Physical Fitness Surveillance and Monitoring Systems Inventory for Children and Adolescents: A Scoping Review with a Global Perspective.

Surveillance of health-related physical fitness can improve decision-making and intervention strategies promoting health for children and adolescents. However, no study has comprehensively analyzed surveillance/monitoring systems for physical fitness globally. This review sought to address this gap by identifying: (1) national-level surveillance/monitoring systems for physical fitness among children and adolescents globally, (2) the main barriers and challenges to implementing surveillance/monitoring systems, and (3) governmental actions related to existing surveillance/monitoring systems. We used a scoping review to search, obtain, group, summarize, and analyze available evidence. Our review involved three stages: (1) identification of surveillance systems through a systematic literature review, with complementary search of the grey literature (e.g., reference lists, Google Scholar, webpages, recommendations), (2) systematic consultation with relevant experts using a Delphi method to confirm/add systems and to gather and analyze information on the barriers and challenges to implementing systems, and (3) Web searches for public documents on government sites and surveillance/monitoring system pages, and direct internet searches to identify relevant governmental actions related to surveillance systems. A total of 15 fitness surveillance/monitoring systems met our inclusion criteria. Experts identified a lack of government support and funding, and the low priority of fitness on the public health agenda as the main barriers/challenges to implementation. Several governmental actions related to surveillance systems were identified, including policies, strategies, programs, and guidelines. We propose a Global Observatory of Physical Fitness to help address these issues.

Meeting muscle-strengthening recommendation is associated with lower adiposity, higher physical fitness and healthier lifestyle in adolescents: The EHDLA study.

AIM: To determine the prevalence of adolescents who meet muscle-strengthening activities (MSA) recommendation and their associations with anthropometric variables, physical fitness, and lifestyle behaviours in a sample of Spanish adolescents aged 12-17 years. METHODS: This was a cross-sectional study using data from The Eating Healthy and Daily Life Activities (EHDLA) Study. Participants reported the days on which they engaged in MSA (≥3 days per week were considered to meet World Health Organization recommendation). Physical fitness was assessed with the ALPHA fitness battery. Additionally, body mass index, waist circumference, skinfolds and body fat percentage were assessed. Lifestyle variables were recreational screen time, sleep time and adherence to the Mediterranean diet. The associations between MSA and outcome variables were tested with linear and logistic regressions. RESULTS: Of the 852 participants, 48% met MSA recommendation. Meeting MSA recommendation was associated with lower adiposity and higher performance in the shuttle run test, maximal oxygen consumption, standing long jump, speed-agility, flexibility, lower screen time (in weekdays) and higher adherence to the Mediterranean diet. CONCLUSION: Engaging in MSA once or twice a week was linked with more desirable health outcomes than not engaging in such activities. However, meet with MSA recommendation (i.e., at least 3 days per week) reinforced these benefits.

Maintaining an active lifestyle from adolescence to adulthood might alleviate the adverse association of preterm birth with cardiometabolic health.

AIMS: We aimed to determine whether physical activity attenuates preterm birth's adverse effects on adult cardiometabolic health. METHODS: This retrospective study utilized data from the Add Health Study, a prospective cohort conducted in the United States. During Wave V (mean age: 37 years; 60.7% women; mean body mass index: 29 kg/m2; mean waist circumference: 95 cm), we evaluated cardiometabolic risk factors and preterm birth status (i.e., born <37 weeks). Self-reported physical activity data was collected through questionnaires during Waves I (ages 12-19) and Wave V. An "active lifestyle" was defined by adherence to recommendations during both waves, spanning from adolescence to adulthood. RESULTS: The sample, comprising 3320 individuals, with 9.5% being preterm, included 7.6% who remained physically active throughout both adolescence and adulthood. Preterm-born individuals who were inactive had higher rates of obesity (incidence rate ratio [IRR] = 1.39, 95% confidence interval (CI) 1.05-1.84), abdominal obesity (IRR = 1.46, 95% CI 1.11-1.92), hyperlipidemia (IRR 3.50, 95% CI 1.94-4.29), type 2 diabetes (IRR = 2.37, 95% CI 1.12-5.01), and metabolic syndrome (IRR = 2.61, 95% CI 1.17-5.80) compared to active term-born individuals. Maintaining an active lifestyle appeared to decrease the risk of obesity and hyperlipidemia in adults born preterm (p > 0.05). CONCLUSIONS: While preterm birth is associated with an elevated risk of adult cardiometabolic risk, maintaining an active lifestyle appeared to slightly mitigate the risk of obesity and hyperlipidemia in adults born preterm.

Can an active lifestyle reduce the risk of obesity in adulthood among adolescents with Attention-Deficit/Hyperactivity Disorder symptoms? An ambispective cohort study.

Various studies have associated Attention-Deficit/Hyperactivity Disorder (ADHD) with obesity, but the role of physical activity in this connection is uncertain. This study examined whether adopting an active lifestyle can mitigate the link between adolescent ADHD and the risk of adult obesity. Longitudinal data from the Add Health Study (Waves I, III, and V) were used. Participants self-reported ADHD symptoms (hyperactivity/impulsivity, inattention, combined) during Wave III and self-assessed their recent moderate-to-vigorous physical activity. An "active lifestyle" required meeting activity criteria in both adolescence (Wave I) and adulthood (Wave III-V). Of 2609 participants, 1.42 % exhibited combined ADHD symptoms. A non-linear relationship was observed between inattentive/hyperactive scores and body mass index (BMI) and waist circumference (WC). Individuals with ≥ 6 hyperactivity/impulsivity symptoms had higher BMI (1.29 kg/m²) and WC (1.27 cm) at adulthood. Logistic regressions indicate that, compared to individuals without ADHD maintaining an active lifestyle, both inactive participants with and without ADHD show an elevated risk of obesity (odds ratio [OR]=1.56 to 2.63) and abdominal obesity in adulthood (OR = 1.51 to 2.50). Mediation analysis models further confirm these findings, suggesting that physical activity may explain this association. Though exact mechanisms warrant further exploration, adopting an active lifestyle offers promise for reducing obesity risk among individuals with ADHD symptoms.

Comprehensive management of children and adolescents with type 1 diabetes mellitus through personalized physical exercise and education using an mHealth system: The Diactive-1 study protocol.

Introduction: The use of new technologies presents an opportunity to promote physical activity, especially among young people with type 1 diabetes (T1DM), who tend to be less active compared to their healthy counterparts. The aim of this study is to investigate the impact of a personalized resistance exercise program, facilitated by the Diactive-1 App, on insulin requirements among children and adolescents diagnosed with T1DM. Methods and analysis: A minimum of 52 children and adolescents aged 8-18 years, who were diagnosed with T1DM at least 6 months ago, will be randomly assigned to either a group engaging in an individualized resistance exercise program at least 3 times per week over a 24-week period or a waiting-list control group. The primary outcome will be the daily insulin dose requirement. The secondary outcomes will include glycemic control, cardiometabolic profile, body composition, vascular function, physical fitness, 24-hour movement behaviors, diet, and psychological parameters. The usability of the app will also be assessed. Ethics and dissemination: Ethical approval to conduct this study has been granted by the University Hospital of Navarra Research Board (PI_2020/140). Parents or legal guardians of minors participating in the study will provide written consent, while children and adolescents will sign an assent form to indicate their voluntary agreement. The trial's main findings will be shared through conference presentations, peer-reviewed publications, and communication directly with participating families. This study aims to offer valuable insights into the holistic management of children and adolescents with T1DM by utilizing personalized exercise interventions through an mHealth system. Trial registration: NCT06048757.

Is meeting with the 24-h movement recommendations linked with suicidality? Results from a nationwide sample of 44,734 U.S. adolescents.

BACKGROUND: To our knowledge, only few studies have analyzed the relationship between meeting the 24-h movement guidelines and suicidality in adolescents. The aim of this study was twofold: first, to examine the association between meeting the 24-h movement recommendations and suicidal ideation, suicide planning, and attempted suicide in a representative sample of adolescents from the U.S.; and second, to test whether age group, sex, or race moderate these associations. METHOD: This is a cross-sectional study including pooled data from the 2011, 2013, 2015, 2017, 2019, and 2021 high school Youth Risk Behavior Surveys (YRBS). A total sample of 44,734 participants (48.5 % females) was included. The recommendations of the 24-h movement guidelines included physical activity, screen time, and sleep duration. Suicidality was examined considering three suicide-related behaviors: suicidal ideation (yes/no), suicide planning (yes/no), and attempted suicide (at least one time or more during the past 12 months). RESULTS: Adolescents who met all three recommendations showed a lower likelihood of suicidal ideation (odds ratio [OR] = 0.49, 95 % confidence interval [CI] 0.37 to 0.64, p < 0.001), suicide planning (OR = 0.51, 95 % CI 0.37 to 0.68, p < 0.001), and attempted suicide (OR = 0.66, 95 % CI 0.44 to 0.96, p = 0.038) than those who did not meet all the recommendations. Overall, when younger adolescents, female adolescents, and adolescents of minority races met the 24-h movement recommendations, they had lower odds of suicide-related outcomes than when they did not. LIMITATIONS: This is a cross-sectional study using self-reported data. It is not possible to establish cause-and-effect relationships, and the results could be influenced by some biases. CONCLUSION: This study suggests that meeting the 24-h movement recommendations could play a relevant role in the prevention of suicidal ideation, planning suicide, and attempted suicide in a nationwide sample from the U.S. adolescents.

Incidence of type 1 diabetes mellitus in children and adolescents under 20 years of age across 55 countries from 2000 to 2022: A systematic review with meta-analysis.

AIMS: The aim of this study was to determine the global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents under 20 years of age from 2000 to 2022. MATERIALS AND METHODS: Two reviewers searched three electronic databases (PubMed, Web of Science, and CINAHL) for studies published between January 2000 and November 2022. Pooled estimates of T1DM incidence with a 95% confidence interval (CI) per 100,000 person-years were calculated by country/region, sex, age, and COVID-19 pandemic period (pre-COVID-19 and pandemic). RESULTS: The study included 126 studies from 55 countries and 18 regions. The incidence rate (IR) of T1DM from 2000 to 2022 was 14.07 (95%CI, 12.15-16.29) per 100,000 person-years. Finland and high-income North America had the highest IR, with 56.81 (95%CI, 55.91-57.73) and 28.77 (95%CI, 26.59-31.13) per 100,000 person-years, respectively. The IR was 13.37 (95%CI, 10.60-16.88) per 100,000 person-years in boys and 13.87 (95%CI, 11.51-16.70) per 100,000 person-years in girls. There were statistically significant differences among different age ranges: 0-4 versus 5-9 and 10-14 years old (p < 0.001); 5-9 versus 15-19 (p < 0.001) and 10-14 versus 15-19 years old (p = 0.003). Finally, during the pandemic period (2020-2022), the IR was 24.84 (95%CI, 17.16-35.96) per 100,000 person-years, which was higher but not significant compared with the prepandemic period (2017-2019) of 13.56 (95%CI, 7.49-24.56) per 100,000 person-years (p = 0.090). CONCLUSIONS: The IR of T1DM in children and adolescents under 20 years of age is substantial, especially during the pandemic period, although it varies across regions. More reliable data from additional countries are needed to determine the worldwide incidence of T1DM.

Acute effect of physical activity on academic outcomes in school-aged youth: A systematic review and multivariate meta-analysis.

BACKGROUND: There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the last two decades. We aimed to systematically determine the acute effects of physical activity on academic outcomes in school-aged youth and to examine possible moderators. METHODS: We conducted a systematic search using PubMed, Web of Science, SPORTDiscus, and PsycINFO databases (from inception to 11th January 2023) for studies assessing the acute effects of physical activity on academic performance-related outcomes in school-aged youth. A univariate and multivariate meta-analysis was conducted based on a random-effects model with restricted maximum likelihood used to pool the academic outcomes results (Hedge's g). RESULTS: We included 11 articles (803 children and adolescents [range: 6-16 years]) in the systematic review. Overall, acute physical activity increased academic outcomes (Hedge's g = 0.35, 95% CI: 0.20-0.50). Multivariate meta-analyses revealed that physical activity increased academic performance in mathematics (Hedge's g = 0.29, 95% CI: 0.16-0.42) and language (Hedge's g = 0.28, 95% CI: 0.09-0.47). Only behavior change techniques (Hedge's g = 0.54, 95% CI, 0.18-0.90, p < 0.001) played a significant role in this relationship. CONCLUSIONS: A single bout of physical activity can improve academic outcomes in school-aged youth, which may serve as a complementary tool for the educational field. However, the observed heterogeneity in the results indicates that we should interpret the findings obtained with caution.

Combined aerobic and muscle-strengthening activity guidelines and their association with obesity in US adolescents.

Most of the evidence on physical activity for maintaining a healthy weight in adolescents is based solely on aerobic physical activity alone, with little attention given to the muscle strength component. This study aimed to investigate the associations between aerobic activities and muscle-strengthening activities (MSA) and overweight/obesity among a representative sample of adolescents. Data from the United States-based Youth Risk Behavior Surveillance System for the 2011-2019 cycle were used in this cross-sectional study. Adolescents self-reported their adherence to aerobic and MSA guidelines, as well as their height and weight. Overweight and obesity were defined using the age- and sex-specific criteria of the Centers for Disease Control and Prevention, with a body mass index (BMI) ≥85th and ≥95th percentiles, respectively. We examined the associations between adherence to physical activity guidelines (reference: not meeting either of the physical activity guidelines) and overweight/obesity or obesity using binary logistic regressions. These analyses were adjusted for race/ethnicity, sex, age, screen time, sleep duration, tobacco, alcohol, fruit, vegetables, and soda consumption. A total of 42 829 adolescents (48.98% girls) were included in the study. Of these, 22.23% met both guidelines for physical activity, 30.47% had overweight/obesity, and 14.51% had obesity. Compared with meeting neither guideline, meeting both aerobic and MSA guidelines was associated with lower odds of having overweight/obesity (odds ratio [OR] = 0.64, 95% confidence interval [CI], 0.60 to 0.68) and obesity (OR = 0.52, 95% CI 0.48 to 0.56). These results were consistent across years of assessment, sex, and race/ethnicity. In conclusion, our results highlight the importance of MSA, which is often overlooked in physical activity recommendations in many studies, in combating childhood obesity in the United States.

Physical Performance and Amyloid-ß in Humans: A Systematic Review and Meta-Analysis of Observational Studies.

BACKGROUND: Accumulation of amyloid-ß (Aß) plaques is one of the main features of Alzheimer's disease (AD). Physical performance has been related to dementia risk and Aß, and it has been hypothesized as one of the mechanisms leading to greater accumulation of Aß. Yet, no evidence synthesis has been performed in humans. OBJECTIVE: To investigate the association of physical performance with Aß in humans, including Aß accumulation on brain, and Aß abnormalities measured in cerebrospinal fluid (CSF) and blood. METHODS: A systematic review with multilevel meta-analysis was performed from inception to June 16th, 2022. Studies were eligible if they examined the association of physical performance with Aß levels, including the measure of physical performance as a predictor and the measure of Aß as an outcome in humans. RESULTS: 7 articles including 2,619 participants were included in the meta-analysis. The results showed that physical performance was not associated with accumulation of Aß in the brain (ES = 0.01; 95% CI -0.21 to 0.24; I2 = 69.9%), in the CSF (ES = -0.28; 95% CI -0.98 to 0.41; I2 = 91.0%) or in the blood (ES = -0.19; 95% CI -0.61 to 0.24; I2 = 99.75%). Significant heterogeneity was found across the results , which posed challenges in arriving at consistent conclusions; and the limited number of studies hindered the opportunity to conduct a moderation analysis. CONCLUSIONS: The association between physical performance and Aß is inconclusive. This uncertainly arises from the limited number of studies, study design limitations, and heterogeneity of measurement approaches. More studies are needed to determine whether physical performance is related to Aß levels in humans.

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight: A Systematic Review and Network Meta-Analysis.

Importance: Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. Objective: To compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. Data Sources: For this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023. Study Selection: Randomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. Data Extraction and Synthesis: Data extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023. Main Outcomes and Measures: The primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). Results: This analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, -4.38 µU/mL [95% CI, -5.94 to -2.82 µU/mL]) and HOMA-IR (MD, -0.87 [95% CI, -1.20 to -0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate. Conclusions and Relevance: These findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.

Effects of lifestyle-based interventions to improve Mediterranean diet adherence among the young population: a meta-analysis of randomized controlled trials.

CONTEXT: Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed. OBJECTIVE: The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years-18 years and (2) to examine the potential factors related to those intervention effects. DATA SOURCES: A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023. DATA EXTRACTION: Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]). DATA ANALYSIS: Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%). CONCLUSION: Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD2022369409.

Are 24-hour movement recommendations associated with obesity-related indicators in the young population? A meta-analysis.

OBJECTIVE: This study aimed to determine the relationship between meeting all three 24-hour movement recommendations (i.e., physical activity, sleep duration, and screen time) and obesity-related indicators among young people. METHODS: Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Library). RESULTS: Meeting the 24-hour movement recommendations was cross-sectionally associated with lower overall obesity-related indicators (r = -0.09, 95% CI: -0.11 to -0.06), but no longitudinal association was found. Regarding each obesity-related indicator separately, meeting all three recommendations was related to lower odds of overweight/obesity (odds ratio = 0.65, 95% CI: 0.56 to 0.76) and obesity alone (odds ratio = 0.28, 95% CI: 0.16 to 0.50). An inverse relationship between meeting 24-hour movement recommendations and BMI, BMI z score, waist circumference, and body fat was also found. Regarding subgroup analysis, the association between 24-hour movement recommendations and overall obesity-related indicators was similar regardless of sex, comparison used (meeting all three vs. not meeting [i.e., those who met zero to two of the movement behaviors] or meeting all three vs. none), and type of measure to assess 24-hour movement recommendations (i.e., self-reported or accelerometer-based measures). CONCLUSIONS: Meeting all 24-hour movement recommendations may be a crucial factor in maintaining a healthy weight status in the young population.

Centile reference curves of the ultrasound-based characteristics of the rectus femoris muscle composition in children at 4-11 years old.

Quantitative diagnostic ultrasound has been proposed as a way to characterize muscle structure, but there is a lack of normative data for children. This study aims to establish age-specific normal ranges for echo-intensity (EI), cross-sectional area (CSA), muscular thickness (MT), and subcutaneous adipose thickness (SAT) values of the rectus femoris muscle in typically developing children. The study recruited 497 children (288 boys and 209 girls) aged 4-10.9 years (mean age 7.39 years), and muscle parameters were measured using 2D B-mode ultrasound. Percentile values and reference curves were calculated using the Lambda, Mu, and Sigma method (LMS). The results showed small variation between measurements for boys compared to girls, with the most significant difference in EI, CSA, and MT values. EI decreased with age, with the most pronounced curve in boys. SAT increased in both sexes, with a slightly higher increase in girls after the age of 9.0 years. This study provides the first age-specific reference norms for the rectus femoris muscle architecture in children, and further research is needed to validate these curves and determine their clinical utility.

Are Physical Activity Interventions Effective in Improving Health-Related Quality of Life in Children and Adolescents? A Systematic Review and Meta-Analysis.

CONTEXT: Physical activity (PA) interventions improve well-being and positive mental health in children and adolescents, but the results of previous systematic reviews included participants with chronic medical conditions and did not accurately assess the multidimensional nature of health-related quality of life (HRQoL). OBJECTIVE: The aims of this meta-analysis were to (1) evaluate the effects of PA interventions on several domains of HRQoL in healthy <18-year-olds and (2) examine the effectiveness of interventions on HRQoL according to whether they were successful in increasing PA, the type of intervention delivered, and the duration of the intervention. DATA SOURCES: PubMed (Medline), EMBASE, the Cochrane Library, SCIELO, SPORTDiscus, and PEDro databases were systematically searched from inception to September 30, 2022. STUDY SELECTION: Experimental studies that examined the effectiveness of PA interventions on HRQoL participants aged <18 years. STUDY DESIGN: Systematic review with meta-analysis and meta-regression. LEVEL OF EVIDENCE: Level 1. METHODS: Random-effects models were used to calculate pooled effect size (ES) for total HRQoL score and its dimensions. Subgroup analyses were conducted to examine the effect of PA program characteristics. RESULTS: A total of 17 studies were included. Pooled ES (95% CI) estimations were as follows: 0.179 (0.045, 0.002) for total HRQoL score, 0.192 (0.077, 0.306) for physical well-being, 0.158 (0.080, 0.237) for psychological well-being, 0.118 (0.044, 0.192) for autonomy and parent relation, 0.135 (0.043, 0.227) for social support and peers, and 0.129 (-0.013, 0.270) for school environment. Subgroup analyses suggested there were no differences in the effectiveness of the interventions by category of PA increase or by type and duration of intervention. CONCLUSION: Exercise interventions are an effective strategy for improving overall HRQoL and its most significant domains in children and adolescents.

Association Between Daily Physical Education Attendance and Meeting 24-Hour Movement Guidelines in Adolescence and Adulthood.

PURPOSE: To investigate the relationship between participation in physical education lessons (PELs), i.e., minutes or frequency per week, and meeting the 24-hour movement guidelines (i.e., physical activity, screen time, and sleep duration) during adolescence (12-17 years old) and adulthood (33-39 years old). METHODS: We analyzed data from individuals who participated in Waves I (1994-1995) and V (2016-2018) of the National Longitudinal Study of Adolescent Health. We determined total weekly minutes of PELs and PELs participation by asking how many days adolescents attended PELs in an average week at school, with three possible responses as follows: 0, 1-4, or 5 days/week. Movement behaviors were assessed through self-completed questionnaires in both waves. RESULTS: Daily PELs participation during adolescence was related to higher odds of meeting five of more weekly sessions of moderate-to-vigorous physical activity and all three guidelines in both sexes compared with adolescents who reported no days of PELs per week (men: incidence rate ratio [IRR] = 1.70, 95% CI 1.02-3.12; women: IRR = 3.81, 95% CI 1.65-8.77). Additionally, each additional weekly hour of PELs increased the likelihood of meeting all three recommendations (men: IRR = 1.11, 95% CI 1.05-1.35; women: IRR = 1.67, 95% CI 1.27-2.24). During adulthood, daily PELs was also related to a higher likelihood of meeting all three recommendations in both sexes (men: IRR = 1.04, 95% CI 1.01-1.07; women: IRR = 1.07, 95% CI 1.00-1.11). Each additional weekly hour of PELs increased the odds of meeting all three recommendations (men: IRR = 1.02, 95% CI 1.01-1.05; women: IRR = 1.03, 95% CI 1.01-1.06). DISCUSSION: Daily PELs attendance was linked to healthy movement behaviors during adolescence, and these benefits could extend into adulthood.

Environmental tobacco smoke exposure and 24-h movement guidelines in Spanish young people.

Background: No prior research has investigated how exposure to environmental tobacco smoke is related to the combination of 24-h movement behaviors among young populations thus far. The aim of this study was to examine the associations between exposure to secondhand smoke and the 24-h movement guidelines. Methods: This is a cross-sectional study using data from the last available wave of the Spanish National Health Survey [2017], a nationally representative survey of the Spanish children and adult population. The final sample included 4,378 (49.0% girls) Spanish young people aged 2-14 years. Results: A lower likelikood of meeting screen time (ST) and all three 24-h movement guidelines were found in those exposed to environmental tobacco smoke in unadjusted models. After adjusting for several covariates, meeting screen time [odds ratio (OR) =0.76; 95% confidence interval (CI), 0.59-0.97], sleep duration (OR =0.75; 95% CI, 0.58-0.96), and all three 24-h movement guidelines (OR =0.63; 95% CI, 0.44-0.91) reached significance after adjusting for potential confounders. Conclusions: Given the inverse associations found, environmental tobacco smoke exposure should be a relevant factor to consider when promoting 24-h behaviors in the young population. Avoiding exposure to tobacco smoke in the environment is essential, as it can potentially influence the 24-h movement behaviors of young people, and consequently, the health benefits associated with such behaviors.

Effects of Resistance Training on Academic Outcomes in School-Aged Youth: A Systematic Review and Meta-Analysis.

BACKGROUND: The primary aim of our systematic review and meta-analysis was to investigate the effect of resistance training on academic outcomes in school-aged youth. METHODS: We conducted a systematic search of six electronic databases (CINAHL Complete, PsycINFO, SCOPUS, Ovid MEDLINE, SPORTDiscus and EMBASE) with no date restrictions. Studies were eligible if they: (a) included school-aged youth (5-18 years), and (b) examined the effect of resistance training on academic outcomes (i.e., cognitive function, academic achievement, and/or on-task behaviour in the classroom). Risk of bias was assessed using the appropriate Cochrane Risk of Bias Tools, funnel plots and Egger's regression asymmetry tests. A structural equation modelling approach was used to conduct the meta-analysis. RESULTS: Fifty-three studies were included in our systematic review. Participation in resistance training (ten studies with 53 effect sizes) had a small positive effect on the overall cognitive, academic and on-task behaviours in school-aged youth (standardized mean difference (SMD) 0.19, 95% confidence interval (CI) 0.05-0.32). Resistance training was more effective (SMD 0.26, 95% CI 0.10-0.42) than concurrent training, i.e., the combination of resistance training and aerobic training (SMD 0.11, 95% CI - 0.05-0.28). An additional 43 studies (including 211 effect sizes) examined the association between muscular fitness and cognition or academic achievement, also yielding a positive relationship (SMD 0.13, 95% CI 0.10-0.16). CONCLUSION: This review provides preliminary evidence that resistance training may improve cognitive function, academic performance, and on-task behaviours in school-aged youth. PROSPERO REGISTRATION: CRD42020175695.

Association of intrinsic capacity with incidence and mortality of cardiovascular disease: Prospective study in UK Biobank.

BACKGROUND: The World Health Organization proposed the concept of intrinsic capacity (IC; the composite of all the physical and mental capacities of the individual) as central for healthy ageing. However, little research has investigated the interaction and joint associations of IC with cardiovascular disease (CVD) incidence and CVD mortality in middle- and older-aged adults. METHODS: Using data from 443 130 UK Biobank participants, we analysed seven biomarkers capturing the level of functioning of five domains of IC to calculate a total IC score (ranging from 0 [better IC] to +4 points [poor IC]). Associations between IC score and incidence of six long-term CVD conditions (hypertension, stroke/transient ischaemic attack stroke, peripheral vascular disease, atrial fibrillation/flutter, coronary artery disease and heart failure), and grouped mortality from these conditions were estimated using Cox proportional models, with a 1-year landmark analysis to triangulate the findings. RESULTS: Over 10.6 years of follow-up, CVD morbidity grouped (n = 384 380 participants for the final analytic sample) was associated with IC scores (0 to +4): mean hazard ratio (HR) [95% confidence interval, CI] 1.11 [1.08-1.14], 1.20 [1.16-1.24], 1.29 [1.23-1.36] and 1.56 [1.45-1.59] in men (C-index = 0.68), and 1.17 [1.13-1.20], 1.30 [1.26-1.36], 1.52 [1.45-1.59] and 1.78 [1.67-1.89] in women (C-index = 0.70). In regard to mortality, our results indicated that the higher IC score (+4 points) was associated with a significant increase in subsequent CVD mortality (mean HR [95% CI]: 2.10 [1.81-2.43] in men [C-index = 0.75] and 2.29 [1.85-2.84] in women [C-index = 0.78]). Results of all sensitivity analyses by full sample, sex and age categories were largely consistent independent of major confounding factors (P < 0.001). CONCLUSIONS: IC deficit score is a powerful predictor of functional trajectories and vulnerabilities of the individual in relation to CVD incidence and premature death. Monitoring an individual's IC score may provide an early-warning system to initiate preventive efforts.