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      Leisure Time Physical Inactivity and Sedentary Behaviour and Lifestyle Correlates among Students Aged 13–15 in the Association of Southeast Asian Nations (ASEAN) Member States, 2007–2013


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          The aim of this study was to examine the relationship between self-reported leisure time physical inactivity frequency and sedentary behaviour and lifestyle correlates among school children in the Association of Southeast Asian Nations (ASEAN) region. The analysis included 30,284 school children aged 13–15 years from seven ASEAN countries that participated in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The measure asked about overall physical activity, walking or biking to school, and on time spent sitting. Overall, the prevalence of physical inactivity was 80.4%, ranging from 74.8% in Myanmar to 90.7% in Cambodia and sedentary behaviour 33.0%, ranging from 10.5% in Cambodia and Myanmar to 42.7% in Malaysia. In multivariate logistic regression, not walking or biking to school, not attending physical education classes, inadequate vegetable consumption and lack of protective factors (peer and parental or guardian support) were associated with physical inactivity, and older age (14 and 15 years old), coming from an upper middle income country, being overweight or obese, attending physical education classes, alcohol use, loneliness, peer support and lack of parental or guardian supervision were associated with sedentary behaviour. In boys, lower socioeconomic status (in the form of having experienced hunger) and coming from a low income or lower middle income country were additionally associated with physical inactivity, and in girls, higher socioeconomic status, not walking or biking to school and being bullied were additionally associated with sedentary behaviour. In conclusion, a very high prevalence of leisure physical inactivity and sedentary behaviour among school going adolescents in ASEAN was found and several factors identified that may inform physical activity promotion programmes in school-going adolescents in ASEAN.

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          Most cited references43

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          Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011.

          To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults. Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome. Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance. There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            A physical activity screening measure for use with adolescents in primary care.

            To develop a reliable and valid physical activity screening measure for use with adolescents in primary care settings. We conducted 2 studies to evaluate the test-retest reliability and concurrent validity of 6 single-item and 3 composite measures of physical activity. Modifications were based on the findings of the 2 studies, and a best measure was evaluated in study 3. Accelerometer data served as the criterion standard for tests of validity. In study 1 (N = 250; mean age, 15 years; 56% female; 36% white), reports on the composite measures were most reliable. In study 2 (N = 57; mean age, 14 years; 65% female; 37% white), 6 of the 9 screening measures correlated significantly with accelerometer data. Subjects, however, had great difficulty reporting bouts of activity and distinguishing between intensity levels. Instead, we developed a single measure assessing accumulation of 60 minutes of moderate to vigorous physical activity. Evaluated in study 3 (N = 148; mean age, 12 years; 65% female; 27% white), the measure was reliable (intraclass correlation, 0.77) and correlated significantly (r = 0.40, P<.001) with accelerometer data. Correct classification (63%), sensitivity (71%), and false-positive rates (40%) were reasonable. The "moderate to vigorous physical activity" screening measure is recommended for clinical practice with adolescents.
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              Physical activity and sedentary behavior among schoolchildren: a 34-country comparison.

              To describe and compare levels of physical activity and sedentary behavior in schoolchildren from 34 countries across 5 WHO Regions. The analysis included 72,845 schoolchildren from 34 countries that participated in the Global School-based Student Health Survey (GSHS) and conducted data collection between 2003 and 2007. The questionnaire included questions on overall physical activity, walking, or biking to school, and on time spent sitting. Very few students engaged in sufficient physical activity. Across all countries, 23.8% of boys and 15.4% of girls met recommendations, with the lowest prevalence in Philippines and Zambia (both 8.8%) and the highest in India (37.5%). The prevalence of walking or riding a bicycle to school ranged from 18.6% in United Arab Emirates to 84.8% in China. In more than half of the countries, more than one third of the students spent 3 or more hours per day on sedentary activities, excluding the hours spent sitting at school and doing homework. The great majority of students did not meet physical activity recommendations. Additionally, levels of sedentariness were high. These findings require immediate action, and efforts should be made worldwide to increase levels of physical activity among schoolchildren. Copyright (c) 2010 Mosby, Inc. All rights reserved.

                Author and article information

                Role: Academic Editor
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                International Journal of Environmental Research and Public Health
                15 February 2016
                February 2016
                : 13
                : 2
                [1 ]ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamothon, Nkohn Pathom 73170, Thailand; supaprom@ 123456yahoo.com
                [2 ]Department of Research & Innovation, University of Limpopo, Turfloop Campus, Sovenga 0727, South Africa
                [3 ]HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria 0001, South Africa
                Author notes
                [* ]Correspondence: karl.pel@ 123456mahidol.ac.th ; Tel.: +66-2-441-0207; Fax: +66-2-441-9044
                © 2016 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).


                Public health
                physical inactivity,sedentary behaviour,prevalence,overweight,health risk behaviour,mental health,protective factors,asean


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