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Schools are ideal settings to promote adolescent physical activity (PA), yet school-based interventions have shown limited long-term impact. This position paper presents key issues surrounding school-based PA interventions. Collaborative conceptual thinking drawing on multi-author expertise and available evidence advanced our understanding and opinion. Key arguments: 1) the adoption of a systems approach, which maximizes partnership action and leverages policy, is crucial for understanding the complexities of implementing whole-school programs; 2) a reorientation to an assets perspective optimizes existing strengths and resources allowing greater emphasis on the full range of physical, cognitive, emotional and social benefits that PA provides, and 3) a move beyond traditional positivist research designs to advance our knowledge of what works better, for whom and in what context is needed for greater progress We provide suggestions, specifically advocating for systems approaches, as a realistic way to improve how we support PA in schools in the future. [ABSTRACT FROM AUTHOR]

Time in which children is engaged in screen time such as TV viewing is a serious health problem and might reduce the use of the time for other potential activities such as play outside or being engaged in physical activity. In addition, it was suggested that children's screen time increases with age and patterns begin in preschool years. Therefore, the aim of the present study was to explore the association between obesity status and weight-related room environment (TV at room) and play outside in preschool girls. This study included 120 preschool girls (4–6 years old). Data were collected through parents' questionnaire about (yes/no) children have TV in bedroom and the perception of playing outside. Multivariate regression was used to determine the association between BMI and play outside with TV in the bedroom. Girls either classified as overweight (OR: 2.6; CI: 1.1–6.0; P ≤ 0.034) or obese (OR: 4.0; CI: 1.2–13.2; P ≤ 0.02) were more likely to have TV in room compared to their lean peers. Girls whose parents reported less outdoor play (

This study aimed to evaluate the associations between muscular fitness and inflammatory biomarkers and to investigate the relationship between muscular fitness and selected clustered inflammatory biomarkers in adolescents. This is a cross-sectional analysis with 529 adolescents (267 girls) aged 12-18 years. Handgrip strength and standing long jump tests assessed MF. Continuous scores of clustered inflammatory biomarkers (sum of Z-scores of C-reactive protein [ CRP], C3, C4, fibrinogen, and leptin); metabolic risk factor ( MRF) score (sum of Z-scores of SBP, triglycerides, ratio total cholesterol [ TC]/ HDL, HOMA- IR, and waist circumference [ WC]) were computed. Regression analyses showed an inverse association between muscular fitness score (β=−.204; P<.021) and clustered score of inflammatory biomarkers, adjusted for age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet, cardiorespiratory fitness ( CRF), MRF score, and body fat. Analysis of covariance showed that adolescents with an adverse inflammatory profile with low levels of muscular fitness exhibit the poorest MRF score ( F3,525=6.461; P<.001), adjusted for age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet, CRF, and body fatness. The inflammatory state seems to explain a significant part of the highest MRF score and in adolescents with high inflammatory status and low muscular strength. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the independent and combined association of physical activity (PA) and sitting time (ST) with allcause mortality in older adults with diabetes. A total of 611 individuals representative of the Spanish diabetic population aged ≥ 60 years. Participants were selected in 2000/2001 and were prospectively followed-up through 2011. PA and ST were self-reported at baseline. Study associations were summarized as hazard ratios (HR) and their 95 % confidence interval (CI). During a mean follow-up of 8.3 years, 282 deaths occurred. The HR (95 % CI) of mortality for very/moderately active individuals compared to those who were inactive/less active was 0.59 (0.45, 0.78). The association between ST and mortality was nonlinear (P < 0.001 in spline analysis), and mortality was increased only among individuals who reported a ST > 8 h/day (HR = 1.77, 95 % CI 1.25, 2.52). The HR (95 % CI) of mortality was 0.50 (0.32, 0.77) in participants who either were very/ moderately active or had ST ≤ 8 h/day, and 0.32 (0.20, 0.50) in those with both health behaviors, compared to those with none of these behaviors. In conclusion, among older adults with diabetes, high PA and less ST are independently and jointly associated with lower risk of all-cause mortality. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to verify whether or not adolescents' perception of physical activity (PA) facilities in their neighbourhood affects moderate-vigorous physical activity level (MVPA). Methods: The final sample comprised 320 Portuguese adolescents (59.7 % girls) aged 14-18 years and enrolled in 9th-12th school grade. The Neighbourhood Environment Walkability Scale-Youth survey was used to evaluate the distance perception from adolescents' homes to PA facilities. MVPA level was evaluated by accelerometers GT1M, and Evenson's cut-points were considered. Results: Boys were more active than girls, mean SD (57.86, 21.05 vs. 51.02, 20.42, p = 0.04). PA facilities type and proximity perception were not associated to MVPA level ( p > 0.05), after adjusting for gender, age, socio-economic status, body mass index, and waist-height ratio. Conclusion: Type and number of PA facilities perceived nearest to home were not related with MVPA level in this Portuguese adolescent sample. However, girls who perceived a school with recreation facilities near their home showed an association with MVPA intensity. [ABSTRACT FROM AUTHOR]

Objectives: School Physical Education (SPE) is an excellent way to improve moderate and vigorous physical activity (MVPA). To improve health and fitness, the guidelines recommend that at least 50% of class time should be spent in MVPA, though few studies on this assumption have been conducted. The objective of this study was to quantify the amount of MVPA undertaken during a SPE class, according to age and gender. Methods: This study was conducted in three randomly selected Portuguese public schools. A random sample of 191 teenage volunteers aged between 12 and 17 years, composed of 98 males (14.51 ± 1.75 years) and 93 females (14.59 ± 1.83 years) was recruited. An accelerometer was used by each subject to assess MVPA. Results: The mean time spent in MVPA during SPE class (MVPA/SPE) was 25.36 ± 15.69 minutes, which corresponds to 28.18% of the total time spent in SPE class. Males spend significantly more time in MVPA/SPE than females (28.95 vs. 21.58 minutes; p <0.05). As age increased, time spent in MVPA/SPE tended to decrease; the 12-year-old adolescents tended to spend more time in MVPA/SPE compared with the 17-year-olds (30.40 vs. 20.80 minutes). Conclusion: The proportion of MVPA during SPE class time fell short of the 50% recommended by guidelines to improve health. Males spend significantly more time in MVPA/SPE than females and, in both genders, as age increases, time spent in MVPA/SPE tends to decrease. [ABSTRACT FROM AUTHOR]

The lack of physical activity (PA) in children is an important health risk factor. Previous studies have shown that some environmental features may be associated with PA levels. Objectives: Find and comprehend which environmental features were mostly positively associated with children's physical activity. Methods: Twenty-eight studies were systematically reviewed. This research was used to assess the association between environmental features and physical activity among children (ages 3 to 12) who fulfilled the selection criteria. Results: Results across the various studies showed that facilities and parks/playgrounds are mostly positively associated with children's PA. Sidewalks and bike lanes were positively associated to PA in all studies. Safety, traffic and weather showed inconsistent associations with children's PA. Conclusions: Beginning to understand which environmental features contribute more to PA in children can lead to increased levels of PA. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to objectively assess pre-school children's total physical activity ( TPA) patterns and compliance with guidelines and to examine differences relative to parental education. Methods The sample consisted on 509 healthy pre-school children, aged 3-6 years recruited from kindergartens located in the metropolitan area of Porto, Portugal. The PA was assessed for 7 consecutive days by accelerometry. For TPA, we followed the guidelines of the National Association for Sport and Physical Education ( NASPE) (children who spent at least >120 min per day in active play). For TPA, we calculated the proportion of children who spent at least >120 min per day in active play and moderate-to-vigorous physical activity (MVPA), we calculated the proportion of children who spent at least >60 min per day in active play. Parental education was analysed according to the Portuguese education system. Results Children with parents in the highest education level were less active than children from low and middle education level ( P ≤ 0.001) in all patterns of PA (week and weekend). Regarding TPA during the week we found that the majority of children from low and middle parental education meet the NASPE guidelines. On the other hand, more than half the children from high parental education did not meet these recommendations ( P ≤ 0.001) and MVPA recommendations ( P ≤ 0.05). In both recommendations, children from low parental education were twice more likely to meet the recommendations compared with children belonging to high parental education. Conclusion Parent education was negatively associated with children's daily physical activity patterns and compliance with guidelines. [ABSTRACT FROM AUTHOR]

What is already known about this subject Diet and physical activity ( PA) are recognized as important factors to prevent abdominal obesity ( AO)., Studies have found an inverse relationship between milk intake or milk products and body weight and/or body fat in children and adolescents., Evidence suggests that low levels of PA are associated with AO in youth., What this study adds Our study explored the combined association of milk intake and PA on AO in adolescents, which are most often studied in isolation., Our findings suggested that adolescents with high milk intakes, regardless of whether they were active or low active, were less likely to have AO., Our findings could have a great epidemiological interest and bring important evidence in the field of AO management among adolescents., Background Diet and physical activity ( PA) are recognized as important factors to prevent abdominal obesity ( AO), which is strongly associated with chronic diseases. Some studies have reported an inverse association between milk consumption and AO. Objective This study examined the association between milk intake, PA and AO in adolescents. Methods A cross-sectional study was conducted with 1209 adolescents, aged 15-18 from the Azorean Archipelago, Portugal in 2008. AO was defined by a waist circumference at or above the 90th percentile. Adolescent food intake was measured using a semi-quantitative food frequency questionnaire, and milk intake was categorized as 'low milk intake' (<2 servings per day) or 'high milk intake' (≥2 servings per day). PA was assessed via a self-report questionnaire, and participants were divided into active (>10 points) and low-active groups (≤10 points) on the basis of their reported PA. They were then divided into four smaller groups, according to milk intake and PA: (i) low milk intake/low active; (ii) low milk intake/active; (iii) high milk intake/low active and (iv) high milk intake/active. The association between milk intake, PA and AO was evaluated using logistic regression analysis, and the results were adjusted for demographic, body mass index, pubertal stage and dietary confounders. Results In this study, the majority of adolescents consumed semi-skimmed or skimmed milk (92.3%). The group of adolescents with high level of milk intake and active had a lower proportion of AO than did other groups (low milk intake/low active: 34.2%; low milk intake/active: 26.9%; high milk intake/low active: 25.7%; high milk intake/active: 21.9%, P = 0.008). After adjusting for confounders, low-active and active adolescents with high levels of milk intake were less likely to have AO, compared with low-active adolescents with low milk intake (high milk intake/low active, odds ratio [ OR] = 0.412, 95% confidence intervals [ CI]: 0.201-0.845; high milk intake/active adolescents, OR = 0.445, 95% CI: 0.235-0.845). Conclusion High milk intake seems to have a protective effect on AO, regardless of PA level. [ABSTRACT FROM AUTHOR]

Aim:The benefits of promoting physical activity (PA) in counteracting the high prevalence of childhood obesity have become increasingly important in the past decade. The aim of this study was to examine the association between compliance of daily PA recommendations and the risk of being overweight or obese in preschool-aged children.Methods:The sample comprised 607 children aged 4-6 years, recruited from kindergartens located in the metropolitan area of Porto, Portugal. Preschooler's body mass index was classified according to International Obesity Task Force. PA was assessed during 7 consecutive days by accelerometer. Children were classified as meeting or not meeting PA recommendations based on two guidelines: (i) at least 3 h per day of total PA (TPA); and (ii) at least 1 h per day of moderate to vigorous PA (MVPA).Results:The prevalence of overweight and obesity was 23.5 and 10.6% in girls and 17.2 and 8.9% in boys. In all, 90.2 and 97.3% of girls met the 1 h MVPA and 3 h TPA recommendations, respectively. In all, 96.2 and 99.4% boys met the 1 h MVPA and 3 h TPA recommendations, respectively. Boys were significantly more likely to achieve the 1 h MVPA and 3 h TPA recommendations than girls (P0.001). Not meeting the 1 h MVPA guideline was associated with obesity status (OR: 3.8; IC: 1.3-10.4), in girls, but not boys. No other statistically significant associations were found.Discussion:These findings suggest that over 90% of children met the recommended guidelines. There is an association with low levels of MVPA and higher obesity status among preschool girls. Further, longitudinal studies are needed to confirm these data. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze longitudinal associations between cardiorespiratory fi tness, physical activity and body mass index in a 4-year longitudinal study. 170 students (97 girls and 73 boys) aged at baseline from 11 to 17 years were followed. Students performed 20-m-SR; physical activity patterns and parents' education were evaluated using a standard questionnaire. Body mass index was categorized according to established cut points. In a multilevel analysis using MLwIN, 2 level structures were defi ned: fi rst for individuals and second for time observations. In a longitudinal 2 level analysis, cardiorespiratory fi tness was negatively associated with body mass index for girls and boys, respectively (p < 0.05; R 2 = 0.63; 0.62), especially with obesity category (p < 0.01; R 2 = 0.58; 0.60). In girls, independent associations were observed between CRF and PA categories regarding participation "almost every day" in organized (p < 0.05; R 2 = 0.50) and non-organized sports outside school (p < 0.05; R 2 = 0.52) and participation in sports competitions (p < 0.05; R 2 = 0.51). In boys, associations were found only with participation in sports competitions (p < 0.05; R 2 = 0.50). The results highlight the importance of youth participation in organized activities and competitive sports over time to achieve health-related fi tness benefi ts. [ABSTRACT FROM AUTHOR]

Estimates of daily energy expenditure are important to studies of physical activity and energy balance. Objective measures are not always feasible and further research is needed to validate survey instruments and diaries. The study validates estimated activity energy expenditure (AEE) based on a 3-day diary protocol relative to AEE derived from uniaxial accelerometry in adolescents, 265 girls and 227 boys (12.5-16.4 years). Participants completed the diary and wore a GT1M Actigraph accelerometer on the same days. Height and weight were measured. Correlations between protocols were significant ( P<0.001) but moderate, r=0.65 in males and r=0.69 in females. The highest correlation occurred among males on Friday, r=0.74 ( P<0.01). Controlling for body mass, partial correlations between protocols decreased to 0.44 and 0.35 in males and females, respectively. About 97% of the cases fell within the limits of agreement in a Bland-Altman plot. The criterion of inclusion for the accelerometer excluded 18% of the initial sample. In summary, the 3-day diary was completed without any major problems and provided a reasonably valid alternative for assessing AEE. Concordance between methods was slightly lower for individuals with higher values of AEE. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between cardiac autonomic control derived from heart rate variability (HRV), high-sensitivity C-reactive protein (hs-CRP) and physical activity (PA) levels measured using accelerometers. A total of 80 healthy university students volunteered to participate in this study (20.56 ± 0.82 years, 1.36 ± 1.5 mg/L of hs-CRP). The participants were divided into groups based on tertiles of hs-CRP. Analysis of covariance adjusted to PA was used to assess group differences in HRV. Associations between hs-CRP, HRV indices and PA were analyzed using Pearson's correlation. The participants at the highest tertile of hs-CRP (tertile 3) had lower cardiac vagal modulation (SDNN, tertile 1=78.05 ± 5.9,tertile 2=82.43 ± 5.9,tertile 3=56.03 ± 6.1; SD1, tertile 1=61.27 ± 5.3, tertile 2=62.93 ± 5.4, tertile 3=40.03 ± 5.5). In addition, vagal indices were inversely correlated with hs-CRP but positively correlated with PA (SDNN r=−0.320, SD1 r=−0.377; SDNN r=0.304, SD1 r=0.299; P<0.05). Furthermore, the most physically active subjects had lower levels of hs-CRP and the highest levels of vagal modulation. [ABSTRACT FROM AUTHOR]

Aim: To analyse whether changes in physical activity index (PAI), screen time (ST: television, computer) and body mass index (BMI) made a contribution to longitudinal changes in fitness of children and adolescents. Additionally, we analysed the interaction between baseline fitness level and changes in fitness. Methods: This is a 3-year longitudinal study of 345 high school students aged 11–19 years. Students performed curl-ups, push-ups and 20-m shuttle run tests from Fitnessgram. PA and ST were evaluated using a standard questionnaire. Standardized scores of fitness tests were summed. Changes over time were calculated as Δ1 (2007 minus 2006), Δ2 (2008 minus 2007) and Δ3 (2008 minus 2006). Results: Changes in PAI were positively and independently associated with changes in fitness in Δ1, Δ2 and Δ3. Changes in BMI were negatively associated with changes in fitness in Δ3. Participants highly fit at baseline were those who showed positive changes in PAI over Δ3, decreased changes in ST and had the lowest increase in BMI over 3 years compared with those low-fit at baseline. Conclusions: Changes in BMI were associated with changes in fitness over 3 years. However, changes in PAI were the best predictor for changes in fitness in each year and over the 3 years of evaluation in youth. [ABSTRACT FROM AUTHOR]

This study analyzed the scientific publications about Physical Activity (PA) interventions and cognition in children and adolescents between 2009 and 2019, indexed in the Web of Science database, by conducting a bibliometric analysis. The co-occurrence analysis between journals, authors, countries, institutes, co-cited references, and keywords was considered. One hundred seventy-two studies, published in 90 journals, were identified. Active collaborations between high-income countries were observed, mainly U.S researchers, which also have the largest international network. "Physical Activity," "Exercise", "Cognition," "Executive Function," "Academic Performance,"Aerobic Fitness" "Children" and "Adolescents" were the most common keywords seen in the studies. Most of the publications target school children and preadolescents, followed by adolescents. This bibliometric analysis allows a broader understanding of the current state of the art on the relationship between PA intervention and cognition in children and adolescents, and can support future researches, which should cover gaps as collaboration between low-middle income countries, and further evidence in early childhood. [ABSTRACT FROM AUTHOR]

Abstract 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. Highlights • Road safety perception (RSP) is an important factor for park use for physical activity. • RSP is associated with less distance from home to the park. • RSP is a mediator and explains 16% of the association. [ABSTRACT FROM AUTHOR]

Summary Introduction We investigated the associations between total and different domains of physical activity and resting heart rate in adolescents. Summary of facts and results The sample was composed of 716 girls and 515 boys aged between 14 to 17 (15.55 ± 1.07) years. Resting heart rate was evaluated using an oscillometric device. Physical activity was assessed using a questionnaire, taking into consideration the different domains (leisure and sports practice). The relationship between resting heart rate and the different physical activity domains was analyzed by means of Linear Regression. After adjustment for body mass index, total physical activity (β = −0.54) and sports practice (β = −0.62) were inversely associated with high resting heart rate. Conclusion Results indicate that practice of sports constitutes an important tool against high resting heart rate values. [ABSTRACT FROM AUTHOR]

Objectives: To identify the clustering of physical inactivity in leisure, work, commuting and household contexts, and the sociodemographic factors associated with the clustering of inactive behaviour in different domains among Brazilian adults. Study design: Cross-sectional population-based study. Methods: The study was performed in Florianopolis, capital of Santa Catarina, one of the southern states of Brazil, from September 2009 to January 2010. Adults aged 20-59 years were interviewed. Physical inactivity in each domain was defined as non-participation in specific physical activities, using a validated Brazilian questionnaire. Clustering of physical inactivity was identified by the ratio between observed prevalence and expected prevalence of 16 different combinations. Multinomial logistic regression was used in the analysis of sociodemographic factors associated with clustering of physical inactivity. Results: Of the 1720 interviewees, the greatest differences between the observed and expected proportions were observed in simultaneous physical inactivity in the leisure and household domains for men, and physical inactivity in the leisure domain alone for women (59% and 88%, respectively); these differences were higher than expected if the behaviours were independent. Physical inactivity in two or more domains was observed more frequently in men and in individuals with a higher per-capita family income. Ageing was associated with physical inactivity in three or four domains. Conclusions: Physical inactivity was observed in different domains according to gender. Men and older individuals with a higher per-capita family income were more likely to exhibit physical inactivity when all domains were considered together. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The purpose of this study was to compare the effects of two exercise programs of 8 months duration on lipid profiles in older women. Methods: In 2006, 77 women from Porto, Portugal, aged 60–79 years were randomly assigned into a multicomponent exercise (ME) program or resistance exercise (RE) program. Before- and after-training, body composition, daily physical activity (DPA), aerobic endurance, plasma concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed. Training was performed twice weekly. The protocol for the ME included aerobic exercise, muscular endurance exercises and activities targeted to improve balance and flexibility. The RE protocol included leg press, leg extensions and curls, double chest raises, lateral raises, overhead press and abdominal exercises. Results: Significant decreases in TG (−5.1%, p =0.006), and significant increases in HDL-C (9.3%, p <0.001) were observed in the ME group. Following 8 months no significant changes were observed on lipid profile in RE group, although lipid- and lipoprotein-related variables tended to alter favorably. Both regimens resulted in significant improvements on 6-min walk test (6.4%, p =0.001 for ME; and 6.0%, p =0.044 for RE). No significant changes were observed in total DPA and body fat in either group after exercise interventions. No significant correlations were found between body composition, physical activity, aerobic endurance, and lipid profile. Conclusions: The data suggested that 8 months of ME may be more effective than RE for inducing favorable changes in plasma lipoprotein and lipid profiles. [Copyright &y& Elsevier]

Regular physical activity and/or sports practice play an important role in peak bone mass. However, the role of different physical-sportive approaches on bone health is not fully understood, especially in low-income children. The aim of this study was to analyze the changes in bone markers (bone mineral density–BMD and bone metabolism) promoted by two different exercise programs (osteogenic sport and Physical Education–PE) in low-income children. An 8-month intervention program in children (8.07 ± 1.38 years at baseline) was conducted in two groups, Martial Arts (G1, n = 14) and PE (G2, n = 12). BMD was obtained by dual energy X-ray absorptiometry. To determine bone metabolism, serum osteocalcin and alkaline phosphatase (ALP) were collected as indicators of bone formation. General Linear Model (GLM) - ANOVA was used to analyze longitudinal effects in repeated measures with adjustments for maturational stages, calcium consumption and serum vitamin D. The within the groups analysis highlighted significant differences for BMD at the arms and spine, and for serum ALP for both groups. After the interventions, G1 presented significant changes in BMD of the total body, femoral neck, proximal total femur and spine (P ≤ 0.05), while G2 presented statistically significant changes in serum ALP levels. The group × time analysis showed significant differences in BMD at the arms (Δ% G1 = 8.1 vs. Δ% G2 = 3.7), and at the spine (Δ% G1 = 5.7 vs. Δ% G2 = 5.0). and in serum ALP (Δ% G1 = 61.1 vs. Δ% G2 = 171.0). Both exercise programs increased BMD in the arms and the spine and increased serum alkaline phosphatase levels of low-income children, even after adjustments for potential confounders. [ABSTRACT FROM AUTHOR]