Non-competitive Physical Activity Research Articles

Moderate Exercise Improves Cognitive Function in Healthy Elderly People: Results of a Randomized Controlled Trial.

Background:Physical activity in the elderly is recommended by international guidelines to protect against cognitive decline and functional impairment.Objective:This Randomized Controlled Trial (RCT) was set up to verify whether medium-intensity physical activity in elderly people living in the community is effective in improving cognitive performance.Design:RCT with parallel and balanced large groups.Setting:Academic university hospital and Olympic gyms.Subjects:People aged 65 years old and older of both genders living at home holding a medical certificate for suitability in non-competitive physical activity.Methods:Participants were randomized to a 12-week, 3 sessions per week moderate physical activity program or to a control condition focused on cultural and recreational activities in groups of the same size and timing as the active intervention group. The active phase integrated a mixture of aerobic and anaerobic exercises, including drills of “life movements”, strength and balance. The primary outcome was: any change in Addenbrooke's Cognitive Examination Revised (ACE-R) and its subscales.Results:At the end of the trial, 52 people completed the active intervention, and 53 people completed the control condition. People in the active intervention improved on the ACE-R (ANOVA: F(1;102)=4.32, p=0.040), and also showed better performances on the memory (F(1;102)=5.40 p=0.022) and visual-space skills subscales of the ACE-R (F(1;102)=4.09 p=0.046).Conclusion:A moderate-intensity exercise administered for a relatively short period of 12 weeks is capable of improving cognitive performance in a sample of elderly people who live independently in their homes.Clinical Trials Registration No: NCT03858114

Do Adolescents Who Meet Physical Activity Recommendations on Weekdays Also Meet Them on Weekends? A Cross-Sectional Study in Colombia.

The purpose of this study was to examine whether Colombian adolescents fulfill physical activity (PA) recommendations by type of day depending on several variables. A cross-sectional study was carried out on a sample of 2624 adolescents from Neiva (Colombia) using the Seven Day PA Recall and the Family Affluence Scale II self-reported questionnaires. Statistical analyses were performed to find any differences by gender, socioeconomic status, PA recommendations accomplishment, participation in organized and non-organized PA, parents’ involvement in sport, and adolescents’ academic achievement, and to determine the probability of complying with the PA guidelines. Only 12.3% of the participants met the PA recommendations on weekdays and weekends. Girls maintained their (in)active patterns during the week more than boys (84.4% vs. 70.7%, respectively), while more boys than girls changed them according to the type of day (25.3% vs. 19.6%). Participation in organized sports was the predictor variable with the highest probability of both boys and girls complying with the PA recommendations on weekdays. Non-organized activities were more likely to make girls more active on weekends. In conclusion, a wider offer of organized and non-competitive PA over the weekend and broader sports schedules should be provided to youth in Neiva.

A 22-year-old woman with unexplained exertional dyspnoea

A 22-year-old woman was referred to our respiratory outpatient clinic to undergo a cardiopulmonary exercise test (CPET), following presentation with a 2-year history of progressive unexplained exertional dyspnoea (ED). Specifically,...

Social Physique Anxiety and pressure to be thin in adolescent ballet dancers, rhythmic gymnastics and swimming athletes

Participation in sports may influence negative body image and Social Physique Anxiety (SPA) as there is pressure by significant others to have a certain body image. The aim of the present study was to examine possible differences in SPA and perceived pressure to be thin between female preadolescent and adolescent ballet dancers, rhythmic gymnastics, and swimming athletes, and to predict SPA by global self-esteem, pressure to be thin, BMI, and training age. In the study participated 23 ballet dancers, 47 rhythmic gymnastics athletes, and 32 swimming athletes. They completed self-reported questionnaires assessing SPA, perceived pressure to be thin by coaches, parents and friends, global self esteem, and body image. There were no significant differences between groups in SPA, global self-esteem, perceived pressure to be thin, and in rates of body image (χ2 = 1.65, p = .800). Hierarchical linear regression showed that SPA was predicted significantly by global self-esteem and BMI (R = .58, R2 = .34, F(6,95) = 8.13, p < .001). It seems that there are similarities between ballet dancers, rhythmic gymnastics athletes, and swimming athletes although ballet is considered as a non-competitive physical activity. Intervention programs in order to reduce SPA and enhance global self-esteem should be addressed to each group.

New Approach to School Health Initiatives: Using Fitness Measures Instead of Body Mass Index to Evaluate Outcomes

Oklahoma Cooperative Extension Service provided elementary school students with a program that included a noncompetitive physical activity component: circuit training that combined cardiovascular, strength, and flexibility activities without requiring high skill levels. The intent was to improve fitness without focusing on body mass index as an indicator of fitness. Youths (111) in grades 3–5 underwent President's Council on Fitness, Sports, and Nutrition testing at baseline and program completion. Significant improvements were observed in average fitness measures among youths who participated in the circuit training. Extension professionals looking for new tools to use with school-based physical activity programs may consider circuit training as a noncompetitive means of improving youth physical fitness and fitness measures as more appropriate outcome indicators.

Why inner-city high-school students attend after-school physical activity clubs

Objective: The population of young people most vulnerable to low levels of physical activity (e.g. urban/minority/low socio-economic status/female/non-athletes) often has the least access to physical activity opportunities and resources. It has been suggested that a comprehensive, school-based approach, including prudent use of time before, during and after the school day may be an effective way to increase overall physical activity, but little is known about why urban students voluntarily participate in these extracurricular programmes. Using social cognitive theory as a framework, this study examines urban high-school students’ rationale for attending after-school physical activity clubs designed to provide fun, safe, supportive places to do physical activities with friends. Design and setting: Qualitative study in an urban school district. Method: Over a 2-year period, adult leaders within 14 inner-city schools in a large urban district in the Midwest USA held 938 physical activity club sessions targeting traditionally inactive youth to promote non-competitive physical activity. Interviews with student participants ( n = 278) and researcher field observations ( n = 115) were used as primary data sources. Results: Three primary themes emerged to explain the voluntary participation of high-school students in after-school physical activity clubs: (a) social affiliation, especially group identification and establishing relationships with adult leaders and likeminded peers; (b) health and performance, including improving physical health and performance in other athletic endeavours; and (c) the ‘right’ types of activities and focus, including those that were student-centred, non-competitive and culturally relevant. Conclusion: Creation and sustainability of successful inner-city physical activity clubs will largely hinge upon the capitalisation on an understanding of the motivations of an urban student population.

Physical activity intervention (Movi-Kids) on improving academic achievement and adiposity in preschoolers with or without attention deficit hyperactivity disorder: study protocol for a randomized controlled trial.

BackgroundThe prevention of obesity and improvement of academic achievement in children are concerns of industrialized societies. Obesity has been associated with psychological disorders, including attention deficit hyperactivity disorder, whose prevalence has been estimated at 6.8 % in Spanish children and adolescents. It is known that physical activity is positively related to academic achievement and negatively related to the risk of obesity in children. However, studies to test the effectiveness of physical activity interventions in improving academic achievement in preschool children are scarce and have some weaknesses that threaten their validity. Moreover, very few studies have examined their effectiveness in improving symptoms of attention deficit hyperactivity disorder. This paper outlines a two-year multidimensional preschool intervention (Movi-Kids) aimed at preventing obesity and improving academic achievement in children with or without attention deficit hyperactivity disorder.Methods/DesignTwenty-one schools from Ciudad Real and Cuenca, Spain, were randomized to intervention and control groups. In the first academic year, children in the third grade of preschool and the first grade of primary school in the intervention group received the Movi-Kids intervention. In the second academic year, schools were crossed over to the other group. The intervention included children, parents and teachers, and the school environment, and consisted of: (i) three hour-long sessions of recreational non-competitive physical activity after school, weekly, (ii) educational materials for parents and teachers addressing sedentary lifestyle risks and (iii) playground modifications to promote physical activity during breaks. Primary outcome measures of this study were academic achievement (intelligence, cognition, memory, attention and perception), assessed by the Battery of General and Differential Aptitudes, and adiposity measures (body mass index, waist circumference, triceps skinfold thickness and body fat percentage). Secondary outcome measures were: attention deficit hyperactivity disorder risk, motor skills, health-related quality of life and sleep quality. These variables will all be measured in both groups at baseline and at the end of the first and second academic years.DiscussionIt seems reasonable that an intervention to promote physical activity based on playground games will be useful for simultaneously improving academic achievement and controlling obesity.Trial registrationClinicalTrials.gov NCT01971827.

Rationale and methods of a randomised cross-over cluster trial to assess the effectiveness of MOVI-KIDS on preventing obesity in pre-schoolers.

BackgroundChildhood obesity has become an alarming worldwide increasing public health problem. The earlier adiposity rebound occurs, the greater the risk of becoming obese during puberty and adolescence. It has been speculated about the potential influence of vigorous physical activity on modifying the age of onset of adiposity rebound. Moreover, studies aimed to evaluate the effectiveness of physical activity interventions programs on reducing adiposity and other cardiovascular risk factors in children younger than 6 years are scarce. This paper describes the rationale and methods of a study aimed to test the effectiveness of a two-years multidimensional pre-school intervention on preventing obesity and improving physical fitness during the adiposity rebound period.Methods/DesignTwenty-one schools from the provinces of Cuenca and Ciudad Real, Spain, were randomised to an intervention and a control arm. In the first academic year, children in third grade of pre-school and first grade of primary school in the intervention group received the physical activity intervention (MOVI-KIDS). After an academic year schools were crossed over to the alternative arm. According to the socio-ecological model, the intervention included children, their parents and teachers, and the school environment where MOVI-KIDS was conducted. MOVI-KIDS consisted of: i) three-h/week sessions of recreational non-competitive physical activity in after-school time; ii) educational materials to parents and teachers about physical activity benefits and sedentary lifestyle risks; and iii) modifications in the playground to promote physical activity during recess. Baseline and post-intervention outcomes are going to be measured in both arms three times, at the beginning and at the end of first academic year, and at the end of the second academic year. Primary outcomes included body mass index, waist circumference, triceps skinfold thickness, percentage of both body fat and fat-free mass, and blood pressure. Secondary end points were physical activity, fitness, and carotid intima-media thickness.DiscussionThis paper reports the design of a randomised cross-over cluster trial aimed at assessing the effectiveness of the multidimensional physical activity intervention (MOVI-KIDS) during two years in pre-school children.Trial registrationClinical trials.gov: NCT01971840. (Date of registration: Initial Release: 10/07/2013; Record Verification: 23/10/2013).

Gender differences on effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trial.

BackgroundStudies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren.MethodsCluster randomized trial study of 712 schoolchildren, 8–10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization.ResultsAmong girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (−1.1 mm; 95% confidence interval [CI] -2.3 to −0.7), body fat % (−0.9%; 95% CI −1.3 to −0.4), waist circumference (−2.7 cm; 95% CI −4.5 to −0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (−1.4 cm; 95% CI −2.6 to −0.1; P = 0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P = 0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered.ConclusionsAn extracurricular intervention of non-competitive physical activity during an academic year, targeting all schoolchildren regardless of body weight, is a safe and effective measure to reduce adiposity in both genders and to improve cardiometabolic risk profile in girls.Trial registrationClinical trials NCT01277224.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-014-0154-4) contains supplementary material, which is available to authorized users.

"I'd Rather Dance Outside": A Phenomenological Examination of Youth Experiences in Outdoor, Noncompetitive Physical Activity

Research has shown that youth with low levels of fitness or little interest in organized sports and traditional physical education are more likely to participate in noncompetitive outdoor physical activity. However, little is known about what influences youths’ decisions to participate in these activities. This study examined rural young adolescents’ experiences of participating in noncompetitive outdoor physical activity. In depth qualitative interviews were conducted with young adolescents aged 11-13 years (N = 24) from one rural middle school to elicit detailed descriptions of experiences of participation in outdoor physical activities. Interview transcripts were analyzed inductively and emergent themes related to young adolescents’ participation in outdoor, noncompetitive physical activity were identified. Twelve themes were categorized as either respondents’ relationship with the outdoors, activity preferences, and external conditions that determine participation. The results of the study indicate the presence of a complex dynamic relationship of social and physical environmental factors influencing young adolescents’ participation in outdoor activities. These include parental and peer influence, personal choice and enjoyment, spending time outdoors, appreciation for nature, availability of equipment, and previous experiences of participation. More research is needed to corroborate the results of the study and to better understand youths’ preferences for noncompetitive versus competitive physical activity.

Factors Related to Rural Young Adolescents' Participation in Outdoor, Noncompetitive Physical Activity

Purpose: Young adolescents who have little interest in participating in competitive team sports are at an increased risk for physical inactivity. Noncompetitive outdoor physical activity can provide young adolescents with increased opportunities to participate in physical activities that appeal to them and have positive health effects. The purpose of this study was to examine factors related to rural young adolescents' participation in noncompetitive outdoor physical activity to inform intervention design. Method: Young adolescents aged 10 to 14 years old (N = 1,032) from 1 rural county completed a self-administered questionnaire assessing constructs from self-determination theory (SDT) and the theory of planned behavior (TPB) related to noncompetitive outdoor physical activity. Structural equation modeling was used to examine an integrated conceptual model of hypothesized relationships among constructs. Results: The hypothesized conceptual model provided a good fit to the data with greater perceptions of autonomy support and self-determined motivation having statistically significant positive indirect effects on participation in noncompetitive outdoor physical activity mediated by the constructs of the TPB. All direct paths in the model were statistically significant; however, the direct effect of attitudes on intention was weak (.08) and self-determined motivation had no indirect effect on intention through attitudes (.03). Conclusions: Constructs of SDT and TPB should be accounted for by interventions targeting noncompetitive outdoor physical activity among young adolescents. More research is needed to determine young adolescents' preferences for noncompetitive and competitive physical activity and the potential influence that noncompetitive outdoor physical activity may have on total daily physical activity.

Plasma serotonin, tryptophan, hematological, and functional responses to horse trekking

Horse trekking is a noncompetitive physical activity conducted as a recreation and leisure experience, but so far potential effects on physiological changes in horses have not been investigated. The aim of the present research was to study whether trekking would affect plasma serotonin (5-hydroxytryptamine [5-HT]) concentrations in platelet poor plasma samples, together with its precursor tryptophan, and other hematological and functional variables. The study was carried out on 28 clinically healthy horses, habitually used for trekking, of which 18 participated in a 2-day trekking event, and 10 were used as the control group. The results obtained showed a significant effect of exercise on the serotonin, red blood cell, white blood cell, platelet, hematocrit, hemoglobin, heart rate, respiratory rate, and rectal temperature changes. These effects are probably related to a combination of submaximal exercise and some degree of dehydration. Prolonged and aerobic exercise, like that involved in trekking, could affect both the release of 5-HT from the stores in the blood stream as well as hematological and functional adaptations in response to physical effort. Moreover, results confirm a physiological influence of 5-HT in the regulation of the vascular system, induced by exercise. The present findings imply that assessment of plasma 5-HT as well as hematological and functional variables may be proposed as an additional tool to evaluate the physiological adjustment in response to physical activity in trained horses that may influence their performance.

Physical Activity Recommendations for Patients With Electrophysiologic and Structural Congenital Heart Disease: A Survey of Canadian Health Care Providers

Determining safe levels of physical activity for children and adolescents with electrophysiologic and structural congenital heart disease is a challenging clinical problem. The body of evidence for making these recommendations is limited and likely based on expert opinion, medicolegal concerns, and perceived risks of sudden cardiac death (SCD) with activity. The Bethesda Conference has established consensus guidelines for determining the eligibility of athletes with cardiovascular abnormalities for competitive sports and their disqualification from them. However, literature on guidelines for noncompetitive physical activity is not available. A survey was designed to determine practice patterns for patients with electrophysiologic and structural congenital heart disease. Between July 2011 and December 2011, approximately 350 health care providers working with this group of patients were recruited by email or while attending professional meetings. The survey received 81 responses, primarily from pediatric cardiologists (70 %). The findings indicate that the majority of Canadian cardiac care providers surveyed are only partially implementing current recommendations. Areas of variance included physical activity recommendations for hypertrophic cardiomyopathy, long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, and heart transplantation, among others. The development of comprehensive consensus guidelines for activity recommendations was supported by 96 % of the respondents. The heterogeneity of responses may be attributable to conflicting and poorly evidenced information in the literature, a lack of emphasis on recreational activity, an entrenched tendency toward bed rest in the cardiology community, and a lack of awareness by cardiac care providers regarding the actual risk associated with physical activity in electrophysiologic and structural congenital heart disease. A balanced discussion is required in considering both the significant benefit of physical activity in reducing cardiovascular risk factors and the small possibility of SCD in children and young adults with electrophysiologic and structural congenital heart disease.

An adaptive community-based participatory approach to formative assessment with high schools for obesity intervention*.

In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity.

Correlates of Physical Activity among College Students

There is limited Irish research which focuses on rates of physical activity and the correlates of physical activity among college students, typically aged 18–22 (Clán Survey, 2003). A questionnaire examining participation rates in and correlates of physical activity was administered to a representative sample of 532 students in colleges within the Republic of Ireland. Key correlates of physical activity were further explored using interviews ( n = 16) of Irish coaches/college sport personnel and college students. A significantly higher percentage of males reported participation in organized physical activity/sport (male = 57.8%, female = 27.5%; p ≤ .001), whereas females were more likely to participate in unorganized physical activity (female = 74%, male = 56.8%; p ≤ .001). Intrinsic motivational factors (e.g., fun/ enjoyment, fitness, fondness of competition, interest) were found to be primary positive correlates of physical activity/sport for both males and females. Barriers to physical activity were elements associated with college life (e.g., lack of time, coursework) as well as lack of interest. Significant multivariate effects were obtained for gender and the correlates leading to participation in organized and unorganized physical activity/sport. Univariate analysis revealed that psychological and social correlates were significantly related to engagement in organized physical activity/sport among gender and more pronounced among males. However, only psychological correlates were significantly associated to participation in unorganized physical activity among gender and more prevalent among females. Cognizance of intrinsic influences should be taken when developing physical activity promotional strategies with Irish college students. Among Irish females, emphasis should be placed on the development of unorganized noncompetitive physical activity.

Assisted Reproductive Technologies: Medical Safety Issues in the Older Woman

Abstract Previous study has shown that in the United States, most maternal deaths and severe obstetric complications due to chronic disease are potentially preventable through improved medical care before conception. Many women who need assisted reproductive technology (ART) because of infertility are older than the average pregnant woman. Risks for such chronic diseases as obesity, diabetes mellitus, chronic hypertension, cardiovascular disease (CVD), and malignancy greatly increase with maternal age. Chronic illness increases the risk of the in vitro fertilization (IVF) procedure and is also associated with increased obstetric risk and even death. The objective of this review is to outline the potential risks for older women who undergo ART procedures and pregnancy and to characterize guidelines for evaluation before enrollment in ART programs. A PubMed search revealed that very few studies have related to pre-ART medical evaluation. Therefore, we suggest a pre-ART medical assessment, comparable to the recommendations of the American Heart Association before noncompetitive physical activity and the American Society of Anesthesiologists before elective surgery. This assessment should include a thorough medical questionnaire and medical examination. Further evaluation and treatment should follow to ensure the safety of ART procedures and of ensuing pregnancies.

Motivos de práctica en el ámbito de la actividad física no competitiva

El objetivo del estudio fue conocer cuáles son los motivos de práctica en el ámbito de la actividad física no competitiva. Para ello se administró la escala de medición de los motivos de actividad física revisada (MPAM-R, Motives for Physical Activity Measure-Revised) de Ryan, Frederick, Lepes, Rubio y Sheldon (1997) y validada en España por Moreno, Cervelló y Martínez (2007) a una muestra compuesta por 271 sujetos adultos practicantes de actividades físicas no competitivas. Se realizó un análisis factorial de componentes principales de la escala y un análisis de correlación de las distintas subescalas. Los resultados manifiestan que las principales razones para realizar actividades físicas son el fomento de las relaciones sociales así como la obtención de placer y diversión, por delante de otras como la competencia, el mantenimiento y mejora de la salud y la apariencia.

Older Athletes’ Perceived Benefits of Competition

Intense sport competition is typically associated with young people. Also, much of the literature on exercise for older adults focuses on benefits derived from regular physical activity, such as walking, dancing and fitness classes, and suggests that one should avoid extremely strenuous exercise. The rising phenomenon of older people competing in sport presents a challenge to these assumptions. In 2009, approximately 28,000 athletes from 95 countries gathered in Sydney, Australia to compete across 28 different sports at the World Masters Games. We interviewed 44 competitors (23 females, 21 males; aged 56-90 years; M=72) about what they gained from competing in sport that extended beyond non-competitive physical activity outcomes. Five key themes emerged from the data. The first theme, “I like a challenge”, depicts Masters sport as an ideal context to test one’s abilities. In particular, lifelong athletes (or those who had returned to sport after a long break) enjoyed the satisfaction of knowing they “can still do it”! On the other hand, Masters competitions provide space for older people to begin sport in later life, as the second theme highlights, “I discovered that at this age group I could win things”! Theme three, “I’m more motivated to work harder”, describes how regular competitions provided goals for participants which structured their training. Also, the act of competing brought out their best performances. The fourth theme, “You know where you stand”, shows how participants liked that competition enabled them to compare themselves with others of their own age cohort. The final theme, “Travel” and “companionship”, explains how the organized, competitive structure of Masters sport and its club system allowed for regular travel, the establishment of ongoing friendships and weekly social interaction. Our data suggest that sport provides unique benefits to participants above and beyond those gained from general physical activity.

Assessment of an after-school physical activity program to prevent obesity among 9- to 10-year-old children: a cluster randomized trial

To assess the impact of a physical activity program on obesity in primary school children. Cluster-randomized controlled trial with 10 intervention and 10 control schools. A total of 1044 children, mean age 9.4 years (s.d.=0.7) at baseline, of the Province of Cuenca, Spain. Recreational, non-competitive physical activity program conducted after school hours on school premises. The program consisted of three 90-min sessions per week, for 24 weeks. Body mass index (BMI), triceps skin-fold thickness (TST) and percentage body fat. Secondary measures were blood lipids and blood pressure. Measurements were made at the beginning (September 2004) and at the end of the program (June 2005). Since schools rather than children were randomized, mixed regression models were used to adjust for individual-level covariates under cluster randomization. There were no differences in BMI between the intervention and control groups. Compared with controls, intervention children showed a decrease in TST in both boys (-1.14 mm; 95% confidence interval (CI) -1.71 to -057; P<0.001) and girls (-1.55 mm; 95% CI -2.38 to -0.73; P<0.001), as well as a reduction in the percentage of body fat in girls (-0.58%; 95% CI -1.04 to -0.11; P=0.02). Furthermore, the intervention boys exhibited a decrease in apolipoprotein (apo) B levels (-4.59; 95% CI -8.81 to -0.37; P=0.03) and an increase in apo A-I levels (13.57; 95% CI 7.95-19.20; P<0.001). Blood lipid results in girls were very similar. No changes in total cholesterol, triglycerides or blood pressure were associated with the intervention in either sex, except for an increase in diastolic blood pressure (1.55 mm Hg; 95% CI 0.19-2.91; P=0.03) in the intervention versus control boys. An after-school program of recreational physical activity reduced adiposity, increased apo A-I and decreased apo B in primary school children.

The Be A Fit Kid Program

Be A Fit Kid is an individualized and noncompetitive physical activity and nutrition program created in response to the dramatic rise in obesity and its related risk for type 2 diabetes and heart disease in American youth. Adolescents with intellectual disabilities and/or physical limitations may be at even greater risk for obesity, type 2 diabetes, and heart disease due to less exposure to health promotion programs than adolescents without disabilities. PURPOSE 1.) To assess the percent of adolescents with disabilities in the present sample exceeding recommendations for body composition and total cholesterol levels and 2.) To improve fitness, dietary habits, body composition, and total cholesterol levels following 3 months of participation in the Be A Fit Kid program. METHODS The sample consisted of 16 adolescents, aged 12–15 years, with disabilities including autism, Asperger's syndrome, mental impairment, cerebral palsy, and severe attention deficit disorder. All adolescents were ambulatory. The program met two to three times each week for 90 minutes during the elective period of the school day for 3 months. Height and weight were measured for calculation of body mass index (BMI), skinfolds were measured for estimation of body fat, blood was collected for measurement of cholesterol levels, dietary habits were analyzed from 24-hour food records, nutrition knowledge was assessed by a simple nutrition test, and fitness was estimated from the mile run and sit-ups. RESULTS Over half of the sample had high BMI, high body fat, and high levels of total cholesterol at baseline. Following the intervention, significant improvements were observed in the mile run (p=0.023), sit-ups (p=0.000), and nutrition knowledge (p=0.017). Approaching significant reductions were observed in body fat (0.080) and total cholesterol levels (0.087). Over 70% of the sample reduced their intake of soda, cheese, red meat, and refined sugar, increased their intake of whole grains, vegetables, fruit, unsaturated fats, and chose a lower fat milk. CONCLUSION Baseline data emphasize the need for health promotion program in adolescents with disabilities. The significant improvements in fitness and nutrition knowledge, and the near significant reductions in body fat and total cholesterol levels in this small sample of adolescents with disabilities following the Be A Fit Kid intervention are encouraging and suggest that individualized and noncompetitive health promotion programs focusing on fitness and nutrition can be well-received by adolescents with intellectual disabilities and may be effective in altering the development of lifestyle-related diseases.