Interventions on School Physical Activity Incorporating the Ecological Model in LATAM: A Systematic Review.

The general public recommendation to accumulate 30 minutes of daily physical activity on most, preferably all, days of the week was recently modified by the National Academy of Science Institute of Medicine to at least 60 minutes of cumulative daily physical activity to maintain cardiovascular health at a maximal level. Data suggest that regular physical activity, even as little as 30 minutes daily, can positively impact cardiovascular health by improving many of the major risk factors associated with coronary heart disease, including hypertension, dyslipidemia, obesity, insulin resistance, and endothelial function. With the recent and rapid rise in the rate of obesity in the United States, a doubling of the dose of physical activity daily may help offset the trend of increased caloric intake that has contributed to this epidemic. We briefly review the evidence regarding the amount and intensity of physical activity necessary to alter these cardiovascular risk factors with the goal of reducing coronary events.

The coronavirus 2019 (COVID-19) pandemic has led to laws and policies including national school closures, lockdown or shelter in place laws, and social distancing recommendations that may translate to higher overall screen time among children and adolescents for the duration of these laws and policies. These policies may need to be periodically re-instated to control future COVID-19 recurrences or other national emergencies. Excessive screen time is associated with cardiovascular disease risk factors such as obesity, high blood pressure, and insulin resistance because it increases sedentary time and is associated with snacking.

Among children, the health benefits of regular physical activity are well known, as are the harmful effects of inactivity and a sedentary lifestyle. Consequently, since September 2022, French elementary schools have been obliged to offer 30 minutes of daily physical activity to their pupils. However, this measure comes up against numerous constraints, and few schools manage to meet this obligation. To facilitate the implementation of this measure, exergames, or active video games, could be a promising lever for incorporating physical activity into school time. The aim of this study is to evaluate the effects perceived by teachers of an intervention based on exergaming, conducted with pupils in classes ranging from CP to CM2 (grades 1 to 5), at a rate of one 30-minute session per day, for four weeks. Semi-structured interviews were conducted with the teachers of each class after the intervention. Analysis of our interviews shows a perceived increase, compared with before the intervention, in their pupils' motivation for the subjects targeted by the intervention, a maintenance of a high level of motivation for physical activity, and an improvement in relations between pupils. Our study suggests that exergaming could be an effective means of facilitating the implementation of 30 minutes of daily physical activity in schools, but also of promoting motivation and a better relational climate. Consequently, these results encourage the widespread use of this type of device.

BackgroundDespite the importance of social support in promoting physical activity, little is known about the relative influence of the type or source of social support on adolescent girls' physical activity and sedentary behaviors. This study examined the associations of two types of social support (social participation in and social encouragement for physical activity) and two social support sources (family and friends) with self-reported daily minutes of physical activity and sedentary behavior among sixth-grade girls in Texas.MethodsA secondary analysis of 718 sixth-grade girls between the ages of 10 to 14 was performed using cross-sectional baseline data from an osteoporosis prevention intervention study. Physical activity and sedentary behaviors (television-video viewing and computer-video game playing) were assessed using 3 administrations of the Self-Administered Physical Activity Checklist; social support indicators were assessed with Likert-type items from a psychosocial questionnaire.ResultsIn multiple linear regression analyses, friend physical activity participation (partial correlation coefficient (r) = 0.10, p = .009) and friend (r = 0.12) and family encouragement (r = 0.11) (p < .01, respectively) were positively related to moderate-to-vigorous physical activity in the full model with other support variables, BMI and ethnicity; friend encouragement was the only variable positively related to vigorous physical activity (r = 0.11, p = .005). Family participation in physical activity had the strongest negative correlation with total minutes of television-video viewing and computer-video playing (r = -0.08, p < .05).ConclusionFindings lend support to the importance of social support for physical activity among adolescent girls but suggest that the source and type of social support may differ for physical activity and sedentary behaviors. Further research is needed to assess the causal or reciprocal relation between the roles of friends and family in promoting physical activity and of family physical activity in decreasing sedentary behaviors among early adolescent girls.

The after-school period provides an opportune context for adolescent physical activity. This study examined how characteristics of after-school recreation environments related to adolescent physical activity. Participants were 889 adolescents aged 12 to 17 (mean = 14.1, SD = 1.4) from 2 US regions. Adolescents reported on whether their school offered after-school supervised physical activity, access to play areas/fields, and presence of sports facilities. Outcomes were accelerometer-measured after-school physical activity, reported physical activity on school grounds during nonschool hours, attainment of 60 minutes of daily physical activity excluding school physical education, and BMI-for-age z-score. Mixed regression models adjusted for study design, region, sex, age, ethnicity, vehicles/licensed drivers in household, and distance to school. School environment variables were all significantly associated with self-reported physical activity on school grounds during non-school hours (P < .001) and attainment of 60 minutes of daily physical activity (P < .05). Adolescents' accelerometer-measured after-school physical activity was most strongly associated with access to supervised physical activity (P = .008). Policies and programs that provide supervised after-school physical activity and access to play areas, fields, and sports facilities may help adolescents achieve daily physical activity recommendations.

Larger brain volumes are often associated with more free-living physical activity (PA) in cognitively normal older adults. Yet, whether greater brain volumes are associated with more favorable (less fragmented) PA patterns, and whether this association is stronger than with total PA, remains unknown. Brain magnetic resonance imaging and wrist-worn accelerometer data were collected in 301 participants (mean age = 77 [SD = 7] years, 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Linear regression models were fit to examine whether brain volumes (cc) were cross-sectionally associated with: (a) total daily PA minutes and (b) activity fragmentation (mean number of PA bouts / total PA minutes × 100). Sensitivity analyses were conducted by adjusting for counterpart PA variables (eg, fragmentation covariate included in the PA minutes model). Greater white matter volumes in the parietal and temporal lobes were associated with higher daily PA minutes (2.6 [SE = 1.0] and 3.8 [0.9] min/day, respectively; p < .009 for both) after adjusting for demographics, behavioral factors, medical conditions, gait speed, apolipoprotein E e4 status, and intracranial volume. Greater temporal white matter volume was associated with lower fragmentation (-0.16% [0.05], p = .003). In sensitivity analyses, observed associations between brain volumes and daily PA minutes remained significant while associations with fragmentation no longer remained significant. Our results suggest white matter brain structure in cognitively normal older adults is associated with the total amount of PA and, to a lesser extent, the PA accumulation patterns. More work is needed to elucidate the longitudinal relationship between brain structure and function and PA patterns with aging.

Introduction: Adolescents are individuals in the 10–19year age group; there are 253 million adolescents in India. Growth and development are predominant during adolescence, a relatively healthy time. Good diet, physical activity, sleep, and screen time are pillars of good health. Aims &amp; Objectives: To identify lifestyle practices such as diet, physical activity, sleep, and screen time among adolescents in the outpatient and inpatient services, Departments of Paediatrics and Paediatric Surgery, Christian Medical College, Vellore. Methods: A descriptive study design employing a non-probability purposive sampling technique was used to recruit 1420 adolescents. Written consent and assent were obtained, demographic and clinical variables were collected using interviews, and the lifestyle practice was assessed using a modified YRBS questionnaire. Results: 70.8% of the adolescents were in the age group of 10-14 years; males and females were almost equal (46.2 and 53.8%), 73.6% lived in nuclear families, and 19.4% had a BMI of 23 adult equivalent. Regarding diet in the past 7 days, 41.3% did not consume green/vegetable salads, and 89.7% of the adolescents ate breakfast daily, but the meals of 81.4% did not contain 25% carbohydrates. 42.2% did not meet the recommended 60 minutes of daily physical activity, and 51% were not a part of any sports team in the past year. Most (33.8%) of the adolescents slept for about 8 hours during the school days, but 68% reported difficulty falling asleep. Most participants (58.7% and 59.2%) stopped screentime just before sleep on weekdays and weekends. Conclusion: Adolescence is when lifestyle behaviours that affect present and future health begin. Therefore, helping adolescents establish healthy lifestyles and avoid developing health risk behaviours is crucial and should be started before these behaviours are firmly established. Keywords: Adolescents, Lifestyle, Diet, Physical Activity, Sleep, Screen time.

BackgroundCOVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students.MethodsThis paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively.ResultsWe obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia.ConclusionsAlthough there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.

The research that links excessive screen time to adverse health outcomes is based on self-reported screen use. Few studies have documented how passively-sensed smartphone and app use relate to health behaviors like activity and sitting. Furthermore, they have not considered that daily fluctuations in smartphone/app use may have different relationships to these behaviors than a person's usual smartphone/app use. This study evaluated whether physical activity or sedentary (sitting) behavior are associated with either smartphone screen time or specific smartphone app use by adolescents and young adults during the COVID-19 pandemic. Adolescents and young adults aged 13-29 years wore activPAL4 micro activity monitors while their smartphones logged daily screen time and app use durations for nine days. Data were collected in 2020-2021 and analyzed in 2022-2023. Participants (N = 125) had a mean (SD) age of 19.7 (4.3) years. Participants' usual smartphone screen time was negatively associated with daily step counts. Daily deviations in smartphone screen time were negatively associated with daily step counts and moderate-vigorous physical activity durations. Time spent on Instagram, YouTube and, to a lesser extent, TikTok were linked with reduced activity levels. Daily sedentary behavior was not associated with usual or daily screen time. Interventions to promote physical activity during the transition into adulthood may benefit from limiting excessive smartphone screen time. Specific intervention targets could include limiting use of apps with infinite scrolling feeds algorithmically tuned to maintain user engagement, such as Instagram, YouTube and TikTok.

BackgroundNumerous school-based interventions for childhood obesity have been emerging in mainland China in recent decades, but little is known about the effectiveness of such interventions. This study aims to assess the effectiveness of school-based interventions for childhood obesity conducted in mainland China.MethodsA systematic search was undertaken in eight databases to identify both randomized and non-randomized controlled trials from January 1990 to December 2015 examining the effectiveness of school-based obesity interventions. A random effects meta-analysis was conducted assessing the impact of included interventions on (body mass index) BMI. The quality of each included studies were assessed using Effective Public Health Practice Project Quality Assessment Tool. A P value <0.05 (two-sided) was considered statistically significant.ResultOf the seventy-six included studies, we found physical activity and health education were the two most common components of interventions. More treatment studies were effective compared with prevention studies (85.0% vs. 58.3%). Comprehensive interventions involving physical activity and health education appeared more effective than the physical activity only interventions in both obesity treatment and prevention studies. The meta-analyses showed comprehensive interventions involving physical activity and health education had larger effect on the change of BMI than physical activity only interventions (treatment studies: -1.80 kg/m2 (95% CI: -2.15,-1.44) vs. -0.91 kg/m2 (95% CI: -1.15,-0.67); prevention studies: -0.19 kg/m2 (95% CI: -0.27, -0.11) vs. +0.05 kg/m2 (95% CI: -0.04, +0.15)).ConclusionsComprehensive school-based interventions may assist in tackling the rising prevalence of childhood obesity in mainland China.

Addressing Racial/Ethnic Differences in Age-Related Declines in Physical Activity During Adolescence

Sedentary behavior and lack of physical activity among children in Indonesia is an important issue that needs to be addressed. It is estimated that 57% of children in Indonesia have insufficient physical activity. Studies have shown that children who engage in sedentary behaviors are at an increased risk for various negative health outcomes, including obesity, type 2 diabetes, cardiovascular disease, and poor mental health, compared to physically active ones. This article aims to provide recommendations to increase physical activity and reduce passive behavior in children in Indonesia. This is a commentary article developed from observing the recent progress of sedentary behavior and lack of physical activity among children in Indonesia and the potential consequences. The level of inactive behavior in children in Indonesia is relatively high. Factors that contribute to sedentary behavior and lack of physical activity among children in Indonesia are the increasing use of electronic devices and screen time, the lack of safe and accessible places to be physically active, the COVID-19 pandemic, as well as cultural and social norms that prioritize academic achievement over physical activity. To address sedentary lifestyles among children, there is a need for a comprehensive approach that addresses both the individual and societal factors contributing to the problem. This might include increasing access to healthy food options, promoting physical activity, and implementing education programs to raise awareness about the importance of healthy eating and physical activity, as well as limiting screen time.

Among Australian adults who met the public health guideline for the minimum health-enhancing levels of physical activity, we examined the dose-response associations of television-viewing time with continuous metabolic risk variables. Data were analyzed on 2031 men and 2033 women aged > or = 25 yr from the 1999-2000 Australian Diabetes, Obesity and Lifestyle study without clinically diagnosed diabetes or heart disease, who reported at least 2.5 h.wk of moderate- to vigorous-intensity physical activity. Waist circumference, resting blood pressure, and fasting and 2-h plasma glucose, triglycerides, and high-density-lipoprotein cholesterol (HDL-C) were measured. The cross-sectional associations of these metabolic variables with quartiles and hours per day of self-reported television-viewing time were examined separately for men and for women. Analyses were adjusted for age, education, income, smoking, diet quality, alcohol intake, parental history of diabetes, and total physical activity time, as well as menopausal status and current use of postmenopausal hormones for women. Significant, detrimental dose-response associations of television-viewing time were observed with waist circumference, systolic blood pressure, and 2-h plasma glucose in men and women, and with fasting plasma glucose, triglycerides, and HDL-C in women. The associations were stronger in women than in men, with significant gender interactions observed for triglycerides and HDL-C. Though waist circumference attenuated the associations, they remained statistically significant for 2-h plasma glucose in men and women, and for triglycerides and HDL-C in women. In a population of healthy Australian adults who met the public health guideline for physical activity, television-viewing time was positively associated with a number of metabolic risk variables. These findings support the case for a concurrent sedentary behavior and health guideline for adults, which is in addition to the public health guideline on physical activity.

Three key health behaviors, physical activity (PA), sedentary behavior (SB) and sleep (SLP), have been identified by the 24-h framework as movement behaviors. School-based interventions targeting these multiple health behaviors among children have the potential to increase health outcomes. Despite this, the efficacy and sustainability of school-based movement behavior interventions among children has not been evaluated yet. To fill this gap in literature, this systematic review will aim to: (1) Summarize and classify movement behavior strategies used in literature to improve PA, SB and SLP in/from school in children; and (2) measure the effect of movement behavior strategies used in literature to improve PA, SB and SLP in children. The review protocol was registered in PROSPERO (CRD42020199154). A systematic search will be conducted between 2010 to 2020 in five databases: Pubmed, Scopus, SPORTDiscuss, The Cochrane Library and Web of Science. Risk of bias and quality assessment will be evaluated and measured according to the recommended tools. This systematic review will provide information about which kind of school-based movement behavior interventions are effective, sustainable and the best to implement in children.

Parents play a critical role in shaping children's attitudes, beliefs, and behaviors, including those around physical activity and inactivity. Our ability to identify which practices effectively promote children's physical activity and limit inactivity is limited by existing measurement instruments. This project will present a newly developed physical activity parenting practices survey, the psychometric properties of this survey's scales, and their association with child physical activity and screen time behaviors. A sample of 324 parents with 2- to 5-yr-old children from central North Carolina completed a series of questionnaires, including this newly developed survey of physical activity parenting practices. Child physical activity was assessed by ActiGraph GT3X accelerometers and parent report. Exploratory factor analysis was used to identify physical activity parenting practice constructs, and Pearson correlation was used to explore relations between constructs and child physical activity. Fourteen parent practices used to either control or support children's physical activity or screen time were identified. Limits on screen time (r = -0.44), use of screen time to control behavior (r = 0.23), exposure to TV (r = 0.33), and parent modeling of physical activity (r = 0.37) were all significantly associated with children's TV viewing. Use of physical activity to control child behavior was significantly associated with time spent outside (r = 0.15) and minutes of moderate or vigorous physical activity (r = 0.16). Several supportive practices were associated with time outside (+) and TV time (-). Results provide support for this new measure of physical activity parenting practices and identify several practices that are clearly associated with child physical activity.