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Vloga športnih in gibalnih aktivnosti pri obravnavi vedenjskih težav mlajših šolarjev
Abstract
Ukvarjanje z gibalno aktivnostjo ob ohranjanju zdravja in telesnega razvoja ponuja otroku možnosti za socializacijo in navezovanje stikov ter s tem predstavlja enega izmed ključnih dejavnikov njegovega socialnega razvoja in obvladovanja nezaželenih oblik vedenja. Namen raziskave je bil proučiti povezave med gibalno in športno aktivnost otrok v prostem času in vedenjskimi težavami pri otrocih drugega vzgojno-izobraževalnega obdobja osnovne šole. Zbiranje podatkov je potekalo s standardiziranim vprašalnikom ocenjevanja socialnih spretnosti otrok SSRS - Social Skills Rating System, ki smo ga prevedli in priredili za uporabo v slovenskem prostoru, ter vprašalnikom o prostočasni gibalni in športni aktivnosti. V raziskavi je sodelovalo 1782 otrok, povprečne starosti 10,40 ± 0,93 let, ki so bili v raziskavo izbrani z tri-stopenjskim slučajnostnim vzorčenjem iz 16 osnovnih šol vseh statističnih regij Slovenije. Dobljene ugotovitve so pokazale, da so anketirani otroci dovolj gibalno aktivni glede na priporočila Svetovne zdravstvene organizacij. Pomemben prispevek imajo pri tem organizirane prostočasne športne aktivnosti na osnovnih šolah, v katere je redno vključenih 43,9 % otrok. Pojavlja se povprečna prisotnost vedenjskih težav, pri čemer nekoliko izstopa pojav hiperaktivnosti. Prostočasna gibalna in športna aktivnost je statistično značilno povezana zlasti z obvladovanjem introvertiranega in hiperaktivnega vedenja pri otroku, medtem ko gledanje televizije in uporaba računalnika obratno prispevati k večji hiperaktivnosti in ekstravertiranosti.
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Introduction: The purpose of this study was to establish the effective time parameters of physical education (PE) lessons and the amount of time that children spent in moderate to vigorous physical activity (MVPA). Methods: The study involved a total of 189 thirdgrade pupils (94 boys and 95 girls), aged 8 to 9 years, from five primary schools in the Slovenian coastal region. We used an accelerometer in each school to measure the quantity and intensity of activity during three PE lessons led by the class teacher and / or PE teachers. Results: We found that the average duration of a PE lesson was 36.6 ± 7.7 minutes: lesson preparation time 14.9 ± 7.7 minutes, the main activity 19.3 ± 7.1 minutes and the conclusion 1.8 ± 2.4 minutes. Time spent in MVPA was 13.2 ± 4.1 minutes, with no statistical differences between genders (P = 0.338). An average PE lesson carried outdoor on the outside playground lasted an average 7 minutes less than lesson in the gym (P = 0.066), and the average PE lesson's effective time was shorter by 1.5 minutes as well (P = 0.011). The children led by both teachers together showed, on average, that their MVPA had been shortened by 3.5 minutes. There were no statistical differences between a PE teacher and a classroom teacher. Furthermore, it was revealed that the time spent in MVPA tends to decrease proportionally with the increase in the number of children participating actively in the PE lesson (r = .12; P = 0.092).
Background:
This is the first assessment of the Republic of Slovenia's efforts to synthesize and report physical activity (PA) standards for children and youth following the Active Healthy Kids Global Alliance grading system model.
Methods:
The Republic of Slovenia Report Card relies on research findings published in peer-reviewed journals, data compiled from national databases, and government initiatives which have been monitoring physical fitness standards in schools for the past 34 years (SLOfit and ACDSi). The Report Card initiative has been jointly coordinated by the University of Primorska and the University of Ljubljana. A Research Work Group consisting of 12 representatives from various aspects of Slovenia's public, private, and government sectors convened to evaluate evidence and assign grades for each PA indicator.
Results:
Grades (A, highest, to F, lowest; INC, incomplete) for Slovenia are as follows: Overall Physical Activity (A-), Organized Sport Participation (B-), Active Play (D), Active Transportation (C), Sedentary Behaviors (B+), Family and Peers (INC), Schools (A), Community and the Built Environment (INC), and Government (B+).
Conclusions:
This inclusive PA report indicates that overall physical activity minutes remain high in Slovenian children and youth; however, more research is needed to determine the effects of family life, peer influences, and the built environment on active play behaviors.
Upon the sample of 2023 fourth class pupils of primary schools in the Gorenjska region (1048 boys and 975 girls) the relations between the participation in the out-of-school sports activities and success in school were studied. Data were collected by means of a questionnaire designed upon the data collected in previous studies (Petrović et al., 1998). The main aim of our research was to establish eventual statistically significant differences between the frequency of participation in out-of-school sports activities and the success in school as well as between the form of participation in out-of-school sports activities and the success in school. Statistically significant differences between the variables was verified by means of the chi-squared test. As statistically significant were considered differences between the variables presenting values of the Pearson's coefficient 0,05 and lower than 0,05. The research confirmed that statistically important differences do exist. Pupils who regularly participate in sports activities achieve a better learning success. Similarly, there is also a statistically significant differences between learning success and the form of sport activity. Pupils who train in sport clubs or under a trainers' supervision achieve a better success in school than those who participate in non-organised sports activities.
The Analysis of Children’s Development in Slovenia (ACDSi) is a decennial study on children’s and adolescents’ somatic, motor, psychological and social development in Slovenia. In 2014, the study included 1,479 adolescents and young adults between 14 and 24 years of age. From its beginnings in 1970, it has been characterised as an interdisciplinary study of physical anthropology, kinesiology, psychology and sociology. In its third cycle on adolescents in 2014, the study was expanded to include public health issues. The aim of the study is to observe the secular trends of the somatic and motor development of adolescents in Slovenia regarding the psychological, social and health determinants that shape contemporary adolescents’ lifestyles. This paper describes the protocol of the ACDSi 2014 study with regards to its organisation, sampling and methods.
The aim of this study was to analyse the relationships between energy intake, energy expenditure (physical activity), physical fitness, body mass index and certain eating habits (breakfast and snacks after 8 p.m.) of 11-year-old children. A cluster sample of 72 children (35 boys and 37 girls), aged 11.8 (±0.3) years was used for this purpose. The measurements took place during two weekdays and two weekend days. Physical activity (energy expenditure) was assessed with multiplesensor body monitors (SenseWear Armband; BodyMedia Inc., Pittsburgh, PA, USA). Energy intake and frequency of breakfast and snacks after 8 p.m. were assessed using a self-report questionnaire (My Pyramid Tracker Tutorial; USDA, Center for Nutrition Policy and Promotion, USA). Physical fitness levels were evaluated according to the results of the tests: sit-ups, bent arm hang, 600 m run and 20 m endurance shuttle-run using the Eurofit protocols and peak VO2, which was measured with a Cosmed K4b2 portable gas analyser. A Pearson correlation coefficient was used to test the correlations between observed variables, and a multivariate analysis of variance was used to test the influence of certain eating habits (breakfast-regular and occasional; snacks after 8 p.m.-occasional and never) on physical fitness according to sex and age. Mann-Whitney test was used to analyse the differences in in the central tendency between boys and girls. The results show that boys and girls, especially those with increased BMI, reported a one-third lower intake than reported in other studies. Girls were less physically active than boys. In both groups, the physical activity levels were higher during the week than on weekends, but the energy intakes were higher during the weekends. There were no statistically significant correlations between BMI and physical activity levels. BMI was significantly associated with all selected tests of physical fitness except the situps test. The relationship between the frequency of the two observed meals, physical fitness and sex of the children was negligible. We can conclude that the assessment of energy intake using a self-report questionnaire is problematic in this age group, especially among those with higher BMI. The measurements of physical activity levels showed that children should be more active during weekends.
During adolescence, a drop of interest in physical activity in girls' free time and a stagnation in some physical fitness indicators can be observed. The physical fitness of a sample of 14,920 girls from three different types of secondary-school educational programmes (academic, technical and vocational) with different amounts of physical education lessons in the curriculum was analysed. Data from the Slovenia's monitoring system of students' physical fitness (SLOFIT), including three morphological measures and eight motor tests, was used. A multivariate analysis of variance was used to test the differences between the type of programme and the age of students. There are statistically significant (p<0.001) differences between the educational programmes for the entire set of tested morphological and motor variables. The educational programme is a much more important factor (about 7% of explained variances) than age (0.4%). It better explains the differences in motor variables than morphological variables. Girls from the academic programme are taller and have thinner triceps skinfolds. They also show better motor fitness than their counterparts from technical and vocational programmes. However, it cannot be concluded that all the variability is due to the secondary-school educational programme, because the results are also influenced by some interpersonal and social factors that were not controlled in our study. Nevertheless, more action is needed to compensate certain inequalities between young girls, especially those from vocational schools.
Many international studies have examined the gross motor skills of children studying in special schools while local studies of such nature are limited. This study investigated the gross motor skills of children with Mild Learning Disabilities (MLD; n = 14, M age = 8.93 years, SD =.33) with the Test of Gross Motor Development-2 (TGMD-2, Ulrich, 2000). The TGMD-2 consists of 12 items equally divided into two subtests (locomotor and object control). The locomotor subtest includes run, gallop, hop, leap, horizontal jump and slide while the object control subtest includes strike a stationary ball, stationary dribble, kick, catch, overhand throw and underhand roll. The results revealed significant differences in 8 out of 12 test items: gallop, hop, leap, horizontal jump, slide, strike, dribble and roll at mastery level between children with MLD and TGMD-2 norm population. The authors suggest motor interventions for children with MLD to improve their gross motor skills.
Samopodoba je skupek predstav, pojmovanj in občutij, ki jih imamo o sebi, ter ima pomembno funkcijo pri uravnavanju in usmerjanju našega vedenja. Oblikovanje samopodobe predstavlja eno izmed temeljnih razvojnih nalog otroštva in mladostništva. Sodobni strukturni modeli samopodobe poudarjajo njeno večplastnost, sestavljeno iz različnih specifičnih področij udejstvovanja, na katerih ima posameznik izkušnje. Telesna samopodoba je ena od sestavin splošne podobe o sebi; lahko rečemo, da je prvinska in najbolj elementarna, saj se začne razvijati v najzgodnejšem obdobju posameznikovega ţivljenja in je ključna za oblikovanje ostalih sestavin samopodobe. Preučevanje telesne samopodobe otrok in mladostnikov je izjemnega pomena v povezavi z njihovo gibalno/športno aktivnostjo in tudi v smislu spodbujanja razvoja telesne samopodobe, ki bo imela pozitivne učinke na celostno samopodobo in samospoštovanje otrok. Namen prispevka je, opredeliti vsebino telesne samopodobe, predstaviti različne pripomočke za njeno empirično raziskovanje ter navesti raziskovalne izsledke slovenskih in tujih avtorjev na tem področju. Poleg tega poudarjamo motivacijsko vlogo telesne samopodobe za gibalno/športno udejstvovanje otrok in mladostnikov.
Con el presente trabajo hemos pretendido determinar cuáles han sido las competencias profesionales más valoradas por los estudiantes de la Titulación de Maestro en Educación Física para su posterior desempeño laboral. Estudio descriptivo y de corte transversal, en el que participan 439 estudiantes de magisterio de la especialidad de Educación Física de las universidades Andaluzas de Granada, Jaén y Almería. Mediante un cuestionario diseñado al efecto, denominado Cuestionario de Competencias Profesionales del Maestro en EF, cuya finalidad es obtener información sobre la relevancia que otorgan los estudiantes a los distintos tipos de competencias: transversales, básicas del docente y específicas del maestro especialista, utilizando una gradación de respuesta tipo Likert de cuatro opciones. El análisis descriptivo, nos ha permitido ordenar las competencias más valoradas y el análisis inferencial, ha posibilitado establecer las diferencias en función del género y del curso de los estudiantes (t student y ANOVA de un factor respectivamente). Se destaca como más relevante la capacidad para trabajar en equipo, la capacidad para estimular y transmitir valores y la capacidad de establecer la relación necesaria entre la actividad física con los hábitos de higiene, posturales y de salud.
Physical activity (PA) levels are a key performance indicator for policy documents in Ireland. The first Ireland Report Card on Physical Activity in Children and Youth aims to set a robust baseline for future surveillance of indicators related to PA in children and youth.
Data collected between 2003-2010 on more than 35,000 7- to 18-year-old children and youth were used and graded using a standardized grading system for 10 indicators.
Grades assigned for the indicators were as follows: overall physical activity levels, D-; sedentary behavior (TV viewing), C-; organized sport participation, C-: physical education, D-; active play, inconclusive (INC); active transportation, D; school, C-, community and the built environment, B; family, INC; and government, INC.
PA recommendations exist in Ireland but this Report Card has shown that participation is still low. A number of promising policies, programs and services are in place but these require thorough evaluation and adequate resourcing. Agreement and implementation of a common framework for the systematic surveillance of indictors related to PA of children and youth is necessary to monitor change over time and ensure the impact of promising work is captured.
Prevention is the most effective remedy against drug abuse. On the one hand, physical activity triggers a series of factors which compel us to adopt healthy dietary behaviours and, on the other, it constitutes drug abuse prevention, as it is itself a kind of body and mind stimulant. The research at hand aims at establishing the degree of familiarity with and abuse of narcotic drugs (such as, for instance, cigarettes, alcohol and marijuana) in pupils in relation to the frequency of their engagement in sports activities. The sample comprised 748 children, 194 male and 189 female fourth graders (with an average age of 10 years ± 5 months) and 201 male and 164 female seventh graders (with an average age of 13 years ± 4 months). The indicated data were obtained within the framework of the project "Physical/sports activity for health" carried out by the Institute for Kinesiology Research at the Science and Research Centre of Ko-per, University of Primorska, Slovenia. We have applied the IPAQ survey instrument (International Physical Activity Questionnaire), which we had tailored somewhat to the age and specific features of respondents. For the purposes of establishing the relationship between non numeric variables, we have applied correspondence analysis. For numeric variables, we have applied the analysis of variance and the independent samples t-test. All hypotheses were verified at the 5% statistical risk level (p = 0.05). The results attested to a statistically significant relationship between sports activ-ity, smoking and alcohol and marijuana abuse in pupils. The fact is that the drug abuse problem cannot be remedied in its entirety, but we could, however, alleviate it substantially. One of the most relevant factors in decreasing drug abuse is therefore also the engagement of youth in appropriate sports activities (during leisure time, in particular), which should be directed and planned accordingly by parents and teachers.
This joint UNESCO-NWCPEA Project comprised a World-wide Physical Education Survey to inform the development of benchmark Indicators on Quality Physical Education (QPE) in schools and Quality Physical Education Teacher Education/Training (QPETE/T) in provider institutions as well as principles of a Physical Education Basic Needs Model. The Project was in line with a CIGEPS’ mandate to ameliorate physical education policy and delivery around the world.
The Survey adopted a multi-method/pluralistic approach to data generation from a range of sources including a specifically designed structured survey questionnaire translated into officially used UNESCO and several other languages seeking quantitative and qualitative data, as well as information derived from recent and current international, continental regional and national physical education-related studies. The questionnaire was distributed to UNESCO Member States’ National Commissions and to physical education/school sport-related personnel including government-level officials through higher education academics and professionals to school-based practitioners (physical education specialist and ‘generalist’ teachers responsible for teaching physical education in schools) by institutional and personal networks. The Survey was underpinned by a comprehensive literature review that drew from a wide range of primary and secondary sources. Data were generated for 232 countries/autonomous regions (Africa 43, Asia 23, Europe 57, Latin America 23, Middle East 14, North America 61 and Oceania 11).
Background:
The Active Healthy Kids 2014 England Report Card aims to provide a systematic assessment of how England is performing in relation to engaging and facilitating physical activity (PA) in children and young people.
Methods:
The systematic methods and processes that underpin the Active Healthy Kids Canada Report Card were used and adapted. Data and evidence were consolidated, reviewed by a panel of content experts, and used to inform the assignment of letter grades (A, B, C, D, F) to 9 core indicators related to PA.
Results:
Children's Overall Physical Activity received a grade of C/D. Active Transportation and Organized Sport Participation received grades of C and C-, respectively. The indicators of School and Community and the Built Environment were graded favorable with grades of A- and B, respectively. Active Play, Sedentary Behaviors, Family and Peers, and Government Strategies and Investments were graded as INC (incomplete) due to a lack of nationally representative data and/or as a result of data not mapping onto the benchmarks used to assign the grades.
Conclusions:
Substantial provision for PA opportunities in England exists. Yet more effort is required to maximize use of these resources to increase PA participation.
Competences are intensively discussed in the context of cross-curricular themes, such as Sustainable Development and Education for Sustainable Development (ESD), especially in light of the United Nations Decade for ESD (2004-2015). Recent literature on ESD lists a number of competences for ESD in various fields with the exception of teacher education. A competence model for ESD for educators was generated in the Austrian research project KOM-BiNE (Competences for ESD in Teacher Education) as part of a large-scale EU project. The KOM-BiNE competence model consists of areas of competences within fields of action. The constituent elements of the competence model are described in detail and are illustrated with examples.
The ACDSi 2013 study is a continuation of a 40-year old decennial study on children’s biological, psychological and social development. From its beginnings in 1970, the study has been characterised as an interdisciplinary study of physical anthropology, kinesiol- ogy, psychology and sociology, but in its fifth cycle, in 2013, its focus was expanded to include paediatrics and public health. The aim of the study is to follow secular trends of the somatic and motor development of children regarding the psychological, social and health determinants that shape contemporary children’s lifestyles. The paper describes the protocol of the ACDSi 2013 study with regards to its organisation, sampling and methods.
This paper examines Slovenian physical education (PE) teachers' (n = 85) estimations of their own actual and desired professional competencies with the aim of diagnosing the main needs of practising PE teachers and resolving them within a revised Slovenian Physical Education Teacher Education (PETE) curricula and through continued professional development programmes. Results show that PE teachers realistically acknowledge their own deficiencies within certain areas of practice, that during their training they are required to develop knowledge that is not directly applicable in PE classes, thus further detracting from the development of more relevant practically orientated knowledge, and that the reorganization of the Slovenian educational system during the last 15 years presented widespread demands that were not accompanied by appropriate professional institutional support. Their relative disinterest in the competencies developed through the subdisciplinary studies indicates that the mode and contents of the subdisciplinary subjects in the present PETE curriculum should be reviewed and refocused on the contents of the revised primary and secondary school curricula.
Outwitted He drew a circle to shut us out Heretic, rebel, a thing to flout. But love and I had the wit to win We drew a circle that took him in. Edwin Markham, Quatrains The record of human accomplishments and the progress of civilization can, in many ways, be charted by the actions of history’s most gifted and talented contributors to the arts, sciences, and all other areas of human performance. As early as 2200 b.c., the Chinese had developed an elaborate system of competitive examinations to select outstanding persons for government positions (DuBois, 1970), and down through the ages almost every culture has had a special fascination for persons who have made notable contributions to their respective areas of interest and involvement. The areas of performance in which one might be recognized as a “gifted” person are determined by the needs and values of the prevailing culture, and scholars and laypersons alike have debated (and continue to debate) the age-old issues of how certain human abilities, personalities, and environmental conditions contribute to what we call giftedness. A fascination with persons of unusual ability and potential for extraordinary expertise in any and all fields of human performance has given rise to an area of study in psychology and education called gifted education. In a very general sense, this field focuses on two major questions: 1. What makes giftedness? 2. How can we develop giftedness in young people and adults?.
Introduction: This paper forms part of a group of studies regarding job placement of univer- sity graduates. The main objective of this study in particular is to present the extent of job placement among Education graduates with a Physical Education specialty from the University of Granada, Melilla Campus, as well as their acquisition of appropriate professional com- petencies during their training process.
Method: The target population for this study are all students from the first six graduating classes of the University of Granada, Melilla, who earned a Primary Education degree with a specialty in Physical Education from the College of Education and Humanities. The final sample was made up of 72 subjects. Data was collected using the “Questionnaire for evaluat- ing degree programs and social/labor placement of University of Jaen graduates”, developed as part of the research project “Social/labor placement: an evaluation of ongoing, vocational learning”. The questionnaire was adapted for this study.
Results: Measurement of professional competency acquisition in Physical Education Teach- ers was carried out for three times: before entering the university program, after completing their degree, and after taking ongoing professional development coursework. Results, then, refer to the degree of acquisition of a list of proposed competences at these three points in time. In addition, the different competencies are compared between those graduates who are working and those who are not.
Discussion or Conclusion: It was confirmed that the competency related to knowledge of information technologies, as measured before beginning university training, presents a degree of significance in favour of those graduates who do not work as compared to those who are working. The same occurs at the end of university training. During this second period, sig- nificant differences are also seen with regard to the competency planning one’s work and time. It can be shown that after university training, acquisition of competencies has increased. Likewise, after taking ongoing development coursework, significant differences are obtained for the competency of knowledge of information technologies. Finally, we find significant differences regarding technical knowledge related to physical education, and creative, inno- vative and critical ability.
The ability of skeletal muscles to produce force at a high velocity, which is crucial for success in power and sprint performance, is strongly influenced by genetics and without the appropriate genetic make-up, an individual reduces his/her chances of becoming an exceptional power or sprinter athlete. Several genetic variants (i.e. polymorphisms) have been associated with elite power and sprint performance in the last few years and the current paradigm is that elite performance is a polygenic trait, with minor contributions of each variant to the unique athletic phenotype. The purpose of this review is to summarize the specific knowledge in the field of genetics and elite power performance, and to provide some future directions for research in this field. Of the polymorphisms associated with elite power and sprint performance, the α-actinin-3 R577X polymorphism provides the most consistent results. ACTN3 is the only gene that shows a genotype and performance association across multiple cohorts of elite power athletes, and this association is strongly supported by mechanistic data from an Actn3 knockout mouse model. The angiotensin-1 converting enzyme insertion/deletion polymorphism (ACE I/D, registered single nucleotide polymorphism [rs]4646994), angiotensinogen (AGT Met235Thr rs699), skeletal adenosine monophosphate deaminase (AMPD1) Gln(Q)12Ter(X) [also termed C34T, rs17602729], interleukin-6 (IL-6 -174 G/C, rs1800795), endothelial nitric oxide synthase 3 (NOS3 -786 T/C, rs2070744; and Glu298Asp, rs1799983), peroxisome proliferator-activated receptor-α (PPARA Intron 7 G/C, rs4253778), and mitochondrial uncoupling protein 2 (UCP2 Ala55Val, rs660339) polymorphisms have also been associated with elite power performance, but the findings are less consistent. In general, research into the genetics of athletic performance is limited by a small sample size in individual studies and the heterogeneity of study samples, often including athletes from multiple-difference sporting disciplines. In the future, large, homogeneous, strictly defined elite power athlete cohorts need to be established though multinational collaboration, so that meaningful genome-wide association studies can be performed. Such an approach would provide unbiased identification of potential genes that influence elite athletic performance.
This study examines development of social competence, and behavior problems in kindergarten children during a specific period of childhood.
A sample of 499 kindergarten children (244 girls and 255 boys) with the age range of 2 years up to 5 years and 6 months was selected using the random stratified sampling method. To collect data, California Preschool Social Competence Scale and Social Skills Rating System were completed by kindergarten teachers.
The trend analysis shows that both the linear and quadratic trends for verbal facility were statistically significant. Similarly, both the linear and cubic trends were significant for considerateness, and the linear trend tendency was significant for subscales of extraversion, response to unfamiliar and task orientation. Pearson's correlation coefficient yielded a low-to-moderate and negative correlation patterns between social component and problem behaviors.
The study findings indicate a significant linear trend between the progression in social competence and increasing age, consequently leading to a decrease in social problems for children whose age was from 2 years up to 5 years and 6 months.
Research on life course epidemiology and the fetal and childhood origins of chronic disease has grown steadily during the past two decades. It has long been observed that height, a stable marker of early childhood conditions, has a strong negative association with all-cause mortality but heterogeneous association with cause-specific mortality. In their meta-analysis, the Emerging Risk Factors Collaboration 1 provides one of the most systematic and comprehensive pieces of evidence of these associations to date, overall and for a large number of causes. These robust findings confirm what has been previously reported in single studies and systematic reviews (e.g. the negative association between height and coronary heart disease) and add clarity where results were previously discrepant (e.g. pancreatic cancer) or lacking (e.g. bladder cancer). The range of sensitivity analyses provided gives further confidence in the reported associations. A particularly noteworthy finding is that of similar associations for men and women, whereas previous studies found effect modification by gender. 2 Although income was not measured, and residual bias due to this and other omitted or poorly measured covariates are a concern, these findings are consistent with what we know: the association between height and morbidity/mortality is robust to adjustment, including adjustment for socioeconomic position. 3 The same has been found for the association between height and intergenerational outcomes, 4 although the association between height and non-health components of well-being may be largely explained by income and education. 5 In contrast, there is evidence that the association between traditional measures of socio-economic position and health outcomes is overestimated when height is not included in analytic models. 6
The development of effective prevention initiatives requires a detailed understanding of the characteristics and needs of the target audience. To properly identify at-risk individuals, it is crucial to clearly delineate risky from acceptable behavior. Whereas health behavior campaigns commonly use single conditions (e.g., lack of condom use) to identify high-risk cohorts, many risk behaviors are more complex and context dependent, rendering a single condition approach inadequate. Out-of-bounds skiing, an activity associated with voluntary exposure to avalanche hazard, is an example of such a multifaceted risk-taking activity. Using a dataset from an extensive online survey on out-of-bounds skiing, we present an innovative approach for identifying at-risk individuals in complex risk environments. Based on a risk management framework, we first examine risk-taking preferences of out-of-bounds skiers with respect to exposure and preparedness-the two main dimensions of risk management-separately. Our approach builds on existing person-centered research and uses Latent Class Analysis to assign survey participants to mutually exclusive behavioral classes on these two dimensions. Discrete Choice Experiments are introduced as a useful method for examining exposure preferences in the context of variable external conditions. The two class designations are then combined using a risk matrix to assign overall risk levels to each survey participant. The present approach complements existing person-centered prevention research on the antecedents of risk-taking by offering a process-oriented method for examining behavioral patterns with respect to the activity itself. Together, the two approaches can offer a much richer perspective for informing the design of effective prevention initiatives.
This study was constructed as a comparison group pre-test/post-test quasi-experiment to assess the effect of the implementation of the PE curriculum by specialist PE teachers on children's physical development and physical fitness.
146 classes from 66 Slovenian primary schools were assigned to quasi-test (71) and quasi-control (75) groups. Data from the SLOFIT database was used to compare the differences in physical fitness and development between groups of children whose PE lessons were delivered by specialist PE teachers from the second grade onwards (quasi-test, n = 950) or by generalist teachers in all first three grades (quasi-control, n = 994). The Linear Mixed Model was used to test the influence of specialist PE teachers' teaching.
The quasi-control group showed significantly lower improvement of physical fitness by -0.07 z-score units (95% CI -0.12 to 0.02) compared to the quasi-test group. A significant difference of -0.20 (-0.27 to -0.13) was observed in explosive strength, and of -0.15 (-0.23 to -0.08) in running speed, and in flexibility by -0.22 (-0.29 to -0.14). No significant differences in physical development were observed.
Specialist PE teachers were more successful than generalist teachers in achieving greater improvement of children's physical fitness, but no differences were observed in physical development of quasi-test and quasi-control group.
To investigate the relationship between rural to urban migration and physical activity (PA) in India.
6,447 (42% women) participants comprising 2077 rural, 2,094 migrants and 2,276 urban were recruited. Total activity (MET hr/day), activity intensity (min/day), PA Level (PAL) television viewing and sleeping (min/day) were estimated and associations with migrant status examined, adjusting for the sib-pair design, age, site, occupation, education, and socio-economic position (SEP).
Total activity was highest in rural men whereas migrant and urban men had broadly similar activity levels (p<0.001). Women showed similar patterns, but slightly lower levels of total activity. Sedentary behaviour and television viewing were lower in rural residents and similar in migrant and urban groups. Sleep duration was highest in the rural group and lowest in urban non-migrants. Migrant men had considerably lower odds of being in the highest quartile of total activity than rural men, a finding that persisted after adjustment for age, SEP and education (OR 0.53, 95% CI 0.37, 0.74). For women, odds ratios attenuated and associations were removed after adjusting for age, SEP and education.
Our findings suggest that migrants have already acquired PA levels that closely resemble long-term urban residents. Effective public health interventions to increase PA are needed.
The present study summarises the work developed by the ALPHA (Assessing Levels of Physical Activity) study and describes the procedures followed to select the tests included in the ALPHA health-related fitness test battery for children and adolescents. The authors reviewed physical fitness and health in youth findings from cross-sectional studies. The authors also performed three systematic reviews dealing with (1) the predictive validity of health-related fitness, (2) the criterion validity of field-based fitness tests and (3) the reliability of field-based fitness tests in youth. The authors also carried out 11-methodological studies to determine the criterion validity and the reliability of several field-based fitness tests for youth. Finally, the authors performed a study in the school setting to examine the reliability, feasibility and safety of the selected tests. The selected fitness tests were (1) the 20 m shuttle run test to assess cardiorespiratory fitness; (2) the handgrip strength and (3) standing broad jump to assess musculoskeletal fitness, and (4) body mass index, (5) skinfold thickness and (5) waist circumference to assess body composition. When there are time limits, the authors propose the high-priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness. The time required to administer this battery to a group of 20 youth by one physical education teacher is less than 2 h. In conclusion, the ALPHA fitness tests battery is valid, reliable, feasible and safe for the assessment of health-related physical fitness in children and adolescents to be used for health monitoring purposes at population level.
The objective was to examine the tracking of obesity from childhood to young adulthood in Slovenia.
A subsample included 4833 children from the Slovenian national sample (n 21 777) who were included in the SLOFIT monitoring system from 1997 to 2008, with complete data at 7 years and 18 years.
A 12-year prospective cohort study. Height, weight and triceps skinfold thickness (TSF) were measured at 7, 11, 14 and 18 years. The BMI cut-off points of the International Obesity Taskforce were used to identify excess weight and obesity.
The survey was conducted in Slovenian primary and secondary schools from 1988 to 2008 but only the data from the measurements in 1997, 2001, 2004 and 2008 are presented.
Height, weight and BMI at 18 years were well predicted from childhood and became more predictable with age, while TSF was not. Obese and overweight children had the greatest risk of becoming obese or overweight young adults. The history of their weight shows that 40.0 % of males and 48.6 % of females who were obese at 18 years had already been obese at 7 years.
Overweight or obese Slovenian children are more likely to become overweight or obese adolescents and young adults than reported in other similar European and American studies, which indicates the need for early prevention and treatment of excess weight and obesity.
Today's rich digital information environment is characterized by the multitude of data sources providing information that has not yet reached its full potential in eHealth. The aim of the presented approach, namely CrowdHEALTH, is to introduce a new paradigm of Holistic Health Records (HHRs) that include all health determinants. HHRs are transformed into HHRs clusters capturing the clinical, social and human context of population segments and as a result collective knowledge for different factors. The proposed approach also seamlessly integrates big data technologies across the complete data path, providing of Data as a Service (DaaS) to the health ecosystem stakeholders, as well as to policy makers towards a "health in all policies" approach. Cross-domain co-creation of policies is feasible through a rich toolkit, being provided on top of the DaaS, incorporating mechanisms for causal and risk analysis, and for the compilation of predictions.
Background
Attention deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders affecting some 8–10% of children worldwide. Increasing research has shed light on the life course of the disorder, suggesting that majority of children with ADHD will continue to have persistent symptoms into adulthood. The mainstay of ADHD management has been pharmacologic and behavioural/psychological interventions, with little attention paid to exercise as a potential management strategy. A systematic review, examining both the short-term and long-term effects of exercise on children with ADHD, is timely and necessary to guide further research in this area.
Methods
Using the keywords [exercise OR physical OR activity OR sport] AND [attention deficit hyperactivity disorder OR ADHD OR ADDH], a preliminary search on the PubMed and Ovid database yielded 613 papers published in English between 1-Jan-1980 and 1-July-2016. Full articles were also reviewed for references of interest.
Results
A total of 30 studies were included in this systematic review. Both short-term and long-term studies support the clinical benefits of physical activity for individuals with ADHD. Cognitive, behavioural and physical symptoms of ADHD were alleviated in most instances, and the largest intervention effects were reported for mixed exercise programs. No adverse effects arising from physical exercise were reported in any of the studies, suggesting that exercise is a well-tolerated intervention.
Conclusion
Physical activity, in particular moderate-to-intense aerobic exercise, is a beneficial and well-tolerated intervention for children and adolescents with ADHD. Future research should include more adequately-powered trials and investigate the ideal exercise prescription.
Research on the effects of physical activity on children with attention deficit hyperactivity disorder is promising, yet no attempt has been made to integrate current findings using meta-analytic techniques. Using a meta-regression, the present study examined the effectives of physical activity for children with attention deficit hyperactivity disorder on a number of cognitive, behavioral, and emotional outcomes. From 20 empirical studies, 164 effect sizes quantifying the effectiveness of physical activity for children with attention deficit hyperactivity disorder were extracted from 22 independent samples. Results indicated an overall moderate-to-large effect for physical activity on children with attention deficit hyperactivity disorder, with a significant effect for emotion/mood. Limitations of the study, future directions, and implications for school professionals are discussed.
Objective To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9–17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).
Methods A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9–17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for .
Results Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative ). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.
Conclusions This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.
This study aimed to develop a reliable, valid, and feasible method for assessing physical activity among children ages 5-6 and 10-12 years. Test-retest reliability of a parental proxy questionnaire and a children's self-report questionnaire was assessed in 280 children and parents. The criterion validity of the questionnaires was assessed using accelerometry. The proxy questionnaire provided a reliable measure of the type, frequency, and duration of children's physical activity. Neither version of the questionnaire provided an accurate estimate of individual children's physical activity. To assess the type, frequency, intensity, and duration of children's activity, a combination of questionnaire and objective measures should be employed.
The Active Healthy Kids Scotland Report Card aims to consolidate existing evidence, facilitate international comparisons, encourage more evidence-informed physical activity and health policy, and improve surveillance of physical activity.
Application of the Active Healthy Kids Canada Report Card process and methodology to Scotland, adapted to Scottish circumstances and availability of data.
The Active Healthy Kids Scotland Report Card 2013 consists of indicators of 7 Health Behaviors and Outcomes and 3 Influences on Health Behaviors and Outcomes. Grades of F were assigned to Overall Physical Activity, Sedentary Behavior (recreational screen time), and Obesity Prevalence. A C was assigned to Active Transportation and a D- was assigned to Diet. Two indicators, Active and Outdoor Play and Organized Sport Participation, could not be graded. Among the Influences, Family Influence received a D, while Perceived Safety, Access, and Availability of Spaces for Physical Activity and the National Policy Environment graded more favorably with a B.
The Active Healthy Kids Canada process and methodology was readily generalizable to Scotland. The report card illustrated low habitual physical activity and extremely high levels of screen-based sedentary behavior, and highlighted several opportunities for improved physical activity surveillance and promotion strategies.
Objectives
This multi-center study was conducted to objectively evaluate energy expenditure and physical activity (PA) patterns on school days and weekends in urban 11-year-olds.Methods
The sample consisted of 241 children from three cities: Zagreb, Ljubljana (both in Central Europe) and Ann Arbor (United States). Energy expenditure and PA were assessed during two school days and two weekend days using a multiple-sensor body monitor.ResultsDifferences between the cities were observed for all PA variables. The highest level of moderate to vigorous PA (MVPA) was noted in Ljubljana boys [284 (98) min/day] and the lowest in Zagreb girls [179 (95) min/day]. In Zagreb and Ljubljana, boys were more physically active than girls, while in Ann Arbor the opposite was observed. In contrast, no gender difference in sedentary behavior was observed in any of the cities. A decline in PA from school days to weekends was noted in all city groups in both genders. However, the magnitude of the reduction in daily energy expenditure differed between the cities, with the largest differences being observed in Ljubljana and the smallest in Ann Arbor. In all three city groups, the great majority of boys and girls achieved current recommendations of 60 min of MVPA either during school days or weekends.Conclusions
Weekends seem to be an appropriate target when promoting PA in 11-year-olds in all the cities included in the study. Increasing vigorous activity on weekends seems to be of particular importance in Zagreb and Ljubljana. Am. J. Hum. Biol., 2014. © 2014 Wiley Periodicals, Inc.
The sport environment is an inviting but largely untapped naturalistic laboratory for behavioral research and intervention. We discuss some of the advantages that this environment offers psychological researchers, then illustrate the manner in which basic and applied behavioral research can be carried out in the area of youth sports. Two programs of research and intervention are described. The first involved the use of behavioral assessment to study the effects of coaching behaviors on child athletes and to develop and evaluate a cognitive-behavioral coach training program. The second research program studied the interactive effects of life stress, social support, and cognitive-behavioral coping skills on injury vulnerability in adolescent athletes. Implications of the findings for behavioral intervention programs designed to reduce injury vulnerability are discussed.
The tenth anniversary of "Measurement in Physical Education and Exercise Science" causes one to reflect on the major measurement issues impacting physical education and exercise science in the latter half of the 20th century. This anniversary causes us to contemplate how this history has brought us to where we are today and what it portends for the future. The purpose of this report is to provide the authors' interpretation of these significant events. In this article, the authors reflect on five important events have most highly influenced measurement of physical fitness and physical activity in the past half century and will continue to influence measurement experts well into the 21st century. The events are: (1) Initial nationwide interest--Publication of "Minimum muscular fitness tests in school children" by Kraus and Hirshland (1954) in the 1954 "Research Quarterly;" (2) Health-related fitness construct--The development of the "health-related fitness" concept and its differentiation from performance-based youth fitness testing; (3) National youth fitness studies--National studies of youth fitness in the 1980s: the two National Children and Youth Fitness Studies (National Children and Youth Fitness Study [NCYFS], 1985; NCYFS II, 1987) and the National School Population Fitness Survey (President's Council on Physical Fitness and Sports [PCPFS], 1986; (4) Evaluation perspectives--The move from norm-referenced to criterion-referenced evaluation of youth physical fitness; and (5) Measuring activity vs. fitness--The interest in assessment of physical activity (the process) rather than assessment of physical fitness (the product). The authors then indicate how each event interacted with the others, how each led to where we are today, and how these have combined to influence measurement and evaluation in physical education, exercise science and kinesiology. (Contains 1 table and 1 figure.)
Some researchers in sports attribute elite performance to genetic talent. However, they do not offer complete genetic accounts that specify the causal processes involved in the activation and expression of the dormant genes in DNA during practice in the athletes' development that lead to the emergence of the distinctive physiological and anatomical attributes (innate talent). This article argues that it is possible to account for the development of elite performance among healthy children without recourse to unique talent (genetic endowment)-excepting the innate determinants of body size. This account based on the expert-performance approach shows that the distinctive characteristics of elite performers are adaptations to extended and intense practice activities that selectively activate dormant genes that all healthy children's DNA contain. The expert-performance approach has provided accounts for elite performance in several domains of expertise, such as music, ballet, chess, and medicine. This article shows how the superior performance of athletes can be captured and reproduced under laboratory conditions to discover the mechanisms mediating superior performance. The discovered mechanisms have, so far, been shown to reflect predominantly complex skills and physiological adaptations acquired over years and decades as a result of high daily levels of activities, which were specially designed to improve performance (deliberate practice). The second part of this article describes the development of expert performance in sports as an extended series of stable states of adaptation with associated physiological mechanisms that mediate performance. One section describes how frequent intense engagement in certain types of practice activities is shown to induce physiological strain which cause biochemical changes that stimulate growth and transformation of cells, which in turn leads to associated improved adaptations of physiological systems and the brain. A careful review of the published evidence on the heritability of acquisition of elite sports achievement failed to reveal reproducible evidence for any genetic constraints for attaining elite levels by healthy individuals (excluding, of course, the evidence on body size). The theoretical framework of expert performance explains individual differences in attained performance by the factors that influence the engagement in sustained extended deliberate practice, such as motivation, parental support, and access to the best training environments and teachers. Consequently, the development of expert performance will be primarily constrained by individuals' engagement in deliberate practice and the quality of the available training resources. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
To implement effective non-communicable disease prevention programmes, policy makers need data for physical activity levels and trends. In this report, we describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries. Worldwide, 31·1% (95% CI 30·9-31·2) of adults are physically inactive, with proportions ranging from 17·0% (16·8-17·2) in southeast Asia to about 43% in the Americas and the eastern Mediterranean. Inactivity rises with age, is higher in women than in men, and is increased in high-income countries. The proportion of 13-15-year-olds doing fewer than 60 min of physical activity of moderate to vigorous intensity per day is 80·3% (80·1-80·5); boys are more active than are girls. Continued improvement in monitoring of physical activity would help to guide development of policies and programmes to increase activity levels and to reduce the burden of non-communicable diseases.
Height is a classic complex trait with common variants in a growing list of genes known to contribute to the phenotype. Using a genecentric genotyping array targeted toward cardiovascular-related loci, comprising 49,320 SNPs across approximately 2000 loci, we evaluated the association of common and uncommon SNPs with adult height in 114,223 individuals from 47 studies and six ethnicities. A total of 64 loci contained a SNP associated with height at array-wide significance (p < 2.4 x 10(-6)), with 42 loci surpassing the conventional genome-wide significance threshold (p < 5 x 10(-8)). Common variants with minor allele frequencies greater than 5% were observed to be associated with height in 37 previously reported loci. In individuals of European ancestry, uncommon SNPs in IL11 and SMAD3, which would not be genotyped with the use of standard genome-wide genotyping arrays, were strongly associated with height (p < 3 x 10(-11)). Conditional analysis within associated regions revealed five additional variants associated with height independent of lead SNPs within the locus, suggesting allelic heterogeneity. Although underpowered to replicate findings from individuals of European ancestry, the direction of effect of associated variants was largely consistent in African American, South Asian, and Hispanic populations. Overall, we show that dense coverage of genes for uncommon SNPs, coupled with large-scale meta-analysis, can successfully identify additional variants associated with a common complex trait.
The health of Canadian children and youth has deteriorated in the past few decades and physical inactivity is a powerful contributor. Active Healthy Kids Canada (AHKC; www.activehealthykids.ca) is a national not-for-profit organization with a mission to inspire the nation to engage all children and youth in physical activity by providing expertise and direction to policy makers and the public on how to increase and effectively allocate resources and attention toward physical activity for Canadian children and youth. Annually, for the past 7 years, the AHKC Report Card has consolidated and translated research knowledge to drive social action for policy change relating to physical activity among children and youth. Original published articles and key surveillance data from national and regional surveys are reviewed. A group of content experts from across Canada meet semiannually to review the evidence and assign letter grades. The AHKC Report Card has played a key role in informing discussions that have led to action on physical inactivity in Canada. Further evidence of the Report Card's influence is in the replication of the model in several other jurisdictions, including Saskatchewan and Ontario, Canada; Louisiana, United States; South Africa; Mexico; and Kenya.
Increases in the numbers of people participating in snow sports raise safety concerns. Despite declining numbers of skiing injuries among recreational skiers, collisions resulting in severe injuries appear to be on the rise. Skiers' risk of injury depends on a considerable number of different factors but only a few studies have investigated risk-taking behaviour and knowledge of proper skiing behaviour. To promote safe skiing the International Ski Federation (FIS) introduced regulations in 1967. We investigated participants' familiarity with the FIS regulations on the ski slopes in relation to age, skiing ability and country of origin. Random interviews were conducted with 1450 recreational skiers at 17 ski resorts in Tyrol, an Austrian province. A questionnaire assessing skiers' knowledge of existing rules, their intuitive behaviour in given situations and perceptions of safety was developed. The study revealed that beginners, young skiers and those who were not local residents displayed insufficient knowledge. Risk-inducing situations that could result in collisions, such as moving upwards during carving, were largely assessed incorrectly. Appropriate intuitive behaviour increases with experience, and beginners are less able to implement FIS regulations than more experienced skiers. Ski resorts, the media and schools should direct educational efforts toward these high-risk groups. More research is needed to determine the causal connection between skiing injuries and disregard of the FIS Rules.
p>En el marco de la Declaración de Bolonia, la identificación de las competencias de cadadisciplina adquiere una gran relevancia de cara a la elaboración de los futuros planes deestudio. Por ello, el objetivo que se planteó en el presente estudio fue realizar una primeraaproximación al perfil competencial del Licenciado en Ciencias de la A. Física y del Deporte.Participaron 92 expertos, vinculados a los diferentes ámbitos profesionales del sector, a loscuales se les administró un cuestionario con el fin de que valoraran la importancia quetenían 37 competencias, previamente seleccionadas, para un desempeño profesionalbrillante. Los resultados obtenidos en el estudio mostraron que las diez competencias másvaloradas eran: responsabilidad, capacidad de planificación, capacidad para tomardecisiones, confianza en uno mismo, identificación con el proyecto, capacidad de escucha,iniciativa, automotivación, creatividad y capacidad para establecer relaciones sociales.
Palabras Clave: licenciado, actividad física, deporte, competencias profesionales.</p
Year-round training in a single sport beginning at a relatively young age is increasingly common among youth. Contributing factors include perceptions of Eastern European sport programs, a parent's desire to give his or her child an edge, labeling youth as talented at an early age, pursuit of scholarships and professional contracts, the sporting goods and services industry, and expertise research. The factors interact with the demands of sport systems. Limiting experiences to a single sport is not the best path to elite status. Risks of early specialization include social isolation, overdependence, burnout, and perhaps risk of overuse injury. Commitment to a single sport at an early age immerses a youngster in a complex world regulated by adults, which is a setting that facilitates manipulation - social, dietary, chemical, and commercial. Youth sport must be kept in perspective. Participants, including talented young athletes, are children and adolescents with the needs of children and adolescents.
To explore associations between developmental coordination disorder (DCD) and attention, language, social skills, and academic ability in a population-based cohort.
We analyzed data (N = 6902) from the Avon Longitudinal Study of Parents and Children (ALSPAC). Probable DCD was defined as children below the 15th centile of the ALSPAC Coordination Test aged 7 years with functional impairment in activities of daily living or handwriting, excluding children with neurologic difficulties or an IQ of <70. Four developmental domains were assessed by using standardized tests between the ages of 7.5 and 9 years: attention; language skills (expressive language, comprehension, short-term memory); social skills (nonverbal skills and social communication); and academic ability (reading and spelling). The worst 5% of each trait was used to define impairment. We used multiple logistic regression models to assess the association between probable DCD and each trait. Our final model controlled for IQ, socioeconomic factors, and other developmental traits not in the domain assessed.
A total of 346 (5.0%) children met criteria for probable DCD. Probable DCD was associated with difficulties in attention (odds ratio [OR]: 1.94 [95% confidence interval (CI): 1.17-3.24]), nonword repetition (OR: 1.83 [95% CI: 1.26-2.66]), social communication (OR: 1.87 [95% CI: 1.15-3.04]), reading (OR: 3.35 [95% CI: 2.36-4.77]), and spelling (OR: 2.81 [95% CI: 2.03-3.90]).
Children with probable DCD had an increased risk of difficulties in attention, social skills, reading, and spelling. These additional difficulties need to be screened for during assessment and considered when formulating interventions.
To date, it is unclear which measure of obesity is the most appropriate for risk stratification.
The aim of the study was to compare the associations of various measures of obesity with incident cardiovascular events and mortality.
We analyzed two German cohort studies, the DETECT study and SHIP, including primary care and general population.
A total of 6355 (mean follow-up, 3.3 yr) and 4297 (mean follow-up, 8.5 yr) individuals participated in DETECT and SHIP, respectively.
We measured body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) and assessed cardiovascular and all-cause mortality and the composite endpoint of incident stroke, myocardial infarction, or cardiovascular death.
In both studies, we found a positive association of the composite endpoint with WHtR but not with BMI. There was no heterogeneity among studies. The relative risks in the highest versus the lowest sex- and age-specific quartile of WHtR, WC, WHR, and BMI after adjustment for multiple confounders were as follows in the pooled data: cardiovascular mortality, 2.75 (95% confidence interval, 1.31-5.77), 1.74 (0.84-3.6), 1.71 (0.91-3.22), and 0.74 (0.35-1.57), respectively; all-cause mortality, 1.86 (1.25-2.76), 1.62 (1.22-2.38), 1.36 (0.93-1.69), and 0.77 (0.53-1.13), respectively; and composite endpoint, 2.16 (1.39-3.35), 1.59 (1.04-2.44), 1.49 (1.07-2.07), and 0.57 (0.37-0.89), respectively. Separate analyses of sex and age groups yielded comparable results. Receiver operating characteristics analysis yielded the highest areas under the curve for WHtR for predicting these endpoints.
WHtR represents the best predictor of cardiovascular risk and mortality, followed by WC and WHR. Our results discourage the use of the BMI.