Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults.

BACKGROUND: Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status. AIM: Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep. METHODS: A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio. RESULTS: Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport. CONCLUSIONS: Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.

The role of school medicine in the early detection and management of adolescent idiopathic scoliosis.

OBJECTIVE: To analyze the trends in scoliosis screenings over 10 years (2010 vs. 2020). To assess the management of schoolchildren with a preliminary diagnosis of adolescent idiopathic scoliosis by school medicine specialists. METHODS: Historical data were used for the year 2009/2010, and a cross-sectional study was conducted during the school year 2019/2020 on 18,216 pupils of 5th, 6th, and 8th elementary school grades. A forward bend test was used to detect clinical features of scoliosis and some positive findings were referred to orthopedists or physiatrists for further evaluation. RESULTS: In the analyzed 10-year period abnormal forward bend test findings increased from 4.9 to 5.8% (by 18.4%; P < 0.001). While its prevalence escalated markedly in girls (from 5.8 to 8.3%; P < 0.001), a modest but significant decrease, from 3.8 to 3.2% (P = 0.018), was noted in boys. Most pupils had low to moderate curves, and its prevalence was some 6.5 times higher in girls (P < 0.001). The forward bend test positive predictive value was 84.7%. Discrete forward bend test aberrations were managed by school medicine specialists only. CONCLUSION: While actively promoting scoliosis screening in children, we have shown that forward bend test is an acceptable tool for early adolescent idiopathic scoliosis detection in school medicine. In collaboration with other specialists and using additional diagnostic methods, school medicine specialists can ensure early detection and appropriate interventions, avoiding the potential harms of radiation exposure.

The Outcome of COVID-19 Lockdown on Changes in Body Mass Index and Lifestyle among Croatian Schoolchildren: A Cross-Sectional Study.

Globally, the COVID-19 pandemic altered adults' and children's lifestyles and habits, causing an increase in body weight. Adolescents are sensitive to habit changes and, because of their insufficient capacity to deal with the unexpected COVID-19 changes, were at greater risk of noncommunicable disease development due to the consequences of adopting unhealthy habits. The survey aimed to reveal the changes in nutritional status and lifestyle habits of school children in Croatia and to assess their nutrition knowledge and emotional state and feelings about COVID-19 lockdown. Self-reported data from 1370 school children aged 10 to 15 years were obtained to examine the influence of the lockdown on their nutritional status, lifestyle and emotional status, and to assess their nutrition knowledge. The study revealed that the COVID-19 lockdown has caused an increase in the proportion of overweight and obesity among Croatian school children who changed their lifestyle habits towards being less physically active, spending more time using screen-based media and revealing potential psychological distress. However, the schoolchildren had a high adherence to the Mediterranean diet assessed with the Mediterranean Diet Quality Index for children and adolescents KIDMED index and had good nutrition knowledge. Public health programs promoting a healthy lifestyle and involving the whole family, in a school environment, could provide children with a healthy adulthood.

Associations between Adherence to the Mediterranean Diet and Lifestyle Assessed with the MEDLIFE Index among the Working Population.

The adherence to the Mediterranean diet is beneficial for cardiovascular diseases prevention. The study aim is to use Mediterranean lifestyle (MEDLIFE) questionnaire for estimation of Mediterranean lifestyle habits among the working population and to establish MEDLIFE score correlation with the risk factors for cardiovascular diseases. In the study has participated 366 workers from Croatia, which fulfilled MEDLIFE and validated food frequency questionnaire (FFQ) questionnaire. The multivariate logistic regression was performed to evaluate the association between MEDLIFE index, workers' obesity and cardiovascular diseases risk. The lowest adherence to Mediterranean lifestyle was associated to younger, low education, body fat above acceptable ranges and unfavorable lipid profile. Significant association to Mediterranean lifestyle was more among women (p = 0.002), middle aged (p = 0.02), highly physically active (p = 0.009) and those who play collective sports >2 h/w (p = 0.001), having body fat within acceptable range (p = 0.003), total cholesterol less (p = 0.03) and high-density lipoproteins (HDL-C) (p = 0.04) more than recommended. Inverse significant association was for high educational level (p = 0.02). The Mediterranean lifestyle adherence is associated to lower risk factors for cardiovascular diseases among studied working population. MEDLIFE index revealed that physical activity and conviviality are better ingrained among younger population but not the Mediterranean diet.

Prevalence, Knowledge and Attitudes Concerning Dietary Supplements among a Student Population in Croatia.

The aim of this study was to determine the prevalence of usage and the knowledge and attitudes towards dietary supplements among medical sciences and nonmedical sciences students from Croatia. The study was conducted based on a questionnaire about dietary supplement usage, knowledge and attitudes. The prevalence of dietary supplement use, among 910 university students was 30.5%. The most-used dietary supplements were vitamins (18.0% in medical sciences students and 9.8% in non-medical sciences students). For all students, the internet (66.1%) was the most common source of information, followed by healthcare professionals (33.2%). The most common reason for taking dietary supplements was to maintain good health (26.4%). Use of the internet rather than health professionals as a trusted information source should be revised among this young population. Supplement intake was significantly associated with body mass index (BMI) (p = 0.016) and physical activity (p = 0.050). Students with normal BMI (61.5%) and the most physically active students (37.7%) took significantly more dietary supplements. Results of this study could help medicine faculties to improve their curriculum and support the development of public health messages aimed at wise and safe use of dietary supplements.