Gymnastik- och idrottshögskolan, GIH

AIM: Investigate the longitudinal relationship between physical activity, organised physical activity, fitness, screen time and academic performance among Swedish adolescents.

METHODS: Data from 1139 adolescents at age 13, included vigorous physical activity (accelerometry), fitness (submaximal ergometer test), screen time and organised physical activity participation (self-reported) and academic performance (math and Swedish grades at ages 13 and 16 from registry). Academic performance at age 16 was categorised as A-D (higher grades or pass) or E, F (fail or at-risk of failing). Multilevel logistic regression models were used to examine the relationships while adjusting for gender, parental education, parental country of birth and academic performance at age 13.

RESULTS: Higher fitness at age 13 was associated with increased odds of receiving A-D at age 16 (OR: 1.04 per mL, 99% CI 1.00, 1.07, p = 0.003). High screen time during weekdays was associated with reduced odds (OR: 0.40, 99% CI 0.20, 0.81, p = 0.001) compared to low screen time.

CONCLUSION: Academic performance at the end of compulsory school (age 16) was related to fitness and screen time 3 years earlier. These findings create a paradigm for future randomised controlled trials to explore how influencing these factors might affect academic performance.

Introduction: There is an association between physical activity and both health and academic performance. However, there is still a lack of consensus on how to engage adolescents in physical activity interventions in secondary schools. One approach to better understand the activities and strategies supporting effective implementation is to involve school staff and adolescents in the early stages of planning and preparing for interventions. Therefore, the aim of this study is to explore how multiple stakeholders, including school staff, students, and experts, perceive the barriers and facilitators for implementing a school-based intervention that extends the school day with additional physical activity in Sweden.

Material and methods: This inductive explorative qualitative study involved 16 participants. Three focus groups with school staff, including principals (n = 3), teachers (n = 6), and students (n = 4), and three interviews with experts were conducted. The planned intervention and its components were presented to the participants in the focus group and interviews to discuss them based on their previous experiences and thoughts of implementing physical activities or health promotion programmes in their schools or with adolescents. Data were analysed using qualitative content analysis.

Results: Three categories emerged: (1) “types of activities offered”, highlighting the importance of designing activities that are fun, inclusive and unusual; (2) “integration of the activities into school curriculum” to promote sustainability of the intervention and incorporate physical activity throughout the school day and across school subjects, and (3) “Management support and funding” referring to the funded time and facilities that teachers leading the activities need to facilitate implementation.

Conclusions: Before implementing extra physical activity in a school setting, it is important to understand what activities enhance students' motivation and the type of support teachers need from the school principal and administration. This includes funding for teachers' time, appropriate scheduling of the activities, and access to facilities.

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.

Gymnastik- och idrottshögskolan (GIH) har sedan 2017 arbetat i en serie forskningsstudier finansierade av Stiftelsen för kunskaps- och kompetensutveckling, KKS. Studierna har fokuserat på både barn, vuxna och äldre. Sedan 2021 finns vid GIH ett forskningscentrum med fokus på fysisk aktivitet och hjärnhälsa, det vill säga goda kognitiva funktioner och god psykisk hälsa, kallat E-PABS (Center of Excellence in Physical Activity, Healthy Brain Functions and Sustainability). Forskningen inom E-PABS täcker många ämnesområden och innefattar epidemiologi, beteendeförändring, kognitiv neurovetenskap, fysiologi och molekylär biokemi.

Denna rapport bygger på studier inom projektet ”Fysisk aktivitet och hälsosamma hjärnfunktioner hos skolungdomar”, som genomfördes under 2017–2023. Projektet hade tre delar, en epidemiologisk, en fysiologisk och en etnografisk del som tillsammans syftade till att svara på frågorna ”Vilket är sambandet mellan fysisk aktivitet, stillasittande beteende, kost och hälsosamma hjärnfunktioner hos barn och ungdomar, och hur kan fysisk aktivitet som främjar sunda hjärnfunktioner långsiktigt hållbart implementeras i skolor?”

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.

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).

Gymnastik- och idrottshögskolan (GIH) har sedan 2017 arbetat i en serie forskningsstudier finansierade av Stiftelsen för kunskaps- och kompetensutveckling, KKS. Studierna har fokuserat på både barn, vuxna och äldre. Sedan 2021 finns vid GIH ett forskningscentrum med fokus på fysisk aktivitet och hjärnhälsa, det vill säga goda kognitiva funktioner och god psykisk hälsa, kallat E-PABS (Center of Excellence in Physical Activity, Healthy Brain Functions and Sustainability). Forskningen inom E-PABS täcker många ämnesområden och innefattar epidemiologi, beteendeförändring, kognitiv neurovetenskap, fysiologi och molekylär biokemi.

Denna rapport bygger på studier inom projektet ”Fysisk aktivitet och hälsosamma hjärnfunktioner hos skolungdomar”, som genomfördes under 2017–2023. Projektet hade tre delar, en epidemiologisk, en fysiologisk och en etnografisk del som tillsammans syftade till att svara på frågorna ”Vilket är sambandet mellan fysisk aktivitet, stillasittande beteende, kost och hälsosamma hjärnfunktioner hos barn och ungdomar, och hur kan fysisk aktivitet som främjar sunda hjärnfunktioner långsiktigt hållbart implementeras i skolor?”

Purpose: Beneficial acute effects of dietary nitrate have been demonstrated on working memory in adults, with changes in cerebral blood flow (CBF) being a potential mechanism. However, these effects have not been studied in adolescents. Moreover, having breakfast compared to skipping may also exhibit positive effects on working memory. Therefore, this randomized crossover trial investigated the acute effects of nitrate and breakfast on working memory and changes in task-related CBF in adolescents.  Methods: This trial will recruit at least 43 adolescents (13–15 years old). There were three experimental breakfast conditions: (1) none, (2) regular, and (3) regular breakfast with high nitrate in the form of concentrated beetroot juice. Working memory (1-, 2-, 3-back tests) and task-related CBF (prefrontal cortex oxygenated and deoxygenated-hemoglobin changes estimated using functional near-infrared spectroscopy) were measured immediately after breakfast and 130 min later. The data collection for this study is ongoing, thus results for 35 adolescents are presented here and due to blinding of the researcher we are unable to report at this time in which condition these effects occurred, but will be revealed by the time of the conference, as well as for the results on changes in CBF.  Results: Preliminary results from the ongoing study showed that from pretest to posttest there was a statistically significant improvement in reaction time in all three conditions for all three n-back tests, but no intervention effects. Accuracy, however, improved from pretest to posttest in only one condition, for all three nback tests (β [95% confidence interval] from linear mixed-effects models with subject as random effect: 1-back 2.8[1.2-4.3], 2-back 2.6[0.9-4.2], 3-back 3.6[2.2-5.0]), and there was a tendency towards an intervention effect between this breakfast condition and another on the accuracy of the 3-back test (P for time-by-condition interaction 0.07).   Conclusions: The results from this study will increase our understanding into the effects of breakfast and its composition (i.e., nitrate-rich) on acutely improving working memory in adolescents and the potential mechanisms. In turn, the results will inform on whether policies on providing breakfast in schools should be considered to improve students' cognitive performance.

BACKGROUND: Inorganic nitrate has been shown to acutely improve working memory in adults, potentially by altering cerebral and peripheral vasculature. However, this remains unknown in adolescents. Furthermore, breakfast is important for overall health and psychological well-being. Therefore, this study will investigate the acute effects of nitrate and breakfast on working memory performance, task-related cerebral blood flow (CBF), arterial stiffness, and psychological outcomes in Swedish adolescents.

METHODS: This randomised crossover trial will recruit at least 43 adolescents (13-15 years old). There will be three experimental breakfast conditions: (1) none, (2) low-nitrate (normal breakfast), and (3) high-nitrate (concentrated beetroot juice with normal breakfast). Working memory (n-back tests), CBF (task-related changes in oxygenated and deoxygenated haemoglobin in the prefrontal cortex), and arterial stiffness (pulse wave velocity and augmentation index) will be measured twice, immediately after breakfast and 130 min later. Measures of psychological factors and salivary nitrate/nitrite will be assessed once before the conditions and at two-time points after the conditions.

DISCUSSION: This study will provide insight into the acute effects of nitrate and breakfast on working memory in adolescents and to what extent any such effects can be explained by changes in CBF. This study will also shed light upon whether oral intake of nitrate may acutely improve arterial stiffness and psychological well-being, in adolescents. Consequently, results will indicate if nitrate intake from beetroot juice or if breakfast itself could acutely improve cognitive, vascular, and psychological health in adolescents, which can affect academic performance and have implications for policies regarding school meals.

TRIAL REGISTRATION: The trial has been prospectively registered on 21/02/2022 at https://doi.org/10.1186/ISRCTN16596056. Trial number: ISRCTN16596056.

BACKGROUND: Adolescence is a transition period in which positive experiences of physical activity have the potential to last into later adulthood. These experiences are influenced by socioeconomic determinants, leading to health inequalities. This study aims to explore adolescents' experiences and participation in a multi-component school-based intervention in schools located in socioeconomically advantaged and disadvantaged areas in Sweden.

METHODS: A qualitative design was used to evaluate how participants experienced the intervention. The intervention was a multi-component school-based intervention. It was conducted in six schools (four control and two intervention schools) with a total of 193 students and lasted one school year. It was teacher-led and consisted of three 60-minute group sessions per week: varied physical activities, homework support with activity breaks, and walks while listening to audiobooks. In total, 23 participant observations were conducted over eight months and 27 students participated in focus groups. A content analysis was conducted.

RESULTS: The results describe a main category 'Engaging in activities depending on socioeconomic status' and three generic categories: 1. Variations in participation in PA together with classmates and teachers; 2. Variations in engagement in PA after school; and 3. Differences in time and place allocated to do homework and listen to audiobooks. These categories illustrate how participants looked forward to the physical activities but used the time spent during the walks and homework support differently depending on how busy they were after school. Frequently, those who were busiest after school were also those from the advantaged area, and those who had little to do after school were from the disadvantaged area.

CONCLUSION: Socioeconomic factors influence participants' possibilities to engage in the intervention activities as well as how they use their time in the activities. This study showed that it is crucial to support adolescents' participation in physical activities by providing structure and engaging well-known teachers in the activities, especially in schools located in disadvantaged areas.