How to design and establish a national school-based physical fitness monitoring and surveillance system for children and adolescents: A 10-step approach recommended by the FitBack network.

BACKGROUND: Providing individual- and population-level data on children's physical fitness (PF) is a crucial public health and education priority. However, few national fitness monitoring or surveillance systems are currently in practice internationally. We aim to summarize the current European PF monitoring and surveillance systems for school-aged children and to provide experience-based guidelines on how to design such systems. METHODS: The FitBack network consists of experts from diverse backgrounds with the common interest to improve the accessibility of PF monitoring for young people globally. Through FitBack network, we identified and compared the national or regional PF monitoring and surveillance systems currently in operation across Europe. We formulated a 10-step approach for designing and establishing one's own system, based on analysis of experienced strengths, weaknesses, opportunities, and threats to monitoring childhood fitness. RESULTS: We identified a total of eight PF monitoring systems in Finland, France, Galicia of Spain, Hungary, Lithuania, Portugal, Serbia, and Slovenia. The FitBack network recommends the following steps for designing and establishing one's own system: (1) set up mission statements and aims, (2) involve stakeholders, (3) utilize scientific background, (4) governance structure, (5) ensure sufficient funding, (6) data management planning, (7) provide meaningful feedback, (8) conduct pilot testing, (9) plan implementation process, and (10) invest in communication with stakeholders. CONCLUSIONS: This study provides an updated overview of the best practices for school-aged children's fitness monitoring and surveillance in Europe. Additionally, it offers a 10-step approach to assist in the creation of similar systems in Europe or globally.

Study protocol for the ACTIVE SCHOOL study investigating two different strategies of physical activity to improve academic performance in Schoolchildren.

BACKGROUND: Previous research has suggested that school-based physical activity (PA) interventions may have a positive impact on academic performance. However, existing literature on school-based interventions encompasses various forms of PA, spanning from vigorous intensity PA outside the academic classes to light intensity PA and movement integrated into academic learning tasks, and results on academic performance are inconclusive. ACTIVE SCHOOL will implement two different PA interventions for one school year and assess the effects on the pupils' academic performance, with math performance as the primary outcome. METHODS/DESIGN: The ACTIVE SCHOOL project consists of two phases: 1) Development phase and 2) Randomized Controlled Trial (RCT). In phase one, two interventions were developed in collaboration with school staff. The two interventions were tested in an 8-weeks feasibility study. In phase two, a RCT-study with three arms will be conducted in 9-10-year-old children for one school year. The RCT-study will be carried out in two intervention rounds during the school years 2023/2024 and 2024/2025. Schools will be randomized to one of two interventions or control;1) Run, Jump & Fun intervention (4 × 30 min/week of moderate-to-vigorous physical activity; 2) Move & Learn intervention (4 × 30 min/week focusing on embodied learning in math and Danish lessons); or 3) a control condition, consisting of normal teaching practices. Outcome measures include academic performance, PA level, cognitive functions, cardiorespiratory fitness, anthropometry, well-being and school motivation (collected before, during and after the intervention period). A process evaluation will be conducted to assess implementation. DISCUSSION: The ACTIVE SCHOOL study will expand knowledge regarding the impact of PA on academic performance. The study will have the potential to significantly contribute to future research, as well as the scientific and educational debate on the best way to implement PA to support education and learning. TRIAL REGISTRATION: The study was registered on the 25th of October 2022 in ClinicalTrials.gov, NCT05602948.

Associations Between Sedentary Time, Physical Activity, and Cardiovascular Health in 6-Year-Old Children Born to Mothers With Increased Cardiometabolic Risk.

PURPOSE: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. METHOD: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48-70 MHz vascular ultrasound, and accelerometery. RESULTS: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (ß = -6.6; 95% confidence interval, -12.5 to -0.7) and positively associated with left ventricular mass (ß = 6.8; 1.4-12.3), radial intima-media thickness (ß = 11.4; 5.4-17.5), brachial intima-media thickness (ß = 8.0; 2.0-14.0), and femoral intima-media thickness (ß = 1.3; 0.2-2.3). MVPA was inversely associated with body fat percentage (ß = -3.4; -6.6 to -0.2), diastolic blood pressure (ß = -0.05; -0.8 to -0.1), and femoral (ß = -18.1; -32.4 to -0.8) and radial (ß = -13.4; -24.0 to -2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. CONCLUSIONS: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood.

Parenthood and changes in physical activity from early adulthood to mid-life among Finnish adults.

This study examined longitudinal associations between parenthood-related factors and physical activity from young adulthood to midlife over a 19-year follow-up period. Participants (n = 761) at the ongoing Cardiovascular Risk in Young Finns Study responded to a self-report questionnaire in their adulthood (in 1992, 2001, 2007, and 2011). Participants were classified as meeting or not meeting an aerobic physical activity recommendation. Parenthood-related factors included the age of having their first child and the number and age of the children. Analyses of generalized estimation equations were performed and adjusted for several demographic and health-related covariates. Both mothers and fathers with children under 6 years were less likely to be involved in physical activity than participants without children. However, meeting the aerobic physical activity recommendations did not differ between parents with a youngest child who was 6 years old or older as compared to the childless participants. The older the youngest child was, the more likely the parents were to be physically active. Participants who became a parent relatively late, at the age of 30 or older, seemed less likely to meet the aerobic physical activity recommendation during follow-up than those who had their first child at the age of 26-29. The results indicate that parenthood does not seem to have a long-lasting negative impact on adults' physical activity, and the individuals reached a similar level of physical activity in midlife than they had before parenthood.

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network.

OBJECTIVES: (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. METHODS: This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. RESULTS: A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). CONCLUSION: This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Metabolic health, menopause, and physical activity-a 4-year follow-up study.

BACKGROUND: In women, metabolic health deteriorates after menopause, and the role of physical activity (PA) in mitigating the change is not completely understood. This study investigates the changes in indicators of metabolic health around menopause and evaluates whether PA modulates these changes. METHODS: Longitudinal data of 298 women aged 48-55 years at baseline participating in the ERMA and EsmiRs studies was used. Mean follow-up time was 3.8 (SD 0.1) years. Studied indicators of metabolic health were total and android fat mass, waist circumference, waist-to-hip ratio (WHR), systolic (SBP) and diastolic (DBP) blood pressure, blood glucose, triglycerides, serum total cholesterol, and high- (HDL-C) and low-density (LDL-C) lipoprotein cholesterol. PA was assessed by accelerometers and questionnaires. The participants were categorized into three menopausal groups: PRE-PRE (pre- or perimenopausal at both timepoints, n = 56), PRE-POST (pre- or perimenopausal at baseline, postmenopausal at follow-up, n = 149), and POST-POST (postmenopausal at both timepoints, n = 93). Analyses were carried out using linear and Poisson mixed-effect models. RESULTS: At baseline, PA associated directly with HDL-C and inversely with LDL-C and all body adiposity variables. An increase was observed in total (B = 1.72, 95% CI [0.16, 3.28]) and android fat mass (0.26, [0.06, 0.46]), SBP (9.37, [3.34, 15.39]), and in all blood-based biomarkers in the PRE-POST group during the follow-up. The increase tended to be smaller in the PRE-PRE and POST-POST groups compared to the PRE-POST group, except for SBP. The change in PA associated inversely with the change in SBP (-2.40, [-4.34, -0.46]) and directly with the change in WHR (0.72, [0.05, 1.38]). CONCLUSIONS: In middle-aged women, menopause may accelerate the changes in multiple indicators of metabolic health. PA associates with healthier blood lipid profile and body composition in middle-aged women but does not seem to modulate the changes in most of the studied metabolic health indicators during the menopausal transition.

Associations of parental physical activity trajectories with offspring's physical activity patterns from childhood to middle adulthood: The Young Finns Study.

We investigated the association of parental physical activity (PA) trajectories with offspring's youth and adult PA. Self-reported PA data were extracted from the Young Finns Study with three follow-ups for parents between 1980 and 1986 and nine follow-ups for their offspring in youth between 1980 and 2011 (aged 9-39 years, n = 2402) and in adulthood in 2018. Accelerometer-derived PA was quantified in 2018-2020 (aged 43-58 years, n = 1134). Data were analyzed using mixture models and conducted in 2022. We identified three trajectories for fathers and mothers (high-stable activity, 20.2%/16.6%; moderate-stable activity, 50.5%/49.6%; and low-stable activity, 29.4%/33.7%) and four for youth male and female offspring (persistently active, 13.4%/5.1%; increasingly active, 32.1%/43.1%; decreasingly active, 14.4%/12.6%; and persistently low-active, 40.1%/39.1%). Compared to low-stable active parents, high-stable active fathers had a higher probability of having their sons and daughters classified as persistently active, increasingly active, and decreasingly active in youth (Brange = 0.50-1.79, all p < 0.008), while high- and moderate-stable active mothers had significantly increased likelihood of having their daughters classified as persistently active and decreasingly active in youth (Brange = 0.63-1.16, all p < 0.009). Fathers' and mothers' high-stable activity was associated with higher self-reported PA of adult offspring than parental low-stable activity. Persistently active and increasingly active offspring in youth accumulated more adult total PA, moderate-to-vigorous PA, step counts, and self-reported PA than persistently low-active ones (all p < 0.036). Parental persistent PA, particularly paternal persistent PA, predicts offspring's PA concurrently and prospectively. Increasing and maintaining PA in youth predicts higher PA levels in midlife.

Associations of resting and peak fat oxidation with sex hormone profile and blood glucose control in middle-aged women.

BACKGROUND AND AIMS: Menopause may reduce fat oxidation. We investigated whether sex hormone profile explains resting fat oxidation (RFO) or peak fat oxidation (PFO) during incremental cycling in middle-aged women. Secondarily, we studied associations of RFO and PFO with glucose regulation. METHOD AND RESULTS: We measured RFO and PFO of 42 women (age 52-58 years) with indirect calorimetry. Seven participants were pre- or perimenopausal, 26 were postmenopausal, and nine were postmenopausal hormone therapy users. Serum estradiol (E2), follicle-stimulating hormone, progesterone, and testosterone levels were quantified with immunoassays. Insulin sensitivity (Matsuda index) and glucose tolerance (area under the curve) were determined by glucose tolerance testing. Body composition was assessed with dual-energy X-ray absorptiometry; physical activity with self-report and accelerometry; and diet, with food diaries. Menopausal status or sex hormone levels were not associated with the fat oxidation outcomes. RFO determinants were fat mass (ß = 0.44, P = 0.006) and preceding energy intake (ß = -0.40, P = 0.019). Cardiorespiratory fitness (ß = 0.59, P = 0.002), lean mass (ß = 0.49, P = 0.002) and physical activity (self-reported ß = 0.37, P = 0.020; accelerometer-measured ß = 0.35, P = 0.024) explained PFO. RFO and PFO were not related to insulin sensitivity. Higher RFO was associated with poorer glucose tolerance (ß = 0.52, P = 0.002). CONCLUSION: Among studied middle-aged women, sex hormone profile did not explain RFO or PFO, and higher fat oxidation capacity did not indicate better glucose control.

Physical activity and health-related quality of life among high-risk women for type 2 diabetes in the early years after pregnancy.

BACKGROUND: Previous studies have shown that physical activity (PA) correlates positively with health-related quality of life (HRQoL) in the general population. Few studies have investigated associations between device-measured PA and HRQoL among premenopausal women at risk for type 2 diabetes (T2D). In addition to physical well-being, general well-being improved by PA has been suggested to strengthen PA's benefits in reducing metabolic diseases. The aim of this study was to examine the associations between PA and HRQoL (general and dimensions) among high-risk women in the early post-pregnancy years when T2D risk is highest and to estimate whether current obesity or prior gestational diabetes (GDM) modified these associations. METHODS: This cross-sectional study of high-risk women [body mass index (BMI) ≥ 30 kg/m2 and/or prior GDM)]4-6 years after delivery measured sleep, sedentary time, daily steps, and light (LPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) with the SenseWear ArmbandTM accelerometer for seven days and HRQoL with the 15D instrument. RESULTS: The analyses included 204 women with a median (IQR) age of 39 (6.0) years and a median BMI of 31.1 kg/m2 (10.9). 54% were currently obese (BMI ≥ 30 kg/m2), and 70% had prior gestational diabetes (GDM+). Women with obesity had lower PA levels than women with normal weight or overweight (p < 0.001) but there was no difference between the GDM+ or GDM- women. Women with both current obesity and GDM+ had highest sedentary time and lowest PA levels. The whole sample's median 15D score was 0.934 (IQR 0.092), lower among women with obesity compared to the others (p < 0.001), but not different between GDM+ or GDM-. There was a positive correlation between VPA (adjusted rs = 0.262 p = 0.001) and the 15D score. After grouping according to BMI (< and ≥ 30 kg/m2), the associations remained significant only in women without obesity. Among them, sleep, total steps, MVPA, and VPA were positively associated with 15D. CONCLUSIONS: Higher PA levels are associated with better HRQoL among high-risk women with normal weight and overweight but no differences were found among women affected by obesity in the early years after pregnancy. Trial registration Ethics committees of Helsinki University Hospital (Dnro 300/e9/06) and South Karelian Central Hospital (Dnro 06/08).

Longitudinal associations between parental and offspring's leisure-time physical activity: The Young Finns Study.

PURPOSE: The longitudinal influence of parental leisure-time physical activity (LTPA) on their offspring's LTPA is poorly understood. This study examined the longitudinal associations between parental LTPA and offspring's LTPA at two-time intervals. METHOD: Child (offspring) participants (N = 3596) were enrolled from the Cardiovascular Risk in Young Finns Study in 1980. Their LTPA was self-rated through nine phases from baseline to 2018 and categorized by year into youth (1980-1986) and adult (1992-2018) LTPA. Parental LTPA was assessed with a single self-reported question at three phases from 1980 to 1986. Latent growth curve modeling stratified by gender was fitted to estimate the potential pathways between parental LTPA and offspring's youth and adult LTPA. RESULTS: Higher initial levels of paternal and maternal LTPA were independently associated with greater initial levels of youth and adult LTPA of offspring in both genders, respectively, except maternal LTPA, which did not associate with male offspring's adult LTPA. The initial levels of paternal LTPA were directly related to changes in male offspring's youth LTPA after adjusting for age, residential place, paternal education and occupation, having siblings, and offspring's body mass index. CONCLUSION: Our study demonstrates that the initial levels of parental LTPA are directly linked to the initial levels of offspring's LTPA during youth and adulthood, while changes in parental LTPA are unrelated to changes in offspring's youth and adult LTPA for either gender over time. These results imply that higher initial levels of LTPA in parents may serve as a predictor of offspring's LTPA across life stages.

Behaviours that prompt primary school teachers to adopt and implement physically active learning: a meta synthesis of qualitative evidence.

BACKGROUND: Physically active learning (PAL) - integration of movement within delivery of academic content - is a core component of many whole-of-school physical activity approaches. Yet, PAL intervention methods and strategies vary and frequently are not sustained beyond formal programmes. To improve PAL training, a more comprehensive understanding of the behavioural and psychological processes that influence teachers' adoption and implementation of PAL is required. To address this, we conducted a meta-synthesis to synthesise key stakeholders' knowledge of facilitators and barriers to teachers' implementing PAL in schools to improve teacher-focussed PAL interventions in primary (elementary) schools. METHODOLOGY: We conducted a meta-synthesis using a five-stage thematic synthesis approach to; develop a research purpose and aim, identify relevant articles, appraise studies for quality, develop descriptive themes and interpret and synthesise the literature. In the final stage, 14 domains from the Theoretical Domain Framework (TDF) were then aligned to the final analytical themes and subthemes. RESULTS: We identified seven themes and 31 sub-themes from 25 eligible papers. Four themes summarised teacher-level factors: PAL benefits, teachers' beliefs about own capabilities, PAL teacher training, PAL delivery. One theme encompassed teacher and school-level factors: resources. Two themes reflected school and external factors that influence teachers' PAL behaviour: whole-school approach, external factors. Ten (of 14) TDF domains aligned with main themes and sub-themes: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Goals, Environmental Context and Resources, Social influences and Emotion. CONCLUSIONS: Our synthesis illustrates the inherent complexity required to change and sustain teachers' PAL behaviours. Initially, teachers must receive the training, resources and support to develop the capability to implement and adapt PAL. The PAL training programme should progress as teachers' build their experience and capability; content should be 'refreshed' and become more challenging over time. Subsequently, it is imperative to engage all levels of the school community for PAL to be fully integrated into a broader school system. Adequate resources, strong leadership and governance, an engaged activated community and political will are necessary to achieve this, and may not currently exist in most schools.

Physical inactivity from youth to adulthood and adult cardiometabolic risk profile.

Adults with a low physical activity (PA) level are at increased risk for cardiometabolic diseases, but little is known on the association between physical inactivity since youth and cardiometabolic health in adulthood. We investigated the association of persistent physical inactivity from youth to adulthood with adult cardiometabolic risk factors. Data were drawn from the ongoing Cardiovascular Risk in Young Finns Study with seven follow-ups between 1980 and 2011 (baseline age 3-18 years, n = 1961). Physical activity data from a standardized questionnaire was expressed as a PA-index. Using the PA-index, four groups were formed: 1)persistently physically inactive (n = 246), 2)decreasingly active (n = 305), 3)increasingly active (n = 328), and 4)persistently active individuals (n = 1082). Adulthood cardiometabolic risk indicators included waist circumference, body mass index (BMI), blood pressure, and fasting lipids, insulin, and glucose. Clustered cardiometabolic risk was defined using established criteria for metabolic syndrome. Persistently physically inactive group was used as a reference. Compared to the persistently physically inactive group, those who were persistently active had lower risk for adult clustered cardiometabolic risk (RR = 0.67;CI95% = 0.53-0.84; Harmonized criteria), obesity (BMI > 30 kg/m2, RR = 0.76;CI95% = 0.59-0.98), high waist circumference (RR = 0.82;CI95% = 0.69-0.98), and high triglyceride (RR = 0.60;CI95% = 0.47-0.75), insulin (RR = 0.58;CI95% = 0.46-0.74) and glucose (RR = 0.77;CI95% = 0.62-0.96) concentrations as well as low high-density lipoprotein cholesterol (HDLC) concentration (RR = 0.78;CI95% = 0.66-0.93). Comparable results were found when persistently physically inactive individuals were compared with those who increased PA. The results remained essentially similar after adjustment for education, diet, smoking, and BMI. Persistently physically inactive lifestyle since youth is associated with an unfavorable cardiometabolic risk profile in adulthood. Importantly, even minor increase in PA lowers the cardiometabolic risk.

Childhood physical activity as a labor market investment.

This study examined the role of physical activity and changes in physical activity levels during childhood in long-term labor market outcomes. To address this important but under-researched theme, the study utilized data drawn from longitudinal research, the Cardiovascular Risk in Young Finns Study (YFS), and from registries compiled by Statistics Finland. The study consisted of children aged 9 (n = 1565) and 15 (n = 2445) at the time their physical activity was measured. Labor market outcomes, including employment status, average employment months, and average unemployment months, were calculated from 1997 to 2010, when the participants were aged 20 to 48 years. Regression models were used to assess the relationship between physical activity and labor market outcomes. The results show that the consequences of childhood physical activity may be far-reaching, as higher childhood physical activity was positively related to the probability of being employed and employment months and was negatively related to unemployment months. On average, a one-unit increase in physical activity index was related to a 1% higher probability of being employed, 0.10 more months of yearly employment, and 0.05 fewer months of yearly unemployment. The results also imply that persistently active individuals had the highest level of employment and the lowest level of unemployment compared with other activity groups. In conclusion, investments in childhood physical activity may not only promote health and well-being but may also correlate with better labor market outcomes later in life, providing both personal and societal benefits.

How physical activity, fitness, and motor skills contribute to math performance: Working memory as a mediating factor.

PURPOSE: The purpose of this study was to examine whether physical activity, fitness, and motor skills have an indirect association with math performance via cognitive outcomes and if so, through which aspects of cognition? METHODS: This study comprised 311 6th-9th grade adolescents (12-17 years [M age = 14.0 years], 59% girls) from seven schools throughout Finland in 2015. Math performance was measured via a teacher-rated math achievement and the Basic Arithmetic test. Cognitive functions were measured by broad cognitive test battery. Physical activity was assessed with a self-reported questionnaire and a hip-worn accelerometer. Aerobic fitness was estimated using a maximal 20-m shuttle run test, muscular fitness with curl-up and push-up tests, and motor skills with a 5-leaps test and a throwing-catching combination test. Structural equation modeling was applied to examine the associations. RESULTS: In both boys and girls, motor skills had a positive indirect association with math outcomes through visuospatial working memory. Among girls, muscular fitness had a positive indirect association with math outcomes through visuospatial working memory. Aerobic fitness was positively associated with math achievement, but the indirect path via cognition was not observed. Self-reported physical activity had a borderline indirect positive association with math outcomes through visuospatial working memory. Accelerometer-based physical activity did not correlate with math performance. CONCLUSION: Motor skills and muscular fitness had indirect positive associations with math performance, mediated by visuospatial working memory. The results give support to the viewpoints that the connections between motor skills, fitness, and physical activity to academic skills are mediated via specific cognitive skills.

Physical fitness development in relation to changes in body composition and physical activity in adolescence.

The decline in adolescents' physical fitness (PF) in recent decades has raised concerns about current population's possible future challenges with health and physical functional capacity. This study explored the associations between body composition, physical activity, maturation, and PF development in adolescents. Furthermore, PF development of adolescents with low initial PF was assessed. A 2-year observational study was conducted between spring 2013 and 2015. Nine comprehensive schools and their 10- to 13-year-old students were invited to participate in the study (1778), and a total of 971 students (54.6%) agreed. Cardiorespiratory fitness (20-meter shuttle run), muscular fitness (push-ups), fundamental movement skills (5-leaps test), body composition (bioelectrical impedance analysis), moderate-to-vigorous physical activity (accelerometer), and pubertal status (self-assessment questionnaire) were measured at 1-year intervals. Latent growth curve modeling (LGM) was used to study PF development over time. Change in fat mass had the strongest and most coherent associations with PF development during adolescence. Fat-free mass, moderate-to-vigorous physical activity, and pubertal status were associated with PF development, although not systematically. Subgroup analyses showed that PF development in the low fitness group followed a similar pattern as the whole population. However, their PF remained significantly lower throughout the 2-year period. The findings suggest that fat accumulation is an essential detrimental factor for PF development during adolescence. Actions to prevent excessive fat accumulation might help to prevent future declines in functional capacity. Indications that low fitness levels sustain during adolescence highlight the relevance of detecting these individuals and providing interventions already before adolescence.

Life-course leisure-time physical activity trajectories in relation to health-related behaviors in adulthood: the Cardiovascular Risk in Young Finns study.

BACKGROUND: Evidence on whether leisure-time physical activity (LTPA) facilitates individuals' adoption of multiple healthy behaviors remains scarce. This study investigated the associations of diverse longitudinal LTPA trajectories from childhood to adulthood with diet, screen time, smoking, binge drinking, sleep difficulties, and sleep duration in adulthood. METHODS: Data were drawn from the Cardiovascular Risk in Young Finns Study. Participants were aged 9-18 years (N = 3553; 51% females) in 1980 and 33-49 years at the latest follow-up in 2011. The LTPA trajectories were identified using a latent profile analysis. Differences in self-reported health-related behaviors across the LTPA trajectories were studied separately for women and men by using the Bolck-Croon-Hagenaars approach. Models were adjusted for age, body mass index, education level, marital status, total energy intake and previous corresponding behaviors. RESULTS: Persistently active, persistently low-active, decreasingly and increasingly active trajectories were identified in both genders and an additional inactive trajectory for women. After adjusting the models with the above-mentioned covariates, the inactive women had an unhealthier diet than the women in the other trajectories (p <  0.01; effect size (ES) > 0.50). The low-active men followed an unhealthier diet than the persistently and increasingly active men (p <  0.01; ES > 0.50). Compared to their inactive and low-active peers, smoking frequency was lower in the increasingly active women and men (p <  0.01; ES > 0.20) and persistently active men (p <  0.05; ES > 0.20). The increasingly active men reported lower screen time than the low-active (p <  0.001; ES > 0.50) and persistently active (p <  0.05; ES > 0.20) men. The increasingly and persistently active women reported fewer sleep difficulties than the inactive (p <  0.001; ES > 0.80) and low-active (p <  0.05; ES > 0.50 and > 0.80, respectively) women. Sleep duration and binge drinking were not associated with the LTPA trajectories in either gender, nor were sleep difficulties in men and screen time in women. CONCLUSIONS: Not only persistently higher LTPA but also an increasing tendency to engage in LTPA after childhood/adolescence were associated with healthier diet and lower smoking frequency in both genders, having less sleep difficulties in women and lower screen time in increasingly active men. Inactivity and low activity were associated with the accumulation of several unhealthy behaviors in adulthood. Associations were stronger in women.

Education leads to a more physically active lifestyle: Evidence based on Mendelian randomization.

Physical inactivity is a major health risk worldwide. Observational studies suggest that higher education is positively related to physical activity, but it is not clear whether this relationship constitutes a causal effect. Using participants (N = 1651) drawn from the Cardiovascular Risk in Young Finns Study linked to nationwide administrative data from Statistics Finland, this study examined whether educational attainment, measured by years of education, is related to adulthood physical activity in terms of overall physical activity, weekly hours of intensive activity, total steps per day, and aerobic steps per day. We employed ordinary least squares (OLS) models and extended the analysis using an instrumental variables approach (Mendelian randomization, MR) with a genetic risk score as an instrument for years of education. Based on the MR results, it was found that years of education is positively related to physical activity. On average, one additional year of education leads to a 0.62-unit higher overall physical activity (P < .01), 0.26 more hours of weekly intensive activity (P < .05), 560 more steps per day (P < .10), and 390 more aerobic steps per day (P < .09). The findings indicate that education may be a factor leading to higher leisure-time physical activity and thus promoting global health.

Accelerometer-measured and self-reported physical activity in relation to extraversion and neuroticism: a cross-sectional analysis of two studies.

BACKGROUND: Personality reflects relatively stable and pervasive tendencies in feeling, thinking and behaving. While previous studies have found higher extraversion and lower neuroticism to be linked to higher self-reported physical activity levels, larger studies using accelerometer-measured physical activity are lacking. This study investigated the cross-sectional associations of extraversion and neuroticism with both accelerometer-measured and self-reported physical activity and the role of these personality traits in possible discrepancies between these two measures of physical activity among Finnish adults. METHODS: Two community-dwelling samples were used in this study: a) 47-55-yr-old women (n = 1098) and b) 70-85-yr-old women and men (n = 314). In both samples, extraversion and neuroticism were assessed by the 19-item short form of the Eysenck Personality Inventory. Physical activity was assessed with hip-worn tri-axial accelerometers and self-reported questions. Regression analyses were adjusted by age, BMI and education. RESULTS: In the middle-aged women, neuroticism was negatively associated with accelerometer-measured leisure time moderate-to-vigorous physical activity (ß = -.07, p = .036) and with self-reported physical activity (ß = -.08, p = .021), while extraversion was positively associated with self-reported physical activity (ß = .10, p = .005). No associations of extraversion or neuroticism with physical activity were found in the older men and women. Older adults who scored high in neuroticism reported less physical activity than what was measured by accelerometers (ß = -.12, p = .039). Extraversion was not associated with discrepancy between self-reported and accelerometer-measured leisure time physical activity in either sample. CONCLUSIONS: Neuroticism was associated with lower leisure-time physical activity levels and extraversion with higher self-reported physical activity among middle-aged women. Neuroticism and extraversion were unrelated to physical activity among older adults, but older adults with high neuroticism seemed to underreport their physical activity level. The role of personality in the discrepancy between self-reported and device-based physical activity warrants further research.

Testing a physical education-delivered autonomy supportive intervention to promote leisure-time physical activity in lower secondary school students: the PETALS trial.

BACKGROUND: Inadequate physical activity in young people is associated with several physical and mental health concerns. Physical education (PE) is a potentially viable existing network for promoting physical activity in this population. However, little research has been conducted on whether PE teachers can influence students' engagement in leisure-time physical activity. The present study therefore examined the efficacy of an intervention aimed at increasing PE teachers' autonomy support on students' leisure-time physical activity (the PETALS trial). The intervention was guided by the trans-contextual model (TCM) explaining the processes by which PE teachers' provision of autonomy support during PE promotes students' motivation and engagement in physical activity in their leisure time. METHODS: The study adopted a cluster-randomized, waitlist control intervention design with randomization by school. Participants were PE teachers (N = 29, 44.83%female; M age = 42.83, SD = 9.53 yrs) and their lower secondary school students (N = 502, 43.82%female; M age = 14.52, SD = 0.71 yrs). We measured TCM constructs, including perceived autonomy support, autonomous motivation in PE and leisure time, beliefs and intentions towards leisure-time physical activity, and physical activity behavior at baseline, post-intervention, and at one-, three-, and six-months. Study hypotheses were tested through a series of ANOVAs and structural equation models using post-intervention and one-month follow-up data. RESULTS: We found no changes in TCM constructs or physical activity behavior in either group at post-intervention or at 1 month. Path analyses supported two propositions of the TCM as change variables: perceived autonomy support had a significant effect on autonomous motivation in PE and autonomous motivation in PE had a significant effect on autonomous motivation in leisure time. Although we found a direct effect of autonomous motivation in leisure time on physical activity, we did not find support for the third premise of the TCM that autonomous motivation in leisure time indirectly affects physical activity through beliefs and intentions. CONCLUSIONS: Current findings did not support the efficacy of the PETALS intervention at changing physical activity behavior and TCM constructs. More research is required to determine whether the TCM predictive validity is supported when other model variables are manipulated through experimental and intervention studies. TRIAL REGISTRATION: ISRCTN, ISRCTN39374060 . Registered 19 July 2018. Prospectively registered.

Validity and Reliability of a Single Question for Leisure-Time Physical Activity Assessment in Middle-Aged Women.

PURPOSE: To investigate the validity and test-retest reliability of a single seven-level scale physical activity assessment question (SR-PA L7) and its three-level categorization (SR-PA C3). METHODS: The associations of SR-PA L7 and C3 with accelerometer-measured leisure-time physical activity (ACC-LTPA) and with the results of four different physical performance tests (6-min walk [n = 733], knee extension [n = 695], vertical jump [n = 731], and grip force [n = 780]) were investigated among women aged 47-55 years participating in the Estrogenic Regulation of Muscle Apoptosis study (n = 795). The reliability was studied using Spearman correlations with 4-month test-retest period (n = 152). RESULTS: SR-PA L7 and C3 had low correlations with ACC-LTPA (rs = .105-.337). SR-PA L7, SR-PA C3, and ACC-LTPA explained comparable but small amount of variance of the physical performance test results. The reliability analysis provided moderate agreement (rs = .707 and .622 for SR-PA L7 and C3, respectively). CONCLUSIONS: SR-PA L7 and C3 demonstrated limited validity and reasonable repeatability.