Introduction: A neighbourhood’s environmental characteristics can positively or negatively influence health and well-being. To date, no studies have examined this concept in the context of Saudi Arabian youth. Therefore, this study aimed to evaluate the association between a neighbourhood’s environmental characteristics and health risk factors among Saudi Arabian youth. Methods: A total of 335 secondary-school students (175 males, 160 females), aged 15–19 years old, participated. Body mass index (BMI) and waist circumference measurements were taken, and physical activity (steps) was measured via pedometer. The perceived neighbourhood environment was assessed using the International Physical Activity Questionnaire Environment Module (IPAQ-E). Results: Significant differences were found between the youths from urban, rural farm, and rural desert locations in terms of BMI, waist circumference, daily steps, accessibility, infrastructure, social environment, household vehicles, safety, and access to facilities (p < 0.001). Rural desert youths were less active, and males (26.43 + 8.13) and females (24.68 + 5.03) had higher BMIs compared to the youths from other areas. Chi-square analysis revealed a significant difference (χ21 = 12.664, p < 0.001) between the genders as to social-environment perceptions. Males perceived their neighbourhood as a social environment more than was reported by females (68.39% and 50.28%, respectively). Pearson’s correlation revealed negative significant relationships between steps and both safety of neighbourhood (r = −0.235, p < 0.001) and crime rate (r = −0.281, p < 0.001). Discussion: Geographical location, cultural attitudes, lack of facilities, and accessibility impact youth physical-activity engagement and weight status; this includes environmental variables such as residential density, neighbourhood safety, household motor vehicles, and social environment. Conclusions: This is the first study examining associations with neighbourhood environments in the youths of the Kingdom of Saudi Arabia. Significant associations and geographical differences were found. More research and policy interventions to address neighbourhoods’ environmental characteristics and health risk factors relative to Saudi Arabian youth are warranted.

Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group.

Despite the breadth of health benefits associated with regular physical activity (PA), many children in the UK are not sufficiently active enough to meet health guidelines, and tend to become less active as they mature into and throughout adolescence. Research has indicated that children’s school, home and neighbourhood environments can all significantly influence their opportunities to engage in moderate-to-vigorous physical activity (MVPA). However, less is known about how children’s MVPA patterns within these key environments may change across the school year. The current mixed-methods case study aims to explore this issue by tracking key stage 2 (KS2) and key stage 3 (KS3) children’s MVPA patterns across the school year. Fifty-eight children (29 boys, 29 girls, KS2 = 34, KS3 = 24) wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days in the first term of school (autumn), before these measurements were repeated in the two remaining school terms (winter–summer). A subsample of children (n = 6–8 per group) were invited to take part in one of six focus groups each term to further explore their PA behaviours and identify the barriers and facilitators to PA. The children’s MVPA was significantly lower (p = 0.046) in term 2 (winter/spring term) than during the warmer terms (autumn and summer). All the locations showed reductions in MVPA in term 2, except indoor MVPA, which increased, and MVPA on foot in the neighbourhood, which remained consistent. Focus groups revealed location, friends, and the variety of options to be associated with MVPA, and poor weather, parental permission, and time limitations to be barriers to MVPA. This mixed-methodological, repeated-measures design study highlights differences in the activity patterns and perceptions of children over the school year. Future studies should implement longitudinal, multi-method approaches to gain deeper insight into how children’s PA behaviours differ over time. Consequently, this can inform future health policies promoting children’s PA throughout the year.

The school environment is ideally placed to facilitate physical activity (PA) with numerous windows of opportunity from break and lunch times, to lesson times and extracurricular clubs. However, little is known about how children interact with the school environment to engage in PA and the other locations they visit daily, including time spent outside of the school environment i.e., evening and weekend locations. Moreover, there has been little research incorporating a mixed-methods approach that captures children’s voices alongside objectively tracking children’s PA patterns. The aim of this study was to explore children’s PA behaviours according to different locations. Sixty children (29 boys, 31 girls)—35 key stage 2 (aged 9–11) and 25 key stage 3 (aged 11–13)—wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days. A subsample of children (n = 32) were invited to take part in one of six focus groups to further explore PA behaviours and identify barriers and facilitators to PA. Children also completed a PA diary. The KS2 children spent significantly more time outdoors than KS3 children (p = 0.009). Boys engaged in more light PA (LPA) when on foot and in school, compared with girls (p = 0.003). KS3 children engaged in significantly more moderate PA (MPA) at school than KS2 children (p = 0.006). Focus groups revealed fun, enjoyment, friends, and family to be associated with PA, and technology, costs, and weather to be barriers to PA. This mixed methodological study highlights differences in the PA patterns and perceptions of children according to age and gender. Future studies should utilize a multi-method approach to gain a greater insight into children’s PA patterns and inform future health policies that differentiate among a range of demographic groups of children.

Background The co-occurrence of unhealthy lifestyles, calls for interventions that target multiple health behaviours. This study investigates the clustering of health behaviours and examines demographic differences between each cluster. Methods In total, 934 adults from Queensland, Australia completed a cross-sectional survey assessing multiple health behaviours. A two-step hierarchical cluster analysis using multiple iterations identified the optimal number of clusters and the subset of distinguishing health behaviour variables. Univariate analyses of variance and chi-squared tests assessed difference in health behaviours by socio-demographic factors and clusters. Results Three clusters were identified: the 'lower risk' cluster (n = 436) reported the healthiest profile and met all public health guidelines. The 'elevated risk' cluster (n = 105) reported a range of unhealthy behaviours such as excessive alcohol consumption, sitting time, fast-food consumption, smoking, inactivity and a lack of fruit and vegetables. The 'moderate risk behaviour' cluster (n = 393) demonstrated some unhealthy behaviours with low physical activity levels and poor dietary outcomes. The 'elevated risk' cluster were significantly younger and more socio-economically disadvantaged than both the 'lower and moderate risk' clusters. Discussion Younger people who live in more deprived areas were largely within the 'elevated risk' cluster and represent an important population for MHBC interventions given their wide range of unhealthy behaviours.

BACKGROUNDIncreasingly the health impacts of physical inactivity are being distinguished from those of sedentary behavior. Nevertheless, deleterious health prognoses occur when these behaviors combine, making it a Public Health priority to establish the numbers and salient identifying factors of people who live with this injurious combination.METHODSUsing an observational between-subjects design, a nonprobability sample of 22,836 participants provided data on total daily activity. A 2-step hierarchical cluster analysis identified the optimal number of clusters and the subset of distinguishing variables. Univariate analyses assessed significant cluster differences.RESULTSHigh levels of sitting clustered with low physical activity. The Ambulatory & Active cluster (n = 6254) sat for 2.5 to 5 h·d(-1) and were highly active. They were significantly younger, included a greater proportion of males and reported low Indices of Multiple Deprivation compared with other clusters. Conversely, the Sedentary & Low Active cluster (n = 6286) achieved ≤60 MET·min·wk(-1) of physical activity and sat for ≥8 h·d(-1). They were the oldest cluster, housed the largest proportion of females and reported moderate Indices of Multiple Deprivation.CONCLUSIONSPublic Health systems may benefit from developing policy and interventions that do more to limit sedentary behavior and encourage light intensity activity in its place.

The negative health consequences of physical inactivity are independent from those of sedentary behaviour. However,injurious health prognoses occur when these behaviours coalesce. Whilst physical inactivity and sedentary behaviour are irreducible components of modern lifestyles, the evidence base connecting the two behaviours is limited.Aggregating our knowledge of how these behaviours cluster and who they cluster with may facilitate the development of more effective policy and intervention. PURPOSE: This study investigates how physical activity and sedentary behaviour cluster. It further examines how individuals cluster through shared behaviours and characteristics. METHODS: A non-probability sample of 22,836 participant’s self-reported demographics and completed the International Physical Activity Questionnaire (IPAQ). Using an observational between-subjects design, a 2-step hierarchical cluster analysis identified the optimal number of clusters and the subset of distinguishing variables. Univariate analyses assessed significant cluster differences. RESULTS: A three cluster solution was identified. There were 27.7% (n=6,254) of participants assigned to cluster 1 (Ambulatory& Active), 44.4% (n=10,028) of participants within cluster 2 (Moderation) and 27.9% (6,286) of participants allocated to cluster 3 (Sedentary& Low Active). The ‘Ambulatory& Active’ (n=6,254) cluster sat for 2.5 to 5 hours daily and were highly active. In comparison, the ‘Sedentary& Low Active’ cluster (n=6,286) achieved ≤60 MET.min.wk-1 of physical activity and sat for ≥8 hours daily. CONCLUSIONS:This study adopted an original approach to understanding how people can be classified according to similarities in physical activity and sedentary behaviour. Data indicated that high levels of sedentary behaviour, determined by sitting time, clustered with low levels of physical activity. Importantly, the clusters can be distinguished conceptually and are likely to respond differently to varying approaches and/or interventions; therefore they are amenable to Public Health campaigns. Given the associated health implications, policy or intervention that is responsive to ‘Sedentary & Low Active’ group’s needs is not only a major Public Health challenge, but a best buy.

School recess provides children with an important opportunity to participate in regular physical activity (PA). Previous literature has called for the utilisation of advanced tracking systems (such as GPS) to be combined with direct observation assessments to enhance current understanding of the influences on young people’s school-based PA patterns. PURPOSE: To investigate the effects of implementing schoolyard modifications on children’s PA patterns during recess, by utilising an innovative methodological approach. METHODS: A quasi-experimental intervention study was conducted in 3 elementary schools from Central England (UK) involving 77 children (43 M; 34 F). Children wore integrated GPS and heart-rate devices during school recess periods on 4 consecutive weekdays on 3 separate occasions (pre-intervention baseline; 1 month after installation; 3.5 months after installation). The ‘System for Observing Play and Leisure Activity in Youth’ was utilised to observe the PA levels of all users of the playground. Schoolyard interventions were conducted in School 1 whereby a multi-use games area (MUGA) was installed, and in school 2 a climbing wall and trim trail were installed. Repeated measures ANOVA compared the recess PA levels of children across the 3 testing stages. RESULTS: There were significant differences in the recess moderate-to-vigorous PA (MVPA) levels of children between the 3 testing stages within school 1 (p=0.021), and school 2 (p=0.030), but not within the control group (p>0.05). The installation of the MUGA within school 1 enhanced playground space management and caused a significant short-term positive effect on males’ recess MVPA between baseline (15mins MVPA) and testing stage 2 (28mins MVPA), but not stage 3 (18mins MVPA). The introduction of trim-trails and climbing walls within school 2 promoted a significant longer term increase in females’ MVPA (from 8.75mins in stage 1 to 12.41mins in stage 3). CONCLUSION: The study provided an insight into how the implementation of different schoolyard facilities can have a varying effect on the PA patterns of males and females, the intensity of children’s PA and the longevity of the intervention impact. Future research needs to explore the impact of specific schoolyard facilities on promoting PA within traditionally ‘less active groups’ of children.

Objectives To compare the anthropometric and lifestyle characteristics of active and inactive adolescents in Saudi Arabia and Britain. Methods A school‐based cross‐sectional study was conducted at four cities in Saudi Arabia (Riyadh and Al‐Khobar; N = 1,648) and Britain (Birmingham and Coventry; N = 1,158). The participants (14‐ to 18‐year‐olds) were randomly selected using a multistage stratified cluster sampling. Measurements included anthropometric [BMI, Waist circumference (WC), Waist to height ratio], screen time, validated physical activity questionnaire and dietary habits. Results British males were lighter ( P = 0.04, 64.4 vs. 68.2 kg), and had lower values for WC ( P = 0.003, 77.1 vs. 78.7 cm) than Saudi males. Males ( P = 0.0001) were significantly more active than females but the difference between inactive Saudi and British females was greater than that between inactive Saudi and British males. Being female was significantly ( P < 0.001) associated with lower activity levels in both the Saudi and British adolescents. Having lower frequency of fruit intake was significantly ( P < 0.001) associated with lower activity levels, whereas increased frequency of consumption of French fries/potato chips was significantly ( P = 0.008) associated with increased activity levels in Saudi adolescents. Among British adolescents, lower frequency of breakfast was ( P = 0.045) associated with lower activity levels, increased frequency of consumption of sweetened beverages was significantly ( P = 0.005) associated with higher activity levels. Higher energy drinks intake frequency was significantly ( P = 0.007) associated with higher activity levels. Conclusion The present study identifies crosscultural differences and similarities in lifestyle habits in adolescents from Britain and Saudi Arabia. Activity status (active vs. inactive) appears to play an important role in other lifestyle related behaviors, with active adolescent more likely to engage in healthy dietary behavior than their inactive peers, irrespective of country of origin. Am. J. Hum. Biol. 26:635–642, 2014. © 2014 Wiley Periodicals, Inc.

Objectives: Obesity is a leading risk factor for global mortality, promoted by poor dietary habits and sedentary behaviour. This study explores the clustering and differences in dietary habits, body mass index (BMI) and physical activity (PA) amongst youth from United Kingdom (UK) and Saudi Arabia (SA). Methods: 2290 males and females aged 15-17 years completed a self-report questionnaire and an objective measure of BMI. Results: Youth from SA had a higher prevalence of overweight/obesity and lower levels of PA than youth from the UK. Males were more physically active than females across both countries. Three clusters were identified: a "high risk" cluster with least healthy dietary habits, low PA and high BMI; a "moderate cluster" with moderate healthy dietary habits, PA and BMI; a "low risk" cluster with healthiest dietary habits, greatest PA and the lowest BMI compared to the other clusters. There were more SA youth in the high and moderate risk clusters compared to UK youth. Conclusions: Exploring cross-cultural and demographic characteristics of youth enables the identification of similarities and differences that might lead to the development of universal intervention strategies.

Background:Active school commuting is widely regarded as a key opportunity for youth to participate in physical activity (PA). However, the accurate measurement of the commute home from school and its contribution to total free-living moderateto- vigorous PA (MVPA) is relatively unexplored.Methods:Seventy-five adolescents (38 males, 37 females) wore an integrated GPS and heart rate device during after-school hours for 4 consecutive weekdays.Results:Active commuters were significantly more active (11.72 minutes MVPA) than passive commuters (3.5 minutes MVPA) during their commute home from school (P = .001). The commute home of walkers and cyclists on average contributed 35% of their total free-living PA. However, there was no significant difference in the overall free-living PA levels of passive and active commuters (P > .05). A total 92.7% of the youth living within 1.5 miles of the school actively commuted, compared with 16.7% of the youth who lived further away. Socioeconomic differences in commuting patterns were also evident.Conclusions:The findings highlighted the significant proportion of total free-living PA that was attributed to active commuting home from school. The study demonstrates the usefulness of utilizing GPS and heart rate data to accurately track young people’s after-school PA. Demographic influences and implications for future research are discussed.

This study investigated the cross-cultural differences and similarity in health behaviors between Saudi and British adolescents. A school-based cross-sectional study was conducted at four cities in Saudi Arabia (Riyadh and Al-Khobar; N = 1,648) and Britain (Birmingham and Coventry; N = 1,158). The participants (14–18 year-olds) were randomly selected using a multistage stratified cluster sampling technique. Measurements included anthropometric, screen time, validated physical activity (PA) questionnaire and dietary habits. The overweight/obesity prevalence among Saudi adolescents (38.3%) was significantly (p < 0.001) higher than that found among British adolescents (24.1%). The British adolescents demonstrated higher total PA energy expenditure than Saudi adolescents (means ± SE = 3,804.8 ± 81.5 vs. 2,219.9 ± 65.5 METs-min/week). Inactivity prevalence was significantly (p < 0.001) higher among Saudi adolescents (64%) compared with that of British adolescents (25.5%). The proportions of adolescents exceeding 2 h of daily screen time were high (88.0% and 90.8% among Saudis and British, respectively). The majority of Saudi and British adolescents did not have daily intakes of breakfast, fruit, vegetables and milk. MANCOVA showed significant (p < 0.05) gender by country interactions in several lifestyle factors. There was a significant (p < 0.001) gender differences in the ratio of physical activity to sedentary behaviors. In conclusion, Saudi and British adolescents demonstrated some similarities and differences in their PA levels, sedentary behaviors and dietary habits. Unhealthy lifestyle behaviors among adolescents appear to be a cross-cultural phenomenon.

Purpose. The aims of this study were to explore the lifestyle of young people living in Al-Ahsa Governorate; to investigate differences due to gender, age, school type, and geographical location. Methods. 1270 volunteered youth (15–19 years) completed a self-report questionnaire that contained 47 items relating to patterns of physical activity (PA), sedentary activity, and eating habits. The questionnaire allows the calculation of total energy expenditure in metabolic equivalent (MET-min) values per week. Results. Significant differences in the PA levels of youth were evident with regard to gender, geographical areas, and type of school. Also, normal weight males reported the highest levels of PA compared to overweight and obese. Conclusions. Youth living in rural desert were less physically active than those living in urban or rural farm environments. Youth of “normal” weight were more active than obese. Males were more active than females and PA levels appeared to decline with age.

This study explores differences in weight status, obesity and patterns of physical activity (PA) in relation to gender and age of youth from two culturally, environmentally and geographically diverse countries, the United Kingdom (UK) and Saudi Arabia (SA). A total of 2,290 males and females (15–17 years) volunteered to participate in this study. Participants completed a validated self-report questionnaire that contained 47 items relating to patterns of PA, sedentary activity and eating habits. The questionnaire allows the calculation of total energy expenditure in metabolic equivalent (MET-min) values per week. Significant differences in percentage of overweight/obese and levels of PA were evident between the youth from the two countries, with males being generally more physically active than females. Additionally, there were significant associations between Body Mass Index (BMI), PA and sedentary behaviors; the youth with higher BMI reported lower levels of PA and higher amounts of sedentary time. These findings highlight the diverse nature of lifestyle of youth living in different geographical areas of the world and the need for further research to explore the socio-cultural factors that impact on the prevalence of obesity and patterns of PA of youth in different populations.

The built environment in which young people live has a significant influence on their physical activity (PA). However, little is known regarding how youth from suburban and rural settings utilise their surrounding environments to participate in free-living PA. 50 adolescents aged 13–14 years old (22 rural; 28 suburban) wore an integrated GPS and heart rate device during non-school hours and completed a daily PA diary over 7 days. Descriptive statistics and analyses of variance were used to explore differences in the amount and location of moderate-to-vigorous physical activity (MVPA) between genders and youth from different geographical settings. Suburban youth participated in significantly (p = 0.004) more daily PA (52.14 minutes MVPA) and were more extensive in their utilisation of their surroundings, compared to rural youth (26.61 minutes MVPA). Suburban youth visited more public recreational facilities and spent significantly more time outdoors and on local streets (109.71 minutes and 44.62 minutes, respectively) compared to rural youth (55.98 minutes and 17.15 minutes, respectively) during weekdays. Rural youth on average spent significantly more time within the home (350.69 minutes) during weekends compared to suburban youth (214.82 minutes). Rural females were the least active group of adolescents, participating in the least amount of daily PA (20.14 minutes MVPA) and spending the least amount of time outdoors (31.37 minutes) during weekdays. Time spent outdoors was positively associated with PA. The findings highlight the disparity in PA levels and the utilisation of the surrounding built environment between youth from two different geographical settings and possible environmental causes are discussed. The study supports the use of GPS (combined with other methods) in investigating geographical differences in young people's PA and movement patterns. This method provides a wealth of information that may assist future policies and interventions in identifying environmental characteristics that promote PA in youth from different geographical settings.