Open Access
What is the role of adherence to 24-hour movement guidelines in relation to physical fitness components among adolescents?
(Wiley, 2023) Tapia-Serrano, Miguel Ángel; López Gil, José Francisco; Sevil-Serrano, Javier; García Hermoso, Antonio; Sánchez-Miguel, Pedro Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa–1225/2022
Background: Physical inactivity, excessive sedentary time, and lack of sleep time have been independently associated with lower health-related physical fitness. However, little is known about the combined association between 24-h movement guidelines (i.e., physical activity, recreational screen time, and sleep duration) and components of physical fitness. Objective: The main aim was to examine the likelihood of having high/very high levels on different components of physical fitness based on meeting with 24-h movement guidelines. Methods: In this cross-sectional study, 1276 Spanish youths (13.07±0.86; 55.88% boys), aged 11–16 years, completed self-reported questionnaires on physical activity, recreational screen time, and sleep duration. Physical fitness components were assessed by 20-m shuttle-run test, standing long jump test, handgrip strength test, and 4×10-m shuttle-run test. Meeting 24-h movement guidelines was defined as: 9–11h/day (children aged 5–13) or 8–10h/day (adolescents aged 14–17) of sleep, ≤2h/day of recreational screen time and at least 60min/day of moderateto-vigorous physical activity. The probability of having a high/very high score for each physical fitness components (i.e., ≥60th centile according to the normative cut-off points for European adolescents) in relation to adherence to 24-h movement guidelines was analyzed using a series of binary logistic regressions. Results: Participants who met the three 24-h movement guidelines were more likely to have high/very high for cardiorespiratory fitness (OR=3.31; 95% CI: 1.79, 6.14; p<0.001), standing long jump (OR=1.91; 95% CI: 1.06, 3.45; p=0.031), muscular fitness (OR=2.05; 95% CI: 1.09, 3.86; p=0.048) and physical fitness (OR=1.99; 95% CI: 1.08, 3.66; p=0.012), but not for handgrip strength (OR=1.15; 95% CI: 0.64, 2.01; p=0.636) and speed/agility (OR=1.65; 95% CI: 0.92, 2.96; p=0.093), compared to those who did not meet all three recommendations. Conclusion: Since meeting the three 24-h movement guidelines increased the likelihood of having higher levels in most physical fitness components, it seems necessary to promote these movement behaviors early in life, as they could serve as a gateway for improving health-related fitness in future generations.
Open Access
Prevalence of meeting all three 24-h movement guidelines and its correlates among preschool-aged children
(Wiley, 2023) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Rincón Pabón, David; Martínez-Jamioy, Edwar Nicolas; Rivera-Ruiz, Rosemberg; Castellanos-Montaña, Sebastián; Atencio Osorio, Miguel Alejandro; Carrillo Arango, Hugo Alejandro; Alonso Martínez, Alicia; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The aim of the present study was twofold: first, to determine the meeting all three 24-h movement guidelines in Colombian preschool-aged children, and second, to explore the associations between different socio-ecological correlates and the meeting of these guidelines. This was a cross-sectional study with data from the Encuesta Nacional de Situación Nutricional (ENSIN-2015) in Colombia, 2015–2016. The sample comprised 3002 low-income preschoolers (3–4 years old, 50.7% boys). Data on physical activity, screen time, and sleep time were collected using the Cuestionario para la Medición de Actividad Física y Comportamiento Sedentario, reported by their parents. In total, 18 potential correlates (individual, interpersonal, organizational, and community level) were analyzed. Backward binary logistic regression analysis was performed with the potential correlates as independent variables and meeting all three 24-h movement guidelines as dependent variables. The prevalence of preschoolers meeting all three 24-h movement guidelines or none was 4.8% and 16.6%, respectively. In the final model, boys (odds ratio [OR] = 1.87, 95% confidence interval [CI] 1.00–3.50) and those who do not have television in their bedroom (OR = 2.09, 95%CI 1.05–4.14) were more likely to meet all three 24-h movement guidelines compared to with girls and those who have television, respectively. In conclusion, strategies to promote adherence to all 24-h movement guidelines among low-income preschoolers are warranted, and should focus on actions considering the importance of sex and home environment changes to support these movement behaviors.
Open Access
Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis
(BMC, 2024-07-01) Muñoz Pardeza, Jacinto; López Gil, José Francisco; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =– 0.63, 95% credible interval [95% CrI] – 1.09 to – 0.16) and nutritional supplements (n = 146, SMD =– 0.49, – 0 .92 to – 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =– 0.79, 95% CrI – 1.19 to – 0.34) and (n = 57, SMD =– 0.62, 95% CrI – 1.18 to – 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.
Embargo
Twenty-four-hour movement guidelines and depressive symptoms: association, temporal trends and moderators over a ten-year period among 45,297 US adolescents
(Springer, 2025-02-24) López Gil, José Francisco; Solmi, Marco; García Hermoso, Antonio; Vancampfort, Davy; Fabiano, Nicholas; Schuch, Felipe; Stubss, Brendon; Smith, Lee; Torous, John; Firth, Joseph; Ciencias de la Salud; Osasun Zientziak
The aims of the present study were: (1) to examine the association between meeting the 24-h movement guidelines and depressive symptoms among U.S. adolescents; (2) to analyze the temporal trends of this association; and (3) to test whether sex, age, or race/ethnicity moderate these associations. This is a cross-sectional study using repeated data collection from the high school Youth Risk Behavior Surveys (YRBS), involving 45,297 adolescents in the US (49.7% females). Data were collected bi-annually between 2011 and 2021. These surveys represent cross-sectional snapshots rather than a longitudinal study, capturing data at distinct points in time across multiple years. The three 24-h movement guidelines, including guidelines for physical activity, screen time, and sleep duration were assessed by self-reported questions. Depressive symptoms were assessed by the question “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing your usual activities?” with yes/no answer options. A generalized linear mixed model (GLMM) was employed to gauge the association between adherence to the 24-h movement guidelines (exposure) and the likelihood of having depressive symptoms (outcome). The year of data collection was included as a random intercept in the mixed-effects model to account for potential variations in depressive symptoms across different time points. The model was further adjusted for covariates, including sex, age, race/ethnicity, alcohol and tobacco consumption, school bullying, cyberbullying, and excess weight. Adolescents meeting all three 24-h movement guidelines (physical activity, screen time, and sleep) had the lowest probability of depressive symptoms (21.3%, 95% CI 17.3–25.3%) compared to those meeting none (37.6%, 95% CI 33.4–41.8%). Significant protective effects were observed across all adherence levels (p < 0.05). Over the 2011–2021 period, adherence remained consistently associated with reduced depressive symptoms, with the strongest effects seen in 2019 and 2021. Younger adolescents, males, and White individuals showed the greatest benefits, while females, older adolescents, Black, Hispanic/Latino, and individuals from other racial/ethnic groups exhibited weaker protective effects despite adherence. Findings from the present study highlight the importance of encouraging adherence to 24-h movement guidelines as a potential strategy to reduce depressive symptoms in adolescents. Notably, the protective effects of adherence varied across sociodemographic groups, with younger adolescents, females, and White individuals experiencing the greatest benefits.
Open Access
A cluster randomized controlled trial of the Archena Infancia Saludable project on 24-h movement behaviors and adherence to the mediterranean diet among schoolchildren: a pilot study protocol
(MDPI, 2023) López Gil, José Francisco; García Hermoso, Antonio; Smith, Lee; Gallego, Alejandra; Victoria-Montesinos, Desirée; Ezzatvar, Yasmin; Hershey, María Soledad; Gutiérrez Espinoza, Héctor; Mesas, Arthur; Jiménez-López, Estela; Sánchez-Miguel, Pedro Antonio; López-Benavente, Alba; Moreno Galarraga, Laura; Chen, Sitong; Brazo-Sayavera, Javier; Fernández-Montero, Alejandro; Alcaraz, Pedro E.; Panisello Royo, Josefa María; Tárraga López, Pedro J.; Kales, Stefanos N.; Ciencias de la Salud; Osasun Zientziak
Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention’s “halo” effect on parents’/guardians’ 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6–13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
Open Access
Mediterranean diet-based interventions to improve anthropometric and obesity indicators in children and adolescents: a systematic review with meta-analysis of randomized controlled trials
(Elsevier, 2023) López Gil, José Francisco; García Hermoso, Antonio; Sotos-Prieto, Mercedes; Cavero-Redondo, Iván; Martínez Vizcaíno, Vicente; Kales, Stefanos N.; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, 1225%2F2022
To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean dietbased interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen’s d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d=- 0.14; 95% CI: 0.26, 0.01; I 2= 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I 2= 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3–18 y). This trial was registered at PROSPERO as CRD42023386789.