Is sport enough? Contribution of sport to overall moderate- to vigorous-intensity physical activity among adolescents

Strategies to Improve Physical Activity and Nutrition Behaviours in Children and Adolescents: A Review

Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.

Characteristics of 24-hour movement behaviours and their associations with mental health in children and adolescents

Background

Time-use estimates are typically used to describe 24-hour movement behaviours. However, these behaviours can additionally be characterised by other easily measured metrics. These include sleep quality (e.g., sleep efficiency), 24-hour rest-activity rhythmicity (e.g., between-day rhythm variability), and directly measured acceleration metrics (e.g., intensity gradient). Associations between these characteristics and youth mental health are unclear. This study aimed to [1] compare 24-hour movement behaviour characteristics by sex and age groups, [2] determine which movement behaviour characteristics were most strongly associated with mental health outcomes, and [3] investigate the optimal time-use behaviour compositions for different mental health outcomes.

Methods

Three-hundred-and-one children and adolescents (age 9-13 y; 60% girls) wore accelerometers for 24-hours/day over 7-days. Overall mental health, externalising, and internalising problems were self-reported using the Strengths and Difficulties Questionnaire. 24-hour movement behaviour characteristics were categorised as time-use estimates, sleep quality, 24-hour activity rhythmicity, and directly measured acceleration. Linear mixed models and compositional data analysis were used to analyse the data in alignment with the study aims.

Results

Time-use estimates, directly measured accelerations, and 24-hour rest-activity rhythm metrics indicated that children were significantly more physically active (p = .01-<0.001) than adolescents. Children were also less sedentary (p < .01), slept longer (p = .02-0.01), and had lower sleep efficiency. Boys were significantly more active than girls (p < .001) who in turn accrued more time in sleep (p = .02). The timing of peak activity was significantly later among adolescents (p = .047). Overall mental health and externalising problems were significantly associated with sleep, sedentary time, sleep efficiency, amplitude, and inter-daily stability (p = .04-0.01). The optimal time-use compositions were specific to overall mental health and externalising problems and were characterised by more sleep, light and vigorous physical activity, and less sedentary time and moderate physical activity than the sample's mean time-use composition.

Conclusions

Extracting and examining multiple movement behaviour characteristics from 24-hour accelerometer data can provide a more rounded picture of the interplay between different elements of movement behaviours and their relationships with mental health than single characteristics alone, such as time-use estimates. Applying multiple movement behaviour characteristics to the translation of research findings may enhance the impact of the data for research users.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-023-00021-9.

Effects of Group-Play Moderate to Vigorous Intensity Physical Activity Intervention on Executive Function and Motor Skills in 4- to 5-Year-Old Preschoolers: A Pilot Cluster Randomized Controlled Trial

The aim of the present study is to examine the effect of group-play intervention on executive function (EF) in preschoolers. This group-play intervention was integrated as moderate to vigorous physical activity and cognitively loaded exercise to promote EF in preschoolers. An 8-week group-play MVPA intervention program, consisting of a series of outdoor physical and cognitively loaded games, was designed to improve preschoolers' EF. This intervention program was implemented in group-play form, and conducted by teachers who received standardized training before the intervention. Two classes of second grade preschoolers (N = 62) were randomly allocated to experimental (n = 30, M age = 4.16, SD = 0.29) and control (n = 32, M age = 4.7, SD = 0.43) groups. The intervention group received the intervention three times a week, while the control group exercised as usual in preschool. Before, in the middle of, and after the intervention, 10-m running, standing broad jump, throwing, body flexion, balance beam, and skip jump were assessed as tests of motor skills. In addition, three components of EF were measured separately before, in the middle of, and after the intervention: inhibitory control was assessed by using the silly sound Stroop task, working memory was tested using the empty house task, and shifting was assessed using the dimensional change card sorting task. Although both groups showed an increasing trend in terms of motor skills and EF during the intervention, the increasing amounts of the intervention group were significantly higher than the control group. The findings of the present study suggested that group-play intervention has positive effects on aspects of EF in addition to motor skills in preschoolers.

A systems thinking approach to understanding youth active recreation

Background

Active recreation contributes to child and adolescent physical activity, however, factors affecting uptake are poorly understood at the systems level. The aims of this study were: (1) to use systems analysis methods to understand youth active recreation in Victoria, Australia, (ii) identify potential system leverage points to enhance active recreation, and (iii) explore stakeholder views of systems analysis methods for informing practice and policy decision-making.

Methods

Phase 1: Umbrella review of systematic reviews (2013–2018), synthesising evidence for correlates, determinants and intervention evidence for promoting active recreation. Phase 2: Development of three systems models (ActorMap and two ActivMaps), depicting active recreation actors/organisations, correlates, determinants and intervention evidence. Phase 3: Development of causal loop diagrams (CLDs) and identification of leverage points based on the Action Scales Model. Phase 4: Model feedback via stakeholder interviews (n = 23; 16 organisations).

Results

From the literature, 93 correlates and determinants, and 49 intervention strategies were associated with child and adolescent active recreation; the majority located at a social or individual level. Ten potential system leverage points were identified in the CLDs, which differed for pre-schoolers versus children and adolescents. Only time outdoors (an event leverage point) emerged for all age groups. Changes to the built and natural environment (i.e., land use planning, urban design) as a complete domain was a key structural leverage point for influencing active recreation in children and adolescents. Subject matter experts and stakeholder interviews identified 125 actors operating across seven hierarchical active recreation system levels in Victoria. Stakeholder interviews identified 12 areas for future consideration and recommendations for practice/policy influence.

Conclusions

Our findings underscore the need for dynamic models of system behaviour in active recreation, and to capture stakeholder influence as more than a transactional role in evidence generation and use. Effective responses to youth inactivity require a network of interventions that target specific leverage points across the system. Our models illustrate areas that may have the greatest system-level impact, such as changes to the built and natural environment, and they provide a tool for policy, appraisal, advocacy, and decision-making within and outside of government.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01292-2.

Cross-sectional and longitudinal associations of active travel, organised sport and physical education with accelerometer-assessed moderate-to-vigorous physical activity in young people: the International Children's Accelerometry Database

BACKGROUND

Physical activity (PA) declines during childhood. Important sources of PA are active travel, organised sport and physical education (PE), but it is unclear how these domain-specific PA sources contribute to (changes in) daily moderate-to-vigorous PA (MVPA) in young people. This study aimed to examine (1) the cross-sectional association between domain-specific physical activity (i.e., active travel, organised sport and PE) and daily minutes in accelerometer-assessed MVPA; and (2) the longitudinal association between domain-specific physical activity at baseline and change in daily minutes in MVPA.

METHODS

Participants (baseline age 11.3 ± .1.2 years) were drawn from three studies in the International Children's Accelerometry Database. The contribution of self-reported standardised active travel, organised sport and PE to accelerometer-measured daily minutes in MVPA was examined using linear regression. In cross-sectional analyses, MVPA was regressed on each PA domain in separate models, adjusted for study, age, sex, maternal education, season, and monitor wear time. In longitudinal analyses, change in MVPA was regressed on each of the baseline PA domains, additionally adjusting for changes in season and wear time, follow-up duration, and baseline MVPA. R-squared was used to compare variance explained by each PA domain.

RESULTS

In the cross-sectional analyses (n = 3871), organised sport (standardised β = 3.81, 95% confidence interval [95%CI] = 3.06, 4.56) and active travel (β = 3.46, 95%CI = 2.73, 4.19) contributed more to daily MVPA than PE (β = 0.82, 95%CI = -0.02, 1.66). Compared to the base model which included only covariates (R2 = 21.5%), organised sport (absolute change: + 1.9%) and active travel (+ 1.7%) models explained more of the variance than the PE model (± < 0.1%). Associations followed a similar pattern in the longitudinal analyses (n = 2302), but none of the PA domains predicted change in MVPA (organised sport: standardised β = 0.85, 95%CI = -0.03, 1.72; active travel: β = 0.68, 95%CI = -0.14, 1.50; PE: β = 0.02, 95%CI = -0.87, 0.91).

CONCLUSIONS

A multi-sectoral approach covering a wide range of PA domains should be promoted to minimise the age-related decline in MVPA during childhood.

Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.

Failure to Launch: Predictors of Unfavourable Physical Activity and Sedentary Behaviour Trajectories from Childhood to Adolescence: The Gateshead Millennium Study

In a previous study based on this cohort, only 15% of the participants belonged to a favourable physical activity/sedentary behaviour trajectory group (characterised by relatively high moderate–vigorous intensity physical activity and relatively low sedentary behaviour across childhood and adolescence). Since this favourable trajectory is protective against obesity, we aimed to identify factors associated with membership of this group. In this longitudinal study, 671 participants were assessed at ages 7, 9, 12 and 15 years. Participants’ demographics, socio-economic status (SES) and physical activity environment such as, sports club participation and commuting school were assessed at ages 7, 9 and 12 and analysed with favourable trajectory membership as an outcome using multinomial logistic regression. Sex (male) and SES (higher) were the non-modifiable factors associated with favourable trajectory group. Of the modifiable factors, commuting to school at age 7, a safe environment to play at age 7 and sports club participation at age 12 were all associated with more than 2.0 times increased probability of being in the most favourable trajectory. Future interventions to promote a favourable trajectory could focus on girls and participants with low SES. Promoting active commuting, safe local spaces to play and sports participation should also help lead to a favourable trajectory for physical activity and sedentary behaviour across childhood and adolescence.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Interactions Between Race/Ethnicity and Gender on Physical Activity Among US High School Students: Youth Risk Behavior Survey 2011-2017

BACKGROUND/PURPOSE

Most adolescents do not meet the recommended amount of physical activity. Female, Black, and Hispanic students have significantly less physical activity than White male students. Physical activity of Asian or Multiple Race students have not been reported. The purpose of this research is to estimate differences in physical activity by race/ethnicity and gender among US high school students to examine whether Black Hispanic, Asian and multiple race female students and 11th grade and 12th grade female students have significantly lower physical activity levels.

DESIGN/METHODS

This study is a secondary analysis of cross-sectional data from the high school Youth Risk Behavior Survey, a biennial, nationally representative survey of US high school students. Four waves of data were pooled from 2011 to 2017 YRBS (N = 59,397). Dependent variables were the number of active days per week a student was physically active, and whether the student was physically active for zero, 5 or more, or 7 days per week. Data were analyzed using R software.

RESULTS

Asian students and students in grade 12 had the fewest number of physically active days per week. Female students were less physically active than male students. Significant negative interactions were measured in female gender by race/ethnicity (Black or Hispanic) and female gender by grade levels for the number of physically active days per week and for zero physically active days per week. The gender disparity in physical activity was significantly more pronounced among Black and Hispanic students. The reduction in physical activity by grade level was also significantly greater among female students.

DISCUSSION

Efforts to increase physical activity are especially needed among Asian, Black, and Hispanic, and upper-grade female students.

PRACTICAL IMPLICATIONS

Further research is needed to identify explanations and solutions for the significantly lower physical activity among Asians, female minority students, and students in upper grades.

The Impact of Organised Sport, Physical Education and Active Commuting on Physical Activity in a Sample of New Zealand Adolescent Females

BACKGROUND

The majority of adolescents do less physical activity than is recommended by the World Health Organization. Active commuting and participation in organised sport and/or physical education individually have been shown to increase physical activity in adolescents. However, how these domains impact physical activity both individually and in combination has yet to be investigated in a sample of New Zealand female adolescents from around the country.

METHODS

Adolescent females aged 15-18 y (n = 111) were recruited from 13 schools across eight locations throughout New Zealand to participate in this cross-sectional study. Participants completed questions about active commuting, and participation in organised sport and physical education, before wearing an Actigraph GT3X (Actigraph, Pensacola, FL, USA) +24 h a day for seven consecutive days to determine time spent in total, MVPA and light physical activity.

RESULTS

Active commuters accumulated 17 min/d (95% CI 8 to 26 min/d) more MVPA compared to those who did not. Those who participated in sport accumulated 45 min/d (95% CI 20 to 71 min/d) more light physical activity and 14 min/d (95% CI 5 to 23 min/d) more MVPA compared to those who did not. Participation in physical education did not seem to have a large impact on any component of physical activity. Participation in multiple domains of activity, e.g., active commuting and organised sport, was associated with higher accumulation of MVPA but not light activity. Conclusion Active commuting and sport both contribute a meaningful amount of daily MVPA. Sport participation has the potential to increase overall activity and displace sedentary behaviour. A combination of physical activity domains may be an important consideration when targeting ways to increase physical activity in adolescent females.

Is the physical activity environment surrounding primary schools associated with students' weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study

OBJECTIVES

To explore whether the physical activity (PA) environment (walkability, greenspace and recreational facilities) surrounding regional primary schools is associated with children's PA levels, active transport and weight status. Limited research on this topic has been conducted outside of major cities.

DESIGN

Cross-sectional ecological study using baseline data from two large-scale obesity prevention interventions.

SETTING

Eighty (n=80) primary schools across two regional areas in Victoria, Australia.

PARTICIPANTS

Students aged 8-13 years (n=2144) attending participating primary schools.

OUTCOME MEASURES

Measured weight status (body mass index z-score, proportion overweight/obese) and self-reported PA behaviours (meeting PA recommendations and active travel behaviour).

RESULTS

When adjusted for student and school demographics, students had significantly increased odds of using active transport to or from school when the school neighbourhood was more walkable (OR 1.21 (95% CI 1.09 to 1.35), had a greater number of greenspaces (OR 1.35 (95% CI 1.20 to 1.53)) and a greater number of recreational facilities (OR 1.18 (95% CI 1.07 to 1.31)). A higher cumulative PA environment score was also associated with a higher proportion of children using active transport (OR 1.33 (95% CI 1.28 to 1.51)). There were no significant associations between the PA environment measures and either weight status or meeting the PA recommendations in adjusted models.

CONCLUSIONS

This study is the first of its kind exploring school neighbourhood environments and child weight status and PA in regional areas of Australia. It highlights the potential of the environment surrounding primary schools in contributing to students' active travel to and from school. Further research with the use of objective PA measurement is warranted in regional areas that have been under-researched.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry (ANZCTR.org.au) identifier 12616000980437; Results.

The Contribution of Gaelic Football Participation to Youth Physical Activity Levels

The primary aim of this study was to describe the contribution of Gaelic football participation to youth physical activity (PA) levels. Secondary aims were to objectively quantify the overall daily PA levels of participants across sex and age, to determine the PA levels achieved during Gaelic football practice sessions and games, and to compare PA levels on days with organized sporting activity (sports days) and days without organized sporting activity (non-sports days). One hundred and sixty adolescents (87 male, 73 female; mean age 14.5 ± 1.8 yrs.) wore an activPAL accelerometer to determine total sitting/lying time, standing time, light intensity physical activity (LIPA), moderate physical activity (MPA), vigorous physical activity (VPA) and moderate-to-vigorous physical activity (MVPA) during a seven day measurement period, including during Gaelic football participation. Participants achieved an average of 58.5 ± 23.6 minutes of MVPA daily. Males accumulated significantly more MVPA daily than females (Males=70.8±22.1 min; Females = 45.5 ± 16.5 min; p < 0.001; ηp² = 0.401) and time spent in MVPA daily significantly decreased with age (p < 0.001; ηp² = 0.299). Participants accumulated significantly more MVPA during games (36.0 ± 9.2 min/hr (60%)) than practice sessions (29.0 ± 8.3 min/hr (48%); p < 0.001; d = 0.80). On sports days, participants accumulated significantly more time in MVPA (Sports Days = 70.1 ± 36.0 min; Non-Sports Days = 54.2 ± 34.0; p < 0.001; d = 0.45) and were 2.16 times more likely to achieve 60 minutes of MVPA (OR = 2.16; 95% CI = 1.60-2.92) than on non-sports days. The results reveal that Gaelic football provides an opportunity for adolescents to accumulate PA, however, participants currently spent more than 50% of their practice time inactive or in low intensity activities. An opportunity remains to enhance the contribution of Gaelic football to overall daily PA levels, by replacing time spent inactive with time in MVPA.

Interplay between adolescent physical activity and life satisfaction: gender as potential effect modifier

OBJECTIVES

Recently, adolescents fall short of adequate physical activity (PA) requirements, though the benefits of active lifestyle are well documented. In this study, we analyzed how the PA is associated with life satisfaction among adolescent girls and boys.

METHODS

Data for this study were collected in April-June 2018 during the international HBSC survey in Lithuania (n = 4191, aged 13.9 ± 1.69 years). From self-report questionnaire, the indicators reflecting PA, life satisfaction, body image, somatic complaints, wellbeing, demographic, and socioeconomic status were analyzed. Bivariate analysis used Chi-squared test, multivariate associations-logistic regression method.

RESULTS

Moderate-to-vigorous PA was sufficient among 18% of schoolchildren, while 66% of respondents met vigorous PA requirements. For boys vigorous PA can be regarded as the predictor of better life satisfaction (OR = 1.63, p < 0.05), while for girls the moderate-to-vigorous PA is observed as a risk factor for lower life satisfaction at borderline significance (OR = 0.67, p = 0.053).

CONCLUSIONS

Addressing the PA and life satisfaction interplay, we identify essential differences between genders. Schools, parents, and policy makers should enable the adolescents with more opportunities and equipment for vigorous rather than moderate-to-vigorous PA.

Ten Research Priorities Related to Youth Sport, Physical Activity, and Health

Background: Sport has been identified as one of the 7 best investments for increasing physical activity levels across the life span. Several questions remain on how to effectively utilize youth sport as a strategy for increasing physical activity and improving health in youth. The purpose of this paper is to identify the main research priorities in the areas of youth sport and physical activity for health.Methods: An international expert panel was convened, selected to cover a wide spectrum of topics related to youth sport. The group developed a draft set of potential research priorities, and relevant research was scoped. Through an iterative process, the group reached consensus on the top 10 research priorities.Results: The 10 research priorities were identified related to sport participation rates, physical activity from sport, the contribution of sport to health, and the overall return on investment from youth sport. For each research priority, the current evidence is summarized, key research gaps are noted, and immediate research needs are suggested.Conclusion: The identified research priorities are intended to guide researchers, policymakers, and practitioners to increase the evidence base on which to base the design, delivery, and policies of youth sport programs to deliver health benefits.

Physical activity and dietary habits of older children and adolescents in Germany - Cross-sectional results of the 2017/18 HBSC study and trends

Numerous findings are known to exist between dietary habits, physical activity, and child and adolescent health. Here, we will use data from the most recent Health Behaviour in School-aged Children (HBSC) study to describe dietary habits and patterns of physical activity. Using the survey data for 11-, 13- and 15-year-old students from across Germany, we report findings for key indicators of diet and physical activity for the 2017/18 cycle. By comparing these findings with data from the 2009/10 and 2013/14 survey cycles, we also consider current trends. Results from the most recent cycle show that 10.0% of girls and 16.9% of boys meet the World Health Organization's (WHO) physical activity recommendations. Across all HBSC cycles, this is the lowest figure so far. Concerning dietary habits, 50.6% of girls and 59.0% of boys reported having breakfast every morning. Data for daily fruit, vegetable and soft drink consumption emphasises the need to promote a healthy diet among adolescents. For all indicators of physical activity and diet, differences between girls and boys are apparent. Girls' intake of fruit and vegetables is higher and they consume fewer soft drinks, yet boys are more physically active and have breakfast more regularly. For the majority of indicators of dietary habits and physical activity, considerable inequalities relating to family affluence are observed. An important implication of the study results for dietary habits and physical activity of older children and adolescents is the need to foster settings-based approaches to promote physical activity and a healthy diet that integrate a gender-sensitive perspective.

Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions

In the early twenty-first century, societies around the world are facing the paradoxal epidemic development of PCa as a non-communicable disease. PCa is the most frequently diagnosed cancer for men in several countries such as the USA. Permanently improving diagnostics and treatments in the PCa management causes an impressive divergence between, on one hand, permanently increasing numbers of diagnosed PCa cases and, on the other hand, stable or even slightly decreasing mortality rates. Still, aspects listed below are waiting for innovate solutions in the context of predictive approaches, targeted prevention and personalisation of medical care (PPPM / 3PM).A.PCa belongs to the cancer types with the highest incidence worldwide. Corresponding economic burden is enormous. Moreover, the costs of treating PCa are currently increasing more quickly than those of any other cancer. Implementing individualised patient profiles and adapted treatment algorithms would make currently too heterogeneous landscape of PCa treatment costs more transparent providing clear "road map" for the cost saving.B.PCa is a systemic multi-factorial disease. Consequently, predictive diagnostics by liquid biopsy analysis is instrumental for the disease prediction, targeted prevention and curative treatments at early stages.C.The incidence of metastasising PCa is rapidly increasing particularly in younger populations. Exemplified by trends observed in the USA, prognosis is that the annual burden will increase by over 40% in 2025. To this end, one of the evident deficits is the reactive character of medical services currently provided to populations. Innovative screening programmes might be useful to identify persons in suboptimal health conditions before the clinical onset of metastasising PCa. Strong predisposition to systemic hypoxic conditions and ischemic lesions (e.g. characteristic for individuals with Flammer syndrome phenotype) and low-grade inflammation might be indicative for specific phenotyping and genotyping in metastasising PCa screening and disease management. Predictive liquid biopsy tests for CTC enumeration and their molecular characterisation are considered to be useful for secondary prevention of metastatic disease in PCa patients.D.Particular rapidly increasing PCa incidence rates are characteristic for adolescents and young adults aged 15-40 years. Patients with early onset prostate cancer pose unique challenges; multi-factorial risks for these trends are proposed. Consequently, multi-level diagnostics including phenotyping and multi-omics are considered to be the most appropriate tool for the risk assessment, prediction and prognosis. Accumulating evidence suggests that early onset prostate cancer is a distinct phenotype from both aetiological and clinical perspectives deserving particular attention from view point of 3P medical approaches.

Isotemporal substitution of sedentary behavior for physical activity on cardiorespiratory fitness in children and adolescents

Both sedentary behavior (SB) and physical activity (PA) are associated with cardiorespiratory fitness (CRF) and independent of each other. Due to the limited time during school for children and adolescents, it is necessary to explore the isotemporal substitution of SB for PA on CRF.A total 536 eligible participants selected from the 7 traditional administrative regions of China were included in this study. The outcome was CRF, determined using a 20-meter shuttle run test, and exposures were SB, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured with accelerometers. We analyzed the cross-sectional associations of substituting SB with LPA, MVPA, and combinations of LPA and MVPA with CRF, using an isotemporal substitution model.Reallocating SB into MVPA was associated with higher CRF for male (P < .01) and female (P < .01) children and female adolescents (P < .05). In the mixed redistribution, the ratio of LPA to MVPA for male children and female adolescents started from 16:4 and 14:6, respectively, tended toward improvements in CRF. For female children, regardless of the ratio of LPA to MVPA, it was always associated with higher CRF.Reallocating SB into MVPA isotemporally was positively associated with CRF for male and female children and female adolescents but not for male adolescents. MVPA is the key factor to improve CRF when combinations of LPA and MVPA replace SB. The combined approach can provide basis for the selection of target and monitoring variables in intervention studies, and has more flexible choices for improving CRF that are more consistent with the daily PA habits of children and adolescents.

Association between Club Sports Participation and Physical Fitness across 6- to 14-Year-Old Austrian Youth

Changes in social and built environments most likely contribute to a decline in physical activity (PA) and physical fitness in children and adolescents. Organized sports may be an important component in ensuring adequate fitness, which is an important aspect in general health and well-being. The present study examines differences by club sports participation in cardiorespiratory endurance, muscular strength, power, speed, agility, flexibility and balance in 3293 (55.1% male) Austrian children and adolescents between 6 and 14 years of age. Anthropometric measurements (height and weight) were taken and participants completed the German motor test during regular class time. Even though there was no significant difference in body weight between club sports participants and non-club sports participants, club sports participation was associated with higher physical fitness, particularly regarding endurance, strength, power, and agility. Differences by club sports participation, however, declined during the elementary school years (6-10 years of age), while they became more pronounced during middle school years (10-14 years of age). Club sports participation, therefore, may be a viable option in the promotion of physical fitness, particularly during adolescence. At younger ages, other sources of PA, such as physical education and free play, however, should be considered to ensure sufficient fitness levels that contribute to a healthy and active lifestyle.