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

Adolescent physical activity during school days: a comparative study before and after COVID-19 pandemic restrictions

Background

Physical activity (PA) during the school day is crucial for the health and well-being of adolescents. This study examines the impact of the COVID-19 pandemic on youth PA patterns to better understand these changes and to provide guidelines for school programming.

Methods

Differences in PA within specific segments of the school day were examined before and after the pandemic using the Youth Activity Profile questionnaire. Participants included 956 boys and 1,317 girls from 21 high schools. The study involved 12 Czech and 9 Polish high schools before the pandemic and 9 Czech and 8 Polish high schools after the pandemic.

Results

Both Czech and Polish boys and girls exhibited significantly less transportation PA to and from school and reduced PA during the school day after the pandemic compared to before. Additionally, Czech and Polish boys were significantly less physically active during school breaks, and Czech boys and girls had notably less PA during physical education lessons. The pandemic disrupted the habit of regular PA on school days, particularly evident in the decline of PA to and from school.

Conclusion

The study confirms a significant difference in PA of Czech and Polish adolescents in various segments of the school day after students return to school following pandemic restrictions. Promoting achievement of the recommendations in the segments of the school day and in comprehensive school PA programs should be an important part of school health and education policy and public health promotion for adolescents.

The Impact of Distance Education during the COVID-19 Pandemic on Physical Activity and Well-Being of Czech and Polish Adolescents

BACKGROUND

The aim of this study was to identify the changes in the structure of weekly physical activity (PA) and well-being among adolescent boys and girls between habitual education (HE) and distance education (DE) during the pandemic in secondary schools.

METHODS

The research was carried out in 12 Czech and 18 Polish schools during 2019 to 2020 academic session for HE and 2020 to 2021 academic session for DE. The research involved 723 girls and 626 boys aged 15 to 18 years. The structure of the weekly PA was assessed using the International Physical Activity Questionnaire-Long Form, while well-being was assessed using the World Health Organization-5 Well-Being Index.

RESULTS

There was a statistically significant decrease of PA among boys in school PA, transportation PA, recreation PA, vigorous PA, moderate PA, walking, and overall weekly PA during the DE resulting from the pandemic. In girls, during DE, a decrease was observed in school PA, vigorous PA, and overall PA. During DE, a high level of well-being was reported by only 34.9% of girls (43.8% during HE) and 50% of boys (65.6% during HE).

CONCLUSIONS

The observed low PA and high incidence of depressive symptoms in adolescents in distance education during pandemic constraints are a challenge for schools to change in supporting physical activity, eliminating similar negative impacts on school life in the future.

It Is Not Called Recess Anymore: Breaktime in Middle School

BACKGROUND

School recess offers students a break from the rigors and immobility of academic learning, and a chance for social interaction, play, and physical activity. The recess literature is based on elementary schools, with little attention to older students. Early adolescents also need school breaks, and this study offers some of the first findings on how to organize this time to best support the developmental needs of middle schoolers.

METHODS

The study explores middle school breatktime in 3 schools in California. It uses observations, interviews, and a student survey conducted in 2018. Data were coded thematically and analyzed.

RESULTS

Findings indicate a tradeoff between socialization and physical activity among students who falls along age and gender lines. Adults viewed their roles mainly as safety monitors, including both physical and emotional safety. They were aware of the limitations of their breaktime offerings, which generally included access to outdoor and a few alternative indoor spaces, and attributed not having more options to lack of resources.

CONCLUSIONS

Findings demonstrate the complexities of organizing breaktime space for early adolescents. Middle schools must plan their breaks with attention to developmentally appropriate activities, including games and sports as well as opportunities for other kinds of social interactions in safe, supportive environments.

Time Trends of Step-Determined Physical Activity Among Adolescents With Different Activity Levels in Czech Republic

BACKGROUND

This study aimed to present step-determined physical activity trends in adolescents with different activity levels over a period of 10 years.

METHODS

Pedometers were used to monitor weekly physical activity in 1855 boys and 2648 girls aged 15-19 years recruited from 155 schools in the Czech Republic between 2009 and 2018. Trends for average steps/day and percent of accumulating various levels of steps/day (<10,000, 10,000-13,000, and >13,000 steps/d) were analyzed by sex.

RESULTS

There was a statistically significant decrease in average steps/day between 2009-2010 and 2017-2018 in boys from 12,355 (3936) steps/d to 10,054 (3730) steps/d and girls from 11,501 (3278) steps/d to 10,216 (3288) steps/d. The percent accumulating <10,000 steps/d increased by 21% in boys and 12% in girls. The percent achieving >13,000 steps/d decreased by 17% in boys and 10% in girls.

CONCLUSIONS

Objectively collected evidence indicates an overall decrease in Czech adolescents' steps/day over a 10-year period concurrent with an increase in the percent of boys and girls accumulating <10,000 steps/d. These trends are concerning as they portend a decline in physical activity as adolescents transition to adulthood and continue to age, which also may have major health implications.

Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades

BACKGROUND

This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic.

METHODS

The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews".

RESULTS

Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively.

CONCLUSIONS

Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.

Change in physical fitness due to the COVID-19 pandemic lockdown in French adolescents: a comparison between two independent large samples from Diagnoform battery

Numerous studies reported a significant decline in physical activity level in adolescents as a result of the COVID-19 lockdown. Physical fitness is recognized as a powerful marker of health in youth. The aim of this study was to evaluate the impact of the COVID-19 pandemic lockdown on health-related physical fitness in French adolescents. Two cross-sectional studies were performed comparing two different groups of French adolescents, before (sample 1) and after the first lockdown (sample 2). A total of 1231 adolescents (aged to 16.5 ± 1.5 years) participated in the two cross-sectional studies. Complete data for physical fitness and anthropometrics data were obtained. Adolescents from sample 2 showed lower physical fitness levels compared to adolescents from sample 1. Regarding physical fitness for boys and girls, physical fitness levels were significantly lower in both sex between adolescents from the sample 1 and adolescents from the sample 2, except for cardiorespiratory fitness and flexibility for boys and girls, respectively. The physical fitness global score was also significantly lower between adolescents from the sample 1 and 2 for boys (-9.8%, p < 0.01) and girls (-16.2%; p < 0.01), respectively. Overall, the higher difference was found for performance in the speed body displacement test (-30%). A difference of 12.8% and 25% was observed for boys and girls, respectively.   Conclusion: COVID-19 pandemic lockdown had a negative impact on physical fitness in French youth. This study highlights the need to develop, in a near future, prevention programmes in order to improve the physical fitness in youth. What is Known: • COVID-19 pandemic deeply impacted lifestyle habits. A worrying decrease of physical activity, associated to a dramatic increase of time spent in sedentary behaviors was found in many coutries. What is New: • Our study bring first data on the health-related physical fitness consequences due to lockdown in French adolescents. Our study demonstrate the negative impact of COVID-19 pandemic lockdown on health-related physical fitness in French adolescents.

A Higher Step Count Is Associated with the Better Evaluation of Physical Education Lessons in Adolescents

The current study aimed to determine: (a) the step counts of boys and girls in habitual physical education (PE) lessons during school teaching practice, (b) the association between the physical load and the evaluation of PE lessons in boys and girls, and (c) the differences in the meeting of the recommendations for PA in PE lessons between Czech and Polish boys and girls. A total of 4092 adolescents from 74 Czech and 58 Polish secondary schools participated in the study. The step counts were monitored using pedometers, while the attitudes towards PE were assessed using a PE lesson evaluation questionnaire. On average, the Czech boys reached 2476 steps (Polish boys reached 2148 steps) and the Czech girls reached 1766 steps (Polish girls reached 1946 steps) in their PE lessons. A higher step count in PE lessons was associated with higher odds of a positive evaluation of PE lessons in boys (OR = 1.35, 95% CI = 1.123–1.626, p = 0.001) and girls (OR = 1.72, 95%CI = 1.449–2.032, p < 0.001). This study provides evidence that a higher step count in PE is associated with a positive evaluation of PE lessons in boys and girls. The findings are important to support the restoration habits on a regular PA in the post-pandemic time.

Does Vigorous Physical Activity Contribute to Adolescent Life Satisfaction?

Background: Physical and mental health are the basis of life satisfaction (LS), even during adolescence. The aim of this study was to identify the associations between LS and types of physical activity (PA) in Czech and Polish boys and girls. Methods: The research involved 933 girls and 663 boys aged 15–19 years. LS was diagnosed using the Bern Subjective Well-Being Questionnaire and the WHO-5 Well-Being Index. The International Physical Activity Questionnaire-long form (IPAQ-LF) questionnaire was used to identify the types of weekly PA. Results: Adolescents with the highest LS had more recreational, moderate, vigorous, and total weekly PA. The strongest associations between LS and PA were in the Czech and Polish boys and girls who participated in vigorous PA (VPA). The recommendations for VPA were fulfilled by 45% of Czech and 46% of Polish boys and 40% of Czech and 50% of Polish girls, with the highest LS. The most significant positive moderator between LS and PA was participation in organized PA. Boys with the highest LS were 1.94 times more likely to meet the weekly recommendation of VPA than boys with the lowest LS. Similarly, girls with the highest LS were 1.77 times more likely to meet these recommendations. Conclusions: Promoting both current subjective well-being and organized PA, with an emphasis on achieving the VPA recommendations, may support general LS and a healthy lifestyle in adolescents.

The Association between Participation in Organized Physical Activity and the Structure of Weekly Physical Activity in Polish Adolescents

The main aim of the study was to determine the associations of participation in organized physical activity (OPA), and the structure of weekly physical activity (PA) with meeting the PA recommendations among Polish boys and girls. The research was conducted between 2012 and 2019 in the Silesian region of Poland among 3499 secondary school students. To determine the structure of PA (school, transportation, home, recreation, vigorous moderate, and walking), the International Physical Activity Questionnaire-Long Form (IPAQ-LF) questionnaire was used. Adolescents participating in OPA showed significantly more PA (p < 0.001) than non-participating adolescents. The strongest associations were observed between participation in OPA and vigorous PA. The weekly recommendation of vigorous PA was met by 61% of the students with three or more lessons of OPA per week, 29% of students with one or two lessons of OPA per week, and 24% of students not participating in OPA. Therefore, boys and girls with no OPA are at greatest risk of health issues. Schools, sports clubs, and leisure institutions should increase the participation of adolescents in OPA, especially non-participants. Comprehensive school PA programs should especially include those forms of OPA that respect health weaknesses, individual talents for specific types of PA, and preferred types of PA among adolescents.

Physical Activity Recommendations in the Context of New Calls for Change in Physical Education

The current social, health, and educational changes in society require an adequate response in school-based physical activity (PA), including physical education (PE) lessons. The objective of this study was to identify the real average step counts of Czech and Polish adolescents during PE lessons, and propose recommendations for improving PE programs. This research was carried out in 143 Czech and 99 Polish schools. In the research, a total of 4911 adolescents aged 12–18 years were analyzed as part of teaching practice and 1827 in the context of habitual school practice. Steps were monitored using pedometers. The average step count per PE lesson was 2390 in Czech and Polish boys, while girls achieved 1851 steps. In both countries, boys were subject to greater physical strain in PE lessons compared to girls, both in teaching practice (F(4088,3) = 154.49, p < 0.001, η_p² = 0.102) and school practice (F(1552,3) = 70.66, p < 0.001, η_p² = 0.103). Therefore, the priority in PE lessons is to increase the amount of PA for girls, achieve the objectives of PE during PA, and use wearables to improve awareness of PA and improve physical literacy, as well as to support hybrid and online PE as a complement to traditional PE.

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.

Estimation of Engagement in Moderate-to-Vigorous Physical Activity from Direct Observation: A Proposal for School Physical Education

This study aimed to test an observational momentary time sampling tool to estimate in-class moderate-to-vigorous physical activity (MVPA), in terms of validity, reliability and agreement between observational momentary time sampling and accelerometry, and to develop a regression equation to estimate MVPA from observational momentary time sampling. The sample comprised 78 pupils (38 girls), mean age 14.0 ± 1.1 years. Measurements were taken in three similar Physical Education classes, on three different days. To monitor MVPA, we applied the observational momentary time sampling method. Students wore an ActiGraph GT3X+ accelerometer. Reliabilities were determined by the intraclass correlations, the agreement between methods was analyzed using the Bland–Altman method, and a multiple regression analysis was performed to estimate the equation. The observational momentary time sampling showed good reliability across time (0.59 < r < 0.72, p < 0.001). It was significantly correlated with accelerometry (r = 0.51, p < 0.001). The MVPA assessed via accelerometer could be predicted from the following equation: Y = 44.3 + 0.47⋅(MVPA observational momentary time sampling method) + 8.0⋅(sex; with 0 = girls and 1 = boys). This observational momentary time sampling method is a stable and reliable tool to estimate MVPA. A regression equation using the score of observational momentary time sampling and sex can be used to better estimate the real MVPA.

Adolescents' Physical Activity in Education Systems Varying in the Number of Weekly Physical Education Lessons

Purpose: School physical activity (SPA) is a significant component of daily PA. We investigated differences in PA between boys and girls in two differing education systems-Poland and the Czech Republic-which have four and two physical education lessons (PELs) per week, respectively. Method: This project was conducted from 2012-2016 at 17 Polish and 23 Czech secondary schools (N = 921; mean age = 16.2 ± 0.7 years). ActiTrainer accelerometers were used to monitor participants' PA and heart rate during school days. Weekly PA was measured using pedometers. Subjective levels of weekly PA were self-reported on the International Physical Activity Questionnaire-long form. Results: The Polish education system enabled adolescents to meet the recommendations for moderate-to-vigorous PA more likely than did the Czech system. SPA also represented a higher portion of daily PA in the Polish (vs. Czech system); however, the differences in total daily step count between Polish and Czech adolescents were non-significant. SPA accounted for 30-37% of the daily PA (as measured by step count) of Polish girls (23-30% of Czech girls) and 28-39% of Polish boys (25-37% of Czech boys). Conclusions: Participation in PELs was associated with a higher rate of meeting SPA recommendations in both countries. Compared with the Czech Republic, more PELs in the Polish education system was associated with increased daily vigorous PA and a greater portion of SPA in daily PA. Differences in overall daily and weekly moderate-to-vigorous PA between Polish and Czech adolescents were non-significant.

Physical Activity Recommendations for Segments of School Days in Adolescents: Support for Health Behavior in Secondary Schools

School physical activity (PA) is an indispensable part of daily PA, the foundation for developing lifelong PA and fitness, and an easy way to gain physical and health literacy. School PA is equally important for understanding the continuity of physical and mental health, even in broader psychosocial aspects. Regarding long-term outcomes, significant attention has been paid to the determination of daily and weekly recommendations for adolescent PA. However, comprehensive approaches suggesting recommendations for PA in segments of the school day are rare. This study aimed to (a) provide a rationale for PA recommendations in segments of school days and incorporate it into generally accepted PA recommendations, and (b) promote radical changes in the educational process toward a healthy school lifestyle through PA recommendations in segments of school days. The results of research conducted in 98 secondary schools in the Czech Republic and 104 secondary schools in Poland from 2009 to 2017 were used in this study. In total, 3,860 boys and 5,237 girls from the Czech Republic and 3,052 boys and 3,329 girls from Poland, all aged 15-19, participated. We recommended at least 2,000 steps (or 10 min of moderate-to-vigorous PA) for the before school segment and at least 6,000 steps (or 30 min of moderate-to-vigorous PA) for the after-school segment. For the time spent at school, we further recommended at least 500 steps/h (alternatively, at least 3,000 steps/school time), 20 min of moderate-to-vigorous PA (≥3METs or 60% HRmax), and at least one HRsubmax/max response to significant stress during PA to mitigate educational stress and high levels of sedentary behavior in schools. PA should account for at least 25% of school time, even on days with no scheduled physical education lessons. We propose using PA recommendations in segments of school days to achieve positive changes in the educational process and school lifestyle. Acceptance of PA recommendations in segments of school days theories on physical education could help refine and concretize demands for changes in PA and lifestyle in secondary schools. In practice, it could support the creation of innovative and comprehensive school PA programs. Future research should focus on obtaining evidence in support for adolescent PA by applying PA recommendations in segments of school days.

Physical Activity of Secondary School Adolescents at Risk of Depressive Symptoms

BACKGROUND

The aim of the study is to analyze the associations between depressive symptoms (DS), well-being and different types of physical activity (PA) in adolescents.

METHODS

Overall, 368 girls and 228 boys aged 15-19 years were involved in the research. To explore the composition of weekly PA, we used the IPAQ-Long questionnaire, and a pedometer was used to monitor weekly PA. The prevalence of DS was diagnosed by the Bern Subjective Well-Being Questionnaire and the WHO-5 Well-Being Index.

RESULTS

The girls and boys who reported the most DS and the lowest level of well-being had significantly less weekly recreational PA. The girls who reported the fewest DS had a 2.12 times greater odds of meeting the 11,000 steps/day recommendation than did the girls with the most DS, whereas we did not detect statistically significant differences in rates of meeting the recommendation in the boys with distinct levels of DS.

CONCLUSIONS

The study confirms the stronger negative associations between DS and PA, especially among girls. The greatest opportunities for behavioral change in adolescents at the highest risk of DS are in the promotion of recreational PA.

Secular Trends in the Achievement of Physical Activity Guidelines: Indicator of Sustainability of Healthy Lifestyle in Czech Adolescents

(1) Background: The increasing socio-economic and educational demands on adolescents should be reflected in their lifestyles accordingly. The aim of the study was therefore to identify the trends in the achievement of physical activity (PA) guidelines by Czech adolescents through objective and subjective PA monitoring. (2) Methods: The research was carried out between 2010 and 2017 and involved 49 secondary schools, 2 higher vocational schools, and 8 universities in the Czech Republic. In total, the projects involved 1129 girls and 779 boys. PA monitoring was performed by Yamax SW-700 pedometers and IPAQ-long questionnaires. (3) Results: The results according to the average number of steps/day confirm a decrease in the amount of PA in boys and girls and in the achievement of the recommended 11,000 steps/day. However, the estimates of meeting the recommended weekly PA expressed as MET-min/week based on the IPAQ-long questionnaire are not so convincing about the decrease. (4) Conclusions: The combination of objective monitoring of weekly PA using wearables and subjective estimates of weekly PA using a questionnaire regarding the ease of application, appears to be a sufficient indicator of the status of and trend in PA and thus the sustainability of a healthy lifestyle in youths.

Physical Activity in 15-17-Year-Old Adolescents as Compensation for Sedentary Behavior in School

The traditional concept of education and school settings significantly contribute to the sedentary behavior of adolescents at secondary schools. The aim of this study is to identify the volume and intensity of physical activity (PA) that adolescent boys and girls engage in during recesses, after school, and during the day to compensate for sedentary behavior in lessons. The study was conducted at 29 Czech and 9 Polish schools. The study involved 868 girls and 409 boys aged 15-17 years. An ActiTrainerTM accelerometer was used to monitor PA and heart rate. Participants were divided into four quartile groups. Most sedentary boys and girls had less PA and showed a worse ratio of physical inactivity (PI)/PA than non-sedentary participants during recesses. In the after-school period, there were no significant differences. On school days, most sedentary boys and girls showed lower PA, a worse ratio of PI/PA, fewer steps·hour-1, and lower energy expenditure than their non-sedentary counterparts. Vigorous PA of ≥8 METs was reached by 48% of most sedentary boys (75% non-sedentary) and 47% of most sedentary girls (54% non-sedentary). Most sedentary adolescents do not compensate for their sedentary behavior in lessons with higher PA intensity or volume during recesses, after-school, or in overall daily PA.

Composition of weekly physical activity in adolescents by level of physical activity

Background

Physical activity (PA) in adolescence is crucial for lifelong healthy lifestyle, and attention is needed to adolescents at health risk due to insufficient PA. This study investigates the composition of weekly PA in adolescents by PA level and provides a rationale for change in their lifestyles.

Methods

The research was conducted at 66 schools in Poland between 2009 and 2016, among 949 girls and 650 boys aged 15–18 years. We used pedometers to monitor weekly PA with data assessed using the Indares web app. The participants were split into three groups by mean daily step count (lower, < 9000; middle, 9000–12,999; and higher, ≥ 13,000 steps/day), as a reliable and non-expensive indicator of PA.

Results

We did not observe statistically significant differences in composition of 7-day PA between participants with varying levels of PA, regardless of their gender (F_(12,9558) = 0.60; p = 0.841; η_p² > 0.000). The smallest differences in daily step counts by PA level were found on Mondays and the biggest on Fridays and Saturdays, in boys and girls; the differences between average school and average weekend days were most pronounced in less active girls (1677 steps/day) and boys (1886 steps/day). During the school week, the highest proportion of less active girls met the 11,000 steps/day recommendation on Fridays (21.9%), statistically significantly less than on other school days (p < 0.001). Similarly, less active boys (22.2%) had significantly less activity on Fridays than on other school days, except for Mondays (p = 0.143) Analogous pattern was apparent also in more active adolescents.

Conclusions

Less active adolescents have comparable composition of weekly PA to the more active ones but they can hardly meet the generally accepted PA recommendations. Better understanding of weekly PA composition and rates of meeting PA recommendations by day of the week can lead to more efficient interventions improving lifestyles. The recommendation of 9000 steps/day most days of the week, thus, appears appropriate for less active adolescents, as a motivating achievable goal.

Academic Stress and Physical Activity in Adolescents

The issue of work-related mental health needs to be addressed at the school level. The aim of this study was to explore the associations between academic stress (AS) of adolescent boys and girls and their physical activity (PA) during recesses and after school and to propose measures to promote the adoption of lifelong healthy working habits. Adolescents from 16 schools in the Czech Republic and 6 schools in Poland participated in the study (187 boys and 339 girls). Monitoring of PA and cognitive stress was conducted during one school day. We used ActiTrainer accelerometers to monitor PA and physical inactivity. Data on time of PA and self-reported AS in school lessons were collected using recording sheets. We split the participants into two groups: those without a self-reported stressor and those who indicated one or more stressors. Differences in overall PA during recesses, as well as after-school PA, between boys with and without AS were not statistically significant for any PA characteristics. We observed similar results for girls. Repeated measures ANOVA confirmed that differences in PA (steps/hour) during recesses following particular lessons between participants with and without AS were not statistically significant in boys or girls (F (4,1612) = 1.83, p=0.121 , η p 2=0.005). It is noteworthy that girls with AS were statistically significantly more likely to meet the 6000 steps after school time recommendation (39%) than girls without AS (18%; p < 0.001). The study did not confirm the assumption that adolescents reporting AS have less PA during recesses or even after school than adolescents without AS. However, the overall low PA of adolescents during recesses and after school highlights the need to compensate for AS by adequate PA. This is especially true for adolescents with recurrent AS in several consecutive lessons.

[Influence of daily and weekly activities in the physical activity levels of school children: a cross-sectional study]

Introduction

Introduction: the distinct activities related to an active lifestyle that schoolchildren perform during the day and week interact to influence the children's total level of physical activity. Objective: to identify the influence that the activities developed by school children during the different times of the day and the week have on the levels of physical activity. Method: a cross-sectional study conducted in 3,598 public school students aged between 10 and 14 years. The demographic characteristics were evaluated, as well as the levels of physical activity through the Physical Activity Questionnaire for Schoolchildren (PAQ-C). A multivariate logistic regression analysis was performed as statistical analysis using the SPSS v.24 software program. The raw odds ratio (OR) was estimated. Results: in all, 64.3% of the students failed to comply with physical activity recommendations. Students who are more inactive include those who do not perform enough physical activity during the weekend [OR: 3.7 (95% CI: 2.9-4.5)], those who are not physically active after school [OR: 3.1 (95% CI: 2.3-4.2)], those who do not practice activities such as jumping in their free time [OR: 3.2 (95% CI: 1.9-5.2)], and those who do not ride a bicycle [OR: 3.7 (95% CI: 2.7-5.1)]. Conclusions: the levels of physical activity in students depend on the integration of different contexts and periods during the day and the week. The influence of weekend activities and physical education shows the role that the family and school play in the acquisition and practice of an active lifestyle.

Behavioural Patterns of Physical Activity and Nutritional Habits among Urban and Rural Students

Background:

Adolescence is considered as one of the most vulnerable periods. The deficiencies and poor nutritional habits and lack of physical activity will have irreparable consequences in adulthood. This study was aimed to determine the behavioural patterns of nutritional and physical activity among the urban and rural students in Urmia, Iran.

Methods:

The present study was designed and implemented using a sectional and descriptive-analytic approach. Using a stratified random sampling method, 194 males and 191 female high school students were chosen to participate. Health-Promoting Lifestyle Profile II (HPLPII) was used for data collection. The overall average score of physical activity in students was 55.57 ± 4.88, and in the aspect of nutritional behaviour it was equal to 64.04 ± 3.67.

Results:

No significant difference was observed between physical activity, nutritional behaviours and socio-demographic variables (gender, type of school, place of residence, parental education). Based on multivariate regression analysis, there was a significant relationship between physical activity and the field of education. Furthermore, a significant relationship was found between children’s nutritional behaviour and mothers’ education.

Conclusion:

Considering importance of mothers’ role in upbringing adolescents and forming their healthy behavioural patterns and the significant relationship of mothers’ education and healthy behaviours, training and increasing health literacy level of this class of population can be an imperative step in promoting the mental and physical health of adolescents.

Influence of air pollution exposure on adolescents' objectively-measured physical activity and sedentary behavior

Although regular physical activity is recommended for health, highly contaminated air exposure acts to the detriment of the benefits produced in individuals. The purpose of the present study was to compare the accelerometer-measured physical activity and sedentary behavior during the whole day, in-school time, out-of-school time, and school breaks between highly contaminated air days and non-highly contaminated air days in Chilean adolescents. Nineteen adolescents from Santiago of Chile were assessed by a GT3X accelerometer. The vertical axis and steps per minute for the whole day, and both of these variables together with the percentage of time of moderate-to-vigorous physical activity level in the out-of-school time period were higher in highly contaminated air days than in non-highly contaminated air days (p < 0.05; with effect sizes from r = 0.36 to r = 0.46). Results for sedentary behavior were similar in both conditions for every period of time analyzed. These results allow us to conclude the lack of awareness of the participants in this research regarding the health repercussions in relation to the physical activity performed during air pollution exposure. Some strategies in order to improve the Chilean adolescents' physical activity and sedentary behavior are suggested and discussed.

Validity of Garmin Vívofit 1 and Garmin Vívofit 3 for School-Based Physical Activity Monitoring

PURPOSE

Activity trackers are useful tools for physical activity promotion in adolescents, but robust validity evaluations have not been done under free-living conditions. This study evaluated the validity of the Garmin Vívofit 1 (G1) and Garmin Vívofit 3 (G3) in different settings and contexts.

METHODS

The participants (girls: 52%, age: 15.9 [1.9] y) wore the G1 and G3 on their nondominant wrist and the Yamax pedometer on their right hip for a period of 1 week. Validity was examined in 4 discrete segments (before school, in school, after school, and whole day). The criterion method was the Yamax pedometer.

RESULTS

Both the G1 and G3 could be considered equivalent to the Yamax pedometer regarding the before school, in school, and whole day segments. The G1 showed wider limits of agreement than G3.

CONCLUSIONS

The G1 and G3 trackers exhibited acceptable validity for 3 of the 4 segments (before school, in school, and whole day measurements). The results were less accurate during the after-school segment. The evidence that the validity of the monitors varied depending on the setting and context is an important consideration for research on adolescent activity patterns.

Health Literacy in School

Health literacy is a core element of patient-centered healthcare. Poor health literacy is a silent epidemic across the globe as it affects every aspect of health. Schools bear an important role in increasing health literacy. Improving health literacy in adolescence is supposed to improve the later life as adolescents are used to carry their modified behavior lifelong. Various school-based interventions covering physical and mental health have been studied and found to be effective. International bodies recommend incorporation of health-related tasks into school lessons and considered that teaching the young people will be a good investment for future. Multisectoral collaborations and locally proved effective strategies are the practical challenges. This chapter aims to focus on health literacy, global scenario of health literacy, measurement tools, role of school, interventions, limitations, and challenges of health literacy.

Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women

This study was aimed at the evaluation of relationship between visceral fat area (VFA) and physical activity (PA) with the metabolic syndrome (MetS) risk in the physically active postmenopausal women. A total of 85 attendants of the University of the Third Age (U3A) aged 62.8 ± 5.9 years (median time since menopause 11.8 y), participated in this study. VFA was assessed by bioimpedance method using InBody 720 analyzer. PA was assessed using the ActiGraph GT1 M accelerometer. Fasting levels of serum lipids (TG, HDL), serum glucose, waist circumference (WC) and blood pressure were measured to diagnose MetS according to NCEP-ATP III criteria. In 73 out of 85 participants the VFA exceeded the upper normal level of 100 cm², however, in almost a half of this group (n = 36) with elevated VFA (139.5 ± 26.1 cm² on average), only 2 out of 5 criteria for MetS diagnosis were met. Participants were physically active, making on average 10,919 ± 3435 steps/day. The risk of MetS occurrence in women with VFA > 100 cm² was twelve times higher (OR 12.33; CI 95% [1.5; 99.8]) than in the group with VFA < 100 cm². The participants from the group with the highest PA level (≥12,500 steps/day) were at almost 4 times lower risk for MetS, than their less active counterparts (OR 3.84; CI 95% [1.27;11.64]). Increased level of VFA is a strong risk factor for the MetS in postmenopausal women, however high level of regular PA above the threshold of 12,500 steps/day may substantially reduce it.