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Gregory A. Hand, Robin P. Shook, Daniel P. O’Connor, Madison M. Kindred, Sarah Schumacher, Clemens Drenowatz, Amanda E. Paluch, Stephanie Burgess, John E. Blundell and Steven N. Blair

Background: The present study examined, among weight-stable overweight or obese adults, the effect of increasing doses of exercise energy expenditure (EEex) on changes in total daily energy expenditure (TDEE), total body energy stores, and body composition. Methods: Healthy, sedentary overweight/obese young adults were randomized to one of 3 groups for a period of 26 weeks: moderate-exercise (EEex goal of 17.5 kcal/kg/wk), high-exercise (EEex goal of 35 kcal/kg/wk), or observation group. Individuals maintained body weight within 3% of baseline. Pre/postphysical activity between-group measurements included body composition, calculated energy intake, TDEE, energy stores, and resting metabolic rate. Results: Sixty weight-stable individuals completed the protocols. Exercise groups increased EEex in a stepwise manner compared with the observation group (P < .001). There was no group effect on changes in TDEE, energy intake, fat-free mass, or resting metabolic rate. Fat mass and energy stores decreased among the females in the high-exercise group (P = .007). Conclusions: The increase in EEex did not result in an equivalent increase in TDEE. There was a sex difference in the relationship among energy balance components. These results suggest a weight-independent compensatory response to exercise training with potentially a sex-specific adjustment in body composition.

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Walter Herzog

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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen Bogart, Bridget Hatfield and Samuel W. Logan

Background: Children and adolescents with disabilities often report low levels of physical activity (PA). Estimating the magnitude of PA disparities has been previously challenged by underreporting and variability in subsampling of disability. Using the National Survey of Children’s Health, this study estimated the population-level PA disparities experienced and the association between disability status and PA engagement. Methods: Weighted prevalence of PA engagement (National Physical Activity Guidelines for Americans (2nd edition) and sports participation) was compared across disability groups for children (n = 20,867, 6–11 y) and adolescents (n = 28,651, 12–17 y) and found to be 12%. Age-stratified multivariable logistic regressions estimated the likelihood of PA engagement as a function of disability status and type, after adjusting for child and household factors. Results: Children, but not adolescents, with disabilities had significantly lower odds of being sufficiently active compared with peers without disabilities (adjusted odds ratio = 0.75; 95% confidence interval, 0.60–0.94). Across age groups, the lowest prevalence rates were observed among those experiencing function and mobility disabilities. Children and adolescents were significantly less likely to participate in sports compared with peers. Conclusion: Children with function and mobility disabilities were identified as priority subpopulations least likely to be sufficiently active. The disparity in sports participation highlights a critical intervention point for increasing PA among children with disabilities.

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Hannah G. Calvert, Lindsey Turner, Julien Leider, Elizabeth Piekarz-Porter and Jamie F. Chriqui

Background: Schools are a setting in which students learn about the importance of lifelong physical activity (PA). Best practice guidelines indicate that schools should provide students with adequate physical education (PE) minutes and opportunities to engage in PA throughout the school day. Methods: Data from the nationally representative School Nutrition and Meal Cost Study in 2014–2015 were utilized to assess PA practices (including PE) at 412 public elementary schools. These data were linked to state- and district-level policy data from the National Wellness Policy Study to examine the relationships between state law and school district policies and school practices. Results: Just over half of the schools were in a state with a policy regarding PE minutes. The comprehensiveness and strength of PA policies were higher at the district level than the state level, but were still low overall. Comprehensiveness of PA policies at the state level, but not at the district level, was related to schools within those states that provide more PA practices. Conclusions: Existence of PE and PA policies at the state level appears to be an important predictor of school PA practices. Having more comprehensive policies at the state level may be an important facilitator of school implementation of comprehensive PA practices.

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Ignacio Perez-Pozuelo, Thomas White, Kate Westgate, Katrien Wijndaele, Nicholas J. Wareham and Soren Brage

Background: Wrist-worn accelerometry is the commonest objective method for measuring physical activity in large-scale epidemiological studies. Research-grade devices capture raw triaxial acceleration which, in addition to quantifying movement, facilitates assessment of orientation relative to gravity. No population-based study has yet described the interrelationship and variation of these features by time and personal characteristics. Methods: 2,043 United Kingdom adults (35–65 years) wore an accelerometer on the non-dominant wrist and a chest-mounted combined heart-rate-and-movement sensor for 7 days free-living. From raw (60 Hz) wrist acceleration, we derived movement (non-gravity acceleration) and pitch and roll (forearm) angles relative to gravity. We inferred physical activity energy expenditure (PAEE) from combined sensing and sedentary time from approximate horizontal arm angle coupled with low movement. Results: Movement differences by time-of-day and day-of-week were associated with forearm angles; more movement in downward forearm positions. Mean (SD) movement was similar between sexes ∼31 (42) mg, despite higher PAEE in men. Women spent longer with the forearm pitched >0°, above horizontal (53% vs 36%), and less time at <0° (37% vs 53%). Diurnal pitch was 2.5–5° above and 0–7.5°below horizontal during night and daytime, respectively; corresponding roll angles were ∼0° (hand flat) and ∼20° (thumb-up). Differences were more pronounced in younger participants. All diurnal profiles indicated later wake-times on weekends. Daytime pitch was closer to horizontal on weekdays; roll was similar. Sedentary time was higher (17 vs 15 hours/day) in obese vs normal-weight individuals. Conclusions: More movement occurred in forearm positions below horizontal, commensurate with activities including walking. Findings suggest time-specific population differences in behaviors by age, sex, and BMI.

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Salomé Aubert, Julien Aucouturier, Jeremy Vanhelst, Alicia Fillon, Pauline Genin, Caroline Ganière, Corinne Praznoczy, Benjamin Larras, Julien Schipman, Martine Duclos and David Thivel

Background: Insufficient levels of physical activity and increasing sedentary time among children and youth are being observed internationally. The purpose of this paper is to summarize findings from France’s 2018 Report Card on physical activity for children and youth, and to make comparisons with its 2016 predecessor and with the Report Cards of other countries engaged in the Global Matrix 3.0. Methods: The France’s 2018 Report Card was developed following the standardized methodology established for the Global Matrix 3.0 by grading 10 common physical activity indicators using best available data. Grades were informed by national surveys, peer-reviewed literature, government and nongovernment reports, and online information. Results: The expert panel awarded the following grades: overall physical activity, D; organized sport participation and physical activity, C−; active play, INC; active transportation, C−; sedentary behaviors, D−; physical fitness, B–; family and peers, INC; school, B; community and the built environment, INC; and government, C. Conclusions: Very concerning levels of physical activity and sedentary behaviors among French children and youth were observed, highlighting the urgent need for well-designed national actions addressing the presented physical inactivity crisis. The top 3 strategies that should be implemented in priority to improve the lifestyle of French children and youth are provided.