Parent-Child Associations in Accelerometer-Measured Physical Activity and Sedentary Behaviour: The FAMIPASS Study.

Parent-child patterns in objectively measured movement behaviours were the highlight of this study. A total of 381 families (337 mothers, 256 fathers, 190 daughters, and 191 sons) from 36 randomly selected schools and kindergartens provided valid accelerometer data. Sedentary behaviour and physical activity (PA) were assessed using ActiGraph accelerometers. Spearman's rho was used to evaluate parent-child associations, while logistic regression analysis (the backward LR method) was used to recognize factors related to children's achievement of PA recommendations. Results indicated that girls engaged more in light PA, while boys showed higher levels of moderate and vigorous PA. Mothers spent less time sitting and more time in light PA compared to fathers, resulting in higher total PA levels. Father-son pairs showed a stronger association in total PA than mother-son pairs. Children aged 6-10 years and those with mothers who engaged in more vigorous PA were more likely to meet PA recommendations compared to younger children and those with less active mothers.

Accelerometer-measured sleep behaviour and parent-child sleep guideline adherence and sleep quality in Czech families with children aged 3-8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study.

Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents' influence on the child's sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.

Changes in the prevalence of obesity in Czech adolescents between 2018 and 2022 and its current non-genetic correlates - HBSC study.

BACKGROUND: The main aim of the study is to examine changes in the prevalence of obesity in Czech adolescents between 2018 and 2022 and its current non-genetic correlates with respect to the adolescents' families'socioeconomic status (SES) in 2022. METHODS: The sample of 24,535 adolescents (n = 11,629/12,9062018/2022; boys: 50.4/50.6%2018/2022) aged 10.5-16.5 years that was analysed was drawn from two nationally representative cohorts of Czech youngsters from the last two cycles of the Health Behaviour in School-aged Children (HBSC) online questionnaire survey from 2018 to 2022. Obesity is represented by the > 97th percentile interval on the World Health Organization Body Mass Index percentile chart, with distinctions by sex and the age of adolescents. The differences in the prevalence of obesity between boys and girls from all SES family categories in 2018 and 2022 were tested using a chi-square test (χ2). Multiple logistic regression analysis with repeated measures was used to analyse correlates of obesity in 2022. RESULTS: Between 2018 and 2022, there was no significant difference in the prevalence of obesity in girls or boys in any of the SES categories of families. Adolescents from low-SES families have the highest prevalence of obesity, 11% for boys and 5.8% for girls, significantly higher (p < .001) than its prevalence among adolescents from high-SES families, by + 4.8% points for boys and + 3.9% points for girls. Among adolescents from low-SES families, individuals who engaged in moderate-to-vigorous physical activity (PA) daily (p < .005) or vigorous PA three times per week (p < .05) were significantly less likely to be obese than their less active peers. Skipping breakfast significantly (p < .05) increased the odds of obesity, but only among adolescents from low-SES families. Shorter screen time (ST) significantly (p < .05) reduced the odds of obesity for all categories of adolescent SES. CONCLUSIONS: Obesity is most pronounced in adolescents from low-SES families as a result of a long-term positive energy balance mediated by unbalanced behaviour. Significantly lower odds of obesity in adolescents from low-SES families were confirmed to be associated with regular practice of the recommended PA, shorter ST, and not skipping breakfast.

FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study: protocol for a cross-sectional study.

INTRODUCTION: The development of children's healthy and active lifestyles, including habit formation for optimal 24-hour movement behaviour, is associated with their family environment. A whole-family study collecting comprehensive data that can evaluate family lifestyle behaviours in different settings in depth has the potential to provide the evidence-based information needed for national guidelines, for designing interventions and for supporting policy-makers' decisions. METHODS AND ANALYSIS: The FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study is a nationally representative cross-sectional study that will recruit 500 families (with at least 1 child aged between 3 and 8 years) from the urban and rural parts of all three regions of the Czech Republic. To examine the relationship between family environment and children's healthy development (eg, healthy weight) and children's active lifestyle behaviour, anthropometric measures, parents' health-related behaviour (including dietary habits, alcohol and tobacco use, screen time and bedtime rules and 24-hour movement behaviour), socioeconomic data and data about the characteristics of the home and neighbourhood will be collected from parents and children. The 24-hour movement behaviour (eg, sleep, sedentary behaviour and physical activity) will be monitored using wGT3X-BT and GT9X Link ActiGraph accelerometers placed on the non-dominant wrist of the children and their parents for 7 consecutive days. The accelerometers will be set up for each family separately, using the group proximity mode, allowing proximity tagging between devices and establishing the time spent together and parent-child coactivities. ETHICS AND DISSEMINATION: The overarching methodological protocol of the FAMIPASS project was approved by the Ethics Committee of the Faculty of Physical Culture, Palacký University Olomouc, Czech Republic (reference number: 25/2021). The results and findings will be reported to: (1) the participating families and (2) school representatives and will be (3) presented at national and international conferences and (4) disseminated via peer-reviewed publications.

Perceived stress of adolescents during the COVID-19 lockdown: Bayesian multilevel modeling of the Czech HBSC lockdown survey.

Objective: Long-term isolation, including lockdowns and quarantines, may have a distressing effect on anyone experiencing it. Adolescent brain architecture is very sensitive to environmental adversities, and the mental health development of adolescents may be particularly vulnerable during the pandemic era. In order to better understand the triggers for perceived adolescent stress (PSS) during the COVID-19 lockdown, the present study aimed to assess the effects of social well-being and changes in time use during the lockdown, as well as the family COVID experience of adolescents. Methods: The sample for this study comprised n = 3,440 adolescents (54.2% girls; mean age = 13.5 ± 1.6 years). Bayesian correlations between PSS, health and well-being variables were assessed. PSS was then modeled as an outcome variable in a series of nested Bayesian multilevel regression models. Results: The negative impact of the COVID-19 lockdown was more apparent in girls. PSS was moderately correlated with adolescent health and well-being. The strongest predictor of higher level of PSS was frequent feeling of loneliness. On the contrary, lower level of PSS was most associated with having someone to talk to. Conclusion: Long-term social isolation of adolescents could be harmful to their mental health. Psychological coping strategies to prevent the consequences of social isolation and development of mental health problems should be promoted on the individual, family, and even community level.

The Czech Republic's 2022 Report Card on Physical Activity for Children and Youth: A rationale and comprehensive analysis.

Background/Objective: The second edition of the Czech Republic's Report Card on Physical Activity for Children and Youth was released in 2022. This paper describes the development of the Report Card and presents a comprehensive summary of the main findings. Methods: The multi-level search strategy was developed by the national expert panel to identify the available sources that provide data related to the physical activity of Czech children and adolescents. The data were used to assign grades to ten core and two additional indicators. Results: A total of 28 sources provided data that allowed grades to be assigned to 11 out of the 12 indicators. Grade B was assigned to six indicators (School: B+, Community and Environment: B, Organized Sport and Physical Activity: B-, Active Transportation: B-, Family and Peers: B-, Sleep: B-), grade C to three indicators (Overall Physical Activity: C+, Active Play: C, Physical Literacy: C), and grade D to two indicators (Government: D+, Sedentary Behaviors: D). No grade for the "Physical Fitness" indicator could be assigned due to a lack of data collected in the reference period 2018-2019. Conclusions: Although the family, school, and built environment provided a variety of opportunities to be physically active, a high proportion of children and adolescents did not meet the current physical activity guideline and were exposed to excessive sedentary behavior. A multisectoral and multidisciplinary response is required to reduce the health and economic burden of physical inactivity and excessive sedentary behavior among Czech children and adolescents.

Weekday-Weekend Sedentary Behavior and Recreational Screen Time Patterns in Families with Preschoolers, Schoolchildren, and Adolescents: Cross-Sectional Three Cohort Study.

BACKGROUND: Excessive recreational screen time (RST) has been associated with negative health consequences already being apparent in preschoolers. Therefore, the aim of this study was to reveal parent-child sedentary behavior, and RST patterns and associations with respect to the gender, age category of children, and days of the week. METHODS: Our cross-sectional survey included 1175 parent-child dyads with proxy-reported RST data collected during a regular school week during the spring and fall between 2013 and 2019. The parent-child RST (age and RST) relationship was quantified using Pearson's (rP) correlation coefficient. RESULTS: Weekends were characterized by longer RST for all family members (daughters/sons: +34/+33 min/day, mothers/fathers: +43/+14 min/day) and closer parent-child RST associations than on weekdays. The increasing age of children was positively associated with an increase in RST on weekdays (+6.4/+7.2 min per year of age of the daughter/son) and weekends (+5.8/+7.5 min per year of age of the daughter/son). CONCLUSIONS: Weekends provide a suitable target for implementation of programs aimed at reducing excessive RST involving not only children, but preferably parent-child dyads.

12-Year Trends in Active School Transport across Four European Countries-Findings from the Health Behaviour in School-Aged Children (HBSC) Study.

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.

Parent-child dyads and nuclear family association in pedometer-assessed physical activity: A cross-sectional study of 4-to-16-year-old Czech children.

The main aim of this study is to examine familial aggregation in pedometer-assessed physical activity (PA) and proxy-reported screen time (ST) with estimating which of the parents' lifestyle indicators help their offspring achieve step count (SC) recommendations under daily life conditions. The analysis included 773 parent-child dyads (591 mother-child, 182 father-child) and 511 nuclear family triads (mother-father-child) with data ambulatory PA monitored with a Yamax pedometer during a regular school/working week during the spring and autumn between 2013 and 2019. Based on Logistic regression analysis, an achievement of 10,000 steps a day by the mothers significantly (p < 0.001) increases the odds ratio of their children reaching the recommended daily SC in the parent-child dyads. Obesity/overweight of mothers (fathers) significantly (p < 0.05) increases (reduces) the chance of their children reaching the recommended daily SC in the analysis of the nuclear family triads. For both overweight/obese and non-overweight children, the odds of reaching the recommended daily SC are significantly (p < 0.05) increased by their regular participation (≥ twice per week) in organised leisure-time PA (analysis of the nuclear family triads) and non-excessive entertainment ST (≤2 h per day) in the mother-child and nuclear family triads. Despite the different mother-/father-child behavioural associations, SC of parents are positively associated with SC of their children (Linear regression analysis). The involvement of children in regular participation in organised leisure activities (at least twice a week) and limiting their excessive entertainment ST might be important factors contributing to the achievement of the recommended daily SC by children.

The Relationship between Obesity and Physical Activity of Children in the Spotlight of Their Parents' Excessive Body Weight.

BACKGROUND: The study reveals the relationships between daily physical activity (PA) and the prevalence of obesity in family members separated according to the participation of their offspring in organized leisure-time physical activity (OLTPA), and answers the question of whether the participation of children in OLTPA is associated with a lower prevalence of obesity in offspring with respect to parental PA and body weight level. METHODS: The cross-sectional study included 1493 parent-child dyads (915/578 mother/father-child aged 4-16 years) from Czechia selected by two-stage stratified random sampling with complete data on body weight status and weekly PA gathered over a regular school week between 2013 and 2019. RESULTS: The children who participated in OLTPA ≥ three times a week had a significantly lower (p < 0.005) prevalence of obesity than the children without participation in OLTPA (5.0% vs. 11.1%). Even in the case of overweight/obese mothers/fathers, the children with OLTPA ≥ three times a week had a significantly lower (p < 0.002) prevalence of obesity than the children without OLTPA (6.7%/4.2% vs. 14.9%/10.7%). CONCLUSIONS: The cumulative effect of regular participation in OLTPA and a child's own PA is a stronger alleviator of children's obesity than their parents' risk of overweight/obesity.

Test-Retest Reliability of a Questionnaire on Motives for Physical Activity among Adolescents.

The aim of this study was to investigate the test-retest reliability of the motives for undertaking physical activity (PA) items from the Health Behavior in School-Aged Children (HBSC) study questionnaire among Slovak and Czech adolescents and to determine whether this reliability differs by gender, age group and country. We obtained data from 580 students aged 11 and 15 years old (51.2% boys) who participated in a test and retest study with a four-week interval in 2013 via the Health Behavior in School-Aged Children cross-sectional study in the Czech Republic and Slovakia. We estimated the test-retest reliability of all 13 dichotomized motives by using Intraclass Correlation Coefficients (ICC) and Cohen's Kappa statistics, for continuous and dichotomized motives, respectively. Test-retest reliability showed moderate agreement for nine motives (ICC from 0.41 to 0.60) and fair agreement for four motives (ICC from 0.33 to 0.40). Kappa statistics were similarly moderate to large (0.33 to 0.61), except for three motives with small or trivial correlations. The motives "To improve my health" and "To enjoy the feeling of using my body" had consistently low Kappas and correlations. Overall, the results of this study suggest that most questions on motives for PA on the HBSC questionnaire have acceptable test-retest characteristics for use among adolescents.

Excessive body weight of children and adolescents in the spotlight of their parents' overweight and obesity, physical activity, and screen time.

OBJECTIVES: The main aim of this study was to bridge the research gap in the countries of Central Europe using the family dyad approach to examine the associations of parents' overweight/obesity, physical activity (PA), and screen time (ST) with excessive body weight in their offspring. METHODS: The cross-sectional study included 1101 parent-child dyads (648/453 mother/father-child aged 4-16) selected by two-stage stratified random sampling with complete data on body weight categories, weekly PA (Yamax pedometer), ST (family logbook) collected over a regular school/working week during the spring and autumn seasons between 2013 and 2019. Binary logistic regression analyses were used to identify which of parents' lifestyle indicators were associated with the overweight/obesity of their offspring. RESULTS: The mother's overweight/obesity significantly increases her children's odds of overweight/obesity. Concerning fathers, active participation in organized leisure-time PA and reaching 10,000 steps per day significantly reduce the odds of overweight/obesity in their children and adolescent offspring. CONCLUSIONS: The cumulative effect of parental participation in organized leisure-time PA with their own family-related PA can be a natural means of preventing the development of overweight/obesity in their offspring.

Parent-Child Physical Activity Association in Families With 4-to 16-Year-Old Children.

BACKGROUND: The main aim of this study was to quantify the associations between parents' and children's physical activity by age, gender, and the day of the week on the basis of a pedometer-measured step count (SC). METHODS: The sample comprised data from 4-to 16-year-old children and their parents from the Czech Republic (1102 mother-child dyads and 693 father-child dyads). The parents and their children wore the Yamax SW200 pedometer during seven days of monitoring. RESULTS: The strongest SC association was found between mothers and daughters aged 4-7.9 years on weekdays (rp = 0.402; p < 0.01) and at weekends (rp = 0.577; p < 0.01). In children aged 8-16, the parent-child association is gender-specific, with the father-son relationship being dominant, especially at weekends (weekend SC: fathers-sons8-11.9 y rp = 0.416, p < 0.01; fathers-sons12-16 y rp = 0.443, p < 0.01). An increase of 1000 steps in the fathers (mothers) is associated with an increase of more than 400 (200) steps in their sons (daughters). CONCLUSIONS: This study confirms a strong parent-child SC relationship in children younger than eight years of age. In older children, the parent-child SC association is gender-specific and dominated by the father-son relationship, particularly on weekends. The SC associations that are revealed can be used for the development of physical activity programs for adolescents.

Time-trends and correlates of obesity in Czech adolescents in relation to family socioeconomic status over a 16-year study period (2002-2018).

BACKGROUND: The main objective of the study is to analyse the changes in the prevalence of obesity among Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents' families and to find SES-separated correlates of adolescents' obesity in 2018. METHODS: A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5-16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in Czechia. Chi-square (χ2) tests were performed to assess the changes in the prevalence of obesity in both genders and all SES categories of adolescents between 2002 and 2018, and SES category-related differences in the prevalence of obesity in 2018 separately for boys and girls. A series of multiple stepwise logistic regression (backward elimination) analyses were used to reveal obesity correlates separately for SES categories of adolescents. RESULTS: Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of obesity in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: + 7.5% points (p.p.); girls + 2.4 p.p.). When all the survey cycles were compared, the highest prevalence of obesity was evident in the low-SES adolescents in 2018, both in girls (5.1%) and boys (12.0%). Regardless of the adolescent SES category, the lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity (PA), participation in organized sport, and daily consumption of sweets. In addition, at least 60 min of moderate-to-vigorous PA significantly reduced the odds of obesity in adolescents of low and high SES categories. CONCLUSIONS: An unreasonable increase in the prevalence of obesity in adolescents with low SES highlights the need to prevent obesity in adolescents with a low-SES background. Additionally, significantly higher odds of obesity in 11- and 13-year-old adolescents from low-SES families, compared with their peers aged 15, indicated an expectable rise in obesity in older low-SES adolescents in the near future.

Vigorous physical activity in relation to family affluence: time trends in Europe and North America.

OBJECTIVES: The aim of the study was to determine secular trends in vigorous physical activity (VPA) among adolescents in relation to family affluence across 34 countries. METHODS: This study used data from the Health Behaviour in School-aged Children (HBSC) study from 34 countries in Europe and North America. Adolescents (N = 501,647) aged 11, 13 and 15 years across three survey cycles (2006, 2010, 2014) self-reported data on VPA and a family affluence scale (FAS) using standardized questionnaires. RESULTS: A significant increase in VPA was found in low-FAS boys (girls) in four (10) countries and a decrease in four (three) countries. In high-FAS boys (girls), a significant increase was observed in nine (11) countries and a decrease in two(three) countries. An overall significant increase in meeting the VPA recommendations was found in high-FAS boys (OR 1.11; 95% CI 1.06-1.16) and in all FAS groups in girls, with the largest effect being found among high-FAS girls (OR 1.24; 95% CI 1.18-1.30). CONCLUSIONS: A country-specific increase in VPA was observed primarily in the medium- and high-FAS categories. This study suggests a need to focus on increasing VPA efforts, especially in low- and medium-FAS boys.

Can organized leisure-time activities buffer the negative outcomes of unstructured activities for adolescents' health?

OBJECTIVES: We aimed to assess the associations of involvement in selected unstructured activities (UA) with health-risk behaviours and academic achievement and the degree to which the participation in organized leisure-time activities (OLTA) changes these associations. METHODS: Using a sample of 6935 Czech adolescents aged 13 and 15 years, we investigated adolescents' weekly involvement in hanging out, visiting shopping malls for fun and meeting friends after 8 p.m., OLTA and engagement in three health-risk behaviours and academic achievement. RESULTS: Weekly involvement in the selected UA was associated with higher odds for regular smoking, being drunk, having early sexual intercourse and low academic achievement. Concurrent participation in OLTA did not buffer these negative outcomes, except for sexual experience. However, those highly engaged only in UA were more likely to participate in the health-risk behaviours and report worse academic achievement than those participating in any OLTA concurrently. CONCLUSIONS: The selected UA are strongly associated with an increased occurrence of adolescents' health-risk behaviours and low academic achievement. Concurrent participation in OLTA does not buffer these negative outcomes significantly, but adolescents engaged only in UA consistently report the least favourable outcomes.

Weekday-weekend variations in mother-/father-child physical activity and screen time relationship: A cross-sectional study in a random sample of Czech families with 5- to 12-year-old children.

This study assessed the associations between these factors in a random sample of Czech families with preschool and school-aged children. A nationally representative sample comprised 185 families with preschool children and 649 families with school-aged children (dyads; both parents and child n = 365, mother and child n = 730, and father and child n = 469). The participants wore Yamax Digiwalker SW-200 pedometers at least four weekdays and both weekend days and completed family logbooks (anthropometric parameters, daily step counts (SC), and screen time (ST)). When a parent (fathers at weekends and mothers both on weekdays and at weekends) achieved 10,000 SC per day, their children were also significantly (OR = 2.93-6.06, 95% CI = 2.02-9.26) more likely to meet the daily SC recommendation. On the contrary, the involvement of fathers in organized leisure-time PA reduced their children's odds of meeting the SC recommendation on weekdays (OR = 0.53, 95% CI = 0.31-0.89) and at weekends (OR = 0.41, 95% CI = 0.24-0.72). The excessive ST of parents at weekends reduced the odds of their children meeting the SC recommendation (mother-child dyads: OR = 0.44, 95% CI = 0.26-0.72; father-child dyads: OR = 0.63, 95% CI = 0.37-1.06). High levels of parents' PA contribute to the achievement of the recommended daily PA in children on weekdays and at weekends. Excessive weekend ST of parents reduces their odds of their children achieving the recommended daily PA; however, the influence of parents' PA on their children's achieving the recommended daily PA is stronger than the inhibitory effect of ST.

Trends and correlates of overweight/obesity in Czech adolescents in relation to family socioeconomic status over a 12-year study period (2002-2014).

BACKGROUND: This study examined a) trends in overweight/obesity, moderate-to-vigorous physical activity (MVPA), and screen time (ST) among Czech adolescents over a 12-year study period (2002-2014) in relation to family affluence (FA) and b) correlates of adolescent overweight/obesity from different FA categories. METHODS: A nationally representative sample of 18,250 adolescents (51.4% girls) aged 10.5-16.5 years was drawn from the Czech Health Behaviour in School-aged Children questionnaire-based surveys in 2002, 2006, 2010, and 2014. Using the FA scale, the socioeconomic status (SES) of the respondents' families was assessed. SES-stratified trends in the prevalence of overweight/obesity meeting the MVPA (≥60 min/day), and ST (≤2 h/day) recommendations were assessed using logistic regression. RESULTS: A trend-related significant increase (p < 0.05) in the prevalence of overweight/obesity was observed in low-/medium-FA boys and medium-/high-FA girls. Unlike in high-FA adolescents, a significant decrease was revealed in the rates of meeting the MVPA recommendation in low-FA boys (28.9%2002 → 23.3%2014, OR = 0.75, 95% CI = 0.59-0.95, p < 0.05) and girls (22.3%2002 → 17.3%2014, OR = 0.73, 95% CI = 0.57-0.92, p < 0.01). A significant (p < 0.001) trend-related increase in excessive ST was evident in adolescents regardless of gender and FA category. Generally, girls and older adolescents had lower odds of overweight/obesity than boys and 11-year-old adolescents. While in the high-FA category of adolescents, achieving 60 min of MVPA daily and the absence of excessive ST on weekdays significantly (p < 0.01) reduced their odds of being overweight/obese, in low-FA adolescents this was not the case. CONCLUSIONS: High rates of overweight/obesity and a poor level of daily MVPA among low-FA children provide disturbing evidence highlighting the necessity of public health efforts to implement obesity reduction interventions for this disadvantaged population.

Physical Activity Among Adolescents With Long-Term Illnesses or Disabilities in 15 European Countries.

Physical activity (PA) is an important health-promoting behavior from which adolescents with long-term illnesses or disabilities (LTID) can benefit. It is important to monitor differences across countries in adherence with PA recommendations for health. The aim of this study was to compare PA levels among 15 European countries after disaggregating data by disability. Data from pupils (mean age = 13.6 years, SD = 1.64) participating in the 2013/2014 Health Behavior in School-aged Children study were analyzed to compare adolescents without LTID, with LTID, and with LTID that affects their participation (affected LTID). Logistic regression models adjusted for age and family affluence, stratified by gender and country group with PA recommendations for health as the outcome variable. With the data pooled, 15% (n = 9,372) of adolescents reported having LTID and 4% (n = 2,566) having affected LTID. Overall, fewer boys with LTID met PA recommendations for health than boys without LTID, although it was not statistically significant either at the national levels or for girls.