Showing papers in "International Journal of Behavioral Nutrition and Physical Activity in 2008"

A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

Abstract: Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults. Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted. Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores. The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report – direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.

Does parenting affect children's eating and weight status?

Abstract: Background Worldwide, the prevalence of obesity among children has increased dramatically. Although the etiology of childhood obesity is multifactorial, to date, most preventive interventions have focused on school-aged children in school settings and have met with limited success. In this review, we focus on another set of influences that impact the development of children's eating and weight status: parenting and feeding styles and practices. Our review has two aims: (1) to assess the extent to which current evidence supports the hypothesis that parenting, via its effects on children's eating, is causally implicated in childhood obesity; and (2) to identify a set of promising strategies that target aspects of parenting, which can be further evaluated as possible components in childhood obesity prevention.

Physical education, school physical activity, school sports and academic performance

Abstract: The purpose of this paper is to review relationships of academic performance and some of its determinants to participation in school-based physical activities, including physical education (PE), free school physical activity (PA) and school sports. Linkages between academic achievement and involvement in PE, school PA and sport programmes have been examined, based on a systematic review of currently available literature, including a comprehensive search of MEDLINE (1966 to 2007), PSYCHINFO (1974 to 2007), SCHOLAR.GOOGLE.COM, and ERIC databases. Quasi-experimental data indicate that allocating up to an additional hour per day of curricular time to PA programmes does not affect the academic performance of primary school students negatively, even though the time allocated to other subjects usually shows a corresponding reduction. An additional curricular emphasis on PE may result in small absolute gains in grade point average (GPA), and such findings strongly suggest a relative increase in performance per unit of academic teaching time. Further, the overwhelmingly majority of such programmes have demonstrated an improvement in some measures of physical fitness (PF). Cross-sectional observations show a positive association between academic performance and PA, but PF does not seem to show such an association. PA has positive influences on concentration, memory and classroom behaviour. Data from quasi-experimental studies find support in mechanistic experiments on cognitive function, pointing to a positive relationship between PA and intellectual performance. Given competent providers, PA can be added to the school curriculum by taking time from other subjects without risk of hindering student academic achievement. On the other hand, adding time to "academic" or "curricular" subjects by taking time from physical education programmes does not enhance grades in these subjects and may be detrimental to health.

Development of a compendium of energy expenditures for youth.

Abstract: Background: This paper presents a Compendium of Energy Expenditures for use in scoring physical activity questionnaires and estimating energy expenditure levels in youth. Method/Results: Modeled after the adult Compendium of Physical Activities, the Compendium of Energy Expenditures for Youth contains a list of over 200 activities commonly performed by youth and their associated MET intensity levels. A review of existing data collected on the energy cost of youth performing activities was undertaken and incorporated into the compendium. About 35% of the activity MET levels were derived from energy cost data measured in youth and the remaining MET levels estimated from the adult compendium. Conclusion: The Compendium of Energy Expenditures for Youth is useful to researchers and practitioners interested in identifying physical activity and energy expenditure values in children and adolescents in a variety of settings.

Active commuting to school: How far is too far?

Abstract: Walking and cycling to school provide a convenient opportunity to incorporate physical activity into an adolescent's daily routine. School proximity to residential homes has been identified as an important determinant of active commuting among children. The purpose of this study is to identify if distance is a barrier to active commuting among adolescents, and if there is a criterion distance above which adolescents choose not to walk or cycle. Data was collected in 2003–05 from a cross-sectional cohort of 15–17 yr old adolescents in 61 post primary schools in Ireland. Participants self-reported distance, mode of transport to school and barriers to active commuting. Trained researchers took physical measurements of height and weight. The relation between mode of transport, gender and population density was examined. Distance was entered into a bivariate logistic regression model to predict mode choice, controlling for gender, population density socio-economic status and school clusters. Of the 4013 adolescents who participated (48.1% female, mean age 16.02 ± 0.661), one third walked or cycled to school. A higher proportion of males than females commuted actively (41.0 vs. 33.8%, χ2 (1) = 22.21, p < 0.001, r = -0.074). Adolescents living in more densely populated areas had greater odds of active commuting than those in the most sparsely populated areas (χ2 (df = 3) = 839.64, p < 0.001). In each density category, active commuters travelled shorter distances to school. After controlling for gender and population density, a 1-mile increase in distance decreased the odds of active commuting by 71% (χ2 (df = 1) = 2591.86, p < 0.001). The majority of walkers lived within 1.5 miles and cyclists within 2.5 miles. Over 90% of adolescents who perceived distance as a barrier to active commuting lived further than 2.5 miles from school. Distance is an important perceived barrier to active commuting and a predictor of mode choice among adolescents. Distances within 2.5 miles are achievable for adolescent walkers and cyclists. Alternative strategies for increasing physical activity are required for individuals living outside of this criterion.

Environmental determinants of active travel in youth: A review and framework for future research

Abstract: Many youth fail to meet the recommended guidelines for physical activity. Walking and cycling, forms of active travel, have the potential to contribute significantly towards overall physical activity levels. Recent research examining the associations between physical activity and the environment has shown that environmental factors play a role in determining behaviour in children and adolescents. However, links between the environment and active travel have received less attention. Twenty four studies were identified which examined the associations between the environment (perceived or objectively measured) and active travel among youth aged 5–18 years. Findings were categorised according to the location of the environmental measure examined; attributes of the neighbourhood, destination and the route between home and destination. Results from the reviewed studies indicated that youth active travel is positively associated with social interactions, facilities to assist active travel and urban form in the neighbourhood as well as shorter route length and road safety en-route. A conceptual framework is presented which highlights the associations between active travel behaviours and environmental factors, drawing upon both existing and hypothesised relationships. We provide a review of the available literature and present a novel theoretical framework that integrates the environment into the wider decision making process around travel choices for children and adolescents. Further work should explore associations where gaps in understanding have been identified, and account for the main moderators of behaviour so hypothesised associations can be confirmed.

Perceived sports competence mediates the relationship between childhood motor skill proficiency and adolescent physical activity and fitness: a longitudinal assessment

Abstract: The purpose of this paper was to investigate whether perceived sports competence mediates the relationship between childhood motor skill proficiency and subsequent adolescent physical activity and fitness. In 2000, children's motor skill proficiency was assessed as part of a school-based physical activity intervention. In 2006/07, participants were followed up as part of the Physical Activity and Skills Study and completed assessments for perceived sports competence (Physical Self-Perception Profile), physical activity (Adolescent Physical Activity Recall Questionnaire) and cardiorespiratory fitness (Multistage Fitness Test). Structural equation modelling techniques were used to determine whether perceived sports competence mediated between childhood object control skill proficiency (composite score of kick, catch and overhand throw), and subsequent adolescent self-reported time in moderate-to-vigorous physical activity and cardiorespiratory fitness. Of 928 original intervention participants, 481 were located in 28 schools and 276 (57%) were assessed with at least one follow-up measure. Slightly more than half were female (52.4%) with a mean age of 16.4 years (range 14.2 to 18.3 yrs). Relevant assessments were completed by 250 (90.6%) students for the Physical Activity Model and 227 (82.3%) for the Fitness Model. Both hypothesised mediation models had a good fit to the observed data, with the Physical Activity Model accounting for 18% (R2 = 0.18) of physical activity variance and the Fitness Model accounting for 30% (R2 = 0.30) of fitness variance. Sex did not act as a moderator in either model. Developing a high perceived sports competence through object control skill development in childhood is important for both boys and girls in determining adolescent physical activity participation and fitness. Our findings highlight the need for interventions to target and improve the perceived sports competence of youth.

Relationships between the home environment and physical activity and dietary patterns of preschool children: a cross-sectional study

Abstract: To assess relationships between characteristics of the home environment and preschool children's physical activity and dietary patterns. Homes of 280 preschool children were visited and information obtained by direct observation and parent interview regarding physical and nutritional characteristics of the home environment. Children's physical activity, sedentary behaviour and dietary patterns were measured using standardised parent-report questionnaires. Associations were analysed using analysis of variance and correlation. Parental physical activity (p = 0.03–0.008), size of backyard (p = 0.001) and amount of outdoor play equipment (p = 0.003) were associated with more outdoor play. Fewer rules about television viewing (p < 0.001) and presence of playstation (p = 0.02) were associated with more indoor sedentary time. Higher fruit and vegetable intake was associated with restricting children's access to fruit juice (p = 0.02) and restricting high fat/sugar snacks (p = 0.009). Lower intake of non-core foods was associated with restricting children's access to fruit juice (p = 0.007), cordial/carbonated drinks (p < 0.001) and high fat/sugar snacks (p = 0.003). Lower fruit and vegetable intake was associated with reminding child to 'eat up' (p = 0.007) and offering food rewards to eat main meal (p = 0.04). Higher intake of non-core foods was associated with giving food 'treats' (p = 0.03) and offering food rewards to eat main meal (p = 0.04). The availability of food groups in the home was associated with children's intake of these foods (fruit and vegetables, p < 0.001; fat in dairy, p = <0.001; sweetened beverages, p = 0.004–<0.001; non-core foods, p = 0.01–<0.001). Physical attributes of the home environment and parental behaviours are associated with preschool children's physical activity, sedentary behaviour and dietary patterns. Many of these variables are modifiable and could be targeted in childhood obesity prevention and management.

The Children's Eating Behaviour Questionnaire: factorial validity and association with Body Mass Index in Dutch children aged 6–7

Abstract: The Children's Eating Behaviour Questionnaire (CEBQ) is a parent-report measure designed to assess variation in eating style among children. In the present study we translated the CEBQ and examined its factor structure in a sample of parents of 6- and 7-year-old children in the Netherlands. Additionally, associations between the mean scale scores of the instrument and children's body mass index (BMI) were assessed. In total, 135 parents of primary school children aged 6 and 7 completed the questionnaire (response rate 41.9%). Children's BMI was converted into standardised z-scores, adjusted for child gender and age to examine the association between mean scale scores and child weight status. Results generally confirmed the theoretical factor structure, with acceptable internal reliability and between-subscale correlations. Linear regression analyses revealed that BMI z-scores were positively associated with the 'food approach' subscales of the CEBQ (food responsiveness, enjoyment of food, emotional overeating) (β's 0.15 to 0.22) and negatively with 'food avoidant' subscales (satiety responsiveness, slowness in eating, emotional undereating, and food fussiness) (β's -0.09 to -0.25). Significant relations with child BMI z-scores were found for food responsiveness (p = 0.02), enjoyment of food (p = 0.03), satiety responsiveness (p = 0.01) and slowness in eating (p = 0.01). The results support the use of the CEBQ as a psychometrically sound tool for assessing children's eating behaviours in Dutch children and the study demonstrates its applicability in overweight-related studies.

Effects of calorie labeling and value size pricing on fast food meal choices: Results from an experimental trial

Abstract: Although point-of-purchase calorie labeling at restaurants has been proposed as a strategy for improving consumer food choices, a limited number of studies have evaluated this approach. Likewise, little research has been conducted to evaluate the influence of value size pricing on restaurant meal choices. To examine the effect of point-of-purchase calorie information and value size pricing on fast food meal choices a randomized 2 × 2 factorial experiment was conducted in which participants ordered a fast food meal from one of four menus that varied with respect to whether calorie information was provided and whether value size pricing was used. Study participants included 594 adolescents and adults who regularly ate at fast food restaurants. Study staff recorded the foods ordered and consumed by each participant. Participants also completed surveys to assess attitudes, beliefs and practices related to fast food and nutrition. No significant differences in the energy composition of meals ordered or eaten were found between menu conditions. The average energy content of meals ordered by those randomized to a menu that included calorie information and did not include value size pricing was 842 kcals compared with 827 kcals for those who ordered their meal from a menu that did not include calorie information but had value size pricing (control menu). Results were similar in most analyses conducted stratified by factors such as age, race and education level. Additional research is needed to better evaluate the effects of calorie labeling and value size pricing on fast food meal choices. Studies in which participants are repeatedly exposed to these factors are needed since long term exposure may be required for behavior change.

The contribution of preschool playground factors in explaining children's physical activity during recess

Abstract: Background Low levels of physical activity are characteristic in preschoolers. To effectively promote physical activity, it is necessary to understand factors that influence young children's physical activity. The present study aimed to investigate how physical activity levels are influenced by environmental factors during recess in preschool.

Tracking of leisure-time physical activity during adolescence and young adulthood: a 10-year longitudinal study

Abstract: The purpose of this study was to show how participation in leisure-time physical activity changes between ages 13 to 23, and to what extent engaging in specific types of sports tracks into young adulthood. The sample comprised 630 subjects who responded to questionnaires at age 13, with seven follow-ups over a 10-year period in the Norwegian Longitudinal Health Behaviour Study. The associations between adolescent participation in global and specific types of leisure-time physical activity were examined by analyses of variance, regression analysis and growth curve analysis. The findings suggest that the transition from adolescence to adulthood is, on average, a period of decline in physical activity, but with the decline levelling off into adulthood. The decline was significantly greater among males than females. There were substantial individual differences in the amount of change, in particular among males. Jogging alone and cycling, recreational activities such as skiing and hiking, and ball games, showed a high degree of tracking from age 15 to 23. The findings indicate low associations between participation in specific types of activities during adolescence and global leisure-time physical activity in young adulthood, while participation in several adolescent physical activities simultaneously was moderately related to later activity. Thus, being involved in various types of physical activity may offer good opportunities for establishing lifelong involvement in physical activity, independent of the specific type of activity. The observed variation in change might suggest a need for a more targeted approach, with a focus on subgroups of individuals. The group of inactive youth may be considered as a high risk group, and the findings suggest that adolescent males who are inactive early seem likely to continue to be inactive later. The observed heterogeneity in change highlights the limitation of previous approaches to analyzing physical levels over time, and suggests that multilevel analysis should be used in future research on longitudinal data on physical activity.

Couch potatoes to jumping beans: A pilot study of the effect of active video games on physical activity in children

Abstract: The primary objective of this pilot study was to evaluate the effect of active video games on children's physical activity levels. Twenty children (mean ± SD age = 12 ± 1.5 years; 40% female) were randomised to receive either an active video game upgrade package or to a control group (no intervention). Effects on physical activity over the 12-week intervention period were measured using objective (Actigraph accelerometer) and subjective (Physical Activity Questionnaire for Children [PAQ-C]) measures. An activity log was used to estimate time spent playing active and non-active video games. Children in the intervention group spent less mean time over the total 12-week intervention period playing all video games compared to those in the control group (54 versus 98 minutes/day [difference = -44 minutes/day, 95% CI [-92, 2]], p = 0.06). Average time spent in all physical activities measured with an accelerometer was higher in the active video game intervention group compared to the control group (difference at 6 weeks = 194 counts/min, p = 0.04, and at 12 weeks = 48 counts/min, p = 0.06). This preliminary study suggests that playing active video games on a regular basis may have positive effects on children's overall physical activity levels. Further research is needed to confirm if playing these games over a longer period of time could also have positive effects on children's body weight and body mass index. ACTRN012606000018516

Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature

Abstract: Background Eating away from home has increased in prevalence among US adults and now comprises about 50% of food expenditures. Calorie labeling on chain restaurant menus is one specific policy that has been proposed to help consumers make better food choices at restaurants. The present review evaluates the available empirical literature on the effects of calorie information on food choices in restaurant and cafeteria settings.

Joint associations of multiple leisure-time sedentary behaviours and physical activity with obesity in Australian adults

Abstract: Background Television viewing and physical inactivity are independently associated with risk of obesity. However, how the combination of multiple leisure-time sedentary behaviours (LTSB) and physical activity (LTPA) may contribute to the risk of obesity is not well understood. We examined the joint associations of multiple sedentary behaviours and physical activity with the odds of being overweight or obese.

Validation of a survey instrument to assess home environments for physical activity and healthy eating in overweight children

Abstract: Few measures exist to measure the overall home environment for its ability to support physical activity (PA) and healthy eating in overweight children. The purpose of this study was to develop and test the reliability and validity of such a measure. The Home Environment Survey (HES) was developed to reflect availability, accessibility, parental role modelling, and parental policies related to PA resources, fruits and vegetables (F&V), and sugar sweetened drinks and snacks (SS). Parents of overweight children (n = 219) completed the HES and concurrent behavioural assessments. Children completed the Block Kids survey and wore an accelerometer for one week. A subset of parents (n = 156) completed the HES a second time to determine test-retest reliability. Finally, 41 parent dyads living in the same home (n = 41) completed the survey to determine inter-rater reliability. Initial psychometric analyses were completed to trim items from the measure based on lack of variability in responses, moderate or higher item to scale correlation, or contribution to strong internal consistency. Inter-rater and test-retest reliability were completed using intraclass correlation coefficients. Validity was assessed using Pearson correlations between the HES scores and child and parent nutrition and PA. Eight items were removed and acceptable internal consistency was documented for all scales (α = .66–84) with the exception of the F&V accessibility. The F&V accessibility was reduced to a single item because the other two items did not meet reliability standards. Test-retest reliability was high (r > .75) for all scales. Inter-rater reliability varied across scales (r = .22–.89). PA accessibility, parent role modelling, and parental policies were all related significantly to child (r = .14–.21) and parent (r = .15–.31) PA. Similarly, availability of F&V and SS, parental role modelling, and parental policies were related to child (r = .14–36) and parent (r = .15–26) eating habits. The HES shows promise as a potentially valid and reliable assessment of the physical and social home environment related to a child's physical activity and eating habits.

The validation of a home food inventory

Abstract: Home food inventories provide an efficient method for assessing home food availability; however, few are validated. The present study's aim was to develop and validate a home food inventory that is easily completed by research participants in their homes and includes a comprehensive range of both healthful and less healthful foods that are associated with obesity. A home food inventory (HFI) was developed and tested with two samples. Sample 1 included 51 adult participants and six trained research staff who independently completed the HFI in participants' homes. Sample 2 included 342 families in which parents completed the HFI and the Diet History Questionnaire (DHQ) and students completed three 24-hour dietary recall interviews. HFI items assessed 13 major food categories as well as two categories assessing ready-access to foods in the kitchen and the refrigerator. An obesogenic household food availability score was also created. To assess criterion validity, participants' and research staffs' assessment of home food availability were compared (staff = gold standard). Criterion validity was evaluated with kappa, sensitivity, and specificity. Construct validity was assessed with correlations of five HFI major food category scores with servings of the same foods and associated nutrients from the DHQ and dietary recalls. Kappa statistics for all 13 major food categories and the two ready-access categories ranged from 0.61 to 0.83, indicating substantial agreement. Sensitivity ranged from 0.69 to 0.89, and specificity ranged from 0.86 to 0.95. Spearman correlations between staff and participant major food category scores ranged from 0.71 to 0.97. Correlations between the HFI scores and food group servings and nutrients on the DHQ (parents) were all significant (p < .05) while about half of associations between the HFI and dietary recall interviews (adolescents) were significant (p < .05). The obesogenic home food availability score was significantly associated (p < .05) with energy intake of both parents and adolescents. This new home food inventory is valid, participant-friendly, and may be useful for community-based behavioral nutrition and obesity prevention research. The inventory builds on previous measures by including a wide range of healthful and less healthful foods rather than foods targeted for a specific intervention.

Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating

Abstract: Food behaviours, attitudes, environments and knowledge are relevant to professionals in childhood obesity prevention, as are dietary patterns which promote positive energy balance. There is a lack of valid and reliable tools to measure these parameters. The aim of this study was to determine the reliability and relative validity of a child nutrition questionnaire assessing all of these parameters, used in the evaluation of a community-based childhood obesity prevention project. The development of the 14-item questionnaire was informed by the aims of the obesity prevention project. A sub-sample of children aged 10–12 years from primary schools involved in the intervention was recruited at the project's baseline data collection (Test 1). Questionnaires were readministered (Test 2) following which students completed a 7-day food diary designed to reflect the questionnaire. Twelve scores were derived to assess consumption of fruit, vegetables, water, noncore foods and sweetened beverages plus food knowledge, behaviours, attitudes and environments. Reliability was assessed using (a) the intra class correlation coefficient (ICC) and 95% confidence intervals to compare scores from Tests 1 and 2 (test-retest reliability) and (b) Cronbach's alpha (internal consistency). Validity was assessed with Spearman correlations, bias and limits of agreement between scores from Test 1 and the 7-day diaries. The Wilcoxon signed rank test checked for significant differences between mean scores. One hundred and forty one students consented to the study. Test 2 (n = 134) occurred between eight and 36 days after Test 1. For 10/12 scores ICCs ranged from 0.47–0.66 (p 0.05) for 10/12 (test-retest reliability) and 3/7 (validity) scores. This child nutrition questionnaire is a valid and reliable tool to simultaneously assess dietary patterns associated with positive energy balance, and food behaviours, attitudes and environments in Australian school children aged 10–12 years. Thus it can be used to monitor secular changes in these parameters and measure the effectiveness of this and other obesity prevention projects with similar aims.

Validity and repeatability of the EPIC physical activity questionnaire : A validation study using accelerometers as an objective measure

Abstract: A primary aim of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study is to examine the association between total physical activity levels (comprising occupational, household and recreational activity) and the incidence of cancer. We examined the validity and long-term repeatability of total physical activity measurements estimated from the past-year recall EPIC questionnaire, using accelerometers as an objective reference measure. Participants included 100 men and 82 women aged 50–65 years. Criterion validity was assessed by comparing the physical activity estimates from the EPIC questionnaire with total activity estimated from the average of three separate 7-day accelerometer periods during the same (past-year) period. Long-term repeatability of the EPIC questionnaire was assessed by comparing the responses from the baseline and 10-month administrations. Past-year EPIC estimates were also compared with the Friedenreich Lifetime Total Physical Activity Questionnaire to examine whether recent activity reflected lifetime activity. Accelerometer total metabolic equivalent (MET)-hours/week were positively associated with a total physical activity index (Spearman rank correlation ρ = 0.29, 95% confidence interval (CI) 0.15, 0.42) and with non-occupational activity estimated in MET-hours/week (ρ = 0.21, 95% CI 0.07, 0.35). Stratified analyses suggested stronger correlations for non-occupational activity for participants who were male, had a lower BMI, were younger, or were not full-time workers, although the differences in correlations between groups were not statistically significant. The weighted kappa coefficient for repeatability of the total physical activity index was 0.62 (95% CI 0.53, 0.71). Spearman correlations for repeatability of components of activity were 0.65 (95% CI 0.55, 0.72) for total non-occupational, 0.58 (95% CI 0.48, 0.67) for recreational and 0.73 (95% CI 0.66, 0.79) for household activity. When past-year activity was compared to lifetime estimates of activity, there was fair agreement for non-occupational (ρ = 0.26) activity, which was greater for household activity (ρ = 0.46) than for recreational activity (ρ = 0.21). Our findings suggest that the EPIC questionnaire has acceptable measurement characteristics for ranking participants according to their level of total physical activity. The questionnaire should be able to identify the presence or absence of reasonably strong aetiological associations when either recent or long-term activity is the responsible factor.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial

Abstract: Background: Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. Objective: Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. Method: Sixty-three women and 16 men (49.2 years ± 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. Results: Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p =

The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review

Abstract: Regular self-weighing has been a focus of attention recently in the obesity literature. It has received conflicting endorsement in that some researchers and practitioners recommend it as a key behavioral strategy for weight management, while others caution against its use due to its potential to cause negative psychological consequences associated with weight management failure. The evidence on frequent self-weighing, however, has not yet been synthesized. The purpose of this paper is to evaluate the evidence regarding the use of regular self-weighing for both weight loss and weight maintenance. A systematic literature review was conducted using the MEDLINE, CINAHL, and PsycINFO online databases. Reviewed studies were broken down by sample characteristics, predictors/conditions, dependent measures, findings, and evidence grade. Twelve studies met the inclusion/exclusion criteria, but nearly half received low evidence grades in terms of methodological quality. Findings from 11 of the 12 reviewed studies indicated that more frequent self-weighing was associated with greater weight loss or weight gain prevention. Specifically, individuals who reported self-weighing weekly or daily, typically over a period of several months, held a 1 to 3 kg/m2 (current) advantage over individuals who did not self-weigh frequently. The effects of self-weighing in experimental studies, especially those where self-weighing behaviors could be isolated, were less clear. Based on the consistency of the evidence reviewed, frequent self-weighing, at the very least, seems to be a good predictor of moderate weight loss, less weight regain, or the avoidance of initial weight gain in adults. More targeted research is needed in this area to determine the causal role of frequent self-weighing in weight loss/weight gain prevention programs. Other open questions to be pursued include the optimal dose of self-weighing, as well as the risks posed for negative psychological consequences.

Parental influences on adolescents' physical activity and sedentary behavior: longitudinal findings from Project EAT-II.

Abstract: Background The long-term role that parental encouragement and attitudes about fitness and exercise play in adolescents' physical activity and sedentary behavior habits remains unclear. This paper aims to longitudinally examine how parental encouragement to be physically active and parental concern about staying fit are associated with adolescents' physical activity and sedentary behavior habits five years later.

The change in weight perception of weight status among the overweight: comparison of NHANES III (1988–1994) and 1999–2004 NHANES

Abstract: This study seeks to determine whether perception of weight status among the overweight has changed with the increasing overweight/obesity prevalence. The perception of weight status was compared between overweight participants (BMI between 25.0–29.9 kg/m2) from NHANES III (1988–1994) and overweight participants from NHANES 1999–2004. Perception of weight status was assessed by asking participants to classify their weight as about the right weight, underweight or overweight. Comparisons were made across age groups, genders, race/ethnicities and various income levels. Fewer overweight people during the NHANES 1999–2004 survey perceived themselves as overweight when compared to overweight people during the NHANES III survey. The change in distortion between the survey periods was greatest among persons with lower income, males and African-Americans. The increase in overweight/obesity between the survey years (NHANES III and NHANES 1999–2004 has been accompanied with fewer overweight people perceiving themselves as overweight.

Physical activity across the curriculum: Year one process evaluation results

Abstract: Background Physical Activity Across the Curriculum (PAAC) is a 3-year elementary school-based intervention to determine if increased amounts of moderate intensity physical activity performed in the classroom will diminish gains in body mass index (BMI). It is a cluster-randomized, controlled trial, involving 4905 children (2505 intervention, 2400 control).

What do parents and preschool staff tell us about young children's physical activity: a qualitative study

Abstract: Physical activity and small screen recreation are two modifiable behaviours associated with childhood obesity and the development of chronic health problems. Parents and preschool staff shape behaviour habits in young children. The aims of this qualitative study were to explore the attitudes, values, knowledge and understanding of parents and carers of preschool-age children in relation to physical activity and small screen recreation and to identify influences upon these behaviours. This research involved a focus group study with parents and carers of the target population. A purposive sample of 39 participants (22 parents, 17 carers) participated in 9 focus groups. Participants were drawn from three populations of interest: those from lower socioeconomic status, and Middle-Eastern and Chinese communities in the Sydney (Australia) metropolitan region. All participants understood the value of physical activity and the impact of excessive small screen recreation but were unfamiliar with national guidelines for these behaviours. Participants described the nature and activity patterns of young children; however, the concept of activity 'intensity' in this age group was not a meaningful term. Factors which influenced young children's physical activity behaviour included the child's personality, the physical activity facilities available, and the perceived safety of their community. Factors facilitating physical activity included a child's preference for being active, positive parent or peer modelling, access to safe play areas, organised activities, preschool programs and a sense of social connectedness. Barriers to physical activity included safety concerns exacerbated by negative media stories, time restraints, financial constraints, cultural values favouring educational achievement, and safety regulations about equipment design and use within the preschool environment. Parents considered that young children are naturally 'programmed' to be active, and that society 'de-programs' this behaviour. Staff expressed concern that free, creative active play was being lost and that alternate activities were increasingly sedentary. The findings support the relevance of the socioecological model of behavioural influences to young children's physical activity. In this age group, efforts may best be directed at emphasising national guidelines for small screen recreation and educating families and carers about the importance of creative, free play to reinforce the child's inherent nature to be active.

Relationships between frequency of family meals, BMI and nutritional aspects of the home food environment among New Zealand adolescents.

Abstract: Previous research has documented the positive effects of family meals on the dietary quality of adolescents. The objective of the current study is to examine associations between frequency of family meals and body mass index (BMI), other aspects of the home food environment, and related nutrition behaviors. Data were collected during baseline measurements of the Pacific Obesity Prevention In Communities study. In total, 3245 ethnically diverse students completed a questionnaire about their nutrition behaviors and were weighed and measured for height. In total, 42% of adolescents ate a family meal on all of the previous five school nights. Frequency of family meals was modestly associated with BMI in bivariate analysis (p = 0.045), but lost significance when demographic characteristics were included in the model. Frequency of family meals was associated with many positive aspects of home food environment and positive nutrition behaviors, including parental support for healthy eating, limits on television use, having fruit available at home, consuming five fruits and vegetables a day, eating breakfast, and bringing lunch from home. Surprisingly, no relationships were observed between frequency of family meals and accessibility and consumption of many high fat/high sugar foods. Our findings suggest that the positive effect of family meals may reflect an overall positive home food environment. Families who have meals together have more healthful foods available at home and support their child in eating healthfully. There were no relationships between family meals and high fat/high sugar foods; this suggest that while families may prioritize eating together, messages about limiting the availability and consumption of these snack foods are not getting through.

Personal and environmental correlates of active travel and physical activity in a deprived urban population

Abstract: Background: Environmental characteristics may be associated with patterns of physical activity in general or with particular types of physical activity such as active travel (walking or cycling for transport). However, most studies in this field have been conducted in North America and Australia, and hypotheses about putative correlates should be tested in a wider range of sociospatial contexts. We therefore examined the contribution of putative personal and environmental correlates of active travel and overall physical activity in deprived urban neighbourhoods in Glasgow, Scotland as part of the baseline for a longitudinal study of the effects of opening a new urban motorway (freeway). Methods: We conducted a postal survey of a random sample of residents (n = 1322), collecting data on socioeconomic status, perceptions of the local environment, travel behaviour, physical activity and general health and wellbeing using a new 14-item neighbourhood rating scale, a travel diary, the short form of the International Physical Activity Questionnaire (IPAQ) and the SF-8. We analysed the correlates of active travel and overall physical activity using multivariate logistic regression, first building models using personal (individual and household) explanatory variables and then adding environmental variables. Results: Active travel was associated with being younger, living in owner-occupied accommodation, not having to travel a long distance to work and not having access to a car, whereas overall physical activity was associated with living in social rented accommodation and not being overweight. After adjusting for personal characteristics, neither perceptions of the local environment nor the objective proximity of respondents' homes to motorway or major road infrastructure explained much of the variance in active travel or overall physical activity, although we did identify a significant positive association between active travel and perceived proximity to shops. Conclusion: Apart from access to local amenities, environmental characteristics may have limited influence on active travel in deprived urban populations characterised by a low level of car ownership, in which people may have less capacity for making discretionary travel choices than the populations studied in most published research on the environmental correlates of physical activity.

Physical environmental characteristics and individual interests as correlates of physical activity in Norwegian secondary schools: The health behaviour in school-aged children study

Abstract: The school has been identified as a key arena for physical activity promotion for young people. Effective change of physical activity behaviour requires identification of consistent and modifiable correlates. The study explores students' interests in school physical activity and facilities in the school environment and examines their associations with students' participation in physical activity during recess and their cross-level interaction effect. This cross-sectional study was based on a national representative sample of Norwegian secondary schools and grade 8 students who participated in the Health Behaviour in School-aged Children (HBSC) 2005/06 study. The final sample comprised 68 schools and 1347 students. Physical environment characteristics were assessed through questionnaires completed by the principals, and students' physical activity and interests in physical activity were assessed through student self-completion questionnaires. Most students were interested in more opportunities for physical activity in school. Multilevel logistic regression models demonstrated that students attending schools with many facilities had 4.49 times (95% Confidence Interval (CI) = 1.93–10.44) higher odds of being physically active compared to students in schools with fewer facilities when adjusting for socio-economic status, sex and interests in school physical activity. Also open fields (Odds Ratio (OR) = 4.31, 95% CI = 1.65–11.28), outdoor obstacle course (OR = 1.78, 95% CI = 1.32–2.40), playground equipment (OR = 1.73, 95% CI = 1.24–2.42) and room with cardio and weightlifting equipment (OR = 1.58, 95%CI = 1.18–2.10) were associated with increased participation in physical activity. Both students' overall interests and the physical facilitation of the school environment significantly contributed to the prediction of recess physical activity. The interaction term demonstrated that students' interests might moderate the effect of facilities on recess physical activity. The findings support the use of an ecological approach and multilevel analyses in the investigation of correlates of physical activity that allows for a broader understanding of the influence of and interaction between factors at multiple levels on physical activity behaviour. In the promotion of physical activity in lower secondary schools, the study suggests that programmes should include a focus on environmental facilitation and incorporate strategies to increase students' interests for school physical activity.

Lack of agreement between measured and self-reported distance from public green parks in Glasgow, Scotland

Abstract: Background Reviews have reported mixed findings for associations between physical activity and proximity to a range of environmental resources. Initially most studies used self reported proximity, but more are now using GIS techniques to measure proximity objectively. We know little about the extent of agreement between self reported and directly measured proximity of the same resource.

Does getting a dog increase recreational walking

Abstract: This study examines changes in socio-demographic, environmental and intrapersonal factors associated with dog acquisition in non-dog owners at baseline to 12-months follow-up and the effect of dog acquisition on minutes per week of recreational walking. RESIDE study participants completed self-administered questionnaires (baseline and 12-months follow-up) measuring physical activity, dog ownership, dog walking behavior as well as environmental, intrapersonal and socio-demographic factors. Analysis was restricted to 'Continuing non-owners' (i.e., non-owners at both baseline and follow-up; n = 681) and 'New dog owners' (i.e., non-owners who acquired a dog by follow-up; n = 92). Overall, 12% of baseline non-owners had acquired a dog at follow-up. Dog acquisition was associated with working and having children at home. Those who changed from single to couple marital status were also more likely to acquire a dog. The increase in minutes of walking for recreation within the neighborhood from baseline to follow-up was 48 minutes/week for new dog owners compared with 12 minutes/week for continuing non-owners (p 0.05) after further adjustment for change in baseline to follow-up variables. Increase in intention to walk was the main factor contributing to attenuation of the effect of dog acquisition on recreational walking. This study used a large representative sample of non-owners to examine the relationship between dog acquisition and recreational walking and provides evidence to suggest that dog acquisition leads to an increase in walking. The most likely mechanism through which dog acquisition facilitates increased physical activity is through behavioral intention via the dog's positive effect on owner's cognitive beliefs about walking, and through the provision of motivation and social support for walking. The results suggest that behavioral intention mediates the relationship between dog acquisition and walking and that dogs may have a significant role in the maintenance of owner walking behavior.