2.4. Measures
obesity, overweight, abdominal obesity
OBESITY, DISEASE, CREST, BLIND
The study protocol comprised a first evaluation at the start of the study (T0) and a final evaluation after 6 months of intervention (T1). Data were recorded in the gyms in the morning at nine a.m., and the measurements were carried out by the same evaluators in a “blind” mode in all of the schools and in all of the cities. The height of the children was measured with a Seca stadiometer to the nearest 0.1 cm, while their weight was measured with an Omron balance to the nearest 0.5 kg. Body weight and height were ascertained in duplicate with standard techniques. Waist circumference was measured in duplicate at the iliac crest at mid-respiration using a non-elastic measuring tape.For children and adolescents, the Centers for Disease Control and Prevention defines overweight as a body mass index (BMI: weight in kilograms divided by height in meters squared) between the 85th and 95th percentiles and obesity as a BMI at or above the 95th percentile for sex and age [The ratio between waist circumference and height (WHR) was calculated; in pediatric populations, the cutoff value of 0.48 is used for the WHR to classify abdominal obesity [The relative fat mass (RFM, pediatric) was calculated according to the formula 74—(22 × height (m)/WC (m)) + (5 × sex) using sex = 0 for men and 1 for women; the cut-off points defined by the RFM are more accurate than BMI to provide an estimation of whole-body fat percentage among children [Concerning physical fitness, participants’ levels were determined using a battery of standardized tests. Specifically, they were: the standing long jump test, a test used to assess explosive leg power [These tests are simple and quick to perform, thereby their use is ideal for a school context. The physical fitness tests were conducted for both the intervention group and control group at baseline (T0) and at the end of the intervention (T1).Regarding selective attention and concentration, the d2 test of attention was used. The test consists of 14 lines of characters where respondents should cross out d letters with two dots in 20 s. This time limit is allotted for each line separately. Both pre-test and post-test evaluations were performed for each subject and each participant performed the test only once. Performance in the d2 test was assessed using: (i) the total number of responses (TN), including correct answers and errors (E) in the d2 test, a quantitative measure of working speed, (ii) the standardized number of correct answers minus commission errors (CP), an objective measure of concentration, and (iii) the number of all errors (omission error + commission error) relating to the total number of responses (E%), a qualitative measure of accuracy and completeness were used as indictors for evaluating cognitive function. Errors are defined as omission errors (number of correct answers (e.g., “d” with two dashes) missed) and errands of commission (any distracting element such as a “p” or “d” with a dash or more than two incorrectly marked dashes).Previous research results have indicated that the d2 test has a high degree of reliability to assess cognitive performance in school children to assess the effect of physical activity [To our knowledge, only a few studies have examined manipulative association PA and cognitive function with PWB in primary school students. The 14-item Warwick–Edinburgh mental well-being scale (WEMWBS) is used to measure students’ PWB, including positive affect (feelings of optimism, cheerfulness, and relaxation) and positive functioning (energy, clear thinking, self-acceptance, personal development, competence, and autonomy) [All 14 items were scored positively and the score of each item was summed to yield the total score of the scale. Previous studies have shown that the WEMWBS is a reliable and valid scale for assessing mental well-being in children [