COVID-19 and screen-based sedentary behaviour: Systematic review of digital screen time and metabolic syndrome in adolescents

Preschool-aged children 24-hour movement behaviours before and during COVID-19

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected health, economies, and lifestyles, but little is known about its impact on children. We aimed to investigate changes in 24-hour (h) movement behaviours of pre-school children before and during COVID-19, and factors that influenced these. Children aged 3-6 years were recruited in Beijing in 2019, and their movement behaviours over 24 ​h assessed by questionnaire, as part of the International Study of Movement Behaviors in the Early Years (SUNRISE) study. We conducted the survey again during COVID-19, and compared the children's movement behaviours before and during COVID-19 and associated factors. Overall, 196 parents completed the survey at both time points. The percentage of children meeting movement guidelines decreased during the pandemic (p ​< ​0.01). Total physical activity decreased less among children getting good quality sleep or with more adults in the household (p ​< ​0.01). Children who were not cared for primarily by their mother had a greater decrease in moderate to vigorous intensity physical activity (p ​= ​0.02), but the decrease was smaller among children whose parents used the internet to support their physical activity and/or screen time (p ​< ​0.05). Children who used electronic screen devices in the 2 ​h before bedtime or whose parents reported body temperature in webchats had a greater increase in sedentary screen time (p ​< ​0.05). Children spending more time outdoors showed a smaller decrease in sleep (p ​< ​0.01). Overall, children's movement behaviours changed significantly during the pandemic.

Association of MC4R rs17782313 Genotype With Energy Intake and Appetite: A Systematic Review and Meta-analysis

CONTEXT

The melanocortin-4 receptor gene (MC4R) is associated with a higher risk of obesity by the presence of the C allele in rs17782313, but the mechanisms are not clear.

OBJECTIVE

The present systematic review and meta-analysis aimed to explore the association between the different genotypes of MC4R rs17782313 and energy intake and appetite.

DATA SOURCES

A literature search was conducted up to June 2023 in PubMed, Scopus, Web of Science, and Cochrane Collaboration databases, following PRISMA guidelines.

DATA EXTRACTION

Inclusion criteria were studies in humans measuring energy intake, appetite, or satiety in all ages and physiological conditions. Studies dealing solely with body mass index were excluded. Twenty-one articles representing 48 560 participants were included in the meta-analysis.

DATA ANALYSIS

According to the NHLBI (National Heart, Lung, and Blood Institute) quality-assessment criteria, all case-control studies and 6 out of 17 cohort and cross-sectional studies were classified as "good," while the rest scored as "fair." Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in a (CT+CC) vs TT dominant model, and both random-effects and fixed-effects models were used. A statistically significant association between the presence of the C allele and increased appetite was found (OR = 1.25; 95% CI: 1.01-1.49; P = .038) using the fixed-effects model, but the random-effects model proved nonsignificant. However, no association with energy intake was found. None of the variables considered (sample size, year of publication, sex, age group, type of population, origin, and quality) were identified as effect modifiers, and no publication biases were found after subgroup and meta-regression analyses.

CONCLUSION

To our knowledge, this is the first systematic review and meta-analysis that has analyzed the association between rs17782313 of MC4R and energy intake and appetite. Identifying people genetically predisposed to increased appetite may be of great interest, not only to prevent obesity in younger populations but also to avoid malnutrition in elderly persons. This paper is part of the Nutrition Reviews Special Collection on Precision Nutrition.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023417916.

Assessment of digital eye strain and its associated factors among school children in Palestine

BACKGROUND

Digital eyestrain (DES) is a collection of ocular and vision symptoms caused by prolonged use of digital devices that can greatly impact schoolchildren's daily activities and learning. The main purpose of this study is to assess the prevalence of DES among schoolchildren and the associated risk factors in Palestine.

METHODS

From the 1st of April 2024 to the 30th of May 2024, a total of 492 school children who met the criteria for DES screening in the selected schools were included in the study. A quantitative, cross-sectional design was utilized with a self-structured questionnaire. The sample consisted of schoolchildren aged 11 to 18 years. The questionnaire is structured into three sections: (1) Sociodemographic information, (2) Information regarding the digital device used, and (3) DES assessment by using the Computer Vision Syndrome Questionnaire, and the visual acuity was measured using the Snellen chart. The data was analyzed using SPSS version 25 with a 95% CI.

RESULTS

The study analysis showed that 44.1% of school children experience DES. Snellen chart test analysis showed that 28.25% of students had results exceeding a score of six for either the right or left eye. For both eyes combined, (14.63%) of students had examination results greater than six. After conducting univariate analysis, statistically significant risk factors (p-value less than 0.05) affecting the development of DES in our study were posture, smartphone use at bedtime, and duration of device use, watching movies, social networking, and screen brightness. Moreover, females, older students, and those using devices closer than 30 cm or owning multiple devices reported higher eyestrain scores.

CONCLUSIONS

The current research found that Palestinian school children significantly experience eyestrain, indicating the influence of digital devices on eye health. The study results emphasize the need for early detection to prevent future eye health complications.

Assessment of Perceived Physical Literacy and Its Relationship with 24-Hour Movement Guidelines in Adolescents: The ENERGYCO Study

Scientific evidence suggests that meeting the 24-hour movement guidelines is associated with numerous health benefits. One concept that emphasizes an individual's active lifestyle is physical literacy (PL). However, the relationship between PL and 24 h movement guidelines in adolescents has not been analyzed to date. The aim of this study was to examine the relationship between perceived physical literacy (PPL) and adherence to the 24-hour movement guidelines in Spanish adolescents. This cross-sectional study included a total of 56 adolescents (mean age 13.2 ± 1.3 years). PL was assessed using the Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI), categorizing participants into low, medium, and high PPL levels. To determine compliance with movement guidelines (24-hour movement), physical activity was assessed through accelerometry, while screen time and sleep duration were evaluated using questionnaires. One-way ANOVA and chi-square analysis were used to examine PPL levels and adherence to the 24-hour movement guidelines. The results indicated that higher levels of PPL were associated with greater adherence to the 24-hour movement guidelines. Specifically, most participants met one or two recommendations as PPL increased (p = 0.002). In the medium PPL group, 50% met one recommendation, 37.5% met two, and 12.5% did not meet any, while in the high PPL group, 52.8% met one recommendation, 41.7% met two, and 5.6% did not meet any. These findings suggest that higher levels of PPL are associated with greater adherence to the 24-hour movement guidelines. Future studies should explore this association in larger samples of Spanish adolescents and should promote the practical implications regarding the importance of designing educational programs. This should be achieved through curricula that are based on PL and that integrate strategies to reduce screen time, promote healthy sleep habits, and foster a comprehensive and sustainable understanding of these among adolescents.

The Impact of the COVID-19 Pandemic on Waist and Hip Circumference and Selected Indicators Related to It Among Adolescents From the Kraków (Poland) Population

OBJECTIVES

The aim of the study was to assess changes in waist and hip circumference, as well as the waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) indices among adolescents (11-15-year-olds) from the Kraków during the COVID-19 pandemic.

METHODS

Cross-sectional studies were conducted in four main districts of the city in the years 2020 and 2022. The study group consisted of 1662 people. Measurements of height, waist circumference, and hip circumference were taken. The collected data were used to calculate the WHR and WHtR indices. Statistical analyses were performed using two-way ANOVA and post hoc Tukey's test, as well as the Kruskal-Wallis test, depending on the normality of distribution.

RESULTS

An increase in hip circumference was observed in most age groups of both sexes. Among 14-15-year-old boys, an increase in waist circumference was observed, while among girls, the majority of cohorts showed the opposite trend. Additionally, in most age groups, a decrease in the values of WHR and WHtR indices was observed in both sexes, except for boys aged 14-15.

CONCLUSION

The study found that government-imposed restrictions related to the COVID-19 pandemic had an impact on waist circumference, hip circumference, WHR, and WHtR indicators among adolescents aged 11-15 from Kraków. While some results showed regression, suggesting potential factors such as reduced physical activity or increased screen time contributing to deteriorating outcomes. On the other hand, not all results changed, which may be attributed to the absence of modifications in dietary habits or physical activity as government restrictions ceased.

Relationship of work-related and leisure-based screen time with obesity: a cross-sectional study on adults including older adults

PURPOSE

The relationship between screen time (ST) and obesity has been demonstrated; however, few studies have differentiated between work-related and leisure-based use in Japanese adults, including older adults. This study aimed to examine the relationship between both work-related and leisure-based ST and obesity in adults.

METHODS

This cross-sectional study was based on a questionnaire survey conducted in 2018. Overall, 9947 adults were invited; 3161 participants (31.8%) returned the questionnaire. Finally, 2488 participants (597 younger men (YM), 792 younger women (YW), 542 older men (OM), 557 older women (OW)) were included. The main exposures were work-related, leisure-based, and total ST. The outcome was obesity (body mass index ≥ 25 kg/m2). Log-binomial regression analysis was used to calculate prevalence ratios (PRs) and confidence intervals (CIs) for obesity with 1-h increments of each ST. Analyses were conducted in all participants and subgroups comprising YM, YW, OM, and OW.

RESULTS

Total ST was significantly associated with obesity in all participants (PR (95% CI) 1.07 (1.04-1.10), YM (1.05 (1.01-1.10)), OM (1.13 (1.05-1.22)), and OW (1.13 (1.02-1.26)). Work-related ST was significantly associated with obesity in all participants (1.08 (1.04-1.12)), YM (1.06 (1.00-1.12)), and OM (1.24 (1.08-1.42)). Leisure-based ST was significantly associated with obesity in all participants (1.09 (1.04-1.14)), YM (1.09 (1.00-1.18)), and YW (1.10 (1.01-1.20)).

CONCLUSION

ST is associated with obesity in Japanese adults including older adults; particularly, work-related ST is associated with obesity in men, and leisure-based ST, in younger individuals.

The mediating effect of social connectedness between internet gaming disorder and somatic symptoms in adolescents: a large sample cross-sectional study

BACKGROUND

Previous studies have indicated that social connectedness can serve as a protective buffer against negative outcomes associated with online victimization. However, the role of social connectedness between Internet gaming disorder and somatic symptoms is still unclear. This study aims to examine the mediating effect of social connectedness on the association between Internet gaming disorder and somatic symptoms.

METHODS

A cross-sectional design was utilized, using questionnaires for data collection and multi-stage stratified cluster sampling. The general demographic questionnaire, Nine-Item Internet Gaming Disorder Scale-Short Form, Social Connectedness Scale-Revised and Patient Health Questionnaire Physical Symptoms were used to collect data. We adopted Pearson's correlation analysis and the PROCESS Macro Model in regression analysis to explore the relationships among Internet gaming disorder, social connectedness and somatic symptoms.

RESULTS

Internet gaming disorder was positively correlated with somatic symptoms (r = 0.20, P < 0.001), while network (r=-0.08, P < 0.001) and real-life social connectedness (r=-0.31, P < 0.001) negatively affected somatic symptoms. The network social connectedness and the real-life social connectedness played a chain mediating role in the development of Internet gaming disorder to somatic symptoms [95%CI: 0.073, 0.088], explaining 45.25% of the total effect value. The difference of real-life social connectedness and network social connectedness played a partial mediating role between Internet gaming disorder and somatic symptoms [95% CI:0.050, 0.062], accounting for 31.28% of the total effect value.

CONCLUSIONS

Real-life social connectedness, network social connectedness, and their disparity all mediated the relationship between Internet gaming disorder and somatic symptoms. Real-life social connectedness acted as a protective factor, while network social connectedness served as a risk factor. Encouraging offline activities and guiding teenagers to use the internet responsibly may help prevent and reduce physical symptoms linked to Internet gaming disorder.

Objectively Measured Physical Activity and Sedentary Behaviour on Cardiovascular Risk and Health-Related Quality of Life in Adults: A Systematic Review

BACKGROUND

This systematic review analysed the association between objectively measured physical activity and sedentary behaviour with cardiovascular risk and HRQoL in adults without previous CVD. Additionally, we analysed the impact of the intensity of the physical activity in this association.

METHODS

The search was carried out in three electronic databases with access until February 2023 to find studies with an observational design. For quality assessment, we used The National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

We identified 5819 references, but only five studies were included. One study shows a positive association between physical activity and HRQoL, while sedentary behaviour was negatively related to HRQoL. Another study showed an association between high-intensity physical activity with a better physical component of HRQoL and low-intensity physical activity with a better mental component of HRQoL. Three studies concluded that higher levels of physical activity are associated with lower levels of cardiovascular risk and higher levels of sedentary behaviour are associated with higher levels of cardiovascular risk.

CONCLUSION

Our findings suggested that people who spend more time being active and spend less time being sedentary appear to have lower cardiovascular risk and higher HRQoL.

Isotemporal substitution analysis of time between sedentary behavior, and physical activity on sleep quality in younger adults: a multicenter study

OBJECTIVE

To evaluate the effects of replacing time spent in sedentary behavior (SB) with moderate to vigorous physical activity on sleep quality in young adults.

METHODS

Multicenter cross-sectional study, carried out with students enrolled in undergraduate courses at universities in Brazil. Sleep quality was assessed using a question of the World Health Organization Quality of Life (WHOQOL-brief) and classified as good or poor sleep quality. SB was evaluated by self-reported total sitting time, and the level of leisure-time PA was classified according to the intensity of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA), which were assessed using a self-reported questionnaire. An isotemporal replacement logistic model was used to evaluate the effects of different SB, MPA, and VPA sessions on sleep quality.

RESULTS

A total of 8,059 study participants were evaluated, the majority had poor sleep quality (64.79%), were physically inactive (48.28%, defined as practicing < 150 min of MPA or < 75 min of VPA per week), and spent ≥ 9 h/day in SB (55.08%). The multivariate model showed an association between non-adherence to wake-based movement guidelines and poor sleep quality, where those with one altered behavior were 43% more likely to have poor sleep quality (OR:1.43;95%CI:1.27 to 1.60), while individuals with two altered behaviors were 97% more likely (OR:1.97;95%CI:1.73 to 2.24). In the isotemporal analysis, replacing MPA and VPA with equivalent time in SB increased the odds of poor sleep at all times assessed, with peaks of 56% for MPA and 68% for VPA.

CONCLUSION

The results of the present study indicate that replacing SB with the same amount of MPA or VPA may reduce poor sleep quality.

A mobile app-based intervention improves anthropometry, body composition and fitness, regardless of previous active-inactive status: a randomized controlled trial

Introduction

The use of mobile apps to promote physical activity in adolescents can improve health-related parameters. However, previous studies have not evaluated whether the benefits depend on the users' prior active or inactive status. Therefore, the main objective was to analyze differences in physical activity levels, adherence to the Mediterranean diet (AMD), anthropometry, body composition, and physical fitness between active and inactive adolescents.

Methods

The study was conducted through a randomized controlled trial (RCT) with 462 adolescents, divided into experimental (EG) and control groups (CG), further categorized as active and inactive. Variables of physical activity, kinanthropometry, body composition, and physical fitness were measured before (pre-test) and after (post-test) a 10-week intervention using step-tracking apps (Strava, Pacer, MapMyWalk, and PokémonGo) at least three times per week.

Results

The results showed that inactive EG adolescents significantly increased their physical activity levels, body mass, and muscle mass, and improved in all fitness variables except the countermovement jump (CMJ). The sum of three skinfolds also significantly decreased. Active EG adolescents increased body and muscle mass and improved in all fitness variables. Additionally, they significantly reduced fat mass and the sum of three skinfolds. All covariates, mainly gender and maturity, had significant effects on the study variables. Comparing changes between the active EG and CG groups, significant differences were found in body mass index (BMI) and CMJ in favor of the EG. However, while significant differences were observed in the study variables when analyzing each app individually, there were no differences between the changes produced by each app in these variables.

Conclusion

After a 10-week program of physical activity promoted through step-tracking apps, improvements were observed in fat variables, cardiorespiratory fitness, and curl-up performance. Furthermore, only inactive adolescents perceived an increase in their level of physical activity. The measurement protocol was registered prior to the start of the intervention at ClinicalTrials.gov (code: NCT04860128).

Examining the evidence between screen time and night eating behaviour with dietary intake related to metabolic syndrome: A narrative review

Screen time (ST) on digital devices has increased in recent decades due to digital development. Furthermore, constant engagement with digital devices alters sleep patterns, leading to nocturnal eating behaviour among users. These phenomena are therefore of great concern, as digital device addiction and night eating are associated with unhealthy food intake, increasing the metabolic syndrome (MetS) risks. The purpose of this review was to examine the evidence of the influence of ST and night eating behaviour (NEB) on dietary intake and its association with MetS based on previous literature. Prolonged ST and NEB have an association with excessive intake of energy from overconsumption of high-sugar and high-fat foods. However, the relationship between digital content and its influence on food intake is inconsistent. A higher MetS risk was found in individuals with longer ST due to a sedentary lifestyle, while positive energy balance and a shift in circadian rhythm contributed to night eaters. ST and NEB presented with a significant influence on food intake in adults. Additionally, unhealthy food intake due to excessive consumption of empty-calorie foods such as sweet and fatty foods due to addiction to electronic devices and eating at night has a detrimental effect on metabolic function. Therefore, improving food intake by reducing ST and night binges is essential to reduce the risk of MetS.

[Consequences of digital media on the health of children and adolescents with a focus on the consumption of unhealthy foods]

Children and adolescents' media time has increased since 2019. Prolonged time spent with media and media multitasking is increasingly being discussed as a health determinant. This narrative review highlights the importance of media time on the development of obesity and metabolic disorders in children and adolescents and discusses in more detail the associations with consumption of unhealthy foods and increased exposure to media food marketing.The prolonged durations that children and adolescents spend with social and digital media in their leisure time are positively related to sensory taste preferences for sweet, fatty, and salty foods as well as to higher snack food and energy intakes. Moreover, prolonged media time is also associated with a long-term increased risk of metabolic syndrome and its single components. The potential of social media for promoting physical activity and healthy eating lies especially in simplifying the inclusion of otherwise hard-to-reach groups. Further, social media may facilitate social support from peers and thus positively influence the well-being of young users.Particularly against the background of the not yet fully developed cognitive abilities of children and adolescents, the article refers to options for action to protect young media users. Exposure to certain social media content appears to negatively relate to children and adolescents' food choices and eating behaviors, supporting the call to regulate advertising directed at young consumers for foods and beverages that do not meet WHO criteria for child-friendly foods in these media.

An investigation into exercise prescription post-COVID-19 pandemic amongst Non-Consultant Hospital Doctors in an acute hospital setting

BACKGROUND

Being sedentary is an independent risk factor for severe COVID-19 infection, suggesting the important role physical activity (PA) has as a modifiable risk factor for COVID-19 outcome.

AIMS

The aim of this study was to evaluate NCHD's exercise prescribing practices and establish how these related to their knowledge, attitudes, and demographics and if their practices had changed since the COVID-19 pandemic began.

METHODS

An online survey was emailed to NCHDs working in city centre teaching hospitals in southern Ireland. Using a combination of forced choice items and five-point Likert scales, questions examined NCHD's knowledge, attitudes, and practices of exercise prescription.

RESULTS

For education, 30% of participants were able to correctly answer both WHO PA guidelines. 10% agreed that they knew where to refer patients for specialist exercise programs. For attitudes, 100% of participants in this study agreed that PA played a role in the prevention of disease. For practices, 36% of participants did not prescribe exercise at all. No participant strongly agreed with being confident in prescribing exercises. 90% did not increase their exercise prescribing practices since the introduction of pandemic restrictions.

CONCLUSIONS

Despite an overall positive attitude towards PA in this study, findings suggest exercise prescribing was not carried out regularly amongst the majority of participants. There was a lack of confidence and knowledge regarding exercise prescribing amongst NCHDs. The majority of NCHDs have not changed their exercise prescribing practices since the COVID-19 pandemic began. Findings suggest there is an urgent need for educational tools and supports to assist doctors with exercise prescribing.

A 6-month exercise intervention clinical trial in women: effects of physical activity on multi-omics biomarkers and health during the first wave of COVID-19 in Korea

BACKGROUND

Coronavirus disease 2019 (COVID-19) was first reported in December 2019 and the first case in Korea was confirmed on January 20, 2020. Due to the absence of therapeutic agents and vaccines, the Korean government implemented social distancing on February 29, 2020. This study aimed to examine the effect of physical activity (PA) on health through changes in multi-omics biomarkers with a 6-month of exercise intervention during the first wave of COVID-19 in Korea.

METHODS

Twenty-seven healthy middle-aged women were recruited and 14 subjects completed the exercise intervention. The mean age (± SD) was 46.3 (± 5.33) and the mean BMI (± SD) was 24.9 (± 3.88). A total of three blood and stool samples were collected at enrollment, after period 1, and after period 2 (3-month intervals). The amount of PA was measured with an accelerometer and by questionnaire. Clinical variables were used, including blood pressure, grip strength, flexibility, and blood glucose levels and lipid markers obtained from laboratory tests. The concentration of blood metabolites was measured by targeted metabolomics. Fecal microbiome data were obtained by 16 S rRNA gene amplicon sequencing.

RESULTS

During the second half period (period 2), Coronavirus disease 2019 occurred and spread out in Korea, and PA decreased compared with the first half period (period 1) (185.9 ± 168.73 min/week to 102.5 ± 82.30 min/week; p = 0.0101). Blood pressure, hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) decreased in period 1 (p < 0.05) and tended to increase again during period 2 (p < 0.05). Forty metabolites were changed significantly during period 1 (FDR p < 0.05), and we found that 6 of them were correlated with changes in blood pressure, HbA1c, and LDL-C via network analysis.

CONCLUSIONS

Our results may suggest that exercise improves health through changes in biomarkers at multi-omics levels. However, reduced PA due to COVID-19 can adversely affect health, emphasizing the necessity for sustained exercise and support for home-based fitness to maintain health.

TRIAL REGISTRATION

The trial is retrospectively registered on ClinicalTrials.gov (NCT05927675; June 30, 2023).

Social Distancing in the COVID-19 Pandemic: Associated Factors, Health Outcomes, and Implications

Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.

Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care

Background

COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure.

Methods

A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection.

Results

A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex.

Conclusion

The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

Association between Children's Difficulties, Parent-Child Sleep, Parental Control, and Children's Screen Time: A Cross-Sectional Study in Japan

Children's screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children's screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children's screen time based on their sleep, difficulties, and parental control among Japanese elementary and junior high school students. A cross-sectional survey was conducted among parents in Japan. Data on screen time duration, parent-child background, strengths and difficulties, sleep variables, and parental control types were collected from 225 households. A regression analysis revealed that high Strengths and Difficulties Questionnaire (SDQ) scores (β = 0.166, p = 0.008), sleep duration (β = -0.281, p < 0.001), and parental control (β = -0.204, p = 0.001) were significantly related to children's screen time. Additionally, it was found that parents' late bedtimes affect children's screen time by mediating children's sleep duration. This study, together with previous research, provides comprehensive insights into design interventions to decrease the screen time of children in the Japanese context.

24-Hour movement behaviours research during the COVID-19 pandemic: a systematic scoping review

OBJECTIVES

Many studies examining 24-hour movement behaviours based on the 24-Hour Movement Guidelines (24HMG) have been published during the COVID-19 pandemic. However, no comprehensive reviews summarized and synthesized the evidence concerning studies using 24HMG. The aim of this scoping review was to synthesize the evidence from the 24HMG studies published during the pandemic.

METHODS

Three electronic databases (Web of Science, PubMed, EBSCO) were utilized to conduct a literature search. The search procedure adhered to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a total of 1339 research articles published in peer-reviewed journals were screened. After eliminating 461 duplicates, 878 articles remained. The titles and/or abstracts of these articles were then cross-checked, and 25 articles were included. Subsequently, two authors independently assessed full-text of articles based on the pre-defined inclusion and exclusion criteria, resulting in the final selection of 16 articles that met the inclusion criteria. Study characteristics (e.g., study population, study design, measurement) were extracted and then summarized. According to the Viable Integrative Research in Time-use Research (VIRTUE) epidemiology, the included studies were further classified into different but interrelated study domains (e.g., composition, determinants, health outcomes).

RESULTS

The majority of included articles focused on children and adolescents as study population. This study primarily demonstrated that a low prevalence of meeting the 24HMG among children and adolescents during the COVID-19 pandemic. There has been a decline in the percentage of individuals meeting the 24HMG compared to the pre-COVID-19 period. The majority of included studies focused on sociodemographic factors when examining the correlates of meeting the 24HMG, while a few studies assessed factors of other domains, such as social, cultural, and environmental aspects.

CONCLUSION

The COVID-19 pandemic had an impact on healthy 24-hour movement behaviours in children and adolescents. In conjunction with the studies conducted during the COVID-19 pandemic, more studies were encouraged to explore the correlates of meeting the 24HMG and the associated health benefits in wider ranges of populations.

Association of Screen Time with Anxiety and Depressive Symptoms in College Students During COVID-19 Outbreak in Shanghai: Mediation Role of Sleep Quality

The study aimed to investigate the associations between different types of screen time (ST) and anxiety and depressive symptoms in college students during the Coronavirus disease 2019 (COVID-19) outbreak in Shanghai, China; the potential mediation role of sleep quality was also examined. A total of 1,550 college students completed an online survey in May 2022. ST, Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, Pittsburgh Sleep Quality Index (PSQI) score, and physical activity were self-reported. Multiple linear regression and mediation analysis were conducted. The results showed that more time spent in TV/movie viewing (>2 h/day) and recreational reading (>1 h/day) was associated with higher levels of anxiety, while more time spent in online social media (>2 h/day) was associated with a higher level of depressive symptoms. In contrast, time spent in online social media (1-2 h/day) was associated with a lower level of anxiety. Meanwhile, recreational reading (2-3 h/day) had a significant indirect effect on anxiety and depressive symptoms through sleep quality. During the COVID-19 outbreak, the associations of ST with anxiety and depressive symptoms varied by the type of screen viewing in college students. The associations of slightly excessive time spent on recreational reading with higher levels of anxiety and depressive symptoms were partially mediated by sleep quality.

Effects of Taiwan's COVID-19 alert levels on the physical activity behaviors and psychological distress of community-dwelling older adults

BACKGROUND

The Taiwanese government implemented stringent preventative health measures to curb the spread of COVID-19. However, these measures negatively affected the physical activity behaviors and psychological distress of individuals. In this study, we investigated the effects of Taiwan's COVID-19 alert-based restrictions on the physical activity behaviors and psychological distress of community-dwelling older adults.

METHODS

In this longitudinal study, 500 community-dwelling older adults were randomly sampled from a health promotion center in Taiwan. Telephone interviews were conducted between May 11, 2021, and August 17, 2021, which coincided with the Level 3 alert period when group physical activities were prohibited. Telephone interviews were again conducted between June 20, 2022, and July 4, 2022, after the alert level was reduced to Level 2 but group physical activities were prohibited period. Through the telephone interviews, data regarding the participants' physical activity behaviors (type and amount) and 5-item Brief Symptom Rating Scale (BSRS-5) scores were collected. Moreover, data regarding physical activity behaviors were collected from the records of our previous health promotion programs, which were conducted before the national alert period. The obtained data were analyzed.

RESULTS

The alert levels influenced physical activity behaviors. Because of strict regulations, physical activity amount decreased during the Level 3 alert period and did not recover rapidly during the Level 2 alert period. Instead of engaging in group exercises (e.g., calisthenics and qigong), the older adults chose to exercise alone (e.g., strolling, brisk walking, and biking). Our findings indicate that the COVID-19 alert level has a significant influence on the amount of physical activity for participants (p < 0.05, partial η2 = 0.256), with pairwise comparisons showing that the physical activity amount decreased significantly across the three time periods (p < 0.05). The psychological distress of the participants did not appear to change during the regulation period. Although the participants' overall BSRS-5 score was slightly lower during the Level 2 alert period compared to the Level 3 alert period, the difference was not statistically significant (p = 0.264, Cohen's d = 0.08) based on a paired t-test. However, the levels of anxiety (p = 0.003, Cohen's d = 0.23) and inferiority (p = 0.034, Cohen's d = 0.159) were considerably higher during the Level 2 alert period than during the Level 3 alert period.

CONCLUSIONS

Our findings indicate that Taiwan's COVID-19 alert levels influenced the physical activity behaviors and psychological distress of community-dwelling older adults. Time is required for older adults to regain their prior status after their physical activity behaviors and psychological distress were affected by national regulations.

Screen time among school-aged children of aged 6-14: a systematic review

BACKGROUND

Screen time refers to the time an individual spends using electronic or digital media devices such as televisions, smart phones, tablets or computers. The purpose of this study was to conduct systematic review to analyze the relevant studies on the length and use of screen time of school-aged children, in order to provide scientific basis for designing screen time interventions and perfecting the screen use guidelines for school-aged children.

METHODS

Screen time related studies were searched on PubMed, EMBASE, Clinical Trials, Controlled Trials, The WHO International Clinical Trials Registry Platform, the Cochrane Central Register of Controlled Trials, CNKI, and Whipple Journal databases from January 1, 2016 to October 31, 2021. Two researchers independently screened the literature and extracted the data, and adopted a qualitative analysis method to evaluate the research status of the length and usage of screen time of school-aged students.

RESULTS

Fifty-three articles were included. Sixteen articles studied screen time length in the form of continuous variables. Thirty-seven articles studied screen time in the form of grouped variables. The average screen time of schoolchildren aged 6 to 14 was 2.77 h per day, and 46.4% of them had an average screen time ≥ 2 h per day. A growth trend could be roughly seen by comparing studies in the same countries and regions before and after the COVID-19 outbreak. The average rates of school-aged children who had screen time within the range of ≥ 2 h per day, were 41.3% and 59.4% respectively before and after January 2020. The main types of screen time before January 2020 were watching TV (20 literatures), using computers (16 literature), using mobile phones/tablets (4 literatures). The mainly uses of screens before January 2020 were entertainment (15 literatures), learning (5 literatures) and socializing (3 literatures). The types and mainly uses of screen time after January 2020 remained the same as the results before January 2020.

CONCLUSIONS

Excessive screen time has become a common behavior among children and adolescents around the world. Intervention measures to control children's screen use should be explored in combination with different uses to reduce the proportion of non-essential uses.

A machine learning approach to predict self-protecting behaviors during the early wave of the COVID-19 pandemic

Using a unique harmonized real-time data set from the COME-HERE longitudinal survey that covers five European countries (France, Germany, Italy, Spain, and Sweden) and applying a non-parametric machine learning model, this paper identifies the main individual and macro-level predictors of self-protecting behaviors against the coronavirus disease 2019 (COVID-19) during the first wave of the pandemic. Exploiting the interpretability of a Random Forest algorithm via Shapely values, we find that a higher regional incidence of COVID-19 triggers higher levels of self-protective behavior, as does a stricter government policy response. The level of individual knowledge about the pandemic, confidence in institutions, and population density also ranks high among the factors that predict self-protecting behaviors. We also identify a steep socioeconomic gradient with lower levels of self-protecting behaviors being associated with lower income and poor housing conditions. Among socio-demographic factors, gender, marital status, age, and region of residence are the main determinants of self-protective measures.

Association between screen time and suspected developmental coordination disorder in preschoolers: A national population-based study in China

Introduction

Excessive screen exposure (ESE) is a growing global public health concern. This study aims to investigate the potential association between ESE and suspected developmental coordination disorder (DCD) in Chinese pre-schoolers, with or without siblings.

Method

A retrospective cohort study was conducted, involving 126,433 children from 551 cities in China. The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was employed to evaluate motor impairment in children, while parents provided information on their children’s screen time in the past year. A mixed and multi-level logistic regression model was used to analyze the associations of all screen exposure measurements from the past year with LDCDQ scores and the risk of suspected DCD.

Results

The prevalence of excessive screen exposure was 67.6% (&gt;1 h per day) and 28.9% (&gt;2 h per day) in Chinese pre-schoolers. One hour’s increase in weekday daily screen time, weekend daily screen time, and screen time before sleep in the past year was associated with a decreased total score of the LDCDQ (β were −0.690, −0.398, and −1.587, p &lt; 0.001) and an increased risk of suspected DCD by 15.3%, 9.1%, and 46.8% when adjusting for the child, family and maternal health characteristics. Excessive screen exposure decreased the total LDCDQ scores by 1.335 (&gt;1 vs. ≤1 h) and 1.162 (&gt;2 vs. ≤2 h) and increased risks of suspected DCD by 44.0% (&gt;1 vs. ≤1 h) and 31.1% (&gt;2 vs. ≤2 h) with statistical significance (each p &lt; 0.05). The stratified analysis showed that the association between screen time and LDCDQ score was stronger in children without siblings than in those with siblings.

Conclusion

The risk of suspected DCD was highest for screen time exposure before bed compared with average weekday and weekend exposures. Parents should be advised to prevent their children from using electronic screens unsupervised, especially in one-child families.

Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany

INTRODUCTION

The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents.

METHODS

A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20-65 years) with at least one child aged 3-17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed.

RESULTS

Parents' answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10-12 years were most severely affected.

CONCLUSION

Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10-12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.

The prevalence of metabolic conditions before and during the COVID-19 pandemic and its association with health and sociodemographic factors

BACKGROUND

There is a dearth of evidence on the relationship between COVID-19 and metabolic conditions among the general U.S. population. We examined the prevalence and association of metabolic conditions with health and sociodemographic factors before and during the COVID-19 pandemic.

METHODS

Data were drawn from the 2019 (N = 5,359) and 2020 (N = 3,830) Health Information National Trends Surveys on adults to compare observations before (2019) and during (2020) the COVID-19 pandemic. We conducted weighted descriptive and multivariable logistic regression analyses to assess the study objective.

RESULTS

During the pandemic, compared to pre-pandemic, the prevalence of diabetes (18.10% vs. 17.28%) has increased, while the prevalence of hypertension (36.38% vs. 36.36%) and obesity (34.68% vs. 34.18%) has remained similar. In general, the prevalence of metabolic conditions was higher during the pandemic (56.09%) compared to pre-pandemic (54.96%). Compared to never smokers, former smokers had higher odds of metabolic conditions (AOR = 1.38, 95% CI = 1.01, 1.87 and AOR = 1.57, 95% CI = 1.10, 2.25) before and during the pandemic, respectively. People with mild anxiety/depression symptoms (before: AOR = 1.52, 95% CI = 1.06, 2.19 and during: AOR = 1.55, 95% CI = 1.01, 2.38) had higher odds of metabolic conditions relative to those with no anxiety/depression symptoms.

CONCLUSION

This study found increased odds of metabolic conditions among certain subgroups of US adults during the pandemic. We recommend further studies and proper allocation of public health resources to address these conditions.

Sedentary Behavior Patterns of the Hungarian Adult Population

BACKGROUND AND AIM

Nowadays, a high level of sedentary behavior (SB) is an important health issue. Many studies have focused on evaluating the physical activity (PA) level, while evaluation of SB has received less attention. The main goal of the present study is to describe the sedentary lifestyle of the Hungarian adult population and identify the vulnerable groups with high amount of sitting time and the patterns of SB. Another aim of this study is to compare the two types of questionnaires (International Physical Activity Questionnaire-IPAQ and Sedentary Behavior Questionnaire-SBQ) related to sitting time.

METHODS

This study analyzed cross-sectional primary data using self-reported questionnaires collected by a Hungarian research market company among the adult population in Hungary. The final sample of this study consisted of 1295 participants with a mean age of 45.9 years (SD = 15.2). Analysis of variance (ANOVA) test with post-hoc (Tukey) analysis were used to analyze the link between sitting time and socio-demographic variables (sex, age, BMI, settlement type, education level, marital status, work category, working hours, employment status, sport activity) and body mass index (BMI).

RESULTS AND CONCLUSIONS

According to the SBQ, on average, Hungarians sit for 469.53 min per day (7.81 h) on weekdays and 421.25 min per day (7.01 h) on weekends, which suggested a significant difference compared to IPAQ data: 287.82 min per day (4.79 h) on weekdays and 224.30 min per day (3.73 h) on weekends. Young people (aged between 18 and 29) were reported to have the highest average sitting time, i.e., 545 min per day (more than 9 h), and are showing the highest prevalence (53%) of sitting at least 480 min (8 h) per day. Sitting workers also had a high average sitting time, i.e., 514.82 min per day, and a high prevalence (49.3%) of sitting at least 480 min (8 h) per day. People who live in the capital city had higher sitting time, especially on working days. Men sat longer than woman, i.e., 19 min on working days and 45 min on weekends. The most frequent sedentary activities are: working on computer (126 min) on working days and watching TV (130 min) on weekends. Our results clearly show that the self-report single-item measure (IPAQ) significantly underestimates sedentary time compared to the multi-item questionnaire (SBQ). We identified vulnerable groups with high sitting times: men, young adults, inhabitants of the capital city and sitting workers. Consequently, these groups should be continuously surveyed, and requires specific interventions and strategies that particularly counteract the increased sitting time.

Change in Prevalence of Hypertension among Korean Children and Adolescents during the Coronavirus Disease 2019 (COVID-19) Outbreak: A Population-Based Study

During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of hypertension among 1428 youths aged 10-18 years using data from the Korea National Health and Nutrition Examination Survey 2018-2020. We assessed the prevalence of hypertension according to sex, age, body mass index (BMI), and residential district. The prevalence of hypertension increased from 7.1% to 12.5% in all participants. In the sex-specific analysis, the prevalence was found to be increased in boys. In the age-specific analysis, the prevalence was found to be increased in youths aged 13-15 years. In the BMI-specific analysis, an increase in the prevalence was prominent in the normal BMI group. In the residential district-specific analysis, the prevalence of hypertension among youth increased in urban areas. Our results show that the prevalence of hypertension increased among Korean children and adolescents during the COVID-19 outbreak. These findings suggest the importance of close monitoring of hypertension among youth during the COVID-19 pandemic.

Joys or Sorrows of Parenting During the COVID-19 Lockdown: A Scoping Review

Objectives: The aim of this scoping review was to map out the existing evidence of the impact of the COVID-19 lockdown on parents of children and adolescents. We sought to: 1) identify parenting domains that were particularly affected by lockdown measures, 2) describe the challenges and opportunities of lockdown measures in these domains, and 3) define protective and exacerbating factors modulating the effect of lockdown measures on parents. Methods: We identified five main domains investigated in the context of parenting during the early COVID-19 lockdown derived from 84 studies: health and wellbeing, parental role, couple functioning, family and social relationships, and paid and unpaid work. For each domain, we listed challenges and opportunities, as well as discriminant factors. Results: The lockdown impacted all five different but interconnected domains, introduced new roles in parents' lives, and particularly affected women and vulnerable populations. Conclusion: This scoping review highlights the importance of approaching public health policymaking from a social justice perspective. Such an approach argues for social and public health policies to promote health accounting for its social, economic, political, and commercial determinants.

Smartphone Use and Inflammation at 2-Year Follow-Up in College Students: The Mediating Role of Physical Activity

Purpose

Smartphone use could lead to being physically inactive and a greater risk for health problems, such as inflammation. However, the associations between smartphone use, physical activity (PA), and systemic low-grade inflammation remained unclear. This study aimed to examine the potential mediating effect of PA on the association between smartphone use and inflammation.

Patients and Methods

A two-year follow-up study was conducted between April 2019 and April 2021. Duration of smartphone use, smartphone dependence and PA were assessed by a self-administered questionnaire. Laboratory analysis of blood samples was performed to evaluate the levels of TNF-α, IL-6, IL-1β, and CRP as biomarkers of systemic inflammation. The correlations between smartphone use, PA, and inflammation were analyzed using Pearson correlation. Structural equation modelling was used to analyze the potential mediating effect of PA on the associations between smartphone use and inflammation.

Results

A total of 210 participants were included with a mean (standard deviation) age of 18.7 (1.0) years, 82 (39%) of whom were males. Smartphone dependence was negatively associated with the total PA level (r=-0.18, P<0.01). PA mediated the associations between the duration of smartphone use and smartphone dependence with inflammatory markers. Specifically, as PA decreased, the duration of smartphone use was more negatively associated with TNF-α (ab=-0.027; 95% CI: -0.052, -0.007) and more positively correlated to IL-6 (ab=0.020; 95% CI: 0.001, 0.046) and CRP (ab=0.038; 95% CI: 0.004, 0.086); smartphone dependency was more negatively associated with TNF-α (ab=-0.139; 95% CI: -0.288, -0.017) and more positively related to CRP (ab=0.206; 95% CI: 0.020, 0.421).

Conclusion

Our study illustrates that there are no direct associations between smartphone use and systemic low-grade inflammation, however, PA level plays a weak but significant mediating effect on the associations between smartphone use and inflammation among college students.

The 2022 India Report Card on physical activity for children and adolescents

Background

With strong evidence of physical inactivity's link to chronic disease and economic burden - particularly with childhood active living behaviors tracking into adulthood - it is imperative to promote physical activity among children and adolescents in India.

Objectives

To evaluate active living patterns among Indian children and adolescents.

Methods

The India Report Card (IRC) team, which consists of experts in India and Canada, systematically collected and appraised evidence on 11 indicators of active living, including 5 behavioral (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior), 2 individual-level (Physical Fitness, Yoga) and 4 sources of influence (Family and Peers, School, Community and Built Environment, Government). Peer-reviewed articles were appraised based on national representativeness, sample size, and data quality. Grey literature was appraised based on comprehensiveness, validity of the sources, and representativeness. All indicators were assessed against parameters provided by the Active Healthy Kids Global Alliance.

Results

Active Transportation and Government Strategies were ranked highest with a B- and C+ grade, respectively. Overall Physical Activity and Schools were assigned a C grade, while Sedentary Behavior and Community and Built Environment were given D grades. Yoga was the lowest ranking indicator with a D- grade. Organized Sport Participation, Active Play, Family and Peers, and Physical Fitness were all graded incomplete.

Conclusions

Active Transportation, Government Strategies, and Overall Physical Activity have improved since the 2018 IRC, a positive trend that needs to be translated to other indicators. However, Sedentary Behavior has consistently worsened, with grades C, C-, and D-, in 2016, 2018, and 2022, respectively. Evidence generated by the 2022 IRC suggests opportunities for improvement not only in India, but also the 56 other countries taking part in Global Matrix 4.0.

Patterns of Physical Activity and Sedentary Behavior During the COVID-19 Pandemic in the Thai 2021 National Health Survey

BACKGROUND

Understanding patterns of physical activity and sedentary behavior is essential, but evidence from low- and middle-income countries remains limited. This study aimed to investigate the prevalence of physical activity and sedentary behavior in the Thai population; their sociodemographic correlates; and the contribution of specific domains to total physical activity.

METHODS

We analyzed data from the 2021 Health Behavior Survey, a nationally representative survey, conducted by the Thailand National Statistical Office during the COVID-19 pandemic. Physical activity and sedentary behavior were assessed using the Global Physical Activity Questionnaire. "Sufficiently active" was defined according to the World Health Organization guidelines. "Highly sedentary" was defined as sitting ≥7 hours per day. The contribution of work, transport, and recreational physical activity was determined as the proportion of total physical activity. Multivariable logistic regression was conducted to determine the correlates of being sufficiently active and being highly sedentary.

RESULTS

Of the total study population (N = 78,717), 71.9% were sufficiently active, whereas 75.8% were highly sedentary. Females, having a labor-intensive work, and living in Bangkok had a higher likelihood of being sufficiently active. Those with higher education and income levels, and living in Bangkok and the Central region had a greater likelihood of being highly sedentary. The work domain contributed the highest proportion toward physical activity (82.1%), followed by the recreation (10.0%) and transport domains (7.9%).

CONCLUSIONS

Policies should focus on promoting transport and recreational physical activity and activity that can break up sedentary behavior among adults because when countries become technologically advanced, physical activity at work declines.

Effects of COVID-19 related physical inactivity on motor skills in children with intellectual disability

BACKGROUND

Children with intellectual disabilities (ID) may show declines in motor skills during the Covid-19 restrictions. This study compared the effects of physical inactivity due to COVID-19 on the motor skills of active and inactive children with ID.

METHOD

In this prospective cohort study, 30 boys with ID were divided into two groups based on study inclusion criteria (mean age 10.86 ± 1.81 active, 10.20 ± 1.42 inactive). The BESS test, the Y test, the Timed Up and Go (TUG) test, and the Bruininks-Oseretsky test-short form were used.

RESULTS

Results showed a significant difference between active and inactive groups in the total score of gross motor skills (P = 0.001), fine motor skills (P = 0.002), motor skills (P = 0.001), postural control (P = 0.01), and dynamic balance (P = 0.01).

CONCLUSIONS

The results showed a significant difference between active and inactive children with ID in terms of gross and fine motor skills after a one-year movement restriction. Therefore, considering the tendency to be sedentary among these people and the subsequent complications caused by this inactivity, including obesity and chronic diseases, it is suggested that parents and educators design practical and numerous exercises and encourage them to be more active and participate in physical activity programs.

Synchronous online lecturing or blended flipped classroom with jigsaw: an educational intervention during the Covid-19 pandemic

BACKGROUND

The Covid-19 pandemic has changed the education system throughout the world. This study aimed to compare synchronous online lecturing with blended flipped classroom plus jigsaw in terms of their effects on the students' learning, communication skills and critical thinking disposition.

METHODS

This is an educational intervention conducted at the Nursing and Midwifery School of Shiraz University of Medical Sciences. Two incoming students of nursing and midwifery were selected by complete enumeration. Then synchronous online lecturing was given to one group (n = 40) and blended flipped classroom and jigsaw to the other (n = 44). After that, given the prevailing conditions, both methods were performed fully online. Then Participants completed an online questionnaire. A researcher-made learning questionnaire, the Interpersonal Communication Skills Questionnaire developed by Fetro, and Ricketts' Critical Thinking Disposition Inventory were used to assess the study variables.

RESULTS

The mean learning scores in the blended group were slightly higher but this difference was not significant (P = 0.767). In the blended group, the mean scores of communication skills were significantly higher after the intervention in all the dimensions, except for empathy & intimacy and listening skills. In the online lecture group, there was no significant difference between before and after the intervention. Communication skills (P < 0.001) scored significantly higher in the blended group after the intervention than that in the synchronous online lecturing group in all the dimensions except for empathy & intimacy. In the online lecture group, there was no significant difference in critical thinking disposition between before and after the intervention. In the blended group, the overall score of critical thinking disposition and its dimensions was significantly higher after the intervention (P < 0.001), except for the perfection dimension. There was no significant difference between the two groups in terms of the mean total score of critical thinking disposition and its dimensions before and after the intervention.

CONCLUSION

Given the global circumstances, the blended method was more effective in promoting learning outcomes and communication skills than synchronous online lectures. Furthermore, it seems that this new approach could improve critical thinking.

Changes in the body composition of boys aged 11-18 years due to COVID-19 measures in the Czech Republic

BACKGROUND

The lockdown measures related to coronavirus disease 2019 (COVID) impacted the health of adolescents by reducing physical activity (PA). The physical changes in response to decreases in PA can be measured with full body composition analysis. The aim of this study was to evaluate the effects of long-term PA restrictions on body fat (BF), fat-free mass (FFM) and skeletal muscle mass (SMM) in adolescents.

METHODS

A total of 1669 boys (before PA restriction (G1): 998; after PA restrictions ended (G2): 671; between the ages of 11 and 18 were included. The measured parameters were body mass (BM), visceral fat area (VFA), BF, FFM and SMM. The whole-body composition was evaluated using bioelectrical impedance analysis (BIA).

RESULTS

Compared to G1, G2 exhibited an increase in BF between 1.2 and 5.1%. This difference was significant in boys aged 13 to 18 years (p < 0.05). VFA increased between 5.3 and 20.5 cm²; this increase was significant in boys aged 13 to 18 years (p < 0.05). SMM decreased between 2.6 and 3.8%, and this decrease was significant in all age groups (p < 0.05). Changes in body composition were not accompanied by any significant changes in BM.

CONCLUSIONS

COVID-19 restrictions reduced PA, resulting in a significant decrease in SMM. This decrease may impact boys' ability to engage in sufficiently varied PA, which may lead to a further decline in PA and subsequent medical consequences in adulthood.

The impact of COVID-19 lockdowns on physical activity amongst older adults: evidence from longitudinal data in the UK

Background

A sedentary lifestyle increases the risk of adverse health outcomes and frailty,particularly for older adults. To reduce transmission during the COVID-19 pandemic, people were instructed to stay at home, group sports were suspended, and gyms were closed, thereby limiting opportunities for physical activity. Whilst evidence suggests that physical activity levels reduced during the pandemic, it is unclear whether the proportion of older adults realising the recommended minimum level of physical activity changed throughout the various stages of lockdown.

Methods

We used a large sample of 3,660 older adults (aged ≥ 65) who took part in the UK Household Longitudinal Study’s annual and COVID-19 studies. We examined changes in the proportion of older adults who were realising the UK Chief Medical Officers’ physical activity recommendations for health maintenance at several time points before and after COVID-19 lockdowns were imposed. We stratified these trends by the presence of health conditions, age, neighbourhood deprivation, and pre-pandemic activity levels.

Results

There was a marked decline in older adults’ physical activity levels during the third national lockdown in January 2021. The proportion realising the Chief Medical Officers’ physical activity recommendations decreased from 43% in September 2020 to 33% in January 2021. This decrease in physical activity occurred regardless of health condition, age, neighbourhood deprivation, or pre-pandemic activity levels. Those doing the least activity pre-lockdown increased their activity during lockdowns and those doing the most decreased their activity levels.

Conclusions

Reductions in older adults’ physical activity levels during COVID-19 lockdowns have put them at risk of becoming deconditioned and developing adverse health outcomes. Resources should be allocated to promote the uptake of physical activity in older adults to reverse the effects of deconditioning.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14156-y.

Variation of parental feeding practices during the COVID-2019 pandemic: a systematic review

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and has resulted in a protracted pandemic. Infections caused by new coronavirus strains, primarily Delta and Omicron and currently highly prevalent globally. In response to the epidemic, countries, and cities implemented isolation and quarantine guidance, such as limiting social contact, which have affected the lifestyles and quality of life of the population. Parental feeding behaviors may vary as a result of factors such as prolonged home isolation of parents and children, lack of supplies during isolation, and stress. This study was designed to assess the available evidence and its implications for parental feeding practices in the context of COVID-19. We screened and reviewed research published in five electronic databases between 2020 and 2022, and eight studies met the selection criteria. Parents were observed to use a variety of feeding practices, including high levels of coercive control and reduction of rules and limits according to Vaughn’s food parenting constructs. The findings suggest that parental feeding practices are changing as a result of the pandemic and that more research is needed to further explore how to provide supportive feeding guidance to parents during emergencies in order to jointly promote child health.

COVID-19 lockdown: Impairments of objective measurements of selected physical activity, cardiorespiratory and sleep parameters in trained fitness coaches

The COVID-19 outbreak resulted in the shutdown of athletic training facilities. Although the effects of these restrictions on daily activity and sleep patterns have been widely analyzed, the employed tools often lacked accuracy, and were based on subjective measures. This study assessed the effects of home confinement on objective physical activity (PA), physiological and sleep parameters in active individuals. Sixteen male elite fitness coaches (age: 29±3 years; height: 183±6 cm; body mass: 82±5 kg, body mass index: 24.7±1.8 kg/m2) participated in this retrospective study. One-way analysis of variance was conducted to analyze selected PA, physiological and sleep parameters collected by smartwatch (Garmin Fenix 6 pro, USA) data during four consecutive months [i.e., pre-confinement, 1st and 2nd months of confinement, and post-confinement, year 2020]. Ramadan intermittent fasting (RIF) month occurred during the 2nd month of confinement. Compared to pre-confinement, significant changes were registered for almost all parameters during the 1st and/or the 2nd month of confinements (p<0.001), with (i) higher values for resting heart rate, sleep latency, and total, light and rapid eye movements sleep times (% change=7-523 %), and (ii) lower values for PA parameters, calories/day spent, average and highest respiratory rates, and deep sleep time during the home confinement period (% change=5-36 %). During the post-confinement month, all parameters regained pre-confinement values. In conclusion, home confinement-induced detraining negatively influenced the objective measurements of cardiorespiratory and sleep parameters among fitness coaches with a deeper effect during the 2nd month of home confinement, possibly due to the effect of RIF.

The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents

Background: Over the last few decades, the time children spend using electronic devices has increased significantly. The aim of the study was to evaluate the impact of screen time on dietary behaviors and physical activity in children and adolescents. Methods: An online survey was conducted among parents of preschool and school-aged children during the COVID-19 lockdown in Poland. There were 3127 surveys used in the analysis. Results: Survey responses referred to 1662 (53%) boys and 1465 (47%) girls, with a mean age of 12.1 ± 3.4 years. During a routine weekday, most children (71%) spent >4 h on educational activities using electronic devices, and 43% of children spent 1−2 h using devices for recreational purposes. The majority of children (89%) were exposed to screens during meals, and ate snacks between main meals (77%). There was an association between screen time and the exposure to screens during meals, and between screen time and time spent performing physical activity. Conclusions: This study revealed that the majority of children were exposed to screens during meals, which is a risk factor of obesity. The promotion of the judicious use of digital devices and healthy dietary habits associated with the use of screens may be an important component of obesity prevention strategies.

A Narrative Review on Prevention and Early Intervention of Challenging Behaviors in Children with a Special Emphasis on COVID-19 Times

Background

COVID-19 and the measures stemming from efforts to control it have affected the psychosocial wellbeing of children and adolescents. The increasing trend of challenging behavior has exerted further pressure on parents and schools. Understanding socioemotional development and interrelating triggers is the key to management. Early interventions prevent the future threat of mental illness and risky acts. Effective strategies are ones that primarily focus on strengthening parent-child interactions.

Aim

The purpose of this paper is to review the literature on the (i) psychosocial and behavioral impacts of COVID-19 on children/adolescents and (ii) approaches to identify determinants of challenging behaviors as a principal guide to effective interventional strategies for children and their families.

Methodology

Electronic database searches of PubMed, ScienceDirect, Medline, and Scopus were conducted to identify studies meeting the inclusion criteria that address the impact of COVID-19 on behaviors, contributing factors, and management in the context of families/schools. The content of the selected articles was themed under five categories, namely the developmental milestones, the Pyramid Model, the Positive Behavioral Support, the management strategies, and the impact of COVID-19 on children/adolescents' behavior.

Results

The present review demonstrates considerable influence of COVID-19 on children and adolescents' behavior and mental wellbeing. It stresses the importance of early family-based interventions focusing on the triggers of challenging behavior. Functional Behavioral Assessment and Behavioral Intervention Plan provide a systematic analysis with a strategic plan that support children's self-regulation and socioemotional intelligence. Regular behavioral screening is vital to promote prevention and early management.

Conclusion

Managing behavioral difficulties remains an area of deficit for parents, teachers, and health care providers. With a quality support, parents and schools will be able to clearly characterize the challenging behavior, understand the causes, reinforce parent-child interactions, and consequently, gain the strategic skills required to apply it within natural settings. Timely interventions will limit the risk of future misconduct and mental disorders.