Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants.

BACKGROUND: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. OBJECTIVES: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. METHODS: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. RESULTS: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). CONCLUSIONS: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

Promotion of health-enhancing physical activity in the sport sector: a study among representatives of 536 sports organisations from 36 European countries.

BACKGROUND: It is a common belief that most sports clubs and organisations are primarily focused on elite sports while placing less emphasis on the promotion of health-enhancing physical activity (HEPA). However, there is a lack of evidence on this topic in the scientific literature. Therefore, the aim of this study was to determine the level and correlates of the commitment of sports organisations in Europe to HEPA promotion. METHODS: Representatives of 536 sports organisations from 36 European countries responded to our survey. A multiple regression analysis was conducted with the commitment of sports organisation to HEPA promotion (0 ["not at all"] - 10 ["most highly"]) as the outcome variable and organisation type ("national sport association" reference group [ref], "European sports federation", "national umbrella sports organisation", "national Olympic committee", "national sport-for-all organisation"), headquarters in a European Union member state ("no" [ref], "yes"), region of Europe ("Western" [ref], "Central and Eastern", "Northern", "Southern"), commitment to elite sports ("low" [ref], "medium", "high"), and awareness of Sports Club for Health (SCforH) guidelines ("no" [ref], "yes") as explanatory variables. RESULTS: Approximately 75.2% (95% confidence interval [CI]: 71.5, 78.8) of sports organisations were highly committed to elite sports. Only 28.2% (95% CI: 24.4, 32.0) of sports organisations reported a high commitment to HEPA promotion. A higher commitment to HEPA promotion was associated with the national Olympic committees (ß = 1.48 [95% CI: 0.41, 2.55], p = 0.007), national sport-for-all organisations (ß = 1.68 [95% CI: 0.74, 2.62], p < 0.001), location in Central and Eastern Europe (ß = 0.56 [95% CI: 0.01, 1.12], p = 0.047), and awareness of SCforH guidelines (ß = 0.86 [95% CI: 0.35, 1.37], p < 0.001). CONCLUSION: From our findings, it seems that most sports organisations are primarily focused on elite sports. Coordinated actions at the European Union and national levels are needed to improve the promotion of HEPA through sports organisations. In this endeavour, it may be useful to consider national Olympic committees, national sport-for-all organisations, and relevant sports organisations in Central and Eastern Europe as role models and to raise the awareness of SCforH guidelines.

Physical Activity of Children and Adolescents in Croatia: A Global Matrix 4.0 Systematic Review of Its Prevalence and Associated Personal, Social, Environmental, and Policy Factors.

BACKGROUND: The previous review of physical activity (PA) among Croatian children and adolescents was conducted a decade ago. Therefore, the aim of this study was to summarize recent evidence on PA of Croatian children and adolescents and associated personal, social, environmental, and policy factors. METHODS: Eighteen experts reviewed the available evidence and provided ratings (from the lowest grade "F" to the highest grade "A+") for the 10 Global Matrix indicators. A systematic search with 100 keywords was conducted in Hrcak, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science for documents published from January 01, 2012, to April 15, 2022. We also conducted internet searches and secondary analyses of data (relative frequencies) from 6 studies. RESULTS: After assessing 7562 references, we included 90 publications in the review and 18 studies (83.3% of medium-to-good quality) in evidence synthesis. We found a high prevalence of insufficient PA (especially among girls) and excessive screen time (especially among boys). PA participation of children and adolescents in Croatia has declined over time. The following grades were assigned to the indicators for Croatia: B- for overall PA, C- for organized sport and PA, C for active play, C- for active transportation, D+ for sedentary behavior, inconclusive for physical fitness, D+ for family and peers, B- for school, B- for community and environment, and D+ for government. CONCLUSIONS: Coordinated actions are needed across sectors to improve PA promotion, with a focus on increasing PA among girls, reducing sedentary screen time among boys, improving parental support for PA, and further development of national PA policies.

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries.

BACKGROUND: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5-17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. METHODS: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. RESULTS: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. CONCLUSIONS: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Improving Practices of Mental Health Professionals in Recommending More Physical Activity and Less Sedentary Behaviour to Their Clients: An Intervention Trial.

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals.Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1972189 .

Prevalence and Correlates of Muscle-Strengthening Activity Participation in Croatia: A Cross-Sectional Study in a National Representative Sample of 4561 Adults.

The World Health Organization recommends adults to engage in muscle-strengthening activity (MSA) at least two times per week. The aim of this study was to determine the prevalence and correlates of MSA in Croatian adults. We analysed self-reported data collected among 4561 Croatians aged ≥18 years within the European Health Interview Survey (EHIS wave 2). We calculated the weighted prevalence of meeting the MSA guidelines, and odds ratios for different population groups, adjusted for a range of sociodemographic and lifestyle variables in a multivariable logistic regression analysis. The prevalence of meeting the MSA guidelines was 8.0% (95% CI: 7.2, 8.8) in the overall sample, 5.4% (95% CI: 4.5, 6.4) among females, and 10.9% (95% CI: 9.6, 12.3) among males. We found significantly lower odds of meeting the MSA guidelines for females, older age groups, inhabitants of sparsely populated areas, those with a low education level, obese individuals, and those who did not rate their health as "very good" (p < 0.05 for all). The vast majority of Croatian adults do not meet the MSA guidelines. Public health initiatives to promote MSA in Croatia should focus on females, seniors, sparsely populated areas, people with low education, obese individuals, and those with impaired health.

Physical activity and sedentary behaviour counselling: Attitudes and practices of mental health professionals.

BACKGROUND: Despite recent interest in the mental health benefits of increasing physical activity (PA) and reducing sedentary behaviour (SB), little is known about PA and SB counselling provided by mental health professionals. Therefore, the aim of this study was to explore the attitudes and practices of mental health professionals in recommending more PA and less SB to their clients. METHODS: Quantitative data were collected using a modified version of the Exercise in Mental Illness Questionnaire in a sample of 17 Australian mental health professionals. The collected data were reported using percentages (for categorical data) and means and standard deviations (for numerical data). Additionally, in focus group discussions, 10 mental health professionals provided in-depth information about their clinical practice, facilitators, and perceived barriers in recommending more PA and less SB. They also provided suggestions on how to potentially improve their PA and SB counselling practices. The focus groups were audio-recorded, transcribed and analysed using thematic analysis. RESULTS: Only 35.3% of participants have undergone formal training in recommending PA in the treatment of mental illness. Most participants (64.7%) ranked PA counselling among the top three types of mental health treatment. All participants reported recommending PA to their clients at least "occasionally", while 88% of them also provided SB counselling. However, the recommendations provided were usually not specific. The most commonly reported barriers for providing PA and SB counselling were a lack of knowledge and confidence. Participants also believed that, if they were more active themselves, they would be in a better position to recommend PA to their clients, by sharing their own experience of evidence-informed strategies designed to increase PA and reduce SB. CONCLUSION: The findings of this study indicate that mental health professionals commonly provide generic PA and SB counselling to their clients. PA and SB counselling in the mental health setting could be improved by: including training on PA and SB counselling in formal education and continued professional training for mental health professionals; implementing interventions to increase PA and reduce SB among mental health professionals themselves; and ensuring support from an exercise or PA promotion specialist as a part of a multi-disciplinary approach to mental health care.

Patterns and correlates of physical activity among middle-aged employees: a population-based, cross-sectional study.

OBJECTIVES: The purpose of this study was to determine the level, pattern and correlates (socio-demographic, lifestyle and work-related) of physical activity among middle-aged employees in Croatia. MATERIAL AND METHODS: In this cross-sectional study the data were collected using a household interview on a random sample of 766 middle-aged employees (52% female) living in Croatia. The International Physical Activity Questionnaire (IPAQ-long) was used to assess physical activity. An additional questionnaire was used to collect data on socio-demographic, lifestyle and work-related correlates. RESULTS: The median (95% CI) total physical activity for the whole sample was 78.7 (69.1-88.3) MET-hours/week. Most physical activity was accumulated in the domain of work (26.4 (20.3-32.5) MET-hours/week) or in domestic activities (19.2(17.8-20.7) MET-hours/week), whilst a significantly lower physical activity was found in the transport (3.3 (2.9-3.7) MET-hours/week) and leisure-time domains (6.5 (5.7-7.3) MET-hours/week). The multiple regression analysis showed an inverse relationship between educational level and the size of settlements with the domestic-related and total physical activity (ß range: -0.11 to -0.22; p < 0.01). Among lifestyle correlates, only alcohol consumption was positively related to the total physical activity (ß = 0.12; p < 0.01), while the perceived level of stress outside work was the only one, which was inversely associated with the work-related (ß = -0.09; p < 0.01) and leisure-time physical activity (ß = -0.10; p < 0.01). CONCLUSIONS: Middle-aged employees in Croatia accumulate most of their daily physical activity in the work and domestic domains. Analysis of the relationship between physical activity and potential socio-demographic, lifestyle, and work-related correlates indicated that physical activity promotional activities should be primarily focused on males, employees living in smaller settlements and those with higher educational levels. The correlates of physical activity among middle-aged employees seem to be domain-specific. Therefore, future studies in this area should consider assessing physical activity in each domain separately.

Domain-specific physical activity and health-related quality of life in university students.

Information on the relationship between domain-specific physical activity (PA) and health-related quality of life (HRQoL) in the general population and specific groups is still scarce. The aim of this study was to determine the relationship between PA in work, transport, domestic and leisure-time domains and HRQoL among university students. PA and HRQoL were assessed in a random stratified sample of 1750 university students using the International Physical Activity Questionnaire - long form and 12-item Short Form Health Survey, respectively. The Spearman's rank correlations, adjusted for age, community size, personal monthly budget, body mass index, smoking habits and alcohol intake ranged from -0.11 to 0.18 in female students and -0.29 to 0.19 in male students. Leisure-time, domestic, transport-related PA and total PA were positively related to HRQoL. Inverse correlations with HRQoL were only found for work-related PA in male students. Multiple linear regression analysis showed that only leisure-time PA was related to the Physical Summary Component score (ß = 0.08 for females and ß = 0.10 for males, P < 0.05). Domain-specific PA levels were not significantly related to the Mental Component Summary score. To get a more comprehensive insight in the relationship between PA and HRQoL, future studies should not only analyse total PA levels but also domain-specific PA levels. The evidence on the positive relationship of leisure-time, transport and domestic PA with HRQoL can potentially be used to support evidence-based promotion of PA in a university setting, and as a hypothesis for future longitudinal studies on such potential causal relationships.

Relationship of back and neck pain with quality of life in the Croatian general population.

OBJECTIVE: The purpose of this study was to determine the prevalence of back pain and neck pain and their relationship with the quality of life in the Croatian general population. METHODS: This was a cross-sectional study using home-based face-to-face interviews of 1030 participants (51.6% females) 15 years or older. Back and neck pain frequencies were assessed using single items and quality of life using the Short Form Survey and Satisfaction with Life Scale. Analysis of covariance was conducted, where back pain or neck pain frequency was used as the categorical predictor; physical component summary or mental component summary, as the dependent variable; and age, body mass index, and physical activity level, as covariates. RESULTS: The prevalence of back pain was 66.3% (95% confidence interval [CI], 62.3%-70.3%) and 62.9% (95% CI, 58.7%-67.2%) in females and males, respectively. The prevalence of neck pain was 58.0% (95% CI, 53.8%-62.2%) for females and 53.6 (95% CI, 49.2%-58.0%) for males. Differences between men and women were not significant (P>.05). Adjusted mean values for physical component summary and mental component summary were substantially lower in participants who reported back or neck pain often/almost always compared with those without pain. Differences ranged from 8.11 to 11.86 points (95% CI, 5.54-13.99) and from 9.61 to 10.99 points (95% CI, 7.35-13.45) in females and males, respectively. CONCLUSIONS: The findings of this study showed that back and neck pain are highly prevalent and negatively related to quality of life in the Croatian general population. These data might raise the awareness of local government health authorities and lead to improvements in health care service for people with back and neck pain.

Physical activity in different domains and health-related quality of life: a population-based study.

PURPOSE: The purpose of this study was to determine the association between physical activity (PA) in different domains (job-related, domestic, transportation, and leisure-time) and health-related quality of life (HRQoL). METHODS: We used the long version of IPAQ and SF-36 to assess PA and HRQoL, respectively, in a random sample of 1,076 Croatian inhabitants. RESULTS: Multiple regression analyses showed a significant relationship between PA and Vitality, Mental Health, and mental summary component score in female participants and Physical Functioning, Bodily Pain, Social Functioning, Mental Health, and physical summary component score in male participants (multiple R range, 0.14-0.21). Leisure-time PA was positively related to HRQoL (ß range, 0.11-0.18), whereas transportation (ß range, -0.10 to -0.14) and domestic (ß range, -0.10 to -0.12) PA was inversely related to HRQoL when adjusted for size of settlement, age, educational level, cigarette consumption, alcohol consumption, and body mass index. CONCLUSIONS: Our study added useful information to the body of evidence on the positive correlation between leisure-time PA and HRQoL. Since transportation and domestic PA were inversely related with several HRQoL scales, in future studies on the relationship between PA and HRQoL it is important to assess domain-specific PA and not only total PA.

Is sports recreation important to university students?

The aim of this research is to examine university students' attitudes on recreational exercise. The sample included 473 students from the University of Zagreb. We analyzed the data by analysis of frequency and a statistical method called "Relation model of action". The results indicated that there were two general courses in students' attitudes on recreation activities. The first course represents general values and the second course reflects the attitudes on specific sports and recreational activities. It can be concluded that university students recognize the importance of exercise but they do not understand its real meaning and they do not exercise regularly. Therefore, it is important to foster positive attitudes towards exercise early in youth, which would allow young people to preserve the healthy habit of exercise throughout their whole life. There is a need for quality system of education, which would start early in childhood.

Physical activity of Croatian population: cross-sectional study using International Physical Activity Questionnaire.

AIM: To determine the physical activity level of the Croatian population in different domains of everyday life. METHODS: A random stratified sample of 1032 Croatians aged 15 years and older was interviewed using the official Croatian long version of the International Physical Activity Questionnaire (IPAQ). Total physical activity and physical activity in each of the 4 life domains--work, transport, domestic and garden, and leisure-time--were estimated. Physical activity was expressed as metabolic equivalent-hours per week (MET-hour/week). RESULTS: Median total physical activity for the whole sample was 58.2 MET-hour/week. Median physical activity in MET-hour/week was 30.4 for work, 5.0 for transportation, 13.1 for domestic and garden, and 6.0 for leisure-time domain. The lowest physical activity was found in the 15-24 age group (42.7 MET-hour/week) and the highest in the 55-64 age group (72.0 MET-hour/week). Multiple regression analysis showed a significant relationship of socio-demographic and health-related characteristics (size of settlements, household income, educational level, age, body mass index, self-rated physical health, and self-rated mental health) with physical activity in all domains (P < 0.001). CONCLUSION: Studies on physical activity in transition countries should include the domains of work and domestic and garden, since if only leisure-time domain is examined, the total physical activity level could be underestimated. As the lowest physical activity was reported by adolescents and young adults, strategies for increasing physical activity in this age group should be developed.