What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials.

BACKGROUND: Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes. OBJECTIVES: To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps. RESULTS: Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes. CONCLUSIONS: There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose-response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies. REGISTRATION: OSF project ( https://osf.io/6auyj/ ) and registration ( https://osf.io/gu8ya ).

Results from Portugal's 2022 report card on physical activity for children and youth.

Background: The purpose of this study is to update results of Portuguese's Report Card on Physical activity (PA) for Children and Adolescents. Methods: The grades were assigned by results derived from the PA and Fitness in Portugal 2021 Portuguese Report Card and corresponds to the third report for the Portuguese children and adolescents. It includes indicators of PA and sedentary behavior (SB) that are common to the GLOBAL matrix 4.0: Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviors, Family and Peers, School, Community and the Environment, Government and Physical Fitness. The search focused on published national evidence/data sources (academia, NGO, governmental) from end 2018 onwards excluding data obtained during the covid-19 pandemic. Results: The grades were assigned as follows: Overall PA (D-), Organized Sport Participation (C-), Active Play (D+), Active Transportation (D-), Sedentary behaviors (C+), Physical Fitness (C), Family and Peers (B), School (A), Community and Environment (B), and Government (B). Conclusion: In line with previous Portuguese Report Cards, a large proportion of Portuguese children and adolescents are not sufficiently active nor fit enough setting urgency for effective strategies. Particular attention should be given to Active play, Active transport and Organized Sports Participation has their grades have decreased. Some actions in selected indicators as Governmental and policy seems promising however results weren't seen yet. Despite the strong support of schools with mandatory curricula in PE no correspondent change is observed in fitness or PA, so more research is needed to find why.

Multidimensional Health Impact of Multicomponent Exercise and Sustainable Healthy Diet Interventions in the Elderly (MED-E): Study Protocol.

Data concerning the combined effect of diet and exercise interventions on overall health in the elderly are scarce. The MED-E project's primary aim is to assess the effect of the different 3-month sustainable healthy diet (SHD) and multicomponent training (MT) interventions on several health outcomes in the elderly. A quasi-experimental study assigned older adults into four groups: (1) SHD, (2) MT, (3) SHD + MT, or (4) control group (CG). The SHD intervention included a weekly offer of a mixed food supply and individual and group nutritional sessions on the principles of an SHD. The MT groups were submitted to 50-min exercise sessions three times a week. The primary outcomes were blood biomarkers and metabolic profile alterations that were assessed pre- and post-intervention. Additionally, data on dietary intake and nutritional adequacy, physical fitness, body composition and anthropometry, cognitive function, quality of life, and geographical data were assessed at the same time points. The MED-E project's study protocol and future results will add to knowledge about the importance and beneficial contribution of combined SHD and MT interventions on healthy ageing policies.

Does parents' perception of the environment associates with outdoor physical activity duration in low-income preschoolers?

Parents' perception of the environment may influence the time spent in outdoor physical activities in pre-school children. This study aimed to analyze the association between parents' perception of the environment and outdoor physical activities outside the school in low-income preschoolers. In total, 129 preschoolers aged 3 to 5 years (4.4 years ± 0.7 years, 50% boys) and their parents participated in the study. An adapted version of the Neighborhood Environmental Walkability Scale was used to obtain parents' environmental perceptions. Outdoor physical activities was measured based on two questions considering the usual time spent in these activities during week and weekend days. Information on sociodemographic was collected by interview. Logistic regression was used to analyze the associations. Statistical analyses were conducted using SPSS, version 21.0. Most preschoolers (76.9%) had ≤ 2 hours/day in outdoor physical activities during the week while at the weekend, 65.9% reached > 2 hours. Parents' perception of unsafe traffic (OR = 0.39; p = 0.03) was associated with higher chances for a shorter time in outdoor physical activities both during the week and at the weekend (OR = 0.46; p = 0.04). Moreover, preschoolers' whose parents perceive a lack of places to walk (OR = 0.33; p = 0.02) and unsafe night time (OR = 0.36; p = 0.04) are more likely to spend less time in outdoor physical activities during the week. After adjustments for sociodemographic confounders, the perception of unsafe traffic (OR = 0.26; p = 0.01) and places to walk (OR = 0.15; p = 0.01) were predictors of preschooler's shorter time in outdoor physical activities during the week. Parents' perception of unsafe traffic and places to walk were associated with less time in outdoor physical activities in low-income preschoolers.

Active and sedentary behaviors in youth (6-14 years old): Data from the IAN-AF survey (2015-2016).

BACKGROUND: Strategic health interventions must be guided by effective surveillance systems that monitor population trends and patterns, therefore we aimed to provide youth's (6-14 years) national prevalence estimates of physical activity (PA), active outdoor play (AOP), sedentary behaviur (SB), and structured PA (SPA). METHODS: Measures of moderate-to-vigorous PA, SB, AOP, and SPA, were obtained for 719 participants in 2 groups (6-9 and 10-14 years) using diaries and questionnaires. National estimates were calculated, by sex, region, and parental education. RESULTS: While 54% (95%CI: 47.4-61.3) of youth meet PA recommendations, the prevalence is lower for the older group (P = .034). Similarly, AOP decreases with age both on weekends, from 94.3% (95%CI: 90.8-97.8) to 68.7% (95%CI: 62.2-75.1), and on weekdays from 84% (95%CI: 76.5-91.5) to 64.8% (95%CI: 59-70.6). Watching TV for ≥2 h/day is extremely high on weekends [71.3% (95%CI: 65.4-77.2)] and more prevalent in boys than girls on weekdays (P = .043). Higher parental education significantly increased SPA and active time. Time in SB was greater in boys [7.26 h (95%CI: 6.87-7.65)] than girls [6.48 h (95%CI: 6.09-6.87)] and increased with age (P < .001). CONCLUSIONS: Almost half of the youth failed to achieve PA guidelines, whereas 71% exceeded recommended TV time on weekends, suggesting the urgency of intervention measures.

Relationship between green space near schools with physical activity and body mass index in portuguese adolescents / Relação entre o espaço verde próximo a escola com a atividade física e índice de massa corporal em adolescentes portugueses

Our aim was to determine the relationship between urban green spaces (UGS) number and green-ness amount close to school with physical activity (PA) and body mass index (BMI) of adoles-cents. Participants (n = 194, aged 13­18 years) were recruited in 75 public secondary schools in the Porto Metropolitan Area. We used a self-administered questionnaire to obtain information on height, weight, age and sex. PA levels were assessed using accelerometers. UGS number and green-ness amount were measured using network buffers by 300, 500, 1000 and 1500 meters around each school, through geographic information system and normalized difference vegetation index (NDVI), respectively. Multilevel regressions were fitted to each green indicator individually. Multilevel models without adjustment showed a direct relationship between PA and NDVI [B = 118.14; 95%CI: 20.71, 215.57] and inverse relationship between PA and UGS number [B = -5.95; 95%CI: -10.06, -1.83] at 300 meters. Multilevel models with adjustment for socioeconomic deprivation showed a direct relationship between BMI and NDVI [B = 83.41; 95%CI: 30.84, 135.98] at 500 meters and a direct relationship between BMI and NDVI [B = 61.68; 95%CI: 3.07, 120.29] at 1000 meters. The present investigation does not support the idea that UGS number and the NDVI close to school promote PA and metabolic health in adolescents, as the results proved to be inconsistent and dependent on the distance threshold used to define geographic proximity

O objetivo foi determinar a relação entre quantidade de espaços verdes (EV ) e quantidade de vegetação na proximidade da escola com a atividade física (AF) e índice de massa corporal (IMC) em adolescentes. Os participantes (n = 194, com idades de 13 a 18 anos) foram recrutados em 75 escolas públicas secundárias da Área Metropolitana do Porto. Altura, peso, idade e sexo foram reportadas por questionário e a AF avaliada por acelerómetros. A quantidade de EV e de vegetação foram medidas em buffers de 300, 500, 1000 e 1500 metros ao redor da escola, através de Sistema de Informação Geográfica e índice de vegetação por diferença normalizada (IVDN), respetivamente. Regressões multinível foram realizadas individualmente com cada indicador de verde. A regressões sem ajuste demonstraram relação direta entre a AF e IVDN [B = 118,14; IC95%: 20,71; 215,57] e relação inversa entre a AF e quantidade de EV [B = -5,95; IC95%: -10,06; -1,83] a 300 metros. Modelos ajustados para a privação socioeconómica, apontaram relação direta entre a AF e IVDN [B = 130,18; IC95%: 7,30; 253,07], relação inversa entre a AF e quantidade de EV [B = -5,67; IC95%: -9,87; -1,47] a 300 metros, relação direta entre o IMC e IVDN a 500 [B = 61,68 ;IC95%: 3,07; 120,29] e a 1000 metros [B = 67,68; IC95%: 3,07; 120,29]. A presente investigação não suporta a ideia de que os EV e o IVDN próximos da escola promovem a AF e a saúde metabólica dos adolescentes, pois os resul-tados foram inconsistentes e dependentes do limiar de distância usado para definir proximidade geográfica

Does parents' perception of the environment associates with outdoor physical activity duration in low-income preschoolers? / A percepção dos pais sobre o ambiente se associa à duração da atividade física ao ar livre em pré-escolares de baixa renda? / ¿La percepción de los padres sobre el entorno se asocia con la duración de la actividad física al aire libre en preescolares de bajos ingresos?

Parents' perception of the environment may influence the time spent in outdoor physical activities in pre-school children. This study aimed to analyze the association between parents' perception of the environment and outdoor physical activities outside the school in low-income preschoolers. In total, 129 preschoolers aged 3 to 5 years (4.4 years ± 0.7 years, 50% boys) and their parents participated in the study. An adapted version of the Neighborhood Environmental Walkability Scale was used to obtain parents' environmental perceptions. Outdoor physical activities was measured based on two questions considering the usual time spent in these activities during week and weekend days. Information on sociodemographic was collected by interview. Logistic regression was used to analyze the associations. Statistical analyses were conducted using SPSS, version 21.0. Most preschoolers (76.9%) had ≤ 2 hours/day in outdoor physical activities during the week while at the weekend, 65.9% reached > 2 hours. Parents' perception of unsafe traffic (OR = 0.39; p = 0.03) was associated with higher chances for a shorter time in outdoor physical activities both during the week and at the weekend (OR = 0.46; p = 0.04). Moreover, preschoolers' whose parents perceive a lack of places to walk (OR = 0.33; p = 0.02) and unsafe night time (OR = 0.36; p = 0.04) are more likely to spend less time in outdoor physical activities during the week. After adjustments for sociodemographic confounders, the perception of unsafe traffic (OR = 0.26; p = 0.01) and places to walk (OR = 0.15; p = 0.01) were predictors of preschooler's shorter time in outdoor physical activities during the week. Parents' perception of unsafe traffic and places to walk were associated with less time in outdoor physical activities in low-income preschoolers.

A percepção dos pais sobre o ambiente pode influenciar o tempo gasto em atividades físicas ao ar livre em crianças pré-escolares. Este estudo teve como objetivo analisar a associação entre a percepção dos pais sobre o ambiente e atividades físicas ao ar livre fora da escola em pré-escolares de baixa renda. No total, 129 pré-escolares de 3 a 5 anos (4,4 anos ± 0,7 anos, 50% meninos) e seus pais participaram do estudo. Uma versão adaptada da Escala de Caminhabilidade Ambiental do Bairro foi usada para obter as percepções ambientais dos pais. A atividade física ao ar livre foi mensurada com base em duas questões considerando o tempo habitual despendido nessas atividades durante a semana e os dias de fim de semana. As informações sociodemográficas foram coletadas por meio de entrevista. Foi utilizada regressão logística para analisar as associações. As análises estatísticas foram realizadas no SPSS, versão 21.0. A maioria dos pré-escolares (76,9%) teve ≤ 2 horas/dia em atividade física ao ar livre durante a semana enquanto no final de semana, 65,9% atingiu > 2 horas. A percepção dos pais sobre o trânsito inseguro (OR = 0,39; p = 0,03) foi associada a maiores chances de menor tempo de atividade física ao ar livre tanto durante a semana quanto no final de semana (OR = 0,46; p = 0,04). Além disso, pré-escolares cujos pais percebem falta de lugares para caminhar (OR = 0,33; p = 0,02) e período noturno inseguro (OR = 0,36; p = 0,04) são mais propensos a passar menos tempo em atividade física ao ar livre durante a semana. Após ajustes para fatores de confusão sociodemográficos, a percepção de trânsito inseguro (OR = 0,26; p = 0,01) e locais para caminhar (OR = 0,15; p = 0,01) foram preditores de menor tempo do pré-escolar em atividade física ao ar livre durante a semana. A percepção dos pais sobre o trânsito inseguro e os lugares para caminhar foram associados ao menor tempo de atividade física ao ar livre entre pré-escolares de baixa renda.

La percepción de los padres sobre el entorno puede influir en el tiempo dedicado a actividades físicas al aire libre en niños en edad preescolar. Este estudio tuvo como objetivo analizar la asociación entre la percepción de los padres sobre el ambiente y la actividade física al aire libre fuera de la escuela en preescolares de bajos recursos. En total, participaron en el estudio 129 preescolares de 3 a 5 años (4,4 años ± 0,7 años, 50% niños) y sus padres. Se utilizó una versión adaptada de la Escala de Caminabilidad Ambiental del Vecindario para obtener las percepciones ambientales de los padres. La actividade física al aire libre se midió a partir de dos preguntas considerando el tiempo habitual dedicado a estas actividades durante los días de semana y los fines de semana. La información sociodemográfica se recogió mediante entrevista. Se utilizó regresión logística para analizar las asociaciones. Los análisis estadísticos se realizaron con SPSS, versión 21.0. La mayoría de los preescolares (76,9%) tenían ≤ 2 horas/día en actividade física al aire libre durante la semana mientras que el fin de semana, el 65,9% alcanzaba > 2 horas. La percepción de los padres sobre el tráfico inseguro (OR = 0,39; p = 0,03) se asoció con mayores posibilidades de pasar menos tiempo en actividade física al aire libre tanto entre semana como en fin de semana (OR = 0,46; p = 0,04). Además, los preescolares cuyos padres perciben la falta de lugares para caminar (OR = 0,33; p = 0,02) e inseguridad en la noche (OR = 0,36; p = 0,04) tienen más probabilidades de pasar menos tiempo en actividade física al aire libre durante la semana. Después de los ajustes por factores de confusión sociodemográficos, la percepción de tráfico inseguro (OR = 0,26; p = 0,01) y lugares para caminar (OR = 0,15; p = 0,01) fueron predictores de menor tiempo en actividade física al aire libre de los preescolares durante la semana. La percepción de los padres sobre el tráfico inseguro y los lugares para caminar se asoció con menos tiempo en actividades físicas al aire libre en preescolares de bajos ingresos.

Urban Green Spaces, Greenness Exposure and Species Richness in Residential Environments and Relations with Physical Activity and BMI in Portuguese Adolescents.

Environmental factors play an important role in obesity-related behaviors. Evidence indicates significant associations between weight and urban green spaces in adults, but it is not clear whether this relationship applies to adolescents. Therefore, our aim was to determine the associations between urban green spaces, greenness exposure and species richness in residential environments with physical activity and body mass index. Sixty-two adolescents between 12 and 18 years of age answered a self-administered questionnaire, providing information on height, weight, age, sex and home address. Data on socioeconomic deprivation were obtained from the European Index of Deprivation for Small Portuguese Areas. Physical activity levels were assessed using accelerometers. Urban green space counts and the normalized difference vegetation index values were measured using buffers along the roads with distances of 300, 500, 1000 and 1500 m from each participant's residence. To quantify the species richness, the species richness index was used. Linear regression models were fitted to analyze whether urban green spaces, exposure to green spaces and species richness counts for each distance were associated with physical activity and self-reported body mass index. We did not find significant associations between the independent variables and the probability of overweight or obesity. The relationship between environmental variables, adolescents' physical activity and body weight seems to be complex and further studies may contribute to better understanding of the topic.

Home Confinement in Previously Active Older Adults: A Cross-Sectional Analysis of Physical Fitness and Physical Activity Behavior and Their Relationship With Depressive Symptoms.

AIM: The aim of our study was to analyze physical activity levels, sitting time, physical fitness, and their relationship with depressive symptoms after home confinement in previously active older adults. METHODS: This cross-sectional study sample comprised 68 older adults (74.24 ± 5.67 years) from a community-based exercise program conducted in Porto, Portugal. After home confinement, participants were assessed in person for lower-body strength (30-s chair stand test), cardiorespiratory fitness (6-min walking test), agility/dynamic balance (8-ft up-and-go test), handgrip strength, and anthropometry. Telephone interviews were performed to evaluate depressive symptoms with the Geriatric Depression Scale - 15 items (GDS-15) and physical activity levels through the International Physical Activity Questionnaire (IPAQ-SV). Individuals were also asked to self-report changes in their physical activity levels and time spent sitting. RESULTS: Ninety percent of older adults self-reported a decrease in overall physical activity levels, and nearly 65% increased daily sitting time during the home confinement. However, previously active older adults still presented high levels of physical fitness (scores above 50th compared with Portuguese normative values) after 11 weeks of home confinement. Overall, 52.9% of participants scored 5 or more points on GDS-15, which is suggestive of depression. Higher levels of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness were found in the non-depressed group compared with the depressed group. Finally, results from multiple regression analysis revealed that MVPA was negatively associated with depression. This model explained 16.4% of the variability seen in depression score, controlled for age, gender, and education. CONCLUSION: Even reporting a decline in physical activity, older adults who previously participated in a formal exercise program, still presented high levels of physical fitness after 11 weeks of home confinement. However, MVPA, but not physical fitness, seems to be an associated depression score in previously active older adults. These results reinforce the importance of older adults to remain physically active, since higher levels of MVPA may have a protective effect on depressive symptoms and, therefore, mitigate the negative impact of home confinement on mental health. Future longitudinal research studies are needed to ascertain these results.

Active Older Adults Keep Aerobic Capacity and Experience Small Reductions in Body Strength During Confinement Due to COVID-19 Outbreak.

The objective of this study was to observe the home-confinement effects on physical fitness, physical activity (PA), and body composition in active older adults, and to compare physical fitness and PA according to quality of life (QoL) during confinement. A total of 72 physically active older adults (61.1% females; 74.24 ± 5.57 years) were assessed pre- and postconfinement for aerobic capacity (6-min walk test), lower (30-s sit-to-stand), and upper (30-s arm-curl) body strength, PA (short-version of the International Physical Activity Questionnaire), and QoL (EQ-5D-visual analogue scale). The pre- and postconfinement comparisons show declines in upper (-2.24 ± 0.45 repetitions; p < .001; η2 = .276) and lower body strength (-2.65 ± 0.42 repetitions; p < .001; η2 = .378) in both genders, but not in aerobic capacity. Ninety percentage of older adults perceived a decline in PA. Older adults reporting high QoL increased 19.27 ± 97.04 m in the 6-min walk test, while the participants with low QoL reduced 28.32 ± 63.27 m (p = .018; η2 = .090). Previously active older adults did not have their aerobic capacity decrease significantly despite a decline in upper and lower body strength during an 11-week home confinement period.

"Body & Brain": effects of a multicomponent exercise intervention on physical and cognitive function of adults with dementia - study protocol for a quasi-experimental controlled trial.

BACKGROUND: Dementia is a leading cause of death and disability that was declared as one of the greatest health and social care challenges of the twenty-first century. Regular physical activity and exercise have been proposed as a non-pharmacological strategy in disease prevention and management. Multicomponent Training (MT) combines aerobic, strength, balance and postural exercises and might be an effective training to improve both functional capacity and cognitive function in individuals with dementia (IwD). Nevertheless, data on the effects of MT in IwD are still limited and the extent to which IwD can retain improvements after an exercise intervention still needs to be elucidated. The aim of "Body & Brain" study is to investigate the effects of a 6-month MT intervention and 3-month detraining on the physical and cognitive function of IwD. Additionally, we aim to explore the impact of this intervention on psychosocial factors and physiologic markers related to dementia. METHODS: This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale - Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver's burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples. DISCUSSION: If our hypothesis is correct, this project will provide evidence regarding the efficacy of MT training in improving physical and cognitive function and give insights about its impact on novel molecular biomarkers related to dementia. This project may also contribute to provide guidelines on exercise prescription for IwD. TRIAL REGISTRATION: ClinicalTrials.gov - identifier number NCT04095962 ; retrospectively registered on 19 September 2019.

Neighborhood environmental factors associated with leisure walking in adolescents.

OBJECTIVE To verify the associations of leisure walking with perceived and objective measures of neighborhood environmental factors stratified by gender and socioeconomic status (SES) in Brazilian adolescents. METHODS Cross-sectional study with a random sample of 1,130 high school students (47.3% girls; aged 14 to 20 years old) from Porto Alegre, Brazil. Leisure walking and SES were self-reported by the adolescents. Perceived environmental factors were assessed through Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Objective measures were evaluated using Geographic Information Systems, with road network calculated around the adolescent's residential address, using 0.5km and 1.0km buffers. Data collection was carried out in 2017 and generalized linear regression models were used. RESULTS Leisure walking was positively associated with access to services (0.5 km buffers [Odds ratio (OR) = 2.22] 1.0 km buffers [OR = 2.17]) and lower distance to parks and squares (0.5 km [OR=2.80] 1.0 km [OR = 2.73]) in girls from low SES. Residential density (0.5 km [OR = 1.57] 1.0 km [OR = 1.54]) and walkability index (0.5 km [OR = 1.17] 1.0 km [OR = 1.20]) were associated with leisure walking in girls from middle SES. Boys from low SES showed an inverse association between crime safety and leisure walking (0.5 km [OR = 0.59] 1.0 km [OR = 0.63]). Neighborhood recreation facilities was positively associated with leisure walking in middle SES (0.5 km [OR = 1.55] 1.0 km [OR = 1.60]). Land use mix (0.5 km [OR = 1.81] 1.0 km [OR = 1.81]), neighborhood recreation facilities (0.5 km [OR = 2.32] 1.0 km [OR = 2.28]) and places for walking (0.5 km [OR=2.07] 1.0 km [OR=2.22]) were positively associated with leisure walking in high SES. CONCLUSION Environmental factors (objectively and subjectively measured) and leisure walking show association in boys and girls of different SES.

Neighborhood environmental factors associated with leisure walking in adolescents

ABSTRACT OBJECTIVE To verify the associations of leisure walking with perceived and objective measures of neighborhood environmental factors stratified by gender and socioeconomic status (SES) in Brazilian adolescents. METHODS Cross-sectional study with a random sample of 1,130 high school students (47.3% girls; aged 14 to 20 years old) from Porto Alegre, Brazil. Leisure walking and SES were self-reported by the adolescents. Perceived environmental factors were assessed through Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Objective measures were evaluated using Geographic Information Systems, with road network calculated around the adolescent's residential address, using 0.5km and 1.0km buffers. Data collection was carried out in 2017 and generalized linear regression models were used. RESULTS Leisure walking was positively associated with access to services (0.5 km buffers [Odds ratio (OR) = 2.22] 1.0 km buffers [OR = 2.17]) and lower distance to parks and squares (0.5 km [OR=2.80] 1.0 km [OR = 2.73]) in girls from low SES. Residential density (0.5 km [OR = 1.57] 1.0 km [OR = 1.54]) and walkability index (0.5 km [OR = 1.17] 1.0 km [OR = 1.20]) were associated with leisure walking in girls from middle SES. Boys from low SES showed an inverse association between crime safety and leisure walking (0.5 km [OR = 0.59] 1.0 km [OR = 0.63]). Neighborhood recreation facilities was positively associated with leisure walking in middle SES (0.5 km [OR = 1.55] 1.0 km [OR = 1.60]). Land use mix (0.5 km [OR = 1.81] 1.0 km [OR = 1.81]), neighborhood recreation facilities (0.5 km [OR = 2.32] 1.0 km [OR = 2.28]) and places for walking (0.5 km [OR=2.07] 1.0 km [OR=2.22]) were positively associated with leisure walking in high SES. CONCLUSION Environmental factors (objectively and subjectively measured) and leisure walking show association in boys and girls of different SES.

What is the effect of a Mediterranean compared with a Fast Food meal on the exercise induced adipokine changes? A randomized cross-over clinical trial.

BACKGROUND: Adipose tissue-derived adipokines are pro-inflammatory cytokines involved in metabolic-related diseases and can be influenced by diet and exercise. We aimed to compare the effect of a Mediterranean (MdM) compared with Fast Food (FFM) meal on the exercise induced adipokines changes. METHODS: In a double blinded cross over trial, 46 participants were randomly assigned to one of two standardized iso-energy pre-exercise meals: FFM or MdM-type. Three hours after each meal, participants completed a treadmill exercise test (EC). Serum adiponectin, resistin, PAI-1, lipocalin-2/NGAL and adipsin were determined by Luminex magnetic bead immunoassay. Wilcoxon signed rank test compared changes before/after meal and before/after EC and a linear mixed model evaluated the effect of meals on the adipokine response to exercise, adjusted for confounders. RESULTS: Thirty-nine participants (mean age of 25, with a standard deviation of 5 years) completed the trial (56% females). For both interventions, a significant reduction of adipsin after each meal and a significant increase of lipocalin, PAI-1, adipsin and resistin, after exercise was observed. When exercise was preceded by a MdM meal a higher increase in adipsin levels was seen. CONCLUSION: Acute exercise induced an increase of circulatory levels of adipsin, resistin, lipocalin and PAI-1, but not adiponectin. A pre-exercise Mediterranean meal potentiated the increase of adipsin after the exercise test, which possibly relates to the immune regulatory role of adipsin. These changes suggest a cross-talk between the immune and metabolic immediate response to exercise and its modulation by the pre-exercise diet composition.

Dietary inflammatory index and academic performance in children.

OBJECTIVE: The main aim of the present study was to examine the association between the Dietary Inflammatory Index (DII®) and academic performance in children. DESIGN: School-based cross-sectional study. The DII was calculated based on dietary information obtained from a single 24h dietary recall. Academic performance was assessed by school records provided by the administrative services (i.e. Maths and Language). SETTING: Porto area (Portugal). SUBJECTS: A total of 524 children (277 girls) aged 11·56 (sd 0·86) years. RESULTS: The DII was associated with academic indicators (standardized ß values ranging from -0·121 to -0·087; all P<0·05). Significant differences were found between quartiles of the DII (P<0·05); children in the fourth quartile had significantly lower scores in all academic indicators compared with children in the first quartile (score differences ranging from -0·377 to -0·292) after adjustment for potential confounders. CONCLUSIONS: The inflammatory potential of diet may negatively influence academic performance. Children should avoid the consumption of a pro-inflammatory diet and adhere to a more anti-inflammatory diet to achieve academic benefits.

Meal-exercise challenge and physical activity reduction impact on immunity and inflammation (MERIIT trial).

BACKGROUND: The effect of a pre-exercise meal as countermeasure to exercise induced immunodepression is poorly known. Also, sedentary behavior is associated with increased cardiometabolic risk but studies on immune changes are lacking. Therefore, we aimed to assess: 1) the impact of a pre-exercise Mediterranean meal (MdM) compared with a fast-food type meal (FFM) on exercise-induced immunological changes and 2) the impact of an induced acute period of sedentary behavior on neuro-immune-endocrine status. METHODS: /Design: This is a two steps clinical trial including: (a) randomized crossover clinical trial, comparing the effect a high-fat/low-nutrient dense meal, FFM, with an isoenergetic similar high-nutrient dense meal, MdM, in the immune response to an exercise challenge (EC) and (b) a pilot trial assessing the neuro-immune-endocrine change induced by acute decreasing by half the usual physical activity level. RESULTS: A total of 46 participants (26 females), median aged 25 years were included. Of those 39-completed protocol, including overweight, physical active and inactive and participants with asthma. There were no differences in the EC between interventions. Dietary factors and physical activity were closely monitored during interventions and kept similar. During physical inactivity induction, 31% reached the target of 50% reduction in mean step number and 77% reached a 30% reduction. CONCLUSION: The use of a pre-exercise meal to modulate immune response and the understanding of the immunological impact of physical inactivity might help to establish future recommendations on how to practice exercise in a safer way and to recognize the potential impact of inactivity.

Self-rated health among youth and its associations with physical activity outside school, body mass index and television time in an urban municipality of Portugal / Saúde autorrelatada entre jovens e suas associações com a prática de atividade física fora da escola, índice de massa corporal e tempo de tela em um município urbano de Portugal

This study examined associations of physical activity (PA) outside school, Body mass index (BMI) and television time (TVT) with Self-rated health (SRH) among youth. A total of 1,121 adolescents aged from 10-18 years old participated in this cross-sectional study. PA was obtained through a questionnaire. TVT was accessed by asking the participant how many hours/day did they watch TV in the preceding week. BMI [weight (kg)/ height2 (m)] were used as an indicator of children's nutritional status. Associations of self-reported PA, TVT and BMI to SRH were assessed by gender, using Chi Squared and multivariate logistic regression controlling for mothers' education level. High levels of physical activity (boys: OR = 2.43; 95%CI: 1.24 to 4.78; girls: OR = 2.02; 95%CI: 1.26 to 3.24) were significantly associated with better SRH in adolescents. Obese/overweight boys were less likely to report positive SRH (OR = 0.41; 95%CI: 0.20 to 0.81) compared to their normal-weight peers. TVT in both genders and being overweight/obese in girls was not significantly associated with SRH. Results suggest that positive SRH is associated with PA levels, in both boys and girls, and with better nutritional status in boys.

Este estudo analisou as associações entre a autoavaliação da saúde (AAS) com a atividade física (AF) fora do contexto escolar, o índice de massa corporal (IMC) e o tempo de televisão (TTV). Um total de 1.121 adolescentes de 10 a 18 anos de idade participaram deste estudo transversal. A AF foi mensurada por questionário. O TTV foi obtido pela questão "Na última semana quantas horas por dia você passou assistindo TV?". O IMC foi utilizado como indicador do estado nutricional. As associações entre a AAS e as restantes variáveis foram determinadas, separadamente por gênero, pelo Chi-quadrado e regressão logística multivariada, controlando para a escolaridade da mãe. Níveis elevados de AF foram associados a uma melhor AAS (rapazes: OR = 2,43; IC95%: 1,24-4,78; meninas: OR = 2,02; IC95%: 1,26-3,24). Rapazes com sobrepeso/obesidade apresentaram menor chance de autoavaliarem o estado de saúde de forma positiva (OR = 0,41; IC95%: 0,20-0,81) quando comparados aos de peso corporal normal. O TTV não se associou à AAS em rapazes nem em meninas. Ter sobrepeso/obesidade não se mostrou significativamente associado a AAS em meninas. Os resultados do nosso estudo sugerem que maiores níveis de AF em rapazes e em meninas e menor IMC nos rapazes se associam a uma melhor AAS.

Gender Differences in the Domain-Specific Contributions to Moderate-to-Vigorous Physical Activity, Accessed by GPS.

BACKGROUND: Identifying where children spend their activity-time may help define relevant domains for effective PA promotion and better understand the relation between PA and environment. Our study aimed to identify how boys and girls allocate their active time in the different domains. METHODS: 374 children (201 girls; mean age = 11.7 years) wore an accelerometer and a GPS for 7 days. PALMS software combined data, categorized nonsedentary time and bouts of moderate-to-vigorous physical activity (MVPA). Geographical information system allocated activity into 4 domains: school, leisure, transport and home. RESULTS: Overall, a higher proportion of time in MVPA was found in the transport domain (45.5%), school (30.5%), leisure (21.3%), and home (2.7%). Gender differences were found for the proportion of time spent across domains. Girls (54.5%) had more MVPA than boys (35.2%) in the transport domain, whereas boys spent more MVPA time in school (37.0%) and leisure (24.9%) than girls (24.7% and 18.1, respectively). CONCLUSIONS: Interventions to increase transport behavior may be relevant for children's MVPA. School is an important domain for boys PA, while for girls increasing the supportiveness of the school environment for PA should be a priority. Strategies should consider gender differences when targeting each domain.

Cardiorespiratory fitness, but not physical activity, is associated with academic achievement in children and adolescents.

BACKGROUND: Cardiorespiratory fitness (CRF) and physical activity (PA) seem to have positive effects on academic achievement (AA), although in most studies, objective methods of assessment have not been used. AIM: To examine the associations of CRF and PA with AA. SUBJECTS AND METHODS: A sample of 640 youngsters (10-18 years) participated in this cross-sectional study. CRF was estimated with the 20-metre shuttle run test and PA was measured using accelerometers. School grades were used to describe AA using mathematics and native language final grades. The relationship between CRF and PA with AA was analysed using ANCOVA. RESULTS: Results show a significant effect of CRF levels on native language grades, after adjustment for confounders [F(3,414) = 3,99 p < 0.05], but not for mathematics [F(3,360) = 0.95 p > 0.05]. No significant effects of PA levels on AA were found. CONCLUSIONS: CRF is associated with moderate-to-vigorous PA (MVPA) and higher levels of CRF may influence AA. CRF is positively correlated with MVPA, suggesting that higher amounts of MVPA might improve CRF and indirectly influence AA. Since CRF is dependent on higher intensities of PA, we can suggest a focus on implementing improvement strategies to increase the intensity of physical education lessons.

Examining the utility of thresholds for aerobic fitness related to resting blood pressure and BMI in Portuguese children.

OBJECTIVES: This study examined the utility of the Ruiz et al. cut-points when examining body mass index (BMI) and resting blood pressure in young people. METHODS: Two hundred fifty-six children (154 girls and 102 boys) aged 7-16 years underwent assessment of BMI, physical maturation, resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and cardiorespiratory fitness using breath by breath gas analysis during treadmill testing to exhaustion. RESULTS: Results from a series of 2 (fit vs. unfit) × 2 (gender) ways analysis of covariance, controlling for maturation indicated higher SBP in the unfit group compared to the fit group (P = 0.001), higher DBP in the unfit group compared to the fit group (P = 0.04) and higher BMI (in unfit) than fit children (P = 0.0001). Males had significantly higher BMI than females (P = 0.04). Maturation as a covariate was significantly and positively associated with SBP (P = 0.003), DBP (P = 0.004), and BMI (P = 0.001). CONCLUSIONS: This study suggests that the Ruiz et al. cut-points are valid in distinguishing between children with higher and lower BMI and resting BP values.