Prevalence, trends and risk factors of thinness among Greek children and adolescents: Prevalence and risk factors of thinness

Introduction: Thinness affects more children and adolescents than obesity. Thus, the aim of the study is to present the recent estimates of thinness, the secular trend prevalence and associated risk factors, in Greek schoolchildren. Methods: Epidemiological study. Population data from the recent estimates are derived from a school-based health survey polled in 2015 on 336,014 participants aged 4- to 17-year-old. Secular trend (1996-2015) participants included a total of 300,104 children aged 8- to 9-year-old. Physical activity, dietary habits and sedentary activities were assessed through self-completed questionnaires. The gender and age-specific body mass index cut-off points proposed by International Obesity Task Force were used in order to define weight groups. Results: Percent 8.4 % of girls and 6.5% of boys were thin (all grades included). The prevalence of thinness decreased with age more in boys (from 13.8% at 4-year-old to 5.1% at 17-year-old, p < 0.001), than in girls (from 10.9% at 4-year-old to 8.7% at 17-year-old, p<0.001). Sufficient dietary habits (OR: 0.87, 95%CI: 0.77-0.97) and adequate physical activity levels (OR = 0.92, 95% CI: 0.85-0.99) associated with decreased risk of thinness. Thin schoolchildren performed better in aerobic fitness test than normalweight ones. Between 1996 and 2015, thinness rates decreased from 8.0% to 6.5% in boys (p = 0.046) and from 10.6% to 8.4% in girls (p = 0.036). Conclusions: Thinness is an overlooked phenomenon, which prevalence rates seem to decrease in Greece. Actions need to be taken from public policy makers in order to establish and maintain a healthy body weight in schoolchildren.&nbsp

DURATION, INTENSITY, AND CONTENT OF PHYSICAL EDUCATION CLASSES IN A REPRESENTATIVE SAMPLE OF CHILDREN ATTENDING 5TH AND 6TH GRADES OF PRIMARY EDUCATION

Physical Education (PE) is an educational process that develops the knowledge, skills, attitudes, and well-being of children, through games, sports, exercises, etc. The study aimed to evaluate the parameters of physical activity (PA) during PE class and to investigate the content, time, and intensity of children who participated in PE class, by gender and obesity status. PA and PE items were assessed by a self-administrated PA checklist, proper for children. A representative sample of Greek boys and girls aged 10 to 12 years (N=3195) participated in the study. Boys incorporated higher levels of moderate to vigorous PA (MVPA) (62 ± 45 min/d) than girls (27 ± 33 min/d, p<0.05). Students, who participated in PE classes, presented increased total PA (139 ± 2 vs. 116 ± 51 min/d, p<0.05) and MVPA (62 ± 38 vs. 40 ± 32 min/d, p<0.05), and a higher percentage of them met (77 vs. 66%, p<0.05) the recommended PA levels than those who didn't participate. Among participants in PE classes, boys reported higher time of MVPA than girls (19.4 ± 23.9 vs. 10.3 ± 17.7 min/d, p<0.05), while girls had more time in light PA as compared to boys (15.1 ± 18.1 vs. 20.5 ± 21.3 min/d, p<0.05). There were no significant differences between normal-weight and overweight/obese participants in PE classes neither in PA sub-components (total PA, LPA, and MVPA) nor in sports/games did they participate. PE classes play a significant role in students' levels of PA, especially for overweight/obese children.  Article visualizations

TEACHING SUBJECTS AND PARTICIPATION RATES IN PHYSICAL EDUCATION COURSES AMONG CHILDREN AGED 10 TO 12 YEARS

Physical activity (PA) is a parameter of children's life that is straight connected to the benefits of their life (protection against obesity, better psychological profile, and predisposition for increased levels of PA as adult etc.). The purpose of the present study was to evaluate parameters of PA during Physical Education (PE) classes and to explore the subjects that the children participate in the PE course. PA, PE, and sedentary behaviors were assessed by a self-administrated PA checklist, proper for children. Body mass index (BMI) was calculated from measured body weight and height. A representative sample of Greek boys and girls aged 10 to 12 years (N=3195) participated in the study. Results showed that boys had higher levels of total and vigorous-intensity PA (VPA), than girls (all p-values<0.05), while girls presented higher light-to-moderate intensity PA as compared to boys. In those days that students participated in PE classes, total PA and VPA were higher in comparison with days didn't, in both sexes (p<0.001), while, a greater proportion of children met the current recommendations for PA (86.1% vs. 69.1% for boys and 68.4% vs. 53.5% for girls). During PE classes, boys participated in a greater proportion than girls in basketball and soccer (all p-values<0.05), while, more girls in comparison to boys participated in volleyball, dance, and jump-rope (all p-values<0.05). Stratified data analysis by BMI category among children who participated in PE classes did not reveal significant differences in time participated in PE components among categories, except for games (e.g. chase, tag) among boys. In conclusion, boys have higher levels of total PA than girls, while, it seems that school and PE classes play a significant role in students' levels of PA which could grow up further with interventions as the increase of hours in PE lessons.  Article visualizations

Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the EYZHN (National Action for Children’s Health) program

Introduction: The aim of the study was to present the most recent estimates of obesity (total and central) prevalence in Greek children and risk factors associated with.  Methods: Population data derived from a yearly, school-based health survey carried out in 2015 on 336,014 (51% boys) children aged 4 to 17 years old from almost 40% of all schools of primary and secondary education in Greece. Anthropometric and physical fitness measurements were obtained by trained investigators. Dietary habits, physical activity status, sedentary activities and sleeping hours were assessed through self-completed questionnaires. The gender and age specific Body Mass Index (BMI) cut-off points were used in order to define BMI groups.Results: The prevalence of overweight and obesity in the whole population was 22.2% and 9.0% in boys and 21.6% and 7.5% in girls, respectively. Obesity presented decreasing trends in the transition from childhood to adolescence. Central obesity was diagnosed in 95.3% and 93.5% of the simple obese boys and girls, respectively, in almost two to three of overweight children (68.6% of boys and 64.3% of girls), and in 12% of normal weight children. Age, physical fitness, low adherence to Mediterranean diet, insufficient sleeping hours, inadequate physical activity levels and increased screen time were all associated with higher odds of total and central obesity.Conclusions: Serious and urgent actions need to be taken from public health policy makers in order not only to prevent a further increase in obesity rates but, more important, to treat obesity and/or the obesity associated co-morbidities.

Impact of physical activity category on incidence of cardiovascular disease:Results from the 10-year follow-up of the ATTICA Study (2002–2012)

The aim of the study was to examine the effects of physical activity (PA) level on 10-year cardiovascular disease (CVD) incidence, taking into consideration several clinical and lifestyle risk factors along with the potential moderating role of gender. An analysis was undertaken on data from the ATTICA prospective cohort study (10-year follow-up, 2002–2012), which followed a Greek adult population (aged 18–89 years). A total n = 317 of fatal and nonfatal CVD events occurred among the 2020 participants. After adjusting for the lifestyle and clinical risk factors as potential confounders, odds ratio (ORs) of CVD risk of individuals who reported being sufficiently active and highly active were decreased by 58% (95% CI: 0.30, 0.58) and 70% (95% CI: 0.15, 0.56), when compared to those who were inactive/insufficiently active, respectively. Men had nearly two-fold increase in risk of CVD (95% CI: 1.62, 2.18) versus women. Stratified analysis by gender, revealed that sufficiently active men, had 52% (95% CI: 0.24, 0.97) reduced risk of CVD incidence when compared to inactive males, while, for women, the role of PA lost significance following adjusting for lifestyle factors. The current data suggests a beneficial effect of even moderate physical activity levels on 10-year incidence of CVD, reinforcing the importance of physically activity, especially for men

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network

OBJECTIVES (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. METHODS This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. RESULTS A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). CONCLUSION This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network

Objectives (1) To develop reference values for health-related fitness in European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. Methods This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test–retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. Results A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). Conclusion This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network

Objectives (1) To develop reference values for health-related fitness in European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. Methods This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of Physical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test–retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. Results A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu)

Διαχρονική εξέλιξη δεικτών ανάπτυξης, επιπολασμού της παχυσαρκίας, δεικτών αθλητικών ικανοτήτων και διατροφικών συνηθειών σε μαθητές Α'θμιας εκπαίδευσης σε πανελλαδικό δείγμα: αξιοποίηση των συμπερασμάτων στο μάθημα της φυσικής αγωγής

Με σκοπό την διερεύνηση του επιπολασμού της παχυσαρκίας και της επίδρασης σε αυτήν παραγόντων όπως, η φυσική κατάσταση, η φυσική δραστηριότητα (ΦΔ), το περιβάλλον, και οι διατροφικές συνήθειες, διενεργήθηκε ετήσια, σχολική μελέτη υγείας από το 1997 έως το 2009 στον Ελληνικό χώρο, σε σύνολο 866.874 παιδιών (αγόρια 50,9%) ηλικίας 7-12 ετών. Καταγράφηκαν, τα ποσοστά των επιπέδων της παχυσαρκίας, μετρήθηκαν οι επιδόσεις των παιδιών σε δοκιμασίες φυσικής κατάστασης, τα επίπεδα της ΦΔ, διερευνήθηκε η επίδραση του τόπου κατοικίας στις παραπάνω μεταβλητές και τέλος, εκτιμήθηκαν διατροφικές συνήθειές τους. Ο επιπολασμός της παχυσαρκίας των παιδιών ηλικίας 7-12 ετών στη χώρα μας κυμαίνεται, από 10,6% έως 12,3% στα αγόρια και από 9,5% έως 11,3% στα κορίτσια. Κατά το χρονικό διάστημα από το 1997 έως το 2009, καταγράφηκε μία άνοδος του επιπολασμού της παχυσαρκίας από 7,2% σε 10,7% στα κορίτσια (p<0,001) και από 8,1% σε 11,9% στα αγόρια (p<0,001), αν και τα τελευταία χρόνια (2003-2009) εμφανίζεται σταθεροποίησή τους. Ταυτόχρονα, η αερόβια ικανότητα των παιδιών (1997-2007) μειώθηκε κατά περίπου 5,5% (p<0,001), ενώ βρέθηκε ότι 2 στα 3 παχύσαρκα παιδιά έχει ταυτόχρονα και χαμηλή αερόβια αντοχή. Σε σχέση με τα κορίτσια, τα αγόρια κατέγραψαν υψηλότερα επίπεδα ΦΔ, ενώ τα νορμοβαρή παιδιά δήλωσαν μεγαλύτερο χρόνο ΦΔ σε σχέση με τα υπέρβαρα και τα παχύσαρκα, του ίδιου φύλου (p<0,05). Ο επιπολασμός της παχυσαρκίας ήταν υψηλότερος στις αγροτικές περιοχές σε σύγκριση με τις αστικές παρά τα υψηλότερα επίπεδα της φυσικής κατάστασης και της φυσικής δραστηριότητας των παιδιών των αγροτικών περιοχών. Τέλος οι διατροφικές συνήθειες των παιδιών της χώρας μας όπως αποτυπώνονται από το ερωτηματολόγιο που αναπτύξαμε είναι μέτριες, ενώ φαίνεται ότι ένα υψηλότερο ποσοστό παχύσαρκων παιδιών υιοθετεί μη ”υγιεινές’’ διατροφικές πρακτικές