Correction: Radman et al. Prevalence of Key Modifiable Cardiovascular Risk Factors among Urban Adolescents: The CRO-PALS Study. Int. J. Environ. Res. Public Health 2020, 17, 3162.

The authors regret to acknowledge that a mistake has been made in the original article [...].

Assessment of Nutrient Intake and Diet Quality in Adolescent Dietary Supplement Users vs. Non-Users: The CRO-PALS Longitudinal Study.

Dietary supplement users tend to have a better diet quality and overall prudent lifestyle. The main goals of this research were to report the prevalence and type of dietary supplements among Croatian adolescents and to examine the differences in the diet quality among dietary supplement users vs. non-users at the beginning (15/16 y) and at the end of high school education (18/19 y). This research is based on results of the longitudinal CRO-PALS study in which 607 adolescents participated, who had complete dietary, anthropometric, and physical activity data at the beginning (15/16 y) and at the end of their high school education (18/19 y). The dietary assessment method used was a single multi-pass 24 h recall. Dietary supplement users were divided into two groups for the purposes of statistical analysis-users of vitamin and multivitamin preparations (VMV) and users of mineral and multivitamin preparations (MMV). As they aged, there was an increase in the consumption of dietary supplements, and the most frequently used preparation in both age groups was vitamin C (23.7% of users). Dietary supplement users had a higher intake of non-carbonated sweetened drinks and a lower intake of fruits and vegetables in both genders and both age groups. Fast food intake was higher among dietary supplement girl users and boys who were not dietary supplements users in both age groups. Dietary supplement users had a higher achieved average intake of most micronutrients (values obtained only from food) in both genders and both age groups (with exceptions for certain vitamins and minerals). By observing other parameters for assessing the diet quality in this research, we can conclude that girls who do not use dietary supplements have a better diet quality in both age groups.

Physical Activity of Children and Adolescents in Croatia: A Global Matrix 4.0 Systematic Review of Its Prevalence and Associated Personal, Social, Environmental, and Policy Factors.

BACKGROUND: The previous review of physical activity (PA) among Croatian children and adolescents was conducted a decade ago. Therefore, the aim of this study was to summarize recent evidence on PA of Croatian children and adolescents and associated personal, social, environmental, and policy factors. METHODS: Eighteen experts reviewed the available evidence and provided ratings (from the lowest grade "F" to the highest grade "A+") for the 10 Global Matrix indicators. A systematic search with 100 keywords was conducted in Hrcak, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science for documents published from January 01, 2012, to April 15, 2022. We also conducted internet searches and secondary analyses of data (relative frequencies) from 6 studies. RESULTS: After assessing 7562 references, we included 90 publications in the review and 18 studies (83.3% of medium-to-good quality) in evidence synthesis. We found a high prevalence of insufficient PA (especially among girls) and excessive screen time (especially among boys). PA participation of children and adolescents in Croatia has declined over time. The following grades were assigned to the indicators for Croatia: B- for overall PA, C- for organized sport and PA, C for active play, C- for active transportation, D+ for sedentary behavior, inconclusive for physical fitness, D+ for family and peers, B- for school, B- for community and environment, and D+ for government. CONCLUSIONS: Coordinated actions are needed across sectors to improve PA promotion, with a focus on increasing PA among girls, reducing sedentary screen time among boys, improving parental support for PA, and further development of national PA policies.

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

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

Does time of the day matter? Temporal associations between physical activity and quality and quantity of subsequent sleep in adolescents.

Temporal associations between moderate-to-vigorous physical activity (MVPA) at four different multi-hour intervals during the day and the following indicators of sleep quality and sleep quantity in adolescents were examined. This research is a part of the CRO-PALS study, including 129 adolescents (48 boys, 81 girls; mean age ± SD = 15.6 ± 0.4 years) having complete data on sleep and MVPA measured by the SenseWear Pro3 Armband monitor. As data had a hierarchical structure, repeated measures multilevel modelling was used to assess the associations between PA and sleep. During school nights, in girls, morning MVPA was not related to following indicators of sleep quality and sleep quantity. At the same time, evening MVPA was linked with longer sleep onset latency (ß = 0.064; 95%CI = 0.025 to 0.103) and higher wake after sleep onset (ß = 0.156; 95%CI = 0.0482 to 0.2638). Moreover, during weekend nights, morning MVPA was not associated with sleep, while evening MVPA was accompanied by longer sleep onset latency (ß = 0.058; 95%CI = 0.023 to 0.093), higher wake after sleep onset (ß = 0.104; 95%CI = 0.012 to 0.20), and negatively with sleep efficiency (ß = -0.019; 95%CI = -0.037 to -0.001). In boys the specific multi-hour interval of performing physical activity was not associated with any of indicators of sleep quality. In conclusion, while no strong relations between MVPA and sleep were seen among boys, in girls morning hours MVPA resulted in better sleep patterns over school nights, while afternoon MVPA was followed with slight worsening of some indicators of sleep quality across the whole week.

CHANGES IN PHYSICAL ACTIVITY LEVELS IN PATIENTS WITH ACUTE CORONARY SYNDROME BETWEEN THE FIRST AND THIRD DECADES OF THE 21st CENTURY.

Sedentary lifestyle and obesity increase the risk of coronary disease (CAD). The aims of this prospective study were to estimate the trends in physical activity (PA) level, accuracy of the Baecke's/LRC-PA questionnaires, and trends in obesity parameters (body mass index-BMI/waist-to-hip ratio-WHR) in patients with acute coronary syndrome (ACS) in the last two decades. We grouped 209 patients with ACS (UAP-unstable angina, STEMI-ST-elevation myocardial infarction, NSTEMI-non STEMI) by year of admission (Group 2002-05/Group 2017) and compared them by the levels of PA (Baecke's/LRC-PA questionnaires) and obesity parameters (BMI, WHR). Group 2017 had higher WHR (1.02 vs. 0.97) and leisure PA index (LI) (3.00 vs. 2.50), as well as less high and very low activity patients (P<0.05). Patients with UAP/STEMI had higher WHR in 2017 (1.02 vs. 0.96, 1.02 vs. 0.99, respectively) (P<0.05) and had lower LI in 2002-05 (2.50 vs. 3.25, 2.75 vs. 3.50, respectively) (P<0.05). In conclusion, leisure PA and WHR was increased in the study period both in patients with ACS and in the general population. We emphasize the usage of more precise methods for evaluation of PA and obesity (Baecke's/Four-point LRC-PA questionnaires, WHR), and that only increased PA with dietary changes leads to reduction of central obesity and risk of ACS.

Incidence of cardiovascular events when watching intense football matches - sex differences.

INTRODUCTION: FIFA World Cup represent one of the world's greatest phenomena. The spectators watch the matches of national teams with great emotional involvement. It is well documented fact that emotional stress can be a trigger of unwanted cardiovascular (CV) event. AIM: The aim of this retrospective study was to determine whether there had been an increase in the number of the emergency admissions for CVD in the Emergency Room and Clinic for Cardiovascular Diseases of the Sestre milosrdnice University Hospital Centre during and after the matches that the Croatian national team played in the FIFA World Cup 2018. METHODS: The hospital's database was examined for the dates when Croatia played its matches, plus two more days after each match. An unexposed period that included the same dates in 2017 and 2019 was formed. RESULTS: 1093 cases were assessed. The incidence of CV admissions during the exposed period was 1.15 (95% confidence interval [CI]; 1.02 to 1.31) times higher than during the unexposed period. There was a 1.30 (95% CI; 1.1 to 1.54) times higher incidence in women compared to the unexposed period. Arrhythmias and angina pectoris were the CVDs that occurred more frequently in the exposed period. CONCLUSION: This study showed that watching Croatian national team's matches and cheering represented an additional risk for a CV incident, especially in women.

THE ROLE OF ANTHROPOMETRIC PARAMETERS AND PHYSICAL ACTIVITY LEVEL IN PATIENTS WITH ACUTE CORONARY SYNDROME ADMITTED TO THE INTENSIVE CARDIAC CARE UNIT.

Anthropometric parameters have a role in diagnosing obesity, which increases the risk of acute coronary syndrome (ACS). The aim of the study was to assess the impact of obesity and physical activity level on the severity and long-term prognosis of ACS. A total of 116 patients with ACS were analyzed according to baseline (demography, medical history, anthropometry), severity (clinical presentation, in-hospital complications, laboratory, echocardiography, coronary angiography) and prognostic parameters (major adverse cardiovascular events during a six-year period). The levels of obesity and physical activity (Baecke/Lipid Research Clinics physical activity questionnaires) were compared with a sample of the Croatian general population. Study results showed the subjects with a higher number of narrowed coronary arteries (CAs) to have higher body mass index (BMI) and waist circumference (WC); those with stenosed left anterior descending artery and anterior myocardial infarction (MI) had higher BMI; waist-to-hip ratio (WHR) positively correlated with creatine kinase and negatively with left ventricle ejection fraction (p<0.05). Inactive patients more often had multi-vessel coronary disease and anterior MI; patients with a higher leisure physical activity index had a lower number of affected CAs, lower rate of stent implantations and lower stent length, while those with a higher work physical activity index had a lower rate of anterior MI (p<0.05). During the follow-up, inactive patients had more strokes and deaths (p<0.05). Our patients had higher body weight, WC and WHR, as well as lower leisure time and total physical activity indices than the general population (p<0.05). In conclusion, ACS is less severe and has better long-term prognosis in less obese patients with a higher level of physical activity. Patients with ACS are more obese and have lower total, as well as leisure time physical activity indices than the general population.

Agreement between the SHAPES Questionnaire and a Multiple-Sensor Monitor in Assessing Physical Activity of Adolescents Using Categorial Approach: A Cross-Sectional Study.

This study aimed to evaluate the agreement between a 7-day recall questionnaire and multiple-sensor monitor in identifying sufficiently active adolescents. A total of 282 students involved in the CRO-PALS study were randomly selected for a device-based measurement of physical activity (PA) using the SenseWear Armband device (SWA) no more than three weeks before or after having fulfilled the SHAPES questionnaire. Valid data was obtained from 150 participants (61 boys; 89 girls) and included in the analysis. In boys, SHAPES exhibited high specificity (92.3%), overall percent agreement (85.0%), and significant agreement (κ = 0.32, p = 0.014) with the SWA in recognising sufficiently active individuals. Conversely, no agreement was detected for quartiles of PA, although boys that were classified in the first and in the fourth quartile by SHAPES differed in device-based measured duration of MVPA (134 [95%CI: 109-160] vs. 87 [95%CI: 65-108], p = 0.032); and VPA (39 [95%CI: 23-56] vs. 14 [95%CI: 6-22], p = 0.011). In girls, no significant agreement between the two methods was found in any of the analyses. It appears that the SHAPES questionnaire is effective to identify individuals that comply with PA recommendations and to distinguish between the most active and the least active individuals for adolescent boys, but not for girls.

Can Injuries Be Predicted by Functional Movement Screen in Adolescents? The Application of Machine Learning.

ABSTRACT: Karuc, J, Misigoj-Durakovic, M, Sarlija, M, Markovic, G, Hadzic, V, Trost-Bobic, T, and Soric, M. Can injuries be predicted by functional movement screen in adolescents? The application of machine learning. J Strength Cond Res 35(4): 910-919, 2021-This study used machine learning (ML) to predict injuries among adolescents by functional movement testing. This research is a part of the CRO-PALS study conducted in a representative sample of adolescents and analyses for this study are based on nonathletic (n = 364) and athletic (n = 192) subgroups of the cohort (16-17 years). Sex, age, body mass index (BMI), body fatness, moderate-to-vigorous physical activity (MVPA), training hours per week, Functional Movement Screen (FMS), and socioeconomic status were assessed at baseline. A year later, data on injury occurrence were collected. The optimal cut-point of the total FMS score for predicting injury was calculated using receiver operating characteristic curve. These predictors were included in ML analyses with calculated metrics: area under the curve (AUC), sensitivity, specificity, and odds ratio (95% confidence interval [CI]). Receiver operating characteristic curve analyses with associated criterium of total FMS score >12 showed AUC of 0.54 (95% CI: 0.48-0.59) and 0.56 (95% CI: 0.47-0.63), for the nonathletic and athletic youth, respectively. However, in the nonathletic subgroup, ML showed that the Naïve Bayes exhibited highest AUC (0.58), whereas in the athletic group, logistic regression was demonstrated as the model with the best predictive accuracy (AUC: 0.62). In both subgroups, with given predictors: sex, age, BMI, body fat percentage, MVPA, training hours per week, socioeconomic status, and total FMS score, ML can give a more accurate prediction then FMS alone. Results indicate that nonathletic boys who have lower-body fat could be more prone to suffer from injury incidence, whereas among athletic subjects, boys who spend more time training are at a higher risk of being injured. Conclusively, total FMS cut-off scores for each subgroup did not successfully discriminate those who suffered from those who did not suffer from injury, and, therefore, our research does not support FMS as an injury prediction tool.

Is Adiposity Associated with the Quality of Movement Patterns in the Mid-Adolescent Period?

This study examined the association between functional movement (FM) and adiposity in adolescent population (16-17 years). This study was conducted in a representative sample of urban adolescents as the part of the CRO-PALS longitudinal study (n = 652). Body mass index (BMI), a sum of four skinfolds (S4S), waist and hip circumference were measured, and FM was assessed via Functional Movement ScreenTM (FMSTM). Furthermore, total FMSTM screen was indicator of FM with the composite score ranged from 7 to 21, with higher score indicating better FM. Multilevel analysis was employed to determine the relationship between different predictors and total FMS score. In boys, after controlling for age, moderate-to-vigorous physical activity, socioeconomic status, and total FMS score was inversely associated with BMI (ß = -0.18, p < 0.0001), S4S (ß = -0.04, p < 0.0001), waist circumference (ß = -0.08, p < 0.0001), and hip circumference (ß = -0.09, p < 0.0001). However, among girls, in adjusted models, total FMS score was inversely associated with S4S (ß = -0.03, p < 0.0001), while BMI (ß = -0.05, p = 0.23), waist circumference (ß = -0.04, p = 0.06), and hip circumference: ß = -0.01, p = 0.70) failed to reach statistical significance. Results showed that the association between adiposity and FM in adolescence is sex-specific, suggesting that boys with overweight and obesity could be more prone to develop dysfunctional movement patterns. Therefore, exercise interventions directed toward correcting dysfunctional patterns should be sex-specific, targeting more boys with excess weight rather than adolescent girls with excess weight.

Movement quality in adolescence depends on the level and type of physical activity.

OBJECTIVES: This study examined the relationship between functional movement and physical activity (PA) levels in adolescents. DESIGN: Cross-sectional study. SETTING: This research is a part of the CRO-PALS longitudinal study conducted in a random sample of adolescents in Zagreb at the Faculty of Kinesiology, University of Zagreb, Croatia. PARTICIPANTS: Seven hundred and twenty-five adolescents aged between 16 and 17 years were included. MAIN OUTCOME MEASURE: Total Functional Movement Screen score (total FMS score). RESULTS: After adjusting for age, body fat and SES, both VPA and MVPA showed minor but significant effects on total FMS score among girls (ß = 0.011, p = 0.001, ß = 0.005, p = 0.006, respectively), but not in boys (ß = 0.004, p = 0.158; ß = 0.000, p = 0.780). Regarding PA type, volleyball and dance improved total FMS score (ß = 1.003, p = 0.071; ß = 0.972, p = 0.043, respectively), while football was associated with lower FMS score (ß = -0.569, p = 0.118). CONCLUSION: Results suggest that the PA level is positively associated with the functional movement in adolescent girls, but not in boys, where the type of PA moderates these associations. Therefore, functional movement patterns incorporated into physical education curriculum could be beneficial to the musculoskeletal health of the children.

Eveningness in Energy Intake among Adolescents with Implication on Anthropometric Indicators of Nutritional Status: The CRO-PALS Longitudinal Study.

Shifting of energy intake towards a later time in the day is associated with an increased risk of obesity in adults. However, there is a lack of data for adolescents. The aim of this study was to investigate adolescents eveningness in energy intake (EV) and its association with anthropometric indicators of nutritional status. This investigation was based on results from the Croatian physical activity in adolescence longitudinal study (CRO-PALS). The cohort included 607 adolescents (50.25% females and 49.75% males) who were assessed at the age of 15/16 and 18/19. A single multi-pass 24-h recall was used as a dietary assessment method, while anthropometric indicators of nutritional status included body mass index (BMI), waist to hip ratio (WHR) and the sum of four skinfolds. The School Health Action, Planning and Evaluation System (SHAPES) questionnaire was used to assess active daily energy expenditure and sedentary behaviors. EV was significantly higher at 18/19 years compared to 15/16 years in whole population (p < 0.01), among male adolescents (p < 0.01), but not among female adolescents (p > 0.05). Although a significant correlation between EV and WHR was found in females at the age of 15/16 (p < 0.01), the results of this study suggest that EV has no or a minor effect on anthropometric indicators of nutritional status in adolescence.

Indicators of nutritional status and physical activity level as factors associated with the onset of menarche of ten year old girls from Zadar county, Croatia.

OBJECTIVES: The aim is to determine the differences in nutritional status and level of physical activity (PA) of ten year old menstruating and non-menstruating girls. METHODS: On the sample of 208 girls, fourth graders of elementary schools in Croatia, the indicators of nutritional status were measured: body mass index(BMI), body fat % and waist to hip ratio(WHR), while the PA was assessed using PAQ-C questionnaire. Welch´s t-test was applied to establish the differences and multivariate regression analysis was applied to establish the relationships. RESULTS: Menstruating girls have significantly higher body mass (43.42 kg±8.31 vs. 38.64 kg±8.33), waist circumference (68.10 cm ± 9.86 vs. 62.22 cm ± 7.16), hip circumference (80.81 cm ± 7.24 vs. 76.63 cm ± 7.7), BMI (19.70 ± 3.42 vs. 17.74 ± 3.10), body fat % (28.05 ± 7.54 vs. 21.98 ± 7.67) and WHR (0.84 ± 0.06 vs. 0.81 ± 0.05) in comparison to non-menstruating girls, while non-menstruating girls have significantly higher PA level (2.93 ± 0.57 vs. 2.68 ± 0.57). The regression analysis have shown a significant relationship between body fat % and the onset of menarche (ß=-0.23, SEß=0.07, p<0.01). CONCLUSIONS: Results show differences in the indicators of nutritional status of girls with regard to the status of maturity. Increased nutritional status and body fat % may be indicators of the accelerated developmental tempo and a determinant for the earlier onset of menarche.

Prevalence of Key Modifiable Cardiovascular Risk Factors among Urban Adolescents: The CRO-PALS Study.

The occurrence of chronic diseases in youth has become a serious global issue requiring early prevention. Due to the specific environment in large cities, urban youth are especially exposed to risky lifestyle patterns. OBJECTIVE: This survey aimed to determine the prevalence of key modifiable cardiovascular risk factors in the adolescent population of the Croatian capital Zagreb. METHODS: A clustered two-stage random sample design was employed to select a representative group of 903 adolescents (girls n = 444; boys n = 459; age 15.6 ± 0.4) starting their secondary education. Participants were invited to fulfil an electronic questionnaire meant to collect data on daily physical activity, screen time and tobacco use. In addition, anthropometric and blood pressure measurements were taken by medically trained personnel. Data that were not originally categorical were dichotomized based on internationally accepted cut-off values for each risk factor, summarized for females and males, and presented as percentages and 95% confidence intervals. RESULTS: The outcomes suggest that that more than one half did not meet the recommended daily physical activity (girls 59.4%; boys 45.5%), while about one quarter exceeded 2 hours of screen time per day and had high blood pressure (girls 26.6% and 21.6%; boys 27.0% and 27.0%, respectively). Moreover, the results indicated nearly one fifth of adolescents had excess weight (girls 16.1%; boys 22.2%) and a similar proportion smoked tobacco (girls 20.8%; boys 17.0%). CONCLUSIONS: Local and regional health stakeholders should make additional efforts to promote healthy lifestyles in urban teenagers. Special emphasis should be placed on promoting physical activity.

Does Sex Dimorphism Exist in Dysfunctional Movement Patterns during the Sensitive Period of Adolescence?

This study aimed to investigate sex difference in the functional movement in the adolescent period. Seven hundred and thirty adolescents (365 boys) aged 16-17 years participated in the study. The participants performed standardized Functional Movement Screen™ (FMSTM) protocol and a t-test was used to examine sex differences in the total functional movement screen score, while the chi-square test was used to determine sex differences in the proportion of dysfunctional movement and movement asymmetries within the individual FMSTM tests. Girls demonstrated higher total FMSTM score compared to boys (12.7 ± 2.3 and 12.2 ± 2.4, respectively; p = 0.0054). Sex differences were present in several individual functional movement patterns where boys demonstrated higher prevalence of dysfunctional movement compared to girls in patterns that challenge mobility and flexibility of the body (inline lunge: 32% vs. 22%, df = 1, p = 0.0009; shoulder mobility: 47% vs. 26%, df = 1, p < 0.0001; and active straight leg raise: 31% vs. 9%, df = 1, p < 0.0001), while girls underperformed in tests that have higher demands for upper-body strength and abdominal stabilization (trunk stability push-up: 81% vs. 44%, df = 1, p < 0.0001; and rotary stability: 54% vs. 44%, df = 1, p = 0.0075). Findings of this study suggest that sex dimorphisms exist in functional movement patterns in the period of mid-adolescence. The results of this research need to be considered while using FMSTM as a screening tool, as well as the reference standard for exercise intervention among the secondary school-aged population.

Obesity in Adolescents Who Skip Breakfast Is Not Associated with Physical Activity.

It has been hypothesized that breakfast consumption is generally associated with healthy lifestyle behaviors, such as increased physical activity. The aim of this study was to examine the relations between breakfast consumption, adiposity measures and physical activity among adolescents. This investigation is a part of the Croatian physical activity in adolescence longitudinal study (CRO-PALS). This investigation is based on 802 participants (48% girls and 52% boys), aged between 15.2 and 16.0 years. Physical activity level and sedentary behaviors were assessed using the SHAPES questionnaire. Adiposity measures included the sum of four skinfolds, and multi-pass 24-h recall was used as the dietary assessment method. Participants who consumed breakfast had significantly lower body fat % (p = 0.011 for boys; p ≤ 0.001 for girls) compared to breakfast non-consumers. Physical activity has no mediating effect in the association of breakfast consumption on adiposity in boys (Sobel's t = -0.541; p = 0.588) and girls (Sobel's t = 1.020; p = 0.307). Breakfast consumption was negatively associated with adiposity only in the boys at the highest tertile of physical activity (p = 0.04). Physical activity has no mediating effect on the associations between breakfast consumption and adiposity, but has a moderation effect only in the most active boys. Breakfast consumption might exert beneficial effects only in the most active male adolescents, but not in the inactive ones.

Relation between Weight Status, Physical activity, Maturation, and Functional Movement in Adolescence: An Overview.

Obesity, low level of physical activity and dysfunctional movement patterns presents one of the leading health issues that can contribute to increased risk for developing not only metabolic and cardiovascular disease, but also musculoskeletal problems. The aim of this paper is to summarize literature and evidence about relationship between functional movement (FM) patterns, physical activity (PA) level and weight status in average adolescent population. In addition, this paper summarized current evidence about relations between maturation effects and functional movement among athletic adolescent populations. Summary of current evidence suggests that decreased physical activity level is negatively correlated to functional movement in adolescence. Additionally, most studies suggest that weight status is negatively correlated to functional movement patterns although there is conflicting evidence in this area. Evidence consistently showed that overweight and obese adolescents exhibit poorer functional movement compared to normal weight adolescents. In addition, it appears that maturation has effects on functional movement in athletic populations of adolescents. It is therefore important that practitioners consider interventions which develop optimal functional movement alongside physical activity and weight management strategies in children, in order to reduce the risks of injuries and pathological abnormality arising from suboptimal movement patterns in later life.

One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS).

Background Little is known about the concurrent change in physical activity (PA), sedentary behavior (SB) and sport participation (SP) during adolescence. The main purpose of this prospective and partly objective study was to simultaneously investigate PA, SBs and SP changes between the 1st and 2nd grades of high school in urban adolescents. Methods In this 1-year follow-up study, the participants were 81 secondary-school students (28 boys and 53 girls) aged 15.5 years at the baseline. PA was assessed with the SenseWear Armband multi-sensor activity monitor, while SBs were assessed by using School Health Action, Planning and Evaluation System (SHAPES) PA questionnaire. The SHAPES questionnaire was supplemented with two questions inquiring about SP in organized sports in school and outside of school. Results PA decreased markedly in both genders between the 1st and 2nd grades of high school. Total energy expenditure (TEE) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls (p for both <0.001), while mean daily active energy expenditure (AEE) decreased by 7 kcal/kg/day (p < 0.001) and 3 kcal/kg/day (p = 0.04) in boys and girls, respectively. Similarly, the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls (p for both <0.001). At the same time vigorous PA was cut by 14 min/day (p < 0.001) and 3 min/day (p = 0.003) in boys and girls, respectively. Conversely, time spent in SBs did not show any change. Conclusion In conclusion, a decline in PA between the 1st and 2nd grades of high school was marked but was not accompanied with an increase in SBs. Policies aimed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA.

Is School Type Associated with Objectively Measured Physical Activity in 15-Year-Olds?

The main aims of this study were: (1) to determine the objectively assessed physical activity (PA) patterns in urban 15-year-old male and female adolescents according to school type and (2) to assess the differences in PA between school days and weekend days. In this cross-sectional study, participants were 187 secondary-school male and female adolescents (61.4% females) attending grammar and vocational schools. Patterns of PA were objectively evaluated using a multi-sensor body monitor for 5 consecutive days. Confounders assessed included biological age, socio-economic status, sum of 4 skinfolds, maximal temperature and the amount of rainfall. Males and females from grammar schools achieved higher total daily energy expenditure (TEE) and active energy expenditure (AEE) compared to their peers from vocational schools (TEE: 50 ± 12 kcal/kg/day vs. 47 ± 12 kcal/kg/day, p = 0.02; AEE: 23 ± 5 kcal/kg/day vs. vocational = 21 ± 6 kcal/kg/day, p = 0.04). No differences in time spent in light (LPA), moderate (MPA) or vigorous (VPA) physical activity were noted between the two groups (p = 0.16-0.43). Next, a significant decline in TEE and MPA between school days and weekends was observed (p< 0.001 and p = 0.02, respectively), while VPA remained the same throughout the week (p = 0.76). Weekly patterns of PA did not show differences by school type or gender (p for interactions = 0.21-0.50). In addition, significantly lower amount of MPA was accumulated during weekends compared to school days, resulting in lower TEE, regardless of school type or gender. Policies and strategies on PA in adolescents should focus vocational schools and weekend days.