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1.
PurposeTo evaluate the potential of a year-round school calendar (180-day school year distributed across 12 months) as an intervention compared to a traditional school calendar (180-day school year distributed across 9 months) for mitigating children's weight gain and fitness loss via a natural experiment.MethodsHeight, weight, and cardiorespiratory fitness (CRF) (i.e., Fitnessgram Progressive Aerobic Cardiovascular Endurance Run) were measured in children (5–12 years old) in 3 schools (2 traditional, 1 year-round, n = 990 students, age = 8.6 ± 2.4 years, 53.1% male, 68.9% African American) from 1 school district. Structure (represented by the presence of a school day) was the independent variable. Changes in body mass index (BMI), age- and sex-specific BMI z-scores (zBMI), BMI percentile, percent of overweight or obese children, and CRF (Progressive Aerobic Cardiovascular Endurance Run laps completed) were assessed for summer 2017 (May–August 2017), school year 2017/2018 (August 2017–May 2018), and summer 2018 (May–August 2018). Primary analyses examined the overall change in weight and CRF from summer 2017 until summer 2018 via multilevel mixed effects regression, with group (traditional vs. year-round calendar), time, and a group-by-time interaction as the independent variables. Secondary regression analyses estimated differences in change within and between groups during each time period, separately.ResultsYear-round students gained less BMI (difference in ∆ = –0.44, 95% confidence interval (CI): –0.67 to –0.03) and less CRF (difference in ∆ = –1.92, 95%CI: –3.56 to –0.28) than students attending a traditional school overall. Compared with traditional students, during both summers, year-round students gained less BMI (summer 2017 difference in ∆ = –0.15, 95%CI: –0.21 to –0.08; summer 2018 difference in ∆ = –0.16, 95%CI: –0.24 to –0.07) and zBMI (summer 2017 difference in ∆ = –0.032, 95%CI: –0.050 to –0.010; summer 2018 difference in ∆ = –0.033, 95%CI: –0.056 to –0.009), and increased CRF (summer 2017 difference in ∆ = 0.40, 95%CI: 0.02–0.85; summer 2018 difference in ∆ = 0.23, 95%CI: –0.25 to 0.74). However, the opposite was observed for the school year, with traditional students gaining less BMI and zBMI and increasing CRF compared with year-round students (difference in BMI ∆ = 0.05, 95%CI: 0.03–0.07; difference in zBMI ∆ = 0.012, 95%CI: 0.005–0.019; difference in Progressive Aerobic Cardiovascular Endurance Run laps ∆ = –0.43, 95%CI: –0.58 to –0.28).ConclusionThe year-round school calendar had a small beneficial impact on children's weight status but not CRF. It is unclear if this benefit to children's weight would be maintained because gains made in the summer were largely erased during the school year. Trajectories of weight and CRF gain/loss were consistent with the structured days hypothesis.  相似文献   

2.
BackgroundRegular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.MethodsHospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement.ResultsThe median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = –0.57 (95% confidence interval (95%CI): –1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: –0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: –0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: –0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050).ConclusionAmong hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.  相似文献   

3.
BackgroundAdopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens. However, the lifestyles of children with mental, behavioral, and developmental disorders (MBDDs) remains under-described within the literature of public health field. This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.MethodsData were from the 2016–2020 National Survey of Children's Health—A national, population-based, cross-sectional study. We used the data of 119,406 children aged 6–17 years, which included 38,571 participants with at least 1 MBDD and 80,835 without. Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity, screen time, and sleep duration.ResultsAmong children with MBDDs, 20.3%, 37.0%, 60.7%, and 77.3% met the physical activity, screen time, sleep, and at least 1 of the 24-hour movement guidelines. These rates were lower than those in children without MBDDs (22.8%, 46.2%, 66.7%, and 83.4%, respectively; all p < 0.001). Children with MBDDs were less likely to meet these guidelines (odds ratio (OR) = 1.21, 95% confidence interval (95%CI): 1.13–1.30; OR = 1.37, 95%CI: 1.29–1.45; OR = 1.29, 95%CI: 1.21–1.37; OR = 1.45, 95%CI: 1.35–1.56) than children without MBDDs. Children with emotional disorders had the highest odds of not meeting these guidelines (OR = 1.43, 95%CI: 1.29–1.57; OR = 1.48, 95%CI: 1.37–1.60; OR = 1.49, 95%CI: 1.39–1.61; OR = 1.72, 95%CI: 1.57–1.88) in comparison to children with other MBDDs. Among children aged 12–17 years, the difference in proportion of meeting physical activity and screen time guidelines for children with vs. children without MBDD was larger than that among children aged 6–11 years. Furthermore, the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.ConclusionChildren with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs. In educational and clinical settings, the primary focus should be on increasing physical activity and limiting screen time in children aged 12–17 years who have MBDDs; and specifically for white children who have MBDDs, increasing physical activity may help.  相似文献   

4.
PurposeThis study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise (MSE) recommendations and identify correlates of meeting the MSE recommendations.MethodsCross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study, a nationally representative sample of Chinese children and adolescents (n = 80,413; mean age = 13.7 years; 53.9% girls) and their parents, were analyzed. Children and adolescents who reported engaging ≥3 days (up to 7 days) of MSE per week were classified as meeting the MSE recommendations. MSE, demographics, lifestyle behaviors (sport participation, moderate-to-vigorous physical activity, screen time, and sleep duration), exercise intention, peer and parental support, and parental MSE participation were assessed through self-reports. Logistic regression models were used to determine the correlates of meeting the MSE recommendations. The analyses were completed in 2020.ResultsOverall, 39.3% of children and adolescents met the MSE recommendations. Girls, 10th–12th graders, minorities, those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations. Children and adolescents who were proficient in ≥2 sports were more likely to meet the MSE recommendations (adjusted odds ratio (aOR) = 1.44, 95% confidence interval (95%CI): 1.26–1.65), as were those with more moderate-to-vigorous physical activity (aOR = 1.57, 95%CI: 1.53–1.61). Additionally, children and adolescents with high exercise intention (aOR = 1.60, 95%CI: 1.51–1.69), those whose parents met the adult MSE recommendations (aOR = 1.46, 95%CI: 1.40–1.52), and those who received high peer (aOR = 1.27, 95%CI: 1.20–1.34) and parental support (aOR = 1.07, 95%CI: 1.04–1.12) were more likely to meet the MSE recommendations.ConclusionLess than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations. The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.  相似文献   

5.
BackgroundPhysical activity (PA) in the early years is associated with a range of positive health outcomes. Fundamental motor skill (FMS) competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood. However, to date, no studies have meta-analyzed the association between PA and FMS in the early years.MethodsSix electronic databases were searched for articles published up to April 2019. Cross-sectional and longitudinal studies were included if they targeted children (ages 3–6 year) as the population of the study and assessed the association between objectively measured PA and FMS. Total FMS, total physical activity (TPA), and moderate-to-vigorous physical activity (MVPA) data were meta-analyzed using a random effects model.ResultsWe identified 24,815 titles and abstracts. In total, 19 studies met the inclusion criteria, including 14 cross-sectional and 4 longitudinal studies, as well as 1 study with cross-sectional and longitudinal analysis. There was a significant but small positive association between FMS and MVPA (r = 0.20, 95% confidence interval (CI): 0.13–0.26) and TPA (r = 0.20, 95%CI: 0.12–0.28). Findings from longitudinal studies revealed that PA drives FMS in early childhood. Mediation was explored in 1 study, which found that perceived motor competence did not mediate the association between FMS and PA.ConclusionUsing a meta-analysis, this study is the first to show a positive association between FMS, MVPA, and TPA in the early years of childhood, suggesting that the association begins at an early age. Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood. More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.  相似文献   

6.
Background:Gross motor skills are postulated to have a bidirectional relationship with physical activity(PA);however,no study has tested this relationship before and after a summer break.The purpose of this study was to examine the bidirectional relationships between school PA and gross motor skills in children before and after a summer break.Methods:Participants were a sample of 440 children recruited from 3 low-income schools(age=8.9±1.2 years,mean±SD).PA was assessed as average school-day step counts using Yamax DigiWalker pedometers(Yamasa Tokei Keiki,Tokyo,Japan)worn for 5 consecutive school days.Gross motor skills were assessed using the Test for Gross Motor Development,3 rd edition.Data were collected at 2 timepoints:at the end of spring semester(T1)and at the beginning of the subsequent fall semester(T2).An age-and body mass index-adjusted cross-lagged model was employed to relate T1 school step counts with T2 gross motor skills and T1 gross motor skills with T2 school step counts.Results:T1 gross motor skills significantly predicted T2 school step counts(β=0.24,95%confidence interval(95%CI):0.08-0.40,p=0.003);however,Tl school step counts did not predict T2 gross motor skills(β=0.04,95%CI:-0.06 to 0.14,p=0.445).The model explained 35.4%and 15.9%of the variances of T2 gross motor skills and T2 school step counts,respectively.Additional analyses indicated that these relationships were driven primarily by ball skills.Conclusion:The relationship between gross motor skills and school PA was not bidirectional;however,higher gross motor skills,specifically ball skills,predicted higher school PA after a 3-month summer break.  相似文献   

7.
ObjectiveThis cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.MethodsData were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3–6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.ResultsMultiple linear regression analysis showed that “having grandparents as primary caregivers” (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1–57.2); LTSB (ln): 0.19 (0.11–0.28)) and “having a television (for LTSB (ln): 0.13 (0.00–0.25)) or computer (for LTSB (ln): 0.13 (0.03–0.23)) in the child's bedroom” were both associated with higher SB. Furthermore, “having grandparents as primary caregivers” was associated with less MVPA (β (95%CI): ?7.6 (?14.1 to ?1.2)), and “active commuting to school by walking” correlated with more MVPA (β (95%CI): 9.8 (2.2–17.4)). The path model showed that “more neighborhood PA facilities close to home” was indirectly related to higher LTPA (ln), which was partly mediated by “outdoor play” (path coefficients (95%CI): 0.005 (0.002–0.008)) and “going to these facilities more often” (path coefficients (95%CI): 0.013 (0.008–0.018)). Traffic safety was not a correlate.ConclusionFamily structure and media exposure in the home maybe important factors in shaping preschoolers’ PA patterns. Built environmental correlates could indirectly influence preschoolers’ LTPA through parental help with engaging in active behaviors.  相似文献   

8.
Background:Physical activity,sleep,and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms.However,it is not clear whether it is the movement behavior itself or other contextual factors that are related to depressive symptoms.The objective of the present study was to examine the associations between self-reported and accelerometer-measured movement behaviors and depressive symptoms in adolescents.Methods:Cross-sectional data from 610 adolescents(14-18 years old)were used.Adolescents answered questions from the Center for Epidemiological Studies Depression scale and reported time spent watching videos,playing videogames,using social media,time spent in various physical activities,and daytime sleepiness.Wrist-worn accelerometers were used to measure sleep duration,sleep efficiency,sedentary time,and physical activity.Mixed-effects logistic regressions were used.Results:Almost half of the adolescents(48%)were classified as being at high risk for depression(score≥20).No significant associations were found between depressive symptoms and accelerometer-measured movement behaviors,self-reported non-sport physical activity,watching videos,and playing videogames.However,higher levels of self-reported total physical activity(odd ratio(OR)=0.92,95%confidence interval(95%CI):0.86-0.98)and volume of sports(OR=0.88,95%CI:0.79-0.97),in minutes,were associated with a lower risk of depression,while using social media for either 2.0-3.9 h/day(OR=1.77,95%CI:1.58-2.70)or>3.9 h/day(OR=1.67,95%CI:1.10-2.54),as well as higher levels of daytime sleepiness(OR=1.17,95%CI:1.12-1.22),were associated with a higher risk of depression.Conclusion:What adolescents do when they are active or sedentary may be more important than the time spent in the movement behaviors because it relates to depressive symptoms.Targeting daytime sleepiness,promoting sports,and limiting social media use may benefit adolescents.  相似文献   

9.
BackgroundThis study examined the joint associations of sleep patterns and physical activity (PA) with all-cause, cardiovascular disease (CVD), and cancer mortality.MethodsA total of 341,248 adults (mean age = 39.7 years; men: 48.3%) were included in the study, with a 15-year follow-up. Participants reported sleep duration and disturbances (difficulty falling asleep, easily awakened, or use of sleeping medication). PA was classified into 4 levels: <7.5, 7.5–14.9, 15.0–29.9, and ≥30.0 metabolic equivalent hours per week (MET-h/week). To understand the joint associations of sleep patterns and PA with mortality, Cox proportional hazard models were conducted, with exposure variables combining sleep duration/disturbances and PA.ResultsCompared with the reference group (sleeping 6–8 h/day), individuals who slept >8 h/day had higher risk for all-cause mortality (hazard ratio (HR) = 1.307, 95% confidence interval (95%CI): 1.248–1.369), CVD mortality (HR = 1.298, 95%CI: 1.165–1.445), and cancer mortality (HR = 1.128, 95%CI: 1.042–1.220). Short sleep duration was not associated with mortality risk. Increased risk of all-cause and CVD mortality was found in participants who had difficulty falling asleep (HR = 1.120, 95%CI: 1.068–1.175; HR = 1.163, 95%CI: 1.038–1.304, respectively), and used sleeping medication (HR = 1.261, 95%CI: 1.159–1.372; HR = 1.335, 95%CI: 1.102–1.618, respectively) compared with those who slept well. Long sleep duration and sleep disturbances were not associated with risk of all-cause and CVD mortality among individuals achieving a PA level of ≥15 MET-h/week, and in particular among those achieving ≥30 MET-h/week.ConclusionLong sleep duration, difficulty falling asleep, and use of sleeping medication were related to a higher risk of death. Being physically active at a moderate intensity for 25–65 min/day eliminated these detrimental associations.  相似文献   

10.
PurposeThe aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes (glycated hemoglobin and fasting glucose) and type 2 diabetes mellitus (T2DM) in adulthood, 14 and 22 years later.MethodsWe analyzed data from apparently healthy adolescents aged 12–18 years who participated in Waves I and II (1994–1996, n = 14,738), Wave IV (2008–2009, n = 8913), and Wave V (2016–2018, n = 3457) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the United States. Physical activity, screen time, and sleep duration were measured using questionnaires, and the 24-h guidelines were defined as: 5 or more times moderate-to-vigorous physical activity per week, ≤2 h per day of screen time, and 9–11 h of sleep for 12–13 years and 8–10 h for 14–17 years. Capillary and venous whole blood was collected and analyzed to determine glycated hemoglobin and fasting glucose for Waves IV and V, respectively.ResultsOnly 2.1% of the adolescents met all the 3 guidelines, and 37.8% met none of them. In both waves IV and V, adolescents who met physical activity and screen time guidelines had lower odds of T2DM in adulthood than those who did not meet any of these guidelines (Wave IV; prevalence ratio (PR) = 0.57, 95% confidence interval (95%CI): 0.21–0.89; Wave V: PR = 0.43, 95%CI: 0.32–0.74). Only for Wave V did adolescents who met all 3 guidelines have lower odds of T2DM at follow-up compared with those who did not meet any of these guidelines (PR = 0.47, 95%CI: 0.24–0.91). Also, for each increase in meeting one of the 24-h recommendations, the odds of T2DM decreased by 18% (PR = 0.82, 95%CI: 0.61–0.99) and 15% (PR = 0.85, 95%CI: 0.65–0.98) in adulthood for Waves IV and V, respectively.ConclusionPromoting all 24-h movement guidelines in adolescence, especially physical activity and screen time, is important for lowering the potential risk of T2DM in adulthood.  相似文献   

11.
BackgroundMeeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.MethodsFour electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.ResultsSixty-three studies comprising 387,437 individuals (51% girls) aged 3–18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%–7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%–21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%–4.27%) than in boys (6.89%, 95%CI: 5.89%–7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%–22.92%; boys, 12.95%, 95%CI: 6.57%–19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%–13.84%), 10.31% (95%CI: 7.49%–13.12%), and 2.68% (95%CI: 1.78%–3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%–11.64%) of preschoolers, 15.57% (95%CI: 11.60%–19.54%) of children, and 28.59% (95%CI: 22.42%–34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = –0.37, 95%CI: –0.65 to –0.09; p = 0.010).ConclusionMost young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.  相似文献   

12.
BackgroundPhysical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety; however, few studies jointly examine these risk factors. This study aimed to prospectively examine the joint association of physical activity (PA) and insomnia symptoms with onset of poor mental health in adults.MethodsParticipants from the 2013 to 2018 annual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health (Mental Health Inventory-5 >54) in 2013, and who completed at least 1 follow-up survey (2014–2018), were included (n = 10,977). Poor mental health (Mental Health Inventory-5 ≤ 54) was assessed annually. Baseline (2013) PA was classified as high/moderate/low, and insomnia symptoms (i.e., trouble sleeping) were classified as no insomnia symptoms/insomnia symptoms, with 6 mutually exclusive PA-insomnia symptom groups derived. Associations of PA–insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models.ResultsThere were 2322 new cases of poor mental health (21.2%). Relative to the high PA/no insomnia symptoms group, there were higher odds (odds ratio and 95% confidence interval (95%CI)) of poor mental health among the high PA/insomnia symptoms (OR = 1.87, 95%CI: 1.57–2.23), moderate PA/insomnia symptoms (OR = 1.93, 95%CI: 1.61–2.31), low PA/insomnia symptoms (OR = 2.33, 95%CI: 1.96–2.78), and low PA/no insomnia symptoms (OR = 1.14, 95%CI: 1.01–1.29) groups. Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health, with the odds increasing as PA decreased.ConclusionThese findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.  相似文献   

13.
ObjectiveParents may use various information sources to obtain information about sport-related concussions (SRC). This study examined SRC-related information sources used by parents of United States middle school children (age: 10–15 years).MethodsA panel of 1083 randomly selected U.S. residents, aged ≥18 years and identifying as parents of middle school children, completed an online questionnaire capturing parental and child characteristics, and utilization and perceived trustworthiness of various sources of SRC-related information. Multivariable logistic regression models identified factors associated with utilizing each source. Adjusted odds ratios (OR) with 95% confidence intervals (95%CIs) excluding 1.00 were deemed significant.ResultsDoctors/healthcare providers (49.9%) and other healthcare-related resources (e.g., Centers for Disease Control and Prevention, WebMD) (37.8%) were common SRC-related information sources; 64.0% of parents utilized ≥1 of these sources. Both sources were considered “very” or “extremely” trustworthy for SRC-related information among parents using these sources (doctors/healthcare providers: 89.8%; other healthcare-related resources: 70.9%). A 10-year increase in parental age was associated with higher odds of utilizing doctors/healthcare providers (adjusted odd ratio (ORadjusted) = 1.09, 95%CI: 1.02–1.16) and other healthcare-related resources (ORadjusted = 1.11, 95%CI: 1.03–1.19). The odds of utilizing doctors/healthcare providers (ORadjusted = 0.58, 95%CI: 0.40–0.84) and other healthcare-related resources (ORadjusted = 0.64, 95%CI: 0.44–0.93) were lower among parents whose middle school children had concussion histories versus the parents of children who did not have concussion histories.ConclusionOne-third of parents did not report using doctors/healthcare providers or other healthcare-related resources for SRC-related information. Factors associated with underutilization of these sources may be targets for future intervention. Continuing education for healthcare providers and educational opportunities for parents should highlight accurate and up-to-date SRC-related information.  相似文献   

14.
BackgroundWhether or not there is targeted pharmacotherapy for dementia, an active and healthy lifestyle that includes physical activity (PA) may be a better option than medication for preventing dementia. We examined the association between leisure-time sedentary behavior (SB) and the risk of dementia incidence and mortality. We further quantified the effect on dementia risk of replacing sedentary time with an equal amount of time spent on different physical activities.MethodsIn the UK Biobank, 484,169 participants (mean age = 56.5 years; 45.2% men) free of dementia were followed from baseline (2006–2010) through July 30, 2021. A standard questionnaire measured individual leisure-time SB (watching TV, computer use, and driving) and PA (walking for pleasure, light and heavy do-it-yourself activity, strenuous sports, and other exercise) frequency and duration in the 4 weeks prior to evaluation. Apolipoprotein E (APOE) genotype data were available for a subset of 397,519 (82.1%) individuals. A Cox proportional hazard model and an isotemporal substitution model were used in this study.ResultsDuring a median 12.4 years of follow-up, 6904 all-cause dementia cases and 2115 deaths from dementia were recorded. In comparison to participants with leisure-time SB <5 h/day, the hazard ratio ((HR), 95% confidence interval (95%CI)) of dementia incidence was 1.07 (1.02–1.13) for 5–8 h/day and 1.25 (1.13–1.38) for >8 h/day, and the HR of dementia mortality was 1.35 (1.12–1.61) for >8 h/day. A 1 standard deviation increment of sedentary time (2.33 h/day) was strongly associated with a higher incidence of dementia and mortality (HR = 1.06, 95%CI: 1.03–1.08 and HR = 1.07, 95%CI: 1.03–1.12, respectively). The association between sedentary time and the risk of developing dementia was more profound in subjects <60 years than in those ≥60 years (HR = 1.26, 95%CI: 1.00–1.58 vs. HR = 1.21, 95%CI: 1.08–1.35 in >8 h/day, p for interaction = 0.013). Replacing 30 min/day of leisure sedentary time with an equal time spent in total PA was associated with a 6% decreased risk and 9% decreased mortality from dementia, with exercise (e.g., swimming, cycling, aerobics, bowling) showing the strongest benefit (HR = 0.82, 95%CI: 0.78–0.86 and HR = 0.79, 95%CI: 0.72–0.86). Compared with APOE ε4 noncarriers, APOE ε4 carriers are more likely to see a decrease in Alzheimer's disease incidence and mortality when PA is substituted for SB.ConclusionLeisure-time SB was positively associated with the risk of dementia incidence and mortality. Replacing sedentary time with equal time spent doing PA may be associated with a significant reduction in dementia incidence and mortality risk.  相似文献   

15.
Little is known about the association between environmental characteristics and types of physical activity in adolescents in a Latin American context. The aim of this study was to examine the association between perceived neighborhood environmental characteristics and different types of physical activity in 2,874 adolescents from Joao Pessoa, Paraiba State, Northeastern Brazil. The types of activity measured by questionnaire (≥10 min/day) included sports, physical exercises, active commuting and recreational activities. Neighborhood characteristics were measured by a 15-item scale. Multilevel analyses showed that adolescents who reported “having places they liked to go to” (OR = 1.41; 95%CI: 1.10–1.79) and “places with opportunities to practice” (OR = 1.29; 95%CI: 1.01–1.65) were more likely to play sports. “Seeing interesting things while walking” (OR = 1.24; 95%CI: 1.01–1.53) and “Seeing other adolescents engaged in physical activity” (OR = 1.47; 95%CI: 1,05–2,06) were associated with exercises. “Seeing other adolescents engaged in physical activity” (OR = 1.47; 95%CI: 1.18–1.82), “the neighborhood is not violent” (OR = 1.29; 95%CI: 1.04–1.60) and “having places they like to go to” (OR = 1.59; 95%CI: 1.13–2.25) were positively associated and “places with opportunities to practice” (OR = 0.79; 95%CI: 0.63–0.98) inversely related to active commuting. “Seeing other adolescents engaged in physical activities” (OR = 1.31; 95%CI: 1.05–1.63) and “seeing interesting things while walking” (OR = 1.26; 95%CI: 1.02–1.56) were associated with recreational activities. Neighborhood environmental characteristics associated with the physical activity vary with the type of practices adopted by adolescents.  相似文献   

16.
BackgroundThe coronavirus disease-2019 (COVID-19) pandemic and national lockdowns took away opportunities for children to be physically active. This study aimed to determine the effect of the COVID-19 lockdown on accelerometer-assessed physical activity (PA) in children in Wales.MethodsEight hundred participants (8–18 years old), stratified by sex, age, and socio-economic status, wore Axivity AX3 accelerometers for 7 days in February 2021, during the lockdown, and in May 2021, while in school. Raw accelerometer data were processed in R-package GGIR, and cut-point data, average acceleration (AvAcc), intensity gradient, and the acceleration above which the most active X minutes are accumulated (MX) metrics were extracted. Linear mixed models were used to assess the influence of time-point, sex, age, and socioeconomic status (SES) on PA.ResultsDuring lockdown, moderate-to-vigorous PA was 38.4 ± 24.3 min/day; sedentary time was 849.4 ± 196.6 min/day; mean ± SD. PA levels increased significantly upon return to school (all variables p < 0.001). While there were no sex differences during lockdown (p = 0.233), girls engaged in significantly less moderate-to-vigorous PA than boys once back in school (p < 0.001). Furthermore, boys had more favorable intensity profiles than girls (intensity gradient: p < 0.001), regardless of time-point. PA levels decreased with age at both time-points; upper secondary school girls were the least active group, with an average M30 of 195.2 mg (while in school).ConclusionThe lockdown affected boys more than girls, as reflected by the disappearance of the typical sex difference in PA levels during lockdown, although these were re-established on return to school. Upper secondary school (especially girls) might need specific COVID-recovery intervention.  相似文献   

17.
BackgroundCardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association.MethodsWe searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses.ResultsData were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28–0.61) and 0.27 (95%CI: 0.16–0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74–0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48–1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26–0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76–0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36–1.32).ConclusionA better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population.  相似文献   

18.
BackgroundWeight-loss-induced fat loss improves cardiometabolic health in individuals with overweight and obesity; however, weight loss can also result in bone loss and increased fracture risk. Weight-loss-induced bone loss may be attenuated with exercise. Our aim was to compare changes in bone mineral density (BMD) in adults with overweight and obesity who undertook diet-induced weight loss alone or in combination with exercise.MethodsWe included randomized controlled trials (RCTs) in adults with overweight or obesity (aged ≥18 years; body mass index ≥25 kg/m2) that prescribed diet-induced weight loss alone or in combination with supervised exercise, and measured any bone structural parameters. Risk of bias was assessed using the Cochrane Risk of Bias tool. Random-effects meta-analyses determined mean changes and net mean differences (95% confidence intervals (95%CIs)) in the percentage of areal BMD (aBMD) change between groups.ResultsWe included 9 RCTs. Diet-induced weight loss led to significant losses in femoral neck aBMD (mean change: −1.73% (95%CI: −2.39% to −1.07%), p < 0.001) and total hip aBMD (−2.19% (95%CI: −3.84% to −0.54%), p = 0.009). Femoral neck aBMD losses were significantly greater in the diet-induced weight loss group compared to the exercise plus diet-induced weight loss group (net difference: −0.88% (95%CI: −1.73% to −0.03%)); however, there were no differences in aBMD changes at any other skeletal site: total hip (−1.96% (95%CI: −4.59% to 0.68%)) and lumbar spine (−0.48% (95%CI: −1.81% to 0.86%)). aBMD changes did not differ significantly according to exercise modality (resistance exercise, aerobic exercise, or a combination of the two) during diet-induced weight loss.ConclusionDiet-induced weight loss led to greater femoral neck bone loss compared to diet-induced weight loss plus exercise. Bone loss at the total hip and lumbar spine was not attenuated by exercise during diet-induced weight loss. The lack of consistent skeletal benefits may be due to the insufficient duration and/or training intensities of most exercise interventions. Additional RCTs with appropriate, targeted exercise interventions should be conducted.  相似文献   

19.
BackgroundLittle is known about the association between different types of physical activity (PA) and chronic back conditions (CBCs) at the population level. We investigated the association between levels of total and type-specific PA participation and CBCs.MethodsThe sample comprised 60,134 adults aged ≥16 years who participated in the Health Survey for England and Scottish Health Survey from 1994 to 2008. Multiple logistic regression models, adjusted for potential confounders, were used to examine the association between total and type-specific PA volume (walking, domestic activity, sport/exercise, cycling, football/rugby, running/jogging, manual work, and housework) and the prevalence of CBCs.ResultsWe found an inverse association between total PA volume and prevalence of CBCs. Compared with inactive participants, the fully adjusted odds ratio (OR) for very active participants (≥15 metabolic equivalent h/week) was 0.77 (95% confidence interval (CI): 0.69–0.85). Participants reporting ≥300 min/week of moderate-intensity activity and ≥75 min/week of vigorous-intensity activity had 24% (95%CI: 6%–39%) and 21% (95%CI: 11%–30%) lower odds of CBCs, respectively. Higher odds of CBCs were observed for participation in high-level manual domestic activity (OR = 1.22; 95%CI: 1.00–1.48). Sport/exercise was associated with CBCs in a less consistent manner (e.g., OR = 1.18 (95%CI: 1.06–1.32) for low levels and OR = 0.82 (95%CI: 0.72–0.93) for high levels of sport/exercise).ConclusionPA volume is inversely associated with the prevalence of CBCs.  相似文献   

20.
Purpose:The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.Methods:We systematically searched PubMed,Web of Science,and MEDLINE for studies on injury incidence published from inception to April 2020.Injury data were extracted,alongside information on injury location,severity,type,cause,and sport discipline.Incidence of injuries was presented per 1000 athlete-days,with 95%confidence intervals(95%CIs).Results:The search identified 462 articles,and 22 were included in our review.The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days(95%CI:2.97-4.01).Lower extremity had the highest injury incidence(1.54 per 1000 athletedays,95%CI:1.24-1.84).Incidence rates of slight,mild,moderate,and severe injuries were 0.26,0.31,0.57,and 0.59 per 1000 athlete-days,respectively.Contusion had the highest incidence rate(1.82 per 1000 athlete-days,95%CI:1.01-2.63).The most common cause of injury was contact trauma(3.20 per 1000 athlete-days,95%CI:1.32-5.08).Freestyle skiing had the highest incidence rate(6.83 per 1000 athlete-days,95%CI:4.00-9.66),and Nordic skiing had the lowest rate(2.70 per 1000 athlete-days,95%CI:1.94-3.46).Conclusion:Professional skiers and snowboarders have a substantial risk of sustaining injuries.Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.  相似文献   

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