Introduction to the Active Living Research Reference List January – July 2008


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A. A. Mahfouz, I. Abdelmoneim, M. Y. Khan, A. A. Daffalla, M. M. Diab, K. S. Al-Gelban and H. Moussa. (2008). Obesity and related behaviors among adolescent school boys in Abha City, Southwestern Saudi Arabia. Journal Of Tropical Pediatrics. 54, 120-124.
Using stratified sampling technique 2696 adolescent school boys (aged 11-19 years) in Abha City, Southwestern Saudi Arabia were interviewed and examined for weight and height using standardized techniques. The overall prevalence of obesity and overweight in the present study amounted to 16. Using logistic regression analysis, lack of exercise practice in the previous week in general [aOR = 1.352, 95 confidence interval (CI) = 1.0661.941] or in the class (aOR = 1.446, 95 CI = 1.0831.931) were significantly associated with obesity. The present study showed that obesity among adolescent school boys in Abha City is a public health problem. There is a need for a national program in the country to prevent and control obesity among adolescents. The program should incorporate: dietary management of obesity, promotion of physical activity, health education campaigns and consideration of the possibility of providing facilities for practicing physical activity and exercise in the community.

R. M. Malina, M. E. P. a. Reyes, S. K. Tan and B. B. Little. (2008). Physical activity in youth from a subsistence agriculture community in the Valley of Oaxaca, southern Mexico. Applied Physiology, Nutrition & Metabolism. 33, 819.

Observations of activities of contemporary subsistence agricultural communities may provide insights into the lifestyle of youth of 2 to 3 generations ago. The purpose of this study was to document age- and sex-associated variation in household activities and daily steps walking to school of youth 9-17 years in an indigenous subsistence agricultural community in Oaxaca, southern Mexico. Activities during leisure were also considered. A cross-sectional survey of a rural Zapotec-speaking community was undertaken, and respondents included 118 boys and 152 girls, aged 8.7-17.9 years. Household and leisure activities were documented by questionnaire and subsequent interview. Household activities were classified by estimated intensity for before and after school and on the weekend, and an estimate of METS per day accumulated while doing chores was derived. Number of steps from home to school was estimated. Contingency table analysis and MANCOVA controlling for age was used to evaluate results. Household activities tended to cluster at light and moderate intensities in girls and at moderate to moderate-to-vigorous intensities in boys. Estimated METS per day in ~2 h of chores differed significantly by sex. Secondary school girls expended significantly more METS per day in chores than primary school girls, but there was no difference by school level in boys. The daily round trip from home to school was ~2400 steps for primary students and ~2700 and ~3100 steps for secondary boys and girls, respectively. Television viewing and participation in sports were major leisure activities for boys and girls. Daily household chores, walking, and leisure activities suggest moderately active and moderately-to-vigorously active lifestyles in girls and boys, respectively, in this indigenous subsistence agricultural community.

J. J. Martin, N. McCaughtry and B. Shen. (2008). Predicting physical activity in Arab American school children. Journal Of Teaching In Physical Education. 27, 205-219.

Theoretically grounded research on the determinants of Arab American children's physical activity is virtually nonexistent. Thus, the purpose of our investigation was to evaluate the ability of the theory of planned behavior (TPB) and social cognitive theory (SCT) to predictArab American children's moderate-to-vigorous physical activity (MVPA). Children (N = 348, ages 10-14) completed questionnaires assessing the TPB and SCT constructs as well as MVPA. Using multiple regression analyses we were able to account for 9% of the variance in MVPA. Based on standardized beta-weights, variance accounted for, and the significance of F change, we concluded that SCT variables were better predictors of MVPA compared with the TPB constructs. In particular, barrier self-efficacy was the most critical variable within SCT and supports the potentially valuable role that efficacy cognitions play in promoting MVPA in Arab American children.

J. J. D. Martin, L. S. Hernandez, M. G. Gonzalez, C. P. Mendez, C. R. Galan and S. M. Guerrero. (2008). Trends in childhood and adolescent obesity prevalence in Oviedo (Asturias, Spain) 1992-2006. Acta Paediatrica. 97, 955-958.

Aim: To analyse obesity and overweight prevalence trend in Oviedo (Spain) during the last 14 years. Patients and Methods: Two cross-sectional studies were conducted in the same five public schools of the urban area of Oviedo in 1992 and 2004-06. One thousand one hundred sixty-five children and young adults between the age of 6 and 17 years were studied in 1992 and 1312 in 2004-06. Obesity and overweight were defined according to the International Obesity Task Force cut-off values. Results: Body mass index (BMI) values (20.5 +/- 3.6 vs. 20.1 +/- 3.3 p = 0.02) and obesity prevalence (6.3% vs. 4.5% p < 0.05) were significantly higher in the 2004-06 cohort, while overweight prevalence showed a non-significant increase. Obesity prevalence increased in both sexes in the 6-11-year group. In adolescent females, a four-fold increase was observed, from 0.9% in 1992 (95% CI: -0.1 to 1.9) to 3.8% in 2004-06 (95% CI: 1.8-6). A slight non-significant decrease was observed in adolescent males (6.6% in 1992 to 5.8% in 2004-06). Conclusion: Obesity and overweight are increasing in children and adolescents in Oviedo at a level similar to that observed in studies conducted in developed countries. This obesity epidemic is becoming an important public health issue.

A. E. Matthews. (2008). 'Children and obesity: a pan-European project examining the role of food marketing'. Eur J Public Health. 18, 7-11.

BACKGROUND: Rising levels of obesity in school-age children across Europe are causing increasing concern. The 'Children, Obesity and associated avoidable Chronic Diseases' project sought to examine the effects of promotion within food marketing, given the influential role it plays in children's diets. METHOD: A questionnaire and data-collection protocol was designed for the national co-ordinators, facilitating standardized responses. Co-ordinators collected data from within 20 European Union countries relating to food promotion to children. RESULTS: Results showed that unhealthy foods such as savoury snacks and confectionary were the most commonly marketed and consumed by children across all countries. Television was found to be the prime promotional medium, with in-school and internet marketing seen as growth areas. Media literacy programmes designed specifically to counterbalance the effects of food marketing to children were reported by only a few of the 20 countries. An ineffective and incoherent pattern of regulation was observed across the countries as few governments imposed tough restrictions with most preferring to persuade industry to voluntarily act with responsibly. Most health, consumer and public interest groups supported food marketing restrictions whilst industry and media groups advocated self-regulation. CONCLUSION: Recommendations include the amendment of the European Union's Television Without Frontiers Directive to ban all TV advertising of unhealthy food to children, the adoption of a commonly agreed European Union definition of an 'unhealthy' food, and the establishment of a mechanism for pan-European monitoring of the nature and extent of food marketing to children and its regulation.

W. Maziak, K. D. Ward and M. B. Stockton. (2008). Childhood obesity: are we missing the big picture? Obesity Reviews. 9, 35-42.

Childhood obesity is increasing worldwide, raising alarm about future trends of cardiovascular disease, diabetes and cancer. This article discusses what may underlie our failure to respond effectively to the obesity epidemic, and presents a wider perspective for future research and public health agendas. So far targeting individual-level determinants and clinical aspects of childhood obesity has produced limited success. There is growing interest in understanding the wider determinants of obesity such as the built environment (e.g. walkability), social interactions, food marketing and prices, but much needs to be learned. Particularly, we need to identify distal modifiable factors with multiple potential that would make them attractive for people and policymakers alike. For example, walking-biking-friendly cities can reduce obesity as well as energy cosumption, air pollution and traffic delays. Such agenda needs to be driven by strong evidence from research involving multi-level influences on behaviour, as well as the study of wider politico-economic trends affecting people's choices. This article highlights available evidence and arguments for research and policy needed to curb the obesity epidemic. The upstream approach underlying these arguments aims to make healthy choices not only the most rational, but also the most feasible and affordable.

W. J. McCarthy, A. K. Yancey, J. M. Siegel, W. K. Wong, A. Ward, J. Leslie and E. Gonzalez. (2008). Correlation of obesity with elevated blood pressure among racial/ethnic minority children in two Los Angeles middle schools. Prev Chronic Dis. 5, A46.

INTRODUCTION: To identify anthropometric and fitness correlates of elevated blood pressure, serum cholesterol, and glycated hemoglobin, we examined anthropometric and physiologic biomarkers among racial/ethnic minority children aged 11 to 13 years in two urban Los Angeles middle schools. We explored the potential for using obesity or fitness level as screening variables for cardiovascular disease risk factors in these students. METHODS: During regularly scheduled physical education classes, we collected data on demographic characteristics, height, weight, blood pressure, nonfasting total serum cholesterol, glycated hemoglobin, time to run/walk 1 mile, and a range of self-reported behaviors. A total of 199 sixth-graders (121 Latinos, 78 African Americans) participated in the study. RESULTS: Bivariate analyses indicated that 48.6% of sixth-graders were of desirable weight, 17.5% were overweight, 29.9% were at risk for overweight, and 4.0% were underweight. Higher weight was associated with higher levels of serum cholesterol, systolic blood pressure, and diastolic blood pressure (P values for all associations <.02) but not with glycated hemoglobin. Multivariate analyses maintained the findings with regard to blood pressure but not serum cholesterol. CONCLUSION: Overweight status could be a screening variable for identifying youth at risk for high blood pressure. Obesity prevention and intervention programs and policies need to target low-income racial/ethnic minority children. Assessment of hypertension status also seems warranted in low-income racial/ethnic minority sixth-graders, as does early intervention for children at high risk.

H. McKay and E. Smith. (2008). Commentary: Winning the Battle Against Childhood Physical Inactivity: The Key to Bone Strength? Journal of Bone & Mineral Research. 23, 980.

The article focuses on the effect inactivity has on bone strength in children and in adults. It states that randomized controlled trials showed increased bone accrual in girls and boys who participated in a 10-to 12-minute moderate impact circuit training program, and similar increases in other trails of children participating in impact exercise programs.

T. L. McKenzie and D. Kahan. (2008). Physical activity, public health, and elementary schools. Elementary School Journal. 108, 171-180.

Physical inactivity is a serious public health problem that is associated with numerous preventable diseases. Public health concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by differentiating physical activity from associated concepts (e. g., physical education, physical fitness) and then summarizes the literature related to the importance of physical activity for children and the need for its promotion in elementary schools. We describe numerous opportunities for children to accrue physical activity in elementary schools (e. g., physical education classes, program integration with other subject areas, recess, extracurricular programs, and active transport to school) and provide recommendations for sound educational practice.

J. M. Mellor, R. B. Rapoport and D. Maliniak. (2008). The impact of child obesity on active parental consent in school-based survey research on healthy eating and physical activity. Evaluation Review. 32, 298-312.

Previous studies have shown that active consent procedures result in sampling bias in surveys dealing with adolescent risk behaviors such as cigarette smoking and illicit drug use. To examine sampling bias from active consent procedures when the survey topic pertains to childhood obesity and associated health behaviors, the authors pair data obtained from both active and passive consent procedures. The authors find that parents of children who are overweight or at risk for being overweight are significantly less likely to give active consent. In addition, parents of children enrolled in lower grades are more reluctant to consent to participate.

D. Menschik, S. Ahmed, M. H. Alexander and R. W. Blum. (2008). Adolescent physical activities as predictors of young adult weight. Arch Pediatr Adolesc Med. 162, 29-33.

OBJECTIVE: To examine the relationship between increased physical activity in adolescence and adult weight status. DESIGN: Cohort study based on data from the National Longitudinal Study of Adolescent Health. SETTING: In-home interviews. PARTICIPANTS: A total of 3345 adolescents in grades 8 to 12 with body mass index (calculated as weight in kilograms divided by height in meters squared) data available at baseline and 5 years later. Main Exposures Days per week of curricular and extracurricular physical activity. MAIN OUTCOME MEASURE: Overweight status (body mass index > or =25) 5 years after baseline. RESULTS: Increasing participation in certain extracurricular physical activities and physical education decreased the likelihood of young adulthood overweight. Regarding extracurricular physical activities, the likelihood of being an overweight adult was reduced most (ie, 48%) by performing certain wheel-related activities (ie, rollerblading, roller skating, skateboarding, or bicycling) more than 4 times per week. Each weekday that adolescents participated in physical education decreased the odds of being an overweight adult by 5%, with participation in all 5 weekdays of physical education decreasing the odds by 28%. In general, physical activity predicted normal-weight maintenance better than weight loss. CONCLUSION: These data underscore the important role that school-based and extracurricular physical activity play in reducing the likelihood of transitioning to overweight as young adults.

B. G. Meriaux, A. L. Hellstrom and S. Marild. (2008). Identification and follow-up of obesity in ten-year-old school children. Int J Pediatr Obes. 3, 102-8.

OBJECTIVE: Growth surveillance of children in school health services is a routine in Sweden. We describe the effect at follow-up of an overt identification of obesity in school children. METHODS: Follow-up data were collected in two populations of ten-year-old children with obesity. Children in the study group belonged to a cohort born in 1990. Here the presence of obesity had been identified at the routine growth screening, and intervention activities against obesity had been actively offered. Controls belonged to a cohort born in 1989. RESULTS: Of the 176 children with obesity, 91 were in the study group (41 girls) and 85 (44 girls) in the control group. No differences were found between the groups in age, gender or body mass index at baseline. At follow-up, after one to two years, children in the study group had a modest but significantly more pronounced decrease in the relative body mass index, compared with controls. The mean difference between the populations in body mass index standard deviation score (z-score) after adjustment for baseline body mass index and follow-up time was -0.14 (95% confidence interval: -0.25 to -0.02; P=0.027). Socioeconomic status, gender, follow-up time and group were independent predictors for change in body mass index z-score. CONCLUSIONS: To identify children with obesity in a routine school health survey may be a crucial initial step in the management of childhood obesity.

M. L. Mietus-Snyder and R. H. Lustig. (2008). Childhood obesity: Adrift in the "Limbic Triangle". Annual Review Of Medicine. 59, 147-162.

The prevalence and severity of childhood obesity have increased steadily over the post three decades. The human species evolved to rigorously defend its lower limit for weight and adiposity but is tolerant of the upper limit, which, until recent times, was rarely approached. Neuroendocrine mechanisms within the limbic core of the brain prevent starvation (ventromedial hypothalamus), heighten reward (ventral tegmental area and nucleus accumbens), and attenuate stress (amygdala), in order to promote food-seeking and ingestive behavior and to conserve energy output. In a stressful modern environment with ready access to calorie-dense, highly palatable foods and limited venues for activity, normal, reflexive responsiveness to these three drives makes weight gain all but inevitable. The obesity that ensues often engenders insulin resistance, which undermines the ability of normal hunger and satiety signals to accurately modulate energy intake versus expenditure. Obesity interventions that rely on cognitive information alone cannot free children from this "limbic triangle." Integrated multidisciplinary family- and community-based education, effective stress reduction, and a societal commitment to alter the food and built environments are all necessary components to battle the global obesity epidemic.

F. Moola, G. E. Faulkner, J. A. Kirsh and J. Kilburn. (2008). Physical activity and sport participation in youth with congenital heart disease: perceptions of children and parents. Adapt Phys Activ Q. 25, 49-70.

This study explored perceptions toward physical activity and sport in the lives of youth with congenital heart disease. Thirteen cardiac participants were interviewed in the presence of their parents, and a process of inductive analysis was conducted. Sport was not considered a valued pursuit despite the belief that it is essential for the attainment of good health. Low-self efficacy and fatigue were influenced by covert fears and exclusion and further decreased the value ascribed to sport and physical activity. Nontraditional activities, support from others, and perceptions of mastery played a crucial role in enabling participation and facilitated the journey toward recovery. Findings are discussed within the context of self-efficacy theory and may inform the design of safe and enjoyable physical activity opportunities for this population.

L. A. Moreno, M. Gonzalez-Gross, M. Kersting, D. Molnar, S. de Henauw, L. Beghin, M. Sjostrom, M. Hagstromer, Y. Manios, C. C. Gilbert, F. B. Ortega, J. Dallongeville, D. Arcella, J. Warnberg, M. Hallberg, H. Fredriksson, L. Maes, K. Widhalm, A. G. Kafatos and A. Marcos. (2008). Assessing, understanding and modifying nutritional status, eating habits and physical activity in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr. 11, 288-99.

OBJECTIVES: To identify the main knowledge gaps and to propose research lines that will be developed within the European Union-funded 'Healthy Lifestyle in Europe by Nutrition in Adolescence' (HELENA) project, concerning the nutritional status, physical fitness and physical activity of adolescents in Europe. DESIGN: Review of the currently existing literature. RESULTS: The main gaps identified were: lack of harmonised and comparable data on food intake; lack of understanding regarding the role of eating attitudes, food choices and food preferences; lack of harmonised and comparable data on levels and patterns of physical activity and physical fitness; lack of comparable data about obesity prevalence and body composition; lack of comparable data about micronutrient and immunological status; and lack of effective intervention methodologies for healthier lifestyles. CONCLUSIONS: The HELENA Study Group should develop, test and describe harmonised and state-of-the-art methods to assess the nutritional status and lifestyle of adolescents across Europe; develop and evaluate an intervention on eating habits and physical activity; and develop and test new healthy food products attractive for European adolescents.

N. D. Muth. (2008). Preventing Childhood Obesity. IDEA Fitness Journal. 5, 58.

The article looks at the efforts to overcome childhood obesity in the U.S. Prevalence of obesity increased from 5% in the 1960s to 17% in 2004. The Office of the Surgeon General launched the Childhood Overweight and Obesity Prevention Initiative to coordinate and expand programs for preventing obesity. A fitness facility was introduced by Overtime Fitness Inc. founders to address the special interests and needs of teens. Highlights of the report "Progress in Preventing Childhood Obesity: How Do We Measure Up?" are presented.

P. R. Nader, R. H. Bradley, R. M. Houts, S. L. McRitchie and M. O'Brien. (2008). Moderate-to-vigorous physical activity from ages 9 to 15 years. Jama-Journal Of The American Medical Association. 300, 295-305.

Context Decreased physical activity plays a critical role in the increase in childhood obesity. Although at least 60 minutes per day of moderate- to- vigorous physical activity (MVPA) is recommended, few longitudinal studies have determined the recent patterns of physical activity of youth. Objective To determine the patterns and determinants of MVPA of youth followed from ages 9 to 15 years. Design, Setting, and Participants Longitudinal descriptive analyses of the 1032 participants in the 1991- 2007 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development birth cohort from 10 study sites who had accelerometer- determined minutes of MVPA at ages 9 (year 2000), 11 (2002), 12 (2003), and 15 (2006) years. Participants included boys (517 [50.1%]) and girls (515 [49.9%]); 76.6% white (n= 791); and 24.5% (n= 231) lived in low- income families. Main Outcome Measure Mean MVPA minutes per day, determined by 4 to 7 days of monitored activity. Results At age 9 years, children engaged in MVPA approximately 3 hours per day on both weekends and weekdays. Weekday MVPA decreased by 38 minutes per year, while weekend MVPA decreased by 41 minutes per year. By age 15 years, adolescents were only engaging in MVPA for 49 minutes per weekday and 35 minutes per weekend day. Boys were more active than girls, spending 18 and 13 more minutes per day in MVPA on the weekdays and weekends, respectively. The rate of decrease in MVPA was the same for boys and girls. The estimated age at which girls crossed below the recommended 60 minutes of MVPA per day was approximately 13.1 years for weekday activity compared with boys at 14.7 years, and for weekend activity, girls crossed below the recommended 60 minutes of MVPA at 12.6 years compared with boys at 13.4 years. Conclusion In this study cohort, measured physical activity decreased significantly between ages 9 and 15 years.

M. S. Nanney, C. Bohner and M. Friedrichs. (2008). Poverty-related factors associated with obesity prevention policies in Utah secondary schools. J Am Diet Assoc. 108, 1210-5.

To address the childhood obesity epidemic, numerous national agencies have outlined specific school policy recommendations for nutrition and physical activity. The extent to which current policies differ by socioeconomic status and geographic location is yet to be determined. This cross-sectional study examined select school nutrition and physical activity policies by markers for poverty among 209 middle and high schools in Utah (82% response rate). The results show that students' opportunities to establish healthful dietary and physical activity patterns differed by economic circumstances and geographic location. Schools with the highest percentage of free and reduced-price lunch enrollment and schools in rural areas were both less likely to offer a variety of healthful foods outside of the school meal program (ie, competitive foods and drinks) and intramural activities or physical activity clubs. Schools with highest free and reduced-price lunch enrollment were more likely to allow the purchase of unhealthful snacks during lunchtimes than schools with low enrollment (28.4% vs 7.6%, P=0.01). Schools in rural communities were less likely to promote walking and bicycling to school compared with other locations (47.4% rural vs 67.1% urban and 63.6% suburban, P=0.06). Current school policies related to nutrition and physical activity may not be conducive to reducing the childhood overweight problem among children attending schools in areas with increased risk factors due to poverty or rural location in Utah.

A. Nash, D. Secker, M. Corey, M. Dunn and D. L. O'Connor. (2008). Field testing of the 2006 World Health Organization growth charts from birth to 2 years: assessment of hospital undernutrition and overnutrition rates and the usefulness of BMI. JPEN J Parenter Enteral Nutr. 32, 145-53.

BACKGROUND: The World Health Organization (WHO) recently released a growth standard, a first attempt at describing how children should grow in an ideal environment. These charts introduce body mass index (BMI)-for-age percentiles for children younger than 2 years. Adopting the WHO standard may affect the number of children screened to require follow-up; hence, field testing needs to be completed in a tertiary care center where the incidence of suboptimal nutrition is high. The objectives of this study were to quantify differences between the new WHO and 2000 Centers for Disease Control and Prevention (CDC) growth charts for children younger than 2 years. The interchangeability of the WHO weight-for-length and WHO BMI percentiles was also assessed. METHODS: Percentile scores were computed for children younger than 2 years (n = 547) admitted to a pediatric tertiary health care center in Toronto, Canada. RESULTS: The WHO standard identified more children younger than 2 years as at risk of overweight/obesity compared with the CDC reference (21.0% vs 16.6%, >or=85th weight-for-length percentile) and fewer children as wasted (18.6% vs 23.0%, <5th weight-for-length percentile). The WHO BMI-for-age and WHO weight-for-length percentiles were highly correlated (r2 = 0.83) but not interchangeable. For approximately 9% of all children, and approximately 16% of those aged 25 percentile points. CONCLUSIONS: These data describe for the first time the magnitude of differences in the number of children screened as undernourished (4.4% decrease) or overnourished (4.4% increase) with adoption of the WHO standard in a tertiary care setting. Furthermore, the WHO's BMI-for-age and weight-for-length percentiles for children younger than 2 years are correlated but are not interchangeable.

L. Nhantumbo, J. Maia, S. Saranga and A. Prista. (2008). [Physical activity among children and adolescents in a rural community in Mozambique: effects of age, sex, and nutritional status]. Rev Panam Salud Publica. 23, 171-8.

OBJECTIVE: To determine the association between physical activity levels of children and adolescents of a rural community in Mozambique and their age, sex, and nutritional status. METHOD: The sample comprised 845 boys and girls from 7-16 years of age. Weight and height were measured, while physical activity level was determined using a questionnaire developed and validated for the population of Mozambique. Nutritional status was determined according to criteria recommended by the World Health Organization. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were used to test the interaction between age and sex and between nutritional groups, respectively. RESULTS: Age and sex significantly influenced all types of activities except walking, for which the effect of sex was not significant (F = 0.4, P = 0.517). Girls were more active than boys. Age and sex were significantly associated only in relation to household chores (F = 1.933, P = 0.044) and sports (F = 2.32, P =0.014). In boys, only the total activity coefficient was different among nutritional groups (F = 3.44, P = 0.017), with boys of normal weight presenting a higher level of activity as compared to boys with low height or both low weight and height. In girls, significant differences were observed only in relation to household chores (F = 2.65, P = 0.049), with girls of normal and low weight differing from the other nutritional groups and those with low height differing from girls low in both weight and height. CONCLUSIONS: The results suggest that in rural Mozambique, deficits in height, weight, or both did not limit the physical activity levels of children and adolescents.

S. B. Nye. (2008). A Physical Activity Program for Elementary Schools. JOPERD: The Journal of Physical Education, Recreation & Dance. 79, 36.

The article presents an outline of the process on how to create a developmentally appropriate physical activity program in elementary schools. It is stated that the National Association for Sport and Physical Education (NASPE) has recommended that elementary school children should receive quality physical education instruction for a minimum of 150 minutes in a week. NASPE has further recommended guidelines for the physical activity of children ages five through twelve. Accordingly, activity sessions should last at least 15 minutes that include a range of age-appropriate fitness activities, incorporate positive role models, and encourage students to make their own pace or intensity while engaging in activities.

A. D. Okely, M. L. Booth, L. Hardy, T. Dobbins and E. Denney-Wilson. (2008). Changes in physical activity participation from 1985 to 2004 in a statewide survey of Australian adolescents. Arch Pediatr Adolesc Med. 162, 176-80.

OBJECTIVE: To examine changes in physical activity during a 19-year period between 2 representative cohorts of adolescents from New South Wales, Australia. DESIGN: Repeat cross-sectional study. SETTING: Randomly selected secondary schools from New South Wales, the most populous state in Australia. PARTICIPANTS: One thousand fifty-five adolescents surveyed in May through October 1985 (with the Australian Health and Fitness Survey) and 1226 adolescents surveyed in March through April 2004 (with the New South Wales Schools Physical Activity and Nutrition Survey). Participants were aged 12 to 15 years. MAIN OUTCOME MEASURES: The proportion meeting current guidelines for physical activity (60 min/d of moderate to vigorous physical activity) and time spent in moderate to vigorous physical activity assessed by self-reported participation in physical activity using the same questionnaire at both time points. RESULTS: All of the age and sex groups reported increases in both the prevalence of physical activity (mean increase range, 11.7%-20.0%) and in the minutes per week spent in moderate to vigorous physical activity (median increase range, 135-175 minutes). These findings remained the same after additional adjustment for age, socioeconomic status, and cultural background. CONCLUSIONS: Physical activity participation has considerably increased during the past 19 years among adolescents in the state of New South Wales, Australia. These findings provide important information about trends in compliance with physical activity recommendations and in time spent in physical activity. They could help to explain what aspects may need to be promoted to maximize the role of physical activity in reducing the high and increasing rates of child and adolescent obesity.

F. B. Ortega, J. R. Ruiz, M. J. Castillo and M. Sjostrom. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes (Lond). 32, 1-11.

This review aims to summarize the latest developments with regard to physical fitness and several health outcomes in young people. The literature reviewed suggests that (1) cardiorespiratory fitness levels are associated with total and abdominal adiposity; (2) both cardiorespiratory and muscular fitness are shown to be associated with established and emerging cardiovascular disease risk factors; (3) improvements in muscular fitness and speed/agility, rather than cardiorespiratory fitness, seem to have a positive effect on skeletal health; (4) both cardiorespiratory and muscular fitness enhancements are recommended in pediatric cancer patients/survivors in order to attenuate fatigue and improve their quality of life; and (5) improvements in cardiorespiratory fitness have positive effects on depression, anxiety, mood status and self-esteem, and seem also to be associated with a higher academic performance. In conclusion, health promotion policies and physical activity programs should be designed to improve cardiorespiratory fitness, but also two other physical fitness components such us muscular fitness and speed/agility. Schools may play an important role by identifying children with low physical fitness and by promoting positive health behaviors such as encouraging children to be active, with special emphasis on the intensity of the activity.

R. R. Pate, K. McIver, M. Dowda, W. H. Brown and C. Addy. (2008). Directly observed physical activity levels in preschool children. Journal Of School Health. 78, 438-444.

BACKGROUND: Millions of young children attend preschools and other structured child development programs, but little is known about their physical activity levels while in those settings. The purpose of this study was to describe the physical activity levels and demographic and school-related correlates of physical activity in children attending preschools, using a direct observation measurement system. METHODS: The Observational System for Recording Physical Activity in Children-Preschool Version was used to measure physical activity levels and related factors in four hundred ninety-three 3- to 5-year-old children in 24 preschools. A minimum of six hundred 30-second observation intervals were recorded for each child. Physical (height/weight) and demographic data also were collected. RESULTS: Children engaged in moderate-to-vigorous physical activity (MVPA) during less than 3% of the observation intervals and were sedentary during more than 80% of the observation intervals. Boys were more likely than girls to engage in MVPA (p =.01), and 3-year-old boys were more active than 4- and 5-year-old boys (p =.01). The preschool that a child attended explained 27% of the variance in activity levels. CONCLUSIONS: The study indicates that young children are physically inactive during most of their time in preschool. The preschool that a child attended was a stronger predictor of physical activity level than any other factor examined. Additional research is needed to identify the characteristics of preschools in which children are more active.

S. Peter, L. Biro, A. Nemeth and M. Antal. (2008). [Association between birth weight and childhood obesity in a Budapest metropolitan survey]. Orv Hetil. 149, 407-10.

INTRODUCTION: According to epidemiological investigations, association between birth weight and overweight and obesity in childhood/adolescence is ambiguous. AIM: The purpose of the study was to investigate the association between birth weight and overweight and obesity in childhood and adolescence. METHODS: Birth and actual anthropometric data of school children and secondary school students from metropolitan schools were analyzed. Overweight/obesity were established by standardized (sex, age) body mass index, and obesity also by body fat percent. RESULTS: Data of 1,334, 7- to 19-year-old children and adolescents (725 boys and 609 girls) were evaluated. Prevalence of overweight/obesity was similar in the case of persons with low (19.36%) and normal birth weight (18.96%), while in the case of persons with high birth weight this rate was 25.98%. Based on body fat percent, the prevalence of obesity in the latter group was also higher than in groups with low and normal birth weight (18.11% vs. 12.89% and 12.66%). CONCLUSIONS: Among macrosomic babies the rate of overweight and obesity is higher than among normal or low-birth-weight babies, particularly in childhood.

P. Pliner and T. Saunders. (2008). Vulnerability to freshman weight gain as a function of dietary restraint and residence. Physiol Behav. 93, 76-82.

Although many studies have found that students gain weight during their first year at college, many others have not. Participants in the present study were classified according to their scores on the Herman/Polivy Restraint Scale and their place of residence-at home or on campus. Body weight was assessed early in the academic year and five months later. At the same sessions participants completed a questionnaire pertaining to their eating habits prior to beginning college (first session) and since coming to college (second session). Overall weight gain was 1.5 kg; those most likely to gain weight were restrained eaters living on campus, who gained an average of 4.1 kg. In addition, changes in eating habits were a significant independent predictor of weight gain.

M. L. Potestio, L. McLaren, A. Robinson Vollman and P. K. Doyle-Baker. (2008). Childhood obesity: perceptions held by the public in Calgary, Canada. Can J Public Health. 99, 86-90.

OBJECTIVE: To investigate the perceptions about causes and prevention of childhood obesity held by the adult public in Calgary, Canada. DESIGN: Using a cross-sectional survey design, adults were recruited from a shopping mall located in a region of Calgary, Alberta characterized by mixed ethnic and socio-economic residents. SUBJECTS: 264 adults in Calgary, Canada. MEASUREMENTS: Participants completed a self-administered questionnaire that involved rating the importance of 25 potential causes of obesity and 13 potential preventive measures, using a four-point Likert scale anchored by "not important" and "very important". Demographic information including age, sex, educational level, parental status, and self-reported weight and height was also collected. RESULTS: Principal components analysis of questionnaire items revealed five "cause" factors ('parental responsibility', 'over-consumption and media promotion of unhealthy foods', 'misuse/overuse of modern technology', 'children's lack of knowledge and motivation', 'physical activity environment') and two "prevention" factors ('healthy public/private policy and targeted intervention', and 'media campaigns and compulsory physical education'). Tests for group differences revealed that women ranked 'over-consumption of unhealthy foods and media influence' and 'physical activity environment' as more important causes of childhood obesity than men. Additionally, persons classified as obese ranked 'misuse/overuse of modern technology' and 'healthy public/private policy and targeted intervention' as more important than those persons classified as under/normal weight. CONCLUSION: By providing a snapshot of views held by the public regarding childhood obesity in this large Canadian city, this study offers preliminary guidance about publicly acceptable intervention strategies for use by health promotion researchers and policy-makers.

J. J. Puder and S. Kriemler. (2008). [Can we stop the epidemic of childhood obesity?]. Praxis (Bern 1994). 97, 17-23.

Childhood obesity influences body weight in the adult and is intrinsically associated with multiple co-morbidities. In the past 20 years, the prevalence of overweight and obese school children in Switzerland has increased by three to six-fold. One out of every four to five children is overweight or obese. Thus, primary prevention is absolutely essential. Excess weight results from a positive energy balance. According to the current literature, changes in the quantity and quality of nutrition, a reduction in physical activity, an increase in sedentary lifestyles, including media consumption, as well as a reduction of sleep time are the most important external factors that promote the development of childhood obesity after infancy. Hereby, the intrauterine milieu and genetic factors also play a role. The obesity epidemic particularly affects children born to overweight parents, children with low socio-economic status, and migrants. Randomized, controlled studies aimed at medium to long-term (> or =1 year) reductions in BMI or fat tissue have mainly been school-based and sometimes involved the family as well. Unfortunately, these studies only produced unanimously negative or modest results. We believe that successful and sustainable prevention must contain 3 elements: (1) A relatively intensive and sustained modification of the individual's behavior that appropriately accounts for the multifactorial causes of childhood obesity. (2) A concurrent adaptation of external conditions that enable behavioral modifications. (3) Incorporation of socio-economic and political aspects.

O. Receveur, K. Morou, K. Gray-Donald and A. C. Macaulay. (2008). Consumption of key food items is associated with excess weight among elementary-school-aged children in a Canadian first nations community. J Am Diet Assoc. 108, 362-6.

The present analyses aim to identify differences in selected dimensions of diet quality and quantity across body mass index (BMI) categories for Mohawk children in grades 4 through 6 so as to enhance ongoing community intervention strategies within the Kahnawake School Diabetes Prevention Project (KSDPP). Using 24-hour recalls (n=444), no observable differences in energy intake, percent fat, energy density, or diet diversity across BMI categories were observed. Using a new method, we compared the frequency of use and the amounts consumed for only the most-frequently consumed food items across BMI categories. Compared to normal-weight children, and after adjusting for age, children "at risk of overweight" consume potato chips more frequently (P=0.017) and crackers less frequently (P=0.153), while overweight children consumed larger portions of french fries (P=0.027). We conclude that, in this group of children, consuming slightly more french fries or potato chips than what is already consumed by normal-weight children appears to compromise diet quality as far as overweight is concerned.

J. P. Rey-Lopez, G. Vicente-Rodriguez, M. Biosca and L. A. Moreno. (2008). Sedentary behaviour and obesity development in children and adolescents. Nutrition Metabolism And Cardiovascular Diseases. 18, 242-251.

Sedentary lifestyle patterns in children and adolescents, i.e. playing digital games, using computers and especially watching television, have been associated with obesity. However, not all sedentary behaviour has shown the same relevance to, and relationship with, obesity. Therefore, we conducted a review including published studies found in PubMed and other medical journals, dated between January 1990 and April 2007. The ages of the children and adolescents who were the object of the study ranged between 2 and 18 years. For the purpose of this paper, we selected cross-sectional, longitudinal and intervention studies. Sufficient evidence exists to recommend setting a limit to the time spent watching TV, especially for younger children. However, video games and computers do not represent such a high risk compared to watching TV, when they do not replace physical activity too much. In fact, there is no evidence to suggest that sedentary behaviour displaces physical activity levels. Mechanisms that explain the link between sedentariness and obesity are also discussed. Finally, future studies should take into account important mediators such as socioeconomic status and family structure. (C) 2007 Elsevier B.V. All rights reserved.

J. A. Rimmer and J. L. Rowland. (2008). Physical activity for youth with disabilities: a critical need in an underserved population. Dev Neurorehabil. 11, 141-8.

The recommended amount of daily physical activity for youth is 60 minutes a day, most days of the week. Youth with disabilities are not achieving this target and are significantly less active and more obese than their non-disabled peers. The combination of the health risks associated with physical inactivity and obesity presents a serious health concern in this population. While there is a small amount of research on interventions aimed at improving fitness among youth with disabilities, the majority of these studies were conducted in clinical settings where most or all of the common barriers to participation were eliminated (e.g. transportation, lack of knowledgeable staff, adaptation of programmes and/or facilities to child's needs). One of the most important challenges for paediatric rehabilitation and healthcare professionals is finding ways to increase physical activity and fitness among youth with disabilities in community-based settings. The use of information technology (IT) to customize physical activity programmes for youth with disabilities offers a promising approach to addressing this important health issue in the future.

P. B. Rukavina and W. Li. (2008). School physical activity interventions: do not forget about obesity bias. Obesity Reviews. 9, 67-75.

Obesity bias is the tendency to negatively judge an overweight or obese individual based on assumed and/or false character traits, such as being physically unattractive, incompetent, lazy and lacking self-discipline. Obesity biases, such as teasing or weight criticism during physical activity (PA), can be psychologically or emotionally damaging for overweight children and adolescents. Ultimately, the effects students experience over time may create a psychological barrier and students can become resistant to schools' health and PA interventions that promote lifestyle changes. Fortunately, the psychological effects of obesity bias are mediated by social buffers and coping mechanisms. Several PA-related researchers have proposed strategic intervention components, but no studies have been completed in PA settings. The purpose of this review was to discuss the nature and different types of obesity bias in PA settings. Major theoretical frameworks of the aetiology and change mechanisms of obesity biases from the psychological literature were reviewed and direct applications for strategic component interventions were made for PA settings. Because of the pervasiveness and entrenchment of obesity bias, it is obvious that multiple theoretical frameworks need to be considered and even combined to create safe and caring school PA environments for students.

C. M. Sabiston and P. R. E. Crocker. (2008). Examining an integrative model of physical activity and healthy eating self-perceptions and Behaviors among adolescents. Journal Of Adolescent Health. 42, 64-72.

Purpose: This study tested a comprehensive model of physical activity and healthy eating behavior. Methods: A sample of older adolescents (boys n = 206, girls n = 326) volunteered to complete a scientifically supported questionnaire assessing physical activity and healthy eating perceptions of competence, values, and behaviors once during class time. Results: Confirmatory factor analysis suggested the data fit the model well. Tests of group differences supported factorial invariance, and revealed higher physical activity perceptions of competence, value, and behavior as well as lower healthy diet value and behavior for adolescent boys compared with girls. Perceptions of competence for healthy diet were also higher among boys. Path modeling demonstrated a good model fit, whereby behavior-specific perceptions of competence and values were significant correlates of physical activity for the total sample and subsamples of boys and girls (R-2=.41-.53). Perceptions of competence and values were also significant correlates of healthy diet for the total sample (R-2=.34) and boys (R-2=.42). Subjective values were significant correlates of healthy diet for girls (R-2=.30). Structural invariance suggested that the models were not significantly different for adolescent boys and girls. Conclusions: These results demonstrate the saliency of the comprehensive model in understanding physical activity and healthy eating behaviors among older adolescents. Further tests of the model are needed to advance theory exploring both physical activity and healthy eating behaviors, and to inform intervention strategies targeting adolescent health.

S. J. Salvy, E. Kieffer and L. H. Epstein. (2008). Effects of social context on overweight and normal-weight children's food selection. Eat Behav. 9, 190-6.

Although most eating occurs in a social context, the impact of peer influence on child food consumption and selection of healthy and unhealthy snacks has not been the object of systematic experimental study. The present experiment assessed the effects of peer interaction on energy intake and food choices in 18 overweight and 21 non-overweight youth. Participants had access to high and low-calorie food items and were provided with several games as alternatives to eating. On one occasion, participants were tested alone and on another occasion they were tested in dyads with an unfamiliar peer. Consistent with previous results, we found that overweight children ate substantially more when alone than when in the presence of a peer and also more when alone than the lean children in the same condition. Non-overweight youths' food intake was unaffected by the social context. Findings also indicated that the best predictor of whether participants consumed healthy snack foods was if the other youth in the dyad also consumed healthy snack foods. These findings suggest that the presence of peers can influence overweight children's energy intake and also influence healthier food selection in both overweight and non-overweight children.

I. N. Sener, R. B. Copperman, R. M. Pendyala and C. R. Bhat. (2008). An analysis of children's leisure activity engagement: examining the day of week, location, physical activity level, and fixity dimensions. Transportation. 35, 673-696.

This paper presents a detailed analysis of discretionary leisure activity engagement by children. Children's leisure activity engagement is of much interest to transportation professionals from an activity-based travel demand modeling perspective, to child development professionals from a sociological perspective, and to health professionals from an active lifestyle perspective that can help prevent obesity and other medical ailments from an early age. Using data from the 2002 Child Development Supplement of the Panel Study of Income Dynamics, this paper presents a detailed analysis of children's discretionary activity engagement by day of week (weekend versus weekday), location (in-home versus out-of-home), type of activity (physically active versus passive), and nature of activity (structured versus unstructured). A mixed multiple discrete-continuous extreme value model formulation is adopted to account for the fact that children may participate in multiple activities and allocate positive time duration to each of the activities chosen. It is found that children participate at the highest rate and for the longest duration in passive unstructured leisure activities inside the home. Children in households with parents who are employed, higher income, or higher education were found to participate in structured outdoor activities at higher rates. The child activity modeling framework and methodology presented in this paper lends itself for incorporation into larger activity-based travel model systems where it is imperative that children's activity-travel patterns be explicitly modeled-both from a child health and well-being policy perspective and from a travel forecasting perspective.

M. Share and M. Strain. (2008). Making schools and young people responsible: a critical analysis of Ireland's obesity strategy. Health & Social Care In The Community. 16, 234-243.

Worldwide reports of an obesity 'epidemic' prompted the Irish government to appoint a multidisciplinary Taskforce, whose report was published in May 2005. This paper critically analyses the report and its recommendations for reducing health risks among families, children and young people. Using a Foucauldian perspective, we question the report's individualizing focus and support for a strategy which responsibilises schools, families and young people and relies on individuals to do 'the right thing'. Specifically, we examine the Taskforce recommendations for the education sector, and identify their dependence upon a discourse of governmentality, under categories of individualization, responsibilization and freedom of choice, participation and techniques for management of the self. We conclude that the report fails to address the multi-faceted and complex nature of obesity, and obscures the social, economic and material realities of the lives of pupils and schools.

E. Simsek, S. Akpinar, T. Bahcebasi, D. A. Senses and K. Kocabay. (2008). The prevalence of overweight and obese children aged 6-17 years in the West Black Sea region of Turkey. International Journal Of Clinical Practice. 62, 1033-1038.

Objective: To assess the prevalence of overweight and obese Turkish children. Design: Cross-sectional study in school children. Subjects: A total of 6924 children (3281 boys and 3643 girls) aged 6-17 years from the West Black Sea region of Turkey. Measurements: Overweight and obese were defined using international age- and sex-specific cutoff points for body mass index. The data were analysed by age, sex, residence and socioeconomic level. Results: The overall prevalence of overweight and obesity was 10.3% and 6.1% respectively. The overall prevalence of obesity in boys and girls was 7.0% and 5.4%, respectively, and the difference was significant (chi(2) = 8, p = 0.004). The prevalence of obesity in urban and rural areas was 7.7% and 3.9%, respectively, and the difference was significant (chi(2) = 40, p < 0.001). The prevalence of overweight boys and girls in urban areas was 11.6% and 13.2%, respectively, but the difference was not significant (chi(2) = 2, p > 0.05). However, the prevalence of overweight boys and girls in rural areas was 4.8% and 9.4%, respectively, and the difference was significant (chi(2) = 25, p < 0.001). Although the prevalence of obesity differed significantly between boys and girls in urban children (chi(2) = 13, p < 0.001), no significant difference was detected in the prevalence between boys and girls from rural areas (chi(2) = 0.4, p > 0.5). The prevalence of obesity was significantly higher in private schools than in public schools (chi(2) = 48, p < 0.0001). The prevalence of overweight and obese Turkish children aged 6-17 years is considerably lower than in most European countries. The children in urban settings and higher socioeconomic groups had a higher prevalence of overweight and obesity. The Westernisation of the behaviour patterns of children and living in an urban setting in a developing country are risk factors for obesity.

G. K. Singh, M. D. Kogan and P. C. van Dyck. (2008). A multilevel analysis of state and regional disparities in childhood and adolescent obesity in the United States. Journal Of Community Health. 33, 90-102.

This study examines state- and regional disparities in obesity prevalence among 46,707 US children and adolescents aged 10-17 years before and after adjusting for individual socioeconomic and behavioral characteristics and area deprivation measures. The 2003 National Survey of Children's Health was used to calculate obesity prevalence in nine geographic regions and in the 50 states and the District of Columbia (DC). Logistic regression was used to estimate odds of obesity and adjusted prevalence. OLS regression was used to determine the amount of variance explained by income inequality, poverty, and violent crime rates. The prevalence of childhood obesity varied substantially across geographic areas, with the Southcentral regions of the US having the highest prevalence (>= 18%) and the Mountain region the lowest prevalence (11.4%). Children in West Virginia, Kentucky, Texas, Tennessee, and North Carolina (adjusted prevalence > 18.3%) had over twice the odds of being obese than their Utah counterparts (adjusted prevalence = 10.4%). Geographic disparities in obesity were similar for male and female children. Individual characteristics such as race/ethnicity, household socioeconomic status, neighborhood social capital, television viewing, recreational computer use, and physical activity accounted for 55% of the state and 25% of the regional disparities in obesity. Area poverty rates accounted for an additional 18% of the state variance in adjusted obesity prevalence. Although individual and area level socioeconomic factors are important predictors, substantial geographic disparities in childhood and adolescent obesity remain. Prevention efforts targeting individual risk factors as well as contextual social and environmental factors may reduce geographic disparities in childhood and adolescent obesity.

A. Sjoberg, L. Lissner, K. Albertsson-Wikland and S. Marild. (2008). Recent anthropometric trends among Swedish school children: evidence for decreasing prevalence of overweight in girls. Acta Paediatr. 97, 118-23.

AIM: To assess the recent prevalence of overweight and obesity in 10 year old children in Goteborg, Sweden. METHODS: Cross-sectional data on weight and height from school health examinations, including fourth grade children, born in 1974 (n=4126), 1990 (n=4683) and 1994 (n=4193) and measured in academic years 1984/1985, 2000/2001 and 2004/2005, were used. Weight classification was based on age- and sex-specific body mass index cutoff values. The two latest cohorts were classified according to socio-economic areas. RESULTS: Between 2000/2001 and 2004/2005, the prevalence of overweight plus obesity in girls decreased from 19.6% to 15.9% (p<0.01). Prevalence of obesity was 3.0% and 2.5% (nonsignificant), respectively. In boys, all differences between the corresponding cohorts were nonsignificant: 17.1% versus 17.6% were overweight (including obese) and 2.9% versus 2.8% were obese. In 1984/1985, prevalence of overweight plus obesity was only 8.6% among girls and 7.2% among boys, while 0.8% and 0.7% were classified as obese, respectively. The socio-economic gradient in overweight prevalence remained, particularly in girls. CONCLUSIONS: This study suggests that the obesity epidemic in 10-11 year olds may be easing off in urban Sweden, and possibly reversing among girls. Even if future monitoring confirms these findings, much health promoting work still remains since the power of the 'obesogenic environment' will probably continue to be strong.

D. T. Smith, M. J. Vendela, R. T. Bartee and L. J. Carr. (2008). Body mass index in rural first grade schoolchildren: progressive increase in boys. J Rural Health. 24, 40-8.

CONTEXT: Childhood overweight is a global health problem. Monitoring of childhood body mass index (BMI) may help identify critical time periods during which excess body weight is accumulated. PURPOSE: To examine changes in mean BMI and the prevalence of at-risk-for overweight in repeated cross-sectional samples of rural first grade schoolchildren between 1999 and 2004. METHODS: BMI was determined in 479 first graders from a rural Wyoming school district. BMI and gender-specific BMI-for-age percentiles were determined and evaluated over the 6 years. Children were also classified as normal or at-risk-for overweight according to CDC classification procedures. FINDINGS: From 1999 to 2004, there was a significant increase in the average BMI of first graders, 15.8+/-2.2 kg/m2 versus 16.8+/-2.2 kg/m2, respectively (P<.05). First grade boys had a progressive increase in BMI from 1999 to 2004 (15.6+/-2.2 kg/m2 compared to 17.3+/-2.2 kg/m2, respectively), but no change was evident for first grade girls. There was an approximate 4-fold increase in the percentage of rural first grade boys classified as at-risk-for overweight between 1999 and 2004. CONCLUSIONS: A progressive increase in the BMI and the significant increase in prevalence of at-risk-for overweight in rural first grade boys highlight the need for future gender and age group-specific investigations. Focus should be given to primary prevention programs targeting potentially vulnerable time periods when excess weight gain may be occurring.

A. C. Sollerhed, E. Apitzsch, L. Rastam and G. Ejlertsson. (2008). Factors associated with young children's self-perceived physical competence and self-reported physical activity. Health Education Research. 23, 125-136.

The aim of this study was to identify factors associated with self-reported physical activity (PA), self-perceived physical fitness and competence in physical education (PE) among young children. The study included physical tests, anthropometric measures and a questionnaire. The study group comprised 206 children (114 boys and 92 girls, aged 8-12 years). Positive Odds Ratio was used in the logistic regression analyses. High level of self-reported PA was associated with membership of sport clubs and high self-perceived physical fitness. Variables associated with high self-perceived competence in PE were low age, high physical performance, living with both parents, high self-perceived physical fitness, male gender and enjoying PE. Variables associated with high self-perceived physical fitness were low age, high performance in endurance running, high self-reported PA, positive self-perceived body function and high self-perceived competence in PE. Correlations between children's self-perceived competence in PE and actual measured physical performance, between the self-perceived fitness and endurance performance and between self-reported PA and physical performance could be seen as a form of concurrent validity. One implication of the study for practitioners might be that children's own perceptions of their physical competence and activity levels could be used to roughly identify groups of children who are at risk of remaining physically inactive and therefore more prone to be unhealthy.

S. A. Stoddard, M. Y. Kubik and C. Skay. (2008). Is school-based height and weight screening of elementary students private and reliable? J Sch Nurs. 24, 43-8.

The Institute of Medicine recommends school-based body mass index (BMI) screening as an obesity prevention strategy. While school nurses have provided height/weight screening for years, little has been published describing measurement reliability or process. This study evaluated the reliability of height/weight measures collected by school nurses and the privacy of the measurement process. Interrater reliability for height/weight measures was computed on 70 elementary students, comparing measurements collected by a trained researcher to those collected by 7 school nurses. Students arrived in small groups to private measurement spaces. Height agreement was 80% for younger and 85% for older students. Agreement for weight was 97% and 100%, respectively. Reliability for weight was very good. Reliability for height was good, but results suggest careful attention to the collection process is required. Nurses may benefit from regular training on measurement procedures. The results of this study suggest that school nurses provide BMI screening that is private and reliable.

S. D. Stovitz, J. B. Schwimmer, H. Martinez and M. T. Story. (2008). Pediatric obesity: the unique issues in Latino-American male youth. Am J Prev Med. 34, 153-60.

Pediatric obesity in the United States has been steadily rising over the past few decades, and it is a clear risk factor for adult obesity and obesity-related morbidity and mortality. A review of the literature from three major national databases reveals that the prevalence rates of obesity within Latino male children and adolescents is, in general, higher than other major gender-ethnic groups. Additionally, obese Latino male youth seem to be especially prone to a variety of obesity-related morbidities. Given the rising percentage of Latinos among our nation's youth, there is an urgency to develop and implement clinical and community research strategies to prevent and treat obesity within this high-risk gender-ethnic group. This article reviews the prevalence of pediatric obesity within the three largest databases in the U.S. with Latino representation. The paper then discusses unique issues in the etiology and ramifications of obesity within young Latino-American boys, reviews the few intervention studies that focus on Latino youth, and discusses potential strategies for further research.

S. D. Stovitz, L. M. Steffen and A. Boostrom. (2008). Participation in physical activity among normal- and overweight Hispanic and non-Hispanic white adolescents. Journal Of School Health. 78, 19-25.

BACKGROUND: The purpose of this study was to determine the relation between weight status and participation in physical activity (PA) among Hispanic and non-Hispanic white (NHW) adolescent boys and girls. METHODS: In this cross-sectional study, height and weight were measured and a modified 2001 Youth Risk Behavior Survey was administered to 1302 Hispanic and NHW adolescents, aged 14-17 years, attending high school in Nueces County, Texas. Linear regression analysis was used to assess the relation between weight status (normal weight or "at risk for overweight and overweight" [AR&O]) and PA, including moderate PA, vigorous PA, strength training, participation in team sports, and TV viewing, according to gender and ethnicity. RESULTS: Thirty-eight percent of adolescents were AR&O, including 32% and 48% of Hispanic girls and boys, respectively, and 22% and 35% of NHW girls and boys, respectively. As expected, boys reported participating in more PAs than girls. Compared with NHW girls, both normal weight and AR&O Hispanic girls reported significantly fewer bouts of moderate activity, less involvement in team sports, and more time watching TV. Normal weight boys reported participating in significantly more vigorous activity than those who were AR&O. Hispanic boys reported more strength training than NHWs; however, they watched significantly more hours of TV than NHW boys. CONCLUSIONS: Hispanic and NHW high school students reported participation in different PAs; this information may be useful for planning health and physical education curriculum.

H. N. Sweeting. (2008). Gendered dimensions of obesity in childhood and adolescence. Nutr J. 7, 1.

BACKGROUND: The literature on childhood and adolescent obesity is vast. In addition to producing a general overview, this paper aims to highlight gender differences or similarities, an area which has tended not to be the principal focus of this literature. METHODS: Databases were searched using the terms 'obesity' and 'child', 'adolescent', 'teenager', 'youth', 'young people', 'sex', 'gender', 'masculine', 'feminine', 'male', 'female', 'boy' and 'girl' (or variations on these terms). In order to limit the potential literature, the main focus is on other reviews, both general and relating to specific aspects of obesity. RESULTS: The findings of genetic studies are similar for males and females, and differences in obesity rates as defined by body mass index are generally small and inconsistent. However, differences between males and females due to biology are evident in the patterning of body fat, the fat levels at which health risks become apparent, levels of resting energy expenditure and energy requirements, ability to engage in certain physical activities and the consequences of obesity for the female reproductive system. Differences due to society or culture include food choices and dietary concerns, overall physical activity levels, body satisfaction and the long-term psychosocial consequences of childhood and adolescent obesity. CONCLUSION: This review suggests differences between males and females in exposure and vulnerability to obesogenic environments, the consequences of child and adolescent obesity, and responses to interventions for the condition. A clearer focus on gender differences is required among both researchers and policy makers within this field.

A. Z. Taha. (2008). Self-reported knowledge and pattern of physical activity among school students in Al Khobar, Saudi Arabia. East Mediterr Health J. 14, 344-55.

The aim of this cross-sectional study was to determine the self-reported knowledge and pattern of physical activity among a sample of 1240 male and 1331 female intermediate and secondary school students in Al-Khobar city, Saudi Arabia. The majority of male and female students knew that physical activity is protective against diseases in general (92.9% and 91.8% respectively) and in the prevention of obesity (69.4% and 78.5%) but had poor knowledge about the role of physical activity in the prevention of diabetes mellitus and hypertension. Significantly more male students than female students practised physical activity 3+ times per week (45.6% versus 33.7%). Age and the knowledge that exercise protects from obesity were the main determinants of the practice of physical activity among male students.

S. G. Trost, R. R. Rosenkranz and D. Dzewaltowski. (2008). Physical Activity Levels among Children Attending After-School Programs. Medicine & Science in Sports & Exercise. 40, 622.

The article presents a study that examines physical activity (PA) levels of children attending after-school programs and evaluates after-school PA differences in groups defined by sex and weight status. The researchers uploaded stored activity counts to a customized data-reduction program to determine minutes of sedentary (SED), light (LPA), moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA)physical activity. It found that boys exhibited higher levels of MPA, VPA and MVPA and lower levels of SED and LPA than girls. It concludes that after-school programs are important contributor to the PA of attending children and ample room for improvement exists by making better use of existing time devoted to PA.

F. Trudeau and R. J. Shephard. (2008). Physical education, school physical activity, school sports and academic performance. International Journal Of Behavioral Nutrition And Physical Activity. 5,

Background: The purpose of this paper is to review relationships of academic performance and some of its determinants to participation in school-based physical activities, including physical education (PE), free school physical activity (PA) and school sports. Methods: Linkages between academic achievement and involvement in PE, school PA and sport programmes have been examined, based on a systematic review of currently available literature, including a comprehensive search of MEDLINE (1966 to 2007), PSYCHINFO (1974 to 2007), SCHOLAR.GOOGLE.COM, and ERIC databases. Results: Quasi-experimental data indicate that allocating up to an additional hour per day of curricular time to PA programmes does not affect the academic performance of primary school students negatively, even though the time allocated to other subjects usually shows a corresponding reduction. An additional curricular emphasis on PE may result in small absolute gains in grade point average (GPA), and such findings strongly suggest a relative increase in performance per unit of academic teaching time. Further, the overwhelmingly majority of such programmes have demonstrated an improvement in some measures of physical fitness (PF). Cross-sectional observations show a positive association between academic performance and PA, but PF does not seem to show such an association. PA has positive influences on concentration, memory and classroom behaviour. Data from quasi-experimental studies find support in mechanistic experiments on cognitive function, pointing to a positive relationship between PA and intellectual performance. Conclusion: Given competent providers, PA can be added to the school curriculum by taking time from other subjects without risk of hindering student academic achievement. On the other hand, adding time to "academic" or "curricular" subjects by taking time from physical education programmes does not enhance grades in these subjects and may be detrimental to health.

M. D. Tsiros, N. Sinn, A. M. Coates, P. R. Howe and J. D. Buckley. (2008). Treatment of adolescent overweight and obesity. Eur J Pediatr. 167, 9-16.

Adolescence is a vulnerable period for the development of obesity, and adolescent weight tracks strongly into adulthood. Previous reviews of treatment strategies have failed to discriminate between adolescents and children, thereby, disregarding the uniqueness of this population. Hence, this review aims to summarise the evidence for treatment approaches for adolescent obesity. Pubmed, OVID, EBSCOhost and Google Scholar were searched for randomised controlled trials, meta-analyses and systematic reviews testing treatments for overweight/obese adolescents (aged 12-19 years), published from 1982-2006 in English. Eligible studies had to assess either weight, percentage overweight, body mass index (BMI) or body fat. Thirty-four randomised controlled trials were eligible. The results of this review indicate that the safety and efficacy of surgical and pharmacotherapy treatments for adolescent obesity is uncertain. Diet and physical activity approaches may improve obese status in the short term. However, obesity interventions appear more effective when strategies are combined, rather than when used in isolation. Psychological interventions, such as behavioural and cognitive behavioural therapy, show promise in achieving the necessary lifestyle changes for obesity reduction; however, long-term follow-up studies are needed. There were multiple limitations in appraising the literature. Inconsistent definitions of overweight/obesity make comparisons between studies difficult. Many studies have not used direct adiposity measures, have failed to assess pubertal status or have not used an exclusive adolescent sample. We conclude that, despite these limitations, current evidence indicates that behavioural and cognitive behavioural strategies combined with diet and physical activity approaches may assist in reducing adolescent obesity,although long-term follow-up studies are needed.

C. Tudor-Locke, B. E. Ainsworth and B. M. Popkin. (2008). Patterns of physical activity and overweight among 7-13-year-old Russian children: A 7-year nationally representative monitoring study. Research Quarterly For Exercise And Sport. 79, 10-17.

This is a repeated cross-sectional study of overweight and physical activity (PA) and inactivity patterns of successive samples of 7-13-year-old Russian children who were surveyed six times between 1995 and 2002 as part of the Russian Longitudinal Monitoring Survey. This analysis focused on moderate/vigorous (MOD/VIG) PA (e.g., active commuting to school, during school MOD/VIG PA as part of physical education classes, and/or before/after school MOD/VIG PA) and inactivity patterns (e.g., television viewing habits) obtained through parent proxy-reports of 3,50 7 boys (M age = 10.1 years, SD = 2.0, body mass index = 17.5 kg/m(2), SD = 3.0) and 3,273 girls (M age = 10.1 years, SD = 2.0; body mass index = 17.2 kg/m(2), SD = 3. 0). Time spent in MOD/VIG PA appears to be on the rise, while the proportion of those actively commuting to school is decreasing, especially among girls.

G. Turconi, M. Guarcello, L. Maccarini, F. Cignoli, S. Setti, R. Bazzano and C. Roggi. (2008). Eating habits and behaviors, physical activity, nutritional and food safety knowledge and beliefs in an adolescent Italian population. J Am Coll Nutr. 27, 31-43.

OBJECTIVE: The present study evaluates eating habits and behaviors, and nutritional and food safety knowledge of a group of Italian adolescents. DESIGN: A dietary questionnaire previously constructed and tested was self-administered during school time. Each section was evaluated using a separate score. SETTING: The study was carried out as a part of a nutritional surveillance project in the Aosta Valley Region, Northern Italy. SUBJECTS: Five hundred and thirty-two adolescent subjects, aged 15.4 +/- 0.7 years, attending the second year of secondary schools participated in the study. MEASURES: We evaluated eating habits, physical activity, meaning of healthy and unhealthy dietary habits and food, self-efficacy, barriers affecting healthy food choices, nutritional and food safety, weight, height, Body Mass Index (BMI). RESULTS: Only 37.0% of the sample have satisfactory eating habits; 18.5% have a very active lifestyle; only 8.6% have quite good nutritional knowledge, 2.4% have satisfactory food safety knowledge, although 43.7% have good hygiene practices. CONCLUSIONS: The results point out unhealthy behaviors influencing adolescents' eating habits and suggest which of these must be considered in order to develop tailored nutrition interventions, improving adolescents' consciousness aimed at adopting a healthy lifestyle.

M. Wake, P. Hardy, M. G. Sawyer and J. B. Carlin. (2008). Comorbities of overweight/obesity in Australian preschoolers: a cross-sectional population study. Archives Of Disease In Childhood. 93, 502-507.

Objective: To determine relationships between body mass index (BMI) status and indicators of health and morbidity in a nationally-representative population sample of preschool children. Methods: Data from the 4-5-year-old cohort in the first wave (2004) of the Longitudinal Study of Australian Children were studied. Main outcome measures were: measured child BMI, categorised as non-overweight, overweight and obese using International Obesity TaskForce cutpoints; parent-reported child global health, health-related quality of life, mental health problems, asthma, sleep problems, injuries, special health care needs, and level of parental concern about the child's weight. Regression methods were used to assess associations with child's BMI status, adjusted for socio-demographic factors. Results: BMI was available for 4934 (99%) children; 756 (15.3%) were overweight and 258 (5.2%) obese. Compared to non-overweight children, parents of overweight and obese children reported a higher prevalence of special health care needs (adj OR 1.72, 95% CI 1.20 to 2.46), but other health outcomes were similar. Parental concern about the child's weight was low among the overweight (14.4%) and non-overweight (17.8%) children, but rose to 52.7% in the obese. However, parental concern was unrelated to any of the specific health problems studied. Conclusions: Despite a high prevalence of overweight/obesity, parents of overweight and obese children reported relatively few additional health burdens over and above those of the non-overweight preschoolers. These findings may shed light on the disparity between strong public concern and parents' expressed lack of concern about overweight/obesity in their own children around the time of school entry.

J. Wardle, S. Carnell, C. M. Haworth and R. Plomin. (2008). Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment. Am J Clin Nutr. 87, 398-404.

BACKGROUND: Body mass index (BMI) has been shown to be highly heritable, but most studies were carried out in cohorts born before the onset of the "obesity epidemic." OBJECTIVE: We aimed to quantify genetic and environmental influences on BMI and central adiposity in children growing up during a time of dramatic rises in pediatric obesity. DESIGN: We carried out twin analyses of BMI and waist circumference (WC) in a UK sample of 5092 twin pairs aged 8-11 y. Quantitative genetic model-fitting was used for the univariate analyses, and bivariate quantitative genetic model-fitting was used for the analysis of covariance between BMI and WC. RESULTS: Quantitative genetic model-fitting confirmed substantial heritability for BMI and WC (77% for both). Bivariate genetic analyses showed that, although the genetic influence on WC was largely common to BMI (60%), there was also a significant independent genetic effect (40%). For both BMI and WC, there was a very modest shared-environment effect, and the remaining environmental variance was unshared. CONCLUSIONS: Genetic influences on BMI and abdominal adiposity are high in children born since the onset of the pediatric obesity epidemic. Most of the genetic effect on abdominal adiposity is common to BMI, but 40% is attributable to independent genetic influences. Environmental effects are small and are divided approximately equally between shared and non-shared effects. Targeting the family may be vital for obesity prevention in the earliest years, but longer-term weight control will require a combination of individual engagement and society-wide efforts to modify the environment, especially for children at high genetic risk.

G. J. Welk. (2008). The Role of Physical Activity Assessments for School-Based Physical Activity Promotion. Measurement in Physical Education & Exercise Science. 12, 184.

The emphasis in public health on lifestyle physical activity in recent years has focused attention on the promotion of lifetime physical activity as the primary objective of physical education. If used properly, physical activity and physical fitness assessments can enhance individual promotion of physical activity and also provide valuable outcome measures to facilitate home and community support for physical education. This article describes the importance of comprehensive evaluation of physical education and emphasizes the importance of including assessments of both physical activity and physical fitness for promoting physical activity. Effective evaluation practices are needed to optimize the effectiveness of physical education programming.

D. S. West, J. M. Raczynski, M. M. Phillips, Z. Bursac, C. Heath Gauss and B. E. Montgomery. (2008). Parental recognition of overweight in school-age children. Obesity (Silver Spring). 16, 630-6.

OBJECTIVE: Examine the accuracy of parental weight perceptions of overweight children before and after the implementation of childhood obesity legislation that included BMI screening and feedback. METHODS AND PROCEDURES: Statewide telephone surveys of parents of overweight (BMI > or = 85th percentile) Arkansas public school children before (n = 1,551; 15% African American) and after (n = 2,508; 15% African American) policy implementation were examined for correspondence between parental perception of child's weight and objective classification. RESULTS: Most (60%) parents of overweight children underestimated weight at baseline. Parents of younger children were significantly more likely to underestimate (65%) than parents of adolescents (51%). Overweight parents were not more likely to underestimate, nor was inaccuracy associated with parental education or socioeconomic status. African-American parents were twice as likely to underestimate as whites. One year after BMI screening and feedback was implemented, the accuracy of classification of overweight children improved (53% underestimation). African-American parents had significantly greater improvements than white parents (P < 0.0001). DISCUSSION: Parental recognition of childhood overweight may be improved with BMI screening and feedback, and African-American parents may specifically benefit. Nonetheless, underestimation of overweight is common and may have implications for public health interventions.

R. P. Wildman, D. F. Gu, P. Muntner, X. Q. Wu, K. Reynolds, X. F. Duan, C. S. Chen, G. Y. Huang, L. A. Bazzano and J. He. (2008). Trends in overweight and obesity in Chinese adults: Between 1991 and 1999-2000. Obesity. 16, 1448-1453.

Objective: The aim of this study was to evaluate trends in BMI and the prevalence of overweight (BMI >= 25 kg/m(2)) and obesity (BMI = 30 kg/m(2)) between 1991 and 1999-2000 among Chinese adults. Methods and Procedures: In this study, two population-based samples of Chinese adults aged between 45 and 79 years (n = 7,858 during each period), and comparable in the distributions of age, gender, degree of urbanization, and region (North/South) were used. Height and weight were measured using identical procedures at each period, and BMI was calculated as weight (in kilogram) divided by height (in square meter). Results: From 1991 to 1999-2000, the mean BMI increased from 21.8 to 23.4 kg/m(2) among men and from 21.8 to 23.5 kg/m(2) among women (each P < 0.001). Among men, the prevalence of overweight and obesity increased from 9.6 and 0.6%, respectively, in 1991 to 20.0 and 3.0%, respectively, in 1999-2000 (each P < 0.001). Among women, the prevalence of overweight and obesity increased from 14.5 and 1.8%, respectively, in 1991 to 26.5 and 5.2%, respectively, in 1999-2000 (each P < 0.001). The prevalence of overweight and obesity increased in all age groups, in rural and urban areas, and in North and South China, with greater relative increases in obesity among older age groups, South China, and rural areas (P interaction < 0.05). Discussion: Overweight and obesity increased tremendously during the 1990s in China. These data underscore the need for national programs in weight maintenance and reduction, to prevent obesity-related outcomes in China.

K. J. Williams, C. A. Taylor, K. N. Wolf, R. F. Lawson and R. Crespo. (2008). Cultural perceptions of healthy weight in rural Appalachian youth. Rural Remote Health. 8, 932.

INTRODUCTION: Rates of overweight among US children have been rising over the past three decades. Changes in lifestyle behaviors, including dietary and physical activity habits, have been examined thoroughly to identify correlates of weight status in children. Youth in rural US Appalachia are at a disproportionately greater risk for obesity and related health complications. Inadequate physical activity and poor dietary habits are two primary causes of obesity that have been noted in West Virginia adolescents. Few existing data describes the decisional balance in performing lifestyle behaviors, nor the perceptions of these youth regarding their beliefs about weight. The purpose of this study was to identify the perceptions of a healthy weight in rural Appalachian adolescents. METHODS: Ninth grade students were recruited from classroom presentations in four high schools throughout West Virginia. Interested parent-caregiver pairs returned forms to indicate interest in participation. Separate focus group interviews were conducted concurrently with adolescent and parents or caregivers to identify the cultural perceptions of a healthy weight. Questions were developed using grounded theory to explore how a healthy weight was defined, what factors dictate body weight, the perceived severity of the obesity issue, and the social or health ramifications of the condition. Verbatim transcripts were analyzed to identify dominant themes, and content analysis provided text segments to describe the themes. This article describes the data obtained from the adolescent focus groups. RESULTS: When asked what defined a healthy weight, the adolescents who participated in the focus groups placed great value on physical appearance and social acceptability. Students believed there was a particular number, either an absolute weight or body mass index value that determined a healthy weight. These numbers were usually conveyed by a physician; however, there was also a general acceptance of being 'thick' or a reliance on 'feeling healthy' as a determinant of maintaining a healthy weight. Despite these beliefs, many teens had unrealistic and unhealthy perceptions of weight. Female participants were more concerned with weight than males, some to the point of obsession. Both males and females expressed a social stigma associated with overweight. Issues of guilt and diminished self-esteem were prevalent. When asked about the extensiveness of the problem of childhood overweight, the students indicated that a degree of familiarity with being overweight has developed and 'you just get used to [seeing] it.' Because of the rising rates of chronic disease in this region, a fear was evident in these youth about the increased risk of developing these conditions in those who are overweight. Experiences with family members with diabetes and cardiovascular disease fueled these concerns, which instilled a fear of becoming overweight in many of the students. Many perceptions of healthy weight and appropriate body size were shaped by the media and entertainment industry. Additionally, some participants admitted to performing unsafe practices to reduce body mass, such as very low calorie diets or fasting. CONCLUSIONS: Youth in rural Appalachia present similar perceptions about weight as other children; however, differences in perceived healthy lifestyle habits and a general acceptance of a higher average body weight present additional challenges to addressing the increasing problem of child overweight. Despite the relative isolation of many of these communities, the media has a profound impact on weight valuation that has been intertwined with school-based health education and cultural values of health. These data will provide valuable information for the development of obesity prevention programs in rural Appalachia.

C.-Z. Wojtek, Z. Weimo, T. Bazzarre, D. Castelli, K. Graber and A. Woods. (2008). "We Move Kids"-The Consensus Report from the Roundtable to Examine Strategies for Promoting Walking in the School Environment. Medicine & Science in Sports & Exercise. 40, S603.

The article highlights the roundtable discussion of public health professionals related to the factors of childhood physical activity and patterns of engagement on October 15, 2005 in the U.S. The discussion aimed to identify practical and effective strategies for increasing physical activity and walking in school setting. Topics include promotion of physical activity, barriers for promotion of activity and integration of activity with other health behaviors. Strategies on how students, teachers, school administrators, parents and community could the address the barriers are presented.

K. Yuasa, M. Sei, E. Takeda, A. A. Ewis, H. Munakata, C. Onishi and Y. Nakahori. (2008). Effects of lifestyle habits and eating meals together with the family on the prevalence of obesity among school children in Tokushima, Japan: a cross-sectional questionnaire-based survey. J Med Invest. 55, 71-7.

Obesity in children has become a major global public health concern. The prevention of obesity must start from early childhood in order to establish sound lifestyle habits and promote healthy adulthood. In this study, we evaluated factors associated with the prevention of obesity and the development of healthy lifestyle habits in children. A cross-sectional, questionnaire-based survey was performed in elementary and junior high school students in Tokushima Prefecture, Japan, during the summer of 2004. The questionnaire consisted of 30 items such as physique, sleep, eating habits, diet, exercise, free time, and attending after-school lessons. Our study revealed that eating meals as a family every day is associated with a lower rate of obesity as well as getting good lifestyle habits such as eating balanced meals and getting enough sleep. Of the 3,291 students who responded to the questionnaire, 2,688 (81.7%) reported that they eat meals with their family every day. The percentage of students who eat meals with their family every day decreased with increasing school grade, with the lowest percent in the junior high school students. However, the results regarding female junior high school students revealed a marked association between eating meals with the family every day and good lifestyle habits. We recommend that parents and school teaching staff encourage the establishment of sound, healthy lifestyle habits in children from early childhood as an effective measure for the prevention of obesity.

X. G. Zhang, Z. Q. Sun, X. Z. Zhang, L. Q. Zheng, S. S. Liu, C. L. Xu, J. J. Li, F. F. Zhao, J. Li, D. Y. Hu and Y. X. Sun. (2008). Prevalence and associated factors of overweight and obesity in a chinese rural population. Obesity. 16, 168-171.

Background: Overweight and obesity are now considered as a serious health problem, and a very important risk factor for many diseases. Objective: This study was designed to investigate the epidemiologic features of overweight and obesity among rural adults in China. Method and Procedures: A cross-sectional survey was conducted during 2004-2005, using a multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. A total of 29,970 adults, aged >= 35 years, were examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the classification by the World Health Organization. Results: Overall, the prevalence of overweight was 18.6%; 15.1% in men and 22.1% in women. The prevalence of obesity was 1.7%; 1.2% in men and 2.2% in women. Multivariable logistic regression revealed certain risk factors of obesity that included being a women, Mongolian nationality and education status of over junior high school level. Moderate physical activity alone was shown as protective factor. Discussion: Although the prevalence of obesity was low, overweight was relatively high in the Chinese rural population, especially in adult women. Gender, diet, physical activity, education levels, and ethnicity were associated with the prevalence of these health conditions.

J. Ziviani, D. Macdonald, H. Ward, D. Jenkins and S. Rodger. (2008). Physical Activity of Young Children: A Two-Year Follow-Up. Physical & Occupational Therapy in Pediatrics. 28, 25.

Inadequate physical activity in children is a major health concern. The purpose of this study was to examine changes in physical activity of boys and girls, between 6-8 and 8- 10 years of age and how activity patterns correlated with selected family, child, and environment factors. The sample included 59 children without motor delays (26 boys and 23 girls) between 8 and 10 years of age. Twenty-two of the children participated in a previous study at 6-8 years of age. Parents completed a questionnaire on their children's non-physical and physical activities. Children wore a pedometer during two weekdays and two weekend days. The results indicate that girls spent more time on homework and reading and on crafts and indoor play than boys. Girls spent more time on musical and cultural activities and boys spent more time on screen-based activities at 8-10 years of age. Children spent significantly less time on physical activity at 8-10 years of age. Boys took more steps per day than girls on weekends. The average number of steps taken per weekday increased for boys, but not girls, at 8-10 years of age. There was an inverse relationship between body mass index and number of steps taken per day (weekdays r = -.28; weekend r = -.32). Socioeconomic status was associated with the number of steps taken by children on weekends (r =.34). The results have implications for physical activities for girls and school and community programs for children.

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