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Background: In July, 2019, the World Health Organization (WHO) commenced work to update the 2010 Global Recommendations on Physical Activity for Health and established a Guideline Development Group (GDG) comprising expert public health scientists and practitioners to inform the drafting of the 2020 Guidelines on Physical Activity and Sedentary Behavior. The overall task of the GDG was to review the scientific evidence and provide expert advice to the WHO on the amount of physical activity and sedentary behavior associated with optimal health in children and adolescents, adults, older adults (> 64 years), and also specifically in pregnant and postpartum women and people living with chronic conditions or disabilities. Methods: The GDG reviewed the available evidence specific to each sub-population using systematic protocols and in doing so, identified a number of gaps in the existing literature. These proposed research gaps were discussed and verified by expert consensus among the entire GDG.Results: Evidence gaps across population sub-groups included a lack of information on: 1) the precise shape of the dose-response curve between physical activity and/or sedentary behavior and several of the health outcomes studied; 2) the health benefits of light-intensity physical activity and of breaking up sedentary time with lightintensity activity; 3) differences in the health effects of different types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; screen time; television viewing); and 4) the joint association between physical activity and sedentary time with health outcomes across the life course. In addition, we acknowledge the need to conduct more population-based studies in low- and middleincome countries and in people living with disabilities and/or chronic disease, and to identify how various sociodemographic factors (age, sex, race/ethnicity, socioeconomic status) modify the health effects of physical activity, in order to address global health disparities. Conclusions: Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda. ; Public Health Agency of Canada ; Government of Norway

Background: The World Health Organization (WHO) released in 2020 updated global guidelines on physical activity and sedentary behaviour for children, adolescents, adults, older adults and sub-populations such as pregnant and postpartum women and those living with chronic conditions or disabilities. Objective: To summarize the evidence on the associations between physical activity, sedentary behaviour, and health-related outcomes used to inform the 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years. Methods: The update of the WHO guideline recommendations for children and adolescents utilized and systematically updated the evidence syntheses on physical activity and sedentary behaviour conducted for the 2016 Canadian 24-Hour Movement Guidelines for Children and Youth, the 2019 Australian 24-Hour Movement Guidelines for Children and Young People (5–17 years), and the 2018 Physical Activity Guidelines for Americans, Second Edition. Systematic reviews published from 2017 up to July 2019 that addressed the key questions were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rate the certainty of the evidence for the entire body of evidence. Results: The updated literature search yielded 21 relevant systematic reviews. The evidence base reviewed (i.e., existing and new systematic reviews) provided evidence that greater amounts and higher intensities of physical activity as well as different types of physical activity (i.e., aerobic and muscle and bone strengthening activities) are associated with improved health outcomes (primarily intermediate outcomes). There was sufficient evidence to support recommendations on limiting sedentary behaviours, which was not addressed in the 2010 WHO guidelines. However, there is still insufficient evidence available to fully describe the dose-response relationships between physical activity or sedentary behaviour and health outcomes, and whether the associations vary by type or domain of physical activity or sedentary behaviour.Conclusions: Addressing the identified research gaps will better inform guideline recommendations in children and adolescents, and future work should aim to prioritize these areas of research. In the meantime, investment and leadership is needed to scale up known effective policies and programs aimed at increasing activity in children and adolescents. ; Public Health Agency of Canada ; Government of Norway ; Canadian Institutes of Health Research (CIHR) ; CHEO Research Institute ; Research Council of Norway 249932/F20 ; University of Manchester P123958 ; UK Research and Innovation Future Leaders Fellowship MR/T021780/1 ; NICM-Blackmores Institute Fellowship ; National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust ; University of Bristol ; Spanish Ministry of Economy and Competitiveness DEP2016-79512-R DEP2017-91544-EXP ; University of Granada, Research and Knowledge Transfer Fund (PPIT) ; Excellence Actions Programme: Units of Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES) ; Andalusian Regional Government ; Regional Ministry of Economy, Knowledge, Enterprises and University ; European Union (EU) SOMM17/6107/UGR

Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150-300 min of moderate-intensity, or 75-150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets. ; Public Health Agency of Canada ; Government of Norway

Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the "obesity paradox," and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery. ; From the John Ochsner Heart and Vascular Institute, Ochsner Clinical School—The University of Queensland School of Medicine, New Orleans, Louisiana; Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, Illinois; PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain; Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri; and the Northwestern University, Feinberg School of Medicine, Chicago, Illinois. Dr. Ortega receives support for research activity from the Spanish Ministry of Economy and Competitiveness and FEDER (DEP2016-79512-R); additional funding from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Unit of Excellence on Exercise and Health (UCEES); and the European Union's Horizon 2020 research and innovation programme under grant agreement No. 667302. Dr. Kushner has served on the advisory board for Novo Nordisk, Weight Watchers, and Retrofit. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

BACKGROUND/OBJECTIVES: A low fitness status during childhood and adolescence is associated with important health-related outcomes, such as increased future risk for obesity and cardiovascular diseases, impaired skeletal health, reduced quality of life and poor mental health. Fitness reference values for adolescents from different countries have been published, but there is a scarcity of reference values for pre-pubertal children in Europe, using harmonised measures of fitness in the literature. The IDEFICS study offers a good opportunity to establish normative values of a large set of fitness components from eight European countries using common and well-standardised methods in a large sample of children. Therefore, the aim of this study is to report sex- and age-specific fitness reference standards in European children. SUBJECTS/METHODS: Children (10 302) aged 6–10.9 years (50.7% girls) were examined. The test battery included: the flamingo balance test, back-saver sit-and-reach test (flexibility), handgrip strength test, standing long jump test (lower-limb explosive strength) and 40-m sprint test (speed). Moreover, cardiorespiratory fitness was assessed by a 20-m shuttle run test. Percentile curves for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentiles were calculated using the General Additive Model for Location Scale and Shape (GAMLSS). RESULTS: Our results show that boys performed better than girls in speed, lower- and upper-limb strength and cardiorespiratory fitness, and girls performed better in balance and flexibility. Older children performed better than younger children, except for cardiorespiratory fitness in boys and flexibility in girls. CONCLUSIONS: Our results provide for the first time sex- and age-specific physical fitness reference standards in European children aged 6–10.9 years. ; European Union (EU) 016181 ; Volkswagen ; Spanish Government RYC-2011-09011 ; VR (research council in Sweden) ; FORTE (research council in Sweden) ; FORMAS (research council in Sweden)

During the COVID-19 pandemic, entire populations were instructed to live in homeconfinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (−29.5%) and vigorous (−18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods. ; High Sports Council (Consejo Superior de Deportes, CSD) of the Ministry of Culture and Sports of the Government of Spain 45/UPB/20 ; Basque Government (Eusko Jaurlaritza) PRE_2019_1_0373 ; Spanish Ministry of Science and Innovation-MINECO RYC-2014-16938

This study was conducted under the umbrella of the ActiveBrains and the SmarterMove projects supported by the MINECO/FEDER (DEP2013-47540, DEP2016-79512-R, RYC-2011-09011) and the CoCA project supported by the European Union's 2020 research and innovation programme (667302). JHM is supported by a grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). AR is supported by the NIHR Leicester Biomedical Research Centre, and the Collaboration for leadership in Applied Health Research and Care (CLAHRC) East Midlands. SS is supported by the French National Research Agency (ANR-19-CE36-0004-01). RW is supported by a Medical Research Council Industrial Strategy Studentship (MR/S502509/1). Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Funds (ERDF in English, FEDER in Spanish, project ref: B-CTS-355-UGR18), the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES), Junta de Andalucia,Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). In addition, funding was provided by the SAMID III network, RETICS, funded by the PN I+D+I 2017-2021 (Spain), ISCIIISub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/0022), the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). ; The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers' decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines. ; Spanish Government DEP2013-47540 DEP2016-79512-R RYC-2011-09011 ; CoCA project - European Union's 2020 research and innovation programme 667302 ; Spanish Government FPU15/02645 ; NIHR Leicester Biomedical Research Centre ; Collaboration for leadership in Applied Health Research and Care (CLAHRC) East Midlands ; French National Research Agency (ANR) ANR-19-CE36-0004-01 ; Medical Research Council Industrial Strategy Studentship MR/S502509/1 ; Andalusian Operational Programme ; European Regional Development Funds (ERDF in English, FEDER in Spanish) B-CTS-355-UGR18 ; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence ; Scientific Excellence Unit on Exercise and Health (UCEES), Junta de Andalucia,Consejeria de Conocimiento, Investigacion y Universidades ; European Commission SOMM17/6107/UGR ; SAMID III network, RETICS - PN I+D+I 2017-2021 (Spain) ; EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTI ; ISCIIISub-Directorate General for Research Assessment and Promotion ; European Commission RD16/0022

This research was supported by grants from the National Institutes of Health (CA154647, CA047988, CA182913, HL043851, HL080467, and HL099355). EJS was supported by the Intramural Research Program at the National Institute on Aging. JHM was supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). CC-S was supported by a grant from the Spanish Ministry of Science and Innovation (FJC2018-037925-I). Additional funding was provided by the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES) to FBO. The funders had no role in preparing and conducting this manuscript, in interpreting and deciding to publish the results, or in drafting the manuscript. drafting this manuscript. Open Access funding provided by the National Institutes of Health (NIH). ; Background: While physical activity has consistently been associated with decreased mortality rates, it remains unknown if there is a single "ideal" combination of time in physical activities of different intensities and sedentary behavior (SB) associated with the lowest rate. This study examined the associations of combinations of time in moderate-to-vigorous intensity (MVPA), higher-light intensity (HLPA), lower-light intensity activities (LLPA), and SB with mortality rates in older women. Methods: This prospective cohort study included 16,676 older women from throughout the United States enrolled in the Women's Health Study. Women wore accelerometers on their hip from 2011 to 2015 and were followed through 2017 (mean (SD) of 4.3 (1.1) years). Deaths were confirmed with medical records, death certificates, or the National Death Index. Compositional Cox regression models were used. Results: The mean (SD) age was 72 (5.7) years at accelerometer wear; 503 women died. Compared to the least active women (mean, 3 min/day MVPA, 27 min/day HLPA, 162 min/day LLPA, and 701 min/day SB): compositional models showed an inverse L-shaped dose-response association of MVPA replacing other behaviors with mortality rates mortality rates (P = .02); SB relative to LLPA, HLPA, and MVPA was directly associated with mortality rates in a curvilinear dose-response manner (P < .001); replacing 10 min of SB for MVPA (HR (95% CI) = .86 (.73–.98)) or for HLPA (HR (95% CI.94 (.88–1.00)) associated with 14 and 6% lower mortality rates, respectively; a 47% risk reduction (HR [95% CI] = .53 [.42–.64]) was observed among women meeting physical activity guidelines (mean, 36 min/day MVPA, 79 min/day HLPA, 227 min/day LLPA and 549 min/day SB); and similar mortality rate reductions of 43% (HR (95% CI) = .57 (.41–.73)) were observed with increases in HLPA and LLPA without increasing MVPA, e.g., reallocating SB to 90 min/day of HLPA plus 120 min/day of LLPA. Conclusions: There was no "ideal" combination of physical activities of different intensities and SB associated with the lowest mortality rates. Of particular relevance to older women, replacing SB with light intensity activity was associated with lower mortality rates, and "mixing and matching" times in different intensities yielded equivalent mortality risk reductions. ; United States Department of Health & Human Services National Institutes of Health (NIH) - USA CA154647 CA047988 CA182913 HL043851 HL080467 HL099355 ; Intramural Research Program at the National Institute on Aging ; Spanish Ministry of Education, Culture and Sport FPU15/02645 ; Spanish Government FJC2018-037925-I ; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence ; Scientific Excellence Unit on Exercise and Health (UCEES) ; United States Department of Health & Human Services ; National Institutes of Health (NIH) - USA

The funding agencies supporting this work are as follows: Italy: the Ministry of Agricultural, Food and Forestry Policies Ireland: The Health Research Board; The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw); and Norway: The Research Council of Norway, Division for Society and Health. The pooling of the data was funded through a grant from the National Prevention Research Initiative (Grant Number: G0701877) (http://www.mrc.ac.uk/research/initiatives/national-preventionresearch- initiative-npri/). The funding partners relevant to this award are: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [MC_UU_12015/3; MC_UU_12015/7], The Research Council of Norway (249932/F20), Bristol University, Loughborough University and Norwegian School of Sport Sciences. ; Background: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2–18 years) from 18 different European countries. Results: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe. ; The pooling of the data was funded through a grant from the National Prevention Research Initiative (Grant Number: G0701877) ; This work was additionally supported by the Medical Research Council [MC_UU_12015/3; MC_UU_12015/7], The Research Council of Norway (249932/F20)

Aims Cardiorespiratory fitness, muscular strength, and obesity in adulthood are risk factors for cardiovascular disease (CVD). However, little is known regarding the associations of these risk factors, already in adolescence, with later disability due to chronic CVD. Hence, we investigated associations of cardiorespiratory fitness, muscular strength, and body mass index (BMI) in adolescence with later chronic disability due to specific causes of CVD disability (i.e. cerebrovascular disease, ischaemic heart disease and heart failure). Methods and results This population-based cohort study included 1 078 685 male adolescents (16–19 years) from the Swedish military conscription register from 1972 to 1994. Cardiorespiratory fitness (bicycle ergometer test), muscular strength (knee extension strength), and BMI were measured during the conscription examination. Information about disability pension due to CVD was retrieved from the Social Insurance Agency during a mean follow-up of 28.4 years. Cardiorespiratory fitness was strongly and inversely associated with later risk of chronic CVD disability for all investigated causes. The association was particularly strong for ischaemic heart diseases (hazard ratio 0.11, 95% confidence interval 0.05–0.29 for highest vs. lowest fitness-quintiles). Furthermore, overweight/obesity were associated with CVD disability for all investigated causes. Conversely, associations of muscular strength with CVD disability were generally weak. Conclusions This study provides evidence for associations between low levels of cardiorespiratory fitness and obesity with later risk of chronic disability due to CVD. Preventive actions may begin at young ages and include promotion of cardiorespiratory fitness and healthy body weight. ; Karolinska Institutet 201802043 ; Swedish Society of Medicine ; County Council of Ostergotland, Sweden ; Henning and Johan Throne-Holst Foundation ; Strategic Research Area Health Care Science, Karolinska Institutet/Umea University ; European Union (EU) 667 302 ; University of Granada Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES) ; Junta de Andalucía, Consejeria de Conocimiento, Investigacion y Universidades European Regional Development Fund (ERDF) SOMM17/6107/UGR ; SAMID III network, RETICS - PN IthornDthornI 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion (ERDF) RD16/0022 ; EXERNET Research Network on Exercise and Health in Special Populations DEP200500046/ACTI

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01585/full#supplementary-material ; Physical inactivity is recognized as a determinant of low physical fitness and body composition in preschool children, which in turn, are important markers of health through the lifespan. Objective methods to assess physical activity, physical fitness and body composition in preschool children are preferable; however, they have some practical limitations in the school context. Therefore, the aim of this study was to test whether a single question regarding physical activity level of preschool children, reported by their parents, could be used as an alternative screening tool of physical fitness and body composition. The information was obtained from 10 different cities throughout Spain, gathering a total of 3179 healthy preschool children (52.8% boys and 47.2% girls) aged 3–5 years. Physical activity levels of preschool children were reported by parents using a single question with five response options (very low, low, average, high, or very high). Physical fitness and body composition were assessed with the PREFIT fitness battery. The results showed that parents' perception of their children's physical activity was positively associated with all objectively measured physical fitness components (brange = −0.094 to 0.113; all p < 0.020); and negatively with body composition indicators as measured (brange = −0.113 to −0.058; all p < 0.001). The results showed significant differences in all physical fitness and body composition z-scores across the parent-reported physical activity levels (all p < 0.017 and all p < 0.001, respectively), as well as, for the fitness index (p < 0.001). Our study suggests that in school settings with insufficient resources to objectively assess fitness and body composition, parentsreported physical activity level by means of a single question might provide useful information about these important health markers in preschool children. ; FBO was supported by the Spanish Ministry of Economy and Competitiveness – MINECO/FEDER DEP2016-79512-R, the European Union's Horizon 2020 Research and Innovation Programme under the grant agreement no. 667302, the University of Granada, Plan Propio de Investigación 2016, Excellence Actions: Units of Excellence, the Unit of Excellence on Exercise and Health (UCEES), the Junta de Andalucia, Consejeria de Conocimiento, Investigación y Universidades, the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI), the SAMID III Network, RETICS, funded by the PN I+D+I 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion, and the European Regional Development Fund (ERDF) (Ref. RD16/002). IL was supported by the Spanish Ministry of Economy and Competitiveness (DEP2016-78377-R), the "Fondos Estructurales de la Unión Europea (FEDER), Una manera de hacer Europa", the Public University of Navarra, Plan de Promoción de Grupos de Investigación, and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). DJ-P was supported by a grant from the Spanish Ministry of Science and Innovation – MINECO (RYC-2014-16938), the Spanish Ministry of Economy and Competitiveness – MINECO/FEDER (DEP2016-76123-R), the Government of Andalusia, Integrated Territorial Initiative 2014–2020 for the province of Cádiz (PI-0002-2017), the European Union's ERASMUS+SPORT Programme (Grant Agreement 603121-EPP-1-2018-1-ES-SPO-SCP), and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI).

Background We investigated the validity of REE predictive equations before and after 12-week energy-restricted diet intervention in Spanish obese (30 kg/m2>BMI<40 kg/m2) women. Methods We measured REE (indirect calorimetry), body weight, height, and fat mass (FM) and fat free mass (FFM, dual X-ray absorptiometry) in 86 obese Caucasian premenopausal women aged 36.7±7.2 y, before and after (n = 78 women) the intervention. We investigated the accuracy of ten REE predictive equations using weight, height, age, FFM and FM. Results At baseline, the most accurate equation was the Mifflin et al. (Am J Clin Nutr 1990; 51: 241–247) when using weight (bias:−0.2%, P = 0.982), 74% of accurate predictions. This level of accuracy was not reached after the diet intervention (24% accurate prediction). After the intervention, the lowest bias was found with the Owen et al. (Am J Clin Nutr 1986; 44: 1–19) equation when using weight (bias:−1.7%, P = 0.044), 81% accurate prediction, yet it provided 53% accurate predictions at baseline. Conclusions There is a wide variation in the accuracy of REE predictive equations before and after weight loss in non-morbid obese women. The results acquire especial relevance in the context of the challenging weight regain phenomenon for the overweight/obese population. ; The present study was supported by the University of the Basque Country (UPV 05/80), Social Foundation of the Caja Vital- Kutxa and by the Department of Health of the Government of the Basque Country (2008/111062), and by the Spanish Ministry of Science and Innovation (RYC-2010-05957).

FBO research activity was supported by the Spanish Ministry of Economy and Competitiveness—MINECO/FEDER DEP2016-79512-R; the European Union's Horizon 2020 research and innovation program under Grant Agreement No. 667302; the University of Granada, Plan Propio de Investigación 2016, Unit of Excellence on Exercise and Health (UCEES); the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Fund (ERDF), ref. SOMM17/6107/ UGR; the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI); and the SAMID III network, RETICS, funded by the PN I+D+I 2017-2021 (Spain), ISCIII Sub-Directorate-General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/002). AN was supported by the Ministry of Economy and Competitiveness and the Instituto de Salud Carlos III through the CIBERFES (CB16/10/00239), the Seneca Foundation through the unit of excellence (Grant 19899/GERM/15), and the Ministry of Science Innovation and Universities RTI2018-093528-B-I00 (all of which are cofinanced by FEDER). CCS is supported by the Spanish Ministry of Science, Innovation and Universities (FJC2018-037925-I). The views expressed are those of the authors and do not reflect the official policy or position of the institutions they belong to. ; Background: There is strong evidence suggesting that higher levels of cardiorespiratory fitness (CRF) are associated with a healthier metabolic profile, and that CRF can serve as a powerful predictor of morbidity and mortality. In this context, a smartphone app based on the 2-km walk test (UKK test) would provide the possibility to assess CRF remotely in individuals geographically distributed around a country or continent, and even between continents, with minimal equipment and low costs. Objective: The overall aim of this study was to evaluate the validity and reliability of 2kmFIT-App developed for Android and iOS mobile operating systems to estimate maximum oxygen consumption (VO2max) as an indicator of CRF. The specific aims of the study were to determine the validity of 2kmFIT-App to track distance and calculate heart rate (HR). Methods: Twenty participants were included for field-testing validation and reliability analysis. The participants completed the UKK test twice using 2kmFIT-App. Distance and HR were measured with the app as well as with accurate methods, and VO2max was estimated using the UKK test equation. Results: The validity results showed the following mean differences (app minus criterion): distance (& ndash;70.40, SD 51.47 meters), time (& ndash;0.59, SD 0.45 minutes), HR (& ndash;16.75, SD 9.96 beats/minute), and VO2max (3.59, SD 2.01 ml/kg/min). There was moderate validity found for HR (intraclass correlation coefficient [ICC] 0.731, 95% CI & ndash;0.211 to 0.942) and good validity found for VO2max (ICC 0.878, 95% CI & ndash;0.125 to 0.972). The reliability results showed the following mean differences (retest minus test): app distance (25.99, SD 43.21 meters), app time (& ndash;0.15, SD 0.94 seconds), pace (& ndash;0.18, SD 0.33 min/km), app HR (& ndash;4.5, 13.44 beats/minute), and app VO2max (0.92, SD 3.04 ml/kg/min). There was good reliability for app HR (ICC 0.897, 95% CI 0.742-0.959) and excellent validity for app VO2max (ICC 0.932, 95% CI 0.830-0.973). All of these findings were observed when using the app with an Android operating system, whereas validity was poor when the app was used with iOS. Conclusions: This study shows that 2kmFIT-App is a new, scientifically valid and reliable tool able to objectively and remotely estimate CRF, HR, and distance with an Android but not iOS mobile operating system. However, certain limitations such as the time required by 2kmFIT-App to calculate HR or the temperature environment should be considered when using the app. ; Spanish Ministry of Economy and Competitiveness-MINECO/FEDER DEP2016-79512-R ; European Commission 667302 ; University of Granada, Plan Propio de Investigacion 2016, Unit of Excellence on Exercise and Health (UCEES) ; Junta de Andalucia ; European Commission SOMM17/6107/UGR RD16/002 ; EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTI ; SAMID III network, RETICS - PN I+D+I 2017-2021 (Spain) ; ISCIII Sub-Directorate-General for Research Assessment and Promotion ; Ministry of Economy and Competitiveness CB16/10/00239 ; Instituto de Salud Carlos III through the CIBERFES CB16/10/00239 ; Fundacion Seneca 19899/GERM/15 ; Ministry of Science Innovation and Universities - FEDER RTI2018-093528-B-I00 ; Spanish Ministry of Science, Innovation and Universities FJC2018-037925-I

This study investigated physical activity (PA) and sedentary time (SED) in relation to hippocampal gray matter volume (GMV) in pediatric overweight/obesity. Ninety-three children (10 ± 1 year) were classified as overweight, obesity type I, or type II–III. PA was assessed with non-dominant wrist accelerometers. GMV was acquired by magnetic resonance imaging (MRI). Neither PA nor SED associated with GMV in the hippocampus in the whole sample (p > 0.05). However, we found some evidence of moderation by weight status (p < 0.150). Moderate-to-vigorous PA (MVPA) positively associated with GMV in the right hippocampus in obesity type I (B = 5.62, p = 0.017), which remained when considering SED, light PA, and sleep using compositional data (γ = 375.3, p = 0.04). Compositional models also depicted a negative association of SED relative to the remaining behaviors with GMV in the right hippocampus in overweight (γ = −1838.4, p = 0.038). Reallocating 20 min/day of SED to MVPA was associated with 100 mm3 GMV in the right hippocampus in obesity type I. Multivariate pattern analysis showed a negative-to-positive association pattern between PA of increasing intensity and GMV in the right hippocampus in obesity type II–III. Our findings support that reducing SED and increasing MVPA are associated with greater GMV in the right hippocampus in pediatric overweight/obesity. Further studies should corroborate our findings. ; MINECO/FEDER DEP2013-47540 DEP2016-79512-R RYC-2011-09011 ; Spanish Ministry of Education, Culture and Sport FPU15/02645 FPU17/04802 ; Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz PI-0002-2017 ; Spanish Government FJC2018-037925-I ; Alicia Koplowitz Foundation ; Spanish Ministry of Economy and Competitiveness RTI2018-095284-J-100 ; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence ; Scientific Excellence Unit on Exercise and Health (UCEES) ; Junta de Andalucia ; Consejeria de Conocimiento, Investigacion y Universidades ; European Union (EU) ; SAMID III network, RETICS - PN I + D+I 2017-2021 (Spain) ; ISCIII-Sub-Directorate General for Research Assessment and Promotion ; European Union (EU) RD16/0022 ; EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTI

Background: New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. Methods: A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health. ; La Caixa Foundation 100010434 LCF/BQ/PR19/11700007 ; University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES) ; Junta de Andalucía SOMM17/6107/UGR ; European Union (EU) SOMM17/6107/UGR