Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants.

BACKGROUND: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. OBJECTIVES: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. METHODS: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. RESULTS: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). CONCLUSIONS: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

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.

Promotion of health-enhancing physical activity in the sport sector: a study among representatives of 536 sports organisations from 36 European countries.

BACKGROUND: It is a common belief that most sports clubs and organisations are primarily focused on elite sports while placing less emphasis on the promotion of health-enhancing physical activity (HEPA). However, there is a lack of evidence on this topic in the scientific literature. Therefore, the aim of this study was to determine the level and correlates of the commitment of sports organisations in Europe to HEPA promotion. METHODS: Representatives of 536 sports organisations from 36 European countries responded to our survey. A multiple regression analysis was conducted with the commitment of sports organisation to HEPA promotion (0 ["not at all"] - 10 ["most highly"]) as the outcome variable and organisation type ("national sport association" reference group [ref], "European sports federation", "national umbrella sports organisation", "national Olympic committee", "national sport-for-all organisation"), headquarters in a European Union member state ("no" [ref], "yes"), region of Europe ("Western" [ref], "Central and Eastern", "Northern", "Southern"), commitment to elite sports ("low" [ref], "medium", "high"), and awareness of Sports Club for Health (SCforH) guidelines ("no" [ref], "yes") as explanatory variables. RESULTS: Approximately 75.2% (95% confidence interval [CI]: 71.5, 78.8) of sports organisations were highly committed to elite sports. Only 28.2% (95% CI: 24.4, 32.0) of sports organisations reported a high commitment to HEPA promotion. A higher commitment to HEPA promotion was associated with the national Olympic committees (ß = 1.48 [95% CI: 0.41, 2.55], p = 0.007), national sport-for-all organisations (ß = 1.68 [95% CI: 0.74, 2.62], p < 0.001), location in Central and Eastern Europe (ß = 0.56 [95% CI: 0.01, 1.12], p = 0.047), and awareness of SCforH guidelines (ß = 0.86 [95% CI: 0.35, 1.37], p < 0.001). CONCLUSION: From our findings, it seems that most sports organisations are primarily focused on elite sports. Coordinated actions at the European Union and national levels are needed to improve the promotion of HEPA through sports organisations. In this endeavour, it may be useful to consider national Olympic committees, national sport-for-all organisations, and relevant sports organisations in Central and Eastern Europe as role models and to raise the awareness of SCforH guidelines.

Accuracy and Precision of Consumer-Grade Wearable Activity Monitors for Assessing Time Spent in Sedentary Behavior in Children and Adolescents: Systematic Review.

BACKGROUND: A large number of wearable activity monitor models are released and used each year by consumers and researchers. As more studies are being carried out on children and adolescents in terms of sedentary behavior (SB) assessment, knowledge about accurate and precise monitoring devices becomes increasingly important. OBJECTIVE: The main aim of this systematic review was to investigate and communicate findings on the accuracy and precision of consumer-grade physical activity monitors in assessing the time spent in SB in children and adolescents. METHODS: Searches of PubMed (MEDLINE), Scopus, SPORTDiscus (full text), ProQuest, Open Access Theses and Dissertations, DART Europe E-theses Portal, and Networked Digital Library of Theses and Dissertations electronic databases were performed. All relevant studies that compared different types of consumer-grade monitors using a comparison method in the assessment of SB, published in European languages from 2015 onward were considered for inclusion. The risk of bias was estimated using Consensus-Based Standards for the Selection of Health Status Measurement Instruments. For enabling comparisons of accuracy measures within the studied outcome domain, measurement accuracy interpretation was based on group mean or percentage error values and 90% CI. Acceptable limits were predefined as -10% to +10% error in controlled and free-living settings. For determining the number of studies with group error percentages that fall within or outside one of the sides from previously defined acceptable limits, two 1-sided tests of equivalence were carried out, and the direction of measurement error was examined. RESULTS: A total of 8 studies complied with the predefined inclusion criteria, and 3 studies provided acceptable data for quantitative analyses. In terms of the presented accuracy comparisons, 14 were subsequently identified, with 6 of these comparisons being acceptable in terms of quantitative analysis. The results of the Cochran Q test indicated that the included studies did not share a common effect size (Q5=82.86; P<.001). I2, which represents the percentage of total variation across studies due to heterogeneity, amounted to 94%. The summary effect size based on the random effects model was not statistically significant (effect size=14.36, SE 12.04, 90% CI -5.45 to 34.17; P=.23). According to the equivalence test results, consumer-grade physical activity monitors did not generate equivalent estimates of SB in relation to the comparison methods. Majority of the studies (3/7, 43%) that reported the mean absolute percentage errors have reported values of <30%. CONCLUSIONS: This is the first study that has attempted to synthesize available evidence on the accuracy and precision of consumer-grade physical activity monitors in measuring SB in children and adolescents. We found very few studies on the accuracy and almost no evidence on the precision of wearable activity monitors. The presented results highlight the large heterogeneity in this area of research. TRIAL REGISTRATION: PROSPERO CRD42021251922; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251922.

Comparative effectiveness of school-based interventions targeting physical activity, physical fitness or sedentary behaviour on obesity prevention in 6- to 12-year-old children: A systematic review and meta-analysis.

A systematic search of the literature was performed to compare the effects of interventions that targeted sedentary behaviours or physical activity (PA) or physical fitness on primary prevention of obesity in 6- to 12-year-old children. The search identified 146 reports that provided relevant data for meta-analysis. Point estimates in % body fat were higher for fitness interventions compared with PA interventions (standardized mean difference = -0.11%; 95% CI = -0.26 to 0.04, and -0.04%; 95% CI = -0.15 to 0.06, respectively). Including sedentary behaviour to a PA- or fitness-oriented intervention was not accompanied by an increase in intervention effectiveness, as the point estimates were slightly smaller compared with those for PA- or fitness-only interventions. Overall, the effects tended to be larger in girls than in boys, especially for PA + sedentary behaviour interventions. There was some evidence for inequality, as the effects on body mass index were seen when interventions were delivered in the general population (standardized mean difference = -0.05, 95% CI = -0.07 to -0.02), but not in groups of disadvantaged children (standardized mean difference = -0.01, 95% CI = -0.29 to 0.19). In conclusion, school-based PA interventions appear to be an effective strategy in the primary prevention of childhood obesity among 6- to 12-year-old children, but targeting sedentary behaviour in addition to PA or fitness does not increase the effectiveness of the intervention.

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.

Brain Breaks® Physical Activity Solutions in the Classroom and on Attitudes toward Physical Activity: A Randomized Controlled Trial among Primary Students from Eight Countries.

Classroom-based physical activity (PA) interventions have received considerable attention due to improvements seen in academic achievement, classroom behaviors, and attitude toward PA. The purpose of this study was to evaluate the effectiveness of the Brain Breaks® Physical Activity Solutions in changing children's attitudes toward PA. Students (N = 3036) aged 8-11 years from schools in Croatia, Lithuania, Macedonia, Poland, Romania, Serbia, South Africa, and Turkey were randomly assigned to either a control or an experimental group. The experimental group received Brain Breaks® videos during classroom sessions throughout the four months of intervention. Student attitudes toward PA were measured using the Attitudes toward Physical Activity Scale (APAS) before and after the intervention. Repeated measures ANOVA indicated a time interaction effect for all APAS variables except fitness. Time-by-group interaction effects with different effect sizes were found for most APAS variables, with the greatest gain effect noted in the experimental group for self-efficacy, followed by learning from the videos concerning PA benefits, exercise importance, and enjoyment from engaging in PA. This study provides evidence supporting Brain Breaks® in terms of learning experience, attitudes towards PA, and personal motivation. Using exercise videos is recommended as an interactive, technology-based PA solution that can be easily integrated into the school setting.

Effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults: a systematic review and meta-analysis.

BACKGROUND: No systematic reviews of the effectiveness of interventions for reducing non-occupational sedentary behaviour are available. Therefore, the aim of this systematic review was to assess the effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults. METHODS: An electronic search of nine databases was performed. Randomised controlled trials (RCT) and cluster RCTs among adults testing the effectiveness of interventions aimed to reduce non-occupational sedentary behaviour were considered for inclusion. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias. RESULTS: Nineteen studies that evaluated multicomponent lifestyle interventions, counselling or education, television (TV) control devices and workplace interventions were included. Evidence from the meta-analyses suggested that interventions can reduce leisure sitting time in adults in the medium term (-30 min/day; 95% CI -58 to -2), and TV viewing in the short term (-61 min/day; 95% CI -79 to -43) and medium term (-11 min/day; 95% CI -20 to -2). No significant pooled effects were found for transport sitting time, leisure-time computer use and longer term outcomes. No evidence was available on the effectiveness of interventions for reducing non-occupational sedentary time in older adults. CONCLUSIONS: The findings of this systematic review suggest the interventions may be effective in reducing non-occupational sedentary behaviour in the short to medium term in adults. However, no significant effect was found on longer term outcomes. The quality of evidence was, however, low to very low. No evidence was available on the effectiveness of non-occupational interventions on reducing sedentary time in older adults. Further high-quality research with larger samples is warranted.

Sleep Duration and Sleep Quality Associated with Dietary Index in Free-Living Very Old Adults.

The main purpose of the present study was to determine the associations between sleep duration and sleep quality with respect to dietary habits. In this cross-sectional study, 810 free-living older adults aged ≥85 years were recruited from six neighborhoods from the city of Zagreb. Diet, sleep duration and sleep quality were assessed using self-reported questionnaires. The associations between sleep duration and sleep quality with respect to dietary habits were examined using generalized estimating equations with Poisson regression analyses. After adjusting for body-mass index, self-rated health, psychological distress, physical activity, socioeconomic status, chronic disease/s, sex and age, we revealed that 'short' (<7 h; Rate Ratio (RR) = 0.43; 95% CI(confident interval) 0.30 to 0.64) and 'long' (>8 h; RR = 0.26; 95% CI 0.11 to 0.48) sleep durations and 'good' sleep quality (RR = 1.13; 95% CI 1.06 to 1.20) were associated with a 'moderate-to-high' healthy diet. When sleep duration and sleep quality were entered simultaneously into Model 3, 'short' (RR = 0.28; 95% CI 0.16 to 0.44 and 'long' (RR = 0.27; 95% CI 0.15 to 0.52) sleep duration and 'good' sleep quality (RR = 1.14; 95% CI 1.05 to 1.25) remained associated with a 'moderate-to-high' healthy diet. Our study shows that both 'short' and 'long' sleep duration and 'good' sleep quality are associated with 'moderate-to-high' healthy diets.

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.

Effects of linear and daily undulating periodized resistance training programs on measures of muscle hypertrophy: a systematic review and meta-analysis.

BACKGROUND: Periodization is an important component of resistance training programs. It is meant to improve adherence to the training regimen, allow for constant progression, help in avoiding plateaus, and reduce occurrence and severity of injuries. Previous findings regarding the effects of different periodization models on measures of muscle hypertrophy are equivocal. To provide a more in-depth look at the topic, we undertook a systematic review of the literature and a meta-analysis of intervention trials comparing the effects of linear periodization (LP) and daily undulating periodization (DUP) resistance training programs on muscle hypertrophy. MATERIALS AND METHODS: A comprehensive literature search was conducted through PubMed/MEDLINE, Scopus, Web of Science, SPORTDiscus, Networked Digital Library of Theses and Dissertations (NDLTD) and Open Access Theses and Dissertations (OATD). RESULTS: The pooled standardized mean difference (Cohen's d) from 13 eligible studies for the difference between the periodization models on muscle hypertrophy was -0.02 (95% confidence interval [-0.25, 0.21], p = 0.848). CONCLUSIONS: The meta-analysis comparing LP and DUP indicated that the effects of the two periodization models on muscle hypertrophy are likely to be similar. However, more research is needed in this area, particularly among trained individuals and clinical populations. Future studies may benefit from using instruments that are more sensitive for detecting changes in muscle mass, such as ultrasound or magnetic resonance imaging.

Reliability and Validity of the Inline Skating Skill Test.

This study aimed to examine the reliability and validity of the inline skating skill test. Based on previous skating experience forty-two skaters (26 female and 16 male) were randomized into two groups (competitive level vs. recreational level). They performed the test four times, with a recovery time of 45 minutes between sessions. Prior to testing, the participants rated their skating skill using a scale from 1 to 10. The protocol included performance time measurement through a course, combining different skating techniques. Trivial changes in performance time between the repeated sessions were determined in both competitive females/males and recreational females/males (-1.7% [95% CI: -5.8-2.6%] - 2.2% [95% CI: 0.0-4.5%]). In all four subgroups, the skill test had a low mean within-individual variation (1.6% [95% CI: 1.2-2.4%] - 2.7% [95% CI: 2.1-4.0%]) and high mean inter-session correlation (ICC = 0.97 [95% CI: 0.92-0.99] - 0.99 [95% CI: 0.98-1.00]). The comparison of detected typical errors and smallest worthwhile changes (calculated as standard deviations × 0.2) revealed that the skill test was able to track changes in skaters' performances. Competitive-level skaters needed shorter time (24.4-26.4%, all p < 0.01) to complete the test in comparison to recreational-level skaters. Moreover, moderate correlation (ρ = 0.80-0.82; all p < 0.01) was observed between the participant's self-rating and achieved performance times. In conclusion, the proposed test is a reliable and valid method to evaluate inline skating skills in amateur competitive and recreational level skaters. Further studies are needed to evaluate the reproducibility of this skill test in different populations including elite inline skaters.

Urban and rural fitness level: comparison between Italian and Croatian students.

The goal of this study was to investigate the differences in physical fitness in relation to urban or rural living environment and between two countries: Italy and Croatia. Over 14,000 students were tested during physical education (PE) lessons. Croatian students were taller and heavier than Italian students, with women achieving better results in flexibility. Urban students were fitter in abdominal strength than rural students. Age seemed to be the major factor influencing the performance. This study's results indicate a trend: urban students performed "indoor" tests better than rural students; the opposite may be true for rural students. Living environment, socio-economic-status, or cultural correlation differences could be decreased during school experiences. Thus, PE programs could train all people toward an adequate, age-based fitness level.