Insights and Advances in Physical Activity Research on Youth with Type 1 Diabetes.
Most youth with type 1 diabetes (T1D) do not meet the guidelines for physical activity engagement, thereby diminishing potential benefits to physical and mental health. This review synthesizes the recent literature on physical activity among youth with T1D and offers recommendations for future research. Studies highlight challenges related to the use of inconsistent measurement tools, which prevent definitive conclusions about the mechanistic factors underlying low physical activity in youth. There has been limited research examining young children and youth newly diagnosed with T1D. Additionally, most interventions to promote physical activity in youth with T1D have involved structured and supervised exercise sessions, leaving a gap in knowledge regarding the potential impact of unstructured and unsupervised exercise interventions. To address these gaps, rigorous studies employing validated measures of physical activity in youth are needed. Interventions should incorporate developmentally appropriate behavioral science theories and emerging technologies in their design. Additional priorities include integrating diabetes technologies into clinical care, more real-world data to improve the accuracy of machine learning models for predicting dysglycemia, and advancing personalized mHealth interventions to promote physical activity in youth. While physical activity is an important area of pediatric diabetes research, gaps remain in our knowledge and intervention development. Physical activity consultations should be a part of routine diabetes care for youth. Research can inform these consultations by providing strategies to promote physical activity uptake and maintenance and by exploring ways to leverage new technologies to help youth with T1D exercise safely.
- Research Article
23
- 10.1123/pes.2015-0041
- Jun 11, 2015
- Pediatric exercise science
The purpose of this systematic review was to explore whether birth weight, early growth and motor development act as determinants of physical activity in children and youth. We performed a systematic literature search on the possible early life determinants. A meta-analysis was performed on the association between birthweight and objectively measured physical activity. We identified 9 studies examining birth weight, in which none of the studies with objectively measured physical activity observed an association between birth weight and physical activity. The meta-analysis confirmed this result (b=-3.08, 95% CI -10.20, 4.04). The 3 studies examining early growth and physical activity in youth differ in methodology and the results are inconsistent. Two studies suggest an association between earlier motor development and physical activity and sport participation in youth. This was not confirmed in a third study. Our meta-analysis suggests that birth weight is not an important determinant of physical activity in youth. Available data does not allow firm conclusions whether early growth and motor development act as determinants of physical activity in youth.
- Research Article
8
- 10.1152/japplphysiol.90624.2008
- May 15, 2008
- Journal of Applied Physiology
which unique insights can be gained from the investigations of the physiology of the growing child? Are there pragmatic outcomes to research in children's exercise science that bear specific utility to this age group or to their future life? What importance do exercise responses in youth bear to our
- Research Article
972
- 10.1111/j.1467-789x.2006.00264.x
- Aug 22, 2006
- Obesity Reviews
Obesogenic environments are thought to underlie the increased obesity prevalence observed in youth during the past decades. Understanding the environmental factors that are associated with physical activity (PA) in youth is needed to better inform the development of effective intervention strategies attempting to halt the obesity epidemic. We conducted a systematic semi-quantitative review of 150 studies on environmental correlates of youth PA published in the past 25 years. The ANalysis Grid for Environments Linked to Obesity (ANGELO) framework was used to classify the environmental correlates studied. Most studies retrieved used cross-sectional designs and subjective measures of environmental factors and PA. Variables of the home and school environments were especially associated with children's PA. Most consistent positive correlates of PA were father's PA, time spent outdoors and school PA-related policies (in children), and support from significant others, mother's education level, family income, and non-vocational school attendance (in adolescents). Low crime incidence (in adolescents) was characteristic of the neighbourhood environment associated with higher PA. Convincing evidence of an important role for many other environmental factors was, however, not found. Further research should aim at longitudinal and intervention studies, and use more objective measures of PA and its potential (environmental) determinants.
- Research Article
22
- 10.4278/ajhp.121023-arb-516
- Nov 1, 2014
- American Journal of Health Promotion
To determine if the sex of the child moderates the relationships between perceptions of the physical/social environments and moderate to vigorous physical activity (MVPA) in youth. Cross-sectional. North Carolina. A final sample of 711 children, 8 to 17 years of age, was available for analysis. Self-reported presence of environmental factors previously identified to be associated with physical activity in youth was collected via survey. Daily MVPA was assessed via accelerometry for a minimum of 4 days. Multilevel linear regression models were employed, adjusted for clustering at the county and individual level. MVPA was first regressed onto sex and environmental perception items while controlling for grade and race. The interaction term between sex and environmental perception was then added to the model. A significant positive association was observed in the first models between MVPA and two items related to parent permission to (1) walk and (2) ride a bike in the neighborhood. These effects were fully moderated by sex, with males indicating "yes" on these items exhibiting 6.87 and 5.21 more minutes of MVPA (respectively) than males indicating "no." Environmental perceptions appear to be related to MVPA, but this relationship is present only in males. Future research should be conducted to identify modifiable social and physical characteristics that are associated with MVPA in females.
- Research Article
23
- 10.1177/1559827607308557
- Jan 1, 2008
- American Journal of Lifestyle Medicine
National recommendations call for children and adolescents to accumulate at least 60 minutes of moderate to vigorous physical activity on most days of the week and for physicians to counsel their patients about physical activity. Physical inactivity tracks from childhood into adulthood, and among youth, it is associated with unfavorable risk factor profiles that promote the development of cardiovascular and metabolic chronic diseases. Few studies of clinical interventions to promote physical activity in children and youth have been published, and the paucity of evidence describing effective interventions and significant barriers limit delivery of counseling. However, existing studies provide evidence about elements of counseling most likely to be effective to guide clinical interventions and inform future research. Based on a literature review, this article offers guidance for incorporating physical activity promotion into clinical care, identifies gaps in current evidence, and suggests methodologic considerations for future research.
- Research Article
90
- 10.1111/cob.12230
- Dec 10, 2017
- Clinical Obesity
Targeting physical inactivity in children is pertinent to aiding in the decrease of childhood obesity rates. Only 33% of adolescents are obtaining the recommended goal of at least 60 min of physical activity per day. The objectives of this review are to summarize professional recommendations for physical activity and exercise in children and adolescents, and identify family-centred strategies that can be implemented by weight management clinicians. Clinically oriented recommendations and policy statements from professional organizations were identified through literature and internet searches, summarized using rubrics of aerobic, muscle strengthening and bone strengthening exercise, then examined for details on family-based focus, inclusion of child developmental stage and age, and application to the prevention and treatment of obesity. Current recommendations give guidelines for the amount of physical activity that children should acquire and how many days a week activities should occur. However, available guidelines need an improved approach to addressing the role of the parents and caregivers in targeting physical activity and weight management in youth. Efforts must be taken in order to make sure that the types of physical activity offered are both suitable and enjoyable. Sports, games, free play and other age appropriate activities are adequate ways to increase moderate to vigorous physical activity in children. Differentiating physical activities types in accordance with developmental stage, level of enjoyment, and family characteristics is needed to establish sustainable habits. One paediatric obesity program has developed approaches to teaching families fun and engaging ways to be active together.
- Research Article
13
- 10.1089/dia.2021.2525.abstracts
- Jun 1, 2021
- Diabetes Technology & Therapeutics
Background and Aims: The measures for Sars-Cov-2 (COVID-19) pandemic containment produced a decrease of active life-style in children and adolescents with type 1 diabetes (T1D) and worsened the disease management. Nowadays, telemedicine became fundamental to assist and monitor patients and tele-exercise is an innovative instrument to implement physical activity (PA) practice. We provided an online exercise program with the aim to investigate adherence, enjoyment and health benefits in T1D children. Metabolic control prior and after the program was also considered. \nMethods: 50 children and adolescent with T1D were recruited for a 1-month training program provided by sport specialists through an online platform. The survey investigated subjective perception of functional capacities, the PA level, time spent in sedentary activities, mean glycemia values and insulin dose. The training was supervised five days a week through an online platform and each session will last 60 minutes. Every session was a combination of aerobic and resistance exercises adapted to the age of participants. \nResults: We obtained a positive answer to proposal. An increased PA level and a decreased time spent in sedentary activities were recorded. No difficulties during PA program was referred. A limited changes in mean glycemia values and insulin dose was noted. \nConclusions: Since, during a period of confinement, the possibility to maintain an active lifestyle in safe condition is essential, our online program will help TD1 children to achieve PA goals. We are also confident that PA implementation will help to better manage diabetes therapy.
- Research Article
24
- 10.1123/jpah.10.2.198
- Jun 13, 2012
- Journal of Physical Activity and Health
The primary aim of this population-based study was to determine if arterial stiffness is associated with cardiovascular disease (CVD) risk factor clustering and physical activity in youth 12-14 years old. We hypothesized that arterial stiffness would be positively associated with CVD risk factor clustering and negatively associated with physical activity in a dose-response manner in this cohort of youth. This was a cross sectional study of 485 youth recruited from the 1995 Manitoba birth cohort. The primary outcome, arterial stiffness, was assessed noninvasively using conventional pulse wave analysis and velocity. The primary exposure variables included 1) a measure of cardiometabolic risk, defined as a composite of novel and traditional risk factors for cardiovascular disease and type 2 diabetes and 2) self-reported physical activity. Neither cardiometabolic risk factor clustering, nor physical activity were associated with either measure of arterial stiffness in this cohort of youth 12-14 years. Cardiometabolic risk decreased with increasing levels of vigorous physical activity, (P < .05) and increased with increasing body mass index. Cardiometabolic risk factor clustering and physical activity are not associated with arterial stiffness in youth 12-14 years of age. Increased vigorous physical activity is associated with reduced cardiometabolic risk in youth independent of body mass index.
- Research Article
27
- 10.1519/jsc.0000000000003098
- Mar 13, 2019
- Journal of Strength & Conditioning Research
Lankhorst, K, Takken, T, Zwinkels, M, van Gaalen, L, Velde, St, Backx, F, Verschuren, O, Wittink, H, and de Groot, J. Sports participation, physical activity, and health-related fitness in youth with chronic diseases or physical disabilities: the health in adapted youth sports study. J Strength Cond Res 35(8): 2327-2337, 2021-Youth with chronic diseases or physical disabilities (CDPD) often show reduced fitness and physical activity (PA) levels and participate less in organized sports compared with healthy peers. The purpose of this study was to examine the associations between participation in sports and health-related fitness and PA in youth with CDPD. A total of 163 subjects (mean age 14 years; range 8-19 years) with CDPD were included in this cross-sectional study, with 81 participating in organized sports and 82 not. Subjects were recruited between October 2014 and November 2016. Aerobic and anaerobic fitness, agility, and muscle strength were assessed in the laboratory, whereas PA was monitored in daily life using accelerometry during 1 week. Linear regression analyses were used to assess the associations of sports participation (independent variable) with health-related fitness and PA (dependent variables). Results show that youth with CDPD participating in organized sports 2 times a week performed better on all outcome measures. They reached a higher peak oxygen uptake (difference of 4.9 ml O2·kg-1·min-1, P = 0.001) compared with their peers not participating in sports. Also, anaerobic fitness, agility, muscle strength, and PA were all positively associated with sports participation. Moreover, the association between sports participation and aerobic fitness was mediated by PA for 31% (P = 0.045). In conclusion, participation in sports is associated with both higher levels of PA and health-related fitness in youth with CDPD. Promotion and stimulation of participation in sports seems a good way to promote health-related fitness as well as a healthy active lifestyle in youth with CDPD.
- Research Article
3
- 10.1177/02646196221099151
- Jun 7, 2022
- British Journal of Visual Impairment
Recent research has found a positive relationship between functional body image and physical activity in typically developing youth; however, functional body image has not been studied in youth with visual impairments. Youth with visual impairments tend to have a lower body image and engage in less physical activity than their sighted peers. The purpose of this study was to determine differences in functional body image between youth with and without visual impairments and the relationship between functional body image and physical activity in youth with visual impairments. Twenty youth with visual impairments and 20 youth without disabilities completed the embodied image scale and the organized sport (OS) and active physical recreation (AR) activity categories of the Children’s Assessment of Participation and Enjoyment, which measures five dimensions of activity participation. Mann–Whitney U tests revealed that participants with visual impairments had lower functional satisfaction ( p = .006) and marginally lower functional investment ( p = .059) than participants without disabilities. The correlation analysis revealed several significant positive relationships: functional values with AR where ( r = .472), functional satisfaction with AR intensity ( r = .459) and AR enjoyment ( r = .501), and functional investment with AR ( r = .554) and OS enjoyment ( r = .655). There were significant negative relationships between functional investment and AR diversity ( r = −.475) and intensity ( r = −.501). This suggests that youth with visual impairments have lower satisfaction and investment in their functional body image; however, those who enjoyed OS and AR activities tended to be more satisfied and invest more in their functional body image.
- Research Article
49
- 10.1186/1471-2458-10-303
- Jun 3, 2010
- BMC Public Health
BackgroundChildhood and adolescence are critical periods of habit formation with substantial tracking of lifestyle and cardiovascular risk into adulthood. There are various guidelines on recommended levels of physical activity in youth of school-age. Despite the epidemic of obesity and diabetes in China, there is a paucity of data in this regard in Chinese youth. We examined the association of self-reported level of physical activity and cardiovascular risk in Hong Kong Chinese youth of school-age.MethodsThis was a cross-sectional study conducted in 2007-8 in a school setting with 2119 Hong Kong Chinese youth aged 6-20 years. Physical activity level was assessed using a validated questionnaire, CUHK-PARCY (The Chinese University of Hong Kong: Physical Activity Rating for Children and Youth). A summary risk score comprising of waist circumference, blood pressure, fasting plasma glucose and lipids was constructed to quantify cardiovascular risk.ResultsIn this cohort, 21.5% reported high level of physical activity with boys being more active than girls (32.1% versus 14.1%, p < 0.001). Regression analysis showed physical activity level, sex and pubertal stage were independently associated with cardiovascular risk score.ConclusionSelf-reported level of physical activity is associated with cardiovascular risk factors in Chinese youth after adjusting for sex and pubertal stage.
- Research Article
10
- 10.1097/dbp.0000000000001192
- May 19, 2023
- Journal of developmental and behavioral pediatrics : JDBP
The aims of this study are to (1) compare physical activity (PA) and sedentary activity (SA) in youth with and without Down syndrome (DS and non-DS) and examine the relationships of PA and SA with their traditional risk factors (age, sex, race, and body mass index Z score [BMI-Z]) and (2) explore the relationship of PA with visceral fat (VFAT) in both groups. SenseWear accelerometry data from at least 2 weekdays and 1 weekend day were collected from youth with DS (N = 77) and non-DS (N = 57) youth. VFAT was measured by dual x-ray absorptiometry. In age-, sex-, race-, and BMI-Z-adjusted models, those with DS engaged in more minutes of light PA (LPA) ( p < 0.0001) and less SA ( p = 0.003) and trended toward fewer minutes of moderate-to-vigorous PA (MVPA) ( p = 0.08) than non-DS youth. No race or sex differences in MVPA were detected in those with DS, unlike non-DS. After additional adjustment for pubertal status, the relationship between MVPA and VFAT approached significance ( p = 0.06), whereas the relationships of LPA and SA with VFAT were maintained ( p ≤ 0.0001 for both). Youth with DS engage in more LPA compared with non-DS, which, in typically developing populations, can confer a more favorable weight status. Increasing the opportunity for youth with DS to engage in LPA as part of their activities of daily living may offer a viable strategy for achieving healthy weight when barriers restrict pursuit of more vigorous PA.
- Research Article
45
- 10.1080/02640414.2016.1161219
- Apr 12, 2016
- Journal of Sports Sciences
ABSTRACTThis study evaluates how domains of physical activity (PA) in youth predict later PA and assesses factors influencing changes in sports participation. Young people from the Children’s Sport Participation and Physical Activity study (n = 873; baseline age 10–18 years; 30.4% male) completed self-report surveys in 2009 and 2014. In a multiple linear regression analysis, participation frequency in club sport (β = 0.18) and extracurricular sport (β = 0.13) significantly predicted PA 5 years later, adjusted for age, sex and urban/rural classification (P < 0.01). Overall, rates of regular (at least once per week) youth sports participation were high (males 79.3–85.5%; females 74.8–83.2%). Uptake and dropout of specific sports varied widely. Despite high levels of migration into and out of Gaelic games, they remained popular at follow-up. Weight training was the only sport that increased in both sexes (P < 0.05). Fitness, friends and enjoyment were top motivations for taking up a new sport. Other commitments, a lack of interest and time were important factors leading to sports dropout. PA promotion strategies should include youth sport, take into consideration what sports are attractive to young people and address reasons for uptake and dropout.
- Research Article
11
- 10.1080/02640414.2021.1976487
- Oct 8, 2021
- Journal of Sports Sciences
Resistance training (RT) may have a positive impact on specific correlates of physical activity (PA) in inactive and/or obese youth, with strength as a possible underlying mechanism. The aim of this study was to investigate this. Twelve participants (aged 8.9 ± 1.0 years) were assigned to an experimental group (EG) or control group (CG). Pre and post intervention assessments for strength, physical self-perceptions (PSPs), weight status, fundamental movement skills (FMS), and PA levels were completed. The EG participated in a twice-weekly 10-week RT programme. There were significant group x time interactions for FMS (CAMSA total P = 0.016, CAMSA skill score P = 0.036) and stretch stature (P = 0.002) (EG larges changes than the CG). Large effect sizes for the differences in change scores between the EG and CG were evident for CAMSA total score (Hedges’ g = 0.830, P = 0.138), CAMSA skill score (Hedges’ g = 0.895, P = 0.112) and relative strength (Hedges’ g = 0.825, P = 0.140). This study demonstrated that a 10-week RT intervention has a positive effect on strength and FMS, and may also benefit weight status and PSPs. This study supports the development of RT interventions to develop these correlates, and increase PA levels.
- Front Matter
12
- 10.1136/bjsports-2021-104509
- Sep 16, 2021
- British Journal of Sports Medicine
There is a global concern surrounding the current lifestyle behaviours and future health and well-being of youth.1 Levels of physical activity, aerobic and muscular fitness in youth are in decline2...