Childhood and adolescent predictors of leisure time physical activity during the transition from adolescence to adulthood: a population based cohort study

The relationship between jump and sprint performance in preschool children

BACKGROUND

Physical activity may help prevent the development of adverse health disorders in children. Thus, it is fundamental to assess key physical skills, such as jumping and running, from an early age. Several studies proposed test batteries to evaluate these motor skills in preschoolers, but no research studied their association. Therefore, this study aimed to evaluate the relationship between jump performance, including force production parameters, and sprint performance in preschool children.

METHODS

Twenty-nine preschoolers, aged 4 to 5, underwent assessments, including countermovement jumps (CMJ) and standing long jumps (SLJ) on a force plate. Then they performed a 10-meter linear sprint assessed using photocells.

RESULTS

Regression models revealed that SLJ distance emerged as a significant predictor (R2=49.3%, P<0.001) of sprint horizontal velocity, while, for sprint momentum (R2=34.3%), both SLJ distance (P=0.004) and SLJ vertical peak force (P=0.036) were found to be significant predictors.

CONCLUSIONS

The findings showed that short-distance (i.e., 10 m) linear sprint performance, both velocity and momentum, in preschoolers may be predicted mainly using SLJ assessment. These findings underscore the importance of early motor skill development in shaping physical abilities and their potential relationship in preschool children.

Long-term recreational exercise patterns in adolescents and young adults: Trajectory predictors and associations with health, mental-health, and educational outcomes

Individual and societal factors influencing the formation of long-term recreational exercise habits during the transition from adolescence to young adulthood are not well explored. Using data from the Longitudinal Survey of Australian Youth (LSAY), a population-representative cohort study of Young People followed from age 15 to 25, we aimed to (1) model longitudinal recreational exercise trajectories from age 16 to 24, (2) examine predictors at age 15 of entering these trajectories, and (3) explore the association between the trajectories and health, mental health and educational achievement outcomes measured at the final study wave (age 25). Self-reported recreational exercise frequency data from 9353 LSAY participants were analysed using group-based trajectory modelling. We modelled the evolution of two patterns of recreational exercise behaviour: daily exercise, as per public health guidelines (Model 1); and at least once weekly exercise (Model 2). Model 1 trajectories were guideline-adherent exercisers (17.9% of the sample), never guideline exercisers (27.5%), guideline drop-outs (15.2%) and towards guideline (39.4%); Model 2 trajectories were weekly exercise (69.5% of the sample), decreasing (17.4%), increasing (4.8%), and infrequent (8.3%). For both models, at age 15, trajectory membership was predicted by gender, self-efficacy, time spent participating in sport, time spent watching TV, parental socioeconomic status, and academic literacy. At age 25, people in the guideline-adherent exerciser trajectory (model 1) reported better general health relative to other trajectories, Those in the weekly exerciser trajectory (model 2) had better general health and reduced rates of psychological distress, were happier with life and were more optimistic for the future relative to participants in less than weekly trajectory groups. Exercise-promoting interventions for Young People should specifically address the needs of females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage.

Genetic confounding in the association of early motor development with childhood and adolescent exercise behavior

INTRODUCTION

Early motor development has been found to be a predictor of exercise behavior in children and adolescents, but whether this reflects a causal effect or confounding by genetic or shared environmental factors remains to be established.

METHODS

For 20,911 complete twin pairs from the Netherlands Twin Register a motor development score was obtained from maternal reports on the timing of five motor milestones. During a 12-year follow-up, subsamples of the mothers reported on the twins' ability to perform seven gross motor skills ability (N = 17,189 pairs), and weekly minutes of total metabolic equivalents of task (MET) spent on sports and exercise activities at age 7 (N = 3632 pairs), age 10 (N = 3735 pairs), age 12 (N = 7043 pairs), and age 14 (N = 3990 pairs). Multivariate phenotypic and genetic regression analyses were used to establish the predictive strength of the two motor development traits for future exercise behavior, the contribution of genetic and shared environmental factors to the variance in all traits, and the contribution of familial confounding to the phenotypic prediction.

RESULTS

Significant heritability (h2) and shared environmental (c2) effects were found for early motor development in boys and girls (h2 = 43-65%; c2 = 16-48%). For exercise behavior, genetic influences increased with age (boys: h2age7 = 22% to h2age14 = 51%; girls: h2age7 = 3% to h2age14 = 18%) paired to a parallel decrease in the influence of the shared environment (boys: c2age7 = 68% to c2age14 = 19%; girls: c2age7 = 80% to c2age14 = 48%). Early motor development explained 4.3% (p < 0.001) of the variance in future exercise behavior in boys but only 1.9% (p < 0.001) in girls. If the effect in boys was due to a causal effect of motor development on exercise behavior, all of the factors influencing motor development would, through the causal chain, also influence future exercise behavior. Instead, only the genetic parts of the regression of exercise behavior on motor development were significant. Shared and unique environmental parts of the regression were largely non-significant, which is at odds with the causal hypothesis.

CONCLUSION

No support was found for a direct causal effect in the association between rapid early motor development on future exercise behavior. In boys, early motor development appears to be an expression of the same genetic factors that underlie the heritability of childhood and early adolescent exercise behavior.

Tracking of Cardiorespiratory Fitness from Childhood to Mid-adulthood

High cardiorespiratory fitness (CRF) in adulthood is important for survival from major chronic diseases and preserving good health. We examined how childhood CRF tracks, or persists, into adulthood. Among a cohort of 748 school children followed over 34 years, we found child CRF correlated with young- (r = 0.30) and mid-adulthood (r = 0.16) CRF.

Competitive Sports Participation is Associated with Decreased Risk of Obesity in Children with Bicuspid Aortic Valve

Individuals with bicuspid aortic valve (BAV) have historically been advised to avoid contact sports and isometric exercise for risk of increasing aortic dilation and valve disease. There is mounting evidence that current sports participation guidelines qualify children for a high rate of sports exclusion, and that this population is at increased risk of obesity. The primary aim of this study was to evaluate relationship between sports participation and aortic dilation in children with bicuspid aortic valve and secondarily the relationship between competitive sports participation and obesity. We performed a review of children between the ages of 8 and 17 years with isolated BAV followed at Oregon Health & Science University. We excluded those with other congenital heart diseases, genetic conditions, prior cardiac intervention, and inability to ambulate independently. Parents completed a phone survey detailing their child's level of daily activity and participation in competitive sports. Demographic information and most recent echo findings were collected from the electronic medical record. We found no difference between the aortic diameters of athletes vs non-athletes. We also found that sports participation and daily activity were both associated with a decreased likelihood of obesity (OR 0.24, 95% CI 0.078-0.73 and OR 0.24, 95% CI 0.081-0.71 respectively). In summary, in our sample population, competitive sports participation was associated with a decreased risk of obesity. Competitive sports participation does not appear to be associated with an increased risk of aortic dilation in our population.

Peers' parental education and cardiovascular disease risk in adulthood: The mediating role of health-related behaviors

RATIONALE

Although there is a growing body of empirical evidence on the relationship between peers' parental education and adolescents' educational outcomes, little is known about whether exposure to highly educated peers' parents is associated with improved physical health in adulthood.

OBJECTIVE

This study investigated the relationship between the education level of peers' parents (Wave I) and the risk of developing cardiovascular disease (CVD) in adulthood (Wave IV). Moreover, we considered a set of health-related behaviors (Wave II) as the underlying mechanisms linking peers' parental education to later-life physical health such as substance use (smoking, binge drinking, and marijuana use) and other lifestyle behaviors (physical activity, sedentary behavior, and unhealthy dietary habits).

METHODS

Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), spanning respondents' adolescence to adulthood, were used. To address the endogenous school selection problem and account for the unobserved school-level confounders, this study exploited quasi-experimental within-school/across-cohort variation in peer composition. To formally test for mediation, Sobel tests were conducted.

RESULTS

The results of this study revealed that independent of own parents' education levels, exposure to higher levels of peers' parental education is associated with a lower CVD risk score in adulthood. For a one-standard-deviation increase in peers' parental education-that is, about a 0.98-year increase in grademates' parental educational attainment, a CVD risk in adulthood increased by about 6.2%. Our mediation analyses showed that part of this association is explained by a decrease in substance use (27% for smoking, 10% for binge drinking, and 11% for marijuana use). In contrast, none of the other lifestyle behaviors evaluated significantly mediated the association.

CONCLUSION

The study's findings suggest that the role of peers' parents should not be overlooked when developing health-promoting interventions for adolescents. Policymakers and practitioners may wish to increase opportunities for students to benefit from health-related social learning from their peers' highly educated parents.

Parent and Pediatrician Perspectives on Physical Activity Promotion in Pediatric Primary Care: A Preliminary Mixed Methods Study

PURPOSE

To elicit preliminary pediatrician and parent perspectives on physical activity (PA) counseling and identify opportunities for improvement.

DESIGN

Mixed methods, including a cross-sectional survey and semi-structured interviews.

SETTING AND PARTICIPANTS

Primary care pediatricians (N = 73; 40% response rate) within a single large healthcare system and parents of students (N = 20) participating in a local school-based PA program in eastern Massachusetts.

METHODS

Electronic survey of pediatricians assessing opinions of American Academy of Pediatrics (AAP) PA guidelines and potential PA promotion tools; semi-structured qualitative interviews with parents assessing overall discussion, education, and recommendations relating to PA.

ANALYSIS

We report descriptive statistics for survey items and bivariate analyses comparing responses by physician characteristics. We performed thematic analysis of qualitative interviews and present results through an implementation science framework.

RESULTS

In this preliminary study, pediatricians reported adoption, appropriateness, and lower perceived effectiveness of PA counseling. School-based programs and educational materials were most often chosen as PA promotion tools. Responses varied by pediatrician characteristics. While parents reported satisfaction, opportunities for improvement included connections with community resources and continued conversations with the child about PA.

CONCLUSIONS

Pediatricians and parents highlighted gaps in PA counseling in primary care. While results are preliminary given small sample size, this study provides actionable targets to support PA promotion as a preventive health priority in this setting.

The Park Rx trial to increase physical activity among low-income youth

BACKGROUND

The Park Rx study is a prospective, randomized controlled trial implemented within a federally qualified health center serving a low-income population in Washington, DC.

DESIGN AND SETTING

The 5-year randomized controlled trial will recruit 500 children, ages 6-16 to be randomized to receive either a park prescription (Park Rx) during routine clinical visits (intervention arm) or care as usual (control arm).

INTERVENTION

Park prescriptions promote both physical activity and exposure to nature. The prescription includes a place (i.e., park), an activity, a frequency, and a duration. Compared to usual care, we expect children receiving a park prescription will have greater physical activity levels and improved physical and mental health outcomes.

IMPLICATIONS

The results of the Park Rx trial will demonstrate the efficacy of the intervention and whether it will increase time spent in nature-rich areas (i.e., parks); have any biological impacts on health, including reducing hypercholesterolemia, hypertriglyceridemia, HbA1c, body mass index (BMI), and impact mental health, including stress and cognitive functioning.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04114734. Registered on October 3, 2019.

Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course

Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living.

•

The determinants of different types of leisure-time physical activity differ significantly.

•

Social-demographic factors have a strong impact on sports participation, followed by recreational-WCP, and then dog walking.

•

Changes in marital status and work seem to be important events for joining sports and the other two activities, respectively.

•

Neighborhood characteristics primarily affect participation in recreational-WCP and dog walking.

•

Study-related physical activity time and work-related physical activity time mainly impact sports participation.

Sports participation, activity, and obesity in children who have undergone the Fontan procedure

BACKGROUND

Children with CHD are at risk for obesity and low levels of activity. These factors are associated with an increased risk of poor outcome. Participation in organised sports is an important avenue for children to maintain physical activity, though the relationship between sports participation and obesity has not been examined in the Fontan population.

METHODS

We performed a cross-sectional study of children aged 8-18 who had been evaluated between January 1, 2015 and October 1, 2019 at the Doernbecher Children's Hospital outpatient paediatric cardiology clinic and had previously undergone a Fontan. Patients were excluded if they were unable to ambulate independently or if they had undergone a heart transplant. Patient characteristics were recorded from the electronic medical record. Parents were interviewed via a telephone survey and asked to describe their child's activity levels and sports participation.

RESULTS

Our final cohort included 40 individuals, 74% were male. The overall prevalence of obesity (CDC BMI >95% for sex/age) in the cohort (23%) was significantly higher in non-athletes (33%) than athletes (0) (p = 0.02). There was no difference in cardiac complications or comorbidities between athletes and non-athletes. Athletes were more likely to meet daily activity recommendations (p = 0.05).

CONCLUSION

Fontan patients who do not participate in sports are significantly more likely to be obese and less likely to be active than those who do. This is the first study to demonstrate the association between competitive sports participation and decreased likelihood of obesity in the Fontan population.

The influence of specialization and the level of physical activism on leisure options for students of the Faculty of Physical Education and Sports

Leisure activities, their dynamics in ontogenesis and the way of managing the time allocated to them are a topic that is frequently researched. Purpose: to investigate students' attitudes, aiming at aspects related to forms of leisure, depending on specialization and level of physical activism, by applying a questionnaire. Material and method: The research took place in the academic year 2019-2020, on a number of 180 students of the Faculty of Physical Education and Sports in Galați. The differences for the pairs of independent specialty variables (PES / physical education and sport and PT / physical therapy), respectively physical activity (HLPA / high level of physical activity, and LLPA / low level of physical activity were analyzed, by applying the techniques of MANOVA and ANOVA calculation. Results: Multivariate analysis indicates significant effects of the physical activity variable on the items of the questionnaire for leisure budget factors, preferred leisure activities, leisure sports activities, and for the specialty variable significant effects are determined only at leisure sports activities, so the level of physical activism will generate more differences between the opinions expressed compared to the specialization of students. Univariate test results indicate significant F values (P <0.05) for a number of items, with weaker values, dominant for PT and LLPA groups. Sports activities and socializing on the internet (defining variant of young people) are at the top, so they do not exclude each other. Conclusion: the students from the PES and HLPA groups stand out through a better organization of free time, high satisfaction of its capitalization, a greater involvement in the variants of active leisure and superior socialization, and those from the PT and LLPA groups allocate more time to watching on TV and using the internet. Keywords: physical activism, specialization, questionnaire, active and passive leisure options, opinions

Temporal patterns of sleep and eating among children during school closure in Japan due to COVID-19 pandemic: associations with lifestyle behaviours and dietary intake

OBJECTIVE

To identify temporal patterns of sleep and eating among school-age children during school closure due to the COVID-19 pandemic and to examine their associations with lifestyle behaviours and dietary intake.

DESIGN

In this cross-sectional study, questionnaires were used to assess sleep and eating times, lifestyle behaviours and dietary intake during school closure. Latent class analysis was performed to identify temporal patterns of sleep and eating based on self-reported clock times for wake-up, going to bed and eating meals. Lifestyle behaviours and dietary intake were compared between latent classes.

SETTING

Forty-eight primary and secondary schools in Japan.

PARTICIPANTS

Totally, 6220 children (aged 8-15 years).

RESULTS

Four patterns, labelled 'Very early (20 % of children)', 'Early (24 %)', 'Late (30 %)' and 'Very late (26 %),' were identified and ordered according to the circadian timing. Latter patterns were characterised by later timings of sleep and eating, especially in clock times for wake-up, breakfast and lunch compared with earlier patterns. Children with latter patterns had a less physically active lifestyle, longer screen time (≥4 h/d), shorter study time (<2 h/d) and more frequent skipping of breakfast and lunch than those with earlier patterns. In addition, children with latter patterns had lower intakes of several vitamins, vegetables, fruits, fish and shellfish and dairy products and higher intakes of sugar and confectionaries and sweetened beverages.

CONCLUSION

More than half of the participants had later wake-up, breakfast and lunch during school closure, which was associated with more unfavourable lifestyles and dietary intakes.

Adolescents Are Less Physically Active Than Adults After Anterior Cruciate Ligament Reconstruction

Background:

Sources of physical activity (PA) and motivation for return to sport after anterior cruciate ligament reconstruction (ACLR) differ between adolescents and adults. It is unclear whether these differences influence participation in PA during the first year after ACLR when individuals are transitioning from rehabilitative care to unrestricted activity.

Purpose:

To compare device-assessed measures of PA between adolescents and adults at 6 to 12 months after ACLR.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Included were 22 adolescents (age, 15.9 ± 1.2 years; time since surgery = 8.0 ± 2.1 months) and 23 adults (age, 22.5 ± 5.0 years; time since surgery = 8.2 ± 2.1 months) who were cleared for unrestricted PA after primary unilateral ACLR. Participants were considered physically active if they met their age-specific United States Department of Health and Human Services PA guidelines. Participants wore an accelerometer-based PA monitor for at least 7 days. Daily minutes of moderate to vigorous–PA (MVPA) and daily step counts were reported and compared between age groups using analysis of covariance, with monitor wear time and sex included as covariates. The association between age group and meeting age-specific PA guidelines was assessed using binary logistic regression and reported as an odds ratio.

Results:

Adults with ACLR participated in 16 minutes more MVPA per day (49 ± 22 vs 33 ± 16 minutes per day; P < .001) and took 2212 more steps per day (8365 ± 2294 vs 6153 ± 1765 steps per day; P < .001) when compared with adolescent participants. In addition, 83% of adults were physically active, compared with 9% of adolescents (odds ratio = 60.2; 95% CI, 7.6-493.4).

Conclusion:

Adolescents with ACLR were less physically active than adults with ACLR, and only 9% of adolescents met aerobic PA guidelines. This is concerning because PA patterns adopted early in life are predictive of PA patterns in adulthood. Our findings indicate a need to better understand underlying causes of reduced PA among adolescents with ACLR and to develop intervention strategies that promote engagement in adequate PA after rehabilitation.

High School Football and Risk for Depression and Suicidality in Adulthood: Findings From a National Longitudinal Study

Background

There is growing public concern regarding the potential long-term effects of playing football on brain health, specifically that playing football before and during high school might cause damage to the brain that manifests years or decades later as depression or suicidality. This study examined if playing high school football was associated with increased lifetime risk for depression, suicidality over the past year, or depressed mood in the past week in men aged between their middle 30 s to early 40 s.

Methods

Publicly available data from the National Longitudinal Study of Adolescent to Adult Health were analyzed. This longitudinal, prospective cohort study sampled nationally representative U.S. youth starting in 1994–1995 (Wave I) and most recently in 2016–2018 (Wave V). A total of 3,147 boys participated in Wave I (median age = 15), of whom 1,805 were re-assessed during Wave V (median age = 38).

Results

Of the 1,762 men included in the study, 307 (17.4%) men reported being diagnosed with depression and 275 (15.6%) reported being diagnosed with an anxiety disorder or panic disorder at some point in their life. When comparing men who played high school football to those who did not, there were no differences in the proportions of the sample who had a lifetime diagnosis of depression, lifetime diagnosis of anxiety/panic disorders, suicidal ideation in the past year, psychological counseling in the past year, or current depressed mood. However, men who received psychological counseling and/or experienced suicidal ideation during adolescence were significantly more likely to report a lifetime history of depression, suicidal ideation in the past year, and current depressed mood.

Conclusion

Individuals who reported playing football during adolescence did not have an increased risk of depression or suicidal ideation when they were in their middle 30 s to early 40 s, but mental health problems during adolescence were associated with an increased risk for psychological health difficulties more than 20 years later.

Physical Activity Surveillance in Adolescents with Type 1 Diabetes: A Pilot Mixed-Methods Investigation

Type 1 diabetes (T1D) affects over 2,500 children in Ireland. Insulin replacement is the mainstay of treatment for T1D, and physical activity (PA) is an important, modifiable lifestyle factor for sustaining health. Surveillance of PA for both research and clinical purposes in paediatric T1D has been limited. This study deployed both quantitative (accelerometry) and qualitative (self-report) measures to assess habitual PA patterns in children with T1D. Twenty-one participants (9 females, 12 males) between 10 and 17 years (mean 13.7 ± 1.94 years) were recruited from an Outpatients Paediatric Diabetes Clinic. Total steps, standing time (minutes (mins)) and sitting time (mins) were recorded using the activPAL 3 microactivity monitor. Clinical parameters (HbA1c, insulin regimen, and weight centiles) were measured. A self-report diary was used to measure perceived activity levels. The findings of this study show that participant children with T1D are not achieving the required steps per day to sustain physical health (recommended minimum 11,500). Females (mean = 7,306 steps ± 5,468) achieved significantly less (p = 0.001) steps per day compared to males (10,806 steps ± 5,904). No significant differences were found between genders for sitting time or standing time. Overweight or obesity was identified in 44% of female participants and 15% of male participants. Mean HbA1c for both females 8.25% (67 mmol/mol) and males 7.97% (64 mmol/mol) was above the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommended <7.0% (53 mmol/mol) for children. Further research is warranted to investigate PA promotion strategies in populations of children with paediatric T1D.

The Influence of Socio-Demographic Factors on the Forms of Leisure for the Students at the Faculty of Physical Education and Sports

The study investigates the influences of gender, area of origin and age stage variables and also of the interaction between them, on the free time behavior of the students at the Faculty of Physical Education and Sports from Galati. The questionnaire applied in the academic year 2019–2020 had 85 items and was structured on 4 factors: leisure budget, leisure limiting factors, preferred leisure activities, and leisure sports activities. The multivariate/MANOVA analysis showed statistically significant data for some of the analyzed items, with values of F associated with thresholds p < 0.05. The results support longer screen time for urban areas and for those <25 years and time limitation for the favorite activities of students >25 years, while reading had higher stress scores for men and students <25 years. Men tended to limit their free time working overtime and women limited their free time due to housework. Students from rural areas and men >25 years were more stressed by socializing on the internet and shopping. Financial limitations for preferred activities were higher for women and students <25 years—women read more and visited their friends more often while men had higher scores in relation to involvement in physical activities throughout the week, an aspect also reported for those <25 years. Students >25 years spent more time with their family, while those <25 years socialized more on the internet and had better scores when going out with friends. Those in urban areas did more jogging, men had better scores in relation to playing sports games, higher indicators for the satisfaction generated by sports activity, and women preferred jogging and cycling/rollerblading. Sports games and different types of fitness were the most common variants practiced at the level of the studied group. Conclusion: There was no dominant orientation of the investigated group towards forms of passive leisure and there were no cases of sedentariness, even if the use of technologies (video games, socializing on the Internet and TV) were forms of leisure often used by students.

Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging

Background

Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration.

Methods

In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables.

Results

Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62–1.55), 0.48 (95% CI: 0.27–0.85) and 0.44 (95% CI: 0.25–0.80) for individuals with HDL-C levels within the 1.15–1.39, 1.40–1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes).

Conclusions

Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-021-01499-5.

Enabling Food Environment in Kindergartens and Schools in Iran for Promoting Healthy Diet: Is It on the Right Track?

Enabling policies related to kindergarten and school food environments can be effective approaches in preventing childhood obesity. This study investigated policies and/or programs with direct or indirect effects on the food environment in kindergartens and schools in Iran. In this scoping review, we systematically searched PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran from January 1990 to October 2020, to identify literature on policies/programs affecting the food environment in kindergartens and schools in Iran. A total of 30 studies and policy documents were included in this review relevant to eight policies/programs. These programs have helped to control food availability in schools, increase nutritional awareness, positively influence physical function and school performances, and reduce malnutrition in rural kindergartens. However, improving the food environment in schools and kindergartens requires proper revisions and local adaptation of many of these policies, strengthening of cross-sectoral collaborations, provision of necessary financial and human resources, and ensuring regular monitoring and evaluation. Reflecting on Iran's health policies and interventions provides insight into the progress achieved and challenges faced. Lessons can benefit the country itself, as well as other countries with similar contexts.

Exploring activity levels in physical education lessons in the UK: a cross-sectional examination of activity types and fitness levels

OBJECTIVES

To establish pupil fitness levels, and the relationship to global norms and physical education (PE) enjoyment. To measure and describe physical activity (PA) levels during secondary school PE lessons, in the context of recommended levels, and how levels vary with activity and lesson type.

METHODS

A cross-sectional design; 10 697 pupils aged 12.5 (SD 0.30) years; pupils who completed a multistage fitness test and wore accelerometers to measure PA during PE lessons. Multilevel models estimated fitness and PE activity levels, accounting for school and class-level clustering.

RESULTS

Cardiorespiratory fitness was higher in boys than girls (ß=-0.48; 95% CI -0.56 to -0.39, p<0.001), within absolute terms 51% of boys and 54% of girls above the 50th percentile of global norms. On average, pupils spent 23.8% of PE lessons in moderate-to-vigorous PA (MVPA), and 7.1% in vigorous PA (VPA). Fitness-focused lessons recorded most VPA in co-educational (ß=1.09; 95% CI 0.43 to 1.74) and boys-only lessons (ß=0.32; 95% CI -0.21 to 0.85). In girls-only lessons, track athletics recorded most VPA (ß=0.13; 95% CI -0.50 to 0.75) and net/wall/racket games (ß=0.97; 95% CI 0.12 to 1.82) the most MVPA. For all lesson types, field athletics was least active (ß=-0.85; 95% CI -1.33 to -0.36). There was a relationship of enjoyment of PE to fitness (ß=1.03; 95% CI 0.83 to 1.23), and this relationship did not vary with sex (ß=-0.14 to 0.23; 95% CI -0.16 to 0.60).

CONCLUSIONS

PE lessons were inactive compared with current guidelines. We propose that if we are to continue to develop a range of sporting skills in schools at the same time as increasing levels of fitness and PA, there is a need to introduce additional sessions of PE activity focused on increasing physical activity.

TRIAL REGISTRATION NUMBER

NCT03286725.

Understanding Behavioral Regulation Towards Physical Activity Participation: Do We Need a Paradigm Shift to Close the Gender Gap?

Despite the well-established benefits of physical activity for both physical and psychological health, current inactivity prevalence continues to be particularly alarming among adolescents and youth. Equally of great concern is the existence of striking gender differences that represent a serious threat to reverse this problem. We aimed to analyze gender-related differences in self-reported physical activity and motivational regulations in a population-based sample of Spaniard adolescents and young adults (n = 9949). To this aim, we used an explanatory mixed-methods design by integrating quantitative and qualitative data using self-determination theory (SDT) as an analytic framework. Our results reported a gender imbalance in physical activity levels and autonomous forms of motivation to the detriment of adolescent girls and young women. An earlier and steeper age-related decline both in activity and volitional types of motivation was observed in girls. Qualitative outcomes depicted a range of key cognitive and contextual mechanisms undermining the degree to which physically active behaviors are volitionally undertaken among women. These findings highlight the importance of implementing gender-sensitive policy approaches and may have a useful application in suggesting how contextual factors and exercise settings can be addressed to foster volitional types of physical activity engagement in adolescent girls and young women.

Physical Activity Drops During Summer Holidays for 6- to 9-Year-Old Children

Regular physical activity (PA) reduces the health risk of childhood obesity and associated chronic diseases as well as mental health problems. Since PA declines as children age as well with future generations it is of highest importance to intervene in school and out-of-school settings. Out-of-school periods affect children's PA as it is mainly left to the interest and motivation of their parents. We compared accelerometer-based PA patterns in 93 6- to 9-year old children assessed four times: before (May/June), during (August), and after (September) summer holidays and at a 1-year follow up (May/June). Before summer holidays children were assessed also for anthropometry and motor tests. During summer holidays overall PA decreased by 18% (p < 0.001), physical inactivity increased by 5.5% (p < 0.001), moderate PA decreased by 53% (p < 0.001) and moderate to vigorous PA decreased by 45% (p < 0.001) when compared to before summer holidays. Furthermore, overall PA remained diminished also after summer holidays by 8.8% (p = 0.001) but recovered to baseline values at 1-year follow up. About 30% of overall PA and moderate to vigorous PA decrease during summer holidays could be explained by children's fitness level as a greater decrease was found in children with better results in standing long jump and 300-meter running time. Our finding detects an alarming summer holiday decrease in children PA that should not be neglected in future studies and intervention designs.

Exercise Addiction and Satisfaction of Fitness Center Users as Precursors to the Intention of Continuing to Engage in Physical Activity

Exercise addiction occurs when a person engages in excessive physical activity until they lose control. Among individuals attending fitness centers, the risk of developing exercise addiction has been estimated to be close to 10%. The objective of this study was to determine whether exercise addiction may be an antecedent of satisfaction with the service received and/or of the intention of continuing to partake in leisure-time physical activity at fitness centers in a direct or indirect manner. A total of 361 individuals (29.05 ± 11.40 years old) who were physically active at Spanish fitness centers were asked to respond to a questionnaire on exercise addiction, satisfaction with the sports service, and their intention to continue to engage in physical activity. A multi-group analysis was conducted to check for differences in relationships by sex. The results show the relationships between addiction, satisfaction, and intention to continue physical activity. The standardized values display differences between men and women, with women exhibiting the highest values for the relationships between addiction and the rest of the constructs. Satisfaction with the sports service is a mediator in the relationship between exercise addiction and intention to engage in leisure-time physical activity.

Physical Activity Levels for Girls and Young Adult Women versus Boys and Young Adult Men in Spain: A Gender Gap Analysis

Despite that the health benefits of physical activity (PA) are clear, during the last years, a noticeable plateau or slight increase in physical inactivity levels in Spanish adolescents and young adults has been reported. In addition, there seems to be a progressive reduction of the total PA performed with age in both adolescent and young women as well as adult men. We aimed to analyze these changes with age in moderate-to-vigorous physical activity (MVPA) in a sample of Spanish adolescents and young adults within the age range of 15–24 years old (n = 7827), considering the gender and using the short form of the International Physical Activity Questionnaire. For that, we implemented a two-way analysis of variance (ANOVA) considering both the gender and the age group surveyed. Generally, our findings showed a reduction in the daily MVPA performed from adolescence to young adulthood in Spaniards. Within these reductions, girls reduce their PA levels at a different age and pace in adolescence and young adulthood in comparison to boys. Though girls were less active than boys in the 15–18 year age range, these differences were no longer significant at older ages. Our results point out the necessity of implementing different policy approaches based on gender (i.e., for girls and young women), since reductions in the MVPA performed occur at particular ages and paces in comparison to boys and young men. This difference indicates that the traditional approach during adolescence and young adulthood is inadequate for tackling physical inactivity without considering the population’s gender.

Sampling sports during adolescence, exercise behaviour in adulthood, and the mediating role of perceived variety in exercise

Objective: Physical activity levels decline from adolescence to adulthood, but participation in a variety of sports during childhood and adolescence (i.e., sampling) may increase physical activity behaviour during adulthood. We examined the association between sampling sports during adolescence and moderate-vigorous exercise behaviour in adulthood, and we assessed whether this relationship is mediated by perceived variety in exercise. Design: Study 1- prospective longitudinal; Study 2- cross-sectional. Our main outcome was exercise behaviour. Results: In study 1 (n = 775), sampling more sports during adolescence (b = .25, p < .01; 95% CI [.12, .39]) predicted increased frequency of exercise behaviour in young adulthood. In study 2 (n = 108), sampling more sports in adolescence (β = .08, p = .03; 95% CI [.03, .17]) was indirectly associated with exercise behaviour in adulthood through perceived variety in exercise. Conclusion: These findings add to the evidence that sampling sports during adolescence is positively associated with moderate-vigorous exercise during adulthood, and the experience of variety may, in part, explain this relationship. This research generates new hypotheses regarding a potential psycho-social mediator (perceived variety in exercise) of the sampling-exercise behaviour relationship.

Basic Psychological Needs, Physical Self-Concept, and Physical Activity Among Adolescents: Autonomy in Focus

The contribution of this research lies in its dual approach to the question of physical activity (PA) among adolescents, combining objective measurement of PA by teenagers and a comparison of psychological satisfaction through physical activities involving differing degrees of autonomy (i.e., organized or unstructured). Using the conceptual framework of Self-Determination Theory, the analysis also examines the relationship between levels of PA among adolescents and physical self-concept and satisfaction of basic psychological needs during exercise. The study surveyed 129 first-year higher secondary education students from schools in the city of A Coruña. Satisfaction of basic psychological needs during organized and unstructured physical activities was measured using the Basic Psychological Needs in Exercise Scale. PA levels were assessed based on step count per day for a week as measured by an accelerometer. The results show that the daily step average recorded by students (7,400) is below the minimum recommended levels of PA for this age group, that students are more active on weekdays than at the weekend, and that there is no significant difference in PA levels between male and female subjects (T = 0.23, p < 0.05, d = 0.04). Findings from the comparative analysis of the three basic psychological needs show greater satisfaction of the need for autonomy during unstructured activities (T = 6.15, p < 0.001, d = 0.68), and greater satisfaction of the need for competence during organized activities (T = −2.50, p < 0.05, d = 0.27). No variation in terms of sex was found in relation to satisfaction of the need for autonomy or relatedness from unstructured activities; however, girls showed notably lower satisfaction than boys in relation to the need for competence (T = −2.62, p < 0.01, d = 0.49). Self-esteem was found to play an important mediating role and observed to be strongly related to sex (T = −5.16, p < 0.001, d = 0.90). Organized PA was found to provide greater need satisfaction among boys than girls across all categories. The study showed no relationship between psychological variables and objectively measured PA (Pillai’s trace: F = 0.86, p > 0.05, η² = 0.08, observed power = 0.66). Basic psychological needs show significant positive interrelation between them and a significant positive relationship between them and physical self-concept, as expected based on previous literature.

Are There Any Differences between First Grade Boys and Girls in Physical Fitness, Physical Activity, BMI, and Sedentary Behavior? Results of HCSC Study

The transition from kindergarten to school is associated with a variety of negative changes. After entry to elementary school physical activity level decreases. Moreover, physical fitness level of children over the past decades have rapidly declined. Children are spending an increasing amount of time in the environments that require constant sitting. We evaluated the differences between boys and girls in physical fitness, frequency of undertaking of different forms of physical activity, prevalence of underweight and overweight, and time spent on sedentary behavior. A total of 212 first grade pupils (mean age 6.95 ± 0.43) from two standard urban schools in Poznań participated in the study. Compared to girls, boys obtained better results in 20-meter run (4.9 s and 5.0 s, p < 0.01), sit-ups (16.8 and 15.3, p < 0.05), six-minute run (829.7 m and 766.4 m, p < 0.001), and standing broad jump (106.8 cm and 99.7 cm, p < 0.01). In the sit-and-reach test girls achieved higher results than boys (17.0 cm and 14.4 cm, p < 0.001). There were no gender differences in prevalence of underweight and overweight. In conclusions, difference between genders should be taken into consideration during designing physical activity programs in the aspects of intensity and forms of physical activities.

Green Exercise: How Are Characteristics of Urban Green Spaces Associated with Adolescents' Physical Activity and Health?

This study investigates associations between characteristics of urban green spaces (UGSs) and adolescents’ self-reported green exercise (GE), general health, and body mass index (BMI). Data were collected through face-to-face personal interviews with 384 adolescents ages 13–19 between 1 March and 31 May, 2018 in UGSs in Aydın, Turkey. Multivariate regression analyses were conducted to examine associations controlling for confounding factors. Stratified analyses were also conducted to determine differences between boys and girls. Positive associations with the duration of GE included many trees, lawns, soccer fields and basketball courts, play equipment, and self-reported general health. Whereas increased BMI was associated with increased benches/ seating, lawns and exercise trails were positively associated with self-reported general health. Negative relationships with increased BMI included many trees, open areas, and outdoor fitness equipment. Increased distance from UGSs was negatively associated with the frequency of GE. In stratified analyses, positive associations between boys’ duration of GE and self-reported general health were found. Whereas soccer fields and basketball courts were associated with girls’ frequency of GE, exercise trails and play equipment were correlated with girls’ self-reported general health. Negative associations with the boys’ frequency of GE included increased BMI and screen time. Whereas increased distance from UGSs was negatively associated with girls’ frequency of GE, many trees, lawns, exercise trails, play equipment, open areas, flowerbeds, and outdoor fitness equipment were negatively correlated with girls’ increased BMI. Findings suggest that adolescents’ GE and health could be promoted with many trees, lawns, flowerbeds, open areas, play and outdoor fitness equipment, exercise trails, and soccer fields and basketball courts. Findings of this study should be tested with longitudinal or intervention studies in future research.

Investigating Adolescent Girls' Perceptions and Experiences of School-Based Physical Activity to Inform the Girls' Peer Activity Intervention Study

BACKGROUND

Adolescent girls are likely to be less active than adolescent boys. A range of factors including multiple psychosocial aspects are thought to influence their engagement in physical activity (PA). This study aimed to explore adolescent girls' perceptions and experiences of school-based PA to inform a subsequent intervention, the Girls Peer Activity (G-PACT) project.

METHODS

The Youth Activity Profile was used to assess adolescent girls' current PA levels. Open-ended questions were used to investigate girls' perceptions and experiences of school-based PA. Focus groups stratified by PA level were then conducted to explore their perceptions and experiences in depth. The focus group data were analyzed using inductive thematic analysis.

RESULTS

The master themes emanating from the focus groups were noncompetitive activities and after-school sport culture for lower active girls. Higher active girls' master themes were PA perceptions and physical education. Regardless of activity level, participants reported greater enjoyment from PA when participating with friends and having choice over activities provided within the school setting.

CONCLUSIONS

The findings highlight the importance of choice, peer groupings, noncompetitive opportunities, and PA competence to adolescent girls' school-based PA behaviors. The school environment can support and restrict girls' engagement in PA. The findings will be applied to the design, content, and implementation of the G-PACT project.

Cardiorespiratory fitness and health-related quality of life in adolescents: A longitudinal analysis from the LabMed Physical Activity Study

OBJECTIVE

The purpose of this study was to examine the longitudinal associations between cardiorespiratory fitness and health-related quality of life (HRQoL) in a sample of adolescents, and to determine whether changes in cardiorespiratory fitness were associated with HRQoL over a 2-year follow-up.

METHODS

This is a longitudinal analysis with 571 Portuguese adolescents (274 boys and 297 girls) aged 12-18 years. HRQoL was measured with the Kidscreen-10 questionnaire; the 20 m shuttle-run was used to estimate cardiorespiratory fitness; socioeconomic status was assessed with the Family Affluence Scale; and pubertal stage was assessed with Tanner stages. Linear regression and analysis of covariance (ancovas) were used to examine the associations between cardiorespiratory fitness and HRQoL.

RESULTS

HRQoL decreased over a 2-year period both in boys and girls (P < .05). Moreover, girls at baseline and at follow-up reported significantly lower HRQoL values than boys (between subjects P < .001). After adjustments for potential confounders, regression analyses showed significant cross-sectional associations between cardiorespiratory fitness and HRQoL both at baseline (B = 0.095; P = .023) and at follow-up (B = 0.090; P = .012). ancova showed that adolescents whose cardiorespiratory fitness decreased over time exhibited lower scores of HRQoL at follow-up, compared to those with persistent high cardiorespiratory fitness; this held after adjustments for age, sex, socioeconomic status, and pubertal stage.

CONCLUSIONS

Changes in cardiorespiratory fitness during adolescence were associated with HRQoL over a 2-year period. This study suggests that improving cardiorespiratory fitness could be an important strategy in improving the HRQoL of adolescents.

Validation of Cardiorespiratory Fitness Measurements in Adolescents

Cardiorespiratory fitness (CRF) is an important indicator of adolescent cardiovascular well-being and future cardiometabolic health but not always feasible to measure. The purpose of this study was to estimate the concurrent validity of the non-exercise test (NET) for adolescents against the Progressive Aerobic Capacity Endurance Run (PACER^®) and direct measures of VO_2max as well as to examine the concurrent validity of the PACER^® with a portable metabolic system (K4b^2™). Forty-six adolescents (12-17 years) completed the NET prior to performing the PACER^® while wearing the K4b^2™. The obtained VO_2max values were compared using linear regression, intra-class correlation (ICC), and Bland-Altman plots, and α was set at 0.05. The VO_2max acquired directly from the K4b^2™ was significantly correlated to the VO_2max indirectly estimated from the NET (r = 0.73, p < 0.001, r² = 0.53, ICC = 0.67). PACER^® results were significantly related to the VO_2max estimates from the NET (r = 0.81, p < 0.001, r² = 0.65, ICC = 0.72). Direct measures from the K4b^2™ were significantly correlated to the VO_2max estimates from the PACER^® (r = 0.87, p < 0.001, r² = 0.75, ICC = 0.93). The NET is a valid measure of CRF in adolescents and can be used when an exercise test is not feasible.

Participation in sports in childhood and adolescence and physical activity in adulthood: A systematic review

The aim of this study was to systematically review the literature to verify the association between participation in sports (PS) in childhood and adolescence and physical activity (PA) in adulthood. A systematic search was conducted in the following databases: Medline (PUBMED), Web of Science, Scopus, and SPORTDiscus, LILACS and SciELO. All steps of the process followed the recommendations of the PRISMA FlowDiagram. After all the steps of the process, 29 articles were included for analysis. In general, only three of the studies analyzed found no relation between PS in childhood and adolescence and PA in adulthood. However, a positive relationship was found to be weak in only 7% of the studies, a moderate relation in 62% of the studies, and a strong relation in 21%. It was found that higher weekly frequencies of PS; persistence of at least three years of PS and, finally, the highest level of practice and/or competition reached were related to higher levels of PA in adulthood. Thus, it can be concluded that there is a positive association considered moderate to strong between PS in childhood and adolescence and PA in adulthood.

Muscular fitness and cardiorespiratory fitness are associated with health-related quality of life: Results from labmed physical activity study

BACKGROUND

Adolescents' physical fitness levels are an important indicator of their lifestyle and seem to have positive consequences in health-related quality of life (HRQoL).

OBJECTIVE

The purpose of this study is to analyse the combined associations of cardiorespiratory fitness and muscular fitness with HRQoL and to assess the differences between HRQoL scores across groups of cardiorespiratory fitness and muscular fitness in Portuguese adolescents.

DESIGN

This is a cross-sectional analysis with 567 Portuguese adolescents aged 12-18 years-old.

METHODS

HRQoL was measured using the Kidscreen-10 questionnaire. Cardiorespiratory fitness was estimated with the 20-m shuttle-run test. Muscular fitness was evaluated using the handgrip and the standing long jump tests and a muscular fitness index was computed by means of standardized measures of both tests. Socioeconomic status was assessed using the Family Affluence Scale. Body composition (body mass and height) was measured according to standard protocols. Accelerometers were used to obtain objective physical activity time. Pubertal stage was assessed using Tanner stages. Adherence to the Mediterranean diet was assessed using the KIDMED index. Participants were divided into four groups based on low or high values of both cardiorespiratory and muscular fitness. Regression analysis, mediation analysis and ANCOVA were performed.

RESULTS

HRQoL was positively associated with cardiorespiratory fitness (B = 0.112; p < 0.05) and muscular fitness score (B = 0.328 p < 0.05), after controlling for potential confounders. However, when both fitness variables were entered in the same model only cardiorespiratory fitness remained significantly associated with HRQoL (B = 0.093 p < 0.05). Cardiorespiratory fitness acted as a full mediator variable on the relationship between muscular fitness and HRQoL in adolescents (p < 0.05). ANCOVA showed that adolescents with high cardiorespiratory fitness/high muscular fitness exhibit better HRQoL scores when compared to those with low muscular fitness/low cardiorespiratory fitness and with those with low muscular fitness/high cardiorespiratory fitness (p < 0.05).

CONCLUSIONS

In adolescents, the combination of high cardiorespiratory fitness and high muscular fitness was positively associated with a better HRQoL.

Predictors of dropout in the school-based multi-component intervention, 'Mexa-se'

To identify the predictors of dropout in the 'Mexa-se' intervention according to the body mass index (BMI) category. This was a controlled, non-randomized study. The intervention included: (i) increase in the intensity of physical activities (PA) in physical education (PE) classes; (ii) active recess; (iii) educational sessions on PA, nutrition and body image; and (iv) educational materials. Dropout was considered when students dropped out of intervention, or did not reach 75% attendance in PE classes. The independent variables were gender, age, study period, socioeconomic status, BMI, PA, screen time, food consumption, health perception, attitudes toward PA, self-efficacy for PA, perception of the school environment, body image and self-esteem. Binary logistic regression analysis was used. The dropout rate was 26.8%. In the total sample and among students with an adequate BMI, there was a greater probability of dropout with an increase in age. For overweight students, increased age and socioeconomic status, and studying in the afternoon period were predictors of dropout from the intervention. Socio-demographic factors were predictors of dropout from the 'Mexa-se' intervention; the associated factors differed based on the BMI category.

Knowledge, Attitudes, and Beliefs of Youth Club Athletes Toward Sport Specialization and Sport Participation

Background:

There are a variety of proposed motivations for sport specialization, such as improving sport skills to an elite level, making all-star or travel teams, or receiving a scholarship or professional contract. However, there has not been a quantitative examination of the attitudes and beliefs that may be contributing to the trend of sport specialization and year-round sport participation.

Purpose:

The primary aim was to describe the attitudes and beliefs of youth club sport athletes regarding sport specialization and sport participation. A secondary objective was to investigate whether an association exists between the level of sport specialization and the belief in receiving a college scholarship.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 974 youth athletes (578 female; mean age, 14.2 ± 1.6 years) completed an anonymous questionnaire that focused on attitudes and beliefs toward sport specialization and sport participation. Questions were developed utilizing the feedback of a panel of content area experts and the University of Wisconsin Survey Center. Data were summarized using frequencies, proportions (%), and means ± SDs.

Results:

Fewer than half of all athletes (45.8%) believed that specialization increased their chances of getting injured either “quite a bit” or “a great deal.” However, 91% of athletes believed that specialization increased their chances of getting better at their sport either “quite a bit” or “a great deal.” Similarly, the majority of athletes believed that specialization increased their chances of making their high school team (80.9%) or a college team (66.9%) either “quite a bit” or “a great deal.” Overall, 15.7% of athletes believed that they were either “very” or “extremely” likely to receive a college scholarship based on athletic performance. Highly specialized athletes were nearly twice as likely to have a high belief in receiving a college scholarship compared with low-specialization athletes (20.2% vs 10.2%, respectively; χ² = 18.8; P = .001).

Conclusion:

Most youth athletes in this study believe that specialization increases their sport performance and ability to make not only a college team but also their high school team. Highly specialized athletes were more likely to believe that they will receive a college scholarship.

Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health

BACKGROUND

The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated.

METHODS

A total of 258,146 participants (49% women), aged 19-70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO_2max) were obtained.

RESULTS

Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81-0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17-1.23) for exercising regularly and a normal/high VO_2max in adulthood. For men, the ORs were significantly lower (range: 0.66-0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood.

CONCLUSIONS

Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO_2max, and metabolic health in adulthood up to 70 years.

Diabetes Risk Factor Knowledge Varies Among Multiracial College Students

All racial/ethnic groups are at higher risk for type 2 diabetes compared to whites, but it is unknown if young adults recognize their risk. Risk knowledge and individual risk perception were examined in 1579 multiracial urban college students. Students have little knowledge of diabetes risk factors; identifying less than three of ten. Considerable variation exists in the understanding of risk; only .02 % of Asian, 14.0 % of Hispanic and 22.8 % of black students recognized that their race increased risk. Among those with ≥3 risk factors (n = 541) only 39 % perceived their risk. These under-estimators had lower knowledge scores (p = .03) than those who acknowledged their risk; indicating that the cause of under-estimating risk may be, at least, in part due to a lack of information. There is a pressing need to heighten understanding of type 2 diabetes risk among young adults to decrease the future burden of this disease.

Diversity of leisure-time sport activities in adolescence as a predictor of leisure-time physical activity in adulthood

Because sustained physical activity is important for a healthy life, this paper examined whether a greater diversity of sport activities during adolescence predicts higher levels of leisure-time physical activity (LTPA) in adulthood. From sport activity participation reported by 17-year-old twins, we formed five groups: 1, 2, 3, 4, and 5+ different sport activities. At follow-up in their mid-thirties, twins were divided into four activity classes based on LTPA, including active commuting. Multinomial regression analyses, adjusted for several confounders, were conducted separately for male (N=1288) and female (N=1770) participants. Further, conditional logistic regression analysis included 23 twin pairs discordant for both diversity of sport activities in adolescence and LTPA in adulthood. The diversity of leisure-time sport activities in adolescence had a significant positive association with adulthood LTPA among females. Membership in the most active adult quartile, compared to the least active quartile, was predicted by participation in 2, 3, 4, and 5+ sport activities in adolescence with odds ratios: 1.52 (P=.11), 1.86 (P=.02), 1.29 (P=.39), and 3.12 (P=5.4e-05), respectively. Within-pair analyses, limited by the small sample of twins discordant for both adolescent activities and adult outcomes, did not replicate the association. A greater diversity of leisure-time sport activities in adolescence predicts higher levels of LTPA in adulthood in females, but the causal nature of this association remains unresolved.

Objectively Measured Physical Activity in Patients After Anterior Cruciate Ligament Reconstruction

BACKGROUND

Returning to a healthy level of physical activity is among the most commonly discussed clinical goals for patients recovering from anterior cruciate ligament reconstruction (ACLR). However, physical activity has not been objectively measured in this population.

PURPOSE

To investigate differences in the mean time (min/d) spent in moderate-to-vigorous physical activity (MVPA) as well as the daily step count (steps/d) between patients who underwent ACLR and matched controls. A second purpose was to investigate relationships between MVPA and objective assessments of the daily step count and Tegner and Marx activity scales.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

Physical activity was assessed using ActiGraph accelerometers in 33 participants with a history of primary unilateral or bilateral ACLR (mean time from surgery, 27.8 ± 17.5 months; range, 6-67 months) as well as in 33 healthy controls (matched on age, sex, and activity level). Participants wore the accelerometer for 7 days and completed the International Knee Documentation Committee subjective form and the Tegner and Marx activity scales. Independent t tests were used to determine differences in each dependent variable per group.

RESULTS

Patients who underwent ACLR spent less time in MVPA (ACLR: 79.37 ± 23.95 min/d; control: 93.12 ± 23.94 min/d; P = .02) and had a lower daily step count (ACLR: 8158 ± 2780 steps/d; control: 9769 ± 2785 steps/d; P = .02) compared with healthy matched controls. However, the Marx (ACLR median: 11.0 [interquartile range (IQR), 7-14]; control median: 12.0 [IQR, 8-13]; P = .85) and Tegner (ACLR median: 6.0 [IQR, 5-8]; control median: 7.0 [IQR, 6-8]; P = .12) scores did not differ between the groups, and no relationships were observed between objectively measured physical activity and scale measures ( P > .05), except for a moderate relationship between the Tegner score and daily step count in the ACLR group ( r = 0.36, P = .04). Only 24% of patients who underwent ACLR met the guideline of 10,000 steps per day compared with 42% of controls.

CONCLUSION

Patients who underwent ACLR spent less time in MVPA and had a lower daily step count compared with highly matched controls (age, sex, and activity level) with no history of knee injuries. This was true despite being similar in activity levels, which brings into question the utility of the Tegner and Marx activity scales.

Tracking of muscular strength and power from youth to young adulthood: Longitudinal findings from the Childhood Determinants of Adult Health Study

OBJECTIVES

Low muscular fitness levels have previously been reported as an independent risk factor for chronic disease outcomes. Muscular fitness tracking, the ability to maintain levels measured at one point in time to another point in time, was assessed from youth to adulthood to provide insight into whether early identification of low muscular fitness in youth is possible.

DESIGN

Prospective longitudinal study.

METHODS

Study including 623 participants who had muscular fitness measures in 1985 (aged 9, 12 or 15 years) and again 20 years later in young adulthood. Measures of muscular fitness were strength (right and left grip, leg, shoulder extension and flexion measured by dynamometer, and a combined strength score) and power (standing long jump distance).

RESULTS

Strength and power were relatively stable between youth and adulthood; the strongest tracking correlations were observed for the combined strength score (r=0.47, p≤0.001), right grip strength (r=0.43, p≤0.001) and standing long jump (r=0.43, p≤0.001). Youth in the lowest third of muscular fitness had an increased risk of remaining in the lowest third of muscular fitness in adulthood (strength: relative risk (RR)=4.70, 95% confidence interval (CI) (3.19, 6.92); power: RR=4.06 (2.79, 5.90)).

CONCLUSIONS

Youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood. These findings warrant investigation into the long term effects of early interventions that focus on improving low muscular fitness levels in youth which could potentially improve adult muscular fitness and reduce future chronic disease outcomes.

The Role of Urban Environment, Social and Health Determinants in the Tracking of Leisure-Time Physical Activity Throughout Adolescence

PURPOSE

Adolescence may be a period particularly relevant for acquisition of lifelong habits of physical activity (PA). We investigated the tracking of leisure-time PA from 13 to 17 years old and the influence of urban environment and other determinants.

METHODS

As part of the EPITeen cohort (Portugal), we evaluated 969 adolescents living in the city of Porto. Participants were assembled in public and private schools at 13 years and reevaluated at 17 years. Leisure-time PA was evaluated by self-reported questionnaires. The shortest routes from residence to urban green spaces and open sports spaces were calculated using the street network within a Geographical Information System. Odds ratio (OR) and 95% confidence intervals were calculated by multinomial logistic regression.

RESULTS

Among sedentary girls at 13 years, 33.1% were still sedentary at 17 years, 39.8% changed to low, 22.3% to moderate, and only 4.6% changed to vigorous PA. In boys, the respective values were 32.3%, 17.3%, 36.2%, and 14.2%. High PA levels were maintained by 19.5% of the girls and by 41.1% of the boys. After adjustment for parental education and body image at 13 years, practice of sports at 13 years was strongly associated with stable high PA at 17 years: in girls OR = 3.96 (2.21, 7.12); in boys OR = 6.81 (3.30, 14.07). Distance to urban green spaces or to open sports spaces was not associated to changes in leisure-time PA.

CONCLUSION

Practice of sports in early adolescence may be important to promote maintenance of high PA. Urban environment in the vicinity of residence did not affect changes in the practice of leisure-time PA.

High School Sport Specialization Patterns of Current Division I Athletes

Background:

Sport specialization is a strategy to acquire superior sport performance in 1 sport but is associated with increased injury risk. Currently, the degree of high school specialization among Division I athletes is unknown.

Hypothesis:

College athletes will display increased rates of specialization as they progress through their high school careers.

Study Design:

Descriptive epidemiological study.

Level of Evidence:

Level 4.

Methods:

Three hundred forty-three athletes (115 female) representing 9 sports from a Midwest Division I University completed a previously utilized sport specialization questionnaire regarding sport participation patterns for each grade of high school. McNemar and chi-square tests were used to investigate associations of grade, sport, and sex with prevalence of sport specialization category (low, moderate, high) (a priori P ≤ 0.05).

Results:

Specialization increased throughout high school, with 16.9% (n = 58) and 41.1% (n = 141) of athletes highly specialized in 9th and 12th grades, respectively. Football athletes were less likely to be highly specialized than nonfootball athletes for each year of high school (P < 0.001). There was no difference in degree of specialization between sexes at any grade level (P > 0.23).

Conclusion:

The majority of Division I athletes were not classified as highly specialized throughout high school, but the prevalence of high specialization increased as athletes progressed through high school. Nonfootball athletes were more likely to be highly specialized than football athletes at each grade level.

Clinical Relevance:

Most athletes who are recruited to participate in collegiate athletics will eventually specialize in their sport, but it does not appear that early specialization is necessary to become a Division I athlete. Athletes should be counseled regarding safe participation in sport during high school to minimize injury and maximize performance.

Changes in sport and physical activity participation for adolescent females: a longitudinal study

BACKGROUND

Participation in sport and physical activity is reported to decline during adolescence, particularly for females. However we do not have a clear understanding of changes in the context (i.e., modes and settings) of participation throughout adolescence. This study investigated longitudinal changes in physical activity participation and the specific modes and settings of physical activity, together with cross-sectional comparisons, for two age cohorts of female adolescents.

METHODS

Survey of 729 adolescent girls (489 recruited in Year 7 and 243 in Year 11). Participation in eight different modes/settings was reported. PA was measured using 24-h recall diary and metabolic equivalent weighted energy expenditure (MET-min) in Leisure Time Moderate and Vigorous Physical Activity (LTMVPA) on the previous day was calculated.

RESULTS

There were no significant changes in duration or total MET-min of LTMVPA on previous day. However, there were significant changes in the modes/settings of participation across time. Participation in school physical education rose during early adolescence before decreasing significantly, and participation in competitive sport and club sport significantly decreased over time; however there were increases in non-competitive forms of physical activity.

CONCLUSIONS

Overall levels of physical activity did not significantly decrease over adolescence, which is positive for physical health. However, the transition from structured sport to non-organised physical activity may effect social and psychological health, which needs to be further examined.

Motor Performance as Predictor of Physical Activity in Children: The CHAMPS Study-DK

PURPOSE

Physical activity (PA) is associated with several health benefits in children, and PA habits developed in childhood tend to persist into adulthood. PA may be the foundation of a healthy lifestyle, and motor performance has been shown to be positively associated with PA in cross-sectional studies. The purpose of this study was to explore the longitudinal relation between motor performance and PA in a 3-yr follow-up study.

METHODS

Longitudinal analyses were performed using data from 673 participants (44% boys, 6-12 yr old) who had been included in the Childhood Health Activity and Motor Performance School study-DK. Baseline motor performance tests consisted of vertical jump, shuttle run, hand grip strength, backward balance, precision throw, and cardiovascular fitness. Composite z-scores were generated to express health-related fitness and performance-related fitness. PA was measured by accelerometer at baseline and at 3-yr follow-up and was expressed as a percentage of time in moderate-to-vigorous PA.

RESULTS

Cardiovascular fitness, vertical jump, health-related fitness, and performance-related fitness showed significant positive associations with 3-yr follow-up measures of PA in both sexes. Furthermore, shuttle run showed significant inverse associations with follow-up measures of PA for both sexes.

CONCLUSIONS

Cardiorespiratory fitness, shuttle run, vertical jump, health-related fitness, and performance-related fitness were significantly associated with time spent in moderate-to-vigorous PA at 3-yr follow-up. The clinical relevance of the results indicates that cardiorespiratory fitness and shuttle run in childhood may be important determinants of PA in adolescence.

Teachers' perceptions of physical education content and influences on gender differences

Abstract Boys and girls do not show the same interest in physical education classes. Teachers are the architect so that such participation can achieve the educational and social benefits purported by physical education. The aim of this study was to analyze whether teachers perceive that some contents are more appropriate for boys, excluding girls' participation. The methodology combines two instruments: a questionnaire and a semistructured interview. Participants were 18 Spanish secondary education teachers (14 males and 4 females) of physical education. Teachers think there is still a masculine approach to physical education classes. The boys prefer sports and physical fitness contents, whereas the girls prefer expressive contents, especially dancing. Teachers' suggestions to improve girls' participation are provided that most girls usually grant less importance to the more competitive physical education contents, whereas the majority of boys are more participative and they hardly help the girls. This means that teachers should present the benefits of physical activity in such a way that fulfills their educational purpose.

Adolescent Physical Education Class Participation as a Predictor for Adult Physical Activity

BACKGROUND

The aim of this study was to determine whether engagement in more physical education (PE) classes during one high school year is associated with change in physical activity (PA) from adolescence to young adulthood.

METHODS

Data were from 1774 participants in Waves 2 (high school, 1996) and 4 (young adulthood, 2008) of the National Longitudinal Study of Adolescent to Adult Health. The predictor was number of PE classes/week in high school (daily, some, or none). The outcome was change in moderate-to-vigorous physical activity (ΔMVPA) over the 12-year period. ΔMVPA was based on differences in MVPA scores derived at each wave from responses to a physical activity behavior recall (range, -9 to 9 scale score or -15 to 15 MVPA episodes/week). Multivariable generalized linear models examined the association between PE participation and ΔMVPA, adjusting for sociodemographics, weight status, and school clustering.

RESULTS

In high school, 34.7% participated in daily PE, whereas 50.1% participated in none. Participation in more PE classes was associated with greater MVPA in high school (mean MVPAW2none = 3.11, standard deviation [SD] = 1.99; mean MVPAW2some = 3.70, SD = 2.00; mean MVPAW2daily = 4.31, SD = 1.95; p < 0.0001). Overall, MVPA decreased over the 12 years (median ΔMVPA = -1.0, or 1-2 MVPA episodes/week). MVPA decreased more for males (median ΔMVPAmale = -1.0, interquartile range [IQR] = -3.0 ± 1.0; median ΔMVPAfemale = 0.0, IQR = -2.0 ± 2.0; p < 0.0001) and those who had participated in some/daily PE (median ΔMVPAsome = -1.0, IQR = -3.0 ± 1.0; median ΔMVPAdaily = -1.0, IQR = -3.0 ± 1.0) than those not in PE (median ΔMVPAnone = 0.0, IQR = -2.0 ± 2.0; p < 0.0001). The relationship between PE and ΔMVPA was maintained in multivariable analyses (βsome = -0.58, standard error [SE] = 0.18; p = 0.002; βdaily = -0.93, SE = 0.16; p < 0.001).

CONCLUSIONS

High school PE participation did not prevent declining PA from adolescence to young adulthood.