Physical activity has decreased in Finnish children and adolescents from 2016 to 2022.

BACKGROUND: Varying trends in children's and adolescents' physical activity (PA) have been reported during the last 10-20 years. Trends in sedentary behavior (SB) have been studied only rarely. The purpose of the present study was to describe population-based trends in accelerometer-measured PA, standing and SB, among Finnish 7-15-year-old children and adolescents, and to evaluate the potential influence of the COVID-19 pandemic on these behaviors. METHOD: A cross-sectional population-based Finnish school-aged physical activity Study (FSPA) measured daily steps, vigorous (VPA), moderate (MPA), moderate-to-vigorous (MVPA), light physical activity (LPA), standing, and SB by an accelerometer for seven consecutive days in 2016, 2018, and 2022 (n = 7.080, 57% girls). The data was analyzed by multivariate regression analysis. RESULTS: In 2016, participants took on average 10.305 steps per day, and spent 0:15 (h: min) in VPA, 1:37 in MPA, 1:52 in MVPA, 3:48 in LPA, 0:55 in standing and 7:52 in SB. From 2016 to 2018, daily steps, MPA, LPA, and standing increased [229 steps (95% Confidence Interval, CI 70-387), 0:03 (CI 0:01 - 0:04), 0:11 (CI 0:09 - 0:14), and 0:07 (CI 0:05 - 0:08), respectively], while VPA and SB decreased [0:01 (CI 0:00-0:02) and 0:20 (CI 0:16 - 0:24), respectively]. From 2018 to 2022, daily PA and standing declined [751 steps (CI 562-939), VPA 0:02 (CI 0:01 - 0:03), MPA 0:09 (CI 0:07 - 0:11), MVPA 0:11 (CI 0:09 - 0:14), LPA 0:08 (CI 0:05 - 0:11), and standing 0:01 (CI 0:01 - 0:03)] while SB increased 0:21 (CI 0:16 - 0:25) indicating potential influence of the pandemic. CONCLUSIONS: Children and adolescents became physically less active from 2016 to 2022. The potential effects of the COVID-19 were seen as declined PA and increased sedentariness from 2018 to 2022.

Perceived coaches' health promotion activity, maintenance of participation in sports, and lifestyle habits among emerging adults: a four-year follow-up study.

OBJECTIVES: This study focused on how adolescents' perceptions of coaches' health promotion activity predict maintained participation and dropout in organized sports in emerging adulthood. In addition, differences in lifestyle habits between maintainers, dropouts, and nonparticipants in organized sports were explored. MATERIALS AND METHODS: Overall, 616 adolescents reported organized sports participation in the Finnish Health Promoting Sports Club (FHPSC) study at ages 15 and 19. Of these, 323 reported coach's health promotion activity on health topics at the age of 15. An index of a coach's general health promotion activity was formed. At age 19, all study participants reported their lifestyle habits. RESULTS: Among males, those who had perceived coaches' general health promotion activity as frequent were more likely to be maintainers than dropouts (48.6% vs. 20.0%) (p = .002). Among females, there was no significant difference (32.0% vs. 28.4%). Logistic regression analysis adjusted for gender showed that perceiving coach's general health promotion activity as frequent increased the odds of being a maintainer rather than a dropout. Moreover, maintainers had higher odds of having healthy lifestyle habits when compared to nonparticipants (related to physical activity; sleep; fruit and vegetable consumption; and cigarette use) or dropouts (related to physical activity; and cigarette use). In addition, dropouts had higher odds of having healthy lifestyle habits than nonparticipants (related to sleep; and cigarette use). CONCLUSIONS: Perceiving coaches' health promotion activity as frequent was related to maintained participation in organized sports among males. Maintainers were more likely to have more healthy lifestyle habits than nonparticipants and dropouts. There is a need to invest in coaches' health promotion activity when it is infrequent. A more detailed understanding is needed of coaches' health promotion activity that supports both maintained participation in sports, especially among females, and healthy lifestyle habits in emerging adulthood.

There is a need to invest in coaches' health promotion activity when it is infrequent in order to support adolescents' continued participation in organized sports and healthy lifestyle habits in emerging adulthood.

Sports-related factors predicting maintained participation and dropout in organized sports in emerging adulthood: A four-year follow-up study.

This study explored sports-related factors predicting organized sports participation in emerging adulthood. In the Finnish Health Promoting Sports Club (FHPSC) study, 354 sports club participants aged 15 at baseline reported their main sport, onset age, training volume, current competitive level, and future competitive orientation and participated in the follow-up study at age 19. There were differences in the proportions of maintainers and dropouts in a few sports: football (maintainers 58.6%), and among females, skating (maintainers 60.7%), and swimming (dropouts 80.0%). A binary logistic regression analysis showed that those who had started their main sport by school age (females OR 3.05/95% CI 1.34, 6.98; males OR 3.97/95% CI 1.48, 10.64) and had competed at national top level plus had aimed at success at the adult level competitions in future (females OR 3.42/95% CI 1.16, 10.09; males OR 3.58/95% CI 1.12, 11.41; among females, also had competed at national top level plus had aimed at success at junior level competitions [OR 3.42/95% CI 1.20, 9.78]) were more likely maintainers than dropouts. Early onset in the main sport and competitiveness were related to maintained sports participation while the opposites were related to dropouts in the current organized sports system.

Psychosocial and health behavioural characteristics of longitudinal physical activity patterns: a cohort study from adolescence to young adulthood.

BACKGROUND: The decline in physical activity (PA) during adolescence is well-established. However, while some subgroups of adolescents follow the general pattern of decreased activity, others increase or maintain high or low activity. The correlates and determinants of different PA patterns may vary, offering valuable information for targeted health promotion. This study aimed to examine how psychosocial factors, health behaviours, and PA domains are associated with longitudinal PA patterns from adolescence to young adulthood. METHODS: This prospective study encompassed 254 participants measured at mean ages 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (activity maintainers, inactivity maintainers, decreasers from moderate to low PA, decreasers from high to moderate PA, increasers) via a data-driven method, K-Means for longitudinal data. Multinomial logistic regression was used to analyse the associations between health behaviours, psychosocial factors, PA domains, and different PA patterns. RESULTS: A lack of sports club participation characterised inactivity maintainers throughout adolescence. Difficulties in communicating with one's father at age 15 were associated with higher odds of belonging to inactivity maintainers and to decreasers from moderate to low PA. Lower fruit and vegetable consumption at age 19 was also related to increased odds of belonging to the groups of inactivity maintainers and decreasers from moderate to low PA. Smoking at age 19 was associated with being a decreaser from moderate to low PA. CONCLUSIONS: Diverse factors characterise longitudinal PA patterns over the transition to young adulthood. Sports club participation contributes to maintained PA. Moreover, a father-adolescent relationship that supports open communication may be one determinant for sustained PA during adolescence. A healthier diet and non-smoking as a young adult are associated with more favourable PA development.

Is health promotion in sports clubs associated with adolescent participants' fruit and vegetable consumption?

BACKGROUND: Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. METHODS: The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. RESULTS: Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001). CONCLUSION: Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.

Longitudinal physical activity patterns and the development of cardiometabolic risk factors during adolescence.

PURPOSE: To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood. METHODS: This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (via a data-driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear-time. RESULTS: Insulin and BMI increased among decreasers from moderate to low PA (ß for insulin 0.23, 95% CI 0.03-0.46; ß for BMI 0.90; CI 0.02-1.78). The concentration of HDL cholesterol decreased (ß -0.18, CI -0.31 to -0.05) and that of glucose increased (ß 0.18, CI 0.02-0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic ß -6.43, CI -12.16 to -0.70; diastolic ß -6.72, CI -11.03 to -2.41). CONCLUSIONS: Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline.

Adolescent use of social media and associations with sleep patterns across 18 European and North American countries.

OBJECTIVE: Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use). DESIGN, SETTING, AND PARTICIPANTS: Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study. MEASUREMENTS: Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data. RESULTS: For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results. CONCLUSIONS: These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep.

Factors associated with body size perception among adolescent goal-oriented sports participants and non-participants: a cross-sectional Finnish study.

BACKGROUND: Regardless of competitive athletes' body image pressures, only few studies have focused on adolescent sport participants' body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents' body size perception has not been studied. We examined the factors associated with adolescents' competitive goals in sports and body size perception, and the associations between adolescents' competitive goals in sports and body size perception. METHODS: The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14-16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations. RESULTS: Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p < 0.001 in girls; 74% vs 61%, p < 0.001 in boys). More than one-fourth of girls with competitive goals in sports perceived themselves as overweight, although only 7% of them were overweight. Adolescents with appearance/weight motives to exercise and poor perceived physical fitness had higher odds of perceived fatness. Additionally, BMI was positively associated with perceived fatness and negatively with perceived thinness. Having competitive goals in sports was not independently associated with perceived fatness or perceived thinness. CONCLUSIONS: Adolescents' BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports.

Loneliness, subjective health complaints, and medicine use among Finnish adolescents 2006-2018.

AIMS: Loneliness is an important public health challenge for all ages. This study reports time trends of loneliness among adolescents over a 12-year period and analyses the strength of the associations between loneliness, health complaints, and medicine use. METHODS: Data were derived from the cross-sectional Finnish Health Behaviour in School-aged Children study conducted in 2006, 2010, 2014, and 2018. The study population is based on a random sample of schools with 20,444 participants aged 11-15 years. The trends were analysed with a Mantel-Haenszel test, and the strength of the associations was evaluated by mixed-effects logistic and linear regressions. RESULTS: An increasing prevalence in frequent loneliness (2006: 11%; 2018: 15%) was evident over the 12-year study period, especially in girls and 15-year-olds. Among all adolescents, loneliness was associated with a higher risk of recurrent health complaints and medicine use to treat the corresponding health issues, especially nervousness (odds ratio 5.8) and sleeping difficulties (odds ratio 7.6). CONCLUSIONS: Adolescence is a period of higher risk of frequent loneliness and associated health complaints. In this study, loneliness was common among adolescence and an increasing trend of loneliness was observed between 2006 and 2018. Also, psychosomatic health complaints and medicine use were strongly associated with loneliness. Persistent loneliness is a significant health risk and failure to resolve loneliness before entering adulthood may imply significant concerns for future well-being.

Young People in the Social World of Physical Activities: Meanings and Barriers.

Physical inactivity has become one of the leading risk factors for non-communicable diseases (NCDs) and death worldwide. From the future perspective it is alarming that in the group of young people few meet the recommendations. In this respect, physical activity promotion in general and physical education have challenges and new approaches are needed. In this study, the theoretical framework is based on the physical activity relationship (PAR) approach and the barriers were grouped according to the ecological model. The aim of the study was firstly to present both the meanings and barriers of physical activity in a comprehensive Finnish population of 11-15 year old (n = 2728) and secondly to examine how the number of important meanings and mentioned barriers associate with each other with physical activity levels. Data were collected using a questionnaire. To examine how the meanings and barriers associate with each other and with the PA level, chi-squared test (χ2), Pearson correlation and General linear model (ANCOVA) were used. Logistic regression was applied to estimate effect sizes by odds ratios and 95% confidence intervals. According to the results, the associations between physical activity with the meanings and barriers were reverse and linear. The more important the meanings were found to be, the more likely the study participants were physically active, whereas the more barriers participants reported, the less active they were. The approach which utilizes meanings and barriers has a lot of untapped potential for the promotion of physical activity and physical education. With the right actions, some barriers could be removed or dampened, and by opening up and deepening meanings, PAR could be strengthened.

Resting electrocardiogram and blood pressure in young athletes and nonathletes: A 4-year follow-up.

A follow-up data on electrocardiogram (ECG) and blood pressure (BP) changes in adolescent athletes are scarce. We compared ECG and BP between adolescent athletes and nonathletes in a 4-year follow-up. A total of 154 youth sports clubs (SC) in Finland and 100 secondary schools for comparison data participated in this observational follow-up study. Those who maintained or adopted SC participation are referred to as 'Always athletes' (n = 137), those who never participated in SC as 'Never athletes' (n = 108) and those who dropped out ofSC during the follow-up as 'Changers' (n = 116). The mean age of the participants was 15.5 (0.6) years in all study groups at baseline. Resting ECG including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis and QT interval and BP were measured from all participants at baseline and after follow-up. 'Always athletes' had lower resting heart rate, more negative T-wave axis and higher QRS amplitude than 'Never athletes' at baseline and at 4 years (p < 0.05). 'Changers' had lower resting heart rate, more negative T-wave axis and higher QRS amplitude, systolic BP and pulse pressure than 'Never athletes' at baseline (p < 0.05). None of the observed differences at baseline, were visible at 4 years (p > 0.05) except the difference in T-wave axis (p = 0.028). The significant group × time interaction between 'Changers' and 'Never athletes' was found for QRS amplitude (p = 0.017). Adolescent athletes have several training-induced cardiovascular adaptations, which return towards the levels of nonathletes after cessation of regular training.

Profiles of Internet Use and Health in Adolescence: A Person-Oriented Approach.

(1) Background: Internet use has become an integral part of adolescents' daily lives. It is important to understand how adolescents use the internet, and how this use is associated with demographic factors and health from a person-oriented perspective. (2) Methods: The study applied the Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408), descriptive observation, latent class analysis, and multinomial logistic regression analysis. (3) Results: Entertainment activities (listening to music) and socially oriented activities (liking posts, talking online) were the most prevalent among adolescents, but gender differences emerged. Five different internet user profiles were identified (encompassing interest-driven, friendship-driven, abstinent, irregular, and excessive users). Interest-driven users participated in interest- and media-oriented activities. Adolescents in the interest-driven user group were more likely to be boys and participants with low academic achievement, high parental monitoring, and high problematic social media use. Friendship-driven users participated in socially oriented activities. Adolescents in the friendship-driven user group were more likely to be girls and participants aged 13 or 15, with high peer and family support. Abstinent users participated only in entertainment, while irregular users showed no particularly high involvement in any internet activity. Adolescents in the abstinent and irregular user groups were likely to be boys and participants aged 11 with high family support. Excessive users had high involvement in internet activities overall. Adolescents in the excessive user group were more likely to be participants with high problematic social media use and were most likely to feel low and tired on school mornings. (4) Conclusion: The study confirmed the prevalence of internet use. It identified five internet user profiles and differences between user profiles regarding individual and social factors and health outcomes.

Physical activity from adolescence to young adulthood: patterns of change, and their associations with activity domains and sedentary time.

BACKGROUND: Longitudinal studies demonstrate an average decline in physical activity (PA) from adolescence to young adulthood. However, while some subgroups of adolescents decrease activity, others increase or maintain high or low activity. Activity domains may differ between subgroups (exhibiting different PA patterns), and they offer valuable information for targeted health promotion. Hence, the aim of this study was to identify PA patterns from adolescence to young adulthood; also to explore the associations of (i) changes in PA domains and in sedentary time, (ii) sociodemographic factors, and (iii) self-rated health with diverging PA patterns. METHODS: The observational cohort study data encompassed 254 adolescents at age 15 and age 19. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Logistic regressions were applied in further analysis. RESULTS: Five PA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, participation in sports clubs (SC, 41-97%) and active commuting (AC, 47-75%) was common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Inactivity maintainers reported the lowest amount of weekly school physical education. Dropout from SC - in contrast to non-participation in SC - was associated with higher odds of being a decreaser from high PA, and with lower odds of being an inactivity maintainer. Maintained SC participation was associated with higher odds of belonging to the decreasers from high PA, and to the combined group of activity maintainers and increasers; also with lower odds of being an inactivity maintainer. Maintenance/adoption of AC was associated with decreased odds of being an inactivity maintainer. Self-reported health at age 19 was associated with the patterns of maintained activity and inactivity. CONCLUSIONS: PA patterns diverge over the transition to adulthood. Changes in SC participation and AC show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.

Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes.

CONTEXT: Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. OBJECTIVE: To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. DESIGN: Cross-sectional study. SETTING: A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. PATIENTS OR OTHER PARTICIPANTS: We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools. MAIN OUTCOME MEASURE(S): Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. RESULTS: No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). CONCLUSIONS: Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.

Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non-athletes.

To determine the prevalence of menstrual dysfunction (MD; ie, oligomenorrhea or amenorrhea) and attitudes toward body weight among athletes and non-athletes, we studied a cohort of athletes and non-athletes, in adolescence (14-16 years) and subsequently in young adulthood (18-20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioral characteristics that might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre-participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non-athletes (4.7% vs 0%, P = .03). In young adulthood, athletes reported MD more frequently than non-athletes (38.7% vs 5.6%, P < .001). Athletes had less desire than non-athletes to lose weight at both time points, and in adolescence, athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non-athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence. Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non-athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliest feasible phase of an athlete's career.

Haemoglobin, iron status and lung function of adolescents participating in organised sports in the Finnish Health Promoting Sports Club Study.

OBJECTIVES: To compare laboratory test results and lung function of adolescent organised sports participants (SP) with non-participants (NP). METHODS: In this cross-sectional study, laboratory tests (haemoglobin, iron status), and flow-volume spirometry were performed on SP youths (199 boys, 203 girls) and their NP peers (62 boys, 114 girls) aged 14-17. RESULTS: Haemoglobin concentration <120/130 g/L was found in 5.8% of SP and 5.1% NP (OR 1.20, 95% CI 0.54 to 2.68). Ferritin concentration below 15 µg/L was found in 22.7% of both SP and NP girls. Among boys ferritin <30 µg/L was found in 26.5% of SP and 30.2% of NP (OR 0.76, 95% CI 0.40 to 1.47). Among SP iron supplement use was reported by 3.5% of girls and 1.5% of boys. In flow-volume spirometry with bronchodilation test, 7.0% of SP and 6.4% of NP had asthma-like findings (OR 1.17, 95% CI 0.54 to 2.54); those using asthma medication, that is, 9.8% of SP and 5.2% of NP were excluded from the analysis. CONCLUSIONS: Screening for iron deficiency is recommended for symptomatic persons and persons engaging in sports. Lung function testing is recommended for symptomatic persons and persons participating in sports in which asthma is more prevalent.

Individual- and environmental-related correlates of moderate-to-vigorous physical activity in 11-, 13-, and 15-year-old Finnish children.

The objective of this study was to analyze the associations of various individual- and environmental-related factors with subgroups of daily, frequent, moderate and low moderate-to-vigorous physical activity (MVPA) among children and adolescents. Data were obtained from the Finnish School-age Physical Activity (FSPA) study 2016 from 4677 national representative 11-, 13-, and 15-year-old children and adolescents. MVPA and individual- and environmental-related factors were assessed by a questionnaire and analyzed by two-level logistic regression. Seventeen of the twenty-one variables were statistically significantly associated with MVPA. However, only three variables were statistically significant in all MVPA subgroups, whereby self-directed PA at least twice a week, fewer perceived barriers, and higher peer support increased the odds of participating in more MVPA. The results from this study showed essential differences among the MVPA subgroups, also supporting previous findings, whereby various individual- and environmental-based factors are associated with children and adolescents' levels of MVPA. Challenges to designing and implementing effective interventions are based on the need to account for individual differences within the population, as well as the varied connections between PA with different social and physical environments where children and adolescents' PA takes place. PA interventions with various actions at multiple levels are warranted.

Health asset profiles and health indicators among 13- and 15-year-old adolescents.

OBJECTIVES: We examined the associations between adolescents' health assets and various health indicators (smoking, alcohol use, sleep length, physical activity, healthy eating, oral health, self-reported health, multiple health complaints). METHODS: A nationally representative sample was drawn from Finnish-speaking schools, comprising 13- and 15-year-old adolescents (n = 3833). The measures taken covered the adolescents' health assets, which were labelled Family-financial, Psychological, Family-social, Friends-social, School-social, and Human. Our analysis applied two-step cluster analysis and multilevel mixed-effects binary logistic regression. RESULTS: Six asset profiles were identified: 'Limited in most assets, despite medium affluence', 'Mostly average assets, but low affluence', 'Mostly average assets, though high affluence', 'Mostly above average assets', 'Rich in most assets', and 'Rich in all assets'. There were significant differences between the profiles in terms of risk level and desirable level health outcomes. CONCLUSIONS: Adolescents differ in their asset profiles. Having multiple health assets appears to protect adolescents from risky behaviour or poor health, and to promote positive health. There is a need for health initiatives to develop a range of health-protecting and health-promoting assets, rather than focus on only one.

Test-retest reliability of adolescents' self-reported physical activity item in two consecutive surveys.

BACKGROUND: National monitoring of school-aged physical activity (PA) behaviours is necessary to inform policy makers. The Finnish School-aged Physical Activity (FSPA - LIITU in Finnish) is a physical activity monitoring study, collecting data from young adolescents aged 11 to 15 years through a nationally representative sample. This study included a single self-reported item question on moderate to vigorous intensity physical activity (MVPA) from the preceding seven days. The question is used widely in the WHO Collaborative Cross-National Health Behaviour in School-aged Children (HBSC) study as a measure of meeting international PA recommendations. This study evaluated the test-retest reliability of the aforementioned MVPA item in two consecutive surveys while observing gender and age categorisation differences. METHODS: In this study, Finnish adolescents with mean ages of 11.5y, 13.5y and 15.5y (n = 2752) completed the HBSC and FSPA surveys in two 45 min class periods without a break in 2014. The HBSC survey completion mode was through pen and paper, and the FSPA study through a web-based questionnaire. The same MVPA question appeared in both surveys. Response alternatives (0-7 days per week) were grouped into four, and two categories in the analyses. Cohen's Kappa and ICC statistics were performed to test the intra-rater test-retest reliability of the measure. RESULTS: According to Cohen's Kappa, there was moderate agreement through the use of four (0.503) and two (0.599) categories, however, the proportion of adolescents that met the recommended daily 60 min of MVPA was 8% lower in the FSPA study than in the HBSC study (19% vs 27%). In addition, ICC for MVPA, as continuous variable (0-7 days) had good to excellent reliability (range 0.694-0.765) for boys and girls aged 13 to 15 years, but only fair (0.565) for boys aged 11. CONCLUSIONS: This study demonstrated that single item MVPA item was considered to have acceptable reliability of the measure for monitoring purposes of 13- and 15-year old boys, and 11y-, 13- and 15y-old girls meeting the international PA recommendations. There were differences in the prevalence in daily MVPA due to survey design.

Does sports club participation contribute to physical activity among children and adolescents? A comparison across six European countries.

Aims: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden. Methods: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression. Results: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4-6.4) and VPA recommendation (OR 2.8-5.0) than non-participants. Conclusions: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations.