Enrollment in physical education is associated with health-related behavior among high school students

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

Purpose

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

Method

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

Results

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

Discussion/conclusion

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

Identifying latent classes of physical activity profiles over time among adolescents in Ontario, Canada

BACKGROUND

Physical activity behaviours are known to be highly correlated. Adolescents who participate in one type of physical activity (e.g., physical education) have a greater likelihood of participating in other physical activities (e.g., organized sports); however, little research has examined participation rates in various physical activity behaviours concurrently. This study identified longitudinal physical activity profiles among secondary school aged youth in Ontario, Canada.

METHODS

We used data from the COMPASS Study, a school-based prospective cohort study of adolescents in Canada. Using a repeated measures latent class analysis, Ontario students who participated in grade 9 PE in 2015-16 were analysed through to 2018-19 (n = 1,917). Latent classes were defined by: PE participation, guideline adherence (≥ 60 min/day of moderate to vigorous activity over the last 7 days), and sport participation (varsity, community, and/or intramural). Multinomial logistic regression models were used to examine associations between latent class membership and student characteristics.

RESULTS

Three distinct latent classes were identified for females and four were identified for males. These classes were: (1) Guidelines (high probability of guideline adherence; females: 44%; males: 16%), (2) PE & Sports (high probability of PE and sport participation; females: 33%; males: 43%), (3) Guidelines & Sports (high probability of guideline adherence and sport participation; females: 23%; males: 23%;), and (4) Inactive (low probability of all physical activity indicators; males: 18%). Strength training, sleep, and English grade were associated with class membership among females. Ethno-racial identity, weekly spending money, strength training, and English and math grades were associated with class membership among males.

CONCLUSIONS

Findings suggest that latent physical activity profiles differ by sex. Guideline adherence was the most common class among females, indicating high levels of independent physical activity, whereas PE & Sport participation was the most common class among males, indicating greater tendency towards organized activities. Additionally, a substantial number of male students were not engaging in any physical activity. Participation in both PE and sports did not necessarily lead to meeting physical activity guidelines, highlighting that these activities alone may not be providing sufficient levels of physical activity that align with current recommendations for Canadian youth.

Association Between Daily Physical Education Attendance and Meeting 24-Hour Movement Guidelines in Adolescence and Adulthood

PURPOSE

To investigate the relationship between participation in physical education lessons (PELs), i.e., minutes or frequency per week, and meeting the 24-hour movement guidelines (i.e., physical activity, screen time, and sleep duration) during adolescence (12-17 years old) and adulthood (33-39 years old).

METHODS

We analyzed data from individuals who participated in Waves I (1994-1995) and V (2016-2018) of the National Longitudinal Study of Adolescent Health. We determined total weekly minutes of PELs and PELs participation by asking how many days adolescents attended PELs in an average week at school, with three possible responses as follows: 0, 1-4, or 5 days/week. Movement behaviors were assessed through self-completed questionnaires in both waves.

RESULTS

Daily PELs participation during adolescence was related to higher odds of meeting five of more weekly sessions of moderate-to-vigorous physical activity and all three guidelines in both sexes compared with adolescents who reported no days of PELs per week (men: incidence rate ratio [IRR] = 1.70, 95% CI 1.02-3.12; women: IRR = 3.81, 95% CI 1.65-8.77). Additionally, each additional weekly hour of PELs increased the likelihood of meeting all three recommendations (men: IRR = 1.11, 95% CI 1.05-1.35; women: IRR = 1.67, 95% CI 1.27-2.24). During adulthood, daily PELs was also related to a higher likelihood of meeting all three recommendations in both sexes (men: IRR = 1.04, 95% CI 1.01-1.07; women: IRR = 1.07, 95% CI 1.00-1.11). Each additional weekly hour of PELs increased the odds of meeting all three recommendations (men: IRR = 1.02, 95% CI 1.01-1.05; women: IRR = 1.03, 95% CI 1.01-1.06).

DISCUSSION

Daily PELs attendance was linked to healthy movement behaviors during adolescence, and these benefits could extend into adulthood.

Is Participation in Physical Education Classes Related to Physical Activity and Sedentary Behavior? A Systematic Review

Background: The aim of this systematic review was to summarize the results and assess the methodological quality of studies that analyzed the relation between physical education participation, physical activity, and sedentary behavior in schoolchildren. Methods: Searches were conducted for original cross-sectional and longitudinal observational studies published in Portuguese, English, and Spanish between January 2007 and August 2020, on the PubMed, Web of Science, Scientific Electronic Library Online, Education Resources Information Center, and Scopus databases. Results: A total of 60 articles (68 independent samples) were included in the revision (58 cross-sectional and 2 longitudinal observational studies). With regard to methodological quality, 27%, 52%, and 21% of the studies were classified as high, moderate, and low methodological quality, respectively. Physical activity was analyzed in 93% of the studies (n = 56) and sedentary behavior in 33% (n = 20). The higher frequency of physical education participation was associated with higher physical activity levels (56 of 68 results – 54/65 cross-sectional and 2/3 longitudinal studies) and less sedentary behavior (14 of 24 results), even after stratifying analyses by type and methodological quality. Conclusion: Physical education class participation may contribute to students being physically more active and less likely to engage in sedentary behavior.

The prevalence and correlates of physical activity/inactivity and sedentary behaviour among high-school adolescents in Iran: a cross-sectional study

Background

Physical inactivity and sedentary behaviour are the main risk factors for non-communicable diseases in all stages of life. However, there is a lack of reliable data regarding the recommended level of physical activity and its correlates related to physical inactivity and sedentary behaviour among school students in Iran. The aim of the present study was to report the prevalence and correlates of physical activity/inactivity and sedentary behaviour among Iranian high school adolescents.

Methods

The Global School-based Student Health Survey (GSHS) was used for data collection. Related data comprising socio-demographics, health risk behaviour and protective factors were obtained from 1517 high school students. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (physical inactivity/sedentary behaviour).

Results

The prevalence of recommended physical activity by WHO was 27.8%, physical inactivity 72.2% and sedentary behaviour 71.4%. Being female, being overweight or obese, walking/cycling to or from school on 1–4 days, sitting 3 or more hours/day (sedentary behaviour), insufficient vegetable intake, being bullied and lack of parental support, peer support and parental connectivity (protective factors) were positively associated with physical inactivity. On the other hand, walking/cycling to or from school on 5–7 days and inadequate fruit intake were negatively associated with physical inactivity. Walking/cycling to or from school on 1–4 days, being physically inactive, inadequate fruit intake and being bullied were positively associated with sedentary behaviour.

Conclusion

The prevalence of physical inactivity and sedentary behaviour was high in our studied sample. Interventions that address the issue of active school transport, sedentary behaviour, fruit and vegetable intake, family and peer support and bullying should be given more priority by the public health authorities.

Participation in Physical Education Classes and Health-Related Behaviours among Adolescents from 67 Countries

The present study sought to examine the associations between participation in physical education (PE) classes and a range of health-related behaviours among adolescents. Secondary analysis of self-reported data from the Global Student Health Survey, collected between 2010 and 2017 from 222,121 adolescents (N = 117,914 girls; 49.0%; aged 13–17 years) from 67 countries and five world regions, was carried out. Participation in PE classes (0, 1–2, ≥3 days/week) was the independent variable. Physical activity (PA); sedentary behaviour (SB); active travel to school; fruit, vegetables, and alcohol consumption; and smoking; as well as adopting ≥5 of these healthy behaviours; were the dependent variables. Complex samples logistic regressions were performed to explore the associations between participation in PE classes and health-related behaviours. The results revealed that 18.2% of adolescents did not take part in PE classes. A total of 56.7% and 25.1% of adolescents reported participating in PE classes on 1–2 and ≥3 days/week, respectively. Only 26.8% of adolescents adopted ≥5 healthy behaviours. Participation in PE classes was positively associated with PA, active travel, fruit consumption, and vegetable consumption (only for ≥3 days/week), but was negatively associated with meeting SB recommendations, and with not smoking (only for girls and ≥3 days/week). Overall, PE participation was positively associated with adopting ≥5 healthy behaviours, with favourable results found for those who attended more PE classes. The findings revealed a positive association between participation in PE classes and a range of health-related behaviours among adolescents. This suggests that, worldwide, quality PE should be delivered at least 3 days per week up to daily to promote healthy lifestyles among adolescents.

Physical Education and Its Importance to Physical Activity, Vegetable Consumption and Thriving in High School Students in Norway

Earlier research indicates that physical education (PE) in school is associated with positive outcomes (e.g., healthy lifestyle, psychological well-being, and academic performance). Research assessing associations with resilience and thriving indicators, such as the 5Cs of Positive Youth Development (PYD; competence, confidence, character, caring, and connection) is limited and more so in the Norwegian context. The aim of the present study was to investigate associations between PE grade (reflecting students’ effort in theoretical and practical aspects of the subject) and the 5Cs as well as healthy behaviors (physical activity (PA), fruit and vegetable consumption), using cross-sectional data collected from 220 high school students in Norway (M_age = 17.30 years old, SD = 1.12; 52% males). Results from structural equation modelling indicated positive associations between PE grade and four of the 5Cs (competence, confidence, caring, and connection; standardized coefficient: 0.22–0.60, p < 0.05) while in logistic regressions, a unit increase in PE grade was associated with higher likelihood of engaging in PA and vegetable consumption (OR = 1.94; 95% CI = 1.18–3.18 and OR = 1.68; 95% CI = 1.08–2.63, respectively). These significant findings suggest the need for policies and programs that can support effective planning and implementation of PE curriculum. However, further research is needed to probe into the role of PE on youth health and development with representative samples and longitudinal designs.

The Impact of Changes in Physical Education Class Enrollment on Moderate-to-Vigorous Physical Activity Among a Large Sample of Canadian Youth

BACKGROUND

Few youth engage in sufficient daily moderate-to-vigorous physical activity (MVPA), and the likelihood of meeting guidelines declines through secondary school. Physical education (PE) can afford youth with opportunities for MVPA. Therefore, the purpose of this study was to investigate the impact of changes in PE enrollment on MVPA and MVPA guideline adherence in Ontario and Alberta secondary students.

METHODS

Linked survey data was used from 1514 students who participated in year 3 (2014/2015 baseline) and year 6 (2017/2018 follow-up) of the COMPASS Study. Regression models tested whether changes in PE enrollment predicted changes in self-reported MVPA (minutes) and MVPA guideline adherence from grade 9 (baseline) to grade 12 (follow-up), controlling for sports participation and sociodemographic variables.

RESULTS

Students who remained enrolled in PE in grade 12 reported a daily average of 30 minutes more MVPA. Among students meeting MVPA guidelines and enrolled in PE in grade 9, students not taking PE in the current term in grade 12 were less likely to continue to meet guidelines than students currently enrolled in PE (adjusted odds ratio 0.53; 95% confidence interval: 0.36, 0.78; p < .0013).

CONCLUSIONS

Findings from this study could inform the future implementation of a mandatory PE credit for upper year secondary students.

Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates

OBJECTIVES

The study assessed the prevalence and associated factors of behavioural risk factors of non-communicable diseases (NCDs) among adolescents in four Caribbean countries.

CONTENT

In all 9,143 adolescents (15 years = median age) participated in the cross-sectional "2016 Dominican Republic, 2016 Suriname, 2017 Jamaica, and 2017 Trinidad and Tobago Global School-Based Student Health Survey (GSHS)". Eight behavioural risk factors of NCDs were assessed by a self-administered questionnaire.

SUMMARY

Prevalence of each behavioural NCD risk factor was physical inactivity (84.2%), inadequate fruit and vegetable intake (82.2%), leisure-time sedentary behaviour (49.6%), daily ≥2 soft drinks intake (46.8%), ever drunk (28.6%), twice or more days a week fast food consumption (27.6%), having overweight/obesity (27.4%), and current tobacco use (13.8%). Students had on average 3.6 (SD=1.4), and 79.0% had 3-8 behavioural NCD risk factors. In multivariable linear regression, psychological distress and older age increased the odds, and attending school and parental support decreased the odds of multiple behavioural NCD risk factors.

OUTLOOK

A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered and several factors independently contributing to multiple behavioural NCD risk factors were identified.

Physical education class participation is associated with physical activity among adolescents in 65 countries

In this study we examined the associations of physical education class participation with physical activity among adolescents. We analysed the Global School-based Student Health Survey data from 65 countries (N = 206,417; 11-17 years; 49% girls) collected between 2007 and 2016. We defined sufficient physical activity as achieving physical activities ≥ 60 min/day, and grouped physical education classes as '0 day/week', '1-2 days/week', and ' ≥ 3 days/week' participation. We used multivariable logistic regression to obtain country-level estimates, and meta-analysis to obtain pooled estimates. Compared to those who did not take any physical education classes, those who took classes ≥ 3 days/week had double the odds of being sufficiently active (OR 2.05, 95% CI 1.84-2.28) with no apparent gender/age group differences. The association estimates decreased with higher levels of country's income with OR 2.37 (1.51-3.73) for low-income and OR 1.85 (1.52-2.37) for high-income countries. Adolescents who participated in physical education classes 1-2 days/week had 26% higher odds of being sufficiently active with relatively higher odds for boys (30%) than girls (15%). Attending physical education classes was positively associated with physical activity among adolescents regardless of sex or age group. Quality physical education should be encouraged to promote physical activity of children and adolescents.

Behavioral Risk Factors Of Non-Communicable Diseases Among A Nationally Representative Sample Of School-Going Adolescents In Indonesia

Background

The aim of this study was to investigate the prevalence and correlates of behavioral non-communicable diseases (NCD) risk factors among adolescents in Indonesia.

Methods

Cross-sectional national data were analyzed from 11,124 in-school adolescents (mean age 14.0 years) of the Indonesia Global School-Based Student Health Survey (GSHS) in 2015. Seven behavioral NCD risk factors (substance use, dietary behavior, overweight or obesity, low physical activity, and sedentary behavior) were assessed by questionnaire in a classroom setting.

Results

The prevalence of low physical activity was 87.8%, insufficient fruit and vegetable intake 76.8%, having soft drinks daily 27.9%, leisure-time sedentary behavior 27.3%, overweight or obesity 15.8%, current tobacco use 12.8%, and alcohol use 4.4%. From the seven behavioral NCD risk factors, the mean was 2.5 (SD=1.0), and almost half (46.5%) had at least three risk factors. In adjusted linear regression analysis, being a boy, increasing age and psychological distress increased the odds and hunger or food insecurity and parental support decreased the odds for having behavioral risk factors.

Conclusion

A high co-occurrence of behavioral risk factors was identified. Several risk factors (older age, boys, distress, and poor parental support) were identified that can be targeted in intervention programs.

Prevalence and Correlates of Behavioral Non-Communicable Diseases Risk Factors among Adolescents in the Seychelles: Results of a National School Survey in 2015

The aim of this study was to investigate the prevalence and correlates of behavioral non-communicable disease (NCD) risk factors among a national sample of school-going adolescents in the Seychelles. Cross-sectional data were analyzed from 2540 school adolescents (median age 14 years, interquartile range = 2), in the Seychelles "Global School-Based Student Health Survey (GSHS)" in 2015. Behavioral NCD risk factors (current tobacco use, current alcohol use, inadequate fruit and vegetable consumption, soft drink consumption, overweight or obesity, physical inactivity, and leisure-time sedentary behavior) were assessed by self-report. Among the seven individual behavioral risk factors, the highest prevalence was physical inactivity (82.7%), followed by daily soft drink consumption (68.3%), inadequate fruit and vegetable consumption (60.9%), leisure-time sedentary behavior (51.0%), current alcohol use (47.6%), overweight or obesity (28.2%), and current tobacco use (23.4%). The total mean number of behavioral NCD risk factors was 3.6 (Standard Deviation = 1.3), and the proportion of co-occurrence of having three or more behavioral NCD risk factors was 80.7%. In adjusted linear regression analysis, male sex, older age, and psychological distress were positively, and school attendance and peer support were negatively associated with the total number of behavioral NCD risk factors. A high prevalence of multiple behavioral NCD risk factors were found and several associated factors were identified, such as male sex, older age, psychological distress, school truancy, and lack of peer support, which may help in aiding intervention programs in this population.

Physical Education Classes, Physical Activity, and Sedentary Behavior in Children

PURPOSE

This study aimed to examine the associations between participation frequency in physical education (PE) classes and objective measures of physical activity (PA) and sedentary behavior (SB) in children from 12 countries at different levels of development.

METHODS

This multinational, cross-sectional study included 5874 children 9-11 yr old from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. PA and SB were monitored for seven consecutive days using a waist-worn accelerometer. PA and SB data were presented for weekdays (times in and out of school) and weekend days. Participation frequency in PE classes was determined by questionnaire. Multilevel modeling analyses stratified by sex were used.

RESULTS

Overall, 24.8% of children self-reported participation in PE classes ≥3 times per week (25.3% in high-income countries [HIC] and 24.3% in low- and middle-income countries [LMIC]). After adjusting for age, sex, parental education, and body mass index z-score, results showed that children from low- and middle-income countries who took PE classes one to two times per week were more likely to present better indicators of PA and shorter time in SB in and out of school. In HIC, boys that participated in PE classes were more likely to meet the moderate-to-vigorous PA recommendations and to present better indicators of PA (in school) and shorter time in SB in and out of school. For girls in HIC, attending PE classes increased the likelihood of spending more time in moderate-to-vigorous PA, especially if they attended ≥3 times per week.

CONCLUSION

Attending PE classes is associated with a higher level of PA and a lower level of SB in and out of school during weekdays in children from countries at various levels of development.

Fruit and vegetable consumption, leisure-time physical activity, and sedentary behavior among children and adolescent students in Uganda

INTRODUCTION

Fruit and vegetable (FV) intake and participation in leisure-time physical activity (PA) and in sedentary behavior in accordance with the recommendations are met in a minority of populations including children and adolescents.

OBJECTIVE

To describe the frequency of FV intake, leisure-time PA, and sedentary behavior, assess compliance with international recommendations, and how selected factors are associated with these recommendations.

METHODS

The FV consumption and PA questionnaire items previously assessed for reliability in a Ugandan setting were used to gather information about FV consumption, PA, and sedentary behavior among 621 children and adolescents attending schools in Kampala Uganda. The results of FV consumption and PA were categorized as adequate or inadequate while sedentary behavior was categorized as adequate or excess. The relationship between FV consumption, PA, and sedentary behavior with selected independent variables was verified by chi-square test statistic.

RESULTS

Half of the participants (50%) reported inadequate fruit consumption, and 76% of them reported inadequate vegetable consumption. More children (68%) than young adolescents (52%) and older adolescents (44%) met their daily recommendation for fruit consumption. A similar trend was observed for vegetable consumption. Adequacy of FV intake was significantly associated with participant's age, level of education, school ownership, and type of school. Less of 8- to 17-year-olds (14%) than 18 years and above olds (41%) met their weekly recommendation for leisure-time PA. Majority of participants (54%) participated in acceptable levels of sedentary behaviors. Leisure-time PA was significantly associated with age category and school ownership while sedentary behavior was significantly associated with participant's age and education level.

CONCLUSIONS

The intake of FV and participation in leisure-time PA was not adequate in the study population. A significant proportion of participants engaged in excess sedentary behavior. Developing and implementing strategies to increase FV intake and PA among children and adolescents in schools should be a national priority.

EXERCISE OR PHYSICAL ACTIVITY: WHICH IS MORE STRONGLY ASSOCIATED WITH THE PERCEPTION OF SLEEP QUALITY BY ADOLESCENTS?

OBJECTIVE

To analyze the association of exercises and physical activity with the perception of sleep quality by adolescents.

METHODS

This is a cross-sectional epidemiological survey with statewide coverage, whose sample was composed of 6,261 adolescents (14-19 years old) who were selected by random sampling of conglomerates. The Global School-Based Student Health Survey questionnaire was used for data collection. The chi-square test and the binary logistic regression were applied for data analyses.

RESULTS

In the sample, 29% of adolescents did not exercise and were not classified as physically active. Adolescents who did not exercise were more likely to present a negative perception of sleep quality (OR 1.13, 95%CI 1.04-1.28, p=0.043). No association between the level of physical activity and the perception of sleep quality was found (OR 1.01, 95%CI 0.89-1.14, p=0.868). Those who practiced exercises only had less chance of perceiving sleep quality as poor (OR 0.82, 95%CI 0.71-0.95). However, those who practiced exercise and had a physically active life had less chances of having a negative perception of their sleep (OR 0.79, 95%CI 0.68-0.93).

CONCLUSIONS

Practicing physical activity alone was not enough to increase the chances of positive sleep quality perception. Only physical exercise had a positive association with sleep quality perception.

Overweight or obesity and related lifestyle and psychosocial factors among adolescents in Brunei Darussalam

This study aimed to assess overweight and obesity and associated factors in school-going adolescents in Brunei Darussalam. The sample included 2599 school-going adolescents that responded to the Global School-based Student Health Survey (mean age 14.7 years, SD = 1.4). Body weight status was assessed based on self-reported height and weight and the international child body mass index standards. The relationship between lifestyle factors, including physical activity and dietary behaviour, and overweight or obesity were assessed using logistic regression analyses. Results indicate a prevalence of overweight or obesity of 35.1% and obesity of 17.3%. In multivariable regression analysis, bullying victimisation was positively and frequent fast food consumption, having experienced hunger and meeting physical activity recommendations were negatively associated with overweight or obesity. High prevalence rates of overweight or obesity were found and several risk factors identified, which can assist in guiding interventions.

ASSOCIATION BETWEEN PERCEPTION OF SLEEP QUALITY AND ASSIMILATION OF CONTENT COVERED IN CLASS

Objective:

To analyze the association between self-perception of sleep quality and assimilation of content covered in classes by adolescents.

Methods:

Epidemiological cross-sectional study conducted with 481 high-school students (14 to 19 years), both genders, enrolled in public schools in the city of Caruaru, Pernambuco, and selected by random cluster sampling strategy. Analyses were conducted using the Chi-square test and binary logistic regression.

Results:

44.1% of the adolescents reported learning difficulties during classes, 77.1% slept less than eight hours per day, and 28.9% had a bad perception of their sleep quality. Young people who studied at least one extra hour per day out of school had less difficulty in assimilating class content (OR=0.34; 95%CI 0.19-0.58). We also found that participants who reported a bad perception of sleep quality were more likely to have learning difficulties at school (OR=1.73; 95%CI 1.13-2.65) regardless of gender, age, school shift, study time out of school, and sleeping hours.

Conclusions:

Perception of sleep quality was associated with learning difficulties at school regardless of the number of sleeping and study hours.

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.

PHYSICAL EDUCATION CLASSES AND HEALTH OUTCOMES IN BRAZILIAN STUDENTS

Objective:

To analyze the association between participation and physical activity during Physical Education classes with health outcomes in Brazilian students.

Methods:

681 Brazilian students (50.5% female) aged 10 to 17 years participated in this cross-sectional study. Independent variables analyzed were participation and physical activity during Physical Education classes, both assessed using a self-report questionnaire. The outcomes were: cardiorespiratory fitness (20-meter Shuttle Run test), muscle strength (Push-up test), overweight and obesity (body mass index) and high blood pressure. Statistical analysis was conducted by Poisson regression to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI) adjusted for confounding variables (age, sex, parental education, physical activity and sedentary behavior), considering the complex sample design.

Results:

Participation in Physical Education classes was not associated with any of the studied variables. Being active during Physical Education classes was associated with achieving health related criteria for cardiorespiratory fitness (PR=1.34, 95%CI 1.16-1.55) and muscle strength (PR=1.36, 95%CI 1.09-1.71). The same did not occur for overweight (PR=1.04, 95%CI 0.95-1.14), obesity (PR=1.02, 95%CI 0.91-1.05), or high blood pressure (PR=0.98, 95%CI 0.90-1.06).

Conclusions:

Students who reported being active during classes presented a higher likelihood to achieve the health criteria for cardiorespiratory fitness and muscle strength. However, classes traditionally offered in Brazil do not protect students from overweight, obesity, or high blood pressure.

ASSOCIAÇÃO ENTRE A ATIVIDADE FÍSICA DE LAZER E DE DESLOCAMENTO COM A VARIABILIDADE DA FREQUÊNCIA CARDÍACA EM ADOLESCENTES DO SEXO MASCULINO

Objective:

To investigate the association between heart rate variability (HRV) parameters with leisure time and commuting physical activities in adolescent boys.

Methods:

The sample included 1152 male adolescents aged 14 to 19 years. The variation of consecutive heart beats (RR intervals) was assessed and HRV parameters in time (SDNN, RMSSD, pNN50) and frequency domains (LF/HF) were calculated. Leisure time and commuting physical activities were obtained using a questionnaire. A binary logistic regression was performed between HRV parameters and physical activity.

Results:

Leisure time physical activity was associated with SDNN, RMSSD, pNN50, while LF/HF was not associated. These associations were stronger when adolescents were also physically active for more than six months. Commuting physical activity was not associated with any HRV parameter. Boys who practiced commuting physical activity and were also physically active for more than six months presented a lower chance of having low SDNN and RMSSD.

Conclusions:

Leisure time physical activity was associated with better HRV and these associations were enhanced when adolescents were physically active for more than six months. Commuting physical activity was not associated with HRV parameters; however, it became associated with better HRV when adolescents were physically active in commuting for more than six months.

Clustering of chronic diseases risk factors among adolescents: a quasi-experimental study in Sousse, Tunisia

Background The objective of the study was to evaluate the effectiveness of a school-based physical activity and nutritional behavior intervention, on the reduction of clustering of chronic diseases risk factors among school children. Materials and methods A quasi-experimental school-based intervention was conducted with an intervention group and a control group in the region of Sousse in Tunisia. The intervention was implemented between 2010 and 2013, with data collected at pre and at post intervention. Studied risk factors were: smoking, sedentary behavior, low fruit and vegetable intake and obesity. Odds ratios (ORs) were used to calculate the clustering of two risk factors. We calculated ORs in each group before and after the intervention. Results In the intervention group, the prevalence of adolescents that had no risk factors has significantly increased (p = 0.004). In the control group the prevalence of adolescents carrying two or more risk factors has increased (p = 0.06). The results showed that all risk factors tended to cluster together in both groups. In the intervention group, the calculated OR for smoking and sedentary behavior decreased after assessment (OR = 5.93) as well as the OR for smoking and low fruit and vegetable intake (OR = 3.26). In the control group, all ORs increased, showing an enhancement of the association. Conclusion This study showed the effectiveness of a school-based intervention in reducing the clustering of chronic diseases risk factors.

Previous blood pressure measurement and associated factors in student adolescents

Objective

To identify prevalence of previous blood pressure measurement and analyze some associated factors in adolescents.

Methods

This cross-sectional study included 6,077 adolescents aged 14 to 19 years. Demographic characteristics included (sex, age, period of study, region of residence, work, skin color, and economic) status, history of blood pressure measurement within last 12 months, local of blood pressure measurement, and reading obtained. To assess associations between previous blood pressure measurement with demographic characteristics and high blood pressure we used descriptive statistics and logistic regression analysis.

Results

Out of the adolescents, 56.8% reported no blood pressure measurement within the last 12 months. The health centers and the physician’s office were most mentioned places for blood pressure measurement (28.3% and 36.9%, respectively). Boys (odds ratio of 1.64 95%CI: 1.46-1.84) aged 14 to 16 years (odds ratio of 1.12; 95%CI: 1.01-1.25), whose economic status was unfavorable (odds ratio of 1.48; 95%CI: 1.32-1.67) were significantly associated with no blood pressure measurement. Working was a protective factor for was not blood pressure measurement (odds ratio of 0.84; 95%CI: 0.73-0.97).

Conclusion

Most of adolescents did not have their blood pressure measured within the last 12 months. Boys aged 14 to 16 years and those with unfavorable economic status had higher chance of not having their blood pressure measured.

Leisure Time Physical Inactivity and Sedentary Behaviour and Lifestyle Correlates among Students Aged 13-15 in the Association of Southeast Asian Nations (ASEAN) Member States, 2007-2013

The aim of this study was to examine the relationship between self-reported leisure time physical inactivity frequency and sedentary behaviour and lifestyle correlates among school children in the Association of Southeast Asian Nations (ASEAN) region. The analysis included 30,284 school children aged 13–15 years from seven ASEAN countries that participated in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The measure asked about overall physical activity, walking or biking to school, and on time spent sitting. Overall, the prevalence of physical inactivity was 80.4%, ranging from 74.8% in Myanmar to 90.7% in Cambodia and sedentary behaviour 33.0%, ranging from 10.5% in Cambodia and Myanmar to 42.7% in Malaysia. In multivariate logistic regression, not walking or biking to school, not attending physical education classes, inadequate vegetable consumption and lack of protective factors (peer and parental or guardian support) were associated with physical inactivity, and older age (14 and 15 years old), coming from an upper middle income country, being overweight or obese, attending physical education classes, alcohol use, loneliness, peer support and lack of parental or guardian supervision were associated with sedentary behaviour. In boys, lower socioeconomic status (in the form of having experienced hunger) and coming from a low income or lower middle income country were additionally associated with physical inactivity, and in girls, higher socioeconomic status, not walking or biking to school and being bullied were additionally associated with sedentary behaviour. In conclusion, a very high prevalence of leisure physical inactivity and sedentary behaviour among school going adolescents in ASEAN was found and several factors identified that may inform physical activity promotion programmes in school-going adolescents in ASEAN.

The Role of Physical Education Lessons and Recesses in School Lifestyle of Adolescents

BACKGROUND

This study investigates school lifestyle among adolescents in terms of physical activity (PA) structure: (1) adolescents participating in a physical education lesson (PEL) versus (2) aggregate recess time exceeding 60 minutes.

METHODS

The research was conducted in 24 secondary schools in the Czech Republic (boys N = 208, girls N = 433). For the whole day (1-3 days) participants wore the ActiTrainer accelerometer, which monitored PA, and heart rate. A total of 1122 school days were recorded.

RESULTS

Both boys and girls participating in a PEL reported significantly better results compared with nonparticipating individuals regarding all indicators of volume and intensity of school PA (SPA). In most SPA indicators, longer aggregate recess time (>60 minutes) had a statistically significant effect, particularly on the volume of SPA. The recommended 500 steps/hours for SPA was achieved by 83% of boys participating in PEL and 69% of girls. In contrast just 32% of nonparticipating boys and 31% of girls reached this level. With longer recess time the recommendation was met by 43% of boys (42% of girls) compared with 26% of boys (23% of girls) with shorter recess time.

CONCLUSIONS

An increase in SPA and an improved lifestyle in adolescents on school days are significantly supported more by PELs than by longer recess time.

Aggregation of the four main risk factors to non-communicable diseases among adolescents

OBJECTIVE

It was to investigate the cluster of four main risk behaviors (smoking, alcohol, physical inactivity and low consumption of fruits and vegetables) related to chronic diseases from Northeastern Brazil.

METHODS

Cross-sectional study with a representative sample (n = 600) of high school students from public schools in Caruaru, Pernambuco, Brazil. The cluster was evaluated by comparing the observed prevalence expected in all the possibilities of coupling between the behaviors. The logistic regression analysis was performed by grouping three or four behaviors, after adjusting for independent variables.

RESULTS

With the exception of smoking, other risk behaviors had prevalence rates above 20%. Only 0.3% (95%CI 0.1 - 1.3) of the students presented the four risk behaviors simultaneously, while 15.3% (95%CI 12.3 - 18.2) did not present anyone. Risk behaviors tended to cluster, particularly smoking and alcohol consumption, being more pronounced among boys, and physical inactivity and low consumption of fruits and vegetables among girls (p < 0.05). Regression analysis indicated that, among the independent variables, those students who do not have physical education classes were 2.1 times more likely to have three or more risk behaviors added.

CONCLUSIONS

The results of this study allow us to establish the prevalence of risk behaviors in cluster, which may have important implications for health policies and practices. It is suggested that educational and health actions are tested in schools, and physical education classes can be an important context for intervention.

[Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents]

OBJECTIVE

To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents.

METHODS

A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4,207, 14-19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model.

RESULTS

Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9-11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors.

CONCLUSIONS

The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).

Association between resting heart rate and cardiovascular risk factors in adolescents

This cross-sectional study was performed in 2011 and included 4619 Brazilian adolescents (14-19 years old) to analyze the association between elevated resting heart rate (RHR) and cardiovascular risk factors in boys and girls. RHR and blood pressure were measured using an oscillometric monitor. Overweight was assessed by body mass index and abdominal obesity by waist circumference. Physical activity levels and sedentary behaviors were obtained using a questionnaire. The effect of clustering of cardiovascular risk factors on RHR was analyzed. For boys, abdominal obesity (b = 0.106, p = 0.003), high sedentary behavior (b = 0.099, b < 0.001), physical inactivity (b = 0.049, p = 0.034), and high blood pressure (b = 0.160, p < 0.001) were associated with RHR, whereas for girls, only high blood pressure was associated with RHR (b = 0.259, p < 0.001), after adjustment for age, period of the day, and other cardiovascular risk factors. Boys with five risk factors presented significantly higher (p < 0.05) RHR values (82.5 ± 13.4 beats min(-1)) than those for boys without any cardiovascular risk factors (68.8 ± 10.4 beats min(-1)). The girls with five risk factors presented a mean RHR value of 89.8 ± 9.9 beats min(-1) that was higher (p < 0.05) than that for girls who had no risk factors (79.6 ± 10.9 beats min(-1)).

CONCLUSIONS

Our study demonstrated that while RHR was associated with cardiovascular risk factors in both sexes, the clustering of risk factors amplified the elevation of RHR in a gender-dependent fashion.

WHAT IS KNOWN

• Resting heart rate is a marker of cardiovascular disease and mortality in adults and associated with risk factor such as higher levels of blood pressure, triglycerides, glucose, and obesity in children and adolescents.

WHAT IS NEW

• The data from the current study suggest that the risk factor clustering is associated with elevated resting heart rate in adolescents and that the clustering of risk factors amplifies the elevation of resting heart rate in a gender-dependent fashion.

Are smoking and passive smoking related with heart rate variability in male adolescents?

Objective

To analyze the relation between smoking and passive smoking with heart rate variability parameters in male adolescents.

Methods

The sample consisted of 1,152 males, aged 14 and 19 years. Data related to smoking and passive smoking were collected using a questionnaire. RR intervals were obtained by a heart rate monitor, on supine position, for 10 minutes. After collecting the RR intervals, time (standard deviation of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals and the percentage of adjacent intervals over 50ms) and frequency domains (low and high frequency and sympathovagal balance) parameters of heart rate variability were obtained.

Results

No significant differences between smoker and nonsmoker adolescents were observed in heart rate variability parameters (p>0.05). Similarly, heart rate variability parameters did not show significant difference between exposed and not exposed to passive smoking (p>0.05).

Conclusion

Cigarette smoking and passive smoking are not related to heart rate variability in adolescence.

Multilevel analyses of school and children's characteristics associated with physical activity

BACKGROUND

Children spend most of their awake time at school, and it is important to identify individual and school-level correlates of their physical activity (PA) levels. This study aimed to identify the between-school variability in Portuguese children PA and to investigate student and school PA correlates using multilevel modeling.

METHODS

The sample included 1075 Portuguese children of both sexes, aged 6-10 years, from 24 schools. Height and weight were measured and body mass index (BMI) was estimated. Physical activity was estimated using the Godin and Shephard questionnaire (total PA score was used); cardiorespiratory fitness was estimated with the 1-mile run/walk test. A structured inventory was used to access information about the school environment. A multilevel analysis (level-1: student-level; level-2: school-level) was used.

RESULTS

Student-level variables (age, sex, 1-mile run/walk test) explained 7% of the 64% variance fraction of the individual-level PA; however, school context explained approximately 36% of the total PA variance. Variables included in the model (school size, school setting, playground area, frequency and duration of physical education class, and qualification of physical education teacher) are responsible for 80% of the context variance.

CONCLUSIONS

School environment is an important correlate of PA among children, enhancing children's opportunities for being active and healthy.

Prática esportiva e participação nas aulas de educação física: fatores associados em estudantes de Londrina, Paraná, Brasil

O objetivo deste estudo foi analisar os fatores associados à prática esportiva e participação nas aulas de educação física. A amostra foi composta por 827 jovens, selecionados em dois estágios e estratificados por região da cidade de Londrina, Paraná, Brasil. Foram analisadas a prática esportiva, participação nas aulas de educação física e variáveis sociodemográficas, comportamentais e ambientais. Os fatores associados à participação nas aulas de educação física foram: sexo masculino, idade (10-13 anos), percepção de atividade física igual ou elevada, prática esportiva, movimentação durante as aulas e realizar aulas na quadra. Para a prática esportiva, os fatores associados foram o sexo masculino, idade (10-13 anos), percepção de atividade física igual/elevada, atividade física (≥ 7horas/semana), participação nas aulas de educação física, possuir ≥ 10 amigos, prática de esportes com amigos e frequência de utilização de lugares para a prática. Esses fatores devem ser considerados nos programas de incentivo à prática esportiva e à participação nas aulas de educação física.

Epidemiology of physical inactivity, sedentary behaviors, and unhealthy eating habits among brazilian adolescents

This systematic review analyzed the prevalence of physical inactivity, sedentary behaviors and unhealthy eating habits among Brazilian adolescents. Searches were conducted in five databases (Lilacs, SciELO, Medline, Web of Science, and Google Scholar) and in the references cited in the articles retrieved. The literature search yielded 5,872 potentially relevant titles and a total of 69 studies met all the inclusion criteria. The risk behavior most often evaluated was physical inactivity (48/69; 69.6%), and its prevalence rate ranged from 2.3% to 93.5%. Twenty-eight studies estimated the prevalence of physical inactivity at over 50%. Most studies observed the prevalence of greater physical inactivity among girls. The prevalence of sedentary behaviors (lengthy screen time or TV use) was also frequently over 50%. Several variables were used to identify unhealthy eating habits, and some criteria/studies have indicated unhealthy eating habit estimates at close to 100% among adolescents. In conclusion, the estimates of these risk behaviors among Brazilians adolescents were very close to or even greater than those found in developed countries in several studies analyzed in this review.

The Effect of a Wellness Program on Adolescent Females

Guided by Bandura’s Social Cognitive Theory, the purpose of this study was to examine the effect of a comprehensive wellness intervention on total wellness, physical fitness, and self-efficacy for health promoting behaviors in adolescent females, ages 14 to 19, enrolled in physical education (PE) classes in Grades 9 to 12. The intervention was administered in an experimental pre-test, post-test, two group design in rural east Texas. Participants ( n = 153) were randomly assigned to a 12-week intervention or control group. Independent t-tests to determine differences between the intervention and control groups were nonsignificant for overall wellness and physical fitness. The Wellness Essential-Self subscale score was significantly higher in the intervention group, t(64, 36) = 2.67, p = .005, d = .84. Self-Efficacy Health Promotion subscale scores for the intervention group were also significantly higher, t(20,28) = 2.60, p = .006, d = .74. The intervention has potential to improve overall wellness in adolescent females.

Programas de intervenção nas escolas brasileiras: uma contribuição da escola para a educação em saúde

Artigo com objetivo de revisar programas de intervenção direcionados à saúde realizados nas escolas brasileiras. Pesquisaram-se dados dos bancos Lilacs, SciELO e Medline, dissertações, teses e documentos oficiais. Foram encontrados dez programas de saúde e um número reduzido de intervenções em atividade física nas escolas. Nos núcleos de apoio à saúde da família, identificou-se pequena participação dos profissionais de educação física. Concluiu-se que os programas de intervenção realizados nas escolas estão reduzindo o sedentarismo e integrando ações de educação à saúde; e que, nos programas de apoio à saúde da família, faz-se necessária maior participação dos profissionais de educação física.

The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross-sectional study

Background

The adoption of health-related behaviors is an important part of adolescence. This study examined the prevalence and correlates of the isolated and simultaneous presence of behavioral risk factors for cardiovascular health (BRFCH) among adolescents in Curitiba, Southern Brazil.

Methods

A cross-sectional study was performed with 1,628 adolescents (aged 11-17.9 years, 52.5% males) that were randomly selected from 44 public schools. Self-report instruments were used to assess the variables. Six BRFCH were analyzed: insufficiently active, excessive TV watching, current alcohol and tobacco use, daily soft drinks consumption and inadequate fruit and vegetable consumption. Sociodemographic and behavioral variables were studied as possible correlates of the presence of BRFCH.

Results

The BRFCH with the highest prevalence were insufficiently active (50.5%, 95% confidence interval [95% CI]: 48.0-52.9) and daily soft drinks consumption (47.6%, 95% CI: 45.1-50.0). Approximately 30% of the adolescents presented three or more BRFCH simultaneously. Girls, adolescents who did not participate in organized physical activity, and who used computer/video games daily were the main high-risk subgroups for insufficiently active. Boys and those who used computer/video games daily were the high-risk subgroups for daily soft drinks consumption. For excessive TV watching, we identified to be at risk those who were from a high economic class, unemployed, and who used computer/video games daily. For current alcohol use, we identified older adolescents, who were from a high economic class and who worked to be at risk. Older adolescents, who worked and who spent little active time during a physical education class were the high-risk subgroups for current tobacco use. For inadequate fruit and vegetable consumption, we identified those who did not participate in organized physical activity to be at risk. Older adolescents, who were from a high economic class, who did not participate in organized physical activity and who used computer/video games daily were the high-risk subgroups for simultaneous BRFCH.

Conclusions

We found a high prevalence of BRFCH among adolescents, both isolated and simultaneously. The correlates of the presence of BRFCH can contribute to healthy policies among Brazilian adolescents, mainly focusing on high-risk subgroups for a health risk behavior.

Intrapersonal, behavioral, and environmental factors associated with meeting recommended physical activity among rural Latino youth

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 3 60 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level.

Associations between diet quality and physical activity measures among a southern Ontario regional sample of grade 6 students

The purpose of this study was to determine diet quality and physical activity behaviours of grade 6 students by sex and body weight status, and to determine the associations between diet quality and physical activity behaviours. The Web-based Food Behaviour Questionnaire, which included a 24-h diet recall and the modified Physical Activity Questionnaire for Older Children (PAQ-C), was administered to a cross-section of schools (n = 405 students from 15 schools). Measured height and weight were used to calculate body mass index and weight status (Cole et al. 2000). A Canadian version of the Healthy Eating Index (HEI-C) was used to describe overall diet quality. The mean HEI-C was 69.6 (13.2) with the majority (72%) falling into the needs improvement category. The overall mean physical activity score was 3.7 out of a maximum of 5, with obese subjects being less active compared with normal weight and overweight (p < 0.001). Ordinal logistic regression analysis (of HEI-C vs. all measures of the PAQ-C, sex, and weight status) revealed that HEI-C ratings were likely to be higher in students that walked to and from school 5 days per week (vs. 0 days per week; odds ratio 3.18, p = 0.010); and were active 1 evening per week (vs. none; odds ratio 3.48, p = 0.039). The positive association between diet quality and some aspects of physical activity suggests possible clustering of health behaviours. Future research should test the potential benefits of promoting 1 health behaviour (e.g., healthy eating) with another (e.g., physical activity).