Self-reported physical activity in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study.

OBJECTIVE: To describe self-reported physical activity (PA) patterns in the various domains (school, home, transport, leisure time) and intensity categories (walking, moderate PA, vigorous PA) in European adolescents. Furthermore, self-reported PA patterns were evaluated in relation to gender, age category, weight status category and socio-economic status (SES). DESIGN: Cross-sectional study. SETTING: Ten European cities. SUBJECTS: In total, 3051 adolescents (47·6 % boys, mean age 14·8 (sd 1·2) years) completed an adolescent-adapted version of the validated International Physical Activity Questionnaire. RESULTS: The total sample reported most PA during leisure time (485 min/week) and least PA at home (140 min/week). Boys reported significantly more school-based PA (P < 0·001), leisure-time PA (P = 0·003), vigorous PA (P < 0·001) and total PA (P = 0·002) than girls, while girls reported more home-based PA (P < 0·001) and walking (P = 0·002) than boys. Self-reported PA at school (P < 0·001), moderate PA (P < 0·001), vigorous PA (P < 0·001) and total PA (P < 0·001) were significantly higher in younger age groups than in older groups. Groups based on weight status differed significantly only in leisure-time PA (P = 0·004) and total PA (P = 0·003), while groups based on SES differed in all PA domains and intensities except transport-related PA and total PA. CONCLUSIONS: The total sample of adolescents reported different scores for the different PA domains and intensity categories. Furthermore, patterns were different according the adolescents' gender, age, weight status and SES.

Evaluation of a computer-tailored physical activity intervention in adolescents in six European countries: the Activ-O-Meter in the HELENA intervention study.

PURPOSE: The present study investigates the effect of the Activ-O-Meter, an internet-based computer-tailored physical activity intervention in adolescents in six European centers involved in the HELENA study. METHODS: Adolescents (12-17 years old) from Vienna, Ghent, Heraklion, Dortmund, Athens, and Stockholm were randomized into intervention and control schools. Participants in the intervention condition received the computer-tailored advice at baseline and after 1 month. Participants in the control condition received a generic standard advice. Effects were evaluated after 1 (n = 675) and 3 months (n = 494) using multi-level modeling. Physical activity levels were measured using the International Physical Activity Questionnaire for adolescents (IPAQ-A). RESULTS: After 1 month, the intervention group reported higher levels of moderate (beta = -32.8, 95% CI (confidence interval): -64.2 to -1.4) and vigorous (beta = -28.0, 95% CI: -50.7 to -5.3) physical activity in leisure time, as well as higher levels of cycling for transport (beta = -19.1, 95% CI: -34.4 to -7.6) compared to the control group. After 3 months, when the intervention group had received the tailored feedback twice, intervention effects were even stronger. Favorable changes in physical activity levels of all intensities and in different contexts were found in the tailored group compared to the control group. Among adolescents not reaching the physical activity recommendations at baseline similar effects as in the total sample were found. CONCLUSIONS: The data indicated that the computer-tailored physical activity intervention had positive effects on physical activity levels among the adolescents. However, the implementation of the computer-tailored intervention in the schools was not feasible in all countries.

The potential role of taxes and subsidies on food in the prevention of obesity in Europe.

BACKGROUND: Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. METHODS: Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. RESULTS: Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. CONCLUSIONS: Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

Policy options for obesity in Europe: a comparison of public health specialists with other stakeholders.

OBJECTIVE: To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS). DESIGN: Structured interviews using multicriteria mapping, a computer-based, decision-support tool. SETTING: Nine European countries. SUBJECTS: A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors. MEASUREMENTS: A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. RESULTS: The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important. CONCLUSION: There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.