The impact of state physical education requirements on youth physical activity and overweight

To combat childhood overweight in the US, which has risen dramatically in the past three decades, many medical and public health organizations have called for students to spend more time in physical education (PE) classes. This paper is the first to examine the impact of state PE requirements on student PE exercise time. It also exploits variation in state laws as quasi-natural experiments in order to estimate the causal impact of PE on overall student physical activity and weight. We study nationwide data from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state minimum PE requirements from the 2001 Shape of the Nation Report.We find that high school students with a binding PE requirement report an average of 31 additional minutes per week spent physically active in PE class. Our results also indicate that additional PE time raises the number of days per week that girls report having exercised vigorously or having engaged in strength-building activity. We find no evidence that PE lowers BMI or the probability that a student is overweight.We conclude that raising PE credit requirements may make girls more physically active overall but there is not yet the scientific base to declare raising PE requirements an anti-obesity initiative for either boys or girls.     

An assessment of Australian school physical activity and nutrition policies

Objective: This study's objective was to identify and assess existing physical activity and nutrition policies for Australian schools. Methods: Policies were identified through a search of the websites of national and state/territory education departments and school associations, and were subsequently assessed against specific criteria. Results: Policies were identified for government schools, but only for one non‐government school association. Physical activity policies were identified at the national level and for six of eight state/territories. The national policy was mandated, and most state/territory physical activity policies were mandated and consistent with the national policy. Several physical activity policies did not meet expert recommendations for time and instructor qualifications. Nutrition policies were identified at the national level and all eight states/territories. The national policy was not mandated, but all state/territory nutrition policies were mandated and consistent with the national policy and relevant guidelines. Most physical activity and nutrition policies lacked information about implementation monitoring. Conclusions: To improve school practices, policies are needed that are mandated and consistent with expert recommendations, use clear language, and specify monitoring and accountability mechanisms. Implications for public health: Improvements in school policies can promote physical activity and healthy eating behaviours to positively influence student outcomes across Australia.     

Physical education and physical activity: results from the School Health Policies and Programs Study 2006

BACKGROUND: Comprehensive school-based physical activity programs consist of physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, interscholastic sports, and walk and bike to school initiatives. This article describes the characteristics of school physical education and physical activity policies and programs in the United States at the state, district, school, and classroom levels. METHODS: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n=453). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=988) and with a nationally representative sample of teachers of required physical education classes and courses (n=1194). RESULTS: Most states and districts had adopted a policy stating that schools will teach physical education; however, few schools provided daily physical education. Additionally, many states, districts, and schools allowed students to be exempt from participating in physical education. Most schools provided some opportunities for students to be physically active outside physical education. Staff development for physical education was offered by states and districts, but physical education teachers generally did not receive staff development on a variety of important topics. CONCLUSIONS: To enhance physical education and physical activity in schools, a comprehensive approach at the state, district, school, and classroom levels is necessary. Policies, practices, and comprehensive staff development at the state and district levels might enable schools to improve opportunities for students to become physically active adults.     

Home environments,physical activity,and energy expenditure among low-income overweight and obese women

Ecologic models of physical activity identify multiple environmental domains that influence activity levels, including the home. This study examined aspects of the home environment associated with objective measures of physical activity in overweight and obese women. Study participants were recruited through three federally qualified health centers in rural southwest Georgia as part of a randomized controlled trial of a home-environment-focused weight gain prevention intervention. Data collected from February 2011 to December 2012 were from 301 participants who completed baseline interviews and wore accelerometers for 7 days. Most were African American (83.4%) and obese (50.5%) or morbidly obese with body mass index ≥40 (35.6%). Mean age was 50.6 years. Participants were highly sedentary, with 7.9 hours of non-sedentary time per week, primarily in light activity. In a multivariate model, exercise equipment (p = .03), family support (p = .02), and full-time employment (p = .03) were positively associated with non-sedentary time, whereas age (p = .003), living in a more rural area (p = .03), and having an exercise space (p = .01) were negatively associated. Home environments may be promising targets for programs aimed at increasing activity levels among overweight and obese women.     

久坐时间及体力活动与儿童超重肥胖的联合关系研究

目的 探明久坐时间(ST)、体力活动(PA)与儿童超重肥胖的联合关系,为从身体活动角度制定儿童超重肥胖的防控策略提供依据。方法 本研究采用分层整群随机抽样方法,于2017年3-6月共抽取3 936名广州市7~12岁儿童。采用信效度良好的问卷评估儿童的ST和PA水平,儿童超重肥胖依据中国肥胖工作组制定的标准进行判定。每天进行课后ST≥2 h/d视为高ST,每天参加中高等强度PA≥60 min/d视为高PA;高、低ST和PA两两交叉分组后形成四组别。结果 广州市7~12岁儿童总体的超重肥胖率为21.5%。低ST高PA、低ST低PA、高ST高PA、高ST低PA四组别儿童的超重肥胖率分别为18.9%,17.8%,23.1%和22.3%。在控制了混杂因素后,与低ST高PA组儿童相比较,高ST高PA组儿童的超重肥胖风险是其1.286倍(95%CI:1.078~1.724),高ST低PA组儿童的超重肥胖风险是其1.219倍(95%CI:1.059~1.641)。结论 ST、PA与儿童超重肥胖间存在联合关系,有关部门从身体活动角度防控儿童超重肥胖时,除了考虑增加儿童中高等强度PA水平,也应多关注减少课后ST。     

Physical education resources, class management, and student physical activity levels: a structure-process-outcome approach to evaluating physical education effectiveness

BACKGROUND: This study was conducted to empirically evaluate specific human, curricular, and material resources that maximize student opportunities for physical activity during physical education (PE) class time. A structure-process-outcome model was proposed to identify the resources that influence the frequency of PE and intensity of physical activity during PE. The proportion of class time devoted to management was evaluated as a potential mediator of the relations between resource availability and student activity levels. METHODS: Data for this cross-sectional study were collected from interviews conducted with 46 physical educators and the systematic observation of 184 PE sessions in 34 schools. Regression analyses were conducted to test for the main effects of resource availability and the mediating role of class management. RESULTS: Students who attended schools with a low student-to-physical educator ratio had more PE time and engaged in higher levels of physical activity during class time. Access to adequate PE equipment and facilities was positively associated with student activity levels. The availability of a greater number of physical educators per student was found to impact student activity levels by reducing the amount of session time devoted to class management. CONCLUSION: The identification of structure and process predictors of student activity levels in PE will support the allocation of resources and encourage instructional practices that best support increased student activity levels in the most cost-effective way possible. Implications for PE policies and programs are discussed.     

Physical self-concept and physical activity enjoyment in elementary school children

The present study examined gender differences and relationships of seven specific domains of physical self-concept (PSC) (Strength, Endurance, Speed, Flexibility, Coordination, Global Sport Competence, and Appearance) and physical activity enjoyment (PAE) in 447 elementary school children by self-report questionnaires. Boys reported higher self-concepts of Strength, Endurance, Speed, Coordination, and Global Sport Competence than girls. Conversely, girls showed higher self-concepts of Flexibility than boys. Moreover, all seven specific domains of children's PSC and PAE were positively interrelated and children's self-concepts of Endurance and Global Sport Competence predicted their PAE. Implications for physical education targeting to enhance children's PSC and PAE are discussed.     

左旋肉碱类膳食补充对超重肥胖成年人体格指标的影响

目的 评价左旋肉碱类膳食补充对超重肥胖成年人减重干预的有效性。方法 招募北京居住一年以上20～50岁符合标准的志愿者120名,采用随机对照研究设计,将受试者随机分组,干预组60名,对照组60名。给予干预组左旋肉碱类膳食补充,同时两组均给予健康生活宣传材料,干预期为6个月。对受试者进行基线和终期2次常规体检,包括身高、体重、腰围、臀围和体脂率。结果 干预6个月后,干预组60名研究对象的体重、腰围、臀围、体质指数(Body mass index,BMI)、腰臀比和体脂率相较于对照组有明显改善,干预组体重下降2.76(SD:1.81)kg,腰围下降4.46(SD:4.34)cm,臀围下降3.48(SD:2.65)cm,BMI下降0.99(SD:0.68)kg/m²,腰臀比下降0.01(SD:0.04),体脂率下降0.97(SD:2.00)%,干预组和对照组上述指标差异具有统计学意义(体重差值t=6.277, P<0.001; 腰围差值t=5.010, P<0.001; 臀围差值t=4.452, P<0.001; 体质指数差值t=6.264, P<0.001; 腰臀比差值t=2.347, P<0.05; 体脂率差值t=2.873, P<0.05); 不同性别之间腰臀比和体脂率变化具有差异。结论 左旋肉碱类膳食补充配合运动与健康宣教能够有效降低超重肥胖人群BMI、腰臀比和体脂率水平,为超重肥胖人群减重方法的选择提供参考。     

Governmental interventions and youth physical activity in France

Data from a representative sample of 2474 French youth show that, despite a 7-year French Ministry of Health strategy for nutrition and physical activities, adolescents' motivation to practise sports and physical activities decreased significantly between 2001 and 2008. While this paper focuses on the context of physical activity in France, the general discussion may be applicable to other countries concerned with the obesity pandemic.     

血透患者体力活动水平自我管理教育效果分析

目的 探讨自我管理教育对维持性血液透析(MHD)患者体力活动水平的影响。方法 采用便利抽样的方法抽取80例规律透析患者,随机分为对照组40例和干预组40例;对照组进行常规护理教育,干预组在此基础上进行6个月的自我管理教育,干预前后通过人类活动概况量表(HAP)来比较2组患者体力活动水平。结果 干预6个月后,干预组患者的最大活动得分(MAS)[(77.18±16.43)分]和校正活动得分(AAS)[(68.34±17.29)分]均高于对照组[(70.01±15.26)和(60.14±16.26)分],差异均有统计学意义(P<0.05)。结论 自我管理教育能有效的提高MHD患者的体力活动水平。     

健康教育对改善儿童贫血效果分析

目的了解儿童贫血状况,探讨贫血与家长营养知识、饮食行为的关系。方法采用随机抽样方法,抽取北京市大兴林校街道的1200名儿童。对这些儿童家长进行营养知识、饮食行为和贫血患病率调查,并开展健康教育。结果健康教育后儿童的贫血患病率为（5.83%）,比健康教前儿童贫血患病率（12.42%）显著降低。结论加强健康教育、普及营养知识、纠正偏食的习惯、注意食物多样化等,是防治儿童贫血的重要措施。     

有氧运动与营养教育对高总胆固醇男生血脂健康体适能及运动行为影响

目的探讨有氧运动与营养教育对高总胆固醇男生血脂、健康体适能及运动行为的影响,为培养大学生正确的营养与健康观念,养成良好的运动习惯提供参考。方法以河南省4所高校总胆固醇高于200 mg/d L的140名男大学生依随机方式分为骑自行车+营养教育(BE)组和控制(C)组。BE组进行6周的有氧运动干预,每周3次,每次60 min,运动强度为50%～70%心跳率储备量(HRR)及每周60 min营养教育课程。受试者分别于干预前后检测血脂、健康体适能、每日食物摄入量及运动行为。结果 BE组体质量指数(body mass index,BMI)、腰臀比均低于C组[(25. 57±1. 77)(28. 88±2. 10) kg/m²,(0. 81±0. 03)(0. 87±0. 06)]; BE组心肺适能优于C组[(54. 45±5. 31)(50. 00±5. 29)](t值分别为5. 89,6. 11,4. 74,P值均<0. 01)。C组总胆固醇(TC)高于BE组[(229. 90±25. 63)(195. 90±34. 79) mg/d L],BE组高密度脂蛋白胆固醇...     

艾滋病/性病/安全性行为同伴教育项目评价设计

  目的  探讨饮食知识健康教育和运动干预方式对中国城市初中生体质指数（BMI）和肥胖水平的干预效果,为青少年肥胖控制提供科学依据。  方法  于2015年9月,在天津、内江、大连抽取初一和初二1 491名学生作为研究对象,随机分为干预组（720人）和对照组（771人）,对干预组进行综合干预（健康教育和运动干预）,对照组进行普通干预（发放健康手册和知识讲座）,为期10月,干预前后分别进行问卷调查和体格测量。  结果  干预组肥胖学生BMI由干预前的30.1 kg/m² 下降为28.9 kg/m²,对照组肥胖学生BMI由干预前的29.9 kg/m² 下降为29.4 kg/m²,干预组肥胖学生BMI下降显著高于对照组。其中,干预组肥胖男生BMI由干预前的30.0 kg/m² 下降为28.6 kg/m²,对照组肥胖男生BMI由干预前的29.5 kg/m² 下降为28.9 kg/m²,干预组肥胖男生BMI下降显著高于对照组（P < 0.05）;在肥胖女生中干预不显著（P > 0.05）。干预组学生工作日久坐行为时间由干预前的4.2 h下降为4.1 h,对照组学生干预前后均为4.4 h;干预组学生每周吃水果蔬菜天数由干预前的4.5 d增加为5.1 d,对照组学生干预前后均为4.8 d,2组比较差异有统计学意义（P < 0.05）。  结论  健康教育和运动干预相结合有助于提高学生体力活动水平,明显降低肥胖学生尤其是男生肥胖水平,但干预效果仍存在性别差异。     

The effect of playground- and nature-based playtime interventions on physical activity and self-esteem in UK school children

School playtime provides opportunities for children to engage in physical activity (PA). Playground playtime interventions designed to increase PA have produced differing results. However, nature can also promote PA, through the provision of large open spaces for activity. The purpose of this study is to determine which playtime interventions are most effective at increasing moderate-to-vigorous physical activity (MVPA) and if this varies by school location. Fifty-two children from an urban and rural school participated in a playground sports (PS) and nature-based orienteering intervention during playtime for one week. MVPA was assessed the day before and on the final day of the interventions using accelerometers. Intervention type (p?p?r?=?0.32; p?p?>?0.05). The provision of PS influences PA the most; however, a variety of interventions are required to engage less fit children in PA.     

Changes in physical activity in pre-schoolers and first-grade children: longitudinal study in the Czech Republic

Background The transition from kindergarten to first year at school is associated with a variety of psychosocial changes in children. The aim of this longitudinal study was to identify the changes in children's physical activity (PA) upon entry to first year at school; and to identify the days of the school week that exhibit low PA. Methods We monitored the PA levels of 176 children twice: initially in kindergarten and again in first‐year classes at school. The age (mean ± standard deviation) of children at kindergarten was 5.7 ± 0.5 years and 6.7 ± 0.5 years at the first year of elementary school. We evaluated PA employing the activity energy expenditure (AEE – kcal/kg/day) from Caltrac accelerometer and daily amount of steps (STEPS) from Yamax pedometer. Participants were monitored over 7 days to include a weekend. Results The mean AEE was 11.5 in pre‐school girls and 12.9 kcal/kg/day in boys; and STEPS were 9923 steps/day in girls and 11 864 in boys on weekdays. At weekends, it was 11.5 kcal/kg/day in girls and 12.7 kcal/kg/day in boys and 10 606 steps/day in girls and 11 182 steps/day in boys. The mean AEE and STEPS in first‐grade girls and boys was 9.9 and 9.8 kcal/kg/day respectively, and 7911 and 8252 steps/day respectively on weekdays, and 8.8 and 9.0 kcal/kg/day and 6872 and 7194 steps/day respectively at weekends. First‐grade school children had significantly lower PA than pre‐school children on weekdays (P < 0.0001) and at weekends (P < 0.0001). Decline in PA on weekdays was during time spent at school (P < 0.0001) and not during after‐school children's leisure time. Conclusion The parts of the week when first‐grade school children show low PA are the times spent in lessons and in after‐school nursery and at weekends. PA needs to be promoted using intervention programmes mainly during the after‐school nursery programmes and at weekends.     

加强体育锻炼对集居儿童单纯性肥胖体重控制和体能影响的研究

【目的】　对托幼机构儿童单纯性肥胖者加强体育锻炼以控制体重增长及体能的提高。　【方法】　以身高标准体重值为肥胖判断标准。自 2 0 0 1年 9月～ 2 0 0 1年 12月选择肥胖儿童较集中的 15所幼儿园中的 188名超重及肥胖儿童 ,随机分为实验组 (G1 =91例 )和对照组 (G2 =97例 ) ,实验组儿童按适应阶段、过渡阶段、锻炼阶段进行循序渐进式加强体育锻炼 ,体育锻炼方式根据不同年龄儿童选择青蛙跳、摸高跳、跳障碍物、跑步、跳绳等。干预前后进行体重、身高、体能等测试。　【结果】　肥胖实验组儿童体重增长值为 ( 0 .84± 1.2 0 )kg、对照组儿童体重增长值为 ( 1.0 3± 1.0 0 )kg。经统计学检验t =1.5 ,P =0 .2 2。再以干预前体重为协因子 ,进行协方差分析 ,显示两组差异无显著性 (P >0 .0 5 )。肥胖实验组经干预体能明显优于对照组。　【结论】　通过加强体育锻炼 ,肥胖儿童的体重有一定控制 ,但效果尚无统计学意义。可能与干预周期欠短 ,体育锻炼方式的掌握欠佳等有关。通过加强体育锻炼肥胖儿童的体能有较明显的提高     

A cross‐sectional study of barriers to physical activity among overweight and obese patients with type 2 diabetes in Iran

The objective of this study was to identify common barriers to physical activity practice among overweight/obese patients with type 2 diabetes in Iran and their associations with physical activity level. In this cross‐sectional study, 146 overweight/obese volunteers with type 2 diabetes were recruited from diabetes clinics in Tabriz, Iran, between July 2012 and March 2013. A Persian version of the long‐format International Physical Activity Questionnaire was used to assess physical activity level. A 12‐item structured questionnaire was designed to assess physical activity barriers. The validity and reliability of the latter scale were assessed by related measures. An exploratory factor analysis with the principal component analysis extraction method and varimax rotation was performed to extract the underlying factors. Multivariate regression analysis was used to assess the relationship between barriers and physical activity level. About 73% of patients had moderate physical activity. Factor analysis yielded four factors as barriers to physical activity including: (i) negative attitude towards physical activity, (ii) discouragement, (iii) physical problems and (iv) cost/environmental factors. These factors explained about 51% of the total variance. There was a negative relationship between the factor ‘physical problems’ and physical activity level (P = 0.024). Overall, there were some barriers to physical activity. Health counsellors should address these barriers to increase the patients' adherence to physical activity recommendations. Physical conditions of the patients must be taken into account.     

济宁市中小学生营养教育效果评价

目的评价营养教育对中小学生营养知识、态度及行为的影响效果，为有效开展营养知识教育提供科学依据。方法采用分层整群随机抽样方法，选择曲阜市区中小学校各1所作为干预组，选择条件齐同的邹城市为对照组，干预组以6种营养宣传教育材料为基础，用大众和人际传播方式进行为期一年的营养宣传教育，干预前后分别对中小学生进行营养知识、态度及行为问卷调查。结果基线和终期调查共中小学生1082名，营养教育后，小学生营养知识知晓率、平均得分、优良率分别从35．3％上升到76．0％，3．83分上升到8．10分，7．3％上升到81．6％；中学生分别从54．6％上升到83．6％，6．78分上升到8．87分，16．8％上升到96．5％。营养态度平均得分、及格率，小学分别从4．17分上升到4．80分，64．7％上升到91．6％；中学生分别从4．76分上升到4．92分，72．2％上升到97．6％，每天吃早餐、食鸡蛋、蔬菜水果、饮奶、喝饮料、白开水和每周体育锻炼3次以上人数百分比指标均明显高于对照组和教育前（P〈0．01）。对照组终期和基线调查结果差异无统计学意义（P〉0．05）。结论在中小学校开展营养教育后，学生营养知识水平明显提高，营养态度显著改善，膳食行为和生活方式有了一定的改变。