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Background: The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective. Methods: As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA. Results: Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β = 18.020, 95% CI [5.890 to 30.149], p = 0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β = − 21.921, CI [−36.195 to −7.647], p = 0.003) and perceptions of air pollution (β = − 12.472, CI [−23.797 to −1.147], p = 0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β = 32.391, CI [9.264 to 55.518], p = 0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models. Conclusions: These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health. Methods: This cross-sectional case–control study was performed on 110 apparently healthy unmarried, nonpregnant, nonlactating, postmenarchal adolescent girls and young women aged 11 to 24 years residing in urban slums with the same number of age-matched controls from NS areas. Anthropometric, dietary, physical-activity and bone-health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography—DXA and pQCT—respectively) were evaluated using standard protocols. A P value of < 0.05 was considered statistically significant. Results: Slum girls were significantly shorter and lighter and had lower dietary intakes of calcium and protein after adjusting for total daily calorie intake than NS girls (P < 0.05). Areal bone-mineral density (BMD) at lumber spine (0.940 ± 0.13 vs1.042 ± 0.15 g/cm2), femur and total body (less-head), bone-mineral apparent density adjusted for volume at the lumbar spine (0.295 ± 0.04 vs 0.319 ± 0.04 g/cm3) and height-adjusted bone density at femur (0.862 ± 0.011 vs 0.905 ± 0.011 g/cm2) were significantly lower in slum dwelling participants as compared to their NS counterparts (P < 0.05). After adjusting for confounders like sunlight exposure, anthropometric parameters and dietary calcium intake, area of dwelling was still a significant factor for the difference in BMD. Conclusions: The potential determinants of poor bone density and geometry in girls and young women residing in slums include residential location, dietary habits, and physical activity levels. Despite adjustments for confounding factors, differences in bone health between those in slum and nonslum areas suggest adaptations developed over generations of deprivation in these individuals, necessitating urgent intervention. [ABSTRACT FROM AUTHOR]

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results:Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation. [ABSTRACT FROM AUTHOR]

Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (β = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify correlates of nutrition label awareness and use, particularly subgroup differences among consumers. Two label types were assessed: (1) nutrition facts tables (NFt) in Australia, Canada, Mexico, UK, and USA and (2) front-of-package (FOP) labels, including mandatory Guideline Daily Amounts (Mexico), voluntary Health Star Ratings (Australia) and voluntary Traffic Lights (UK).Design: Respondents were recruited using Nielsen Consumer Insights Global Panel (n 21 586) and completed online surveys in November-December 2018. Linear regression and generalised linear mixed models examined differences in label use and awareness between countries and label type based on sociodemographic, knowledge-related and dietary characteristics.Setting: Australia, Canada, Mexico, UK and USA.Participants: Adults (≥18 years).Results: Respondents from the USA, Canada and Australia reported significantly higher NFt use and awareness than those in Mexico and the UK. Mexican respondents reported the highest level of FOP label awareness, whereas UK respondents reported the highest FOP label use. NFt use was higher among females, 'minority' ethnic groups, those with higher nutrition knowledge and respondents with 'adequate literacy' compared with those with 'high likelihood of limited literacy'. FOP label use was higher among those with a 'high likelihood of limited literacy' compared with 'adequate literacy' across countries.Conclusions: Lower use of mandatory Guideline Daily Amount labels compared with voluntary FOP labelling systems provides support for Mexico's decision to switch to mandatory 'high-in' warning symbols. The patterns of consumer label use and awareness across sociodemographic and knowledge-related characteristics suggest that simple FOP labels may encourage broader use across countries. [ABSTRACT FROM AUTHOR]

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations' human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of "C-," "D+," and "C-" was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed. [ABSTRACT FROM AUTHOR]

Background: This study compares results of physical activity report cards from 9 countries with low to medium human development indices, participating in the Global Matrix 3.0 initiative. Methods: Country-specific report cards were informed by relevant data and government policy documents, reporting on 10 core indicators of physical activity for children and youth. Data were synthesized by report card working groups following a harmonized process. Grade assignments for each indicator utilized a standard grading rubric. Indicators were grouped into one of 2 categories: daily behaviors and settings and sources of influence. Descriptive statistics (average grades) were computed after letter grades were converted into interval variables. Spearman's rank correlation coefficients were calculated for all correlation analyses. Results: Mean grades for daily behaviors were higher (C) than those for settings and sources of influence (D+). Twenty-nine out of the possible 90 grades were assigned an incomplete. There were moderate to strong positive and negative relationships between different global indices and overall physical activity, organized sport and physical activity, active play, family, community and environment, and government. Conclusions: Findings demonstrate an urgent need for high-quality data at the country level in order to better characterize the physical activity levels of children and youth in countries with low to medium human development indices. [ABSTRACT FROM AUTHOR]