Associations of physical activity type, volume, intensity, and changes over time with all-cause mortality in older adults: The Seniors-ENRICA cohorts.

OBJECTIVE: To assess the association of physical activity (PA) type, volume, intensity, and changes over time with all-cause mortality in older adults. METHODS: We used data from 3518 and 3273 older adults recruited in the Seniors-ENRICA-1 and 2 cohorts. PA was assessed with the EPIC questionnaire. Participants reported how many hours they spent a week in walking, cycling, gardening, do-it-yourself (DIY), sports, and housework. Then, time at each intensity (moderate PA [MPA], vigorous PA [VPA], moderate-to-vigorous PA [MVPA] and total PA) was calculated. Changes in PA were calculated from the date of the baseline interview to Wave 1. All-cause mortality was ascertained up January 31, 2022. Analyses were performed with Cox regression models, adjusting for the main confounders. RESULTS: Walking, gardening, sports, and housework was associated with lower mortality (ranged 20%-46%). Also, MPA, VPA, MVPA was associated with lower risk of mortality (ranged 28%-53%). Analyses of PA change showed that, compared no PA participation (at baseline nor Wave 1), maintain walking, sports, and housework (ranged 28%-53%) and maintaining MPA, VPA, and MVPA (ranged 32%-36%) levels was linked to decreased mortality risk. Those who increased, maintained, or even decreased total PA had lower mortality (57%, 52%, and 36%, respectively) than those with consistently very low PA. CONCLUSIONS: The lower mortality was observed in those with a high baseline level of total PA. Maintaining PA levels such as walking, gardening, and housework, or at all analyzed intensities, was related to lower mortality.

Dose-response relationship between device-measured physical activity and incident type 2 diabetes: findings from the UK Biobank prospective cohort study.

BACKGROUND: Most studies investigating the association between physical activity (PA) and the risk of type 2 diabetes are derived from self-reported questionnaires, with limited evidence using device-based measurements. Therefore, this study aimed to investigate the dose-response relationship between device-measured PA and incident type 2 diabetes. METHODS: This prospective cohort study included 40,431 participants of the UK Biobank. Wrist-worn accelerometers were used to estimate total, light, moderate, vigorous and moderate-to-vigorous PA. The associations between PA and incident type 2 diabetes were analysed using Cox-proportional hazard models. The mediating role of body mass index (BMI) was tested under a causal counterfactual framework. RESULTS: The median follow-up period was 6.3 years (IQR: 5.7-6.8), with 591 participants developing type 2 diabetes. Compared to those achieving < 150 min/week of moderate PA, people achieving 150-300, 300-600 and > 600 min/week were at 49% (95% CI 62-32%), 62% (95% CI 71-50%) and 71% (95% CI 80-59%) lower risk of type 2 diabetes, respectively. For vigorous PA, compared to those achieving < 25 min/week, individuals achieving 25-50, 50-75 and > 75 min/week were at 38% (95% CI 48-33%), 48% (95% CI 64-23%) and 64% (95% CI 78-42%) lower type 2 diabetes risk, respectively. Twelve per cent and 20% of the associations between vigorous and moderate PA and type 2 diabetes were mediated by lower BMI, respectively. CONCLUSIONS: PA has clear dose-response relationship with a lower risk of type 2 diabetes. Our findings support the current aerobic PA recommendations but suggest that additional PA beyond the recommendations is associated with even greater risk reduction. TRIAL REGISTRATION: The UK Biobank study was approved by the North West Multi-Centre Research Ethics Committee (Ref 11/NW/0382 on June 17, 2011).

Longitudinal effects of FTO gene polymorphism on body composition, cardiorespiratory fitness, physical activity, inflammatory markers, and cardiovascular risk in children and adolescents. "The UP & DOWN study".

The role of polymorphism rs9939609 of the FTO gene has been related with fat mass and cardiovascular risk in adults, but it remains unclear in children and adolescents. Hence, the main aim of this study was to determine the FTO polymorphism effects on body composition, cardiorespiratory fitness (CRF), physical activity (PA), inflammatory markers, and cardiovascular risk both in cross-sectional analysis and after two-years of follow-up in children and adolescents. A total of 2129 participants were included in this study. The rs9939609 polymorphism was genotyped. Body composition measurements, CRF, and moderate-to-vigorous PA (MVPA) were determined at baseline and after two-year of follow-up. Moreover, plasma leptin and adiponectin were also determined as inflammatory markers. Furthermore, an index of cardiovascular disease risk factors (CVDRF-I) was calculated. Codominant (TT vs. TA vs. AA) and dominant (AA+AT vs. TT) models were applied for statistical analysis. The results showed a main effect of the FTO genotype on body composition measures in both first and third year (p < 0.05), with lower adiposity in TT compared with AA or AA+AT group. These differences were maintained after accounting for pubertal maturity, sex, age, VO2 max, and MVPA. Moreover, lower leptin level was observed in TT compared to AA+AT group in the third year. An interaction in Gene*Time*Sex was found in height and neck circumference in dominant model (p = 0.047; p = 0.020, respectively). No differences were found in CRF, MVPA nor CVDRF-I between groups. Hence, homozygous TT allele could be a protective factor against weight gain from early childhood.

Sedentary behaviour profiles and longitudinal associations with academic performance in youth: The UP&DOWN study.

The current study evaluated longitudinal associations between profile transitions of context-specific sedentary behaviour (SB) and changes in academic performance (AP) among school-aged youth. Participants were 466 children and 717 adolescents (50.8% males) aged 8-18 years (children = 7.92 ± 0.41 years; adolescents = 11.85 ± 1.53 years). Non-school SBs and AP were evaluated at baseline and two years later. General linear mixed models were implemented, controlling for age, region, parental education, body mass index, and cardiorespiratory fitness. Cross-sectionally, participants with an Educative-profile (i.e., highest scores in doing homework with/without computer and reading for fun) had higher AP when compared to other profiles. Longitudinally, males who changed from a Screen- to an Educative-profile had higher AP than males who changed from an Educative- to a Social- or Screen-SB profile (p < 0.01). No significant differences were found in females. These findings show the importance of analysing SB patterns from a qualitative perspective (i.e., context-specific for boosting school children AP) and highlighting time spent in educative as the most positive for AP, as well the need to implement interventions to reduce time on screen and social behaviours, especially targeting males.

Long-term leisure-time physical activity and risk of all-cause and cardiovascular mortality: dose-response associations in a prospective cohort study of 210 327 Taiwanese adults.

OBJECTIVES: We aimed to investigate the dose-response associations of long-term leisure-time physical activity (LTPA) obtained from repeated measures with all-cause and cardiovascular disease (CVD) mortality outcomes in Taiwanese adults. METHODS: We included 210 327 participants with self-reported LTPA at least in two medical examinations (867 968 data points) for up to 20 years (median, IQR: 4.8 years, 2.3-9.0). Dose-response relationships were modelled with restricted cubic spline functions and Cox regressions HRs (95% CIs) adjusted for main covariates. RESULTS: During up to 23 years of follow-up (3 655 734 person-years), 10 539 participants died, of which 1919 of CVD. We observed an inverse, non-linear dose-response association between long-term LTPA and all-cause and CVD mortality. Compared with the referent (0 metabolic equivalent of task (MET) hours/week), insufficient (0.01-7.49 MET hours/week), recommended (7.50-15.00 MET hours/week) and additional (>15 MET hours/week) amounts of LTPA had a lower mortality risk of 0.74 (0.69-0.80), 0.64 (0.60-0.70) and 0.59 (0.54-0.64) for all-cause mortality and 0.68 (0.60-0.84), 0.56 (0.47-0.67) and 0.56 (0.47-0.68) for CVD mortality. When using only baseline measures of LTPA, the corresponding mortality risk was 0.88 (0.84-0.93), 0.83 (0.78-0.88) and 0.78 (0.73-0.83) for all-cause and 0.91 (0.81-1.02), 0.78 (0.68-0.89) and 0.80 (0.70-0.92) for CVD mortality. CONCLUSION: Long-term LTPA was associated with lower risks of all-cause and CVD mortality. The magnitude of risk reductions was larger when modelling repeated measures of LTPA compared with one measure of LTPA at baseline.

Cross-sectional and prospective associations of sleep, sedentary and active behaviors with mental health in older people: a compositional data analysis from the Seniors-ENRICA-2 study.

BACKGROUND: Most studies on the effects of sleep, sedentary behavior (SB), and physical activity (PA) on mental health did not account for the intrinsically compositional nature of the time spent in several behaviors. Thus, we examined the cross-sectional and prospective associations of device-measured compositional time in sleep, SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) with depression symptoms, loneliness, happiness, and global mental health in older people (≥ 65 years). METHODS: Data were taken from the Seniors-ENRICA-2 study, with assessments in 2015-2017 (wave 0) and 2018-2019 (wave 1). Time spent in sleep, SB, LPA and MVPA was assessed by wrist-worn accelerometers. Depression symptoms, loneliness, happiness, and global mental health were self-reported using validated questionnaires. Analyses were performed using a compositional data analysis (CoDA) paradigm and adjusted for potential confounders. RESULTS: In cross-sectional analyses at wave 0 (n = 2489), time-use composition as a whole was associated with depression and happiness (all p < 0.01). The time spent in MVPA relative to other behaviors was beneficially associated with depression (γ = -0.397, p < 0.001), loneliness (γ = -0.124, p = 0.017) and happiness (γ = 0.243, p < 0.001). Hypothetically, replacing 30-min of Sleep, SB or LPA with MVPA was beneficially cross-sectionally related with depression (effect size [ES] ranged -0.326 to -0.246), loneliness (ES ranged -0.118 to -0.073), and happiness (ES ranged 0.152 to 0.172). In prospective analyses (n = 1679), MVPA relative to other behaviors at baseline, was associated with favorable changes in global mental health (γ = 0.892, p = 0.049). We observed a beneficial prospective effect on global mental health when 30-min of sleep (ES = 0.521), SB (ES = 0.479) or LPA (ES = 0.755) were theoretically replaced for MVPA. CONCLUSIONS: MVPA was cross-sectionally related with reduced depression symptoms and loneliness and elevated level of happiness, and prospectively related with enhanced global mental health. Compositional isotemporal analyses showed that hypothetically replacing sleep, SB or LPA with MVPA could result in modest but significantly improvements on mental health indicators. Our findings add evidence to the emerging body of research on 24-h time-use and health using CoDA and suggest an integrated role of daily behaviors on mental health in older people.

Correlates of dual trajectories of physical activity and sedentary time in youth: The UP & DOWN longitudinal study.

Trajectories of physical activity and sedentary time (SED) may differ between subgroups of youth. The aim of this study was to identify group-based dual trajectories of physical activity and SED and explore individual, social, and environmental correlates of these trajectories. Longitudinal data (three time points, baseline 2011-2012) of Spanish youth (n = 1597, mean age = 11.94 ± 2.52, 50.9% boys) were used. Moderate-to-vigorous physical activity (MVPA) and SED were assessed objectively at each time point, and 21 potential correlates were self-reported at baseline. Parallel process growth mixture models identified shared categorical latent groups, adjusting for school and age. Multinomial logistic regression models identified baseline correlates of a given trajectory. Four shared categorical latent groups were identified: (1) stable MVPA and decreasing SED (4%); (2) stable MVPA and increasing SED (3%); (3) consistently higher MVPA (18%); and (4) stable low MVPA and slight increase in SED (75%). Multinomial logistic regression models with group 3 as reference found: negative affect (RRR = 0.90, 95% CI 0.84-0.97), parental screen-time rules (RRR = 1.15, 95% CI 1.00-1.33), and household media equipment (RRR = 1.17, 95% CI 1.05-1.30) predicted likelihood of group 1 membership; cons of reducing SED (RRR = 2.70, 95% CI 1.77-4.10) predicted likelihood of group 2 membership; and co-participation in physical activity with friends (RRR = 0.80, 95% CI 0.69-0.94), fathers' modeling of TV viewing (RRR = 1.22, 95% CI 1.02-1.47), and household media equipment (RRR = 1.16, 95% CI 1.02-1.31) predicted likelihood of group 4 membership. Results suggest that strategies to improve MVPA and SED behaviors among youth may need to be multifaceted, targeting all levels of influence.

Bidirectional longitudinal associations of fatness with physical fitness in adolescents with Down syndrome. The UP&DOWN Longitudinal study.

BACKGROUND: The aim of this study was to examine the bidirectional longitudinal associations of several markers of fatness and physical fitness in adolescents with Down syndrome. METHODS: This study comprised a total of 111 adolescents (41 females), aged from 11 to 20 years with complete data at the baseline. We had a drop-out of <10% from the baseline to the 2-year follow-up. The ALPHA health-related fitness test battery for youth was used. RESULTS: Our results show that all fatness variables at the baseline were associated with a 2-year change in cardiorespiratory fitness (ß ranging from -0.32 to -0.38; all p < .05), but not with muscular and motor fitness (p > .05). However, no associations were found between physical fitness components as predictors and fatness indicators (p > .05). CONCLUSIONS: Results suggest that reducing fatness during adolescence might represent a modifiable factor to improve cardiorespiratory fitness at the 2-year follow-up, but not vice versa since associations were not bidirectional.

Changes in and the mediating role of physical activity in relation to active school transport, fitness and adiposity among Spanish youth: the UP&DOWN longitudinal study.

BACKGROUND: Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents. METHODS: This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011-12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators. RESULTS: Multilevel analyses observed decreases in LPA between T0-T1 (ß = - 11.27; p < 0.001) and T0-T2 (ß = - 16.27; p < 0.001) and decreases in MVPA between T0-T2 (ß = - 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (ß = 0.78; p = 0.028) and T0-T2 (ß = 0.81; p = 0.046). Path analyses showed that AST was directly positively associated with MVPA at T1 (all, ß ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (ß = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations. CONCLUSIONS: Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

Twenty four-hour activity cycle in older adults using wrist-worn accelerometers: The seniors-ENRICA-2 study.

OBJECTIVES: This study aimed: (a) to provide a detailed description of sleep, sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) over the complete 24-hours period using raw acceleration data in older adults; and (b) to examine the differences in the 24-hours activity cycle by sex, age, education, and body mass index (BMI). METHODS: Population-based cohort comprising 3273 community-dwelling individuals (1739 women), aged 71.8 ± 4.5 years, participating in the Seniors-ENRICA-2 study. Participants wore a wrist-worn ActiGraph GT9X accelerometer for 7 consecutive days, and the raw signal was processed using the R-package GGIR. RESULTS: Participants reached 21.5 mg as mean acceleration over the whole day; 32.3% (7.7 h/d) of time was classified as sleep, 53.2% (12.7 h/d) as SED, 10.4% (148.6 min/d) as LPA, and 4.1% (59.0 min/d) as MVPA. No marked differences were found in sleep-related variables between socio-demographic and BMI groups. However, women showed higher LPA but lower SED and MVPA than men. Moreover, SED increased whereas LPA and MVPA decreased with age. Participants with obesity (BMI ≥ 30 kg/m2 ) accumulated more SED and less LPA and MVPA than those without obesity. As expected, adherence to physical activity recommendations varied widely (9.2%-76.6%) depending on the criterion of MVPA accumulation. CONCLUSION: Objective assessment of the 24-hour activity cycle provides extensive characterization of daily activities distribution in older adults and may inform health-promotion interventions in this population. Women, the oldest old, and those with obesity offer relevant targets of strategies to improve lifestyle patterns.

Changes in the school and non-school sedentary time in youth: The UP&DOWN longitudinal study.

The aims of this study were (i) to examine the sedentary time (ST) during different time periods [i.e., weekend, out-of-school weekdays hours, school hours, recess, physical education classes (PEC)] in children and adolescents; (ii) to identify 2-year longitudinal changes in the ST for these periods; and (iii) to examine if ST at baseline is associated with ST 2 years later. This was a 2-year follow-up study with 826 (51.9% boys) children and 678 (50.7% boys) adolescents. Accelerometers were used to assess ST. Students spent more than 60% of their weekend, out-of-school hours and school hours in ST. During these periods, girls and adolescents were more sedentary than boys and children, respectively (p < 0.05). Over 2-year follow-up, ST increased during the weekend, out-of-school hours, school hours and recess in all subgroups studied (p < 0.001). ST during PEC declined 2% per year in children (p < 0.001) but it increased in adolescents (p < 0.05). ST during the periods analysed at baseline was lowly associated with ST during these periods 2 years later (intraclass correlations from <0.001 to 0.364). Interventions in these settings may be adequate if the intention is to avoid ST increase in students.

Does modality matter? A latent profile and transition analysis of sedentary behaviours among school-aged youth: The UP&DOWN study.

The aims of this study were to identify profiles of sedentary behaviour (SB) patterns, based on leisure-time self-reported SB modalities (screen, educative, social, and relaxing) and to evaluate changes in these profiles over 2 years among Spanish youth aged 8-18 years. Latent profile analysis (LPA), a data-driven analytic approach, was used to identify groups of boys and girls (n = 1553; 48% girls; mean±SD age: 12.56 ± 2.49 y) with distinct SB profiles using the SB modalities (time/d) as input variables. Latent transition analysis, an extension of LPA that uses longitudinal data, was used to analyse 2-year changes in these profiles. At baseline, four and three SB profiles were found among boys (labelled: screen, educative, social, and relaxing) and girls (labelled: screen/social, educative, and relaxing), respectively. Overall, more girls (range: 48%-67%) had the same profile over time, than boys (40%-52%). Participants with a screen or relaxing SB profile at baseline were more likely to have an educative profile after 2 years. Youth with a social and an educative SB profile at baseline were more likely to transition to profiles characterized by higher screen and social SB, respectively. Using a novel and person-centered approach, this study identified gender-specific SB profiles that were moderately stable over time.

Associations of daily activities measured by a pattern-recognition activity monitor with overall and abdominal obesity in older people: the IMPACT65+ study.

OBJECTIVES: The aims of the present study were: (i) to analyze the associations of the time spent in daily activities (i.e., lie, recline, passive sit, active sit, stand, walk at slow pace, walk at average pace, walk at brisk pace, and other activities) with body mass index (BMI) and waist circumference (WC); and (ii) to examine how theoretically reallocating time between these daily activities is associated with BMI and WC. METHODS: The sample included 437 older adults (288 women), aged 65 to 92 years, participating in the IMPACT65+ study. The time in daily activities was assessed by the Intelligent Device for Energy Expenditure and Activity (IDEEA). BMI and WC were measured following standardized procedures. Associations of daily activities with BMI and WC were examined using linear regression models adjusting for potential confounders. Isotemporal substitution models were performed to estimate the theoretical effect of replacing one activity with another activity while holding total time constant. RESULTS: The time spent lying and reclining was associated with increased BMI and WC, while the time spent standing, walking at average pace, and walking at brisk pace was associated with decreased BMI and WC. Isotemporal substitution analyses revealed significant hypothetical reductions in BMI and WC when reallocating 15 min from lying or reclining to standing or walking at average pace. Moreover, replacing 15 min from any sedentary activity or light physical activity (except for walking at average pace) with an equal amount of time in walking at brisk pace was associated with lower BMI and WC. CONCLUSIONS: This is the first study examining the activity specific and isotemporal associations of daily behaviors (considering body postures and movements) with overall and abdominal obesity in older people. The results could be used in the development of specific recommendations encouraging an active lifestyle in older people.

Muscle Fitness Cut Points for Early Assessment of Cardiovascular Risk in Children and Adolescents.

OBJECTIVES: To study the cross-sectional and longitudinal (2-year follow-up) association between muscle fitness and cardiovascular disease (CVD) risk factors in youth; whether there are muscle fitness cut points associated with CVD risk (cross-sectional); and whether the health-related muscle fitness cut points identified at baseline are associated with CVD risk 2 years later. STUDY DESIGN: In total, 237 children (110 girls) aged 6-10 years and 274 adolescents (131 girls) aged 12-16 years with complete data were included in the study (10.3% drop out). The handgrip strength and the standing long jump tests were used to assess muscle fitness. CVD risk score was computed with sum of 2 skinfolds, systolic blood pressure, insulin, glucose, triglycerides, and total cholesterol/high density lipoprotein cholesterol. RESULTS: Muscle fitness at baseline was associated inversely with single CVD risk factors and CVD risk score at baseline and 2-year follow-up (all P < .05). Receiver operating characteristics curve analyses showed a significant discriminating accuracy of handgrip strength in identifying CVD risk in children and adolescents (boys: ≥ 0.367 and ≥0.473; girls: ≥ 0.306 and ≥0.423 kg/kg body mass, respectively, all P < .001). Similarly, the standing long jump cut points for children and adolescents were ≥104.5 and ≥140.5 in boys, and ≥81.5 and ≥120.5 cm in girls, respectively (all P < .05). These cut points were associated with CVD risk 2 years later (all P < .01). CONCLUSIONS: Muscle fitness is associated with present and future cardiovascular health in youth, and is independent of cardiorespiratory fitness. It should be monitored to identify youth at risk who could benefit from intervention programs.

Changes in compliance with school-based physical activity recommendations in Spanish youth: The UP&DOWN longitudinal study.

The study aimed (a) to examine changes in physical activity (PA) during the whole day, school hours, recess, and physical education classes (PEC) during a 2-year period in primary and secondary students; (b) to identify changes in the proportion of compliance with specific PA recommendations for these periods; and (c) to examine whether PA levels at baseline are associated with PA levels 2 years later. Eight hundred and fourteen (51.8% boys) children and 658 (50.1% boys) adolescents from 41 Spanish schools participated in the study. Hip-worn accelerometers were used to assess PA during different time periods. Light PA (LPA) declined during the whole day, school hours, recess (all P < 0.001, except child girls for recess), and PEC (all, P < 0.05) in children and adolescents. Moderate-to-vigorous PA (MVPA) during the whole day and recess declined in child boys (P < 0.01 and P < 0.001, respectively) and adolescent boys (P < 0.001 and P < 0.05, respectively). MVPA during PEC declined in adolescent boys (P < 0.001) and adolescent girls (all P < 0.05). The proportion of compliance with the specific PA recommendations for these periods declined (P < 0.05), except for PEC in adolescent girls. PA during the whole day at baseline was moderately associated with PA during the whole day years later (ICCs = 0.210-0.544, with one exception), but this association was lower for the school-based PA. In conclusion, time spent in MVPA and LPA during the whole day and recess declined over time in child and adolescent boys and during PEC in adolescents. These findings highlight the need to promote PA interventions in these settings.

Associations of total sedentary time, screen time and non-screen sedentary time with adiposity and physical fitness in youth: the mediating effect of physical activity.

The aims of the present study were: i) to examine the associations of total accelerometer-based sedentary time (ST) and specific-domain self-reported ST (i.e., screen-based, educational-based, social-based, and other-based ST) with adiposity and physical fitness in youth; and ii) to analyse the mediation effect of physical activity (PA) on associations. This study was conducted with 415 children (9.1 ± 0.4 years) and 853 adolescents (13.6 ± 1.6 years) in Spain during 2011-2012. Total ST and PA were assessed by accelerometry. Leisure-time spent in twelve sedentary behaviours was self-reported. Adiposity and physical fitness was measured following the ALPHA battery for youth. Total accelerometer-based ST was positively associated with global adiposity score in children, and negatively associated with global physical fitness score in children and adolescents; but relationships were not independent of PA. PA mediated all associations of accelerometer-based and self-reported ST with adiposity or physical fitness in children. Conversely, screen-, educational-, social-, and other-based ST were negatively related to physical fitness in adolescents, independently of PA. These findings give an impetus to developing effective strategies for specifically promoting PA in children and for increasing PA while reducing ST in adolescents in order to produce improvements on adiposity and physical fitness.

A longitudinal perspective of eating disorder risk in immigrant and Spanish native adolescents: The longitudinal up & down study.

OBJECTIVES: Previous research has postulated immigrant status as a relevant factor influencing eating disorder (ED) risk in adolescents. The present study assesses differences by sex in ED risk between Spanish native and immigrant adolescent populations residing in Spain and analyzes longitudinal differences in ED risk between immigrant and native adolescents over 2-year follow-up. METHOD: The study sample was 981 adolescents aged 11-19 years at baseline. ED risk was evaluated using the Spanish version of the SCOFF Questionnaire. Logistic regression was used to value associations between country of origin and ED risk prevalence by sex, as well as changes in ED risk at 2-year follow-up. RESULTS: Immigrant adolescent girls and boys presented greater ED risk than their Spanish counterparts. Prospective analyses showed that immigrant boys presented greater likelihood of acquiring ED risk over 2 years compared to Spanish adolescent boys. CONCLUSION: Immigrant adolescent populations, particularly boys, seem to be vulnerable to ED. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Lifestyle Clusters in School-Aged Youth and Longitudinal Associations with Fatness: The UP&DOWN Study.

OBJECTIVES: To identify lifestyle clusters in children and adolescents, to analyze associations between lifestyle clusters and body fat percentage (BFP) at baseline and 2 years later, and to examine if BFP at baseline is associated with BFP 2 years later. STUDY DESIGN: This longitudinal study involved 1634 Spanish youth (804 girls) aged 8-18 years (mean, 12.45 ± 2.51 years). Cluster analysis was performed by including objectively measured sedentary time and physical activity and self-reported screen time and diet. The associations between cluster membership and BFP was analyzed through general linear models. All the analyses were separated by 3 age groups: older children, younger adolescents, and older adolescents. RESULTS: Four clusters were identified in the 3 age groups: (1) healthy lifestyle cluster (high moderate-to-vigorous physical activity, low screen and total sedentary time), (2) predominantly sedentary cluster, (3) mainly screen time consumers cluster, and (4) nonhealthy lifestyle cluster (predominantly low moderate-to-vigorous physical activity and unhealthy diet). Participants belonging to the healthy lifestyle cluster showed significantly lower BFP at baseline and 2 years later compared with the other profiles. These differences remained significant when adjusted by BFP at baseline within the younger adolescents. Moreover, BFP at baseline positively predicted BFP 2 years later in all groups. CONCLUSIONS: These findings identify distinct lifestyle patterns. These clusters could be useful to develop interventions to reduce overweight and obesity in children and adolescents.

Association between Clustering of Lifestyle Behaviors and Health-Related Physical Fitness in Youth: The UP&DOWN Study.

OBJECTIVES: To examine clustering of lifestyle behaviors in Spanish children and adolescents based on screen time, nonscreen sedentary time, moderate-to-vigorous physical activity, Mediterranean diet quality, and sleep time, and to analyze its association with health-related physical fitness. STUDY DESIGN: The sample consisted of 1197 children and adolescents (597 boys), aged 8-18 years, included in the baseline cohort of the UP&DOWN study. Moderate-to-vigorous physical activity was assessed by accelerometry. Screen time, nonscreen sedentary time, Mediterranean diet quality, and sleep time were self-reported by participants. Health-related physical fitness was measured following the Assessing Levels of Physical Activity battery for youth. A 2-stage cluster analysis was performed based on the 5 lifestyle behaviors. Associations of clusters with fatness and physical fitness were analyzed by 1-way ANCOVA. RESULTS: Five lifestyle clusters were identified: (1) active (n = 171), (2) sedentary nonscreen sedentary time-high diet quality (n = 250), (3) inactive-high sleep time (n = 249 [20.8%]), (4) sedentary nonscreen sedentary time-low diet quality (n = 273), and (5) sedentary screen time-low sleep time (n = 254). Cluster 1 was the healthiest profile in relation to health-related physical fitness in both boys and girls. In boys, cluster 3 had the worst fatness and fitness levels, whereas in girls the worst scores were found in clusters 4 and 5. CONCLUSIONS: Clustering of different lifestyle behaviors was identified and differences in health-related physical fitness were found among clusters, which suggests that special attention should be given to sedentary behaviors in girls and physical activity in boys when developing childhood health prevention strategies focusing on lifestyles patterns.

Physical activity attenuates the impact of poor physical, mental, and social health on total and cardiovascular mortality in older adults: a population-based prospective cohort study.

PURPOSE: To examine the separate and joint associations of physical activity and levels of physical, mental, and social health with long-term all-cause and cardiovascular disease (CVD) mortality in older adults. METHODS: A cohort of 4008 individuals representative of the non-institutionalized population of Spain aged 60 years and older was analyzed. Information on physical activity was self-reported. Physical and mental health were assessed with the SF-36 questionnaire, and social health with a 4-item score on network structure and social engagement. Participants were categorized as being in a good, intermediate, or poor health according to tertiles of the score in each health dimension. Analyses were performed with Cox regression and adjusted for main confounders, including levels in the other two health dimensions. RESULTS: Over a median follow-up of 14 years, a total of 1811 deaths occurred, 674 due to CVD. Hazard ratios (95% confidence interval) for all-cause mortality were 1.35 (1.18-1.55), 1.18 (1.02-1.36), and 1.37 (1.18-1.58) for poor vs. good physical, mental, and social health, respectively (all p trend < 0.001). Being physically active was associated with a 28% (15-39%), 31% (19-42%), and 19% (5-31%) lower all-cause mortality in participants with poor physical, mental, and social health, respectively. In each health dimension, physically active individuals with poor health showed a similar or lower all-cause mortality than those who had intermediate or good health but were physically inactive. Results for CVD mortality were similar to those for all-cause death. CONCLUSIONS: Physical activity might attenuate the excess all-cause and CVD mortality associated with poor physical, mental, and social health.