A locally developed instructional program that was started by a teacher, helped by crowd-sourced funding and then evaluated by the Johnson Foundation and North Carolina has reported reductions in BMI after one year in a small scale quasi-experimental study published in the October 2015 issue of the Journal of School Health. "Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) is an educational and behavioral intervention in seventh grade. Teachers in 2 schools delivered the MATCH curriculum, with 1 control school. Using a quasi-experimental design, outcome measures included lessons completed, body mass index (BMI), BMI z-score (zBMI), BMI percentile, weight category, and self-reported lifestyle behaviors. We used multiple regression models to compare group results. For the MATCH group (N = 189), teachers provided lessons over 14 weeks; the control group (N = 173) received usual curriculum. Post-intervention, the MATCH group had significant decreases in BMI measures compared with the control. In combined overweight and obese participants, the mean (95% confidence interval) zBMI change was −0.05 (−0.07, −0.03) in MATCH and −0.01 (−0.04, 0.02) in control, p = .034 between groups. After 1 year, improvements are sustained: for the overweight subgroup, the mean zBMI decreased from 1.34 to 1.26 post-MATCH, then to 1.26 after 1 year; for the obese subgroup, mean zBMI = 2.16, to 2.13 post-MATCH to 2.08 after 1 year. Self-reported lifestyle behaviors showed no differences." Read more>> (An item from the ISHN Member information service)
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A research review identified in this week's news/reports describes how cooperation between governments, municipalities and school boards is required if schools are going to be able to get beyond projects and "passive" responses to this intervention that has the most impact on daily physical actiivity among students. Without this type of cooperation, it is unlikely that exhortations to parents to forget about those challenges (and sometimes legal charges) and let their children freely walk to school. This evidence review was done for the education ministry of Ontario, Canada. It assessed the impact of adopting active school transportation policies within governments, municipalities and school boards. "The searches of health, education and sports databases identified 608 abstracts. Governments have increased their focus on increasing both active travel to school and physical activity. Many US states have policies. that may impact active travel in school in addition to the Safe Routes to School SRTS program. Six categories of state statutory (legislative) and administrative (regulatory) laws were examined (minimum busing distance, hazardous route exemptions to the distance requirement (hazards, traffic or unsafe crossing), sidewalk requirements near schools, crossing guards, traffic control measures (e.g., speed bumps) and speed zones around schools." All of these measures had some effect. "The odds of having walking school bus (WSB) program is significantly associated with district policies and a state law requiring crossing guards. However, none of the other state law variables were strongly associated with a WSB program. There is limited literature that assesses the impact of municipalities adopting active transportation policies, which is often associated with millions of funding invested. Further research is needed." Read more >> (An item from the ISHN Member information service)
Much attention on actual activity levels in PE classes and other parts of the school day has been generated by concerns about childhood obesity/overweight. Ironically, this focus on quantity (which is being proved over-reaching in terms of weight loss). Further, it may detract from the more important function of teaching movement skills in PE classes. An article in Issue #2, 2015 of Asia-Pacific Journal of Health, Sport and Physical Education suggests "moving back to movement" as a core purpose of PE. "This paper provides a greater insight into why human motion has high value and should be utilised more in advocacy and implementation in health and education, particularly school health and physical education. It will illuminate where the impact of human motion is taken for granted and undervalued. It will also reveal compelling research findings from a range of disciplines not traditionally included in the field that support motion's value to human existence across the lifespan. An article in September 2015 Issue of Sports Medicine calls for further investigation. "Evidence indicates that motor competence is positively associated with perceived competence and multiple aspects of health (i.e., physical activity, cardiorespiratory fitness, muscular strength, muscular endurance, and a healthy weight status. Thus, it is an appropriate time to examine published data that directly or indirectly relate to specific pathways noted in the conceptual model linking movement skills with these fitness factors." (An item from the ISHN Member information service)
An article in Issue #5, 2015 of Journal of Science and Medicine in Sport reports a systematic review of physical activity and cognition in adolescents. The results are described as positive but, in fact, the reviews appear to be mixed. "The purpose is to perform a systematic review of the evidence on the associations between physical activity and cognition by differentiating between academic and cognitive performance measures.A total of 20 articles met the inclusion criteria, 2 of them analyzed both cognitive and academic performance . Four articles (18%) found no association between physical activity and academic performance, 11 (50%) found positive association and one showed negative association (5%). Five articles (23%) found positive association between physical activity and cognitive performance and one showed negative association (5%). The findings of these studies show that cognitive performance is associated with vigorous physical activity and that academic performance is related to general physical activity, but mainly in girls". The authors suggest that "Results of the review support that physical activity is associated with cognition, but more research is needed to clarify the role of sex, intensity and type of physical activity and some psychological variables of this association." While there is likely little doubt, based on common sense, that we are all alert and functioning better when we are active, especially immediately after taking an activity break, the real question is how much activity makes a difference for young people (who are usually quite active on average) and how much impact is created from increased moderate activity achieved in schools (which other studies often measure in marginal gains of a few minutes in multiple activities such as recess, walking to school, increased activity in PE classes, PA breaks in classrooms etc. Read more >> (An item from the ISHN Member information service)
As the realization that physical activity alone does not significantly affect body weight or obesity gradually grows in the research, policy-making and practice, it is important to note that there are other real and important physical benefits from increased levels of activity. An article in the September 2015 Issue of International Journal of Behavioral Nutrition and Physical Activity highlights some of those benefits. "Physical activity (PA), weight-bearing exercises (WBE) and muscle strength contribute to skeletal development, while sedentary behaviour (SB) adversely affects bone health. Previous studies examined the isolated effect of PA, SB or muscle strength on bone health, which was usually assessed by x-ray methods, in children. Little is known about the combined effects of these factors on bone stiffness (SI) assessed by quantitative ultrasound. We investigated the joint association of PA, SB and muscle strength on SI in children. This study suggests that already an additional 10 min/day of MPA or VPA or the participation in WBE may result in a relevant increase in SI in children, taking muscle strength and SB into account. Our results support the importance of assessing accelerometer-based PA in large-scale studies. This may be important when deriving dose–response relationships between PA and bone health in children." Read more >> (An item from the ISHN Member information service)
(An item from the ISHN Member information service) A letter/article in Issue #11, 2015 of Public Health Nutrition makes a good point in response to an earlier article suggesting that BMI should be replaced as a measure of obesity by the time it takes a child to run 500 meters. The argument is made well by differentiating "fitness" from "fatness". The physical fitness to run that distance is quite a different construct than a simplistic height/weight ration such as BMI. Further, there are more sophisticated measures of body fat (waist circumference, waist to to height ratio and abdominal fat etc) that can replace BMI if needed. However it is this simple clarification of fitness and fatness that may be even more important to consider, especially in the light of increasing evidence that physical activity alone has little impact on body weight. Increasingly, researchers are turning to diet/healthy eating and accompanying mental states (boredom, loneliness,k stress) as the dominant factors. Read more>>
(An item from the ISHN Member information service) Readers of this blog will know that we have been tracking the relationship (or lack thereof) between physical activity and overweight/obesity. Two Articles in July 2015 Issue of International Journal of Obesity continue the discussion. One article suggests that self-reporting of eating and activity behaviours are not sufficiently accurate and objective measurement is required. Another article reports on a study that "identified an unhealthy cluster of TV viewing with ED food/drink consumption, which predicted overweight/obesity in a small longitudinal sample of Australian children. Cluster stability was fair to moderate over 3 years and is a novel finding. A third behaviour examined in the study, physical activity was apparently not as significant as the eating/TV watching behaviours. This finding continues our growing realization that eating and activity may be independent factors/behaviours rather than linked and that it may be wiser to focus on eating, especially when combined with television viewing. Read more>>
(An item from the ISHN Member information service) Three articles in June 2015 Issue of International Journal of Environmental Research and Public Health seek to make the case for "risky" outdoor play for all children. The first article reported on a "systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression". The second review article examined "the relationship between outdoor time and: (1) physical activity, (2) cardiorespiratory fitness, (3) musculoskeletal fitness, (4) sedentary behaviour; or (5) motor skill development in children aged 3–12 years. We identified 28 relevant studies that were assessed for quality using the GRADE framework. The systematic review revealed overall positive effects of outdoor time on physical activity, sedentary behaviour, and cardiorespiratory fitness, although causality could not be assumed due to a lack of RCTs". The third article was a position paper based on the two articles. Read More>>
(An item from the ISHN Member information service) The actual time spent in moderate or vigorous physical Activity in after school dance classes was reported in an article in June 2015 Issue of Pediatrics. The actual physical activity time was similar to that of PE classes in schools, with the choices made about the specific activity (ie type of dance) having a big impact on the level of activity. "Data were collected in 17 private studios and 4 community centers in San Diego, California. A total of 264 girls from 66 classes participated (n =154 children; n = 110 adolescents). Physical activity was measured with accelerometers, and activity levels during class were calculated. RESULTS: Participants recorded an average of 17.2 ± 8.9 minutes of moderate-to-vigorous physical activity (36% of class), but this varied by age and dance type. For children, dance type differences were observed with percent of class in moderate-to-vigorous physical activity ranging from 13.6% (Latin-flamenco) to 57% (hip-hop). For adolescents, there were no differences across dance types. Children were more active than adolescents in all types except ballet. Children and adolescents were more active in private compared with community center classes.Read more>>
(An item from the ISHN Member information service) Three articles in Issue #4, 2015 of Environment & Behavior help us to understand why and how decisions are made by parents and students in regards to their transportation to and from school. Since this physical activity is the biggest contributor to the amount of moderate or vigorous activity undertaken each day, this understanding is important. As in other behaviors, gender, climate, safety and the physical environments of the school and neighbourhood make a difference. The first article reporting on girls choices of pedestrian route in four sites in the US found that "Shorter distance had the strongest positive association with route choice, whereas the presence of a greenway or trail, higher safety, presence of sidewalks, and availability of destinations along a route were also consistently positively associated with route choice at both sites." The second study "analyze the influence of several environmental factors (temperature, precipitation, mode and duration of school transport, perception of physical activity [PA] opportunities, and perceived neighborhood walkability) on adolescent’s daily moderate to vigorous physical activity (MVPA) levels of two European mid-sized cities". Temperature, precipitation made a difference but not perceived walkability. The third article "examined the relationship between the physical environment characteristics of primary schools and active school transport among 3,438 5- to 12-year-old primary school children in the Netherlands. The environmental characteristics were categorized into four theory-based clusters (function, safety, aesthetics, and destination). The correlations between the clusters and active school transport were examined, and multilevel regression analyses were used to examine the association between the clusters and active school transport. No correlations were found between environmental clusters and active school transport for younger children (age 5-9), but for older children (age 9-12), strong positive correlations were found between aesthetics and active transport as were found for safety and active transport. School neighborhood aesthetics were related to active transport for older primary school children. Presence of parks, good maintenance of green spaces, and absence of litter in the school environment contributed most to the positive association. Read more>>
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