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.

What are the correlates of intention to be physically active in Brazilian adolescents? A network analysis.

OBJECTIVE: The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents. METHODS: This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations. RESULTS: We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities. CONCLUSION: In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents.

Global prevalence and gender inequalities in at least 60 min of self-reported moderate-to-vigorous physical activity 1 or more days per week: An analysis with 707,616 adolescents.

BACKGROUND: Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity (MVPA). However, using only this cut-off could hide important information. For instance, from a population-level point of view, increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels. Also, including a more sensitive cut-point of ≥1 day per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice. Thus, the current study aims to estimate the prevalence of ≥60 min of MVPA ≥1 days per week among adolescents globally, and to describe any relevant gender inequalities. METHODS: We used representative datasets from 146 countries/territories collected between 2003 and 2019. MVPA was self-reported. Participants were grouped into younger (≤14 years old) and older (>14 years old) adolescents. Crude Poisson regression models were used to identify the relative differences in ≥60 min of MVPA ≥1 days per week between boys and girls, and random-effects meta-analysis models were used to identify the pooled estimates. Analyses were stratified by country and region. RESULTS: Approximately 80% of both younger and older adolescents reported ≥60 min of MVPA ≥1 days per week. This prevalence was ≥94% in Europe and Central Asia and North America, while the estimates for the other regions were <77%. The prevalence of ≥60 min of MVPA ≥1 days per week was higher among boys than girls, with the largest differences occurring among the oldest adolescents (PR≤14y: 1.04 (95% confidence interval (95%CI): 1.03‒1.04) vs. PR>14y: 1.09 (95%CI: 1.08‒1.10)). CONCLUSION: Approximately 8 out of 10 adolescents reported accumulating ≥60 min of MVPA ≥1 day per week, with notable differences between regions. Gender differences were observed in several countries, especially among the oldest adolescents. Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve ≥60 min of MVPA ≥1 days per week and reducing gender inequalities.

U-SMILE: a brief version of the Short Multidimensional Inventory on Lifestyle Evaluation.

INTRODUCTION: Lifestyle Medicine comprises six domains: diet, substance use, physical activity, stress management, social connection, and sleep. The comprehensive assessment of lifestyle is challenging, but the "Short Multidimensional Inventory on Lifestyle Evaluation" (SMILE) was developed to fill out this gap. In this paper, we describe the development and the psychometric properties (internal consistency, concurrent and convergent validity) of a shorter version of the SMILE among university students. METHODS: Data from a cross-sectional study including 369 students from 10 Brazilian universities were used. Considering a theoretical nomological net, we performed exploratory factor analysis to obtain the most parsimonious, interpretable and good-fitting model. RESULTS: The final model was called U-SMILE, comprised 24 items, and presented acceptable internal consistency (Cronbach's α = 0.73, McDonald's ω = 0.79). To evaluate the concurrent validity of the U-SMILE, we compared it to the original SMILE and found a high correlation between the instruments (Spearman's r= 0.94). Furthermore, we evaluated convergent validity by examining the U-SMILE correlation with the PHQ-9 (Spearman's r= -0.517), and GAD-7 (Spearman's r= -0.356), two validated instruments to screen for depression and anxiety, respectively. DISCUSSION: Our findings suggest that the U-SMILE is a valid instrument for assessing lifestyle among university students. We recommend that the use of U-SMILE to evaluate overall lifestyle scores rather than individual domain scores. Finally, we discuss the importance of clarifying the definitions of lifestyle and related constructs in future research.

Are more physical education classes related to less time in leisure-time sedentary behavior? An analysis including adolescents from 73 countries.

This study aimed to verify the association between the weekly frequency of physical education (PE) classes and leisure sitting time among adolescents. We analyzed data from 73 countries using the Global School-based Student Health Survey (283,233 adolescents between 11 and 18 years of age). Leisure sitting time and weekly frequency of PE classes were self-reported. Sex, age, and food insecurity were used as covariates and the analyses were stratified by world regions and country income level. Poisson regression models (random-effects meta-analysis) were used for the main analyses. In comparison with 1 PE class per week (reference group), those with no PE classes presented a lower prevalence of ≥ 3 h/d of leisure sitting time (PR [95%CI] = 0.94 [0.91; 0.98]). On the other hand, adolescents with 2 days (PR [95%CI] = 1.06 [1.02; 1.26]), 3-4 days (PR [95%CI] = 1.17 [1.12; 1.22]), and 5 days (PR [95%CI] = 1.08 [1.04; 1.11]) of PE classes presented a higher likelihood of ≥ 3 h/d of leisure sitting time. No clear differences were observed for the different world regions and country income levels. We conclude that a higher weekly frequency of PE classes is associated with increased leisure sitting time among adolescents worldwide.

Internalization of extracellular vesicles from Lactobacillus johnsonii N6.2 elicit an RNA sensory response in human pancreatic cell lines.

Cells of all domains of life can secrete extracellular vesicles (EV). These secreted vesicles have been indicated as vehicles carrying molecules that facilitate intra- and inter-species interaction. Lactobacillus johnsonii N6.2, a bacterium used in probiotic preparations, has been shown to produce nano-sized EV. In the present work we used L. johnsonii N6.2 EV, concentrated from exosome depleted MRS supernatant, to identify the uptake mechanisms of EV and the impact of the RNA cargo in the EV on the upregulation of the cellular response of ßlox5 human pancreatic cells. Using eukaryotic uptake inhibitors, it was found that EV are internalized by the clathrin/dynamin mediated endocytosis pathway. Further co-localization experiments with the endosome markers RAB5, RAB7 and LAMP1 as well as calcein indicated that EV escape the endosome shortly after RAB7 fusion. Using the expression of the 2',5'-oligoadenylate synthetase (OAS) host pathway, previously identified as targeted by L. johnsonii EV, we found that the host cellular response to the EV are dependent on the integrity of the external components of the EV as well as on the RNA cargo. Global transcriptome analysis was performed on EV and the bacterial whole cell. It was found that the RNA transcripts found within the EV largely represent the most abundantly transcribed genes in the bacterial cells such as those associated with protein synthesis and glycolysis. Further analysis showed an enrichment of smaller size transcripts as well as those encoding for membrane bound or extracellular proteins in L. johnsonii's EV.

Social isolation is associated with higher leisure-time sedentary behavior and lower physical activity practice: A multi-country analysis of data from 79 countries from the Global School-Based Student Health Survey.

AIM: To investigate the association of social isolation with physical activity and leisure-time sedentary behavior among adolescents. METHODS: We used data from the Global School-based Health Survey, including a representative sample of 296,861 adolescents (11-18y) from 79 countries (48.9% girls, 14.5 ± 1.6 years). Social isolation was estimated by combining the self-reported number of friends and loneliness perception. Physical activity and leisure-time sedentary behavior were assessed through questionnaires. Multinomial logistic regression models were created to analyze the associations of social isolation with physical activity and leisure-time sedentary behavior. RESULTS: Compared with those practicing ≥60 min of physical activity during 1-4 days/week, social isolation was associated with a higher prevalence of not practicing physical activity (Prevalence ratio [PR]:1.24; 95%CI:1.19-1.29), and a lower prevalence of practicing during ≥5d/wk. (PR:0.91; 95%CI:0.88-0.94). Compared with <4 h/d of leisure-time sedentary behavior, being socially isolated was also associated with a higher prevalence of 4-7 h/d (PR: 1.08; 95%CI:1.03-1.14) and ≥ 8 h/d (PR: 1.24; 95%CI:1.16-1.33) of leisure-time sedentary behavior. Compared with those participants without elevated leisure-time sedentary behavior and with those practicing adequate physical activity, social isolation was independently associated with a higher prevalence of physical inactivity (PR: 1.20; 95%CI: 1.15-1.26) and elevated leisure-time sedentary behavior (PR: 1.21; 95%CI: 1.14-1.30), as well as with both risk factors simultaneously (PR: 1.36; 95%CI: 1.28-1.45). CONCLUSION: Reducing social isolation could be an important component of future interventions to reduce sedentary behavior and physical inactivity among adolescents.

Mentally-passive sedentary behavior and incident depression: Mediation by inflammatory markers.

BACKGROUND: Sedentary behavior (SB; time spent sitting, as distinct from lack of exercise or physical activity) is associated with depression, yet little is known about the relationship between different types of SB (e.g., mentally-passive versus mentally-active) with depression and potential biological mediators of these associations. METHODS: We used cohort data from the 1958 National Child Development Study (n = 4607; 50.4 % women), conducted in UK, employing the 44 y and 46 y waves as baseline, and the 50 y and 55 y waves as follow-up. Participants reported time spent in TV viewing and watching videos (mentally-passive SB); and, time sitting while doing light activities such as deskwork or driving a car during worktime (mentally-active SB). Depression diagnosis was self-reported during the initial and follow-up waves. Waist circumference, C-reactive protein, and glycated hemoglobin were examined as potential mediators. RESULTS: Mentally-passive SB was associated with incident depression (HR: 1.43; 95%CI: 1.19; 1.71), while there was no association for mentally-active SB. Waist circumference (coefficient: -0.03; 95%CI: -0.05; -0.01; 9.2 %) and C-reactive protein (coefficient: -0.03; 95%CI: -0.04; -0.01; 8.3 %), but not glycated hemoglobin, partly mediated the association for mentally-passive SB. CONCLUSIONS: In the relationship of mentally-passive SB with incident depression, the mediating contributions of waist circumference and C-reactive protein point to possible inflammatory-related mechanisms.

Future burden of non-communicable diseases attributable to overweight in Chile: a multistate life table modeling study.

BACKGROUND: Previous studies have quantified the current burden of diseases attributable to overweight in Chile. However, no study has estimated the attributable burden of overweight in the future. Herein, we estimated the potential impact of different trajectories in the prevalence of overweight on the incidence and mortality from non-communicable diseases (NCDs) in Chilean adults from 2019 to 2030. METHODS: A multistate life table modelling was used to estimate the business-as-usual (BAU: if the current rate of increase in BMI persist through the next 11 years; i.e., 0.4% per year from 2003 to 2017) and three counterfactual scenarios (1: the increase rate of overweight is reduced by half; 2: maintanance of the current prevalence of overweight; 3: the prevalence of overweight is reduced by 6.7%) over a 11-year simulation period for burden of NCDs attributable to overweight in Chilean adults aged 20 to 80 years. The model inputs included nationally representative data of body mass index, national official demographic records, NCDs from the Global Burden of Disease study in 2019, and relative risks from a published meta-analysis. RESULTS: If the current trends of increase in overweight are maintained in Chile, approximately, 669 thousand cases and 117 thousand deaths from NCDs will occur from 2020 to 2030. In case the increase rate of overweight is reduced by half during this period, around 7 thousand cases and 1.4 thousand deaths from NCDs would be prevented, while achieving no increase in the prevalence of overweight would avert 10 thousand cases and 2 thousand deaths. In the optimistic scenario of reducing the prevalence of overweight by 6.7% until 2030, approximately 25 thousand cases and 5 thousand deaths from NCDs would be prevented. CONCLUSION: We estimated that the number of NCDs cases and deaths that could be avoided by decreasing the prevalence of overweight in Chilean adults. Preventive programs aimed to reduce overweight may have a high impact on the future burden of NCDs in Chile.

Combined association of physical activity and sitting time with cardiometabolic risk factors in Chilean adults.

In this study we examined the combined association of physical activity and sitting time with cardiometabolic risk factors in adults in Chile. This is a cross-sectional study based on 3201 adults aged from 18 to 98 years from the Chilean National Health Survey (2016-2017) who responded to the GPAQ questionnaire. Participants were considered inactive if spent < 600 METs-min/wk-1 in physical activity. High sitting time was defined as ≥ 8 h/day. We classified participants into the following 4 groups: active and low sitting time; active and high sitting time; inactive and low sitting time; inactive and high sitting time. The cardiometabolic risk factors considered were metabolic syndrome, body mass index, waist circumference, total cholesterol, and triglycerides. Multivariable logistic regression models were performed. Overall, 16.1% were classified as inactive and high sitting time. Compared to active participants with low sitting time, both inactive participants with low (OR: 1.51; 95% CI 1.10, 1.92) and high sitting time (1.66; 1.10, 2.22) had higher body mass index. Similar results were found for high waist circumference: inactive participants with low (1.57; 1.14, 2.00) and high sitting time (1.84; 1.25, 2.43). We found no combined association of physical activity and sitting time with metabolic syndrome, total cholesterol, and triglycerides. These findings may be useful to inform programs focused on obesity prevention in Chile.

Handgrip strength, physical activity and incident mild cognitive impairment and dementia.

OBJECTIVE: We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia. METHODS: We used prospective data from 14 European countries participating in the Survey of Health, Ageing, and Retirement in Europe. 19,686 participants free of dementia and mild cognitive impairment (64.9 ± 8.7 years) were followed up for a mean of 10.2 years. Moderate to vigorous physical activity was self-reported, and handgrip strength was assessed with a dynamometer. Mild cognitive impairment was defined as 1.5 standard deviations below the mean of the standardized global cognition score, while dementia was determined by physician diagnosis. Gender, age, country, education, presence of chronic diseases, depressive symptoms, limitations in activities of daily living, body mass index, and baseline cognitive levels were used as covariates. Cox proportional hazards as well as mediation models were used. RESULTS: Moderate to vigorous physical activity for at least 1 day per week was independently associated with lower incident mild cognitive impairment (HR: 0.85; 95%CI: 0.74-0.98). A 10 % increase in handgrip strength was associated a 6 % lower hazard for incident mild cognitive impairment (0.94; 0.92-0.97) and 5 % lower hazard for incident dementia (0.95; 0.93-0.98). Handgrip strength partly mediated the association of moderate to vigorous physical activity with mild cognitive impairment (Coefficient: 0.03; 95%CI: 0.01-0.05; 17.9 %). CONCLUSIONS: Physical activity is independently associated with a lower incidence of mild cognitive impairment.

Physical Activity and Sitting Time Patterns and Sociodemographic Correlates Among 155,790 South American Adults.

BACKGROUND: To estimate the prevalence of different physical activity (PA) domains and sitting time (ST), and to analyze the association with sociodemographic indicators. METHODS: Data from the most recent nationally representative survey from each of the South American countries, comprising 155,790 adults (18-64 y), were used. Data on leisure-time, transport, and occupational PA (all 3 domains as nonzero), total PA (≥150 min/wk), and ST (≥8 h/d) were assessed by specific questionnaires in each survey. Gender, age group (18-34, 35-49, and 50-64 y), and education (quintiles) were used as sociodemographic factors. Random effect meta-analysis of the association between sociodemographic factors and PA and ST were conducted. RESULTS: The prevalence of PA guidelines compliance and elevated ST in South America was 70.3% and 14.1%, respectively. Women were less likely to achieve the recommended levels of total and domain-based PA. Participants in the highest quintile of education were more likely for elevated ST (2.80, 2.08-3.77), lower occupational PA (0.65, 0.44-0.95), but higher leisure-time PA (3.13, 2.31-4.27), in comparison with lowest quintile. Older adults were less likely to participate in total and leisure-time PA. CONCLUSION: Our findings highlight the urge to tackle the inequalities in PA practice in South America, especially gender and education inequalities, for leisure-time PA.

Effects of two years of physically active lessons on cognitive indicators in children.

Our purpose was to evaluate the effect of physically active lessons (PAL) on the cognitive performance of children during two years of follow-up. Four classes (second grade of elementary school) were divided into two intervention classes (n = 34) and two control classes (n = 27). Evaluations were performed before the intervention (M1), after 3 (M2) and 9 (M3) months in the 1st year, and 14 (M4) and 18 (M5) months in the 2nd year. The intervention was based on PAL integrated with the curricular components, which stimulated the children to stand or move in the classroom. Cognitive performance was evaluated using three computerized tests for response inhibition, selective attention, and cognitive flexibility. The children in the intervention classes presented improved cognitive performance in the execution of all tasks along the two years follow-up, in both correct answers and time reactions, with exception of correct answers of visual search. For the intervention classes, in most of the tasks, the mean differences confidence interval of 95% did not include the 0 on the two last moments of evaluation, and in all cases, the mean differences of them between M1 versus M5 were significantly different with high values of effect size (cohen -d > 1). PAL promotes modest improvements in diverse cognitive functions in children.

Exchanging screen for non-screen sitting time or physical activity might attenuate depression and anxiety: A cross-sectional isotemporal analysis during early pandemics in South America.

OBJECTIVES: To examine the theoretical substitutions of screen exposure, non-screen sitting time, moderate and vigorous physical activity with depressive and anxiety symptoms in South American adults during the COVID-19 pandemic. DESIGN: A cross-sectional study during the first months of the COVID-19 pandemic with data from 1981 adults from Chile, Argentina, and Brazil. METHODS: Depressive and anxiety symptoms were assessed using the Beck Depression and Anxiety Inventories. Participants also reported physical activity, sitting time, screen exposure, sociodemographic, and tobacco use data. Isotemporal substitution models were created using multivariable linear regression methods. RESULTS: Vigorous physical activity, moderate physical activity, and screen exposure were independently associated with depression and anxiety symptoms. In adjusted isotemporal substitution models, replacing 10 min/day of either screen exposure or non-screen sitting time with any intensity of physical activity was associated with lower levels of depressive symptoms. Improvements in anxiety symptoms were found when reallocating either screen exposure or non-screen sitting time to moderate physical activity. Furthermore, replacing 10 min/day of screen exposure with non-screen sitting time was beneficially associated with anxiety (B = -0.033; 95 % CI = -0.059, -0.006) and depression (B = -0.026; 95 % CI = -0.050, -0.002). CONCLUSIONS: Replacement of screen exposure with any intensity of physical activity or non-screen sitting time could improve mental health symptoms. Strategies aiming to reduce depressive and anxiety symptoms highlight physical activity promotion. However, future interventions should explore specific sedentary behaviors as some will relate positively while others negatively.

The mediation role of social network size and perception in the association between physical activity and depressive symptoms: a prospective analysis from the SHARE study.

OBJECTIVES: To investigate the mediating role of social network size and perceived quality in the associations of physical activity with quality of life and depressive symptoms in middle-aged and older adults. METHOD: We analyzed information of 10,569 middle-aged and older adults from waves 2 (2006-2007), 4 (2011-2012), and 6 (2015) of the Survey of Health, Ageing, and Retirement in Europe study (SHARE). Data on physical activity (moderate and vigorous intensities), social network (size and quality), depressive symptoms (EURO-D scale), and quality of life (CASP) were self-reported. Sex, age, country of residency, schooling, occupational status, mobility, and baseline values of the outcome were used as covariates. We created mediation models to test the mediating effect of social network size and quality in the association between physical activity and depressive symptoms. RESULTS: Social network size partly mediated the association between vigorous physical activity and depressive symptoms (7.1%; 95%CI: 1.7-12.6) as well as the association between moderate (9.9%; 1.6-19.7) and vigorous (8.1%; 0.7-15.4) physical activity and quality of life. Social network quality did not mediate any of the associations tested. CONCLUSION: We conclude that social network's size, but not satisfaction, mediates part of the association of physical activity with depressive symptoms and quality of life in middle-aged and older adults. Future physical activity interventions among middle-aged and older adults should consider increasing social interactions to facilitate benefits for mental health-related outcomes.