Walkability and socio-economic status in relation to walking, playing and sports practice in a representative Spanish sample of youth: The PASOS study.

PURPOSE: Physical activity (PA) provides multiple health-related benefits in children and adolescents, however, at present, the majority of young people are insufficiently physically active. The aim of this study was to evaluate if neighborhood walkability and/or socio-economic status (SES) could affect the practice of walking, play outdoors and sports practice in a representative sample of Spanish children and adolescents. METHODS: A sample of 4092 youth (aged 8-16 years old) from 245 primary and secondary schools in 121 localities from each of the 17 Spanish autonomous communities participated in the study. Walk Score was used to evaluate walkability of the neighborhood and household income was used as an indicator of SES. A 7-item self-reported validated questionnaire, was used to assess PA levels, and in a subsample of 10% of the participants, randomly selected from the entire sample, PA was objectively measured by accelerometers. RESULTS: Youth from more walkable areas reported more minutes walking per day compared with those from less walkable neighborhoods (51.4 vs 48.8 minutes, respectively). The lowest average minutes spent in playing outdoors was found among participants from low-SES and low-walkable neighborhoods. Neighborhood SES influenced on the participation in team sports during the weekend, being this participation higher in high SES neighborhoods. CONCLUSION: Providing high walkable environments seems a good strategy to promote PA regardless SES levels. It seems that improving the walkability is a key component to partially overcome the SES inequalities, especially in urban areas with low SES. High-SES environments can offer better sports facilities and more organized physical activities than low-SES ones.

Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades.

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8-16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998-2000, n = 1001) and PASOS (2019-2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019-2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019-2020 (mean ± SE: 6.9 ± 0.04) and the 1998-2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.

Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study.

Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16-0.48), severe obesity (OR = 0.20; 95% CI: 0.05-0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23-0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.

Gender Influences on Physical Activity Awareness of Adolescents and Their Parents.

The imbalances between the actual physical activity (PA) of adolescents and the subjective perception both they and their parents have in this regard can play an important role in perpetuating inactive lifestyles. The aim of this study is to analyse these discrepancies by considering gender as a conditioning factor. The participants in the study were 1697 adolescents, 1244 mothers and 1052 fathers in the educational communities of 26 secondary schools located in urban environments of the Autonomous Community of Galicia (Spain). With regard to actual physical activity, a high prevalence of sedentarism (82.1%) was revealed, this being even more acute in girls (87.8%). However, the perceived levels of activity differed significantly from the actual ones with a clear general overestimation both by the adolescents and their parents. When further exploring the data, gender influences were also detected both in adolescent and parental perceptions, since the high rates of overestimation in sedentary individuals were lower in girls and, on the contrary, the low rates of underestimation in active individuals were higher in girls. Moreover, although the level of agreement between actual and perceived physical activity was low overall, with Cohen's kappa values ranging from 0.006 to 0.047, the lowest values were observed in the case of girls. In conclusion, both the adolescents and their parents were incapable of correctly assessing the actual physical activity of the former, so it seems that the general population lacks knowledge about the amount of physical activity that adolescents need to do to achieve a healthy lifestyle. Consequently, it would be advisable to implement health education campaigns and awareness-raising interventions directed to young people as well as to their parents and, in doing so, gender must be considered by establishing distinct program designs in terms of this variable.

Parental assessment of physical education in the school curriculum: A brief report on the influence of past experiences as students.

The aim of this study was to analyse the relationship between parents' past experience as Physical Education (PE) students and the importance they give to PE within the school curriculum. Parents of 1834 teenagers from Spain and Portugal participated in the study (1834 fathers and 1834 mothers). An 11 item questionnaire was used for data collection. The measures studied were: socio-demographic characteristics, parent´s past experience as PE students, and importance that parents gave to PE in the school curriculum. The results suggest that parents' past experiences as PE student condition their evaluation of the importance that PE should have in the school curriculum. As the past experience as PE student deteriorated and as age increased, there was an increase in the probability that parents evaluate PE as deserving a less important status in their children's curriculum. These findings can contribute to understanding how the parents' past experiences as PE students seem to partially model the value judgements that they make later in life regarding the importance of the subject.