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      Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)

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          Abstract

          China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation’s youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China’s more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6–17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.

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

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

            The Lancet, 380(9838), 247-257
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              Systematic review of the health benefits of physical activity and fitness in school-aged children and youth

              Background The purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings. Methods The systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered. Results Physical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required. Conclusion The following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                November 2020
                29 May 2020
                : 54
                : 22
                : 1321-1331
                Affiliations
                [1 ] Shanghai University of Sport , Shanghai, China
                [2 ] departmentDepartment of Physical, Health and Arts Education , Ministry of Education of People’s Republic of China , Beijing, China
                [3 ] Nanjing Medical University , Nanjing, Jiangsu, China
                [4 ] Shanghai Municipal People's Government , Shanghai, China
                [5 ] departmentSchool of Medicine , Nanjing University , Nanjing, Jiangsu, China
                [6 ] Shanghai Municipal Education Commission , Shanghai, China
                [7 ] departmentDepartment of Developmental and Behavioral Pediatrics , Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai, China
                [8 ] departmentShenzhen Key Laboratory of Affective and Social Neuroscience , Shenzhen University , Shenzhen, Guangdong, China
                [9 ] departmentInstitute of Sports Medicine , General Administration of Sport of China , Beijing, China
                [10 ] departmentTianjin Key Laboratory of Exercise Physiology and Sports Medicine , Tianjin University of Sport , Tianjin, China
                [11 ] China Institute of Sport Science , Beijing, China
                [12 ] departmentSchool of Aerospace Medicine , Fourth Military Medical University , Xi'an, Shaanxi, China
                [13 ] departmentDepartment of Rehabilitation Medicine , The Sixth Affiliated Hospital of Sun Yat-sen University , Guangzhou, China
                [14 ] Shanghai Municipal Center for Disease Control and Prevention , Shanghai, China
                [15 ] departmentDepartment of Sports Science and Clinical Biomechanics , University of Southern Denmark, Faculty of Health Sciences , Odense, Denmark
                [16 ] departmentSchool of Physical Education and Sports Training , Shanghai University of Sport , Shanghai, China
                [17 ] departmentCollege of Health Solutions , Arizona State University , Phoenix, Arizona, USA
                [18 ] departmentDepartment of Exercise and Health Science , Willamette University , Salem, Oregon, USA
                [19 ] Oregon Research Institute , Eugene, Oregon, USA
                Author notes
                [Correspondence to ] Professor Peijie Chen, Shanghai University of Sport, Shanghai 200438, China; chenpeijie@ 123456sus.edu.cn
                Author information
                http://orcid.org/0000-0003-2075-3133
                http://orcid.org/0000-0003-2953-3911
                http://orcid.org/0000-0002-1461-9838
                http://orcid.org/0000-0001-6644-4702
                Article
                bjsports-2020-102261
                10.1136/bjsports-2020-102261
                7606574
                32471813
                5a3540b7-a52d-4b17-9682-ded8c99d5d23
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 08 May 2020
                Funding
                Funded by: The National Social Science Fund of China;
                Award ID: 19ZDA352
                Categories
                Consensus Statement
                1506
                2314
                Custom metadata
                unlocked

                Sports medicine
                exercises,fitness,sports,adolescent,body weight
                Sports medicine
                exercises, fitness, sports, adolescent, body weight

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