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      Physical activity and dietary habits of older children and adolescents in Germany – Cross-sectional results of the 2017/18 HBSC study and trends

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          Abstract

          Numerous findings are known to exist between dietary habits, physical activity, and child and adolescent health. Here, we will use data from the most recent Health Behaviour in School-aged Children (HBSC) study to describe dietary habits and patterns of physical activity. Using the survey data for 11-, 13- and 15-year-old students from across Germany, we report findings for key indicators of diet and physical activity for the 2017/18 cycle. By comparing these findings with data from the 2009/10 and 2013/14 survey cycles, we also consider current trends. Results from the most recent cycle show that 10.0% of girls and 16.9% of boys meet the World Health Organization’s (WHO) physical activity recommendations. Across all HBSC cycles, this is the lowest figure so far. Concerning dietary habits, 50.6% of girls and 59.0% of boys reported having breakfast every morning. Data for daily fruit, vegetable and soft drink consumption emphasises the need to promote a healthy diet among adolescents. For all indicators of physical activity and diet, differences between girls and boys are apparent. Girls’ intake of fruit and vegetables is higher and they consume fewer soft drinks, yet boys are more physically active and have breakfast more regularly. For the majority of indicators of dietary habits and physical activity, considerable inequalities relating to family affluence are observed. An important implication of the study results for dietary habits and physical activity of older children and adolescents is the need to foster settings-based approaches to promote physical activity and a healthy diet that integrate a gender-sensitive perspective.

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          Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

          Summary Background Physical activity has many health benefits for young people. In 2018, WHO launched More Active People for a Healthier World, a new global action on physical activity, including new targets of a 15% relative reduction of global prevalence of insufficient physical activity by 2030 among adolescents and adults. We describe current prevalence and trends of insufficient physical activity among school-going adolescents aged 11–17 years by country, region, and globally. Methods We did a pooled analysis of cross-sectional survey data that were collected through random sampling with a sample size of at least 100 individuals, were representative of a national or defined subnational population, and reported prevalence of of insufficient physical activity by sex in adolescents. Prevalence had to be reported for at least three of the years of age within the 10–19-year age range. We estimated the prevalence of insufficient physical activity in school-going adolescents aged 11–17 years (combined and by sex) for individual countries, for four World Bank income groups, nine regions, and globally for the years 2001–16. To derive a standard definition of insufficient physical activity and to adjust for urban-only survey coverage, we used regression models. We estimated time trends using multilevel mixed-effects modelling. Findings We used data from 298 school-based surveys from 146 countries, territories, and areas including 1·6 million students aged 11–17 years. Globally, in 2016, 81·0% (95% uncertainty interval 77·8–87·7) of students aged 11–17 years were insufficiently physically active (77·6% [76·1–80·4] of boys and 84·7% [83·0–88·2] of girls). Although prevalence of insufficient physical activity significantly decreased between 2001 and 2016 for boys (from 80·1% [78·3–81·6] in 2001), there was no significant change for girls (from 85·1% [83·1–88·0] in 2001). There was no clear pattern according to country income group: insufficient activity prevalence in 2016 was 84·9% (82·6–88·2) in low-income countries, 79·3% (77·2–87·5) in lower–middle-income countries, 83·9% (79·5–89·2) in upper–middle-income countries, and 79·4% (74·0–86·2) in high-income countries. The region with the highest prevalence of insufficient activity in 2016 was high-income Asia Pacific for both boys (89·0%, 62·8–92·2) and girls (95·6%, 73·7–97·9). The regions with the lowest prevalence were high-income western countries for boys (72·1%, 71·1–73·6), and south Asia for girls (77·5%, 72·8–89·3). In 2016, 27 countries had a prevalence of insufficient activity of 90% or more for girls, whereas this was the case for two countries for boys. Interpretation The majority of adolescents do not meet current physical activity guidelines. Urgent scaling up of implementation of known effective policies and programmes is needed to increase activity in adolescents. Investment and leadership at all levels to intervene on the multiple causes and inequities that might perpetuate the low participation in physical activity and sex differences, as well as engagement of youth themselves, will be vital to strengthen the opportunities for physical activity in all communities. Such action will improve the health of this and future young generations and support achieving the 2030 Sustainable Development Goals. Funding WHO.
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            Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies

            Abstract Background: Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods: PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results: For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90–0.94, I2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76–0.92, I2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90–0.95, I2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95–0.99, I2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87–0.93, I2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.
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              Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth.

              Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.
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                Author and article information

                Journal
                J Health Monit
                J Health Monit
                JoHM
                Journal of Health Monitoring
                Robert Koch Institute (Nordufer 20 13353 Berlin, Germany )
                2511-2708
                16 September 2020
                September 2020
                : 5
                : 3
                : 21-36
                Affiliations
                [1 ] University of Education Heidelberg Faculty of Natural and Sociological Sciences , Department of Prevention and Health Promotion
                [2 ] University of Education Heidelberg Heidelberg Centre for Prevention and Health Promotion
                [3 ] University of Education Heidelberg Faculty of Natural and Sociological Sciences , Department of Nutrition and Home Economics
                [4 ] Bielefeld University School of Public Health , Department Prevention and Health Promotion
                [5 ] Eberhard Karls University Tübingen Institute of Sport Science
                [6 ] Fulda University of Applied Sciences Department of Nursing and Health Science, Fulda Public Health Centre
                [7 ] Eberhard Karls University Tübingen Interfaculty Research Institute for Sport and Physical Activity
                Author notes
                Corresponding author Prof. Dr Jens Bucksch, University of Education Heidelberg, Faculty of Natural and Sociological Sciences, Department of Prevention and Health Promotion, Im Neuenheimer Feld 561, PO Box 104240, 69032 Heidelberg, Germany, E-mail: bucksch@ 123456ph-heidelberg.de
                Article
                10.25646/6900
                8734148
                35146271
                20307ef9-9481-47d8-aee2-2717694afc34
                © Robert Koch Institute. All rights reserved unless explicitly granted.

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 February 2020
                : 04 June 2020
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 44, Pages: 16
                Funding
                Funded by: Martin Luther University Halle-Wittenberg (Prof. Dr Richter)
                Funded by: Brandenburg University of Technology Cottbus (Prof. Dr Bilz)
                Funded by: Heidelberg University of Education (Prof. Dr Bucksch)
                Funded by: Bielefeld University (Prof. Dr Kolip)
                Funded by: Eberhard Karls University Tübingen (Prof. Dr Sudeck)
                Funded by: University Medical Center Hamburg-Eppendorf (Prof. Dr Ravens-Sieberer)
                Award Recipient : Data collection for the study
                No external funds were used to conduct this study. Data collection for the study was financed with funds provided by the Martin Luther University Halle-Wittenberg (Prof. Dr Richter), Brandenburg University of Technology Cottbus (Prof. Dr Bilz), Heidelberg University of Education (Prof. Dr Bucksch), Bielefeld University (Prof. Dr Kolip), Eberhard Karls University Tübingen (Prof. Dr Sudeck) and the University Medical Center Hamburg-Eppendorf (Prof. Dr Ravens-Sieberer).
                Categories
                Focus

                physical activity,diet,trends over time,prevalence,hbsc,health reporting

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