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
Development and validation of a scale measuring perceived barriers to physical activity in Spanish for children and adolescents with type 1 diabetes: the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) questionnaire
(Elsevier, 2025-06-01) García Hermoso, Antonio; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Muñoz Pardeza, Jacinto; Chueca-Guindulain, María J.; Burillo Sánchez, Elisabeth; Ezzatvar, Yasmin; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Aims: To develop and validate the psychometric properties, reliability, and criterion validity of the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) in Spanish-speaking children and adolescents with type 1 diabetes. Method: A cross-sectional study was conducted with a sample of 93 Spanish-speaking children and adolescents with type 1 diabetes. The PABS-1 questionnaire was developed by experts and refined with patient feedback. Its validity was assessed by comparing results with accelerometer data, linking scores to objective physical activity measures. Results: The PABS-1 showed good internal consistency, with a Cronbach’s alpha (α) coefficient of 0.89, indicating strong reliability. Confirmatory factor analysis supported a four-factor structure, with physical, diabetes-related, psychological, and environmental barriers showing good fit indices (comparative fit index [CFA] = 0.94, root mean square error of [RMSEA] = 0.06, standardized root mean square residual [SRMR] = 0.05). Although the associations were small, the total PABS-1 score was significantly negatively correlated with cardiorespiratory fitness (Spearman’s rho [ρ]= -0.15, p = 0.035) and moderate-to-vigorous physical activity (ρ = − 0.12, p = 0.039). Among the four factors, motivational barriers exhibited the strongest associations with physical activity and fitness, showing significant negative correlations. Conclusions: The PABS-1 is a valid and reliable tool for assessing perceived barriers to physical activity in Spanish-speaking children and adolescents with type 1 diabetes.
Open Access
Physical fitness and activity levels as predictors of subjective well-being in youths with type 1 diabetes mellitus: a 2-year longitudinal analysis of the diactive-1 cohort study
(Wiley, 2025-03-05) Muñoz Pardeza, Jacinto; López Gil, José Francisco; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Yáñez-Sepúlveda, Rodrigo; Ezzatvar, Yasmin; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Subjective well-being (SWB), including cognitive and affective components, may be influenced by the management of type 1diabetes mellitus (T1DM). Physical fitness and adherence to physical activity (PA) are associated with better glycaemic stabilityand diabetes management. However, the relationship with SWB is not yet understood. The aim of the study was to determinethe relationship between physical fitness, PA, and SWB over two years in youths with T1DM. This longitudinal study involved83 participants (aged 6–18 years; 44.6% girls) from the Diactive-1 Cohort. Physical fitness was assessed by spirometry (peak ox-ygen consumption) and dynamometry (handgrip strength). PA domains were measured using triaxial accelerometers, whereasthe number of days participating in muscle-strengthening activities was assessed using a question. The Cuestionario Único deBienestar Escolar was used to determine SWB. Glycaemic stability was determined when glycosylated hemoglobin < 7%, coef-ficient of variability ≤ 36%, and time-in-range target > 70% were met. The linear mixed models used considered three assess-ments and subject variability, showing significant associations between overall physical fitness (unstandardized beta coefficient[B] = 1.778, 95% confidence interval [CI] 0.413–3.158; p = 0.012) and total PA (B = 0.034, 95% CI 0.005–0.063; p = 0.020) withSWB. Although time did not moderate the association with physical fitness (p = 0.116), this was true for PA only in the secondyear (p = 0.020). In contrast, glycaemic stability did not moderate the associations (p > 0.05). In conclusion, physical fitness andPA are associated with greater SWB in young people with T1DM, which may play a role in the psychological aspects of diseasemanagement.
Embargo
Physical fitness and sleep-related problems among adolescents: findings from the EHDLA study
(Wiley, 2025-03-19) Muñoz Pardeza, Jacinto; Ezzatvar, Yasmin; Gutiérrez Espinoza, Héctor; Páez-Herrera, Jacqueline; Olivares-Arancibia, Jorge; Yáñez-Sepúlveda, Rodrigo; García Hermoso, Antonio; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak
Physical fitness, particularly cardiorespiratory fitness, has been shown to positively impact sleep quality. However, the relation-ship between overall physical fitness and sleep-related problems in adolescents remains underexplored. Therefore, the aim ofthis study was to analyze the association between overall physical fitness and sleep-related problems in adolescents. This cross-sectional study included 812 adolescents (median age: 14 years [interquartile range = 12–17]; 54.9% girls) from the Eating Healthyand Daily Life Activities (EHDLA) data. Physical fitness was measured objectively using the Assessing the Levels of PHysicalActivity and fitness (ALPHA-Fit) battery for children and adolescents and a flexibility test, while sleep-related problems wereevaluated using the BEARS sleep screening tool (B = Bedtime problems, E = Excessive daytime sleepiness, A = Awakenings dur-ing the night, R = Regularity and duration of sleep, S = Snoring). Generalized linear models were used to examine the associationof overall physical fitness with the different components of sleep-related problems. The odds of experiencing sleep-related prob-lems decreased significantly with each kilogram increase in handgrip strength (odds ratio [OR] = 0.97, 95% confidence interval[CI] 0.94–0.99), and with each standard deviation increase in overall physical fitness (OR = 0.76, 95% CI 0.59–0.99). In contrast,despite not statistically significant, an increase in long jump appeared to reduce the sleep-related problems (OR = 0.91; 95% CI0.82–1.02), while a longer time in the 4×10-m shuttle run test might increase sleep problems (OR = 1.12; 95% CI 0.98–1.28). Inconclusion, greater levels of physical fitness, particularly muscular strength, may be key for reducing sleep-related problems,emphasizing the importance of personalized training programs.
Open Access
Twenty-four-hour movement guidelines during adolescence and its association with obesity at adulthood: results from a nationally representative study
(Springer, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
To determine the association between adherence to the 24-h movement guidelines during adolescence with obesity at adulthood 14 years later in a nationally representative cohort. We analyzed data from 6984 individuals who participated in Waves I (1994–1995) and IV (2008–2009) of the National Longitudinal Study of Adolescent Health (Add Health) in the USA. Obesity was defined by the International Obesity Task Force cut-off points at Wave I and adult cut-points at Wave IV (body mass index [BMI]≥30 kg/m2 and waist circumference [WC]≥102 cm in male and 88 cm in female). Physical activity, screen time and sleep duration were self-reported. Adolescents who met screen time recommendation alone (β = −1.62 cm, 95%CI −2.68 cm to −0.56), jointly with physical activity (β = −2.25 cm, 95%CI −3.75 cm to −0.75 cm), and those who met all three recommendations (β = −1.92 cm, 95%CI −3.81 cm to −0.02 cm) obtained lower WC at Wave IV than those who did not meet any of these recommendations. Our results also show that meeting with screen time recommendations (IRR [incidence rate ratio] = 0.84, 95%CI 0.76 to 0.92) separately and jointly with physical activity recommendations (IRR = 0.86, 95%CI 0.67 to 0.97) during adolescence is associated with lower risk of abdominal obesity at adulthood. In addition, adolescents who met all 24-h movement recommendations had lower risk of abdominal obesity later in life (IRR = 0.76, 95%CI 0.60 to 0.97). Conclusion: Promoting the adherence to the 24-h movement guidelines from adolescence, especially physical activity and screen time, seems to be related with lower risk of abdominal obesity later in life, but not for BMI.
Embargo
Physical activity is related to lower levels of neurofilament light and plasma tau protein: a 22-year follow-up study from adolescence to adulthood
(Elsevier, 2025-06-01) Ezzatvar, Yasmin; López Gil, José Francisco; Yáñez-Sepúlveda, Rodrigo; Olivares-Arancibia, Jorge; Páez-Herrera, Jacqueline; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Purpose: To investigate the association between physical activity (PA) and neurodegeneration biomarkers from adolescence to adulthood by examining tau protein and neurofilament light chain (NfL) levels in blood samples. Methods: The study analyzed data from adolescents aged 12–19 years who participated in Waves I (1994–1996) and V (2016–2018) of the Add Health study over a span of 22 years. It assessed PA through self-reported questionnaires. Neurodegeneration measures at Wave V used venous blood collected via phlebotomy. Samples were analyzed using single-molecule array (Simoa) technology on a Quanterix HD-1 analyzer, using digital enzyme-linked immunosorbent assay to quantify NfL and tau proteins from serum and plasma samples. Results: In the present study, 3,182 individuals participated, with females comprising 61% of the sample. Participants adhering to the PA guidelines in both waves reported lower levels of NfL (−0.583 pg/mL, 95% bias-corrected and accelerated (BCa) confidence interval (CI): −1.235 to −0.068) and tau protein levels (−0.244 pg/mL, 95% BCa CI: −0.405 to −0.078). Adjusted analyses confirmed significant lower levels of tau protein (−0.210 pg/mL, 95% BCa CI: −0.350 to −0.072) for Wave I adherents and even lower levels in NfL (−0.421 pg/mL, 95% BCa CI: −0.929 to −0.007) and tau protein levels (−0.229 pg/mL, 95% BCa CI: −0.412 to −0.053) for active participants in both waves. Discussion: Our findings suggest that consistent engagement in PA may reduce certain neurodegenerative biomarkers, potentially influencing neurological health outcomes.
Open Access
Factors associated with meeting the WHO physical activity recommendations in pregnant colombian women
(Springer Nature, 2022) López Gil, José Francisco; Izquierdo Redín, Mikel; García Hermoso, Antonio; Alonso Martínez, Alicia; Rincón Pabón, David; Morales Osorio, Marco Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015–2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01–0.18); Mestizo: OR 0.12, 95% CI (0.06–0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06–4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.
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.
Open Access
Trajectories of 24-h movement guidelines from middle adolescence to adulthood on depression and suicidal ideation: a 22-year follow-up study
(BMC Public Health, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Ramírez Vélez, Robinson; López Gil, José Francisco; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: The 24-h movement guidelines for youth and adults recommend the specific duration of physical activity, sedentary time, and sleep duration to ensure optimal health, but little is known about its relationship to mental health indicators. The aim of the study was to explore the association between 24-h movement guidelines in adolescence and its trajectories from middle adolescence (12–17 years old) to adulthood (33–39 years old) with depression and suicidal ideation in adulthood. Methods: This prospective cohort study included individuals who participated in Waves I (1994–1995) and V (2016–2018) of the National Longitudinal Study of Adolescent Health (Add Health) in the United States. Physical activity, screen time and sleep duration were measured using questionnaires. Adults were categorized as having depression if they had a self-reported history of depression and/or prescription medication-use for depression in the previous four weeks. Suicidal ideation was assessed by a self-reported single question in both waves. Poisson regression analyses were used to estimate the incidence rate ratio (IRR) of depression and suicidal ideation at adulthood, according to meeting specific and combinations of 24-h movement guidelines at Wave I and its trajectories from adolescence to adulthood. Results: The study included 7,069 individuals (56.8% women). Adolescents who met physical activity guidelines and all three guidelines at middle adolescence had lower risk of depression (IRR = 0.84, 95%CI 0.72 to 0.98) and suicidal ideation (IRR = 0.74, 95%CI 0.55 to 0.99) at adulthood than those who did not meet any of these guidelines, respectively. Individuals who met the guidelines for screen time and all three guidelines in both adolescence and adulthood had lower risk of depression (screen time, IRR = 0.87, 95% CI 0.72 to 0.98; all three, IRR = 0.37, 95% CI 0.15 to 0.92) and suicidal ideation (screen time, IRR = 0.74, 95% CI 0.51 to 0.97; all three, IRR = 0.12, 95% CI 0.06 to 0.33) than those who never met the guidelines. Additionally, individuals who did not meet all three guidelines in adolescence but met the guidelines in adulthood had lower risk of suicidal ideation than those who never met the guidelines (IRR = 0.81, 95%CI 0.45 to 0.89). Conclusion: Our findings highlight the importance of promoting and maintaining adherence to the 24-h movement guidelines from middle adolescence to adulthood to prevent mental health problems. However, our findings must be interpreted carefully due to declared limitations, e.g., the self-reported assessments which are subject to sources of error and bias or that the dataset used to gauge meeting a guidelines (1994–1996) was made later (2016).