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Item Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study(Springer, 2022) Onywera, Vincent O; Lang, Justin J; Olds, TimBackground The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. Methods Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. Results There was strong between-panel agreement (panel 1: rs = 0.76, p < 0.01; panel 2: rs = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) “conduct longitudinal studies to assess changes in fitness and associations with health”. This was followed by (ii) “use fitness surveillance to inform decision making”, and (iii) “implement regular and consistent international/national fitness surveys using common measures”. Conclusions The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.Item Physical activity and active transportation behaviour among rural, peri-urban and urban children in Kenya, Mozambique and Nigeria: The PAAT Study(PLOS, 2022) Onywera, Vincent O; Wachira, Lucy-Joy; Hayker, Sylvester O.; Larouche, Richard; Oyeyemi, Adewale LAbstract Background Physical activity (PA) is associated with numerous health benefits among children and youth. However, few studies have examined how active transportation (AT) and device-based measures of PA vary within and between countries in sub-Saharan Africa. Purpose This cross-sectional study sought to investigate the prevalence and correlates of AT and device-measured PA among children living in urban, peri-urban and rural areas in three African countries representing Eastern, Western and Southern regions of Africa. Methods 3,205 participants (53.3% girls; 46.7% boys) aged 10–12 years were recruited in Kenya, Nigeria and Mozambique. Data were collected using a child questionnaire, a parent/guardian questionnaire and PiezoRx® pedometers. ANCOVA and binary logistic regression analyses were used to examine the correlates of AT and PA while controlling for gender, age, parent education and vehicle ownership. Results Participants accumulated an average of 45.6±23.5 min/day of moderate-to-vigorous physical activity (MVPA) and 11,215±4,273 steps/day. Kenyan and Mozambican children were significantly more active than their Nigerian counterparts (p<0.001). Only 23% met the MVPA guidelines of 60 min/day. 65.1% of participants engaged in AT to school (and 67.8% for the trip back home) with no gender differences. Living in a rural area, lower parent education, lower vehicle ownership and higher motorcycle ownership were associated with higher odds of AT. Other correlates of AT were country specific. Girls accumulated less daily MVPA than boys in all countries. MVPA was positively associated with living in less urbanized areas in Nigeria and Mozambique. In Kenya, lower parental education and AT were associated with higher MVPA. Nigerian children’s daily MVPA decreased with age and the number of parent-perceived barriers to AT. Conclusions Majority of children engaged in AT, but still failed to meet MVPA recommendations. Most correlates of AT and PA were country-specific, suggesting that strategies to encourage both behaviors should be informed by local evidence.Item Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings from the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys(Human Kinetics, 2022) Onywera, Vincent O; Pratt, Michael; Dionyssiotis, Yannis; Wendel-Vos, Wanda; Puloka, Viliami KulikefuBackground: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.Item Why are COVID-19 effects less severe in Sub-Saharan Africa? Moving more and sitting less may be a primary reason(Elsevier, 2022) Onywera, Vincent O; Wachira, Lucy-Joy; Arena, Ross; Sallis, James F.; Oyeyemi, Adewale L.The world is entering a new phase of the coronavirus disease 2019 (COVID-19) health crisis with the lifting of social and physical distancing as well as lockdown restrictions to control the pandemic. Scientific evidence obtained during the COVID-19 pandemic to this point have brought clear themes to the forefront. One important theme pertains to who is at a higher risk for poorer outcomes if infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clearly, indi viduals with risk factors for chronic disease and one or more chronic disease diagnoses are at significantly higher risk for poor outcomes with SARS-CoV-2 infection.1,2 Moreover, unhealthy lifestyle behaviors (i.e., physical inactivity, poor nutrition, smoking and excess body mass) are the leading cause for the high incidence and prevalence of chronic disease the world was facing well before the COVID-19 pandemic.3 In fact, physical inactivity and chronic diseases were both characterized as pandemics prior to COVID-19Item Association between dietary behaviours and weight status of school children: results from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) -Kenya(2020) Onywera, Vincent O; Wachira, Lucy-Joy; Muthuri, Stella; Ocholla, Sophie; Tremblay, MarkABSTRACT Background: Sub-Saharan African countries are undergoing rapid urbanization resulting in vast changes in dietary habits. Dietary practices involving excess energy intake have been associated with overweight/obesity. We assessed the dietary behavior of children and their relationships with weight status. Methods: Data was collected in Kenya, as part of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). The study recruited 563 children aged 9–11 years from 29 schools in Nairobi. A seven-day food frequency questionnaire was used to assess dietary intake. Dietary behaviors such as consumption of breakfast, school lunch, meals prepared/eaten away from home, emotional eating and snacking while watching television were also assessed. Body mass index (BMI-for-age and sex) was used as the indicator of weight status. Results: Of the sample, 53.5% were girls; 20.8% were classified as overweight/ obese; 72.9% ate meals out of home regularly; 55.2% ate lunch provided by the school; and only 76% had breakfast on all weekdays. Eating more when happy, eating fried foods while watching television, and consumption of vegetables were positively associated with BMI. Majority of overweight children were female (56.6%) and the type of school attended predicted BMI, F(6, 536) = 18.371, p < 0.0001, R2 = 0.171. BMI was negatively associated with consumption of cakes/pastries (χ2 = 14.7, V = 0.165, p = 0.023), potato crisps (χ2 = 21.6, V = 0.197, p = 0.003), and fast foods (χ2 = 13.5, p = 0.036). ANOVA results revealed no significant differences in the consumption of foods with BMI except for vegetables (p = 0.003). Conclusions: Children have healthy diets rich in fruits and vegetables and low in energy-dense foods. Also, less healthy diets were observed in children with CONTACT Lucy-Joy Wachira wachira.lucy@ku.ac.ke Department of Physical Education, Exercise and Sport Science, Kenyatta University, Nairobi, Kenya CHILD AND ADOLESCENT OBESITY 2021, VOL. 4, NO. 1, 1–22 https://doi.org/10.1080/2574254X.2020.1842014© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Lower BMI. There is need for interventions targeting the overweight/obese children, particularly those of higher SES.