotas (Brazil) birth cohort study, followed at 11 (N = 4,452), 15 (N = 4,325), and 18 years of age (N = 4,106). The study recorded the use of medicines in the previous 15 days, continuous use of some medication, level of physical activity (by questionnaire and accelerometry), and screen time (TV, computer, and videogame). One-third of adolescents had used at least one medicine in the previous 15 days and approximately 10% were on some continuous medication. In the adjusted analysis, the results showed that higher levels of physical activity at 18 years and less screen time at 15 years in boys were associated with lower overall use of medicines (p < 0.05). For boys, physical activity at 11 and 18 years were inversely related to continuous medication (p < 0.05). More physically active boys and those with less screen time in adolescence showed lower use of medicines at 18 years of age.

Prevalência de estilo de vida sedentário entre adolescentes

Objetivo: Identificar a prevalência de estilo de vida sedentário entre adolescentes e conhecer a concordância entre os resultados obtidos por dois instrumentos padronizados de medida. Métodos: Estudo descritivo, transversal, que avaliou 132 estudantes de 14 a 18 anos. As variáveis de estudo foram: sexo, idade, níveis de atividade física com a utilização do Questionário Internacional de Atividade Física em sua versão curta, e média diária de passos com a utilização do pedômetro por, no mínimo, 4 dias consecutivos. Resultados: A prevalência de sedentarismo avaliada pelo questionário foi de 19,7% e a identificada pelo pedômetro foi de 8,3% (p=0,021). Não foi identificada correlação entre os resultados dos diferentes instrumentos. A concordância entre os métodos foi fraca (k=0,021). Conclusão: A prevalência do sedentarismo foi menor quando avaliada pelo pedômetro e não houve correlação com os resultados da avaliação pelo questionário. A concordância foi fraca entre os dois instrumentos de medida.

The impact of web-based HOT (Healthy Outcomes for Teens) Project on risk for type 2 diabetes: a randomized controlled trial

BACKGROUND

The HOT (Healthy Outcome for Teens) Project is an innovative online educational intervention for middle school children for prevention of diabetes and obesity by balancing food intake with physical activity. The objective was to improve knowledge, outcome expectations, self-efficacy, and self-reported food intake and skills and to compare a passive online learning (POL) control group with an active online learning (AOL) treatment group by implementing a social cognitive theory (SCT)-grounded online intervention.

SUBJECTS AND METHODS

In total, 214 participants were recruited from three middle schools. Full data were secured for 181 students. Six valid, reliable questionnaires were administered online, pre/post, to both the AOL and POL groups to assess knowledge gain, self-reported intake, and meal planning skills, as well as change in SCT constructs.

RESULTS

Subjects in the AOL group improved significantly for all five categories of planning a meal questionnaire (P=0.001) and also for outcome expectations for exercise (P=0.001). At postintervention, no significant differences were found for composite scores of exercise self-efficacy, weight efficacy lifestyle, and rapid eating assessment plan questionnaires between AOL versus POL (by Mann-Whitney test).

CONCLUSIONS

We conclude that teens participating in the AOL version of the HOT Project intervention acquired skills for planning a meal and improved outcome expectations for exercise.