Objectively measured sedentary behaviour in overweight and obese prepubertal children: challenging the school.

Sedentary lifestyle is associated with unfavourable health outcomes; however, few studies have analysed the daily fluctuations of sedentary behaviour in children. The aim was to characterise sedentary behaviour in low active, overweight/obese prepubertal children and to examine whether there were daily, age- or gender-based differences. In this observational study free-living movement was measured by accelerometry for one week. Eighty-eight low active, overweight/obese children (8- to 12-year-olds) were included. Analysis was conducted for weekends, weekdays, school time and non-school time on weekdays. Participants spent half of their waking hours engaged in sedentary behaviour (48.1%). Short sedentary bouts (1-4 min) accounted for 86% of sedentary time. Sedentary time was similar on weekends and non-school time, while it was highest during school time. Interventions for the management of childhood obesity should include strategies for shifting sedentary time to physical activity on weekends and non-school time and implementing more activity-permissive classroom lessons.

Free Play with Certain Equipment Constrains the Emergence of Exploratory Behavior and Physical Activity in Preschoolers.

The aim of this study was to establish whether various types of play equipment differentially constrain exploratory behavior and spontaneous physical activity patterns in preschoolers when they play freely with them. Fourteen children, 3-4 years old, played with four different types of equipment. The children wore an accelerometer and data were analyzed taking into account overall physical activity, the time spent at different intensity levels of move-ment, and the entropy of the time series. All trials were video-recorded and a systematic observation instrument was used to register actions and interactions with partners and equipment. The data were subsequently analyzed by means of principal component analysis (PCA) and the dynamic overlap order parameter, to identify the rate and breadth of exploratory behavior on different time scales. Our results revealed that the children were physically less active when playing with portable and small equipment. The PCA showed that when playing without equipment, the children usually played standardized games, like playing tag, in groups. Movement patterns were more or less varied depending on the equip-ment, and thus some equipment constrained the emergence of different types of games or motor behavior.

Metabolic risk management, physical exercise and lifestyle counselling in low-active adults: controlled randomized trial (BELLUGAT).

BACKGROUND: The primary aim of this study is to evaluate the effectiveness of different doses (intensity) of supervised exercise training - concomitant with lifestyle counselling - as a primary care intervention tool for the management of metabolic syndrome risk factors in low-active adults with one or more such factors (programme name in Catalan: Bellugat de CAP a peus). METHODS/DESIGN: Three-arm, randomized controlled clinical trial implemented in the primary care setting, with a duration of 40 weeks (16 weeks intervention and 24-week follow-up). Adults aged 30 to 55 years with metabolic risk factors will be randomized into three intervention groups: 1) aerobic interval training (16 supervised training lessons) plus a healthy lifestyle counselling programme (6 group and 3 individual meetings); 2) low-to-moderate intensity continuous training (16 supervised training lessons) plus the same counselling programme; or 3) the counselling- programme without any supervised physical exercise. The main output variables assessed will be risk factors for metabolic syndrome (waist circumference, blood pressure, and levels of plasma triglycerides, high-density lipoproteins and glucose), systemic inflammation, cardiorespiratory fitness, physical activity and sedentary behaviour, dietary habits, health-related quality of life, self-efficacy and empowerment. Economic factors will also be analysed in order to determine the cost-effectiveness of the programme. These variables will be assessed three times during the study: at baseline, at the end of the intervention, and at follow-up. We estimate to recruit 35 participants per group. DISCUSSION: The results of this study will provide insight into the immediate and medium-term effects on metabolic risk and lifestyle of a combined approach involving aerobic interval training and a multidisciplinary behavioural intervention. If effective, the proposed intervention would provide both researchers and practitioners in this field with a platform on which to develop similar intervention programmes for tackling the repercussions of an unhealthy lifestyle. TRIAL REGISTRATION: Clinical trials.gov. NTC02832453 . Registered 6 July 2016 (retrospectively registered).

Energy expenditure in low active overweight and obese children at varying treadmill grades.

UNLABELLED: This study aimed to evaluate differences between low active overweight and obese children in terms of energy expenditure (EE), ventilation (VE), and cardiac response during graded submaximal treadmill testing at constant speed. METHODS: We categorized 20 children into two weight groups according to the International Obesity Task Force criteria: overweight (n = 10; age = 9.7 ±1.34 years) and obese (n = 10; age = 10.4 ± 1.4 years). Children performed treadmill testing at a constant speed (1.53 m·s-1) and increasing grade (0%, 4%, and 8%). every 3 min. RESULTS: The EE across all grades was significantly higher (p < .001) in obese than in overweight children. Differences at each grade disappeared when EE was adjusted by body mass; however, several differences remained when the EE was adjusted by fat-free mass or body surface area. The increase in EE with increasing grade was greater in obese children (effect size between 0% and 8% for EE was 1.17). BMI z-score and fat mass (kg) were the main predictors of EE (Kcal·min-1) and contributed to explaining 66%, 70%, and 83.4% of the variance in EE at 0%, 4% and 8% gradients respectively. CONCLUSION: We suggest that when assessing EE response to exercise, the degree of obesity should be taken into consideration.

Short-Term Panax Ginseng Extract Supplementation Reduces Fasting Blood Triacylglycerides and Oxygen Consumption during Sub-Maximal Aerobic Exercise in Male Recreational Athletes.

Ginseng, a popular herbal supplement among athletes, is believed to enhance exercise capacity and performance. This study investigated the short-term effects of Panax ginseng extract (PG) on aerobic capacity, lipid profile, and cytokines. In a 14-day randomized, double-blind trial, male participants took 500 mg of PG daily. Two experiments were conducted: one in 10 km races (n = 31) and another in a laboratory-controlled aerobic capacity test (n = 20). Blood lipid and cytokine profile, ventilation, oxygen consumption, hemodynamic and fatigue parameters, and race time were evaluated. PG supplementation led to reduced total blood lipid levels, particularly in triacylglycerides (10 km races -7.5 mg/dL (95% CI -42 to 28); sub-maximal aerobic test -14.2 mg/dL (95% CI -52 to 23)), while post-exercise blood IL-10 levels were increased (10 km 34.0 pg/mL (95% CI -2.1 to 70.1); sub-maximal aerobic test 4.1 pg/mL (95% CI -2.8 to 11.0)), and oxygen consumption decreased during the sub-maximal aerobic test (VO2: -1.4 mL/min/kg (95% CI -5.8 to -0.6)). No significant differences were noted in race time, hemodynamic, or fatigue parameters. Overall, PG supplementation for 2 weeks showed benefits in blood lipid profile and energy consumption during exercise among recreational athletes. This suggests a potential role for PG in enhancing exercise performance and metabolic health in this population.

Evaluation of a family intervention programme for the treatment of overweight and obese children (Nereu Programme): a randomized clinical trial study protocol.

BACKGROUND: Obesity is mainly attributed to environmental factors. In developed countries, the time spent on physical activity tasks is decreasing, whereas sedentary behaviour patterns are increasing.The purpose of the intervention is to evaluate the effectiveness of an intensive family-based behavioural multi-component intervention (Nereu programme) and compared it to counselling intervention such as a health centre intervention programme for the management of children's obesity. METHODS/DESIGN: The study design is a randomized controlled multicenter clinical trial using two types of interventions: Nereu and Counselling. The Nereu programme is an 8-month intensive family-based multi-component behavioural intervention. This programme is based on a multidisciplinary intervention consisting of 4 components: physical activity sessions for children, family theoretical and practical sessions for parents, behaviour strategy sessions involving both, parents and children, and lastly, weekend extra activities for all. Counselling is offered to the family in the form of a monthly physical health and eating habits session. Participants will be recruited according the following criteria: 6 to 12 year-old-children, referred from their paediatricians due to overweight or obesity according the International Obesity Task Force criteria and with a sedentary profile (less than 2 hours per week of physical activity), they must live in or near the municipality of Lleida (Spain) and their healthcare paediatric unit must have previously accepted to cooperate with this study. The following variables will be evaluated: a) cardiovascular risk factors (anthropometric parameters, blood test and blood pressure), b) sedentary and physical activity behaviour and dietary intake, c) psychological aspects d) health related quality of life (HRQOL), e) cost-effectiveness of the intervention in relation to HRQOL. These variables will be then be evaluated 4 times longitudinally: at baseline, at the end of the intervention (8 months later), 6 and 12 months after the intervention. We have considered necessary to recruit 100 children and divide them in 2 groups of 50 to detect the differences between the groups. DISCUSSION: This trial will provide new evidence for the long-term effects of childhood obesity management, as well as help to know the impact of the present intervention as a health intervention tool for healthcare centres. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01878994.

Assessing an educational booklet for promotion of healthy lifestyles in sedentary adults with cardiometabolic risk factors.

OBJECTIVES: 1) To evaluate and improve the suitability and readability of an educational booklet designed for use in an intervention aimed at promoting healthy lifestyles as a way to manage cardiometabolic risk factors in adults with low levels of physical activity and 2) to check its acceptability to real end users. METHODS: A 7-phase methodology was used. The evaluation committee (9 experts, 6 potential end users) scored the booklet using the Suitability Assessment of Materials (SAM) and health education material (HEM) questionnaires on two occasions (original and revised version). Acceptability was also assessed by 75 real end users after a lifestyle intervention. RESULTS: The SAM and HEM scores of the revised booklet were respectively 10% (SD = 9%) and 10% (SD = 7%) higher than the original booklet scores. The revised version attained "superior" scoring in all questionnaires: SAM, 87% (SD = 8%); HEM, 3.5 (SD = 0.4) out of 4; Acceptability, 3.7 (SD = 0.4) out of 4. CONCLUSIONS: The suitability and readability of an educational booklet-to promote a healthy lifestyle-were improved following a systematic peer-review evaluation prior to its use in an intervention. PRACTICE IMPLICATIONS: Improving the suitability and readability of educational resources can have a positive impact on patient knowledge and awareness, and hence on intervention effectiveness.

Semisupervised Physical Exercise and Lifestyle Counseling in Cardiometabolic Risk Management in Sedentary Adults: Controlled Randomized Trial (BELLUGAT).

BACKGROUND: The purpose of this study was to evaluate the feasibility and effectiveness of a high-intensity semisupervised exercise program alongside lifestyle counseling as an intervention for managing cardiometabolic risk in sedentary adults. METHODS: A 40-week 3-arm randomized controlled clinical trial (16-wk intervention and 24-wk follow-up) was used. Seventy-five sedentary adults (34-55 y) with at least 1 cardiometabolic risk factor were randomized into one of the following arms: (1) aerobic interval training (AIT) plus lifestyle counseling (n = 25), (2) low- to moderate-intensity continuous training plus lifestyle counseling (traditional continuous training, TCT) (n = 27), or (3) lifestyle counseling alone (COU) (n = 23). Metabolic syndrome severity scores, accelerometer-based physical activity, and self-reported dietary habits were assessed at baseline, after the intervention, and at follow-up. RESULTS: AIT was well accepted with high enjoyment scores. All groups showed similar improvements in metabolic syndrome severity scores (standardized effect size = 0.46) and dietary habits (standardized effect size = 0.30). Moderate to vigorous physical activity increased in all study groups, with the number of responders higher in AIT and TCT groups (50%) than in COU group (21%). Both AIT and TCT had a greater impact on sedentary behavior than COU (63.5% vs 30.4% responders). CONCLUSIONS: AIT appears to be a feasible and effective strategy in sedentary individuals with cardiometabolic risk factors. AIT could be included in intervention programs tackling unhealthy lifestyles.

Enhancing Multimodal Learning Through Traditional Sporting Games: Marro360°.

Different international organizations and initiatives highlight the contribution of the traditional sporting games (TSGs) to favor the diversity of knowledge, values, and attitudes necessary for today's society. TSG such as Marro trigger multimodal learning contexts (driving conducts, interpersonal and organic relationships), with great interest in the educational and sports initiation field. The purpose of two studies presented in this manuscript was to examine the 360° multimodal strategic intervention (decisional, relational, and organic) of two teams faced in a Marro game. For this study, a quasi-experimental design was used composed by a single test applied to two non-equivalent teams. Mixed methods were used with an observational methodology in Quadrant III: nomothetic, punctual, and multidimensional. Fourteen university students participated [mean (M) = 20.49, standard deviation (SD) = 2.18]. Three internal logic variables were studied: outcome, role, and subrole; and three variables referred to the dimensions of motor conduct: relationship, risk in the decision, and physical effort. A mixed ad hoc registration system was designed with acceptable margins of data quality. For Study 1, cross-tabulations and classification trees were applied, while for Study 2 strategic T-patterns were identified. The relevance of the scoreboard (p < 0.001; Effect Size = 0.386) and the realization of the role (p < 0.001; ES = 0.091) for the study of multimodal strategic chains in the Marro game were confirmed. The detection of regularities in specific interaction (Hunters against Hares) by Theme (p < 0.005) allowed for interpretation of the process of strategic conducts of both teams during the game. Knowing the strategic chains of playful coexistence among equals through a multimodal range of variables and approaches has revealed an unusual dynamic picture. The study provides scientific evidence for the physical education teacher on the dynamics of the game of Marro. The pedagogical application of these contributions must be made according to curricular interests.

Effectiveness of a Multi-Component Intervention for Overweight and Obese Children (Nereu Program): A Randomized Controlled Trial.

INTRODUCTION: Treatment of childhood obesity is a complex challenge for primary health care professionals. OBJECTIVES: To evaluate the effectiveness of the Nereu Program in improving anthropometric parameters, physical activity and sedentary behaviours, and dietary intake. METHODS: Randomized, controlled, multicentre clinical trial comparing Nereu Program and usual counselling group interventions in primary care settings. The 8-month study recruited 113 children aged 6 to 12 years with overweight/obesity. Before recruitment, eligible participants were randomly allocated to an intensive, family-based multi-component behavioural intervention (Nereu Program group) or usual advice from their paediatrician on healthy eating and physical activity. Anthropometric parameters, objectively measured sedentary and physical activity behaviours, and dietary intake were evaluated pre- and post-intervention. RESULTS: At the end of the study period, both groups achieved a similar decrease in body mass index (BMIsd) compared to baseline. Nereu Program participants (n = 54) showed greater increases in moderate-intense physical activity (+6.27% vs. -0.61%, p<0.001) and daily fruit servings (+0.62 vs. +0.13, p<0.026), and decreased daily soft drinks consumption (-0.26 vs. -0.02, p<0.047), respectively, compared to the counselling group (n = 59). CONCLUSIONS: At the end of the 8-month intervention, participants in the Nereu Program group showed improvement in physical activity and dietary behaviours, compared to the counselling group. TRIAL REGISTRATION: ClinicalTrials.gov NCT01878994.