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Yara Fidelix, Mara C. Lofrano-Prado, Leonardo S. Fortes, James O. Hill, Ann E. Caldwell, João P. Botero and Wagner L. do Prado

Background: Physical activity may be as effective as some drugs for improving psychological outcomes; however, vigorous exercise may be needed for improving these outcomes in adolescents with obesity. The aim of this study is to examine the effects of low- and high-intensity training on self-esteem and symptoms of depression and anxiety in adolescents with obesity. Methods: A total of 62 pubertal adolescents with obesity (age 15 [1.5] y, body mass index 34.87 [4.22] kg/m2) were randomized into high-intensity group (HIG, n = 31) or low-intensity group (LIG, n = 31) for 24 weeks. All participants also received nutritional, psychological, and clinical counseling. Body composition and measures of depressive symptoms, anxiety, and self-esteem were assessed at baseline and after 24 weeks. Results: Depressive symptoms decreased significantly in both HIG (d = 1.16) and LIG (d = 0.45) (P ≤ .01). Trait anxiety decreased after 24 weeks for HIG (d = 0.81, P = .002) and LIG (d = 0.31, P = .002). No changes were observed in state anxiety or self-esteem. Conclusions: Results from the present study demonstrate that 24 weeks of multidisciplinary intervention improves depression and anxiety symptoms in adolescents with obesity; however, the magnitude of changes is higher in HIG compared with LIG.

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Mohammad Siahpush, Trish D. Levan, Minh N. Nguyen, Brandon L. Grimm, Athena K. Ramos, Tzeyu L. Michaud and Patrik L. Johansson

Background: The mortality benefits of meeting the US federal guidelines for physical activity, which includes recommendations for both aerobic and muscle-strengthening activities, have never been examined among smokers. Our aim was to investigate the association between reporting to meet the guidelines and all-cause, cancer, cardiovascular disease, and respiratory disease mortality among smokers. Methods: We pooled data from the 1998–2009 National Health Interview Survey, which were linked to records in the National Death Index (n = 68,706). Hazard ratios (HR) were computed to estimate the effect of meeting the physical activity guidelines on mortality. Results: Smokers who reported meeting the guidelines for physical activity had 29% lower risk of all-cause mortality (HR: 0.71; 95% confidence interval [CI], 0.62–0.81), 46% lower risk of mortality from cardiovascular disease (HR: 0.54; 95% CI, 0.39–0.76), and 26% lower risk of mortality from cancer (HR: 0.74; 95% CI, 0.59–0.93), compared with those who reported meeting neither the aerobic nor the muscle-strengthening recommendations of the guidelines. Meeting the aerobic recommendation of the guidelines was associated with a 42% decline in that risk (HR: 0.58; 95% CI, 0.44–0.77). Conclusion: Smokers who adhere to physical activity guidelines show a significant reduction in mortality.

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Kavita A. Gavand, Kelli L. Cain, Terry L. Conway, Brian E. Saelens, Lawrence D. Frank, Jacqueline Kerr, Karen Glanz and James F. Sallis

Background: To examine relations between parents’ perceived neighborhood recreation environments and multiple measures of adolescent physical activity (PA). Methods: Participants (N = 928; age 14.1 [1.4] y, 50.4% girls, and 33.4% nonwhite/Hispanic) and their parents were recruited. Teen moderate to vigorous PA (MVPA) was assessed with 7-day accelerometry. Self-reported total PA, PA near home, and PA at recreation locations were also assessed. Proximity of home to 8 types of recreation facilities was reported by parents. Mixed-model linear regressions relating environments to various measures of PA were adjusted for demographics and neighborhood clustering. Results: Perceiving more availability of recreation facilities around home was related to higher reports of days per week with 60+ minutes of PA (b = 0.153; P < .05), reported PA time near home (b = 0.152; P < .001), PA time at recreation facilities (b = 0.161; P < .001), accelerometer-measured total MVPA (b = 1.741; P < .05), and nonschool MVPA (b = 1.508; P < .01). Adolescents living in lowest quintile of recreation facility availability averaged 27.6 (3.2) minutes per day of total MVPA versus 49.8 (3.5) minutes per day for those living in highest quintile. Conclusions: Adolescents living in neighborhoods that parents reported having more availability of recreation facilities around homes had higher activity across 5 indicators of PA.

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Ryan D. Burns, Youngwon Kim, Wonwoo Byun and Timothy A. Brusseau

Background: To examine the relationships among school day sedentary times (SED), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) with gross motor skills in children using Compositional Data Analysis. Methods: Participants were 409 children (mean age = 8.4 [1.8] y) recruited across 5 low-income schools. Gross motor skills were assessed using the test for gross motor development—third edition (TGMD-3), and physical activity was assessed using accelerometers. Isometric log-ratio coordinates were calculated by quantifying the relative proportion of percentage of the school day spent in SED, LPA, and MVPA. The associations of the isometric log-ratio coordinates with the TGMD-3 scores were estimated using general linear mixed-effects models adjusted for age, body mass index, estimated aerobic capacity, and school affiliation. Results: A higher proportion of the school day spent in %MVPA relative to %SED and %LPA was significantly associated with higher TGMD-3 total scores (γ MVPA = 14.44, P = .01). This relationship was also observed for the ball skills subtest scores (γ MVPA = 16.12, P = .003). Conclusions: Replacing %SED and %LPA with %MVPA during school hours may be an effective strategy for improving gross motor skills, specifically ball skills, in low-income elementary school-aged children.

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Stephanie L. Stockwell, Lindsey R. Smith, Hannah M. Weaver, Daniella J. Hankins and Daniel P. Bailey

Background: The objective of this study was to investigate the associations between sedentary behavior patterns and cardiometabolic risk in children using a monitor that accurately distinguishes between different postures. Methods: In this cross-sectional study, 118 children (67 girls) aged 11–12 years had adiposity, blood pressure, lipids, and glucose measured, and then they wore an activPAL device to record sitting, standing, and stepping for 7 consecutive days. Data were analyzed using multiple linear regression. Results: After adjustment for potential confounders and moderate to vigorous physical activity, the number of breaks in sitting was significantly negatively associated with adiposity (standardized β ≥ −0.546; P ≤ .001) and significantly positively associated with high-density lipoprotein cholesterol (β = 0.415; P ≤ .01). Time in prolonged sitting bouts was significantly negatively associated with adiposity (β ≥ −0.577; P ≤ .001) and significantly positively associated with high-density lipoprotein cholesterol (β = 0.432; P ≤ .05). Standing time was significantly negatively associated with adiposity (β ≥ −0.270; P ≤ .05) and significantly positively associated with high-density lipoprotein cholesterol (β = 0.312; P ≤ .05). Conclusions: This study suggests that increasing the number of breaks in sitting and increasing standing time are beneficially associated with cardiometabolic risk and should be considered in health promotion interventions in children.

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Astrid C.J. Balemans, Han Houdijk, Gilbert R. Koelewijn, Marjolein Piek, Frank Tubbing, Anne Visser-Meily and Olaf Verschuren

Background: It is questionable whether postures that are regarded as sedentary behavior in able-bodied persons evoke comparable physiological responses in adults with stroke or cerebral palsy (CP). This study aimed to compare metabolic demand and muscle activity in healthy controls, adults with stroke, and adults with CP during sedentary behavior and light physical activities. Methods: Seventy-one adults (45.6 [18.9] y, range 18–86) participated in this study, of which there were 18 controls, 31 with stroke, and 22 with CP. The metabolic equivalent of task (MET) and level of muscle activation were assessed for different sedentary positions (sitting supported and unsupported) and light physical activities (standing and walking). Results: During sitting supported and unsupported, people with mild to moderate stroke and CP show comparable MET and electromyographic values as controls. While sitting unsupported, people with severe stroke show higher METs and electromyographic values (P < .001), and people with severe CP only show higher METs compared with controls (P < .05) but all below 1.5 METs. Standing increased electromyographic values in people with severe stroke or CP (P < .001) and reached values above 1.5 METs. Conclusions: Physiologic responses during sedentary behavior are comparable for controls and adults with mild to moderate stroke and CP, whereas higher metabolic demands and muscle activity (stroke only) were observed in severely affected individuals.

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Alessandra Prioreschi and Lisa K. Micklesfield

Background: This study reported compliance with 24-hour physical activity and sedentary behavior guidelines, and associations with adiposity in the first 2 years of life. Methods: Participants (N = 119) were recruited from Soweto, South Africa. Visceral and subcutaneous abdominal adipose tissue was measured by ultrasound. Participation in 2 movement behaviors (physical activity and sedentary time) was reported by mothers. Differences in adiposity between those meeting each individual guideline, as well as the combination of both movement guidelines, compared with those not meeting the guidelines were assessed. Results: Only 5% of infants met the sedentary guidelines; however, 58% met the physical activity guidelines. Subcutaneous adipose tissue was significantly higher in those meeting the physical activity guideline (0.50 [0.01] vs 0.47 [0.01] cm, P = .03) compared with those not meeting the guideline. Meeting the screen time component of the sedentary guideline was associated with higher visceral adipose tissue (β = 0.96, P < .01), while meeting one guideline compared with meeting none was associated with higher subcutaneous adipose tissue (β = 0.05, P = .01). Conclusions: Most infants and toddlers from this low- to middle-income setting were not meeting sedentary behavior guidelines. Both behaviors were associated with abdominal adiposity, but not with body mass index z score; implying these movement behaviors may impact abdominal fat deposition rather than body size.

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Christina M. Patch, Caterina G. Roman, Terry L. Conway, Ralph B. Taylor, Kavita A. Gavand, Brian E. Saelens, Marc A. Adams, Kelli L. Cain, Jessa K. Engelberg, Lauren Mayes, Scott C. Roesch and James F. Sallis

Background: A common hypothesis is that crime is a major barrier to physical activity, but research does not consistently support this assumption. This article advances research on crime-related safety and physical activity by developing a multilevel conceptual framework and reliable measures applicable across age groups. Methods: Criminologists and physical activity researchers collaborated to develop a conceptual framework. Survey development involved qualitative data collection and resulted in 155 items and 26 scales. Intraclass correlation coefficients (ICCs) were computed to assess test–retest reliability in a subsample of participants (N = 176). Analyses were conducted separately by age groups. Results: Test–retest reliability for most scales (63 of 104 ICCs across 4 age groups) was “excellent” or “good” (ICC ≥ .60) and only 18 ICCs were “poor” (ICC < .40). Reliability varied by age group. Adolescents (aged 12–17 y) had ICCs above the .40 threshold for 21 of 26 scales (81%). Young adults (aged 18–39 y) and middle-aged adults (aged 40–65 y) had ICCs above .40 for 24 (92%) and 23 (88%) scales, respectively. Older adults (aged 66 y and older) had ICCs above .40 for 18 of 26 scales (69%). Conclusions: The conceptual framework and reliable measures can be used to clarify the inconclusive relationships between crime-related safety and physical activity.

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Connie L. Tompkins, Erin K. Shoulberg, Lori E. Meyer, Caroline P. Martin, Marissa Dennis, Allison Krasner and Betsy Hoza

Background: According to the US Institute of Medicine guideline, preschool-aged children should participate in ≥15 minutes of physical activity (PA) per hour or 3 hours per day over 12 hours. Examinations of PA guideline compliance to date averaged time spent in PA over several days; however, children could exceed the guideline on some days and not on others. Therefore, this cross-sectional study examined PA guideline compliance in preschool children based on number of minutes per hour (average method) and percentage of days the guideline was met (everyday method). Methods: PA was measured by accelerometry during the preschool day for up to 10 days in 177 children (59.3% males, M age = 4.23). Minutes per hour and percentage of time in light, moderate to vigorous, and total PAs were calculated. Percentage of days in compliance was determined by number of days in compliance (defined as the child active on average ≥15 min/h) divided by total accelerometer days. Results: Children engaged in PA, on average, 17.01 minutes per hour, suggesting that on average, children are meeting the guideline. However, children were only in compliance with the PA guideline 62.41% of assessment days. Conclusions: Findings demonstrate the importance of examining compliance with both the average and everyday methods to more accurately portray level of Institute of Medicine PA guideline compliance.

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Angela Maria Hoyos-Quintero and Herney Andrés García-Perdomo

Objective: To evaluate the relationship between biologico-demographical, sociocultural, and environmental factors and the performance of physical activity in early childhood. Methodology: A systematic search was carried out of the databases MEDLINE, EMBASE, CENTRAL, and LILACS, as well as Google Scholar, Open Grey,, DARE, PROSPERO, Health Technology Assessment, and the World Health Organization International Clinical Trials Registry Platform, from their first records to June 2018. The selection criteria were previously defined with respect to population age and article theme. No meta-analyses were carried out due to the heterogeneity of the studies. Results: The percentage of moderate to vigorous physical activity runs between 3% and 47%. Environmental and sociocultural factors were identified as exerting a greater influence on children’s physical activity in early childhood, with the environmental factors being, according to almost all the study authors, the greater of the two. Conclusions: According to the studies included in this research project, the factors identified as associated with moderate to vigorous physical activity are environmental (play in open spaces) and sociocultural (the role of the family and the physical activity of the mother). The evidence is not strong enough to conclude that biologico-demographic factors are significantly influential in the physical activity at this age.