Effects of a school-based physical activity intervention on cardiometabolic health 5 years after cessation.

BACKGROUND: While there have been several school-based physical activity (PA) interventions targeting improvement in cardiovascular disease (CVD) risk factors, few have assessed long-term effects. The aim of this paper was therefore to determine intervention effects on CVD risk factors 5 years after cessation. METHODS: Two schools were assigned to intervention (n = 125) or control (n = 134). The intervention school offered 210 min/week more PA than the control school over two consecutive years (fourth and fifth grades). Follow-up assessment was conducted 5-year post-intervention (10th grade) where 180-210 (73%-85%) children provided valid data. Outcomes were CVD risk factors: triglyceride, total-to-high-density-lipoprotein-cholesterol ratio (TC:HDL ratio), insulin resistance, blood pressure (BP), waist circumference, and cardiorespiratory fitness (VO2peak ). Variables were analyzed individually and as a composite score through linear mixed models, including random intercepts for children. RESULTS: Analyses revealed significant sustained 5-year intervention effects for HDL (effect sizes [ES] = 0.22), diastolic BP (ES = 0.48), VO2peak (ES = 0.29), and composite risk score (ES = 0.38). These effects were similar to the immediate results following the intervention. In contrast, while TC:HDL ratio initially decreased post-intervention (ES = 0.27), this decrease was not maintained at 5-year follow-up (ES = 0.09), whereas WC was initially unchanged post-intervention (ES = 0.02), but decreased at 5-year follow-up (ES = 0.44). CONCLUSION: The significant effects of a 2-year school-based PA intervention remained for CVD risk factors 5 years after cessation of the intervention. As cardiometabolic health can be maintained long-term after school-based PA, this paper demonstrates the sustainability and potential of schools in the primary prevention of future CVD risk in children.

Group exercise membership is associated with forms of social support, exercise identity, and amount of physical activity.

Exploring whether the mechanisms underlying the positive relationship between group exercise and physical activity are forms of social support - emotional, validation, informational, instrumental, and companionship and exercise identity. Participants (n=506; M age = 34.3) completed a 235-item questionnaire assessing physical activity, exercise identity, social support, and other determinants of physical activity. Exploratory path analysis was used to model group exercise membership, forms of social support, exercise identity, and metabolic equivalent (MET) minutes/wk. Women and men had similar yet varying results. For women, group exercise membership was significantly associated with MET-minutes/wk (ß = 0.11) and exercise identity (ß = 0.17). There was a significant association between exercise identity and MET-minutes/wk (ß = 0.38). Women perceived belonging to an exercise group provides emotional (ß = 0.36), validation (ß = 0.25), informational (ß = 0.35), instrumental (ß = 0.19), and companionship (ß = 0.46) support. Validation (ß = 0.11), informational (ß = 0.21), and companionship (B = 0.17) were significantly associated with exercise identity for women. For men, group exercise membership was not significantly associated with MET-minutes/wk or exercise identity. Exercise identity was significantly associated with MET-minutes/wk (ß = 0.46). Men perceived belonging to their group provides emotional (ß = 0.31), validation (ß = 0.32), informational (ß = 0.33), and companionship (ß = 0.34). Validation (ß = 0.22), informational (ß = 0.30), and emotional (ß = 0.23) were significantly associated with exercise identity for men. Belonging to an exercise group is associated with forms of social support that strengthen exercise identity.

Physical activity preferences of 10-year-old children and identified activities with positive and negative associations to cardiorespiratory fitness.

AIM: This study investigated children's physical activity (PA) preferences, as these can aid the design of school-based interventions. METHODS: Data were collected in 2014 as a part of the Active Smarter Kids study and 1026 students (52% boys) from 57 Norwegian primary schools completed a questionnaire about their favourite physical activities at a mean age of 10.2 ± 0.3 years. We identified five patterns of PA and studied whether gender, cardiorespiratory fitness and abdominal adiposity were associated with these patterns. RESULTS: Soccer and slalom skiing were the favourite activities, and the most pronounced gender differences were for activities favoured by girls, which included dancing, gymnastics, exercising to music and jumping rope (p < 0.001). When the five component patterns were analysed using linear mixed-effect models, this showed a strong female preference for dancing, gymnastics, exercising to music and climbing. Cardiovascular fitness was negatively associated with frisbee, dodgeball, baseball and floorball, and positively associated with team handball, volleyball and basketball and with slalom skiing and cross-country skiing. It was interesting that the children's preferences were not related to their abdominal adiposity. CONCLUSION: The results showed different gender-based PA preferences and positive and negative associations with cardiovascular fitness, but no relationship with abdominal adiposity.

Systematic Review of Physical Education-Based Physical Activity Interventions Among Elementary School Children.

Physical education (PE)-based interventions are a popular method to target children's physical activity (PA) and fitness; however, little is known about their effectiveness or what factors lead to successful interventions. This paper: (1) systematically reviews studies examining PE interventions designed to impact PA, fitness, and/or body composition; and (2) makes recommendations for new research directions based upon these findings. Our systematic review was limited to experimental and quasi-experimental studies conducted in elementary schools. We conducted literature searches using predetermined keywords in 3 databases, identified a total of 4964 potentially relevant studies, and screened their abstracts and full texts for eligibility. This resulted in 12 relevant studies. We used criteria established by Downs and Black (1998) to assess each study's methodological quality. PE interventions consistently showed increases in moderate-to-vigorous PA or vigorous PA during PE class but were less consistent in impacting leisure-time PA. PE interventions affected body composition differentially, depending on the assessment used (i.e., body mass index or skinfold thickness). Half of the studies assessing fitness did not show a significant impact; however, those that did were designed to influence fitness outcomes. Few studies assessed psychosocial determinants regarding PA, and no study demonstrated significant impacts on constructs other than knowledge. Interventions often contained multiple components (e.g., diet, family) implemented alongside PE interventions. Identifying effective intervention components was difficult due to lack of process evaluation. We identify the need for future research to use more objective and accurate PA measurements and adiposity, incorporate measurement of psychological constructs, expand interventions' theoretical basis, and include strong process evaluation.

Active learning improves on-task behaviors in 4th grade children.

While increased opportunities for physical activity (PA) are a critical, public health need for children, school-based interventions often place teachers in the position to choose between PA and time spent on academic lessons. Active learning is designed to overcome this by combining PA with academic material. Moreover, teachers are likely to be more responsive to change in academic-related outcomes than in PA. This study utilizes a large, cluster randomized control trial in which student attention, or time on task (TOT) and accelerometer-based PA is assessed in conjunction with active learning. Participants were 2716 children (46% male, 46% white) from 28 elementary schools in Central Texas that were assigned to either: 1) active learning (math n = 10; spelling n = 9); or 2) traditional, sedentary academic lessons (n = 9). PA was measured with accelerometers. TOT was measured through a momentary time sampling protocol. A series of three-level (student, classroom, school) regression models estimated the effect of the intervention. The intervention lead to significantly increased TOT. Moreover, the dose of PA (steps) during the intervention was positively associated with the increase in TOT. In contrast, a greater dose of PA was associated with reduced TOT for students in control schools. Race, gender, and SES did not moderate these effects. Planned PA - as a part of an active, academic lesson - positively impacted TOT. In contrast, a traditional, sedentary lesson was associated with lower TOT. This differential impact offers intriguing possibilities to better understand the relationship between PA and academic performance.

The effect of a two-year school-based daily physical activity intervention on a clustered CVD risk factor score-The Sogndal school-intervention study.

To evaluate changes in clustered cardiovascular disease (CVD) risk factors in 9-year-old children following a 2-year school-based physical activity intervention. In total, 259 children (age 9.3 ± 0.3 years) were invited, of whom 256 participated. The intervention group (63 boys, 62 girls) carried out 60-minute teacher-controlled daily physical activity over two school years. The control group (62 boys, 69 girls) had the curriculum-defined amount of physical education (45 minutes twice each week). Of these, 67% (171 total, 91 intervention) successfully completed both baseline and post-intervention of six CVD risk factors: systolic blood pressure (SBP), triglyceride (TG), total cholesterol-to-high-density lipoprotein cholesterol ratio (TC:HDL ratio), waist circumference (WC), the homeostasis model assessment for insulin resistance (HOMA), and peak oxygen uptake (VO2peak ). All variables were standardized by sex prior to constructing a cluster score (sum of z scores for all variables). The effect of the intervention on the cluster score was analyzed using linear multiple regression. The cluster score improved after the intervention (ES = .29). Furthermore, the analyses showed significant effects in favor of the intervention group for systolic blood pressure (ES = .35), total cholesterol-to-HDL-c ratio (ES = .23), triglyceride (ES = .40), and VO2peak (ES = .57). A teacher-led school-based physical activity intervention that is sufficiently long and includes a substantial amount of daily physical activity can beneficially modify children's clustered CVD risk profile.

Gender-specific effects of physical activity on children's academic performance: The Active Smarter Kids cluster randomized controlled trial.

Active learning combines academic content with physical activity (PA) to increase child PA and academic performance, but the impact of active learning is mixed. It may be that this is a moderated relationship in which active learning is beneficial for only some children. This paper examine the impact of baseline academic performance and gender as moderators for the effects of active learning on children's academic performance. In the ASK-study, 1129 fifth-graders from 57 Norwegian elementary schools were randomized by school to intervention or control in a physical activity intervention between November 2014 and June 2015. Academic performance in numeracy, reading, and English was measured and a composite score was calculated. Children were split into low, middle and high academic performing tertiles. 3-way-interactions for group (intervention, control)∗gender (boys, girls)∗academic performance (tertiles) were investigated using mixed model regression. There was a significant, 3-way-interaction (p=0.044). Both boys (ES=0.11) and girls (ES=0.18) in the low performing tertile had a similar beneficial trend. In contrast, middle (ES=0.03) and high performing boys (ES=0.09) responded with small beneficial trends, while middle (ES=-0.11) and high performing girls (ES=-0.06) responded with negative trends. ASK was associated with a significant increase in academic performance for low performing children. It is likely that active learning benefited children most in need of adapted education but it may have a null or negative effect for those girls who are already performing well in the sedentary classroom. Differences in gendered responses are discussed as a possible explanation for these results. TRIAL REGISTRATION: Clinicaltrials.gov registry, trial registration number: NCT02132494.

DXA estimates of fat in abdominal, trunk and hip regions varies by ethnicity in men.

OBJECTIVE: The aim of this study was to determine whether the quantity of fat is different across the central (that is, android, trunk) and peripheral (that is, arm, leg and gynoid) regions among young African-American (AA), Asian (AS), Hispanic (HI) and non-Hispanic White (NHW) men. SUBJECTS AND METHODS: A cohort of 852 men (18-30 years; mean total body fat percent (TBF%)=18.8±7.9, range=3.7-45.4) were assessed for body composition in five body regions via dual-emission X-ray absorptiometry (DXA). RESULTS: HI men (21.8±8.3) had higher TBF% than AA (17.0±10.0), NHW (17.9±7.2) and AS (18.9±8.0) groups (P-values <0.0001). AS had a lower BMI (23.9±3.4) than all other groups, and NHW (24.7±3.2) had a lower BMI than HI (25.7±3.9) and AA (26.5±4.7; P-values<0.0001). A linear mixed model (LMM) revealed a significant ethnicity by region fat% interaction (P<0.0001). HI men had a greater fat% than NHW for every region (adjusted means (%); android: 29.6 vs 23.3; arm: 13.3 vs 10.6; gynoid: 27.2 vs 23.8; leg: 21.2 vs 18.3; trunk: 25.5 vs 20.6) and a greater fat% than AA for every region except the arm. In addition, in the android and trunk regions, HI had a greater fat% than AS, and AS had a higher fat% than AA. Finally, the android fat% for AS was higher than that of NHW. When comparing the region fat% within ethnicities, the android region was greater than the gynoid region for AS and HI, but did not differ for AA and NHW, and the arm region had the least fat% in all ethnicities. CONCLUSIONS: Fat deposition and body fat patterning varies by ethnicity.

Stress reactivity after maximal exercise: the effect of manipulated performance feedback in endurance athletes.

This study was designed to assess the effect of performance feedback on stress reactivity after recovery from maximal exercise. Forty competitive athletes were recruited to complete a maximal exercise test. Performance feedback was manipulated after the exercise test to give four groups: (1) high performance, (2) low performance, (3) accurate feedback and (4) no exercise control. Cardiovascular reactivity was assessed during psychological stress. The results indicate that accurate feedback participants experienced lower relative reactivity to stress (lower mean arterial pressure) than their no-exercise counterparts. These results demonstrate that the stress-buffering effect of exercise extends to maximal exercise. In addition, high-performance participants experienced lower relative reactivity than low-performance participants. Thus, low-performance feedback was sufficient to remove the buffering effect of exercise. There were no differences between the high-performance and accurate feedback conditions, or between the low-performance and control conditions.

Adolescent weight management and perceptions: an analysis of the National Longitudinal Study of Adolescent Health.

Researchers investigated contemporary weight management activities and weight perceptions among adolescents and determined the effects of school health education on these perceptions and activities. This national, random sample of more than 6,500 adolescents (grades 7-12) measured perceived weight, weight change efforts, weight change activities, Body Mass Index, and health education for weight management. Results indicate that most adolescents: 1) take part in efforts to manage their weight, although many struggle with perceiving their weight; 2) engage in appropriate weight change efforts; and 3) report receiving school health education that positively effects some aspects of their weight management behavior. Thus, adolescents are concerned about weight and perceptions of weight and are engaging in a variety of weight change activities for weight maintenance and weight change. School health education appears to have some effect in improving adolescent health behavior, and discussion centers on this topic.

State anxiety following resistance exercise: the role of gender and exercise intensity.

Two experiments were conducted to investigate the effect of resistance exercise on state anxiety. In experiment 1, participants engaged in three 20-min bouts of resistance exercise, with intensity set as a function of perceived exertion. Results indicated that the relationship between resistance exercise and anxiety was moderated by both exercise intensity and gender. Although females reported no change in anxiety, males reported an increase in anxiety following moderate- and high-intensity exercise, and a decrease in anxiety following low intensity exercise. Experiment 2 was designed to replicate these findings utilizing a more precise manipulation of exercise intensity. Results indicated that the change in anxiety was again moderated by exercise intensity but was unaffected by gender. Both males and females reported increases in anxiety following 20 min of high-intensity exercise (75-85% of 1 RM), as well as significant decreases in anxiety following low-intensity exercise (40-50% of 1 RM).

The Sports Inventory for Pain: a confirmatory factor analysis.

This investigation was designed to assess the factorial validity of the Sports Inventory for Pain (SIP) which was completed by 182 undergraduate students. Responses were subjected to a confirmatory factor analysis designed to test the hypothesized underlying factor structure. Of five proposed subscales, only the items for the Cognitive and Coping subscales reasonably fit the hypothesized structure. To improve the fit of the model, factors were allowed to correlate, and the worst fitting item from each of the subscales was removed. The modified model also failed to adequately fit the data. Lastly, the items corresponding to the worst fitting subscale were dropped from the analysis. Again, the modified model failed to fit the data. Discussion suggests a possible respecification of the SIP.

Post-exercise analgesia: replication and extension.

This study was designed to investigate whether post-exercise analgesia occurs following an ad lib exercise routine. All of the 17 male participants exercised on a regular basis. In an exercise setting (student gymnasium) they participated in 20 min of self-selected exercise, while in the neutral setting (laboratory) they rested quietly for 20 min. Pain was induced via the gross pressure device. Pain threshold and pain tolerance were measured twice, with an interval of 20 min, in both the exercise and the neutral setting. Pain threshold was stable in the exercise setting. A significant increase in pain tolerance followed the 20 min bout of exercise, indicating a post-exercise analgesic response. These results support the prediction that the analgesic effect of exercise is not limited to controlled experimental conditions, but generalizes to naturally occurring situations.