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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.]

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]

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 the present study was to examine the associations of objectively measured physical activity (PA) with several markers of fatness and fitness in a relatively large sample of adolescents with Down syndrome (DS). This study comprised a total of 100 adolescents with DS (37 females) aged 11-20 years-old, and a sex-matched sample of 100 adolescents without disabilities, participating in the UP&DOWN study. The ALPHA health-related fitness test battery for adolescents was used to assess fatness and fitness. PA was measured by accelerometry. Adolescents with DS had higher fatness and significantly lower fitness levels in all variables measured than adolescents without DS (all p<0.05). Moderate-to-large effects were observed in fatness variables (d=0.65-1.42), but particularly large values were found in fitness variables (d=2.05-2.43). In addition, PA levels was not associated with fatness variables, whereas total PA and vigorous PA were associated with all fitness variables (p<0.05), and moderate-vigorous PA (MVPA) was associated with muscular fitness (p<0.05), after adjusting for potential confounders. Further analysis revealed that there were differences in fitness by tertiles of vigorous PA between the lowest and the highest groups in all fitness variables (all p<0.05). However, no significant differences were found in fitness by tertiles of MVPA according with PA guidelines (≥60min in MVPA). Our findings indicate that PA levels are not associated with fatness variables, whereas high PA levels, in particular vigorous PA, are positively associated with high fitness in adolescents with DS. [ABSTRACT FROM AUTHOR]

The current study aimed at analyzing the associations between latent transitions based on sedentary time and physical activity levels and changes in Health-Related Quality of Life (HRQoL), positive affect, and negative affect over two years in children and adolescents. Longitudinal design. Participants were 1099 children and adolescents (544 girls) aged 8–18 years old (11.72 ± 2.39 years). Sedentary and physical activity levels were assessed by accelerometry. Well-being was approached through self-reported HRQoL, positive affect, and negative affect. Latent profile and latent transition analysis were developed at baseline and 2-year follow-up. Furthermore, we analyzed the cross-sectional relationship between lifestyle profiles and well-being, as well as the associations between profiles transitions and changes in well-being indicators. Four profiles were identified at both time-points, respectively: highly sedentary (7.7% and 8.3%), sedentary (34.4% and 35.9%), active (46.3% and 44.3%), and highly active (11.6% and 11.5%). Participants belonging to the highly active profiles showed better HRQL (p < 0.05 at both timepoints) than sedentary participants, and better positive affect (p < 0.05 at follow-up) than those in sedentary and active profiles. Lifestyle profiles were unstable to moderate stable, where sedentary and active profiles were the most stable patter (63.7% and 61.9%, respectively), and highly sedentary and highly active were the least (34.1% and 38.3%, respectively). Changing from an active to a sedentary profile was associated with a significantly greater decrease on the positive affect than keeping on active or changed from a sedentary to an active profile, whereas changing to an active profile attenuated the decrease in HRQoL. This study identified lifestyle profiles transitions among young population, and demonstrates the importance of these behaviors patterns on well-being indicators. These findings suggest the development of practical interventions aimed at promoting healthy lifestyles (i.e., increasing PA and reducing ST) in those youth with sedentary profiles, which will cause an increase on feelings of well-being. • Four profiles were found (highly sedentary, sedentary, active, and highly active). • Active profiles were associated with better HRQoL and positive affect. • Lifestyle profiles were unstable to moderate stable, ranging from 34.1% to 63.7%. • Changing to a sedentary profile caused a greater decrease on positive affect. • Changing to an active profile attenuated the decrease in HRQoL. [ABSTRACT FROM AUTHOR]