Restoration in mental health after visiting urban green spaces, who is most affected? Comparison between good/poor mental health in four European cities.

Several mechanisms have been proposed to explain the association between green space and health, and one of these is the restoration theory, based on the idea that it is possible to increase mental health and decrease stress visiting a natural environment. The aims of the present study were to understand what activities are most related to restoration and if these are the same for people with poorer and better mental health. A questionnaire was administered in four European cities and data about restoration outcomes, type of activity carried out in green spaces and mental health were collected and analyzed. A cross sectional design was used and total of 3134 respondents participated to the questionnaire. The restoration experience was measured with the restoration outcome score, and the mental health was evaluated with a subscale related to mental health of the Medical Outcome Short Form. Participants were divided in two groups according to mental health score. A multiple regression analysis was performed to investigate the association between mental health, type of activity and restoration. The cities showed a similar trend in the association between restoration and type of activity performed in green environment. People with poorer mental health seem to be more sensitive to the positive effect of visiting the green environment and restoration was more evident in these people than in those with better mental health. At the same time, the type of activity was less evident in people with better mental health, and they seemed to be less influenced by the visiting of green space. Green prescription is important for the entire population: people with poorer mental health could have important restorative effects and people with better mental health could continue to protect their well-being using green space.

The effects of an active breaks intervention on physical and cognitive performance: results from the I-MOVE study.

BACKGROUND: The present quasi-experimental study aimed to evaluate the effects of active breaks intervention (ABs) to promote physical and cognitive improvement in primary school. METHODS: The active breaks group (ABsG) performed 10 min of ABs three times per school day and the control group (CG) did normal lessons. The baseline and follow-up evaluation was conducted respectively in October 2019 and in May 2021. Cognitive performance was assessed using working memory test, physical performance was analyzed with ActiGraph accelerometers and physical fitness tests, quality of life was monitored using the Paediatric Quality of Life questionnaire (PedsQL) and classroom behavior was collected with an ad hoc questionnaire. RESULTS: We enrolled 153 children (age: 7.61 ± 1.41, 54.2% males). Working memory significantly increased in the ABsG (ΔWM: 1.30 ± 1.17) than in CG (ΔWM: 0.96 ± 1.20). The 6 min Cooper test increased in the ABsG (Δ: 1.77 ± 136.03) but not in CG (Δ: -156.42 ± 187.53), P < 0.05. The weekly physical activity levels increased in both groups; however, the sedentary behavior significantly increased both in ABsG and CG. Children reported improvements in their quality of school life including feeling better in class and in school when using ABs; moreover, children improved their time on task behaviors in ABsG. CONCLUSION: The present study has proven to be effective on children's physical and cognitive performance.

The impact of COVID-19 on physical activity behaviour in Italian primary school children: a comparison before and during pandemic considering gender differences.

BACKGROUND: The World Health Organization stated an average of 60 min of Moderate to Vigorous Physical Activity (MVPA) that children should accumulate every day. Nevertheless physical inactivity is growing and, due to restrictions imposed during pandemic, PA levels of children might be more negatively affected. The study aimed to analyse the impact of COVID-19 on the PA of an Italian sample of primary school children by comparing it before and during COVID-19 considering gender differences. METHODS: A pre-post analysis (October 2019-January 2021) was conducted using a randomized sample (N = 77) from the I-MOVE study settled in an Italian primary school. Both objective (Actigraph accelerometers) and self-reported (PAQ-c questionnaires) assessments of PA were performed. Changes were compared using T-Student and Chi-Square test. Gender differences were calculated using Anova. RESULTS: Weekly and daily minutes time spent in MVPA significantly decreased respectively by - 30.59 ± 120.87 and - 15.32 ± 16.21 from before to during pandemic while the weekly time spent in sedentary behaviour increased (+ 1196.01 ± 381.49). PAQ-c scores followed the same negative trend (- 0.87 ± 0.72). Boys seem to have suffered more than girls from the imposed restrictions. CONCLUSION: These findings outline the need for strategies to promote PA and reduce sedentary behaviours in children to prevent COVID-19 restriction long-term effects.

Bioelectrical impedance analysis versus reference methods in the assessment of body composition in athletes.

The present systematic review aimed to compare the accuracy of Bioelectrical Impedance Analysis (BIA) and Bioelectrical Impedance Vector Analysis (BIVA) vs. reference methods for the assessment of body composition in athletes. Studies were identified based on a systematic search of internationally electronic databases (PubMed and Scopus) and hand searching of the reference lists of the included studies. In total, 42 studies published between 1988 and 2021 were included. The methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies as recommended by the National Institute of Health. Twenty-three studies had an overall good rating in terms of quality, while 13 were rated as fair and 6 as poor, resulting in a low to moderate risk of bias. Fat mass was inconsistently determined using BIA vs. the reference methods, regardless of the BIA-technology. When using the foot to hand technology with predictive equations for athletes, a good agreement between BIA and the reference methods was observed for fat-free mass, total body, intra and extra cellular water. However, an underestimation in fat-free mass and body fluids was found when using generalized predictive equations. Classic and Specific BIVA represented a valid approach for assessing body fluids (Classic BIVA) and percentage of fat mass (Specific BIVA). The present systematic review suggests that BIA and BIVA can be used for assessing body composition in athletes, provided that foot-to-hand technology, predictive equations, and BIVA references for athletes are used.

Generalized bioelectric impedance-based equations underestimate body fluids in athletes.

The current study aimed: (i) to external validate total body water (TBW) and extracellular water (ECW) derived from athlete and non-athlete predictive equations using radioisotope dilution techniques as a reference criterion in male and female athletes; (ii) in a larger sample, to determine the agreement between specific and generalized equations when estimating body fluids in male and female athletes practicing different sports. A total of 1371 athletes (men: n = 921, age 23.9 ± 1.4 y; women: n = 450, age 27.3 ± 6.8 y) participated in this study. All athletes underwent bioelectrical impedance analyses, while TBW and ECW were assessed with dilution techniques in a subgroup of 185 participants (men: n = 132, age 21.7 ± 5.1 y; women: n = 53, age 20.3 ± 4.5 y). Two specific and eight generalized predictive equations were tested. Compared to the criterion methods, no mean bias was observed using the athlete-specific equations for TBW and ECW (-0.32 to 0.05, p > 0.05) and the coefficient of determination ranged from R2  = 0.83 to 0.94. The majority of the generalized predictive equations underestimated TBW and ECW (p < 0.05); R2 ranged from 0.66 to 0.89. In the larger sample, all the generalized equations showed lower TBW and ECW values (ranging from -6.58 to -0.19, p < 0.05) than specific predictive equations; except for TBW in female power/velocity (one equation) athletes and team sport (two equations). The use of generalized BIA-based equations leads to an underestimation of TBW, and ECW compared to athlete-specific predictive equations. Additionally, the larger sample indicates that generalized equations overall provided lower TBW and ECW compared to the athlete-specific equations.

Body image perception and body composition in early adolescents: a longitudinal study of an Italian cohort.

BACKGROUND: Adolescence is a sensitive period of life in which everyone faces physical and psychological changes. No longitudinal studies considering changes in body image perception and body composition in Italian adolescents have been carried out. The aims of this study were to evaluate the longitudinal change in body composition and weight status in a sample of Italian students of both sexes over the 3 years of middle school and to analyse the influence of these parameters on the perception and satisfaction of one's own body image. METHODS: Sixty-four males and seventy females were followed longitudinally from 11 to 14. Age at first measurement was 11.8 ± 0.3 yrs. in males and 11.9 ± 0.3 yrs. in females, then the students were measured again after 1 year and 2 years. Anthropometric measurements were collected and body composition was assessed by skinfolds. Maturity status was detected by age at menarche in females and by estimated age at peak height velocity in males; sports practice was assessed by a questionnaire. Body Silhouette Charts were used to assess body image perception. The degree of body image dissatisfaction and improper perception of weight status were evaluated. Univariate and multivariate analyses were applied. RESULTS: Height, sitting height, leg length, and weight increments were higher in males than in females, and in both sexes the sitting height increment was higher than that of leg length. Skinfold thicknesses and percentage of body fat, showed a decrease in males and an increase in females over the 3 years. About 90% of the sample practiced sport during the 3 years. No significant variations in body image perception were observed among repeated measures but significantly differences were observed between sexes. Although the girls showed a lower incidence of overweight and obesity than boys, girls had a higher dissatisfaction than males. Males were less accurate in one's perception of one's own weight status. CONCLUSIONS: The changes in body composition observed in the sample of the present study were in accordance with their maturity stage. An increase in parameters connected with adiposity is observed in females and a decrease in males. Body image perception did not seem to change with growth, but associations were found between body image perception and BMI and sex. Monitoring body image perception in young adolescents, especially in females and in overweight/obese subjects, is a priority to prevent nutritional disorders.

Variations in epiphyseal fusion and persistence of the epiphyseal line in the appendicular skeleton of two identified modern (19th-20th c.) adult Portuguese and Italian samples.

OBJECTIVES: The aim of this work is to study age, sex, and population variations in epiphyseal fusion and persistence of the epiphyseal line in the appendicular skeleton of two identified modern (19th-20th c.) adult skeletal samples, using a specifically designed macroscopic scoring method. The use of epiphyseal closure and persistence of the epiphyseal line as an adult-age marker is also discussed. MATERIALS AND METHODS: This study examined 981 adult skeletons of both sexes from two identified modern (20th c.) skeletal samples from the Sassari Collection (Museum of Anthropology, University of Bologna, Italy) and the Colecção de Esqueletos Identificados (Museum of Anthropology, University of Coimbra, Portugal). Our scoring method considers a five-degree scale, from nonfusion (Degree 0) to complete fusion (Degree 4). In addition, the persistence of the epiphyseal line, a feature that is not commonly collected during routine anthropological analyses, is taken into account here as Degree 3. RESULTS: Intra- and interobserver errors of 1.2% and 5.2%, respectively, were found, suggesting a good reproducibility of this scoring method. Some sites show variable degrees of epiphyseal fusion still in adult skeletons (e.g., secondary center of ossification of the clavicle, iliac crest, ischial tuberosity, distal epiphysis of the radius and ulna). CONCLUSIONS: Population differences have been observed, showing a delay in the complete epiphyseal closure for the Sassari sample compared to the Coimbra sample. Degree 3 seems to be a good adult-age indicator for individuals less than 35-year-old.

Height prediction in elite Italian rugby players: A prospective study.

OBJECTIVES: We investigated the validity of the Mirwald equation as an estimate of height in a cohort of rugby players. METHODS: This was a prospective study with agreement analysis of height assessments conducted in 39 male youth rugby players (mean age 15.1 ± 0.9 years). During the 2007/2008 season, 151 young athletes were selected by rugby coaches using subjective decisions based on current performance and future potential. The rugby players were measured by physician experts and their height was estimated using the Mirwald formula (MF). Only 39 athletes were finally selected because they reached an elite level, allowing actual adult height to be collected from the official team websites in June 2018. Method agreement was assessed by intraclass correlation coefficient, regression, and plotted by Bland and Altman analysis. RESULTS: Twenty athletes played in the Italian National team and 19 in the First Italian Division (Eccellenza). Overall, they presented an early maturation and the MF was able to accurately estimate height. The MF underestimated height (187.4-189.1 cm) and showed a high association with actual adult players' height (r = 0.925, P < .001). CONCLUSIONS: Our results demonstrate that the MF, whose estimation of stature is based on height, sitting height, body mass, and leg length is able to predict stature in rugby players.

Anthropometry, Physical and Movement Features, and Repeated-sprint Ability in Soccer Players.

This study aimed to evaluate the associations of anthropometry, functional movement patterns (FMP) and physical performance characteristics with repeated-sprint ability (RSA) in male youth soccer players. Thirty six athletes (ages 16.6±0.5 years, BMI 22.0±1.3 kg/m2) completed the RSA test and other physical tests including countermovement jump with (CMJA) and without the help of arms (CMJ), 10-m and 20-m straight-line sprints, Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo), and functional movement screen (FMS). In addition, a battery of anthropometric variables was measured. RSA performance components such as best time (BT), mean time (MT) and sprint decrement were calculated. Results showed that measures of physical performance derived from horizontal plane in 10-m and 20-m sprints, were more strongly associated (p<0.01) with RSA performance than those obtained with CMJ or CMJA (p<0.05). High correlations (p<0.01) were found between MT, BT and Yo-Yo distance (r=-0.79, r=-0.67, respectively), as well as with FMS scores (r=-0.68, r=-0.58, respectively). Anthropometric measures, such as fat mass, upper fat area, thigh fat area, calf muscle area, and endomorphy were associated with RSA components (p<0.05). Predictors for the RSA performance identified in the stepwise multivariate analysis included Yo-Yo distance, time in sprints, FMP, and calf muscle area.

The Effect of a 20-Week Corrective Exercise Program on Functional Movement Patterns in Youth Elite Male Soccer Players.

CONTEXT: Poor functional movement patterns negatively affect the ability to perform fundamental movements with precision and efficiency, increasing injury risk in athletes. OBJECTIVES: To examine the effect of a 20-week corrective exercise program during the competitive season on functional movement patterns in youth elite male soccer players. DESIGN: Cohort study. SETTING: Team facilities. PARTICIPANTS: Sixty-five youth elite male soccer players (age: 15.89 [0.53] y; weight: 67.42 [6.78] kg; and stature: 175.20 [6.34] cm). Of the 4 teams, 2 were randomly selected to take part in the corrective program. Thus, the players were placed into 2 groups: corrective exercise program and control group. INTERVENTION: Corrective exercise program. MAIN OUTCOME MEASURES: Functional Movement Screen (FMS) was used to assess the presence of dysfunctional, asymmetrical, and painful movements in the players before and after the intervention period. In addition to considering the FMS total score (FMStotal), we separated the screen into 3 parts: FMSmove, FMSflex, and FMSstab. A repeated-measures analysis of variance was conducted to determine the effectiveness of the training program on FMS scores. The chi-square test was performed to determine whether there were significant changes in the frequencies of asymmetric and dysfunctional movements after 20 weeks. RESULTS: No athlete experienced severe injuries during the intervention period. There was a significant group by time interaction (P < .01) for FMStotal, FMSmove, and FMSstab, in which only the corrective exercise program increased their scores after the intervention period (P < .05). A chi-square analysis showed a significant (P < .05) decrease in asymmetric and dysfunctional movements at the follow-up in corrective exercise program, whereas these changes were not observed in the control group. CONCLUSIONS: Youth elite soccer players demonstrate a high prevalence of asymmetric movements during FMS testing, but their functional movement patterns can be improved during the competitive season following a specific corrective exercise program.

Functional Movement Patterns and Body Composition of High-Level Volleyball, Soccer, and Rugby Players.

CONTEXT: Sports practice leads athletes to develop a specific body composition, coordination patterns, and basic motor skills based on the different tactical and physical needs. OBJECTIVES: To present and compare a wide range of functional movement patterns and body composition (BC) parameters of high-level male athletes playing different sports and to determine if there was a relationship between the parameters examined. DESIGN: Cross-sectional study. SETTING: Team facilities. PARTICIPANTS: A total of 30 volleyball, 25 soccer, and 30 rugby players (age = 25.9 [5.0] y and body mass index = 25.6 [4.1] kg/m2). INTERVENTIONS: Functional movement patterns and anthropometric measurements were collected by a physician specifically trained. MAIN OUTCOME MEASURES: Body mass index, fat mass, fat-free mass, upper-arm muscle and fat area, calf muscle and fat area, thigh muscle and fat area, and functional movement screen (FMS) scores. In addition to considering the FMS total score, the authors separated the screen into 3 parts: FMSmove, FMSflex, and FMSstab. RESULTS: The rugby players showed a higher number of asymmetrical and dysfunctional movements than the other athletes (P < .01), while the highest scores in FMSflex were obtained by the volleyball players (P < .01). In addition, most of the asymmetrical and painful movements in the athletes were measured on the shoulder mobility test. Muscle and fat areas differed significantly among the athletes (P < .05). Significant associations were found between movement patterns and several BC variables. In particular, large negative correlations were measured between percentage of fat mass (r = -.616; P < .01), upper-arm fat area (r = -.519; P < .01), and FMS total score. CONCLUSIONS: Functional movement patterns and BC differ in athletes according to the sport practiced. Furthermore, reaching an optimal BC is essential to achieve a satisfactory quality of movement.

Changes in Phase Angle and Handgrip Strength Induced by Suspension Training in Older Women.

This study aimed to present a suspension exercise training program suitable for older adults and to verify the effect of 12 weeks of training on handgrip strength (HS) and anthropometric and bioelectrical impedance parameters in older adults. Thirty older women (age 66.1±4.7 years, BMI 30.6±5.3 kg/m2) were randomly assigned to one of two groups: a training group (TG, n=15) or a control group (CG, n=15). The TG participated in a 12-week suspension training program, while the CG maintained their normal physical activity habits for the duration of the study. Anthropometric, bioelectrical impedance and strength parameters were evaluated before and after the intervention period. There was a significant group by time interaction (p<0.05) for triceps, biceps, subscapular skinfold, percentage of fat mass, phase angle (PhA), resistance, reactance, specific resistance, specific reactance and HS, with significant improvements in the TG after the intervention period (p<0.05) even after adjusting for age and BMI. The results suggest that suspension training promotes increases in PhA and HS in older women.

Anthropometry and Functional Movement Patterns in Elite Male Volleyball Players of Different Competitive Levels.

Toselli, S and Campa, F. Anthropometry and functional movement patterns in elite male volleyball players of different competitive levels. J Strength Cond Res 32(9): 2601-2611, 2018-The aim of this study was to establish specific profiles for anthropometry and functional movement parameters and identify which characteristics can be modified by training to achieve a better quality of movement in elite male volleyball players competing at the Italian National League (Super Lega = 39, aged 25.6 ± 4.7 years and A2 = 30, aged 26.2 ± 5.3 years). Another aim was to value functional movement patterns in relation to morphological traits, with special focus on differences by division and playing positions. Statistical significance was set at p ≤ 0.05. According to discriminant analysis, the differences between players of the 2 Divisions were primarily due to nonmodifiable parameters (humerus width, height, and bicrestiliac width) and modifiable parameters (contracted arm circumference and muscle area of upper arm). Our results highlighted differences according to playing positions. Middle hitters and opposites were taller, heavier and generally showed wide dimensions in contracted arm circumference, upper limb length widths, and handgrip strength than the players of the other roles. Percentage of fat mass was low in players of all roles, such as endomorph somatotype component. Ectomorphic component was maximal in middle hitters, whereas mesomorphic component was maximal in liberos. The players of the 2 Divisions did not show differences in the movement patterns, even if approximately 33% of them showed a dysfunctional movement, with a prevalence of asymmetric movements in the shoulder mobility test. Multiple regression showed that, in volleyball players, an optimal flexibility and mobility was closely related to anthropometric characters with particular emphasis on body fat.

Sports activities in preschool children differed between those born to immigrants and native Italians.

AIM: Despite the health benefits of physical activity in early childhood, little is known about sports practices in preschool children with different ethnic origins. The aim of this study was to investigate the sport activity patterns in native and immigrant children in northern Italy. The influence of some child and family determinants on the child's practice of club-organised sport was analysed to plan interventions. METHODS: The study group comprised 2682 preschool children (49.5% girls) aged 5.9 ± 0.3, 2396 fathers and 2478 mothers. All the children had their height and weight measured and their parents completed a self-administered questionnaire on their child's sports participation and family characteristics. RESULTS: Sports activities were significantly more frequent in native Italian girls than in native Italian boys and immigrant girls. Multiple linear regression analysis showed that the weekly amount of club-organised sport in preschool children was related to the sex and migrant status in the whole sample, to paternal educational level and occupation in the native-born sample and to paternal body mass index, offspring and paternal occupation in the immigrant group. CONCLUSION: This study highlighted the need to develop specific interventions for native and immigrant preschool children to promote a healthy lifestyle.

Body image perception of African immigrants in Europe.

Nutritional disorders are now spreading worldwide both in developed and developing countries. Body image ideals and dissatisfaction have been linked to a number of poor health outcomes, including nutritional disorders. While previous studies have offered insight into weight status and body image perception of immigrants in North America, very few studies have analysed these aspects in migrants from Africa to Europe. Our review examines the effects of the migration process on beauty ideals and body dissatisfaction in African immigrants in Europe compared to residents in their own countries. The PubMed, PsycINFO and Google Scholar databases were searched for studies published from January 2000 till November 2015. Of the 730 titles identified, 26 met the inclusion criteria and were included in the present review. Among African residents, the body preferences depend on the country of residence and their socio-cultural status. Ethnic groups living in great isolation or with low incomes still have an ancestral idea of beauty, preferring a shapely body. However ethnic groups living in urban areas are moving toward Westernization of beauty ideals, preferring underweight or normal weight bodies. This review highlights that both residents and migrants are at high risk of nutritional disorders due to the adoption of Western beauty ideals. The results suggest that body dissatisfaction and BMI are increasing from Southern Africa to Europe according to a geographical gradient (described for females by Spearman's coefficient and linear regression, respectively). We emphasize the need for monitoring of the weight and psychological status of immigrants and the development of specific preventive strategies in European countries.

Weight status, fatness and body image perception of North African immigrant women in Italy.

OBJECTIVE: To investigate the nutritional status of North African (NA) immigrant women in Italy, analysing their body size, adiposity and body image perception in comparison to Italian natives and NA residents. DESIGN: The study utilized a cross-sectional design. Anthropometric traits were directly measured and a few indices were computed as proxy measures of nutritional status and adiposity. Body image perception was assessed using silhouette drawings. ANCOVA, adjusted for age, was used to compare anthropometric traits among different groups of women and the χ 2 test to analyse differences in the prevalence of nutritional status. SETTING: Italy and North Africa (Tunisia, Morocco). SUBJECTS: A sample of 433 women aged 18-60 years old: NA immigrants (n 105); Italians (n 100); Tunisians (n 104); Moroccans (n 124). RESULTS: Overweight/obesity prevalence was very high in immigrants (79·8 %). Immigrants had the highest BMI value, the greatest hip circumference and mid upper-arm circumference. Their triceps skinfold thickness was significantly higher than that of Italians, but lower than that of NA residents. CONCLUSIONS: NA immigrant women in Italy showed a higher incidence of overweight compared with Italians and NA residents. All groups showed a preference for a thinner body in comparison to their actual bodies and the immigrants are the most dissatisfied. Immigrants remain a high-risk group for obesity. Assessment of their body composition and health risk profile should be improved by using specific anthropometric measures that are easy to collect even in the case of large migration flows.

Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy.

OBJECTIVE: To examine the health status of ethnic minorities in Italy. Furthermore, we aimed to assess the association between anthropometric and blood parameters connected with health status. DESIGN: A cross-sectional study. Anthropometric data were collected by direct measurements and blood glucose, total cholesterol and TAG were analysed. SETTING: Bologna, northern Italy. SUBJECTS: A multi-ethnic sample of adult immigrants and Roma. RESULTS: Significant correlations between anthropometric and blood parameters were found. Among the ethnic groups, Roma males had the highest values of glucose, total cholesterol and TAG. In the females the situation was more balanced among ethnic groups. CONCLUSIONS: The data from this survey indicate that poor health status is a very common problem among ethnic groups living in Italy, especially the Roma. The use of anthropometric parameters as rapid indicators of health status in screenings of a large number of subjects could be an effective and cheap method to provide preliminary indications on individuals or ethnic groups at greater risk of poor health.

Psychosocial health among immigrants in central and southern Europe.

Migration exposes people to a number of risks that threaten their health, including those related to psychosocial health. Self-perceived health is usually the main indicator used to assess psychosocial health. Electronic databases were used to examine the literature on the psychosocial health of immigrants in Europe and of North Africans living in their own countries. Immigrants of various ethnic groups show a similar risk of psychosocial disorders but generally present a higher risk than the local population. This risk is related to gender (being higher in women), poor socio-economic status and acculturation, discrimination, time elapsed since migration and age on arrival in the new country. Although the stressors and situations the different ethnic groups experience in the host country may be shared, the way they deal with them may differ according to cultural factors. There is a need to collect detailed data on psychosocial health among the various immigrant groups in Europe, as well as to monitor this aspect in North African residents who lack access to specific services.

Health, growth and psychosocial adaptation of immigrant children.

The increasing population diversity in Europe demands clarification of possible ethnic influences on the growth and health of immigrant children and their psychosocial adaptation to the host countries. This article assesses recent data on immigrant children in Europe in comparison to European natives by means of a systematic review of the literature on growth patterns and data on children's health and adaptation. There were wide variations across countries in growth patterns and development of immigrant children and natives, with different trends in Central and Northern Europe with respect to Southern Europe. In general, age at menarche was lower in immigrant girls, while male pubertal progression seemed faster in immigrants than in European natives, even when puberty began after. Owing to the significant differences in anthropometric traits (mainly stature and weight), new reference growth curves for immigrant children were constructed for the largest minority groups in Central Europe. Possible negative effects on growth, health and psychosocial adaptation were pointed out for immigrant children living in low income, disadvantaged communities with a high prevalence of poor lifestyle habits. In conclusion, this review provides a framework for the health and growth of immigrant children in Europe in comparison to native-born children: the differences among European countries in growth and development of migrants and non-migrants are closely related to the clear anthropological differences among the ethnic groups due to genetic influences. Higher morbidity and mortality was frequently associated with the minority status of these children and their low socio-economic status. The observed ethnic differences in health reveal the need for adequate health care in all groups. Therefore, we provide suggestions for the development of health care strategies in Europe.

Prevalence of overweight and obesity in adults from North Africa.

The share of North African immigrants in Europe is growing continuously. In this review, we aimed to systematically analyse and describe the literature on weight status and physical activity in North African adults, both in their home country and after immigration to Europe. Existing data on North African residents and on North African immigrants in Europe were analysed by a systematic search on PUBMED. There is a wide variation among countries in the prevalence of overweight/obesity, with immigrants showing higher values. The overall results revealed a higher prevalence of overweight and obesity in females than in males in North African residents. Females also show higher levels of obesity among immigrants. In particular, literature reports indicate that 1.3-47.8% of North African residents and 3.6-49.4% of North African immigrants in adult age are overweight or obese. Physical inactivity is higher than 20% in males and 40% in females in North African residents. The highest frequency of physically inactive or lightly active people among immigrants was observed in first-generation Sudanese and Moroccans in Amsterdam (males: 57.1%; females: 74.2%), with increasing rates in second-generation females. The results underline a higher health risk in North African immigrants than in residents. Specific public health strategies should be adopted in various populations of North African origin to control the obesity epidemic.