Short- and long-term effects of a multi-component physical activity intervention in primary school

There is compelling evidence that physical activity has numerous health benefits during childhood and adolescence. Insufficient levels of physical activity on the other hand can consequently affect cardiovascular and bone health, which may result in severe chronic diseases later in life. Cardiovascular disease and osteoporosis are two of the major chronic diseases affecting a large proportion of the adult population. Both diseases have their origins in childhood and it has been shown that for both, physical activity plays an important role in their prevention. The number of children not being sufficiently active has reached an alarming level and threatens to impose major health burdens worldwide. Thus, developing effective strategies to enhance children’s physical activity levels is of paramount interest for public health. School provides an optimal setting for physical activity promotion, since all children spend a large portion of their time there. This dissertation discusses a school-based randomized controlled trial aimed at increasing children’s physical activity levels and consequently their cardiovascular and bone health. The „Kinder- und Jugendsportstudie“ (KISS) is a school-based physical activity intervention lasting one school year. Of all primary school classes in the cantons of Aargau and Baselland comprising about 10% of the Swiss population, 28 first and fifth grade classes were randomly selected and allocated into an intervention (16 classes; n=297 children) and a control (12 classes, n=205 children) group. The mandatory and stringent multi-component intervention program consisted of daily physical education lessons, daily short activity breaks during academic lessons, and physical activity homework. Children in the control group had the compulsory three physical educations per week. The aim of this dissertation was to assess the effectiveness of KISS on cardiovascular risk and bone health and to explore whether the program was sufficiently effective in order to maintain health benefits over the following three years. In addition, this dissertation will provide a systematic update of existing school-based intervention studies aiming at increasing children’s physical activity and a quantification of physical education-related physical activity. There is strong evidence that school provides a promising setting for physical activity promotion. All school-based intervention studies done in recent years showed positive effects in at least one domain of physical activity. The most successful interventions had the design of a randomized controlled trial, were done over one school year using a multi-component approach integrated into the school curriculum, taught by physical education experts and involving family members. A common intervention strategy was to increase quantity and/or quality of physical education lessons. The particular role of physical education and its contribution to overall physical activity was the center of attention in the second publication of this dissertation. Even if children’s physical activity levels during physical education are relatively low, physical education contributes substantially to overall physical activity. Due to its nature of being a randomized controlled trial in children with a stringent physical activity program in and outside physical education over one school year and with the inclusion of physical education experts, KISS had excellent pre-conditions for being an effective program. Indeed, the results after nine month of intervention are promising. Compared to controls, children of the intervention group showed 14% reduced cardiovascular risk score, 5% reduced body mass index and skinfold thickness, 6% improved aerobic fitness, 18% higher physical activity levels, and 5-8% higher bone mineral content and bone mineral density. Three years after cessation of the program, intervention children still showed higher aerobic fitness and bone mineral content levels at weight-bearing sites of the skeleton compared to the control group. All other beneficial effects have disappeared. Even if short-term effects of the intervention are promising, the major key from a public health perspective is whether the effects of the prevention done during childhood will persist into late adolescence and adulthood. Although the maintained effects on aerobic fitness and bone health have considerable impact on public health, most of the beneficial health effects were not maintained three years after the intervention. This indicates that an intervention over one year is too short for maintained overall health effects. Thus, physical activity programs throughout the school years are needed. Our findings contribute to the growing body of evidence that school-based interventions can increase children’s health; however the major challenge now, is to find effective implementation strategies to transfer such programs into the real-world setting

Variation in sport participation, fitness and motor coordination with socioeconomic status among Flemish children

Socioeconomic status (SES) is often indicated as a factor that influences physical activity and associated health outcomes. This study examined the relationship between SES and sport participation, morphology, fitness and motor coordination in a sample of 1955 Flemish children 6-11 years of age. Gender, age and SES-specific values for morphologic dimensions, amount and type of sport participation and fitness and motor coordination tests were compared. SES was positively and significantly associated with sport participation and sports club membership in both sexes. Although differences were not consistently significant, morphologic dimensions and tests of fitness and motor coordination showed a trend in favor of children from higher SES. The results suggest that public and local authorities should consider providing equal opportunities for children in all social strata and especially those in the lower SES to experience the beneficial effects of sport participation through which they can enhance levels of physical fitness and motor coordination

A Portrait of Preteens in Santa Clara and San Mateo Counties: What We Know About 9- to 13-Year Olds

This report, commissioned by the Lucile Packard Foundation for Children's Health and the Preteen Alliance, presents a profile of the preteen population in Santa Clara and San Mateo counties in California. Data compiled from a wide variety of sources depict the demographic and economic characteristics of the preteen population in the two counties, as well as detailed information about their emotional, behavioral, physical and academic health compared to available data on preteens in the state and the nation. Recommendations to increase community awareness about the particular issues and needs of youth in this age range and to address gaps in available data are offered

The Scientific Competitiveness of Nations

We use citation data of scientific articles produced by individual nations in different scientific domains to determine the structure and efficiency of national research systems. We characterize the scientific fitness of each nation (that is, the competitiveness of its research system) and the complexity of each scientific domain by means of a non-linear iterative algorithm able to assess quantitatively the advantage of scientific diversification. We find that technological leading nations, beyond having the largest production of scientific papers and the largest number of citations, do not specialize in a few scientific domains. Rather, they diversify as much as possible their research system. On the other side, less developed nations are competitive only in scientific domains where also many other nations are present. Diversification thus represents the key element that correlates with scientific and technological competitiveness. A remarkable implication of this structure of the scientific competition is that the scientific domains playing the role of "markers" of national scientific competitiveness are those not necessarily of high technological requirements, but rather addressing the most "sophisticated" needs of the society