Gareth Stratton

• PhD
• Professor of Paediatric Exercise Science at Swansea University

Physical fitness is a key indicator of children’s health, yet amidst rising inactivity and obesity, data on Kenyan children are scarce. This study assessed health- and skill-related fitness differences between rural and urban Kenyan children while examining demographic influences. Cardiorespiratory fitness (CRF), BMI, strength, flexibility, speed,...

Introduction In the UK, the number of ethnically diverse older adults (OA) is growing. These individuals suffer complex health issues that are made worse by socioeconomic status, acculturation experiences and language barriers. Additionally, this varied group is the least active and a highly sedentary subgroup in the general population, which poses...

The 24-hour movement behaviours, including sleep, sedentary behaviour (SB), and moderate-to-vigorous physical activity (MVPA) are crucial for a child’s healthy growth and development. Yet, the full 24-hour movement behaviour composition has not been thoroughly explored in children with suspected Developmental Coordination Disorder (sDCD). The aim o...

Background The decreasing prevalence of physical activity (PA) among urban children in Sub-Saharan Africa is a growing public health concern. More emphasis should focus on examining the influence of parental PA behaviour on the children’s PA patterns. We explored associations of 24 hour (h) accelerometer-measured movement behaviours of guardian-chi...

Introduction: Glucose homeostasis may be dependent on liver conditions and influence health-related markers and quality of life (QoL) objective measurements. This study aimed to analyze the interactions of glycemia with liver and health status in a prediabetic population. Subjects and methods: This study included 2220 overweight/obese prediabetics...

Purpose Health and Attainment of Pupils in a Primary Education National (HAPPEN) is a primary school national cohort which brings together education, health and well-being research in line with the Curriculum for Wales framework. Health, education and social care data are linked and held in the Secure Anonymised Information Linkage (SAIL) Databank....

Introduction Evidence suggests that sedentary behaviour (SB) and physical activity (PA) are important indicators of well-being and quality of life in older adults (OAs). However, OAs are the least active and highly sedentary of all the age groups. The present study intends to examine the feasibility of a wearable gadget to remind users to break sit...

Background Child poverty remains a major global concern and a child's experience of deprivation is heavily shaped by where they live and the stability of their local neighbourhood. This study examines frequencies and patterns of residential mobility in children and young people (CYP) at a population level using novel geospatial techniques to assess...

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hyper...

Background Teachers are recognized as ‘key agents’ for the delivery of physical activity programs and policies in schools. The aim of our study was to develop and evaluate a tool to assess teachers’ capability, opportunity, and motivation to deliver school-based physical activity interventions. Methods The development and evaluation of the Capabil...

Background Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing physical activity and/or healthy eating) that reduce body weight and normalize metabolic levels (eg, HbA1c). For interventions to be successful, it is important to influence...

There is a lack of studies focused explicitly on the impact of the home environment on older adults’ sedentary behaviour (SB) and physical activity (PA). The present study aims to investigate older adults’ perception of their home environment and its impact on their PA and SB. A qualitative exploratory research design was employed to conduct 33 in-...

Purpose HAPPEN is a primary school national cohort which brings together education, health and wellbeing research in line with the Curriculum for Wales framework for health and wellbeing. Health, education and social care data of primary school children are linked and held in the Secure Anonymised Information Linkage (SAIL) Databank. In addition, s...

Background Routine monitoring of Body Mass Index (BMI) in general practice, and via national surveillance programmes, is essential for the identification, prevention, and management of unhealthy childhood weight. We examined and compared the presence and representativeness of children and young people’s (CYPs) BMI recorded in two routinely collecte...

Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in...

Background Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. Objective Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegeta...

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data...

In response to increasing concerns about the mental health and wellbeing of university students and staff, policy aims have shifted towards a ‘whole-university approach’ to mental health and wellbeing. This policy advocates for a culture wherein mental health and wellbeing are a key priority across all levels (individual, societal, environmental)....

Background There are few studies that focus explicitly on the impact of the home environment on older adults’ sedentary behaviour (SB) and physical activity (PA) using the socio-ecological model (SEM). This study aims to investigate older adults’ PA and SB within the home environment integrating the SEM as a theoretical framework. Methods A qualit...

Background Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited. Objectives To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use. Design A retrospective, dynamic longitudinal panel study. Setting...

Objectives Youth obesity has increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. This study examines whether more walkable neighbourhoods are associated with lower levels of overweight/obesity for adolescents compared to less walkable neighbourhoods, after considerin...

Purpose There is a lack of studies focused explicitly on the impact of the home physical environment on older adults’ sedentary behaviour (SB) and physical activity (PA). Therefore, the present study aims to investigate older adults’ perception of their home environment and its impact on their PA and SB. Methods A qualitative exploratory research...

The aim of this study was to examine associations in motor competence between children with additional learning needs (ALN) and typically developing children. This cross-sectional study involved a nationally representative cohort of 4555 children (48.98% boys; 11.35 ± 0.65 years) from sixty-five schools across Wales (UK). Demographic data were coll...

Background Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW...

Background Routine monitoring of Body Mass Index (BMI) in general practice, and via national surveillance programmes, is essential for the identification, prevention, and management of low or excess childhood weight. We examined and compared the presence and representativeness of children and young people’s (CYPs) BMI recorded in two routinely coll...

Background/Objectives Some individuals with overweight/obesity may be relatively metabolically healthy (MHO) and have a lower risk of cardiovascular disease than those with metabolically unhealthy overweight/obesity (MUO). We aimed to compare changes in body weight and cardiometabolic risk factors and type 2 diabetes incidence during a lifestyle in...

Natural environments can promote well-being through multiple mechanisms. Many studies have investigated relationships between residential green/blue space (GBS) and well-being, fewer explore relationships with actual use of GBS. We used a nationally representative survey, the National Survey for Wales, anonymously linked with spatial GBS data to in...

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural an...

Objective: The study aimed to compare dietary patterns in preadolescents in urban areas with different physical activity and socioeconomic profiles in Nairobi, Kenya. Design: Cross-sectional. Participants: Preadolescents aged 9-14 years (n = 149) living in low- or middle-income areas in Nairobi. Variables measured: Sociodemographic character...

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty. This cr...

Introduction Housing is a major contributing factor to health, and better housing condition has been linked to improved general and psychological health. There has also been strong evidence that the physical environment within the home setting substantially impacts sedentary behaviour and physical activity in children. However, there is a lack of r...

Objective: The aim of this study was an assessment of post hoc associations among circadian rhythm parameters, physical activity (PA), and cardiometabolic risk factors in adults with obesity and prediabetes after 3 years of weight loss maintenance. Methods: Circadian rhythm parameters (continuous wrist-temperature measurements), PA, systolic and...

Opportunities for children to be physically active during the COVID-19 pandemic were limited, resulting in a decrease in overall physical activity and an increase in sedentary behaviour during the lockdown restrictions of the pandemic. This study further explored these changes across various stages of the restrictions, starting during the first UK-...

Background Like many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement gu...

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4...

Introduction: Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments An...

Background During the 2020 UK COVID-19 lockdown restrictions, children spent almost all of their time at home, which had a significant influence on their physical activity (PA) and sedentary behaviour. This study aimed to: 1) determine changes to the social and physical environment at home and children’s home-based sitting, PA, standing and sitting...

Background Identifying muscle weakness is challenging, because the reduction of strength with aging does not depend only on sarcopenia, but also on sensorimotor deficits. Nevertheless, this identification is improved by adjusting muscle strength allometrically, by removing the influence of body size. However, the effectiveness of foreign models to...

Background Youth have experienced unprecedented restrictions during the COVID-19 pandemic. It is important to ascertain youth's perceptions of how the lockdown restrictions have impacted their well-being. Given the varying restrictions imposed in different countries, exploring the impact relative to the specific restrictions is imperative. This stu...

Objectives In Wales almost a quarter of adults and 1 in 8 reception age children are obese. Linked data is a key tool to understanding the role of the built environment on obesity rates and is an important part of developing strategies to combat the obesity epidemic in Wales. ApproachWe set out to develop an analytical platform for generating evide...

Background The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 inte...

Purpose: Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitti...

Aims/hypothesis Lifestyle interventions are the first-line treatment option for body weight and cardiometabolic health management. However, whether age groups or women and men respond differently to lifestyle interventions is under debate. We aimed to examine age- and sex-specific effects of a low-energy diet (LED) followed by a long-term lifestyle...

Introduction: Changing lifestyle habits to achieve and maintain weight loss can be effective in prevention of Type II diabetes. Ability to resist temptations is considered one of the key factors in behavior change. This study examined how habit strength, motivation, and temptations for an energy-dense diet developed during the maintenance stage of...

This is the fourth Active Healthy Kids (AHK) Wales Report Card. The 2021 card produced grades on children and young people’s physical activity (PA) using pre-COVID-19 data that were not used in previous versions. Eleven quality indicators of PA were graded through expert consensus and synthesis of the best available evidence. Grades were assigned a...

OBJECTIVE To examine whether the effect of a 3-year lifestyle intervention on body weight and cardiometabolic risk factors differs by prediabetes metabolic phenotype. RESEARCH DESIGN AND METHODS This post hoc analysis of the multicenter, randomized trial, PREVention of diabetes through lifestyle interventions and population studies In Europe and a...

The COVID-19 pandemic forced school closures, resulting in home schooling, more time spent at home and fewer opportunities for physical activity (PA). This study explored factors influencing PA and sedentary behaviours (SB) within the home environment during the first lockdown, starting in March 2020. Twenty semi-structured interviews (20 parents a...

The United Kingdom and Ireland have a well-established research base in motor competence (MC) research, ranging from reporting and monitoring levels of MC, developing assessment tools for MC, providing innovative curriculum and intervention design to support learning and development, as well as providing advocacy for particular groups, such as thos...

Background & aims Low-energy diet replacement is an effective tool to induce large and rapid weight loss and improve metabolic health, but in the long-term individuals often experience significant weight regain. Little is known about the role of animal-based foods in weight maintenance and metabolic health. We aimed to examine longitudinal associat...

Objective: The coronavirus disease-2019 (COVID-19) pandemic and national lockdowns took away opportunities for children to be physically active. This study aimed to determine the effect of the COVID-19 lockdown on accelerometer-assessed physical activity (PA) in children in Wales. Methods: 800 participants (8-18 years old), stratified by sex, ag...

Physical activity is promoted in the asthma population through pulmonary rehabilitation, but limited funding and facilities are available. This review aimed to examine the effectiveness of interventions that promote physical activity and identify the behaviour change techniques (BCTs) and other intervention components used. Five databases were sear...

This longitudinal study examines the associations between foundational movement skills (FMS) competency, moderate-to-vigorous physical activity (MVPA) and weight status among children (n = 75) attending preschools in deprived areas from early to late childhood. Twelve FMS were assessed using the Children’s Activity and Movement in Preschool Motor S...

The associations between swimming and cycling abilities and fitness levels in 9–11-year-old children were examined. A cross-sectional study involving 2258 children (50.7% boys; aged 10.52 ± 0.6 years) from 33 schools across Wales, participated in Swan/BridgeLinx health, fitness, and lifestyle programmes between 2013–2019. Health and fitness data we...

Abstract: Lack of physical activity is a global public health problem causing not only morbidity and premature mortality, but it is also a major economic burden worldwide. One of the cornerstones of a physically active lifestyle is Motor Competence (MC). MC is a complex biocultural attribute and therefore, its study requires a multi-sectoral, multi...

This study was performed to evaluate the profile of overweight individuals with pre-diabetes enrolled in PREVIEW who were unable to achieve a body weight loss of ≥8% of the baseline value in response to a 2-month low-energy diet (LED). Their baseline profile reflected potential stress-related vulnerability that predicted a reduced response of body...

Background: Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high...

Plant-based diets are recommended by dietary guidelines. This secondary analysis aimed to assess longitudinal associations of an overall plant-based diet and specific plant foods with weight-loss maintenance and cardiometabolic risk factors. Longitudinal data on 710 participants (aged 26–70 years) with overweight or obesity and pre-diabetes from th...

Background Growing cross-sectional evidence links access to green-blue spaces with mental health benefits, but studies at an individual level and at a national population scale are scarce. This gap can be addressed through the Secure Anonymised Information Linkage (SAIL) Databank, which allows household-level green-blue spaces access and exposure d...

Background Evidence that greenspaces are related to mental health and wellbeing mostly relies on residential exposure and few studies have considered actual use. We aimed to link the National Survey for Wales (NSW) to environmental metrics to determine whether there is an association between increased residential exposure to greenspace and subjecti...

This study used linear regression analyses to investigate the influence of parent-reported home-specific social and individual factors on: (i) 235 children's home-based objectively measured overall sitting time, breaks in sitting, and PA, and; (ii) the home physical environment via an audit. Parental importance assigned to active play for children...

Objective: Breast cancer treatment can negatively impact cardiac function in some breast cancer patients. Current methods (MUGA, echocardiography) used in clinical practice to detect abnormal cardiac changes as a result of treatment suffer from important limitations. Use of alternative techniques that would offer safe, inexpensive and non-invasive...

Background Observed associations of high-protein diets with changes in insulin resistance are inconclusive. Objectives We aimed to assess associations of changes in both reported and estimated protein (PRep; PEst) and energy intake (EIRep; EIEst) with changes in HOMA-IR, glycated hemoglobin (HbA1c), and BMI (in kg/m2), in 1822 decreasing to 833 ad...

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This study aimed to examine the associations between play behaviors during preschool recess and foundational movement skills (FMS) in typically developing preschool children. One hundred and thirty-three children (55% male; mean age 4.7 ± 0.5 years) from twelve preschools were video-assessed for six locomotor and six object-control FMS using the Ch...

Introduction: functional limitation is a result of sarcopenia and is associated with loss of skeletal muscle mass (SMM). Cost-effective methods are important for the identification of sarcopenia. Objective: to propose cutoff points for normalized calf circumference (CC) in order to identify low SMM in older women based on their functional limita...

Objective: Stress, sleep, eating behavior, and physical activity are associated with weight change and insulin resistance (IR). The aim of this analysis was the assessment of the overall and sex-specific associations of psychobehavioral variables throughout the 3-year PREVIEW intervention using the homeostatic model assessment of IR (HOMA-IR), BMI...

Background: Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. Aim: To compare the long-term effects of two diets [high protein (HP)-low...

Objective: To examine longitudinal and dose-dependent associations of dietary glycemic index (GI), glycemic load (GL), and fiber with body weight and glycemic status during 3-year weight loss maintenance (WLM) in adults at high risk of type 2 diabetes. Research design and methods: In this secondary analysis we used pooled data from the PREVentio...

Background: Prevalence of obesity has reached a global pandemic with high incidence of Type 2 Diabetes (T2D). New Zealand is no exception with 65% overweight including 32% obese, and T2D incidence of 10.9%. The risk of T2D in Maori, Pacific and Asian is double that of Caucasians. Aims: PREVIEW-NZ investigated the effect of an 8-week low energy diet...

This study aimed to explore how social distancing and self-isolation measures, aimed at protecting vulnerable groups from COVID-19, affected the wellbeing and physical activity levels among adults diagnosed with asthma. Twenty-seven participants took part across four online focus groups. Transcripts were analysed using thematic analysis. Participan...

Purpose: To examine (1) associations between body fat percent (BF) and lifestyle behaviors in children aged 9-11 years and (2) the consistency of these associations over a 10-year period. Methods: In this repeat, cross-sectional study, 15,977 children aged 9-11 years completed an anthropometric assessment and the SportsLinx Lifestyle survey betwe...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

BACKGROUND The prevalence of non-communicable diseases (NCDs) is increasing in the lower middle-income countries as these countries transition to unhealthy lifestyles which are mostly predominant in urban areas. OBJECTIVE The purpose of this paper is to describe the protocol; design, methods, and study population characteristics of a study explain...

Introduction Green and blue spaces (GBS), such as parks, woodlands, rivers, and beaches, are thought to be important for mental health and wellbeing. Our longitudinal cohort contains objective household-level environment data linked at the invidual level to routinely recorded mental health data, augmented with cross sectional self-reported health b...

Objective The aim of this project was to document a partnership working process from a cross-sectoral and cross-cultural participatory health research study focused on promoting physical activity among women from Black, Asian and minority ethnic (BAME) backgrounds. Design A participatory health research paradigm was used to support this pilot feas...

Dance is considered a unique form of art, as performers express messages through bodily movements (Martin, 1989). As a holistic activity, dance contributes towards embodied cognition with continual interactions between the body, mind and environment (Thompson, 2016). In this chapter, the authors present a case study on the effective use of Laban Mo...

Comprehensive and meaningful policy analysis in the field of physical activity is difficult, not least because of the variable influence of other policy domains. However, in 2011 a Policy Assessment Tool (PAT) was developed by members of the WHO European Network for the Promotion of Health- Enhancing Physical Activity (HEPA Europe) and tested in se...

Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled ana...

Objective: The aim of this project was to document a partnership working process from a cross-sectoral and cross-cultural participatory health research study focused on promoting physical activity among women from Black, Asian and minority ethnic (BAME) backgrounds. Design: A participatory health research paradigm was used to support this pilot fe...

Aim: To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss. Materials and met...

Background Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. Objectives The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA‐IR), at 2 years after randomization to a high pro...

Objectives This study aimed to quantify the relationships between enabling, predisposing and reinforcing ecological factors on motor competence and investigate potential sex, weight status, and school level differences. Methods Data were collected from 429 children (52% boys; aged 11.1 ± 0.6 years; 87% white British). Cardiorespiratory fitness (20...