Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations.

This study supported the usefulness of the TGMD-2 as a process-oriented instrument to measure gross motor development in early childhood in Belgium. However, it also demonstrated that caution is warranted when using the US reference norms.

Objective: The aim of the present study was to explore the existence of clusters in multiple lifestyle behaviours, including physical activity (PA), sedentariness and food habits, in young adolescents. The present study also investigated whether the identified groups could be characterised by gender and components of health-related physical fitness, especially weight status and cardiorespiratory fitness (CRF). Design: A cross-sectional survey. Leisure-time PA, sedentary behaviour and food consumption were assessed by a questionnaire. Overweight prevalence was estimated using BMI (kg/m 2 ) calculated from self-reported height and weight. CRF was measured using a 20 m shuttle-run test. Setting: The study was conducted in four middle schools in Flanders, Belgium. Subjects: The sample size was 317 seventh grade students aged 11-12 years. Results: Four reliable and meaningful lifestyle clusters could be identified, labelled as 'Sporty media-oriented mixed eaters' (boys: n 34; girls: n 16), 'Academic healthy eaters' (boys: n 30; girls: n 58), 'Inactive healthy eaters' (boys: n 38; girls: n 57) and 'Inactive media-oriented unhealthy eaters' (boys: n 35; girls: n 49). The lifestyle clusters could not be characterised by adolescents' weight status. Among boys, the 'Sporty media-oriented mixed eaters' group performed significantly better on the shuttle-run test than those in clusters with the lowest levels of PA (clusters 3 and 4). Conclusions: Our results showed that healthy and risk-related behaviours may coexist in some groups of young adolescents. Isolated unhealthy behaviours, such as high levels of screen-based media use or high consumption of energydense food items, are not necessarily related with negative health outcomes, on the condition that these risk-related behaviours co-occur with more healthenhancing behaviours such as PA. Dramatic increases in childhood obesity over the past decades suggest the predominance of influential behavioural factors over genetic factors. It is generally believed that today's environment enforces an inactive lifestyle that is likely to contribute to a positive energy balance and childhood obesity (1) . Despite the important role of nutrition (energy input) and physical activity (PA; energy output) in the prevention of childhood obesity, there seems to be limited research addressing the relationship between multiple health behaviours or clusters based on this energy-balance approach (2)(3)(4) . Previous literature in this area has mainly focused on describing bivariate associations between PA and sedentary behaviour (5) , PA and food choices (6,7) or sedentary behaviour and food choices (8,9) . Although significant relationships may exist between two health behaviours, the reported correlations are predominantly weak and often too small to be of much clinical or practical significance. Nevertheless, the low correlations between health-related behaviours does not exclude the existence of clusters or groups of young people who show negative health profiles due to factors such...

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.