Physical activity in Filipino youth: the Cebu Longitudinal Health and Nutrition Survey

OBJECTIVE: To describe physical activity (PA) and inactivity levels of Filipino youth aged 14-16 y. DESIGN: PA type and patterns were assessed in an adolescent cohort enrolled in the Cebu Longitudinal Health and Nutrition Survey. SUBJECTS: A total of 1053 males (aged 15.6+/-0.5 y; body mass index (BMI)=18.6+/-2.6 kg/m(2)) and 990 females (aged 14.6+/-0.5 y; BMI=18.8+/-2.4 kg/m(2)). MEASUREMENTS: PA was assessed by (1) self-reported usual PA (questionnaire); (2) 24-h objective monitoring (Caltrac accelerometer); and (3) 24 h recalls of PA during the objectively monitored time frame. RESULTS: As measured by Caltrac, males expended 378.0+/-164.5 kcal and females 271.0+/-105.4 kcal. The measurement approaches employed agreed in expected ways, given the limitations of each. Together the approaches used indicated that the primary sources of PA for this population are chores and active commuting. In all, 40% of the sample walked to school, less than 1% rode a bicycle, 22% rode in/on motorized transport, and 37% used some combination of walking and motorized transport. Further, gender differences exist for type, frequency, and duration of physical activities performed by Filipino youth. Specifically, females report engaging in few leisure-time physical activities and more household chores. In total, 48% of Filipino youth report watching > or =2 h/day of television; relatively few youth (7%) report watching >4 h/day at this time. An 18% of males report no vigorous activities compared to 87% of females. CONCLUSION: Clear gender differences in PA patterns and levels exist in Filipino adolescents. Nonsport/exercise type activities (eg chores and active commuting) currently provide a large proportion of daily activity for both males and females, however. It is anticipated that as modernization and technological advancement continue in this developing country, these primary sources of PA will decrease.     

Parent-child physical activity relationships in 12-year old French students do not depend on family socioeconomic status

OBJECTIVES: Regular physical activity (PA) in young needs to be promoted to prevent obesity and subsequent diabetes. Influences of parental PA on adolescents' activity level have been studied with discordant results and the effect of socioeconomic status (SES) on these relationships is not clarified. METHODS: Cross-sectional population-based survey of about 3000 12-year old French students and their parents. Familial associations were assessed with logistic regression models taking into account SES and children's and parents' corpulence. Sport involvement and sedentary behaviors were assessed by standardized questionnaires filled out separately by children and parents, the latter also reporting their educational data and family income tax. RESULTS: Participation in structured PA outside school was higher for boys (74%) than for girls (58%, p<10-5) and a high sedentary behavior (watching television, playing computer/video games and reading > or =2h/day) was observed in one-third of the sample, both in boys and in girls. Children were more likely to participate in structured PA outside school when both parents practiced sport as compared to neither parent practicing it, with an odd ratio OR (95%CI) of 1.97 (1.4-2.8) for boys and 1.56 (1.2-2.1) for girls. Familial associations of inactivity were significant for boys only. A greater percentage of adolescents had a high level of sedentary behavior when both parents versus no parents watched television > 2h/day (OR 1.95 (1.52.6)). Parent-child physical activity relationships were not modified by the family SES or the children's or parents' weight status. CONCLUSION: Parental involvement in sport is an important correlate of a young adolescent's participation in structured PA outside school, whatever the family SES or corpulence of the family members.     

Physical activity and determinants of physical activity in obese and non-obese children.

OBJECTIVE: To compare the physical activity (PA) patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children. DESIGN: Cross-sectional study. SUBJECTS: One-hundred and thirty-three non-obese and 54 obese sixth grade children (mean age of 11.4+/-0.6). Obesity status determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES-1. MEASUREMENTS: Objective measurements were collected of PA over a 7-day period using the CSA 7164 accelerometer: total daily counts; daily moderate (3-5.9 METs) physical activity (MPA); daily vigorous physical activity (> or =6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (> or =3 METs, MVPA). Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games. RESULTS: Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10 and 20 min bouts of MVPA. Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active. CONCLUSIONS: The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity. Interventions to promote PA in obese children should endeavor to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modeling of PA.     

Physical activity is inversely related to waist circumference in 12-y-old French adolescents

BACKGROUND AND OBJECTIVE: Waist circumference (W) has been shown to be a good predictor of cardiovascular risk. The aim of this study was to investigate whether physical activity (PA) is related to W in adolescents as previously shown in adults. DESIGN AND SUBJECTS: Cross-sectional population-based survey of 2,714 12-y-old adolescents from the eastern part of France. MEASUREMENTS: Body mass index (BMI) and W were measured. Structured PA, active commuting to and from school and sedentary activities (SED), for example television viewing, computer/video games and reading and different potential confounders (dietary habits, parental overweight, family annual income tax and educational level) were assessed by a questionnaire. RESULTS: The adolescents had a mean BMI of 19.0+/-3.4 kg/m2, and 20.2% of them were overweight, with no gender difference. Boys had a greater W than girls (67.6+/-9.1 vs 65.7+/-8.9 cm, P<0.0001). In all, 42% of the girls and 25% of the boys did not practice any structured PA outside school and less than 40% of the adolescents commuted actively to school more than 20 min/day. About one-third of the adolescents devoted more than 2 h/day to SED. In univariate analyses, BMI was negatively associated with structured PA but significantly only for girls (P<0.01) and positively associated with SED for both genders (P<0.0001 for girls, P<0.01 for boys). W was negatively associated with structured PA and positively associated with SED both in girls (P<0.0001 and P=0.03, respectively) and boys (P<0.01 and P=0.08, respectively). Multiple general linear models show that SED is associated with BMI, independently of structured PA, in both genders. On the other hand, structured PA was inversely associated with W, independently of SED. The inverse relation between structured PA and W persisted after additional adjustment on BMI, with a greater effect of PA for the adolescents with higher BMI. CONCLUSIONS: In 12-y-old adolescents, structured PA is inversely associated with W, an indicator of total adiposity but also more specifically of abdominal fat. This suggests that PA may have a beneficial effect on youth metabolic and cardiovascular risks, in particular in the presence of overweight..     

Association of obesity with physical activity, television programs and other forms of video viewing among children in Mexico city.

OBJECTIVE: To assess the association of physical activity, television program viewing and other forms of video viewing with the prevalence of obesity among school children. DESIGN: Cross-sectional study. SUBJECTS: 712 children, 9-16 y old, from a low- and a middle-income town in the Mexico City area. MEASUREMENTS: Children completed a self administered questionnaire to assess time spent in physical activity and television viewing, and diet. Height weight and triceps skinfolds were measured. The outcome variable was obesity, and the covariates were hours of television programs and other video viewing, physical activity, energy intake, percentage of energy from fat, town of location of school, age, gender and perception of mother's weight status. RESULTS: Among 461 children with complete information, 24% were classified as obese. Children reported an average of 4.1 +/- 2.2 h/d watching television (2.4 +/- 1.5 h/d for TV programs and 1.7 +/- 1.5 h/d for video cassette recorder (VCR) or videogames), and 1.8 +/- 1.3 h/d in moderate and vigorous physical activities. Odds ratios (OR) of obesity were 12% higher for each hour of television program viewing per day (OR = 1.12, 95% confidence interval (CI) 1.02,-1.22), and 10% lower for each hour of moderate/vigorous physical activity per day (OR = 0.90, 95% CI 0.83-0.98), controlling for age, gender, town and perception of mother's weight status. Children in the middle-income town had higher adjusted odds of obesity (OR = 2.58, 95% CI 1.47-4.54). CONCLUSION: Physical activity and television viewing, but not VCR/videogames use, were related to obesity prevalence in Mexican children 9-16 y old.     

Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis

OBJECTIVE: To review the empirical evidence of associations between television (TV) viewing, video/computer game use and (a) body fatness, and (b) physical activity. DESIGN: Meta-analysis. METHOD: Published English-language studies were located from computerized literature searches, bibliographies of primary studies and narrative reviews, and manual searches of personal archives. Included studies presented at least one empirical association between TV viewing, video/computer game use and body fatness or physical activity among samples of children and youth aged 3-18 y. MAIN OUTCOME MEASURE: The mean sample-weighted corrected effect size (Pearson r). RESULTS: Based on data from 52 independent samples, the mean sample-weighted effect size between TV viewing and body fatness was 0.066 (95% CI=0.056-0.078; total N=44,707). The sample-weighted fully corrected effect size was 0.084. Based on data from six independent samples, the mean sample-weighted effect size between video/computer game use and body fatness was 0.070 (95% CI=-0.048 to 0.188; total N=1,722). The sample-weighted fully corrected effect size was 0.128. Based on data from 39 independent samples, the mean sample-weighted effect size between TV viewing and physical activity was -0.096 (95% CI=-0.080 to -0.112; total N=141,505). The sample-weighted fully corrected effect size was -0.129. Based on data from 10 independent samples, the mean sample-weighted effect size between video/computer game use and physical activity was -0.104 (95% CI=-0.080 to -0.128; total N=119,942). The sample-weighted fully corrected effect size was -0.141. CONCLUSION: A statistically significant relationship exists between TV viewing and body fatness among children and youth although it is likely to be too small to be of substantial clinical relevance. The relationship between TV viewing and physical activity is small but negative. The strength of these relationships remains virtually unchanged even after correcting for common sources of bias known to impact study outcomes. While the total amount of time per day engaged in sedentary behavior is inevitably prohibitive of physical activity, media-based inactivity may be unfairly implicated in recent epidemiologic trends of overweight and obesity among children and youth. Relationships between sedentary behavior and health are unlikely to be explained using single markers of inactivity, such as TV viewing or video/computer game use.     

Association of physical activity with insulin sensitivity in children

BACKGROUND: Physical activity (PA) has been shown to improve insulin resistance and other cardiovascular disease risk factors in normal and diabetic adults and in obese youth, but not in non-diabetic, normal-weight children. METHODS: Data from 357 non-diabetic children (10-16 y) were used to examine cross-sectional associations with PA. Insulin sensitivity was assessed with a euglycemic hyperinsulinemic clamp and expressed as M(ffm) (glucose utilization/kg of fat-free mass/min). RESULTS: Correlations were adjusted for age, sex, race and Tanner stage. PA was significantly correlated with fasting insulin and insulin sensitivity (r=-0.12, P=0.03 and r=0.13, P=0.001, respectively), more strongly in children with above-median systolic blood pressure (r=-0.17, P=0.03 and r=0.35, P=0.0001, respectively). Further adjustment for body mass index, body fat percentage, waist circumference or lipids did not alter these observations. CONCLUSIONS: Physical activity is correlated with lower fasting insulin and greater insulin sensitivity in childhood. These results are consistent with the hypothesis that increasing physical activity among youth may reduce the incidence of type 2 diabetes in children and adolescents.     

Cigarette, alcohol use and physical activity among Myanmar youth workers, Samut Sakhon Province, Thailand

Over 1.2 million migrants from Myanmar are currently residing in Thailand. Little information is known about Myanmar youth risk behaviors. This cross-sectional study aimed to determine the prevalence and the factors associated with cigarette and alcohol use, and physical inactivity, among Myanmar youth working in a harbor town in Samut Sakhon Province, Thailand. One hundred and seventy-seven young workers aged 15-24 years, living in the study area, were interviewed by structured questionnaire. About 21.5% were current smokers, 25.4% were alcohol drinkers, and 36.7% were physically inactive. Univariate analysis indicated one variable was significantly associated with cigarette smoking: education level higher than primary school (OR=2.3, 95% CI 1.02-5.0), Three variables were significantly associated with alcohol drinking: married status (OR=2.2, 95%CI 1.02-4.5); non-seafood-processing workers, i e, street vendors, construction laborers, etc. (OR=3.4, 95% CI 1.7-7.1), and high job stress due to supervisor/boss (OR=2.1 95% CI 1.1-4.2). Two variables were significantly associated with physical inactivity: female youth (OR=3.9 95% CI 2.1-7.5), and education level higher than primary school (OR=0.4, 95% CI 0.2-0.8). The prevalence of smoking, alcohol drinking and physical inactivity among Myanmar migrant youths was quite high. Government and non-government organizations should co-operate to provide interventions to reduce youths' risk behaviors.     

Intensity and frequency of physical activity and high blood pressure in adolescents: A longitudinal study

Despite limited evidence on the association between physical activity (PA) and blood pressure (BP) in youth, experts recommend that adolescents engage regularly in moderate‐to‐vigorous PA. We examined the relationships between PA intensity and frequency and the likelihood of having high BP in a population‐based cohort of adolescents from Montréal, Canada. PA was self‐reported every 3 months from grade 7 to 11, and BP was measured at ages 12.8, 15.2, and 17.0 years on average. We analyzed data from 993 participants (mean [SD] age = 16.0 [1.0], 51.6% female) with BP data at ages 15.2 and/or 17.0 years, using pooled ordinal logistic regression. BP (normal/elevated/hypertensive range) was the outcome, and past‐year PA intensity and frequency were potential predictors. Eight percent of participants had elevated BP (120‐129/<80), and 3.2% had BP in the hypertensive range (≥130/≥80). Participants engaged in a median (interquartile range) of 7.0 (4.5, 9.3) and 5.5 (2, 10.8) moderate and vigorous PA sessions/week, respectively. After adjusting for age, sex, mother's education, use of alcohol and cigarette consumption, engaging in PA more intense than light during the previous year was associated with a lower odds of having BP in the hypertensive range (ORs [95% CIs] = 0.93 [0.88, 0.97] to 0.97 [0.94, 0.99]). The relationships were not altered by adjusting for BMI. Our findings support recommendations that adolescents engage in at least moderate PA on a regular basis to prevent development of BP in the hypertensive range.     

Reduced risk for overweight and obesity in 5- and 6-y-old children by duration of sleep--a cross-sectional study

OBJECTIVE: To assess the relationship between sleep duration and adiposity in 5- and 6-y-old Bavarian children. DESIGN: Cross-sectional study. SUBJECTS: A total of 6862 German children aged 5-6 y participating in the obligatory health examination in Bavaria, southern Germany. MEASUREMENTS: Routine data were collected on the height and weight of children at the time of school entry in six public health offices in 1999 and in another two in 2000. Body fat mass was estimated by BIA performed in three of those offices. An extensive questionnaire was given to all children's parents in order to assess risk factors for overweight and obesity. The main outcome measures were overweight, defined by a body mass index (BMI) above the 90th centile and obesity, defined by a BMI above the 97th centile for the German children in Bavaria. Excessive body fat was defined as fat mass above the 90th centile for all German children seen in this survey. The main exposure was usual sleeping hours on week days. RESULTS: The prevalence of obesity decreased by duration of sleep: < or =10 h, 5.4% (95% CI 4.1-7.0), 10.5-11.0 h, 2.8% (95% CI 2.3-3.3), and > or =11.5 h, 2.1% (95% CI 1.5-2.9). Similar relations were found with the prevalence of overweight and excessive body fat. These effects could not be explained by confounding due to a wide range of constitutional, sociodemographic and lifestyle factors. The adjusted odds ratio for obesity were: for sleeping 10.5-11.0 h, 0.52 (95% CI 0.34-0.78) and 0.46 (95% CI 0.28-0.75) for sleeping 11.5 h. CONCLUSION: The effect of sleep duration on obesity in children reflects a higher body fat composition and appears to be independent of other risk factors for childhood obesity.     

Diagnostic value of maximal-outer-diameter and maximalmural-thickness in use of ultrasound for acute appendicitis in children

MM： To evaluate the maximal-outer-diameter （MOD） and the maximal-mural-thickness （MMT） of the appendix in children with acute appendicitis and to determine their optimal cut-off values to diagnose acute appendicitis.
METHODS： In total, 164 appendixes from 160 children between 1 and 17 years old （84 males, 76 females; mean age, 7.38 years） were examined by high-resolution abdominal ultrasound for acute abdominal pain and the suspicion of acute appendicitis. We measured the MOD and the MMT at the thickest point of the appendix. Patients were categorized into two groups according to their medical records： patients who had surgery （surgical appendix group） and patients who did not have surgery （non-surgical appendix group）. Data were analyzed by MedCalc v.9.3. The rank sum test （Mann-Whitney test） was used to evaluate the difference in the MOD and the MMT between the two groups. ROC curve analysis was used to determine the optimal cut-off value of the MOD and the MMT on diagnosis of acute appendicitis.
RESULTS： There were 121 appendixes （73.8%） in the non-surgical appendix group and 43 appendixes （26.2%） in the surgical appendix group. The median MOD differed significantly between the two groups （0.37 cm vs 0.76 cm, P〈 0.0001）, and the median MMT also differed （0.15 cm vs 0.33 cm, P 〈 0.0001）. The optimal cut-off value of the MOD and the MMT for diagnosis of acute appendicitis in children was 〉 0.57 cm （sensitivity 95.4%, specificity 93.4%） and 〉 0.22 cm （sensitivity 90.7%, specificity 79.3%）, respectively.
CONCLUSION： The MOD and the MMT are reliable criteria to diagnose acute appendicitis in children. An MOD 〉 0.57 cm and an MMT 〉 0.22 cm are the optimal criteria.     

Validity and reproducibility of a questionnaire on physical activity and non-activity for school children in Mexico City

OBJECTIVE: To assess the validity and reproducibility of a self-reported questionnaire on physical activity and inactivity, developed for children aged 10-14 in Mexico City. MATERIAL AND METHODS: Between May and December 1996, a self-reported physical activity and inactivity questionnaire was developed and applied twice to a sample of 114 students aged 10 to 14, from a low and middle income population of Mexico City. The children's mothers completed the same questionnaire, and two 24-hour recalls of physical activity were used for comparison. Statistical analysis consisted of central tendency and dispersion measures and Pearson's correlation coefficient. RESULTS: Correlations between hours per day spent in physical activity and inactivity from the children's questionnaire and the 24-hour recall data, were 0.03 for moderate activity, 0.15 for vigorous activity, and 0.51 (p = 0.001) for watching television, adjusted by age, gender, town, and illness prior to the administration of the questionnaire. Compared to the 24-hour recall data, the questionnaire overestimated the time spent watching television, reading or participating in vigorous activity, and underestimated the time engaged in moderate activity. Statistically significant (p < 0.05) six-month reproducibility values were observed for watching television (r = 0.53), sleeping (r = 0.40), moderate (r = 0.38), and vigorous activity (r = 0.55). CONCLUSIONS: Among children of Mexico City aged 10-14, the questionnaire showed acceptable validity in estimating the time watching television, and acceptable reproducibility of the time watching television, vigorous and moderate activity.     

Factors associated with in-school physical activity among urban children with asthma

Objective: A cross-sectional study was conducted to determine if in-school physical activity (PA) varied by age, gender, weight and asthma status, participation in physical education (PE), outdoor recess, and other in-school PA among urban schoolchildren with asthma. Methods: PA was measured by tri-axial accelerometers. Height and mass were measured and overweight defined as BMI ≥85th percentile. Asthma impairment and risk were assessed as per national guidelines, and asthma status variable with three categories (mild, moderate, and severe) was created. Multivariable generalized linear mixed models adjusting for clustering due to school and student were fitted to identify variables predictive of PA. Results: 108 children with asthma participated. Children spent 374 minutes in school, of which 253 minutes were sedentary, 105 minutes in light PA, and 16 minutes in moderate-to-vigorous PA (MVPA). Only 3 participants reached the recommended ≥30 minutes/day of MVPA. Multivariable analysis revealed age, gender, participation in PE class, outdoor recess, and other in-school PA as independent predictors of PA. BMI and asthma status were not associated with PA. Conclusions: Children with asthma were mostly sedentary at school. Older children and girls were particularly at risk for inactivity. PE, recess, and other in-school PA participation are modifiable factors that should be targeted in school-based interventions aimed at increasing PA in this population.     

Original article: the influence of aspirin on the proaggregatory action of adrenaline after cardiopulmonary bypass in man

We recently showed that collagen-induced platelet aggregation (PA) is enhanced by adrenaline ex vivo following cardiopulmonary bypass in man. Collagen-induced PA is impaired following bypass and this may contribute to postoperative blood loss, and aspirin treatment may further aggravate bleeding. To determine the influence of aspirin on the proaggregatory action of adrenaline following bypass, we assessed the effect of aspirin on collagen-induced PA before and after bypass, and following adrenaline infusion after bypass. Using optical aggregometry and hirudinised platelet rich plasma, in non-aspirin-treated controls (n=6), collagen (1.0 pg/ml) induced PA (median amplitude; cm) was maximal before bypass (13.7) and impaired at 10 min after bypass (11.5, P=0.03). PA was inhibited by aspirin (1 mM) before bypass (7.2 vs 13.7, P=0.03), and following bypass in aspirin-treated controls (3.3 vs 11.5, P=0.03). In aspirin-treated patients given adrenaline after bypass (n = 6), PA before adrenaline was impaired to a similar extent as in aspirin-treated controls (2.4 vs 3.3), but was enhanced following intravenous adrenaline infusion (0.55-1.1 nmol kg(-1) min(-1)) for 3-10 min (5.2 vs 2.4, P=0.03), with no change in controls at 20 min post-bypass (4.1 vs 3.3). This study indicates that at normocalcaemia, adrenaline enhanced collagen-induced PA in aspirin-treated patients, despite impairment of PA, but only at a high concentration of collagen. These findings indicate that aspirin-treatment may further impair collagen-induced PA following bypass, by limiting the proaggregatory effect of adrenaline.     

Environmental correlates of physical activity in youth – a review and update

Obesogenic environments are thought to underlie the increased obesity prevalence observed in youth during the past decades. Understanding the environmental factors that are associated with physical activity (PA) in youth is needed to better inform the development of effective intervention strategies attempting to halt the obesity epidemic. We conducted a systematic semi-quantitative review of 150 studies on environmental correlates of youth PA published in the past 25 years. The ANalysis Grid for Environments Linked to Obesity (ANGELO) framework was used to classify the environmental correlates studied. Most studies retrieved used cross-sectional designs and subjective measures of environmental factors and PA. Variables of the home and school environments were especially associated with children's PA. Most consistent positive correlates of PA were father's PA, time spent outdoors and school PA-related policies (in children), and support from significant others, mother's education level, family income, and non-vocational school attendance (in adolescents). Low crime incidence (in adolescents) was characteristic of the neighbourhood environment associated with higher PA. Convincing evidence of an important role for many other environmental factors was, however, not found. Further research should aim at longitudinal and intervention studies, and use more objective measures of PA and its potential (environmental) determinants.     

Physical activity,functional ability,and disease activity in children and adolescents with juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is a chronic condition known to cause pain-related complications in youth and affect children’s physical functioning. There is no data in Arabic children with JIA about the impact of illness upon their physical activity. The objective of this study was to explore physical activity (PA) in children and adolescents with JIA compared with a healthy population and to examine associations between PA, functional ability, and disease activity. Our study included patients with JIA and group control aged between 8 and 17 years. The diagnosis was used according to the International League of Association of Rheumatology (ILAR) criteria 2001. Sociodemographic data and clinical features were collected. Physical activity level and energy expenditure were assessed with a 1-day activity diary and the metabolic equivalent (MET), respectively. Functional ability was assessed with the Moroccan version of the Childhood Health Assessment Questionnaire (CHAQ). Disease activity was measured using the Juvenile Arthritis Disease Activity Score (JADAS). Fifty patients and 50 controls were included (mean?±?SD age 11.5?±?3.3 and 10.5?±?3.8 years, respectively; p?=?0.49) with masculine predominance n?=?30 (59.6 %) and n?=?29 (58 %), respectively (p?=?0.26). The median disease duration was 4.3 years (2–5). The median analog scale (VAS) pain was 20 (10–40). Fourteen patients (28 %) had an active disease. Patient population consisted in majority of oligoarticular arthritis (28 %), 14 patients. The mean of energy expenditure and physical activity were significantly higher in the JIA group. The JIA group spent more time in bed and less time on moderate to vigorous PA than the control group. There is no significant relationship between PA, functional ability, and disease activity. Our study suggests that children and adolescents with JIA have low PA levels and are at risk of losing the benefits of PA. Low PA is not related to functional ability, disease duration, and disease activity in children and adolescent with JIA. A large cohort is necessary to confirm these results.     

Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982-1997

OBJECTIVE: To examine the prevalence of overweight and obesity in the entire population of 5- and 6-y-old children entering school in Germany, Bavaria, and to assess time trends over the last 15 y and the impact of ethnicity. DESIGN: Cross-sectional studies were based on the obligatory school entry health examinations: all health districts of Bavaria in 1997 (n=127 735); three health districts every 5 y from 1982 to 1997 (n=16 281). MEASUREMENTS: Body mass index (BMI; kg/m(2)) was calculated and the prevalence of overweight and obesity was defined based on national and international agreed cut-off points. Ethnicity was measured as German and non-German nationality. RESULTS: The prevalence of overweight and obese children as defined by international reference values was 9.4 and 3.1% for 5-y-old boys, 10.0 and 2.9% for 6-y-old boys, 12.2 and 3.3% for 5-y-old girls and 12.4 and 3.3% for 6-y-old girls. The whole BMI distribution in non-German children compared to German children was shifted to the right with median values in non-German children 0.3-0.5 kg/m(2) higher. In these the prevalence of overweight/obesity was 1.9/2.4 times higher for boys and 1.5/1.9 times higher for girls. The time trend between 1982 and 1997 shows an increase of the BMI distribution in the upper percentiles, whereas the lower percentiles did not change substantially. The increased prevalences of overweight/obesity for both sexes as defined by international references increased from 8.5/1.8% in 1982 to 12.3/2.8% in 1997. CONCLUSION: This large study on all children entering school in Bavaria in 1997 shows patterns of overweight and obesity which are comparable with other European data but are lower than US and Australian data. Increasing prevalences since 1982 indicate that overweight and obesity in children are of increasing public health importance in Bavaria. The upwards shift of the BMI distribution in non-German children needs further investigation.     

Cardiovascular fitness and physical activity in children with and without impaired glucose tolerance

OBJECTIVE: To examine differences in cardiovascular fitness (VO(2max)) and physical activity levels in overweight Hispanic children with normal glucose tolerance (NGT) vs impaired glucose tolerance (IGT). PARTICIPANTS: A total of 173 overweight (BMI percentile 97.0 +/- 3.1) Hispanic children ages 8-13 years with a family history of type 2 diabetes. METHODS: VO(2max) was measured via a maximal effort treadmill test and open circuit spirometry. Physical activity was determined by questionnaire. Glucose tolerance was established by a 2-h oral glucose challenge (1.75 g of glucose/kg body weight). IGT was defined from an oral glucose tolerance test as a 2-h plasma glucose level > or =140 and <200 mg/dl. RESULTS: IGT was detected in 46 of the 173 participants (approximately 27%); no cases of type 2 diabetes were identified. No significant differences were found between youth with NGT and those with IGT in absolute VO(2max) (2.2 +/- 0.6 vs 2.1 +/- 0.5 l/min), VO(2max) adjusted for gender, age, and body composition (2.2 +/- 0.2 vs 2.1 +/- 0.2 l/min), or recreational physical activity levels (8.7 +/- 8.2 vs 6.9 +/- 6.2 h/week). CONCLUSION: Overweight Hispanic youth with IGT exhibit similar levels of VO(2max) and physical activity compared to their NGT counterparts. Longitudinal analyses are necessary to determine whether fitness/activity measures contribute significantly to diabetes risk over time in this group.     

Physical activity, leisure habits and obesity in first-grade children.

BACKGROUND: Overweight and obesity are already on the rise in early childhood years. The relationships between genetic factors, malnutrition and physical inactivity are the underlying mechanisms. In this study, we examine the association between body indices, motor abilities and active (sport) and passive (television/computer) leisure time activities in a cohort of first-grade pupils. METHODS: The study group consisted of 344 children (51.5% male, 48.5% female). They were 6.8+/-0.4 years old, height was 123.9+/-4.9 cm, weight 24.8+/-5.0 kg, body mass index (BMI) 16.1+/-2.3 kg/m. After determination of the anthropometric data, a fitness test was performed in order to determine motor abilities. Parents were questioned about their children's leisure time activities, using a standardized questionnaire. Differences between BMI groups were evaluated using multivariate ANCOVA, adjusted for gender and age. RESULTS: Based on German BMI references, overweight and obesity were found in 12% of the children. They had poorer results with respect to endurance (P<0.001), leg strength (P=0.002), co-ordination and balance (P=0.045) and spent more leisure time in watching television and at the computer (each P<0.001). No differences were found between their active leisure habits such as club sports. DISCUSSION: Our examinations with first-grade children show no differences in active leisure habits between obese children and their counterparts, although the former had poorer results in motor abilities, but they spend more time on sedentary leisure habits like audiovisual media. A possible explanation is their fewer regular daily activities.