Three times as much physical education reduced the risk of children being overweight or obese after 5 years

The association between childhood motor performance and developmental trajectories of sport participation over 5 years in Danish students aged 6-16-year-old

Sports participation has potential to promote physical activity in youth. Unfortunately, sports participation and physical activity may decline from childhood to adolescence and into adulthood. Globally, only 20% of 13-15-year-olds meet the World Health Organisation recommendations for physical activity. This study aimed to investigate the 5-year trajectories of sports participation and their association with baseline motor performance in Danish school children as part of the Childhood Health Activity and Motor Performance School Study-Denmark (CHAMPS-DK), a school-based physical activity intervention study which investigated the health benefits of increased physical education lessons. Five distinct trajectories were identified, with group 1 maintained a stable trajectory of little to no sports participation, and group 2 showing a low decreasing trend. Group 3-5, the most sports active, demonstrated increasing sport participation at different rates. Baseline motor performance score was associated with the two most active sports participation groups. Students who were more physically active during school hours participated less in organised leisure time sports. This suggest focusing on improving motor performance in youth may support future sports participation and thus health-related physical activity. But also, that it might be necessary to engage and maintain children and adolescents in leisure time sports while implementing physical activity promotion interventions.

Moderating Role of Physical Fitness in the Association Between TV Time and Adiposity Parameters in Adolescents

PURPOSE

To identify whether physical fitness (PF) components play a moderating role in the relationship between TV time and adiposity levels.

DESIGN

Cross-sectional study.

SETTING

Few studies have examined if different PF levels modify the association between TV time and adiposity in adolescents. Studies often focus on the isolated relationships between obesity and TV time, or obesity and PF levels.

SUBJECTS

1071 adolescents (617 girls), aged 12 to 17 years.

MEASURES

Cardiorespiratory fitness (CRF), abdominal muscular endurance, and lower limb strength were evaluated using the protocols of the Projeto Esporte Brasil fitness testing battery. TV time was obtained using a self-reported questionnaire. Body mass index (BMI) and waist circumference (WC) were also assessed. Moderation analyses were conducted through multiple linear regression models with the following associations tested in different models: PF components, TV time, and interaction (PF component x TV time) with adiposity parameters (BMI and WC).

RESULTS

A significant interaction term was found for CRF and TV time in the association with both WC (β: -.005; 95% CI: -.009; -.001; P = .012) and BMI (β: -.002; 95% CI: -.004; -.001; P = .009).

CONCLUSION

CRF moderates the relationship between TV time and adiposity measures in this cross-sectional analysis. These data support strategies looking at increasing physical activity levels to improve CRF and avoid the development of excess abdominal obesity and excess weight.

Physiotherapy and related management for childhood obesity: A systematic scoping review

INTRODUCTION

Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity.

METHOD

A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy.

RESULTS

From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively.

CONCLUSION

When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.

Tracking of cardiometabolic risk in a Brazilian schoolchildren cohort: a 3-year longitudinal study

BACKGROUND

Clustering of cardiometabolic risk factors is a sign of detrimental health. Tracking is a term used to describe a variable longitudinal stability across time. High tracking provides the chance to determine which cardiometabolic risk factors should be the target of early treatment and prevention efforts. The present study aims to analyze the tracking of cardiometabolic risk factors and clustered cardiometabolic risk score in children across a 3-year time span, and to verify the odds of staying at risk (measured by the clustered score) from baseline to follow-up.

METHODS

Longitudinal study that included 354 (155 boys) children, aged 7-12 years at baseline. A clustered score was calculated by summing the systolic blood pressure, waist circumference, triglycerides, glucose, and the TC/HDL-C ratio Z-scores divided by five. A second clustered score was calculated including cardiorespiratory fitness (CRF).

RESULTS

CRF and anthropometric parameters presented high tracking (r≥0.662), whereas the cardiometabolic parameters exhibited low-to-moderate tracking (0.100≤r≤0.571). The clustered scores' tracking was moderate (r≥0.508; r≥0.588 [CRF]). Participants in the higher risk groups at baseline presented 3.81 (95% CI: 2.40; 6.05) and 4.64 (95% CI: 2.85; 7.56), including CRF, times higher chance of remaining at risk three years later. Moreover, participants in the worst profile regarding CRF or anthropometrics at baseline presented at least 4.00 times higher chance of being at risk three years later.

CONCLUSIONS

Participants with worst CRF and adiposity had an increased risk of presenting higher clustered risk after three years.

Physical fitness attenuates the genetic predisposition to obesity in children and adolescents

Obesity is an important risk factor associated with non-communicable cardiometabolic diseases. Previous studies have indicated that children and adolescents with a predisposed genetic risk for obesity could benefit from an active lifestyle, but there are no studies investigating whether physical fitness moderates the association of genetics and obesity. The aim of this study was to verify the moderating role of physical fitness in the relationship between genetic risk score (GRS) and body mass index (BMI) in children and adolescents. This cross-sectional study was carried out with 1471 children and adolescents, aged between 6 and 17 years from Santa Cruz do Sul, Brazil. Weight and height were assessed to determine BMI. Physical fitness components (cardiorespiratory fitness [CRF], lower limb strength [LLS], upper limb strength, and abdominal strength) were evaluated. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analyses were tested using linear regression models, and the interactions were represented by physical fitness components X GRS (categorical variable). All analyses were adjusted for skin color/ethnicity, sex, and sexual maturation. Significant interactions for CRF (P = 0.041), LLS (P = 0.041), and abdominal strength (P = 0.046) X 5 and 6 risk alleles with BMI were found only in adolescents. In addition, there was evidence that fitness components attenuated the high genetic predisposition to high BMI. Physical fitness components are moderators in the relationship between GRS and BMI in adolescents. These findings highlight the need for interventions targeting to improve this aspect, which is an important health indicator in all ages.

Three times as much physical education reduced the risk of children being overweight or obese after 5 years

AIM

We evaluated the effect that increasing physical education lessons from 1.5 to 4.5 hours per week for 5 years had on the body mass index (BMI) and waist circumferences of children aged 5-11 years at inclusion.

METHODS

From 2008 to 2013, six intervention schools in Svendborg, Denmark, delivered 4.5 hours of physical education lessons per week to 750 children. Meanwhile, four matched control schools gave 549 children the standard 1.5 hours of physical education lessons per week. Measurements were taken at baseline and yearly for 5 years. Of the 1299 children, 81 joined the schools after 2008.

RESULTS

At baseline, the percentage of overweight children was 12% in the intervention schools and 13% in the control schools, whereas 15% and 19% were abdominal obese, respectively. After 5 years, the respective risks of remaining abdominal obese or overweight were 43% and 51% in the intervention schools and 78% and 84% in the control schools. Mean BMI increased 0.450 kg/m² more in the control group over the five-year period. The intervention was not effective in decreasing the average waist circumference.

CONCLUSION

Three times as much physical education lessons per week, for 5 years, effectively decreased BMI and the likelihood of remaining overweight or obese.