A bidirectional Mendelian randomisation study to evaluate the relationship between body constitution and hearing loss.

Hearing loss and hearing disorders represent possible mediating pathways in the associations between noise exposures and non-auditory health outcomes. In this context, we assessed whether the noise-obesity associations should consider hearing functions as possible mediators and applied Mendelian randomisation (MR) to investigate causal relationships between body constitution and hearing impairments. We obtained genetic associations from publicly available summary statistics from genome-wide association studies in European ancestry adult populations (N= from 210,088 to 360,564) for (i) body constitution: body mass index (BMI), waist circumference (WC) and body fat percentage (BFP), and (ii) hearing loss: sensorineural hearing loss, noise-induced hearing loss, and age-related hearing impairment (ARHI). We employed colocalisation analysis to investigate the genetic associations for BMI and ARHI liability within an FTO locus. We conducted bi-directional MR for the 'forward' (from body constitution to hearing) and 'reverse' directions. We applied the random effects inverse variance-weighted method as the main MR method, with additional sensitivity analyses. Colocalisation analysis suggested that BMI and ARHI shared a causal variant at the FTO gene. We did not find robust evidence for causal associations from body constitution to hearing loss and suggested that some associations may be driven by FTO variants. In the reverse analyses, ARHI was negatively associated with BMI [effect size - 0.22 (95% CI - 0.44 to - 0.01)] and BFP [effect size - 0.23 (95% CI - 0.45 to 0.00)], supporting the notion that ARHI may diminish body constitution. Finally, our data suggest that there is no strong evidence that hearing explains the association between noise exposure and body constitution.

Influence of Farm Environment on Asthma during the Life Course: A Population-Based Birth Cohort Study in Northern Finland.

We investigated the influence of a farming environment on asthma at three time points from birth to 46 years using the Northern Finland Birth Cohort 1966 (n = 10,926). The prevalence of asthma was investigated by postal questionnaires at 14, 31 and 46 years of age. Exposure to a farming environment was assessed by a postal questionnaire at birth and at 31 and 46 years of age. Odds ratios (ORs) and their 95% confidence intervals (95% CIs) for the prevalence of asthma were obtained from multinomial logistic regression, stratified by sex. Being born in a farmer family was potentially causally associated with lower risk of asthma in males at 31 years of age (OR 0.56, 95% CI 0.37, 0.85) and in females at 46 years of age (OR 0.64, 95% CI 0.44, 0.95). Working as a farmer was not associated with asthma. Exposure to a farming environment in childhood may have a lifelong impact on developing asthma from birth through young adulthood and until middle age, indicating that 'immune deviation' may persist throughout life.

Above average increases in body fat from 9 to 15 years of age had a negative impact on academic performance, independent of physical activity.

AIM: The associations between body fat levels and physical activity with academic performance are inconclusive and were explored using longitudinal data. METHODS: We enrolled 134/242 adolescents aged 15, who were studied at the age of nine and agreed to be followed up from April to May 2015 for the Health behaviours of Icelandic youth study. Accelerometers measured physical activity, body mass indexes (BMI) were calculated and dual-energy X-ray absorptiometry scans assessed the participants' body composition at nine and 15. Their language and maths skills were compared to a growth model that estimated the academic performances of children born in 1999. RESULTS: Higher than normal body fat levels between the ages of nine and 15 were negatively associated with maths performance, but the same association was not found for Icelandic language studies. These were Pearson's r = -0.24 (p = 0.01) for BMI and Pearson's r = -0.34 (p = 0.01) for the percentage of body fat. No associations were found with changes in physical activity. CONCLUSION: Children who put on more body fat than normal between the ages of nine and 15 had an increased risk of adverse academic performance that was independent of changes in physical activity.

Associations of Leukocyte Telomere Length With Aerobic and Muscular Fitness in Young Adults.

Decline in both telomere length and physical fitness over the life course may contribute to increased risk of several chronic diseases. The relationship between telomere length and aerobic and muscular fitness is not well characterized. We examined whether there are cross-sectional associations of mean relative leukocyte telomere length (LTL) with objective measures of aerobic fitness, muscle strength, and muscle endurance, using data on 31-year-old participants of the Northern Finland Birth Cohort 1966 (n = 4,952-5,205, varying by exposure-outcome analysis). Aerobic fitness was assessed by means of heart rate measurement following a standardized submaximal step test; muscular fitness was assessed by means of a maximal isometric handgrip strength test and a test of lower-back trunk muscle endurance. Longer LTL was associated with higher aerobic fitness and better trunk muscle endurance in models including adjustment for age, sex, body mass index, socioeconomic position, diet, smoking, alcohol consumption, physical activity level, and C-reactive protein. In a sex-stratified analysis, LTL was not associated with handgrip strength in either men or women. LTL may relate to aspects of physical fitness in young adulthood, but replication of these findings is required, along with further studies to help assess directions and causality in these associations.

Associations of Physical Activity and Sedentary Behavior With Adolescent Academic Achievement.

The Northern Finland Birth Cohort 1986 (N = 8,061) was used to investigated the joint associations of physical activity and sedentary behavior with academic achievement. Logistic regression analysis was used to evaluate how classes formed by latent class analysis (LCA) according to overall physical activity, sports club membership, viewing TV, using a computer, reading books and magazines, other sedentary activities, and sleep were associated with grade-point average. When adjusted for gender, self-rated health, and mother's education, physically active adolescents and generally active adolescents were about twice as likely to have high grade-point average compared with sedentary TV viewers.

Accelerometer-Measured Physical Activity and Sedentary Time Differ According to Education Level in Young Adults.

This study examined the association of education level with objectively measured physical activity and sedentary time in young adults. Data from the Finnish ESTER study (2009-2011) (n = 538) was used to examine the association between educational attainment and different subcomponents of physical activity and sedentary time measured using hip-worn accelerometers (ActiGraph GT1M) for seven consecutive days. Overall physical activity, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity and sedentary time were calculated separately for weekdays and weekend days. A latent profile analysis was conducted to identify the different profiles of sedentary time and the subcomponents of physical activity. The educational differences in accelerometer-measured physical activity and sedentary time varied according to the subcomponents of physical activity, and between weekdays and weekend days. A high education level was associated with high MVPA during weekdays and weekend days in both sexes, high sedentary time during weekdays in both sexes, and a low amount of light-intensity physical activity during weekdays in males and during weekdays and weekend days in females. The results indicate different challenges related to unhealthy behaviours in young adults with low and high education: low education is associated with a lack of MVPA, whereas high education is associated with a lack of light-intensity physical activity and high sedentary time especially during weekdays.

High levels of physical activity and cardiorespiratory fitness are associated with good self-rated health in adolescents.

BACKGROUND: Adolescent self-rated health is a strong predictor of future illness. In this study we investigated whether physical activity and cardiorespiratory fitness are associated with self-rated health among adolescents aged 16 years. METHODS: The study sample comprised 7,063 adolescents from the Northern Finland Birth Cohort 1986 (NFBC 1986) who responded to a postal questionnaire in 2001 to 2002. Self-rated health was measured by a single-item question, while physical activity was evaluated by a set of questions concerning the intensity and volume of physical activity outside school hours. Cardiorespiratory fitness was measured with a submaximal cycle ergometer test. Odds ratios (OR) and their 95% confidence intervals (95% CI) for good self-rated health were obtained from multinomial logistic regression. RESULTS: High levels of physical activity (boys: OR 5.50, 95% CI 3.16 to 9.58; girls: OR 4.25, 95% CI 2.37 to 7.61) and cardiorespiratory fitness (boys: OR 1.85, 95% CI 1.05 to 3.24; girls: OR 2.62, 95% CI 1.47 to 4.66) were associated with very good self-rated health in adolescents. CONCLUSIONS: High levels of physical activity and cardiorespiratory fitness are positively associated with adolescents' self-rated health. Public health promotion activities that foster physical activity and cardiorespiratory fitness may benefit young people's overall health and well-being.

Internal consistency and stability of the CANTAB neuropsychological test battery in children.

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computer-assessed test battery widely use in different populations. The internal consistency and 1-year stability of CANTAB tests were examined in school-age children. Two hundred-thirty children (57% girls) from five schools in the Jyväskylä school district in Finland participated in the study in spring 2011. The children completed the following CANTAB tests: (a) visual memory (pattern recognition memory [PRM] and spatial recognition memory [SRM]), (b) executive function (spatial span [SSP], Stockings of Cambridge [SOC], and intra-extra dimensional set shift [IED]), and (c) attention (reaction time [RTI] and rapid visual information processing [RVP]). Seventy-four children participated in the follow-up measurements (64% girls) in spring 2012. Cronbach's alpha reliability coefficient was used to estimate the internal consistency of the nonhampering test, and structural equation models were applied to examine the stability of these tests. The reliability and the stability could not be determined for IED or SSP because of the nature of these tests. The internal consistency was acceptable only in the RTI task. The 1-year stability was moderate-to-good for the PRM, RTI, and RVP. The SSP and IED showed a moderate correlation between the two measurement points. The SRM and the SOC tasks were not reliable or stable measures in this study population. For research purposes, we recommend using structural equation modeling to improve reliability. The results suggest that the reliability and the stability of computer-based test batteries should be confirmed in the target population before using them for clinical or research purposes.

The associations of objectively measured physical activity and sedentary time with cognitive functions in school-aged children.

Low levels of physical activity among children have raised concerns over the effects of a physically inactive lifestyle, not only on physical health but also on cognitive prerequisites of learning. This study examined how objectively measured and self-reported physical activity and sedentary behavior are associated with cognitive functions in school-aged children. The study population consisted of 224 children from five schools in the Jyväskylä school district in Finland (mean age 12.2 years; 56% girls), who participated in the study in the spring of 2011. Physical activity and sedentary time were measured objectively for seven consecutive days using the ActiGraph GT1M/GT3X accelerometer. Self-reported moderate to vigorous physical activity (MVPA) and screen time were evaluated with the questions used in the "WHO Health Behavior in School-aged Children" study. Cognitive functions including visual memory, executive functions and attention were evaluated with a computerized Cambridge Neuropsychological Test Automated Battery by using five different tests. Structural equation modeling was applied to examine how objectively measured and self-reported MVPA and sedentary behavior were associated with cognitive functions. High levels of objectively measured MVPA were associated with good performance in the reaction time test. High levels of objectively measured sedentary time were associated with good performance in the sustained attention test. Objectively measured MVPA and sedentary time were not associated with other measures of cognitive functions. High amount of self-reported computer/video game play was associated with weaker performance in working memory test, whereas high amount of computer use was associated with weaker performance in test measuring shifting and flexibility of attention. Self-reported physical activity and total screen time were not associated with any measures of cognitive functions. The results of the present study propose that physical activity may benefit attentional processes. However, excessive video game play and computer use may have unfavorable influence on cognitive functions.

Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence.

OBJECTIVE: To prospectively investigate the association and directionality between attention-deficit/hyperactivity disorder (ADHD) symptoms and obesity from childhood to adolescence in the general population. We examined whether obesogenic behaviors, namely, physical inactivity and binge eating, underlie the potential ADHD symptom-obesity association. We explored whether childhood conduct disorder (CD) symptoms are related to adolescent obesity/physical inactivity. METHOD: At 7 to 8 years (n = 8,106), teachers reported ADHD and CD symptoms, and parents reported body mass index (BMI) and physically active play. At 16 years (n = 6,934), parents reported ADHD symptoms; adolescents reported physical activity (transformed to metabolic equivalent of task [MET] hours per week) and binge eating; BMI and waist-hip ratio (WHR) were measured via clinical examination. Obesity was defined using the International Obesity Task Force (IOTF) cut-offs for BMI and the 95th percentile cut-off for WHR. RESULTS: Childhood ADHD symptoms significantly predicted adolescent obesity, rather than the opposite. Inattention-hyperactivity symptoms at 8 years were associated with indices of obesity at 16 years (obese BMI: odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.10-3.33; 95th percentile WHR: OR = 1.71, 95% CI = 1.05-2.78), adjusted for gender, baseline BMI, physical activity, family structure change, and maternal education. Child CD symptoms associated with indices of adolescent obesity. Reduced physically active play in childhood predicted adolescent inattention (OR = 1.61, 95% CI = 1.16-2.24). Childhood ADHD and CD symptoms were linked with physical inactivity in adolescence (inattention-hyperactivity; OR = 1.60, 95% CI = 1.20-2.13), but not binge eating. Physical inactivity mediated the associations. CONCLUSIONS: Children with ADHD or CD symptoms are at increased risk for becoming obese and physically inactive adolescents. Physical activity may be beneficial for both behavior problems and obesity.

Physical activity, sedentary behavior, and academic performance in Finnish children.

PURPOSE: This study aimed to determine the relationships between objectively measured and self-reported physical activity, sedentary behavior, and academic performance in Finnish children. METHODS: Two hundred and seventy-seven children from five schools in the Jyväskylä school district in Finland (58% of the 475 eligible students, mean age = 12.2 yr, 56% girls) participated in the study in the spring of 2011. Self-reported physical activity and screen time were evaluated with questions used in the WHO Health Behavior in School-Aged Children study. Children's physical activity and sedentary time were measured objectively by using an ActiGraph GT1M/GT3X accelerometer for seven consecutive days. A cutoff value of 2296 counts per minute was used for moderate-to-vigorous physical activity (MVPA) and 100 counts per minute for sedentary time. Grade point averages were provided by the education services of the city of Jyväskylä. ANOVA and linear regression analysis were used to analyze the relationships among physical activity, sedentary behavior, and academic performance. RESULTS: Objectively measured MVPA (P = 0.955) and sedentary time (P = 0.285) were not associated with grade point average. However, self-reported MVPA had an inverse U-shaped curvilinear association with grade point average (P = 0.001), and screen time had a linear negative association with grade point average (P = 0.002), after adjusting for sex, children's learning difficulties, highest level of parental education, and amount of sleep. CONCLUSIONS: In this study, self-reported physical activity was directly, and screen time inversely, associated with academic achievement. Objectively measured physical activity and sedentary time were not associated with academic achievement. Objective and subjective measures may reflect different constructs and contexts of physical activity and sedentary behavior in association with academic outcomes.

Physical activity and obesity mediate the association between childhood motor function and adolescents' academic achievement.

The global epidemic of obesity and physical inactivity may have detrimental implications for young people's cognitive function and academic achievement. This prospective study investigated whether childhood motor function predicts later academic achievement via physical activity, fitness, and obesity. The study sample included 8,061 children from the Northern Finland Birth Cohort 1986, which contains data about parent-reported motor function at age 8 y and self-reported physical activity, predicted cardiorespiratory fitness (cycle ergometer test), obesity (body weight and height), and academic achievement (grades) at age 16 y. Structural equation models with unstandardized (B) and standardized (ß) coefficients were used to test whether, and to what extent, physical activity, cardiorespiratory fitness, and obesity at age 16 mediated the association between childhood motor function and adolescents' academic achievement. Physical activity was associated with a higher grade-point average, and obesity was associated with a lower grade-point average in adolescence. Furthermore, compromised motor function in childhood had a negative indirect effect on adolescents' academic achievement via physical inactivity (B = -0.023, 95% confidence interval = -0.031, -0.015) and obesity (B = -0.025, 95% confidence interval = -0.039, -0.011), but not via cardiorespiratory fitness. These results suggest that physical activity and obesity may mediate the association between childhood motor function and adolescents' academic achievement. Compromised motor function in childhood may represent an important factor driving the effects of obesity and physical inactivity on academic underachievement.

Factors related to seeking health care among adolescents with musculoskeletal pain.

Musculoskeletal pain is common among adolescents, but little is known about the factors that affect seeking health care for the problem. We examined the care-seeking pattern among adolescents reporting musculoskeletal pain. The study consisted of adolescents aged 16 years from the 1986 Northern Finland Birth Cohort who responded to a mailed questionnaire in 2001 and reported musculoskeletal pain over the preceding 6 months (n=5052). Logistic regression analyses were performed to assess whether enabling resources, need factors, personal health habits, and psychological problems were associated with seeking health care for musculoskeletal pain. Musculoskeletal pain during the preceding 6 months was reported by 68% of boys and 83% of girls in the study population. Only 16% of boys and 20% of girls reporting pain had sought medical care. Among both boys and girls, care-seeking was associated with being a member of a sports club (boys, odds ratio [OR] 2.1; girls, OR 1.5) and having one (boys, OR 2.1; girls, OR 1.8) or at least 2 (boys, OR 2.2; girls, OR 2.1) other health disorders. In addition, it was associated with a high physical activity level (OR 1.5) and low self-rated (OR 1.5) health among girls. Reporting pain in other anatomical areas decreased the likelihood of seeking care for pain among both genders. In conclusion, relatively few adolescents with musculoskeletal pain had consulted a health professional for the problem. Being physically active (trauma), participating in organized sport (accessibility of care), and having other health problems may explain why an adolescent seeks care for musculoskeletal pain.

Suspected motor problems and low preference for active play in childhood are associated with physical inactivity and low fitness in adolescence.

BACKGROUND: This prospective longitudinal study investigates whether suspected motor problems and low preference for active play in childhood are associated with physical inactivity and low cardiorespiratory fitness in adolescence. METHODOLOGY/PRINCIPAL FINDINGS: The study sample consisted of the Northern Finland Birth Cohort 1986 (NFBC 1986) composed of 5,767 children whose parents responded to a postal inquiry concerning their children's motor skills at age 8 years and who themselves reported their physical activity at age 16 years. Cardiorespiratory fitness was measured with a cycle ergometer test at age 16 years. Odds ratios (OR) and their 95% confidence intervals (95% CI) for the level of physical activity and fitness were obtained from multinomial logistic regression and adjusted for socio-economic position and body mass index. Low preference for active play in childhood was associated with physical inactivity (boys: OR 3.31, 95% CI 2.42-4.53; girls: OR 1.79, 95% CI 1.36-2.36) and low cardiorespiratory fitness (boys: OR 1.87, 95% CI 1.27-2.74; girls: OR 1.52, 95% CI 1.09-2.11) in adolescence. Suspected gross (OR 2.16, 95% CI 1.33-3.49) and fine (OR 1.88, 95% CI 1.35-2.60) motor problems were associated with physical inactivity among boys. Children with suspected motor problems and low preference for active play tended to have an even higher risk of physical inactivity in adolescence. CONCLUSIONS/SIGNIFICANCE: Low preference for active play in childhood was associated with physical inactivity and low cardiorespiratory fitness in adolescence. Furthermore, children with suspected motor problems and low preference for active play tended to have an even higher risk of physical inactivity in adolescence. Identification of children who do not prefer active play and who have motor problems may allow targeted interventions to support their motor learning and participation in active play and thereby promote their physical activity and fitness in later life.

Risk factors for persistence of multiple musculoskeletal pains in adolescence: a 2-year follow-up study.

Musculoskeletal pain in multiple sites is common already in adolescence, and may lead to subsequent musculoskeletal complaints in adulthood. We examined predictive factors for the persistence of multiple musculoskeletal pains in adolescence over a 2-year time span. A postal questionnaire was administered to a subsample of the Northern Finland Birth Cohort 1986 (n=1773) when subjects were aged 16 and 18. The adjusted odds ratios (OR) and 95% confidence intervals (CI) for the possible risk factors of new-onset of multiple pains at 18 years and 2-year persistence of multiple pains were obtained using multinomial logistic regression. Multiple musculoskeletal pains were common; 43% of boys and 63% of girls at 16, and 61% of boys and 81% of girls at 18 reported pain in more than one site during the last 6 months. Moreover, multiple pains had a high persistence rate, as 75% of boys and 88% of girls with multiple pains at 16 reported multiple pains also at 18. In the multivariate analysis, emotional and behavioral problems (internalizing problems, OR 2.3; externalizing problems, OR 2.2), and high sitting time (OR 1.6) among boys, and internalizing problems (OR 3.7), high physical activity level (OR 1.6), short sleeping time (OR 1.7), and smoking (OR 1.9) among girls were predictive factors for the persistence of multiple pains. No statistically significant associations between the baseline variables and new-onset multiple pains were found. Multiple musculoskeletal pains appear to have a high tendency to persist in adolescence; both psychosocial factors and lifestyle factors contribute to this vulnerability.

Psychosocial, mechanical, and metabolic factors in adolescents' musculoskeletal pain in multiple locations: a cross-sectional study.

Recent studies indicate that adolescents often experience musculoskeletal pains in two or more body locations. However, previous studies have mainly focused on localized pains, and the determinants of multiple musculoskeletal pains in adolescents are not well known. The present study was set to evaluate the role of psychosocial, mechanical, and metabolic factors in adolescents' musculoskeletal pains in multiple locations. The study population consisted of the 1986 Northern Finland Birth Cohort; 15- to 16-year-old adolescents (n=6986), who responded to a mailed questionnaire in 2001. We assessed the associations of emotional and behavioral problems, physical activity, sitting time, sleeping time, overweight and smoking with musculoskeletal pains using multinomial logistic regression. Multiple pains were common, 23% of boys and 40% of girls reported feeling pain in at least three locations over the past 6 months. These pains were not only associated with anxious/depressed symptoms, withdrawn/depressed symptoms, somatic complaints, rule-breaking and aggressive behavior, social problems, thought and attention problems, but also with high physical activity level, long sitting time, short sleeping time and smoking, among both boys and girls. In addition, pain in three to four locations associated with overweight in girls. A high number of psychosocial, mechanical and metabolic factors associated strongly with multiple pains. In conclusion, multiple musculoskeletal pains were strongly associated with psychosocial complaints, but also with mechanical and metabolic factors. Reported musculoskeletal pains in multiple locations in adolescence may have both peripheral (trauma, decreased regenerative ability) and central (sensitivity) causes.

Emotional and behavioral problems in relation to physical activity in youth.

PURPOSE: Physical inactivity is known to be associated with mental health problems in adulthood, but the association in youth is unclear. This study evaluated the association between the level of physical activity and the prevalence of emotional and behavioral problems in Finnish adolescents. METHODS: The study population consisted of the Northern Finland Birth Cohort 1986 including 7002 adolescents who responded to a postal inquiry in 2001-2002 at the age of 15-16 yr. They completed the Youth Self-Report questionnaire assessing their emotional and behavioral problems and a questionnaire concerning their moderate- to vigorous-intensity physical activity (MVPA). The odds ratios (OR) and their 95% confidence intervals (95% CI) for having different emotional and behavioral problems were obtained in 2007 from logistic regression and adjusted for family type, income, parents' education, and body mass index. RESULTS: In boys, physical inactivity (1 h or less of MVPA per week) was associated with anxious/depressed symptoms (OR = 2.9, 95% CI = 1.5-5.7), withdrawn/depressed symptoms (OR = 2.8, 95% CI = 1.8-4.2), social problems (OR = 3.6, 95% CI = 1.8-5.1), thought problems (OR = 2.3, 95% CI = 1.1-5.2), and attention problems (OR = 1.9, 95% CI = 1.0-3.4) when compared to being physically active (4 h or more of MVPA per week). In girls, physical inactivity was associated with withdrawn/depressed symptoms (OR = 2.3, 95% CI = 1.5-3.6), somatic complaints (OR = 1.4, 95% CI = 1.0-1.9), social problems (OR = 3.2, 95% CI = 1.7-6.1), attention problems (OR = 2.1, 95% CI = 1.3-3.2), and rule-breaking behavior (OR = 1.8, 95% CI = 1.3-2.5) compared to being physically active. CONCLUSIONS: Physical inactivity was associated with several emotional and behavioral problems in adolescents. Future research should investigate the mechanisms behind these associations and the effectiveness of physical activity in the treatment of emotional and behavioral problems among young people.

Adolescents' physical activity in relation to family income and parents' education.

OBJECTIVE: Regular physical activity provides young people with important physical, mental, and social health benefits. This study aimed to evaluate the relationship of family income and parents' level of education with physical activity in Finnish adolescents. METHOD: The study population consisted of the Northern Finland Birth Cohort 1986, including 5457 boys and girls aged 15-16 years, and their parents who responded to a postal inquiry in 2001-2002. The associations between social background and adolescents' physical activity were analyzed in 2005 using cross-tabulation and multivariate logistic regression. RESULTS: High parental education was associated with adolescents being physically active. In boys father's high educational level (OR: 0.56; CI: 0.33, 0.95), and in girls both mother's (OR: 0.55; CI: 0.31, 0.98) and father's (OR: 0.35; CI: 0.20, 0.61) high educational levels were related to the least time spent watching TV. High family income was associated with being an active sports club member in boys (OR: 2.43; CI: 1.74, 3.40) and girls (OR: 2.67; CI: 1.81, 3.94). Adolescents' participation in different types of physical activity varied according to family income. CONCLUSIONS: Economic support for youth sports and informing parents on ways to encourage adolescents' physical activity are recommended to ensure equal opportunities for youths to participate in different physical activities.