Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

This study supported the usefulness of the TGMD-2 as a process-oriented instrument to measure gross motor development in early childhood in Belgium. However, it also demonstrated that caution is warranted when using the US reference norms.

Objective: The aim of the present study was to explore the existence of clusters in multiple lifestyle behaviours, including physical activity (PA), sedentariness and food habits, in young adolescents. The present study also investigated whether the identified groups could be characterised by gender and components of health-related physical fitness, especially weight status and cardiorespiratory fitness (CRF). Design: A cross-sectional survey. Leisure-time PA, sedentary behaviour and food consumption were assessed by a questionnaire. Overweight prevalence was estimated using BMI (kg/m 2 ) calculated from self-reported height and weight. CRF was measured using a 20 m shuttle-run test. Setting: The study was conducted in four middle schools in Flanders, Belgium. Subjects: The sample size was 317 seventh grade students aged 11-12 years. Results: Four reliable and meaningful lifestyle clusters could be identified, labelled as 'Sporty media-oriented mixed eaters' (boys: n 34; girls: n 16), 'Academic healthy eaters' (boys: n 30; girls: n 58), 'Inactive healthy eaters' (boys: n 38; girls: n 57) and 'Inactive media-oriented unhealthy eaters' (boys: n 35; girls: n 49). The lifestyle clusters could not be characterised by adolescents' weight status. Among boys, the 'Sporty media-oriented mixed eaters' group performed significantly better on the shuttle-run test than those in clusters with the lowest levels of PA (clusters 3 and 4). Conclusions: Our results showed that healthy and risk-related behaviours may coexist in some groups of young adolescents. Isolated unhealthy behaviours, such as high levels of screen-based media use or high consumption of energydense food items, are not necessarily related with negative health outcomes, on the condition that these risk-related behaviours co-occur with more healthenhancing behaviours such as PA. Dramatic increases in childhood obesity over the past decades suggest the predominance of influential behavioural factors over genetic factors. It is generally believed that today's environment enforces an inactive lifestyle that is likely to contribute to a positive energy balance and childhood obesity (1) . Despite the important role of nutrition (energy input) and physical activity (PA; energy output) in the prevention of childhood obesity, there seems to be limited research addressing the relationship between multiple health behaviours or clusters based on this energy-balance approach (2)(3)(4) . Previous literature in this area has mainly focused on describing bivariate associations between PA and sedentary behaviour (5) , PA and food choices (6,7) or sedentary behaviour and food choices (8,9) . Although significant relationships may exist between two health behaviours, the reported correlations are predominantly weak and often too small to be of much clinical or practical significance. Nevertheless, the low correlations between health-related behaviours does not exclude the existence of clusters or groups of young people who show negative health profiles due to factors such...

The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations.

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.

BackgroundThe increasing rates of obesity among children and adolescents, especially in those from lower socio-economic backgrounds, emphasise the need for interventions promoting a healthy diet and physical activity. The present study aimed to examine the effectiveness of the ‘Health Scores!’ program, which combined professional football player role models with a school-based program to promote a healthy diet and physical activity to socially vulnerable children and adolescents.MethodsThe intervention was implemented in two settings: professional football clubs and schools. Socially vulnerable children and adolescents (n = 165 intervention group, n = 440 control group, aged 10-14 year) provided self-reported data on dietary habits and physical activity before and after the four-month intervention. Intervention effects were evaluated using repeated measures analysis of variance. In addition, a process evaluation was conducted.ResultsNo intervention effects were found for several dietary behaviours, including consumption of breakfast, fruit, soft drinks or sweet and savoury snacks. Positive intervention effects were found for self-efficacy for having a daily breakfast (p < 0.01), positive attitude towards vegetables consumption (p < 0.01) and towards lower soft drink consumption (p < 0.001). A trend towards significance (p < 0.10) was found for self-efficacy for reaching the physical activity guidelines. For sports participation no significant intervention effect was found. In total, 92 pupils completed the process evaluation, the feedback was largely positive.ConclusionsThe ‘Health Scores!’ intervention was successful in increasing psychosocial correlates of a healthy diet and PA. The use of professional football players as a credible source for health promotion was appealing to socially vulnerable children and adolescents.

This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely 'research into HPSC activity' and 'research into HPSC networks'. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) - both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation.

BackgroundConventional face-to-face weight loss and weight control programs are very labor intensive for both the patient and the provider. It is unclear to what extent conventional programs can be (partially) completed by mobile health (mHealth) apps.ObjectiveThe aim of this study was to compare the effectiveness of different weight loss programs using a combination of conventional and mobile programs among adults who are overweight (body mass index [BMI]>29 kg/m²).MethodsA single-blinded randomized controlled trial among obese adults was performed from September 2015 to March 2016. The study took place in Leuven, Belgium. Of the 102 eligible (BMI >29 kg/m²) adults, 81 (79%) completed the study. The three intervention groups consisted of a conventional face-to-face weight loss program, a weight loss app program (app group), and a partial face-to-face and partial app program (combi group). All intervention groups received the same advice from a dietician and a physical activity coach during a 12-week period. The control group did not receive any information during the same period. Primary outcomes were weight reduction (5% decrease of baseline weight in kg), BMI, metabolic risk factors, dietary pattern, and physical activity.ResultsSignificant more participants in all three intervention groups lost at least 5% or more of their weight at baseline compared with the control group. No significant difference was found between the combi group and the conventional group. A trend was found that more participants in the combi group lost 5% or more compared with the app group (19%), P=.06. A significant time x group effect was found for BMI and metabolic risk factors, with the control group having the worst results and the combi group being significantly better with regard to BMI compared with the app group. No significant group x time effects were found for the intake of different food and drinks and moderate to vigorous physical activity (MVPA).ConclusionsThe results of this study show that a conventional weight loss program could partially be completed with an mHealth program without affecting the effectiveness.Trial RegistrationClinicaltrials.gov NCT02595671; https://clinicaltrials.gov/ct2/show/NCT02595671 (Archived by WebCite at http://www.webcitation.org/6w1H0x1Q6)