Evelin Mäestu

Background : Comprehensive school-based physical activity (PA) interventions are considered effective for fostering movement-supportive school cultures. This study examined differences in fourth-grade students’ satisfaction with PA opportunities between schools participating in the School in Motion (SiM) network and nonnetwork schools in Estonia from 2018 to 2024. Methods : Data from 77,677 fourth-grade students (participation rate 70%–81%) in the National School Satisfaction Survey were analyzed. Satisfaction was assessed on a 5-point Likert scale and dichotomized into “satisfied” (Ratings 4–5) and “not satisfied” (Ratings 1–3). Proportions of satisfied students were calculated annually, and differences between school types were analyzed using Generalized linear mixed models, with school as a random intercept, adjusting for language of instruction and regional poverty rates. Results : Students in SiM network consistently reported higher satisfaction with PA opportunities in almost all survey years ( P < .001). Overall satisfaction with PA opportunities ranged from 36.5% to 41.9% in SiM network and 29.7% to 34.4% in nonnetwork schools. Differences remained significant after adjusting for socioeconomic factors (odds ratios [OR] = 1.21–1.35; P < .001). The strongest difference was observed for student-organized activities (OR 1.29–2.40), while active lessons (OR 1.16–1.39) and teacher encouragement (OR 1.09–1.31) showed modest but consistent effects. For recess-related opportunities, effects were smaller, ranging from OR 0.98 to 1.19 for indoor recess and OR 0.74 to 1.30 for outdoor recess. Conclusions : Participation in the SiM network was associated with higher student satisfaction with school-based PA opportunities. Whole-of-school approaches may help to promote more equitable access to PA and contribute to movement-supportive school cultures.

Students’ physical activity (PA) levels tend to decrease with increasing age; however, the school day structure can potentially influence students’ PA levels. This study aimed to measure and compare objective levels of PA during recess and school time between schools with different recess types. 15 different schools were selected, and accelerometry-based PA levels of 9–13-year-old students were measured. Schools were selected based on the recess types: (i) ‘daily outdoor recess’; (ii) ‘irregular outdoor recess’; (iii) ‘indoor recess’. The ‘daily outdoor recess’ group reached the highest moderate-to-vigorous PA (MVPA) during recess compared to other groups. ‘Indoor recess’ group had more sedentary time during recess compared to ‘irregular outdoor recess’ and ‘daily outdoor recess’ groups (43.6 ± 1.0%, 34.0 ± 1.0%, 30.8 ± 0.8%, respectively; P < .05). Time in MVPA was unchanged during recess across all grades in the ‘daily outdoor recess’ group (from 22.8% to 25.6%), while decreased MVPA from 27% to 17% and from 21% to 10% was found in ‘irregular outdoor recess’ and ‘indoor recess’ group, respectively; P < .05. Sedentary time increased from 34% to 52% in the ‘indoor recess’ group and from 26% to 43% in the ‘irregular outdoor recess’ group (P < .05). There was a positive association between the recess length and MVPA minutes acquired during recess; however, during a 15–25 min outdoor recess, students spent more time in MVPA compared to a 30–50 min outdoor recess (28%–30.5%, 21%–23%, respectively). The findings emphasize that unstructured outdoor recess has a high potential to maintain the MVPA levels with increasing age.

This study explores how Norwegian and Estonian primary and secondary school pupils experienced participation in decision‐making within the context of school‐based physical activity. A sample of thirty‐eight pupils, aged ten to fifteen years, participated in nine focus groups. Drawing on Hart's ladder of participation combined with Braun and Clarke's reflexive thematic analysis, the analysis presents five themes. Findings revealed a discrepancy between how pupils expressed their views in decision‐making in school‐based physical activity and how they perceived teachers' response to these expressions. It is suggested that future school‐based physical activity programmes should enable all pupils to co‐decide and participate fully.

Background: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. Objective: To identify how to improve surveillance of movement behaviours, from the perspective of experts. Methods: This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from ‘extremely’ to ‘not at all’ important. Consensus was defined as > 70% rating of ‘extremely’ or ‘very’ important. Results: We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research. Conclusions: This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.

Background: This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM), and influencing cardiorespiratory fitness (VO₂max) in Vit-D-deficient middle-aged healthy men. Methods: Participants (n = 28) were quasi-randomly assigned to one of two groups, which, in a double-blind manner, supplemented their diet daily with either Vit-D (8000 IU; VD) or placebo (PLC) during participation in a 12-week supervised RT program. Results: During the intervention, serum Vit-D concentrations increased 2.6-fold (p < 0.001) in the VD group, while no changes occurred in the PLC group. Muscle strength gains (p < 0.001) as measured in seven exercises performed on RT equipment and increases (p < 0.001) in LBM were similar in the two groups. Total fat mass, percent total fat, and percent android fat decreased (p < 0.05) to a similar extent in both groups, but there was no change in VO₂max in either group. Conclusions: In conclusion, in healthy Vit-D-insufficient middle-aged men engaged in resistance training, Vit-D supplementation increases serum 25(OH)D levels but does not enhance gains in muscle strength and LBM, or decreases in fat mass and fat percentage, and does not affect cardiorespiratory fitness.

Introduction: School day structure has the potential to increase students’ physical activity (PA) levels and form positive attitudes about PA. Including various PA opportunities and free play possibilities in the school schedule, especially outdoor recess, can improve students’ moderate-to-vigorous PA (MVPA) levels during school time. Therefore, the main aim of the study was to investigate students’ and their parents’ attitudes about outdoor recess and PA opportunities in schools with different recess opportunities.Methods: Students from grades three to six (9–13-year-olds) and their parents responded to a questionnaire about the effect of outdoor recess and opportunities for PA during the school day. Schools were divided into three groups based on the recess opportunities during the school day: (1) “outdoor recess”, (2) “outdoor recess on some days”, (3) “indoor recess”.Results: Students and parents of the “outdoor recess” group had significantly more positive attitudes about outdoor recess and PA opportunities in school. Students of the “outdoor recess” group stated being significantly more active during their leisure-time compared to other groups. Parents of the “outdoor recess” group stated that the school has asked their opinion regarding PA opportunities during the school day significantly more compared to the other two groups.Discussion: These findings emphasize the positive effect outdoor recess can have on students’ PA beliefs and habits. Parents of the “outdoor recess” group also had more positive attitudes toward PA which is important as parents most likely convey their attitudes and beliefs to their children. In addition, involving and informing parents is critical when changing the school schedule and introducing new school culture, to make the changes last.

This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM) and influencing cardiorespiratory fitness (VO2max) in Vit-D insufficient middle-aged healthy men. Participants (n = 28) were quasi‐randomly assigned to one of the two groups, which, in a double‐blind manner, supplemented their diet daily with either Vit‐D (8000 IU; VD) or placebo (PLC) during participation in a 12‐week supervised RT program. During the intervention, serum Vit‐D concentrations increased 2.6‐fold (p < 0.001) in the VD group, while no changes occurred in the PLC group. Muscle strength gains (p < 0.001) as measured in seven exercises performed on RT equipment and increases (p < 0.001) in LBM were similar in the two groups. Total fat mass, percent total fat, and percent android fat decreased (p < 0.05) to a similar extent in both groups, but there was no change in VO2max in either group. In conclusion, in healthy Vit‐D insufficient middle-aged men engaged in resistance training, Vit‐D supplementation increases serum 25(OH)D levels but does not enhance gains in muscle strength and LBM or decreases in fat mass and fat percentage and does not affect cardiorespiratory fitness.

The aim of this article is to summarize the results of the 2022 Estonian Physical Activity Report Card across 10 indicators based on available scientific data and national databases, and, additionally, to compare the current results with previous Report Card results. A national expert panel, consisting of research and policy experts, identified the available sources and synthesized as well as graded relevant data related to the physical activity (PA) of Estonian children and youth. Grade B was assigned to Organized Sports and Physical Activity (B−), Community and Environment (B+), and Government (B). Grade C was assigned to Overall Physical Activity (C+), Physical Fitness (C+), Family and Peers (C−), and School (C+). The lowest grade, D, was assigned to Active Play (D), Active Transportation (D+), and Sedentary Behaviors (D−). In Estonia, the participation rate in organized sport is relatively high, and government in addition to community support seem to be at a relatively good level. However, a relatively high number of children and youth did not meet the current PA guidelines, and the levels of sedentary behavior and screen time were very high. The PA of children and youth should be a cross-disciplinary priority, and focus should be put on developing schoolyards and outdoor breaks, varied and easily accessible organized sport, the use of active transportation, and the implementation of physical education that supports leisure time activities.