Negative associations between step-up height and waist circumference in 8-year-old children and their parents.

AIM: To study cross-sectional relationships between step-up height and waist circumference (WC), a potential proxy for sarcopenic obesity, in Swedish children and parents. METHODS: Participants were recruited from Swedish schools in disadvantaged areas in 2017. Height, body weight, WC and maximal step-up height were measured in 67 eight-year-old children and parents: 58 mothers, with a mean age of 38.5 and 32 fathers, with a mean age of 41.3. Sedentary time and physical activity were registered by an accelerometer. Associations between maximal step-up height and WC were analysed using Pearson's correlation and adjusted linear regression. RESULTS: Abdominal obesity, WC ≥ 66 centimetres (cm) in children, ≥88 cm in women and ≥102 cm in men, was observed in 13% and 35% of girls and boys, and in 53% and 34% among mothers and fathers, respectively. Negative associations between maximal step-up height and WC were found for children (r = -0.37, p = 0.002) and adults (mothers r = -0.58, p < 0.001, fathers r = -0.48, p = 0.006). The associations remained after adjustments for height, body mass index (BMI) and physical activity in adults. Reduced muscle strength clustered within families (r = 0.54, p < 0.001). CONCLUSION: Associations between reduced muscle strength and abdominal obesity were observed in children and parents. Sarcopenic obesity may need more attention in children. Our findings support family interventions.

"We were all together"- families' experiences of the health-promoting programme - A Healthy Generation.

BACKGROUND: Healthy lifestyle habits, including physical activity (PA), are associated with a broad range of positive psychosocial and physical health benefits. However, there are challenges involved in reaching vulnerable groups in socioeconomically disadvantaged areas. There is a lack of research on family-based PA interventions, specifically considering psychosocial health. The purpose of this study was to explore how families experienced psychosocial aspects of health after participation in a family-based programme, A Healthy Generation. METHODS: A Healthy Generation is a health-promoting, family-based programme delivered in collaboration with local municipalities and sport associations in socioeconomically disadvantaged areas in Sweden. Families with children in grade 2 (8-9 years), including siblings, participate in health-promoting activities, including activity sessions, healthy meals, health information and parental support groups. Data was collected through interviews with parents and children (n = 23) from a controlled pilot trial of the programme. Interviews were audio recorded, transcribed and analysed using a phenomenological hermeneutical method. RESULTS: Three themes and seven sub-themes emerged. The themes were: "A sense of belonging", "Awareness of one's role as a parent" and "Inspiration towards new and healthier behaviours". In terms of A sense of belonging, participation in the programme was the families own free zone, where they also had the opportunity of being together with other families in the programme. For participants that were isolated and lacked a social network, their participation helped them towards social participation. During the programme, parents created an Awareness of one's role as a parent, with new insights on how to act as a parent and they also negotiated differences between each other. Participation in the programme contributed to Inspiration towards new and healthier behaviours such as experience-based insights and healthy lifestyle changes. CONCLUSIONS: This study highlights the importance of co-participation in family-based health-promoting programmes to enhance psychosocial health among families in socioeconomically disadvantaged areas. The results give new insights into participants' experiences of psychosocial aspects of health after participation in a family-based PA programme. This knowledge can contribute to the understanding of how to design health-promoting, family-based interventions to promote psychosocial health in socioeconomically disadvantaged areas. TRIAL REGISTRATION: ISRCTN ISRCTN11660938 . Retrospectively registered 23 September 2019.

Effectiveness of a family intervention on health-related quality of life-a healthy generation, a controlled pilot trial.

BACKGROUND: Physical activity is associated with better health, but knowledge about health promoting interventions, including physical activity for families in disadvantaged areas and the impact on health-related quality of life (HRQOL) is sparse. The aim of this study was to assess HRQOL in children and their parents after participation in the programme "A Healthy Generation". METHODS: The programme is delivered in socioeconomically disadvantaged areas in Sweden and offers physical activity and a healthy meal or fruit twice a week from August to May to families with children in grade 2. Children (n = 67), aged 8-9 years, and their parents (n = 90) participated in this controlled study conducted in four schools, two control and two intervention schools. HRQOL of children and adults was assessed at baseline and follow-up after the intervention with the Pediatric Quality of Life Inventory (PedsQL) 4.0 and the Gothenburg Quality of Life scale, respectively. Analyses of covariance (ANCOVAs), linear regression and Pearson's correlation were conducted. RESULTS: There were no significant differences between intervention and control in HRQOL among children or adults after the intervention. However, in a subgroup of children (n = 20) and adults (n = 29) with initial low HRQOL scores at baseline, there was a significant difference between the intervention group and control group after the intervention (children (total score): p = 0.02; adults (social domain) p = 0.04). Furthermore, within the intervention group, there was a significant relationship between level of participation in "A Healthy Generation" and the physical domain of HRQOL among girls (r = 0.44, p = 0.01), but not boys (r = - 0.07, p = 0.58). CONCLUSION: Participation in the programme "A Healthy Generation" did not show a significant intervention effect on HRQOL in general. However, the findings suggest that HRQOL may be increased for children and adults with low HRQOL in disadvantaged areas. This knowledge can contribute to the development of health promoting interventions in such areas, and to more equitable health. TRIAL REGISTRATION: ISRCTN ISRCTN11660938. Retrospectively registered 23 September 2019.

Effectiveness of a Family Intervention to Increase Physical Activity in Disadvantaged Areas-A Healthy Generation, a Controlled Pilot Study.

There are large social inequalities in health. The purpose of this study was to evaluate the effects of a family intervention on physical activity (PA) and sedentary time (ST) in children and their parents. In this controlled pilot study, all 8-9-year-old children from four schools from a socioeconomically disadvantaged area in Sweden were invited and 67 children and 94 parents were included. The intervention was run by a foundation in co-operation with the municipality. The 9-month program included: (1) activity sessions, (2) healthy meals, (3) health information and (4) parental support groups. PA was primary outcome and ST was secondary outcome, measured by accelerometry. In total, 40 of the children (60%) and 45 of the adults (50%) had at least one day of valid accelerometer data at both baseline and follow-up. Significant intervention effects for the whole group were found in total PA (p = 0.048, mean difference (MD) intervention/control 150 counts per minute) and in vigorous PA (p = 0.02, MD 8 min/day) during the weekends. There were no differences between groups in the other PA variables or ST. This pilot study shows that it is possible to influence PA in families from a disadvantaged area through a family program.

Physical activity patterns measured by accelerometry in 6- to 10-yr-old children.

PURPOSE: To examine differences in patterns of objectively measured physical activity (PA) among weekdays and weekend days and across different time blocks during the day in relation to age and gender. This knowledge is important when planning preventive initiatives aimed at increasing levels of PA in children. METHODS: This is a cross-sectional analysis in 653 girls and 640 boys (6-10 yr) measured during 1 wk with accelerometry. Periods of the day were divided into school time (8:00 a.m. to 1:30 p.m.), after school care time (1:30-4:00 p.m.), and evening time (4:00-9:00 p.m.). Multivariate ANOVA was used to analyze mean PA. RESULTS: Mean daily PA differed significantly across age groups (6-10 yr) in both boys and girls (P < 0.001). Mean (SE) daily PA was significantly lower during weekends compared with weekdays in all age groups (girls 782 (6.7) vs 681 (7.7) counts per min (CPM), P < 0.001; boys 853 (7.1) vs 729 (8.0) CPM, P < 0.001). This decline was similar across low, medium, and highly active children. Mean PA was highest during after school care time on weekdays (girls 879 (9.8) and boys 990 (10.0) CPM) compared with all other periods. The difference in mean PA between boys and girls was highest during school time (P < 0.001) and after school care time (P < 0.001). CONCLUSIONS: The decline in PA in children may start already at the age of 6 yr. The school setting may be an important arena for targeting activity levels in girls because the difference in PA levels between girls and boys is most pronounced during school time. In both girls and boys, PA levels are disproportionally low during weekends and might be important targets for interventions aimed to increase PA.