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Title: Levels of Physical Activity, Physical Fitness and

Overweight/Obesity in Children and Adolescents

Statement of the Problem

The aim of this thesis was to increase knowledge and strengthen evidences about the associations

between physical activity, physical fitness and overweight/obesity in a cross-sectional,

longitudinal and intervention perspective. Therefore, we used a cross-sectional and longitudinal

design as well as an interventional study. In this context the following specific objectives were

set

I. !naly"e the relationship of different physical fitness components, namely, strength,

flexibility and #$% with overweight/obesity.

II. &xamine the relationship of physical fitness levels and objectively measured physical

activity, with overweight/obesity.

III. !naly"e associations of physical activity, sedentary activities and 'verweight/obesity

with #$%.

I(. Investigate in a longitudinal perspective how variations in body mass index, physical

activity index and sedentary activities, are associated with variations in physical fitness

(. Investigate in a longitudinal perspective, how variations in physical fitness, )!I, and

sedentary activities can influence the risk of weight gain over three years.

(I. !naly"e is an extracurricular intervention program can contribute to the increase of

moderate to vigorous activities e in children and adolescents with overweight/obesity.

ethodology

This chapter will present the general information about the samples, instruments and methods

used. *pecifications of each instrument and method can be found in the six papers +#hapter III

The data for the first five studies were collected in &scola *ecundria de (alongo. This school

has an average population of approximately 00 students, from 1th to th grade, from to 2

years old. 3ata collection took place throughout the school years of 004-05, 005-01 and 001-

06 during the months of 'ctober and 7ovember.

%or longitudinal data we gathered 894 students with the same evaluations over the 8 years :;I,

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%or the sixth paper, data was collected in the Intervention )rogram =!#'$3!>. This program

designed for overweight and obese children and adolescents has two one-hour sessions per week.

The sample included 9 subjects from 5 to 5 years old. The sample was collected in ;ay 004,near the end of the program.

!"#" eas$rements

!"#"#" %$estionnaires

*everal ?uestions were gathered for different variables five ?uestions for physical activity

index +)!I, ?uestions related to time spent watching T( or using computer during the

week and weekend 8 ?uestions related to type and time used in transportation house/school.

The whole ?uestionnaire can be found in the supplement session.

!"#"!" Accelerometers

*tudents used accelerometers from ;TI !ctigraph throughout seven consecutive days. !t

least five days of recording with a minimum of 0 hours registration per day, was set as an

inclusion criterion. 3ata was analysed with specific software +;!@Affe,

www.mrc.epid.cam.ac.uk using -minute epoch. )hysical activity intensities were based upon

specific cut points. In the second paper we used the threshold for ;()! B000 counts/min,

which corresponds to a walking of about 8-9 Cm/h +:rage et al., 008. %or the sixth paper we

used )uyau et al., +00 cut points.

!"#"&" Fitness tests

%ive tests from %itnessgram were used curl-ups, push-ups, trunk lift, back-save sit and reach

and 0-m shuttle run. These tests are included in )ortuguese #urricula for )& classes

+)rudencial %IT7&**D$!;, 229.

!"#"' Anthro(ometry

@eight was measured using a @oltain stadiometer and body mass was measured with an

electronic weight scale +Tanita Inner *can :# 48. :;I was calculated from the ratio

weight/height +Cg.m- . Ehen :;I was categori"ed in normal weight, overweight andobesity, specific cut points were used adjusted to age and gender +#ole, :elli""i, %legal, F

3iet", 000. Triceps, sub scapular and mid calf skin fold thickness were measured according

to +@eyward, 226. ! @arpenden *kin fold #alliper with a constant pressure of 0 g/mm

was used. The sum of the 8 G-scores from skin fold thickness measurements was calculated as

a final value.

!"#")" at$ration criteria

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#hildren and adolescents were interviewed separately during evaluation. &ach subject was

asked to self-assess his/her stage of secondary sex characteristics. H *tage of breast

development in females and pubic hair in males was evaluated according to TannerJs criteria

+Tanner F Ehitehouse, 215 used and validated in a similar sample +;ota et al., 00

!"!"&" Parents* ed$cation level

*ocio-economic position was established from )arentsJ educational level. #ategories were based

on the )ortuguese &ducational system + 2 yearsJ education or lessKsub-secondary levelL +

0K yearsJ education K secondary level and +8 #ollege/ ;aster/3octoral degree - higher

education level. These three levels were named as Mow, ;iddle and @igh level of education.

*imilar procedures have previously been applied in the )ortuguese context +;ota F *ilva,

222.

Table . &valuations and percentage of students assessed per year

+F+-CS:

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SO.+C OF TS0S:

!ires, Muisa +002. Mevels of )hysical !ctivity, )hysical %itness and

'verweight/'besity in #hildren and !dolescents

)orto M. !ires. 3octoral dissertation in )hysical !ctivity and @ealth.

$esearch #entre in )hysical !ctivity, @ealth and Meisure, %aculty of

*ports K Aniversity of )orto

https//ciafel.fade.up.pt/filesNdownload/luisaNaires.pdf

S$bmitted by:

7ica ;ateo3aryl Mumacad

!ngelika )aragas

!irah To?uero3eniece $on?uillo

Section:I!905