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Background: Pediatricians’ clinical practice and health interventions in youths require instruments with adequate psychometric properties to assess physical activity (PA), sedentary behaviors (SB), and their subdomains. Objective: To assess the psychometric properties of the Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) in healthy French children and adolescents. Methods: The CAPAS-Q has been developed through a rigorous collective procedure and consists of a 31 items self-administered questionnaire evaluating children’s 7-day PA and SB dimensions and subdomains. Participants (n = 103, aged 8–18 years old) completed the questionnaire twice (7 days apart) and wore an ActiGraph GT3X+ accelerometer for 7 days. Anthropometric measurements and body composition were assessed. Results: Cronbach alpha for PA and SB dimensions were 0.71 and 0.68, respectively. Reproducibility was found moderate to good, with Lin’s coefficients of 0.69 and 0.68 for PA and SB dimensions, respectively. Reproducibility was higher for adolescents compared to children. PA dimension was positively correlated with moderate PA, vigorous PA, moderate to vigorous PA, and total PA times and negatively correlated with SB time (p < 0.05). SB dimension and screen time were positively correlated with SB time and negatively correlated with LPA, MPA, MVPA, and total PA times (p < 0.05). Spearman correlation coefficients were fair to moderate, ranging between 0.23–0.45. Conclusion: The CAPAS-Q proposes a reliable and valid evaluation of French children and adolescents’ PA and SB, providing clinicians with potential intervention levels to improve youth movement behaviors.

Background: There is an alarming and constant worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from France’s 2020 Report Card on physical activity for children and youth, comparing its results to its 2 previous editions (2016 and 2018). Methods: France’s 2020 Report Card follows the standardized methodology established by the Active Healthy Kids Global Matrix, grading 10 common physical activity indicators using the best available evidence. The grades were informed by national surveys, peer-reviewed literature, government and nongovernment reports, and online information. Results: The expert panel awarded the following grades: Overall Physical Activity: D; Organized Sport Participation and Physical Activity: C−; Active Play: INC; Active Transportation: C−; Sedentary Behaviors: D−; Family and Peers: D−; Physical Fitness: D; School: B−; Community and the Built Environment: F; Government: C. Conclusions: This 2020 edition of France’s Report Card again highlights the alarming levels of physical activity and sedentary behaviors among French children and adolescents, calling for the development of effective national action. It also draws attention to the particular deleterious effects of the COVID-19 confinement on youth’s movement behaviors, which significantly worsened the situation.

Despite the accumulation of scientific evidence supporting the benefits of physical activity, the general population remains insufficiently active and this situation is even worsened for some specific populations such as obese people (Barker et al., 2019). It is therefore becoming urgent to develop interventions that can effectively change individuals' behavior. In this context, “e-health” interventions and gamification appear to be a particularly promising avenue to improve physical activity and reduce attrition rates of current programs. This study protocol aims to present a randomized, two-arm intervention design that will examine the efficacy of a digital intervention based on play and teamwork for an obese sample. Fifty patients will be recruited at the hospital of Clermont-Ferrand, France and randomized into two groups: the experimental group will receive digital supervised sessions of PA in videoconference and a gamification of PA through a mobile app and will be compared to an active control group representing the traditional care program (supervised physical activity three times per week during three months). Informed by the tenets of the social identity approach and built around behavior change techniques, implemented via the principles of gamification, this three-month intervention has the objective to improve physical activity adherence. Objective and self-reported PA, quality of live, physical condition and psychological variables like motivation or perceived discrimination will be assessed before, at the end of the intervention and then at the issue of a 6-month follow up in order to evaluate the long-term effect of the intervention. We make the assumption that the intervention will be efficient by the development of an intrinsic motivation through the process of gamification on the one hand. On the other hand, through the in-group collaboration with other people who share the same stigmatized criteria that will help participants to overcome weight stigmas, acting generally as physical activity barriers. This poster presentation will introduce the conception of the intervention, the experimental design and proposed evaluation of the trial. If the effectiveness of this intervention is confirmed, its implementation in the health circuit could reduce the costs and constraints associated to face-to-face support.

Background There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France. Methods Based on individual sedentary behaviour time, relative risk to develop cardiovascular disease, colon cancer, breast cancer and all-causes of premature mortality were identified. From relative risk and prevalence of sedentary behaviour time, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the National Health Insurance were used to calculate the annual average costs per case for each disease. Disease-specific and total healthcare costs attributable to prolonged sedentary behaviour time were calculated. Indirect costs from productivity loss due to morbidity and premature mortality were estimated using a friction cost approach. Results In France, 51 193 premature deaths/year appear related to a prolonged daily sedentary behaviour time. Each year prolonged sedentary behaviour cost 494 million € for the national health insurance. Yearly productivity loss due to premature mortality attributable to prolonged sedentary behaviour cost 507 million € and yearly productivity loss due to morbidity cost between 43 and 147 million €. Conclusion Significant saving and many deaths could be avoided by reducing prolonged sedentary behaviour prevalence in France. To address this issue, strong responses should be implemented to tackle sedentary behaviour, complementary to physical activity promotion.

Resume Cinq millions de deces par an dans le monde pourraient etre evites si les recommandations d’activite physique (AP) etaient respectees. Le risque attribuable de mortalite liee a l’inactivite physique est de 6 % et la fraction preventive de 15 %. Les etudes ont demontre avec un haut niveau de preuves scientifiques que l’activite physique et sportive reguliere permettait de prevenir et de traiter la plupart des maladies chroniques non transmissibles : maladies cardiovasculaires, diabete de type 2, cancer du colon, du sein, de l’endometre. L’AP contribue aussi a la prevention des principaux facteurs de risques de ces maladies. En France, quelles que soient les tranches d’âge, l’AP est consideree comme insuffisante au regard des recommandations de l’OMS et les temps de sedentarite atteignent 12 h/jour. Les enfants sont les plus impactes par cette association « inactivite et sedentarite ». Pour modifier ce comportement associant insuffisance d’activite physique et sedentarite des le plus jeune âge, les changements doivent concerner tous les composants de l’AP et de la sedentarite (ecole, etudes, vie professionnelle, loisirs), des le plus jeune âge, tout au long de la vie jusqu’aux seniors.

IntroductionPhysical inactivity and excessive sedentary behaviours are major preventable causes in both the development and the treatment of obesity and type 2 diabetes mellitus (T2DM). Nevertheless, current programmes struggle to engage and sustain physical activity (PA) of patients over long periods of time. To overcome these limitations, the Digital Intervention Promoting Physical Activity among Obese people randomised controlled trial (RCT) aims to evaluate the effectiveness of a group-based digital intervention grounded on gamification strategies, enhanced by social features and informed by the tenets of the self-determination theory and the social identity approach.Methods and analysisThis trial is a two-arm parallel RCT testing the effectiveness of the Kiplin digital intervention on obese and patients with T2DM in comparison to the usual supervised PA programme of the University Hospital of Clermont-Ferrand, France. A total of 50 patients will be randomised to one of the two interventions and will follow a 3-month programme with a 6-month follow-up postintervention. The primary outcome of the study is the daily step count change between the baseline assessment and the end of the intervention. Accelerometer data, self-reported PA, body composition and physical capacities will also be evaluated. To advance our understanding of complex interventions like gamified and group-based ones, we will explore several psychological mediators relative to motivation, enjoyment, in-group identification or perceived weight stigma. Finally, to assess a potential superior economic efficiency compared with the current treatment, we will conduct a cost–utility analysis between the two conditions. A mixed-model approach will be used to analyse the change in outcomes over time.Ethics and disseminationThe research protocol has been reviewed and approved by the Local Human Protection Committee (CPP Ile de France XI, No 21 004-65219). Results will inform the Kiplin app development, be published in scientific journals and disseminated in international conferences.Trial registration numberNCT04887077.

Points essentiels La triade est liee a une disponibilite energetique insuffisante. Il existe un continuum entre la severite du deficit energetique, la severite des troubles du cycle et l’atteinte osseuse. L’os represente l’urgence clinique de la triade. Le retour a des cycles reguliers apres plusieurs episodes d’irregularites menstruelles ne s’accompagne pas toujours d’une restauration totale de la densite osseuse. La prise en charge nutritionnelle est l’etape majeure et indispensable avec augmentation de l’apport energetique et/ou une reduction de l’activite physique et sportive.

Resume Objectifs L’inactivite physique est la premiere cause de mortalite evitable dans le monde. La sedentarite est un nouveau facteur de risque identifie de maladies cardiovasculaires, de diabete et de certains cancers. Les recommandations internationales preconisent pour les adultes au moins 30 mins d’activite physique moderee a vigoureuse par jour et un temps sedentaire quotidien inferieur a 7 heures. Les medecins generalistes liberaux (MGL) ont pour mission de promouvoir ces recommandations mais il n’est pas sur qu’ils les appliquent a eux-memes. L’objectif de cette etude exploratoire etait d’evaluer le respect des recommandations internationales concernant l’activite physique et la sedentarite d’un groupe de MGL du sud-ouest de la France. Materiels et methodes L’activite physique de 94 MGL (55,3 % de femmes) âges en moyenne de 42,7 ans a ete mesuree avec des accelerometres Actigraph® GT3X pendant sept jours consecutifs. L’enregistrement de leur temps sedentaire et de leur niveau habituel d’activite physique moderee a vigoureuse a ete complete par un auto-questionnaire portant sur le temps de travail et l’activite physique. Le recueil des donnees s’est deroule en mars 2019 dans cinq departements francais (Landes, Gironde, Pyrenees-Atlantiques, Hautes-Pyrenees et Gers). Resultats Les MGL etaient significativement plus sedentaires et plus inactifs les jours de travail que les jours de repos. Les femmes etaient significativement plus sedentaires et moins actives que les hommes les jours de travail. Seuls 51,1 % des MGL respectaient les recommandations internationales d’activite physique durant les jours de travail alors que 77,6 % respectaient les recommandations durant les jours de repos. Tous les MGL etaient sedentaires plus de 7 heures par jour de travail et 94,7 % etaient sedentaires plus de 7 heures par jour de repos. Conclusion Les medecins generalistes liberaux devraient augmenter leur niveau d’activite physique moderee a vigoureuse et diminuer leur temps sedentaire au quotidien. Ces donnees doivent etre prises en compte pour l’amelioration de leurs conditions de travail.

Introduction Regular physical activity (PA) is recommended by all type 2 diabetes mellitus (T2DM) management guidelines. The OPADIA study aimed to determine whether using a specific patient questionnaire (Optima-PA©) could help T2DM patients increase their PA by leading to better physician-patient communication and improved levels of shared decision making concerning Specific, Measurable, Acceptable, Realistic, Timely (SMART)-PA micro-objectives. Methods Physicians participating in this multicentre, prospective, randomised, real-life study were allocated to a standard group (T2DM patients managed according to usual clinical practice, n = 24) or the OPTIMA-PA group (additional use of the questionnaire, n = 30). The main outcome was the percentage of inclusion visits ending with the setting up of at least one SMART-PA micro-objective. Other outcomes were the impact of the OPTIMA-PA questionnaire on patient perceptions of shared decision making (ENTRED questionnaire) and the impact of the OPTIMA-PA questionnaire and establishing SMART-PA micro-objectives as well as patient-perceived physician empathy (ENTRED questionnaire) and GP aptitude for patient-centredness (SEPCQ scores) on patient PA levels over a 3-month period (IPAQ-SF scores). Results One hundred twenty-two patients were included in the standard group and 134 in the OPTIMA-PA group. Unexpectedly, more inclusion visits ended with SMART-PA micro-objectives being set up in the standard group (p

Background: Insufficient levels of physical activity and increasing sedentary time among children and youth are being observed internationally. The purpose of this paper is to summarize findings from France’s 2018 Report Card on physical activity for children and youth, and to make comparisons with its 2016 predecessor and with the Report Cards of other countries engaged in the Global Matrix 3.0. Methods: The France’s 2018 Report Card was developed following the standardized methodology established for the Global Matrix 3.0 by grading 10 common physical activity indicators using best available data. Grades were informed by national surveys, peer-reviewed literature, government and nongovernment reports, and online information. Results: The expert panel awarded the following grades: overall physical activity, D; organized sport participation and physical activity, C−; active play, INC; active transportation, C−; sedentary behaviors, D−; physical fitness, B–; family and peers, INC; school, B; community and the built environment, INC; and government, C. Conclusions: Very concerning levels of physical activity and sedentary behaviors among French children and youth were observed, highlighting the urgent need for well-designed national actions addressing the presented physical inactivity crisis. The top 3 strategies that should be implemented in priority to improve the lifestyle of French children and youth are provided.

UNSTRUCTURED Not applicable.

International audience; Objective Regular physical activity (PA) is a key element in chronic disease management. We studied the effect of a recent legislative framework given to physical activity prescription (PAP) on practices, motivations, barriers, and needs for PAP in primary care among general practitioners (GP) of the Auvergne-Rhone-Alpes region, France.Methods Our cross-sectional survey used a self-administrated questionnaire through two recruitment methods: e-mail address (online group) and face-to-face (office group). Based on the data pertaining to demography, motivation scores, needs, and barriers, we analyzed the profiles of participating GPs.Results Among the 283 GPs, online participants (n = 250) were younger than office participants (n = 33) (46 +/- 11 vs. 51 +/- 12 years, p = 0.0083), and were physically more active (80% vs 51%, p = 0.0006). Regular PA was also critical in the profile of current prescribers (OR = 2.83 (95%CI [1.28, 7.00]), p = 0.015). The motivation score for PAP was high and equal in both groups (10.5 +/- 3.3 in a maximum of 15), but multiple barriers emerged, which demonstrated age-dependent variations in the score. Young GPs mostly identified self-imposed barriers (exercise referral, PAP training), while for older GPs these barriers were equally attributable to patients.Conclusion Although the legislative framework given to PAP in France was associated with a 12% increase in the number of prescribers, PA remains poorly prescribed in primary care, even among the most motivated physicians.

While academic achievement has been associated with physical activity, the present work questions the potential association between the physical fitness level of adolescents and the type of school they attend, ranging from academic to technical schools. 20,228 young French students from 76 schools (9,196 females), mean age 15.8±1.8 years, performed the Diagnoform© test. This dataset includes two higher education institutions (n=870), 37 general high schools (n=13,125), 18 professional-oriented high schools (n=3,569), 5 agricultural high schools (n=132), 2 vocational training centers (n=202) and 12 rural vocational training centers (n=1,137). In higher education institutions and general high schools, girls showed better performances for all physical tests. A decreasing Quotient of overall Physical fitness Condition (QPC) was observed for both genders from urban higher education schools to rural and technical institutions (p

International audience; With highly variable types of coronavirus disease 2019 (COVID-19) symptoms in both severity and duration, there is today an important need for early, individualized, and multidisciplinary strategies of rehabilitation. Some patients present persistent affections of the respiratory function, digestive system, cardiovascular function, locomotor system, mental health, sleep, nervous system, immune system, taste, smell, metabolism, inflammation, and skin. In this context, we highlight here that hydrothermal centers should be considered today as medically and economically relevant alternatives to face the urgent need for interventions among COVID-19 patients. We raise the potential benefits of hydrotherapy programs already existing which combine alternative medicine with respiratory care, physical activity, nutritional advice, psychological support, and physiotherapy, in relaxing environments and under medical supervision. Beyond the virtues of thermal waters, many studies reported medical benefits of natural mineral waters through compressing, buoyancy, resistance, temperature changes, hydrostatic pressure, inhalations, or drinking. Thermal institutions might offer individualized follow-up helping to unclog hospitals while ensuring the continuity of health care for the different clinical manifestations of COVID-19 in both post-acute and chronic COVID-19 patients. Our present review underlines the need to further explore the medical effectiveness, clinical and territorial feasibility, and medico-economic impacts of the implementation of post-COVID-19 patient management in hydrotherapeutic establishments.

International audience; Background: Acute dietary-induced energy deficits have been shown to favor compensatory appetitive responses. The aim of this study was to compare energy intake (EI), appetite sensations and the hedonic responses to equivalent energy deficits induced by dietary restriction alone and combined with exercise in adolescents with obesity.Methods: In a within-subjects design, seventeen adolescents with obesity (12-16 years, Tanner stage 3-5, 6 males) randomly completed three 14 h conditions: (i) control (CON); (ii) deficit induced by diet only (Def-EI) and; (iii) deficit induced by combined diet and physical exercise (Def-mixed). Breakfast and lunch were cali-brated to generate a 500 kcal deficit in Def-EI and 250 kcal deficit in Def-mixed. A 250 kcal deficit was created through a cycling exercise set at 65% VO2peak in Def-mixed. Ad libitum EI, macronutrients and relative EI (REI) were assessed at dinner, subjective appetite sensations taken at regular intervals, and food reward measured before dinner.Results: EI at dinner was significantly lower in Def-EI compared to CON (p = 0.014; Effect size (ES):-0.59 [-1.07;-0.12]), with no difference between Def-mixed and both CON and Def-EI. Total REI was lower in both deficit conditions compared with CON (Def-mixed: p < 0.001; ES:-3.80 [-4.27;-3.32], Def-EI: p < 0.001; ES:-4.90 [-5.37;-4.42] respectively), indicating incomplete compensation for the energy deficits. Absolute protein ingestion at dinner was lower in Def-EI than Def-mixed (p = 0.037; ES:-0.50 [-0.98;-0.03]) and absolute lipid ingestion was lower in Def-EI than in CON (p = 0.033; ES:-0.51 [-0.99;-0.04]). A higher proportion of protein and a lower proportion of carbohydrates was observed in Def-mixed than in Def-EI (p = 0.078; ES:-0.42 [-0.90; 0.04] and p = 0.067; ES: 0.44 [-0.03; 0.92] respectively). Total area under the curve for appetite sensations were similar between conditions. Explicit liking for sweet relative to savoury food was lower in Def-mixed compared to CON (p = 0.027; ES:-0.53 [-1.01;-0.06]) with no difference in food reward between Def-EI and CON.Conclusion: Neither of the two acute isoenergetic deficits led to subsequent appetitive compensation, with the dietary deficit even inducing a lower ad libitum EI at the subsequent dinner. Further studies are needed to better understand the appetitive response to dietary and exercise energy balance manipulations in this population.

School-based multi-component educational interventions have been encouraged to improve children’s movement behaviors. The present study evaluates the effect of the Globe Trotter Initiative on physical activity (PA) level, sedentary time, physical fitness and activity preferences in primary school children. A total of 361 children (9–10 years) participated in this cluster-randomized trial. Nine schools were randomized as control (CON, 121 children) or Globe Trotter schools (GT, 240 children). Physical fitness, body composition, anthropometric characteristics, PA level, sedentary behaviors, physical self-perception, and activity preferences were evaluated at baseline (T0) and after the one-month intervention (T1). Grip strength performance and overall completion time of the obstacle course show a significant time effect (p < 0.001) in both groups (no group effect). PA level and physical self-perception did not significantly show time nor group effects. The sedentary behavior score displays a significant “time × group” interaction effect (p = 0.04) with a significant reduction between T0 and T1 in the GT group only (p < 0.001). The explicit liking for sedentary activities shows a significant “time × group” interaction (p = 0.02) with a significant decrease between T0 and T1 in the GT group only (p < 0.001). The explicit wanting for sedentary activities show a significant “time × group” interaction (p = 0.02) with a significant decrease between T0 and T1 in the GT group only (p < 0.001). The short-term, multi-component, behavioral, educational GT intervention had beneficial effects on primary-school-aged children’s sedentary time and implicit preference for physical over sedentary activities.

International audience; While a declined physical activity level (PAL) and an increase of sedentary behaviors at all ages during the COVID-19–induced first confinement period have been unanimously observed worldwide, the lately instituted new social distancing strategies and lockdowns around the world require the formulation and dissemination of adapted and accessible recommendations to promote physical activity (PA) and limit the progression of sedentary time (SED) in the upcoming weeks. From a public health perspective, it appears imperative to encourage the adoption of healthy movementbehaviors despite the new activity restrictions imposed by governments to slow down the alarming progression of the SARS-CoV-2 pandemic.

Rapid weight loss (RWL) is a common precompetitive strategy used by athletes in weight-class sports and carries with it an increased risk to future cardiometabolic health. The Rapid Weight Loss Questionnaire (RWLQ) is a self-reported tool designed to identify and characterize such weight loss practices.After developing a reliable and reproducible French version of the RWLQ (RWLQ-FR), the present study aims to analyse RWL patterns among French weight-class athletes and to point out potential relationships between such practices and risk of subsequent weight gain.A test-retest analysis was performed in 54 athletes to test the questionnaire reproducibility before applying it in a cohort of 168 weight-cycling athletes (23.78 ± 9.25 y, 67.6 ± 12.6 kg, 81 males and 87 females, n = 24 strength sports and n = 144 various combat sports).The test-retest showed good agreement of the RWLQ-FR (Rho = 0.794, [0.696-0.893]). Athletes reported losing an average of 4.1 ± 2.9% of their initial weight in 13.1 ± 9.6 days, with the main methods used being an increase in exercise, training in rubber or plastic suits, and gradual dieting. The average weight recovery in a week was 3.5 ± 2.8% and results showed that the athletes with the lower inter-season weight (weight outside of the training and competition season) regained the more weight (p = 0.025). The average RWLQ-FR score was 31.9 ± 17.3 and athletes who began to lose weight earlier in their competitive carrier had the higher scores (p = 0.032).The present study demonstrates relationships between the pattern of RWL practices and potential increased risk of subsequent weight gain in weight-cycling athletes, and the need to better understand the long-term health-related risks.

Background Sedentary behaviour (SB) and low levels of physical activity (PA) are predictors of morbidity and mortality. Tertiary employees spend a considerable amount of their daily time seated and new efficient strategies to both reduce sedentary time and increase physical activity are needed. In that context, the REMOVE study aims at evaluating the health effects of a 24-week cycling desk intervention among office workers. Methods A prospective, open-label, multicentre, two-arm parallel, randomized controlled trial (RCT) will be conducted in office-sitting desk workers. Office workers (N = 80) who have 0.8 full time equivalent hours (FTE) and 75% of this time in a sitting position will be recruited from tertiary worksites in Clermont-Ferrand, France. Subjects will be randomly assigned to one of the two following interventions: (i) PPM6: performance of two 30 min of cycling desk (using portable pedal exercise machine—PPM) per working day for 6 months or (ii) CTL_PPM3: 3 months with no intervention (control) followed by 3 months during which workers will be asked to complete two 30 min of PPM per working day. At baseline (T0), at 3 months (T1) and at 6 months (T2) after the start of the interventions, primary outcomes; 7-day PA and SB (3D-accelerometers), secondary outcomes; body composition (bioelectrical impedance), physical fitness (aerobic fitness, upper and lower limb strength), metabolic outcomes (fasting blood samples), self-perceived stress, anxiety, quality of life at work and job strain (questionnaires), tertiary outcomes; resting metabolic rate and cycling energy expenditure (indirect calorimetry) and eating behaviours (questionnaires) will be measured. An ergonomic approach based on observations and individual interviews will be used to identify parameters that could determine adherence. Discussion The REMOVE study will be the first RCT to assess the effects of cycling workstations on objectively measured PA and SB during working and non-working hours and on key physiological and psychological health outcomes. This study will provide important information regarding the implementation of such cycling workstations in office workers and on the associated potential health benefits. Trial registration ClinicalTrials.govNCT04153214. Registered on November 2019, version 1

Letter; International audience

Five million deaths per year worldwide could be prevented if physical activity (PA) recommendations were followed. Scientific studies have shown with a high level of evidence that PA prevents and treats most chronic diseases. It also contributes to the prevention of the main risk factors for these diseases. In France, whatever the age group, physical activity is considered insufficient in relation to the recommendations of the World Health Organisation. However, over the last ten years, public policies have been moving in the direction of promoting physical activity.

Active-desks are emerging strategies aiming at reducing sedentary time while working. A large inter-individual variability in energy expenditure (EE) profile has been identified and has to be explored to better optimize and individualize those strategies. Thus the present study aimed at comparing the metabolic and physical profile of individuals characterized as high spenders (H-Spenders) versus low spenders (L-Spenders) based on EE during a cycle-desk low intensity exercise. 28 healthy women working in administrative positions were enrolled. Anthropometric, body composition and fasting metabolic profile parameters were assessed. EE was determined by indirect calorimetry, at rest and during a 30-min cycle-desk use. Participants were categorized as H-Spenders and L-Spenders using the median of the difference between EE at rest and during the 30-min exercise. H-Spenders had higher mean EE (p p = 0.009) during exercise. H-Spenders displayed higher values for fasting plasma insulin (p = 0.002) and HOMA-IR (p = 0.002) and lower values for HDL-cholesterol (p = 0.014) than L-Spenders. The percentage of body fat mass was significantly higher in H-Spenders (p = 0.034). Individuals expending more energy during a low intensity cycling exercise presented a less healthy metabolic profile compared with L-Spenders. Future studies will have to explore whether the chronic use of cycle-desks during work time can improve energy profile regarding metabolic parameters.

International audience; Introduction: A national confinement was imposed in France in March 2020 during 55 days to prevent the spread of the virus and protect vulnerable people such as older individuals. This study aimed to describe the movement behaviors, and their determinants, of elderly people (≥ 65 years) during the confinement. Methods: An online survey was conducted from April 1st, 2020 to May 6th, 2020 by the National Observatory for Physical Activity and Sedentary behaviors. This study compared the level of physical activity (PA), sitting and screen time before and during the confinement and identified the impact of initial PA, sedentary profiles of the participants and housing conditions.Results: 1,178 people were included in this study. Reaching PA recommendations before lock-down was associated with the change in PA level during lock-down (p < .001). Besides, geographic location was associated with the change in PA, sitting time and screen time during lock-down (respectively p = .03, p = .02, p = .02).Conclusion: This study confirm the negative impact of confinement on senior movement behaviors, whether or not they met with public health recommendations prior to the pandemic. The housing conditions of older people must be also taken into future public health policies.

The aim of the present study was to evaluate whether the COVID-19-related confinement and social restrictions affected the levels of physical fitness and academic achievement in primary school French children. A total of 206 primary school children (106 before confinements and 100 after restrictions) completed a test battery evaluating their anthropometric characteristics, body compositions, activity preferences, cognitive performances and physical fitness. The performance of the Standing Long Jump was better at T0 (169.9 ± 142.5 cm) compared to T1 (135.2 ± 31.4 cm) (p = 0.0367), and the Medicine Ball Throw performance declined from T0 to T1 (297.3 ± 81.1 cm vs. 249 ± 52 cm, p &lt, 0.0001). Motor skills (26.9 ± 6.2 s vs. 30.9 ± 5.4 s, 0.0001), the shuttle-run test (stages completed), Maximal Aerobic Speed, and the estimated VO2max were lower at T1 compared to T0 (p &lt, 0.0001). Executive functioning was found to be greater at T0 compared to T1 (p &lt, 0.0001). Explicit liking or wanting for sedentary or physical activities did not change between T0 and T1. Both overall physical fitness and cognitive performance drastically declined among primary school French children with the COVID-19-related public health restrictions, which reinforces the need to urgently develop preventive strategies in anticipation of further mitigation measures.

BACKGROUND: The present study examines the effects of the COVID-19 confinement on healthrelated behaviors (physical activity, sedentary behaviors) of young French children. METHODS: Parents of 348 French children under 6 years of age completed an online survey launched during the first days of the initial COVID-19-related confinement. They were asked to indicate whether their kids increased, decreased or maintained their physical activity level, time spent in sedentary behaviors, and sleep time. Information regarding the configuration of their home environment (access to outdoor facilities, implantation area) and lifestyle habits (solitary activity, parents' solicitation; nap time; night waking episodes and night duration) were also collected. RESULTS: A total of 25.0% of the children were reported to decrease, 24.7% maintained and 50.3% increase their physical activity during the confinement. Greater proportions of kids who had access to a collective (51.4%) or individual (53.7%) outdoor area increased their physical activity. Regardless of the housing situation (urban, suburban or rural) or access to outdoor facilities, the majority of children increased their screen time (60.4%). Two-thirds (66.7%) of parents reported nap time remained unchanged for their kids. Fifty-one percent of parents admitted a link between teleworking and their kids' screen time. CONCLUSIONS: Health behaviors were differentially impacted in very young kids during a confinement period. Importantly, a majority of parents admitted a causal effect of telecommuting on their kids' screen exposure. The present results also show that the proneness to increase physical activity during confinement is positively related to access to a favorable outdoor environment.

Immersed exercise has been shown to induce higher energy expenditure and no difference or increase in food intake compared with similar exercise on land. In this study, we compared the effects of acute high-intensity cycling performed on land versus when immersed on subsequent energy intake (EI), appetite sensations and perceived exertion (RPE) in healthy men. Ten participants in a postprandial condition completed three experimental visits in a randomized order: a control condition (CONT); a high-intensity interval cycling exercise performed on land (HIIE-L) and the same exercise while immersed in water (HIIE-A) with a similar targeted heart rate. We observed no difference in energy and macronutrient intake and in area under the curve (AUC) for appetite sensations between sessions. The RPE at the end of HIIE-L was negatively correlated with EI (r=–0.67; p

UNSTRUCTURED Methods to measure physical activity and sedentary behaviors typically quantify the amount of time devoted to these activities. Among patients with chronic diseases, these methods can provide interesting behavioral information, but generally do not capture detailed body motion and fine movement behaviors. Fine detection of motion may provide additional information about functional decline that is of clinical interest in chronic diseases. This perspective paper highlights the need for more developed and sophisticated tools to better identify and track the decomposition, structuration, and sequencing of the daily movements of humans. The primary goal is to provide a reliable and useful clinical diagnostic and predictive indicator of the stage and evolution of chronic diseases, in order to prevent related comorbidities and complications among patients.

Methods to measure physical activity and sedentary behaviors typically quantify the amount of time devoted to these activities. Among patients with chronic diseases, these methods can provide interesting behavioral information, but generally do not capture detailed body motion and fine movement behaviors. Fine detection of motion may provide additional information about functional decline that is of clinical interest in chronic diseases. This perspective paper highlights the need for more developed and sophisticated tools to better identify and track the decomposition, structuration, and sequencing of the daily movements of humans. The primary goal is to provide a reliable and useful clinical diagnostic and predictive indicator of the stage and evolution of chronic diseases, in order to prevent related comorbidities and complications among patients.

Conflits d’interet des auteurs Martine Duclos declare des participations a des comites d’experts pour l’Agence nationale de securite sanitaire de l’alimentation, de l’environnement et du travail (Anses), l’Institut national du cancer (INCa), la Haute Autorite de sante (HAS), la Caisse nationale de l’assurance maladie (CNAM), ainsi que des contributions retribuees pour des comites (boards) d’experts et des conferences pour Merck Sharp & Dohme (MSD). Catherine Berne declare avoir beneficie d’invitations avec prise en charge financiere pour participation a des reunions scientifiques et/ou medicales de la part de Dinno Sante, Elivie, Pierre Fabre, Vitalaire; de remunerations en tant qu’investigateur d’etudes cliniques par Dinno Sante et Novartis. Muriel Tschudnowskydeclare avoir des liens d’interet avec Abbott, Asdia, Dinno Sante, Isis, Lilly France, Medtronic, Merck Sharp & Dohme (MSD), Nestle Home Care, Novartis, Novo Nordisk, Orkyn, Sanofi-aventis. Aurelien Descatoire declare avoir recu des honoraires pour des formations/ conferences et activites de consultant de Roche Diabetes Care et Vitalaire. Jean-Francois Gautier declare avoir percu des honoraires pour conferences ou en tant que consultant de AstraZeneca, Eli Lilly, Merck Sharp & Dohme (MSD), Novo Nordisk, Sanofi. Said Bekkadeclare avoir percu des honoraires en tant que conferencier pour AstraZeneca, Lilly France, Medronic, Novo Nordisk, Sanofi. Sylvia Franc declare etre membre de comite d’experts (« boards ») pour Novo Nordisk, Roche Diabetes Care, Sanofi ; avoir percu des honoraire en tant que conferenciere pour Lilly France et Novo Nordisk ; avoir beneficiee de financement de projets/programme de Recherche du Fond Merck Sharp & Dohme (MSD) Avenir. Marc de Kerdanet, Jerome Trublet, Elodie Lespagnol, Elsa Heyman, Boris Lormeau: declarent n’avoir aucun conflit d’interet en lien avec cet article.

The use of systemic glucocorticoids (GCs), as well as local injections, continues to be a controversial issue in the sport/anti-doping community. There is widespread and legitimate use of GCs for numerous health conditions, yet there are concerns about side effects and the possibility of enhanced athletic performance in limited settings. This is compounded by the uncertainty regarding the prevalence of GC use, mechanisms underlying physiological effects and complex pharmacokinetics of different formulations. While WADA continues to promote research in this complex area, some international sporting federations, major event organisers and professional sports leagues have introduced innovative rules such as needle policies, mandatory rest periods and precompetition guidelines to promote judicious use of GCs, focusing on athlete health and supervision of medical personnel. These complementary sport-specific rules are helping to ensure the appropriate use of GCs in athletes where overuse is a particular concern. Where systemic GCs are medically necessary, Therapeutic Use Exemptions (TUEs) may be granted after careful evaluation by TUE Committees based on specific and strict criteria. Continued vigilance and cooperation between physicians, scientists and anti-doping organisations is essential to ensure that GC use in sport respects not only principles of fairness and adherence to the rules but also promotes athlete health and well-being. The purpose of this narrative review is to summarise the use and management of GCs in sport illustrating several innovative programmes by sport leagues and federations.

BACKGROUND: The specific impact of neuropathic pain and recommended neuropathic pain treatments on the hormonal and immune status of patients has been so far poorly explored. This study aimed at studying, in real life, the hypothalamic-pituitary-adrenal axis and the cytokine profile of patients with neuropathic pain. It also explored their links with cognition, emotion, quality of life, and drug treatment. METHODS: This prospective study (clinicaltrials.gov NCT01543425) included 60 patients with neuropathic pain and 60 age- and gender-matched healthy volunteers after obtaining signatures of informed consent. A number of parameters were measured: adrenocorticotropic hormone, cortisol, cortisol awakening response, dehydroepiandrosterone sulphate, sex hormone binding globulin, testosterone, 17-β-estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, cytokines, brain-derived neurotrophic factor, and vitamin D. Psychological parameters were assessed by questionnaires. RESULTS: Patients with neuropathic pain had lower levels of adrenocorticotropic hormone (P = 0.009) and dehydroepiandrosterone sulphate (P < 0.001) than controls, and the cortisol awakening response was impaired. Patients were more depressed and anxious (P < 0.001) and had a diminished quality of life (P < 0.001), which was influenced by cytokines (P = 0.0067) and testosterone (P = 0.028). Antidepressants and antiepileptics appeared to interfere with testosterone and cognitivo-emotional domains. CONCLUSION: An impairment of the hormonal status and of the immune system was observed in patients. It identified testosterone as a potential pivotal mediator between antidepressants/antiepileptics and quality of life. Further studies must address the exact impact of different types of drugs on central effects, of gender differences, and of the immune system of neuropathic pain.

International audience; The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.

International audience; Background: Relationships between the severity of obesity and bone health remain underexplored.Objectives: To compare whole-body and localized bone mineral content (BMC) and density (BMD), trabecular bone score (TBS) and hip geometry and strength between adolescents with obesity versus extreme obesity.Methods: This cross-sectional study included 154 adolescents (12-15 years, 62% females) who were classified as having obesity (OG, [95th-99th] percentile) or extreme obesity (EOG, >99th percentile). Fat mass (FM), lean mass (LM), BMC, BMD for total-body-less-head (TBLH), lumbar spine (LS), hip, TBS and geometric and strength indices at the narrow-neck (NN), femoral shaft (FS) and intertrochanteric regions (IT) were assessed by Dual-X-ray Absorptiometry (DXA).Results: There was no significant sex-interaction. For both sexes, TBLH BMC and BMD were not different between groups. TBS was lower in EOG compared with OG in both sexes in univariate analysis and after adjustment with maturation and body weight (p < 0.05). Hip BMD was significantly higher in the EOG compared to OG only after adjustment with maturation and fat mass percentage (p < 0.05 for men, p < 0.01 for women). For both sexes, TBLH, LS and hip BMC and BMD positively correlated with weight, BMI, LM and FM. TBS negatively correlated with BMI-percentile in both sexes, with a negative correlation with FM for males alone. Hip BMC and BMD, BMD, ACT and CSA at the three hip sites positively correlated with BMI-percentile in males.Conclusions: Extreme obesity impacts bone health depending on anatomical sites, altering lumbar trabecular bone in both males and females adolescents.

This study was conducted to assess the validity and reliability of a new questionnaire, the ONAPS-PAQ, developed to assess physical activity (PA) and sedentary behaviors (SB) in the general population. A total of 137 healthy adults aged 18 to 69 years were included. Following completion of two physical activity questionnaires (ONAPS-PAQ and GPAQ, the Global physical activity questionnaire) to study concurrent validity, participants wore an accelerometer (UKK-RM42) for 7 days to study criterion validity. A subsample (n = 36) also completed a 7-day-interval test–retest protocol to assess its reliability. Reliability was tested by the intraclass correlation coefficient (ICC) and Kappa coefficient, concurrent and criterion validity by the Spearman correlation coefficient (ρ) and Bland-Altman plot analyses. The ONAPS-PAQ showed good reliability (ICC = 0.71–0.98, Kappa = 0.61–0.99) and concurrent validity (ρ = 0.56–0.86), but only poor criterion validity (ρ = 0.26–0.41), and wide limits of agreement. Self-reported and accelerometer-measured SB were better correlated with ONAPS-PAQ than GPAQ (0.41 vs. 0.26, respectively) and medians were comparable, whereas the GPAQ underestimated SB (SBacc = 481 (432–566), SBONAPS = 480 (360–652), SBGPAQ = 360 (240–540) min·day−1, median (q1-q3)). The ONAPS-PAQ provides good reliability and acceptable validity for the measurement of PA and SB and seems to provide a better assessment of SB than GPAQ.

Background: While the popularity of aquatic physical activities continues to grow among women, the effects on energy expenditure (EE) and appetite control remain unknown. The objective of this study was to examine the effect of water temperature during aqua-cycling session on EE, rate of perceived exertion, energy intake, appetite sensations, and food reward in healthy premenopausal women. Methods: Participants completed three experimental sessions, in the postprandial condition, in a randomized order: a land control session (CON), an aqua-cycling session in 18 °C (EXO18), and an aqua-cycling session in 27 °C (EXO27). The EE, food intake, appetite sensations, and food reward were investigated for each condition. Results: EXO18 induced a significant increase in EE (p p p p p p p p Conclusion: An exposure to a moderately cold-water during aqua-cycling is an efficient strategy to promote increased EE and decreased hunger, which may be effective for energy balance management in healthy premenopausal women.

BACKGROUND Lack of physical activity (PA) and sedentary behaviors are leading risk factors for noncommunicable diseases (NCDs). Web- and smartphone-based interventions are effective in increasing PA in older adults and in patients with NCD. In many countries, spa therapy, commonly prescribed to patients with NCD, represents an ideal context to initiating lifestyle changes. OBJECTIVE This study aimed to evaluate, in patients attending spa therapy, the effectiveness of an intervention combining a face-to-face coaching and, when returning home, a web- and smartphone-based PA program on the achievement of PA guidelines (PAG) 12 months after the end of spa therapy. METHODS This was a 12-month, prospective, parallel-group randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received PA usual advice. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants were assessed by phone every 2 months. Primary outcome was meeting PAG (PA ≥600 metabolic equivalent of task) at 12 months. Secondary outcomes were meeting current PAG at 6 months; sedentary time, weight, waist circumference, PA, and quality of life at 6 and 12 months. Objective use data of the web- and smartphone-based PA program were collected. Analytic methods included intention to treat and constrained longitudinal data analyses. RESULTS The study sample included 228 participants (n=176, 77.2% females) with a mean age of 62.4 (SD 6.7) years and a mean BMI of 28.2 (SD 4.2) kg/m2. Approximately 53.9% (123/228) of the participants were retired. No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group than in the control group (81% vs 67% respectively, odds ratio 2.34, 95% CI 1.02-5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight, and waist circumference at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in the intervention group than in the control group (mean difference: 4.1, 95% CI 1.9-6.3; P CONCLUSIONS PA increased in both the intervention group and the control group. However, at 12 months, more participants met PAG in the intervention group compared with the controls. This indicates that the web- and smartphone-based program could have maintained PA in the intervention group. In addition, a spa therapy seems to be an ideal time and framework to implement PA education. CLINICALTRIAL ClinicalTrials.gov NCT02694796; https://clinicaltrials.gov/ct2/show/NCT02694796

Background: The aim of this study was to investigate energy expenditure, food intake and appetite feelings in response to water- vs. land-based cycling exercises in healthy young women. Methods: Anthropometric measurements and body composition were assessed among 20 women who performed four experimental sessions in a randomized order: (i) a rest condition (CONT), (ii) a 30-min aqua-cycling exercise session (WAT), (iii) a 30-min land-cycling exercise session at the same rpm (LAND), (iv) a land-cycling session at the same heart rate and isoenergetic to WAT (LAND-Iso). Energy expenditure and substrate oxidation were measured by indirect calorimetry, ad libitum energy intake during subsequent lunch was assessed with appetite feelings recorded at regular intervals. Results: Energy expenditure was higher during the 30-min WAT than during CONT and LAND (p &lt, 0.001). Carbohydrate oxidation was higher in the WAT session compared to CONT and LAND (p &lt, 0.05). LAND-Iso duration was significantly increased (+14 min) to reach the same energy expenditure as in the WAT condition (p &lt, 0.05). There was no differences in food intake between sessions. Conclusion: While further studies are needed to optimize the chronic energetic effects of aqua-cycling, the present study suggests that this exercise modality could represent an efficient strategy to induce acute energy deficit.

Objectives The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes.Design Cross-sectional survey.Participants The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network.Outcome measures From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development.Results Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations.Conclusions While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.

Background: The French National Observatory for Physical Activity and Sedentary Behaviors conducted a national survey aiming to evaluate the potential effects of confinement on the population’s physical activity levels and sedentary behaviors. Methods: In close collaboration with the French Ministry of Sports and a selected expert committee, 3 different questionnaires investigating 3 subgroup populations were included in the survey: (1) children, (2) adolescents, and (3) adults. Results: Forty-two percentage of children, 58.7% of adolescents, 36.4% of adults, and 39.2% of older people had reduced physical activity levels. Particularly, active transportation and endurance practices showed a significant decrease, while domestic, muscular strengthening, and flexibility activities increased. Sitting time and screen time increased, respectively, in 36.3% and 62.0% of children, 25.5% and 69.0% in adolescents, 24.6% and 41.0% in adults, and 36.1% and 32.1% in seniors. Conclusion: The COVID-19 confinement period led to important modifications in individual movement behaviors at all ages, particularly favoring decreased physical activity and increased sedentariness. These findings suggest that the authors need to inform and encourage people to maintain and improve their physical activities and to change their sedentary time habits during postconfinement and during the period of a potential future lockdown.

International audience; Physical activity (PA) has a demonstrated role in three types of tumor cancer: Sedentary behavior; breast, colon, endometrium, and a likely role in four to five other cancers with risk reduction Cancer survivors; of 25% in the most active subjects vs the least physically active. After cancer's diagnosis, there Mechanisms; is a positive association between PA and reduction in the risk of recurrence and overall and Fatigue; specific mortality in patients with non-metastatic breast, colon and prostate cancer. In cancer Physical activity survivors, post-diagnosis PA may also have beneficial effects on fatigue, quality of life, body image and self-esteem, emotional well-being, sexuality, sleep disturbance, social functioning, anxiety, and pain at varying follow-up periods. There is a growing body of research evidence that links sedentary behavior (time spent sitting) with cancer risk. These scientific data highlight the major rote of PA and limitation of sitting time both in cancer prevention but also in the management of patients during and after cancer. (C) 2020 Societe francaise de nutrition.

International audience; The efficacy of weight loss interventions might be affected by the metabolic profile of adolescents with obesity. In this study, we hypothesized that the initial diagnosis of the MS, or its persistence after an intervention, will not reduce the efficacy of a 16-week multidisciplinary weight loss program. Ninety two adolescents (12-15 years; 62 girls) with obesity completed baseline anthropometric and body composition evaluation (DXA). Lipid profile, insulinemia, glycaemia and blood pressure were measured and metabolic syndrome (MS) diagnosed. The adolescents then followed a 4-month inpatient multidisciplinary weight management program. All measurements were performed before (T0) and after 4 months of intervention (T1). Body weight, body mass index (BMI) and percentage of fat mass (%FM) decreased significantly between T0 and T1 (P < .001), with no difference in fat-free mass (kg). All metabolic variables (except blood pressure) were improved. 47.6% of the whole sample presented with MS at baseline against 35.7% at T1. Body weight (P = 0.006), BMI (P = 0.0261), %FM (P = 0.0211), hip circumference (= 0.0131), BMI percentile (P = 0.0319), and diastolic blood pressure (P = 0.0365) showed a time x group interaction and their deltas (variations between T0 and T1) were significantly different between adolescents with and without MS at baseline. There was no significant difference between adolescents with persistent and nonpersistent MS except for Delta BMI percentile that deceased significantly more in the non persistent group (P = 0.0115). According to our results, the efficacy of weight loss interventions is not reduced in adolescents initially diagnosed with MS or different between those who present a persistent or nonpersistent MS after the intervention.

International audience; Introduction: In France March 14, 2020 a national lockdown was imposed in France for 55 days to prevent the spread of the Covid-19 and all schools were closed. This study aimed to investigate the effects of home confinement as a result of lockdown on the activity (physical activity and sedentary behaviors), and their determinants, on French children (6-10 years) and adolescents (11-17 years).Methods: The National Observatory for Physical Activity and Sedentary behaviors launched an online survey from April 1 st , to May 6 th , 2020 using popular social networks and websites. It compared the level of physical activity (PA), sitting and screen time before and during the lockdown and identified the impact of the initial PA (active vs. inactive), sedentary (high vs. low) profiles of the participants and the housing conditions.Results: 6,491 children were included in this study. Initially active children and adolescents decreased their PA more than those initially inactive (p>0.001), while those who met the sitting time recommendations increased more their sitting time during lockdown (p

International audience; Background: To evaluate the impact of 4 months of a high-intensity interval training (HIIT)-centered weight-management intervention on health-related quality of life (HR-QOL), health perception (HP) and physical self-perception (PSP) in adolescents with obesity.Methods: Fifty-six adolescents with obesity (28 girls; mean body mass index [BMI], 35±4.89 kg/m2; z- BMI, 2.3±0.3; 11-17 years) followed a multidisciplinary weight-management intervention composed of nutritional counseling, HIIT program, and health-related therapeutic education. Anthropometric parameters, body composition (dual X-ray absorptiometry), and maximal aerobic capacities (maximal oxygen consumption [VO2peak]) were assessed, and self-reported questionnaires were used to assess HRQOL (36-item short form survey), HP and PSP at baseline (T0) and post-intervention (T1).Results: Body weight (92.6±18.9 to 85.9±16.2 kg), BMI (35.0±4.8 to 32.1±4.5 kg/m2), z-BMI (2.3±0.3 to 2.1±0.3) and fat mass (36.0%±9.1% to 30.4%±7.8%) were significantly decreased (P

BACKGROUND Gamification refers to the use of game elements in nongame contexts. The use of gamification to change behaviors and promote physical activity (PA) is a promising avenue for tackling the global physical inactivity pandemic and the current prevalence of chronic diseases. However, there is no evidence of the effectiveness of gamified interventions with the existence of mixed results in the literature. OBJECTIVE The aim of this systematic review and meta-analysis is to evaluate the effectiveness of gamified interventions and their health care potential by testing the generalizability and sustainability of their influence on PA and sedentary behavior. METHODS A total of 5 electronic databases (PubMed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials) were searched for randomized controlled trials published in English from 2010 to 2020. Eligibility criteria were based on the components of the participants, interventions, comparators, and outcomes framework. Studies were included when they used gamified interventions in daily life with an active or inactive control group and when they assessed a PA or sedentary behavior outcome. We conducted meta-analyses using a random-effects model approach. Sensitivity analyses, influence analyses, and publication bias analyses were performed to examine the robustness of our results. RESULTS The main meta-analysis performed on 16 studies and 2407 participants revealed a small to medium summary effect of gamified interventions on PA behavior (Hedges g=0.42, 95% CI 0.14-0.69). No statistical difference among different subgroups (adults vs adolescents and healthy participants vs adults with chronic diseases) and no interaction effects with moderators such as age, gender, or BMI were found, suggesting good generalizability of gamified interventions to different user populations. The effect was statistically significant when gamified interventions were compared with inactive control groups, such as waiting lists (Hedges g=0.58, 95% CI 0.08-1.07), and active control groups that included a nongamified PA intervention (Hedges g=0.23, 95% CI 0.05-0.41). This suggests that gamified interventions are not only efficient in changing behavior but also more effective compared with other behavioral interventions. The long-term effect (measured with follow-up averaging 14 weeks after the end of the intervention) was weaker, with a very small to small effect (Hedges g=0.15, 95% CI 0.07-0.23). CONCLUSIONS This meta-analysis confirms that gamified interventions are promising for promoting PA in various populations. Additional analyses revealed that this effect persists after the follow-up period, suggesting that it is not just a novelty effect caused by the playful nature of gamification, and that gamified products appear effective compared with equivalent nongamified PA interventions. Future rigorous trials are required to confirm these findings.

International audience; Background: Sedentary behaviour is a major risk of mortality. However, data are contradictoryregarding the effects of active commuting on mortality.Objectives: To perform a systematic review and meta-analysis on the effects of activecommuting on mortality.Method: The PubMed, Cochrane Library, Embase, and Science Direct databases were searchedfor studies reporting mortality data and active commuting (walking or cycling) to or from work.We computed meta-analysis stratified on type of mortality, type of commuting, and level ofcommuting, each with two models (based on fully adjusted estimates of risks, and on crude orless adjusted estimates).Results: 17 studies representing 829 098 workers were included. Using the fully adjustedestimates of risks, active commuting decreased all-cause mortality by 9% (95% confidenceintervals 3 to 9%), and cardiovascular mortality by 15% (3 to 27%) (p