Gymnastik- och idrottshögskolan, GIH

De positiva effekterna av fysisk aktivitet på hälsa, välbefinnande och kognitiva funktioner är väl belagda i en rad publikationer och kunskapssammanställningar. Regelbunden daglig fysisk aktivitet kan främja psykisk hälsa och välbefinnande hos barn och ungdomar i alla skolåldrar.

Background: Families residing in disadvantaged communities encounter inequalities that restrict their engagement in physical activity. Family-based interventions and health coordinators have been proposed as promising approaches to encourage physical activity among parents and children. However, there is a paucity of knowledge regarding family experiences of such programmes and the ways health coordinators facilitate continued participation in programmes delivered in disadvantaged communities. The study aimed to explore parents’ perceptions of health coordinators in a family-based physical activity programme, Open Activities, delivered in disadvantaged communities in Sweden. Study design: An exploratory design with a qualitative ethnographic approach. Methods: Multiple methods, including 12 interviews, 15 observations and field notes, and prolonged researcher engagement between February 2022 and December 2023, were used to obtain complementary insights into parents’ perceptions and experiences in the Open Activities programme. Data was analysed using reflexive thematic analysis. Results: A main theme and three sub-themes emerged from the analysis. The sub-themes reflect participants’ perceptions of how health coordinators provide a sense of safety for parents and children, making them feel appreciated and motivated to continue participating in the programme. The sub-themes also reflect the struggles that families encounter with security and social disorders in their neighbourhoods and how these difficulties influence their participation in outdoor activities and trust in outside people, including health coordinators. This required health coordinators to demonstrate a deep commitment to their communities, cultivate trust and fairness, and take a more assertive role in enforcing rules and ensuring respect. Conclusion: The involvement of health coordinators, aware of the issues facing disadvantaged communities, could represent a promising avenue for advancing health equity through physical activity. Failure to consider the potential of health coordinators to promote safety can compromise programmes’ sustainability and even exacerbate existing disparities. © 2024 The Authors

Youth with neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD), experience cognitive difficulties in their daily lives. Food insecurity, a public health problem, disproportionately affects youth with neurodevelopmental disorders and is associated with mental health and academic functioning. We examined the association between parent-reported food insecurity and cognitive difficulty among youth after adjusting for factors associated with cognitive difficulty.The 2022 National Survey of Children’s Health, conducted in the United States, is designed to provide parent-reported information on the health and well-being of children and adolescents. Associations between cognitive difficulty, food insecurity, adverse childhood experiences (ACEs), psychiatric conditions, flourishing, receiving federal assistance, and low socioeconomic status were analyzed using binary logistic regressions.There were 6422 youth (aged 6–17) with ADHD and/or LD (63.4% boys). Around half had parent-reported serious cognitive difficulties (50.5%). A third (31.9%) were reported to have mild food insecurity and 6.7% had moderate/severe food insecurity. In the multivariable model [χ2(6) = 1138.25, p < 0.001; Nagelkerke R2 = 0.22], food insecurity [Odds Ratio (OR) = 1.21; 95% confidence interval (CI) = 1.07–1.34)] was an independent predictor of serious cognitive difficulty, in addition to ACEs (OR = 1.121, 95%CI = 1.075–1.168), anxiety or depression (OR = 2.279, 95%CI = 2.041–2.545), flourishing (OR = 0.473, 95%CI = 0.442–0.505), and free or reduced school meals (OR = 1.244, 95%CI = 1.108–1.397).Food insecurity was independently associated with parent-reported cognitive problems among youth with ADHD and LD. Better understanding the mechanisms that underlie the associations between food insecurity, other social determinants of health, and cognitive difficulties can facilitate the development of targeted, evidence-informed interventions to bolster functional and academic outcomes for youth with neurodevelopmental disorders.

Food insecurity, a public health problem, is associated with worse academic and mental health outcomes in adolescents. Correlates of cognitive difficulty among adolescents include neurodevelopmental disorders, psychiatric conditions, and adverse childhood experiences (ACEs). We examined the association between parent-reported food insecurity and cognitive difficulties, after statistically adjusting for neurodevelopmental disorders, psychiatric conditions, and ACEs.The 2021 National Survey of Children’s Health is a parent-reported survey of youth in the United States that addresses their physical and emotional health. Associations between cognitive difficulty, food insecurity, neurodevelopmental and psychiatric conditions, and ACEs were examined using chi-squared tests and binary logistic regressions.Participants were 13,448 adolescents (aged 13–17; 48% girls), and 13.5% had parent-reported cognitive difficulties (14.7% of boys and 12.2% of girls). Among those with cognitive problems, 95% had a diagnosis of a neurodevelopmental or psychiatric condition. In the total sample, 21.7% were rated as having mild food insecurity and 3.4% had moderate–severe food insecurity. ACEs were associated with food insecurity and cognitive difficulties. Binary logistic regressions examined the associations between food insecurity and cognitive difficulties after statistically adjusting for sex, ACEs, and neurodevelopmental and psychiatric conditions [χ2(4) = 3941.339, p < 0.001; Nagelkerke R2 = 0.465]. Food insecurity was independently associated with cognitive difficulty (Odds Ratio = 1.28; 95% confidence interval = 1.15–1.42).Food insecurity was associated with serious cognitive difficulty among adolescents in the United States after adjusting for sex, neurodevelopmental or psychiatric conditions, and ACEs. It is important to better understand the correlates of cognitive difficulties among adolescents to bolster precision care designed to support youth with these difficulties.

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

INTRODUCTION AND AIM: Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden.

METHODS: Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis.

RESULTS: The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences.

CONCLUSIONS: The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.

Health promotion from an early age is key to preventing unhealthy weight development in childhood, and parental involvement is essential. The school-based Healthy School Start intervention aims to promote healthy dietary and activity habits in the home environment and prevent child obesity through parental support. This study evaluated the effectiveness of the third iteration of the programme on children's dietary and activity behaviours, and body composition through a cluster-randomised controlled trial. The trial included 17 schools (8 intervention) in disadvantaged areas in mid-Sweden with 353 families with 5- to 7-year-old children. The primary outcomes were intake of selected healthy and unhealthy foods and beverages measured using photography. Secondary outcomes were physical activity and sedentary time measured by accelerometry, and measured weight and height. All outcomes were assessed at baseline and post-intervention (8 months). Linear multi-level regression showed significant favourable effects of the intervention for intake of sweet beverages (b =  - 0.17, p = 0.04), intake of healthy foods (b = 0.11, p = 0.04), and more time in moderate to vigorous physical activity during weekdays (b = 5.68, p = 0.02). An unfavourable sub-group effect of the intervention was found for children from families with low education regarding sedentary time on weekends (b = 23.04, p = 0.05). The results align with the previous two trials of the programme, indicating that school-based parental support is a useful approach for health promotion in young children in disadvantaged areas. Trial registration: ClinicalTrials.gov: No. NCT03390725, retrospectively registered on January 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03390725 .

Introduction

The family is assumed to be fundamental in youth socialization processes and development, connected to social and cultural practices such as healthy lifestyles and physical activity. However, gender patterns in physical activity among adolescents and the structural drivers of gender inequality (e.g., parentage and siblingship) are poorly understood. The aim of this study was to explore further how gender structures relate to adolescents' time spent being sedentary and physically active, using contemporary gender theory.

Methods

This cross-sectional study involved 1,139 adolescents aged 13-14 and their parents, including 815 mothers and 572 fathers. Physical activity and time spent sedentary were assessed through accelerometry among adolescents and through a self-report questionnaire for parents validated against accelerometry.

Results

The results showed significant relationships between mothers' moderate-to-vigorous physical activity (MVPA) and girls' MVPA on weekdays and weekends, and fathers' MVPA was significantly related to girls' MVPA on weekdays. Our results imply that the relationship between Swedish parents' and adolescent girls' physical activity in higher intensities are to some extent gendered practices. However, time spent sedentary does not seem to show any patterns of being performed according to binary ideas of gender. Further, our exploratory analyses suggest that these results somewhat intersect with parents' educational level and relate to intra-categorical aspects of doing gender. The results also indicate slight gendered patterns in the “doing” of brotherhood for time spent sedentary, however, for boys only on weekends.

Discussion 

The study contributes to the understanding of gender norms as constraints and enablers for adolescents' participation in physical activity. The results can spur public health and physical activity research to apply a contemporary gender theory approach, and to expand the research agenda connected to what relates to gender inequalities in physical activity practices.

AIM: To study cross-sectional relationships between step-up height and waist circumference (WC), a potential proxy for sarcopenic obesity, in Swedish children and parents.

METHODS: Participants were recruited from Swedish schools in disadvantaged areas in 2017. Height, body weight, WC and maximal step-up height were measured in 67 eight-year-old children and parents: 58 mothers, with a mean age of 38.5 and 32 fathers, with a mean age of 41.3. Sedentary time and physical activity were registered by an accelerometer. Associations between maximal step-up height and WC were analysed using Pearson's correlation and adjusted linear regression.

RESULTS: Abdominal obesity, WC ≥ 66 centimetres (cm) in children, ≥88 cm in women and ≥102 cm in men, was observed in 13% and 35% of girls and boys, and in 53% and 34% among mothers and fathers, respectively. Negative associations between maximal step-up height and WC were found for children (r = -0.37, p = 0.002) and adults (mothers r = -0.58, p < 0.001, fathers r = -0.48, p = 0.006). The associations remained after adjustments for height, body mass index (BMI) and physical activity in adults. Reduced muscle strength clustered within families (r = 0.54, p < 0.001).

CONCLUSION: Associations between reduced muscle strength and abdominal obesity were observed in children and parents. Sarcopenic obesity may need more attention in children. Our findings support family interventions.

PURPOSE: Physical activity (PA) breaks during school lessons have been suggested as a promising strategy to improve working memory performance in children and adolescents. There is a lack of studies investigating the underlying physiological mechanisms of PA on cognition, especially among adolescents. This study aimed to investigate the effects of different types of short frequent PA on adolescents' cognitive task-related changes in cerebral blood flow in the prefrontal cortex (PFC) and working memory performance compared to prolonged sitting.

METHODS: In this randomized crossover study, adolescents visited the laboratory on three different occasions for 80-minute sessions of prolonged sitting interrupted by four breaks for three minutes of simple resistance training (SRA), step-up at a pre-determined pace (STEP), or remaining seated (SOCIAL). Before and after each session, cognitive task-related changes in cerebral blood flow (oxygenated-hemoglobin, Oxy-Hb) during working memory tasks (1-, 2-, 3-back tests) were measured using functional near-infrared spectroscopy in the PFC. Accuracy and reaction time were derived from the working memory tasks. Linear mixed-effect models were used to analyze the data.

RESULTS: A total of 17 students participated (mean age 13.6 years, 11 girls). Significant time x condition interactions were noted for Oxy-Hb in the most demanding working memory task (3-back), with a decrease following prolonged sitting in the SOCIAL condition compared to both the SRA (β 0.18, 95% CI 0.12, 0.24) and the STEP (β 0.11, 95% CI 0.05, 0.17). This was observed in parallel with improvements in reaction time following SRA (β -30.11, 95% CI -59.08, -1.13) and STEP (β -34.29, 95% CI -69.22, 0.63) although this was only significant for the SRA and no improvements in the SOCIAL condition.

CONCLUSION: We found that short frequent PA breaks during prolonged sitting among adolescents can prevent the decrease in cognitive task-related changes in cerebral blood flow that occur following prolonged sitting. This was observed simultaneously with improvements in working memory, indicating that changes in cerebral blood flow could be one factor explaining the effects on working memory. Future studies should investigate the efficacy of implementing these PA breaks in schools.

TRIAL REGISTRATION: Retrospectively registered on 21/09/2020, ClinicalTrial (NCT04552626).