Physical activity (PA) practice has been inversely associated to body fat (BF) and recommended as a way to reduce and prevent obesity. The objective of this study was to conduct a systematic review on the association of PA and BF in adolescence. The review includes 18 longitudinal studies found in PubMed database, comprising papers published from January 1990 to July 2014. Studies assessing BF only through body mass index (BMI) were excluded. Among the outcomes analyzed, waist circumference, skinfolds, and absolute and relative fat mass measurement were identified. Questionnaires were the way more predominant to evaluate PA. Most studies showed that PA promotes a protective effect against a higher BF gain. It was concluded that: PA has a protective effect against BF with differences between the genders and according to the BF marker or measurement assessed; higher intensity PA leads to a greater effect against BF gain in both genders; and the maintenance or increase of PA level on BF observed through analysis of change in PA level yielded more consistent findings in the relation between PA and BF.

Citerank: (37) 340964Tackling obesity in the UKWith concern growing that the Foresight analysis—that 50% of the UK population could be obese by 2050, at an annual cost to the nation of around £50 billion per year [2]—substantially underestimates the scale of the unfolding obesity crisis, the College of Contemporary Health is working with the wider policy community to develop a whole systems map of the obesity crisis and the potential responses.7F1CEB7, 348677Implement hard hitting campaigns, similar to those for anti-smokingHarder hitting campaigns, similar to those for anti-smoking, are required.1198CE71, 348678Incentivise GPs to improve patient outcomesThe Quality and Outcomes Framework should be amended to provide incentives for GPs to proactively offer advice to overweight and obese patients and refer them to weight management services where appropriate, rather than simply keeping a register of these patients. [1]565CA4D9, 348679Focus outcomes indicators on action by primary health professionalsThe Quality Outcomes Framework indicators on obesity should include, and focus on, indicators on the action taken by primary healthcare professionals on behalf of overweight or obese patients. [1]565CA4D9, 348680Need to make every contact with patients countGPs and other health professionals should be encouraged and required to make every contact with patients count. Very few patients will cite obesity or weight management as the reason for seeing their GP, and will instead present with conditions that are clearly a result of weight issues. GPs should talk with their patients about weight in these instances. [1]109FDEF6, 348684Improved GP training on obesityGPs should be provided with appropriate support and training to help them have the necessary conversations with patients. Better quality training should be provided both during GP training and for current GPs to help them provide better advice to patients. [1]109FDEF6, 348685Better hydrationGovernment initiatives should include a greater focus on the importance of good hydration in weight management and health outcomes.565CA4D9, 348687More physical activity for kids within and beyond educational settingsThe introduction of compulsory physical education in schools is positive. However, greater promotion of physical activity outside of educational settings is also key to ensure any participation amongst pupils is not limited to school. Similarly, caution is needed to ensure that the promotion of competitive sport does not put off children less disposed to that sport. This could result in children either returning to or increasing their sedentary lifestyle.565CA4D9, 348688Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 24.9% of adults in England are obese—with a body mass index of over 30—62% of adults are either overweight or obese (with a BMI of over 25), and 32% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK is estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179, 348689Encourage physical activity in daily lifeThe Chief Medical Officer’s report (2011) recommends that adults aged 19-64 years undertake 150 minutes of moderate intensity physical activity per week in bouts of 10 minutes or more. [1]565CA4D9, 348695The Quality and Outcomes FrameworkThe QOF was introduced in 2004 as a voluntary incentive scheme for GP practices in the UK. It contains groups of indicators against which practices score points according to their level of achievement, with a higher score leading to higher financial rewards. The aim of the QOF is to highlight priorities for improving patient care and provide incentives for GPs to drive up quality in these areas.82AECCD8, 348704GPs should measure waist circumferenceGPs should measure waist circumference rather than just BMI to help them identify patients who are most at risk and identify the indicators of poor health outcomes. [1]109FDEF6, 348706National Obesity ForumThe National Obesity Forum (NOF) was established in May 2000 to raise awareness of the emerging epidemic of obesity and the effect that it was going to have on both individuals and the NHS.58D3ABAB, 348770Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 352713Who should improve obesity training for healthcare professionals?Who should improve systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.58D3ABAB, 370326Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 371560British Heart Foundation recommends at least 60 minutes every dayThe British Heart Foundation recommends that to maintain their health, children take part in a minimum of 60 minutes of at least moderate intensity physical activity every day. This could include PE lessons, but also swimming, dancing, cycling, most other sports and brisk walking, as well as active play. 1198CE71, 371561Quality and prevalence of physical activity in schools is variableThe Ofsted Physical Education report published in February 2013 found that the physical aspect of physical education was not doing enough to tackle sedentary lifestyles amongst children and young people, with teachers often spending too much time talking and not enough time getting children moving.1198CE71, 396117Improve obesity training for healthcare professionalsImprove systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.565CA4D9, 399546Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 399553Shape the physical environment to encourage physical activity565CA4D9, 399556Improve obesity training for healthcare professionalsImprove systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.565CA4D9, 399584Incentivise GPs to improve patient outcomesThe Quality and Outcomes Framework should be amended to provide incentives for GPs to proactively offer advice to overweight and obese patients and refer them to weight management services where appropriate, rather than simply keeping a register of these patients. [1]565CA4D9, 399606Who should improve obesity training for healthcare professionals?Improve systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.58D3ABAB, 399642Implement hard hitting campaigns, similar to those for anti-smokingHarder hitting campaigns, similar to those for anti-smoking, are required.1198CE71, 399667Better hydrationGovernment initiatives should include a greater focus on the importance of good hydration in weight management and health outcomes.565CA4D9, 399668Encourage physical activity in daily lifeBuild exercise into daily life to promote energy balance. Adults are recommended to take part in 150 minutes of moderate intensity activity every week.565CA4D9, 399695Focus outcomes indicators on action by primary health professionalsThe Quality Outcomes Framework indicators on obesity should include, and focus on, indicators on the action taken by primary healthcare professionals on behalf of overweight or obese patients. [1]565CA4D9, 399734Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 399737Improved GP training on obesityGPs should be provided with appropriate support and training to help them have the necessary conversations with patients. Better quality training should be provided both during GP training and for current GPs to help them provide better advice to patients. [1]109FDEF6, 399768More physical activity for kids within and beyond educational settingsThe introduction of compulsory physical education in schools is positive. However, greater promotion of physical activity outside of educational settings is also key to ensure any participation amongst pupils is not limited to school. Similarly, caution is needed to ensure that the promotion of competitive sport does not put off children less disposed to that sport. This could result in children either returning to or increasing their sedentary lifestyle.565CA4D9, 399787The Quality and Outcomes FrameworkThe QOF was introduced in 2004 as a voluntary incentive scheme for GP practices in the UK. It contains groups of indicators against which practices score points according to their level of achievement, with a higher score leading to higher financial rewards. The aim of the QOF is to highlight priorities for improving patient care and provide incentives for GPs to drive up quality in these areas.82AECCD8, 399831Need to make every contact with patients countGPs and other health professionals should be encouraged and required to make every contact with patients count. Very few patients will cite obesity or weight management as the reason for seeing their GP, and will instead present with conditions that are clearly a result of weight issues. GPs should talk with their patients about weight in these instances. [1]109FDEF6, 399832GPs should measure waist circumferenceGPs should measure waist circumference rather than just BMI to help them identify patients who are most at risk and identify the indicators of poor health outcomes. [1]109FDEF6, 399840British Heart Foundation recommends at least 60 minutes every dayThe British Heart Foundation recommends that to maintain their health, children take part in a minimum of 60 minutes of at least moderate intensity physical activity every day. This could include PE lessons, but also swimming, dancing, cycling, most other sports and brisk walking, as well as active play. 1198CE71, 399841Quality and prevalence of physical activity in schools is variableThe Ofsted Physical Education report published in February 2013 found that the physical aspect of physical education was not doing enough to tackle sedentary lifestyles amongst children and young people,with teachers often spending too much time talking and not enough time getting children moving.1198CE71, 399972Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 23% of adults are obese—with a body mass index of over 30—61% of adults are either overweight or obese (with a BMI of over 25), and 33% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK economy has been estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179

BACKGROUND: A lack of physical activity and overconsumption of energy dense food is associated with overweight and obesity. The neighbourhood environment may stimulate or hinder the development and/or maintenance of a healthy lifestyle. To improve research on the obesogenicity of neighbourhood environments, reliable, valid and convenient assessment methods of potential obesogenic characteristics of neighbourhood environments are needed. This study examines the reliability and validity of the SPOTLIGHT-Virtual Audit Tool (S-VAT), which uses remote sensing techniques (Street View feature in Google Earth) for desk-based assessment of environmental obesogenicity.

METHODS: A total of 128 street segments in four Dutch urban neighbourhoods - heterogeneous in socio-economic status and residential density - were assessed using the S-VAT. Environmental characteristics were categorised as walking related items, cycling related items, public transport, aesthetics, land use-mix, grocery stores, food outlets and physical activity facilities. To assess concordance of inter- and intra-observer reliability of the Street View feature in Google Earth, and validity scores with real life audits, percentage agreement and Cohen's Kappa (k) were calculated.

RESULTS: Intra-observer reliability was high and ranged from 91.7% agreement (k = 0.654) to 100% agreement (k = 1.000) with an overall agreement of 96.4% (k = 0.848). Inter-observer reliability results ranged from substantial agreement 78.6% (k = 0.440) to high agreement, 99.2% (k = 0.579), with an overall agreement of 91.5% (k = 0.595). Criterion validity was substantial to high for most of the categories ranging from 87.3% agreement (k = 0.539) to 99.9% agreement (k = 0.887) with an overall score of 95.6% agreement (k = 0.747).

CONCLUSION:These study results suggest that the S-VAT is a highly reliable and valid remote sensing tool to assess potential obesogenic environmental characteristics.

This document outlines in the broadest sense the wide range of green spaces – from parks and gardens to city farms, country parks, woodlands and wildlife sites to play areas, allotments to urban plazas – and the range of benefits they bring, whether provided and managed by statutory agencies, local authorities or by community led and managed groups such as community gardens or ―Friends Of‖ groups. Throughout this document, when making general points, we use the shorthand phrase ―parks and green spaces‖ to represent the full spectrum of different and diverse green spaces that are available for communities to use and enjoy.

Many of the benefits provided by green spaces and highlighted in this document are equally applicable to streets where there are an abundance of street trees, permeable and well vegetated front and rear garden areas.

We suggest here that the benefits of green space provide a very cost effective means of promoting health and well-being, as well as a mechanism for increasing community and citizen involvement in volunteering. Imaginative use of green space also provides in many cases an excellent Social Return on Investment whilst increasing individual and community engagement.

Policies and changes to the built environment are promising targets for obesity prevention efforts and can be evaluated as 'natural'- or 'quasi'-experiments. This systematic review examined the use of natural- or quasi-experiments to evaluate the efficacy of policy and built environment changes on obesity-related outcomes (body mass index, diet or physical activity).

PubMed (Medline) was searched for studies published 2005-2013; 1,175 abstracts and 115 papers were reviewed. Of the 37 studies included, 18 studies evaluated impacts on nutrition/diet, 17 on physical activity and 3 on body mass index.

Nutrition-related studies found greater effects because of bans/restrictions on unhealthy foods, mandates offering healthier foods, and altering purchase/payment rules on foods purchased using low-income food vouchers compared with other interventions (menu labelling, new supermarkets).

Physical activity-related studies generally found stronger impacts when the intervention involved improvements to active transportation infrastructure, longer follow-up time or measured process outcomes (e.g. cycling rather than total physical activity), compared with other studies.

Only three studies directly assessed body mass index or weight, and only one (installing light-rail system) observed a significant effect. Studies varied widely in the strength of their design and studies with weaker designs were more likely to report associations in the positive direction.