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Introduction: The aims of this study were to examine cross-sectional, and longitudinal association of different measures of obesity and physical fitness with cardiovascular disease (CVD) risk factors in adolescents with Down syndrome. Methods: Longitudinal analysis included 90 adolescents with Down syndrome. Obesity and physical fitness were measured following the ALPHA battery. Blood pressure and blood samplings (glucose, total cholesterol, high-density lipoprotein cholesterol, and serum lipid triglycerides levels (mg/dl) were determinated. Results: In cross-sectional analyses, obesity was positively associated with single CVD risk factors and CVD risk factor index (all p < 0.05). In the prospective analyses, obesity was not associated with single CVD risk factors, but components of physical fitness at baseline impact in some single CVD risk factors (all p < 0.05). Conclusion: Obesity might be more strongly related to current cardiovascular-health, while components of physical fitness might be more related to future cardiovascular-health in adolescents with Down syndrome. [This article was written on behalf of the UP&DOWN Study Group.]

Background: The aim of this study was to examine the bidirectional longitudinal associations of several markers of fatness and physical fitness in adolescents with Down syndrome. Methods: This study comprised a total of 111 adolescents (41 females), aged from 11 to 20 years with complete data at the baseline. We had a drop-out of <10% from the baseline to the 2-year follow-up. The ALPHA health-related fitness test battery for youth was used. Results: Our results show that all fatness variables at the baseline were associated with a 2-year change in cardiorespiratory fitness ([beta] ranging from -0.32 to -0.38; all p < 0.05), but not with muscular and motor fitness (p > 0.05). However, no associations were found between physical fitness components as predictors and fatness indicators (p > 0.05). Conclusions: Results suggest that reducing fatness during adolescence might represent a modifiable factor to improve cardiorespiratory fitness at the 2-year follow-up, but not vice versa since associations were not bidirectional. [This article was written on behalf of the UP, DOWN study group.]

The aims of this study were to examine cross-sectional, and longitudinal association of different measures of obesity and physical fitness with cardiovascular disease (CVD) risk factors in adolescents with Down syndrome. Longitudinal analysis included 90 adolescents with Down syndrome. Obesity and physical fitness were measured following the ALPHA battery. Blood pressure and blood samplings (glucose, total cholesterol, high-density lipoprotein cholesterol, and serum lipid triglycerides levels (mg/dl) were determinated. In cross-sectional analyses, obesity was positively associated with single CVD risk factors and CVD risk factor index (all p <.05). In the prospective analyses, obesity was not associated with single CVD risk factors, but components of physical fitness at baseline impact in some single CVD risk factors (all p <.05). Obesity might be more strongly related to current cardiovascular-health, while components of physical fitness might be more related to future cardiovascular-health in adolescents with Down syndrome. [ABSTRACT FROM AUTHOR]

Background: To assess the validity of the single question to determine sedentary behavior (SB) by using the Global Physical Activity Questionnaire (GPAQ) in older adults. Methods: The sample included 163 participants (96 women) aged 65–92 years. Self-reported SB was obtained from the GPAQ. Objectively measured SB was assessed using the Intelligent Device for Energy Expenditure and Activity. Participants wore the Intelligent Device for Energy Expenditure and Activity continuously during 2 consecutive days while following their daily routine. The relative validity was assessed using the Spearman rank correlation coefficient (ρ), and the agreement was examined using mean bias and 95% limit of agreement with the Intelligent Device for Energy Expenditure and Activity as reference. Results: The results showed small correlations (ρ =.291, P <.001) between the SB from the GPAQ and the objective measures, and ranged from ρ =.217 to ρ =.491 depending on the potential moderator. Similarly, the GPAQ underestimates the SB for approximately 2 hours per day in older adults (limit of agreement = −7.3 to 3.4 h/d). Conclusion: The GPAQ may not be the most suitable questionnaire for measuring SB in this population and should be used with caution because those studies that use this questionnaire in older adults may have an inaccurate measurement of SB levels. [ABSTRACT FROM AUTHOR]

The interday reliability of the Intelligent Device for Energy Expenditure and Activity (IDEEA) has not been studied to date. The study purpose was to examine the interday variability and reliability on two consecutive days collected with the IDEEA, as well as to predict the number of days needed to provide a reliable estimate of several movement (walking and climbing stairs) and nonmovement (lying, reclining, and sitting) behaviors and standing in older adults. The sample included 126 older adults (74 women) who wore the IDEEA for 48 hr. Results showed low variability between the 2 days, and the reliability was from moderate (intraclass coefficient correlation =.34) to high (.80) in most of movement and nonmovement behaviors analyzed. The Bland–Altman plots showed high–moderate agreement between days, and the Spearman–Brown formula estimated that 1.2 and 9.1 days of monitoring with the IDEEA are needed to achieve intraclass coefficient correlations ≥.70 in older adults for sitting and climbing stairs, respectively. [ABSTRACT FROM AUTHOR]

Background: Poor dietary habits and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The Mediterranean Diet (MD) is known to be extremely healthy, associated with lower BMI and a lower risk of obesity in children and adolescents. Therefore, adherence to the MD was compared between Spanish (n = 182) and German (n = 152) children aged 10 to 13 years to examine a possible more "westernized" diet in Spain with a non-Mediterranean country, that traditionally prefers a "Western diet" and to determine the association between adherence to the MD and gender, body composition, and PA levels. Methods: In the German observational longitudinal cohort study and the Spanish cohort study, body composition and questionnaires (KIDMED, Diet Quality (IAES)) were obtained, and accelerometers (Actigraph) were applied to detect PA. Results: Girls had higher BMI-standard deviation score (SDS) than boys and Spanish girls were less active than boys. Differences were detected in MD habits, such as favorable fruit-, vegetables-, fish-intakes, and dairy products in Spanish children and unfavorable consumptions of fast food, processed bakery goods, candies, and sweet beverages in German children. Independently of country, girls, children with lower BMI-SDS and children with higher PA level were related with better diet quality. Conclusion: Spanish children showed higher adherence to MD and diet quality (IAES) compared to German children, but there was a trend toward a more "westernized" diet. Gender, body composition, and PA influenced nutrition regardless of country. [ABSTRACT FROM AUTHOR]

To examine the longitudinal relationships between objectively measured total volume and specific intensities of physical activity (PA) with academic performance in a large sample of youth aged 6‐18 years. A longitudinal study of 1046 youth (10.04 ± 3.10 years) from Spain was followed over 2 years. PA (volume and intensity) was measured by accelerometry. Academic performance was assessed through grades reported on the transcript at the end of the academic year (Mathematics, Language, an average of these two core subjects, and grade point average [GPA]). Longitudinal relationships between PA and four indicators of academic performance were examined using covariance and regression analyses, adjusted for a variety of confounders. Youth Quartile 2 for PA volume at baseline obtained better scores than those who participated in Quartiles 1 or 4 volumes of PA in GPA 2 years later (p = 0.006). There were generally no longitudinal associations between specific PA intensities and any of the academic performance indicators (all p > 0.170). However, a change in light PA over 2 years was inversely associated with three academic indicators in youth (βrange, ‐.103 to ‐ 090; all P < 040). Findings suggest that participants in Quartile 2 volume of PA had a better GPA in comparison with Quartiles 1 and 4 volumes of PA during youth, but there was no association with changes in PA volume over time. PA intensity was generally unrelated to academic performance during youth. However, there was an inverted u‐shape relationship between light PA changes and GPA. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to examine the bidirectional longitudinal associations of several markers of fatness and physical fitness in adolescents with Down syndrome. Methods: This study comprised a total of 111 adolescents (41 females), aged from 11 to 20 years with complete data at the baseline. We had a drop‐out of <10% from the baseline to the 2‐year follow‐up. The ALPHA health‐related fitness test battery for youth was used. Results: Our results show that all fatness variables at the baseline were associated with a 2‐year change in cardiorespiratory fitness (β ranging from −0.32 to −0.38; all p <.05), but not with muscular and motor fitness (p >.05). However, no associations were found between physical fitness components as predictors and fatness indicators (p >.05). Conclusions: Results suggest that reducing fatness during adolescence might represent a modifiable factor to improve cardiorespiratory fitness at the 2‐year follow‐up, but not vice versa since associations were not bidirectional. [ABSTRACT FROM AUTHOR]

Objective: The aims of the present study were to analyze the associations between the socio-demographic and familiar circumstances with: (i) the total leisure-time sedentary behavior (SB) assessed by accelerometry, and (ii) the domain-specific leisure-time SB (i.e., screen-based, educational-based, social-based, and other-based SB), in a sample of Spanish youth. Method: The sample consisted of 1,543 youth (12.02 ± 2.51 years) included in the UP&DOWN study. SB was evaluated by accelerometry and questionnaire. Nationality, location of school, type of school, socio-economic status, parental educational level, parental occupation status, family structure, number of siblings and position among siblings were self-reported by participants or their parents. Linear mixed models, including school and city as random effects, were performed. Results: Several associations were found; however, socio-demographic and family circumstances differently associated with SB according to the domain-specific SB, the sex and the type of day. For example, participants with a father holding a high-skilled occupation spent lower time in screen-based SB during weekdays; and mother occupation status of high qualification was related to higher educational-based SB in boys. Having three or more sibling was associated with lower total SB in boys, while having an obese mother was related to higher screen-based SB on weekends both in boys and girls. Conclusions: Socio-demographic and familiar circumstances are associated with SB in young people, so future interventions should consider multiple and sex-specific factors for reduce SB of young people, focusing especially on youth with a low number of siblings and with parents holding low-skilled employments. [ABSTRACT FROM AUTHOR]

Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs. [ABSTRACT FROM AUTHOR]

The present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&DOWN study (follow-up in schoolchildren and adolescents with and without Down's syndrome). The present study excluded participants with Down's syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β =0·41, se 0·10, P <0·001; β =0·46, se 0·10, P <0·001, respectively) and to positive affect in secondary school girls and boys (β =0·16, se 0·05, P =0·006; β =0·20, se 0·05, P <0·001, respectively) and in primary school boys (β =0·20, se 0·08, P =0·019). At 2-year follow-up, MD adherence was negatively related to negative affect in secondary school adolescent girls and boys (β =–0·15, se 0·07, P =0·047; β =–0·16, se 0·06, P =0·019, respectively), and MD adherence was associated with higher positive affect scores in secondary school girls (β =0·30, se 0·06, P <0·001) and in primary school boys (β =0·20, se 0·09, P =0·023). However, MD adherence at baseline did not predict well-being indicators at 2-year follow-up. In conclusion, higher MD adherence was found to behave as a protective factor for positive well-being in cross-sectional analysis. [ABSTRACT FROM AUTHOR]

Objectives: To develop a questionnaire able to assess time spent by youth in a wide range of leisure-time sedentary behaviors (SB) and evaluate its test-retest reliability and criterion validity.Design: Cross-sectional observational.Methods: The reliability sample included 194 youth, aged 10-18 years, who completed the questionnaire twice, separated by one-week interval. The validity study comprised 1207 participants aged 8-18 years. Participants wore an accelerometer for 7 consecutive days. The questionnaire was designed to assess the amount of time spent in twelve different SB during weekdays and weekends, separately. In order to avoid usual phenomenon of time over reporting, values were adjusted to real available leisure-time (LT) for each participant. Reliability was assessed by using Intraclass Correlation Coefficients (ICC) and weighted (quadratic) kappa (k), and validity was assessed by using Pearson correlation and Bland-Altman plots.Results: The reliability of questionnaire showed a moderate-to-substantial agreement for the most (91%) of items (k=0.43-0.74; ICC=0.41-0.79) with three items (4%) reaching an almost perfect agreement (ICC=0.82-0.83). Only 'sitting and talking' evidenced fair-to-moderate reliability (k=0.27-0.39; ICC=0.34-0.46). The relationship between average sedentary time assessed by the questionnaire and accelerometry was moderate (r=0.36; p<0.001). Systematic biases were not found between questionnaire and accelerometer sedentary time for average day (r=0.05; p=0.11) but Bland-Altman plots suggest moderate discrepancies between both methods of SB measurement (mean=19.86; limits of agreement=-280.04 to 319.76).Conclusions: The questionnaire showed moderate to good test-retest reliability and a moderate level of validity for assessing SB in youth, similar or slightly better to previously published in this population. [ABSTRACT FROM AUTHOR]

The aims of the present study were to assess the association of environmental perception with objective and self-reported physical activity (PA) and the relation between environmental perception and meeting PA recommendations on children and adolescents. A sample of 1520 youth (770 boys) aged 8-18 years (12.1 ±2.5 years) from the UP&DOWN study were included in the data analyses. Environmental perception was assessed with the short adapted version of the ALPHA environmental questionnaire. PA was objectively (accelerometers) and self-reported measured (PA Questionnaire for Children, Patient-centered Assessment and Counseling for Exercise Questionnaire and Finnish PA Index). Linear regression models were used to assess the association of environmental perception with PA. Bivariate logistic regression models were used to assess differences between environmental perception and meeting PA recommendations. Environmental perception was positively associated with both objective and self-reported PA. Some differences were found in the association of environmental perception and PA between sex- and age-specific groups. Youth who perceived a more favourable environment were more likely to meet PA recommendations (at least 60 min . day-1 of moderate to vigorous PA (MVPA)). Results suggest that environmental perceptions of children and adolescents may play an important role in achieving higher levels of PA. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify potential correlates of sedentary time and television (TV) viewing time in youth with Down syndrome (DS). A total of 98 adolescents with DS (63 males) aged 11–20 years old participated in this study. Total sedentary time was measured using accelerometers, while total TV viewing time and potential correlates were measured using proxy-report questionnaire. Analyses of covariance and a stepwise multiple linear regression were performed to examine correlates of total sedentary time and total TV viewing time. Different potential correlates were associated with total sedentary time (mother age, mother TV viewing time, perceived benefits of physical activity, birth order and having nearby shops in the neighbourhood) and total TV viewing time (father TV viewing time, TV viewing time with parents, family dietary habits during watching TV and weekend days time indoor). The identification of correlates associated with sedentary behaviour, principally those considered modifiable such as social and environmental factors, may contribute to development strategies to decrease sedentary behaviour in adolescents with DS and consequently promote a healthier lifestyle. [ABSTRACT FROM PUBLISHER]

Background: Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes., Objective: The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults., Design: A cross-sectional design was used., Methods: The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status)., Results: The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures., Limitations: The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study., Conclusion: The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs., (© 2020 American Physical Therapy Association.)

Background: Whole-body electromyostimulation (WB-EMS) devices are now being used in health and sports training, although there are few studies investigating their benefits. The objective of this research was to evaluate the effectiveness of WB-EMS as a postexercise recovery method and compare it with other methods like active and passive recovery., Methods: The study included nine trained men (age =21±1 years, height =1.77±0.4 m, mass =62±7 kg). Three trials were performed in three different sessions, 1 week apart. Each trial, the participants completed the same exercise protocol and a different recovery method each time. A repeated measures design was used to check the basal reestablishing on several physiological variables (lactate, heart rate, percentage of tissue hemoglobin saturation, temperature, and neuromuscular fatigue) and to evaluate the quality of recovery. The non-parametric Wilcoxon and Friedman ANOVA tests were used to examine the differences between recovery methods., Results: The results showed no differences between methods in the physiological and psychological variables analyzed. Although, the blood lactate concentration showed borderline statistical significance between methods (P=0.050). Likewise, WB-EMS failed to recover baseline blood lactate concentration (P=0.021) and percentage of tissue hemoglobin saturation (P=0.023), in contrast to the other two methods., Conclusions: These findings suggest that WB-EMS is not a good recovery method because the power of reestablishing of several physiological and psychological parameters is not superior to other recovery methods like active and passive recovery.

Introduction: Correlates of physical activity (PA) have not been explored in adolescents with Down syndrome (DS). Understanding correlates of PA could provide information to develop strategies to increase levels of PA in this target population., Objective: The aim of this study was to identify potential correlates of PA in adolescents with DS., Method: Information about levels of PA and their potential correlates was collected in 98 adolescents with DS (63 males, aged 11-20 years) using accelerometers and proxy-reported questionnaires. Analysis of covariance and multiple linear regression analyses were conducted to examine correlates of PA., Result: Our findings showed that participant's age and socioeconomic status were associated with levels of PA as non-modifiable correlates. Also, parental support, father PA, television-viewing time with siblings and with friends were associated with levels of PA as modifiable correlates., Discussion and Conclusion: Both modifiable and non-modifiable factors are associated with levels of PA in adolescents with DS. Therefore, a better understanding of correlates of PA could contribute to develop strategies on PA promotion in adolescents with DS., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: "Obesity" is considered a feature of youth with DS but whether "low physical fitness" is also a feature is unknown., Objective: The aim of this case-control study was to compare the levels of fatness and fitness in adolescents with and without DS., Methods: Participants included 17 (5 girls) adolescents with DS aged 12-18 years and a control group of 94 (45 girls) adolescents without DS aged 12-16 years. The ALPHA health-related fitness test battery for children and adolescents was selected to assess fatness and fitness in both groups., Results: There were no differences in levels of fatness between groups (all P > 0.27). Adolescents with DS had lower levels of fitness in all the tests than adolescents without DS (all P < 0.001)., Conclusion: Adolescents with DS have similar levels of fatness and lower levels of fitness than their peers without DS., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)