Living Situation and Physical Activity in the COVID-19 Pandemic Among American Private University Students.

Many university students experienced changes during the COVID-19 pandemic, including potential changes in physical activity (PA) levels and living situation. As PA behaviors in young adulthood help establish life-long habits and future health outcomes, the purpose of this study was to investigate overall change in PA, as well as change in PA due to living situation, among private university students during the COVID-19 pandemic. Private university students (n = 109) between 18 and 25 years of age completed an online survey that included the International Physical Activity Questionnaire - Short Form. T-tests examined changes in overall time spent in PA from before to during the COVID-19 pandemic, and the differences in MET-minute distributions between groups. Students performed significantly less activity during the COVID-19 pandemic than before (t(108) = 3.51, p = .001, d = 0.493), with 70.6% of all students meeting exercise recommendations before the pandemic and 51.4% after. Students living with vs. without a parent/guardian attained similar PA levels (t(107) = -.114, p = .910) before the pandemic (73.1% vs. 69.9%, respectively), but students living with a parent/guardian engaged in significantly less PA (t(107) = 2.04, p = .044, d = 0.475) than those living without a parent/guardian during the pandemic (37.5% vs. 57.1%, respectively). The declines in PA suggest the need for targeted interventions and education among private university students. In order to maximize the health benefits of PA, it is crucial that activity engagement return to at least pre-COVID-19 levels.

Dietary behaviors and food insecurity among Houston college students during the COVID-19 pandemic.

Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.

Health-Related Physical Fitness and Activity in Homeschool: A Systematic Review With Implications for Return to Public School.

BACKGROUND: The purpose of this systematic review is to summarize what is known about health-related physical fitness (cardiovascular endurance, muscular strength and endurance, flexibility, and body composition) and physical activity among homeschool youth. Findings from this study have implications for all American youth as they return to public school from mandated schooling at home during the COVID-19 pandemic. METHODS: Database engines identified over 22,000 articles with 82 abstracts screened for further review. Of these, 18 full-text articles were additionally screened with 10 cross-sectional articles included in the final review. Articles were condensed into a standard review template and findings were summarized by topic. RESULTS: Cardiovascular endurance findings were inconsistent. Abdominal, but not upper body, muscular strength and endurance were significantly lower in homeschool students. There were no reports on flexibility. Body composition was generally healthy in homeschool students and no differences in physical activity were seen. CONCLUSIONS: Research on health-related physical fitness in homeschool youth is limited and descriptive. Further testing and potential remediation may be needed for cardiovascular endurance, muscular strength and endurance, and flexibility in homeschool youth and their public school counterparts as they return to campus. However, existing literature supports healthy body composition and physical activity in this population.

Feasibility and Acceptability Findings of an Energy Balance Data Repository of Children, Adolescents, and Young Adults with Cancer.

Cancer patients suffer changes in energy balance (EB), the combination of energy intake (nutrition) and energy expenditure (physical activity (PA)), which may influence cancer-related morbidity, mortality, and quality of life. Significant gaps remain in our understanding of the frequency and magnitude of these EB changes. Herein, we report on the feasibility and acceptability of a longitudinal repository of EB outcomes in children, adolescents and young adults (AYA) with cancer along the cancer continuum to fill these gaps. This EB repository includes PA, nutrition, and physical function (PF) parameters. PA data were gathered through activity trackers. Nutritional data were gathered through food diaries and micronutrient labs. PF was assessed with validated objective and patient-reported measures. Feasibility was achieved with >50% enrollment of eligible patients (n = 80, Mage = 18.1 ± 7.5); 26 were children with cancer and 54 were AYAs with cancer. An 88.75% retention rate indicated acceptability. Despite COVID-19 disruptions, >50% of participants provided completed data for PA and micronutrient labs as of April 2020. Food diaries and PF data collection experienced disruptions. Methodological adaptations are in progress to minimize future disruptions. Overall, our findings demonstrate that prospective EB assessments are feasible and acceptable among children and AYAs with cancer.

Youth physical health and years in American homeschools: are they related?

Homeschooling is a growing trend in the USA and abroad with both reported consequences and benefits to youth physical health. The purpose of this study was to examine whether changes in youth physical health could be related to the number of years a student spends in homeschool. Body composition (body mass index and body fat), muscular fitness (lower extremity, abdominal and upper extremity) and cardiorespiratory fitness (Progressive Aerobic Capacity Endurance Run) were assessed in 211 youth ages 5-17. Data analysis showed weak or non-significant relationships between years in homeschool and all aspects of youth physical health. Time spent in homeschool is weakly or not at all related to multiple aspects of youth physical health. Parents and policy makers should not be concerned with detrimental physical health effects of homeschooling on youth.

Organized Sports and Physical Activities as Sole Influencers of Fitness: The Homeschool Population.

Homeschool children may rely solely on organized sports and physical activities to achieve recommended levels of physical activity and fitness. The purpose of this study was to investigate differences in fitness levels between homeschool children who did, and did not, participate in organized sports or physical activities, and then examine relationships between hours per week in sports or physical activities and cardiorespiratory fitness as measured by portions of the FitnessGram® test battery. Organized sports/physical activity participation information was gathered on 100 children ages 10-17 years who completed tests of upper, abdominal, and cardiorespiratory fitness. The current investigation revealed that participation alone was not associated with higher levels of physical fitness as assessed by the 90° push-up test or curl-up test nor was time in participation related to cardiorespiratory fitness as assessed by the Progressive Aerobic Capacity Endurance Run (PACER). These activities alone may be insufficient for meeting physical activity recommendations and improving physical fitness. Therefore, children and adolescents educated at home may need additional opportunities to participate in unstructured daily physical activity.

Validation of Cardiorespiratory Fitness Measurements in Adolescents.

Cardiorespiratory fitness (CRF) is an important indicator of adolescent cardiovascular well-being and future cardiometabolic health but not always feasible to measure. The purpose of this study was to estimate the concurrent validity of the non-exercise test (NET) for adolescents against the Progressive Aerobic Capacity Endurance Run (PACER®) and direct measures of VO2max as well as to examine the concurrent validity of the PACER® with a portable metabolic system (K4b2™). Forty-six adolescents (12-17 years) completed the NET prior to performing the PACER® while wearing the K4b2™. The obtained VO2max values were compared using linear regression, intra-class correlation (ICC), and Bland-Altman plots, and α was set at 0.05. The VO2max acquired directly from the K4b2™ was significantly correlated to the VO2max indirectly estimated from the NET (r = 0.73, p < 0.001, r2 = 0.53, ICC = 0.67). PACER® results were significantly related to the VO2max estimates from the NET (r = 0.81, p < 0.001, r2 = 0.65, ICC = 0.72). Direct measures from the K4b2™ were significantly correlated to the VO2max estimates from the PACER® (r = 0.87, p < 0.001, r2 = 0.75, ICC = 0.93). The NET is a valid measure of CRF in adolescents and can be used when an exercise test is not feasible.

Criterion Validity and Sensitivity to Change of a Pediatric Bioelectrical Impedance Analysis Scale in Adolescents.

BACKGROUND: BMI measures are often used to infer body composition. Bioelectrical impedance analysis (BIA) is a more accurate way to estimate percent body fat (%BF), particularly when screening children who may be overweight. The aim of this study was to determine the validity, sensitivity to change, and diagnostic value of a BIA scale designed specifically for adolescents. METHODS: One hundred twelve adolescents had their body fat assessed using both BIA and dual-energy X-ray absorptiometry (DEXA). Mean difference and limits of agreement (LoA) were calculated for criterion validity. Intraclass correlation coefficients (ICCs) were calculated for sensitivity to change. Sensitivity/specificity for each classification was also assessed. Data from 46 returning adolescents (6-8 months later) were then used to assess sensitivity to change of BIA compared with DEXA. RESULTS: ICC for absolute agreement (range) comparing BIA and DEXA was 0.78 (0.48-0.88). The mean difference between the BIA %BF reading and DEXA was -4.05% (LoA = [4.80%, -12.90%]). Sensitivity and specificity values for the underfat, healthy, overfat, and obese classifications were 0.0/0.89, 0.79/0.46, 0.28/0.92, and 0.5/1.00, respectively. ICC for absolute agreement over time between the BIA %BF and the DEXA %BF was 0.71 (0.242-0.866). CONCLUSIONS: The Tanita BF-689 demonstrated poor-good agreement with DEXA when measuring %BF, poor-moderate agreement when measuring change in %BF over time, high sensitivity for classification into the healthy category and high specificity for classification into the underfat/overfat/obese categories. Compared to DEXA, the BF-689 is accurate, accessible, and efficient in classifying adolescents based on %BF.

How Healthy Is Homeschool? An Analysis of Body Composition and Cardiovascular Disease Risk.

BACKGROUND: Public school children regularly participate in school-based physical activity, physical education, and fitness testing. However, almost 2 million American children are homeschooled. The purpose of this research was to assess the body composition of elementary school-aged homeschool children and their corresponding cardiovascular disease (CVD) risk. METHODS: This research explored the body composition and CVD risk of 145 homeschool children aged 5-11 years using body mass index (BMI), percent body fat, and waist circumference. Chi-square and Mann-Whitney U tests examined differences in CVD risk within the homeschool population. RESULTS: Overall, homeschool children had average BMI z-scores (SD [range]) with a mean of -0.11 (0.97 [-3.47 to 2.53]). Unhealthy classifications were seen in 11.2% of the sample by BMI, 19.6% by percent body fat, and 49.7% by waist circumference. Statistical analysis revealed no difference in CVD risk between sexes (χ2 (1) = 0.062, p = .804) or ethnicities (χ2 (1) = 0.927, p = .336) but increased prevalence in children aged 5-9 years (U = 1427, z = -4.559, p < .001). CONCLUSIONS: Almost half of elementary school-aged homeschool children showed increased risk for CVD and need regular assessment of central adiposity.

Maternal concerns and perceptions of elementary school-age children's weight status.

PURPOSE: The purpose of this study was to identify characteristics associated with maternal concerns for her child becoming overweight, and how these concerns are related to her perceptions of her child's weight. DESIGN: A school-based sample of 55 children and their mothers from Houston, Texas, participated in a cross-sectional survey. Mothers reported on their concerns and perceptions regarding their child's weight. Child and mother height and weight were directly assessed to calculate body mass index (BMI). Covariate-adjusted logistic regression models were conducted. RESULTS: Over one-third of mothers misperceived their child's weight status [9% (n = 5) overestimated; 27% (n = 15) underestimated]. Mothers of sons were less accurate compared with mothers of daughters. For every one unit increase in maternal BMI, mothers had 13% higher odds of being concerned of their child becoming overweight. Concerned mothers had 82% lower odds of underestimating their child's weight. PRACTICE IMPLICATIONS: In order for school-based childhood obesity prevention and intervention programs to be successful, parents must accurately perceive their elementary school-age child's weight status. School nurses can be vital to these efforts through proper training and resources. Nurses can use the "School Nurse Childhood Obesity Toolkit" and motivational interviewing techniques to address parental concerns and perceptions prior to teaching behavior modification strategies to children/families.

Muscular and Cardiorespiratory Fitness in Homeschool versus Public School Children.

PURPOSE: The growth and unregulated structure of homeschooling creates an unknown population in regard to muscular and cardiorespiratory fitness. The purpose of this research was to compare muscular and cardiorespiratory fitness between elementary school aged homeschool and public school children. METHOD: Homeschool children ages 8-11 years old (n = 75) completed the curl-up, 90° push-up, and Progressive Aerobic Capacity Endurance Run (PACER) portions of the FitnessGram to assess abdominal and upper body strength and endurance as well as cardiorespiratory fitness. Comparisons to public school children (n = 75) were made using t tests and chi-square tests. RESULTS: Homeschool children showed significantly lower abdominal (t(148) = -11.441, p < .001; χ2 (1) = 35.503, p < .001) and upper body (t(148) = -3.610, p < .001; χ2 (1) = 4.881, p = .027) strength and endurance. There were no significant differences in cardiorespiratory fitness by total PACER laps (t(108) = 0.879, p = .381) or estimated VO2max (t(70) = 1.187, p = .239; χ2 (1) = 1.444, p = .486). CONCLUSION: Homeschool children showed significantly lower levels of both abdominal and upper body muscular fitness compared with their age and gender matched public school peers but no difference in cardiorespiratory fitness.

Reliability, Validity, and Diagnostic Value of a Pediatric Bioelectrical Impedance Analysis Scale.

BACKGROUND: Accurate body composition assessment is critical to identify children who are overfat or obese. Unlike BMI measures, bioelectrical impedance analysis (BIA) differentiates between lean and fat mass. However, bioelectrical impedance analysis has historically had questionable reliability and validity in children. The aim of this study was to determine the reliability, validity, and diagnostic value of a portable BIA scale (Tanita BF-689; Tanita Corporation, Tokyo, Japan) designed specifically for use within the pediatric population. METHODS: Fifty-five children (males = 26; females = 29) had percent body fat (%BF) assessed twice using BIA and once using dual-energy X-ray absorptiometry (DEXA). Intraclass correlation coefficients (ICCs) were calculated for reliability. Mean difference and limits of agreement were calculated for convergent validity. Sensitivity/specificity for healthy, overfat, and obese classification were assessed. RESULTS: Test-retest ICC was 0.999 (0.999, 0.999). The ICC comparing BIA and DEXA for %BF was 0.788 (-0.167, 0.942). Mean difference between BIA and DEXA was -6.75% (limits of agreement = -0.04%; -13.46%). No gender or proportional bias was observed. Sensitivity/specificity for healthy, overfat, and obese classification were 0.67/0.65, 0.22/0.78, and 0.43/1.0, respectively. CONCLUSIONS: The Tanita BF-689 demonstrates excellent test-retest reliability, moderately strong absolute agreement with DEXA, and high specificity for overfat and obese classification. Compared to DEXA, the BF-689 is an accurate, portable, and efficient means of assessing %BF in elementary school children.