Contribution of physical education to overall physical activity

Evaluating the Influence of Weight Status and Gender on Moderate to Vigorous Physical Activity and Sedentary Time in Physical Education Lessons: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Low physical activity (PA) and excessive sedentary time negatively impact health, contributing to obesity. Physical education (PE) can help reduce the risk of obesity in schoolchildren. This cross-sectional study objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary time during PE in Türkiye, examining the influence of weight status and gender.

METHOD

Accelerometers measured MVPA in 274 children and adolescents (ages 10-14, 49.6% girls). Sedentary time and MVPA were classified based on accelerometer count per 15 s (sedentary: <25; MVPA: ≥574). A two-way Analysis of Covariance (ANCOVA) assessed body mass index (BMI) and gender effects on MVPA and sedentary time.

RESULTS

Students spent 44.5% of PE time sedentary and 43.2% in MVPA, below the recommended 50% of PE in MVPA. Only 45.6% met this target (44.2% males and 47.1% females). Overweight/obese students had higher sedentary time, while normal-weight students engaged in more MVPA (p < 0.05).

CONCLUSIONS

Students did not meet the recommended 50% of PE in MVPA. Increasing MVPA and reducing sedentary time during PE is particularly important for overweight/obese students. Physical education intervention should target students in co-educational classes.

Correlation Between Physical Activity and Learning Concentration, Self-Management, and Interpersonal Skills Among Korean Adolescents

This study aimed to investigate the association between physical activity participation and key developmental competencies-learning concentration, self-management, and interpersonal skills-among Korean adolescents. Data were drawn from the 2021 Study on the State of Play Culture of Children and Adolescents and Measures to Support Growth, conducted by the Korea Adolescent Policy Institute. The study participants included elementary, middle, and high school students in Korea, consisting of 1507 males (53.3%) and 1322 females (46.7%), totaling 2829. We analyzed the data using frequency distribution, chi-square test, and multivariate logistic regression. The results revealed a significant sex difference in the duration of physical activity, with boys spending more time engaging in physical activity than girls. In addition, time spent on physical activities decreased as the school grade level increased. Notably, the more time Korean adolescents spent engaging in daily physical activity, the higher they rated their learning concentration, self-management, and interpersonal skills. These findings suggest the need to promote greater physical activity among adolescents-particularly among girls-which can help improve learning concentration, self-management, and interpersonal skills.

Physical activity behaviors and screen time in young childhood cancer survivors: the Physical Activity in Childhood Cancer Survivors Study

PURPOSE

In childhood cancer survivors (CCS), high physical activity (PA) and low sedentary time may reduce risks of late-effects. PA behaviors and screen time, and how they relate to moderate-to-vigorous PA (MVPA) in CCS, are largely unknown. We examined PA behaviors and screen time, and their cross-sectional associations with MVPA.

METHODS

CCS from any cancer diagnosis (≥ l year post-treatment), aged 9-16 years at study, were eligible in the international Physical Activity in Childhood Cancer Survivors (PACCS) study. PA behaviors (school transport, intensity-effort in physical education ("PE intensity"), leisure-time PA) and screen time were assessed by self-report, and MVPA by accelerometers (ActiGraph GT3X-BT). Multivariable linear regressions were used to assess associations between PA behaviors and screen time with MVPA.

RESULTS

We included 481 CCS (48% girls, mean age 12.2 years). Passive school transport (prevalence 42%) was associated with 10% lower MVPA/day (β = 6.6 min, 95% CI 3.3-10.0), low PE intensity (prevalence 21%) with 16% lower MVPA/day (β = 10.2 min, 95% CI 6.0-14.3), and low leisure-time PA (prevalence 34%) with 15% lower MVPA/day (β = 9.4 min, 95% CI 1.0-17.7), compared to active school transport, high PE intensity and high leisure-time PA, respectively. High screen time was not associated with MVPA.

CONCLUSION

Interventions aiming to increase PA behaviors rather than reducing screen time may be more efficient in promoting a healthy lifestyle in CCS through increased MVPA. Encouraging active transport, high PE intensity, and high leisure-time PA seems important in survivorship care.

IMPLICATIONS FOR CANCER SURVIVORS

Young CCS may benefit from engaging in active transport, high PE intensity, and high leisure-time PA.

Association between time of assessment within a school year and physical fitness of primary school children

The dissociation of effects of age, time of assessment and cohort is a well-known challenge in developmental science. We examined effects of time of assessment in the school year on children's physical fitness using data from 75,362 German third-graders from seven cohorts. Children were tested once either in the first or second school term of third grade. Tests examined cardiorespiratory endurance (6-min run), coordination (star-run), speed (20-m sprint), lower (standing long jump) and upper (ball-push test) limbs muscle power, and flexibility (stand-and-reach test). We estimated the effect of time of assessment using a regression discontinuity design specified in a linear mixed model with random factors child and school and adjusted for age, sex, and cohort effects. Coordination, speed, and upper limbs muscle power were better in second compared to first school term, with boys exhibiting a larger increase of upper limbs muscle power than girls. There was no evidence for changes in cardiorespiratory endurance, lower limbs muscle power, and flexibility between assessments. Previously reported age and sex effects as well as secular fitness trends were replicated. There is thus evidence for improvement of some physical fitness components beyond age and cohort effects that presumably reflects the benefit of physical activity in physical education and other settings. Effects of assessment time should be taken into consideration in performance-based grading or norm-based selection of children.

Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity

Background

Physical activity (PA) is associated with numerous health benefits. Vigorous PA (VPA) may have a greater impact on public health than lower-intensity PA. The incorporation of a specific recommendation on VPA could complement and improve existing recommendations for average daily moderate-vigorous PA (MVPA). Physical education classes could have a positive impact on children's adherence to average daily physical activity recommendations. The aim was to investigate the association between MVPA and VPA in children, as well as adherence to recommendations, and obesity and the presence of physical education classes.

Methods

A cross-sectional study of physical activity was conducted in a sample of 8 and 9-year-old children in Andalusia (Spain). GENEActiv accelerometers were used, placed on the non-dominant wrist for at least eight consecutive days (24-h protocol). School days with and without physical education class, and weekend days were defined. ROC curves were used to calculate the threshold associated with obesity for average daily MVPA and VPA for recommendations.

Results

A total of 360 schoolchildren were included in the analyses (184 girls). An average of 7.7 (SD 1.4) valid days per participant were evaluated, with 19.9 (SD 10.5) and 11.4 (SD 5.1) minutes of VPA performed by boys and girls respectively. 25.8% of the participants were classified with central obesity. The optimal threshold determined with ROC analysis was 12.5 and 9.5 minutes of average daily VPA for boys and girls, respectively (RecVPA), and 75 minutes of average daily MVPA for both sexes (RecMVPA). The RecVPA showed stronger association with obesity. On school days with physical education class, compared to days without this class, children showed increased VPA and MVPA engagement and better compliance with recommendations, with smaller differences in adherence according to sex or obesity.

Conclusions

On days with physical education class, more physical activity was accumulated at all intensities and greater adherence to the recommendations than on days without this class. VPA had a stronger correlation with the absence of obesity than lower-intensity activity. It was also observed that boys were physically more active and had higher adherence to the recommendations than girls.

Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts

Background

The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation.

Objective

To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs.

Methods

A cross-sectional study of the habitual physical activity of 353 children (8-9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively).

Results

The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001).

Conclusion

One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools

BACKGROUND

In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not.

METHODS

PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess.

RESULTS

Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one.

CONCLUSIONS

Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

Individual and environmental parameters in children with and without developmental coordination disorder: associations with physical activity and body mass index

Introduction

Physical Activity (PA) is a complex behavior, and the relevance of other factors such as BMI, SES and children's behavior at school and home still lacks investigation for children, especially those at risk or with Developmental Coordination Disorder (DCD). The objective of this study was to examine whether socioeconomic status (SES), school's spaces for children's movement, active play, screen time, motor skill proficiency, perceived motor competence, and engagement in the physical education lessons were associated with PA and BMI in children with typical development (TD), at risk of DCD (r-DCD), and with DCD.

Methods

Children (N = 352; 4-10-year-old) from six public schools in a major urban city, in southern of Brazil, were assessed regarding motor skill proficiency (locomotor and ball skills), perceived motor competence, and weight status. PA and engagement in the lesson were assessed using pedometers and a behavior checklist of motor experience of success. Parents recorded the daily time that children spent on screen and in active play.

Results

The hierarchical multivariate linear regressions showed that age, sex, SES, Schools with more favorable space for children's movement, locomotor and ball skills, and successful engagement, were associated with PA for children with TD. Age, screen time, locomotor, and successful engagement were associated with BMI. For children at r-DCD, age, sex, SES, with more favorable space for children's movement, and locomotor were associated with PA. Age, active play and screen time were associated with BMI. For children with DCD, sex, SES, Schools with more favorable space for children's movement, screen time, and successful engagement were associated with PA. Age, sex, active play, and screen time were associated with BMI.

Conclusion

Different factors were associated with PA and BMI for children with different levels of motor impairment (r-DCD and DCD) and children with TD.

Basic Motor Competencies of 6- to 8-Year-Old Primary School Children in 10 European Countries: A Cross-Sectional Study on Associations With Age, Sex, Body Mass Index, and Physical Activity

Basic motor competencies (BMC) are a prerequisite for children to be physically active, participate in sports and thus develop a healthy, active lifestyle. The present study provides a broad screening of BMC and associations with age, sex, body mass index (BMI) and extracurricular physical activity (PA) in 10 different European countries. The different country and regional contexts within Europe will offer a novel view on already established BMC associations. The cross-sectional study was conducted in 11 regions in 10 European countries in 2018. The motor competence areas, object movement (OM) and self-movement (SM), were assessed using the MOBAK-1-2 test instrument in 3758 first and second graders (age: M = 6.86 ± 0.60 years; 50% girls) during Physical Education classes. Children were questioned about their extracurricular PA and age. Their body weight and height were measured in order to calculate BMI. Statistical analyses included variances and correlations. The results showed significant differences in BMC levels between countries (OM: F = 18.74, p < 0.001, η2 = 0.048; SM: F = 73.10, p < 0.001, η2 = 0.163) whereas associations between BMC and correlates were similar. Boys performed significantly better in OM while girls performed better in SM. Age was consistently positively related to OM and SM with older children reaching higher levels of BMC than younger ones. While participation rates for extracurricular PA differed widely, participation in ball sports was correlated with OM and SM. Participation in individual sports showed a significant association with SM. In summary, BMC levels of children seem to depend on where they live and are strongly related to their participation in extracurricular PA. Therefore, education and health policies, in order to enhance motor competence development and PA participation, are recommended. Further research on country-specific Physical Education frameworks and their influence on BMC will provide more insights into structural factors and cultural characteristics of BMC development. On a school level, support tools and educational materials for teachers about BMC may enable children to achieve a basic level of motor competencies through Physical Education, contributing to lifelong participation in PA.

Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.

Physical Activity at Growth Induces Bone Mass Benefits Into Adulthood – A Fifteen‐Year Prospective Controlled Study

Daily school physical activity (PA) improves musculoskeletal traits. Whether or not benefits remain in adulthood is debated. We included in this study 131 children that took part in an intervention with 40 minutes of PA per school day (200 minutes per week) from age 6 to 9 years (grade one) to age 14 to 16 years (grade nine), whereas 78 children continued with national recommended school physical education of 60 minutes per week. Measurements were done with dual‐energy X‐ray absorptiometry (bone mineral content [BMC], bone mineral density [BMD], and bone area), and a computerized knee dynamometer (peak torque muscle strength) at study start, at the end of the intervention, and 7 years after the intervention. Group differences from study start and end of the intervention to 7 years thereafter were estimated by analyses of covariance (adjusted for sex and follow‐up time). Musculoskeletal gains from study start to 7 years after termination of the intervention were higher in the intervention group (total body less head BMC +182.5 g [95% confidence interval {CI}, 55.1–309.9] and BMD +0.03 g/cm² [95% CI, 0.003–0.05], femoral neck area + 0.2 cm² [95% CI, 0.1–0.4], and knee flexion peak torque muscle strength at 60 degrees per second +9.2 Nm [95% CI, 2.9–15.5]). There was no attenuation during the 7 years that followed termination of the intervention (all group comparisons p > 0.05). Benefits in musculoskeletal gains remain 7 years after termination of a daily school‐based PA program, without attenuation after termination of the program. Daily school PA may counteract low bone mass and inferior muscle strength in adulthood. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Children's perceptions of factors influencing their physical activity: a focus group study on primary school children

Purpose

Establishing healthy lifestyle behaviours in primary school children is important, as these behaviours are likely to track into adulthood. This study aimed to explore the factors influencing physical activity (PA) in primary school children through their perspectives.

Approach

Eleven focus group discussions and one interview were conducted with 52 children (n = 29 girls) aged 9–12 years from two primary schools in Singapore. Data analyses were conducted using thematic analysis, deductively following the socio-ecological model (SEM) and inductively for themes at each SEM level.

Results

At individual level, children’s perceived enjoyment, health benefits and expectation of rewards motivated them to engage in PA, while time constraints and their apathy towards PA hindered PA engagement. Children’s PA occasions at home were reported to be influenced by parental permission, priorities and availability, and the availability of preferred peers. Physical environmental factors such as opportunities for PA in school, access to facilities for PA and weather influenced children’s time spent on PA and the types of activities they engaged in.

Conclusion

This study summarized some factors that children have reported to influence their PA behaviour. These findings could help inform future interventions aimed at promoting PA among primary school children in Singapore.

Influence of an increased number of physical education lessons on the motor performance of adolescents-A non-interventional cohort study

Increasing the amount of regular physical education lessons in school is currently discussed in many countries in order to increase physical activity in youth. The purpose of this study was to compare the motor performance of pupils from an observation group participating in a school trial of two additional physical education lessons (5 lessons of each 50 min/week) without a specific intervention program to a control group with a regular amount of three physical education lessons (3 lessons of each 50 min/week) as indicated by the standard Austrian school curriculum. In this cohort study motor performance of 140 adolescents (12.7±0.5 years) was assessed by means of the German Motor Performance Test 6–18 over a period of 1.5 years with measurement time points before (T1), after eight months (T2) and at the end of the observation period (T3). Two- and three-way mixed analysis of variance were used to detect time, group and interaction effects. Although the observation group demonstrated a higher total motor performance score at all time points (P = 0.005), the improvement over time in total motor performance (P < 0.001) was more pronounced in the control group. Girls and boys developed differently over time (time*gender interaction: P = 0.001), whereby group allocation did not affect this interaction (time*gender*group: P = 0.167). Anyway, girls of control group tend to benefit most of additional physical education lessons. Sports club members scored significantly higher in motor performance across the observation period (P = 0.018) irrespective of group allocation. These findings indicate that there could be a ceiling effect in what the pupils could achieve in terms of motor performance as the pupils of the observation group might have reached this point earlier than their counterparts in the control group. Nevertheless, sports club membership seems to reveal some benefits. Whether improving quality and specificity of the single physical lessons might be superior to merely adding additional ones needs to be confirmed in future studies.

Importance of Providing Additional Choices in Relation to Pupils' Happiness, Mastery, Well-Being, Contentment, and Level of Physical Activity in Physical Education

Previous research points to the importance of providing support to autonomy in PE, because it has a particularly positive effect on motivation in PE. However, previous research has not examined the association between autonomy and the variables; happiness, mastery, well-being, contentment and activity level in PE. This study examined how increased self-determination affects happiness, mastery, well-being, contentment and activity level in PE. The study is an intervention (cross-over study) with one control group (one class) and two intervention groups (two classes), using questionnaires and accelerometers among 88 tenth graders (41 boys and 47 girls). The three classes included approximately the same number of boys and girls. The intervention groups included, respectively, 30 and 29 pupils in each class, and 29 pupils' in the control group. The pupils' experiences of happiness, mastery, well-being, contentment was measured three times–after a month with, respectively, ordinary PE, teacher-directed PE, and self-organized PE (autonomy), and the activity levels (accelerometer) was measured during the 24 lessons that took part in the period of teacher-directed PE and self-organized PE. Factor analysis, repeated measures ANOVA (mixed method ANOVA design) and paired sample t-tests with Bonferroni correction were performed, in order to look at differences in happiness, mastery, well-being, contentment and activity level during periods of; self-determination, teacher-directed PE and ordinary PE. The results show that self-determination in PE gives the pupil a significant increased experience of happiness, well-being and contentment, and also a higher activity level in PE. The results indicate that increased self-determination in PE can positively affect lower secondary school pupils' happiness, well-being, contentment and activity level in PE, and that teachers should strive to encourage self-determination among pupils in PE. Further research should be based on intervention studies studying self-determination over longer continuous period, in classes with both older and younger pupils.

Familial Correlates of Leisure Time Activities among Polish Early School-Age Children: A Cross-Sectional Study

The after-school period may play a critical role in the accumulation of children’s physical activity and sedentary time. The study aimed to characterize familial correlates of early school-age children’s leisure time activities. A cross-sectional study was conducted among a group of 223 children (mean age 8.7 ± 0.5) and their parents. The percentage of children with daily leisure time physical activity (LTPA) >1 h was 23.32%, and with daily screen time <2 h was 32.74%. The average children’s leisure time physical activity was significantly higher on weekend days than on weekdays (114.85 vs. 89.43 min, p = 0.005). Similarly, the average screen time was higher on weekend days than on weekdays (95.50 vs. 66.10 min, p < 0.001). The multivariate regression analysis revealed that independent predictors of children’s leisure time physical activity were the father’s education level and the father’s occupational status, whereas at least one parent with higher education correlated negatively with children’s longer screen time. The study showed that children’s leisure time activities are associated with parental education and differ significantly between weekdays and weekend days. These findings underline the need for screening for unfavorable health behaviors among early school-age children, and indicate that health promotion programs should be oriented on both parents and children aiming to improve parental health consciousness, reduce screen time and increase physical activity, especially during the weekend.

An Update on Secular Trends in Physical Fitness of Children and Adolescents from 1972 to 2015: A Systematic Review

BACKGROUND

There is evidence that physical fitness of children and adolescents (particularly cardiorespiratory endurance) has declined globally over the past decades. Ever since the first reports on negative trends in physical fitness, efforts have been undertaken by for instance the World Health Organization (WHO) to promote physical activity and fitness in children and adolescents. Therefore, it is timely to re-analyze the literature to examine whether previous reports on secular declines in physical fitness are still detectable or whether they need to be updated.

OBJECTIVES

The objective of this systematic review is to provide an 'update' on secular trends in selected components of physical fitness (i.e., cardiorespiratory endurance, relative muscle strength, proxies of muscle power, speed) in children and adolescents aged 6-18 years.

DATA SOURCES

A systematic computerized literature search was conducted in the electronic databases PubMed and Web of Science to locate studies that explicitly reported secular trends in physical fitness of children and adolescents.

STUDY ELIGIBILITY CRITERIA

Studies were included in this systematic review if they examined secular trends between at least two time points across a minimum of 5 years. In addition, they had to document secular trends in any measure of cardiorespiratory endurance, relative muscle strength, proxies of muscle power or speed in apparently healthy children and adolescents aged 6-18 years.

STUDY APPRAISAL AND SYNTHESIS METHODS

The included studies were coded for the following criteria: nation, physical fitness component (cardiorespiratory endurance, relative muscle strength, proxies of muscle power, speed), chronological age, sex (boys vs. girls), and year of assessment. Scores were standardized (i.e., converted to z scores) with sample-weighted means and standard deviations, pooled across sex and year of assessment within cells defined by study, test, and children's age.

RESULTS

The original search identified 524 hits. In the end, 22 studies met the inclusion criteria for review. The observation period was between 1972 and 2015. Fifteen of the 22 studies used tests for cardiorespiratory endurance, eight for relative muscle strength, eleven for proxies of muscle power, and eight for speed. Measures of cardiorespiratory endurance exhibited a large initial increase and an equally large subsequent decrease, but the decrease appears to have reached a floor for all children between 2010 and 2015. Measures of relative muscle strength showed a general trend towards a small increase. Measures of proxies of muscle power indicated an overall small negative quadratic trend. For measures of speed, a small-to-medium increase was observed in recent years.

LIMITATIONS

Biological maturity was not considered in the analysis because biological maturity was not reported in most included studies.

CONCLUSIONS

Negative secular trends were particularly found for cardiorespiratory endurance between 1986 and 2010-12, irrespective of sex. Relative muscle strength and speed showed small increases while proxies of muscle power declined. Although the negative trend in cardiorespiratory endurance appears to have reached a floor in recent years, because of its association with markers of health, we recommend further initiatives in PA and fitness promotion for children and adolescents. More specifically, public health efforts should focus on exercise that increases cardiorespiratory endurance to prevent adverse health effects (i.e., overweight and obesity) and muscle strength to lay a foundation for motor skill learning.

The Role of Preschool Hours in Achieving Physical Activity Recommendations for Preschoolers

Research on physical activity (PA) in different educational settings could elucidate which interventions promote a healthy school lifestyle in early childhood education (ECE). The aims of this study were: (a) to analyse the PA levels of preschoolers during school hours, as well as the rate of compliance with specific recommendations on total PA (TPA) and moderate-vigorous PA (MVPA); (b) to examine the role of structured movement sessions and recess time in the MVPA levels during school hours; (c) to evaluate the sociodemographic correlates of preschoolers and the school environment on MVPA behaviour during school hours. PA was evaluated with Actigraph accelerometers. Our main findings were that: (a) preschoolers engaged in very little TPA and MVPA during school hours; (b) children showed significantly higher MVPA levels on days with versus without structured movement sessions, and the contribution of the structured sessions to MVPA was significantly higher than that of recess time; (c) gender and age were associated with PA, and a high density of young children on the playground was associated with high levels of vigorous PA, whereas in the classroom, high density was associated with more sedentary behaviour. Structured PA could reduce the gap in achieving international recommendations.

Changes in Self-Reported Physical Activity Predict Health-Related Quality of Life Among South African Schoolchildren: Findings From the DASH Intervention Trial

Introduction: Regular physical activity is associated with multiple health benefits for children. Evidence from cross-sectional studies suggests that physical activity is positively associated with health-related quality of life (HRQoL). The promotion of physical activity, and hence HRQoL, through a school-based intervention is therefore an important endeavor, particularly in disadvantaged areas of low- and middle-income countries, including South Africa.

Methods: We designed a multicomponent physical activity intervention that was implemented over a 20-week period in 2015 in eight disadvantaged primary schools of Port Elizabeth, South Africa. Overall, 758 children aged 8–13 years participated. HRQoL was measured with the 27-item KIDSCREEN questionnaire. Self-reported physical activity was assessed with a single item of the Health-Behavior of School-Aged Children test, and cardiorespiratory fitness with the 20-m shuttle run test. Post-intervention scores were predicted with mixed linear regression models, taking into consideration the clustered nature of the data.

Results: Higher baseline levels as well as increasing levels of self-reported physical activity predicted all dimensions of children's HRQoL. Baseline levels and increases in cardiorespiratory fitness predicted children's self-perceived physical well-being (one of the HRQoL subscales). Participation in the multicomponent physical activity intervention did not affect children's HRQoL.

Conclusion: Higher and increasing self-reported physical activity predict all assessed HRQoL dimensions, which underlines that the promotion of regular physical activity among children living in disadvantaged settings is an important public health measure. Policy makers should encourage schools to create physical activity friendly environments, while schools should implement regular physical education as proposed by the school curriculum.

Determinants of Physical Activity and Sedentary Behavior in German Elementary School Physical Education Lessons

Physical activity (PA) in school physical education (PE) is a signature component of health promotion and health education. The study's aim was to explore PA levels and sedentary time in German elementary school PE lessons and relate them to selected personal and environmental PA determinants. Accelerometer measurements were collected from 328 students (47% male, mean age 8.7 ± 1.2 years) in 11 elementary schools in Baden-Wuerttemberg (Germany). PA levels and sedentary time were analyzed regarding gender, grade, body mass index, selected correlates of active living and health behaviors, as well as the PE teachers' PE education status. In line with previous research, the analyses of PA levels and sedentary time confirm gender and grade differences and highlight older girls as the less active group. Deviant weight status and parents' PA levels were found to be important determinants for PA levels and sedentary time of girls and offer starting points for intervention studies as well as gender-appropriate PE in elementary schools. Specialist PE teacher status proved to be a negative determinant of PA levels and sedentary time for boys and girls and should be investigated in further studies, especially regarding the didactic and methodological background.

Physical activity patterns in a representative sample of adolescents from the largest city in Latin America: a cross-sectional study in Sao Paulo

OBJECTIVES

We examined the patterns of total and domain-specific physical activity (PA) by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo city, Brazil.

DESIGN

Cross-sectional study.

PARTICIPANTS

We included a representative sample of 2682 (52.2% boys) adolescents aged 14-15 years from public and private schools in Sao Paulo, 2017. Socioeconomic status was assessed using a wealth index derived from principal component analysis. Descriptive analyses evaluated differences in total and domain-specific PA by sex, socioeconomic status and maternal education level.

OUTCOME MEASURES

We collected data on the frequency and duration that adolescents spent in each PA domain (active transportation, leisure PA and physical education classes) through a self-report questionnaire.

RESULTS

On average, adolescents spent 197.7 min/week (95% CI 190.6-204.8) in total PA. The proportion of adolescents achieving at least 60 min/day (≥420 min/week) was 12.7% (95% CI 11.4-14.1), with a higher prevalence in boys (18.3%) and in those with higher socioeconomic status (17.4%). Similar patterns were observed for leisure PA and physical education classes. Active transportation was higher in girls (46.0 min/week; 95% CI 42.6-49.6) than in boys (43.4 min/week, 95% CI 39.9-46.6). Boys and adolescents with higher socioeconomic status and higher maternal education level had higher levels of total PA.

CONCLUSIONS

We found a variation in patterns of total and domain-specific PA by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo. Initiatives for promoting PA in adolescents should take these findings into account.

Physical Activity Levels of Chilean Children in a National School Intervention Programme. A Quasi-Experimental Study

Background. Recess is a great opportunity to interrupt sedentary behaviour and increase moderate-to-vigorous physical activity (MVPA) in schoolchildren. This quasi-experimental study aimed to compare the levels of physical activity (PA) during the school day of children in a school intervention programme vs. those in a control group, and to determine compliance with MVPA recommendations. Methods. A sample of 154 schoolchildren (6–12 years old) was obtained from several schools (70 with the intervention and 84 controls). This programme was structured with a duration of 90 min/session and performed three times/week. PA levels were recorded with triaxial accelerometers during the school day: during recess, during a PA session or physical education session (PE), and during lunchtime. No pre-intervention evaluation was performed. Results. The MVPA of the control group was higher than that of the intervention group during the first recess (p < 0.001). None of the groups complied with the recommendations for steps during the PA or PE sessions. During the PA session, sedentary time was lower and MVPA was higher, in the intervention group than in the control group. Fifty percent of the children from the intervention group complied with the MVPA recommendations, vs. 22.7% of those in the control group. Conclusions. The schoolchildren in the intervention group performed more MVPA than those in the control group. Future interventions could include other periods, such as recess and lunchtime, which are opportunities for improving the MVPA levels of schoolchildren.

Improvements in Physical Activity Levels after the Implementation of an Active-Break-Model-Based Program in a Primary School

The aim of this study was to analyze changes in the physical activity levels in students after implementing an active break (AB)-model-based program during the school day. Forty-four fifth-grade primary school children (24 boys, 20 girls, with a mean age = 10.44 ± 0.45) participated in a 17 week program. After intervention, there was an increase in moderate and vigorous total activity during physical education lessons, non-physical education lessons, and recesses. Intervention programs to encourage physical activity and decrease sedentary time are recommended.

A Mixed Methods Study to Examine the Influence of CLIL on Physical Education Lessons: Analysis of Social Interactions and Physical Activity Levels

Physical Education is often selected for applying multilingual initiatives through the use of a content and language integrated learning (CLIL) approach. However, it is still unclear whether the introduction of such an approach might entail losing the essence of physical education and distorting its basic purposes. The aim of this study is to analyze the impact of CLIL on physical education lessons. Given the purpose of this study, a mixed methodological approach based on a sequential exploratory design divided into two different phases is used. We begin with initial qualitative data collection (phase I), consisting of the analysis of interviews with 12 participants (8 teachers and 4 students). Based on its analysis, two foci are identified: social relationships and physical activity. Then, informed by the results obtained, a quantitative approach is used (phase II), differentiating these two sets of data to make a more in-depth analysis of them. On the one hand, a sociometric questionnaire was applied to analyze the social relationships between CLIL students. On the other hand, a quasi-experimental design (n = 49) was implemented using accelerometry to measure moderate to vigorous physical activity (MVPA) in the physical education sessions. Regarding physical activity, the results show that levels of MVPA are higher in the experimental group (CLIL) than in the control group, a result which clarifies the divergent viewpoints of the interviewees. However, focusing on social relationships, the sociometric questionnaire results show that there were no statistically significative changes, although some signs of a slight effect on students’ relationships arise depending on their gender. Therefore, more research would be necessary to further study the effect of CLIL in this regard.

Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design

BACKGROUND

In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both.

METHODS

Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation.

DISCUSSION

The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent.

TRIAL REGISTRATION

The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.

The Role of School in Helping Children and Adolescents Reach the Physical Activity Recommendations: The UP&DOWN Study

BACKGROUND

The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods.

METHODS

The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods.

RESULTS

Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC.

CONCLUSIONS

Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents.

Contribution of Physical Education to the Daily Physical Activity of Schoolchildren in Saudi Arabia

The positive contribution of physical education (PE) to daily physical activity (PA) has been documented in past studies. However, little is known about the contribution of PE to inactive and unfit schoolchildren’s PA. Therefore, the purpose of the present study was to examine the contribution of PE to the daily PA of schoolchildren, especially for inactive and unfit schoolchildren. Accelerometers were used to measure the PA of 111 boys (M_age = 13.6 ± 0.8 years) across 7 days. Moderate-to-vigorous PA (MVPA) was measured during PE classes and on school days with and without PE classes. To measure the time that schoolchildren spent on MVPA, the accelerometer count (i.e., ≥2296 counts/minute) was used. Schoolchildren spent 22% of PE class time in MVPA. Times spent in MVPA were 12.9, 14.7 and 14.8 minutes higher on PE days than on days without PE for all, inactive, and unfit schoolchildren, respectively. Results showed that 40% percent and 24% of the schoolchildren met the recommended levels of PA on PE days and days without PE, respectively. It is concluded that, since PE classes increase daily engagement in MVPA, especially among inactive and unfit schoolchildren, PE classes should be conducted on all school days.

Using the School Environment to Promote Walking amongst Adolescent Females: A Mixed-Method Study

Schools have the potential to promote physical activity (PA) in adolescents through physical education (PE) and extra-curricular PA. The aims of this study were to firstly understand the experiences of adolescent females who participated in a school-based walking programme (the Walking In ScHools (WISH) study) and secondly, to assess the potential for schools to further promote PA outside of structured PE. A sample of female participants (n = 45, mean age 13.1 years) who participated in the WISH study were randomly selected to participate in focus group discussions, to explore their experiences of the intervention. In addition, an online survey was distributed to all post-primary schools (n = 208) in Northern Ireland to assess the provision of extra-curricular PA and further evaluate the feasibility of the WISH study. In total, six focus groups were conducted. Walking during the school day was viewed as an acceptable form of PA by adolescent females, providing an opportunity to be active with friends, and helped participants overcome barriers previously associated with being active at school. Responding schools (n = 59) identified adolescent females and non-sporty pupils as sub-groups who would benefit most from participation in a school-based walking programme. This study has highlighted that the delivery of a walking programme within the school setting is acceptable, warranted and practically feasible from the point of view of adolescent females and key stakeholders within the school setting.

Effect of a Multidimensional Physical Activity Intervention on Body Mass Index, Skinfolds and Fitness in South African Children: Results from a Cluster-Randomised Controlled Trial

Obesity-related conditions impose a considerable and growing burden on low- and middle-income countries, including South Africa. We aimed to assess the effect of twice a 10-week multidimensional, school-based physical activity intervention on children’s health in Port Elizabeth, South Africa. A cluster-randomised controlled trial was implemented from February 2015 to May 2016 in grade 4 classes in eight disadvantaged primary schools. Interventions consisted of physical education lessons, moving-to-music classes, in-class activity breaks and school infrastructure enhancement to promote physical activity. Primary outcomes included cardiorespiratory fitness, body mass index (BMI) and skinfold thickness. Explanatory variables were socioeconomic status, self-reported physical activity, stunting, anaemia and parasite infections. Complete data were available from 746 children. A significantly lower increase in the mean BMI Z-score (estimate of difference in mean change: −0.17; 95% confidence interval (CI): −0.24 to −0.09; p < 0.001) and reduced increase in the mean skinfold thickness (difference in mean change: −1.06; 95% CI: −1.83 to −0.29; p = 0.007) was observed in intervention schools. No significant group difference occurred in the mean change of cardiorespiratory fitness (p > 0.05). These findings show that a multidimensional, school-based physical activity intervention can reduce the increase in specific cardiovascular risk factors. However, a longer and more intensive intervention might be necessary to improve cardiorespiratory fitness.

Objectively evaluated physical activity and sedentary time in primary school children by gender, grade and types of physical education lessons

Background

During the typical school day, physical education (PE) gives children an opportunity for physical activity (PA) and reduces their sedentary time, but little is known about objectively evaluated PA and sedentary time during PE lessons and the differences across genders and grades. There is also a lack of research comparing PA and sedentary time among the different types of PE lessons. The primary aim of this study was to examine primary school students’ moderate-to-vigorous PA (MVPA) levels and sedentary time during PE and whether there are gender or grade differences in a cross-sectional study. The secondary aim was to determine which types of PE lessons are best for increasing PA and reducing sedentary time.

Methods

Objectively evaluated MVPA and sedentary time during PE lessons in Japan with a triaxial accelerometer (Active style Pro HJA-350IT, Omron Healthcare) in girls (n = 221) and boys (n = 181). Minutes of sedentary time were categorized into metabolic equivalents (METs): categories ranged from sedentary time (METs ≤1.5) to MVPA (METs ≥3.0). Time tables and PE lesson types were evaluated using logs maintained by the class teachers.

Results

Time spent in MVPA and sedentary time were 27.3 and 24.3%, respectively. After adjustments for grade, relative body weight and school, boys spent significantly more time in MVPA compared with girls, but with an estimated mean difference of approximately 1 min. After adjustment for gender, relative body weight and school, the younger grades (1st and 2nd) spent significantly more time in MVPA and significantly less time in sedentary time compared with other grades. Moreover, after adjustments for gender, grade, relative body weight and school, the time spent in MVPA during gymnastic and track and field lessons was significantly lower than that during ball game lessons. Sedentary time during gymnastic lessons was significantly longer than in track and field and ball game lessons.

Conclusions

Children did not engage in much MVPA and also spent time in sedentary time during PE, but there are no gender differences. The children were most active during ball game lessons. Therefore, it is important to increase MVPA and reduce sedentary time during PE in both genders.

Physical Education Increases Daily Moderate to Vigorous Physical Activity and Reduces Sedentary Time

BACKGROUND

Physical activity (PA) is important to mental and physical health. Physical education (PE) lessons have the potential to increase daily moderate to vigorous PA (MVPA) and reduce sedentary time (SED). We measured MVPA and SED in primary school PE, determined the contribution of PE to daily MVPA and SED, and compared PA on days with and without PE.

METHODS

PA was measured in 504 first (ages 7-9) and second (ages 10-12) school level children for 1 school week, with inclusion criteria of at least 10 hours of valid data. Linear mixed methods were used for data analysis.

RESULTS

In PE, students spent 28.6 ± 16.5% in MVPA and 29.3 ± 19.8% in SED. Each additional MVPA minute in PE was associated with 1.4 more daily MVPA minutes. On days with PE, students had 12.8 (95% CI 10.5; 15.0) minutes more MVPA and 9.7 (95% CI 16.3; 3.1) minutes less SED compared with days without PE.

CONCLUSIONS

Although MVPA in PE was relatively low and SED high, PE significantly increased daily MVPA and reduced SED, confirming the important role of PE in supporting the healthy development of children.

Physical education policy compliance and Latino children's fitness: Does the association vary by school neighborhood socioeconomic advantage?

OBJECTIVES

To investigate the contribution of school neighborhood socioeconomic advantage to the association between school-district physical education policy compliance in California public schools and Latino students' physical fitness.

METHODS

Cross-sectional Fitnessgram data for public-school students were linked with school- and district-level information, district-level physical education policy compliance from 2004-2005 and 2005-2006, and 2000 United States Census data. Multilevel logistic regression models examined whether income and education levels in school neighborhoods moderated the effects of district-level physical education policy compliance on Latino fifth-graders' fitness levels.

RESULTS

Physical education compliance data were available for 48 California school districts, which included 64,073 Latino fifth-graders. Fewer than half (23, or 46%) of these districts were found to be in compliance, and only 16% of Latino fifth-graders attended schools in compliant districts. Overall, there was a positive association between district compliance with physical education policy and fitness (OR, 95%CI: 1.38, 1.07, 1.78) adjusted for covariates. There was no significant interaction between school neighborhood socioeconomic advantage and physical education policy compliance (p>.05): there was a positive pattern in the association between school district compliance with physical education policy and student fitness levels across levels of socioeconomic advantage, though the association was not always significant.

CONCLUSIONS

Across neighborhoods with varying levels of socioeconomic advantage, increasing physical education policy compliance in elementary schools may be an effective strategy for improving fitness among Latino children.

Predictors of Segmented School Day Physical Activity and Sedentary Time in Children from a Northwest England Low-Income Community

Background: Schools have been identified as important settings for health promotion through physical activity participation, particularly as children are insufficiently active for health. The aim of this study was to investigate the child and school-level influences on children′s physical activity levels and sedentary time during school hours in a sample of children from a low-income community; Methods: One hundred and eighty-six children (110 boys) aged 9–10 years wore accelerometers for 7 days, with 169 meeting the inclusion criteria of 16 h∙day⁻¹ for a minimum of three week days. Multilevel prediction models were constructed to identify significant predictors of sedentary time, light, and moderate to vigorous physical activity during school hour segments. Child-level predictors (sex, weight status, maturity offset, cardiorespiratory fitness, physical activity self-efficacy, physical activity enjoyment) and school-level predictors (number on roll, playground area, provision score) were entered into the models; Results: Maturity offset, fitness, weight status, waist circumference-to-height ratio, sedentary time, moderate to vigorous physical activity, number of children on roll and playground area significantly predicted physical activity and sedentary time; Conclusions: Research should move towards considering context-specific physical activity and its correlates to better inform intervention strategies.

A non-equivalent group pilot trial of a school-based physical activity and fitness intervention for 10-11 year old english children: born to move

Background

PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes.

Methods

Participants were 139 children aged 10–11 years from four schools. For six weeks children in two schools received a twice-weekly pilot ‘Born to Move’ (BTM) physical activity (PA) and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM) schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA), moderate (MPA), vigorous (VPA), and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF), and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0), midway through the intervention (T1), and at the end (T2) using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests.

Results

The BTM group engaged in moderate PA for significantly more lesson time (29.4 %) than the COM group (25.8 %; p = .009, d = .53). The amount of moderate-to-vigorous PA (MVPA) during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group’s T1 PE lesson (11.4 %; p < .001, d = .47). The BTM group were significantly more active during the whole-day (p < .05) and the school-day (p < .01). In both groups push-up test performance increased (p < .001) and CRF test performance decreased (p < .01). Perceived exertion, enjoyment, and perceived competence increased in both groups (p < .05), but the BTM group rated their enjoyment of the T1 BTM lesson higher than the COM group rated their PE lesson (p = .02, d = .56). The children’s and teachers’ responses to the intervention indicated that the delivery aims of enjoyment, engagement, inclusivity, and challenge were satisfied.

Conclusions

The BTM pilot programme has potential to positively impact on physical activity, fitness, and psychosocial outcomes. Further, BTM was enjoyed by the children, and valued by the teachers. This study can inform the design of a modified larger-scale cluster RCT evaluation.

Correlates of sedentary behaviour in 8- to 10-year-old children at elevated risk for obesity

The purpose of this study was to describe correlates of sedentary behaviour (SED) in children at elevated risk of obesity because of parental obesity. Participants were 534 children aged 8-10 years with ≥ 1 obese parent. SED and physical activity (PA) were measured by accelerometer, screen time by self-report, and height, weight, waist circumference, and cardiovascular fitness objectively measured. Data describing the child, parents, friends, and home and neighbourhood environments were from child self-report. Higher total SED time was significantly positively associated with child's age, mother's age, Tanner stage, weight status or waist circumference, less self-reported PA, choosing screen time over PA/sport, mother saying PA/sport good for them, and fewer weekly physical education (PE) classes. Exceeding 2 h/day screen time was significantly associated with child's age, male sex, weight status or waist circumference, choosing screen time over PA/sport, and dinnertime TV viewing. Children regularly watching TV with dinner had 2.3 times greater odds (95% confidence interval (CI) 1.52, 3.58) of exceeding screen time guidelines compared with children rarely watching TV with dinner; children reporting ≤ 2 PE classes/week had 2.4 times greater odds (95% CI 1.41, 4.10) of being in the highest SED tertile compared with children reporting >2 PE classes/week. Hence, the most sedentary children are older, more biologically mature, less active, more overweight/obese, have fewer PE classes, and are more likely to choose screen time over PA and watch TV with dinner compared with less sedentary children. PE opportunities and mealtime TV viewing are potentially modifiable targets for reducing total SED and screen time in children.

Outcomes of a four-year specialist-taught physical education program on physical activity: a cluster randomized controlled trial, the LOOK study

BACKGROUND

The objective of this study was to investigate the effect of a 4-year specialist-taught Physical Education (PE) program on physical activity (PA) among primary school children.

METHODS

A 4-year cluster randomised controlled trial was conducted in children (initially aged 8 years) from 29 primary schools (13 Intervention, 16 Control). Intervention students (N = 457) received 2 × 45 min PE lessons per week from specialist-trained PE teachers (68 lessons per year, 272 lessons over 4 years). Control group students (N = 396) received usual practice PE from generalist classroom teachers. PA during PE lessons was examined using the System for Observing Fitness Instruction Time (SOFIT). Pedometers (steps/day) were worn for 7 days each year, and accelerometers were worn concurrently in the final two years to assess moderate to vigorous (MVPA) and sedentary activity. Linear and generalized mixed models were used to determine differences in Intervention and Control student PA and the proportion of students meeting PA guidelines.

RESULTS

The intervention increased SOFIT-observed student MVPA during PE lessons by 6.5 mins (16.7 v 10.2, p < 0.001). Within intervention schools, participants increased their whole-day step counts (boys = 449 [CI,140 to 756]; girls = 424 [CI,222 to 626]) and minutes of MVPA (boys = 8.0 [CI,6.8 to 9.2]; girls = 3.5 [CI,1.7 to 5.4]) on PE days. However, compared to the Control group the Intervention did not: increase habitual steps/day or MVPA when averaged over 7 days; elicit greater improvements in these measures over time; or increase the odds of meeting step/day or MVPA recommendations. At age 11 years Intervention group boys were 20 mins less sedentary per day (380 [CI,369 to 391] vs 360 [CI,350 to 369]) and this effect was sustained at age 12 years.

CONCLUSIONS

Well-designed specialist-taught PE can improve student PA during PE lessons. However for PE to be a significant contributor to improving habitual PA in pre-adolescent children, daily classes are likely to be required, and even this would need to be supplemented with a wider multicomponent strategy. Our finding of a reduction in sedentary time among Intervention boys warrants further investigation into the potential role PE could play in influencing sedentary behaviour.

Current influences and approaches to promote future physical activity in 11-13 year olds: a focus group study

BACKGROUND

Many children and adolescents are failing to meet current physical activity (PA) guidelines and consequently not achieving the benefits associated with regular participation in PA, with girls consistently less active than boys. In order to design interventions to increase physical activity in adolescents it is important to understand their perceptions of and preferences for physical activity.

METHODS

One hundred eighty participants, mean (SD) age 12.1 (0.5) years, completed the Physical Activity Questionnaire for Children (PAQ-C) and had height and weight measured. This information was used to select a subsample of participants (n64; mean (SD) age 12.3 (0.4) years; 39 females; 25 males; 25 % overweight/obese) to take part in focus group discussions. Participants were grouped based on PAQ-C responses into 'low-active' and 'highly-active' groups, so that those with similar existing levels of PA were in the same focus group. A semi-structured discussion guide was employed to explore the key influences on current PA participation and to actively seek ideas on how best to promote future PA in this population. In total, nine focus groups (mixed-gender) were conducted within the school setting. All focus groups were audio recorded, transcribed verbatim and analysed thematically.

RESULTS

A number of themes emerged in relation to influences on current PA including friendship and peers, family and other people, the consequences of not taking part in PA, changing priorities, and cost and access to resources. With regards to the future provision of PA, participants favoured opportunities to try new activities, increased provision of school-based activities which can be undertaken with friends and activities which incorporated the use of technology and encouragement through rewards and incentives. Gender differences were apparent in relation to the types of activities participants preferred taking part in. Differences were also observed between 'low-active' and 'highly-active' groups in relation to barriers to current participation in PA.

CONCLUSIONS

This study has highlighted a number of influences on current and future participation in PA, which differed based on gender and existing PA levels, for example, maximising the potential of the school day and including technology and incentives. These components can inform targeted interventions to increase PA in low active adolescents.

Sociodemographic and behavioral factors associated with physical activity in Brazilian adolescents

Background

Physical activity in adolescents is associated with short- and long-term health benefits. Physical activity can occur in various domains and is influenced by a complex network of factors. The aims of this study are 1) to describe the physical activity of Brazilian adolescents in physical education classes, during leisure time, and during active commuting and 2) to investigate the socio-demographic and behavioral factors associated with physical activity.

Methods

The representative sample included 109,104 Brazilian students in the final year of elementary school from 2,842 schools. The weekly frequency and duration of physical activity were assessed. A variety of socio-demographic and behavioral factors were studied. A multiple Poisson regression analysis was used to test for associations between physical activity and the socio-demographic and behavioral variables.

Results

Most of the students (97.0%) engaged in physical activity in at least one of the domains studied, especially physical education at school (81.7%) and leisure time physical activity (67.5%). However, only 29% of the adolescents reached the recommended level of physical activity. Among the adolescents who reached the minimum recommended time for physical activity, the various domains contributed the following proportions to total physical activity: leisure time physical activity (PR 12.5; 95% CI 11.17-13.97), active commuting (PR 1.63; 95% CI 1.59-1.67), and physical education at school (PR 1.36; 95% CI 1.29-1.44). The weekly frequency of all activities was greater among boys than among girls. Moreover, nearly two-thirds (61.8%) of students spent more than two hours per day engaging in sedentary behaviors; the prevalence of sedentary behaviors was similar between boys and girls (59.0 and 64.5%, respectively).

Total level of physical activity, leisure time physical activity, and active commuting were associated with higher nutritional scores.

Conclusions

Physical activity is important in any health promotion program. Therefore, it is necessary to invest in policies and interagency initiatives that promote all domains and to ensure that the general population helps determine the scope and design of such policies.

The contributing role of physical education in youth's daily physical activity and sedentary behavior

Background

School physical education (PE) is considered as an effective channel for youth to accumulate moderate-to-vigorous physical activity (MVPA) and reduce sedentary time. The purpose of this study was to determine the contributing role of PE in daily MVPA and sedentary time among youth.

Methods

The study recruited 67 sixth grade children (29 boys; Mean age = 11.75) from two suburban schools at a U.S. Midwest state, 48 of whom contributed ≥10 hours of physical activity (PA) data per day were included for analysis. An objective monitoring tool (i.e., Sensewear armband monitor) was used to capture the participants’ MVPA and sedentary time for 7–14 days. Pearson product–moment correlation analysis (r), multi-level regression analyses, and analysis of variance were conducted for data analysis.

Results

MVPA and sedentary time in PE showed significant positive associations with daily MVPA and sedentary time, respectively (r = 0.35, p < 0.01; r = 0.55, p < 0.01). Regression analyses revealed that one minute increase in MVPA and sedentary behavior in PE was associated with 2.04 minutes and 5.30 minutes increases in daily MVPA and sedentary behavior, respectively, after controlling for sex and BMI. The participants demonstrated a significantly higher level of MVPA (p = .05) but similar sedentary time (p = 0.61) on PE days than on non-PE days. Boys had significantly more daily MVPA (p < .01) and less sedentary time (p < .01) than girls; while higher BMI was associated with more sedentary time (p < .01).

Conclusions

PE displayed a positive contribution to increasing daily MVPA and decreasing daily sedentary time among youth. Active participation in PE classes increases the chance to be more active and less sedentary beyond PE among youth.

High-volume sports club participation and autonomic nervous system activity in children

BACKGROUND

Sixty minutes of daily moderate-to-vigorous physical activity (PA) are recommended for children. This study investigated the additional impact of high-volume sports club participation on the autonomic nervous system in active children, while controlling for acute effects of short-term PA.

MATERIALS AND METHODS

Forty-nine children (29 females) aged 10-13 years were investigated. Sports club participation was assessed with a validated questionnaire. Short-term PA and night-time autonomic tone (spectral power and nonlinear analysis of heart rate variability) were measured with an ambulatory device (Actiheart(®) ). Children were dichotomized into two groups, based on their individual weekly time spent in a sports club: low-volume group < 180 min/week (N = 26) and high-volume group ≥ 180 min/week (N = 23).

RESULTS

Children in the high-volume group exhibited higher indices of vagal tone compared with the children in the low-volume group. Short-term moderate PA had a significant impact on the night course of autonomic activity. Boys showed a linear increase in vagal activity over the night course in relation to volumes of short-term moderate PA of the previous day. A similar but nonsignificant trend was observed for girls.

CONCLUSIONS

In active children, higher volumes of sports club participation have an additional benefit on indices of autonomic tone.

Differences in weight status and energy-balance related behaviors among schoolchildren in German-speaking Switzerland compared to seven countries in Europe

Background

Overweight in children and adolescents have increased significantly and are a major public health problem. To allow international comparisons, Switzerland joined the European study ‘ENERGY’ cross sectional survey consortium that investigated the prevalence of overweight and obesity as well as selected dietary, physical and sedentary behaviors of 10–12 years old pupils across seven other countries in Europe. The aims of the present study was to compare body composition and energy-balance related behaviors of Swiss schoolchildren to those of the seven European ENERGY-countries and to analyze overweight and energy-balance related behaviors of Swiss children according to socio-demographic factors.

Methods

A school-based cross-sectional study among 10–12 year old children was conducted in Switzerland and seven other European countries using a standardized protocol. Body height, weight and waist-circumference were measured by trained research assistants. Energy-balance related behaviors –i.e. selected dietary, physical activity and screen-viewing behaviors were assessed by questionnaires. Weight status and behaviors in Switzerland were compared to the seven European ENERGY countries. Within the Swiss sample, analyses stratified by gender, parental education and ethnicity were performed.

Results

Data of 546 Swiss children (mean age 11.6±0.8y, 48% girls) were obtained and compared to the ENERGY- results (N=7.148; mean age 11.5±0.8y, 48% girls). In Switzerland significantly less children were overweight (13.9%) or obese (2.3%) compared to the average across the ENERGY-countries (23.7% and 4.7%, respectively), and were even somewhat lower than the ENERGY countries with the lowest prevalence. Sugar sweetened beverage intakes and breakfast habits of Swiss children did not differ significantly from those of ENERGY. However, the mean time devoted by Swiss children to walking or cycling to school and attending sports activities was significantly higher and screen time significantly lower compared to the other ENERGY-countries. Within the Swiss, sample relatively large and consistent differences were observed between children from native and non-native ethnicity.

Conclusions

The prevalence of overweight and obesity among Swiss children are substantial but significantly lower compared to all other European ENERGY-Partners, probably due to the fact that Swiss children were found to be more active and less sedentary comparing to the rest of the European sample.