The aim of this systematic review was to summarize the evidence on the associations between the s... more The aim of this systematic review was to summarize the evidence on the associations between the sleep duration or sleep quality and cardiorespiratory and muscular fitness in children and adolescents aged 6-19 years. Material and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and was registered with the international prospective register of systematic reviews PROSPERO network. Three databases (PubMed, SPORTDiscus and Science Direct) were searched until October 2019 for scientific articles concerning sleep duration, sleep quality and physical fitness. Results: Six articles, including 5797 participants, from 11 different countries, were included in the current systematic review. Conclusion: Longer periods of sleep and better sleep quality were associated with higher levels of physical fitness.
Several anthropometric measures, indices and other techniques have been used in the literature on... more Several anthropometric measures, indices and other techniques have been used in the literature on associations between adiposity and MC. Therefore, the aim of this study was to determine the ability of different measures of adiposity to discriminate between low/high motor coordination (MC). Methods A cross-sectional school-based study was conducted on 596 Portuguese children’s, aged 9- 12 years during the 2009/2010 academic year. Weight, height and waist circumference (WC) were objectively measured by standardized protocols. Body fat percentage (BF%) was estimated by bioelectric impedance. Body mass index (weight/hight2) and waist-to-height ratio (WHtR) were computed. MC was assessed with the Körperkoordination Test für Kinder (Kiphard & Schiling, 1974). Cardiorespiratory fitness was predicted by a maximal multistage 20m shuttle-run test of the Fitnessgram Test Battery (Welk & Meredith, 2008). A questionnaire was used for assess mother’s educational level. Receiver operating characteristic (ROC) and logistic regression were performed. Results ROC curve analysis showed that all measures of adiposity performed well on average in identifying low MC, as indicated by the area under the curve greater than 0.6. The ROC performance of BF% showed a slightly better discriminatory accuracy than BMI, WC and WHtR in predicting low MC in girls. In boys, the ROC performance of WC showed a slightly better discriminatory accuracy than BMI, BF% and WHtR in predicting low MC. After adjustments, logistic regression analyses showed that BMI, WC, %BF and WHtR were positively and significantly associated with MC in both sexes, with exception of WHtR in girls. Discussion Measurement issues may potentially play a role in obscuring the relationship between adiposity and MC. BF% and WC showed a slightly better discriminatory accuracy in predicting low MC, for girls and for boys, respectively. References Kiphard, E. J., & Schiling, F. (1974). Körperkoordination Test für Kinder, KTK. Beltz Test Gmbh. Weinheim. Welk, G. J., & Meredith, M. D. (Eds.). (2008). Fitnessgram / Activitygram Reference Guide (3 ed.). Dallas, TX: The Cooper Institute
Medicine and Science in Sports and Exercise, May 1, 2007
The aim of the present study was to determine whether the relation of perceived neighbourhood att... more The aim of the present study was to determine whether the relation of perceived neighbourhood attributes to reported Physical Activity (PA) levels in Azorean adults varied by gender and body mass index (BMI). Methods. 7330 adult participants (4104 women), aged 38.1 ± 9.3 years, from the 2004 Azorean Physical Activity and Health Study. They answered the Environmental Module and the short version of the International Physical Activity Questionnaire (IPAQ). Height and weight were self-reported. Results. After adjustments for age, BMI, education level and island of residence, the dimension Infrastructures, Access to destinations, Social environment and Aesthetics was positively associated with moderate PA level and Health-Enhancing Physical Activity (HEPA) level, only in women. When participants were categorized by BMI status, the same dimension was a significant predictor for moderate PA level in normal weight men and women, and for HEPA level only in overweight/obese women, after controlling for age, education level and island of residence. Conclusions. The dimension Infrastructures, Access to destinations, Social environment and Aesthetics was predictors of higher PA levels in Azorean adults. Targeted programs for Azoreans to increase PA levels should consider that this set of environmental features seem to act synergistically and are positively associated with PA.
Background: For effective public health and surveillance it is important to document the proporti... more Background: For effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status. Methods: The sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP! Study. Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants' screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status. Results: Only 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none. Conclusions: Just under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to promote adherence to the 24-h movement guidelines in toddlers, particularly for screen time, are necessary, as promoting health-related behaviors in early childhood has the potential to provide children a strong foundation for lifelong physical and mental health.
Revista Brasileira de Cineantropometria e Desempenho Humano, Dec 30, 2011
Nowadays, there is growing evidence in literature that Health benefits from regular physical acti... more Nowadays, there is growing evidence in literature that Health benefits from regular physical activity (PA). The variance in PA among children is caused by a number of factors including their motor abilities and coordination. The aim of the study was to analyse the relation between usual PA and gross motor abilities and motor coordination in children aged 6 to 7 years. The sample comprised 21 children, aged in average 6,38±0,50 years. Physical activity was accessed by accelerometry, gross motor abilities by using the Test of Gross Motor Development (TGMD-2) and motor coordination by using the Körperkoordination Test für Kinder (KTK). Subjects met the international recommendations for daily PA; in motor coordination 47,6% of children met normal coordination, nobody reach good or very good coordination, the majority (52,4%) revelled disturbances or insufficiencies of coordination; in locomotion TGMD-2 76,2% of the children met percentile 50 or superior (P50), in object control TGMD-2 28,6% of the children reach P50 or superior, in total TGMD-2 38,1% of the children met P50 or superior. PA was positively correlated with TGMD-2 object control. Low performance attributed to the children in TGMD-2 and KTK tests could be an indicative of insufficient in the development of coordination and gross motor abilities; therefore we believe that this kind of intervention should be targeted at school children mainly in Physical Education classes.
Epidemiological data suggests that the genesis of cardiovascular disease occurs during childhood.... more Epidemiological data suggests that the genesis of cardiovascular disease occurs during childhood. Sedentary time (ST) is a main driver of high blood pressure (BP) in adolescents and adults. However, associations between ST and cardiovascular health in young children are uncertain. Prospective associations between ST and BP were assessed among 172 toddlers (88 boys), aged 19.5 ± 3.9 months at baseline, recruited from the GET-UP! Study, Australia and followed over a 12-month period. BP was measured with a digital monitor and z-scores were computed by age and sex for systolic and diastolic BP. Total ST was measured over 7 days using Actigraph accelerometers and expressed over a 24-h period. Multilevel linear regression models were used to assess regression coefficients and standard errors, predicting BP at follow-up from ST at baseline. Analyses controlled for socio-economic status, height, age, gender, group (intervention or control) and zWC at baseline. Adjusted analyses showed that total ST did not predict systolic or diastolic BP (β = 0.0009, p = 0.368 and β = 0.002, p = 0.05, respectively). Most likely, longer follow-up periods might be needed to confirm or rule out our results, as the effects of cumulative ST over time on BP values are prone to manifest later in life and track into adolescence and adulthood.
Resumo -Actualmente, existe na literatura a evidência unânime, que a prática actividade física (A... more Resumo -Actualmente, existe na literatura a evidência unânime, que a prática actividade física (AF) regular é benéfica para a saúde. A variação na AF nas crianças é resultado de vários factores, nos quais se incluem as habilidades motoras fundamentais (HMF) e a coordenação motora (CM). Analisar a relação entre a AF habitual e as HMF, e a CM em crianças de ambos os sexos com idades de 6 e 7 anos. A amostra foi constituída por 21 crianças com uma idade média de 6,38±0,50. A actividade física habitual foi avaliada por acelerometria, as habilidades motoras fundamentais usando o Test of Gross Motor Development (TGMD-2) e a coordenação motora através do Körperkoordination Test für Kinder (KTK). As crianças deste estudo cumprem as recomendações internacionais de AF regular. No KTK, a maioria das crianças (52,4%) apresentou perturbações da CM e insuficiências coordenativas, 47,6% valores correspondentes a uma CM normal, nenhum sujeito apresentou uma CM boa ou muito boa; no TGMD-2, para a avaliação locomotora, 76,2% das crianças situam-se acima do percentil 50 (P50), na avaliação do controlo de objectos, 28,6% atingem o P50 ou superior, e para o score total do teste, 38,1% alcançam o P50 ou superior. A AF habitual correlacionou-se positivamente com o TGMD-2 controlo de objectos. Estas crianças apresentaram resultados baixos, indiciadores de possíveis insuficiências do desenvolvimento coordenativo e de pobre desenvolvimento das HMF, pelo que se considera que deviam ser alvo de uma especial intervenção, nomeadamente na área da Educação Física.
É do conhecimento público que duas das principais causas do excesso de peso e obesidade é o seden... more É do conhecimento público que duas das principais causas do excesso de peso e obesidade é o sedentarismo e os maus hábitos alimentares. A dieta mediterrânica é considerada um dos modelos de alimentação mais saudáveis. Vários estudos demonstram que nos países mediterrânicos onde se pratica esta dieta a taxa de morbilidade é menor e a esperança média de vida é maior (Serra-Majem, 2004). O excesso de peso pode provocar na criança distúrbios psicológicos que podem conduzir à diminuição do seu rendimento escolar como tal a escola tem a possibilidade de detetar e evitar previamente estas situações (Direção Geral de Saúde, 2007). Com a realização deste estudo pretendo caraterizar uma amostra de adolescentes do 8º ano de escolaridade quanto à sua aptidão cardiovascular, adesão à dieta mediterrânica e verificar a associação longitudinal destas variáveis com a performance académica numa amostra de 183 alunos do 8º ano de escolaridade de uma escola EB 2, 3 Braga que participaram no mesmo projeto no ano transato. Para a determinação da aptidão cardiovascular utilizou-se o teste “vaivém” da bateria de testes Fitnessgram, sendo o teste realizado apenas para este efeito. Para a determinação da adesão ou não da dieta mediterrânica foi aplicado o questionário do índice KIDMED - Mediterranean Diet Quality Índex. Para verificar a associação com a performance académica foram utilizadas as pautas do 1º período dos alunos do 8º ano de escolaridade que participam no estudo. Para a recolha dos dados antropométricos foi utilizada uma balança SECA – 769 para a recolha do peso, altura e cálculo de IMC e para a medição do perímetro da cintura foi utilizada uma fita métrica flexível e inextensível com escala em centímetros. Os resultados verificaram, em 2013, uma evolução positiva dos alunos relativamente à adesão à dieta mediterrânica e VO₂ máximo, sendo a performance académica a única varável onde se averiguou um decréscimo. Não se verificaram longitudinalmente associações estaticamente significativas entre a aptidão cardiovascular e a adesão à dieta mediterrânica com a performance académica. Desta forma, é necessário que os investigadores da área se interessem pelo tema e realizem novos estudos que clarifiquem estas associações.CIEC - Centro de Investigação em Estudos da Criança, UM (UI 317 da FCT
Scandinavian Journal of Medicine & Science in Sports, Nov 14, 2018
Background: In youth, research on the health benefits of breaking up sitting time is inconsistent... more Background: In youth, research on the health benefits of breaking up sitting time is inconsistent. Our aim was to explore the association between the number of breaks in sitting time and adiposity in Australian toddlers. Methods: This study comprised 266 toddlers (52% boys), aged 19.6 ± 4.2 months from the GET-UP! Study, Australia. Body mass index (BMI) was calculated and z-scores by age and sex were computed for waist circumference (WC). Participants were classified as overweight according to the WHO criteria for BMI. For WC, participants with a z-score≥1SD were considered overweight. Sitting time was assessed with activPALs during childcare hours and participants were classified by tertiles of the number of breaks/h in sitting time: /h; 26-39 breaks/h, and >39 breaks/h. Logistic regression assessed odds ratios for non-overweight (BMI or waist circumference categories) by number of breaks in sitting time/h, controlling for age, sex, and socioeconomic status. Results: The number of breaks in sitting time significantly predicted a lower weight status (non-overweight) according to WC values (P for trend = 0.032) after adjustments. Conclusions: Breaking up sitting time was positively associated with toddlers' waist circumference. Future studies are needed to determine whether breaking up sitting time is a protective for cardiometabolic health in toddlers.
OBJECTIVE The aim of this study was to report the prevalence of adequate sleep and the correlates... more OBJECTIVE The aim of this study was to report the prevalence of adequate sleep and the correlates of sleep duration in Portuguese adolescents aged 12-18 years. METHODS Cross-sectional analysis with 1017 adolescents (471 girls) aged 14.6 ± 1.8 years. Adolescents self-reported their sleep duration. RESULTS The percentage of adolescents meeting the guidelines was 72.7%, 60.7% and 51.3%, during a whole week, on weekdays and on weekends, respectively. Boys were always more compliant with the guidelines than girls, for all week categories. A significant difference was found on sleep duration on weekends, between boys and girls (p < 0.001). During weekdays, more adolescents were classified as short sleepers when compared to long sleepers. Younger adolescents were more likely to meet the guidelines over the whole week and on weekdays (OR = 2.23, OR = 2.13, respectively; p < 0.05) and being long sleepers on weekends (OR = 1.49, p < 0.05). Those of medium and low SES were less likely to meet the sleep guidelines for all week categories (ptrend<0.001). Girls were more likely than boys to meet the guidelines or being long sleepers on weekends (OR = 1.78, OR = 2.85, respectively; p < 0.05). CONCLUSIONS During weekends, the percentage of girls sleeping more than recommended is high, indicating a clear compensation of low sleep duration during weekdays. Those of low SES and older adolescents were less likely to meet the sleep guidelines. Policy makers and researchers should consider the potential effects that SES, gender and age might have on sleep duration, when designing targeted interventions to promote adequate sleep duration.
Journal of Science and Medicine in Sport, Feb 1, 2020
ActiGraph accelerometer cut-points are commonly used to classify sedentary behaviour (SB) in youn... more ActiGraph accelerometer cut-points are commonly used to classify sedentary behaviour (SB) in young children. However, they vary from 5counts/5 s to 301counts/15 s, resulting in different estimates and inconsistent findings. The aim was to examine the concurrent validity of ActiGraph GT3X + cut-points against the activPAL for measuring SB in 2-3-year-olds during free-living conditions. Observational validation-study. Sixty children were fitted with the activPAL and ActiGraph simultaneously for at least 2 h. Nine ActiGraph cut-points ranging from 60 to 1488 counts per minute were used to derive SB. Bland & Altman plots and equivalent tests were performed to assess agreement between methods. Estimates of SB according to the different ActiGraph cut-points were not within the activPAL ±10% equivalent interval (-4.05; 4.05%). The ActiGraph cut-points that showed the lower bias were 48counts/15 s (equivalence lower limit: p = 0.597; equivalence upper limit: p < 0.001; bias: -4.46%; limits of agreement [LoA]: -21.07 to 30.00%) and 5counts/5s (equivalence lower limit: p < 0.001; equivalence upper limit: p = 0.737; bias: -5.11%; LoA: 30.43 to 20.20%). For the 25counts/15s, 37counts/15s and 48counts/15s ActiGraph cut-points, the upper limits were within the equivalent interval (p < 0.001) but not the lower limits (p > 0.05). When using the 5counts/5s and 181counts/15s ActiGraph cut-points, lower limits were within the equivalent interval (p < 0.001) but not the upper limits (p > 0.05). Confidence intervals of the remaining ActiGraph cut-points lie outside the equivalent interval. Although none of the ActiGraph cut-points provided estimates of SB that were equivalent to activPAL; estimates from 48counts/15 s and 5counts/5 s displayed the smallest mean bias (˜5%).
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Objective: This systematic review aimed to summarize correlates of sleep duration in children und... more Objective: This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. Methods: Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. Results: One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. Conclusions: Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
Scandinavian Journal of Medicine & Science in Sports, Oct 26, 2016
Available data on the associations between motor competence (MC) and flexibility are limited and ... more Available data on the associations between motor competence (MC) and flexibility are limited and result inconclusive. This study aims to examine the relationship between flexibility and MC in children. The sample comprised 596 Portuguese children (47.1% girls) aged 9.7 AE 0.6 years. Motor competence was evaluated with the body coordination test, K€ orperkoordination Test f€ ur Kinder. Cardiorespiratory fitness (20-m shuttle run), muscular strength (curl-up and push-up tests), and flexibility (back-saver sit and reach and trunk-lift tests) were evaluated using the Fitnessgram Test Battery. Z-scores by age and gender for the physical fitness tests were constructed. Analysis of variance and regression analysis were performed. Participants in the healthy zone groups of both flexibility tests exhibited significantly better scores of MC than the participants under the healthy zone (P < 0.001). Back-saver sit and reach and trunk-lift Z-scores, either individually or as a sum, were significant predictors of MC (P < 0.05 for all) after adjustments for the other physical fitness components, age, body mass index, and socioeconomic status, in both genders. Our findings highlight the importance of promoting and developing flexibility, as well as the other health-related physical fitness components in schoolchildren to reach adequate levels of MC.
Background: There is increasing recognition that sleep is a risk factor for metabolic syndrome (M... more Background: There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia. Methods: This is a cross-sectional analysis from the FUPRECOL study . Participants included 2779 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire. Results: Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR] = 0.71, 95%CI [0.40-0.94]; p = 0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR = 1.36, 95%CI [1.02-1.83]; p = 0.036) and high triglyceride levels in girls (OR = 1.28, 95%CI [1.01-1.63]; p = 0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR = 0. 71, 95%CI [0.55-0.91]; p = 0.009). Conclusions: Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
The aim of this systematic review was to summarize the evidence on the associations between the s... more The aim of this systematic review was to summarize the evidence on the associations between the sleep duration or sleep quality and cardiorespiratory and muscular fitness in children and adolescents aged 6-19 years. Material and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and was registered with the international prospective register of systematic reviews PROSPERO network. Three databases (PubMed, SPORTDiscus and Science Direct) were searched until October 2019 for scientific articles concerning sleep duration, sleep quality and physical fitness. Results: Six articles, including 5797 participants, from 11 different countries, were included in the current systematic review. Conclusion: Longer periods of sleep and better sleep quality were associated with higher levels of physical fitness.
Several anthropometric measures, indices and other techniques have been used in the literature on... more Several anthropometric measures, indices and other techniques have been used in the literature on associations between adiposity and MC. Therefore, the aim of this study was to determine the ability of different measures of adiposity to discriminate between low/high motor coordination (MC). Methods A cross-sectional school-based study was conducted on 596 Portuguese children’s, aged 9- 12 years during the 2009/2010 academic year. Weight, height and waist circumference (WC) were objectively measured by standardized protocols. Body fat percentage (BF%) was estimated by bioelectric impedance. Body mass index (weight/hight2) and waist-to-height ratio (WHtR) were computed. MC was assessed with the Körperkoordination Test für Kinder (Kiphard & Schiling, 1974). Cardiorespiratory fitness was predicted by a maximal multistage 20m shuttle-run test of the Fitnessgram Test Battery (Welk & Meredith, 2008). A questionnaire was used for assess mother’s educational level. Receiver operating characteristic (ROC) and logistic regression were performed. Results ROC curve analysis showed that all measures of adiposity performed well on average in identifying low MC, as indicated by the area under the curve greater than 0.6. The ROC performance of BF% showed a slightly better discriminatory accuracy than BMI, WC and WHtR in predicting low MC in girls. In boys, the ROC performance of WC showed a slightly better discriminatory accuracy than BMI, BF% and WHtR in predicting low MC. After adjustments, logistic regression analyses showed that BMI, WC, %BF and WHtR were positively and significantly associated with MC in both sexes, with exception of WHtR in girls. Discussion Measurement issues may potentially play a role in obscuring the relationship between adiposity and MC. BF% and WC showed a slightly better discriminatory accuracy in predicting low MC, for girls and for boys, respectively. References Kiphard, E. J., & Schiling, F. (1974). Körperkoordination Test für Kinder, KTK. Beltz Test Gmbh. Weinheim. Welk, G. J., & Meredith, M. D. (Eds.). (2008). Fitnessgram / Activitygram Reference Guide (3 ed.). Dallas, TX: The Cooper Institute
Medicine and Science in Sports and Exercise, May 1, 2007
The aim of the present study was to determine whether the relation of perceived neighbourhood att... more The aim of the present study was to determine whether the relation of perceived neighbourhood attributes to reported Physical Activity (PA) levels in Azorean adults varied by gender and body mass index (BMI). Methods. 7330 adult participants (4104 women), aged 38.1 ± 9.3 years, from the 2004 Azorean Physical Activity and Health Study. They answered the Environmental Module and the short version of the International Physical Activity Questionnaire (IPAQ). Height and weight were self-reported. Results. After adjustments for age, BMI, education level and island of residence, the dimension Infrastructures, Access to destinations, Social environment and Aesthetics was positively associated with moderate PA level and Health-Enhancing Physical Activity (HEPA) level, only in women. When participants were categorized by BMI status, the same dimension was a significant predictor for moderate PA level in normal weight men and women, and for HEPA level only in overweight/obese women, after controlling for age, education level and island of residence. Conclusions. The dimension Infrastructures, Access to destinations, Social environment and Aesthetics was predictors of higher PA levels in Azorean adults. Targeted programs for Azoreans to increase PA levels should consider that this set of environmental features seem to act synergistically and are positively associated with PA.
Background: For effective public health and surveillance it is important to document the proporti... more Background: For effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status. Methods: The sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP! Study. Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants' screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status. Results: Only 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none. Conclusions: Just under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to promote adherence to the 24-h movement guidelines in toddlers, particularly for screen time, are necessary, as promoting health-related behaviors in early childhood has the potential to provide children a strong foundation for lifelong physical and mental health.
Revista Brasileira de Cineantropometria e Desempenho Humano, Dec 30, 2011
Nowadays, there is growing evidence in literature that Health benefits from regular physical acti... more Nowadays, there is growing evidence in literature that Health benefits from regular physical activity (PA). The variance in PA among children is caused by a number of factors including their motor abilities and coordination. The aim of the study was to analyse the relation between usual PA and gross motor abilities and motor coordination in children aged 6 to 7 years. The sample comprised 21 children, aged in average 6,38±0,50 years. Physical activity was accessed by accelerometry, gross motor abilities by using the Test of Gross Motor Development (TGMD-2) and motor coordination by using the Körperkoordination Test für Kinder (KTK). Subjects met the international recommendations for daily PA; in motor coordination 47,6% of children met normal coordination, nobody reach good or very good coordination, the majority (52,4%) revelled disturbances or insufficiencies of coordination; in locomotion TGMD-2 76,2% of the children met percentile 50 or superior (P50), in object control TGMD-2 28,6% of the children reach P50 or superior, in total TGMD-2 38,1% of the children met P50 or superior. PA was positively correlated with TGMD-2 object control. Low performance attributed to the children in TGMD-2 and KTK tests could be an indicative of insufficient in the development of coordination and gross motor abilities; therefore we believe that this kind of intervention should be targeted at school children mainly in Physical Education classes.
Epidemiological data suggests that the genesis of cardiovascular disease occurs during childhood.... more Epidemiological data suggests that the genesis of cardiovascular disease occurs during childhood. Sedentary time (ST) is a main driver of high blood pressure (BP) in adolescents and adults. However, associations between ST and cardiovascular health in young children are uncertain. Prospective associations between ST and BP were assessed among 172 toddlers (88 boys), aged 19.5 ± 3.9 months at baseline, recruited from the GET-UP! Study, Australia and followed over a 12-month period. BP was measured with a digital monitor and z-scores were computed by age and sex for systolic and diastolic BP. Total ST was measured over 7 days using Actigraph accelerometers and expressed over a 24-h period. Multilevel linear regression models were used to assess regression coefficients and standard errors, predicting BP at follow-up from ST at baseline. Analyses controlled for socio-economic status, height, age, gender, group (intervention or control) and zWC at baseline. Adjusted analyses showed that total ST did not predict systolic or diastolic BP (β = 0.0009, p = 0.368 and β = 0.002, p = 0.05, respectively). Most likely, longer follow-up periods might be needed to confirm or rule out our results, as the effects of cumulative ST over time on BP values are prone to manifest later in life and track into adolescence and adulthood.
Resumo -Actualmente, existe na literatura a evidência unânime, que a prática actividade física (A... more Resumo -Actualmente, existe na literatura a evidência unânime, que a prática actividade física (AF) regular é benéfica para a saúde. A variação na AF nas crianças é resultado de vários factores, nos quais se incluem as habilidades motoras fundamentais (HMF) e a coordenação motora (CM). Analisar a relação entre a AF habitual e as HMF, e a CM em crianças de ambos os sexos com idades de 6 e 7 anos. A amostra foi constituída por 21 crianças com uma idade média de 6,38±0,50. A actividade física habitual foi avaliada por acelerometria, as habilidades motoras fundamentais usando o Test of Gross Motor Development (TGMD-2) e a coordenação motora através do Körperkoordination Test für Kinder (KTK). As crianças deste estudo cumprem as recomendações internacionais de AF regular. No KTK, a maioria das crianças (52,4%) apresentou perturbações da CM e insuficiências coordenativas, 47,6% valores correspondentes a uma CM normal, nenhum sujeito apresentou uma CM boa ou muito boa; no TGMD-2, para a avaliação locomotora, 76,2% das crianças situam-se acima do percentil 50 (P50), na avaliação do controlo de objectos, 28,6% atingem o P50 ou superior, e para o score total do teste, 38,1% alcançam o P50 ou superior. A AF habitual correlacionou-se positivamente com o TGMD-2 controlo de objectos. Estas crianças apresentaram resultados baixos, indiciadores de possíveis insuficiências do desenvolvimento coordenativo e de pobre desenvolvimento das HMF, pelo que se considera que deviam ser alvo de uma especial intervenção, nomeadamente na área da Educação Física.
É do conhecimento público que duas das principais causas do excesso de peso e obesidade é o seden... more É do conhecimento público que duas das principais causas do excesso de peso e obesidade é o sedentarismo e os maus hábitos alimentares. A dieta mediterrânica é considerada um dos modelos de alimentação mais saudáveis. Vários estudos demonstram que nos países mediterrânicos onde se pratica esta dieta a taxa de morbilidade é menor e a esperança média de vida é maior (Serra-Majem, 2004). O excesso de peso pode provocar na criança distúrbios psicológicos que podem conduzir à diminuição do seu rendimento escolar como tal a escola tem a possibilidade de detetar e evitar previamente estas situações (Direção Geral de Saúde, 2007). Com a realização deste estudo pretendo caraterizar uma amostra de adolescentes do 8º ano de escolaridade quanto à sua aptidão cardiovascular, adesão à dieta mediterrânica e verificar a associação longitudinal destas variáveis com a performance académica numa amostra de 183 alunos do 8º ano de escolaridade de uma escola EB 2, 3 Braga que participaram no mesmo projeto no ano transato. Para a determinação da aptidão cardiovascular utilizou-se o teste “vaivém” da bateria de testes Fitnessgram, sendo o teste realizado apenas para este efeito. Para a determinação da adesão ou não da dieta mediterrânica foi aplicado o questionário do índice KIDMED - Mediterranean Diet Quality Índex. Para verificar a associação com a performance académica foram utilizadas as pautas do 1º período dos alunos do 8º ano de escolaridade que participam no estudo. Para a recolha dos dados antropométricos foi utilizada uma balança SECA – 769 para a recolha do peso, altura e cálculo de IMC e para a medição do perímetro da cintura foi utilizada uma fita métrica flexível e inextensível com escala em centímetros. Os resultados verificaram, em 2013, uma evolução positiva dos alunos relativamente à adesão à dieta mediterrânica e VO₂ máximo, sendo a performance académica a única varável onde se averiguou um decréscimo. Não se verificaram longitudinalmente associações estaticamente significativas entre a aptidão cardiovascular e a adesão à dieta mediterrânica com a performance académica. Desta forma, é necessário que os investigadores da área se interessem pelo tema e realizem novos estudos que clarifiquem estas associações.CIEC - Centro de Investigação em Estudos da Criança, UM (UI 317 da FCT
Scandinavian Journal of Medicine & Science in Sports, Nov 14, 2018
Background: In youth, research on the health benefits of breaking up sitting time is inconsistent... more Background: In youth, research on the health benefits of breaking up sitting time is inconsistent. Our aim was to explore the association between the number of breaks in sitting time and adiposity in Australian toddlers. Methods: This study comprised 266 toddlers (52% boys), aged 19.6 ± 4.2 months from the GET-UP! Study, Australia. Body mass index (BMI) was calculated and z-scores by age and sex were computed for waist circumference (WC). Participants were classified as overweight according to the WHO criteria for BMI. For WC, participants with a z-score≥1SD were considered overweight. Sitting time was assessed with activPALs during childcare hours and participants were classified by tertiles of the number of breaks/h in sitting time: /h; 26-39 breaks/h, and >39 breaks/h. Logistic regression assessed odds ratios for non-overweight (BMI or waist circumference categories) by number of breaks in sitting time/h, controlling for age, sex, and socioeconomic status. Results: The number of breaks in sitting time significantly predicted a lower weight status (non-overweight) according to WC values (P for trend = 0.032) after adjustments. Conclusions: Breaking up sitting time was positively associated with toddlers' waist circumference. Future studies are needed to determine whether breaking up sitting time is a protective for cardiometabolic health in toddlers.
OBJECTIVE The aim of this study was to report the prevalence of adequate sleep and the correlates... more OBJECTIVE The aim of this study was to report the prevalence of adequate sleep and the correlates of sleep duration in Portuguese adolescents aged 12-18 years. METHODS Cross-sectional analysis with 1017 adolescents (471 girls) aged 14.6 ± 1.8 years. Adolescents self-reported their sleep duration. RESULTS The percentage of adolescents meeting the guidelines was 72.7%, 60.7% and 51.3%, during a whole week, on weekdays and on weekends, respectively. Boys were always more compliant with the guidelines than girls, for all week categories. A significant difference was found on sleep duration on weekends, between boys and girls (p < 0.001). During weekdays, more adolescents were classified as short sleepers when compared to long sleepers. Younger adolescents were more likely to meet the guidelines over the whole week and on weekdays (OR = 2.23, OR = 2.13, respectively; p < 0.05) and being long sleepers on weekends (OR = 1.49, p < 0.05). Those of medium and low SES were less likely to meet the sleep guidelines for all week categories (ptrend<0.001). Girls were more likely than boys to meet the guidelines or being long sleepers on weekends (OR = 1.78, OR = 2.85, respectively; p < 0.05). CONCLUSIONS During weekends, the percentage of girls sleeping more than recommended is high, indicating a clear compensation of low sleep duration during weekdays. Those of low SES and older adolescents were less likely to meet the sleep guidelines. Policy makers and researchers should consider the potential effects that SES, gender and age might have on sleep duration, when designing targeted interventions to promote adequate sleep duration.
Journal of Science and Medicine in Sport, Feb 1, 2020
ActiGraph accelerometer cut-points are commonly used to classify sedentary behaviour (SB) in youn... more ActiGraph accelerometer cut-points are commonly used to classify sedentary behaviour (SB) in young children. However, they vary from 5counts/5 s to 301counts/15 s, resulting in different estimates and inconsistent findings. The aim was to examine the concurrent validity of ActiGraph GT3X + cut-points against the activPAL for measuring SB in 2-3-year-olds during free-living conditions. Observational validation-study. Sixty children were fitted with the activPAL and ActiGraph simultaneously for at least 2 h. Nine ActiGraph cut-points ranging from 60 to 1488 counts per minute were used to derive SB. Bland & Altman plots and equivalent tests were performed to assess agreement between methods. Estimates of SB according to the different ActiGraph cut-points were not within the activPAL ±10% equivalent interval (-4.05; 4.05%). The ActiGraph cut-points that showed the lower bias were 48counts/15 s (equivalence lower limit: p = 0.597; equivalence upper limit: p < 0.001; bias: -4.46%; limits of agreement [LoA]: -21.07 to 30.00%) and 5counts/5s (equivalence lower limit: p < 0.001; equivalence upper limit: p = 0.737; bias: -5.11%; LoA: 30.43 to 20.20%). For the 25counts/15s, 37counts/15s and 48counts/15s ActiGraph cut-points, the upper limits were within the equivalent interval (p < 0.001) but not the lower limits (p > 0.05). When using the 5counts/5s and 181counts/15s ActiGraph cut-points, lower limits were within the equivalent interval (p < 0.001) but not the upper limits (p > 0.05). Confidence intervals of the remaining ActiGraph cut-points lie outside the equivalent interval. Although none of the ActiGraph cut-points provided estimates of SB that were equivalent to activPAL; estimates from 48counts/15 s and 5counts/5 s displayed the smallest mean bias (˜5%).
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Objective: This systematic review aimed to summarize correlates of sleep duration in children und... more Objective: This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. Methods: Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. Results: One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. Conclusions: Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
Scandinavian Journal of Medicine & Science in Sports, Oct 26, 2016
Available data on the associations between motor competence (MC) and flexibility are limited and ... more Available data on the associations between motor competence (MC) and flexibility are limited and result inconclusive. This study aims to examine the relationship between flexibility and MC in children. The sample comprised 596 Portuguese children (47.1% girls) aged 9.7 AE 0.6 years. Motor competence was evaluated with the body coordination test, K€ orperkoordination Test f€ ur Kinder. Cardiorespiratory fitness (20-m shuttle run), muscular strength (curl-up and push-up tests), and flexibility (back-saver sit and reach and trunk-lift tests) were evaluated using the Fitnessgram Test Battery. Z-scores by age and gender for the physical fitness tests were constructed. Analysis of variance and regression analysis were performed. Participants in the healthy zone groups of both flexibility tests exhibited significantly better scores of MC than the participants under the healthy zone (P < 0.001). Back-saver sit and reach and trunk-lift Z-scores, either individually or as a sum, were significant predictors of MC (P < 0.05 for all) after adjustments for the other physical fitness components, age, body mass index, and socioeconomic status, in both genders. Our findings highlight the importance of promoting and developing flexibility, as well as the other health-related physical fitness components in schoolchildren to reach adequate levels of MC.
Background: There is increasing recognition that sleep is a risk factor for metabolic syndrome (M... more Background: There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia. Methods: This is a cross-sectional analysis from the FUPRECOL study . Participants included 2779 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire. Results: Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR] = 0.71, 95%CI [0.40-0.94]; p = 0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR = 1.36, 95%CI [1.02-1.83]; p = 0.036) and high triglyceride levels in girls (OR = 1.28, 95%CI [1.01-1.63]; p = 0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR = 0. 71, 95%CI [0.55-0.91]; p = 0.009). Conclusions: Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
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