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This study analyzed associations between physical activity (PA), sedentary behaviors (SB), sleep, and mental health indicators in young adults during the COVID-19 lockdown (15 January-19 April 2021). The participants were 549 Portuguese university students (18-30 years, 57.7% male). Mental health was assessed using the DASS-21 for depression, anxiety, stress, and DASS-21 total score (DASSt). Physical activity (vigorous, moderate, walking) was measured with the IPAQ, while SB (e.g., sitting, screen time) and sleep were evaluated using self-reported measures and the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions showed that sleep quality (β = 2.116), sitting time (ST; β = 0.451), vigorous PA (VPA; β = -0.005), and computer use for work/study (β = 0.444) were significantly associated with overall mental health, DASSt ( R 2 = 0.358). Sleep quality, sitting, and VPA were also linked to depression ( R 2 = 0.308), anxiety ( R 2 = 0.275), and stress ( R 2 = 0.338). Computer use for work/study was additionally associated with anxiety and stress. Overall, poor sleep quality, increased sitting, and computer use for work/study, alongside lower VPA, showed significant associations with poorer mental health outcomes. These findings highlight the importance of sleep, PA, and limiting sedentary behaviors, particularly during lockdowns, in mitigating mental health issues among Portuguese young adults.

Introduction: The classroom environment is ideal for promoting physical activity interventions since children spend most of their day there but often engage in sedentary behavior. Given this context, an emerging trend to promote physical activity is active breaks at school. This systematic review evaluated the effects of school-based physical activity interventions involving active breaks on children and adolescents' classroom behavior, executive functions, and physical fitness., Methods: This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost. Studies published between January 2010 and August 31, 2023, including participants aged 5 to 18, were included. Interventions involving active breaks and outcomes related to classroom behavior, executive functions, and physical fitness were considered., Results: Initially, 145 studies were identified, with 22 duplicates excluded. After screening 123 articles by title and abstract, 86 were excluded. Subsequently, 37 articles underwent full-text screening, resulting in 22 included studies. Six studies showed positive effects on classroom behavior; five studies showed improvements in executive functions, and only two studies indicated increases in physical fitness., Discussion: This review suggests incorporating active breaks during school hours can improve classroom behavior in children and adolescents. However, the effects of active breaks on executive functions and physical fitness are unclear. More research is needed to fully understand the benefits of implementing active break programs in the classroom., Systematic Review Registration: PROSPERO, CRD42023448267, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023448267., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Reyes-Amigo, Salinas-Gallardo, Mendoza, Ovalle-Fernández, Ibarra-Mora, Gómez-Álvarez, Carrasco-Beltrán, Páez-Herrera, Hurtado-Almonácid, Yañez-Sepúlveda, Zapata-Lamana, Sepúlveda-Figueroa, Olivares-Arancibia and Mota.)

The present study aimed at describing and comparing the physical activity (PA) patterns of adolescents from a middle-income country over a 4-year period. This is a longitudinal observational study (four waves of data collection, 2014-2017) with 668 adolescents aged 10-13 years in 2014 (mean age of 11.8 ± 0.8 years), of both sexes (53.3% girls), from public schools in João Pessoa, Paraíba state, Brazil. PA was measured using a questionnaire and pattern operationally defined based on the following indicators: type, frequency, duration, and PA recommendations. The most practiced physical activities during the study period were active commuting, games, dancing, cycling, soccer, and futsal. There was a linear trend to a decline in the number of adolescents engaging in nearly all the physical activities, in the duration of activities and the proportion that met the PA recommendations (52.8% in 2014 to 32.2% in 2017). The adolescents engaged in different physical activities, but these declined over the years., (© 2024 The Author(s). European Journal of Sport Science published by Wiley‐VCH GmbH on behalf of European College of Sport Science.)

This study examined the associations between age, adiposity, physical activity, sedentary behavior, and elevated blood pressure (BP) in 2901 Portuguese children and adolescents aged 2-18. BP, body mass index (BMI), waist-to-height ratio (WHtR), physical activity, and sedentary behavior were measured. Elevated BP was defined as a BP above the 90th percentile for age, sex, and height. Multivariable analyses assessed the prevalence ratios (PR) of elevated BP across age groups, BMI, WHtR, physical activity, and sedentary behavior. Results showed that older age, especially among middle schoolers, was associated with a 1.8 times higher risk of elevated BP than preschoolers. Participants with a higher BMI (overweight/obese) and a WHtR ≥ 0.50 had a 1.49- and 1.4-times higher risk of elevated BP, respectively. Those who did not meet the recommended 60 min of moderate-to-vigorous physical activity (MVPA) per day showed a 1.63 times higher risk of elevated BP, whereas the association between sedentary behavior and BP was not significant after adjustment. These findings highlight age, higher BMI, central obesity, and insufficient physical activity as key factors associated with elevated BP, underscoring the need for early monitoring and intervention to prevent hypertension in this population.

Preschool children spend a large part of their day at school, and a large part of that time they spend in sedentary time. Although sedentary time negatively affects regions of the brain responsible for cognition, it is believed that the type of sedentary time performed can favor executive functions' performance. The present study explored the associations between sedentary time inside and outside preschools with executive function (EF) tasks in preschoolers. Seventy-three preschool children (60% girls; 55.0 ± 9.1 months of age) were objectively assessed for sedentary time and physical activity (PA) using accelerometers (wGT3X). EF was evaluated using the Go/No-Go paradigm through the Early Years Toolbox - YET. Go's inverse efficiency (IE) and the No-Go accuracy were analyzed. To establish possible associations between EF and sedentary time, a structural equation model was conducted after adjustments for sex, age, body mass index, and moderate-to-vigorous PA. A significant and positive association between sedentary time on weekend days and IE (b = 0.61; p  < .001) was observed. The general model explained 52% of the variation in IE and 2.1% in the accuracy of No-Go. The sedentary time on weekend days seems to be related to worse EI. This result emphasizes a context-dependent association between time being sedentary and preschoolers' EF. Further investigations should focus on exploring the type of sedentary behavior children are engaged in different contexts.

Strategies for controlling hypertension include reducing excess fat and increasing muscle mass. However, the effects of exercise interventions on hypertension in adolescents have been little investigated. The purpose was to evaluate the effect of 12 weeks of aerobic exercise on systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the cardiometabolic profile of overweight hypertensive and non-hypertensive boys. The sample included 107 boys diagnosed as overweight, aged between 12 and 17, divided into two non-hypertension groups, one control (GCN, n = 14) and one with exercise (GEN, n = 55), as well as two groups of hypertensives, one control (GCH, n = 12) and one with exercise (GEH, n = 26). The boys were assessed at the study baseline and after 12 weeks in terms of anthropometric parameters, biological maturation, SBP, DBP and mean blood pressure (MBP), lipid, and metabolic profile. The aerobic training programs lasted 12 weeks and were carried out in three weekly sessions at different intensities. The high-intensity interval training session lasted around 35 min at an intensity of 80-100% of the reserve heart rate, and the moderate-intensity of continuous training session lasted 60 min at an intensity of 35-75% of the reserve heart rate. Caloric expenditure was equivalent between the exercises (p = 0.388). CGN and CGH participated only in school physical activities. Repeated measures analysis of variance and clinical effect analysis using Cohen's effect size were used, with a significance level established at p < 0.05. After 12 weeks, all groups increased their height (p < 0.05), but only the exercise groups showed a reduction in anthropometric variables (p < 0.05), with a possibly beneficial effect in GEN (d =  - 0.203; p = 0.003). No differences were found in the variables for the GCN. The GCH and GEH groups reduced SBP (p < 0.05), but only GEH showed a reduction in DBP (p = 0.005) and MBP (p = 0.001). In relation to the lipid profile, GEH maintained HDL-c close to baseline values, while GCH showed a reduction in HDL-c (p = 0.021). Regarding the clinical effect of exercise on hypertension, GEH showed a large and very beneficial effect size on DBP (d =  - 0.916; p = 0.006) and MBP (d =  - 0.926; p = 0.005).Conclusion: Hypertensive boys who practiced physical exercise showed greater effects in reducing blood pressure, indicating the importance of non-drug therapeutic management in overweight adolescents.Trial registration:Brazilian Registry of Clinical Trials RBR-4v6h7b / RBR-6343y7., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Efforts are needed to better understand what are the effective pathways that can optimize success in school-based physical activity interventions. This study aimed to investigate the mediators of a school-based intervention in the practice of physical activity in Brazilian students. The Fortaleça sua Saúde [Strengthen Your Health] program followed 1,085 students (11-18 years) over a semester. This multi-component intervention included training teachers, offering physical activity opportunities, and health education. Self-reported moderate-to-vigorous physical activity and potential mediators (attitude, self-efficacy, social support, perceived neighborhood environment, and physical activity facilities at school) were assessed. The product of coefficient analysis was performed. The sample was composed of 1,085 students (51.5% boys). The total effect of the intervention was 0.706 (95%CI: 0.276; 1.136). A total of 40% of the intervention effect on moderate-to-vigorous physical activity was explained by attitude towards physical activity and social support from friends and teachers. Social support from friends was a significant mediator only among boys (ab: 0.113, 95%CI: 0.027; 0.256), and social support from teachers only among girls (ab: 0.135, 95%CI: 0.019; 0.328); indicating a statistically significant indirect effect of the program on moderate-to-vigorous physical activity via these mediators. A relevant part of the effect of a multicomponent intervention on physical activity among students from vulnerable areas is explained by changes via variables at different levels of the socioecological model, including social support from friends and teachers, and attitude towards physical activity. These results should be considered in public policies.

Background: It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed., Objective: The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence., Methods: A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours., Results: The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P<.001), maximal oxygen uptake (MD -1.006; P<.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P<.001), and push-up test (MD -1.920; P<.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed., Conclusions: A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared., Trial Registration: ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06164041., (©Adrián Mateo-Orcajada, Raquel Vaquero-Cristóbal, Jorge Mota, Lucía Abenza-Cano. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 30.07.2024.)

The 24-h movement guidelines for children and adolescents comprise recommendations for adequate sleep, moderate to vigorous physical activity (MVPA) and sedentary behaviour (SB). However, whether adolescents who meet these 24-h movement guidelines may be less likely to have high blood pressure (HBP) has not been established. The present study assessed the association between meeting 24-h movement guidelines and HBP in a school-based sample of 996 adolescents between 10-17 years (13.2 ± 2.4 years, 55.4% of girls). Blood pressure was measured using a digital oscillometric device, while sleep, MVPA and SB were measured using the Baecke questionnaire. The association between the 24-h movement guidelines and HBP was performed using binary logistic regression adjusted for sex, age, socioeconomic status, and body mass index. It was observed that less than 1% of the sample meet the three 24-h movement guidelines. The prevalence of HBP was lower in adolescents who meet all three movement 24-h guidelines (11.1%) compared to those who did not meet any guidelines (27.2%). Individual 24-h movement guidelines analysis showed that adolescents with adequate sleep were 35% less likely to have HBP (OR = 0.65; 95% CI 0.46-0.91). Meeting sleep guidelines combined with meeting MVPA (OR = 0.69; 95% CI 0.50-0.95) or SB (OR = 0.67; 95% CI 0.48-0.94) was inversely associated with HBP. Adolescents who meet two or three 24-h movement guidelines were respectively 47% (OR = 0.53; 95% CI 0.29-0.98) and 34% (OR = 0.66; 95% CI 0.48-0.91) less likely to have HBP. In adolescents, meeting sleep and 24-h movement guidelines were inversely associated with HBP., (© 2024. The Author(s).)

Background: The importance of movement behaviors for health is well-known, although few studies have examined the compliance with movement guidelines in preschoolers from different living contexts. This study reported the compliance with the 24-h movement behaviors guidelines among low-income Brazilian preschoolers from rural and urban areas, according to age., Methods: A total of 453 preschoolers (n = 222 urban), aged between 3 and 5 years, provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, and screen time were parent-reported. Preschoolers were classified as compliant/non- compliant with the 24-h movement guidelines, according to age. The association between prevalence of compliance with the recommendations and the children's living setting were estimated (SPSS; 27.0)., Results: Preschoolers were active (mean = 299.19 ± 76.42; and 369.76 ± 95.56 min/day in urban and rural areas, respectively), though moderate-to-vigorous physical activity (MVPA) time was below the 60 daily minutes recommended in both urban and rural settings (mean = 38.39 ± 21.36; and 47.32 ± 24.28, respectively). None of the urban children complied with the three recommendations simultaneously, while in the rural area, only 2.6% were compliant. Single movement behaviors compliances in the urban setting were 6.8%, 28.8% and 5.4% for PA, sleep, and screen time, respectively; while for rural settings were 16.5%, 21.2%, and 7.4%. Living in the rural area was related to the compliance with PA recommendation for the 5-year-old preschoolers., Conclusion: In both urban and rural Brazilian areas, very few preschoolers are compliant with the guidelines, and more than one third of the children do not comply with any of the recommendations. Strategies and programs to promote compliance with movement behaviors guidelines should consider children's living setting and their age groups., (© 2024 Wiley Periodicals LLC.)

Background and Objective: One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries., Methods: Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country., Results: Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards., Conclusions: Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Physical education classes are widely accepted as one of the most effective settings for promoting physical activity and health and have often been used to implement physical activity interventions. The aim of this pilot study was to test a physical education intervention program on physical activity levels and physical fitness in a sample of school-age children., Methods: Participants were a convenience sample of 50 children (34 experimental group and 16 in the comparative group) aged between 6 and 11 years old (Mean = 8.28 years). A 21-week intervention was implemented, consisting of high-intensity and physical fitness-focused exercises, in addition to a once-a-month extra class nutritional education. The following variables were evaluated before and post-intervention: physical fitness, sedentary behavior (SB), light physical activity (LPA), moderate physical activity (MVA), and vigorous physical activity (VPA). Propensity score analyses calculated the average treatment effect on the treated (ATET) within a quasi-experimental framework., Results: Physical fitness variables showed improvements after the intervention, specifically for agility (ATET = -0.67 s; p < 0.001), cardiorespiratory fitness (ATET = 89.27 m; p = 0.045), lower limbs power (ATET = 4.47 centimeters; p = 0.025), and speed (ATET = -1.06 s; p < 0.001). For physical activity and SB levels, there were no improvements after intervention implementation., Conclusion: The intervention program showed preliminary effectiveness to improve physical fitness of children, but not SB nor physical activity., (© 2024. The Author(s).)

Background: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners)., Methods: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs., Results: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT., Conclusions: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities., (© 2023. Crown.)

Purpose: Assessment of trends in physical activity (PA) and sedentary time (ST) is important for evaluating the effectiveness of national policies and setting goals to improve population PA. This study describes changes in measured PA and ST through motion sensors of the Portuguese population from 2008 to 2018., Methods: PA and ST were measured with accelerometry from individuals (≥10 yr) participating in the 2008 ( n = 4 532) and 2018 ( n = 6 369) Portuguese PA Surveillance Systems. Changes were analyzed using generalized linear and logistic models adjusted for accelerometer wear time. A weight factor was applied to all analyses in order to achieve national representativeness of the present results., Results: In 2018, 15.4%, 71.2%, and 30.6% of Portuguese youth, adults, and older adults met the PA recommendations. Compared with 2008, the percentage meeting the PA guidelines increased in youth females (4.7% vs 7.7%, P < 0.05) and adult males (72.2% vs 79.4%, P < 0.05). A decrease in ST was observed for adult males, whereas ST increased in all youth. Male youth decreased the number of breaks in ST (BST per hour), whereas a favorable increase was found for both adult and older adult males and females., Conclusions: PA has remained fairly stable between 2008 and 2018 for all groups, except for youth females and adult males. For ST, a favorable decrease was observed for adult males; however, an inverse trend was found in youth. These results are relevant for policy makers to develop health care policies aimed at promoting PA and reducing ST across all age-groups., (Copyright © 2023 by the American College of Sports Medicine.)

Objective: To verify whether parental physical activity and social support are associated with adolescents meeting physical activity recommendations., Methods: This is a cross-sectional study that selected 1,390 adolescents (59.6% girls) from Curitiba, Paraná, Brazil. The IPAQ (International Physical Activity Questionnaire), QAFA (Physical Activity Questionnaire for Adolescents), and ASAFA (Social Support for Physical Activity Practice in Adolescents) questionnaires were applied. Binary logistic regression was used to test the relationship among the study variables., Results: For boys, having parents who "always attend" (OR = 1.96; 95%CI: 1.16-3.32) and having parents or legal guardians who meet the PA recommendations (OR = 2.78; 95%CI: 1.76-4.38) were associated with meeting the PA recommendations. Odds were greater after adjusting for socioeconomic status (OR = 3.47; 95%CI: 1.73-6.96) and schooling level (OR = 4.20; 95%CI: 1.96-9.02). For girls, those with parents or legal guardians who "sometimes encourage them" (OR = 0.61; 95%CI: 0.37-0.98) had lower odds of meeting PA recommendations. These odds were higher after adjusting for socioeconomic status (OR = 2.11; 95%CI: 1.36-3.29) and schooling level (OR = 4.30; 95%CI: 2.41-7.69)., Conclusions: Boys and girls were more likely to meet PA recommendations daily by having parents who meet PA recommendations than by receiving parental social support. These results could help establish future interventions aimed at modifying behaviors related to PA in adolescents.

Background: The role of sociodemographic factors in the association between early sports participation (ESP) and sedentary behavior is unclear. We analyzed the association of ESP with sedentary behavior and identified the influence of sociodemographic factors in adulthood., Methods: A sample of 264 community-dwelling adults was randomly assessed (42.6 [17.0] y old, 57.6% women). Sociodemographic factors (age, gender, and socioeconomic status) and ESP (retrospectively) were assessed by questionnaire. Sedentary behavior was measured by accelerometer and self-reported for domains identification. The association between ESP and sedentary behavior domains and sociodemographic factors was analyzed by Poisson regression and presented in prevalence ratio (PR). Sociodemographic factors were separately included as covariates to identify their role in the main association analysis., Results: The ESP prevalence was 56.4% (n = 149). ESP participants included a higher proportion of men (59.7% vs 20.0%), had a lower age (36.8 [15.3] vs 50.8 [15.9]), and included a smaller proportion of individuals with low socioeconomic status (24.8% vs 43.5%) compared with those without ESP. The ESP was inversely associated with older age (PR = 0.58, P < .001 for middle aged; PR = 0.34, P < .001 for older participants), female gender (PR = 0.79, P < .001), low socioeconomic status (PR = 0.63, P = .036), and TV watching (PR = 0.67, P = .011). ESP was associated with driving (PR = 1.50, P = .028), office/paper work (PR = 1.63, P = .012), and using a cellphone (PR = 1.60, P = .009). The age was the main confounding factor of association between ESP and sedentary behavior, followed by socioeconomic status. No mediation role was identified., Conclusion: The ESP was associated with mentally active behavior domains and inversely associated with mentally passive sedentary behavior domains, but this association was majorly affected by sociodemographic factors, mainly by age.

Physical activity has been linked to higher cardiac autonomic modulation. However, it is not clear in the literature which type of intensity of physical activity (sedentary, light, moderate, or vigorous) could be related to better cardiac autonomic modulation and whether this relationship is similar in men and women. The aim of this study was to analyze the relationship between cardiac autonomic modulation and the different intensities of physical activity in men and women. The sample included 100 men and 131 women. Cardiac autonomic modulation was obtained by heart rate variability (SDNN, RMSSD, LF un, HF un, SD1, and SD2). Time spent in different intensities (sedentary, light, moderate, and vigorous intensity physical activity) was measured using a waist-worn accelerometer for seven days. Linear regression was used to verify the relationship between physical activity and cardiac autonomic modulation, considering the adjustment for age, ethnicity, and socioeconomic level. Among men, a significant relationship of moderate intensity was observed with SDNN (β = 2.442; p  = 0.021) and SD2 (β = 2.936, p  = 0.028), and of vigorous intensity with SDNN (β = 12.826, p  = 0.028), RMSSD (β = 16.370, p  = 0.018), and SD1 (β = 12.344, p  = 0.025) indices. Among women, light-intensity physical activity was significantly related with LFnu (β =  .655, p  = 0.005) and HFnu (β =  -.590, p  = 0.010) . Moderate and v igorous physical activity was associated with better cardiac autonomic modulation in men. Light physical activity was associated with lower sympathetic modulation in women.

Background: The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts., Objective: This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents., Methods: Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel., Results: There was strong between-panel agreement (panel 1: r s  = 0.76, p < 0.01; panel 2: r s  = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures"., Conclusions: The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond., (© 2022. Crown.)

Background: The lack of instruments to assess the level of physical activity in pregnant women, led to the development of the PPAQ (Pregnancy Physical Activity Questionnaire), a self-administered questionnaire, which has already been translated in several countries and has already been used in several studies., Aim(s): Translate and adapt the PPAQ into Portuguese and test its reliability and validity., Methods: An analytical observational study was carried out. Linguistic and semantic equivalence was performed through translation and back-translation and content validity was tested by a panel of experts. To test reliability, a test-retest was performed on a sample of 184 pregnant women, with an interval of 7 days and the ICC was used. To test the criterion validity, Pearson's correlation coefficient (r) was used between the PPAQ and the accelerometer, in a sample of 226 pregnant women., Findings: The questionnaire was considered comprehensive. The ICC values of Reliability were: total score (0.77); sedentary activities (0.87); light-intensity activities (0.76); moderate-intensity activities (0.76); vigorous-intensity activities (0.70). For criterion validity was obtained a coefficient correlation of r = -0.030, considered weak and negative, for total activity., Discussion: This study describes the translation and validation process of the PPAQ questionnaire from English to Portuguese. The final version of the PPAQ was considered as a valid instrument in terms of content to measure physical activity and was referred to as being simple to apply and easy to understand., Conclusion: The PPAQ has content validity, excellent reliability and weak criterion validity, as in the original version., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Santos 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.)

In recent years, the number of pregnant women with obesity has increased exponentially; thus, it is important to evaluate and characterize the physical activity levels of this specific group. The aim of this study is to evaluate the reliability and validity of the Portuguese version of the Physical Activity and Pregnancy Questionnaire and Pregnancy Questionnaire in pregnant women with obesity and to classify physical activity using the Physical Activity and Pregnancy Questionnaire and accelerometry. An analytical observational study was carried out between May and August of 2019 at the University Hospital Center of São João, with a sample of 31 pregnant women with obesity (30.9 ± 4.6 years 36.5 ± 4.6 kg/m 2 of BMI and 21.5 ± 9 gestational weeks). The physical activity of participants was evaluated using an accelerometer and Physical Activity and Pregnancy Questionnaire at two time points (the first visit at the moment of consultation and the second seven days after, with accelerometer retest), the interclass correlation coefficient was used to test reliability between the Physical Activity and Pregnancy Questionnaire filled out at visit1 and the Physical Activity and Pregnancy Questionnaire filled out at visit2, and Pearson's correlation was used to determine validity between the Physical Activity and Pregnancy Questionnaire and accelerometry. The interclass correlation coefficient values for total activity were 0.95, 0.97 for moderate and 0.58 for vigorous intensities. It ranged from 0.74 for sports/exercise to 0.96 for domestic activities. The Pearson's correlations showed that the Physical Activity and Pregnancy Questionnaire is moderately valid for moderate intensity (r = 0.435). A total of 67.7% of the pregnant women complied with international physical activity recommendations.

Background: The risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT)., Objective: The objective of the study was to evaluate the impacts of the Otago Exercise Program (OEP) plus DT cognitive activity on the risk of falling in older adults., Methods: 36 older adults (83.5 ± 5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n = 12), and a control group (CG; n=12). Older adults were evaluated at pre- and post- 12 weeks of intervention. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment., Results: At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p= 0.002; OEPG: p= 0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%)., Conclusion: Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries., Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years., Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world's population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world's population live in countries where PA promotion capacity should be significantly improved., Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5-17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions., Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country., Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally., Conclusions: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Baecke questionnaire have been widely used to assess physical activity. However, the role of educational level on validity and reliability of Baecke questionnaire is still not stablished, being a factor that can potentially influence the accuracy of self-reported measures. The present study aimed to verify the validity and reliability of Baecke questionnaire for the measurement of physical activity in community dwelling adults according to education level. The sample included 251 adults (42.4±17.0 years, 55% of women). Physical activity was self-reported by Baecke questionnaire and objectively measured by accelerometer. The education level (EL) was classified by years of study into low (<8 years), medium (8-11 years) and high (>11 years). A 7-day test-retest reliability was analyzed by intraclass correlation coefficient. The relationship, agreement and validity of the Baecke questionnaire against accelerometry were analyzed by Spearman's correlation, Kappa index, and ROC curve, respectively. The reliability of Baecke questionnaire were r = 0.97 (high EL), r = 0.78 (medium EL), and r = 0.68 (low EL). Sensitivity and specificity were 77% and 71% in high EL, 54% and 80% in medium EL and 33% and 89% in the low EL. Baecke questionnaire proved to be reliable and a valid measurement of habitual physical activity in adults with medium and high EL., Competing Interests: The authors have declared that no competing interests exist.

Objectives: We examined the associations of history and duration in high occupational physical activity (OPA) with long-term total and cause-specific mortality., Methods: The sample included 322 126 participants (135 254 women) from the National Institutes of Health-AARP Diet and Health Study, established in 1995-1996. History and duration in high OPA were reported by participants. All-cause, cardiovascular, cancer and other cause mortality records available through 31 December 2011., Results: The prevalence of high OPA was 52.1% in men and 16.1% in women. During 13.6 years (SD, 3.3) of follow-up, 73 563 participants (25 219 women) died. In age-adjusted models, the risk of death was higher among men (HR 1.14, 95% CI 1.12 to 1.16) and women (HR 1.22, 95% CI 1.18 to 1.26) with a history of high OPA. However, these associations were substantially attenuated in women (HR 1.04, 95% CI 1.00 to 1.07, an 81.8% attenuation) and eliminated in men (HR 1.02, 95% CI 0.99 to 1.04, 85.7% attenuation) after multivariable adjustments. Similar important attenuation results were found when examining duration in high OPA, as well as using cause-specific deaths as the outcomes. Educational attainment and smoking patterns were the main contributors in the excess mortality among people working in highly physically active jobs in both men and women., Conclusion: Participating in high OPA was not consistently associated with a higher mortality risk, after adjustments for education and smoking factors. Workers in high OPA should be aware that they might not be getting all well-known health benefits of being physically active if they are only very active at work., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The aim of this study was to investigate longitudinal associations between physical activity and early childhood neurodevelopment., Methods: Data from 1673 children from the 2015 Pelotas (Brazil) birth cohort study were analyzed. Physical activity was measured using accelerometers on the wrist at ages 1, 2, and 4 years. Neurodevelopment was measured using the Battelle Development Inventory at age 4 years. Linear regression models were used to test trajectories and cumulative associations of physical activity with child neurodevelopment., Results: Of the 3 physical activity trajectories observed, children in the medium (β = 1.17; 95% confidence interval, 0.25 to 2.10) and high (β = 2.22; 95% confidence interval, 0.61 to 3.82) trajectories showed higher neurodevelopment scores than children in the lower activity trajectory. Cumulative analyses showed that children in the highest tertile of physical activity in all follow-ups presented a mean neurodevelopment score 4.57 (95% confidence interval, 2.63 to 6.51) higher than children in the lowest tertile in all follow-ups. All analyses showed a dose-response characteristic of association, with higher physical activity indicating higher neurodevelopment scores., Conclusions: Physical activity may be an important predictor of neurodevelopment through early childhood.

Purpose: To systematically review the literature on the relationship between physical activity and the effect of physical training on brain-derived neurotrophic factor (BDNF) concentrations in children and adolescents., Methods: The searches were conducted in the databases: PubMed, ScienceDirect, Web of Science, Scopus, SPORTDiscus, Latin American and Caribbean Center for Science Information of Health, and SciELO. All original studies that analyzed the relationship between the practice of physical activity and the effect of physical training on plasma and serum BDNF concentrations in children and adolescents were included. The standardized mean difference (SMD), correlation coefficient (r), and 95% confidence interval were calculated., Results: Eleven studies were selected, totaling 1424 children and adolescents. Cross-sectional studies indicated a significant inverse relationship between physical activity and BDNF concentrations in boys (r = -.117 [-.222, -.009]; P = .033), but not in girls (P = .230). Adolescent athletes tend to have lower serum, but higher plasma BDNF concentrations than sedentary ones (SMD = -0.677 [0.188]; P < .001). An increase in serum BDNF was observed after physical training (SMD = 0.437 [0.183]; P = .017), with no effect in the control group (SMD = 0.235 [0.193]; P = .225)., Conclusions: Adolescent athletes tend to show lower serum, but higher plasma BDNF concentrations compared with sedentary individuals. Furthermore, physical training seems to increase serum BDNF concentrations in sedentary adolescents to a small extent.

This study aimed to analyze the relationship between cardiac autonomic modulation (CAM) and cardiovascular parameters (blood pressure and resting heart rate) in a sample of 256 adults, grouped by body mass index and sufficient moderate-to-vigorous physical activity (≥150 min/week). The sample showed different cardiovascular parameters and CAM according to body mass index, but not according to physical activity. Adults who are overweight and physically active presented higher relationship between CAM and blood pressure than those who are insufficiently active, similarly to normal weight groups. Recommended levels of physical activity may play an important role in the relationship of HRV with cardiovascular parameters in overweight adults, regardless of sex, age, socioeconomic level, and central fat. Trial registration: Registered at ClinicalTrials.gov (NCT03986879). Graphical abstract., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Introduction: This study aims to investigate the individual and combined associations of physical activity, sedentary time, diet, and sleep at baseline on cardiorespiratory fitness at 24-month follow-up in adolescents., Methods: The DADOS (Deporte, ADOlescencia y Salud) prospective cohort study was performed between 2015 and 2017. Analyses were conducted in 2020 and included 189 adolescents aged 13.9 (SD=0.3) years at baseline. Vigorous physical activity, total sedentary time, and sleep duration were evaluated by GENEActiv accelerometer. Sleep quality and adherence to a Mediterranean diet were evaluated by questionnaires. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. A healthy lifestyle index was created by including positive scores for each individual behavior, and 3 categories of achievement (≤1, 2, ≥3) were established., Results: Performing high vigorous physical activity and low screen time at baseline were individually associated with the likelihood of achieving high cardiorespiratory fitness at follow-up (OR=3.33 and 3.09, respectively). ANCOVA indicated that adolescents with a healthy lifestyle index ≥3 at baseline showed higher cardiorespiratory fitness at follow-up than those with a healthy lifestyle index of 2 and ≤1 (74.4 [SE=1.5] vs 68.9 [SE=1.4] and 67.8 [SE=1.5] laps, respectively; p<0.01). Adolescents with a healthy lifestyle index ≥3 at baseline were more likely to have high cardiorespiratory fitness at follow-up (OR=3.10) than their peers with ≤1., Conclusions: The results showed a cumulative impact of baseline health-related behaviors on cardiorespiratory fitness at 24-month follow-up in adolescents. These findings underline the key role of promoting a healthy lifestyle to improve adolescents' health., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: To examine the associations between motor competence (MC), moderate to vigorous physical activity (MVPA), and body mass index (BMI) changes over 1 year in preschoolers., Methods: Fifty-four preschoolers (24 girls; 42.4%) aged 4-5 years old from the metropolitan area of Porto, Portugal comprised the sample. Height, body mass, and BMI were calculated. MC was assessed according to the Movement Assessment Battery for Children-2. MVPA was measured by accelerometry. For each participant, changes in MVPA, MC, and BMI over a year were computed. Different levels of MC were calculated; and then data were analyzed., Results: The MVPA increased over time in all levels of MC in the follow-up. The BMI decreased over time for all levels in follow-up (P = .001). The preschoolers classified as at a high level of MC were more likely to spend more time in MVPA (in minutes) than their counterparts with low MC in follow-up. Multiple linear regression analyses, adjusted by sex and age, were fit to predict Δ% MC by Δ% MVPA and Δ% BMI. The Δ% MC was positively associated with Δ% MVPA., Conclusion: Increases in MC were positively associated with MVPA. Higher performance in MC increases due to time spent in MVPA. Improvement of MC in young children has potentially relevant policy implications related to MVPA and public health.

The objective of this study is to analyze the association between combinations of adherence to movement behaviour recommendations and fundamental movement skills (FMS) in preschoolers. This is a cross-sectional study. Participants of the study were 212 preschool children (M = 3.97 years old; 51.4% male), who provided objectively assessed physical activity (PA) data (Actigraph wGT3X), and completed FMS assessments (TGMD-2). Sleep time and screen time were parent-reported through face-to-face interview. Associations between the combination of two or three movement behaviours and FMS were analyzed using structural equation modeling (Mplus; 8.0; p < 0.05). Positive and significant associations were found between adherence to screen + sleep recommendations and locomotor skills (β = 0.23; p = 0.027); and between adherence to PA + screen + sleep recommendations with object control skills (β = 0.28; p = 0.014). Negative and significant associations were found between screen + sleep with object control skills (β = - 0.28; p = 0.007). The adherence to the 24-h movement behaviour recommendations explained locomotor and object control skills variability by 5% and 7%, respectively.Conclusion: The adherence to the combined movement behaviour recommendations may be a more important influence on FMS in preschoolers compared to any single movement behaviour in isolation. What is Known: • The association between the isolated adherence to movement behaviour (physical activity, screen time and sleep time) recommendations and fundamental movement skills (FMS) in preschoolers, and the role of the 24-h movement behaviours on FMS, has been previously reported. What is New: • This study adds important information to the current literature, when highlighting that the combined adherence to physical activity, screen time and sleep time recommendations is positively associated with object control skills (such as throwing and kicking), and the combination of screen time and sleep is positively associated with locomotor skills (such as running and hopping).

ABSTRACT Physical activity (PA) and sedentary behaviours (SB) influence health. Since most people engage in different combinations of both behaviours every day, understanding the socio-demographic characteristics of adults with distinct PA and sitting time (ST) patterns is important to contribute to evidence-based planning of public health strategies. Data from a national survey on diet and activity behaviours (IAN-AF, 2015/16) including 1724 adults (50.5% women, 18-64 years) from a representative sample of Portuguese adults was used in this study. Participants were interviewed face-to-face, and the International Physical Activity Questionnaire (IPAQ) was used. Logistic regression examined the associations between socio-demographic factors each of the four-low/high PA-ST groups. PA low/high categories were defined as in IPAQ, while ST low/high categories were defined according to ST tertiles (≤180 min/day, ≥360 min/day). A 'higher risk' behaviour pattern (low PA/high ST) was present in 37.3% of the adults and was likely associated with a middle household income, and with having 12 or more years of education. The 'lower risk' (high PA/low ST) represented 26.6% of the sample and was likely associated with middle-aged adults and with having a lower educational level. Being male, young and highly educated was related to being physically active and spending large amounts of time in ST. Besides adding to the body of mixed evidence on this theme, the identification of the socio-demographic factors associated with each PA/ST pattern will permit national public health authorities to define policies and tailored actions to promote PA and reduce ST.

Lack of physical activity is a global public health problem causing not only morbidity and premature mortality, but it is also a major economic burden worldwide. One of the cornerstones of a physically active lifestyle is Motor Competence (MC). MC is a complex biocultural attribute and therefore, its study requires a multi-sectoral, multi-, inter- and transdisciplinary approach. MC is a growing area of research, especially in children and adolescents due to its positive association with a plethora of health and developmental outcomes. Many questions, however, remain to be answered in this field of research, with regard to: (i) Health and Developmental-related Associations of MC; (ii) Assessment of MC; (iii) Prevalence and Trends of MC; (iv) Correlates and Determinants of MC; (v) MC Interventions, and (vi) Translating MC Research into Practice and Policy. This paper presents a narrative review of the literature, summarizing current knowledge, identifying key research gaps and presenting questions for future investigation on MC in children and adolescents. This is a collaborative effort from the International Motor Competence Network (IMCNetwork) a network of academics and researchers aiming to promote international collaborative research and knowledge translation in the expansive field of MC. The knowledge and deliverables generated by addressing and answering the aforementioned research questions on MC presented in this review have the potential to shape the ways in which researchers and practitioners promote MC and physical activity in children and adolescents across the world., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

This study aimed to analyze the relationship of physical activity in different domains with cardiac autonomic modulation in adults. A sample of 252 adults was randomly selected, with mean age of 42.1 (± 16.5) years, being 58% of women. Cardiac autonomic modulation was assessed through indexes of heart rate variability in time (SDNN, RMSSD) and frequency (LF, HF) domains for linear method, and by Poincaré plot for non-linear method (SD1, SD2 components). Domains of PA (occupation, sport, leisure time/commuting, and total) were assessed by Baecke's questionnaire. Variables of age, gender, socioeconomic status (questionnaire) and body mass index (objectively measures) were covariates. Occupational PA was positively related to LF (β = 2.39, 95% CI 0.24; 4.54), sports PA was positively related to SDNN (β = 3.26, 95% CI 0.18; 7.05), RMSSD (β = 4.07, 95% CI 0.31; 7.85), and SD1 (β = 2.85, 95% CI 0.11; 5.81), and leisure time/commuting PA was positively related to SDNN (β = 3.36, 95% CI 0.28; 6.70) and RMSSD (β = 3.53, 95% CI 0.46; 7.52) indexes. Total PA was related to RMSSD (β = 1.70, 95% CI 0.04; 3.72). Sports, leisure time/commuting, and total PA were related to higher parasympathetic modulation, while occupational PA was related to higher sympathetic modulation to the heart in adults.

Purpose: The 24-Hour Movement Guidelines (24 hMG) provide specific recommendations, including physical activity (PA), screen-time and sleep-duration, which preschoolers should achieve for a healthy day (24 h). The aim of the current study was to analyse preschooler's adherence with the 24-Hour Movement Guidelines., Methods: The sample comprised 739 preschool children. PA was accelerometer-derived. Screen time and sleep duration were parent-reported through questionnaires. Preschoolers were classified as meeting/not meeting in each guideline and as well as for the overall 24hMG., Results/findings: According to the 24hMG, we found high percentages of preschoolers that met sleep guidelines (80.6%), only around 1/3 of preschool children met PA (28.6%) and a lower proportion met screen-time guidelines (20.3%). We found that 31.7% of the children met at least 2 of the recommendations and that more than half only one (52.8%). Overall, 4.5% of preschool children complied with the 24hMG and 11.1% of the children did not comply with any of the three recommendations., Conclusions: Few preschoolers met PA and screen-time recommendations, which deeply impacts the preschooler's adherence to the 24hMG. Future work should focus on finding solutions for promoting better adherence and mainly identifying ways to reduce screen time and increase PA at these ages.

The present study aimed to analyze the compliance with the 24-h movement guidelines and its association with fundamental motor skills (FMS) in early childhood, considering sex and Body Mass Index (BMI) in a network perspective. Two hundred and twelve preschoolers (109 boys, 4.45 ± 0.78 years old) provided physical activity (PA), sleep duration, screen time, fundamental motor skills (FMS) and BMI data. Relationships between compliance with movement behaviors guidelines, FMS, sex and BMI were calculated using a network analysis. Only two percent of the entire sample complied with the overall 24-h movement behaviors recommendations; while the emerged network in the present study emphasized ball skills as the most critical centrality variable, according to age, reinforcing the importance of ball skills for the engagement and maintenance of PA in children. The present study presents a novel statistical and theoretical perspective that permits hitherto unseen insight into the associations between movement behavior, FMS and their correlates, that appropriately consider the inherent, multifaceted, complexity of these relationships.

Objective: To explore the associations between the eating habits of sons and daughters and the eating habits, sedentary behavior, and physical activity of their fathers and mothers., Design: A cross-sectional survey of adolescents., Setting: The 6 largest schools in Londrina, Brazil., Participants: A total of 842 adolescents, 842 mothers, and 842 fathers participated in this study., Main Outcomes Measures: Eating habits of adolescents and sedentary behavior, physical activity, and eating habits of their fathers and mothers, measured by questionnaire., Analysis: The associations were identified by binary logistic regression, adjusted by adolescent's age, family's socioeconomic status, parents' educational level, and the other parental behavior., Results: Independent of educational level and socioeconomic condition, mothers' eating behaviors seem to be more closely related to their adolescent children's eating behavior (vegetables, fruits, fried foods, soft drinks, and sweets [P = .001]) than fathers' behaviors (fried foods and sweets [P = .01], soft drinks [P = .001]). In addition, the behaviors of mothers were more associated to the behaviors of daughters than to the behaviors of sons (7 vs 5 associated behaviors), while behaviors of fathers were more associated with the behaviors of sons than to the behaviors of daughters (4 vs 2 associated behaviors). No associations were noted for sedentary and physical activity behavior and eating behaviors between adolescents and their parents., Conclusions and Implications: Many eating habits of adolescents were associated with eating habits of both fathers and mothers, emphasizing the importance of family-focused health promotion actions. Future research is needed incorporating into the analyses, among others, the nutritional statuses and the clustering of healthy and unhealthy behaviors of parents and their children., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

In Brazil, physical activity is a priority area in health promotion in the Brazilian Unified National Health System (SUS). The study aims to describe users' profiles and the barriers and facilitators in basic healthcare for participation in programs to promote physical activity. This was a statewide cross-sectional study in municipalities (counties) in Pernambuco State. Between 2 and 21 individuals were interviewed per municipality, using a previous tested instrument, validated in the following dimensions: sociodemographic; health status; participation; information on the program; reasons for participation; facilitators; barriers; and preference of activities. Descriptive and inferential analyses (chi-square) were performed. The sample consisted of 1,153 users, 35.9% of whom between 41-59 years of age; 90.1% lived in urban areas; 58.2% had participated in physical activities for at least a year. Weekly frequency of 3-4 days was 44.9%, and 71.1% practiced activities of an hour or more. The results showed that 40% of the barriers to participation in physical activity programs and 77.5% of the facilitators belonged to the intrapersonal domain. The most prevalent barrier was "current health condition" and the facilitator was the desire "to be healthier". Women perceived more barriers than men. The conclusion is that barriers and facilitators from the intrapersonal domain, related to health, are the main factors involved in users' engagement and retention in programs and interventions to promote physical activity, developed in basic healthcare services in the state of Pernambuco.

This study aimed to verify the effect of a multicomponent intervention on cardiometabolic risk factors (CMRF), and to determine the prevalence of responders on CMRF among children and adolescents with overweight/obesity. This is a quasi-experimental study, developed with 35 children and adolescents with overweight/obesity (control group (CG) = 18; intervention group (IG) = 17), aged between 7 and 13 years. Participants in IG underwent a multicomponent intervention for 12 weeks. The following variables were evaluated: anthropometric measures, maturational stages and CMRF (body fatness, HOMA-IR, triglycerides, high-density and low-density lipoprotein) (HDL-C, LDL-C), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. There was a significant time x group interaction on body fatness (p < 0.001), HOMA-IR (p = 0.01), HDL-C (p < 0.001), LDL-C (p = 0.009) and TC (p < 0.001). The prevalence of responders for CMRF in IG and CG was respectively: body fatness (47%; 0%; p = 0.04), HOMA-IR (58.8%; 16.6%; p = 0.04); triglycerides (17.6%; 5.5%; p = 0.31); HDL-C (76.4%; 5.5%; p = 0.01), LDL-C (35.3%; 5%; p = 0.08), TC (64.7%; 5%; p = 0.01), AST (5.8%; 0%; p = 0.87), ALT (29.4%; 11.1%; p = 0.24) and AST/ALT ratio (24.4%; 22.2%; p = 0.67). Multicomponent intervention induced positive changes on CMRF along with a higher prevalence of positive adaptations in IG than the CG in some of the cardiometabolic outcomes assessed.

Background: The IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents' physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability., Methods: Adolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status., Results: Final country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity., Conclusions: A robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

Background To investigate the associations between adiposity and attained height over a 2-year period in healthy adolescents. Methods One thousand and seventeen adolescents aged 12-18 years participated in this cohort study; 893 (87.8%) were reevaluated 1 year later (T2) and 734 (72.2%) subjects 2 years later (T3). Body fat and anthropometry were measured according to standardized procedures. Socioeconomic status, pubertal stage and lifestyles determinants were gathered and used as confounders. Prospective associations between adiposity and height were examined using generalized linear models. Results Greater adiposity at T1 was significantly associated with a lower attained height over time, when adjusting for confounders, which varied between 0.03 and 1 cm in T2 and 0.1 and 1 cm in T3. Conclusions Excess of adiposity in early adolescence may exert an effect on attained height in late adolescence. This study supports future lifestyles intervention studies aiming at preventing overweight and obesity and improving attained height.

Introduction: Cardiac autonomic modulation is an important marker of cardiovascular health and the practice of physical activity is a fundamental tool for good maintenance or increments in this marker. However, it is not clear in the literature whether different intensities and different domains of physical activity are related in the same way to cardiac autonomic modulation., Objectives: This randomized epidemiologic study will examine the relationship between cardiac autonomic modulation and different intensities and domains of physical activity in a representative sample of adults., Methods: The sample of study will consist of 252 subjects aged from 18 years and above. The sample will be randomized through census sectors in which the neighborhoods, streets, and houses will also be randomized. Cardiac autonomic modulation will be assessed by heart rate variability and the intensity (mild, moderate, intense) of physical activity will be evaluated by means of accelerometers, while the different domains of physical activity (physical activity at work, occupational activities) will be evaluated through a questionnaire. The relationship between cardiac autonomic modulation and different physical activity intensities, as well as the different domains will be analyzed by linear regression, considering a statistical significance of 5% and a 95% confidence interval. This research protocol is registered in ClinicalTrials.gov at number NCT03986879.

Background Cardiorespiratory fitness (CRF) and pubertal stages have been related to many health outcomes, including obesity and adipocytokines. Thus, the present study aimed to analyze the moderator role of CRF and pubertal stage in the relationship between adiposity and adipocytokines in girls. Method This cross-sectional study was performed with 42 pre-pubertal girls aged from 7 to 11 years and 54 post-pubertal girls aged from 13 to 17 years. Blood samples were collected to determine the serum levels of leptin and adiponectin, and then the leptin/adiponectin ratio (L/A ratio) was calculated. CRF, anthropometric and body composition indicators were assessed. For statistical analysis, descriptive statistics and several linear regression models were used. The moderation analysis was tested using the PROCESS macro. Results An interaction between body mass index (BMI) and CRF (β: -0.70; confidence interval [CI]: -1.29, -0.12), as well as between BMI and pubertal stage (β: 0.79; CI: 0.28, 1.30) with leptin, was found. Regarding the L/A ratio, an interaction was found only in BMI × CRF (β: -0.56; CI: -1.06, -0.06). Using a combined interaction (CRF and pubertal stage), the results showed a positive association between BMI with leptin and L/A ratio only in low CRF, pre-pubertal and post-pubertal stages. Conclusion This study suggests a protective role of high levels of CRF in the relationship between BMI and adipocytokines. Despite the effect of pubertal stage, the results suggest that youth should be engaged in physical activity in order to improve CRF levels and consequently improve cardiometabolic health.

Objective: The objective of the study is to examine whether adolescents' road safety perception (RSP) acts as a mediator on the association between the distance from home to the nearest park and the use of the parks for physical activity (PA)., Study Design: This is a cross-sectional study., Methods: The evaluation was through a random sample of 1130 adolescents (534 male), corresponding to 47.3%, 14-20 years old, from Porto Alegre, Brazil. RSP was assessed through some questions of the Neighborhood Environment Walkability Scale for Youth. Park use, socioeconomic status, age, and sex were measured using a questionnaire. Distance from home to the nearest park was evaluated through geographic information system. Data analysis was performed using Pearson correlation, and linear regression models were fitted as per the Baron and Kenny procedures for mediation analyses. All analyses were adjusted for sex and socioeconomic status., Results: Road safety perception is independently associated with less distance from home to the nearest park (P = 0.04) and use of the parks for PA (P = 0.02). Road safety perception is a mediator and explains 16% of the association between park use and distance from home to the park (indirect Effect = -40.9966; 95% confidence interval [CI]: 119.3733-2.2455)., Conclusion: Our findings indicated that RSP is a mediator on the association between the distance from home to the nearest park and the use of the parks for PA. Future studies should take this into consideration frequency and intensity of PA and other environmental characteristics, such as crime, aesthetics, and neighborhood facilities., (Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5-17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports., Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations' human development index (HDI) classification (low or medium, high, and very high HDI)., Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of "C-," "D+," and "C-" was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively., Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards., Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearman's rank correlation coefficients., Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors., Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.

Background: The objective of the study was to investigate the response of 64Arg allele carriers of the ADRB3 gene (Trp64Arg polymorphism) in the anthropometric, cardiorespiratory and metabolic variables in overweight adolescents after a 12-week aerobic exercise and nutritional program., Methods: A total of 92 overweight adolescents, 10-16 years old and of both genders, participated. Body composition, waist circumference (WC), pubertal stage status, blood pressure, glucose, insulin and lipid profile and direct maximal oxygen uptake were assessed at baseline and after 12 weeks of a training program. The homeostasis metabolic assessments [homeostasis model assessment of insulin resistance (HOMA-IR)] and quantitative insulin sensitivity check index (QUICKI) were determined and the Trp64Arg polymorphism of the ADRB3 gene was investigated by Taqman single nucleotide polymorphism (SNP) genotyping assays. Exercise sessions consisted of 100-min aerobic exercise and 20-min stretching, 3 times a week, totalizing 36 sessions. Multivariate analysis of variance (MANOVA), analysis of covariance (ANCOVA) and effect size were used for variables, with p<0.05 considered significant., Results: In baseline, HOMA-IR was higher in carriers of the 64Arg allele and decreased more after 12 weeks than in non-carriers (p=0.01). The anthropometric, physical fitness and metabolic profiles had similar responses after training in carriers and non-carriers., Conclusions: Overweight adolescents present changes in body composition and physical fitness, independent of Trp64Arg genotypes. However, a 12-week aerobic exercise and nutritional program promoted greater reductions in insulin resistance in carriers of the 64Arg allele.

Purpose: The dietary guidelines for the consumption of a variety of fruits and vegetables have been recognized as an important factor for achieving healthy eating patterns to reduce the risk of chronic disease throughout the lifespan. Our aim is to assess the association between fruit and vegetable variety and low-grade inflammation in adolescents., Methods: This cross-sectional analysis was conducted with 412 adolescents (ages 14.4 ± 1.7 years; 52% girls). The consumption of a variety of fruits and vegetables was assessed with a food-frequency questionnaire, considering the number of individual/category of fruit or vegetable intake at least once month, and categorized into tertiles. Blood samples were collected to determine C-reactive protein (CRP), interleukin-6 (IL-6), complement component 3 (C3), and 4 (C4). We created categories of lower or higher (inflammatory state) for each biomarker, considering sex- and age-adjusted median values. Then, we computed an overall inflammatory score, by adding all points awarded wherein one point was assigned if biomarker was higher or zero if lower, and created categories of 0-1 or 2-4 biomarkers above the median. The odds ratio (OR) and 95% interval confidence (95% CI) were calculated from binary logistic regression to estimate the magnitude of association between fruit and vegetable variety and inflammatory biomarkers., Results: Adolescents with a greater variety of vegetable consumption (≥13 categories/month) had lower odds of having a higher CRP (OR 0.31, 95% CI 0.15-0.64, p trend  = 0.004) when compared to those with lower variety consumption (≤6 categories/month), independent of vegetable quantity intake. However, a greater variety of fruit consumption (≥12 categories/month) had higher odds of having a higher IL-6 (OR 4.41, 95% CI 1.67-11.71, p trend  = 0.012), C3 (OR 3.30, 95% CI 1.23-8.86, p trend  = 0.047), and inflammatory score (OR 4.90, 95% CI 1.62-14.86, p trend  = 0.017), when compared to those with lower variety consumption (≤9 categories/month), independent of fruit quantity intake, only for girls., Conclusions: The consumption of a variety of vegetables is inversely associated with lower CRP. This finding supports the current dietary guidelines regarding the consumption of a variety of vegetables. The role of fruit variety in low-grade inflammation should be further studied.

Background: Physical fitness (PF) and adherence to the Mediterranean diet are important indicators of healthy lifestyles. The purpose of this study is to analyze the independent and combined associations between PF and adherence to Mediterranean diet with health-related quality of life (HRQoL) in adolescents., Methods: This is a cross-sectional analysis with 956 Portuguese adolescents aged 12-18 years. HRQoL was measured with the Kidscreen-10 questionnaire. PF was assessed with the ALPHA health-related fitness battery. The 20-m shuttle run test was used for the estimation of cardiorespiratory fitness; handgrip strength and standing long jump tests were applied for the assessment of muscular fitness and the 4 × 10 m shuttle run test for the assessment of motor fitness (speed and agility). The results of the PF tests (cardiorespiratory fitness, muscular fitness and motor fitness) were transformed into standardized values (Z-scores) by age and sex. Adherence to the Mediterranean diet was assessed with the KIDMED index. Regression analysis and analysis of covariance were performed., Results: PF (B = 0.228; P < 0.05) and adherence to the Mediterranean diet (B = 0.259; P < 0.05) were positively associated with HRQoL, after controlling for several variables. Participants classified as high PF and high adherence to Mediterranean diet had on average the highest HRQoL score compared with those with low PF and low adherence to Mediterranean diet (F(3, 939) = 4.270; P = 0.005), after adjustments for potential confounders., Conclusions: The combination of high PF levels and optimal adherence to Mediterranean diet is positively associated with HRQoL.

Purposes: To examine the association between sedentary time (ST) and light physical activity (LPA), moderate- to vigorous-intensity physical activity (MVPA), and body mass index (BMI), and to track these behaviors over a 3-year follow-up in young schoolchildren., Methods: The final sample was 64 children (female: n = 36 or 56.3%), enrolled in schools in Porto, Portugal. Height and mass of children were measured by standard methods, and BMI was then calculated. ST, LPA, and MVPA were measured by accelerometer. Changes (Δ) and relative changes (Δ%) between 2009/2010 and 2012/2013 of ST, LPA, MVPA, and BMI were computed. Multiple linear regression analyses were fit to predict Δ%ST (outcome variable), by Δ%LPA, Δ%MVPA, and Δ%BMI (exposure variables)., Results: ST increased and LPA decreased significantly for whole sample (both Ps < .05). No statistically significant difference was found for MVPA over time. There were no differences for ΔST, ΔLPA, ΔMVPA, and ΔBMI between boys and girls. The Δ%LPA and Δ%MVPA were negatively associated with Δ%ST, whereas Δ%BMI was positively associated. Tracking coefficients varied from moderate to strong., Conclusions: Time spent in ST increases due to displacement of time in LPA. This reinforces public health measures and suggests the need for interventions focusing on offsetting the decline ST and increasing MVPA during childhood.