In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial ...disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025.
Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund (UNICEF), WHO and the World Bank. The Institute for Health Metrics and Evaluation (IHME) has published country-level estimates of obesity in children aged 2-4 years. For children aged 5-19 years, obesity estimates are available from the NCD Risk Factor Collaboration. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2-4 years has increased moderately. In 1975, obesity in children aged 5-19 years was relatively rare, but was much more common in 2016.
It is recognised that the key drivers of this epidemic form an obesogenic environment, which includes changing food systems and reduced physical activity. Although cost-effective interventions such as WHO 'best buys' have been identified, political will and implementation have so far been limited. There is therefore a need to implement effective programmes and policies in multiple sectors to address overnutrition, undernutrition, mobility and physical activity. To be successful, the obesity epidemic must be a political priority, with these issues addressed both locally and globally. Work by governments, civil society, private corporations and other key stakeholders must be coordinated.
This review and meta-analysis (PROSPERO registration number: CRD42020138845) critically evaluates test-retest reliability, concurrent validity and criterion validity of different physical activity ...(PA) levels of three most commonly used international PA questionnaires (PAQs) in official language versions of European Union (EU): International Physical Activity Questionnaire (IPAQ-SF), Global Physical Activity Questionnaire (GPAQ), and European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ). In total, 1749 abstracts were screened, 287 full-text articles were identified as relevant to the study objectives, and 20 studies were included. The studies' results and quality were evaluated using the Quality Assessment of Physical Activity Questionnaires checklist. Results indicate that only ten EU countries validated official language versions of selected PAQs. A meta-analysis revealed that assessment of moderate-to-vigorous PA (MVPA) is the most relevant PA level outcome, since no publication bias in any of measurement properties was detected while test-retest reliability was moderately high (r
= 0.74), moderate for the criterion (r
= 0.41) and moderately-high for concurrent validity (r
= 0.72). Reporting of methods and results of the studies was poor, with an overall moderate risk of bias with a total score of 0.43. In conclusion, where only self-reporting of PA is feasible, assessment of MVPA with selected PAQs in EU adult populations is recommended.
Physical activity questionnaires (PAQs) are a popular method of monitoring physical activity, although their validity is usually low. Descriptions of physical activity levels in questionnaires ...usually rely on physical responses to physical activity. Therefore, we hypothesised that the validity of PAQs would be higher in the more physically fit group of participants. To test this, we conducted a validation study with 179 adults whom we divided into three fitness groups based on their cardiovascular fitness and age. Participants were measured for one week using the UKK RM42 accelerometer and self-reported their physical activity using IPAQ-SF, GPAQ, and EHIS-PAQ. We analysed the differences between fitness groups in terms of validity for each PAQ using ANOVA. We also performed an equivalence testing to compare the data obtained with the PAQs and the accelerometers. The results showed a significant trend toward higher validity for moderate to vigorous physical activity from the low to high fitness group as assessed by GPAQ and IPAQ-SF (low, intermediate and high fitness group: 0.06–0.21; 0.26–0.29; 0.40, respectively). The equivalence testing showed that all fitness groups overestimated their physical activity and underestimated their sedentary behaviour, with the high fitness group overestimating their physical activity the least. However, EHIS-PAQ was found to agree best with accelerometer data in assessing moderate to vigorous physical activity, regardless of fitness group, and had a validity greater than 0.4 for all fitness groups. In conclusion, we confirmed that when using PAQs describing physical responses to physical activity, participants’ fitness should be considered in the interpretation, especially when comparing results internationally.
Current lifestyles are marked by sedentary behaviour; thus, it is of great importance for policymaking to have valid and reliable tools to measure sedentary behaviour in order to combat it. ...Therefore, the aim of this review and meta-analysis is to critically review, assess, and compile the reliability, criterion validity, and construct validity of the single-item sedentary behaviour questions within national language versions of most commonly used international physical activity questionnaires for adults in the European Union: The International Physical Activity Questionnaire-Short Form and the Global Physical Activity Questionnaire. A total of 1749 records were screened, 287 full-text papers were read, and 14 studies were included in the meta-analysis. The results and quality of studies were evaluated by the Quality Assessment of Physical Activity Questionnaires checklist. Meta-analysis indicated moderate to high reliability (r
= 0.59) and concurrent validity (r
= 0.55) of national language versions of single-item sedentary behaviour questions. Criterion validity was rather low (r
= 0.23) but in concordance with previous studies. The risk of bias analysis highlighted the poor reporting of methods and results, with a total bias score of 0.42. Thus, we recommend using multi-item SB questionnaires and smart trackers for providing information on SB rather than single-item sedentary behaviour questions in physical activity questionnaires.
Understanding the growth pattern is important in view of child and adolescent development. Due to different tempo of growth and timing of adolescent growth spurt, individuals reach their adult height ...at different ages. Accurate models to assess the growth involve intrusive radiological methods whereas the predictive models based solely on height data are typically limited to percentiles and therefore rather inaccurate, especially during the onset of puberty. There is a need for more accurate non-invasive methods for height prediction that are easily applicable in the fields of sports and physical education, as well as in endocrinology. We developed a novel method, called Growth Curve Comparison (GCC), for height prediction, based on a large cohort of > 16,000 Slovenian schoolchildren followed yearly from ages 8 to 18. We compared the GCC method to the percentile method, linear regressor, decision tree regressor, and extreme gradient boosting. The GCC method outperformed the predictions of other methods over the entire age span both in boys and girls. The method was incorporated into a publicly available web application. We anticipate our method to be applicable also to other models predicting developmental outcomes of children and adolescents, such as for comparison of any developmental curves of anthropometric as well as fitness data. It can serve as a useful tool for assessment, planning, implementation, and monitoring of somatic and motor development of children and youth.
This study aimed to evaluate the agreement between a 7-day recall questionnaire and multiple-sensor monitor in identifying sufficiently active adolescents. A total of 282 students involved in the ...CRO-PALS study were randomly selected for a device-based measurement of physical activity (PA) using the SenseWear Armband device (SWA) no more than three weeks before or after having fulfilled the SHAPES questionnaire. Valid data was obtained from 150 participants (61 boys; 89 girls) and included in the analysis. In boys, SHAPES exhibited high specificity (92.3%), overall percent agreement (85.0%), and significant agreement (κ = 0.32,
= 0.014) with the SWA in recognising sufficiently active individuals. Conversely, no agreement was detected for quartiles of PA, although boys that were classified in the first and in the fourth quartile by SHAPES differed in device-based measured duration of MVPA (134 95%CI: 109-160 vs. 87 95%CI: 65-108,
= 0.032); and VPA (39 95%CI: 23-56 vs. 14 95%CI: 6-22,
= 0.011). In girls, no significant agreement between the two methods was found in any of the analyses. It appears that the SHAPES questionnaire is effective to identify individuals that comply with PA recommendations and to distinguish between the most active and the least active individuals for adolescent boys, but not for girls.
Objective
The aim of this study was to examine the effectiveness of a real‐world, population‐scaled, school‐based physical activity (PA) intervention that provided two to three additional physical ...education lessons per week to children aged 6 to 14 years in Slovenia.
Methods
More than 34,000 participants from over 200 schools were compared with a similar number of nonparticipants from the same schools. Generalized estimating equations were used to estimate the effects of differing levels of exposure to the intervention (i.e., from 1–5 years) on BMI in children with normal weight, overweight, or obesity at baseline.
Results
BMI was lower in the intervention group, irrespective of participation duration or baseline weight status. The difference in BMI increased with the program duration, with maximal effects being seen after 3 to 4 years of participation, and was consistently larger for children with obesity (peaking at 1.4 kg/m2 95% CI: 1.0–1.9 for girls with obesity and peaking at 0.9 kg/m2 95% CI: 0.6–1.3 for boys with obesity). The program started to become effective at reversing obesity after 3 years, whereas the lowest numbers needed to treat (NNTs) were observed after 5 years (NNTs = 17 for girls and 12 for boys).
Conclusions
The population‐scaled, school‐based PA intervention was effective in preventing and treating obesity. The effects were the greatest in children initially presenting with obesity, such that the program was able to benefit children needing support the most.
Abstract
Background
Physical inactivity has been recognised as a global public health problem that requires concerted action. This calls for systematic physical activity (PA) surveillance as a ...mechanism for assessing the problem and evaluating the effectiveness of related policies. Because countries tend to design their policy measures based on national surveillance data, here we present an inventory of existing national surveillance systems on PA, sedentary behaviour (SB) and sport participation (SP) among adult population in all European Union (EU) Member States.
Methods
As a part of the European Physical Activity and Sports Monitoring System (EUPASMOS) project, a questionnaire was constructed in the form of an on-line survey to collect detailed information on existing national surveillance systems on either PA, SB, or SP. National HEPA focal points from all 27 EU Member States were invited to answer the on-line questionnaire and data collection took part in the period May 2018–September 2019.
Results
National monitoring of PA or SB or SP for adults has been established in 16/27 EU Member States, that host 33 different PA/SB/SP monitoring systems. Apart from 3 countries that are using accelerometers (Finland, Ireland and Portugal), surveillance is typically based on questionnaires. In most Member States these questionnaires have not been validated in the particular language and cultural setting. Next, specific domains and dimensions of PA, SB and SP assessed vary a lot across countries. Only 3 countries (the Netherlands, Portugal and Slovenia) are monitoring all three behaviours while covering most of the domains and dimensions of PA/SB/SP. Lastly, as half of the existing surveillance systems set an upper age limit, in 9/16 countries that are monitoring PA/SB/SP, no data for people older than 80 years are available.
Conclusions
Systematic surveillance of PA is lacking among 11/27 EU countries, with even few monitoring SB and SP. Besides, existing surveillance systems typically fail to assess all dimensions and domains of PA/SB/SP with only three countries maintaining monitoring systems that encompass all three behaviours while covering most of the domains and dimensions of PA/SB/SP. Hence, additional efforts in advocacy of systematic PA surveillance in the EU are called for.
The aim of this study is to describe trends in overweight and obesity among Slovenian youth for the period 1989-2018. Nearly all schoolchildren in Slovenia had their height and weight measured ...annually, which lead to a total of 6,738,510 data-points during the 30-year period. The IOTF cut-off points and Joinpoint regression were used to examine annual percent change (APC) in overweight and obesity prevalence across 3 age groups (7-10, 11-14 and 15-18 years). Obesity approximately tripled, while overweight doubled between 1989 and late 2000s in both genders. Since then overweight has been steadily decreasing in all 3 age groups for boys and in 7-10-year-old girls. Obesity has also been declining since 2009, but only in the youngest boys and girls (APC = - 1.9, 95% CI = - 3.2 to - 0.6 and APC = - 1.6, 95% CI = - 3.0 to - 0.2, respectively). Unfavourable trends were noted only in 15-18-year-old girls, with obesity rising at an unchanged rate over the past 30 years (APC = 4.8, 95% CI = 4.5-5.1). Overweight and obesity among Slovenian youth has increased dramatically over the last 3 decades. Still, during the last decade this rise has been reversed or at least stopped. This reversal of trends was more marked in boys than in girls, and in young children compared to adolescents.
This study aimed to investigate moderators of change in physical activity (PA) levels after 30 days (30-d) of restrictions due to the COVID-19 pandemic in young adults. This research is an extension ...of the CRO-PALS study and analyses for this study were performed on young adults (20–21 y.o., n = 91). Moderate-to-vigorous physical activity (MVPA), sport participation, student and socioeconomic status were assessed pre- and post-30-d restrictions. Differences in MVPA levels were examined using repeated-measures ANOVAs. After 30-d of restrictions, the drop in MVPA in females (−64.8 min/day, p = 0.006) and males was shown (−57.7 min/day, p < 0.00). However, active participants decreased, while non-active peers increased their MVPA level (−100.7 min/day, p < 0.00, and +48.9 min/day, p = 0.051, respectively). Moreover, students and non-students decreased their MVPA level (−69.0 min/day, p < 0.00, and −35.0 min/day, p = 0.22, respectively) as well as sport participants and non-sport participants (−95.3 min/day, p < 0.001, and −53.9 min/day, p < 0.00, respectively). Our results suggest that 30-d of restrictions equally affect females and males where the evident drop in MVPA is seen in both genders. However, active people decreased their PA level during lockdown and the opposite pattern was seen in non-active peers, where restrictions for them can represent an opportunity to change their behavior in a positive direction in order to gain better health status.
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