The Copenhagen Consensus Conference 2016: children, youth, and physical activity in schools and during leisure time

Study protocol for the ACTIVE SCHOOL study investigating two different strategies of physical activity to improve academic performance in Schoolchildren

BACKGROUND

Previous research has suggested that school-based physical activity (PA) interventions may have a positive impact on academic performance. However, existing literature on school-based interventions encompasses various forms of PA, spanning from vigorous intensity PA outside the academic classes to light intensity PA and movement integrated into academic learning tasks, and results on academic performance are inconclusive. ACTIVE SCHOOL will implement two different PA interventions for one school year and assess the effects on the pupils' academic performance, with math performance as the primary outcome.

METHODS/DESIGN

The ACTIVE SCHOOL project consists of two phases: 1) Development phase and 2) Randomized Controlled Trial (RCT). In phase one, two interventions were developed in collaboration with school staff. The two interventions were tested in an 8-weeks feasibility study. In phase two, a RCT-study with three arms will be conducted in 9-10-year-old children for one school year. The RCT-study will be carried out in two intervention rounds during the school years 2023/2024 and 2024/2025. Schools will be randomized to one of two interventions or control;1) Run, Jump & Fun intervention (4 × 30 min/week of moderate-to-vigorous physical activity; 2) Move & Learn intervention (4 × 30 min/week focusing on embodied learning in math and Danish lessons); or 3) a control condition, consisting of normal teaching practices. Outcome measures include academic performance, PA level, cognitive functions, cardiorespiratory fitness, anthropometry, well-being and school motivation (collected before, during and after the intervention period). A process evaluation will be conducted to assess implementation.

DISCUSSION

The ACTIVE SCHOOL study will expand knowledge regarding the impact of PA on academic performance. The study will have the potential to significantly contribute to future research, as well as the scientific and educational debate on the best way to implement PA to support education and learning.

TRIAL REGISTRATION

The study was registered on the 25th of October 2022 in ClinicalTrials.gov, NCT05602948.

Striking a balance: how long physical activity is ideal for academic success? Based on cognitive and physical fitness mediation analysis

Balancing physical activity and studying is an important issue facing Chinese teenagers. Therefore, numerous studies have found that engaging in physical activity can promote academic performance among students. However, what is the optimal duration of physical activity? This study used data from the China Education Panel Survey, with a sample size of 18,009 valid respondents. General linear regression analysis was conducted using Stata 17 software to evaluate the effects of different durations of physical activity, cognitive ability, and physical Fitness on academic performance among adolescents. Furthermore, the "Bootstrap Mediation" method and the "Maximum Likelihood Estimation" method were used to analyze whether physical health and cognitive ability have significant mediating effects. The present study reveals the following findings: (1) There exists a non-linear relationship between students' academic performance and the duration of physical exercise. The greatest improvement in academic performance is observed when the exercise duration reaches 2 hours. (2) Physical exercise can enhance students' academic performance by promoting physical health and cognitive abilities. (3) Gender heterogeneity is observed, with the optimal exercise duration for male students being 2 hours, while female students exhibit the highest academic performance when exercising for one hour. This study provides theoretical guidance for research on adolescents' participation in physical Activity and improving academic performance, enabling adolescents to engage in physical Activity more scientifically and rationally.

Upper Secondary School Pupils' Experience of a Lifestyle Plan Based on Physical Power, Mental Harmony, and Social Capacity

PURPOSE

This study aimed to illustrate upper secondary school pupils' experience using a self-administered web-based health-promoting tool, the Swedish Physical Power, Mental Harmony, and Social Capacity (FMS) student profile.

METHOD

Five upper secondary schools in Sweden were included. Focus group interviews with pupils (10 girls, 5 boys, 15-19 years) were conducted, and data were analyzed using qualitative content analysis.

RESULT

Two themes were generated from six categories: a sense of participation and self-control of health: everyday well-being, objective formulation, disappointment, health awareness, limitations, and health-promoting change. The participants experienced that using the FMS made them aware of factors that influence their health. They also reported that being given feedback visually from the FMS, peers, and staff involved in the school was beneficial in increasing their motivation to maintain a health-promoting change regarding physical activity and lifestyle factors.

CONCLUSION

The use of a self-administered web-based health-promoting tool is viewed as beneficial for raising awareness and motivation to implement strategies that help attain a healthier lifestyle in upper secondary school students regarding factors affecting perceived health.

Burnout Syndrome in Selectable Athletes for the Brazilian Handball Team-Children Category

To investigate the presence of burnout syndrome in child athlete tryouts for the Brazilian Handball Team, before and after the National Development and Technical Improvement Camp is of great interest. A correlational study, with longitudinal design of the before-and-after type, carried out with 64 male athletes in the children's category, immersed in the National Camp for Development and Improvement of Handball Technique, in the municipality of São Bernardo do Campo, São Paulo, Brazil, in December 2018. To evaluate burnout syndrome, we used the Athlete Burnout Questionnaire (ABQ). There was a statistically significant increase of the mean scores for burnout and dimensions (Physical and Emotional Exhaustion = 1.5 to 1.6; p-value < 0.001; Reduced Sense of Accomplishment = 2.7 to 2.9; p-value < 0.001; Sports Devaluation = 1.4 to 1.6; p-value < 0.001; and General Burnout = 1.9 to 2.0; p-value < 0.001). The athletes selected for the national team had lower mean scores for general burnout and dimensions (Physical and Emotional Exhaustion = 1.5; Reduced Sense of Accomplishment = 2.7; Sports Devaluation = 1.5; General Burnout = 1.9). The National Camp for Development and Technical Improvement can have a negative impact on the mental health of athletes. This event is important to select the competitors with greater ability to face the pressure and adversities present in the sport environment.

Questionnaires Measuring Physical Activity in Clinical Pediatric Populations: A Systematic Review

PURPOSE

Regular physical activity (PA) is a cornerstone therapy for many childhood chronic health conditions, and questionnaires offer a simple method for monitoring PA and identifying children who do not meet clinical practice guidelines. The purpose of this systematic review is to determine which questionnaires are most efficacious for assessing PA in children with chronic health conditions.

METHODS

Systematic literature searches were conducted through ProQuest, MEDLINE, Scopus, and SPORTDiscus from January 2010 to August 2020 to identify studies that measured PA with a validated questionnaire in children and adolescents aged 3-18 years old with chronic health conditions. In eligible studies, the validity and reliability of questionnaires were identified, and the modified COnsensus-based Standards for the selection of health status Measurement INstruments checklist and Grading of Recommendations, Assessment, Development, and Evaluations were used to assess the quality and strength of evidence and risk of bias.

RESULTS

Four thousand four hundred and seventy-eight references were extracted, and 10 articles were included for review. From 10 eligible studies, 6 questionnaires were identified, none of which adequately measure PA in clinical pediatric populations.

CONCLUSION

Questionnaires to adequately measure PA in children with chronic conditions are lacking. This compromises the identification of those who do not meet PA guidelines, limiting the opportunity to identify and address factors contributing to low PA levels.

Extracurricular Pulse Activities in School: Students' Attitudes and Experiences

BACKGROUND

Few children and adolescents reach the recommended levels of daily physical activity, which is something that affects their health and wellbeing. Research shows that physical activities could be one factor for improving health and achieving academic goals in children and adolescents.

METHODS

Eight focus group interviews with students 10-15 years old were conducted at two schools with extracurricular pulse activities (ECPAs) during the school day.

RESULTS

In general, the interviewed students at both schools expressed positive attitudes toward ECPAs, emphasizing a felt correlation with physical activities out of school. Phenomena such as motivation, concentration and social relations also seem to profit from ECPAs. However, some students display a critical approach to ECPAs. From a gender perspective, girls embrace ECPAs with more enthusiasm than boys.

CONCLUSIONS

In order to make the best use of positive attitudes and health promotion, schools need to improve structural conditions such as facilities, time pressure, unhygienic conditions, blurry boundaries between ECPAs and Physical Education (PE), uncomprehending teachers, contents and, very importantly, the inclusion of students in the process of planning and implementing ECPAs.

Association between Physical Fitness, Physical Activity Level and Sense of Coherence in Swedish Adolescents; An Analysis of Age and Sex Differences

INTRODUCTION

The aim of this study was to investigate the association between physical fitness, physical activity, and sense of coherence (SOC) in Swedish adolescents (n = 2028 males, n = 1287 females) aged 14 to 18 using a cross-sectional design.

METHODS

Using the Swedish Physical power Mental harmony and Social capacity (FMS) student profile, participants performed physical tests measuring their cardiovascular ability (CV) and muscular strength. Questionnaires were used to measure physical activity levels (PA), the participation in organized physical training, sedentary behavior (SB), screen time, and SOC value. Multiple linear regression analyses were used to analyze the association between SOC and independent variables.

RESULTS

The regression analyses explained a small, shared variance between SOC and the independent variables in boys (4.3%) and girls (3.3%). SB showed a positive association with SOC both in girls (β = 0.114, p = 0.002) and boys (β = 0.109, p = 0.013). Abdominal strength was positively associated, while VO₂max was inversely associated, with SOC (β = 0.113, p = 0.022; β = -0.109, p = 0.026, respectively) in boys. Girls had poorer fitness than boys did across all age groups except at age 18. PA levels decreased from age 14 to 18 in girls and boys, but without differences between sexes. Abdominal strength decreased from age 14 to 18 in girls and boys. In general, girls had lower SOC than boys across all age groups.

CONCLUSIONS

Poor sedentary behavior was significantly associated with weaker SOC for both genders, indicating overall physical activity as the most important factor for stronger SOC. However, emotional support in vulnerable environments may have a bigger impact than physical activity or sedentary behavior on the SOC value for adolescents.

Stable physical activity tracking during children's guided active play

Objective

Physical activity (PA) decreases during childhood with PA tracking statistics showing moderate coefficients in early childhood moving to poor coefficients in late childhood. The age-related instability of PA tracking is attributed to variations in age-related PA behaviors when quantifying PA in different settings (in/out of school, sports camps, and habitual PA). This study has examined the stability of age-related PA for children (from 7 to 11 years) during self-paced guided active play (GAP) sessions separated by 12 months.

Methods

Children (n = 65) recruited from community camps in two consecutive years were assessed for growth and PA participation during GAP sessions (1 h^.d⁻¹ on 2 d^.wk⁻¹) using cooperative games. Accelerometer outputs were used to quantify PA and estimate energy expenditure (EE) and moderate-to-vigorous PA (MVPA). Tracking statistics were assessed by Spearman coefficients (r) and agreement scores for percentile rankings (Kappa (k)) after a 1-year interval.

Results

Grouped data for PA tracking (EE) over the 1-year interval showed strong coefficients (r = 0.88, p = 0.001) and moderate agreement scores (k = 0.54). Boys and girls showed similar results. During the 1-year interval, the MVPA tracking coefficient was r = 0.54 (p = 0.01) with a moderate k score of 0.47. Age-related PA (EE) tracking coefficients at 7 (r = 0.90), 8 (r = 0.88), 10 (r = 0.82), and 11 (r = 0.83) years showed strong coefficients except at 9 years (r = 0.51).

Conclusion

Children's age-related PA tracking (EE and MVPA) is stable during self-paced GAP assessed over a 1-year interval. Since PA tracking is stable in self-paced GAP, GAP should be included in children's PA intervention strategies to improve health and fitness.

Predictors of Academic Performance in High School Students: The Longitudinal ASAP Study

Academic performance is influenced by multitude factors. However, little is known about their relative importance and how they evolve over time. The purpose of the present study was to determine the relative importance of cognitive control, physical, psychological and sociological factors as well as lifestyle habits in predicting academic performance in high school students using cross sectional and longitudinal approaches. One hundred and eighty-five grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) from a single high school completed a 3-year prospective study. Academic performance, cognitive control, physical, psychological and sociological factors as well as lifestyle habits were assessed every year during the 3-year study. Results showed that different combinations of factors were found to predict academic performance measures in both male and female students at baseline and after a 3-year period. For example, in female students, screen time and VO₂ max were found to be important predictors of academic performance, whereas working memory was the only recurring factor in predicting academic performance in male students. Moreover, our models were able to explain between 6.1 to 52.2% of the variation in the change of the different measures of academic performance. Results of the present study show that academic performance may be predicted by a wide range of multiple factors in high school students. Indeed, the factors that predicted academic performance varied between school subjects, sex and study design, highlighting the complexity of predicting academic performance in high school students.

The Exeter Activity Unlimited statement on physical activity and exercise for cystic fibrosis: methodology and results of an international, multidisciplinary, evidence-driven expert consensus

Background

The roles of physical activity (PA) and exercise within the management of cystic fibrosis (CF) are recognised by their inclusion in numerous standards of care and treatment guidelines. However, information is brief, and both PA and exercise as multi-faceted behaviours require extensive stakeholder input when developing and promoting such guidelines.

Method

On 30^th June and 1^st July 2021, 39 stakeholders from 11 countries, including researchers, healthcare professionals and patients participated in a virtual conference to agree an evidence-based and informed expert consensus about PA and exercise for people with CF. This consensus presents the agreement across six themes: (i) patient and system centred outcomes, (ii) health benefits, iii) measurement, (iv) prescription, (v) clinical considerations, and (vi) future directions. The consensus was achieved by a stepwise process, involving: (i) written evidence-based synopses; (ii) peer critique of synopses; (iii) oral presentation to consensus group and peer challenge of revised synopses; and (iv) anonymous voting on final proposed synopses for adoption to the consensus statement.

Results

The final consensus document includes 24 statements which surpassed the consensus threshold (>80% agreement) out of 30 proposed statements.

Conclusion

This consensus can be used to support health promotion by relevant stakeholders for people with CF.

Associations between swimming & cycling abilities and fitness in 9-11 year old boys and girls

The associations between swimming and cycling abilities and fitness levels in 9-11-year-old children were examined. A cross-sectional study involving 2258 children (50.7% boys; aged 10.52 ± 0.6 years) from 33 schools across Wales, participated in Swan/BridgeLinx health, fitness, and lifestyle programmes between 2013-2019. Health and fitness data were collected; namely body composition, cardiorespiratory fitness, muscular strength, flexibility, power, and speed using standardised measures. Children completed an online survey collecting data on swimming and cycling abilities and sports club attendance. Multivariate multilevel regressions were used to examine the associations between measures. The ability to swim and cycle was significantly (p < 0.05) associated with all components of fitness when accounting for age, body mass index (BMI), deprivation, gender, and sports club attendance. Boys outperformed girls with significant interactions between swimming, cycling and cardiorespiratory fitness for gender by swim (p = 0.001) and gender by cycle (p = 0.015). The gender by cycle interaction significantly predicted grip strength and power (p < 0.05). Swimming and cycling are important "milestones" in the journey of motor development and are associated with higher levels of fitness. These activities should be promoted to allow for an optimal development of motor skills, fitness, and health.

Well-being, physical fitness and health profile of 10-12 years old boys in relation to leisure-time sports club activities: a cross-sectional study

OBJECTIVES

This study investigated the correlation between sports club activities and well-being and physical health parameters in 10-12 years old boys.

DESIGN

Cross sectional.

SETTING

Danish schools.

PARTICIPANTS

2293 boys took part in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Questionnaires on participation in sports clubs and well-being and testing of physical health profile through measurement of body composition, resting heart rate (RHR), blood pressure and postural balance, jump and Yo-Yo IR1C performance. Data were analysed by participation in sport and according to the five most frequently reported sports.

RESULTS

Boys enrolled in sports clubs had higher physical well-being (51.7±9.7 vs 45.9±8.7) and psychological well-being (53.3±9.6 vs 51.4±10.0), experienced more peers and social support (50.9±9.9 vs 48.0±11.6), and had a more positive perception of the school environment (48.6±7.5 vs 45.9±8.1) than boys not involved in sports clubs. In addition, they showed better Yo-Yo IR1C (+46%), long jump (9%) and balance test performance (+20%). The boys active in sports clubs had higher relative muscle mass (+6%) and lower fat percentage (-3%), body mass index (-6%) and RHR (-5%) compared with boys not involved in sports clubs (p<0.05). Boys enrolled in football clubs had higher aerobic fitness compared with boys not active in clubs (+11%), handball players (+5%), swimmers (+8%) and badminton players (+7%). Moreover, the boys enrolled in football clubs had lower fat percentage (-17%) and higher relative muscle mass (+4%) than swimmers.

CONCLUSION

Boys participating in club-based sports showed markedly higher levels of well-being and better physical health profiles than boys not involved in sports club activities. Footballers had superior aerobic fitness and body composition compared with those active in other sports. Results suggest that sports club activities seem to be beneficial for young boys' well-being, fitness and physical health profile, with the greatest benefits achieved by boys involved in football.

Pediatric Obesity and Sports Medicine: A Narrative Review and Clinical Recommendations

OBJECTIVE

To review what is known about sports medicine and pediatric obesity, with a focus on injuries and MSK concerns.

DATA SOURCES

Systematically searched MEDLINE (PubMed) for all years, using search combinations to best identify potential publications. Manuscripts were reviewed, summarized, and discussed in detail. Experienced clinicians in sports medicine and pediatric obesity reviewed the final searches for substantive content. Inclusion criteria include English language publications, children ≤18 years old, related to the practice of sports medicine and pediatric obesity. Publications excluded that dealt with non-sports medicine aspects of pediatric obesity, such as increasing physical activity or exercise, or the prevention or treatment of obesity.

MAIN RESULTS

Twenty-eight publications were included for review. Papers fell into 5 groupings: (1) MSK-increased incidence of MSK injury in children with obesity, hypothesized to be a result of changes in biomechanics; (2) weight management-gradual loss while maintaining proper hydration and nutrition for sports performance; (3) fitness/conditioning-children with overweight/obese showed decreased fitness measures and cardiopulmonary conditioning; (4) exertional heat illness-a concern for adolescent athletes with obesity, specifically in football; and (5) differential diagnoses-3 key differential diagnoses were identified for increased awareness: slipped capital femoral epiphysis, Blount's disease, and pes planus. Clinical topics pertinent to sports medicine and pediatric obesity were discussed.

CONCLUSIONS

Sports medicine clinicians should be aware of the common MSK and sports-related conditions in children with obesity. Few studies have focused investigations on issues related to children with obesity participating in sports and other physical activities.

Subjective Health, Physical Activity, Body Image and School Wellbeing among Adolescents in South of Sweden

This study aimed to investigate subjective health and its associations with perceived body image (body appearance and body functioning), physical activity, perceived wellbeing in school, perceived family financial situation, and body mass index among 13- to 15-year-old boys and girls. The study was a cross-sectional study performed in four municipalities in Southern Sweden. Data were obtained from questionnaires completed by adolescents (median age 14; range: 13–15) in Sweden (n = 1518, 51% girls), with a participation rate of 73%. Body weight and body height were measured by school nurses and body mass index was calculated. Logistic regression analyses were carried out with subjective health as the dependent variable. Independent variables included in the model were perceived wellbeing in school, perceived family financial situation, perceived body image, physical activity, body mass index, sex, and residency. Variables significantly associated with good subjective health were good wellbeing in school, a perceived good family financial situation, perceived positive body appearance, perceived positive body functioning, being a boy, and high physical activity. Residency and body mass index were not associated with subjective health. Good subjective health is associated with good wellbeing in school, good family financial situation, positive body image, and high physical activity levels. The results highlight the importance of good school climates, the promotion of positive body image, and increased physical activity for adolescents.

Implementation facilitation of the "11 for Health in Denmark": A case study in a Danish 5th grade class

The “11 for Health in Denmark” concept aims to enhance 10–12‐year‐old schoolchildren's physical activity levels and health knowledge through an 11‐week football intervention and has been shown to induce positive effects in numerous areas. However, little is known about the implementation facilitation of this concept in schools. This case study therefore aims to gain a deeper understanding of the implementation facilitation of “11 for Health” in a Danish 5^th grade class comprising 22 schoolchildren (12 boys and 10 girls, M_age 11.86±) and one teacher. Data were derived from multiple school situations using photographs and videos, observations, and informal interviews. Five themes were identified: (1) environmental and organizational factors impacting on the implementation; (2) familiarization with the concept for the teacher and schoolchildren; (3) previous clique formation; (4) the central role of the teacher; and (5) the importance of how praise partners are allocated. We found high adherence to the “11 for Health” concept, in which the teacher played a key role by applying an autonomy‐supportive style of teaching and using the praise partner concept in a suitable manner. A clique of football‐playing boys was a resource, as their praising of classmates encouraged adherence. However, familiarization with the “11 for Health” concept was a challenge and the clique's competitive nature occasionally built barriers to other schoolchildren without football experience, potentially leading to a more controlled form of motivation. Based on the results, we encourage teachers to apply autonomy‐supportive teaching when applying the “11 for Health” concept.

Could Physical Fitness Be Considered as a Protective Social Factor Associated with Bridging the Cognitive Gap Related to School Vulnerability in Adolescents? The Cogni-Action Project

The first aim was to compare differences between school vulnerability groups, fitness levels, and their combination in adolescent cognitive performance. The second aim was to determine the mediation role of fitness in the association between school vulnerability and cognitive performance. A total of 912 Chilean adolescents aged 10–14 years participated in this study. The school vulnerability index (SVI) assigned by the Chilean Government was categorized into high-, mid-, or low-SVI. Adolescents were classified as fit or unfit according to their global fitness z-score computed from their cardiorespiratory (CRF), muscular (MF), and speed/agility fitness (SAF) adjusted for age and sex. A global cognitive score was estimated through eight tasks based on a neurocognitive battery. Covariance and mediation analyses were performed, adjusted for sex, schools, body mass index, and peak high velocity. Independent analyses showed that the higher SVI, the lower the cognitive performance (F_(6,905) = 18.5; p < 0.001). Conversely, fit adolescents presented a higher cognitive performance than their unfit peers (F_(5,906) = 8.93; p < 0.001). The combined analysis found cognitive differences between fit and unfit adolescents in both the high- and mid-SVI levels (Cohen’s d = 0.32). No differences were found between fit participants belonging to higher SVI groups and unfit participants belonging to lower SVI groups. Mediation percentages of 9.0%, 5.6%, 7.1%, and 2.8% were observed for the global fitness score, CRF, MF, and SAF, respectively. The mediation effect was significant between low- with mid-high-SVI levels but not between mid- and high-SVI levels. These findings suggest that an adequate physical fitness level should be deemed a protective social factor associated with bridging the cognitive gap linked to school vulnerability in adolescents. This favourable influence seems to be most significant in adolescents belonging to a more adverse social background.

The Danish "11 for Health" program raises health knowledge, well-being, and fitness in ethnic minority 10- to 12-year-olds

OBJECTIVES

This study investigated the effects of the health promotion intervention "11 for Health in Denmark" program on 10- to 12-year-old ethnic minority schoolchildren's enjoyment, health knowledge, well-being, and fitness.

METHODS

1122 Danish 5th grade schoolchildren with ethnic minority background from 154 schools were randomized (5:1) to an intervention group (IG, n = 944) or a control group (CG, n = 178). The IG and CG were also divided into subgroups of children active in a sports club (IGPA: n = 644; CGPA: n = 122) and not active in a sports club (IGPI: n = 300, CGPI: n = 56). IG participated in the "11 for Health in Denmark" 11-week program, consisting of 2 × 45 min per week of football drills, small-sided games, and health education, whereas CG continued their regular activities. Pre-post physical testing and questionnaires were applied (short version of the multidimensional well-being questionnaire KIDSCREEN-27, and a 34-item health knowledge questionnaire).

RESULTS

The "11 for Health in Denmark" program was rated moderate-to-high on a 1-5 scale for enjoyment by girls (3.57) and boys (3.65). The intervention had positive between-group effect on health knowledge in relation to hygiene (IG vs GC: 10.6% points (CI95%: 6.9:14.3), p < 0.05), nutrition (9.6% point (CI95%: 7.4:11.8), p < 0.01) and physical activity 4.4% points (CI95%: 2.2:6.6) as well as overall health knowledge (5.7% points, (CI95%: 4.3;7.1), p < 0.05), with similar effects for girls and boys. The IGPI subgroup showed a positive effect on well-being (p = 0.04, school and learning) and also fitness effects on performance and VO₂  max (p = 0.02: p = 0.01). The IGPA subgroup showed a positive effect on fitness scores (p = 0.02, BMI).

CONCLUSION

The intervention program was enjoyable and had a positive impact on health knowledge of ethnic minority background schoolchildren. In addition, the intervention program had the strongest positive effects on well-being and fitness scores for the non-sports club-active children.

Behavioral impact of national health campaigns on healthy lifestyle practices among young adults in Singapore: a cross-sectional study

Background

National health campaigns are often used to improve lifestyle behaviors in the general population. However, evidence specifically in the young adult population is scarce. Given the general deterioration of healthy lifestyle practices from adolescence to young adulthood, it is imperative to study this age group. This study aimed to investigate the behavioral impact of a national health campaign in Singapore on the lifestyle practices of young adults, and whether sex or full-time working and schooling status affected lifestyle practices.

Methods

A total of 594 Singaporean respondents aged 18–39 years old were interviewed via a cross-sectional study in December 2019. Lifestyle practices assessed were diet, exercise, alcohol consumption, current tobacco use, and participation in health screening programs. Other factors investigated included exposure to the national health campaign “War on Diabetes” (WoD), sex, ethnicity, and working/schooling status. Multivariable modified Breslow-Cox proportional hazards models were used to estimate prevalence risk ratios (PRRs) as measures for the associations in this study, after adjusting for potential confounders.

Results

Exposure to the WoD campaign had a significant association with meeting dietary recommendations (PRR = 1.6, 95% CI: 1.0–2.5, p = 0.037), participation in screening (PRR = 1.2, 95% CI: 1.0–1.5, p = 0.028), and current tobacco use (PRR = 0.5, 95% CI: 0.3–0.8, p = 0.003). Males were significantly more likely to meet exercise recommendations (PRR = 2.0, 95% CI: 1.5–2.7, p < 0.001), currently use tobacco (PRR = 3.9, 95% CI: 2.2–6.9, p < 0.001), and consume alcohol excessively (PRR = 1.5, 95% CI: 1.0–2.3, p = 0.046), as compared to females. Working young adults were significantly less likely to meet exercise recommendations (PRR = 0.7, 95% CI: 0.5–0.9, p = 0.019) but significantly more likely to be current tobacco users (PRR = 1.8, 95% CI: 1.1–3.1, p = 0.024), as compared to those who were in school.

Conclusions

While this paper affirms that national health campaigns have significant beneficial associations in diet, health screenings and current tobacco use, policymakers should acknowledge that young adults are an age group with different influences that impact their healthy lifestyle habits. Specific interventions that target these subgroups may be required for better health outcomes. Future studies should evaluate other socio-environmental factors that could play a role in modifying the effect of health campaigns among young adults.

Associations between Community Built Environments with Early Care and Education Classroom Physical Activity Practices and Barriers

The influence of community-built environments on physical activity (PA) support in Early Childhood Education settings (ECEs) is unknown. The purpose of this cross-sectional study was to determine associations between community PA environments and ECE classroom PA practices. We included licensed Oklahoma ECE directors serving 3-to-5-year-old children. Parks and playground locations were exported from Google Earth. National Walkability Index was derived from 2010 US Census data. ArcMap 10.6 was used to geocode ECE locations, which were within an Activity Desert if no parks/playgrounds were located within a 1-mile radius or if Walkability Index was 10.5 or below. Classroom PA practices were determined by using the Nutrition and PA Self-Assessment tool (NAP SACC). Barriers to implementing practices were reported. Most Head Starts (n = 41; 80.3%), center-based childcare settings (CBC; n = 135; 87.0%), and family childcare homes (FCCHs; n = 153; 96.4%) were in an Activity Desert. Parks/playgrounds within a 10-mile buffer were correlated with classroom PA practices in FCCHs only (p < 0.001). Activity Desert status was not related to classroom PA practices for any ECE context (p > 0.029). While FCCHs may be the most vulnerable to lack of park and playground access, overall findings suggest ECEs provide a healthful micro-environment protective of the typical influence of community-built environments.

Exercise Intensity and Technical Involvement in U9 Team Handball: Effect of Game Format

The purpose of this study was to quantify the exercise intensity and technical involvement of U9 boys’ and girls’ team handball during different game formats, and the differences between genders. Locomotor activity (total distance, distance in speed zones, accelerations, and decelerations), heart rate (HR), and technical involvement (shots, goals, and duels) metrics were collected during various 15 min game formats from a total of 57 Danish U9 players (37 boys and 20 girls). Game formats were a small size pitch (20 × 13 m) with 3 vs. 3 players and offensive goalkeepers (S3 + 1) and 4 vs. 4 players (S4), a medium size pitch (25.8 × 20 m) with 4 vs. 4 (M4) and 5 vs. 5 (M5) players, and a large size pitch (40 × 20 m) with 5 vs. 5 (L5) players. Boys and girls covered a higher total distance (TD) of high-speed running (HSR) and sprinting during L5 games compared to all other game formats (p < 0.05; ES = (−0.9 to −2.1), (−1.4 to −2.8), and (−0.9 to −1.3) respectively). Players covered the highest amount of sprinting distance in L5 games compared to all other game formats (p < 0.01; ES = 0.8 to 1.4). In all the game formats, players spent from 3.04 to 5.96 min in 180–200 bpm and 0.03 min to 0.85 min in >200 bpm of the total 15 min. In addition, both genders had more shots in S3 + 1 than M5 (p < 0.01; ES = 1.0 (0.4; 1.7)) and L5 (p < 0.01; ES = 1.1 (0.6; 2.2)). Team handball matches have high heart rates, total distances covered, and high-intensity running distances for U9 boys and girls irrespective of the game format. Locomotor demands appeared to be even higher when playing on larger pitches, whereas the smaller pitch size and fewer players led to elevated technical involvement.

An 11-week school-based 'health education through football programme' improves health knowledge related to hygiene, nutrition, physical activity and well-being-and it's fun! A scaled-up, cluster-RCT with over 3000 Danish school children aged 10-12 years old

ObjectivesOur large-scale cluster randomised controlled trial aimed to investigate the effects on health knowledge and enjoyment of an 11 week 'health education through football' programme for children aged 10-12 years old. Methods 3127 Danish school children (49% girls) aged 10-12 years from a total of 154 schools located in 63% of the Danish municipalities (69 of 98) took part in the analysis. A 5:1 cluster randomisation was performed at school level for the intervention group (IG) or the control group (CG). The twice-weekly 45 min intervention was the '11 for Health in Denmark' programme, which includes health education, football drills and small-sided games. The health education element focused on hygiene, nutrition, physical activity and well-being. Outcomes: The participants completed a 34-item multiple-choice computer-based health knowledge questionnaire preintervention and postintervention. IG also evaluated whether the programme was enjoyable. Results Between-group differences (p<0.05) were observed in overall health knowledge in favour of IG (+7.2% points, 95% CI 6.1% to 8.4%, effect size, ES:0.59), with similar effects for girls (+7.4% points, 95% CI 5.9% to 9.0%, ES:0.57) and for boys (+7.0% points, 95% CI 5.3% to 8.7%, p<0.05, ES:0.51). Marked between-group differences were observed in favour of IG, for health knowledge related to hygiene (IG vs CG:+13.9% points, 95% CI 11.1% to 16.7%, ES:0.53), nutrition (+10.3% points, 95% CI 8.5% to 12.1%, ES:0.53), physical activity (+5.9% points, 95% CI 4.1% to 7.7%, ES:0.36) and well-being (+4.4% points, 95% CI 2.7% to 6.1%, ES:0.28). Both girls and boys gave the programme moderate to high scores for enjoyment (3.6±1.0 and 3.7±1.1, respectively). Conclusion Health education through sport, using the '11 for Health' model, was enjoyable for girls and boys aged 10-12 years old, and improved health knowledge related to hygiene, nutrition, physical activity and well-being.

Effect of Sex, Body Mass Index and Physical Activity Level on Peak Oxygen Uptake Among 14-19 Years Old Adolescents

The aim was to describe longitudinal trends in peak oxygen uptake (VO_2peak) among 14- to 19-year-old adolescents in Norway, and to examine effects of sex, body mass index (BMI), and physical activity (PA) level on VO_2peak during adolescence. Of 124 invited students from two lower secondary schools in Norway, 116 eighth-grade students (61 boys and 55 girls; 14 years old at baseline) volunteered to participate. The study has a longitudinal design with 6 yearly repeated measures of body height and mass, VO_2peak and PA level. VO_2peak allometrically scaled to body mass raised to the power of 0.67 was measured using a walking or running incremental test on a treadmill, whereas PA level was self-reported. Among 696 possible observations, 555 (79.7%) were valid. Multiple linear regression and linear mixed model analyses were used to examine the associations between age, sex, BMI, PA level and VO_2peak. VO_2peak showed a non-linear pattern from age 14 to 19, with a distinct increase for boys peaking at age 17, while the results provide a flatter and more stable curve for girls. Sex, BMI and PA level together explained 43–71% of the variance in VO_2peak at the different age levels. Sex and PA level contributed independently to explain a significant proportion of the variance in VO_2peak at all measurement occasions, while BMI did not. Adjusted sex differences in VO_2peak increased over time, from 26.5 ml·kg^−0.67·min⁻¹ at age 14 to 55.5 ml·kg^−0.67·min⁻¹ at age 19. The independent contribution from PA level to the variance in VO_2peak increased from age 14 to 16 and then decreased. While PA level explained 32.5% of the total variance in VO_2peak for 16-year-olds, this number was 14% in 19-year-olds. In conclusion, aerobic power showed a non-linear pattern during adolescence, peaking at age 17. Sex and PA level explained a large proportion of the variance in VO_2peak, each of them being an independent contributor to VO_2peak. Aerobic power is linked to improved health and seems to depend largely on sex and PA level in adolescents, emphasizing the importance of maintaining a sufficient PA level during adolescence.

Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)

China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation's youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China's more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6-17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.

Assessment of Validity of Children's Movement Skill Quotient (CMSQ) Based on the Physical Education Classroom Environment

The development of movement skills in children is a critical element in promoting physical activity and other positive health trajectories over their lifetime. A reliable and valid assessment tool is essential for evaluating children's movement skills in daily physical education environments. The purpose of this study was to examine the validity of Children's Motor Skills Quotient (CMSQ) used in the classroom setting. Six raters conducted evaluation to participants, and a total of 734 children completed all the test items and were included in the study. Descriptive statistics and Rasch analysis were used in this study. The descriptive statistics were mainly used for calculating the mean, standard deviation, percentage, and internal consistency coefficient. Rasch analysis was used to verify the fitting statistics, project difficulty, and functional differences of the items of the CMSQ. The findings showed that the CMSQ met the assumption of the Rasch model, including the unidimensionality, local independence, person measure, and item difficulty hierarchy. The CMSQ also demonstrated adequate interrater reliability and internal consistency. The differential item functioning (DIF) demonstrated a few items showing different probabilities across sex and age. To maintain the item difficulty hierarchy of the CMSQ, no items were deleted. Overall, the CMSQ seems to have appropriate test items with an appropriate rating scale structure for measuring 6-9-year-old children's movement skills in the physical education classroom environment.

Well-Being, Physical Fitness, and Health Profile of 2,203 Danish Girls Aged 10-12 in Relation to Leisure-time Sports Club Activity-With Special Emphasis on the Five Most Popular Sports

Madsen, M, Larsen, MN, Cyril, R, Møller, TK, Madsen, EE, Ørntoft, C, Lind, RR, Ryom, K, Christiansen, SR, Wikman, J, Elbe, AM, and Krustrup, P. Well-being, physical fitness, and health profile of 2,203 Danish girls aged 10-12 in relation to leisure-time sports club activity-with special emphasis on the five most popular sports. J Strength Cond Res XX(X): 000-000, 2020-This study investigated the relationship between leisure-time sports club activities and well-being as well as physical health parameters in 10-12-year-old Danish girls. Two thousand two hundred three girls took part in the study, which included questionnaires on participation in leisure-time sports clubs, well-being, Yo-Yo intermittent recovery level 1 children's test, long jump, balance tests, body composition, blood pressure (BP), and resting heart rate (RHR). Data were analyzed according to whether the girls participated in leisure-time sport and according to the 5 most frequently reported sports. Girls enrolled in leisure-time sports had higher physical well-being (49.3 ± 8.6 vs. 45.2 ± 8.3), psychological well-being (50.4 ± 9.0 vs. 49.4 ± 9.8), experienced more peer and social support (50.2 ± 10.0 vs. 48.9 ± 10.7), and perceived a more positive school environment (52.5 ± 8.0 vs. 50.5 ± 9.3), as well as showing higher Yo-Yo (+39%), long jump (+10%), and balance performance (+15%) than girls not involved in sport clubs. The girls active in sports clubs had higher relative muscle mass (+5%), lower fat percentage (-11%), body mass index (-5%), RHR (-3.4 b·min), and diastolic BP (-1.4 mm Hg) compared with girls not involved in sport (p < 0.05). Girls who played soccer showed higher aerobic fitness compared with inactive girls (+67%), dancers (+39%), swimmers (+38%), and gymnasts (+16%). Gymnasts had a lower fat percentage than inactive girls (-19%), team handballers (-10%), swimmers (-12%), and soccer players (-4%). Girls participating in club-based leisure-time sports showed higher well-being and better fitness and health profiles than girls not involved in any sports club activities. Girls involved in soccer had better aerobic fitness and gymnasts a lower fat percentage.

Individual- and environmental-related correlates of moderate-to-vigorous physical activity in 11-, 13-, and 15-year-old Finnish children

The objective of this study was to analyze the associations of various individual- and environmental-related factors with subgroups of daily, frequent, moderate and low moderate-to-vigorous physical activity (MVPA) among children and adolescents. Data were obtained from the Finnish School-age Physical Activity (FSPA) study 2016 from 4677 national representative 11-, 13-, and 15-year-old children and adolescents. MVPA and individual- and environmental-related factors were assessed by a questionnaire and analyzed by two-level logistic regression. Seventeen of the twenty-one variables were statistically significantly associated with MVPA. However, only three variables were statistically significant in all MVPA subgroups, whereby self-directed PA at least twice a week, fewer perceived barriers, and higher peer support increased the odds of participating in more MVPA. The results from this study showed essential differences among the MVPA subgroups, also supporting previous findings, whereby various individual- and environmental-based factors are associated with children and adolescents’ levels of MVPA. Challenges to designing and implementing effective interventions are based on the need to account for individual differences within the population, as well as the varied connections between PA with different social and physical environments where children and adolescents’ PA takes place. PA interventions with various actions at multiple levels are warranted.

Bullying Environment Moderates the Relationship Between Exercise and Mental Health in Bullied US Children

BACKGROUND

Exercise reduces the odds of sadness and suicidality in bullied students, but the role of the bullying environment on this relationship remains unknown.

METHODS

Using combined data from the 2013 and 2015 Youth Risk Behavior Survey (N = 29,207), adjusted logistic regression models estimated odds ratios between exercise, sadness, and suicidal ideation and attempt, stratified by bullying exposure (electronically/at school).

RESULTS

Overall, 40.2% of students bullied at school and 48.3% of students bullied electronically reported feeling sad, compared to 22.6% of those not bullied. Bullied students were 2-3 times more likely to report suicidal ideation, and 3-4 times more likely to report suicidal attempt, regardless of bullying context. Students who were bullied at school and exercised 4-7 days per week had lower odds of sadness (adjusted odds ratio [AOR]: 0.64; 95% confidence interval [CI]: 0.51-0.81), suicidal ideation (AOR: 0.66; 95% CI: 0.53-82), and suicidal attempt (AOR: 0.69; 95% CI: 0.48-0.98) compared to those who exercised 0-3 days. There were no protective effects of exercise for students bullied electronically.

CONCLUSIONS

Exercise reduced sadness and suicidality in adolescents bullied at school but not for students who were cyberbullied. Bullying environment should be a primary consideration in school mental health treatment and maintenance paradigms.

Lifestyle Habits Predict Academic Performance in High School Students: The Adolescent Student Academic Performance Longitudinal Study (ASAP)

This study aimed to determine if lifestyle habits could predict changes in cognitive control and academic performance in high school students using a longitudinal approach. One hundred and eighty-seven grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) completed a 3-year prospective study. Lifestyle habits, cognitive control, and academic performance were assessed every year during the 3-year study. Results show that in female students, screen time measures were negatively correlated with academic performance and cognitive control. Furthermore, changes (Δs) in sleeping habits were associated with Δs in academic performance in both genders, whereas Δs in eating habits and in studying time were correlated with Δs in academic performance only in male students. Moreover, in female students, screen time, social media use, and eating habits measures seem to predict the variance in the Δs of cognitive control measures (r² between 8.2% and 21.0%), whereas, in male students, studying time, eating, and sleeping habits appear to explain the variance in the Δs of academic performance measures (r² between 5.9% and 24.8%). In conclusion, results of the present study indicate that lifestyle habits were able to predict Δs in cognitive control and academic performance of high school students during a 3-year period.

An Updated Systematic Review of Childhood Physical Activity Questionnaires

Background and Objective

This review is an update of a previous review published in 2010, and aims to summarize the available studies on the measurement properties of physical activity questionnaires for young people under the age of 18 years.

Methods

Systematic literature searches were carried out using the online PubMed, EMBASE, and SPORTDiscus databases up to 2018. Articles had to evaluate at least one of the measurement properties of a questionnaire measuring at least the duration or frequency of children’s physical activity, and be published in the English language. The standardized COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used for the quality assessment of the studies.

Results

This review yielded 87 articles on 89 different questionnaires. Within the 87 articles, 162 studies were conducted: 103 studies assessed construct validity, 50 assessed test–retest reliability, and nine assessed measurement error. Of these studies, 38% were of poor methodological quality and 49% of fair methodological quality. A questionnaire with acceptable validity was found only for adolescents, i.e., the Greek version of the 3-Day Physical Activity Record. Questionnaires with acceptable test–retest reliability were found in all age categories, i.e., preschoolers, children, and adolescents.

Conclusion

Unfortunately, no questionnaires were identified with conclusive evidence for both acceptable validity and reliability, partly due to the low methodological quality of the studies. This evidence is urgently needed, as current research and practice are using physical activity questionnaires of unknown validity and reliability. Therefore, recommendations for high-quality studies on measurement properties of physical activity questionnaires were formulated in the discussion.

PROSPERO Registration Number

CRD42016038695.

Electronic supplementary material

The online version of this article (10.1007/s40279-018-0987-0) contains supplementary material, which is available to authorized users.

Implementation of a successful long-term school based physical education intervention: Exploring provider and programme characteristics

There is an ongoing need for research focusing on how to implement physical activity programmes into a school setting. This includes documentation of the extent to which programmes are compatible with the basic views of providers and their local practices. The present study explores the Svendborgproject - a programme tripling the amount of physical education in six public schools, sustaining it for 10-years and documenting a decreased incidence of overweight, obesity and cardiovascular risk factors. The aim was to analyse provider and programme characteristics of the Svendborgproject to gain insights into providers motives for adopting, implementing, and maintaining the programme. Six school heads and six teachers were interviewed to explore how they perceived programme compatibility to their school's practice and their own role as providers. Both teachers and school heads found the additional lessons a valuable asset that fitted existing school values and priorities. Additionally, physical education teachers participated in a course providing new perspectives and teaching methods that aided the implementation of the programme. Lastly, school heads stressed that implementation fidelity was heavily dependent on the dedication of physical education teachers and on having simple programme requirements that made it clear what could be expected of the programme.

Girls on the Run: Impact of a Physical Activity Youth Development Program on Psychosocial and Behavioral Outcomes

PURPOSE

Girls on the Run is an after-school physical activity-based positive youth development program designed to enhance girls' social, psychological, and physical development. We evaluated the effectiveness of the program by employing a longitudinal design and mixed methods.

METHODS

Girls (N = 203; aged 8-11 y) completed survey measures of positive youth development constructs (competence, confidence, connection, character, and caring), physical activity, and sedentary behavior prior to, at the end of, and 3 months after the season. Subsamples of girls, coaches, caregivers, and school personnel participated in focus groups. Coaches completed information about their team's community impact project and number of girls who completed the season-ending 5k.

RESULTS

The full sample improved in confidence and connection, whereas girls who started below the preseason average showed the greatest gains from preseason to postseason on all measures, and scores were maintained or continued to improve at follow-up. All stakeholders in focus groups corroborated evidence of season-long improvement in social and emotional behaviors and health outcomes. Involvement in the community impact project contributed to girls' growth in character and empathy skills.

CONCLUSION

Findings provide empirical evidence that Girls on the Run is effective in promoting positive youth development, including season-long and lasting change in competence, confidence, connection, character, caring, and physical activity, especially among girls who exhibited lower preseason scores than their peers.

Could sport be part of pediatric obesity prevention and treatment? Expert conclusions from the 28th European Childhood Obesity Group Congress

•Traditional sports might be considered as part of obesity treatments.•Traditional sports are interesting strategies for the prevention of pediatric overweight and obesity.•A fully adapted medical checkup is mandatory before considering the use of traditional sports for the treatment of pediatric obesity.•Making adaptations in the practice of traditional sports (duration, rules, dimensions of the field) offers possible opportunities for obesity treatment among children and adolescents.

Biking to School: The Role of Bicycle-Sharing Programs in Adolescents

BACKGROUND

The purpose of this study was to: (1) describe modes of transport to school, with a specific focus on the use of public bicycle share programs (PBSP); and (2) assess sociodemographic, psychosocial, and environmental correlates of bike and PBSP use to go to school.

METHODS

A group of 465 adolescents from the International Physical Activity and the Environment Network (IPEN) Adolescent Study (Valencia, Spain) participated in the research. Mixed regression analyses were conducted on the data obtained.

RESULTS

Not having bicycle access, a PBSP card, or a public bike lane close to the school is negatively associated with bicycle use. PBSP is positively associated with physical self-efficacy and bicycle availability and negatively associated with the number of vehicles per drivers at home and not having PBSP stations close to the school.

CONCLUSIONS

The strongest predictive factor, as regards cycling as an active mode of transport to school among adolescents is having a PBSP card. Schools have a crucial role in promoting bicycle use through collaboration when designing public policies that consider access to bike lane networks and PBSP stations and therefore should encourage local government implementation policies and/or increase PBSP stations within 250 m of the school.

Health Effects of Wrist-Loading Sports During Youth: A Systematic Literature Review

BACKGROUND

The benefits and risks of performing popular wrist-loading sports at a young age have not been investigated systematically. We aimed to evaluate positive and negative long-term wrist-related health effects of sports performance requiring repetitive wrist loading during youth.

METHODS

Six databases were searched for cohort and cross-sectional studies. Three investigators selected studies evaluating quantitatively measured health effects of upper extremities in athletes practicing wrist-loading sports (gymnastics, tennis, volleyball, field hockey, rowing, and judo) for minimally 4 months before the age of 18.

RESULTS

A total of 23 studies with 5 outcome measures, nearly all of moderate to good quality, were eligible for inclusion. Bone mineral density and bone mineral content were higher in athletes compared with controls and in tennis players' dominant arm. Mixed results were found for ulnar variance in gymnasts. Handgrip strength was greater in tennis players' dominant arm and in experienced gymnasts.

CONCLUSIONS

Wrist-loading sports performance during youth can promote bone strength in wrists and dominant handgrip strength, but evidence on the lasting of these effects and on prevalence of wrist joint degeneration in former young athletes is limited. For better counseling of young athletes and their parents, future studies with increased comparability are essential, for which recommendations are provided.

Heart Rate and Perceived Experience Differ Markedly for Children in Same- versus Mixed-Gender Soccer Played as Small- and Large-Sided Games

This study examines heart rate (HR) and perceived experience during same- versus mixed-gender soccer played as small- (SSG) and large-sided (LSG) games. HR, rating of perceived exertion (RPE), and fun scores were determined in 134 pupils (50 girls, 84 boys) randomly assigned to same- and mixed-genders formats playing 2x15-min of SSG (2v2, 4v4) and LSG (12v12) in a random order (~50 m²/player). HR was lower (p≤0.03) for girls when playing together with boys than when playing alone (71±10 versus 77±7%HRmax), while being similar for boys playing mixed- or same-gender games (74±7 versus 77±4%HRmax). Boys perceived less fun when playing together with girls than when playing alone (4.4±2.3 versus 6.3±2.3, p<0.001). Irrespective of gender, higher (p<0.001) HRmean, %time>80%HRmax, and RPE were observed during 2v2 (78±9%HRmax, 43±33%, 5.5±2.5) and 4v4 (76±9%HRmax, 39±32%, 5.5±2.7) than during 12v12 (70±10%HRmax, 23±27%, 3.8±2.9). Cardiovascular strain was lower for girls when playing together with boys than when playing alone in LSG. SSG were more intense than LSG when girls played mixed-gender games and when boys played mixed- and same-gender games. When boys played mixed-gender games, SSG were considered more fun than LSG. Physical education teachers and coaches should consider gender and game format differences when using soccer.

Physical activity, cognition and academic performance: an analysis of mediating and confounding relationships in primary school children

Background

Exploring the relationship between physical activity, cognition and academic performance in children is an important but developing academic field. One of the key tasks for researchers is explaining how the three factors interact. The aim of this study was to develop and test a conceptual model that explains the associations among physical activity, cognition, academic performance, and potential mediating factors in children.

Methods

Data were sourced from 601 New Zealand children aged 6–11 years. Weekday home, weekday school, and weekend physical activity was measured by multiple pedometer step readings, cognition by four measures from the CNS Vital Signs assessment, and academic performance from the New Zealand Ministry of Education electronic Assessment Tools for Teaching and Learning (e-asTTle) reading and maths scores. A Structured Equation Modelling approach was used to test two models of variable relationships. The first model analysed the physical activity-academic performance relationship, and the second model added cognition to determine the mediating effect of cognition on the physical activity-academic performance association. Multigroup analysis was used to consider confounding effects of gender, ethnicity and school socioeconomic decile status.

Results

The initial model identified a significant association between physical activity and academic performance (r = 0.225). This direct association weakened (r = 0.121) when cognition was included in the model, demonstrating a partial mediating effect of cognition. While cognition was strongly associated with academic performance (r = 0.750), physical activity was also associated with cognition (r = 0.138). Subgroups showed similar patterns to the full sample, but the smaller group sizes limited the strength of the conclusions.

Conclusions

This cross-sectional study demonstrates a direct association between physical activity and academic performance. Furthermore, and importantly, this study shows the relationship between physical activity and academic performance is supported by an independent relationship between physical activity and cognition. Larger sample sizes are needed to investigate confounding factors of gender, age, socioeconomic status, and ethnicity. Future longitudinal analyses could investigate whether increases in physical activity can improve both cognition and academic performance.

The Importance of Coaches' Autonomy Support in the Leisure Experience and Well-Being of Young Footballers

Drawing on the self-determination framework, the study examined the effect of coaches' autonomy support on the leisure experience of young male football players. Specifically, a model was tested analyzing the long-term predictive power of the players' perceptions of the coaches' autonomy support at the beginning of the season on the subjective vitality of young football players at the end of the season, through needs satisfaction and intrinsic motivation (IM). Moreover, we tested whether the effects of coaches' autonomy support on the aforementioned variables (needs satisfaction, IM, and subjective vitality) at the end of the season remained at the beginning of the following season. Because the coach in the second season was not the same one as in the first season, the perception of coaches' autonomy support at the beginning of the second season was used as a control variable. Three hundred and sixty football players (M age = 12.60 years; SD = 0.52) completed a questionnaire on the variables of interest at the beginning of the first season (T1), at the end of the first season (T2), and at the beginning of the second season (T3). The results of the path analyses showed that players' perceptions of coaches' autonomy support at the beginning of the season (T1) positively predicted needs satisfaction at the end of the first season (T2), which in turn predicted IM at the end of the first season (T2). Additionally, IM significantly and positively predicted subjective vitality at the end of the first season (T2). Finally, needs satisfaction, IM, and subjective vitality at the end of the second season (T2) positively predicted these same variables at the beginning of the second season (T3). Results emphasized the importance of the autonomy support offered by the coach in promoting the quality of young people's leisure experience playing football and its benefits for their well-being.

Objectively measured physical activity, body composition and physical fitness: Cross-sectional associations in 9- to 15-year-old children

The aim of this study was to examine and quantify the cross-sectional associations of body composition (BC), physical activity (PA) and sedentary time (ST) with physical fitness (PF) in children and adolescents. A sample of 594 Finnish students (56% girls), aged 9-15 (12.4 ± 1.3 years) were selected for a study performed in 2013. The measurements of the Move! monitoring system for physical functional capacity were used to measure cardiorespiratory and musculoskeletal fitness and fundamental movement skills. Moderate-to-vigorous PA (MVPA) and ST were measured objectively with an accelerometer and BC by a bioelectrical impedance analysis. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated to represent height-adjusted BC. Associations were explored with a linear regression model. In general, FMI had statistically significant negative associations, while FFMI and MVPA had positive associations with PF. No statistically significant associations were observed between ST and PF. In general, FMI had the strongest association with PF, although some variation occurred with sex and PF component. However, associations were practically relevant only in 20-m shuttle run, push-up, curl-up and 5-leaps test. For example, approximately 5 kg increase in fat mass in 155 cm tall children was estimated to correspond to  8 laps in 20-m shuttle run. Similar increase in fat-free mass corresponded to +4 and +6 laps, and 10 min increase in daily MVPA +3 and +2 laps in 20-m shuttle run, in boys and girls, respectively. Understanding these associations is necessary when interpreting children's PF and designing interventions.

A comparative study found that a seven-year school-based exercise programme increased physical activity levels in both sexes

AIM

This study assessed whether a Swedish school-based exercise intervention programme could increase total physical activity.

METHODS

We followed up 228 children who started school in 1998-2000 seven years later, when they had reached a mean age of 14.8. The 152 children (59% boys) at the intervention school did 200 minutes of physical education per week during that period, and the 76 children (50% boys) in the three control schools did the standard 60 minutes. Questionnaires assessed the durations of total and leisure-time physical activity and screen-time activity at baseline and after five and seven years.

RESULTS

Physical activity and screen-time activity were similar between the two groups before the study started. The intervention group then achieved higher durations of total physical activity than the controls (p < 0.001) and these levels remained in the sex-specific evaluations. There were no differences between the groups in the durations of leisure-time activity (p 0.08-0.77) or screen-time activity (p 0.31-0.91).

CONCLUSION

A school-based exercise intervention programme increased the total duration of physical activity in both sexes without any compensatory increase in screen-time activity. The findings contradict the activity-stat theory, which stated that the duration of physical activity in children is constant.

Longitudinal Changes in Physical Activity Level, Body Mass Index, and Oxygen Uptake Among Norwegian Adolescents

Several studies have investigated activity levels among adolescents, but no study has examined longitudinal changes in physical activity (PA) level, body mass, and oxygen uptake among the same adolescents from the age of 14 to 19 years. The present study examined data from a research project that included a group of randomly selected students (N = 116) with objective measurements of PA (accelerometer data), self-reported PA level, and body mass and oxygen uptake during a 5-year period. The results show a significant decrease in the accelerometer-based PA level over time, from age 14 to 19. At 14 years of age, the minutes of moderate and/or vigorous PA was 66.7 min·day^-1, but was less than half, at only 24.4 min·day^-1, at 19 years of age. The self-reported activity data show a decrease in girls' general activity level over time, while boys' activity level during school breaks decreased strongly during the period: at age 14, 61% of the boys were classified as active, while at age 19, only 11% were physically active. Furthermore, body mass index increased during the period for both genders, while oxygen uptake decreased. Since both BMI and maximal oxygen uptake are important risk factors for future CVD, these findings point toward the importance of maintaining a high activity level during childhood and adolescence, in order to keep fit later in life.

The Effect of an Authentic Acute Physical Education Session of Dance on Elementary Students' Selective Attention

There have been calls to test the potential benefits of different forms of physical activity (PA) to executive function, particularly in authentic settings. Hence, the purpose of this study was to investigate the effect of an acute dance session within an existing physical education class on students' selective attention. The study employed a pre/posttest quasi-experimental design with a comparison group in one Aotearoa, New Zealand, primary school. Participants were 192 students (comparison group = 104 students) in Years 5 and 6. The intervention group participated in a dance-based physical education lesson while the comparison group continued their regular classroom work. PA during the physical education lesson was monitored using accelerometers. Selective attention was assessed at pretest and after the comparison/physical education sessions with the d2 Test of Attention. 2 × 2 ANOVA results suggested a significant time effect for all three measures, no significant group effects for any measures, and significant time by group interactions for TN and CP but not for E%. The intervention group improved significantly more than the comparison group for TN and CP. This study's findings suggest that existing school opportunities focused on cognitively engaging PA, such as dance, can improve aspects of students' selective attention.

Relación entre salud y deporte escolar desde una perspectiva intercultural, un estudio multicaso

Introducción. La salud y el deporte configuran prácticas, creencias y relaciones culturales particulares en cada contexto.Objetivo. Analizar las creencias de estudiantes inmigrantes y mapuche-huilliche sobre la relación entre deporte escolar y salud.Materiales y métodos. Se desarrolló un estudio multicaso cualitativo con enfoque etnográfico. Participaron 71 sujetos subdivididos en dos grupos: uno constituido por estudiantes inmigrantes que participaban de un programa de deporte escolar con principios comprensivos de enseñanza en España (n=47) y otro compuesto por alumnos de la etnia Mapuche-Huilliche que participaban de un programa análogo en Chile (n=24). Para la recolección de datos se aplican tres entrevistas colectivas a cada grupo.Resultados. Ambos colectivos perciben una asociación positiva entre la participación en deporte escolar y el desarrollo de la salud en diferentes dimensiones. Existen diferencias respecto a la interpretación cultural que ambos grupos otorgan al concepto salud y sus posibles relaciones con el deporte escolar. Sin embargo, en ambos contextos existen situaciones en que se considera de forma parcial la cultura de los estudiantes para trabajar sobre estos temas.Conclusiones. Estudiantes inmigrantes y mapuche-huilliche establecen creencias positivas sobre la relación entre deporte escolar y desarrollo de salud en sus diferentes manifestaciones.

Longitudinal Changes in AbsoluteVO2peak, Physical Activity Level, Body Mass Index, and Overweightedness among Adolescents in Vocational and Non-Vocational Studies

The purpose of the study was to examine differences in physical activity level, physical fitness, body mass index, and overweight among adolescents in vocational and non-vocational studies, at the age of 14, 16, and 19, using a 5-year longitudinal design. Students in sport studies had the highest absoluteVO2peak and higher physical activity levels, than students in vocational subjects and students with a specialization in general studies. However, there were no significant differences between students in vocational subjects and students with a specialization in general studies according to absoluteVO2peak and physical activity levels. Students in vocational subjects were significantly more overweight/obese at 19 years of age, compared with the other students. Our findings support previous research pointing to overweightedness as being more widespread among adolescents in vocational programs than in non-vocational programs. However, differences in the physical activity level and physical fitness do not seem to explain these differences.

Behavioral determinants of physical activity across the life course: a "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella systematic literature review

Background

Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course.

Methods

A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, 2016. SLRs and meta-analyses (MAs) of observational studies that investigated the behavioral determinants of PA were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence, and the methodological quality. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42015010616).

Results

Seventeen reviews on 35 behavioral determinants of PA were eligible for this umbrella SLR. Regardless of age, the most investigated determinants were those related with ‘screen use’ and ‘smoking’. For youth, probable positive evidence emerged for ‘previous PA’ and ‘independent mobility and active transport’ among children and adolescents. For the adult population, ‘transition to university’ and ‘pregnancy/having a child’ showed probable negative associations.

Conclusions

Although the majority of the evidence was limited and most of the determinants were not associated with PA, this umbrella SLR provided a comprehensive overview of the associations between behavioral determinants and PA. Youth should be physically active in the early years and increase active transportation to/from school, independent mobility, and ‘free-range activities’ without adult supervision, whilst adult PA behaviors are mostly influenced by the life events. Finally, more research is needed that incorporates prospective study designs, standardized definitions of PA, objective measurement methods of PA assessment, and the use of interactionist and mediational approaches for the evaluation of different behavioral determinants influencing PA behaviors.