SALLIS, J. F., J. J. PROCHASKA, and W. C. TAYLOR. A review of correlates of physical activity of children and adolescents. Med. Sci. Sports Exerc., Vol. 32, No. 5, pp. 963‐975, 2000. Background: Understanding the factors that influence physical activity can aid the design of more effective interventions. Previous reviews of correlates of youth physical activity have produced conflicting results. Methods: A comprehensive review of correlates of physical activity was conducted, and semiquantitative results were summarized separately for children (ages 3‐12) and adolescents (ages 13‐18). The 108 studies evaluated 40 variables for children and 48 variables for adolescents. Results: About 60% of all reported associations with physical activity were statistically significant. Variables that were consistently associated with children’s physical activity were sex (male), parental overweight status, physical activity preferences, intention to be active, perceived barriers (inverse), previous physical activity, healthy diet, program/facility access, and time spent outdoors. Variables that were consistently associated with adolescents’ physical activity were sex (male), ethnicity (white), age (inverse), perceived activity competence, intentions, depression (inverse), previous physical activity, community sports, sensation seeking, sedentary after school and on weekends (inverse), parent support, support from others, sibling physical activity, direct help from parents, and opportunities to exercise. Conclusion: These consistently related variables should be confirmed in prospective

A review of correlates of physical activity of children and adolescents.

The purpose of this report is to provide revised standards and guidelines for the exercise testing and training of individuals who are free from clinical manifestations of cardiovascular disease and those with known cardiovascular disease. These guidelines are intended for physicians, nurses, exercise physiologists, specialists, technologists, and other healthcare professionals involved in exercise testing and training of these populations. This report is in accord with the “Statement on Exercise” published by the American Heart Association (AHA).1

These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training.2 An update of background, scientific rationale, and selected references is provided, and current issues of practical importance in the clinical use of these standards are considered. These guidelines are in accord with the American College of Cardiology (ACC)/AHA Guidelines for Exercise Testing.3

### The Cardiovascular Response to Exercise

Exercise, a common physiological stress, can elicit cardiovascular abnormalities that are not present at rest, and it can be used to determine the adequacy of cardiac function. Because exercise is only one of many stresses to which humans can be exposed, it is more appropriate to call an exercise test exactly that and not a “stress test.” This is particularly relevant considering the increased use of nonexercise stress tests.

### Types of Exercise

Three types of muscular contraction or exercise can be applied as a stress to the cardiovascular system: isometric (static), isotonic (dynamic or locomotory), and resistance (a combination of isometric and isotonic).4,5 Isotonic exercise, which is defined as a muscular contraction resulting in movement, primarily provides a volume load to the left ventricle, and the response is proportional to the size of the working muscle mass and the intensity of exercise. Isometric exercise is defined as a muscular contraction without movement (eg, handgrip) and imposes greater pressure than volume …

Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association

This statement was reviewed by and has received the endorsement of the American College of Sports Medicine. 

Regular physical activity using large muscle groups, such as walking, running, or swimming, produces cardiovascular adaptations that increase exercise capacity, endurance, and skeletal muscle strength. Habitual physical activity also prevents the development of coronary artery disease (CAD) and reduces symptoms in patients with established cardiovascular disease. There is also evidence that exercise reduces the risk of other chronic diseases, including type 2 diabetes,1 osteoporosis,2 obesity,3 depression,4 and cancer of the breast5 and colon.6 This American Heart Association (AHA) Scientific Statement for health professionals summarizes the evidence for the benefits of physical activity in the prevention and treatment of cardiovascular disease, provides suggestions to healthcare professionals for implementing physical activity programs for their patients, and identifies areas for future investigation. This statement focuses on aerobic physical activity and does not directly evaluate resistance exercises, such as weight lifting, because most of the research linking physical activity and cardiovascular disease has evaluated aerobic activity. Whenever possible, the writing group has cited summary articles or meta-analyses to support conclusions and recommendations. This evidence supports the recommendation from the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) that individuals should engage in 30 minutes or more of moderate-intensity physical activity on most (preferably all) days of the week.7

Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure beyond resting expenditure. Exercise is a subset of physical activity that is planned, structured, repetitive, and purposeful in the sense that improvement or maintenance of physical fitness is the objective. Physical fitness includes cardiorespiratory fitness, muscle strength, body composition, and flexibility, comprising a set of attributes that people …

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Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease A Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity)

Objective: Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. Design: Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. Main Outcome Measures: Valid outcomes of physical activity and healthy eating. Results: The 122 evaluations (N 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval 0.26 to 0.36, I 2 69%). The technique, “self-monitoring,” explained the greatest amount of among-study heterogeneity (13%). Interventions that combined selfmonitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). Conclusion: Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating.

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Effective Techniques in Healthy Eating and Physical Activity Interventions: A Meta-Regression

Exercise Standards for Testing and Training A Statement for Healthcare Professionals From the American Heart Association

A controlled trial of physician counseling to promote the adoption of physical activity.

This paper reviews the descriptive epidemiology of physical activity in adolescents. Large population-based studies were reviewed, along with smaller studies using objective monitoring of physical activity. Estimates showed that adolescents engage in physical activity of any intensity for a mean of one hour per day. Approximately two thirds of males and one quarter of females participate in moderate to vigorous activity for 20 min 3 or more days per week. Activity levels decline with increasing age across adolescence, and this decrease is more marked in females than in males. Comparison of these data to physical activity guidelines for adolescents suggests the vast majority are meeting the guideline of accumulating physical activity. However, a substantial number of males, and the majority of females, are not meeting the guideline for moderate to vigorous physical activity.

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Descriptive Epidemiology of Physical Activity in Adolescents

A Multisite Field Test of the Acceptability of Physical Activity Counseling in Primary Care: Project PACE

Regular physical activity is recommended by the U.S. Public Health Service for children and adolescents as a part of an overall approach to lifetime health promotion (1). These recommendations for youth are primarily based on studies of the effects of physical activity on adults. To date, no scientific consensus has emerged about the amount and types of physical activity necessary for health maintenance during the childhood and adolescent years. The absence of a consensus constrains clinicians who may be interested in counseling their pediatric patients about physical activity. The International Consensus Conference on Physical Activity Guidelines for Adolescents was designed to develop empirically based guidelines that can be used by clinicians in their counseling, as well as by policy makers with responsibility for youth health promotion. The following set of papers describes the scientific background for the physical activity guidelines for adolescents, as well as the consensus statement itself. These physical activity guidelines for children and adolescents are based on a systematic review of the scientific pediatric literature. Because of the extremely limited nature of this research in younger children, the present set of papers focuses on physical activity guidelines for adolescents. To be consistent with the Guidelines for Adolescent Preventive Services (2), adolescence was defined as ages 1 1 through 21 years. The steering committee, with the assistance of an advisory group of eminent scientists, commissioned a set of nine review papers that served as the scientific background for empirically based physical activity guidelines for adolescents. Seven papers were designed to summarize the evidence related to the amount of physical activity needed to affect selected health variables in adolescents. Where possible, these papers examined the dose-response relation between physical activity and health variables and identified a level or amount of physical activity that reliably improved health outcomes in adolescents. It was determined

Barbara J. Long

Papers

A controlled trial of physician counseling to promote the adoption of physical activity.

Descriptive Epidemiology of Physical Activity in Adolescents

A Multisite Field Test of the Acceptability of Physical Activity Counseling in Primary Care: Project PACE

Overview of the International Consensus Conference on Physical Activity Guidelines for Adolescents

A multi-media behavior change program for nutrition and physical activity in primary care : pace+ for adults