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The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane's risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges' g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges' g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges' g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges' g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.

The transition from high school to college or university has been shown to be a critical period for weight and fat gain. To date, no European data on weight and fat gain over the full trajectory of college or university are available. Therefore, the purpose of the present study was to investigate weight and fat gain among Belgian university students from freshman through senior year of university. In this prospective observational study, a total of 340 university students were measured six times, i.e. at baseline (start of the first academic year) and at the start of the second semester of the first, second, third, fourth and fifth academic year. Objective measurements included body weight, height, body mass index (BMI), fat%, fat mass, fat free mass and waist circumference. Multilevel modelling was used to assess anthropometric changes over time according to sex. From freshman through senior year of university, individual weight changes ranged from -5.2 to +15.7kg, and respectively 77.4% and 69.3% of students showed increases in BMI and fat%. Stronger increases in weight and BMI were found for males (5.7kg; 1.6kg/m2; both p<0.001) than females (2.2kg; 0.8kg/m2; both p<0.001) over the 4.5 year measuring period. Similarly, waist circumference increased more in males (4.7cm; p<0.001) than in females (1.0cm; p<0.001). In contrast, females (2.5%; p<0.001) showed a higher increase in fat% than males (1.0%; p = 0.019). Across sexes, the highest weight and fat gains were found during the first semester and during the final year of university. Belgian university students gain a significant amount of body weight and body fat from freshman through senior year of university. Similar to the first semester, more pronounced increases in weight and fat were observed during the final year of university. Interventions aiming at preventing weight gain at university should not only focus on freshmen but also on senior students.

Background Current knowledge on the relationship between the physical environment and walking for transportation among older adults (≥ 65 years) is limited. Qualitative research can provide valuable information and inform further research. However, qualitative studies are scarce and fail to include neighborhood outings necessary to study participants’ experiences and perceptions while interacting with and interpreting the local social and physical environment. The current study sought to uncover the perceived environmental influences on Flemish older adults’ walking for transportation. To get detailed and context-sensitive environmental information, it used walk-along interviews. Methods Purposeful convenience sampling was used to recruit 57 older adults residing in urban or semi-urban areas. Walk-along interviews to and from a destination (e.g. a shop) located within a 15 minutes’ walk from the participants’ home were conducted. Content analysis was performed using NVivo 9 software (QSR International). An inductive approach was used to derive categories and subcategories from the data. Results Data were categorized in the following categories and subcategories: access to facilities (shops & services, public transit, connectivity), walking facilities (sidewalk quality, crossings, legibility, benches), traffic safety (busy traffic, behavior of other road users), familiarity, safety from crime (physical factors, other persons), social contacts, aesthetics (buildings, natural elements, noise & smell, openness, decay) and weather. Conclusions The findings indicate that to promote walking for transportation a neighborhood should provide good access to shops and services, well-maintained walking facilities, aesthetically appealing places, streets with little traffic and places for social interaction. In addition, the neighborhood environment should evoke feelings of familiarity and safety from crime. Future quantitative studies should investigate if (changes in) these environmental factors relate to (changes in) older adults’ walking for transportation.

Background Socio-ecological models emphasize the relationship between the physical environment and physical activity (PA). However, knowledge about this relationship in older adults is limited. Therefore, the present study aims to investigate the relationship between area of residence (urban, semi-urban or rural) and older adults' walking and cycling for transportation and recreation. Additionally, relationships between several physical environmental factors and walking and cycling and possible moderating effects of area of residence, age and gender were studied. Methods Data from 48,879 Flemish older adults collected in 2004-2010 through peer research were analyzed. Walking, cycling and environmental perceptions were assessed using self-administered questionnaires. The Study Service of the Flemish Government provided objective data on municipal characteristics. Multilevel logistic regression analyses were applied. Results Urban participants were more likely to walk daily for transportation compared to rural (OR = 1.43; 95% CI = 1.22, 1.67) and semi-urban participants (OR = 1.32; 95% CI = 1.13, 1.54). Urban participants were less likely to cycle daily for transportation compared to semi-urban participants (OR = 0.72; 95% CI = 0.56, 0.92). Area of residence was unrelated to weekly recreational walking/cycling. Perceived short distances to services (ORs ranging from 1.04 to 1.19) and satisfaction with public transport (ORs ranging from 1.07 to 1.13) were significantly positively related to all walking/cycling behaviors. Feelings of unsafety was negatively related to walking for transportation (OR = 0.93, 95% CI = 0.91, 0.95) and recreational walking/cycling (OR = 0.95, 95% CI = 0.92, 0.97). In females, it was also negatively related to cycling for transportation (OR = 0.94, 95% CI = 0.90, 0.98). Conclusions Urban residents were more likely to walk for transportation daily compared to semi-urban and rural residents. Daily cycling for transportation was less prevalent among urban compared to semi-urban residents. Access to destinations appeared to be important for promoting both walking and cycling for transportation and recreation across all demographic subgroups. Additionaly, feelings of unsafety were associated with lower rates of walking for transportation and walking/cycling for recreation in all subgroups and cycling for transportation in females. No clear patterns emerged for other environmental factors.

Background Burnout in secondary school teachers is an increasing concern. More physical activity (PA) and less sedentary behaviour (SB) may be beneficial to reduce burnout risk in this population. However, no longitudinal evidence on the role of PA-intensities across PA-domains and the role of SB-domains exists. Furthermore, the teaching population, characterized by high PA levels, needs to be studied, as literature showed that leisure PA was less effective to reduce burnout risk in employees with physically demanding jobs. Therefore, this study aimed to examine the causal effects of different PA-intensities and -domains and SB-domains on burnout risk in secondary school teachers. Methods In total, 306 Flemish secondary school teachers participated in three measurement moments during the school year 2019–2020 (i.e., start and end of 1st semester, start of 2nd semester). Each measurement moment, burnout risk (including recovery need and the three burnout dimensions: emotional exhaustion, depersonalisation, personal accomplishment), PA-intensities (walking, moderate-intensity PA (MPA) and vigorous-intensity PA (VPA)) in five PA-domains (work, transport, leisure-time, domestic and garden), and SB in three domains (work, transport, leisure-time), as well as sociodemographic factors and work-related factors were assessed. Multiple linear mixed models including selected confounders based on directed acyclic graphs were applied in R. Results MPA during transport and SB at work were negatively associated with emotional exhaustion ( p  = 0.021 and p  = 0.003, respectively). MPA at work was positively associated with personal accomplishment ( p  = 0.049), whereas VPA at work was positively associated with recovery need ( p  = 0.041). Gardening MPA was positively associated with emotional exhaustion ( p  = 0.010), and both gardening and domestic MPA were positively associated with recovery need ( p  = 0.016 and p  = 0.018, respectively). The (negative) association between leisure-time VPA and emotional exhaustion was borderline significant ( p  = 0.055). Conclusions To reduce burn-out risk, our findings suggest teachers to engage in MPA at work and during transport, VPA during leisure-time, and SB at work, and to limit VPA at work as well as gardening and domestic MPA. Altogether, this study highlights the importance of differentiating between PA-intensities across PA-domains and between SB-domains when addressing burnout risk. Future research should measure additional potential confounding factors and employ longer time intervals.

Background During the pregnancy and postpartum period, both women and men experience physiological and psychological changes, which may negatively impact their eating behavior. A clear understanding of determinants of changes in eating behavior during this period is needed to facilitate the development of targeted family-based interventions countering unfavorable dietary changes during this critical life period. Methods Thirteen focus group discussions targeting determinants of changes in eating behavior during pregnancy and postpartum were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. An inductive thematic approach was used to derive main and sub-categories of determinants from the data. The Determinants of Nutrition and Eating (DONE)-framework was employed to systematically organize and label the categories and determinants. Results Two frameworks were developed; one for the pregnancy and one for the postpartum period, comprising determinants of changes in eating behavior in both women and men. Three main levels of determinants were identified: (1) the individual level, including psychological (e.g., ‘health consciousness’), situational (e.g., ‘effort and convenience’) and biological (e.g., ‘discomfort’); (2) the interpersonal level (e.g., ‘social influence’) and (3) the environmental level, including micro- and meso/macro (e.g., ‘home/environment food availability’). Determinants acting as barriers (e.g., ‘time constraints’) or facilitators (e.g., ‘being a role model’) were identified. Many determinants were mentioned during both (e.g., ‘food knowledge’) or just one investigated period (e.g., ‘physiological changes’ during pregnancy, ‘influence of the baby’ postpartum). Finally, some were described by both parents (e.g., ‘self-regulation’), whereas others were mentioned by women (e.g., ‘(perceived) food safety’) or men (e.g., ‘other priorities’) only. Conclusion The developed frameworks set the foundation for the development of future family-based interventions and may be used already by healthcare providers to provide dietary guidance and support for women and men transitioning into parenthood. A focus on the interplay of individual factors at the biological and psychological level together with situational difficulties during pregnancy is recommended. Postpartum, focus should go to support first-time parents to obtain balance of both maintaining one’s own health and taking care of the baby, on improving self-regulation skills, and on coping with related situational constraints.

Secondary schoolteachers face a high recovery need and burnout risk, showing the need for research on how teachers’ recovery need and burnout risk can be reduced/prevented. Physical activity (PA) has shown promise in reducing burnout risk, but the optimal PA intensity and domain remain unclear. This study examined the association of PA intensities across different domains with recovery need and burnout risk in Flemish secondary schoolteachers. A total of 1909 secondary schoolteachers participated in this cross-sectional study conducted in September–October 2019. An online-questionnaire assessed recovery need, burnout dimensions (i.e., emotional exhaustion, depersonalisation, personal accomplishment), and PA intensities (i.e., walking, moderate-intensity PA (MPA), vigorous-intensity PA (VPA)) across five domains: work-related PA, active transport, leisure-time PA, domestic PA and garden PA. Sociodemographic and work-related factors were also questioned. Multiple linear regression models (applied in R) showed that VPA during leisure-time was associated with less recovery need and less emotional exhaustion, whereas moderate-intensity gardening was associated with more recovery need. The association between PA, recovery need and burnout risk depends on the intensity and domain of PA. Secondary schoolteachers may benefit from engaging in leisure-time VPA to reduce/prevent recovery need and burnout symptoms. Longitudinal and experimental studies are needed to establish causal relationships.

Background Mid-March 2020, Belgium went in lockdown to combat the COVID-19-pandemic. Having to provide school-based day care and adapt to online teaching, while all social, cultural and sports events and activities were cancelled, secondary school teachers’ physical activity (PA) and sedentary behaviour (SB) may have been affected considerably. This study investigates the impact of the first Belgian lockdown on PA and SB in Flemish secondary school teachers. Methods This prospective cohort study was conducted throughout the 2019–2020 school year. PA and SB measured in March/April 2020 were compared with a pre-lockdown measurement in January/February 2020. Other pre-lockdown measurements (September/October 2019 and November/December 2019) and one other during-lockdown measurement (May/June 2020) allowed us to control for confounding. Validated questionnaires were used to assess participants’ PA and SB. Generalized linear mixed models were applied in R. Results Among 624 participants (77·2% females, 43·3 ± 10·3 years), increases were observed for total PA (+ 108 min/week;  p  = 0·047), moderate PA (+ 217 min/week;  p  = 0·001), domestic and garden PA (+ 308 min/week;  p  < 0·0001) and leisure-time PA (+ 131 min/week;  p  < 0·0001), whereas work-related PA (-289 min/week;  p  < 0·0001) and active transportation (-38 min/week;  p  =0·005) decreased. No differences were observed for walking ( p  = 1·0) and vigorous PA ( p  = 0·570). Increases were found for total SB (+ 972 min/week;  p  < 0·0001), work-related SB (+ 662 min/week;  p  < 0·0001) and leisure-time SB (+ 592 min/week;  p  = 0·0004), whereas transport-related SB (-290 min/week;  p  < 0·0001) decreased. Conclusion During the lockdown, we found in our sample that Flemish secondary school teachers showed an increase in SB that was 9 times as high as their PA increase. As a government, education network or school, it is crucial to sensitize, promote, and facilitate sufficient MVPA and/or walking, but likewise to discourage SB during pandemic-induced lockdowns.

Background Inter-limb asymmetry is commonly regarded as a potential limitation for athletic performance and a contributor to injury risk. However, the influence of training status and sex on asymmetry in judokas remains poorly understood. Therefore, this study aimed to: (1) quantify inter-limb asymmetry in lean mass, bone mineral density, bone mineral content, and fat mass, and (2) examine how inter-limb morphological asymmetry varies across competitive levels (national vs. European) and sexes among young competitive judokas. Methods Lean mass, bone mineral density, bone mineral content, and fat mass were assessed using Dual-energy X-ray Absorptiometry in 27 male and 21 female competitive judokas aged 13–17 years. Comparisons between limbs were performed using paired-samples t-tests. Differences in asymmetry across competitive levels (national vs. European) and sexes were analyzed using Mann-Whitney U tests. Results Inter-limb asymmetry magnitudes ranged from 1.47% to 8.24% across groups. Overall, judokas showed greater values in the dominant limb compared to the non-dominant limb for most measures ( p  ≤ 0. 010). Mann-Whitney U tests identified significant differences in asymmetry between competitive levels only in lower-limb fat mass for both males ( p  = 0.015) and females ( p  = 0.033), and in lower-limb bone mineral content for females ( p  = 0.039). No significant differences in asymmetry were observed between sexes. Conclusion While inter-limb differences were present, the magnitude of asymmetry was generally small (≤ 8%) and did not differ significantly between competitive levels or sexes. These findings suggest that reducing morphological asymmetry in judokas may not be a priority, regardless of competition level or sex.

Mobile technologies have great potential to promote an active lifestyle in lower educated working young adults, an underresearched target group at a high risk of low activity levels. The objective of our study was to examine the effect and process evaluation of the newly developed evidence- and theory-based smartphone app \"Active Coach\" on the objectively measured total daily physical activity; self-reported, context-specific physical activity; and self-reported psychosocial variables among lower educated working young adults. We recruited 130 lower educated working young adults in this 2-group cluster randomized controlled trial and assessed outcomes at baseline, posttest (baseline+9 weeks), and follow-up (posttest+3 months). Intervention participants (n=60) used the Active Coach app (for 9 weeks) combined with a Fitbit activity tracker. Personal goals, practical tips, and educational facts were provided to encourage physical activity. The control group received print-based generic physical activity information. Both groups wore accelerometers for objective measurement of physical activity, and individual interviews were conducted to assess the psychosocial variables and context-specific physical activity. Furthermore, intervention participants were asked process evaluation questions and generalized linear mixed models and descriptive statistics were applied. No significant intervention effects were found for objectively measured physical activity, self-reported physical activity, and self-reported psychosocial variables (all P>.05). Intervention participants evaluated the Active Coach app and the combined use with the Fitbit wearable as self-explanatory (36/51, 70.6%), user friendly (40/51, 78.4%), and interesting (34/51, 66.7%). Throughout the intervention, we observed a decrease in the frequency of viewing graphical displays in the app (P<.001); reading the tips, facts, and goals (P<.05); and wearing the Fitbit wearable (P<.001). Few intervention participants found the tips and facts motivating (10/41, 24.4%), used them to be physically active (8/41, 19.6%), and thought they were tailored to their lifestyle (7/41, 17.1%). The lack of significant intervention effects might be due to low continuous user engagement. Advice or feedback that was not perceived as adequately tailored and the difficulty to compete with many popular commercial apps on young people's smartphones may be responsible for a decrease in the engagement. A stand-alone app does not seem sufficient to promote an active lifestyle among lower educated working young adults; therefore, multicomponent interventions (using both technological and human support), as well as context-specific sensing to provide tailored advice, might be needed in this population. ClinicalTrials.gov NCT02948803; https://clinicaltrials.gov/ct2/show/results/NCT02948803 (Archived by WebCite at http://www.webcitation.org/71OPFwaoA).