The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64).

Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.

Perceived Physical Literacy Is Associated with Cardiorespiratory Fitness, Body Composition and Physical Activity Levels in Secondary School Students.

BACKGROUND: Overweight and obese adolescents are often associated with lower Physical Activity (PA) levels and low Cardiorespiratory Fitness (CRF). Recently, the concept of Physical Literacy (PL), has been suggested to be associated with higher levels of active behavior and better health in adolescents. The purpose of this study is to investigate the relationships between PL, body composition, cardiorespiratory fitness and physical activity levels in French secondary school students. METHODS: The level of PL was assessed in 85 French adolescents using a French version of the Perceived Physical Literacy Instrument (F-PPLI). Cardiorespiratory fitness was measured by the "20 m adapted walk/shuttle run test". The PA level was assessed by the Youth Risk Behavior Surveillance System questionnaire. Weight status was measured by the Body Mass Index (BMI) and the body composition data. RESULTS: We find a significant association between the PL and the percentage Fat Mass (%FM) (r = -0.43; p ≤ 0.01), between the PL and moderate to vigorous PA (MVPA) per week (r = 0.38; p ≤ 0.01). The PL was associated (r = 0.36; p ≤ 0.01) with the percentage of Skeletal Muscle Mass (%SMM) and cardiorespiratory fitness (r = 0.40; p ≤ 0.05). CONCLUSIONS: Developing the PL for the most disadvantaged secondary school students in a PA program could be a suitable strategy to increase their PA level, reduce their adiposity, and promote better long-term health.

Influence of grade of obesity on the achievement of VO2max using an incremental treadmill test in youths.

The purpose of this study was to analyze the influence of grade of obesity on the probability of achieving a VO2 plateau and threshold secondary criteria for verifying VO2max during a treadmill walk test in youths with obesity. Therefore, 72 youths with obesity (aged 8-16) performed an incremental treadmill walk test to exhaustion during which oxygen uptake (VO2), minute ventilation (VE), heart rate (HR) and rating of perceived exertion were continuously measured. HR corresponding to a "hard" level of perceived exertion was reported and expressed as a percentage of the predicted HRmax. The rate of achievement of criteria for validation VO2max (VO2 plateau; HR>95% theoretical HRmax; RER>1.0; rating of perceived exertion ≥ "hard") was compared between participants with grade I and grade II obesity. 37% of the participants achieved a VO2 plateau and 23% achieved both an HR>95% and RER >1.0. Youths with grade II obesity had lower minute ventilation (p<0.01) tended to be more likely to reach an HR>95% (OR = 0.33; P=0.06) and a "hard" rating of perceived exertion than grade I (OR = 4.5; P=0.07). However, there was no influence of grade of obesity on the achievement of VO2 plateau, and RER>1.0.

The Relationships Between Skeletal Muscle Index and Bone Variables in a Group of Young Adults.

The purpose of this study was to investigate the relationships between skeletal muscle index (SMI) and bone variables in a group of young adults. Three hundred and thirty-five young adults (129 men and 206 women) whose ages ranged from 18 to 35 yr voluntarily participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. Body composition, bone mineral content (BMC), bone mineral density (BMD), geometric indices of hip bone strength and trabecular bone score (TBS) were determined for each individual by Dual-energy X-ray absorptiometry (DXA). Appendicular skeletal mass (ASM, in kg) was calculated by summing the muscle masses of the 4 limbs, assuming that all nonfat and nonebone mass is skeletal muscle. Skeletal muscle index (SMI) was defined as ASM/height². In young men, SMI was positively correlated to WB BMC (r = 0.63; p < 0.001), WB BMD (r = 0.53; p < 0.001), L1-L4 BMC (r = 0.33; p < 0.001), L1-L4 BMD (r = 0.30; p < 0.001), L1-L4 TBS (r = 0.26; p < 0.01), TH BMC (r = 0.61; p < 0.001), TH BMD (r = 0.46; p < 0.001), FN BMC (r = 0.51; p < 0.001), FN BMD (r = 0.46; p < 0.001), FN cross-sectional area (CSA) (r = 0.56; p < 0.001), FN cross-sectional moment of inertia (CSMI) (r = 0.52; p < 0.001) and FN section modulus (Z) (r = 0.54; p < 0.001) but negatively correlated to FN strength index (SI) (r = -0.24; p < 0.01). In young women, SMI was positively correlated to WB BMC (r = 0.61; p < 0.001), WB BMD (r = 0.60; p < 0.001), L1-L4 BMC (r = 0.35; p < 0.001), L1-L4 BMD (r = 0.33; p < 0.001), L1-L4 TBS (r = 0.29; p < 0.001), TH BMC (r = 0.61; p < 0.001), TH BMD (r = 0.53; p < 0.001), FN BMC (r = 0.45; p < 0.001), FN BMD (r = 0.49; p < 0.001), FN CSA (r = 0.60; p < 0.001), FN CSMI (r = 0.52; p < 0.001), and FN Z (r = 0.40; p < 0.001) but negatively correlated to FN SI (r = -0.20; p < 0.01). The current study suggests that SMI is a positive determinant of bone mineral density and geometric indices of hip bone strength in young adults.

Composite Indices of Femoral Neck Strength in Middle-Aged Inactive Subjects Vs Former Football Players.

The purpose of this study was to compare composite indices of femoral neck strength ((compression strength index [CSI], bending strength index [BSI], and impact strength index [ISI]) in inactive middle-aged men (n = 20) and middle-aged former football players (n = 15). 35 middle-aged men participated in this study. Body composition and bone variables were evaluated by dual-energy X-ray absorptiometry. Composite indices of femoral neck strength (CSI, BSI, and ISI) were calculated. Handgrip strength, vertical jump, maximum power of the lower limbs (watts), horizontal jump, maximal half-squat strength, maximal bench-press strength, sprint performance (10 meters), and maximum oxygen consumption (VO2 max, ml/min/kg) were evaluated using validated tests. CSI, BSI, and ISI were significantly higher in football players compared to inactive men. Vertical jump, horizontal jump, maximal half-squat strength, VO2 max and sprint performance were significantly different between the 2 groups. CSI, BSI, and ISI remained significantly higher in football players compared to inactive men after adjusting for physical activity level. The current study suggests that former football practice is associated with higher composite indices of femoral neck strength in middle-aged men.

Muscular power and maximum oxygen consumption predict bone density in a group of middle-aged men.

OBJECTIVE: The purpose of this study was to explore the relationships between several physical performance variables and bone parameters in a group of middle-aged men. METHODS: 50 middle-aged men participated in this study. Body composition and bone variables were evaluated by DXA. Bone mineral density (BMD) was measured at the whole body (WB), total radius (TR), lumbar spine (L1-L4), total hip (TH) and femoral neck (FN). Geometric indices of femoral neck (FN) strength were also calculated by DXA. Handgrip strength, vertical jump, maximum power of the lower limbs (watts), maximal half-squat strength, maximal bench-press strength, sprint performance (10 m) and maximum oxygen consumption (VO2 max, L/min) were evaluated using validated tests. RESULTS: VO2 max (L/min), maximum power of the lower limbs, maximal half-squat strength, maximal bench-press strength, handgrip and lean mass were positively correlated to many bone parameters. Lean mass was the strongest determinant of WB BMC. VO2 max (L/min) was the strongest determinant of WB BMD, TH BMD and FN BMD. Maximum power was the strongest determinant of total radius BMD. CONCLUSION: The current study suggests that VO2 max (L/min), lean mass and maximum power of the lower limbs are the strongest determinants of bone variables in middle-aged men.

Influence of Physical Activity Level on Composite Indices of Femoral Neck Strength in a Group of Young Overweight Men.

The aim of the present study was to explore the influence of physical activity level on composite indices of femoral neck strength (compression strength index [CSI], bending strength index, and impact strength index) in a group of young overweight men. To do so, we compared composite indices of femoral neck strength in active overweight men and insufficiently active overweight men. They were divided into 2 groups based on their physical activity level: 70 active overweight men (engaging in more than 150 minutes of physical activity per week; 8.7 ± 4.8 h/wk) and 26 insufficiently active overweight men (engaging in less than 150 minutes of physical activity per week; 1.2 ± 0.7 h/wk). Height (m) and weight (kg) were measured, and body mass index (kg/m2) was calculated. Bone mineral density was measured by dual-energy X-ray absorptiometry at whole body, lumbar spine, total hip, and femoral neck. Body weight, lean mass, fat mass, and body mass index were not significantly different between the 2 groups. CSI, bending strength index, and impact strength index were significantly higher in active overweight men compared to insufficiently active overweight men. After adjustment for age, physical activity (h/wk) and lean mass, only CSI remained higher in active overweight men compared to insufficiently active overweight men. This study suggests that, in young overweight men, being active (engaging in more than 150 minutes of physical activity per week) is associated with greater composite indices of femoral neck strength. To our knowledge, this is the first study that finds a significant difference regarding composite indices of femoral neck strength between 2 groups of young overweight men with different levels of physical activity.

Does Muscular Power Predict Bone Mineral Density in Young Adults?

The aim of this study was to explore the relationships between maximum power and bone variables in a group of young adults. Two hundred and one young adults (53 men and 148 women) whose ages range from 18 to 35 years voluntarily participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, bone mineral content (BMC) and bone mineral density (BMD) were determined for each individual by dual-energy X-ray absorptiometry. Vertical jump was evaluated using a validated field test (Sargent test). The highest vertical jump was selected. Maximum power (P max, in watts) of the lower limbs was calculated accordingly. In young men, maximum power was positively correlated to whole body (WB) BMC (r = 0.65; p < 0.001), WB BMD (r = 0.41; p < 0.01), L1-L4 BMC (r = 0.54; p < 0.001), total hip (TH) BMC (r = 0.50; p < 0.001), femoral neck (FN) BMC (r = 0.35; p < 0.01), FN cross-sectional area (CSA) (r = 0.33; p < 0.05) and FN cross-sectional moment of inertia (CSMI) (r = 0.50; p < 0.001). In young women, maximum power was positively correlated to WB BMC (r = 0.48; p < 0.001), WB BMD (r = 0.28; p < 0.001), L1-L4 BMC (r = 0.34; p < 0.001), TH BMC (r = 0.43; p < 0.001), TH BMD (r = 0.21; p < 0.01), FN BMC (r = 0.42; p < 0.001), FN BMD (r = 0.31; p < 0.001), FN CSA (r = 0.41; p < 0.001), FN CSMI (r = 0.40; p < 0.001) and FN Z (r = 0.41; p < 0.01). The current study suggests that maximum power is a positive determinant of WB BMC, WB BMD, FN CSA, and FN CSMI in young men. It also shows that maximum power is a positive determinant of WB BMC, WB BMD, TH BMD, FN BMD, FN CSA, FN CSMI, and FN Z in young women.

Nutritional status and eating disorders among medical students from the Cluj-Napoca University centre.

BACKGROUND AND AIMS: The nutritional disorders are modifiable predisposing factors of the current leading causes of morbidity and premature mortality, such as cardiovascular diseases, diabetes and cancers. An early recognition of appropriate interventions could decrease the burden of medical costs and increase the healthy life expectancy. The aims of our study were the description of nutritional status, its associated factors, and the detection of eating disorders among Romanian medical students of the "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca. METHODS: A cross-sectional study was conducted during the 2015-2016 academic year, including medical students from all study years, by an online questionnaire. The statistics, both descriptive and inferential, were calculated using EpiInfo. RESULTS: A total of 222 students from the University Romanian section were included, with a sex-ratio (men:women) of 0.22. The average body mass index of the medical students included was 21.3±3.3 kg/m2, for females it was 20.7±3 kg/m2 and for males 23.9±3.1 kg/m2. For the nutritional disorders such as overweight, the prevalence among males (30%) had a net predominance (p<0.001) over females (4.4%), while for underweight, it was prevalent only for female students (20.3%). Overweight was associated with low academic performance (odds ratio (OR)=7.2; 95% confidence interval (95% CI): 1-53.94), smoking (OR=2.4; 95% CI: 1-5.76) and binge drinking (OR=3; 95% CI: 1.26-7.25). Eating disorders were reported by 25.7% of the students and were significantly more prevalent in students in the second academic study cycle (47.4%; 95% CI: 34.7-60.3%) and in students with jobs (7%; 95% CI: 2.3-16.1%). CONCLUSIONS: In this survey, two different distribution models of nutritional disorders for both genders were identified, with the predominance of overweight among men. Eating disorders were more prevalent among students in the second study cycle and those with jobs at the same time.

Effects of a 12-week physical activities programme on sleep in female university students.

Lack of sleep is known to negatively affect adolescent's health and the links between regular physical activity and sleep are unclear.This pilot study investigated whether the regular practice of physical activities among sedentary female students would improve their sleep. Nineteen female students, identified as sedentary and having poor subjective sleep quality were assigned in two groups to a 12-week university physical activities programme in accordance with the recommendations of World Health Organisation (N = 10) or to a control condition (N = 9). Sleep was assessed with actigraphy before and after the study and with the Pittsburg Sleep Quality 15 Index (PSQI) at the beginning, middle, and end of the study. The intensity of physical activities was controlled by heart rate monitor. The analysis showed that sleep quality in the physical activities group improved, with the mean ± SD PSQI score decreasing from 9.1 ± 1.7 to 4.8 ± 2.0. Despite some limitations, these pilot data indicate that a physical activities programme is feasible to implement in students, and that participation in such a programme improves sleep in 18- 24 -year-old female adolescents. Further potential benefits remain to be investigated in follow-up research.

Evaluation of Global Health in Master Swimmers Involved in French National Championships.

BACKGROUND: Swimming is often recommended as a means of increasing physical activity and gaining health benefits. The present study examined the psychological, social, and physical health states in competitive swimmers engaged in long-term training. METHODS: The study took place during the 4 days of the French master championships in France in 2011 (from 10 to 13 March). Global health parameters were evaluated and compared with general values reported in studies aiming to describe health standard values in France or Europe. All swimmers selected for the event were invited to participate in the study. Setting questionnaires concerning mental and social health (short form 36), physical activity (International Physical Activity Questionnaire), and medication were administered. Peak expiratory flow (l.min-1) was measured, and body mass index (kg.m-2) was calculated from height (m) and body mass (kg). Prevalence of overweight and obesity was calculated by age and gender. Chi-squared tests were used to compare prevalence of overweight and obesity between participants and reference values. Short form 36 scores and physical activity (met.h.week-1) were compared with reference values by single t-tests. Two-way ANOVA was used to compare peak flow results with standard values. The level of significance was set at p < 0.05. RESULTS: Out of 1554 master swimmers, 490 participated in this study (rates of participation = 44.8 and 23.5 % for females and males, respectively). Data showed inequality of health indexes as compared with reference values, despite a significantly higher level of physical activity including swimming activity. The prevalence of obesity was significantly lower (p < 0.05), and peak expiratory flow values were higher among female swimmers (from 7.6 to 17 % higher according to the age, p < 0.05). Perception of vitality was significantly higher for all female swimmers and the older age groups of male swimmers (p < 0.05). Perception of bodily pain indicated significantly lower scores for swimmers than the reference values (p < 0.05). Significantly lower prevalence of swimmers taking medication was noted in comparison with the French national values (p = 0.012). CONCLUSIONS: Compared with reference data from various sources, master competitive swimmers used less medication, had lower rates of obesity in most age groups, had greater peak expiratory flow values suggesting improved lung function, had higher levels of total physical activity, and had more favorable scores for various subscales of the SF-36. The results argue in favor of competitive swimming for its positive effects on health outcomes. KEY POINTS: French master swimmers involved in national championships have many positive health outcomes in terms of weight management, respiratory function, and vitality. However, the very high physical activity level in this competitive context did not result in significantly better levels on all parameters in comparison with their national counterparts (pain perception, social, emotional, and mental health).Positive health outcomes were higher for female master swimmers in terms of weight management, respiratory function, and vitality.The fact that these benefits were not linked with medication consumption could be interesting in an economic context aimed at controlling expenditures on health. Based on these data, we can argue for promoting this form of physical activity across the lifespan.

Maximal oxygen consumption and bone mineral density in a group of young Lebanese adults.

The aim of this study was to explore the relationship between maximal oxygen consumption (VO2 max) and bone mineral density (BMD) in a group of young Lebanese adults. Twenty women and 37 men whose ages range from 18 to 32 yr participated in this study. Informed written consent was obtained from the participants. Body weight and height were measured, and body mass index was calculated. VO2 max was determined by direct measurement while exercising on a bicycle ergometer (Siemens-Elema RE 820; Rodby Elektronik AB, Enhorna, Sweden). Whole body bone mineral content (WB BMC), whole body bone mineral density (WB BMD), lumbar spine BMD (L1-L4 BMD), total hip BMD (TH BMD), and femoral neck BMD (FN BMD) were measured by dual-energy X-ray absorptiometry. In women, VO2 max (expressed as L/mn) was positively correlated to WB BMC (r = 0.82; p < 0.001), WB BMD (r = 0.80; p < 0.001), L1-L4 BMD (r = 0.73; p < 0.001), TH BMD (r = 0.80; p < 0.001), and FN BMD (r = 0.85; p < 0.001). In men, VO2 max (expressed as L/mn) was positively correlated to WB BMC (r = 0.57; p < 0.001), WB BMD (r = 0.53; p < 0.001), L1-L4 BMD (r = 0.50; p < 0.001), TH BMD (r = 0.38; p < 0.01), and FN BMD (r = 0.30; p < 0.05). In both sexes, the positive associations between VO2 max and bone variables (BMC and BMD) remained significant after adjustment for age (p < 0.001). This study suggests that VO2 max (L/mn) is a positive determinant of BMC and BMD in young adults. Aerobic power seems to be a determinant of BMC and BMD in young adults.

Geometric indices of hip bone strength in male professional soccer players.

AIM OF THE STUDY: The aim of this study was to compare geometric indices of hip bone strength in male professional soccer players and controls. METHODS: Twenty-three male professional soccer players and 21 male sedentary subjects whose ages range between 18 and 30 years participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. Daily calcium intake and physical activity were evaluated using validated questionnaires. Hip bone mineral density was measured by dual-energy X-ray absorptiometry (DXA). To evaluate hip bone geometry, DXA scans were analyzed at the narrow-neck (NN), the intertrochanteric (IT) region and the femoral shaft (FS) by the Hip Structure Analysis (HSA) program. Cross sectional area (CSA), an index of axial compression strength, cross sectional moment of inertia (CSMI), an index of structural rigidity, section modulus (Z), an index of bending strength, cortical thickness (CT) and buckling ratio (BR) were measured from bone mass profiles. RESULTS: CSA, CSMI, Z and CT of the three regions (NN, IT and FS) were higher in soccer players compared to controls. After adjustment for either age, body weight, height or physical activity duration (h/week), CSA, CSMI, Z and CT of the three regions remained higher in soccer players compared to controls. CONCLUSION: This study suggests that, in young adult males, soccer practice is associated with greater axial strength, bending strength and structural rigidity indices at the hip.

[Sleep quality is a determinant of hip bone mineral density in a group of young Lebanese men]. / La qualité du sommeil est un déterminant de la densité minérale osseuse de la hanche chez un groupe de jeunes hommes libanais.

INTRODUCTION: The aim of this study was to explore the relationship between sleep quality and bone mineral density (BMD) of the hip in a group of young Lebanese men. METHODS AND RESULTS: Fourteen Lebanese young men from 18 to 30 years (mean age 22.6 years) participated in this study. Weight and height were measured and body mass index (BMI) was calculated. BMD of the total hip (TH) and the femoral neck (FN) was measured by DXA. Daily protein intake (DPI), daily calcium intake (DCI) and sleep quality were evaluated by validated questionnaires. The Pittsburgh sleep quality index (PSQI) was used to assess sleep habits and quality; higher scores represent worse sleep quality. Weight, height, BMI, DCI, DPI and sleep duration were not correlated to BMD values. The Pittsburgh sleep quality index was negatively correlated to femoral neck BMD (r = -0.82; p < 0.001) and to TH BMD (r = -0.54; p < 0.05). CONCLUSION: This study suggests that poor sleep quality affects negatively BMD of the hip in young adult men. Our findings may lead to the development of better preventive approaches to osteoporosis.