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PubMed2004

Self-rated health and physical activity in the European Union.

OBJECTIVES: This article is the first in a series of four that present data about physical activity in the 15 member states of the European Union collected by the Eurobarometer 58.2. On a descriptive and multivariate level, the analysis investigates the relationship between physical activity and self-rated health in the different nations. METHODS: Data were collected in 2002 as part of the Eurobarometer by face-to-face interviews. A total of 16,230 respondents age 15 years and older were interviewed. Sample sizes ranged about 1000 respondents in most nations. Physical activity status (insufficiently active, sufficiently active, and highly active) was assessed using the last 7-days short-version of the International Physical Activity Questionnaire (IPAQ). RESULTS: On a descriptive level of analysis, results indicated positive relationships between physical activity status and self-rated health across populations subgroups as divided by age, gender, income, and educational attainment. Also on a multivariate level of analysis, physical activity status was significantly related to a better self-rated health. In an analysis on the national level, some variations in the predictive power of physical activity status for self-rated health could be observed. CONCLUSION: Results provide some indication for a positive relationship between physical activity, as assessed with the IPAQ, and self-rated health. That in most nations sufficient levels of physical activity were not positively related to self-rated health might be explained by difficulties in assessing moderate forms of physical activity, and also differences of the context (at home, for leisure, at work, for transportation) where physical activity takes place.

Adolescent↗
PubMed1992

Smoking, exercise, and physical fitness.

BACKGROUND: Research on smoking and physical activity provides strong evidence of smoking's negative impact and physical activity's positive impact on long-term health. However, evidence regarding the association between smoking and exercise activity and the independent effects of these factors on fitness is lacking. METHODS: The associations among exercise activity, smoking behavior, and physical fitness were examined in 3,045 Navy personnel. Exercise and smoking behaviors were measured using a lifestyle survey. Physical fitness was assessed using scores on the Navy's Physical Readiness Test. Analyses of variance were conducted to examine the relationships among smoking status, exercise activity, and PRT performance. Multiple regression procedures were used to examine the relationship between smoking and physical fitness after statistically controlling for the effects of exercise. RESULTS: Smoking was associated with lower exercise levels and lower physical endurance--both cardiorespiratory (1.5-mile run) and muscular (sit-ups). After controlling for exercise activity, smoking remained significantly associated with lower physical endurance but was not related to overall body strength (lean body mass) or percentage body fat. CONCLUSION: Smoking is a detriment to physical fitness even among relatively young, fit individuals. Study findings suggest that smokers will have lower physical endurance than nonsmokers, even after differences in the average exercise levels of smokers and nonsmokers are taken into account. Cigarette smokers should be given strong encouragement to stop smoking as part of any effort to improve physical fitness.

Adolescent↗
PubMed2006

Markers of inflammation are inversely related to physical activity and fitness in sedentary men with treated hypertension.

BACKGROUND: Physical inactivity is an important risk factor for atherosclerotic disease. We studied the relationship between physical activity and physical fitness and soluble markers of atherosclerotic activity in men with drug-treated hypertension. METHODS: The participants (n = 177, 40 to 74 years of age), who were randomly recruited from the Hypertension High Risk Management Trial (HYRIM), were overweight and had sedentary lifestyles. The inflammatory markers high-sensitivity C-reactive protein (hs-CRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (SICAM-1) and soluble E-selectin (sE-selectin) and the hemostatic markers soluble thrombomodulin (sTM), von Willebrand factor (vWf), and tissue plasminogen activator antigen (tPAag) were measured. Physical activity was measured by use of a questionnaire. Time to exhaustion in a bicycle test was used as an expression of physical fitness. RESULTS: The hs-CRP showed a significant inverse relationship with physical fitness independent of major cardiovascular risk factors (P = .017) but was not related to physical activity. The sE-selectin was significantly related to physical activity, although only when other factors were taken into account (P = .033), and it had no significant association with physical fitness. In addition there were strong associations between hs-CRP and sICAM-1 and the Framingham Coronary Heart Disease risk score (P < .001). CONCLUSIONS: The observed inverse relations between physical fitness and hs-CRP and between level of physical activity and sE-selectin in drug-treated, hypertensive sedentary men indicates a beneficial effect of good fitness status as well as activity of low intensity on vessel wall inflammation.

Adult↗
PubMed2004

Assessing physical activity during recess using accelerometry.

BACKGROUND: Physical activity guidelines recommend children should engage in 60 min of moderate-to-vigorous physical activity (MVPA) a day. School recess presents an opportunity for children to be physically active during the school day. Limited research has investigated children's activity levels during recess and its contribution to physical activity recommendations. Moreover, no target for physical activity during recess has been set. METHODS: One hundred sixteen boys and 112 girls (aged 5-10 years) from 23 schools had their physical activity during recess quantified using a uniaxial accelerometer during three recess breaks on one school day. The percentage of time spent engaged in moderate, high, and very high intensity activity was calculated using existing thresholds. RESULTS: Boys engaged in more moderate, high, and very high intensity activity than girls. On average, boys and girls spent 32.9% and 23% of recess engaged in physical activity, respectively. CONCLUSIONS: Boys engaged in higher intensity activities than girls. The results suggest that recess can contribute 28 min for boys and 21.5 min for girls toward the accumulation of recommended daily physical activity. However, the physical activity intensities that children engaged in were low during recess. On average, children in this study did not achieve 50% of recess time in physical activity. Interventions for increasing the physical activity of children in the playground are warranted.

Body Mass Index↗
PubMed2002

Physical therapy rehabilitation of the ankle.

Physical therapy intervention following an ankle injury is crucial and essential to returning a patient to his/her prior level of function. Following a physical therapy evaluation, a physical therapy diagnosis is established by relating the physical impairments found (e.g., limitations in range of motion, strength, proprioception, etc.) to functional limitations. The goal of physical therapy intervention is to improve these physical impairments, thereby restoring a patient's normal function. The physical therapist can administer such treatment as joint mobilization, strength training, proprioceptive training, and patient education. Since individuals vary in the extent and severity of physical impairments, physical therapy intervention will also vary on a patient-by-patient basis. Therefore, the purpose of this article is not to serve as a protocol for physical therapy intervention but as a review of evidence-based treatment that is relevant for the impairments found after completing a physical therapy evaluation.

Ankle Injuries↗
PubMed2005

Self-perception of physical competences in preadolescent overweight Chinese children.

OBJECTIVE: To compare self-perceptions of physical competences in overweight and in normal weight preadolescent Chinese children. DESIGN: Cross-sectional study. SETTING: Three primary schools and a university hospital in Hong Kong. SUBJECTS: A total of 634 children, comprising 558 (462 normal weight, 96 overweight) aged 8-12 y randomly sampled from three primary schools, and 76 similar age overweight children recruited from the community for a diet and exercise intervention programme. MEASUREMENTS: Height, weight and percentage body fat were measured. Self-perceptions of physical competences were determined by Physical Self-Descriptive Questionnaire (PSDQ). Corresponding actual physical competences were measured by physical fitness tests. RESULTS: Overweight children perceived themselves to have significantly more body fat than normal weight children, with poorer appearance, sports competence, endurance, coordination, flexibility, overall physical self-concept and self-esteem, but to be no less healthy, no less physically active and no less strong. Overweight children performed less well than normal weight children in measures of endurance, coordination and flexibility but better in strength. Poor self-perception of physical competences appeared only partly related to deficiencies in actual physical competences. CONCLUSION: Overweight children have poorer self-perception of their physical competences but do not perceive themselves to be less strong, healthy or physically active than normal weight children. Exercise programmes for overweight children could be more effective if designed with the knowledge of these self-perceptions.

Body Composition↗
PubMed2006

Testing a model of physical activity and obesity tracking from youth to adulthood: the cardiovascular risk in young Finns study.

OBJECTIVE: To test a potential model of the relationship between physical activity and obesity from youth to adulthood. DESIGN: Longitudinal study data from the cardiovascular risk in young Finns study. SUBJECTS: A total of 1319 boys (n=626) and girls (n=693) aged 9, 12, 15 and 18 years were randomly selected from five university towns and their rural surroundings in 1980. They were followed up for 21 years. In 2001 they were 30, 33, 36 and 39 years old. MEASUREMENTS: Physical activity was assessed by a short questionnaire at two measurement points. Obesity was measured by body mass index (BMI) and sum of skinfolds in 1980 and BMI and waist circumference in 2001. RESULTS: Structural equation analysis (LISREL) indicated that the prevalence of abdominal obesity in adulthood was directly affected by adult physical activity (beta (beta)=-0.16, t=-4.02, P< 0.05 for men, beta=-0.12, t=-3.35, P<0.05 for women) and indirectly via youth physical activity (beta=-0.10, t=-4.68, P< 0.05 for men, beta=-0.07, t=-4.54, P<0.05 for women). Obesity tracked significantly from youth to adulthood (beta=0.41, t=11.13, P<0.05 for men, beta=0.34, t=9.39, P<0.05 for women). Youth physical activity might reduce body weight in youth but was not directly associated with adult abdominal obesity in either men or women. The model accounted 19% of abdominal obesity in men and 13% in women. The path from youth physical activity to adult obesity through youth obesity seemed to be stronger than the path through adult physical activity. CONCLUSIONS: This study lends general support to the hypothesized model that abdominal obesity in adulthood is directly related to adult physical activity and youth overall obesity in both sexes. Youth physical activity had an indirect effect on abdominal obesity through the maintenance of physical activity in adulthood. Participation in and maintaining physical activity from youth to adulthood may have an important role in reducing obesity in adulthood.

Adolescent↗
PubMed2002

The relationship between leg power and physical performance in mobility-limited older people.

OBJECTIVES: The purpose of this study was to assess the influence of leg power and leg strength on the physical performance of community-dwelling mobility-limited older people. DESIGN: Cross-sectional analysis of baseline data from a 12-week randomized controlled exercise-intervention study. SETTING: Exercise laboratory within the Department of Health Science of an urban university. PARTICIPANTS: Forty-five community-dwelling mobility-limited people (34 women, 11 men), aged 65 to 83. MEASUREMENTS: Health status, depression, cognition, physical activity, and falls efficacy; physiological measures of lower extremity strength and power; and measures of physical performance. RESULTS: Through bivariate analyses, leg power was significantly associated with physical performance as measured by stair-climb time, chair-stand time, tandem gait, habitual gait, maximal gait, and the short physical performance battery describing between 12% and 45% of the variance (R2). Although leg power and leg strength were greatly correlated (r = .89) in a comparison of bivariate analyses of strength or power with physical performance, leg power modeled up to 8% more of the variance for five of six physical performance measures. Despite limitations in sample size, it appeared that, through quadratic modeling,the influence of leg power on physical performance was curvilinear. Using separate multivariate analyses, partial R2 values for leg power and leg strength were compared, demonstrating that leg power accounted for 2% to 8% more of the variance with all measures of physical performance. CONCLUSION: Leg power is an important factor influencing the physical performance of mobility-limited older people. Although related to strength, it is a separate attribute that may exert a greater influence on physical performance. These findings have important implications for clinicians practicing geriatric rehabilitation.

Age Factors↗
PubMed1997

Familial aggregation of leisure-time physical activity -- a three generation study.

Studies of parental influence on children's physical activity have had different results. Parental effect on physical activity during adolescence is less studied, and three generation studies have not been carried out. The purpose of our study was to examine intra- and intergenerational associations of leisure time physical activity among family members in three generations. Due to the major changes in society during this time, we also took into consideration the socioeconomic status of the adult subjects. The material consisted of 3254 twins at the age of 16, their parents and grandparents. Twins and their parents received a questionnaire in 1991-1993, which included questions about the health and lifestyle, socioeconomic status and leisure time physical activity. The parents' questionnaire also included questions about their own parents' leisure time physical activity and socioeconomic status. Based on these questions adolescents, parents and grandparents were classified into physical activity classes. The socioeconomic classification of parents and grandparents was based on their occupation. Intragenerational physical activity patterns were significantly associated with each other. Among adolescents the strongest correlation were between monozygotic boys (0.720) and monozygotic girls (0.638). Physical activity patterns were not associated between generations, but there was a significant difference between very active and inactive mothers concerning their daughters' physical activity. Farmers had the lowest proportion of very active subjects only among the parental generation. Because physical activity patterns do not appear to be transmitted from one generation to the next, it is probable that by constant training and education we can obtain the benefits of physical activity.

Adolescent↗
PubMed2002

The relationship between cognitive and physical performance: MacArthur Studies of Successful Aging.

BACKGROUND: The relationship between change in cognitive and physical performance has yet to be fully understood. Because aging decreases the ability to learn new information while preserving more established knowledge, this article examines whether the association between change in cognitive and physical performance depends on the nature of the physical task. METHODS: Data from the MacArthur Research Network on Successful Aging Community Study--a longitudinal three-site, cohort study of high-functioning, disability-free Americans aged 70 to 79 in 1988 (reinterviewed in 1991 and 1995)--are used for this investigation. We examine the association between change in cognitive performance and two categories of physical performance: novel/attentional demanding physical tasks (e.g., standing on a single leg) or routine physical tasks (e.g., walking at a normal pace). Change in physical performance (over 7 years) is regressed on change in cognitive performance (over the same period) controlling for baseline cognitive ability, demographic factors, health status, and behavioral characteristics. RESULTS: The findings suggest that declines in cognitive performance are associated with declines in both novel/attentional demanding and routine physical tasks. In addition to decline in cognition, gender, prevalent health conditions (e.g., cancer, high blood pressure, and the fracture of a hip), and smoking behavior are associated with decline in performance on some physical tasks. CONCLUSIONS: The findings suggest that the successful execution of physical tasks demands cognitive processes regardless of the nature of the task. Researchers using performance-based measures of physical functioning should pay particular attention to the cognitive capacities of their subjects and how these might influence their assessment.

Aged↗
PubMed1996

Is long-term maintenance of health-related physical activity possible? An analysis of concepts and evidence.

The phenomenon of maintenance of health-related physical activity is explored through an analysis of the underlying concepts and of the existing empirical evidence. The following targets were used for the analysis: (1) the concept of health-related physical activity, (2) the concept of maintenance, (3) common manifestations of maintenance in everyday living, (4) the promotional and behavioral characteristics of health-related physical activity, (5) the known determinants of free-living physical activity, and (6) intervention trials on physical activity in free-living groups. The analyses revealed the inherent resistance to adoption and maintenance of physical activity, particularly that of high-intensity and program-centered activities, the persistence, however, of many simple everyday routines and habits, the multiple determinants discovered for free-living physical activity and a few empirical demonstrations of the successful promotion of the maintenance of physical activity over a year or two. The promotion of the maintenance of health-related physical activity seems thus a distinct possibility provided that (1) the promotional situation is analyzed thoroughly, (2) the activity is chosen carefully with an emphasis on moderation in intensity and integration into the participant's life-style, (3) multiple promotional contacts are used, and (4) support from the participant's social and physical environment is provided. There is a need for more research on the maintenance of health-related physical activity using the stages of change models, behavior modification principles, self-control concepts, the concept of intrinsic motivation and the Relapse model. The method of analysis used here could apply to other health-related behaviors as well.

Attitude to Health↗
PubMed1995

Initial health status of patients at outpatient physical therapy clinics.

BACKGROUND AND PURPOSE: The purpose of this study was to characterize the health status of individuals upon initiation of treatment in outpatient physical therapy clinics. SUBJECTS: Six outpatient clinical sites participated in the study. Three clinics were hospital based, and three clinics were privately owned by physical therapists. Patients who were referred with muscular, skeletal, or peripheral nerve involvement and who were not postoperative were included in the study. METHODS: One hundred nine patients completed the SF-36 health status questionnaire, which assessed eight health concepts: physical function, role physical (ie, limitations in role functioning such as duties in the home or at work due to physical problems), bodily pain, vitality, social function, role emotional (ie, limitations in role functioning due to emotional problems), mental health, and general health. RESULTS: Patients referred for treatment to hospital-based or privately owned clinics had similar ages and diagnoses. No differences in health status were found between patients to be treated at hospital-based clinics and those to be treated at privately owned clinics, or between male and female patients. Only physical functioning scores were lower in patients with lower-quarter (lumbar or lower-extremity) disorders versus patients with upper-quarter (cervical or upper-extremity) disorders. All health concept scores, except general health, were found to differ from previously published normative data on the US population. CONCLUSION AND DISCUSSION: A subgroup of patients seeking outpatient physical therapy had lower health concept scores than did the general population in not only the physical domain of health but also the psychological and social domains. These data reinforce the concept that physical impairment interacts with the emotional and social aspects of health. In addition, the health concept scores of our sample as compared with other patient groups who have responded to the SF-36 revealed some similarities and some marked differences. The results suggest that these types of data will provide practicing clinicians, as well as third-party payers and policy-makers, with a greater understanding of the severity of the patient's condition. Because the SF-36 provides information on health not routinely assessed by physical therapists, it may be a useful screening tool. [Mossberg KA, McFarland C. Initial health status of patients at outpatient physical therapy clinics.

Activities of Daily Living↗
PubMed2002

Familial aggregation of physical activity levels in the Québec Family Study.

PURPOSE: Familial aggregation of physical activity phenotypes was investigated in 696 subjects from 200 families of the Quebec Family Study. The mean age of offspring and parents was 27 and 53 yr, respectively. METHODS: The levels of physical activity were estimated using a 3-d diary and a questionnaire dealing with physical activity during the past year. RESULTS: An ANOVA performed on the age and sex adjusted physical activity phenotypes revealed that there were 1.40-1.52 times more variation in physical activity levels between families than within families (0.001 < P < 0.0001), suggesting that physical activity levels aggregate in families. Maximal heritabilities (SEGPATH), adjusted for the degree of spouse resemblance, reached 25%, 16%, 19%, and 17% for the degree of inactivity, time spent in moderate to strenuous physical activities, total level of daily activity, and weekly time spent in the main activity during the previous year, respectively. CONCLUSION: These results suggest that physical activity level is characterized by a significant degree of familial resemblance, and that inactivity has a slightly higher heritability level than moderate to strenuous physical activity or total physical activity phenotypes. The pattern of familial correlations suggests that shared familial environmental factors along with genetic factors are also important in accounting for the familial resemblance in physical activity level.

Adolescent↗
PubMed1996

Self-reported physical exertion in geriatric care. A risk indicator for low back symptoms?

STUDY DESIGN: The study group consisted of 131 female nursing aides who took part in an intervention program with physical training or education. Assessments were performed before the intervention program and after 6 months. At follow-up evaluation, 91 nursing aides remained in the study. OBJECTIVES: To examine if perceived physical exertion was a risk indicator for low back symptoms, and to examine the relationship between perceived physical exertion, aerobic capacity, back endurance, psychological demands, and job control. SUMMARY OF BACKGROUND DATA: Perceived physical exertion frequently is assessed in epidemiologic studies concerning low back symptoms. More information about the relationship between perceived exertion, other potential risk indicators, and symptoms may provide opportunities for effective prevention of symptoms. METHODS: Assessments were obtained by questionnaires and physical capacity tests. RESULTS: The nursing aides who reported high physical exertion and were 45 years of age or older were at greater risk in the follow-up period for reporting new symptoms, continued symptoms with the same intensity, or more intense symptoms from the low back (rate ratio, 3.01; 95% confidence interval, 1.1-8.2). The exposure variable correlated most strongly (r = 0.4) with perceived physical exertion was psychological demands. CONCLUSIONS: The results indicated being aged 45 years or older, combined with high perceived physical exertion, was a risk indicator for low back symptoms. A relationship between perceived physical exertion and psychological demands was observed, but there was no influence of physical capacity on perceived physical exertion.

Adult↗
PubMed2001

The association between physical workload and low back pain clouded by the "healthy worker" effect: population-based cross-sectional and 5-year prospective questionnaire study.

STUDY DESIGN: A population-based cross-sectional and 5-year prospective questionnaire study. OBJECTIVE: To investigate self-reported physical workload as a risk factor for low back pain. SUMMARY OF BACKGROUND DATA: Both physical and psychosocial workplace factors are considered risk factors for low back pain. However, today no consensus has been reached regarding the exact role of these factors in the genesis of low back pain. METHODS: Questionnaire data were collected at baseline for 1397 (and after 5 years for 1163) men and women aged 31--50 years at baseline. Low back pain ("any low back pain within the past year," "low back pain < or = 30 days in total during the past year," "low back pain > 30 days in total during the past year") was analyzed in relation to physical workload (sedentary, light physical, and heavy physical work) using logistic regression and controlling for age, gender, and social group. The proportions of workers changing between the workload groups over the 5-year period were analyzed in relation to low back pain status. RESULTS: At baseline no statistically significant differences in low back pain outcomes were found for workers exposed to sedentary, light physical, or heavy physical work. This was true for all age, gender, and social groups. At follow-up there was a statistically significant dose-response association between any low back pain and longstanding low back pain within the past year and increasing physical workload at baseline also after controlling for age, gender, and social group. Subjects with heavy physical workload at baseline changed statistically significantly more often to sedentary work if they experienced low back pain for more than 30 days out of the past year. CONCLUSIONS: Having a sedentary job might have a protective or neutral effect in relation to low back pain, whereas having a heavy physical job constitutes a significant risk factor. Because of migration between exposure groups (the "healthy-worker" effect), longitudinal studies are necessary for investigating the associations between physical workload and low back pain.

Cross-Sectional Studies↗
PubMed1996

Physical restraints in geriatric care in Sweden: prevalence and patient characteristics.

OBJECTIVE: Physical restraints are used frequently in geriatric care to promote the safety of frail older patients. This study investigated the prevalence of the use of physical restraints in geriatric care and the way in which patient characteristics are related to the use of physical restraints. DESIGN: A point prevalence study of patients cared for in various types of geriatric settings. SETTING: Eight nursing homes, 15 old people's homes, a somatic geriatric clinic, and a psychogeriatric clinic in a health care district in northern Sweden. PARTICIPANTS: A total of 1325 patients, mean age 82 years, 64% of whom were women. MEASUREMENTS: The Multi-Dimensional Dementia Assessment Scale (MDDAS) was used to measure motor function, vision, hearing, speech, ADLs, behavioral symptoms, psychiatric symptoms, use of psychoactive drugs, and the physical and psychological workload of the staff. In addition, questions concerning the use of physical restraints were added to the instrument. RESULTS: Twenty-four percent of the patients were physically restrained. The highest prevalence was found in nursing homes and psychogeriatric care. Physical restraints were found to relate most strongly to cognitive impairment, impaired ADLs, and speech and walking ability. Ninety-four percent of the restrained patients were cognitively impaired. Other variables relating to the use of physical restraints were psychiatric symptoms and behavioral disturbances. CONCLUSIONS: This study has shown that physical restraints are used frequently in geriatric care in Sweden and that cognitive and physical impairments relate very closely to the use of physical restraints.

Activities of Daily Living↗
PubMed1998

Behavioural and biological correlates of physical functioning in middle aged office workers: the UK whitehall II study.

STUDY OBJECTIVES: (1) To identify behavioural and biological correlates of poor physical functioning and (2) to determine whether such associations are independent of disease. DESIGN: Potential correlates were obtained from questionnaires and screening visits at baseline and five year follow up. Physical functioning was measured at follow up using the 10 item scale from the short-form 36 health survey. SETTING: London offices at baseline. PARTICIPANTS: 10,308 civil servants (6895 men and 3413 women), with a median age (range) of 49 years (39-63) at follow up. MAIN RESULTS: Multiple logistic regression showed that cigarette smoking, physical activity, body mass index (BMI), triglycerides, fibrinogen, and insulin were independently associated with poor physical functioning for men. For women, physical activity, eating habits, body mass index, fibrinogen, and insulin were independently associated with poor physical functioning. For example, among men, current smokers who had smoked more than 20 pack years were 1.89 (95% CI 1.35 to 2.67) times as likely to have poor physical functioning as never smokers. Men with BMI of 30 kg/m2 or more were 1.71 (95% CI 1.13 to 2.59) times as likely to have poor physical functioning as those with BMI < 20 kg/m2. The corresponding odds ratio for women was 2.66 (95% CI 1.80 to 3.93). With the exceptions of fibrinogen and insulin, associations remained on exclusion of subjects with physical disease. CONCLUSIONS: Risk factors established for physical diseases are associated with poor physical functioning in a population of working age. These associations may be independent of current disease.

Adult↗
PubMed2002

Physical activity levels of Barbadian youth and comparison to a U.S. sample.

This is the first study to report on physical activity levels of young people in Barbados. The Self-Administered Physical Activity Checklist was administered to 1,579 children aged 8 to 18 years. The majority of youth (69%) reported at least 60 min of physical activity on the previous school day. Boys and younger students reported greater physical activity than girls and older students (p < .001). Participation in physical education was low among primary (30%) and secondary (18%) school students, and youth reported the majority of their physical activity took place after school (58%). Physical activity levels and patterns were similar to those of U.S. youth. Gender and grade differences in physical activity could put girls and older youth at higher risk for health problems such as obesity. Policy recommendations to support youth physical activity in Barbados include mandatory daily physical education and after-school physical activity programs.

Adolescent↗