Search Results (436)

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. Full article

Children and adolescents with type 1 diabetes (T1D) often experience abnormalities in bone health. Studies have consistently demonstrated that youth with T1D have lower bone mineral density (BMD) compared to their healthy peers. Additionally, children with T1D show impaired bone microarchitecture and reduced bone turnover. These factors collectively contribute to an increased risk of fractures across the life span of this population. To optimize bone accrual and reduce fracture risk, several strategies can be employed during childhood and adolescence. First, maintaining good glycemic control is critical, as poor glycemic control has been associated with lower BMD and an increased risk of fractures. Second, specific nutritional recommendations can help improve bone health, including a balanced diet, adequate calcium and vitamin D intake, and careful monitoring of both macronutrient and micronutrient intake. Third, regular physical activity plays a vital role. A systematic review and meta-analysis have shown that youth with T1D are generally less physically active, more sedentary, and have lower cardiorespiratory fitness levels than their non-diabetic peers. This review emphasizes targeted strategies aimed at optimizing skeletal health in the pediatric population with T1D, with a particular focus on the critical roles of glycemic control, nutritional adequacy, and regular physical activity. These modifiable factors may contribute to the reduction of fracture risk across the life span in individuals with T1D. Full article

Background/Objectives: Childhood/youth are ideally the best periods to teach healthy behaviors; unfortunately, children/adolescents are frequently characterized by unhealthy lifestyles and reduced well-being. Lifestyle improvement early in life may play a fundamental role in determining present health, preventing many chronic diseases, and fostering well-being. Having a clear picture of the lifestyle characteristics of a group can help institutions and schools define effective educational and intervention strategies. This observational study aims to examine whether information collected from children and adolescents about their lifestyles and perceptions of well-being could help identify particular groups that deserve specific interventions, implemented by the school, to improve their overall health. Methods: After administering a simple lifestyle/well-being questionnaire to 225 children/adolescents at an Italian school complex, we investigated the relationships between lifestyles and perceptions of well-being by constructing statistical indicators through nonlinear principal component analysis. Then, we defined lifestyle typologies based on lifestyle indicators and studied the distribution of the well-being indicator across such typologies, also adjusting for sex and age effects. Results: The study shows that lifestyle worsens with age (p < 0.001) and influences overall well-being perception. We identified four lifestyle typologies by combining two indicators of sedentary behavior and sleep, and of quality of nutrition and the volume of physical activity. The healthier the lifestyle, the better the overall well-being perception is (represented by the indicator that includes the perceived quality of health, sleep, and academic performance) (p = 0.005). Conclusions: Tailored educational/intervention strategies that consider specific groups’ characteristics, rather than general counseling, might be more effective at improving health/well-being. Full article

Background: COVID-19 led to social isolation, potentially reducing physical activity (PA), increasing sedentary time, and lowering quality of life (QoL). This study investigated the association between these factors in patients with Chagas disease (ChD) during the pandemic. Methods: This cross-sectional study included 187 patients with ChD. PA and sedentary time were assessed by the IPAQ-short and QoL by the WHOQOL-Bref. The relationship between PA levels and sedentary time with QoL were assessed using unadjusted and adjusted generalized linear models. Results: The highest tertile of total PA was positively associated with the psychological (Exp β = 1.11; 95% CI: 1.02–1.22) and environmental (Exp β = 1.12; 95% CI: 1.01–1.23) QoL domains. The intermediate (Exp β = 1.12; 95% CI: 1.01–1.25) and highest (Exp β = 1.14; 95% CI: 1.02–1.27) tertiles of moderate-to-vigorous PA were positively associated with the physical domain. Similarly, both the intermediate (Exp β = 1.11; 95% CI: 1.01–1.22) and highest (Exp β = 1.12; 95% CI: 1.01–1.21) tertiles of moderate-to-vigorous PA were positively associated with the psychological domain. The highest tertile of sedentary time was associated with a decrease in the physical domain (Exp β = 0.88; 95% CI: 0.79–0.98). Conclusions: Higher levels of total and moderate-to-vigorous PA were associated with better QoL, while greater sedentary time was associated with poorer QoL. Full article

Sarcopenia is a musculoskeletal, progressive, and generalized disease characterized by decreased muscle strength and mass, leading to reduced quality of life. Sarcopenia is directly related to age, a sedentary lifestyle, and poor nutrition. The objective of this study was to evaluate the effect of 12-week progressive intensity Resistance Training (RT) associated with nutritional advice on the frequency of sarcopenia in older adults. A total of 74 older adults (37 in the intervention group and 37 in the control group), with a mean age of 69.1 ± 6.85 years, were included in the study. The sarcopenia status of the participants was assessed at baseline and after a 12-week intervention. In the intervention group, resistance training combined with nutritional counseling reduced the prevalence of sarcopenia from 35.14% to 0% (p < 0.001). Additionally, participants in the intervention group showed significant improvements in handgrip strength (from 27.70 ± 10.71 to 30.24 ± 10.38 kg), chair stand test performance (from 14.04 ± 3.46 to 11.67 ± 1.80 s), and time up and go test (from 7.49 ± 1.20 to 6.74 ± 0.95 s) (p < 0.05). On the other hand, the control group increased the incidence of sarcopenia (p < 0.001). After 12 weeks, progressive intensity RT associated with nutritional advice proved to be an effective treatment to reverse sarcopenia and help participants remain non-sarcopenic. In addition, the results of this study provide information about efficient and non-pharmacological sarcopenia treatment. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

Background: While some evidence supports the benefits of food-related tasks, research examining their association with psychosocial health in adolescents remains scarce. The aim of this study was to examine the association between Spanish adolescents’ involvement in food-related household tasks and their psychosocial health. Methods: This cross-sectional study used secondary data from the original Eating Healthy and Daily Life Activities (EHDLA) study. The final sample comprised 273 boys (43.0%) and 361 girls (57.0%). Adolescents self-reported their weekly frequency of involvement in two food-related tasks: meal preparation and grocery shopping, with responses ranging from ‘never’ to ‘seven times’. Psychosocial health was assessed using the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ), comprising five subscales: emotional problems, conduct problems, hyperactivity, peer problems, and prosocial behavior. A total difficulties score was calculated by summing the first four subscales. Generalized linear models were used to evaluate associations between the frequency of food task involvement (categorized into five levels) and SDQ outcomes. All models were adjusted for age, sex, socioeconomic status, body mass index, sleep duration, physical activity, sedentary behavior, and energy intake. Results: Concerning to the frequency of helping to prepare food for dinner, an inverse association was observed between food preparation involvement and several psychosocial problems. Adolescents who helped seven times per week reported significantly lower scores in conduct problems (B = −2.00; 95% CI −3.30 to −0.69; p = 0.003), peer problems (B = −2.83; 95% CI −4.29 to −1.38; p < 0.001), internalizing problems (B = −3.90; 95% CI −7.03 to −0.77; p = 0.015), and total psychosocial difficulties (B = −5.74; 95% CI −10.68 to −0.80; p = 0.023), compared to those who never helped. Conversely, those who helped seven times per week had higher prosocial behavior than their counterparts who never helped (B = 1.69; 95% CI: 0.14 to 3.24; p = 0.033). Regarding the frequency of helping to shop for food, similar patterns were found, with lower conduct problems (B = −2.11; 95% CI −3.42 to −0.81; p = 0.002), peer problems (B = −2.88; 95% CI −4.34 to −1.42; p < 0.001), internalizing problems (B = −4.16; 95% CI −7.28 to −1.04; p = 0.009), and total psychosocial difficulties (B = −6.31; 95% CI −11.24 to −1.39; p = 0.012) associated with more frequent involvement, especially among those who helped five or more times per week. Conversely, adolescents who helped seven times per week had higher prosocial behavior than their peers who never helped (B = 1.56; 95% CI: 0.01 to 3.11; p = 0.049). Conclusions: Although adolescent psychosocial health is influenced by multiple factors, our findings suggest that regular involvement in food-related household tasks may serve as a protective factor against conduct problems, peer problems, internalizing problems, and total difficulties, while also enhancing prosocial behavior. However, given the cross-sectional design, conclusions regarding causality should be made cautiously, and further longitudinal research is needed to confirm these associations and assess their long-term impact. These results highlight the relevance of daily structured routines, such as meal preparation and grocery shopping, as potential support for mental well-being during adolescence. Full article

Cerebral palsy (CP) is one of the most common disorders in childhood that significantly impacts quality of life. Background/Objectives: This study conducted a literature review of physical activity (PA)-based interventions for children and adolescents with CP, highlighting the physical, cognitive, and social benefits, as well as the factors and barriers that influence practice. Methods: The PRISMA methodology was used to identify and analyze the most relevant studies up to December 2024 through specific search equations and the databases Science Direct, Scopus, and Dialnet. Of the 707 articles identified, a total of 62 publications were selected for further analysis. These were subjected to a quality assessment through a checklist based on seven items. Results: The practice of PA guaranteed improvements in balance, postural control, strength, socialization, and self-confidence. On the other hand, some programs, such as Makey Makey, Ballet, aquatic PA, and Matrogymnasia, among others, were highlighted because they promoted an increase in physical practice among the population. However, there are still some barriers, such as sedentary lifestyles (90%), limited accessibility, and a lack of qualified professionals that hinder the intervention and ensure motivation and interest in its practice for those individuals who have not yet begun to practice it. Conclusions: PA is an effective tool to favor quality of life in children and adolescents, as it contributes to their integral development and social inclusion. The need for interdisciplinary strategies to reduce barriers and increase the benefits of PA is emphasized. A joint effort to promote integration in leisure time could promote optimal long-term results. Full article

Compositional Data Analysis (CoDA) is a powerful statistical approach for analyzing 24 h time-use data, effectively addressing the interdependence of sleep, sedentary behavior, and physical activity. Unlike traditional methods that struggle with perfect multicollinearity, CoDA handles time use as proportions of a whole, providing biologically meaningful insights into how daily activity patterns relate to health. Applications in epidemiology have linked variations in time allocation between behaviors to key health outcomes, including adiposity, cardiometabolic health, cognitive function, fitness, quality of life, glycomics, clinical psychometrics, and mental well-being. Research consistently shows that reallocating time from sedentary behavior to sleep or moderate-to-vigorous physical activity (MVPA) improves health outcomes. Importantly, CoDA reveals that optimal activity patterns vary across populations, supporting the need for personalized, context-specific recommendations rather than one-size-fits-all guidelines. By overcoming challenges in implementation and interpretation, CoDA has the potential to transform healthcare analytics and deepen our understanding of lifestyle behaviors’ impact on health. Full article

Health-related quality of life (HRQoL) is a multidimensional construct that encompasses physical, emotional, psychological, and social domains, according to an individual’s perception. Studies have indicated that lifestyle-related factors, such as engaging in physical activity (PA), reducing screen time (ST), and maintaining adequate sleep duration, may contribute to improved HRQoL in adolescents. The present study aimed to examine the associations of the 24 h movement behaviors (PA, ST, and sleep duration) with physical and psychological well-being, and HRQoL in adolescents. This study included 746 adolescents of both sexes, aged 11 to 15 years, enrolled in public schools. Sleep duration was assessed through a specific question related to habitual bedtime and wake-up time. ST was evaluated using a question regarding the daily time spent using recreational electronic devices. PA was measured using accelerometers (ActiGraph GT3X-BT). The KIDSCREEN questionnaire was used to assess physical and psychological well-being and HRQoL. Generalized linear models were used for statistical analysis. Significant associations were observed between meeting sleep duration recommendations and higher HRQoL scores (β = 1.05, 95% CI: 1.01–1.08), as well as psychological well-being (β = 1.07, 95% CI: 1.03–1.11). Additionally, adherence to ST recommendations was significantly associated with higher physical well-being scores (β = 1.07, 95% CI: 1.01–1.14). Concerning the combination of adherence to guidelines, meeting both sleep duration and ST recommendations was significantly associated with higher HRQoL scores (β = 1.08, 95% CI: 1.02–1.15), physical well-being (β = 1.11, 95% CI: 1.03–1.21), and psychological well-being (β = 1.09, 95% CI: 1.01–1.18). The findings of this study highlight the importance of adhering to the 24 h movement guidelines, which may contribute to improved adolescent well-being. Full article

Chronic diseases are a growing concern in aging populations, with physical inactivity playing a major role in their onset and progression. Chronic kidney disease (CKD), which affects approximately 15% of U.S. adults and over 500 million people worldwide, is strongly associated with sedentary behavior. Despite mounting evidence supporting the benefits of exercise training in CKD management, current treatment approaches remain largely pharmacological, with exercise interventions receiving limited emphasis. One challenge is the uncertainty surrounding the most appropriate exercise modalities for CKD patients, particularly those undergoing dialysis. Recent guidelines from leading nephrology organizations advocate for integrating exercise training into CKD care, recommending at least 150 min of moderate-intensity exercise per week. This narrative review examines clinical studies on exercise interventions in dialysis patients, highlighting their impact on health outcomes and quality of life. Additionally, it explores the physiological mechanisms underlying these benefits and assesses nephrologists’ perspectives on prescribing exercise training. By addressing these critical aspects, this review aims to underscore the necessity of incorporating exercise into CKD treatment strategies. Full article

Background/Objectives: Overweight children and childhood obesity are growing public health concerns influenced by early-life nutrition and lifestyle. Irregular eating patterns, sedentary behaviour, and maladaptive eating behaviours significantly contribute to excess weight gain in children. This cross-sectional study comprehensively assessed physical activity, sleep, anthropometric parameters, and eating behaviours in preschool children in Split, Croatia, examining associations between eating behaviours and nutritional status indicators. Methods: A total of 429 children aged 4 to 7 years were recruited from kindergartens in Split-Dalmatia County. Parents completed a lifestyle questionnaire and the Children’s Eating Behaviour Questionnaire (CEBQ). Anthropometric measurements (weight, height, middle upper arm circumference, waist circumference) were recorded and BMI-for-age z-scores calculated. Physical activity and sleep patterns were assessed based on parental reports. Results: A total of 66% of the children had a healthy body weight, 12.6% were underweight, and 21.4% were overweight or obese. Significant sex differences were found in the CEBQ subscale “Slowness in Eating” (p = 0.04). Overweight or obese children showed a higher food responsiveness, while underweight/normal-weight children had greater emotional undereating and slowness in eating. No significant sex differences were observed regarding physical activity. Girls exhibited significantly more frequent daytime napping than boys. Conclusions: This study shows a significant prevalence of overweight and obese preschool children in Split, Croatia. The results underline the importance of promoting healthy eating behaviours and physical activity from an early age. This is the first study applying CEBQ in the Croatian population and suggests that the interventions should target diet quality and unfavourable eating behaviours to prevent future health risks. Full article

Background/Objectives: Excessive screen exposure that negatively impacts a person’s life is referred to as problematic media use (PMU). In healthy children, PMU is associated with a sedentary lifestyle and negative health outcomes. However, this issue is not well understood in children with cerebral palsy (CP). The aim of our study was to evaluate PMU and screen exposure times in children with CP. Methods: All CP patients with variable etiology who were followed up at the child neurology clinic and met the inclusion criteria were included in our study. A total of 91 patients diagnosed with CP and 92 control children, aged 4–11, participated in the study. Daily screen exposure times, sleep durations, and body mass index (BMI) were evaluated. In children with CP, additional data such as the need for special education, CP subtype, epilepsy status, and mobility status were recorded. All participants were administered the long form of the Problematic Media Use Scale, which is valid for children aged 4–11. Results: When comparing screen exposure between the patient group and the control group, the patient group had significantly higher screen exposure (p < 0.001). Spearman’s rho correlation coefficients, calculated to evaluate the relationship between age, sleep duration, screen exposure time and screen addiction questionnaire scores of the children in the patient and control groups, were statistically significant. For the patient group specifically, there was a significant positive relationship between screen exposure duration and screen addiction questionnaire scores (r = 0.380, p < 0.001). Conclusions: In our study, it was seen that problematic media use was no different in CP patients within the same age group. However, screen exposure durations were found to be higher than in the normal population. Full article

Background/Objectives: Long-term effects of post-COVID-19 on several health outcomes remain unclear. We assessed PA and sedentary behaviour changes and explored behaviour-change factors twelve months post-COVID-19 in people with and without Long COVID. Methods: A prospective cohort study followed people treated for COVID-19 in different settings (home, hospital ward, intensive care unit) from twelve months to eighteen months post-COVID-19. Participants with and without Long COVID were identified. PA (Light PA-LPA, Moderate-to-Vigorous PA-MVPA, Steps·day⁻¹), sedentary time, functional capacity (six-minute walk test-6MWT), muscle strength (quadriceps maximal voluntary contraction-QMVC), dyspnoea (modified Medical Research Council scale-mMRC), fatigue, symptoms of anxiety and depression, and health-related quality of life-HRQoL were assessed. Results: Among 148 participants (58 ± 15 years, 54% male), 101 had Long COVID. All remained physically inactive. People with Long COVID significantly increased LPA (LPA_LongCOVID +28 [1; 55] min·day⁻¹; LPA_Controls +6 [−32; 45] min·day⁻¹), and decreased MVPA (MVPA_LongCOVID −4 [−7; −2] min·day⁻¹; MVPA_Controls −4 [−8; 1] min·day⁻¹) and sedentarism (Sedentarism_LongCOVID −47 [−89; −4] min·day⁻¹; Sedentarism_Controls −30 [−88; 28] min·day⁻¹). At eighteen months, higher proportions of individuals with Long COVID had impaired 6MWT (17% vs. 0%), reduced QMVC (25% vs. 6%), dyspnoea (24% vs. 0%), fatigue (67% vs. 13%), symptoms of anxiety (47% vs. 9%) and depression (26% vs. 0%) as well as poor HRQoL (50% vs. 6%). PA and sedentary behaviour changes at eighteen months were associated with dyspnoea and impaired QMVC at twelve months (LPA: mMRC ≥ 2: −41.56 [−129.30; 46.00] min·day⁻¹, Steps·day⁻¹: mMRC: −416.13 [−1223.83; 391.57]; QMVC ≤ 70% predicted: −1251.39 [−2661.69; 158.91], Sedentarism: mMRC ≥ 2: +47.21 [−90.57; 184.99] min·day⁻¹; 0.24 ≤ R² ≤ 0.32). Conclusions: PA and sedentary behaviour remain altered long after COVID-19, with people with Long COVID adjusting to fit lower PA levels, possibly driven by physical limitations and symptoms. Dyspnoea and muscle weakness may influence PA and sedentary behaviour. Full article

(1) Background: A sedentary lifestyle may aggravate temporomandibular disorder (TMD) symptoms, increasing pain sensitivity and functional limitations. Physical exercise is recommended for pain management and improving quality of life. Comparing CrossFit^® athletes to sedentary individuals allows for examining whether regular high-intensity exercise impacts pain sensitivity and functional limitations associated with TMD. This cross-sectional study assessed the signs and symptoms of TMD in CrossFit^® athletes compared to sedentary individuals. (2) Methods: Participants (n = 121) were divided into four groups: sedentary with TMD (n = 39), sedentary without TMD (n = 37), CrossFit^® athletes with TMD (n = 23), and CrossFit^® athletes without TMD (n = 22). TMD signs and symptoms were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I, including mandibular movement patterns, range of motion, joint sounds, muscle pain, and jaw dysfunctions. Statistical analyses included chi-square and Dunn’s post hoc tests, ANOVA, and Kruskal–Wallis tests. Correlation and regression analyses were performed to examine associations between CrossFit^® practice and TMD (p ≤ 0.05). (3) Results: Myofascial pain was the most common diagnosis. All athlete groups exhibited greater mandibular movement amplitudes (unassisted opening without pain, p < 0.001, and protrusion, p = 0.039) and less pain (p < 0.001) than sedentary individuals. Pain reports and palpation-induced pain in muscles and joints were significantly associated with a sedentary lifestyle and TMD (p < 0.001). Joint and muscle pain were more prevalent (frequent) among sedentary participants, regardless of TMD diagnosis. Linear regression analysis showed that sedentary individuals without TMD had significantly reduced unassisted mouth opening amplitudes compared to athletes without TMD (p < 0.05). (4) Conclusions: Pain in the masseter, temporalis, posterior digastric, and medial pterygoid muscles was the most common symptom in sedentary individuals with TMD. They experience higher frequency and intensity of pain, as well as greater limitations in mouth movement. Athletes showed higher frequency of joint noises. Full article