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The problem of the automatic determination of the first and second ventilatory thresholds (VT1 and VT2) from cardiopulmonary exercise test (CPET) still leads to controversy. The reliability of the gold standard methodology (i.e. expert visual inspection) feeds into the debate and several authors call for more objective automatic methods to be used in the clinical practice. In this study, we present a framework based on a collaborative approach, where a web-application was used to crowd-source a large number (1245) of CPET data of individuals with different aerobic fitness. The resulting database was used to train and test an artificial intelligence (i.e. a convolutional neural network) algorithm. This automatic classifier is currently implemented in another web-application and was used to detect the ventilatory thresholds in the available CPET. A total of 206 CPET were used to evaluate the accuracy of the estimations against the expert opinions. The neural network was able to detect the ventilatory thresholds with an average mean absolute error of 178 (198) mlO2/min (11.1%, r = 0.97) and 144 (149) mlO2/min (6.1%, r = 0.99), for VT1 and VT2 respectively. The performance of the neural network in detecting VT1 deteriorated in case of individuals with poor aerobic fitness. Our results suggest the potential for a collective intelligence system to outperform isolated experts in ventilatory thresholds detection. However, the inclusion of a larger number of VT1 examples certified by a community of experts will be likely needed before the abilities of this collective intelligence can be translated into the clinical use of CPET. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we investigated the impact of cardiorespiratory fitness (CRF), quantified as peak oxygen consumption (VO 2peak ), on the relationship between work rates (WR) at the aerobic threshold (AerT) and the point of maximal fat oxidation rate (Fat max )., Methods: A total of 761 untrained adults aged 41-68 completed a one-minute incremental exercise test on a cycle ergometer, using breath-by-breath gas analysis to determine VO 2peak , AerT, and Fat max . AerT was determined using automatic and visual detection methods, and Fat max was determined using indirect calorimetry. Participants were categorized into CRF-groups: low (<25th percentile), medium (≥25th percentile and <75th percentile), and high (≥75th percentile)., Results: Fat max was found at 43 ± 7% WR peak , 37% ± 6% WR peak and 35% ± 7% WR peak in the low, medium, and high CRF-groups, respectively. In contrast, AerT was located at significantly higher relative work rates: 51% ± 8% WR peak , 47% ± 10% WR peak , and 47% ± 11% WR peak in the respective CRF-groups. There was a weak agreement between Fat max and AerT [intraclass correlation coefficient (ICC) = .19, p  < .001], and the ICC decreased from .35 to .12 to .13, while the mean bias ±95% limits of agreement increased from 8% ± 14% WR peak to 8% ± 19% WR peak to 12% ± 44% WR peak from CRF-low to CRF-medium to CRF-high. The mean difference between Fat max and AerT was significantly different among the CRF subgroups: 8% ± 7% WR peak vs. 10% ± 10% WR peak vs. 12% ± 11% WR peak in low, medium, and high CRF-groups, respectively. Nonetheless, multiple regression analysis revealed only a weak positive correlation between the difference in relative work rates (% WR peak ) between Fat max and AerT (dependent variable) and the predictor variables CRF and sex, both identified as significant ( R  = .19, p  < .001)., Conclusion: Our study confirms substantial differences in exercise intensities between Fat max and AerT in untrained adults (10% ± 19% WR peak , ranging from -14% to 53% WR peak ). Importantly, this difference remains relatively consistent across varying CRF levels, emphasizing the distinct nature of Fat max and AerT, with CRF playing a limited role in influencing their relationship in our study's untrained adults., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Pühringer and Ring-Dimitriou.)

The aim of this study is to compare data on the health status, self-reported exercise and non-exercise physical activity as well as fitness parameters, such as grip strength, of people in retirement in two cities that are both considered urban centres according to the statistical office of the European Union (EUROSTAT), but differ by geographic location. Self-reported physical activity questionnaires and objective assessments of physical fitness indicators collected by sports scientists were used and examined for differences. A total of 210 people (66.3 years ± 2.3) in Salzburg ( n = 90) and Vienna ( n = 120) was analysed. While no differences were found in self-reported health, there were differences in self-reported exposure to self-reported exercise and non-exercise physical activity, with the Viennese population being more inactive than their more western comparison group. In addition, the objective indicators for muscle strength, balance and flexibility of the lower extremities differed significantly in favour of the more western Austrian population. We recommend assessing the situation of older people in Austria regarding their physical activity and fitness on a regional basis, even if they live in cities of the same category. Future projects should therefore aim to consider specific regional needs during development and incorporate both subjective and objective indicators when monitoring the success of such programs.

Submaximal ventilatory indices, i.e., point of optimal ventilatory efficiency (POE) and anaerobic threshold (AT), are valuable indicators to assess the metabolic and ventilatory response during cardiopulmonary exercise testing (CPET). The order in which the ventilatory indices occur (ventilatory indices sequencing pattern, VISP), may yield additional information for the interpretation of CPET results and for exercise intensity prescription. Therefore, we determined whether different VISP groups concerning POE and AT exist. Additionally, we analysed fat metabolism via the exercise intensity eliciting the highest fat oxidation rate (Fat max ) as a possible explanation for differences between VISP groups. 761 less trained adults (41-68 years) completed an incremental exercise test on a cycle ergometer until volitional exhaustion. The ventilatory indices were determined using automatic and visual detection methods, and Fat max was determined using indirect calorimetry. Our study identified two VISP groups with a lower work rate at POE compared to AT in VISP POE < AT but not in group VISP POE = AT . Therefore, training prescription based on POE rather than AT would result in different exercise intensity recommendations in 66% of the study participants and consequently in unintended physiological adaptions. VISP POE < AT participants were not different to VISP POE = AT participants concerning VO 2peak and Fat max . However, participants exhibiting a difference in work rate (VISP POE < AT ) were characterized by a higher aerobic capacity at submaximal work rate compared to VISP POE = AT . Thus, analysing VISP may help to gain new insights into the complex ventilatory and metabolic response to exercise. But a methodological framework still must be established., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Pühringer, Ring-Dimitriou, Iglseder, Frey, Trinka and Paulweber.)

Background: To empower healthy aging, digital solutions embed multiple modules for physical activity, cognitive health promotion, and social engagement. Integrating new empowering technologies such as digital exercise monitoring requires assessment measures and analysis procedures, considering variable compliance of users with different modules., Objective: This study aims to assess the influence of a tablet-based and a feedback system-based exercise module on balance and leg strength by considering use adherence instead of the use of the entire multimodular system., Methods: In the prospective cohort study within the fit4AAL project, 83 users (n=67, 81% women; n=16, 19% men; mean age 66.2, SD 2.3 years) used the 2 digital exercise modules of a multimodular physical activity promotion system for >18 weeks. A data-driven clustering method based on the average use frequency of the exercise modules determined the number of user types that met the World Health Organization-recommended training frequency of at least twice per week. On the basis of this use adherence, statistical analysis was performed with features of functional performance tests (unipedal stance, 30-second chair rise, Y-balance, and hurdle step tests). The tests were conducted 6 months before the intervention, immediately before the intervention, and after the intervention, comparing the baseline phase with the 3 feedback use groups of the study (using only the tablet, the tablet and the feedback system, or only the feedback system)., Results: Of the 83 users, 43 (52%) met the World Health Organization-recommended frequency of muscle-strengthening activities. Overall, the feedback use groups achieved, on average, more chair rises in 30 seconds than the baseline group (P=.01; moderate effect size of 0.07). Of the 43 users, 26 (60%) additionally used the feedback system-based exercise module. They improved in balance compared with the users using either the tablet or the feedback system (P=.02). In addition, they improved their leg strength within the group (P=.04) and compared with the baseline (P=.01)., Conclusions: The additional use of a feedback system showed a tendency to positively maintain and influence the already exceptionally high functional performance of older adults. Considering use adherence in future multimodular system studies is crucial to assess the influence of single and combined use of exercise modules on functional performance., (©Verena Venek, Christina Kranzinger, Sonja Jungreitmayr, Susanne Ring-Dimitriou, Hermann Schwameder, Thomas Stöggl. Originally published in JMIR Formative Research (https://formative.jmir.org), 19.09.2022.)

To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 ± 2.2 years, body mass index (BMI) 98.9 ± 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time., Conclusion: Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible., What Is Known: • MVPA and SED times are associated with cardiometabolic risks in youths with obesity. • The relationships between NAFLD markers and concomitant MVPA and SED times have not been studied in this population., What Is New: • Low SED time is associated with healthier liver enzyme profiles and LFC independent of MVPA. • While low SED/high MVPA is the more desirable pattern, low SED/low MVPA pattern would have healthier liver enzyme profile compared with high MVPA/high SED, independent of BMI, suggesting that reducing SED time irrespective of MVPA is needed to optimize liver health., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Physical inactivity remains a leading risk factor for mortality worldwide. Owing to increasing sedentary behavior (activities in a reclining, seated, or lying position with low-energy expenditures), vehicle-based transport, and insufficient physical workload, the prevalence of physical activity decreases significantly with age. To promote sufficient levels of participation in physical activities, the research prototype Fit-mit-ILSE was developed with the goal of making adults aged ≥55 years physically fit and fit for the use of assistive technologies. The system combines active and assisted living technologies and smart services in the ILSE app., Objective: The clustering of health and fitness app user types, especially in the context of active and assisted living projects, has been mainly defined by experts through 1D cluster thresholds based on app usage frequency. We aimed to investigate and present data-driven methods for clustering app user types and to identify usage patterns based on the ILSE app function Fit at home., Methods: During the 2 phases of the field trials, ILSE app log data were collected from 165 participants. Using this data set, 2 data-driven approaches were applied for clustering to group app users who were similar to each other. First, the common approach of user-type clustering based on expert-defined thresholds was replaced by a data-driven derivation of the cluster thresholds using the Jenks natural breaks algorithm. Second, a multidimensional clustering approach using the Partitioning Around Medoids algorithm was explored to consider the detailed app usage pattern data., Results: Applying the Jenks clustering algorithm to the mean usage per day and clustering the users into 4 groups showed that most of the users (63/165, 38.2%) used the Fit at home function between once a week and every second day. More men were in the low usage group than women. In addition, the younger users were more often identified as moderate or high users than the older users, who were mainly classified as low users; moreover, the regional differences between Vienna and Salzburg were identified. In addition, the multidimensional approach identified 4 different user groups that differed mainly in terms of time of use, gender, and region. Overall, the younger women living in Salzburg were the users with highest average app usage., Conclusions: The application of different clustering approaches showed that data-driven calculations of user groups can complement expert-based definitions, provide objective thresholds for the analysis of app usage data, and identify groups that can be targeted individually based on their specific group characteristics., (©Christina Kranzinger, Verena Venek, Harald Rieser, Sonja Jungreitmayr, Susanne Ring-Dimitriou. Originally published in JMIR Formative Research (https://formative.jmir.org), 01.08.2022.)

Today, researchers, practitioners, and physicians measure the concentration of lactate during a graded exercise test to determine thresholds related to the maximal lactate steady state (maxLass) as a sensitive measure of endurance capacity. In the 1970s and 1980s, a group of Cologne-based researchers around Wildor Hollmann, Alois Mader, and Hermann Heck developed the methodology for systematic lactate testing and introduced a 4 mmol . L -1 lactate threshold. Later, they also developed the concept of the maxLass, and Mader designed a sophisticated mathematical model of human energy metabolism during exercise. Mader`s model simulates metabolic responses to exercise based on individual variables such as maximum oxygen uptake ( V ˙ O 2max ) and the maximal rate of lactate formation (ν La.max ). Mader's model predicts that the ν La.max reduces the power at the anaerobic threshold and endurance performance but that a high ν La.max is required for events with high power outputs in elite athletes. Mader's model also assumed before the millennium that the rate of fat oxidation is explained by the difference between glycolytic pyruvate synthesis and the actual rate of pyruvate oxidation which is consistent with current opinion. Mader's model also simulated the V ˙ O 2max slow component in the mid-1980s. Unfortunately, several landmark studies by the Cologne group were only published in German, and as a result, contributions by the Cologne group are under-appreciated in the English-speaking world. This narrative review aims to introduce key contributions of the Cologne group to human metabolism research especially for readers who do not speak German., Competing Interests: Author SW is employed by INSCYD GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wackerhage, Gehlert, Schulz, Weber, Ring-Dimitriou and Heine.)

Modern technologies enable new options in the delivery of physical exercise programs. Specially designed app-based programs can be used to help older people in particular to integrate physical exercise into their daily lives. This study examines the influence of an app-based physical exercise program on selected parameters of physical fitness, such as muscular strength, balance, and flexibility. The women ( n  = 110) were on average 65.3 (± 1.5) years old and, compared to age-specific norm values, healthy. The 14-week intervention consisted of an app-based, unsupervised physical exercise program, in which the exercise frequency and duration of sessions were self-selected. The physical exercise program consisted of simple, functional exercises such as arm circles, squats, lateral raises. The participants were provided with an elastic resistance band and an exercise ball allowing them to increase exercise intensity if needed. Participants were randomly assigned to intervention group (IG) and control group (CG). 71% of the IG used the physical exercise program at least 1.2 times per week, whereas 25% of the IG showed usage rates above four times per week. Significant effects were found in the domains of muscular strength and flexibility. While IG could maintain their performance in isometric muscular strength tests and increased their flexibility, CG faced a decrease in those parameters. Thus, this app-based physical exercise program had positively influenced muscular strength and flexibility in women over 60 years of age., Competing Interests: CK and VV were employed by company Salzburg Research Forschungsgesellschaft mbH. SJ is the owner of MyBodyCoach. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jungreitmayr, Kranzinger, Venek and Ring-Dimitriou.)

Introduction: While international prevention guidelines recently advocated, in addition to moderate and vigorous physical activity (MVPA) guidelines, for a minimization of sedentary (SED) time, recommendations remain to be developed for youths with obesity., Methods: A literature search was conducted in PubMed, the Cochrane Library, plus the reference lists of selected articles for relevant publications in English, including original papers, systematic reviews, and meta-analyses, with search terms "sedentary behaviors" or "sedentary time" or "screen time" AND "children" or "adolescents" AND "obesity" or "adiposity" or "cardiometabolic risk" or "cardiometabolic disease." The results were summarized as a narrative review and presented to the scientific board of the European Childhood Obesity Group (ECOG), who then discussed their implication in clinical practice and proposed the position outlined in this paper., Results: SED and screen times are associated with adiposity and cardiometabolic risks, independently of youths' physical activity (PA) level. Besides considering MVPA and SED times as separate variables, comprehensive studies have questioned the impact of different patterns of MVPA and SED levels. Although lower body adiposity and better cardiometabolic health are achieved among those with desirable movement behavior patterns (i.e., more MVPA/less SED or active/not SED), youths with intermediate patterns (i.e., high MVPA/high SED and low MVPA/low SED, or active/SED and inactive/not SED) have been found to be associated with intermediate risks., Conclusion: There is a need to decrease SED behaviors irrespective of MVPA and to consider PA-SED patterns in youth with obesity. The ECOG encourages anti-obesity strategies targeting both PA and SED behaviors to support the shift from long periods of SED time, especially screen time, to daily routines incorporating bouts of PA. Stepwise or sequential approaches to movement behavior counseling might start with targeting SED at first to decrease cardiometabolic risks when implementing MVPA is not yet possible., (© 2022 S. Karger AG, Basel.)

Obesity is a chronic disease, in which treatment outcomes are highly dependent on patient and family adherence to behavioural recommendations. The role of healthy eating, physical activity, medication adherence as well as adherence to pre- and post-bariatric surgery protocols are of utmost importance for long-term treatment outcomes. Even the best interventions are not likely to reach their maximum benefit without significant levels of adherence on the part of the individual and family. Traditionally, the annual meeting of the European Childhood Obesity Group (ECOG) includes an expert workshop addressing one specific topic within the field of childhood obesity. During the 30th annual meeting, hosted by the University of Pécs, Hungary, as a virtual meeting, "adherence to treatment recommendations in obesity as a chronic disease" was addressed. The discussions that developed during the workshop are summarized in the following article., (© 2022 S. Karger AG, Basel.)

There is evidence that training for strength and balance prevents decline in physical function in old age when the training is personally instructed. It is an open question whether interventions that deliver training via up-to-date technologies can achieve long-term effects. This study examined the effects of an 8-month fitness training program delivered via information and communication technology (ICT) on lower-body strength and balance in female home care users ( n = 72) aged 75 years on average. For statistical analysis, the test group was divided into two subgroups, one who used the program at least 8 times per month ( n = 26) and another one who used the program less often ( n = 17) compared with a control group that received no exercise program ( n = 29). It was found that regular ICT-exercisers exhibited positive effects over time on lower-body strength and balance compared to a decrease in both indicators in irregular exercisers and the control group. The authors see potential in offering exercise programs to people of advanced age via ICT to counteract physical decline in old age.

Obesity affects an increasing number of children and adolescents. Physical activity (PA) is a significant factor in the prevention of excessive body mass in the pediatric population. A significant percentage of pediatric population do not attain the public health recommendation for PA, and typically, those with higher levels of PA have lower content of body fat than less active peers. Although the development of childhood obesity is multifactorial, the decline in energy expenditure is considered as one of the most important determinants of excessive body weight. The lack of intervention causes that excess body weight to remain stable from birth through childhood and adolescence to adulthood. Accordingly, public health interventions are needed to increase the level of PA in the pediatric population. The task force from the European Childhood Obesity Group and the European Academy of Pediatrics reviewed English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from 2018 to August 2020, and developed a consensus statement. This statement presents the role of PA in the prevention of excessive body weight and gives age-appropriate recommendations for PA and recommendations for school-based interventions, parents, and guardians., (Copyright © 2020 Wyszyńska, Ring-Dimitriou, Thivel, Weghuber, Hadjipanayis, Grossman, Ross-Russell, Dereń and Mazur.)

Background: The point of optimal ventilatory efficiency (POE) and the anaerobic threshold (AT) are traditionally considered the same ventilatory indices, but recently differences between them have been reported. Therefore, the aim of this study was to identify different response patterns regarding POE and AT, and to analyse differences in breathing patterns as a possible explanation., Methods: 118 females and 199 males aged 50 to 60 years performed an exercise test with gas analysis. POE and AT were determined, and the breathing patterns concerning ventilation, breathing frequency and tidal volume were assessed., Results and Conclusion: Our study identified two different response patterns concerning the ventilatory indices POE and AT. Participants with a work rate difference between POE and AT (82% of all participants) were not different regarding breathing patterns of breathing frequency and tidal volume. However, the difference in work rate was explained by an early increase in ventilation and a higher aerobic capacity., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Regular physical activity contributes to both maintaining and improving health, and is important for human development throughout the entire lifespan of a person. There is strong evidence for the beneficial effects of physical activity on health, in the areas of all-cause mortality, cancer, cardiovascular health, musculoskeletal health, metabolic health, and neurocognitive health. Physical activity includes any form of movement in which the contraction of skeletal muscles results in an increase in energy consumption. It is quantified and controlled via the frequency, duration, intensity, and weekly extent. All those forms of movement that improve health and in which the risk of injury is low are defined as health-enhancing physical activity. The Austrian recommendations for health-enhancing physical activity include endurance-oriented movement, plus strength and coordination training. Exercise is aimed at initiating adaptation processes, in order to improve functionality. Therefore, it has to be adapted to the different levels of individual performance ability, activity levels, and age, and should be carried out according to certain principles. Exercise leads to a positive change in physiological parameters, which in turn are closely linked to an improvement in the state of health. Through regular endurance-oriented and muscle-strengthening physical activity, far-reaching health effects can be achieved. Nevertheless, undesirable events can occur during activity, and the musculoskeletal and circulatory systems can be particularly affected. However, through adequate preparation, suitable equipment, and appropriate exercise, the personal and also the public health benefits of physical activity and sport can be increased., Competing Interests: Die Autorinnen und Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

In this article, based on international recommendations, we present the Austrian physical activity recommendations for women during and after pregnancy, children of kindergarten age, children, and adolescents. For women during pregnancy and in the first months after delivery, the exercise recommendations do not differ from those for adults. Movement restrictions apply only if health problems are present. Children under 6 years of age should engage in a variety of motor tasks for up to 3 hours a day at medium and high intensity levels, so that they can grow up healthy. In the age group of 6 to 18 years of age, daily exercise of at least one-hour duration is recommended. When choosing the type of exercise, the level of development and the activity levels of children and adolescents should be taken into account. The exercise recommendations are intended for dissemination in the field of health promotion and to serve as the basis for the development and evaluation of health-promoting exercise programs in Austria., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The aim of this study was to compare different methods of detecting ventilatory indices (VI) and to investigate the impact of cardiorespiratory fitness (CRF) level on VI detection. Fifty females and fifty males completed a graded exercise test until volitional exhaustion with continuous gas-exchange measurement. The first and second ventilatory indices (VI-1, VI-2) were detected through different single automatic methods and through a semiautomatic method which combines visual and automatic detection methods. Additionally, the VIs were detected visually by two experts which served as the study specific gold standard. When comparing the semiautomatic method at VI-1 (intraclass correlation coefficients (ICC) 0.88 [0.81, 0.92], Bland-Altman bias ± limits of agreement (LoA) 55 ± 334 ml O 2 · min -1 ) and VI-2 (ICC 0.97 [0.96, 0.98], LoA 1 ± 268 ml O 2 · min -1 ) to the visually detected VI, high levels of agreements and no significant differences were found. This was not the case for any of the other automatic methods. Additionally, we couldn't find any relevant differences regarding the CRF level.We therefore concluded that the semiautomatic detection method should be used for VI detection, as results are more accurate than in any of the single-automatic methods. Abbreviations: CPET: cardiopulmonary exercise test; CRF: Cardiorespiratory fitness; VO 2peak: peak oxygen uptake; VI-1: first ventilatory indices; VI-2: second ventilatory indices; LoA: Bland-Altman bias ± limits of agreement; ICC: intraclass correlation coefficient.

•Traditional sports might be considered as part of obesity treatments.•Traditional sports are interesting strategies for the prevention of pediatric overweight and obesity.•A fully adapted medical checkup is mandatory before considering the use of traditional sports for the treatment of pediatric obesity.•Making adaptations in the practice of traditional sports (duration, rules, dimensions of the field) offers possible opportunities for obesity treatment among children and adolescents.

Background: The prevalence of early childhood overweight and obesity in Austria has reached average European levels of 20% in boys and 18% in girls. The rationale and study protocol of SALTO, Salzburg Together against Obesity will be presented, which is aimed to assist adults in increasing the rate of 4- to 6-year-old children with a healthy body weight., Methods: A controlled longitudinal sequential study design consisting of 14 intervention (IK) and 8 control (CK) kindergarten was used to investigate the effect of actions tailored for teachers and parents on BMI among 4- to 6-year-old children. The study launched in November 2014 was approved by the ethics committee of the University of Salzburg., Results: 681 children, 181 parents (119 mothers, 62 fathers) and 30 teachers were investigated until October 2016. Preliminary analyses revealed that more boys (19%) and fathers (60% IK, 43% CK) were overweight and obese than girls (16%) and mothers (19% IK, 20% CK)., Conclusion: The challenges faced by the SALTO staff in the implementation of health-promoting actions in the kindergarten are manifold. The Community-Oriented Core Setting (COCS) intervention approach will show whether the actions will reduce the percentage of obesity and be sustainable in the long term., (© 2018 The Author(s) Published by S. Karger GmbH, Freiburg.)