A Deep Learning Neural Network to Classify Obesity Risk in Portuguese Adolescents Based on Physical Fitness Levels and Body Mass Index Percentiles: Insights for National Health Policies.

The increasing prevalence of overweight and obesity among adults is a risk factor for many chronic diseases and death. In addition, obesity among children and adolescents has reached unprecedented levels and studies show that obese children and adolescents are more likely to become obese adults. Therefore, both the prevention and treatment of obesity in adolescents are critical. This study aimed to develop an artificial intelligence (AI) neural network (NNET) model that identifies the risk of obesity in Portuguese adolescents based on their body mass index (BMI) percentiles and levels of physical fitness. Using datasets from the FITescola® project, 654 adolescents aged between 10-19 years old, male: 334 (51%), female: n = 320 (49%), age 13.8 ± 2 years old, were selected to participate in a cross-sectional observational study. Physical fitness variables, age, and sex were used to identify the risk of obesity. The NNET had good accuracy (75%) and performance validation through the Receiver Operating Characteristic using the Area Under the Curve (ROC AUC = 64%) in identifying the risk of obesity in Portuguese adolescents based on the BMI percentiles. Correlations of moderate effect size were perceived for aerobic fitness (AF), upper limbs strength (ULS), and sprint time (ST), showing that some physical fitness variables contributed to the obesity risk of the adolescents. Our NNET presented a good accuracy (75%) and was validated with the K-Folds Cross-Validation (K-Folds CV) with good accuracy (71%) and ROC AUC (66%). According to the NNET, there was an increased risk of obesity linked to low physical fitness in Portuguese teenagers.

Obesity Status and Physical Fitness Levels in Male and Female Portuguese Adolescents: A Two-Way Multivariate Analysis.

Obesity and decreasing fitness levels among the youth are growing concerns in Portugal, similar to other developed countries, with implications for health and psychomotor development. Understanding the influence of health determinants such as sex and age are crucial for developing effective public health strategies. This study aimed to analyze the association between sex and chronological age with obesity status and physical fitness in Portuguese adolescents. A total of 170 adolescents (85 males and 85 females) were evaluated for body mass index, abdominal adiposity, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed in a 40 m sprint using the FITescola® physical fitness battery, a Portuguese government initiative. The general model, analyzed using Pillai's trace, showed a significant effect of age and sex on body mass index, abdominal circumference, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed (V = 0.99, F (7) = 10,916.4, p < 0.001, partial η2, sex = 0.22; age = 0.43, sex and age interaction = 0.10). Boys had higher physical fitness levels than girls in most tests, but both sex groups had a significantly higher proportion of non-fit adolescents, with boys showing the highest number of participants classified as non-fit.

Physical Activity and Sedentary Behavior in Adults from Penafiel, Portugal: A Cross-Sectional Study.

The aim of this study was to compare the physical activity (PA) and sedentary behavior (SB) levels of young and middle-aged adults living in and around the municipality of Penafiel and to determine whether they meet PA recommendations. The researchers used the "International Physical Activity Questionnaire" (IPAQ) to measure moderate to vigorous PA and time spent on sedentary behavior (high vs. low). A prospective observational cross-sectional sample of 1105 adults aged 18-63 years, living in the municipality of Penafiel and its surroundings (45% women, 55% men), was used. The results indicated that more than half of the population was inactive (53.8%) and sedentary (54.0%). Men were more likely to be sedentary (59.2%) and inactive (55.6%) than women (inactive: 51.7%, high SB: 47.7%). Regarding daily PA and SB levels, women had higher levels of walks (3.8 ± 2.3; p = 0.034) and vigorous PA (2.2 ± 1.8 min; p = 0.005) per days/week, as well as vigorous PA per minutes/week (75.4 ± 82.1 min; p = 0.034). The time spent on vigorous PA per day was also higher in women (26.2 ± 22.8 min; p = 0.030). However, men had higher values in walking minutes per day (26.3 ± 17.1 min; p = 0.030), SB for weekdays (429.2 ± 141.2 min; p = 0.001), SB for weekends (324.7 ± 163.7 min; p = 0.033) and time spent on SB per minutes/week (2795.6 ± 882.0 min; p = 0.001). The results also showed that the older the adults, the lower the frequency and total time of vigorous PA per week. Young adults (18-28 years) had higher levels of vigorous PA (p = 0.005) than the other age groups (29-39; 40-50 and 51-63 years). Finally, the study found no significant correlation between individual level factors, such as number of children, marital status and monthly income, and PA or SB. Conversely, a significant and negative correlation between SB and levels of PA was found, indicating that the higher the level of PA practice, the lower the SB level. The authors suggest that promoting new PA habits and healthy lifestyles is an important future challenge for sustainability and improving the quality of life in public health.

Associations between Coronavirus and Immune Response, Cardiorespiratory Fitness Rehabilitation and Physical Activity: A Brief Report.

COVID-19 has serious effects on cardiorespiratory capacity. In this sense, physical activity has been identified as beneficial in the treatment of cardiorespiratory diseases due to its anti-inflammatory and immunosuppressive benefits. To date, no study has been found on cardiorespiratory capacity and rehabilitation in patients cured after COVID-19. Thus, this brief report aims to relate the benefits of physical activity to cardiorespiratory function after COVID-19. It is important to know how different levels of physical activity can be related to the different symptoms of COVID-19. In view of this, the objectives of this brief report were to: (1) explore the theoretical associations between COVID-19 symptoms and physical activity; (2) compare the cardiorespiratory function of non-COVID-19 participants and post-COVID-19 patients; and (3) propose a physical activity program to improve the cardiorespiratory fitness of post-COVID-19 patients. Thus, we note that moderate-intensity physical activity (i.e., walking) has a greater beneficial effect on immune function, whereas vigorous activity (i.e., marathon running) tends to temporarily reduce immune function through an imbalance of cytokine types I and II in the hours and days after exercise. However, there is no consensus in the literature in this regard, since other investigations suggest that high-intensity training can also be beneficial, not causing clinically relevant immunosuppression. Physical activity has been shown to be beneficial in improving the clinical conditions most frequently associated with severe COVID-19. Thus, it is possible to infer that physically active individuals seem to be less exposed to the dangers of severe COVID-19 compared to non-active individuals through the benefits of physical activity in strengthening the immune system and fighting infections. The current study demonstrates that physical activity appears to be beneficial in improving the clinical conditions most often associated with severe COVID-19.

The Influence of Abdominal Adiposity and Physical Fitness on Obesity Status of Portuguese Adolescents.

The aim of this study was to verify the relationship between abdominal adiposity and physical fitness in the obesity status of Portuguese adolescents. BMI, abdominal adiposity, and physical fitness tests from the FITescola® were evaluated in a total of 654 Portuguese adolescents, aged 10-19 years old-male: n = 334 (51%), female: n = 320 (49%). For the final model, BMI was positively related with age (ß = 0.25), abdominal adiposity (ß = 0.313), horizontal jump (ß = -0.100), 40 m maximal velocity (ß = 0.274), and aerobic fitness (ß = -0.250, R2 = 0.75, F = 382.2, and p = 0.0001). We conclude that higher age and abdominal adiposity are positively related with a higher adolescent BMI. Furthermore, lower horizontal jump distances and worse times on the 40 m maximal velocity were inversely related with a higher adolescent BMI, and lower aerobic fitness was inversely related with a higher adolescent BMI.

Associations Between Motor Competence, Moderate-to-Vigorous Physical Activity, and Body Mass Index Among Preschoolers Over 1 Year.

BACKGROUND: To examine the associations between motor competence (MC), moderate to vigorous physical activity (MVPA), and body mass index (BMI) changes over 1 year in preschoolers. METHODS: Fifty-four preschoolers (24 girls; 42.4%) aged 4-5 years old from the metropolitan area of Porto, Portugal comprised the sample. Height, body mass, and BMI were calculated. MC was assessed according to the Movement Assessment Battery for Children-2. MVPA was measured by accelerometry. For each participant, changes in MVPA, MC, and BMI over a year were computed. Different levels of MC were calculated; and then data were analyzed. RESULTS: The MVPA increased over time in all levels of MC in the follow-up. The BMI decreased over time for all levels in follow-up (P = .001). The preschoolers classified as at a high level of MC were more likely to spend more time in MVPA (in minutes) than their counterparts with low MC in follow-up. Multiple linear regression analyses, adjusted by sex and age, were fit to predict Δ% MC by Δ% MVPA and Δ% BMI. The Δ% MC was positively associated with Δ% MVPA. CONCLUSION: Increases in MC were positively associated with MVPA. Higher performance in MC increases due to time spent in MVPA. Improvement of MC in young children has potentially relevant policy implications related to MVPA and public health.

Relationship Among Changes in Sedentary Time, Physical Activity, and Body Mass Index in Young Schoolchildren: A 3-Year Longitudinal Study.

PURPOSES: To examine the association between sedentary time (ST) and light physical activity (LPA), moderate- to vigorous-intensity physical activity (MVPA), and body mass index (BMI), and to track these behaviors over a 3-year follow-up in young schoolchildren. METHODS: The final sample was 64 children (female: n = 36 or 56.3%), enrolled in schools in Porto, Portugal. Height and mass of children were measured by standard methods, and BMI was then calculated. ST, LPA, and MVPA were measured by accelerometer. Changes (Δ) and relative changes (Δ%) between 2009/2010 and 2012/2013 of ST, LPA, MVPA, and BMI were computed. Multiple linear regression analyses were fit to predict Δ%ST (outcome variable), by Δ%LPA, Δ%MVPA, and Δ%BMI (exposure variables). RESULTS: ST increased and LPA decreased significantly for whole sample (both Ps < .05). No statistically significant difference was found for MVPA over time. There were no differences for ΔST, ΔLPA, ΔMVPA, and ΔBMI between boys and girls. The Δ%LPA and Δ%MVPA were negatively associated with Δ%ST, whereas Δ%BMI was positively associated. Tracking coefficients varied from moderate to strong. CONCLUSIONS: Time spent in ST increases due to displacement of time in LPA. This reinforces public health measures and suggests the need for interventions focusing on offsetting the decline ST and increasing MVPA during childhood.

Motor fitness and preschooler children obesity status.

The aim of this study was to examine the association between motor fitness (MF) and obesity status in preschool children. The sample comprised 467 children aged 3-6 years. Preschool children body mass index was classified according to International Obesity Task Force and categorised into three levels, normal, overweight and obesity. Total physical activity was assessed by accelerometer and MF test was assessed through two MF tests 10 × 5m shuttle run test (SRT) and a 7 m jumping distance on 2 feet test (J2F). Low MF was considered for MF if SD above 1. A single variable with three categories was created: low MF medium MF and high MF. The prevalence of normal weight, overweight and obesity was 67.6%, 22.7% and 9.7%, respectively. The prevalence of SD > 1 for SRT was 13.7% and 14.4% for J2F, for single variable was 19.2%. Multinomial logistic regression analysis showed that obese preschoolers were more likely six times classified as having low MF level than their non-overweight counterparts (OR: 6.4; IC: 1.3-36.6). This study showed a considerable prevalence of overweight and obesity among preschoolers. Obesity has already been associated with lower MF. Further longitudinal studies are needed to confirm this data.

Parental education and perception of outdoor playing time for preschoolers

Abstract Aim: The objective of this study was to analyze whether or not socioeconomic positions influence outdoor playtime during the week (WK) and on the weekends (WEND). Methods: The sample consisted of 485 (girls; n=223) healthy preschoolers, aged from 3 to 6 years, enrolled in kindergartens from the metropolitan area of Porto, Portugal. Physical Activity (PA) was assessed for 7 consecutive days with an accelerometer. The time playing outdoors during the WK or the WEND was reported by parents. Anthropometric data (weight and height) was collected following standardized protocols. Socioeconomic position was assessed by Parental Education (PE), according to the Portuguese education system. Results: We found differences in time spent playing outdoors either for the WK or WEND, but not for Total PA (TPA), in both sexes. However, regression analysis showed that after age adjustment, BMI and TPA for both sexes, we only found significant associations between low PE (LPE) and high PE (HPE) groups on WK or WEND. However, we found no statistically significant association for boys on the WK (p=0.06). Conclusion: Our findings suggest that socioeconomic position can influence the children's time spent in outdoor activities, especially on the weekends. This may have implications for future interventions with this age group.

Screen time between Portuguese and Brazilian children: a cross-cultural study

Abstract AIMS To verify differences in screen time (ST) (hours watching TV, using computer and/or video game) and to compare the percentage of meeting ST recommendation between Portuguese and Brazilian children. METHODS The sample comprised 369 children aged 9 year-old from Portugal (n=95) and Brazil (n=274). ST average (h/day), physical activity (PA) and socioeconomic status (SES) were estimated by parental-report questionnaire. The Student t test or the Mann-Whitney U test and binary logistic regression analysis were used to verify differences and associations on ST (<2h/day) between cities. All analyses were stratified by gender and adjusted for age, BMI, PA and SES. RESULTS The prevalence of meet ST recommendation was 66.7% and 55.3% between Portuguese girls and boys and 25.0% and 16.4%between Brazilian girls and boys. Portuguese girls (1.58±0.84vs3.40 ± 1.76h/day, p<0.05) and boys (1.74 ± 1.18 vs 4.20 ± 2.30 h/day, p<0.05) had significantly less ST than their Brazilian counterparts. Brazilian girls (OR=7.593; p=0.0001) as well as Brazilian boys (OR=6.564; p=0.0001) were more likely to do not meet ST recommendation, compared with their Portuguese counterparts. CONCLUSIONS Portuguese children were approximately seven times more likely to meet ST recommendation than Brazilian children. Differences between countries should be considered in public policy strategies to reduce ST.(AU)