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Since various dance teaching systems have attracted much attention with the development of Artificial Intelligence (AI) technology, this paper improves the recognition performance of Latin dance teaching systems by optimizing the action recognition model. Firstly, the object detection and action recognition technology under the current AI technology is analyzed, and the Two-stage object detection algorithm and One-stage object detection algorithm are evaluated. Secondly, the technologies and functions contained in the adolescent health Latin dance teaching system are described, including image acquisition, feature extraction, object detection, and action recognition. Finally, the action recognition algorithm is optimized based on object detection, and the rationality and feasibility of the proposed algorithm are verified by experiments. The experimental results show that the optimization algorithm can search the optimal feature subset after five iterations on Undefine Classes of 101 (UCF101) dataset, but it needs seven iterations on Human Motion Database 51 (HMDB51) dataset. Meanwhile, when using support vector machine classifier, the optimization algorithm can achieve the highest accuracy of motion recognition. Regressive Function, Multinomial Naive Bayes and Gaussian Naive Bayes Algorithms have lower prediction delay, as low as 0.01s. Therefore, this paper has certain reference significance for the design and implementation of adolescent health Latin dance teaching system. [ABSTRACT FROM AUTHOR]

Background: Since the early 2000s, there have been marked trends in adolescent health and wellbeing indicators across Europe, North America and Australia. In particular, there have been substantial declines in youth drinking. We know little about how these trends are underpinned by co-occurring indicators within individuals. This paper aims to analyse change over time in how indicators cluster within individuals and differences in these patterns between five countries with different trends in youth drinking., Methods: We analysed four waves of repeat cross-sectional survey data from 15-year-olds in England (n = 5942), Italy (n = 5234), the Netherlands (n = 5408), Hungary (n = 5274), and Finland (n = 7446), which were included in the Health Behaviours in School-aged Children (HBSC) study between 2001/02 and 2013/14. We defined clusters of individuals using multigroup latent class analyses which accounts for change over time. The class indicators included health behaviours, attitudes, wellbeing and relationships. We modelled associations between class membership, sex, and family affluence over time., Results: We identified four classes in all countries: Overall unhealthy, Overall healthy, Moderately healthy and Substance abstainers with behaviour risk indicators. The proportion of adolescents in the Overall unhealthy class declined between 2001/02 and 2013/14 by between 22.8 percentage points (pp) in England and 3.2pp in Italy. The extent to which indicators of health and wellbeing changed as linked clusters differed across countries, but changes in alcohol consumption, smoking, drug use and sexual activity were typically concurrent. Adolescents with low family affluence were more likely to be in the Overall unhealthy class in all years., Conclusions: Improvements in indicators of adolescent health and well-being are due mainly to concurrent declines in drinking, smoking, sexual activity, and cannabis use, but these declines are not consistently associated with improvements in other domains. They have also not led to reductions in inequalities in indicators of health and well-being., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Stevely et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The increasing prevalence of mental health difficulties amongst adolescents is a worldwide concern. Poor mental health in adolescence is associated with a range of mental, physical and social problems in later life. In sub-Saharan Africa, limited data suggests that mental disorders amongst adolescents are common. It is important that interventions to address this are rooted in an understanding of the unique local context and culture. Yet, the current use, development, and effectiveness of adolescent mental health interventions in sub-Saharan Africa is unclear. In response, this paper presents a protocol for two scoping reviews that together will examine the available evidence on promotive, preventive, and treatment interventions for adolescent mental health in sub-Saharan Africa. Methods and analysis: The scoping reviews will follow the five-step methodological framework proposed by Arksey and O'Malley, with further recommendations from the Joanna Briggs Institute. They will review scientific and grey literature published between 2000 and 2021, without restrictions in language or study type. A wide range of sources, including MEDLINE, CINAHL, Global Health, PsychINFO, Cochrane and Google Scholar will be searched. Eligibility screening and data extraction will be done by two independent reviewers, and disagreements resolved by a third reviewer. Data will be summarised in two phases. A narrative synthesis will provide a descriptive profile of all studies included and will explore key concepts related to intervention types, target populations and adaptations to local context. A systematic review element will collate evidence of intervention effectiveness from (cluster) Randomised Controlled Trials. Discussion and dissemination: To the best of our knowledge, these scoping reviews are the first to synthesise a wide range of available evidence on promotive, preventive and treatment interventions for adolescent mental health in sub-Saharan Africa. The results will be published in peer-reviewed publications and will be presented as an evidence base for future intervention development and implementation. [ABSTRACT FROM AUTHOR]

Obesity, along with its associated health issues, is closely tied to lifestyle habits. While certain elements affecting childhood health, such as genetics and ethnicity, are beyond individuals' control, there exists modifiable lifestyle behaviours that can facilitate healthier living. This study employed multiple regression analysis to investigate the relationship between specific modifiable lifestyle behaviours and self-reported health. The independent variables considered included days of moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, breakfast frequency, school night sleep duration, and non-school night sleep duration. These variables were chosen for their practical modifiability within participants' daily lives. The analysis revealed a highly significant overall model (F(13,11363) = 191.117, p <.001), explaining 17.9% of the variance in self-reported health. Notably, higher MVPA levels were associated with improved self-reported health (B = 0.136 to 0.730, p <.001). Additionally, regular breakfast consumption and increased fruit and vegetable intake exhibited positive associations with self-reported health (B = 0.113 to 0.377, p <.001), while girls reported lower self-reported health (B = -0.079, p <.001). School night sleep duration was positively linked to self-reported health (B = 0.071, p <.001). Furthermore, a dose-response relationship between MVPA, dietary habits, and health was identified. These findings hold substantial potential for public health campaigns to promote healthy behaviours and prevent chronic diseases in young individuals. It is imperative to emphasise that all the variables considered in this study are readily modifiable aspects of individuals' lives, offering a promising avenue for personal health and well-being enhancement. [ABSTRACT FROM AUTHOR]

Background: To understand the impact of COVID-19 on implementation of the peer education programme of the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK); repurposing of the RKSK health workers and Peer Educators (PEs) in COVID-19 response activities and effect on adolescents´ health and development issues. Methods: Virtual in-depth interviews were conducted with stakeholders (n = 31) (aged 15 to 54 years) engaged in the implementation of the RKSK and peer education programme at state, district, block, and village levels in Madhya Pradesh and Maharashtra (India). These interviews were thematically coded and analysed to address the research objectives. Results: Despite most peer education programme activities being stopped, delayed, or disrupted during the pandemic and subsequent lockdown, some communication networks previously established, helped facilitate public health communication regarding COVID-19 and RKSK, between health workers, PEs, and adolescents. There was repurposing of RKSK health workers and PEs' role towards COVID-19 response-related activities. PEs, with support from health workers, were involved in disseminating COVID-19 information, maintaining migrant and quarantine records, conducting household surveys for recording COVID-19 active cases and providing essential items (grocery, sanitary napkins, etc.) to communities and adolescents. Conclusion: PEs with support from community health workers are able to play a crucial role in meeting the needs of the communities during a pandemic. There is a need to further engage, involve and build the skills of PEs to support the health system. PEs can be encouraged by granting more visibility and incorporating their role more formally by paying them within the public health system in India. [ABSTRACT FROM AUTHOR]

Background: Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Objectives: Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Design: Systematic overview of systematic reviews. Methods: Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews. Results: From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Conclusions: Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence. Protocol registry number: CRD42013003538, PROSPERO [ABSTRACT FROM AUTHOR]

Background: While school-aged children in low- and middle-income countries remain highly exposed to acute infections, programs targeting this age group remain limited in scale and scope. In this paper, we evaluate the impact of a new and comprehensive primary school-based health intervention program on student-reported morbidity and anthropometric outcomes in Lusaka, Zambia., Methods: A prospective matched control study identified 12 classes in 7 schools for the intervention and 12 classes in 7 matched schools as controls. Teachers in intervention schools were trained to deliver health lessons and to refer sick students to care. In addition, vitamin A and deworming medication were biannually administered to intervention students. The primary study outcome was student-reported morbidity. Secondary outcomes were weight, height, health knowledge, and absenteeism. Multivariable linear and logistic regression models were used to estimate program impact., Results: 380 students ages 4-16 were enrolled in the study in 2015, and 97% were followed up at endline in 2016. The intervention decreased the adjusted odds of self-reported acute illnesses by 38% (95% CI: 0.48, 0.77) and the adjusted odds of stunting by 52% (95% CI: 0.26, 0.87). It also increased health knowledge by 0.53 standard deviations (95% CI: 0.24, 0.81). No impact was found on weight (adjusted mean difference β = 0.17, 95% CI: - 1.11, 1.44) and student absenteeism (adjusted odds ratio (aOR) = 0.89, 95% CI: 0.60, 1.33)., Conclusion: The results presented in this paper suggest that comprehensive school-based health programs may offer a highly effective way to improve students' health knowledge as well as their health status. Given their low cost, a more general adoption and implementation of such programs seems recommendable., Trial Registration: ClinicalTrials.gov Identifier: NCT03607084., Competing Interests: The authors have declared that no competing interests exist.

Background: Routine health check-ups may improve adolescent health, but global guidelines are lacking. Phase 1 of the WHO-coordinated Y-Check Research Programme involved three African cities to co-produce a programme of adolescent health check-ups. We describe a systematic approach to developing a routine adolescent health check-ups and wellbeing programme (Y-Check) to contribute evidence on whether adolescent health check-ups should be part of routine health services in Ghana. Methods: Y-Check Phase 1 was conducted in four communities in Cape Coast Ghana, over two stages using a variety of methods: (a) needs assessment and landscape analysis on the health of adolescents (existing policies/programmes, school system, adolescent health conditions) was conducted through desk-review and interviews with key informants to identify the potential content, delivery strategy and settings for adolescent health check-ups in this context; (b) co-designing the Y-Check intervention framework through person-centred participatory workshops and a consensus-building workshop with multiple stakeholders, including adolescents (10–19 years) and their parents. The study was conducted between January 2020 and October 2020. Results: The Y-Check intervention consists of two check-ups with content that is tailored to the needs of younger adolescents and older adolescents; delivered at both school and community settings by a team of trained staff in multiple steps involving up to four stations. Y-Check includes a referral system for adolescents with any problems that cannot be investigated or treated on-the-spot. Conclusions: Our systematic approach to co-producing Y-Check has resulted in an intervention whose content and structure is determined by the local context, and which was adjudged by multiple stakeholders to be likely to be both useful and acceptable, and which builds on best practice. As a logical next step, the Y-Check will be subjected to pilot testing and implementation research to rigorously evaluate the feasibility, acceptability, coverage, yield of previously undiagnosed conditions and cost of these health check-ups. [ABSTRACT FROM AUTHOR]

Background: In order to gain a deeper understanding of the relationship between physical activity and adolescent mental health in the post COVID-19 pandemic era, self-esteem and social anxiety were used as mediating variables to explore the potential mechanisms by which physical activity affects adolescent mental health. Methods: The study used the HELP-II Health Promoting Lifestyle Scale, the SPIN Social Phobia Scale, the Self-Esteem Scale, and the 10-item Kessler Psychological Distress Scale to administer questionnaires to 400 Chinese secondary school students, and SPSS 26.0 and PROCESS 3.3 were used to process the data. Results: The findings showed that (1) physical activity was significantly and positively associated with mental health; (2) self-esteem and social anxiety played a fully mediating role between physical activity and adolescent mental health respectively; (3) self-esteem and social anxiety played a chain mediating role between physical activity and adolescent mental health. Conclusion: This study reveals the relationship and influencing mechanism between physical activity and adolescent mental health in the post COVID-19 pandemic era. Appropriate interventions for physical activity, self-esteem, and social anxiety may be beneficial to adolescent mental health. The protective role of self-esteem in adolescent mental health should be the focus of future studies, and further investigations into the association between the COVID-19 and adolescent mental health are warranted. [ABSTRACT FROM AUTHOR]

Adolescents with HIV (AWH) face the double burden of dealing with challenges presented by their developmental phase while coping with stigma related to HIV, affecting their mental health. Poor mental health complicates adherence to daily treatment regimens, requiring innovative psychosocial support strategies for use with adolescents. We assessed the effectiveness of a mindfulness and acceptance-based intervention on the mental health of AWH in Uganda. One hundred and twenty-two AWH, mean age 17 ±1.59 (range 15 to 19 years), 57% female, receiving care at a public health facility in Kampala were enrolled in an open-label randomized trial (ClinicalTrials.gov: NCT05010317) with assessments at pre-and post-intervention. The mindfulness and acceptance-based intervention involved weekly 90-minute group sessions for four consecutive weeks facilitated by two experienced trainers. Sessions involved clarifying values, skillfully relating to thoughts, allowing and becoming aware of experiences non-judgmentally, and exploring life through trial and error. The control group received the current standard of care. Three mental health domains (depression, anxiety, and internalized stigma) were compared between the intervention and control groups. A linear mixed effects regression was used to analyze the effect of the intervention across the two time points. Results showed that the intervention was associated with a statistically significant reduction in symptoms of depression (β = -10.72, 95%CI: 6.25, -15.20; p <.0001), anxiety (β = -7.55, 95%CI: 2.66, -12.43; p =.0003) and stigma (β = -1.40, 95%CI: 0.66 to -2.15; p =.0004) over time. Results suggest that mindfulness and acceptance-based interventions have the potential to improve the mental health of AWH. [ABSTRACT FROM AUTHOR]

Background & aims: Emphasis on adolescent HIV has increased worldwide as antiretroviral treatment has greatly extended life expectancies of HIV-positive children. Few evidence-based guidelines exist on the optimal time to disclose to an adolescent living with HIV (ALHIV); little is known about the medical effects of disclosure. This study looked to determine whether disclosure is associated with improved medical outcomes in ALHIV. Prior work has tended to be qualitative, cross-sectional, and with an emphasis on psychosocial outcomes. This paper addresses the adolescent cohort retrospectively (longitudinally), building upon what is already known about disclosure. Methods: Retrospective, longitudinal clinical record reviews of ALHIV seen at Kericho District Hospital between April 2004 and November 2012 were performed. Patient demographics and clinical outcomes were systematically extracted. The student’s t-test was used to calculate changes in mean CD4 count, antiretroviral therapy (ART), and cotrimoxazole adherence pre- vs. post-disclosure. Linear regression modelling assessed for trends in those clinical outcomes associated with age of disclosure. Results: Ninety-six ALHIV (54 female, 42 male) were included; most (73%) entered care through the outpatient department. Nearly half were cared for by parents, and 20% experienced a change in their primary caregiver. The mean time in the study was 2.47 years; mean number of visits 10.97 per patient over the mean time in the study. Mean disclosure age was 12.34 years. An increase in mean ART adherence percentage was found with disclosure (0.802 vs. 0.917; p = 0.0015). Younger disclosure age was associated with significantly higher mean CD4 counts over the course of the study (p = 0.001), and a nonsignificant trend toward a higher mean ART adherence percentage (p = 0.055). Conclusion: ART adherence and improved immunologic status are both associated with disclosure of HIV infection to adolescent patients. Disclosure of an HIV diagnosis to an adolescent is an important means to improve HIV care. [ABSTRACT FROM AUTHOR]

Background: Preconception health provides an opportunity to examine a woman's health status and address modifiable risk factors that can impact both a woman's and her child's health once pregnant. In this review, we aimed to investigate the preconception risk factors and interventions of early pregnancy and its impact on adverse maternal, perinatal and child health outcomes. Methods: We conducted a scoping review following the PRISMA-ScR guidelines to include relevant literature identified from electronic databases. We included reviews that studied preconception risk factors and interventions among adolescents and young adults, and their impact on maternal, perinatal, and child health outcomes. All identified studies were screened for eligibility, followed by data extraction, and descriptive and thematic analysis. Findings: We identified a total of 10 reviews. The findings suggest an increase in odds of maternal anaemia and maternal deaths among young mothers (up to 17 years) and low birth weight (LBW), preterm birth, stillbirths, and neonatal and perinatal mortality among babies born to mothers up to 17 years compared to those aged 19–25 years in high-income countries. It also suggested an increase in the odds of congenital anomalies among children born to mothers aged 20–24 years. Furthermore, cancer treatment during childhood or young adulthood was associated with an increased risk of preterm birth, LBW, and stillbirths. Interventions such as youth-friendly family planning services showed a significant decrease in abortion rates. Micronutrient supplementation contributed to reducing anaemia among adolescent mothers; however, human papillomavirus (HPV) and herpes simplex virus (HSV) vaccination had little to no impact on stillbirths, ectopic pregnancies, and congenital anomalies. However, one review reported an increased risk of miscarriages among young adults associated with these vaccinations. Conclusion: The scoping review identified a scarcity of evidence on preconception risk factors and interventions among adolescents and young adults. This underscores the crucial need for additional research on the subject. [ABSTRACT FROM AUTHOR]

Research into the role of identity orientations (the relative importance an individual places on different personal and social attributes and characteristics when defining her or his identity) in adolescent mental health is extremely limited. Furthermore, the potential mechanisms that might explain the associations between identity orientations and adolescent mental health are poorly understood. This study protocol describes a one-year longitudinal study across three time points to be initiated with the purpose of investigating the mediating role of basic psychological needs satisfaction and frustration in the relationship between identity orientations and various mental health indicators in adolescence. We aim to recruit a large sample of Serbian adolescents (N = 2,000 at Time 1), using a two-stage stratified random sampling. The data will be analyzed using the random intercept cross-lagged panel model (RI-CLPM), and the results will be contrasted with the traditional CLPM. The goal of this study is to make a theoretical contribution to research in the fields of identity, self-determination theory, and adolescent mental health, as well as to provide insights towards the development of evidence-based recommendations for creating prevention and promotion programs aimed at improving the well-being of adolescents. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders among adolescents is on the rise globally. Patients seldom present to mental health physicians, for fear of stigmatization, and due to the dearth of mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to identify the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. Methods: A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana, who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. Results: Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). Conclusion: Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help to reduce stigmatization and improve the management of the disease thus, reducing the burden. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the inequitable impacts of the ongoing COVID-19 pandemic on youth mental health are leading priorities. Existing research has linked income inequality in schools to adolescent depression, however, it is unclear if the onset of the pandemic exacerbated the effects of income inequality on adolescent mental health. The current study aimed to quantify the association between income inequality and adolescent mental health during COVID-19. Material and methods: Longitudinal data were taken from three waves (2018/19 to 2020/21) of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) school-based study. Latent Growth Curve modelling was used to assess the association between Census District (CD)-level income inequality and depressive symptoms before and after the onset of COVID-19. Results: The study sample included 29,722 students across 43 Census divisions in British Columbia, Alberta, Ontario, and Quebec. The average age of the sample at baseline was 14.9 years [standard deviation (SD) = 1.5] and ranged between 12 and 19 years of age. Most of the sample self-reported as white (76.3%) and female (54.4%). Students who completed the COMPASS survey after the onset of COVID reported 0.20-unit higher depressive scores (95% CI = 0.16, 0.24) compared to pre-COVID. The adjusted analyses indicated that the association between income inequality on anxiety scores was strengthened following the onset of COVID-19 (β = 0.02, 95% CI = 0.0004, 0.03), indicating that income inequality was associated with a greater increase in anxiety scores during COVID-19. Discussion: The adjusted results indicate that the association between income inequality and adolescent anxiety persisted and was heightened at the onset of COVID-19. Future studies should use quasi-experimental methods to strengthen this finding. The current study can inform policy and program discussions regarding the effects of the COVID-19 pandemic and pandemic recovery for young Canadians and relevant social policies for improving adolescent mental health. [ABSTRACT FROM AUTHOR]

Numerous studies have documented a strong intergenerational transmission of educational attainment. In explaining this transmission, separate fields of research have studied separate mechanisms. To obtain a more complete understanding, the current study integrates insights from the fields of behavioural sciences and genetics and examines the extent to which paternal involvement and children's polygenic score (PGS) are unique underlying mechanisms, correlate with each other, and/or act as important confounders in the intergenerational transmission of fathers' educational attainment. To answer our research questions, we use rich data from The National Longitudinal Study of Adolescent to Adult Health (n = 4,579). Firstly, results from our mediation analyses showed a significant association between fathers' educational attainment and children's educational attainment (0.303). This association is for about 4 per cent accounted for by paternal involvement, whereas a much larger share, 21 per cent, is accounted for by children's education PGS. Secondly, our results showed that these genetic and behavioural factors are significantly correlated with each other (correlations between 0.06 and 0.09). Thirdly, we found support for genetic confounding, as adding children's education PGS to the model reduced the association between paternal involvement and children's educational attainment by 11 per cent. Fourthly, evidence for social confounding was almost negligible (the association between child's education PGS and educational attainment was only reduced by half of a per cent). Our findings highlight the importance of integrating insights and data from multiple disciplines in understanding the mechanisms underlying the intergenerational transmission of inequality, as our study reveals that behavioural and genetic influences overlap, correlate, and confound each other as mechanisms underlying this transmission. [ABSTRACT FROM AUTHOR]

Introduction: Cultural adaptation of a school-based mental health intervention developed in a high-income country is a cost-effective method to address the mental health needs of adolescents in resource-constrained settings. The aim of this study was to translate and culturally adapt the Resourceful Adolescent Program for Adolescents (RAP-A) for adolescents attending high school in Vietnam. Methods: The translation and adaptation were conducted using a five-step process including (1) initial stakeholder consultation, (2) forward translation, (3) backward translation, (4) adaptation, and (5) finalising the adapted version. An adaptation panel was established, including the RAP-A authors and mental health and public health experts from Australia, and psychology and public health experts from Vietnam. The panel collaborated closely with a group of stakeholders, including bilingual psychologists and psychiatrists, high school (grades 10–12) students and teachers throughout the adaptation process. Results: The adapted version of RAP-A was named 'Happy House'. Happy House was adapted to be delivered in larger groups and in longer sessions than the RAP-A. The 11 sessions in RAP-A were restructured to 6 sessions in Happy House. Major changes were not required for any of the materials. However, some content, illustrations and videos were adapted to be more feasible for the school context and to enhance the comprehensibility, acceptability and appropriateness. Conclusion: Happy House has great potential to be relevant, comprehensible and acceptable for Vietnamese adolescents. Further research is warranted to examine the relevance, comprehensibility, acceptability, and effectiveness of this program on adolescents' mental health before advocating for scaling up program delivery in high schools throughout Vietnam. [ABSTRACT FROM AUTHOR]

Background: India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15–19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15–19) in India during 1990–2006. Methods and Findings: Data from three rounds of the National Family Health Survey of India conducted during 1992–93, 1998–99, and 2005–06 were analyzed. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends were applied, respectively, to understand the trend in the proportion of adolescent mothers utilizing select maternity care services during 1990–2006. Using pooled multivariate logistic regression models, the probability of select maternal healthcare utilization among women by key socioeconomic characteristics was appraised. After adjusting for potential socio-demographic and economic characteristics, the likelihood of adolescents accessing full antenatal care increased by only 4% from 1990 to 2006. However, the probability of adolescent women availing themselves of professional attendance at delivery increased by 79% during the same period. The study also highlights the desolate disparities in maternity care services among adolescents across the most and the least favoured groups. Conclusion: Maternal care interventions in India need focused programs for rural, uneducated, poor adolescent women so that they can avail themselves of measures to delay child bearing, and for better antenatal consultation and delivery care in case of pregnancy. This study strongly advocates the promotion of a comprehensive ‘adolescent scheme’ along the lines of ‘Continuum of Maternal, Newborn and Child health Care’ to address the unmet need of reproductive and maternal healthcare services among adolescent women in India. [ABSTRACT FROM AUTHOR]

Child and adolescent mental health services (CAMHS), especially inpatient units, have arguably never been more in demand and yet more in need of reform. Progress in psychotherapy and more broadly in mental health care is strongly predicted by the therapeutic relationship between professional and service user. This link is particularly pertinent in child and adolescent mental health inpatient services where relationships are especially complex and difficult to develop and maintain. This article describes a qualitative exploration of the lived experienced of 24 participants (8 young people, 8 family members/carers and 8 nursing staff) within inpatient CAMHS across four sites in the UK. We interviewed participants individually and analysed the transcripts using thematic analysis within a critical realist framework. We synthesised data across groups and present six themes, encapsulating the intricacies and impact of therapeutic relationships; their development and maintenance: Therapeutic relationships are the treatment, Cultivating connection, Knowledge is power, Being human, The dance, and It's tough for all of us in here. We hope these findings can be used to improve quality of care by providing a blueprint for policy, training, systemic structures and staff support. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate in the changes in the percentage of adolescents who brush their teeth twice a day and the association with socio-economic status and health behaviors between 2006, 2010 and 2014 among adolescents from the French cross-sectional studies of the Health Behavior in School-aged Children (HBSC) survey. Methods: Our sample included 18727 adolescents aged 11, 13 or 15 years old (y/o). The relationship between toothbrushing frequency (TBF) and eating habits, health and socio-economic status markers, family status, school perception, substance use, sedentary lifestyle and physical activity, together with their evolution over the 3 studies, were investigated using multivariate logistic regression. Results: The proportion of adolescents brushing twice a day increased from 68.8% in 2006 to 70.8% in 2010 and 78.8% in 2014 (p<0.0001). Notable associated factors (p<0.0001) were: being a girl (adjusted Odds Ratio = 1.5) and, even more, an older girl (aOR 1.5 for 15 y/o vs 11 y/o girls), having breakfast (aOR 1.4) and eating fruits daily (aOR 1.6), excellent perceived health (aOR 1.2), obesity or overweight (aOR 0.6), being bullied at school (aOR 0.8), and perceived family wealth (aOR 1.4 for High vs Low). No impact from any associated factor changed over the 3 studies. Conclusions: Among French adolescents, TBF improved from 2006 to 2014. TBF was significantly associated with other health behaviors. These associations stayed similar in 2006, 2010 and 2010. This increase in TBF may be linked with global prevention programs developed during this time period. These programs should be maintained and associated with more specific ones targeting and adapted to disadvantaged populations, in order to reduce inequalities in oral hygiene and oral health. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the effectiveness of the first 6 months of a 24 month multidisciplinary intervention program including circuit training and a balanced diet in children and adolescents with obesity. Methods: A quasi-experimental intervention trial included 242 participants (age [mean±standard deviation]: 11.3±2.06 years, 97 girls) of at least 85th percentile of age- and sex-specific body mass index (BMI). Participants were grouped into three to receive usual care (usual care group), exercise intervention with circuit training (exercise group), or intensive nutritional and feedback intervention with a balanced diet (nutritional group). Primary outcome was BMI z-score, while secondary outcomes included body composition, cardiometabolic risk markers, nutrition, and physical fitness. Results: Among the participants, 80.6% had a BMI ≥ the 97th percentile for age and sex. The BMI z-score of the overall completers decreased by about 0.080 after 6 months of intervention (p < 0.001). After the intervention, both exercise and nutritional groups had significantly lower BMI z-scores than the baseline data by about 0.14 and 0.075, respectively (p < 0.05). Significant group by time interaction effects were observed between exercise versus usual care group in BMI z-score (β, -0.11; 95% confidence interval (CI), -0.20 to -0.023) and adiponectin (β, 1.31; 95% CI, 1.08 to 1.58); and between nutritional versus usual care group in waist circumference (β, -3.47; 95% CI, -6.06 to -0.89). No statistically significant differences were observed in any of the other secondary outcomes assessed. Conclusion: Multidisciplinary intervention including circuit training and a balanced diet for children and adolescents with obesity reduced the BMI z-score and improved cardiometabolic risk markers such as adiponectin and waist circumference. [ABSTRACT FROM AUTHOR]

Background: In the World Health Organization Western Pacific Region (WHO WPRO), most adolescents enroll in secondary school. Safe, healthy and nurturing school environments are critical for adolescent health and development. Yet, there were no systematic reviews found on the efficacy of school-based interventions among adolescents living in low and middle income countries (LMIC) in the Region. There is an urgent need to identify effective school-based interventions and facilitating factors for successful implementation in adolescent health in WPRO. Methods: For this systematic review, we used five electronic databases to search for school-based interventions to promote adolescent health published from January 1995 to March 2019. We searched RCT and non-RCT studies among adolescents between 10 to 19 years old, done in LMIC of WHO WPRO, and targeted health and behaviour, school environment and academic outcomes. Quality of studies, risk of bias and treatment effects were analyzed. Effective interventions and implementation approaches were summarized for consideration in scale-up. Results: Despite a broad key term search strategy, we identified only eight publications (with 18,774 participants). Most of the studies used knowledge, attitudes and behaviours as outcome measures. A few also included changes in the school policy and physical environment as outcome measures while only one used BMI, waist circumference and quality of life as their outcome measures. The topics in these studies included: AIDS, sexual and reproductive health, de-worming, nutrition, obesity, tobacco use, and suicide. Some interventions were reported to be successful in improving knowledge, attitudes and behaviours, but their impact and scale were limited. The interventions used by the different studies varied from those that addressed a single action area (e.g. developing personal skills) or a combination of action areas in health promotion, e.g. developing a health policy, creating a supportive environment and developing personal skills. No intervention study was found on other important issues such as screening, counseling and developing safe and nurturing school environments. Conclusions: Only eight school-based health interventions were conducted in the Region. This study found that school-based interventions were effective in changing knowledge, attitudes, behaviors, healthy policies and environment. Moreover, it was clarified that policy support, involving multiple stakeholders, incorporating existing curriculum, student participation as crucial factors for successful implementation. [ABSTRACT FROM AUTHOR]

Background: Adolescents aged 10–19 represent one sixth of the world’s population and have a high burden of morbidity, particularly in low-resource settings. We know little about the potential of community-based peer facilitators to improve adolescent health in such contexts. Methods: We did a systematic review of peer-facilitated community-based interventions for adolescent health in low- and middle-income countries (LMICs). We searched databases for randomised controlled trials of interventions featuring peer education, counselling, activism, and/or outreach facilitated by young people aged 10–24. We included trials with outcomes across key areas of adolescent health: infectious and vaccine preventable diseases, undernutrition, HIV/AIDS, sexual and reproductive health, unintentional injuries, violence, physical disorders, mental disorders and substance use. We summarised evidence from these trials narratively. PROSPERO registration: CRD42016039190. Results: We found 20 studies (61,014 adolescents). Fourteen studies tested interventions linked to schools or colleges, and 12 had non-peer-facilitated components, e.g. health worker training. Four studies had HIV-related outcomes, but none reported reductions in HIV prevalence or incidence. Nine studies had clinical sexual and reproductive health outcomes, but only one reported a positive effect: a reduction in Herpes Simplex Virus-2 incidence. Three studies had violence-related outcomes, two of which reported reductions in physical violence by school staff and perpetration of physical violence by adolescents. Seven studies had mental health outcomes, four of which reported reductions in depressive symptoms. Finally, we found eight studies on substance use, four of which reported reductions in alcohol consumption and smoking or tobacco use. There were no studies on infectious and vaccine preventable diseases, undernutrition, or injuries. Conclusions: There are few trials on the effects of peer-facilitated community-based interventions for adolescent health in LMICs. Existing trials have mixed results, with the most promising evidence supporting work with peer facilitators to improve adolescent mental health and reduce substance use and violence. [ABSTRACT FROM AUTHOR]

Background: While links between intimate-partner violence (IPV) and HIV risk have been established, less is known about violence perpetrated by people other than intimate partners. In addition, much of the research on IPV has been conducted with adults, while relatively little is known about violence experienced by adolescent girls and young women (AGYW). We examined experiences of sexual violence and associated sexual and mental health among AGYW in Kenya and Zambia. Methods: Using cross-sectional surveys with women aged 15–24 years, we assessed experience of partner sexual violence among respondents who reported a boyfriend/husband in the last 12 months (Kenya N = 597; Zambia N = 426) and non-partner sexual violence among all respondents (Kenya N = 1778; Zambia N = 1915). We conducted logistic regression analyses to examine experiences of sexual violence and health outcomes. Results: Sexual violence from intimate partners over the last year was reported by 19.1 percent of AGYW respondents in Kenya and 22.2 percent in Zambia; sexual violence from non-partners was reported by 21.4 percent in Kenya and 16.9 percent in Zambia. Experience of sexual violence was associated with negative health outcomes. Violence from non-partners was associated with increased odds of STI symptoms and increased levels of anxiety and depression. Results were similar for violence from partners, although only significant in Kenya. While sexual violence from a non-partner was associated with increased HIV risk perception, it was not associated when the violence was experienced from an intimate partner. Conclusions: AGYW reported high levels of sexual violence from both intimate partners and non-partners. These experiences were associated with negative health outcomes, though there were some differences by country context. Strengthening sexual violence prevention programs, increasing sexual violence screening, and expanding the provision of post-violence care are needed to reduce intimate and non-partner violence and the effects of violence on AGYW. [ABSTRACT FROM AUTHOR]

This study explores the relationship between the perceived physical literacy (PL) and physical activity (PA) levels of Hong Kong adolescents by using a cross-sectional study design. A total of 1,945 adolescents aged between 12 and 18, (1,028 male and 917 female) with a mean age of 14.98 (±1.65 years), took part in this study. A Perceived Physical Literacy Instrument (PPLI) and an International Physical Activity Questionnaire for Adolescents (IPAQ-A) were distributed to the participants within the first 15 minutes of PE lessons at their schools. The correlation between perceived PL and PA levels was low but significant (r = 0.227, p < 0.01), as was the correlation between the attributes of PL and PA intensity and the domains of PA (r = 0.067–0.292, p < 0.01). A significant linear equation was computed (F (3, 1941) = 35.679, p < 0.01), with an R2 of 0.052. The metabolic equivalent (MET) minutes representing participants’ predicted PA levels were –5490 + 366.1 (sense of self and self-confidence) + 221.866 (self-expression and communication with others) + 287.748 (knowledge and understanding). Looking at individual factors, the correlation between perceived PL and PA levels showed no significant difference across gender (r male = 0.234; r female = 0.198) but showed a significant difference across grade level (r junior = 0.302; r senior = 0.197), school bands (r band 1 = 0.31; r band 2 = 0.263; r band 3 = 0.191) and socio-economic status (SES) (rlow = 0.225; rmedium = 0.35; rhigh = 0.191). The relationship between perceived PL and PA levels was significantly low but was closely related to the recreational PA, including individual factors such as gender, grade levels, school band and SES. Future studies could focus on school-based PA intervention programmes for perceived PL and the relationship between perceived PL and objective PA levels. [ABSTRACT FROM AUTHOR]

Introduction: Total volumes of physical activity and sedentary behaviour have been associated with cardio-metabolic risk profiles; however, little research has examined whether patterns of activity (e.g., prolonged bouts, frequency of breaks in sitting) impact cardio-metabolic risk. The aim of this review was to synthesise the evidence concerning associations between activity patterns and cardio-metabolic risk factors in children and adolescents aged 5–19 years. Materials and methods: A systematic search of seven databases was completed in October 2017. Included studies were required to report associations between objectively-measured activity patterns and cardio-metabolic risk factors in children and/or adolescents, and be published between 1980 and 2017. At least two researchers independently screened each study, extracted data, and undertook risk of bias assessments. Results: From the 15,947 articles identified, 29 were included in this review. Twenty-four studies were observational (cross-sectional and/or longitudinal); five were experimental. Ten studies examined physical activity patterns, whilst 19 studies examined sedentary patterns. Only one study examined both physical activity and sedentary time patterns. Considerable variation in definitions of activity patterns made it impossible to identify which activity patterns were most beneficial to children’s and adolescents’ cardio-metabolic health. However, potential insights and current research gaps were identified. Discussion and conclusion: A consensus on how to define activity patterns is needed in order to determine which activity patterns are associated with children’s and adolescents’ cardio-metabolic risk. This will inform future research on the impact of activity patterns on children’s and adolescents’ short- and longer-term health. [ABSTRACT FROM AUTHOR]

Objective: This study’s aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities. Methods: We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003–2006, follow-up: 2009–2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models. Results: We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents’ health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower. Conclusions: Because the direct effects of family structure on adolescents’ health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents’ health, prevention programmes and interventions should be directed towards the parent–adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition. [ABSTRACT FROM AUTHOR]

Background: Mortality from acute bacterial meningitis (ABM) in sub-Saharan African adults and adolescents exceeds 50%. We tested if Goal Directed Therapy (GDT) was feasible for adults and adolescents with clinically suspected ABM in Malawi. Materials and methods: Sequential patient cohorts of adults and adolescents with clinically suspected ABM were recruited in the emergency department of a teaching hospital in Malawi using a before/after design. Routine care was monitored in year one (P1). In year two (P2), nurses delivered protocolised GDT (rapid antibiotics, airway support, oxygenation, seizure control and fluid resuscitation) to a second cohort. The primary endpoint was composite mean number of clinical goals attained. Secondary endpoints were individual goals attained and death or disability from proven or probable ABM at day 40. Results: 563 patients with suspected ABM were enrolled in the study; 273 were monitored in P1; 290 patients with suspected ABM received GDT in P2. 61% were male, median age 33 years and 90% were HIV co-infected. ABM was proven or probable in 132 (23%) patients. GDT attained more clinical goals compared to routine care: composite mean number of goals in P1 was 0·55 vs. 1·57 in P2 GDT (p<0·001); Death or disability by day 40 from proven or probable ABM occurred in 29/57 (51%) in P1 and 38/60 (63%) in P2 (p = 0·19). Conclusion: Nurse-led GDT in a resource-constrained setting was associated with improved delivery of protocolised care. Outcome was unaffected. Trial registration: [ABSTRACT FROM AUTHOR]

Trust in government agencies plays a key role in advancing these organizations' agendas, influencing behaviors, and effectively implementing policies. However, few studies have examined the extent to which individuals are aware of and trust the leading United States agencies devoted to protecting the public’s health. Using two national samples of adolescents (N = 1,125) and adults (N = 5,014), we examined demographic factors, with a focus on vulnerable groups, as correlates of awareness of and trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and the federal government. From nine different weighted and adjusted logistic regression models, we found high levels of awareness of the existence of the FDA and CDC (ranging from 55.7% for adolescents’ awareness of the CDC to 94.3% for adults’ awareness of the FDA) and moderate levels of trust (ranging from a low of 41.8% for adults’ trust in the federal government and a high of 78.8% for adolescents’ trust of the FDA). In the adolescent and adult samples, awareness was higher among non-Hispanic Blacks and respondents with low numeracy. With respect to trust, few consistent demographic differences emerged. Our findings provide novel insights regarding awareness and trust in the federal government and specific United States public health agencies. Our findings suggest groups to whom these agencies may want to selectively communicate to enhance trust and thus facilitate their communication and regulatory agendas. [ABSTRACT FROM AUTHOR]

Pesticide-exposed adolescents may have a higher risk of neurotoxic effects because of their developing brains and bodies. However, only a limited number of studies have addressed this risk among adolescents. The aim of this study was to compare neurological outcomes from two cohorts of Egyptian adolescents working as pesticide applicators. In 2005 and 2009, two cohorts of male adolescents working as pesticide applicators for the cotton crop were recruited from Menoufia Governorate, Egypt. The same application schedule and pesticides were used at both times, including both organophosphorus, and pyrethroid compounds. Participants in both cohorts completed three neurobehavioral tests, health and exposure questionnaires, and medical and neurological screening examinations. In addition, blood samples were collected to measure butyryl cholinesterase (BChE) activity. Pesticide applicators in both cohorts reported more neurological symptoms and signs than non-applicators, particularly among participants in the 2005 cohort (OR ranged from 1.18 to 15.3). Except for one test (Trail Making B), there were no significant differences between either applicators or non-applicators of both cohorts on the neurobehavioral outcome measures (p > 0.05). The 2005 cohort showed greater inhibition of serum BChE activity than the 2009 cohort (p < 0.05). In addition, participants with depressed BChE activity showed more symptoms and signs than others without BChE depression (p < 0.05). Our study is the first to examine the consistency of health outcomes associated with pesticide exposure across two cohorts tested at different times from the same geographical region in rural Egypt. This similar pattern of findings across the two cohorts provides strong evidence of the health impact of exposure of adolescents to pesticides. [ABSTRACT FROM AUTHOR]

Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis. [ABSTRACT FROM AUTHOR]

Introduction: haemophilia is an inherited bleeding disorder caused by a deficiency in one of the blood coagulation factors. For people affected by severe haemophilia, the deficiency can cause spontaneous internal bleeding. Most young people with severe haemophilia in the UK follow a preventative treatment regimen (prophylaxis) consisting of several intravenous injections of factor concentrate each week. There is good evidence that prophylaxis reduces bleeds whilst also improving quality of life. However, levels of adherence among young people with haemophilia reported in the existing literature vary widely and are predominately based on estimations made by healthcare professionals and parents. Additionally, drivers of (non)adherence among young people specifically have not been evidenced. Aim: to assess self-reported adherence among young people with haemophilia, provide evidence of psychosocial predictors of adherence, and to establish the associations between non-adherence and number of bleeds and hospital visits. Methods: 91 participants were recruited during outpatient appointments in 13 haemophilia centres across England and Wales, and invited to complete a questionnaire assessing self-reported adherence (VERITAS-Pro), Haemophilia-related pain and impact of pain, Illness Perceptions, Beliefs about Medications, Self-efficacy, Outcome expectations, Positive and Negative Affect, and Social support. Number of hospital visits and bleeds during the previous six months were collected from medical files. Results: Of 78 participants with complete data, just 18% had scores indicating non-adherence. Psychosocial predictors differed between intentional (skipping) and un-intentional (forgetting) non-adherence. Overall, however, better adherence was reported where participants perceived the need for prophylaxis was greater than their concern over taking it as well as having a positive expectancy of its effectiveness, good social support and a stronger emotional reaction to having haemophilia. Conclusion: The findings indicate that adherence is generally good, and that assessing illness and treatment beliefs, social support and outcome expectations may play a valuable role in identifying which individuals are at risk of non-adherence. Interventions aimed at improving adherence should particularly consider improving social support, reducing patients’ concerns about prophylaxis, increasing their belief in the necessity of prophylaxis, and increasing positive outcome expectations. [ABSTRACT FROM AUTHOR]

Background: Polyunsaturated n-3 and n-6 polyunsaturated fatty acids (PUFA) are precursors of biologically active metabolites that affect blood pressure (BP) regulation. This study investigated the association of n-3 and n-6 PUFA and BP in children and adolescents. Methods: In a subsample of 1267 children aged 2–9 years at baseline of the European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cohort whole blood fatty acids were measured by a validated gas chromatographic method. Systolic and diastolic BP was measured at baseline and after two and six years. Mixed-effects models were used to assess the associations between fatty acids at baseline and BP z-scores over time adjusting for relevant covariables. Models were further estimated stratified by sex and weight status. Results: The baseline level of arachidonic acid was positively associated with subsequent systolic BP (β = 0.08, P = 0.002) and diastolic BP (β = 0.07, P<0.001). In thin/normal weight children, baseline alpha-linolenic (β = -1.13, P = 0.003) and eicosapentaenoic acid (β = -0.85, P = 0.003) levels were inversely related to baseline and also to subsequent systolic BP and alpha-linolenic acid to subsequent diastolic BP. In overweight/obese children, baseline eicosapentaenoic acid level was positively associated with baseline diastolic BP (β = 0.54, P = 0.005). Conclusions: Low blood arachidonic acid levels in the whole sample and high n-3 PUFA levels in thin/normal weight children are associated with lower and therefore healthier BP. The beneficial effects of high n-3 PUFA on BP were not observed in overweight/obese children, suggesting that they may have been overlaid by the unfavorable effects of excess weight. [ABSTRACT FROM AUTHOR]

In this study, we aimed to assess the effectiveness of a school-based home-collaborative lifestyle education program for adolescents (PADOK) in reducing poor subjective psychosomatic symptoms (SPS). The study was designed as a two-armed parallel cluster randomised controlled trial and the study population comprised adolescent students (aged 12–14 years, n = 1,565) who were recruited from 19 middle schools in Japan. The PADOK intervention or usual school programme was provided in schools to all eligible participants. The primary outcome was the SPS score at 6 months, while secondary outcomes included lifestyle factors, BMI, and dietary intakes. Analyses were undertaken on an intention to treat (ITT) basis accounting for the clustered design. Nineteen schools were randomised to the PADOK group (10 schools) and control group (9 schools). The numbers of students used for analysis were 1,509 for ITT and 1,420 (94.1%) for PPS. At 6 months, the crude mean change from baseline of the SPS scores by ITT analysis showed a significantly greater reduction in the PADOK group compared to that in the control group (−0.95, 95% CI −1.70 to −0.20, P = 0.016), while those for baseline-adjusted and multivariate-adjusted values showed similar directionality but were not significant (P = 0.063 and P = 0.130). The results indicated that the PADOK program may improve poor SPS scores among adolescents. [ABSTRACT FROM AUTHOR]

Background: The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. Methods: We conducted a longitudinal survey of adolescents (10–18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of ‘cash’ (economic provision) and ‘care’ (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. Findings: Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys’ hunger and girls’ school dropout. For tuberculosis, and for boys’ sexual exploitation and girls’ mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. Interpretation: National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development. [ABSTRACT FROM AUTHOR]

Although several health-risk behaviors of adolescents have been described in the literature, data of high school students who reside at educational institutions in developing countries are scarce. This study aimed to describe behaviors associated with health risks among high school students who reside at an educational public institution and to associate these variables with the length of stay at the institution. This cross-sectional study was conducted during the year 2015 and included 122 students aged 14–19 years at a federal educational institution in the Midwest of Brazil; students were divided into residents of <8 months and those of >20 months. Information concerning the family socioeconomic status and anthropometric, dietary and behavioral profiles was investigated. Despite being physically active, students exhibited risk-associated behaviors such as cigarette and alcohol use and risky sexual behaviors that were exacerbated by fragile socioeconomic conditions and distance from family. A longer time in residence at the institution was associated with an older age (p ≤ 0.001), adequate body mass index (BMI; p = 0.02), nutritional knowledge (p = 0.01), and less doses of alcohol consumption (p ≤ 0.01) compared with those with shorter times in residence. In conclusion, the students exhibited different health-risk behaviors, and a longer institutional residence time, compared with a shorter time, was found to associate with the reduction of health-risk behaviors. [ABSTRACT FROM AUTHOR]

To compare the effects of high-load, low-repetition maximum (LRM) and low-load, high-repetition maximum (HRM) resistance training regimens on muscular fitness in untrained adolescents. Forty-five untrained adolescents of both sexes (13.7±0.8 years; 161.3±7.5 cm, 56.8±13.4 kg) were randomly assigned into one of three groups: 1) LRM (n = 17): volunteers performed three sets of 4-6-repetition maximum (RM); 2) HRM (n = 16): volunteers performed three sets of 12–15 RM; and 3) control (CON, n = 12). Training was performed two times a week for 9 weeks. After training, there were significant increases in 1 RM chest press (LRM = 14.8% and HRM = 14.2%, p<0.05) and squat (LRM = 26.4% and HRM = 25.7%, p<0.05), with no differences between the LRM and HRM groups (p>0.05). Additionally, muscular endurance increased significantly for the chest press (LRM = 14.5% and HRM = 21.8%, p<0.05) and squat test (LRM = 31.4% and HRM = 32.4%, p<0.05) following resistance training, with no difference between the LRM and HRM groups (p>0.05). These results suggest that both high-load, low-repetition and moderate-load, high-repetition resistance training can be prescribed to improve muscular fitness in untrained adolescents. [ABSTRACT FROM AUTHOR]

Background: Low-volume high-intensity interval training holds promise for cardiometabolic health promotion in adolescents, but sustainable interventions must be practical and engaging. We examined the effect of a school-based multi-activity low-volume high-intensity interval training intervention on adolescents’ cardiometabolic health. Methods: In an exploratory controlled before-and-after design, 101 adolescents (mean age ± standard deviation [SD] 14.0 ± 0.3 years) were recruited from four schools; two were designated as intervention sites (n = 41), and two as control (n = 60). The intervention comprised 4 to 7 repetitions of 45 s maximal effort exercise (basketball, boxing, dance and soccer drills) interspersed with 90-s rest, thrice weekly for 10 weeks. Outcomes were non-fasting blood lipids and glucose, waist circumference, high sensitivity C-reactive protein, resting blood pressure, physical activity, twenty-metre shuttle-run test performance and carotid artery intima-media thickness. The difference in the change from baseline (intervention minus control) was estimated for each outcome. Using magnitude-based inferences, we calculated the probability that the true population effect was beneficial, trivial, and harmful against a threshold for the minimum clinically important difference of 0.2 between-subject SDs. Results and Discussion: Mean (± SD) attendance for the intervention (expressed as percentage of available intervention sessions [n = 30]) was 77 ± 13%. Post-intervention, there were likely beneficial effects for triglycerides (-26%; 90% confidence interval -46% to 0%), waist circumference (-3.9 cm; -6.1 cm to -1.6 cm) and moderate-to-vigorous physical activity (+16 min; -5 to 38 min), and a possibly beneficial effect for twenty-metre shuttle-run test performance (+5 shuttles; -1 to 11 shuttles) in intervention participants (vs controls). The role of elevated triglycerides and waist circumference in cardiovascular disease and metabolic syndrome development underlines the importance of our findings. We also demonstrated that school-based low-volume high-intensity interval training can be delivered as intended, thus representing a novel and scalable means of improving aspects of adolescents’ cardiometabolic health. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Social context, specifically within the family, influences adolescent eating behaviours and thus their health. Little is known about the specific mechanisms underlying the effects of parental feeding practices on eating. We explored relationships between parental feeding practices and adolescent eating habits and brain activity in response to viewing food images. Fifty- seven adolescents (15 with type 2 diabetes mellitus, 21 obese and 21 healthy weight controls) underwent fMRI scanning whilst viewing images of food or matched control images. Participants completed the Kids Child Feeding Questionnaire, the Childrens’ Dutch Eating Behaviour Questionnaire (DEBQ) and took part in an observed meal. Parents completed the Comprehensive Feeding Practices Questionniare and the DEBQ. We were particularly interested in brain activity in response to food cues that was modulated by different feeding and eating styles. Healthy-weight participants increased activation (compared to the other groups) to food in proportion to the level of parental restriction in visual areas of the brain such as right lateral occipital cortex (LOC), right temporal occipital cortex, left occipital fusiform gyrus, left lateral and superior LOC. Adolescents with type 2 diabetes mellitus had higher activation (compared to the other groups) with increased parental restrictive feeding in areas relating to emotional control, attention and decision-making, such as posterior cingulate, precuneus, frontal operculum and right middle frontal gyrus. Participants with type 2 diabetes mellitus also showed higher activation (compared to the other groups) in the left anterior intraparietal sulcus and angular gyrus when they also reported higher self restraint. Parental restriction did not modulate food responses in obese participants, but there was increased activity in visual (visual cortex, left LOC, left occipital fusiform gyrus) and reward related brain areas (thalamus and parietal operculum) in response to parental teaching and modelling of behaviour. Parental restrictive feeding and parental teaching and modelling affected neural responses to food cues in different ways, depending on motivations and diagnoses, illustrating a social influence on neural responses to food cues. [ABSTRACT FROM AUTHOR]

Objective: Executive function, impulsivity, and intelligence are correlated markers of cognitive resource that predict health-related behaviours. It is unknown whether executive function and impulsivity are unique predictors of these behaviours after accounting for intelligence. Methods: Data from 6069 participants from the Avon Longitudinal Study of Parents and Children were analysed to investigate whether components of executive function (selective attention, attentional control, working memory, and response inhibition) and impulsivity (parent-rated) measured between ages 8 and 10, predicted having ever drunk alcohol, having ever smoked, fruit and vegetable consumption, physical activity, and overweight at age 13, after accounting for intelligence at age 8 and childhood socioeconomic characteristics. Results: Higher intelligence predicted having drunk alcohol, not smoking, greater fruit and vegetable consumption, and not being overweight. After accounting for intelligence, impulsivity predicted alcohol use (odds ratio = 1.10; 99% confidence interval = 1.02, 1.19) and smoking (1.22; 1.11, 1.34). Working memory predicted not being overweight (0.90; 0.81, 0.99). Conclusions: After accounting for intelligence, executive function predicts overweight status but not health-related behaviours in early adolescence, whilst impulsivity predicts the onset of alcohol and cigarette use, all with small effects. This suggests overlap between executive function and intelligence as predictors of health behaviour in this cohort, with trait impulsivity accounting for additional variance. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate the simultaneous presence of risk factors for non-communicable diseases and the association of these risk factors with demographic and economic factors among adolescents from southern Brazil. Methods: The study included 916 students (14–19 years old) enrolled in the 2014 school year at state schools in São José, Santa Catarina, Brazil. Risk factors related to lifestyle (i.e., physical inactivity, excessive alcohol consumption, smoking, sedentary behaviour and unhealthy diet), demographic variables (sex, age and skin colour) and economic variables (school shift and economic level) were assessed through a questionnaire. Simultaneous behaviours were assessed by the ratio between observed and expected prevalences of risk factors for non-communicable diseases. The clustering of risk factors was analysed by multinomial logistic regression. The clusters of risk factors that showed a higher prevalence were analysed by binary logistic regression. Results: The clustering of two, three, four, and five risk factors were found in 22.2%, 49.3%, 21.7% and 3.1% of adolescents, respectively. Subgroups that were more likely to have both behaviours of physical inactivity and unhealthy diet simultaneously were mostly composed of girls (OR = 3.03, 95% CI = 1.57–5.85) and those with lower socioeconomic status (OR = 1.83, 95% CI = 1.05–3.21); simultaneous physical inactivity, excessive alcohol consumption, sedentary behaviour and unhealthy diet were mainly observed among older adolescents (OR = 1.49, 95% CI = 1.05–2.12). Subgroups less likely to have both behaviours of sedentary behaviour and unhealthy diet were mostly composed of girls (OR = 0.58, 95% CI = 0.38–0.89); simultaneous physical inactivity, sedentary behaviour and unhealthy diet were mainly observed among older individuals (OR = 0.66, 95% CI = 0.49–0.87) and those of the night shift (OR = 0.59, 95% CI = 0.43–0.82). Conclusion: Adolescents had a high prevalence of simultaneous risk factors for NCDs. Demographic (gender and age) and economic (school shift) variables were associated with the most prevalent simultaneous behaviours among adolescents. [ABSTRACT FROM AUTHOR]

Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC) of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs) among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10) students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989) were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC) to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833–0.857) and girls (AUC: 0.763, 95% CI: 0.731–0.795). The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile) and ≥70.7 cm for girls (77th percentile). Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65–5.17) compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77th percentile; the 90th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents’ height, weight and WC should be measured as a standard practice in routine health checkups. [ABSTRACT FROM AUTHOR]

Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents’ visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12–16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents’ behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents’ home or school may stimulate physical activity, if adolescents also experience a safe and familiar social environment. [ABSTRACT FROM AUTHOR]

Optimal nutrition is essential for healthy growth during adolescence. This study aims to investigate the baseline nutritional intake of Malaysian adolescents by gender, body mass index, and places of residence, both urban and rural. A cohort study was conducted consisting of 794 adolescents (aged 13-years) attending 15 public secondary schools from the Central (Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular Malaysia. Qualified dietitians conducted a 7-day historical assessment of habitual food intakes. Facilitated by flipcharts and household measurement tools, detailed information on portion sizes and meal contents were recorded. Nutritionist Pro™ Diet Analysis software was also used to analyze the dietary records.The mean age of the adolescents was 12.86 ± 0.33 y; the mean energy intake was 1659.0 ± 329.6 kcal/d. Males had significantly (P < .001) higher energy intake than females (1774.0 ± 369.8 vs 1595.2 ± 320.6 kcal/d); adolescents in rural schools consumed more energy and cholesterol (P < .001) compared to adolescents in urban schools (1706.1 ± 377.7 kcal/d and 244.1 ± 100.2 mg/d, respectively). Obese adolescents in rural schools consumed more energy and sugar (1987.6 ± 374.0 kcal/d and 48.9 ± 23.0 g/d) (p-value <0.001).The dietary intake of normal weight versus obese adolescents differs by the location of their school. Thus, the implementation of a structured and tailored intervention is recommended to help minimize this nutritional inequality. [ABSTRACT FROM AUTHOR]

This study aims to examine the associations between BMI, disordered eating attitude, body dissatisfaction in female adolescents, and descriptive attributes assigned to silhouettes of varying sizes in male and female adolescents, aged 11 to 15, in rural South Africa. Height and weight were measured to determine BMI. Age and sex-specific cut-offs for underweight and overweight/obesity were determined using the International Obesity Task Force cut-offs. Body image satisfaction using Feel-Ideal Discrepancy (FID) scores, Eating Attitudes Test-26 (EAT-26), and perceptual female silhouettes were collected through self-administered questionnaires in 385 adolescents from the Agincourt Health and Socio-Demographic Surveillance System (HSDSS). Participants self-reported their Tanner pubertal stage and were classified as early pubertal (< = Tanner stage 2), and mid to post pubertal (Tanner stage > 2). Mid to post pubertal boys and girls were significantly heavier, taller, and had higher BMI values than their early pubertal counterparts (all p<0.001). The prevalence of overweight and obesity was higher in the girls than the boys in both pubertal stages. The majority (83.5%) of the girls demonstrated body dissatisfaction (a desire to be thinner or fatter). The girls who wanted to be fatter had a significantly higher BMI than the girls who wanted to be thinner (p<0.001). There were no differences in EAT-26 scores between pubertal groups, within the same sex, and between boys and girls within the two pubertal groups. The majority of the boys and the girls in both pubertal groups perceived the underweight silhouettes to be “unhappy” and “weak” and the majority of girls in both pubertal groups perceived the normal silhouettes to be the “best”. These findings suggest a need for policy intervention that will address a healthy body size among South African adolescents. [ABSTRACT FROM AUTHOR]

Background: Ferritin is associated with various cardiometabolic risk factors such as dyslipidemia, hypertension, obesity, and insulin resistance in adults. We aimed to study the association between serum ferritin levels and dyslipidemia in adolescents, because dyslipidemia is considered an important modifiable cardiovascular risk factor in the young. Methods: We analyzed 1,879 subjects (1,026 boys and 853 girls) from the 2009–2010 Korean National Health and Nutrition Examination Survey IV. Subjects were categorized into quartiles according to their lipid parameters, which were classified according to age and gender. Those in the highest quartile groups for total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations were diagnosed as having dyslipidemia. Those in the lowest quartile for high-density lipoprotein cholesterol (HDL-C) values were diagnosed with abnormal levels. Results: In boys, total cholesterol, LDL-C, and triglyceride concentrations were significantly correlated with serum ferritin levels. In both boys and girls, serum ferritin levels were negatively associated with HDL-C values, even after adjusting for all covariates. Furthermore, there was no significant correlation between serum ferritin levels and total cholesterol, LDL, and triglyceride concentrations in girls. Conclusion: Serum ferritin levels were significantly associated with major dyslipidemia parameters, more prominently in boys than in girls, and this association represents a cardiometabolic risk factor. [ABSTRACT FROM AUTHOR]

Breakfast is often considered the most important meal of the day and children and adolescents can benefit from breakfast consumption in several ways. The purpose of the present study was to describe trends in daily breakfast consumption (DBC) among adolescents across 31 countries participating in the HBSC survey between 2002 to 2010 and to identify socio-demographic (gender, family affluence and family structure) correlates of DBC. Cross-sectional surveys including nationally representative samples of 11–15 year olds (n = 455,391). Multilevel logistic regression analyses modeled DBC over time after adjusting for family affluence, family structure and year of survey. In all countries, children in two-parent families were more likely to report DBC compared to single parent families. In most countries (n = 19), DBC was associated with family affluence. Six countries showed an increase in DBC (Canada, Netherland, Macedonia, Scotland, Wales, England) from 2002. A significant decrease in DBC from 2002 was found in 11 countries (Belgium Fr, France, Germany, Croatia, Spain, Poland, Russian Federation, Ukraine, Latvia, Lithuania and Norway), while in 5 countries (Portugal, Denmark, Finland, Ireland, Sweden) no significant changes were seen. Frequency of DBC among adolescents in European countries and North America showed a more uniform pattern in 2010 as compared to patterns in 2002. DBC increased significantly in only six out of 19 countries from 2002 to 2010. There is need for continued education and campaigns to motivate adolescents to consume DBC. Comparing patterns across HBSC countries can make an important contribution to understanding regional /global trends and to monitoring strategies and development of health promotion programs. [ABSTRACT FROM AUTHOR]

We aimed to estimate the association between sleep duration trajectories and body composition in adolescents. We used data from participants of the 1993 Pelotas (Brazil) Birth Cohort Study who were later followed up at age 18 years (response rate of 81.3%). At the time, 3974 adolescents had complete data on body composition, which was assessed by air displacement plethysmography. Sleep duration was self-reported by participants at ages 11 and 18 years. Analyses were sex-stratified. The mean sleep duration at 11 years was 9.7 (SD 1.4) and 8.4 (SD 1.9) at 18 years. Sleep duration was dichotomized as inadequate (<8 hours/day) or adequate (≥8 hours/day). Mean body mass, fat mass, and fat-free mass indices at 18 years were 23.4 kg/m2 (SD 4.5), 6.1 kg/m2 (SD 3.9) and 17.3 kg/m2 (SD 2.5), respectively. Girls who reported inadequate sleep duration at 11 years of age, but adequate sleep duration at 18, on average experienced an increase in body mass index (β = 0.39 z-scores; 95% CI 0.13, 0.65), fat mass index (β = 0.30 z-scores; 95% CI 0.07, 0.53), and fat-free mass index (β = 0.24 z-scores; 95% CI 0.08, 0.39) compared to those who had adequate sleep duration at both time points. The results suggest that changes in sleep duration across adolescence may impact body composition in later adolescence and that this may differ by sex. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) is a well-known and underused protective factor for numerous health outcomes, and interventions are hampered by lack of objective data. We combined accelerometers with diaries to estimate the contributions to total activity from different domains throughout the day and week in adolescents. Methods: Accelerometric and diary data from 1403 adolescents (45% male, mean age 15.6 ± 0.5 years) were combined to evaluate daily levels and domains of sedentary, light, and moderate-to-vigorous activity (MVPA) during a typical week. Freedson’s cutoff points were applied to determine levels of activity. Total activity was broken down into school physical education (PE), school outside PE, transportation to school, sport, and other time. Results: About 2/3 of adolescents’ time was spent sedentary, 1/3 in light activity, and about 5% in MVPA. Boys and girls averaged 46 (SD 22) and 38 (23) minutes MVPA per day. Adolescents were most active during leisure sport, spending about 30% of it in MVPA, followed by PE (about 20%) transport to school (14%) and either school class time or other time (3%). PE provided 5% of total MVPA, while leisure sport provided 16% and transportation to school 8%. School was the most sedentary part of the day with over 75% of time outside PE spent sedentary. Conclusions: These German adolescents were typical of Europeans in showing low levels of physical activity, with significant contributions from leisure sport, transportation and school PE. Leisure sport was the most active part of the day, and participation did not vary significantly by sex, study center (region of Germany) or BMI. Transportation to school was frequent and thus accounted for a significant fraction of total MVPA. This indicates that even in a population with good access to dedicated sporting activities, frequent active transportation can add significantly to total MVPA. [ABSTRACT FROM AUTHOR]

Background: Few studies have addressed the influence of dietary patterns (DP) during adolescence on the amount of body fat in early adulthood. Objective: To analyze the associations between DP tracking and changes in the period between 15 and 18 years of age and the percentage of body fat (%BF) at age 18 years. Methods: We used data from 3,823 members of the 1993 Pelotas (Brazil) birth cohort. Body density was measured at age 18 years by air displacement plethysmograph (BOD POD) and the %BF was calculated applying the Siri equation. Based on the estimates from the FFQ, we identified DP at ages 15 (“Varied”, “Traditional”, “Dieting” and “Processed meats”) and 18 years (“Varied”, “Traditional”, “Dieting” and “Fish, fast food and alcohol”). The DP tracking was defined as the individual’s adherence to the same DP at both ages. Associations were tested using multiple linear regression models stratified by sex. Results: The mean %BF was 25.0% (95% CI: 24.7 to 25.4), significantly greater for girls than boys (p<0.001). The adherence to any DP at age 15 years was not associated with the %BF at age 18 years. However, individuals who adhered to a “Dieting” DP at age 18 years showed greater %BF (1.30 and 1.91 percentage points in boys and girls, respectively) in comparison with those who adhered to a “Varied” DP. Boys who presented tracking of a “Dieting” DP presented greater average %BF in comparison with others DP, as well as girls who changed from the “Traditional” or “Processed meats” DP to a “Dieting” DP. Conclusion: These results may support public health policies and strategies focused on improving dietary habits of adolescents and young adults and preventing accumulation of body fat, especially among the adolescents with restrictive dietary habits. [ABSTRACT FROM AUTHOR]