Sex-Specific Physical Activity and Weight Status in German Schoolchildren: Interim Results from the Hand on Heart Study

Abstract

Background/objectives: physical activity (PA) in children offers lifelong benefits, yet nearly four in five children are insufficiently active. We examined sex-specific differences in sport participation by sport type and its association with weight status.

Methods: in the ongoing hand-on-heart-study ("Hand-aufs-Herz"), comprehensive data on sociodemographic profiles, PA, and anthropometry were collected from 922 school-aged children, adolescents, and young adults (8-20 years) in Germany. Sex-specific differences in sport participation, sport types, and weight status were analyzed using descriptive statistics and logistic regression models.

Results: based on the eligibility criteria for analysis (ages 8-18 years), 883 pupils were included (mean age 13.1 ± 2.4 years), 406 (46%) were females. Compared to females, males had a 43% higher chance of being members of a sports club and were more likely to spend more days/week on sports (44-85%). Males participated more in football, martial arts, and basketball while females favored gymnastics and volleyball. As age increased, males had a 30% higher likelihood of not being sports club members (females: 13%). Overweight/obese males had twice the risk of lacking sports memberships. The largest body mass index (BMI) difference was found in males and females participating in athletics, with -4.64 kg/m² (males) and -1.99 kg/m² (females) compared to their counterparts without club memberships.

Conclusions: in conclusion, sports participation should be encouraged especially among females and overweight/obese males. Targeted strategies should focus on promoting inclusive and non-competitive activities that cater to their interests.

Keywords: BMI; Hand-on-heart-study (“Hand-aufs-Herz”); adolescents; physical activity; sex differences; sports clubs; sports participation.

Figure 1

Sports club membership and attendance stratified by sex. Differences between sex groups were tested using χ2 test. (A) Proportion of sports club membership in males and females. (B) Proportion of days spent at sports club by males and females.

Figure 2

Sport activities stratified by type and sex. Differences between sex groups within each sport type were tested using the chi-square test. Statistically significant results are shown as *** (p < 0.001) and * (0.01 ≤ p < 0.05).

Figure 3

Sport activity participation by age and sex. (A) Participation in aerobics. (B) Participation in athletics. (C) Participation in basketball. (D) Participation in football. (E) Participation in handball. (F) Participation in martial arts. (G) Participation in other sport activities. (H) Participation in running. (I) Participation in swimming. (J) Participation in volleyball.

Figure 4

Membership to no sports club and weight status in pupils. Values are odds ratios (OR) and 95% confidence intervals based on univarite logistic regression, where normal weight pupils were considered as control group. The dashed line on the forest plots represents the point of no effect (OR = 1). (A) Odds ratios in males and females. (B) Odds ratios in males. (C) Odds ratios in females.

Figure 5

Mean (95%) BMI in pupils by type of sport club membership. Mean values are compared against the control group “No Club” (gray) indicating no membership to any sports club. Significant differences are shown as p < 0.0001 (***), p < 0.001 (**), or p < 0.05 (*) and are based on univariate linear regression models. (A) Odds ratios in males and females. (B) Odds ratios in males. (C) Odds ratios in females.