Lithuanian Sports University e-Journals
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Breaking the Sitting Cycle: Albania’s School-Based Movement Revolution
Full text linkThe “Active Classrooms Albania” initiative was launched to reduce sedentary time and promote physical activity among primary school students, addressing rising levels of childhood obesity and physical inactivity. The project was implemented within the framework of the national Schools for Health programme, aligning with Strategic Objective 1.2 of Albania’s Health Promotion Action Plan 2030. The goal was to foster daily movement in classroom settings through short, structured activity breaks, requiring no additional equipment or time outside the curriculum.
The project was co-developed in 2022 by the Institute of Public Health, in partnership with the Ministry of Health, the Ministry of Education and Sports, and the Schools for Health initiative. The pilot targeted 10 public schools in Tirana and Durrës, selected for their active involvement in health-promotion activities. Stakeholder workshops involving teachers, public health experts, and child psychologists helped tailor the movement routines to classroom realities.
Teachers received training through the project training modules and a practical “Movement Breaks Toolkit”. Activities included stretching, yoga-based breathing, and energy-boosting mini-games, delivered 2–3 times per day during classroom hours. Schools designated a Focal Point to monitor implementation and coordinate between the health and education sectors.
Evaluation took place over six months, combining focus group discussions and observational tools. Key outcomes included:
· A 31% increase in daily moderate activity reported by students.
· 87% of teachers observed improved focus and participation post-activity breaks.
· No interference with academic delivery was reported, and classroom discipline improved.
Feedback indicated strong acceptance from both students and educators.
Following successful results, the initiative was scaled to an additional 25 schools during the 2023 academic year. Materials were incorporated into the national “Qendro Aktiv” platform, and recommendations for integrating movement breaks into national curricula have been submitted to the Ministry of Education.
Conclusion: The initiative demonstrates that integrating low-cost physical activity breaks into routine education is feasible, effective, and scalable. It enhances student engagement, reduces sedentary behaviour, and promotes cross-sectoral collaboration. The project contributes directly to Albania’s national strategy on non-communicable diseases prevention and can serve as a practical model for other low-resource European settings aiming to implement Schools for Health principles
Diet, Sex, and PA: An Evolutionary Perspective on Adipose Tissue Distribution
Full text linkPropose: A healthy lifestyle is essential for optimal body composition in non-adults. Physical activity (PA) and nutrition are two fundamental pillars of this lifestyle. However, certain dietary patterns may either mimic or counteract the benefits of PA, regardless of its intensity. This study aimed to determine whether adipose tissue accumulation is solely influenced by diet in physically active children/adolescents following a Westernised diet.
Methods: Thirty-three participants (boys/girls; 8–17-year-old) from Virginia (US) were assessed anthropometrically and evaluated for PA levels. Regional fat mass (LEGFM%, ARMFM%, and TRUNKFM%) was measured using Dual-Energy X-ray Absorptiometry. PA was recorded over 7-days with a triaxial accelerometer (ActiGraph), measuring moderate-to-vigorous PA (MVPA min/day), considering only ≥4 valid days (≥10 hours/day). Dietary intake was monitored for three days (2 weekdays, 1 weekend day) within the seven days. Protein (PRO% and PROg), fat (FAT% and FATg), carbohydrates (CHO% and CHOg), and total energy intake (EI; kcal/day) were calculated using NDSR software. Resting metabolic rate was measured, and total energy expenditure (TEE; kcal/day) was estimated by adding activity energy expenditure from ActiGraph. Energy balance (EB) was calculated by subtracting EI from TEE.
Stepwise multiple regression analyses were performed to assess the influence of age, body mass (BM), height (H), sex, and MVPA on each fat mass distribution, and the residuals from each analysis were correlated with PRO%, PROg, FAT%, FATg, CHO%, CHOg, EI, and EB.
Results: Our sample exhibited high PA levels (145 MVPA min/day). Macronutrient intake averaged 36.18 FAT%, 48.64 CHO%, and 14.83 PRO%. BM, H, and MVPA min/day (p < 0.01) accounted for 66.58% and 60.29% of the variability only in LEGFM% and ARMFM%. Residual LEGFM% was significantly correlated with CHOg (Adj. R2 = 58.52; p = 0.0014). This relationship was observed only in girls, where lower CHOg intake was linked to higher FATg, with no significant findings in boys.
Conclusion: Regardless of other factors – including high PA – lower CHO intake relative to FAT in girls is linked to increased LEGFM%. Absent in boys, this pattern suggests a female-specific predisposition. From an evolutionary and reproductive ecology perspective, this could represent an adaptive mechanism to store energy in a riskless area, preparing for future reproductive demands
From Checkups to Change: Longitudinal Changes in Lifestyle-Related Factors and Health Following Repeated Occupational Health Assessments
Full text linkPurpose: This study investigated how changes in body weight, perceived health, and exercise frequency varied in relation to time between health profile assessments (HPAs), the number of performed HPAs, and individual characteristics. We hypothesised that frequent HPAs, with shorter intervals, would be associated with more positive outcomes.
Methods: A cohort of 106,005 employees who completed at least two HPAs from 1990 to 2021 was analysed. Baseline age, sex, education, occupation, and baseline values of weight, perceived health, and exercise were included as predictors. Machine learning models (XGBoost) evaluated predictors of change for each outcome. Performance was assessed using root mean squared error, mean absolute error, and R-squared. Model interpretation was aided by SHapley Additive exPlanations and Forward Marginal Effects to examine dose–response relationships and subgroup differences.
Results: All models demonstrated relatively low predictive performance, suggesting that the included predictors did not capture substantial variance in outcomes. Nonetheless, a longer time between HPAs was associated with greater weight gain, while more frequent HPAs predicted slight reductions in weight gain, as well as modest improvements in perceived health and exercise frequency. According to model-derived SHAP values, the mean weight change from year 1 to 5 increased by 0.98, perceived health decreased by 0.21, and exercise frequency decreased by 0.31. Moreover, individuals who received 4–6 HPAs, compared to those who received only two, experienced a –0.10 difference in weight change, a 0.09 improvement in perceived health, and a 0.17 increase in exercise frequency. Subgroup analyses showed younger age groups had larger weight increases, while those with higher education displayed smaller declines in exercise.
Conclusion: Frequent and regular HPAs may play a role in enhancing workplace health promotion by contributing to modest improvements in weight, perceived health, and exercise
How Does Physical Activity Frequency Affect Mental Health in Lithuanian Adolescents
Full text linkPurpose: To examine the relationship between physical activity frequency and mental health among adolescents in Lithuania.
Methods: This cross-sectional study analysed data from the 2018 Lithuanian HBSC survey, including 3,124 adolescents (52.98% girls; mean age = 13.78 ± 1.66 years). Physical activity was measured as the number of days per week with at least 60 minutes of physical activity. Mental health was assessed via life satisfaction (0–10 scale) and subjective health complaints (8 items; 0–32 scale). Adjusted marginal means were obtained from generalised linear mixed models controlling for age, sex, socioeconomic status, BMI, dietary habits (i.e. consumption of fruits, vegetables, sweets, and sugary drinks), and eating patterns (i.e. frequency of breakfast consumption and family meals), with country-level variation included as a random effect.
Results: Higher frequency of physical activity was associated with lower scores on subjective health complaints (unstandardised coefficient [B] = –0.20; 95% confidence interval (CI) = –0.32 to –0.08). Differences in marginal means were observed from three days of physical activity (mean = 7.81; 95% CI = 7.27 to 8.35) compared to zero days (mean = 10.10; 95% CI = 8.88 to 11.33). For life satisfaction, physical activity frequency was positively associated with the outcome (B = 0.09; 95% CI = 0.06 to 0.12), with higher mean scores at six (mean = 8.21; 95% CI = 8.04–8.39) and seven days (mean = 8.15; 95% CI = 8.00–8.29) compared to one (mean = 7.47; 95% CI = 7.17–7.77) or two days (mean = 7.63; 95% CI = 7.44–7.83) of reported physical activity (p < 0.05).
Conclusion: The findings indicate that higher self-reported physical activity frequency is associated with more favourable indicators of mental health among Lithuanian adolescents, particularly in terms of lower subjective health complaints and higher life satisfaction. These findings highlight the need to promote regular physical activity as a public health strategy which correlates with physical and mental health. Public policies should encourage daily physical activity programmes in schools and communities to enhance youth wellbein
Is Curriculum-Based Outdoor Education Associated With Physical Activity Among School-Aged Children?
Full text linkPurpose: Physical activity (PA) among children has decreased in recent decades, raising serious health concerns. Integrating more movement into the school day has been suggested as a method of promoting PA. In this study we investigated the association between curriculum-based outdoor education (OE) and PA among school-aged children, focusing on total PA (TPA) and time spent in different intensities of PA on weekdays, weekend days, during schooltime, leisure time on weekdays, and as daily average.
Methods: This cross-sectional study is part of the LärMiljö (Learning Environment) study, conducted in Swedish-language primary schools (grades 3–6, ages 9–13 years) in seven municipalities in Finland. Data were collected in 2021–2023 from 260 children, their caregivers, and class teachers. Children’s PA was measured for seven consecutive days using hip-worn accelerometers (ActiGraph). The use of OE was reported by the class teacher in an electronic logbook on the same days as the children wore accelerometers. Sociodemographic characteristics were reported by children and caregivers in questionnaires. Linear regression analyses were conducted adjusting for gender, grade, accelerometer wear days, physical education during study period, season of participation, and socioeconomic status.
Results: Of the children participating in the study, 200 (77%) met the criteria for valid device-based PA data and teacher-reported OE data and were included in the analyses. Approximately half (52%) of them had no OE during the study period, whereas the other half had 25–335 minutes of OE. The fully adjusted regression models showed that a higher amount of OE was associated with more moderate-to-vigorous PA (MVPA) as daily average and during schooltime, lighter PA (LPA) and TPA on weekend days, but less LPA during schooltime. In girls, a higher amount of OE was also associated with more TPA during schooltime, and more MVPA and TPA on weekdays.
Conclusion: The findings highlight the potential of integrating OE into teaching to promote PA in school-aged children. In addition, our results suggest that girls may benefit even more than boys from participating in OE in terms of PA.
Support/Funding Source: Folkhälsan Research Center, The Swedish Cultural Foundation in Finland, Stiftelsen Eschnerska Frilasarettet sr Foundation
MOVING for Health: Connecting Physical Literacy and Health Literacy in Four Settings (Schools, Sports Clubs, Communities, Health Centres)
Full text linkThe EU-funded “MOVING for Health” (MfH) project aims to connect physical and health literacy by offering tools, knowledge, and information to promote healthy lifestyles. Since no existing model fully integrates these two literacies, the project addresses this gap by connecting individuals (teachers, trainers, health providers, community developers) and organisational settings (schools, sports clubs, health centres, local communities).
The purpose of the project was to connect physical and health literacies, develop a MOVING for Health model and test the model through a cohort of experienced practitioners from four settings (schools, sports clubs, health centres, and local communities) in Sweden, Spain, and Slovenia.
The MfH initiative was developed based on research and analysis of existing resources, good practices, and principles in the fields of health and physical literacy. These principles acted as basis for the development of an online training tool allowing practitioners to use the tool in four languages: English, Spanish, Slovenian, and Swedish. The tool supports a holistic approach to HEPA promotion, equipping practitioners with skills to support students/pupils, clients/patients, sports club members, and citizens.
The MfH model is currently being tested in three countries (Slovenia, Spain, and Sweden) and in four different settings (schools, sports clubs, health centres, and local communities) to assess how it is understood. The results will provide evidence-based insights that can inform future HEPA policies at both national and European levels.
While a European network of project partners has already been established, efforts continue to expand this network across Europe to exchange knowledge and experiences.
Through international testing of the online tool, the project offers practical guidance for both practitioners and policymakers. Key outcomes include a research report, guiding principles, good practices, a training tool, and an online platform to support ongoing collaboration and knowledge sharing: https://movingforhealth.isca.org/project
Personalised Physical Activity Promotion in Patients With Osteoarthritis Using a Smartphone-Based Solution: The PIANISSIMO Study
Full text linkPurpose: Osteoarthritis is one of the most prevalent musculoskeletal disorders. Physical activity is recommended by international organisations (e.g. European Alliance of Association for Rheumatology [EULAR]) as an effective tool to improve quality of life and reduce disease-related pain in osteoarthritis patients. Yet, these patients often do not meet the levels of physical activity recommended by the World Health Organization (i.e. 7,500 steps/day for patients with chronic diseases). The PIANISSIMO study aims to test adherence and retention of patients with osteoarthritis to a 6-month intervention for the promotion of physical activity using a dedicated mobile application. Furthermore, the study aims to explore the interrelationship between physical activity and pain.
Methods: PIANISSIMO is an innovative intervention based on the ‘Capability, Opportunity, Motivation Behaviour change’ (COM-B) theory. As such, the intervention includes several behaviour change techniques such as weekly steps/day personal goal setting, feedback on performance (daily steps), as well as daily population-tailored notifications about practice opportunities, and physical activity benefits on osteoarthritis and general health. The intervention is delivered through an eponym mobile application, which also collects data, including demographic data, connection logs, daily steps, and weekly pain questionnaires (pain intensity and location). Osteoarthritis patients are recruited thought social media and flyers distribution. Linear mixed model will be used to investigate the influence of daily step counts on pain over the subsequent days.
Results: Forty patients living or working in Luxembourg have been included in the study so far. Descriptive statistics will present demographic data of the population, adherence to the intervention using the number of logins per week, and retention (illustrated as the number of drop-outs over time on a Kaplan–Meier graph). Preliminary data on the association between daily step counts and pain will also be presented.
Conclusion: In order to maximise adherence and retention of the patients to the application, clinicians (i.e. orthopaedic physician, physiotherapists), policy makers (Physical activity representative of the Luxembourg’s Ministry of Health), and patient associations were involved in the creation of the intervention. The PIANISSIMO application is an innovative tool to help osteoarthritis patients reach physical activity recommendations, supporting physicians in patient follow up
Physical Activity Monitoring in Portugal: Looking for a Surveillance System
Full text linkPurpose: This study aimed to analyse the state-of-play of physical activity (PA) surveillance in Portugal. Studies assessing population-level PA were evaluated for their potential to be considered PA surveillance systems (SS) based on their compliance with defined quality criteria.
Methods: A literature search was conducted to identify studies assessing population-level PA in Portugal. Ten quality criteria for PA SS were defined: 1) use of a scientifically validated instrument; 2) repeated measurements over time; 3) assessment of all age groups across the lifespan; 4) use of a nationally representative sample; 5) combination of self-reported data (questionnaires) with objective measures (accelerometers); 6) assessment of PA contexts; 7) collection of sedentary behaviour data; 8) use of the World Health Organization’s cut-off points for sufficient PA levels; 9) interpretation of results based on sociodemographic variables; and 10) public accessibility and dissemination of results. Identified studies were evaluated for compliance with these criteria.
Results: Ten studies were identified and assessed. None of the studies met all quality criteria. Criteria 1) was met by 90% of the studies; 2) 80%; 3) 0%; 4) 50%; 5) 10%; 6) 80%; 7) 100%; 8) 30%; 9) 100%; 10) 100%.
Conclusion: A considerable number of studies assess PA levels in the Portuguese population, some within similar contexts but using different methodologies, leading to inconsistent and difficult-to-compare results. The quality assessment framework used may be applied in other countries to evaluate their data sources. If applied across countries, this framework could support the harmonisation of surveillance practices and enhance comparability, while also contributing to broader international monitoring efforts. In both Portugal and internationally, addressing the identified gaps (specially criteria 3, 4, 5, and 8) is essential to improve PA monitoring. These findings highlight the urgent need for a unified SS to monitor PA in Portugal, enabling more effective evaluation of health promotion policies.
Support/Funding Source: FCT – Fundação para a Ciência e a Tecnologia [Foundation for Science and Technology], UIDB/04750/2020 and LA/P/0064/2020
Profiles of “Health Path” Users and Their Physical Activity Patterns
Full text linkPurpose: Promoting physical activity through urban infrastructures is a major public health priority. In Anglet (France), the “Health Paths” (locally known as “Chemins de la Forme”) are designed to encourage health-enhancing physical activity among residents. This study assesses their impact, focusing on differences between users and non-users across activity intensities.
Methods: A cross-sectional study was conducted with 257 participants (age mean: 47.4 years, 51% women) living in Anglet and surrounding areas. Participants completed a validated 15-minute questionnaire (IPAQ-SV) measuring weekly physical activity across light (LPA), moderate (MPA), and vigorous (VPA) intensities. Group comparisons (users vs non-users of the “Health Paths”) were performed using non-parametric tests (Wilcoxon–Mann–Whitney, Chi-Square) and regression analyses explored factors associated with activity levels, controlling for socio-demographic variables.
Results: Among participants, 234 (91%) reported a regular weekly use of “Health Paths”. The primary motivation reported was to improve health. Users demonstrated higher LPA (782 vs 604 METs-min/week-1, p = 0.172) and MVPA (1,538 vs 1,264 METs-min/week-1, p = 0.102) compared to non-users, although these differences were not statistically significant. However, regression analyses highlighted that frequency of use was positively associated with overall physical activity (β = 0.138, p = 0.002) and LPA (β = 0.181, p = 0.007) but not with MVPA (β = 0.123, p = 0.106).
Conclusion and Implications: While the “Health Paths” effectively increase LPA, they do not significantly increase MVPA levels, which are critical for maximising health benefits according to WHO guidelines. These findings underscore the need for complementary strategies to promote MVPA, aligning with existing literature advocating for multi-level interventions.
Support/Funding Source: None.
Keywords: Urban environment, energy expenditure, public healt
Profiles of Physical Activity and Competence in Children: Associations With Bullying and Peer Context in the Classroom
Full text linkPhysical activity and motor competence are not only critical for children’s physical health but are also associated with social integration and emotional wellbeing. Children who are physically competent and engaged in regular physical activity are often perceived more positively by their peers, while those with lower activity levels or motor skills may experience social exclusion or bullying. This study explores how profiles based on cardiorespiratory fitness, motor competence, perceived sport and physical competence, and device-measured physical activity relate to bullying experiences and the perceived classroom peer context (CRPC).
This cross-sectional study aimed to create profiles based on cardiorespiratory fitness, motor competence, perceived sport and physical competence, and device-measured physical activity, and to examine their association with being bullied and perceived CRPC. All variables were assessed in 339 Finnish schoolchildren. Latent profile analysis was used to identify the profiles. Regression models were employed to analyse the likelihood of being bullied and ANOVA was conducted to examine the differences in CRPC across the profiles
Three profiles were identified: highly physically active and competent, moderately physically active and competent, and poorly physically active and competent. Children in the poorly physically active and competent profile were 3.8 times more likely to be bullied than children in the highly physically active and competent profile, and 2.2 times more likely to be bullied than children in the moderately physically active and competent profile. Also, children in poorly physically active and competent profile reported the lowest levels of peer acceptance and social support.
This study highlights the significant role of physical activity and competence profiles in shaping children’s experiences with bullying, social support, and peer acceptance. Children with lower physical activity and competence were most likely to be bullied and reported the lowest levels of peer acceptance and social support. These findings underscore the importance of fostering an inclusive and supportive peer environment, as well as encouraging physical activity in children, to enhance both their physical wellbeing and social integration within the classroom.
Support/Funding Source: Academy of Finland: The Strategic Research Council