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Regular physical activity and balanced nutrition are important in maintaining a healthy weight. Nonetheless, minority populations, like Hispanics, face challenges (e.g., language barriers and transportation unavailability) that limit their participation in intervention programs to receive benefits. Furthermore, dog companionship has been shown to relate to adolescents' behavioral and socio-emotional development positively, and it has been shown to have the potential to increase physical activity in adolescence. Therefore, this study aimed to examine the feasibility, i.e., program adaptation, limited efficacy, and acceptability, of the two exercise and nutrition education interventions to improve body composition, motivation, and well-being in overweight and obese Hispanic adolescents. This pilot study was a quasi-experimental trial with eight pediatrician-referred participants (M[subscript age] =11.75±1.48) assigned to two parallel arms: (1) BRAVO! and (2) BRAVO!+. Both share identical exercise (24 hours) and nutrition (12 hours) programs centered on the self-determination theory for 12 weeks. The results suggested, first, acceptable attendance (BRAVO! = 56.25%; BRAVO!+ = 64.58%) but poor retention (BRAVO! = 33.33%; BRAVO!+ = 63.63%). Second, the findings suggested promising limited efficacy in BRAVO!+ group, with small but statistically non-significant reductions in participants' BMI (M[subscript baseline] = 33.08±6.13; M[subscript post] = 32.23±6.88; t[3] = 1.633, p = 0.201) and weight (M[subscript baseline] = 78.13±16.22; M[subscript post] = 77.62±17.64; t[3] = 0.485, p = 0.661). In addition, the results suggested high satisfaction and acceptable suitability for both programs and providing important suggestions for the future. In conclusion, our pilot study findings only partially supported the feasibility of the pet-dog-enhanced lifestyle intervention. Although this study found evidence that pet-dog companionship can improve program satisfaction and acceptability of pediatric lifestyle interventions, including a pet-dog in the intervention may contribute to high dropout evidenced in this study.

With this study we aimed to investigate the impact of a 12-week manipulative skills exercise programme on the motor proficiency of young individuals with intellectual disabilities. A total of 32 learners diagnosed with mild intellectual disabilities, with an average age of 17.81 ± 1.44 years, were divided into 2 equal-sized groups: a control group and an experimental group engaged in a manipulative skills intervention programme. Motor proficiency was assessed using the shortform of the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT™-2), while the participants' coordination level was evaluated using the Body Coordination composite of the BOT™-2. Results show that the manipulative skills intervention programme led to significant improvements in the experimental group's total motor proficiency score on the shortform BOT™-2 (45.31 ± 12.01 vs. 37.12 ± 7.00, ANCOVA: F = 48.65, p = 0.00) as well as the Body Coordination composite(42.69 ± 11.31 vs. 39.84 ± 11.75, ANCOVA: F = 44.35, p = 0.00). These findings suggest that the experimental exercise programme had a positive effect on enhancing the motor proficiency of young individuals with mild intellectual disabilities.

Rheumatic diseases are known to be associated with the development of metabolic syndrome, which increases mortality rates due to cardiovascular complications. Although a variety of self-management programs for rheumatic diseases have been developed, few have concentrated on metabolic syndrome. This study aimed to develop and verify a blended (a mixture of telephone and online interventions) metabolic syndrome self-management program. The program was developed in four stages: analysis to identify program contents, website design, website development, and validity testing. A quasi-experimental nonequivalent control group, pretest-posttest design was adopted to verify the program effectiveness in 54 patients with rheumatic disease. The program was initially implemented via telephone for 4 weeks and then self-administered via a web-based platform for 20 weeks. Indices of metabolic syndrome and self-management and quality of life scores were measured as outcome variables. Data were collected three times: before intervention, after 4 weeks of telephone interventions, and after 20 weeks of online self-interventions. The devised program had a significant overall effect on metabolic syndrome indices, metabolic syndrome-related self-management behaviors, and quality of life. Detailed analysis showed the program effectively reduced body mass index, waist circumference, systolic blood pressure, and blood glucose levels and improved metabolic syndrome self-management behaviors. Based on our findings, it can be expected that the use of this program may retard or prevent the progression of metabolic syndrome by improving some metabolic syndrome indices and metabolic syndrome-related self-management behaviors, which are key components of care in rheumatic disease patients with metabolic syndrome. This web-based program appears to be beneficial in public health care settings because it is cost-effective, readily available, and may provide long-term support.

During human childhood, brain development and body growth compete for limited metabolic resources, resulting in a trade-off where energy allocated to brain development can decrease as body growth accelerates. This preregistered study explores the relationship between language skills, serving as a proxy for brain development, and body mass index at three distinct developmental stages, representing different phases of body growth. Longitudinal data from 2002 children in the EDEN mother-child cohort were analyzed using structural equation modeling. Our findings reveal a compelling pattern of associations: girls with a delayed adiposity rebound, signaling slower growth rate, demonstrated better language proficiency at ages 5-6. Importantly, this correlation appears to be specific to language skills and does not extend to nonverbal cognitive abilities. Exploratory analyses show that early environmental factors contributing to enhanced cognitive development, such as higher parental socio-economic status and increased cognitive stimulation, are positively associated with both language skills and the timing of adiposity rebound in girls. Overall, our findings lend support to the existence of an energy allocation trade-off mechanism that appears to prioritize language function over body growth investment in girls.

Children's motor competence (MC) levels tend to be low, and the investigation of variables that facilitate skillfulness is an important concern. The socioecological model is a useful framework to explore factors that influence MC and to inform the development of targeted interventions. This cross-sectional study aimed to perform an exploratory analysis of MC correlates among children. The sample comprised 267 second- and fourth-grade children (120 female; M[subscript age] = 102 months, SD = 14 months) from six primary schools. The children's legal guardian questionnaire collected sociodemographic, behavioral, and family variables. MC was assessed with the Motorische Basiskompetenzen battery. Data analysis involved simple and multiple regression models. The mean total Motorische Basiskompetenzen score was 8.9 (3.4) out of a maximum score of 16. Sex, age, body mass index, and physical activity and sports clubs were significantly related to total MC in all models (p < 0.05). The final model predicted a variance of 24.5%, adjusted R[superscript 2] = 0.245, F(20, 246) = 5.32, p < 0.001, with male sex (B = 2.03) and organized physical activity (B = 0.35) being positively associated with total MC. Fourth grade (B = -3.6) and body mass index (B = -0.23) were negatively associated with MC. The study provides provisional evidence for the role of some sociodemographic and behavioral factors in MC development, which are important to design future MC interventions.

The aim of the study was to evaluate the effects of a twelve-week pilates exercise program on some performance tests and body composition. The research was a quantitative study and experimental research model was used as a model. The study group consisted of 32 female volunteer students aged between 20-23 who were educated at Kirikkale University, Faculty of Sports Sciences, and took pilates lessons. Before starting the exercise program and after finishing the exercise program, the participants' data on anthropometric (body weight, height, body fat ratio and circumference measurements) and performance tests (sit and reach test, vertical jump test, 20 m speed and t-dril test) were collected. The arithmetic means and standard deviations of all data were calculated. The comparison of the measurement values of the participants before and after the exercise program (pre-test and post-test) was made with the paired samples t-test. A statistically significant difference was found between the anthropometric and performance tests (pre-test and post-test) of the participants. Considering the results of the study, it was determined that there were improvements in the physical appearance and physical performance of the individuals with regular pilates exercises, and that pilates exercises had significant effects on both the body composition and muscular endurance of the individuals.

This paper aims to determine whether tracking calories using a mobile application without any nutrition education has a positive effect on the eating behaviors of university students. The concurrent design, one of the mixed methods designs, was used to compare the quantitative and qualitative data analysis results. The participants are 108 university students who voluntarily agreed to participate in the study. In the quantitative part of the study, a calorie tracking form was used; in the qualitative part, an interview form was used to determine eating behaviors. The students were not given any information about healthy nutrition and were only asked to track calories. The change in body mass index values obtained from the calorie tracking form is presented with the Wilcoxon signed ranks test. In evaluating the data obtained from the interview form determining eating behaviors, the data were categorized by content analysis, and the categories were presented as percentage values. According to the data obtained, it has been observed that positive behavioral changes in terms of nutrition can be created even without giving any information about healthy nutrition to the students, just by making them track calories. As a result of the activity, they became aware of which foods would make them gain weight and which would not and gained positive eating behaviors. Based on the results obtained from this study, recommendations for future studies and public health were made.

Healthy nutrition is essential in preventing possible diseases and treating existing diseases by controlling their course. Based on this importance, adolescence is one of the periods to be considered. Adolescence is a fundamental determinant of healthy life in adulthood and old age. Healthy nutrition awareness gained in this period will raise awareness of the adolescent individual herself/himself and the people around her/him. This research aimed to determine the nutrition awareness of middle school students in early adolescence. According to the phenomenology, the research was conducted with eight volunteer students in the 8th grade in a public middle school in the Central Anatolia region in Turkey. Data were collected through semi-structured interviews with each student individually using the "Interview Form about Nutrition Awareness in Adolescence Period" prepared by the researchers. The data were analyzed by using content analysis. As a result of the research, it was determined that the nutrition awareness of middle school students in the early adolescence period was low. In this context, increasing middle school students' nutrition awareness was recommended.

Purpose: To examine the relationship between acculturation indicators and metabolic syndrome among Hispanic adults living in the Dallas-Fort Worth-Arlington, Texas metropolitan area. Methods: This study utilized secondary data collected from a larger 2014 study among 128 Hispanic adults living in Dallas-Fort Worth-Arlington. The current study examined two research questions: (1) Is there a relationship between acculturation indicators (nativity, duration in the United States, and the Short Acculturation Scale for Hispanics score) and metabolic syndrome among Hispanic adults living in Dallas-Fort Worth-Arlington? (2) Is there a relationship between acculturation indicators and the individual markers associated with metabolic syndrome (high waist circumference, high blood pressure, elevated fasting blood glucose, elevated blood triglycerides, and reduced high density lipoprotein cholesterol among Hispanic adults living in Dallas-Fort Worth-Arlington? Results: Most participants were female (aged 40 and older) born outside of the United States. More than half of the participants had been in the United States fewer than 20 years and revealed loweracculturation scores. More than one-third of the participants also had metabolic syndrome. Prevalence of metabolic syndrome was higher among females compared to males. Most participants had abnormal high-density lipoprotein and waist circumference. Acculturation scores and nativity were not associated with abnormal metabolic syndrome markers. Duration in the United States was not associated with metabolic syndrome markers of high waist circumference, reduced high-density lipoprotein, and elevated blood triglycerides. However, duration in the United States was associated with metabolic syndrome markers of high blood pressure and elevated fasting blood glucose. Conclusions and Recommendations: Acculturation is a multifaceted, dynamic phenomenon that influences health at multiple levels. Future studies can explore a range of social-ecological factors that interact with acculturation and health. Because metabolic syndrome is considered a "lifestyle syndrome," there is an additional need to examine behavioral health and relationships among diet, physical activity, and acculturation. Through a social-ecological and culturally relevant lens, health education specialists can lead interprofessional efforts to promote health literacy and healthy lifestyle behaviors among Hispanic individuals and communities. These action steps can be integral components of professional preparation programs that offer students opportunities to engage in service learning and develop core competencies in their disciplines.

The worldwide increase in childhood overweight and obesity underscores the need to study variables like fundamental movement skill (FMS) levels from early childhood. This study investigated the bidirectional longitudinal relationship between body mass index (BMI) and process-oriented FMSs, including locomotor skills and object control skills in 675 Finnish children, aged 3-8 years at baseline (50.5% female, mean age 5.5 years) over 3 years. Standardized BMI-for-age SD scores (BMI SDS z-scores) followed Finnish national standards. The FMS assessment comprised four subtests from the Test of Gross Motor Development, third edition. Age-adjusted standardized residuals of FMS or skill domains and BMI SDS z-scores were used in a two-level, cross-classified, cross-lagged regression analysis, accounting for gender, and baseline value of the dependent variables. The results showed no statistically significant longitudinal relationship between BMI and FMS or its skill domains for either gender in either direction. This suggests that BMI and process-oriented FMS, encompassing locomotor skill and object control skill, develop independently, possibly influenced by unexplored variables. These findings contradict earlier results based on product-oriented measurements, which may include a physical capacity component. The outcomes further underscore the importance of monitoring weight status from early childhood, given its significant association with later-life weight conditions.

Aims: To determine the effect of a 16-week fitness program (strength vs. aerobic) on different indicators of body composition and components of health-related physical fitness in youths with Down syndrome. Methods and procedures outcomes: Fifty adolescents (19 girls and 31 boys; average age, 18.33 ± 1.42 years) with Down syndrome were recruited and randomized to two groups (strength group vs. aerobic group). Adolescents allocated in the aerobic group carried out a physical activity program three times a week for 16 weeks meanwhile adolescents allocated in the strength group performed a fitness program three times a week for 16 weeks. Results: The exercise group had significant improvements in all health-related physical fitness variables (p < 0.05) but not on body composition. Conclusions and implications: A sixteen week fitness program consisting of three sessions of 60 min is able to increase levels of health-related physical fitness but not on body composition in youths with Down syndrome. The aerobic program does not seem to show significant differences.

We estimate the effect of universal free school meal access through the Community Eligibility Program (CEP) on child body mass index (BMI). Through the CEP, schools with high percentages of students qualified for free or reduced-priced meals can offer free breakfast and lunch to all students. With administrative data from a large school district in Georgia, we use student-level BMI measures from the FitnessGram to compare within-student outcomes before and after CEP implementation across eligible and non-eligible schools. We find one year of CEP exposure increased expected BMI percentile by about 0.085 standard deviation, equivalent to a nearly 1.88-pound weight increase for a student of average height. We also find that the program led to a small increase in the likelihood of overweight and limited evidence of a small decrease in the likelihood of underweight. We do not find that the program increased student obesity risk. Examining the effects of CEP on child BMI by grade suggests that the overall effect is largely driven by students in middle schools, highlighting potential heterogeneity in the program's impact across grades. The findings of this paper are relevant for researchers and policy makers concerned with the effects of universal free school meals on student health.

Purpose: This paper aims to evaluate children's literature that focuses on body size issues for elementary readers. Design/methodology/approach: The paper used an evaluative tool based on three categories: content, audience and other considerations. Findings: The evaluative tool was used to evaluate six children's books identified as critical literature supporting body image. The books evaluated focused on body image but were also tied to other themes such as body positivity, body neutrality, self-love, acceptance, diversity and inclusivity. All books acknowledged and celebrated the uniqueness of varied body types. Research limitations/implications: Because of the number of books evaluated, the evaluative results may lack generalizability. Therefore, researchers are encouraged to evaluate other critical children's literature focused on body image. Practical implications: The paper offers recommendations for parents, teachers and schools. Originality/value: This paper encourages the need for parents, teachers and schools to help children embrace body positivity and neutrality so that they would love their skin.

Purpose: This paper delves into the profound influence of societal beauty standards and the prevalence of body shaming in contemporary culture. It explores how these societal norms contribute to self-esteem issues and psychological distress among individuals, particularly young people. Design/methodology/approach: Through the poignant medium of student letters and the power of prayer, it explores the personal experiences and narratives of young individuals who have faced these challenges. Findings: Moreover, this study highlights the transformative role of education in reshaping these societal norms and fostering a culture of body positivity. Originality/value: This study underscores the potential of student letters and the spiritual guidance of prayer as tools for self-reflection and healing, ultimately advocating for the pivotal role of education in promoting body positivity and challenging the constraints of unrealistic beauty standards and body shaming.

Purpose: Previous research demonstrates a consistent association between the media and body and eating related issues in children. Recent research has highlighted a role for "fat talk" to describe discourses around body size and food. One key source of media information is Disney animation films, yet to date no research study has explored the verbal content of this genre. Design/methodology/approach: The present study used a content analysis to examine fat talk in Disney animation films (1937-2021; n = 53) with a focus on the frequency of fat talk, changes over time and differences between the genders and heroic statuses of the givers and receivers of fat talk. Fat talk was defined as relating to both body size and food and could be either positive or negative. Findings: Results revealed that there was more negative than positive fat talk per film; no significant changes over time; males were the givers of significantly more positive and negative fat talk than females and were also the receivers of more negative fat talk; good characters were the givers and receivers of more positive and negative fat talk and more self-directed negative fat talk than bad characters. Practical implications: The results are discussed in terms of possible legislation and parenting interventions to minimise the harm of this genre on young children. Originality/value: Disney animation films may not be as benign as often thought.

Purpose: The study aimed to test the overall changes of health-related fitness (HRF) in minority Chinese college students and to examine HRF differences in gender, race, and year in college. Method: Participants (n = 1320) were minority college students with more than two-thirds females (ie 76.1%), and Hui, Tibetan, and Mongolia consisted of 13.8%, 13.8%, and 11.2%, respectively. Student HRF was tracked for four years. Data were analyzed using multilevel latent growth curve modeling. Results: Muscular strength and endurance were the weakest component in minority college students' HRF, while body mass index was within the category of "excellent". Males outperformed female on all components of HRF. Conclusions: It is suggested that interventions concerning minority females' HRF and muscular strength and endurance for both genders be constructed and tested.

No studies have examined vocational education students' intention to change multiple health risk behaviors and whether baseline characteristics predict behavior change. Participants: Participants were vocational education students in New South Wales, Australia. Methods: Students in the no-intervention control arm of a cluster randomized controlled trial completed an online survey at baseline and 6 months later. Results: Of 450 participants (83.3%) who reported multiple health risk behaviors at baseline, one-third (33.1%) intended to change at least two risk behaviors within 6 months. Participants experiencing symptoms of anxiety [OR = 7.43, 95% CIs 1.26-43.87; p = 0.03] and who intended to change three to four risk behaviors [OR = 23.30, 95% CIs 4.01-135.40; p = 0.001] rather than one behavior had significantly greater odds of changing at least one behavior in 6 months. Conclusions: Interventions could support vocational education students to change behaviors they wish to as well as motivate them to address other risk behaviors.

Objective: To assess how living arrangements influence lifestyle habits and behaviors that impact the health and academic achievement of students. Participants: 876 undergraduate students at a university in Florida. Methods: Students in all colleges were invited to participate in an anonymous survey. The survey was comprised of questions based on living arrangements, grade point average (GPA), anthropometric measures, as well as health behaviors. Data analysis was performed employing least squares regression and Wilcoxon and Kruskal-Wallis Rank Sums Test tests. Results: Different living arrangements were related to different health behaviors, but not one arrangement was associated with unhealthy or healthy habits only. Overall, there was no significant association between students' living arrangement, body-mass index (body mass index), and self-reported GPA. Conclusion: While university students' living arrangements are associated with differences in health behaviors and habits, these differences have no significant impact on students' average BMI or GPA.

Weight stigma is the negative social judgment of people based on their weight. Despite the negative consequences of weight stigma, its prevalence is well-documented including within the physical activity (PA) landscape. Research shows that a wide range of PA-related professionals hold negative attitudes toward fat people, including physical education teachers, kinesiology students, and fitness trainers. This article describes a collaboration across disciplines and fields to develop a weight stigma reduction intervention for exercise professionals. Weight Inclusive Thinking for Fitness Spaces (WIT FITS) is a two-hour, self-paced, interactive online course grounded in the Health at Every Size® paradigm and research-informed strategies for improving exercise professionals' attitudes toward fatness and fostering weight inclusivity in fitness settings. WIT FITS was the result of a three-year interdisciplinary collaboration with scholars from pedagogy, public health, sport and exercise psychology, and nutrition. Community partners involved in the development, implementation, and evaluation of WIT FITS included body liberation activists, web and instructional designers, and campus recreation leaders.

Background: Children living in poverty often are exposed to situations that negatively affect various aspects of their development. So, it is important to propose interventional programs that minimize the negative effects of living in poverty on these children. Objective: To verify the impact of a mastery climate cognitive-motor skills school-based intervention on academic and motor performance, body mass index, and perceptions of competence and self-worth in children living in poverty. Method: 280 children (50% girls), 7- to10-years-old, from Ceará state -- Brazil, participated in this study. Intervention (IG, N = 140) and comparison (N = 140) groups were composed. The Test of Gross Motor Development -- 2, the Self-Perception Profile for Children, the School Performance Test (reading, writing, math), and the Body Mass Index (BMI) were used. Children in the IG participated in a mastery climate intervention and children in the CG in a recreational sports program for 12 weeks (36 sessions /140 min each session/ three times a week) with 60 min of academic activities, 20 min recess and snacks, and 60 min of motor practices. Results: The intervention group showed significant improvement from pre- to post-test, and higher motor, academic (reading, math), perceived competence, social acceptance, and self-worth scores than the comparison group at pos-test (p from 0.031 to <0.001). Conclusion: Mastery climate cognitive-motor intervention positively impacts the motor and academic performance and the self-perceptions of the children living in poverty, reinforcing the need for these interventions to helping children become more proficient and assured about their competences.

Introduction: This article reports the physical abilities and physical wellness of three groups of children with different neurodevelopmental disabilities--Autism, Down Syndrome and Intellectual Disability. Methods: The causal-comparative research method was implemented in this study. The participants comprised 32 students with moderate intellectual disabilities, 18 with autism spectrum disorder, and 22 with Down Syndrome. The body mass index (BMI), flexibility, standing long jump, sitting height, stroke length, and medicine ball throwing levels were measured for physical fitness, and the groups were compared afterward. The Kruskal Wallis-H Test and Mann-Whitney U Test were applied to determine the differences between the groups' physical fitness averages for the statistical analysis. Results: Statistically significant differences were obtained in BMI, standing long jump, stroke length, and medicine ball throwing variables (p < 0.05). However, no statistically significant difference was discovered for the flexibility and sitting height variables (p > 0.05). The BMI, sitting height, and stroke length levels for the group with autism spectrum disorder were higher than the other groups, as the flexibility levels of the group with Down Syndrome were higher than the other groups. Students with intellectual disabilities were demonstrated to have better values than other groups regarding standing long jump and medicine ball throwing performances. Conclusions: Objective information about the physical fitness of individuals with children with different neurodevelopmental disabilities was obtained. In addition, the data obtained with these children will contribute to future plans for movement training as well as the content and frequency of the interventions, and will guide the development of new strategies to develop physical abilities and physical wellness.

The family has a key role in the obesity management of children with autism. This study examines the relationship between the nutrition-physical activity behaviors of autistic children with their families and children's obesity levels during COVID-19 pandemic. The descriptive and cross-sectional study involved 80 parents of autistic children. A positive correlation was found between children's mean BMI values before and during the pandemic (p = 0.000). Family Nutrition and Physical Activity Scale (FNPAS) and Brief Autism Mealtime Behavior Inventory (BAMBI) score were 55.18 ± 7.86 and 31.76 ± 8.79, respectively. In addition, it was found that 32.5% of the children ate more than before the pandemic, 50.0% engaged in less physical activity, and 16.3% didn't do any physical activity. The study results suggesting the risk of obesity.

Objective: Examine how changes in sleep duration, objectively measured by activity trackers, impact weight gain in incoming college freshman. Participants: Incoming college freshmen, age [greater than equal to] 18. Methods: We measured weight and daily sleep duration before college entry and through the 1st college quarter. Additionally, we examined changes in sleep variability, activity levels and smartphone screen time use as possible predictors of weight gain. Results: 75 participants completed the study. Total sleep duration decreased from 437.9 ± SD 57.3 minutes at baseline to 416.5 ± SD 68.6 minutes by the end of the first quarter (p = 6.6 × 10[superscript -3]). (BMI) did not change significantly in this cohort. Higher sleep variability at baseline and an increase in sleep variability were associated with increases in BMI. Smartphone screen use was note to be high (235.2 ± SD 110.3 minutes/day) at the end of the first quarter. Conclusions: College weight gain may be affected by factors other than sleep duration, including sleep variability.

I provide novel evidence on the role of imperfect information in shaping childhood obesity. Between 2003 and 2017, 24 states began requiring schools to perform Body Mass Index assessments on students. Using the 1991 to 2017 National and State Youth Risk Behavior Surveys and a stacked difference-in-differences identification strategy, I show that these state-mandated school-based BMI assessments were associated with an increase in the likelihood that teens described themselves as overweight and reported that they were trying to lose weight. The relationship was most pronounced for overweight teens, suggesting that the assessments improved awareness about BMI status among this group, though I also find that non-overweight teen girls were subsequently more likely to incorrectly describe themselves as overweight. While I do not detect meaningful changes in exercise or calorie-limiting behaviors, I do find that these state-mandated school-based BMI assessments were associated with a modest reduction in BMI.

School-age children with overweight or obesity continue to be problematic in the United States, and are associated with many health, social, and financial problems. Schools provide an excellent venue in which to promote healthy weight in students, and school nurses are well-positioned to play an essential role in controlling obesity. The number of studies reporting relationships among school health infrastructure and prevalence of elevated Body Mass Index (BMI) is limited. The present study explored associations between three components of school health infrastructure (staff, services, budget) and the proportion overweight or obese 1st, 3rd, and 6th grade students, after controlling for selected factors (race, county education level, county poverty level, rurality). Study results supported an independent association between elevated BMI and school health staff. Additionally, independent associations between elevated BMI and the following covariates were supported: household income, race, and parents' educational level. There is an ultimate need for well-designed studies addressing these associations.

Background: Adolescents with overweight or obesity are at greater risk of having physical and psychosocial consequences. With increased disparities and inadequate literature on prevalence of adolescent weight status in rural Appalachia, there is potential for further complications. Unfortunately, adolescent obesity treatment options are often limited, especially in medically underserved regions. Methods: This cross-sectional study of adolescents at eight rural Appalachian schools examined weight status among and associations between body mass index percentile (BMIp) categories and health-related perceptions and weight-control intentions. Previously validated instruments were utilized. Analyses included independent samples t-tests, ANOVA tests, and chi-squared tests. Results: Of 814 adolescents (ages 11-13; 55.0% girls), BMIp revealed 20.8% overweight, 22.7% obese, and 10.6% severely obese. Adolescents with higher BMIp categories reported poorer self-rated health, inaccurate weight perceptions, and greater weight loss intentions (all p < 0.05). Conclusions: Findings, including high prevalence of adolescents with overweight and obesity, emphasize the need for more obesity prevention and treatment options. Schools may be an ideal setting to reach at-risk adolescents and provide obesity prevention and treatment options, especially in medically underserved regions such as rural Appalachia. Opportunities and challenges to apply findings, including school-based obesity programs, are discussed.

Objective: To evaluate the effects of a nutrition education programme conducted during health education lessons on students' adherence to the Mediterranean Diet (MD) and their body mass index (BMI). Design: Quasi-experimental pre-test/post-test research design: two study conditions (intervention and control groups). Setting: Two urban schools, the 11th and 21st primary schools in Limassol, Cyprus. Method: Two hundred and thirty-five fifth- and sixth-grade students participated in the programme. One hundred and fifteen were in the intervention group school (the 11th primary school), and 120 were in the control group school (the 21st primary school). Students in the intervention school participated in nine 80-minute lessons during the health education class. The curriculum focused on the MD and included cooking activities, food tasting and parental involvement. The primary outcomes were subsequent adherence to the MD, nutritional knowledge, self-efficacy physical activity and BMI. Results: Following the implementation of the intervention, the intervention group showed a significant increase in nutritional knowledge, self-efficacy and adherence to the MD (p < 0.001). The intervention group also had significantly higher nutritional knowledge and MD Quality Index scores than the control group (p < 0.001). However, no effect was observed on children's BMI (p > 0.05). Conclusion: The intervention successfully improved children's dietary habits in the intervention group by increasing adherence to the MD, but it did not affect their BMI. The results show some promise for addressing poor nutrition through education.

This study was conducted to evaluate the BMI of the children with intellectual disability and the factors affecting their BMI. This descriptive and cross-sectional study was carried out between March 2016 and April 2016 in Turkey and consisted of 135 children. Children's anthropometric measurements were and their BMI values were calculated. Categorization of children by BMI percentile according to AAP reference values was performed. There was a significant difference between the BMI categories of the children (p < 0.05) and the education level of children's father (x2 = 8.960; p = 0.028), the degree of intellectual disability (x2 = 16.113; p = 0.008), the presence of other disabilities (x2 = 22.013; p = 0.000), type of disability (x2 = 21.359; p = 0.001), the nutrient intake (x2 = 38.935; p = 0.000) and the presence of nutritional problems (x2 = 7.687; p = 0.042). Father's education level, children's degree of disability, child's having presence of other disabilities, child's being dependent in the view of nutrient intake, and child's having nutritional problems were determined as factors affecting BMI.

For undergraduate students, excessive screen time is associated with poorer mental health and greater perceived stress. Objective: The purpose of the present investigation was to determine the potential moderating influence of physical activity and sleep on the relationship between screen time and stress. Participants & Methods: A cross-sectional sample of 513 undergraduate students between Fall 2017 & Spring 2020 were given a questionnaire to assess perceived stress level, physical activity engagement, screen time, and sleep. Results: Stepwise hierarchical regression analyses identified that screen time, sleep, and the three-way interaction between screen time, sleep, and physical activity were associated with stress. Post-hoc decomposition revealed that higher levels of physical activity and sleep both mitigated the relationship between screen time and stress. Conclusions: Findings suggest that modifiable health behaviors such as physical activity and sleep may be important factors for managing the negative effects of screen time on stress in college-aged adults.

The basic timescales governing animal life are generally determined by body size. Pauses in naturally occurring human speech were investigated to determine if pause timescales are also sensitive to body size. Reported is an analysis of pause duration allometry in recorded interviews of 61 athletes. Pauses were divided into three classes based on whether they occurred during fluid speech or whether they preceded or followed a filled pause (i.e., "um"). Allometric laws relating body size to pause size were found for all three classes--larger people take longer pauses. The derived allometric exponents were used to evaluate a theory of how people experience the passage of time. The theory associates the experience of time passage with the distal flow of time through the mathematics of bounded exponential growth. Nonlinearities inherent in the theory are shown to predict, in detail, the way body size interacts with linguistic context in the deployment of pauses. The theory provides a meaningful framework for understanding how time is experienced as a felt quantity and how pauses are negotiated in everyday speech.

To address widespread weight stigma across the physical activity landscape, scholars have emphasized the need to provide exercise professionals with educational programs that help them (a) identify their biases, (b) reflect on their assumptions about higher-weight individuals, and (c) apply tangible strategies to enhance the inclusivity of fitness spaces. This pilot study assessed the impact of an educational intervention on exercise professionals' anti-fat attitudes. The intervention was a two-hour, self-paced, online course titled Weight Inclusive Thinking for Fitness Spaces (WIT FITS). The course scope was designed upon the Health at Every Size® (HAES®) paradigm, attribution theory, and the strategies available in the literature to create weight-inclusive climates within fitness settings. This study was conducted using a one-group pretest-posttest quasi-experimental design. Participants were 36 employees at recreation centers from three public universities in the Western region of the United States. Data were collected during pre-and post-intervention using the anti-fat attitudes test (AFAT), demographics, and a post-course evaluation survey. Results showed participants' anti-fat attitudes significantly decreased from pre-to posttest. Specifically, participants' scores significantly declined in two AFAT subscales: weight control/blame and physical/romantic unattractiveness. Outcomes from this pilot study suggest that the WIT FITS course has the potential to offer a practical, low-cost, and scalable way for in-service professionals to learn about weight and health and improve their attitudes toward larger-bodied people.

The purpose of this study was to examine the association between perceived weight change since high school and perceived factors contributing to weight change, or lack thereof, among college students. Students from a large university in the Northeast of the United States self-reported socio-demographic characteristics, and perceived factors contributing weight change (or lack thereof) via an online survey; and, completed an objective health assessment that included the anthropometric measurements. Of all participants (n = 183), most were men (61.2%), juniors/seniors (89.5%), non-Hispanic white (65.9%). Most participants reported gaining weight since high school (n = 113, 62.1%), and these participants had significantly greater abdominal girth, weight, and body fat percentage than those who maintained their weight (p < 0.005). Perceived factors contributing to weight change explained a significant portion of the variance in perceived weight change, and perceived factors contributing to weight change differed significantly between those who perceived that they had lost or gained weight. In summary, perceived weight gain despite awareness of contributing health behaviors among some students reinforces that supporting/facilitating actual health behavior changes, rather than mere awareness of healthy behaviors, should be the focus of health promotion efforts.

Causal mediation analysis is a popular approach for investigating whether the effect of an exposure on an outcome is through a mediator to better understand the underlying causal mechanism. In recent literature, mediation analysis with multiple mediators has been proposed for continuous and dichotomous outcomes. In contrast, methods for mediation analysis for an ordinal outcome are still underdeveloped. In this paper, we first review mediation analysis methods with a continuous mediator for an ordinal outcome and then develop mediation analysis with a binary mediator for an ordinal outcome. We further consider multiple mediators for an ordinal outcome in the counterfactual framework and provide identification assumptions for identifying the mediation effects. Under the identification assumptions, we propose a regression-based method to estimate the mediation effects through multiple mediators while allowing the presence of exposure-mediator interactions. The closed-form expressions of mediation effects are also obtained for three scenarios: multiple continuous mediators, multiple binary mediators, and multiple mixed mediators. We conduct simulation studies to assess the finite sample performance of our new methods and present the biases, standard errors, and confidence intervals to demonstrate that our proposed estimators perform well in a wide range of practical settings. Finally, we apply our proposed methods to assess the mediation effects of candidate DNA methylation CpG sites in the causal pathway from socioeconomic index to body mass index.

Elementary education is critical as it lays the foundation for learning, critical thinking, social and emotional development, individual growth, and self-confidence. Hence, studying the elementary students' educational progress is immensely important. This manuscript aims to investigate the factors that impact elementary students' academic performance, predict their academic performance, and use the above factors to identify the student's appropriate skilled level group based on their academic performance. In this study, the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) score, a measurement to assess students' early literacy skills for K-6 graders, is used to quantify students' academic performance. A sample of 185 first and second graders and their features, including student's BMI (body mass index), amount of time the student spends watching television, student's gender, number of hours that a student sleeps each night, amount of time that the student spends reading books, student's race, and amount of time that the student spends on physical activity are used. Based on the regression analysis, second graders' academic performances are significantly impacted by their BMI values ([beta] = - 4.002, p < 0.05) and the amount of time students spend reading books ([beta] = 29.14, p < 0.05). The first graders' academic performances are significantly impacted by the amount of sleeping time ([beta] = 41.89, p < 0.01) and their gender ([beta] = - 37.129, p < 0.05). Furthermore, the experimental findings indicate that machine-learning techniques accurately predict the students' appropriate academic group. In the naive Byers classifier, students in the lowest academic performance group can be identified successfully with a sensitivity of 92%, and the students in the highest academic group can be identified with a specificity value of 100%.

Children should engage in at least 60 min of physical activity daily to develop or maintain healthy habits (Centers for Disease Control and Prevention, 2021a). Previous research suggests that contingent attention is a powerful tool for increasing moderate to vigorous physical activity. In this study, the researchers examined the effects of a group game on steps per minute at recess in an inclusive classroom with preschoolers. The researcher taught the game called the T-Rex game in which the game rules (chasing students who were moving) involved contingencies for natural attention to follow moderate to vigorous physical activity. The results showed a functional relation between step count and the group game in which students engaged in higher step counts when the group game was in place than during baseline. These findings extend other work by demonstrating that contingent attention embedded in group games can increase step count.

Dance educators, as the face of dance education, are responsible for teaching and promoting dance equitably regardless of whose body executes the movement. Sizeism and racism have often been the unspoken standards used by dancers and educators to judge the development and proficiency of professional and aspiring dancers. Although seeing these as independent issues of a dancer's identity can be tempting, according to the authors, they would be remiss not to acknowledge the larger systemic forms of oppression at work in the dance field. Racism, sexism, and sizeism often morph and combine to create specific forms of discrimination and obstacles for thick Black women in dance. Uprooting racism and sizeism in dance requires a collective shift and reimagination of or away from the status quo. Every person should feel that they can learn to dance in any classroom regardless of race, gender, or body size. As co-authors, the authors created Thick Like Me, a dance-centered organization to support building justice and liberation in the field. Thick Like Me programming provides an intersectional analysis of racism, sexism, and fatphobia to advocate for thick Black women in dance and beyond. Dance should promote holistic health and body liberation in which all bodies are valued, welcomed, and unharmed.

Using the 2017-2018 National Health and Nutrition Examination Survey (weighted population size = 35,460,209; 8-18 years old; 52.1% males), we compared the obesity prevalence in children and adolescents between body mass index-based (BMI-based) and total percent body fat-based (BF%-based, measured by the dual-energy x-ray absorptiometry) cutoffs. The BMI-based cutoffs exhibited closer alignments (k, 0.88-0.97) in the childhood obesity prevalence, while the absolute (sex-specific) BF% cutoffs had higher prevalence rates than the relative (age- and sex-specific) BF% cutoffs (k = 0.43 [95% CI, 0.38-0.49]), overly labeling Non-Hispanic white and Other race/ethnicity females with obesity. The BF%-based cutoffs had higher prevalence rates in most sex, age, and race/ethnicity groups than the BMI-based cutoffs. Furthermore, the absolute BF% cutoffs overly labeled Hispanic and Other race/ethnicity females with obesity. In summary, childhood obesity prevalence varied by sex, age, race/ethnicity across different cutoffs, with the BMI-based cutoffs showing closer alignments than the BF%-based cutoffs.

Eight percent of adolescent girls were found to be engaged in problematic social media use. Problematic social media use is associated with serious physical and mental consequences. This study aimed to explore the effects of thin-ideal internalization on problematic social media use and the role of selfie-related behaviors and friendship quality. We recruited 903 Chinese adolescent girls with an average age of 13.73 years (ranging from 11 to 16 years) recruited to complete the self-report questionnaire, which contained four measures. Results revealed a moderated mediation model. Girls who had internalized thin-ideal images were more vulnerable to social media's addictive properties, constantly engaged in selfie-related behaviors, and developed subsequent problematic social media use. However, for adolescent girls, high friendship quality buffered against developing problematic social media use, despite selfie-related behaviors. The study provides suggestions to reduce problematic social media use among adolescents to promote their physical and mental health.

Compared to their public-school peers, homeschool students are less physically active, perform worse in health-related physical fitness tests, and have poorer body composition status (Kabiri et al., 2017; Kabiri et al., 2020; Long et al., 2010; Tribby & Berrigan, 2021). The purpose of this study was to examine the impacts of an outdoor education program (OEP) on homeschool adolescents' physical fitness level and life skills. Homeschool students were recruited to participate in a nine-week OEP that included activities such as hiking and mountain biking and a pre- and posttest to assess physical fitness and life skills. Descriptive and inferential (e.g., paired-samples t-tests) statistics were used to analyze the resulting data. Findings reveal that male homeschool students self-report higher levels of life skills and that the OEP had a greater positive impact on males' fitness outcomes. Recommendations for OEP practitioners include developing OEPs that increase the frequency and decrease the duration of physical activity time and emphasize skills such as emotional control. Recommendations for future research are to utilize large, diverse sample sizes and to consider at-home activities that may influence variables of interest.

Parental behaviors and attitudes are effective in health outcomes of children. Obesity among children has been found to be related with limited nutrition knowledge and unhealthy eating and habits. Therefore, this study identified the causes and factors associated with obesity among children and revealed their own routines from the perspective of mothers. Content analysis was used in the current qualitative research. Potential and eligible participants were selected by visiting four preschool centers in Sarab, Iran. The height and weight of 113 children aged 5-6 years were measured by standard scales, along with calculating their body mass index. The mothers of children at or above the 50th percentile were invited to appointments for interviews in the preschool centers. Then, 37 semi-structured face-to-face interviews were carried out with mothers and analyzed by two independent researchers manually. The factors associated with obesity in preschool children were categorized into four main themes, including insufficient physical activity, poor perception of body weight, unhealthy behavioral habits, and genetic factors. The mothers did not consider their children at risk of becoming overweight, as their perceived sensitivity was low. The results of this study can be supportive in designing family and parent-centered interventions to control obesity among children.

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children's Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

COVID-19, which affects the world, undoubtedly seems to have affected university students who receive applied education. Sports Science students continue their sports training within the mask and distance rules by switching to face-to-face teaching during the normalization period. This study aimed to reveal whether the physical activity levels of Sports Science students were affected by Coronavirus-19 phobia after switching to face-to-face training. 432 (female; 152, male; 280) university students from Sports Sciences attended the research. Data from the participants were collected using the Coronavirus-19 Phobia Scale and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The independent sample and Mann-Whitney U test, One-Way, and two-way ANOVA test (Post hoc Tukey) were used in the data analysis. According to the results, the 'psychological' sub-dimension scores of the participants, an increase in body mass index, not doing sports, reducing the vaccine dose, spending COVID-19 in the hospital, and wearing a mask in practical classes increase. In addition, those who wear masks in applied lessons have higher 'somatic,' 'social,' and 'economic' sub-dimension scores. Females' coronavirus-19 phobia, 'psychological' and 'economic' sub-dimensions, and total scale scores are higher than males. Consequently, with the increased physical activity levels of Sports Science students, coronavirus-19 decreases phobia scores.

Adults with autism spectrum disorder and intellectual disability often do not engage in healthy levels of physical activity despite its many benefits. We conducted a randomized control trial to evaluate the effectiveness and feasibility of the Step It Up program, which used supported self-management strategies, on daily step counts, health measures, and perceived quality of life for adults with autism spectrum disorder and intellectual disability. Forty participants, ages 18 to 57, were randomly assigned to a control or intervention group. Males accounted for 70.6% of participant gender. Both groups received Fitbits and Fitbit training, and they participated in pre- and post-assessments. The intervention group participated in the Step It Up program. Participants in the intervention group had significantly higher step counts and lost more weight. Feasibility and acceptability were also high. This study provides valuable data on using a supported self-managed exercise program as well as insight into its feasibility in home settings.

Gastrointestinal symptoms and their relation to physical and mental aspects in adults with an autism spectrum disorder (ASD) are poorly understood, despite their high prevalence. Therefore, the aim of this study is to examine psychological, behavioural and biological factors associated with gastrointestinal symptoms in adults with ASD (traits). We included 31,185 adults from the Lifelines Study. Using multivariable logistic regression, we analysed the association between gastrointestinal symptoms and psychological, behavioural (questionnaire-assessed) and physically measured biological factors in adults with ASD (n = 309), without ASD (n = 30,876), and in the quartiles with highest (n = 7783) and lowest (n = 7783) Autism Spectrum Quotient-10 sum scores. In the ASD-group, gastrointestinal symptoms were associated with psychiatric comorbidity (odds ratio: 2.71, 95% confidence interval: 1.51-4.85), more stress (odds ratio: 1.15, 95% confidence interval: 1.06-1.26), and worse perceived health (odds ratio: 2.32, 95% confidence interval: 1.62-3.34). In the quartile with the highest Autism Spectrum Quotient-10 sum scores, gastrointestinal symptoms were also associated with these psychological factors, and with less physical activity (odds ratio: 0.95, 95% confidence interval: 0.92-0.98). Our study demonstrates that not only adults with ASD but also adults with autistic traits are at increased risk for gastrointestinal symptoms, which is associated with psychological and behavioural factors. This suggests that an integrated psychosomatic approach of gastrointestinal symptoms in adults with ASD (traits) is needed.

The current study is intended to study the mediating role of physical activity (PA) in the relationship between body image (satisfaction/dissatisfaction) and life satisfaction. Moreover, it is intended to investigate how teachers' BMI, age may vary through body image perception. Participants included 781 teachers ranging in age from 20 to 50 years old from all over Oman. A Google form survey was used to recruit participants. The collected data was analysed using SPSS version 23 statistical tools, and the Partial Least Squares (PLS) approach was used for Structural Equation Modelling (SEM) using Smart-PLS Ver 3. The level of body image satisfaction was higher than dissatisfaction. Body image satisfaction has a positive and significant effect on teacher's life satisfaction, while a negative correlation was found between body image dissatisfaction and life satisfaction. Physical activity was a mediation variable in the relationship between body image (satisfaction/dissatisfaction) and life satisfaction. Policymakers should empower individuals to have a positive body image regardless of their size or appearance and it would improve certain areas of their lives, encouraging them to dedicate more energy and time to other critical aspects of their lives such as work, partnerships, and even leisure and enjoyment, resulting in improved overall life satisfaction.

Physical activity (PA) habit decreases and Body Image (BI) becomes important during adolescence. This paper focuses on determining two things: whether the level of participation in PA contributes to adolescents' PA attitudes and their quality of life-related body image and to examine whether there is a difference. The study utilized the cross-sectional design. 1281 individuals in the middle adolescence period participated in the study. Participants were between 15 and 17 years. International Physical Activity Questionnaire Short Form (IPAQ-SF), Cognitive Behavioral Physical Activity Questionnaire (CBPAQ), and Body Image Quality of Life Inventory (BIQLI) were used as data collection tools. According to the study findings, there were significant differences in the BIQLI total, interaction with the opposite sex, and influence behavior/attitude between those who engaged in regular or irregular PA and those who did not engage in PA at all. Difference in the effect on self-efficacy and daily life sub-dimension was found between those who engaged in regular PA and those who did not. Outcome expectation and self-regulation items of those who engaged in PA were higher than for those who did not. Since adolescents are expected to engage in regular or irregular PA, personal barriers in front of them must be removed. It is therefore important to support their attitudes, which positively affects their PA, because participation in PA contributes positively to their PA and BI-related quality of life.

This study investigated the nutritional practices and body mass index (BMI) among secondary school students in Kerian District, Perak. The respondents of this study consisted of 363 first, second, and fourth-grade students who were selected through a simple random sampling method in secondary schools in Kerian District, Perak. Questionnaires were distributed to selected schools in this study. The questionnaire in the study was obtained from the Meal Pattern Questionnaire (MPQ), which requires the socio-economic status of parents' monthly income, students' body mass index, and students' eating habits. The study's findings showed that the nutritional practices among secondary school students are in the presence of moderate, whereas the body mass index of students is also at the level of underweight. Meanwhile, students' socio-economic status is of the low-income group. In addition, there were significant differences in terms of nutritional practices among secondary school students based on the family's socio-economic status. The study's findings also showed no significant relationship between dietary practices and body mass index (BMI) of secondary school students. The findings of this study can be used as a reference and provide conclusive assistance in improving the nutritional practices through learning sessions and learning of Physical and Health Education in schools.

Digital game addiction was classified as a disease by the World Health Organization. It is characterized by impaired control over gaming and increasing priority given to gaming over other activities. Especially for school-age children, there are concerns about the effects of gaming addiction on health problems that are difficult to treat later and on their future careers. This study was conducted to analyze the relationship between academic achievement, body mass index and player types and computer game addiction of secondary school students. Study participants included 289 students attending fifth and sixth grades in a public school in Sivas province during the 2018-2019 academic year in Turkey. The data were analyzed with hierarchical regression analysis. The study findings revealed that digital game addiction was significantly predicted by gender, academic achievement score, computer and smartphone gameplay per-week, but not significantly predicted by the body mass index and player type variables. These findings suggest that male students with high weekly gameplay on computers and smartphones were exposed to a high risk of digital game addiction, and digital game addiction negatively affects academic achievements of the students. Future studies could be carried on focusing on the games and the types of games played by the students with similar variables.