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A correction to the article "Impact of Physical Activity on Caloric and Macronutrient Intake in Children and Adolescents: A Systematic Review and Meta-analysis of Randomized Controlled Trials," that was published in a 2024 issue is presented.

Background: Physical activity is important for children with congenital heart defects (CHD), not only for somatic health, but also for neurologic, emotional, and psychosocial development. Swimming is a popular endurance sport which is in general suitable for most children with CHD. Since we have previously shown that children with CHD are less frequently physically active than their healthy peers, we hypothesized that the prevalence of non-swimmers is higher in CHD patients than in healthy children. Methods: To obtain representative data, we performed a nationwide survey in collaboration with the German National Register of Congenital Heart Defects (NRCHD) and the Institute for Sport Sciences of the Karlsruhe Institute for Technology (KIT). The questionnaire included questions capturing the prevalence of swimming skills and the timing of swim learning and was part of the "Motorik-Modul" (MoMo) from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A representative age-matched subset of 4569 participants of the MoMo wave two study served as a healthy control group. Results: From 894 CHD-patients (mean age of 12.5 ± 3.1 years), the proportion of non-swimmers in children with CHD was significantly higher (16% versus 4.3%; p < 0.001) compared to healthy children and was dependent on CHD severity: Children with complex CHD had an almost five-fold increased risk (20.4%) of being unable to swim, whereas in children with simple CHD, the ability to swim did not differ significantly from their healthy reference group (5.6% vs. 4.3% non-swimmers (p = not significant). Conclusions: According to our results, one in five patients with complex CHD are non-swimmers, a situation that is concerning in regard of motoric development, inclusion and integration, as well as prevention of drowning accidents. Implementation of swim learning interventions for children with CHD would be a reasonable approach. [ABSTRACT FROM AUTHOR]

Oesophageal atresia (EA) is associated with life-long gastrointestinal and respiratory morbidity and other associated malformations. The aim of this study is to compare physical activity (PA) levels of children and adolescents with and without EA. A validated questionnaire (MoMo-PAQ) was used to evaluate PA in EA patients EA (4–17 years), who were randomly matched for gender and age (1:5) with a representative sample of the Motorik-Modul Longitudinal Study (n = 6233). Sports activity per week (sports index) and minutes of moderate to vigorous physical activity per week (MVPA minutes) were calculated. Correlations between PA and medical factors were analysed. In total, 104 patients and 520 controls were included. Children with EA were significantly less active at higher intensities (mean MPVA minutes 462; 95% confidence interval (CI): 370–554) compared to controls (626; 95% CI: 576–676), although there was no statistically significant difference in the sports index (187; 95% CI: 156–220 versus 220; 95% CI: 203–237). A lower mean weight-for-age and height-for-age, additional urogenital (r = − 0.20, p = 0.04) or anorectal malformation (r = − 0.24, p = 0.01) were associated with fewer MVPA minutes. For other medical factors (prematurity, type of repair, congenital heart disease, skeletal malformation or symptom load), no statistically significant association with PA was found. Conclusion: EA patients participated in PA at a similar level but lower intensities compared to the reference cohort. PA in EA patients was largely independent of medical factors. Trial registration: German Clinical Trials Register (ID: DRKS00025276) on September 6, 2021. What is Known: • Oesophageal atresia is associated with a low body weight and height, delayed development of motor skills and impaired lung function and exercise capacity. What is New: • Patients with oesophageal atresia have a similar amount of sports activity per week but engage significantly less in moderate to vigorous physical activities compared to peers. • Physical activity was associated with weight-for-age and height-for-age, but largely independent of symptom load and other medical factors. [ABSTRACT FROM AUTHOR]

Objective: Children with congenital heart defects (CHD) are at high risk for cardiovascular disease in addition to their congenital disease, so it is important to motivate this group of patients to live a physically active lifestyle. A potential influencing determinant of younger children's physical performance is the physical self-concept. The objective of the present study was first to evaluate the correlation between the physical self-concept (PSC) and the participation in physical activities (PA) of a representative group of children with congenital heart disease (CHD), and second to point out differences in comparison to their healthy peer group. Methods: Using the database of PA of the S-BAHn-Study we focused on physical self-concept assessed by the German version of the Physical Self-Description Questionnaire. We compare the obtained data of children with CHD to a representative age-matched sample of 3.385 participants of the Motorik Modul Study. Results: N = 1.198 complete datasets could be included in the analyses. The mean age of patients was 11.6 ± 3.1 years. For the total cohort of patients with CHD and the reference group, PA correlated significantly with a positive PSC (p < 0.001). PA was significantly reduced in all groups of patients despite the severity of their heart defect (p < 0.001). Remarkably, PSC did not differ statistically significantly in patients with simple CHD from the reference collective (p > 0.24). Conclusions: According to this representative survey, there is a clear relation between PA and PSC in the cohort of healthy children and the group of children with CHD throughout the severity of their heart defects. Although PSC did not differ in patients with simple CHD and their healthy peer group, PA was significantly reduced. This gap invites us to reflect on how we could break new ground to promote a physically active lifestyle in children with CHD regardless of the severity of their cardiac defects. [ABSTRACT FROM AUTHOR]

Recurrent pain can be a significant disruption in the activities of daily life, and is not only a health problem in adults but also in children and adolescents. This study analyzed the prevalence of recurrent pain in the current sample (n = 1516; 11–17 years (meanage = 14.4 ± 2.0 years); 50.8% female) of a nationwide study in Germany, evaluated the association of participants' device-based physical activity (PA) with the prevalence of recurrent pain, and assessed whether children and adolescents who reported pain for the last three months accumulated less PA than those who did not. A higher prevalence was found in girls for recurrent headaches (42.2% vs. 28.7%), abdominal pain (28.2% vs. 20.1%), and back pain (26.9% vs. 19.5%). We found higher odds for recurrent headaches in girls (OR = 1.54) and in participants that did not reach at least 60 min of moderate to vigorous PA (MVPA) per day (OR = 2.06). Girls who reported recurrent headaches accumulated 4.7 min less MVPA per day than those without. The prevalence of pain remains at a high level in the German youth and underscores the need for interventions to improve the health situations of children and adolescents. [ABSTRACT FROM AUTHOR]

[Display omitted] • Green space – physical activity (PA) associations explored across urbanicity levels. • Green space and urbanicity assessed with geospatial methods. • Accelerometer-assessed PA for 1,211 youth (6–17 years) • Youth in rural areas engage in less PA with more green space. • Green space – PA associations in cities depend on age, gender, and social status. Green space may be an important physical activity facilitator for children and adolescents. However, to date, most studies focused on urban green space, and few studies investigated associations between green space and physical activity across urban and rural areas, which was the goal of this study. Data were obtained from a German cohort study, including 1,211 youth aged 6–17 years. Residential green space was assessed within a 1000 m street-network buffer using land cover and land use data and divided into quartiles, urbanicity using the European Urbanization Degree, and moderate-to-vigorous physical activity (MVPA) using accelerometers. Associations were investigated via linear regression analysis stratified by urbanicity degree, controlling for relevant confounders. We found that in rural areas, compared to youth in the bottom green quartile, those within the middle (2nd) and upper (3rd) green quartiles engaged in less MVPA. This relationship was not observed for youth in towns and cities. Interactions occurred between green space and socio-demographic characteristics for children and adolescents in cities: Compared to the bottom green quartile, boys or younger children within the middle green quartile engaged in more MVPA. However, socially disadvantaged children and adolescents in cities engaged in less MVPA in the upper compared to the bottom green quartile. Our results show that associations between green space and MVPA do not only differ between urban and rural areas but also among youth sub-populations. These findings are important to consider for planning policies to create inclusive active living environments across urban and rural areas. [ABSTRACT FROM AUTHOR]

The article presents results from Germany's 2018 Report Card on Physical Activity for Children and Youth. It mentions indicators on the basis of which grades are assigned including organized sport participation, active transportation, and sedentary behavior. The report card reveals that proportion of German children and youth meeting the World Health Organization (WHO) recommended levels of PA and with screen time below two hours daily is low.

Background: As children show a more complex but less structured movement behavior than adults, assessment of their many spontaneous and impulsive movements is a challenge for physical activity (PA) assessment. Since neither questionnaires nor accelerometers enable optimal detection of all facets of PA, a multimodal, combined approach of self-reported and device-based methods is recommended. Based on the number of days on which the participants reached the physical activity (PA) values given in the WHO guideline, this study examines 1) the difference between self-reported and device-based, measured PA and 2) whether PA differences between age and gender groups obtained by two methods are comparable.Methods: Participants aged 6-17 years were randomly chosen and data were collected representatively at 167 sample points throughout Germany within the Motorik-Modul Study. PA of n = 2694 participants (52.3% female) was measured using the ActiGraph accelerometer (ACC) and a physical activity questionnaire (PAQ). The sample was divided into three age groups (6-10 yrs. n = 788, 11-13 yrs. n = 823, 14-17 yrs. n = 1083). Numbers of days per week with at least 60 min moderate to vigorous PA (MVPA) were analyzed for both methods.Results: Only every 25th respondent (4%) reaches the WHO standard of 60 min MVPA every day if measured with ACC. Self-reported PA was slightly higher (9%) (meanPAQ = 3.82 days; meanACC = 2.34 days; Fmethod = 915.85; p = <.001; fCohen = .64). The differences between the methods are significantly smaller in younger children than in the older age groups (Fage = 264.2, p < .001; fCohen = .48). The older the subjects are, the lower is the proportion of those who meet the WHO guideline on each day, with girls meeting the guideline less frequently than boys in all age groups.Conclusion: Children and adolescents living in Germany show a very low adherence to the WHO guideline on PA. While younger children are much more active with their free play, especially children over 10 years of age and especially girls should be the target of programs to increase PA. [ABSTRACT FROM AUTHOR]

Background: Physical activity recommendations are reached by only a small part of the population. A common problem is that research findings on public health-related topics such as physical activity promotion are oftentimes not translated into practice. The involvement of relevant stakeholders, such as change agents (role models, decision-makers, and/or knowledge mediators), is a common strategy to implement physical activity recommendations in specific settings, as they have the necessary knowledge of contextual factors. However, dissemination and implementation of physical activity recommendations are often prevented by focusing exclusively on the health sector and by underestimating the individual perceptions and needs of change agents. Therefore, the purpose of this study was to address the problem of how physical activity recommendations can be translated into practice through comprehensive consideration of the situation and context of change agents from various sectors of society at different administrative levels. This allows for deriving recommendations for action on how a national dissemination strategy of physical activity recommendations should be designed.Methods: Qualitative expert interviews were conducted with change agents from different sectors of society and administrative levels in Germany (N = 21). Case selection took place via a sampling plan. The interviews were recorded, transcribed verbatim, and analysed by two trained researchers using qualitative content analysis.Results: The change agents' perceived relevance of physical activity and physical activity promotion and their knowledge of physical activity recommendations varied across different sectors. Nine themes were identified covering the change agents' needs for the implementation of physical activity recommendations: strengthening of political will and cooperation, availability of public space for physical activity, change in awareness and health education, professional qualification, financial incentives, development of physical activity-promoting programmes and structures, provision of resources, bridging the theory-practice gap, and knowledge of physical activity recommendations.Conclusions: This exploratory study contributes to the development of an evidence-based dissemination strategy of physical activity recommendations involving change agents from various sectors. Cross-sectoral needs and obstacles were identified indicating gaps that have to be addressed. Future research should choose practice-oriented approaches to develop dissemination strategies that are adapted to the needs of local contexts. [ABSTRACT FROM AUTHOR]

Background: The self‐rated health of adolescents and young adults is important for estimating future morbidities and mortality. Little is known about how physical fitness in younger populations predicts self‐rated health. This longitudinal study (2003‐2017) aims to explore the effects of physical fitness on self‐rated health on the basis of the German population–based study KiGGS and its in‐depth study, MoMo. Methods: Self‐rated health was assessed using a one‐item scale, and physical fitness was measured with seven test items covering the dimensions of coordination, muscular fitness, and cardiorespiratory fitness. Longitudinal analyses were conducted using the structural equation modeling approach in Mplus 8.0 using the maximum likelihood estimator. Results: The longitudinal samples of the KiGGS/MoMo study (T1, n = 2376; T2, n = 2821; and T3, n = 2047) had a mean age of 8.5, 14.8, and 20.0 years at T1, T2, and T3, respectively. All measurement and structural models had excellent model fits. While the results of the latent regression analysis indicated moderate‐to‐high stability for the coordination and muscular fitness dimensions, only low‐to‐moderate stability coefficients were found for cardiorespiratory fitness and self‐rated health. Furthermore, small significant cross‐lagged regression coefficients revealed that coordination and muscular fitness predicted self‐rated health at later measurement points. Conclusion: To the best of our knowledge, this is the first longitudinal study to demonstrate the positive predictive value of two dimensions of physical fitness, coordination and muscular fitness, on self‐rated health at a later stage. The public health implications are highlighted. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) has beneficial effects on health and health-related quality of life (HRQoL), which is a protective factor of illness and mortality. The purpose of this examination was to investigate if self-reported and device-based measures of PA were related to HRQoL in adolescents.Methods: Participants (N = 1565; 54.3% female; Mage = 14.37 years, SDage = 1.99) were recruited from 167 sample points across Germany. Adolescents self-reported their PA, supplemented by a 1-week examination of device-based PA using accelerometry. Additionally, they completed the multidimensional KIDSCREEN-27 to assess HRQoL.Results: Results showed that self-reported PA was correlated with overall HRQoL, Physical Well-Being, Psychological Well-Being, Social Support & Peers, and School Environment, whereas device-based PA was only correlated with Physical as well as Psychological Well-Being. Further, self-reported PA significantly predicted all facets of HRQoL except for Autonomy and Parent Relations, whereas device-based PA solely heightened the amount of explained variance in the Physical Well-Being subscale.Conclusions: Findings demonstrate the importance of self-reported PA as it is related to almost all facets of HRQoL. Both measures of PA are not congruent in their relationship with HRQoL and thus implications have to be carefully considered. Future studies should investigate the direct effect of PA on HRQoL and health in a longitudinal approach to account for the causality of effects. [ABSTRACT FROM AUTHOR]

Mental health (MH) and behavioral health are fundamental to a good quality of life. Only a few studies have investigated the association between behavioral health (e.g. physical activity (PA), screen time (ST)) and MH from childhood to adolescence. Therefore, we investigated the relationships of PA and ST with MH by sex in an 11-year longitudinal cohort study of German schoolchildren during 2003–2017. A subsample (n  = 686; 55.2% female) of participants from the German Motorik-Modul (MoMo) Longitudinal Study who participated in all 3 measurement phases (mean ages: time 1 (baseline; 2003–2006), 5.57 (standard deviation (SD), 1.00) years; time 2 (wave 1; 2009–2012), 11.85 (SD, 1.03) years; time 3 (wave 2; 2014–2017), 16.86 (SD, 1.04) years) were analyzed with regard to PA, ST, and MH (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, prosocial behavior, and overall strengths and difficulties). Path panel prediction models were fitted with time 1, time 2, and time 3 PA, ST, and MH indicators. PA predicted less television (TV)/video watching in females, and TV/video watching predicted personal computer (PC)/Internet use in both sexes. Behavior and MH results suggested that, for females, higher TV/video watching and PC/Internet use was related to higher MH challenges over the course of maturation. Some preadolescent males' MH challenges increased ST (TV/video watching and PC/Internet use) in adolescence. Researchers should explore innovative and effective methods for reducing childhood ST, especially among females with early signs of MH issues, and addressing preadolescent males' MH challenges. [ABSTRACT FROM AUTHOR]

The impact of COVID-19 on social life has been drastic and global. However, the different numbers of cases and different actions in different countries have been leading to various interesting yet unexplored effects on human behavior. In the present study, we compare the physical activity and recreational screen time of a representative sample of 1711 4- to 17-year-olds before and during the strictest time of the first COVID-19 lockdown in Germany. We found that sports activity declined whereas recreational screen time increased. However, a substantial increase in habitual physical activities leads to an overall increase in physical activity among children and adolescents in Germany. The effects differ in size but not in their direction between age groups and are stable for boys and girls. We conclude from this natural experiment that physical activity among children and adolescents is highly context-driven and mutual and does not act as a functional opposite to recreational screen time. [ABSTRACT FROM AUTHOR]

Blood pressure (BP) tracking from childhood to adulthood has two aspects: the ranking stability relative to others over time and the prediction of future values. This study investigates BP tracking in children and adolescents in Germany in the context of hypertension risk factors. BP was measured and analyzed in 2542 participants of the German Health Examination Survey for Children and Adolescents (t0 2003-2006; 3 to 17-year olds) and of a six year follow-up “Motorik Modul” (t1 2009-2012; 9 to 24-year olds). BP tracking coefficients were calculated from Spearman’s rank-order correlations. Predictive values and logistic regression models were used to forecast t1-BP above the hypertension threshold from t0-BP as well as from baseline and follow-up hypertension risk factors. BP tracking was moderate (0.33-0.50 for SBP and 0.19-0.39 for DBP) with no statistically significant differences between sex and age groups. Baseline hypertensive BP was the strongest independent predictor of hypertensive BP at follow-up (OR 4.3 and 3.4 for age groups 3-10 and 11-17 years) after adjusting for sex, BMI trajectories, birthweight, parental hypertension, and age-group dependent-sports/physical activity. However, the positive predictive value of baseline hypertensive BP for hypertensive BP at follow-up in 3- to 10-year olds was only 39% (34% in 11- to 17-year olds) and increased only moderately in the presence of additional risk factors. Our analysis with population-based data from Germany shows that BP in children and adolescents tracks only moderately over six years. BP in childhood is the strongest independent predictor of future BP but its predictive value is limited. [ABSTRACT FROM AUTHOR]

The correct reference is listed below: Chen, P. I et al. i Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. Correction to: I Scientific Reports i https://doi.org/10.1038/s41598-020-78438-4, published online 11 December 2020 The original version of this Article contained an error in Reference 29, which was incorrectly given as: Chen, P. I et al. i Wuhan coronavirus (2019-nCoV): the need to maintain regular physical activity while taking precautions. [Extracted from the article]

Children in Germany showed positive physical activity changes during the first Covid-19 lockdown in April 2020, but it is unclear how the changes relate to population density, which we investigated in a longitudinal sample of 1711 youth (4-17 years). For each ten citizens more per km2, less positive physical activity changes were observed. For example, a child living in an area with 100 citizens/km2 increased daily life physical activity by 44.50 min/day, whereas a child living in an area with 3000 citizens/km2 only engaged in an additional 9.70 min/day. Policymakers should ensure that youth in densely populated areas have access to physical activity opportunities during the pandemic. [ABSTRACT FROM AUTHOR]