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Associations Between Type and Timing of Physical Activity and Sedentary Behavior With Mental Health in Adolescents and Young Adults

Bruno G.G. da Costa, Antonius J. Van Rooij, Anouk Tuijnman, Travis J. Saunders, and Jean-Philippe Chaput

Background: This cross-sectional study analyzed the association of leisure-time physical activity (PA) and sedentary behavior (SB), nonleisure PA and SB, and total PA and SB in different time segments of the day with mental health among Dutch adolescents and young adults. Methods: A total of 881 participants aged 16–25 years completed an online survey. Mental health was assessed using the Mental Health Inventory-5, and participants also reported sex, age, and income. They filled out a questionnaire of types of PA and SB for each hour of the day. Activities were categorized into nonleisure and leisure, during the morning, afternoon, evening, and for the whole day. Results: Participants (52.8% female, on average 20.8 y) generally engaged in more leisure-time PA and SB during weekends compared with weekdays, and more nonleisure activities on weekdays. Associations varied between time segments and days of the week. Positive associations of leisure-time and total PA during the whole day and evenings with mental health were observed on weekdays. Total, leisure-time, and nonleisure-time SB were associated with worse mental health. Nonleisure PA was not associated with mental health. Conclusions: Leisure-time PA was found to have a favorable association with mental health, particularly in the evenings of weekdays and afternoons of weekend days. On the other hand, leisure SB was associated with poorer mental health in most of the time segments analyzed, and nonleisure SB in the evenings was also related to worse mental health. The type and timing of PA and SB behaviors play an important role in the relationship with mental health.

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Physical Activity and Sitting Time Patterns and Sociodemographic Correlates Among 155,790 South American Adults

André O. Werneck, Raphael H.O. Araujo, Cecilia Anza-Ramírez, Javier Brazo-Sayavera, Christian García-Witulski, Nicolas Aguilar-Farias, Se-Sergio Baldew, Kabir P. Sadarangani, Robinson Ramírez-Vélez, Antonio García-Hermoso, Gerson Ferrari, Felicia Cañete, Ramfis Nieto-Martinez, and Danilo R. Silva

Background: To estimate the prevalence of different physical activity (PA) domains and sitting time (ST), and to analyze the association with sociodemographic indicators. Methods: Data from the most recent nationally representative survey from each of the South American countries, comprising 155,790 adults (18–64 y), were used. Data on leisure-time, transport, and occupational PA (all 3 domains as nonzero), total PA (≥150 min/wk), and ST (≥8 h/d) were assessed by specific questionnaires in each survey. Gender, age group (18–34, 35–49, and 50–64 y), and education (quintiles) were used as sociodemographic factors. Random effect meta-analysis of the association between sociodemographic factors and PA and ST were conducted. Results: The prevalence of PA guidelines compliance and elevated ST in South America was 70.3% and 14.1%, respectively. Women were less likely to achieve the recommended levels of total and domain-based PA. Participants in the highest quintile of education were more likely for elevated ST (2.80, 2.08–3.77), lower occupational PA (0.65, 0.44–0.95), but higher leisure-time PA (3.13, 2.31–4.27), in comparison with lowest quintile. Older adults were less likely to participate in total and leisure-time PA. Conclusion: Our findings highlight the urge to tackle the inequalities in PA practice in South America, especially gender and education inequalities, for leisure-time PA.

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Association Between Domain-Specific Physical Activity and Cardiometabolic Factors in a Multiethnic Asian Population: A Longitudinal Study

Lixia Ge, Saima Hilal, Falk Müller-Riemenschneider, and Chuen Seng Tan

Aims: To examine the association between domain-specific physical activity (PA) and cardiometabolic factors with longitudinal data, which is limited in current literature. Methods: Participants who attended the Singapore Multi-Ethnic Cohort and follow-up surveys were included in this study (N = 3950, mean age: 44.7 y, female: 57.9%). Self-reported moderate- to vigorous-intensity PA (MVPA) for each domain (leisure-time, transportation, occupation, and household) was categorized into 4 levels: no, low, middle, and high MVPA. The longitudinal associations of domain-specific MVPA with cardiometabolic factors including systolic and diastolic blood pressures, low-density and high-density lipoprotein cholesterols, triglycerides, and body mass index were examined using Generalized Estimating Equations, accounting for confounding factors and repeated measurements. Results: There were 5.2% participants who had no MVPA. For each domain, this rate ranged from 22.6% (household) to 83.3% (occupation). Leisure-time and occupation MVPAs had positive and linear associations with high-density lipoprotein cholesterols, corresponding to 0.030 (95% confidence interval, 0.015 to 0.045) mmol/L (leisure-time) and 0.063 (95% confidence interval, 0.043 to 0.083) mmol/L (occupation), when compared high with no respective MVPA. Occupation and household MVPAs were associated with low-density lipoprotein cholesterol. Transportation and occupation exhibited a positive and linear relationship with diastolic blood pressure. None of the domains were associated with body mass index, systolic blood pressures, or triglycerides. Conclusions: This study showed that each domain had differential association with individual cardiometabolic risk factors. As occupation, transportation, or household PA had unfavorable associations with low-density lipoprotein cholesterol or diastolic blood pressure, the overall beneficial impact of higher PA levels may not necessarily hold in the context of domain-specific PA and cardiovascular health. Further investigation is needed to corroborate our findings.

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Longitudinal Association of Changes in Parental Correlates With Screen Time in Chinese Preschoolers

Yan Wu and Sunyue Ye

Background: This study aimed to explore the relationship between the changes in parent-related factors and preschoolers exceeding screen time (ST) recommendations. Methods: A longitudinal analysis using 2-year follow-up data from 4 kindergartens (n = 409) was conducted in Zhejiang, China, from 2019 to 2021. Multivariate logistic regression models were used to determine the potential parental modifiable predictors. Results: The significant associations of baseline ST, change in screen accessibility, and the interaction of preschooler ST with maternal ST change with preschooler follow-up ST were observed. For preschool-aged children with baseline ST ≤ 1 hour per day, the follow-up of preschoolers with ST > 1 hour per day increased significantly when parental clarity of their ST rules decreased or remained low. For preschool children with baseline ST > 1 hour per day, follow-up ST increased significantly when their father kept ST >2 hours per day, when the screen accessibility became or remained easy, or when parental awareness of the ST decreased. Conclusions: Changes in parental correlates played an important role in preschooler ST based on 2-year longitudinal data. Early interventions should focus on improving the clarity of parental rules and perceptions, as well as on reducing parental ST and accessibility of home screens.

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Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews

Virgílio Viana Ramires, Priscila Cristina dos Santos, Valter Cordeiro Barbosa Filho, Alexsandra da Silva Bandeira, Maria Cecilia Marinho Tenório, Edina Maria de Camargo, Fabrício Cesar de Paula Ravagnani, Paula Sandreschi, Victor José Machado de Oliveira, Pedro Curi Hallal, and Kelly Samara Silva

Background: Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. Methods: We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review’s research question. Data charting form included the identification of the study, health outcomes, and PE classes’ strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. Results: An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. Conclusions: These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.

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Impact of Physical Activity and Sedentary Behavior on Spontaneous Female and Male Fertility: A Systematic Review

Alison K. Brinson, Shana G. da Silva, Kathryn R. Hesketh, and Kelly R. Evenson

Background: Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review the association between physical activity and sedentary behavior with spontaneous female and male fertility. Method: PubMed/MEDLINE, Web of Science, CINAHL, SPORTDiscus, and Embase were searched from inception to August 9, 2021. Eligible studies included randomized controlled trials or observational studies, published in English, describing an association between physical activity or sedentary behavior (exposures) and spontaneous fertility (outcome) among women or men. Results: Thirty-four studies from 31 unique populations were included in this review (12 cross-sectional studies, 10 cohort studies, 6 case–control studies, 5 randomized controlled trials, and one case–cohort study). Of the 25 studies among women, the majority identified mixed results (n = 11) or no association (n = 9) between physical activity and female fertility. Seven studies reported on female fertility and sedentary behavior, and 2 found sedentary behavior was associated with decreased female fertility. Of the 11 studies among men, most of the studies (n = 6) found that physical activity was associated with increased male fertility. Two of the studies reported on male fertility and sedentary behavior, and neither identified an association. Conclusions: The association between spontaneous fertility and physical activity in both men and women remains unclear, and the association with sedentary behavior remains largely unexplored.

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Longitudinal Analysis of Patterns and Correlates of Physical Activity and Sedentary Behavior in Women From Preconception to Postpartum: The Singapore Preconception Study of Long-Term Maternal and Child Outcomes Cohort

Anne H.Y. Chu, Natarajan Padmapriya, Shuen Lin Tan, Claire Marie J.L. Goh, Yap-Seng Chong, Lynette P. Shek, Kok Hian Tan, Peter D. Gluckman, Fabian K.P. Yap, Yung Seng Lee, See Ling Loy, Jerry K.Y. Chan, Keith M. Godfrey, Johan G. Eriksson, Shiao-Yng Chan, Jonathan Y. Bernard, and Falk Müller-Riemenschneider

Objective: Longitudinal changes in physical activity (PA) and sedentary behavior patterns from preconception to postpartum are not fully characterized. We examined changes and baseline sociodemographic/clinical correlates of PA and sedentary behavior in women from preconception to postpartum. Methods: The Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohort recruited 1032 women planning pregnancy. Participants completed questionnaires at preconception, 34 to 36 weeks gestation, and 12 months postpartum. Repeated-measures linear regression models were used to analyze changes in walking, moderate to vigorous PA (MVPA), screen time, and total sedentary time, and to identify sociodemographic/clinical correlates associated with these changes. Results: Of the 373 women who delivered singleton live births, 281 provided questionnaires for all time points. Walking time increased from preconception to late pregnancy but decreased postpartum (adjusted means [95% CI]: 454 [333–575], 542 [433–651], and 434 [320–547] min/wk, respectively). Vigorous-intensity PA and MVPA decreased from preconception to late pregnancy but increased postpartum (vigorous-intensity PA: 44 [11–76], 1 [−3–5], and 11 [4–19] min/wk, MVPA: 273 [174–372], 165 [95–234], and 226 [126–325] min/wk, respectively). Screen time and total sedentary time remained consistent from preconception to pregnancy but decreased postpartum (screen: 238 [199–277], 244 [211–277], and 162 [136–189] min/d, total: 552 [506–598], 555 [514–596], and 454 [410–498] min/d, respectively). Individual characteristics of ethnicity, body mass index, employment, parity, and self-rated general health significantly influenced women’s activity patterns. Conclusion: During late pregnancy, walking time increased, while MVPA declined significantly, and partially returned to preconception levels postpartum. Sedentary time remained stable during pregnancy but decreased postpartum. The identified set of sociodemographic/clinical correlates underscores need for targeted strategies.

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A Scoping Review of Disability Assessment in Prospective and Cross-Sectional Studies That Included Device-Based Measurement of Physical Activity

Shelby Carr, Andrew J. Atkin, Andy P. Jones, Richard Pulsford, and Karen Milton

Background: Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of high-quality scientific evidence is due to the extent and nature of disability assessment in physical activity research. This scoping review explores how disability has been measured in epidemiological studies that included accelerometer-based measurement of physical activity. Methods: Data sources: MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus, and CINAHL. Eligibility criteria: Prospective and cross-sectional studies that included an accelerometer measurement of physical activity. Survey instruments used in these studies were obtained, and questions relating to the International Classification of Functioning, Disability and Health domains of (1) health conditions, (2) body functions and structures, and (3) activities and participation, were extracted for analysis. Results: Eighty-four studies met the inclusion criteria, from which complete information on the 3 domains was obtained for 68. Seventy-five percent of studies (n = 51) captured whether a person had at least one health condition, 63% (n = 43) had questions related to body functions and structures, and 75% (n = 51) included questions related to activities and participation. Conclusion: While most studies asked something about one of the 3 domains, there was substantial diversity in the focus and style of questions. This diversity indicates a lack of consensus on how these concepts should be assessed, with implications for the comparability of evidence across studies and subsequent understanding of the relationships between disability, physical activity, and health.

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Association of Walking and Biking to School Policies and Active Commuting to School in Children

Leigh Ann Ganzar, Katie Burford, Yuzi Zhang, Anna Gressett, Harold W. Kohl III, and Deanna M. Hoelscher

Background: Active commuting to school (ACS) can be an important source of physical activity for children. Schools are an important setting for policy-related ACS promotion. The purpose of this study was to examine the association between school policies and ACS, and to assess whether this relation varied by grade. Methods: This cross-sectional study used data from schools recruited to the Safe Travel Environment Evaluation in Texas School study (n = 94). The percent of trips made by active travel modes was measured through tallies among third to fifth grade classrooms from 5 school districts in Central Texas in 2018–2019. School ACS policies and practices were measured through 8 survey items aggregated into a score. Linear mixed effects models were used to assess the association between policies and ACS. Results: School health policy surveys and ACS data were collected from 69 elementary schools. An average of 14.6% of trips to/from school was made using active travel modes. Schools with higher numbers of policies had significantly higher percentages of students using active travel modes (P = .03), and for each additional policy, the predicted percentage of trips made by active travel modes was 1.46% higher. There was a significant interaction effect between school policy and grade, with stronger correlations among higher grades (P = .002). Conclusions: Results from this study demonstrate a correlation between the school policies designed to support walking and biking and ACS. Results from this study can be used to justify the use of school-based policy interventions to promote ACS.

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Device-Measured Change in Physical Activity in Primary School Children During the UK COVID-19 Pandemic Lockdown: A Longitudinal Study

James Scales, Jasmine Chavda, Erika Ikeda, Ivelina Tsocheva, Rosamund E. Dove, Helen E. Wood, Harpal Kalsi, Grainne Colligan, Lewis Griffiths, Bill Day, Cheryll Crichlow, Amanda Keighley, Monica Fletcher, Chris Newby, Florian Tomini, Fran Balkwill, Borislava Mihaylova, Jonathan Grigg, Sean Beevers, Sandra Eldridge, Aziz Sheikh, James Gauderman, Frank Kelly, Gurch Randhawa, Ian S. Mudway, Esther van Sluijs, and Christopher J. Griffiths

Background : Lockdown measures, including school closures, due to the COVID-19 pandemic have caused widespread disruption to children’s lives. The aim of this study was to explore the impact of a national lockdown on children’s physical activity using seasonally matched accelerometry data. Methods: Using a pre/post observational design, 179 children aged 8 to 11 years provided physical activity data measured using hip-worn triaxial accelerometers worn for 5 consecutive days prepandemic and during the January to March 2021 lockdown. Multilevel regression analyses adjusted for covariates were used to assess the impact of lockdown on time spent in sedentary and moderate to vigorous physical activity. Results: A 10.8-minute reduction in daily time spent in moderate to vigorous physical activity (standard error: 2.3 min/d, P < .001) and a 33.2-minute increase in daily sedentary activity (standard error: 5.5 min/d, P < .001) were observed during lockdown. This reflected a reduction in daily moderate to vigorous physical activity for those unable to attend school (−13.1 [2.3] min/d, P < .001) during lockdown, with no significant change for those who continued to attend school (0.4 [4.0] min/d, P < .925). Conclusion: These findings suggest that the loss of in-person schooling was the single largest impact on physical activity in this cohort of primary school children in London, Luton, and Dunstable, United Kingdom.