Harto Hakonen

Physical Activity, Sedentary Behavior, and Academic Performance in Finnish Children

PURPOSE This study aimed to determine the relationships between objectively measured and self-reported physical activity, sedentary behavior, and academic performance in Finnish children. METHODS Two hundred and seventy-seven children from five schools in the Jyväskylä school district in Finland (58% of the 475 eligible students, mean age = 12.2 yr, 56% girls) participated in the study in the spring of 2011. Self-reported physical activity and screen time were evaluated with questions used in the WHO Health Behavior in School-Aged Children study. Childrens physical activity and sedentary time were measured objectively by using an ActiGraph GT1M/GT3X accelerometer for seven consecutive days. A cutoff value of 2296 counts per minute was used for moderate-to-vigorous physical activity (MVPA) and 100 counts per minute for sedentary time. Grade point averages were provided by the education services of the city of Jyväskylä. ANOVA and linear regression analysis were used to analyze the relationships among physical activity, sedentary behavior, and academic performance. RESULTS Objectively measured MVPA (P = 0.955) and sedentary time (P = 0.285) were not associated with grade point average. However, self-reported MVPA had an inverse U-shaped curvilinear association with grade point average (P = 0.001), and screen time had a linear negative association with grade point average (P = 0.002), after adjusting for sex, childrens learning difficulties, highest level of parental education, and amount of sleep. CONCLUSIONS In this study, self-reported physical activity was directly, and screen time inversely, associated with academic achievement. Objectively measured physical activity and sedentary time were not associated with academic achievement. Objective and subjective measures may reflect different constructs and contexts of physical activity and sedentary behavior in association with academic outcomes.

Adolescents’ physical activity at recess and actions to promote a physically active school day in four Finnish schools

The national Finnish Schools on the Move programme support schools with their individual plans to promote school-based physical activity (PA). We examined the changes in adolescents’ recess and overall PA in four lower secondary schools and described the school actions to promote students’ PA and the local contact persons’ perceptions of the effects. Recess and overall PA were assessed four times by anonymous questionnaires from students in grades 7–9 (n = 789) in 2010–12, and local contact persons (n = 7) provided information on school actions with diaries, interviews and surveys. Student data were analysed with descriptive statistics and chi-square tests, and school actions data were analysed with quantitative content analysis. The proportion of students who participated in physical activities at recess at least sometimes increased from 30% to 49% in physically active play and from 33% to 42% in ball games, mostly due to improvements in males’ participation. Females’ participation in recess activities increased in two schools with gender-specific physical activities or facilities. Overall PA levels declined slightly. Organized recess activities, student recess activators and equipment provision and sports facilities development were considered to have affected students’ PA positively. Solutions for getting females more physically active in the school setting are needed.

Measuring Physical Activity in Free-Living Conditions—Comparison of Three Accelerometry-Based Methods

We examined the agreement in time spent on different physical activity (PA) levels using (1) mean amplitude deviation (MAD) of raw acceleration from the hip, (2) wrist-worn Polar Active, and (3) hip-worn Actigraph counts using Freedsons cut-points among adults under free-living conditions. PA was measured in 41 volunteers (mean age 47.6 years) for 14 days. Two MET-based threshold sets were used for MAD and Polar Active for sedentary time (ST) and time spent in light (LPA), moderate (MPA), and vigorous (VPA) PA. Actigraph counts were divided into PA classes, ≤100 counts/min for ST and Freedsons cut-points for LPA, MPA, and VPA. Analysis criteria were simultaneous use of devices for at least 4 days of >500 min/d. The between-method differences were analyzed using a repeated measures analysis of variance test. Bland-Altman plots and ROC graphs were also employed. Valid data were available from 27 participants. Polar Active produced the highest amount of VPA with both thresholds (≥5 and ≥6 MET; mean difference 17.9–30.9 min/d, P < 0.001). With the threshold 3–6 MET for MPA, Polar Active indicated 19.2 min/d more than MAD (95% CI 5.8–32.6) and 51.0 min/d more than Actigraph (95% CI 36.7–65.2). The results did not differ with 3.5–5 MET for MPA [F(1.44, 37.43) = 1.92, P = 0.170]. MAD and Actigraph were closest to each other for ST with the threshold < 1.5 MET (mean difference 22.2 min/d, 95% CI 7.1–37.3). With the threshold <2 MET, Polar Active and Actigraph provided similar results (mean difference 7.0 min/d, 95% CI −17.8–31.7). Moderate to high agreement (area under the ROC curve 0.806–0.963) was found between the methods for the fulfillment of the recommendation for daily moderate-to-vigorous PA of 60 min. In free-living conditions the agreement between MAD, Polar Active, and Actigraph for measuring time spent on different activity levels in adults was dependent on the activity thresholds used and PA intensity. ROC analyses showed moderate to high agreement for the fulfillment of the recommendation for daily MVPA. Without additional statistical adjustment, these methods cannot be used interchangeably when measuring daily PA, but any of the methods can be used to identify persons with insufficient daily amount of MVPA.

Recess physical activity and school-related social factors in Finnish primary and lower secondary schools: cross-sectional associations.

BackgroundParticipation in physical activities provides students with opportunities for social interaction and social skills development. The purpose of this study was to investigate the associations of students’ recess physical activity with school-related social factors.MethodsData were collected in 19 schools countrywide in autumn 2010, and 1463 students from grades 4 and 5 (primary school) and from grades 7 and 8 (lower secondary school) completed an anonymous questionnaire. Multiple linear regression analysis was used to investigate whether self-reported physical activity at recess was associated with peer relationships at school, relatedness to school and school climate. Analyses were adjusted for self-reported overall physical activity and conducted for primary and lower secondary schools. Multi-group analysis was used to test sex differences among the associations.ResultsIn primary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.17, p = 0.007 and girls: b = 0.21, p <0.001), relatedness to school (boys: b = 0.18, p = 0.002 and girls: b = 0.24, p <0.001) and school climate (girls: b = 0.17, p = 0.001), after adjusting for overall physical activity. In lower secondary school, physical activity at recess was positively associated with peer relationships at school (boys: b = 0.09, p = 0.006 and girls: b = 0.12, p = 0.010) but not with other school-related social factors. No sex differences were observed in these associations.ConclusionsOur results suggest that students’ participation in physical activities during school recess is positively associated with students’ school-related social factors. In the future, it would be worthwhile to study how physical activity at recess should be organised in order to support the development of school-related social factors.

Changes in physical activity and sedentary time in the Finnish Schools on the Move program: a quasi‐experimental study

The aim of the Finnish Schools on the Move program is to create a more active and pleasant school day through physical activity (PA). In this quasi‐experimental design, we compared changes in moderate‐to‐vigorous‐intensity physical activity (MVPA) and sedentary time (ST) during the school day and outside school hours for Grades 1–9 over two academic years in four program schools and two reference schools. Altogether 319 girls and boys aged 7–15 participated in the study between 2010 and 2012. MVPA and ST were measured four times over the 1.5‐year follow‐up period for seven consecutive days, using a hip‐worn ActiGraph accelerometer. Linear growth curve modeling was used to examine the effect of the program on MVPA and ST during follow‐up. School day MVPA increased (P = 0.010) and school day ST decreased (P = 0.008) in program primary schools (Grades 1–6) more compared with the reference schools. The effect sizes (Cohens d) for the difference in change (from the first to the last measurement) were small (d = 0.18 and d = −0.27, respectively). No differences in the changes of leisure‐time or whole‐day MVPA and ST between the program and reference schools were observed during follow‐up. In conclusion, the changes in school day MVPA and ST did not translate into positive effects across the whole day. More effective and longer promotion actions are needed for positive changes in PA and ST, especially in lower secondary schools and for all daily segments.

Accelerometer-Measured Physical Activity and Sedentary Time Differ According to Education Level in Young Adults

This study examined the association of education level with objectively measured physical activity and sedentary time in young adults. Data from the Finnish ESTER study (2009–2011) (n = 538) was used to examine the association between educational attainment and different subcomponents of physical activity and sedentary time measured using hip-worn accelerometers (ActiGraph GT1M) for seven consecutive days. Overall physical activity, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity and sedentary time were calculated separately for weekdays and weekend days. A latent profile analysis was conducted to identify the different profiles of sedentary time and the subcomponents of physical activity. The educational differences in accelerometer-measured physical activity and sedentary time varied according to the subcomponents of physical activity, and between weekdays and weekend days. A high education level was associated with high MVPA during weekdays and weekend days in both sexes, high sedentary time during weekdays in both sexes, and a low amount of light-intensity physical activity during weekdays in males and during weekdays and weekend days in females. The results indicate different challenges related to unhealthy behaviours in young adults with low and high education: low education is associated with a lack of MVPA, whereas high education is associated with a lack of light-intensity physical activity and high sedentary time especially during weekdays.

Objectively measured physical activity and sedentary time in young adults born preterm—The ESTER study

Background:Young adults born preterm have higher levels of cardio metabolic risk factors and they report less physical activity than their peers born at term. Physical activity provides important cardio metabolic health benefits. We hypothesized that objectively measured physical activity levels are lower and time spent sedentary is higher among preterm-born individuals compared with controls.Methods:We studied unimpaired participants of the ESTER birth cohort study at age 23.3 y (SD: 1.2): 60 born early preterm (<34 wk), 108 late preterm (34–36 wk), and 178 at term (controls). Physical activity and sedentary time were measured by hip-worn accelerometer (ActiGraph).Results:As compared with controls’ (mean physical activity, 303 counts per minute (cpm; SD 129)), physical activity was similar among adults born early preterm (mean difference = 21 cpm, 95% CI −61, 19) or late preterm (5 cpm, −27, 38). Time spent sedentary was also similar. Adjustments for early life confounders or current mediating characteristics did not change the results.Conclusion:In contrast to our hypothesis, we found no difference in objectively measured physical activity or time spent sedentary between adults born preterm and at term. The previously reported differences may be limited to physical activity captured by self-report.

The prevalence of musculoskeletal pain and use of painkillers among adolescent male ice hockey players in Finland

Participating in competitive sport increases the risk for injuries and musculoskeletal pain among adolescent athletes. There is also evidence that the use of prescription drugs has increased among sport club athletes. The purpose of this study was to evaluate the use of painkillers among young male ice hockey players (IHP) in comparison to schoolboys (controls) and its relation to the prevalence of musculoskeletal pain and problems during activities and sleeping. Information was gathered through a questionnaire, completed by 121 IHP and compared to the responses of 618 age-matched controls. Results showed that monthly existing pain was at 82% for IHP, and 72% for controls, though IHP had statistically more musculoskeletal pain in their lower limbs (56% vs. 44%), lower back (54% vs. 35%), and buttocks (26% vs. 11%). There were no group differences in the neck, upper back, upper limb, or chest areas. The disability index was statistically similar for both groups, as musculoskeletal pain causing difficulties in daily activities and sleeping was reported by a minority of subjects. Despite this similarity, IHP used more painkillers than controls (18% vs. 10%). Further nuanced research is encouraged to compare athletes and non-athletes in relation to painkillers.

Female reproductive factors are associated with objectively measured physical activity in middle-aged women

Physical activity improves health and may delay the onset of several chronic diseases. For women in particular, the rate of these diseases accelerates at middle age; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population. In this study, we focused on determinants that are unique to the female sex, such as childbearing and menopause. The main objective was to characterize the level of physical activity and differences between active and inactive middle-aged Finnish women. In addition, we examined the association of physical activity with female reproductive factors at midlife. The study population consisted of 647 women aged 48 to 55 years who participated in our Estrogenic Regulation of Muscle Apoptosis (ERMA) study during the period from 2015 to 2016. Physical activity was measured objectively using hip-worn accelerometers for seven consecutive days. The outcome measures included the amounts of light intensity physical activity and moderate to vigorous intensity physical activity accumulated in bouts of at least 10 minutes (MVPA10). MVPA10 was used to determine whether women were placed in the active (≥150 min/week) or inactive (<150 min/week) group. Multiple linear regression models were performed with physical activity measures as dependent variables and cumulative reproductive history index, menopausal symptoms, and pelvic floor dysfunction as independent variables. We found that a large portion (61%) of Finnish middle-aged women did not meet the physical activity recommendations of 150 minutes of MVPA10 per week. In the studied cohort, 78% of women experienced menopausal symptoms, and 54% exhibited pelvic floor dysfunction. Perceived menopausal symptoms were associated with greater light physical activity. Perceived pelvic floor dysfunction was associated with lower MVPA10. According to the fully adjusted multiple linear regression models, reproductive factors explained 6.0% of the variation of MVPA10 and 7.5% of the variation of light physical activity. The results increase our knowledge of the factors related to physical activity participation among middle-aged women and indicate that menopausal symptoms and pelvic floor dysfunction should be identified and considered when promoting physical activity for women during midlife. The results emphasize that awareness of female reproductive factors, especially menopausal symptoms and pelvic floor dysfunction, is important for physical activity counseling to effectively help women in performing and sustaining health-enhancing amounts of physical activity. Specifically, the condition of the pelvic floor should be taken into account when identifying the proper activity type and intensity level so that health benefits of physical activity can still be attained without worsening symptoms.

Active commuting to school in Finland, the potential for physical activity increase in different seasons

Background Active commuting to school (ACS) can be a significant source of physical activity and provide many health benefits. Objective This study identified the potential to increase physical activity levels by promoting ACS in Finnish schools and evaluated the effects of season, distance and age on ACS. Design Data were collected with a questionnaire from 5,107 students, aged 10–16, in 45 comprehensive schools in Finland. The distance and the mode of transport to school in different seasons were self-reported. Results The prevalence of ACS was over 80% during spring/fall for those living 0–5 km from school. ACS was inversely associated with the distance to school and was lower in winter compared to spring and fall. Cycling is less common in winter, especially among girls and younger students. The potential for increasing students’ physical activity levels via ACS seems to be largest in winter, especially among students living 1–5 km from school. The variation in the prevalence of ACS between schools was large, especially in winter. Conclusions When planning interventions to promote ACS, one is encouraged to acknowledge and evaluate the potential in the selected target schools in different seasons. The potential varies largely between schools and seasons and is highly dependent on students’ commuting distances.