Physical activity levels of high school students --- United States, 2010

Healthy People 2020 (HP 2020), released in December 2010, outlines numerous public health objectives, including objectives for youth physical activity participation (1). HP 2020 includes three objectives for meeting current federal physical activity guidelines for 1) aerobic physical activity (participation in ≥60 minutes of aerobic activity per day, 7 days per week) (PA 3.1); 2) muscle-strengthening activity (muscle-strengthening activities on ≥3 days per week) (PA 3.2); and 3) aerobic physical activity and muscle-strengthening activity combined (PA 3.3) (1,2). The HP 2020 target for PA 3.1 is 20.2%; targets for PA 3.2 and PA 3.3 are not set because baseline data are not available. To meet the HP 2020 targets for physical activity, promotion of physical activity among female high school students (3), high school students in upper grades (3), and youths with obesity (4) might be warranted, given that these subpopulations are at risk for low levels of physical activity. To determine the proportion of U.S. youths who meet these HP 2020 objectives, CDC analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS), a school-based study conducted by CDC that included height and weight measurements and a survey that measured physical activity and dietary behaviors among a nationally representative sample of students in grades 9--12. This report summarizes the results of that analysis, which indicated that among students nationwide in grades 9--12, 15.3% met the aerobic objective, 51.0% met the muscle-strengthening objective, and 12.2% met the objective for both aerobic and muscle-strengthening activities. To improve youth physical activity participation, efforts are needed among CDC, state and local public health agencies, schools, and other public health partners that promote physical activity.     

中国2015年在校儿童青少年24 h活动水平与超重肥胖的关联

  目的  分析中国7~18岁在校儿童青少年身体活动、视屏行为和睡眠组合达标情况与超重肥胖的相关性,为促进学校超重肥胖防控工作提供依据。  方法  使用2015年中国健康和营养调查数据,依据《加拿大儿童青少年24 h活动指南》对946名7~18岁在校儿童青少年身体活动、视屏行为和睡眠时间的达标情况进行分类,并采用Logistic回归模型分析各行为达标情况及行为组合达标情况与超重肥胖的相关性。  结果  儿童青少年超重肥胖率为21.56%;身体活动、视屏行为和睡眠达标率分别为24.84%,38.69%和57.08%,3类行为组合达标率为6.77%。校正年龄、性别、城乡和民族后,睡眠达标及睡眠与视屏行为组合达标分别与超重肥胖风险呈负相关(OR值分别为0.73,0.58,P值均 < 0.05),但其他行为及行为组合与超重肥胖率相关性无统计学意义。  结论  儿童青少年24 h活动达标率较低,充足睡眠或有助于降低超重肥胖风险。今后研究需注意睡眠和视屏行为的潜在联合作用以及两类行为在儿童超重肥胖防控中的应用。     

Physical activity, smoking, and obesity among Canadian school youth. Comparison between urban and rural schools

BACKGROUND: More information is needed to document the prevalence of health risk factors in youth. The purpose of this study is to compare the prevalence of physical inactivity, smoking and overweight/obesity among youth in urban and rural schools. METHODS: Data were obtained from a Student Physical Activity and Smoking Survey of 2,697 high school students in four urban schools in Ontario and four rural schools in Alberta. Prevalence of physical inactivity was assessed by examining compliance with Canada's Physical Activity Guide to Healthy Active Living, and with daily energy expenditure classification values. Prevalence of smoking was assessed by examining current smoking status. Overweight and obesity prevalences were examined by comparing BMI values to the BMI index for age and sex percentiles set by the Centers for Disease Control and Prevention. RESULTS: Physical activity prevalence was found to be low in our study, with only 57.0% of youth achieving Canada's Physical Activity Guidelines, and with 26.0% classified as sedentary based on the daily energy expenditure classification values. A higher proportion of rural students reported "trying smoking" than urban school students (73.0% versus 64.4%, p<0.001). A significantly higher proportion of rural males were 'overweight' than urban males, and a significantly higher proportion of rural females were 'obese' in comparison to urban females. CONCLUSION: Our findings add further support for an urgent need to promote physical activity among Canadian youth. Additionally, our results suggest that it is especially important to target rural students, particularly girls, for smoking prevention programs. Future studies are required to examine such rural and urban differences within provinces.     

Status of U.S. military retirees and their spouses toward achieving Healthy People 2010 objectives

PURPOSE: To assess the status of U.S. military retirees and their spouses 38 to 64 years of age relative to select Healthy People 2010 objectives and to identify sociodemographic characteristics associated with select health behaviors. DESIGN: Cross-sectional analyses with self-reported standardized measures from the U.S. Department of Defense Population Health Survey, 2003. SETTING: The continental United States. SUBJECTS: U.S. military retirees and their spouses 38 to 64 years of age. MEASURES: Data for this study were self-reported responses to the Population Health Survey. Dichotomous variables were created to indicate whether each Healthy People 2010 objective had been met. Each objective was measurable with the survey by using the definitions set forth in Healthy People 2010. These objectives included healthy weight and obesity based on body mass index (height and weight); daily fruit, vegetable, and grain-product consumption; physical inactivity, moderate physical activity, and vigorous physical activity; binge drinking; cigarette use; and smoking-cessation attempts. RESULTS: The study population did not meet any of the Healthy People 2010 objectives included in this study. Sociodemographic characteristics that were associated with this result included being male, not having a college degree, and a less-than-excellent self-reported general health status. CONCLUSION: Health-promotion interventions are needed to improve the health status of this population and to achieve the goals set forth in Healthy People 2010.     

天津市中学生体力活动睡眠时间及超重肥胖与抑郁症状的关系

目的 了解天津市中学生体力活动、睡眠时间、超重肥胖与抑郁症状的关系,为儿童青少年抑郁的干预提供理论依据。方法 于2019—2021年每年9月采用分层整群抽样方法,从天津市16个区抽取52 747名中学生进行问卷调查,问卷内容包括学生基本信息、抑郁症状、睡眠时间和体力活动时间。采用χ²检验和Logistic回归对数据进行分析。结果 天津市中学生抑郁症状检出率为19.07%,女生高于男生,城区高于农村,住校学生高于走读学生,留守学生高于非留守学生,差异均有统计学意义(χ²值分别为128.44,155.77,35.29,19.15,P值均<0.05)。天津市中学生超重检出率为20.64%,肥胖检出率为22.13%,一周体力活动时间合格率为49.54%,每天户外活动时间合格率为33.64%,睡眠时间合格率为25.77%。Logistic回归分析结果显示,一周体力活动时间合格、每天户外活动时间合格、睡眠时间合格、体质量指数(BMI)合格均与抑郁症状检出率呈负相关,其中睡眠时间合格抑郁症状检出风险最低(OR=0.60,95%CI=0.57～0.63...     

Physical activity trends in Queensland (2002 to 2008): are women becoming more active than men?

Objective: Regular monitoring of population levels of physical activity is an effective way to assess change over time towards meeting public health recommendations. The objective of this study was to determine physical activity trends in Central Queensland over the period 2002 to 2008. Methods: Data was obtained from the Central Queensland Social Survey (CQSS) conducted annually from 2002 to 2008. A total sample of 8,936 adults aged 18 and over participated in seven cross‐sectional surveys. Physical activity was measured using the Active Australia Questionnaire. Binary logistic regression was used to examine trends in sufficient physical activity. Results: Averaged over all survey years 46.5% of study participants met national physical activity guidelines. A small significant upward trend was found for meeting physical activity recommendations across all years (OR=1.03; 95%CI=1.01–1.05), indicating that the odds of meeting the guidelines increased by an average of 3% per year from 2002 to 2008. Slightly more men than women met the activity guidelines (ns); however a significant positive trend in achieving sufficient activity levels was present in women only (4%). Conclusions and Implications: Although an increasing trend for sufficient physical activity was observed, overall physical activity levels in Central Queensland remain suboptimal and more efforts to increase physical activity are needed. The gender differences in physical activity trends indicate that men and women might need to be targeted differently in health promotion messages. The continuous monitoring of population levels of physical activity in Australia, which allow both state specific and international comparisons, is needed.     

Differences in food intake and exercise by smoking status in adolescents

BACKGROUND: Smoking, diet, and lack of exercise are the top preventable causes of death in the United States. Some 23% of high school students currently smoke and many teens do not meet Healthy People 2010 standards for healthy eating or physical activity. This study examined the relationship between smoking and the consumption of fruit, vegetables, milk/dairy products and the frequency of exercise in 10,635 Virginia youth. METHODS: Survey data were collected from middle school (MS; n = 8022) and high school (HS; n = 2613) adolescents participating in youth tobacco prevention/cessation programs. Data were analyzed using chi-square bivariate tests and multivariate regression models. RESULTS: Smokers were significantly less likely than nonsmokers to exercise > or = 3x week and to consume > or = 1 serving/day of vegetables or milk/dairy products. This was more evident in high school than middle school students and in females compared to males. In both HS and MS, a dose-response relationship was detected with higher level smoking associated with lower frequency of eating specified food and exercise. CONCLUSIONS: Smoking is associated with compromised intake of healthy food and exercise. To decrease incident cases of chronic disease later in life, new tailored, innovative interventions are needed that address multiple health behaviors in youth.     

Do childcare menus meet nutrition guidelines? Quantity,variety and quality of food provided in New Zealand Early Childhood Education services

Objective: To describe food provision and evaluate menus in New Zealand childcare services, determining associations with service characteristics and/or cost of menu. Methods: Licensed services in three regions of New Zealand participated in an online survey, uploading a weekly menu where applicable. Menus were scored for compliance with guidelines on quantity, variety and quality of foods served. Bivariate and multivariate associations between menu score and service characteristics were analysed. Results: A total of 257 services participated (30% of 847 services invited). Food was provided daily in 56%, with 34% providing lunch and snacks daily. Of the 57 full menus analysed, only three (5%) met all 10 scoring criteria (mean score of 6.8/10). Higher menu scores were statistically associated with employing a cook, high and low (not medium) neighbourhood deprivation, the Heart Foundation's Healthy Heart Award program; there was no association with food costs. The Healthy Heart Award remained statistically associated with higher menu score after adjustment for other service characteristics. Conclusion: Most menus did not meet current nutrition guidelines for quantity, variety, and limiting ‘sometimes’ and ‘occasional’ foods. Implications for public health: This study provides a baseline for monitoring menu compliance in New Zealand and evidence for nutrition promotion and menu improvement programmes in early education.     

京津冀地区儿童青少年体力活动视屏和睡眠时间与超重肥胖的关系

  目的  了解京津冀地区儿童青少年体力活动、视屏和睡眠状况及其与超重肥胖的关系,为京津冀地区儿童青少年保持健康体型提供参考和借鉴。  方法  2019年11月借助全国学生体质健康调研工作,参考儿童青少年体力活动指南对京津冀地区4 262名中小学生进行体力活动、睡眠状况、视屏时间调查,并采用Logistic回归分析其与超重肥胖之间存在的关联。  结果  京津冀地区儿童青少年超重肥胖检出率为22.03%;其中超重检出率12.01%,肥胖检出率10.02%。男生(26.09%)超重肥胖检出率高于女生(17.88%),差异有统计学意义(χ2=41.77,P < 0.01);城市(24.09%)和汉族(22.74%)儿童青少年超重肥胖检出率高于乡村(21.05%)和少数民族(17.70%),差异均有统计学意义(χ2值分别为5.00,7.63,P值均 < 0.05)。体力活动时间合格率为24.85%,视屏时间合格率为38.69%,睡眠时间合格率为57.09%。体力活动时间、视屏时间、睡眠时间3项均不合格的比例为21.68%,1项合格和2项合格分别占42.80%和28.77%,3项均合格的仅占6.76%。Logistic回归分析显示,睡眠时间合格与超重肥胖发生的风险呈负相关(OR=0.72,95%CI=0.52~0.98);与睡眠时间和视屏时间均未合格者相比,2项合格与超重肥胖的发生风险呈负相关(OR=0.57,95%CI=0.36~0.87)。  结论  京津冀地区儿童青少年体力活动时间合格率较低,保障睡眠时间将对超重肥胖的发生起到保护作用。应注重睡眠时间和视屏时间对儿童青少年超重肥胖的影响,并在以后的防控和干预中得以应用。     

Self-Reported Dietary Intake of Youth with Recent Onset of Type 2 Diabetes: Results from the TODAY Study

Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in young people with type 2 diabetes. The objectives of our study were to assess dietary intake among a large, ethnically diverse cohort of young people with type 2 diabetes and compare intake to current recommendations. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is a multicenter randomized clinical trial of 699 youth aged 10 to 17 years. At baseline, following a run-in period that included standard diabetes education, diet was assessed using a food frequency questionnaire between 2004 and 2009. Analysis of variance and nonparametric tests were used to compare mean and median nutrient intakes; logistic regression was used to compare the odds of meeting predefined dietary intake recommendation cutpoints between subgroups of age, sex, and race–ethnicity. Percent of energy from saturated fat was consistently 13% to 14% across all subgroups—substantially exceeding national recommendations. Overall, only 12% of youth met Healthy People 2010 guidelines for intake of <10% of energy from saturated fat and only 1% of youth met American Diabetes Association recommendations for intake of <7% of energy from saturated fat. Dietary intake fell substantially below other Healthy People 2010 targets; only 3% met calcium intake goals, 11% met fruit consumption goals, 5% met vegetable consumption goals, and 67% met grain intake goals. Overall, dietary intake in this large cohort of young people with type 2 diabetes fell substantially short of recommendations, in ways that were consistent by sex, age, and race–ethnicity. The data suggest a critical need for better approaches to improve dietary intake of these young people.     

Eating Patterns and Leisure-Time Exercise among Active Duty Military Personnel: Comparison to the Healthy People Objectives

ObjectiveTo assess whether active duty military personnel meet Healthy People 2010 objectives for physical activity and fruit, vegetable, and whole-grain intake; the relationship of select demographic characteristics, lifestyle factors (eg, smoking), and eating patterns (eg, frequency and location of meals) on achieving diet and exercise-related Healthy People 2010 objectives; and the relationship of eating patterns to self-reported weight gain.MethodsSecondary data from 15,747 participants in the 2005 Department of Defense Health Related Behaviors Survey was analyzed.ResultsMore than 57% of respondents met the Healthy People 2010 guidelines for moderate or vigorous leisure exercise but only 3% reported eating fruit (once), vegetables (3 times), and whole grains (3 times) daily. Individuals who reported gaining weight during the previous year were more likely to skip breakfast and eat at, or from, a restaurant ≥2 times per week compared with those who did not gain weight (P<0.001). Regression analysis indicated that women were more likely to eat fruits (odds ratio [OR] 1.25) and vegetables (OR 1.20) and less likely than men to eat whole grains (OR 0.76) or engage in moderate or vigorous exercise (OR 0.71). Military personnel who skipped breakfast ≥2 times per week (OR 0.45) or ate at a restaurant/takeout food (OR 0.54) ≥2 times per week were significantly less likely to meet Healthy People 2010 guidelines for food intake (defined as achieving a daily intake of one or more fruits, three or more vegetables, and three or more servings of whole grains) and exercise (OR 0.88 and 0.82, respectively).ConclusionsAlthough the majority of military personnel met guidelines for physical activity, their intake of fruits, vegetables, and whole grains was suboptimal. Skipping breakfast and eating at, or from, restaurants were risk factors for poor nutrient intake and associated with weight gain. These data suggest that skipping breakfast and eating out deter achieving Healthy People 2010 objectives and provide targets for military programs to promote achieving these objectives.     

School-based opportunities for physical activity in West Virginia public schools

BACKGROUND: Schools have the unique potential to provide numerous opportunities for promoting physical activity. This article describes findings from a statewide survey of opportunities for physical activity in West Virginia (WV) schools. The purpose was to provide baseline data for two of the WV Healthy People 2010 objectives related to schools and youth to identify priorities for action. METHOD: Survey questions were adapted from the 2000 School Health Policies and Programs Study (SHPPS), conducted by CDC. Random stratified sampling across school level and size resulted in a final sample of 296 elementary schools, 146 middle and junior high schools, and 124 high schools (total = 566). The overall response rate was 73%. RESULTS: Eleven percent of elementary, 2% of middle or junior high, and 31% of senior high schools met the SHPP's criterion of providing daily physical education. Ninety-four percent of elementary schools reported offering daily recess. Overall, 42.3% of schools provided student and community access to indoor facilities outside of normal school hours, while 80.7% of schools provided access to outdoor facilities beyond normal school hours. CONCLUSIONS: Survey results are being used to target increased physical education in elementary schools and increased opportunities beyond physical education at all school levels.     

Prevalence and socio-demographic correlates of the compliance with the physical activity guidelines in children and adolescents in Germany

ABSTRACT: BACKGROUND: Regular physical activity (PA) is a prerequisite for normal growth and maturation, health, and fitness of children and adolescents. Because of the growing evidence of the health benefits of regular PA, several national and international public health organisations have established PA guidelines. The purpose of this study was to assess the percentage of children and adolescents in Germany who meet the PA guideline of 60 minutes of moderate-to-vigorous PA each day and to evaluate socio-demographic correlates of compliance with the PA guideline. METHODS: The sample consists of 4,529 children and adolescents aged between 4 and 17 years who lived and were registered in the Federal Republic of Germany between 2003 and 2006. The compliance with the PA guideline was assessed using a widely accepted screening measure. Socioeconomic status, immigration background and residential area were assessed using a parent questionnaire. RESULTS: Overall, 13.1% of girls and 17.4% of boys complied with the national guideline of 60 minutes of moderate-to-vigorous PA daily. While compliance was significantly lower in older participants of both gender groups, the steepest decrease in compliance was observed for age groups around the transition time from primary to secondary school. Logistic regression revealed that socioeconomic status and a migration background were significant predictors for compliance in girls and residential area for compliance in boys. CONCLUSIONS: Programs and policy action addressing the problem of decreasing compliance with PA guideline with increasing age are warranted. The transition from primary school to secondary school seems to be a critical stage in life with respect to PA behaviour. Therefore, specific interventions should aim at restructuring and reorganising their daily and physical activities during this transition.     

Factors that Influence Physicians’ and Medical Students’ Confidence in Counseling Patients About Physical Activity

Less than half of US adults and two-thirds of US high school students do not meet current US guidelines for physical activity. We examined which factors promoted physicians’ and medical students’ confidence in counseling patients about physical activity. We established an online exercise survey targeting attending physicians, resident and fellow physicians, and medical students to determine their current level of physical activity and confidence in counseling patients about physical activity. We compared their personal level of physical activity with the 2008 Physical Activity Guidelines of the US Department of Health and Human Services (USDHHS). We administered a survey in 2009 and 2010 that used the short form of the International Physical Activity Questionnaire. A total of 1,949 individuals responded to the survey, of whom 1,751 (i.e., 566 attending physicians, 138 fellow physicians, 806 resident physicians, and 215 medical students) were included in this analysis. After adjusting for their BMI, the odds that physicians and medical students who met USDHHS guidelines for vigorous activity would express confidence in their ability to provide exercise counseling were more than twice that of physicians who did not meet these guidelines. Individuals who were overweight were less likely to be confident than those with normal BMI, after adjusting for whether they met the vigorous exercise guidelines. Physicians with obesity were even less likely to express confidence in regards to exercise counseling. We conclude that physicians and medical students who had a normal BMI and met vigorous USDHHS guidelines were more likely to feel confident about counseling their patients about physical activity. Our findings suggest that graduate medical school education should focus on health promotion in their students, as this will likely lead to improved health behaviors in their students’ patient populations.     

Formal consensus and consultation: a qualitative method for development of a guideline for dementia.

OBJECTIVES: To use a formal consensus method--the nominal group technique--for developing a clinical practice guideline to improve the diagnosis, needs assessment, and management of dementia at the primary/secondary care interface. To assess the usefulness of this method in an area where there is a dearth of clinical trials thus precluding an evidence-based approach. DESIGN: A qualitative and iterative method was used. The guideline was developed by an expert panel using the nominal group technique, incorporating the deliberations of a Primary Care Professionals' Task Group, recent reviews in the scientific literature, information from semistructured interviews with local specialists, and a local questionnaire survey. SETTING: Mainly Bristol but incorporating other parts of the United Kingdom especially the south and west. SUBJECTS: Expert panel group (including users and non-statutory organisations), local general practitioners (GPs), professionals carrying out the health check for people over 75, local geriatricians and psychogeriatricians, and primary care professionals with an interest in dementia. MAIN MEASURES: Items important in dementia from the nominal group in response to three questions on diagnosis, needs assessment, and management, ranked into a series of top 10 items for each area and allocated a score according to relative importance to each member; summary outputs from the questionnaire survey, semistructured interviews, and primary care professionals' task group. RESULTS: A clinical practice guideline covering diagnosis, needs assessment, and management of dementia in primary care was produced in the form of an algorithm and a management sheet. CONCLUSIONS: A formal consensus method can be used as an acceptable alternative to the evidence-based approach when developing guidelines in situations in which evidence is scarce, in which the guideline is intended as an aid in linking different stages of care, and in which practical and political considerations--such as the links between agencies--are important.     

视力障碍青少年身体活动水平和久坐时间调查

了解中国视力障碍青少年日常身体活动模式和久坐行为时间,为指导学生科学合理安排作息时间提供参考.方法 采用加速度计对中国西部地区某特殊教育学校78名7~23岁视力障碍青少年的身体活动水平和模式进行测量.结果 男女生相比,男生身高略高、身体略重(t值分别为2.81,2.46,P值均<0.05).基于Puyan等加速度计切点值,学生平均每天进行轻度身体活动(light physical activity,LPA)时间为(285.18±47.29) min,中等强度身体活动(moderatephysical activity,MPA)时间为(141.92±57.63) min,高强度身体活动(vigorous PA,VPA)时间为(17.66± 14.83) min,中高强度身体活动(moderate-to-vigorous-intensity physical activity,MVPA)时间为(159.58±69.83) min,久坐时间为(988.38±110.18)min.98.7%的受试者达到了WHO关于青少年每天应至少进行60 min中等及以上强度的身体活动的推荐量.结论 中国西部地区特殊学校视障青少年每日进行促进身体健康的身体活动,身体活动水平达到且超过WHO身体活动推荐量.     

Regional differences in movement behaviours of children and youth during the second wave of the COVID-19 pandemic in Canada: follow-up from a national study

ObjectivesPublic health restrictions varied by region during the COVID-19 pandemic and reduced opportunities for children to be physically active. The purpose of this study was to assess regional differences in movement behaviours of Canadian children and youth during the second wave of the COVID-19 pandemic.MethodsA national sample of Canadian parents (n=1568; 58% women) of children and youth (5–17 years of age) completed an online survey. Participants were classified based on region of residence (British Columbia, Prairies, Ontario, Quebec, or Atlantic Canada). Differences in movement and play behaviours (physical activity, outdoor play, sleep, screen time) between children and youth living in different regions were examined.ResultsCompared to children and youth in Quebec (the region with the highest COVID-19 prevalence), children and youth in the Prairies (F_(1,1563)=9.0, p=0.01) and Atlantic Canada (F_(1,1563)=17.1, p<0.001) participated in more moderate-to-vigorous physical activity (MVPA). Compared to Quebec, living in Atlantic Canada increased the odds of meeting the MVPA guideline (odds ratio (OR)=2.1, p=0.02), living in Ontario decreased the odds of meeting the sleep guideline (OR=0.6, p=0.01), and living in Ontario (OR=0.7, p=0.04) or Atlantic Canada (OR=0.6, p=0.049) decreased the odds of meeting the screen time guideline. Children and youth in Atlantic Canada demonstrated smaller declines in outdoor play than their counterparts in Quebec.ConclusionMovement and play behaviours varied between regions of Canada where the highest COVID-19 prevalence corresponded to lower odds of meeting the physical activity guidelines. Low compliance with 24-hour movement guidelines suggests that regional pandemic recovery plans need to prioritize opportunities for healthy movement.     

Dietary and physical activity behaviors of middle school youth: the youth physical activity and nutrition survey

BACKGROUND: Obesity has become a national epidemic among youth. Declining physical activity and poor nutrition contribute to this epidemic. The purpose of this study was to obtain data on middle school students' physical activity and nutrition knowledge and practices. METHODS: The Youth Physical Activity and Nutrition Survey was developed and distributed to a probability sample of Florida public middle schools (n = 73) in spring 2003, producing data from 4,452 students in grades 6-8. RESULTS: Results showed that less than one fourth of youth met expert recommendations for daily fruit and vegetable intake and less than one fifth identified the daily fruit and vegetable serving recommendation. Less than half of students reported eating breakfast daily. More non-Hispanic black youth reported not engaging in vigorous or moderate physical activity during the previous 7 days, and more girls and Hispanic youth reported not attending any physical education classes during the average school week. CONCLUSION: These findings demonstrate that dietary and physical activity behaviors and knowledge among these middle school youth are setting the stage for the obesity epidemic to continue.