应用德尔菲法构建中国7~18岁学生身体活动核心信息

  目的  构建中国7~18岁学生身体活动核心信息,为提高儿童青少年身体活动水平提供依据。  方法  以《加拿大儿童青少年24小时活动指南》为基础框架,在定性研究的基础上,初步形成中国7~18岁学生身体活动核心信息,涵盖身体活动、久坐行为和睡眠3个维度。身体活动包括频度、强度、时间和类型4个主题内容,久坐行为和睡眠包括时间1个主题内容。采用德尔菲法进行3轮咨询。第2轮咨询中,将2014年全国学生体质与健康调研数据分析结果呈现给专家参考。第3轮咨询中,专家通过层次分析法分年龄段对身体活动类型主题下的7项身体素质重要性进行排序。  结果  3轮德尔菲法分别咨询专家25,25和18名;专家问卷回收率分别为100.0%,100.0%,94.4%;专家权威系数分别为0.92,0.93,0.91;Kendall协调系数W值分别为0.63(χ2=237.10,P < 0.01)、0.63(χ2=242.60,P < 0.01)和0.76(χ2=97.05,P < 0.01)。推荐中国7~18岁学生每天进行中、高强度身体活动累计至少达到60 min,以有氧运动为主。其中,每周至少3 d进行高强度身体活动、增强肌肉力量和骨骼健康的身体活动。小学生每天日间户外活动至少2 h,中学生每天日间户外活动至少1 h,推荐2 h。7~12岁学生应多进行增强柔韧素质、协调素质和灵敏素质的身体活动,13~18岁学生应多进行增强力量素质、耐力素质和速度素质的身体活动。久坐行为包括时间1个主题内容,学生应减少久坐行为,尽可能打断长时间久坐行为,控制娱乐性视屏时间和线上学习时间。睡眠包括时间1个主题内容,学生每晚应保证时间适量、不间断的睡眠。  结论  建立中国7~18岁学生身体活动核心信息可以为提高儿童青少年身体活动水平,促进儿童青少年身体健康提供参。     

国际儿童早期24h运动指南的制定与初步解读

儿童早期增加身体活动,减少久坐时间,确保睡眠质量,将促进他们的身心健康和福祉。鼓励儿童养成积极健康的生活方式,每天保持睡眠、久坐行为和体育活动的平衡,以支持他们的健康发展至关重要。国际上《儿童早期24 h运动指南》推荐婴幼儿每天应该花多少时间参与身体活动和高质量的睡眠时间,并提供限制久坐的时间和方法。以加拿大和澳大利亚两国儿童早期24 h运动指南的特征、研制思路、方法和原则进行推介和解读,对研制符合中国国情的《0～6岁儿童24 h运动指南》具有一定的理论参考价值和借鉴作用。     

想要孩子茁壮成长家长这么做

世界卫生组织发布了5岁以下儿童身体活动、久坐行为和睡眠指南。该指南指出,5岁以下儿童尽量少坐在电子屏幕前,或被限制在婴儿车和座位上,有更好的睡眠,有更多玩耍的时间,才能更健康地成长。     

中国儿童青少年身体活动现状及相关影响因素

了解我国儿童青少年身体活动现状及相关影响因素,为提高儿童青少年身体活动水平、增进体质健康提供依据.方法 收集“2014年6~69岁城乡居民体育健身活动及体质状况抽测公报”部分数据指标,采用SPSS 20.0描述分析我国6~19岁儿童青少年身体活动现状及特点,并对影响因素进行逻辑回归筛查.结果 仅8.9%的儿童青少年达到身体活动指南推荐量;每周参加校内外体育健身活动的人数比例达99.8%,但有效负荷低(近1/4运动时强度较小).课外体育活动(OR=6.57,95%CI=5.58~7.73)、校外体育锻炼(OR=6.11,95%CI=5.17~7.22)和体育课(OR=5.32,95%CI=4.49~6.31)是身体活动积极影响因素,做作业时间>2 h/d(OR=0.59,95%CI=0.44~ 0.80)与身体活动量呈负相关;保护因素为父母支持态度、教师带练或教练指导,限制因素为场地设施单一.结论 我国儿童青少年身体活动严重不足,应多角度引导和促进参与积极性身体活动,加强有效体育锻炼、减少静坐行为.     

减少学生非必要久坐行为推动体育和劳动教育生活化

久坐行为日趋发展成为生活常态,非必要久坐行为,尤其是娱乐型视屏行为累计过多,会严重危害人群健康,给社会带来沉重的疾病负担。提升减少久坐行为意识、施行减少久坐行为举措亟待落实。儿童青少年正处于行为习惯的高度可塑期,良好行为习惯的养成直接关系到民族未来人群的体质健康水平。近期,政府部门陆续出台相关政策,鼓励学生“体育、劳动教育”生活化,将政策、理论转化为实际行动尤为关键。     

儿童青少年身体活动与静态行为现状及建成环境关联研究进展

身体活动不足和静坐时间过长是目前国内外研究的热点问题,有必要归纳和总结国内外相关研究进展,进而概述身体活动不足与静态行为的关系,探究身体活动和静态行为对儿童青少年体质健康的影响,以及关联建成环境等重要因素的分析。研究认为,身体活动不足和长期静态行为是儿童青少年目前普遍存在的问题,为促进儿童青少年健康发展,通过改变建成环境增加身体活动、减少静态行为可能作为有效的干预手段和措施。     

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。     

天津市中学生日常行为与体质健康的关联性

目的 探讨以中学生身体活动、屏幕时间、睡眠时间构成的日常行为与体质健康之间的关系,为开展中学生体质健康干预提供参考。方法 采用分层随机整群抽样法,对天津市12所中学1 614名学生进行体质健康测试和日常行为调查,调查内容包括中学生的中高强度身体活动、屏幕时间和睡眠时间状况;参考《加拿大24小时活动指南》将受试者的行为划分为“全达标组”“达标2项组”“达标1项组”和“未达标组”4组;体质健康风险相关因素采用二元Logistic回归分析。结果 仅有5.2%的男生、4.2%的女生3项行为全达标,16.4%的男生、16.3%的女生3项行为均未达标;达标2项组和全达标组体质健康综合评价优良率分别占比77.7%,71.8%。中学生身体活动不足的体质健康风险是达标者的1.76倍,屏幕时间过长体质健康风险是达标者的1.34倍,睡眠时间不足体质健康风险是达标者的2.86倍、超重肥胖风险是达标者的1.49倍(P值均<0.05);与全达标的中学生相比,未达标组体质健康风险是其3.63倍,仅达标1项组是其2.10倍(P值均<0.01)。结论 中学生身体活动、屏幕时间和睡眠时间2项以上达标者更容易获...     

客观测量身体行为的大型人群队列研究进展与实践

受限于传统自我报告问卷测量方法的信、效度，身体行为（身体活动、久坐行为和睡眠）的准确测量受到很大限制。随着科学技术的发展，加速度计等客观测量设备能够更加准确、全面地测量身体行为相关特征，并逐渐为大规模流行病学研究所用。然而，我国乃至亚洲人群尚缺乏采集身体行为客观测量数据的大型队列研究。中国慢性病前瞻性研究（CKB）项目在第三次重复调查（2020年8月至2021年12月）使用Axivity AX3腕式三轴加速度计测量研究对象的日常活动及睡眠情况，最终共纳入全国10个项目地区20 370名研究对象，其中女性占65.2%，年龄（65.4±9.1）岁，不同项目地区研究对象的身体行为活动水平具有较大差异。CKB项目开展的身体行为客观测量数据为描述我国中老年人24 h身体行为特征、探究身体活动、久坐行为、睡眠的健康效应以及其与疾病的深入研究提供了具有重要价值的科研资源。     

儿童青少年身体素养对身体活动促进的意义

儿童青少年身体活动不足,与持续的体质下降及日益严重的肥胖、近视等健康问题密切相关,已成为全球性的公共卫生问题.儿童青少年身体活动促进受到体育科学和公共卫生领域的共同关注.然而,基于健康结果为导向的身体活动促进模式未能收到良好效果.本文基于身体素养概念、身体素养构成要素、直接与间接的证据阐述身体素养与儿童青少年身体活动促进的关系,并指出未来需要更多的实证研究,如开发中国不同年龄和身体状况的儿童青少年群体身体素养测评工具;开展身体素养与身体活动参与及健康关系的纵向研究;身体素养干预对身体活动行为及健康结局的直接影响.身体素养提升成为促进儿童青少年身体活动参与及体质健康的重要途径,降低因身体活动不足带来的公共卫生负担.     

The Health Indicators Associated With Screen-Based Sedentary Behavior Among Adolescent Girls: A Systematic Review

PurposeEvidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls’ sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity.MethodsA structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12–18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls.ResultsStrong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity.ConclusionsScreen-based sedentary behavior is associated with a range of adverse health consequences, but additional longitudinal studies are needed to better understand the health impacts. In addition, screen-time guidelines for youth should be regularly revised and updated to reflect rapid technological changes.     

北京市6～14岁儿童课余身体活动静态行为及睡眠现状

目的 了解北京市6～14岁儿童课余身体活动、静态行为及睡眠时间现状,为指导学龄儿童合理进行身体活动及制定有效干预措施提供参考依据。方法 采用多阶段分层整群随机抽样的方法,抽取北京市3 460名一、三、五及七年级中小学生进行营养与健康状况调查。通过问卷调查收集儿童及家庭的基本信息和儿童的身体活动、静态行为及睡眠等活动信息,并进行统计分析。结果 儿童每日课余身体活动(LTPA)时间的中位数为20.0(8.6, 38.6)min,郊区(18.6 min)和七年级儿童(14.3 min)相比城区及其他年级儿童LTPA时间更短(Z/H值分别为5.12,119.11,P值均<0.01)。儿童平均每日睡眠时间为(8.71±0.76)h,睡眠不足的儿童占比54.7%,随着年级的增加,睡眠不足发生率显著增加(χ²=407.13,P<0.01)。学生每日静态行为时长中位数为195.7(145.0, 255.7)min, 84.5%的儿童每天有超过2 h的静态行为,城区(202.9 min)和肥胖儿童(210.4 min)相比郊区和其他体型儿童静态行为时间更长;且随着年级的...     

Identifying the most proximal multi-level factors associated with meeting each of the 24-h movement behavior recommendations in a sample of autistic adults

BackgroundAutistic adults have poorer 24-h movement behaviors, including lower levels of physical activity, more time spent being sedentary, and shorter sleep duration than neurotypical adults. Social ecological frameworks posit that 24-h movement behaviors are determined by multi-level domains; however, not known is which multi-level factors are most important to meeting each of the 24-h movement behavior guidelines among autistic adults.ObjectiveThis study examined the relative importance of a range of multi-level determinants on meeting guidelines for the 24-h movement behaviors of aerobic physical activity, sedentary behavior, and sleep.MethodsWe administered at cross-sectional electronic survey to a national self-selecting, convenience sample of autistic adults and caregivers of autistic adults residing in the USA. We used machine learning to examine the relative variable importance (VIMP) of 55 multi-level variables with meeting recommendations for physical activity, sedentary behavior, and sleep duration. VIMPs >0 indicate predictive variables/domains.ResultsA greater number of group activities attended in the last 3-months, and greater independence in completing activities of daily living were most important to meeting aerobic physical activity guidelines. Group activity participation and marital status were important to meeting sedentary behavior guidelines while having a fewer number of comorbidities was most important to achieving adequate sleep.ConclusionsThese data support hypotheses about the role of family and social level interventions targeting movement behaviors in autistic adults.     

学龄前儿童久坐行为时间与身体活动水平、心理健康状况的关系

目的 分析学龄前儿童久坐行为时间与身体活动水平、心理健康状况的关系,为制定针对学龄前儿童身体活动、心理健康的干预策略提供参考。方法 2019年1—12月选择本地区所辖幼儿园的145名学龄前儿童作为调查对象,用长处和困难问卷(SDQ)(父母版)、三轴加速度计及配套的ActiLife软件对本次全部调查对象开展调查,汇总心理健康状况异常检出率、久坐行为时间与身体活动水平,利用Pearson/Spearman相关分析法分析学龄前儿童久坐行为时间与身体活动水平、心理健康状况的相关性。结果 本地区学龄前儿童久坐行为时间较长(26.49±7.58)min/h,且主要集中在每日12:00-15:59;学龄前儿童身体活动水平总体以低强度身体活动为主,男生中强度身体活动比例最高,女生低强度身体活动比例最高,不同性别身体活动水平比较差异有统计学意义(χ²=10.504,P=0.005);学龄前儿童心理健康状况异常检出率为50.34%(73/145)。相关性分析结果显示:学龄前儿童久坐行为时间与身体活动水平呈负相关(r=-0.418,P＜0.001),与心理健康状况评分呈正相关(r=0.341,P＜0.001)。结论 学龄前儿童久坐行为时间与身体活动水平、心理健康状况关系密切,应通过提高本地区学龄前儿童身体活动水平,缩短久坐行为时间,进而促进心理健康。     

Sitzendes Verhalten als Risikofaktor im Kindes- und Jugendalter

Background

Sedentary behaviour is already very common in daily life of children and adolescents. An increasing number of studies within the public health context have examined issues around this topic and findings indicate that sedentarism and physical activity are independent behaviours.

Objective and methods

The objective of the current paper is to systematically introduce in terms of a behavioural epidemiology framework into the topic of sedentary behaviour in children and adolescents. The six phases of the framework are described based on a narrative compilation of currently available international reviews and original studies.

Findings and conclusions

From both a conceptual and a public health lens it is recommendable to consider sedentary behaviour as a meaningful indicator of interventions. However, sedentary behaviour is independent of the level of physical activity associated with physical and psychological health. In addition studies showed that it is possible to reduce sitting time through specific interventions. A lot of issues around sedentary behaviour have not been fully understood and researches are especially faced with challenges in terms of measurement and study design. To foster the reduction of sitting time it is necessary to understand the determinants of this behaviour and to examine the interaction and the effectiveness of intervention to reduce sitting time in addition to the promotion of physical activity.     

Resurgence of a New "Clean Living" Movement in the United States

During the late 19th century, a "clean living" movement emerged in the U.S. dominated by efforts to control alcohol consumption, tobacco use, and females' reproductive health. The movement also advocated proper diet, exercise and physical fitness, pure water, and moderation in caffeine and red meat consumption. Remarkably similar concerns have emerged again in contemporary American society. The current "movement" lacks central organization. Rather, it reflects a loosely related coalition of single-issue advocacy groups. Yet, the focus seems remarkably similar to the 19th century movement--legislative limitation of individual choice regarding personal health behavior, particularly with substance use and females' reproductive health. This article reviews the 19th century movement, describes aspects of the contemporary movement, and offers implications and recommendations for school health professionals.     

Examination of the factor structure of physical activity behaviors

Multiple physical activity recommendations exist for behaviors that vary in type and intensity (e.g., vigorous physical activity, strengthening exercises, moderate physical activity). The present study examined underlying dimensions of physical activity behaviors and determined the extent to which factors correspond to national health recommendations. Fifteen variables were drawn from six self-report measures and subjected to factor analysis with quartimax rotation. Participants were 547 university seniors (56% female; 60% Caucasian; mean age = 25 years). TV watching, the only index of sedentary behavior, did not load highly with other items, and was analyzed separately. Three interpretable factors were found: variables related to vigorous physical activity loaded highly on Factor 1; flexibility and strengthening items loaded highly on Factor 2; and moderate and housework activity loaded highly on Factor 3. Factors corresponded closely to national recommendations. Unweighted factor scores and TV watching correlated significantly with physiological indicators of fitness, supporting construct validity.     

Clustering of Dietary Patterns,Lifestyles, and Overweight among Spanish Children and Adolescents in the ANIBES Study

Weight gain has been associated with behaviors related to diet, sedentary lifestyle, and physical activity. We investigated dietary patterns and possible meaningful clustering of physical activity, sedentary behavior, and sleep time in Spanish children and adolescents and whether the identified clusters could be associated with overweight. Analysis was based on a subsample (n = 415) of the cross-sectional ANIBES study in Spain. We performed exploratory factor analysis and subsequent cluster analysis of dietary patterns, physical activity, sedentary behaviors, and sleep time. Logistic regression analysis was used to explore the association between the cluster solutions and overweight. Factor analysis identified four dietary patterns, one reflecting a profile closer to the traditional Mediterranean diet. Dietary patterns, physical activity behaviors, sedentary behaviors and sleep time on weekdays in Spanish children and adolescents clustered into two different groups. A low physical activity-poorer diet lifestyle pattern, which included a higher proportion of girls, and a high physical activity, low sedentary behavior, longer sleep duration, healthier diet lifestyle pattern. Although increased risk of being overweight was not significant, the Prevalence Ratios (PRs) for the low physical activity-poorer diet lifestyle pattern were >1 in children and in adolescents. The healthier lifestyle pattern included lower proportions of children and adolescents from low socioeconomic status backgrounds.     

Sedentary Behavior as a Risk Factor for Physical Frailty Independent of Moderate Activity: Results From the Osteoarthritis Initiative

Objectives. This prospective longitudinal study investigated the association between baseline objectively measured sedentary time and 2-year onset of physical frailty.Methods. We studied 1333 Osteoarthritis Initiative participants 55 to 83 years of age who were at risk for physical frailty, as assessed via low gait speed (< 0.6 m per second) or inability to perform a single chair stand. Baseline sedentary time was assessed through accelerometer monitoring. Hazard ratios (HRs) for physical frailty onset were estimated with discrete survival methods that controlled for moderate physical activity, sociodemographic characteristics, baseline gait and chair stand functioning, and health factors.Results. The incidence of physical frailty in this high-risk group was 20.7 per 1000 person-years. Greater baseline sedentary time (adjusted HR = 1.36 per sedentary hour; 95% confidence interval [CI] = 1.02, 1.79) was significantly related to incident physical frailty after control for time spent in moderate-intensity activities and other covariates.Conclusions. Our prospective data demonstrated a strong relationship between daily sedentary time and development of physical frailty distinct from insufficient moderate activity. Interventions that promote reductions in sedentary behaviors in addition to increases in physical activity may help decrease physical frailty onset.New health care challenges fueled by an aging population are on the horizon. By 2030, 1 in 5 people living in the United States will be older than 65 years.1 Largely as a result of this oncoming wave of aging, a substantial increase in disability is anticipated. Physical frailty, a medical syndrome,2 is a strong risk factor for disability, dependency, and death.3–8 Physical frailty (assessed according to functional performance) reflects decreased physical reserves and vulnerability in old age.9 The demographically aging society of the United States makes prevention and delay of physical frailty a public health priority.Regular physical activity reduces the risk of physical frailty2,8,10 and promotes health benefits, including better quality of life and reduced risk for chronic diseases.11–14 Despite the important publicized benefits of physical activity, US adults primarily engage in sedentary behaviors.15,16 In contrast to the recommendation that people engage in physical activities of moderate intensity or greater (3.0 or more metabolic equivalents), sedentary behavior involves activities at the resting level of energy expenditure (1.0–1.5 metabolic equivalents).17 Working on a computer and watching television18 are common sedentary activities. Prolonged sedentary time has been associated with an increased risk of functional decline and such conditions as obesity, metabolic syndrome, and type 2 diabetes.19–21Physical activity interventions designed to improve health outcomes have largely focused on increasing recommended moderate-intensity activities13 and have addressed sedentary behavior only to a limited degree. Recently, however, there has been a growing interest in the role of sedentary behavior as a separate risk factor for poor health. Sedentary behavior, already associated with poor health outcomes, may have a unique relationship to the development of physical frailty or may reflect only a lack of moderate-intensity physical activity. This is an essential issue to address because if sedentary behavior is demonstrated to be an independent risk factor, reducing such behavior may increase the effectiveness of behavior interventions, particularly among people with activity-inhibiting chronic conditions such as arthritis. However, the limited available information on the relationship between sedentary behavior and physical frailty is problematic owing to a reliance on recall of sedentary behaviors or physical activity.We tested the hypothesis that increased sedentary behavior is related to an increased risk of physical frailty independent of time spent in moderate physical activity. We focused on community-dwelling adults with or at high risk for knee osteoarthritis (OA) who participated in the multisite Osteoarthritis Initiative (OAI). Using detailed, objective physical activity accelerometer monitoring, we investigated the association between time spent in sedentary behavior and the development of physical frailty as determined via longitudinal objective function tests.     

Health Opportunities with Physical Exercise (HOPE): social contextual interventions to reduce sedentary behavior in urban settings

Physical activity interventions targeting social and physical environments of the urban poor hold promise in improving health outcomes in underserved communities. This study randomly assigned overweight, sedentary, economically disadvantaged adults to one of three intervention conditions at The Hope and Healing Center, a large inner-city health facility providing numerous options for exercise. Within the tenets of Social Action Theory, the Health Opportunities with Physical Exercise (HOPE) trial will test the efficacy of two behavior change models, social support and patient-provider interaction, to increase physical activity. In addition to a standard care condition, in which patients have open access to Hope and Healing physical activity programming, patients were assigned to one of two behavior change interventions. Those assigned to patient-peer receive face-to-face, systematic and scheduled encouragement from study-trained 'peer' interventionists at the facility. Patients assigned to patient-provider receive face-to-face, systematic and scheduled encouragement provided by study-trained 'provider' interventionists also at the facility. The primary outcomes of change in exercise behavior will be documented by self-reported physical activity and confirmed by fitness testing at baseline, 6, 12 and 24 months during the 1 year of active intervention and 1 year of relapse prevention follow-up. Intervention conditions will be compared on psychosocial mediators including motivational appraisals, ratings of social support, rapport, problem solving and self-efficacy for overcoming barriers to increased physical activity. Novel aspects of this intervention include: (1) delivery of socially based physical activity interventions to an economically disadvantaged urban population, (2) reduction of environmental barriers to be physically active and (3) emphasis on social interactions influencing health habit change. Results of this study have the potential to identify mechanisms of behavior change that could be adopted by physical activity interventions aimed at reducing sedentary behavior and health disparities in high-risk, underserved populations.