Meeting the 2008 Physical Activity Guidelines for Americans Among U.S. Youth

doi:10.1016/j.amepre.2012.11.016

American Journal of Preventive Medicine

Volume 44, Issue 3, March 2013, Pages 216-222

https://doi.org/10.1016/j.amepre.2012.11.016 Get rights and content

Background

Participation in physical activity brings health benefits for adolescents. However, limited data are available on the percentage of U.S. adolescents who engage in levels of aerobic and muscle-strengthening activities recommended in the 2008 Physical Activity Guidelines for Americans (2008 Guidelines).

Purpose

To examine the prevalence at which U.S. adolescents aged 12–17 years meet the 2008 Guidelines, and whether demographic and BMI variables influence that prevalence.

Methods

Using data from an interviewer-administered self-report questionnaire in the 1999–2006 National Health and Nutrition Examination Survey (analyzed in 2011), estimates were made of the percentage of adolescents who engaged in recommended levels of aerobic and muscle-strengthening activities (≥60 minutes of aerobic activity/day and participation in muscle-strengthening activities ≥3 days/week).

Results

Among 6547 U.S. adolescents aged 12–17 years, 16.3% (95% CI=14.9%, 17.9%) met both aerobic and muscle-strengthening guidelines; 14.7% (13.3%, 16.2%) met the aerobic guideline only, 21.3% (19.4%, 23.3%) met the muscle-strengthening guideline only, and 47.8% (45.4%, 50.1%) met neither guideline. Adjusted for covariates, odds of meeting either the aerobic or muscle-strengthening guideline only or both guidelines versus meeting neither guideline were (p<0.05) higher among boys than girls. The odds of meeting the aerobic guideline only were higher among underweight/normal-weight adolescents than among obese adolescents. No clear pattern was observed by family groups according to poverty-to-income ratio.

Conclusions

Less than 20% of adolescents reported engaging in recommended levels of both aerobic and muscle-strengthening activities.

Introduction

Physical activity has numerous health benefits for youth including increased cardiorespiratory fitness and muscular strength, reduced body fat, improved cardiovascular and metabolic health biomarkers, enhanced bone health, and reduced symptoms of depression and/or anxiety.1, 2, 3 Accordingly, the DHHS detailed physical activity guidelines for youth aged 6–17 years in the 2008 Physical Activity Guidelines for Americans (2008 Guidelines).⁴ These guidelines recommend that youth participate in a minimum of 60 minutes of physical activity daily and engage in muscle-strengthening activity at least 3 days per week. However, there is a gap in existing knowledge about how many U.S. youth engage in physical activity at levels sufficient to meet those guidelines.

Although a few studies have described, separately, levels of aerobic5, 6, 7 and muscle-strengthening activity⁸ in youth, only one, a CDC study⁹ published in 2010, has reported levels of aerobic and muscle-strengthening activities together. That CDC study⁹ assessed aerobic and muscle-strengthening activity levels among U.S. high school students. Self-administered questionnaires, with one question to assess aerobic activity and one to assess muscle-strengthening activity, were used in classrooms, and showed that only one in ten students met the recommended levels of aerobic and muscle-strengthening activities. To augment those CDC findings,⁹ the current study assessed data collected through face-to-face interviews using questions on a broad range of activities.

The primary objectives were to use more-detailed data to examine the prevalence of U.S. adolescents meeting the 2008 Guidelines and to determine whether demographic and BMI variables are associated with meeting the guidelines. Four exclusive assessment criteria based on the 2008 Guidelines were used: meeting the aerobic guideline only, meeting the muscle-strengthening guideline only, meeting both aerobic and muscle-strengthening guidelines, and meeting neither guideline. Assessing levels of physical activity from participation in specific activities will strengthen understanding in this sparsely researched area.

Section snippets

Survey Description

The National Health and Nutrition Examination Survey (NHANES) is a stratified and multistage probability cluster sample survey designed to represent the U.S. non-institutionalized civilian population.¹⁰ Conducted in 2-year cycles, NHANES collects data from participants (of all ages) through household interviews followed by physical examinations, including measurement of height and weight, at a mobile examination center. Physical activity data were collected in household interviews for youth

Results

Nationally representative estimates from the current study were based on a sample of 6547 participants. Selected characteristics of the weighted sample are presented in Table 1. Based on 2008 Guidelines criteria, 14.7% of U.S. adolescents met the aerobic guideline only, and 21.3% met the muscle-strengthening guideline only (Table 2). The percentage of boys who met the aerobic guideline only or the muscle-strengthening guideline only was higher than that for girls. The percentage meeting the

Discussion

The current study found that in a nationally representative sample of 6547 U.S. adolescents in 1999–2006, less than two of ten (<20%) reported meeting both aerobic and muscle-strengthening guidelines, and approximately one half reported meeting neither the aerobic nor the muscle-strengthening guideline. Efforts to increase levels of youth activity currently receive federal support through state, local, and community organizations (www.letsmove.gov; www.saferoutesinfo.org) but the findings of

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Longitudinal trends and predictors of muscle-strengthening activity guideline adherence among Canadian youths
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Muscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5–17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths.
Longitudinal.
Data were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity).
For the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p < 0.001 for linear trend). Population sub-groups less likely to meet the guideline at each wave included females, youth who were underweight or obese, those reporting insufficient aerobic physical activity, those from large urban settings, and youth who identify as Asian.
Among a large sample of Canadian youths, approximately half met the MSE guideline, with this prevalence declining over time. Large-scale MSE interventions are needed to address the low and decreasing adherence to this key modifiable health-related behavior among Canadian youths.
Factors associated with adherence to the muscle-strengthening activity guideline among adolescents
2020, Psychology of Sport and Exercise
Citation Excerpt :
A recent systematic review identified a range of factors associated with adult participation in RT (e.g., education, self-efficacy, subjective norms etc.) (Rhodes, Lubans, Karunamuni, Kennedy, & Plotnikoff, 2017), but no equivalent evidence synthesis has been conducted for children and adolescents. Of the work that has been done, associations have been found between adolescents’ MSA and demographic variables, including sex/gender, race/ethnicity, and socioeconomic status (SES) (Song et al., 2013; Roth et al., 2019); biological variables, such as cardiorespiratory fitness (CRF), muscular fitness (Morrow et al., 2013), and (albeit with mixed findings) body composition (Song et al., 2013; Roth et al., 2019; Morrow et al., 2013); and psychosocial variables, including perceptions/beliefs about PA, and peer/parent social support (Roth et al., 2019). These studies provide insights into several factors that may be relevant for adolescents’ MSA behavior, but as all were conducted with U.S. youth the findings may not be generalizable to young people in other parts of the world.
We aimed to explore associations between guideline-concordant muscle-strengthening activity (MSA) and demographic, biological, psychosocial, and behavioral factors among Australian adolescents.
We used baseline data from the ‘Resistance Training for Teens’ cluster randomized controlled trial (collected April–June 2015). Adolescents (n = 602, mean age = 14.1 ± 0.5 years, 50% female) from 16 schools in New South Wales, Australia self-reported their sex, primary language spoken at home, postal code (for socioeconomic status), resistance training (RT) self-efficacy, motivation for RT, perceived strength, moderate-to-vigorous physical activity (MVPA), screen-time, and sleep. Participants also completed tests of height, weight, cardiorespiratory and muscular fitness, flexibility, and RT skills. MSA was self-reported and participants were dichotomized as ‘meeting’ (3–7 days) or ‘not meeting’ (0–2 days) the MSA guideline. Binary logistic regression with odds ratios (OR) was used to determine associations with adolescents' MSA.
Analyses for each variable group explained a small-to-moderate proportion of the variance in MSA. Sex, muscular fitness, RT self-efficacy, perceived strength, and total MVPA emerged as statistically significant factors. However, only RT self-efficacy (OR = 2.48 [1.37 to 4.50]) and total MVPA (OR = 1.48 [1.22 to 1.79]) were associated with guideline-concordant MSA in the full model, which explained 52% of the variance.
Our study adds to the limited understanding of adolescents' MSA behavior. RT self-efficacy and total MVPA were independently associated with guideline-concordant MSA among Australian adolescents. The findings have implications for the design and delivery of future interventions targeting adolescents’ MSA behavior.
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Regular physical activity is one of the most powerful methods to lower the risk of all-cause mortality, help control multiple medical co-morbidities and improve overall quality of life. For optimal health it is recommended that adults obtain at least 150 min per week of moderate-intensity or 75 min per week of vigorous-intensity aerobic exercise per week along with at least 2 days of muscle-strengthening activity. Despite the known health benefits of exercise and long-standing recommendations from major health, medical and fitness societies, only half of Americans meet these guidelines. The Physical Activity Guidelines for Americans, 2nd edition from the U.S. Department of Health and Human Services provides an update from the 2008 guidelines adding specific recommendations for pre-school children while emphasizing the need to reduce sedentarism across the age spectrum (“move more and sit less”). This document provides a summary of the 2018 Physical Activity Guidelines for Americans as well as the impact of inactivity on health and future directions to improve utilization.
Initial mass media coverage of the 2nd edition of the physical activity guidelines for Americans
2020, Preventive Medicine Reports
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Among adults ages 18–64, only 22.9% met both the physical activity guidelines for moderate to vigorous physical activity and strength training in the past month (Blackwell and Clarke, 2018). Between 1999 and 2006 only 16.3% of adolescents ages 12–17 met both the aerobic and muscle strengthening recommendations, with about half meeting neither of them (Song et al., 2013). The 1st edition of the U.S. Physical Activity Guidelines for Americans was released in 2008 (U.S. Department of Health and Human Services, Centers for Disease Control, 2008).
The 2nd edition of the Physical Activity Guidelines for Americans was released in November of 2018. This document contained specific guidelines for young children, children and adolescents, adults, older adults, pregnant and postpartum women, and adults living with chronic conditions and disabilities as well as safety recommendations. Given the complexity of the recommendations, the aim of this study was to assess which of the guidelines were covered by both print and broadcast media in the three months following the release of the guidelines. LexisNexis was searched for print media as well as transcripts of broadcast media. YouTube was used to search for broadcast television news stories. All retrieved stories (n = 34) were coded independently by two raters on which of the elements of the guidelines were covered. On average, stories covered less than half of the guidelines. Most stories reported aerobic guidelines for adults, children and adolescents and young children. Muscle strengthening and vigorous exercise were covered less frequently. No stories mentioned guidelines for pregnant or postpartum women or adults with disabilities. Print (M = 6.4, sd = 2.7) covered more recommendations than broadcast media (M = 4.0, sd = 1.9, p < .01). Coordinated national efforts are needed to ensure that Americans are aware of the new and complete guidelines.
Preventive care services and health behaviors in children with fragile X syndrome
2019, Disability and Health Journal
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The proportion of influenza vaccination in our cohort was similar to coverage estimations for the general pediatric population for the 2011–2012 influenza season.27,28 Studies of PA have found that approximately 16% of all adolescents 12–17 years of age29 and 12% of high school students30 met 2008 PA guidelines. These estimates are much lower than the proportion meeting PA guidelines in our study, possibly due to the inexact match between the survey and preventive care guidelines.
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We assessed four preventive care outcomes and the total number of preventive care guidelines met among individuals under 21 years from the ongoing Fragile X Online Registry with Accessible Research Database (N = 406) using data from 2012 to 2015. We used adjusted odds ratios (AORs) from multiple logistic regression models to describe associations between demographic factors and preventive care outcomes.
Seventy-five percent of our sample met dental care guidelines, 55.4% met influenza vaccination guidelines, 92.1% met immunization guidelines, and 24.4% met physical activity (PA) guidelines. Compared to children six to 10 years, younger children were less likely to have seen a dentist as recommended (AOR: 0.26) and young adults aged 16–20 were less likely to have received immunizations (AOR: 0.14) or to have engaged in recommended PA (AOR: 0.29). Black participants (AOR: 0.25) were less likely to have received an influenza vaccination than white participants. Individuals with autism (AOR: 0.25) were less likely to have sufficient PA, while individuals with hypersensitivity were more likely to have sufficient PA (AOR: 2.37) than unaffected individuals.
The proportion of young people with FXS that meet basic recommendations in preventive care guidelines varies according to health condition and demographic characteristics. This proportion could be increased for some groups, particularly in the cases of influenza vaccination and physical activity.
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Two-thirds of adolescents who are overweight or have obesity report weight loss intentions. Most report using weight loss strategies consistent with expert recommendations for obesity prevention; however whether they meet recommended fruit and vegetable (F&V) intake and physical activity (PA) recommendations is unknown. We investigated whether weight loss attempts, and weight loss strategies were associated with meeting F&V and PA recommendations. Data were from the 2010 National Youth Physical Activity and Nutrition Study, which surveyed a cross-sectional, nationally representative sample of U.S. high school students. Analyses were restricted to overweight/obese students (n = 2841). Adjusted logistic regression models assessed the odds of meeting daily F&V and weekly PA recommendations after adjusting for grade, sex, race/ethnicity and perceived weight status. Compared to students who were overweight and were not currently intending to lose weight, students who were overweight and intending to lose weight were not more likely to meet F&V or PA. Among students with obesity, those who intended to lose weight were more likely than students who were not currently intending to lose weight to meet F&V recommendations (OR: 3.62, 95% CI: 1.70–7.73). Students who were overweight/obese and used F&V or PA for weight loss were significantly more likely to meet the corresponding recommendation than students intending to lose weight without specific strategies. Weight loss attempts alone do not affect the likelihood of meeting most expert recommendations. Public health efforts emphasizing recommended strategies for healthy eating and active living still need to be encouraged for overweight/obese youth.

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Research articleMeeting the 2008 Physical Activity Guidelines for Americans Among U.S. Youth

Background

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Survey Description

Results

Discussion

J Pediatr

Ann Epidemiol

Public Health

Contemp Clin Trials

Systematic review of the health benefits of physical activity and fitness in school-aged children and youth

Int J Behav Nutr Phys Act

Physical Activity Guidelines Advisory Committee report, 2008

2008 physical activity guidelines for Americans

Moderate-to-vigorous physical activity from ages 9 to 15 years

JAMA

Physical activity in U.S. youth: effect of race/ethnicity, age, gender, & weight status

Med Sci Sports Exerc

Youth risk behavior surveillance, U.S., 2009

MMWR Surveill Summ

Youth risk behavior surveillance, U.S., 2003

MMWR Surveill Summ

Physical activity levels of high school students, U.S., 2010

MMWR Morb Mortal Wkly Rep

National Health and Nutrition Examination Surveys (NHANES)

2000 CDC growth charts for the U.S.: methods and development

Vital Health Stat 11

Research article
Meeting the 2008 Physical Activity Guidelines for Americans Among U.S. Youth