Abstract

The worldwide prevalence of mental disorders in children and adolescents increased constantly. Additionally, the recommended amount of physical activity (PA) is not achieved by this age group. These circumstances are associated with negative impacts on their health status in later life and can lead to public health issues. The exposure to natural green environments (NGE) seems to be beneficial for human health. The compulsory school system offers great opportunities to reach every child with suitable health-related contents and interventions at an early stage. The concept of Education Outside the Classroom (EOtC) uses NGE and sets focus on PA. Therefore, EOtC might be a beneficial educational intervention to promote students health. The association between biological stress markers and sedentary behavior (SB) plus PA is insufficiently evaluated in school settings. This exploratory study aims to evaluate the association between students' cortisol, plus circulating cell-free deoxyribonucleic acid (cfDNA) levels, and their SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). We assessed data from an EOtC program (intervention group [IG], n = 37; control group [CG], n = 11) in three seasons (fall/spring/summer) in outdoor lessons (IG) in a NGE and normal indoor lessons (CG). SB and PA were evaluated by accelerometry, and cortisol and cfDNA levels by saliva samples. Fitted Bayesian hierarchical linear models evaluated the association between cortisol and cfDNA, and compositional SB/LPA/MVPA. A steady decline of cortisol in the IG is associated with relatively high levels of LPA (posterior mean = −0.728; credible interval [CRI 95%]: −1.268; −0.190). SB and MVPA tended to exhibit a similar effect in the CG. A high amount of cfDNA is positively associated with a relatively high amount of SB in the IG (posterior mean, 1.285; CRI: 0.390; 2.191), the same association is likely for LPA and MVPA in both groups. To conclude, LPA seems to support a healthy cortisol decrease in children during outdoor lessons in NGEs. Associations between cfDNA and SB/PA need to be evaluated in further research. This study facilitates the formulation of straightforward and directed hypotheses for further research with a focus on the potential health promotion of EOtC.

Highlights

  • The upsurge in the worldwide prevalence of overweight and obesity in children is anticipated to reach 9.1% in 2020 [1], a high proportion of children do not reach the recommended levels of physical activity (PA) [2, 3], and suffer from mental disorders [4]

  • The present paper aims to address these topics by investigating the relation between biological stress responses and physical activity in students taught in two different school settings: an indoor setting and an outdoor setting in a natural green environments (NGE)

  • We reported that students in the intervention group (IG) exhibited a steady decline of cortisol levels during Education Outside the Classroom (EOtC), whereas no such effect was observed in students in the control groups (CG) during regular school days; the effect was independent of students moderate-to-vigorous PA (MVPA) levels

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Summary

Introduction

The upsurge in the worldwide prevalence of overweight and obesity in children is anticipated to reach 9.1% in 2020 [1], a high proportion of children do not reach the recommended levels of physical activity (PA) [2, 3], and suffer from mental disorders [4]. Chronic stressful events could exert adverse impacts on brain development and result in major mental health-related problems in later life [5, 6]. These circumstances require a need for action to improve children and adolescents health perspectives. The present paper aims to address these topics by investigating the relation between biological stress responses and physical activity in students taught in two different school settings: an indoor setting and an outdoor setting in a NGE. We extend our original investigation [12] by increasing our set of dependent variables and introducing circulating cellfree deoxyribonucleic acid (cfDNA) as an innovative biological marker, sedentary behavior (SB) and light physical activity (LPA) as more differentiated measures of physical activity and by applying advanced statistical models to better describe relations between our measures

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