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Introduction: The aims of this study were to examine cross-sectional, and longitudinal association of different measures of obesity and physical fitness with cardiovascular disease (CVD) risk factors in adolescents with Down syndrome. Methods: Longitudinal analysis included 90 adolescents with Down syndrome. Obesity and physical fitness were measured following the ALPHA battery. Blood pressure and blood samplings (glucose, total cholesterol, high-density lipoprotein cholesterol, and serum lipid triglycerides levels (mg/dl) were determinated. Results: In cross-sectional analyses, obesity was positively associated with single CVD risk factors and CVD risk factor index (all p < 0.05). In the prospective analyses, obesity was not associated with single CVD risk factors, but components of physical fitness at baseline impact in some single CVD risk factors (all p < 0.05). Conclusion: Obesity might be more strongly related to current cardiovascular-health, while components of physical fitness might be more related to future cardiovascular-health in adolescents with Down syndrome. [This article was written on behalf of the UP&DOWN Study Group.]

Background: The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods. Methods: The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods. Results: Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC. Conclusions: Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents.

The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal. [ABSTRACT FROM AUTHOR]

Background: While there is evidence that physical activity, sedentary behaviour (SB) and sleep may all be associated with modified levels of inflammatory markers in adolescents and children, associations with one movement behaviour have not always been adjusted for other movement behaviours, and few studies have considered all movement behaviours in the 24-hour day as an exposure. Purpose: The aim of the study was to explore how longitudinal reallocations of time between moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), SB and sleep are associated with changes in inflammatory markers in children and adolescents. Methods: A total of 296 children/adolescents participated in a prospective cohort study with a 3-year follow-up. MVPA, LPA and SB were assessed by accelerometers. Sleep duration was assessed using the Health Behavior in School-aged Children questionnaire. Longitudinal compositional regression models were used to explore how reallocations of time between movement behaviours are associated with changes in inflammatory markers. Results: Reallocations of time from SB to sleep were associated with increases in C3 levels (difference for 60 min/d reallocation [d60] = 5.29 mg/dl; 95% confidence interval [CI] = 0.28, 10.29) and TNF-α (d60 = 1.81 mg/dl; 95% CI = 0.79, 15.41) levels. Reallocations from LPA to sleep were also associated with increases in C3 levels (d60 = 8.10 mg/dl; 95% CI = 0.79, 15.41). Reallocations from LPA to any of the remaining time-use components were associated with increases in C4 levels (d60 ranging from 2.54 to 3.63 mg/dl; p < 0.05), while any reallocation of time away from MVPA was associated with unfavourable changes in leptin (d60 ranging from 3088.44 to 3448.07 pg/ml; p < 0.05). Conclusions: Reallocations of time between 24-h movement behaviours are prospectively associated with some inflammatory markers. Reallocating time away from LPA appears to be most consistently unfavourably associated with inflammatory markers. Given that higher levels of inflammation during childhood and adolescence are associated with an increased risk of chronic diseases in adulthood, children and adolescents should be encouraged to maintain or increase the level of LPA to preserve a healthy immune system. [ABSTRACT FROM AUTHOR]

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6‐18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008‐2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010‐2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012‐2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term. [ABSTRACT FROM AUTHOR]

Background: Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents. Method: Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health‐related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule). Results: Higher performance on physical fitness components was associated with positive affect (β = −0.176–0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = −0.100–0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76). Conclusions: Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health. [ABSTRACT FROM AUTHOR]

Objective: The aims of the present study were to analyze the associations between the socio-demographic and familiar circumstances with: (i) the total leisure-time sedentary behavior (SB) assessed by accelerometry, and (ii) the domain-specific leisure-time SB (i.e., screen-based, educational-based, social-based, and other-based SB), in a sample of Spanish youth. Method: The sample consisted of 1,543 youth (12.02 ± 2.51 years) included in the UP&DOWN study. SB was evaluated by accelerometry and questionnaire. Nationality, location of school, type of school, socio-economic status, parental educational level, parental occupation status, family structure, number of siblings and position among siblings were self-reported by participants or their parents. Linear mixed models, including school and city as random effects, were performed. Results: Several associations were found; however, socio-demographic and family circumstances differently associated with SB according to the domain-specific SB, the sex and the type of day. For example, participants with a father holding a high-skilled occupation spent lower time in screen-based SB during weekdays; and mother occupation status of high qualification was related to higher educational-based SB in boys. Having three or more sibling was associated with lower total SB in boys, while having an obese mother was related to higher screen-based SB on weekends both in boys and girls. Conclusions: Socio-demographic and familiar circumstances are associated with SB in young people, so future interventions should consider multiple and sex-specific factors for reduce SB of young people, focusing especially on youth with a low number of siblings and with parents holding low-skilled employments. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify profiles of sedentary behaviour (SB) patterns, based on leisure-time self-reported SB modalities (screen, educative, social, and relaxing) and to evaluate changes in these profiles over 2 years among Spanish youth aged 8–18 years. Latent profile analysis (LPA), a data-driven analytic approach, was used to identify groups of boys and girls (n = 1553; 48% girls; mean±SD age: 12.56 ± 2.49 y) with distinct SB profiles using the SB modalities (time/d) as input variables. Latent transition analysis, an extension of LPA that uses longitudinal data, was used to analyse 2-year changes in these profiles. At baseline, four and three SB profiles were found among boys (labelled: screen, educative, social, and relaxing) and girls (labelled: screen/social, educative, and relaxing), respectively. Overall, more girls (range: 48%-67%) had the same profile over time, than boys (40%-52%). Participants with a screen or relaxing SB profile at baseline were more likely to have an educative profile after 2 years. Youth with a social and an educative SB profile at baseline were more likely to transition to profiles characterized by higher screen and social SB, respectively. Using a novel and person-centered approach, this study identified gender-specific SB profiles that were moderately stable over time. [ABSTRACT FROM AUTHOR]

The aims of the present study were: i) to examine the associations of total accelerometer-based sedentary time (ST) and specific-domain self-reported ST (i.e., screen-based, educational-based, social-based, and other-based ST) with adiposity and physical fitness in youth; and ii) to analyse the mediation effect of physical activity (PA) on associations. This study was conducted with 415 children (9.1 ± 0.4 years) and 853 adolescents (13.6 ± 1.6 years) in Spain during 2011-2012. Total ST and PA were assessed by accelerometry. Leisure-time spent in twelve sedentary behaviours was self-reported. Adiposity and physical fitness was measured following the ALPHA battery for youth. Total accelerometer-based ST was positively associated with global adiposity score in children, and negatively associated with global physical fitness score in children and adolescents; but relationships were not independent of PA. PA mediated all associations of accelerometer-based and self-reported ST with adiposity or physical fitness in children. Conversely, screen-, educational-, social-, and other-based ST were negatively related to physical fitness in adolescents, independently of PA. These findings give an impetus to developing effective strategies for specifically promoting PA in children and for increasing PA while reducing ST in adolescents in order to produce improvements on adiposity and physical fitness. [ABSTRACT FROM AUTHOR]

The study aimed (a) to examine changes in physical activity (PA) during the whole day, school hours, recess, and physical education classes (PEC) during a 2‐year period in primary and secondary students; (b) to identify changes in the proportion of compliance with specific PA recommendations for these periods; and (c) to examine whether PA levels at baseline are associated with PA levels 2 years later. Eight hundred and fourteen (51.8% boys) children and 658 (50.1% boys) adolescents from 41 Spanish schools participated in the study. Hip‐worn accelerometers were used to assess PA during different time periods. Light PA (LPA) declined during the whole day, school hours, recess (all P < 0.001, except child girls for recess), and PEC (all, P < 0.05) in children and adolescents. Moderate‐to‐vigorous PA (MVPA) during the whole day and recess declined in child boys (P < 0.01 and P < 0.001, respectively) and adolescent boys (P < 0.001 and P < 0.05, respectively). MVPA during PEC declined in adolescent boys (P < 0.001) and adolescent girls (all P < 0.05). The proportion of compliance with the specific PA recommendations for these periods declined (P < 0.05), except for PEC in adolescent girls. PA during the whole day at baseline was moderately associated with PA during the whole day years later (ICCs = 0.210‐0.544, with one exception), but this association was lower for the school‐based PA. In conclusion, time spent in MVPA and LPA during the whole day and recess declined over time in child and adolescent boys and during PEC in adolescents. These findings highlight the need to promote PA interventions in these settings. [ABSTRACT FROM AUTHOR]

The present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&DOWN study (follow-up in schoolchildren and adolescents with and without Down's syndrome). The present study excluded participants with Down's syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β =0·41, se 0·10, P <0·001; β =0·46, se 0·10, P <0·001, respectively) and to positive affect in secondary school girls and boys (β =0·16, se 0·05, P =0·006; β =0·20, se 0·05, P <0·001, respectively) and in primary school boys (β =0·20, se 0·08, P =0·019). At 2-year follow-up, MD adherence was negatively related to negative affect in secondary school adolescent girls and boys (β =–0·15, se 0·07, P =0·047; β =–0·16, se 0·06, P =0·019, respectively), and MD adherence was associated with higher positive affect scores in secondary school girls (β =0·30, se 0·06, P <0·001) and in primary school boys (β =0·20, se 0·09, P =0·023). However, MD adherence at baseline did not predict well-being indicators at 2-year follow-up. In conclusion, higher MD adherence was found to behave as a protective factor for positive well-being in cross-sectional analysis. [ABSTRACT FROM AUTHOR]

Aims: The purposes of this research were to study the convergent validity of the Mode and Frequency of Commuting To and From School Questionnaire using objectively assessed steps and time spent in different physical activity intensities and to compare the self-reported versus objective journey time in Spanish youths. Methods: Three hundred and eighty-nine Spanish youth aged 7–19 years were asked to complete the questionnaire and wore an accelerometer for five days. The objective commuting distance and time from home to school were estimated using Google MapsTM. Results: There were significant differences between passive and walking participants on step numbers, sedentary time and physical activity levels (except for vigorous physical activity in children). For children, a mean difference of −4.03 minutes between objective measured and self-reported journey time was found (95% limits of agreement were 13.55 and −21.60 minutes). For adolescents, the mean difference was −1.39 minutes (95% limits of agreement were 15.23 and −18.02 minutes). Conclusions: The findings indicated that the Mode of Commuting To and From School Questionnaire showed a convergent validity to assess this behaviour in Spanish youths. Self-reported journey time for walking is comparable to Google MapsTM in adolescents but not in children. [ABSTRACT FROM AUTHOR]

Background: Positive health is likely a buffer against physical and mental illness. Positive health may explain some of the health benefits associated with increasing cardiorespiratory fitness and decreasing fatness in youth. We examined the association of cardiorespiratory fitness and fatness with positive health indicators in 684 (365 boys and 319 girls) Spanish children aged 6–17.9 years. Methods: Positive health indicators were self-reported using items of the Health Behavior in School-aged Children questionnaire. The study health indicators were: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships and academic performance. Weight and height were measured and body mass index was computed. We also measured triceps and calf skinfolds thickness and body fat percentage was estimated. Cardiorespiratory fitness was measured by the 20 m shuttle-run test. Results: Cardiorespiratory fitness was positively associated with life satisfaction in children and adolescents. Fatness was inversely associated with perceived health status in children and adolescents, whereas fatness was inversely associated with life satisfaction, quality of family relationships and academic performance only in children. Conclusion: These findings suggest a link between cardiorespiratory fitness and fatness and positive health indicators, suggesting that improving both fitness and fatness could exert a favourable effect on positive health during childhood and adolescence. [ABSTRACT FROM PUBLISHER]

Background: Children and adolescents can be distinguished by different typologies (clusters) of physical activity and sedentary behavior. How physical activity and sedentary behaviors change over time within different typologies is not known. This study examined longitudinal changes in physical activity and sedentary time among children and adolescents with different baseline typologies of activity-related behavior., Methods: In this longitudinal study (3 annual time points) of children (n = 600, age = 9.2 ± 0.4 years (mean ± SD), 50.3% girls) and adolescents (n = 1037, age = 13.6 ± 1.7 years, 48.4% girls), participants were recruited in Spain in 2011-2012. Latent class analyses identified typologies based on self-reported screen, educational, social and relaxing sedentary behaviors, active travel, muscle strengthening activity, and sport at baseline. Within each typology, linear mixed growth models explored longitudinal changes in accelerometer-derived moderate-to-vigorous physical activity and sedentary time, as well as time by class interactions., Results: Three typologies were identified among children ("social screenies", 12.8%; "exercisers", 61.5%; and "non-sporty active commuters", 25.7%) and among adolescents ("active screenies", 43.5%; "active academics", 35.0%; and "non-sporty active commuters", 21.5%) at baseline. Sedentary time increased within each typology among children and adolescents, with no significant differences between typologies. No changes in physical activity were found in any typology among children. In adolescents, physical activity declined within all typologies, with "non-sporty active commuters" declining significantly more than "active screenies" over 3 years., Conclusion: These results support the need for intervention to promote physical activity and prevent increases in sedentary time during childhood and adolescence. Adolescents characterized as "non-sporty active commuters" may require specific interventions to maintain their physical activity over time., (Copyright © 2021. Production and hosting by Elsevier B.V.)

This paper describes the protocol for a study designed to address the high prevalence (40%) of childhood overweight and obesity in the province of Cádiz, Spain, as a reflection of what is happening worldwide. It is widely known that children who suffer from childhood obesity have a higher risk of developing chronic diseases in adulthood. This causes a decrease in the quality of life and an increase in health spending. In this context, it is necessary to intervene promoting healthy lifestyle habits from an early stage. The objective of this project will be to evaluate the effectiveness of a multimodal intervention (individual, school and family) called "PREVIENE-CÁDIZ" [CADIZ-PREVENT]. The intervention will be focused mainly on diet, physical activity, sedentary lifestyle and sleep, to prevent overweight and obesity in schoolchildren from 8 to 9 years old in the province of Cádiz. It will consist of a 10-session education program carried out in the classroom by the teachers. In addition, children will be assigned two workbooks, one to work on in class and the other at home with parents. A workshop aimed at parents will be included to help teach them how to obtain healthier lifestyle habits. The proposed study will involve a quasi-experimental design with a control group.

During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (-29.5%) and vigorous (-18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.

Background: Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents., Methods: This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011-12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators., Results: Multilevel analyses observed decreases in LPA between T0-T1 (β = - 11.27; p < 0.001) and T0-T2 (β = - 16.27; p < 0.001) and decreases in MVPA between T0-T2 (β = - 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (β = 0.78; p = 0.028) and T0-T2 (β = 0.81; p = 0.046). Path analyses showed that AST was directly positively associated with MVPA at T1 (all, β ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (β = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations., Conclusions: Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

Purpose: The aim of the present study was to analyze the associations of youths' sedentary behavior (SB) with parents' and siblings' SB and physical activity (PA), as well as the associations of youths' coparticipation with parents, siblings, and friends in PA and SB with youths' SB., Methods: The sample consisted of 1543 youths (12.02 ± 2.51 years; 788 boys) enrolled in the baseline cohort of the UP&DOWN study. SB was assessed by accelerometry and questionnaire. Participants reported the time spent by their parents and siblings watching television, playing videogames, surfing the Internet, sitting/resting, and doing PA. Further, participants reported coparticipation with parents, siblings, and friends in these activities. Linear mixed models, including school and city as random effects, were performed., Results: Parents' television time was positively associated with youths' screen-based SB. Coparticipation with friends in playing videogames (in boys) and in surfing the Internet (in girls) showed a positive association with screen-based SB and a negative association with educational-based SB. Moreover, coparticipation with siblings and friends in PA was inversely associated with accelerometer-based SB in boys and girls., Conclusion: Our results emphasize the important role of social modeling in the development of sedentary lifestyles in youths. Interventions aimed at reducing health risk behaviors in youths could be more effective if they are oriented from a social perspective that involves their families and networks of their closest friends., (© 2019 Published by Elsevier B.V. on behalf of Shanghai University of Sport.)

This study investigated the associations between the characteristics of the nearby physical environment with the total and domain-specific leisure-time sedentary behaviour (SB) in young people. The study included 1578 youth (9-18 years) from the UP&DOWN study. Total leisure-time SB was objectively-assessed by accelerometers. Participants self-reported the time spent during leisure-time in different domains of SB (i.e. screen-based, educational-based, social-based, and other-based SB). Information regarding the basic characteristics of the house, the perceived neighbourhood environment, the amount of physical activity facilities, equipment and materials attainable at home, and the media equipment available at home and in the own bedroom was collected. Linear mixed models were performed, including school and city as random effects. The availability of yard was related to lower total SB and time spent surfing the Internet in boys, but not in girls. More favourable perceived neighbourhood environment was associated with lower total SB and time spent playing video games in girls, but not in boys. The amount of physical activity materials at home was negatively associated with screen-based SB, while the availability of a computer in the own bedroom was positively related to the time spent surfing the Internet in boys and girls. The number of televisions at home and having a computer in the own bedroom was associated with lower time in educational-based SB in boys and girls, respectively. Increasing the number of PA materials at home and decreasing the number of TVs at home and the availability of a computer in the bedroom could improve SB profiles of youth.

Objectives: To identify lifestyle clusters in children and adolescents, to analyze associations between lifestyle clusters and body fat percentage (BFP) at baseline and 2 years later, and to examine if BFP at baseline is associated with BFP 2 years later., Study Design: This longitudinal study involved 1634 Spanish youth (804 girls) aged 8-18 years (mean, 12.45 ± 2.51 years). Cluster analysis was performed by including objectively measured sedentary time and physical activity and self-reported screen time and diet. The associations between cluster membership and BFP was analyzed through general linear models. All the analyses were separated by 3 age groups: older children, younger adolescents, and older adolescents., Results: Four clusters were identified in the 3 age groups: (1) healthy lifestyle cluster (high moderate-to-vigorous physical activity, low screen and total sedentary time), (2) predominantly sedentary cluster, (3) mainly screen time consumers cluster, and (4) nonhealthy lifestyle cluster (predominantly low moderate-to-vigorous physical activity and unhealthy diet). Participants belonging to the healthy lifestyle cluster showed significantly lower BFP at baseline and 2 years later compared with the other profiles. These differences remained significant when adjusted by BFP at baseline within the younger adolescents. Moreover, BFP at baseline positively predicted BFP 2 years later in all groups., Conclusions: These findings identify distinct lifestyle patterns. These clusters could be useful to develop interventions to reduce overweight and obesity in children and adolescents., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: We examined the association of cardiorespiratory fitness and fatness with health complaints and health risk behaviors in 691 (323 girls) Spanish children aged 6 to 17.9., Methods: Health complaints and health risk behaviors were self-reported using items of the Health Behavior in School-aged Children questionnaire. Weight and height were measured and body mass index was computed. Cardiorespiratory fitness was measured by the 20-m shuttle-run test, and youth categorized as fit/unfit., Results: Unfit youth were more likely to report health complaints sometime (OR: 2.556, 95% CI: 1.299-5.031; and OR: 1.997, 95% CI: 1.162-3.433, respectively) and health risk behaviors such as drinking alcohol sometime (OR: 5.142, 95% CI: 1.214-21.783; and OR: 2.413, 95% CI: 1.484-3.923) than their fit counterparts. Overweight-obese youth were more likely to report health complaints (OR: 1.732, 95% CI: 1.019-2.945; and OR: 1.983, 95% CI: 1.083-3.629, respectively). The analysis of the combined influence of fitness and fatness revealed that fit youth had lower health complaints index than the fat-unfit and unfat-unfit groups (all P < .05)., Conclusions: Low fitness and overweight-obesity increased the risk of having health complaints in youth, yet high levels of cardiorespiratory fitness might overcome deleterious effects of overweight-obesity on health complaints.

We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.

The aim of this study was to provide percentile values for 9 different muscular strength tests for Spanish children (1,513 boys and 1,265 girls) aged 6 to 17.9 years. The influence of body weight on the muscular strength level across age groups was also examined. Explosive strength was assessed by the throw ball test (upper body), standing broad jump, and vertical jump tests (lower body). Upper-body muscular endurance was assessed by push ups, bent arm hang, and pull ups tests, and abdominal muscular endurance was assessed by sit ups, curl ups in 30 seconds, and curl ups tests. Body mass index (BMI) was calculated. Participants were categorized according to the BMI international cut-off values as underweight, normalweight, overweight, and obese. Boys had significantly better scores than girls in all the studied tests, except in the 3 upper-body muscular endurance tests in the 6- to 7-year-old group and in the push ups test in the 8- to 9-year-old group. Underweight and normalweight individuals showed similar strength levels. Both underweight and normalweight children and adolescents had significantly higher performance than their overweight and obese counterparts in the lower-body explosive strength tests and in the push ups test in boys and bent arm hang test in both boys and girls. In conclusion, percentiles values of 9 muscular strength tests are provided. Percentiles values are of interest to identify the target population for primary prevention and to estimate the proportion of adolescents with high or low muscular strength levels. The overweight and obese groups had worse scores than their underweight and normalweight counterparts, whereas the underweight group had a similar performance to the normalweight group.