Validation of a simplified physical activity record by doubly labeled water technique

Regional Difference in the Impact of COVID-19 Pandemic on Domain-Specific Physical Activity, Sedentary Behavior, Sleeping Time, and Step Count: Web-Based Cross-sectional Nationwide Survey and Accelerometer-Based Observational Study

BACKGROUND

Physical activity (PA) and sedentary behavior (SB) have been affected by the COVID-19 pandemic and its restrictive environments, such as social distancing and lockdown measures. However, regional differences in the changes in domain-specific PA and SB in response to the COVID-19 pandemic are not clearly understood.

OBJECTIVE

This study aimed to examine regional differences in domain-specific PA and SB, as well as sleeping time in response to the COVID-19 pandemic in Japan.

METHODS

A web-based cross-sectional nationwide survey and an accelerometer-based longitudinal observation were conducted. In the web-based survey, we recruited 150 Japanese men and 150 Japanese women for each of the following age groups: 20s, 30s, 40s, 50s, 60s, and 70s (n=1800). A total of 1627 adults provided valid responses to web-based surveillance from June to July 2020. Participants were recruited from urban (Greater Tokyo Area, n=1028), urban-rural (regional core cities, n=459), or rural (regional small and medium cities, n=140) areas. They answered sociodemographic and health-related questions and retrospectively registered the PA data of their average day before and during the COVID-19 pandemic in a web-based PA record system. In the accelerometer-based observation, PA and step count data were obtained using a triaxial accelerometer on people living in urban (n=370) and rural (n=308) areas.

RESULTS

Before the COVID-19 pandemic, there were no significant differences between these 3 regions in the time spent sleeping, staying at home, working or studying, and exercising (P>.05). By contrast, people living in urban areas had a longer duration of SB and transportation and a shorter duration of moderate-to-vigorous PA and lying or napping time compared with people living in rural areas (P>.05). During the COVID-19 pandemic, a significant decrease was observed in transportation time in urban (-7.2 min/day, P<.001) and urban-rural (-2.0 min/day, P=.009) areas but not in rural (-0.4 min/day, P=.52) areas. The moderate-to-vigorous PA was decreased in urban (-31.3 min/day, P<.001) and urban-rural (-30.0 min/day, P<.001) areas but not in rural areas (-17.3 min/day, P=.08). A significant increase was observed in time spent sleeping in urban (+22.4 min/day, P<.001) and urban-rural (+24.2 min/day, P<.001) but not in rural areas (+3.9 min/day, P=.74). Lying or napping was increased in urban (+14.9 min/day, P<.001) but not in rural areas (-6.9 min/day, P=.68). PA and step count obtained using an accelerometer significantly decreased in urban (P<.05) but not in rural areas (P>.05).

CONCLUSIONS

The effect of the COVID-19 pandemic on PA and SB was significantly dependent on living area, even in a single country. The effects of PA and SB were greater in the Greater Tokyo Area and regional core cities but were not observed in regional small and medium cities in Japan.

Physical Activity Evaluation Using a Voice Recognition App: Development and Validation Study

Background

Historically, the evaluation of physical activity has involved a variety of methods such as the use of questionnaires, accelerometers, behavior records, and global positioning systems, each according to the purpose of the evaluation. The use of web-based physical activity evaluation systems has been proposed as an easy method for collecting physical activity data. Voice recognition technology not only eliminates the need for questionnaires during physical activity evaluation but also enables users to record their behavior without physically touching electronic devices. The use of a web-based voice recognition system might be an effective way to record physical activity and behavior.

Objective

The purpose of this study was to develop a physical activity evaluation app to record behavior using voice recognition technology and to examine the app’s validity by comparing data obtained using both the app and an accelerometer simultaneously.

Methods

A total of 20 participants (14 men, 6 women; mean age 19.1 years, SD 0.9) wore a 3-axis accelerometer and inputted behavioral data into their smartphones for a period of 7 days. We developed a behavior-recording system with a voice recognition function using a voice recognition application programming interface. The exercise intensity was determined from the text data obtained by the voice recognition program. The measure of intensity was metabolic equivalents (METs).

Results

From the voice input data of the participants, 601 text-converted data could be confirmed, of which 471 (78.4%) could be automatically converted into behavioral words. In the time-matched analysis, the mean daily METs values measured by the app and the accelerometer were 1.64 (SD 0.20) and 1.63 (SD 0.20), respectively, between which there was no significant difference (P=.57). There was a significant correlation between the average METs obtained from the voice recognition app and the accelerometer in the time-matched analysis (r=0.830, P<.001). In the Bland-Altman plot for METs measured by the voice recognition app as compared with METs measured by accelerometer, the mean difference between the two methods was very small (0.02 METs), with 95% limits of agreement from –0.26 to 0.22 METs between the two methods.

Conclusions

The average METs value measured by the voice recognition app was consistent with that measured by the 3-axis accelerometer and, thus, the data gathered by the two measurement methods showed a high correlation. The voice recognition method also demonstrated the ability of the system to measure the physical activity of a large number of people at the same time with less burden on the participants. Although there were still issues regarding the improvement of automatic text data classification technology and user input compliance, this research proposes a new method for evaluating physical activity using voice recognition technology.

Validity of One-Day Physical Activity Recall for Estimating Total Energy Expenditure in Elderly Residents at Long-Term Care Facilities: CLinical EValuation of Energy Requirements Study (CLEVER Study)

Malnutrition is a severe problem among elderly residents living in long-term care facilities. A simple and accurate estimation for total daily energy expenditure (TEE) is required in order to provide them with an adequate amount of food. The purpose of this study was to validate a physical activity assessment tool for estimating TEE among elderly residents. The data of 58 subjects aged 69-99 y were analyzed in this study. The one-day physical activity recall was filled out by facility staff for a typical day. TEE was measured by the doubly labeled water (DLW) method (TEE_DLW), and predicted by one-day physical activity recall using the basal metabolic rate (pTEE_BMR) and body weight (pTEE_BW). The TEE_DLW, pTEE_BMR and pTEE_BW were 1,129±196 kcal/d, 1,186±251 kcal/d and 1,326±236 kcal/d, respectively. In a regression model, body weight, movement means and sex explained 39.0% of the variance in the difference between pTEE_BMR and TEE_DLW (p<0.05). Percentage of fat mass, body weight, and Barthel Index except mobility explained 47.3% of the variance in the difference between pTEE_BW and TEE_DLW (p<0.05). The current results suggested that pTEE_BW is not recommended to estimate TEE because the error depends on body size, and pTEE_BMR was significantly correlated with TEE_DLW but also included systematic errors in elderly residents. In order to improve the accuracy of the present assessment to estimate TEE, it is necessary to establish a new equation of basal metabolic rate for elderly residents and consider sex and movement means to estimate TEE.

Validity of a triaxial accelerometer and simplified physical activity record in older adults aged 64-96 years: a doubly labeled water study

BACKGROUND

The aim was to examine the validity of a triaxial accelerometer (ACCTRI) and a simplified physical activity record (sPAR) in estimating total energy expenditure (TEE) and physical activity level (PAL) in older adults with the doubly labeled water (DLW) method.

METHODS

A total of 44 Japanese elderly individuals (64-96 years), of which 28 were community-dwelling healthy adults with or without sporting habits (S or NS group) and 16 were care home residents with frailty (F group), were included in the study. Basal metabolic rate (BMR) was measured by indirect calorimetry, TEE was obtained by the DLW method, and PAL was calculated as TEE/BMR. Daily step count was monitored by a pedometer (Lifecorder). The 24-h average metabolic equivalent was assessed by ACCTRI and sPAR.

RESULTS

The TEE_DLW in men was 2704 ± 353, 2308 ± 442, and 1795 ± 338 kcal d^-1, and that in women was 2260 ± 208, 1922 ± 285, and 1421 ± 274 kcal d^-1 for the S, NS, and F groups, respectively. ACCTRI and sPAR systematically underestimated actual TEE (- 14.2 ± 11.6 and - 15.3 ± 12.3% for ACCTRI and sPAR, respectively). After diet-induced thermogenesis was taken into account for ACCTRI and sPAR, TEE_DLW was significantly correlated with TEE_ACCTRI (R² = 0.714) and TEE_sPAR (R² = 0.668). PAL_DLW was also significantly correlated with PAL_ACCTRI (R² = 0.438) and PAL_sPAR (R² = 0.402).

CONCLUSIONS

Age, living conditions, frailty, and sporting habits contribute to TEE and PAL in the elderly population. ACCTRI and sPAR underestimated TEE and PAL, and adequate corrections are required. The corrected ACCTRI and sPAR are both useful tools to estimate TEE and PAL.

Physical activity, sleep, and fatigue in community dwelling Stroke Survivors

Stroke can lead to physiological and psychological impairments and impact individuals' physical activity (PA), fatigue and sleep patterns. We analysed wrist-worn accelerometry data and the Fatigue Assessment Scale from 41 stroke survivors following a physical rehabilitation programme, to examine relationships between PA levels, fatigue and sleep. Validated acceleration thresholds were used to quantify time spent in each PA intensity/sleep category. Stroke survivors performed less moderate to vigorous PA (MVPA) in 10 minute bouts than the National Stroke guidelines recommend. Regression analysis revealed associations at baseline between light PA and fatigue (p = 0.02) and MVPA and sleep efficiency (p = 0.04). Light PA was positively associated with fatigue at 6 months (p = 0.03), whilst sleep efficiency and fatigue were associated at 9 months (p = 0.02). No other effects were shown at baseline, 6 or 9 months. The magnitude of these associations were small and are unlikely to be clinically meaningful. Larger trials need to examine the efficacy and utility of accelerometry to assess PA and sleep in stroke survivors.

A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study

The links between increased participation in Physical Activity (PA) and improvements in health are well established. As this body of evidence has grown, so too has the search for measures of PA with high levels of methodological effectiveness (i.e. validity, reliability and responsiveness to change). The aim of this “review of reviews” was to provide a comprehensive overview of the methodological effectiveness of currently employed measures of PA, to aid researchers in their selection of an appropriate tool. A total of 63 review articles were included in this review, and the original articles cited by these reviews were included in order to extract detailed information on methodological effectiveness.

Self-report measures of PA have been most frequently examined for methodological effectiveness, with highly variable findings identified across a broad range of behaviours. The evidence-base for the methodological effectiveness of objective monitors, particularly accelerometers/activity monitors, is increasing, with lower levels of variability observed for validity and reliability when compared to subjective measures. Unfortunately, responsiveness to change across all measures and behaviours remains under-researched, with limited information available.

Other criteria beyond methodological effectiveness often influence tool selection, including cost and feasibility. However, researchers must be aware of the methodological effectiveness of any measure selected for use when examining PA. Although no “perfect” tool for the examination of PA in adults exists, it is suggested that researchers aim to incorporate appropriate objective measures, specific to the behaviours of interests, when examining PA in free-living environments.

Evidence for energetic tradeoffs between physical activity and childhood growth across the nutritional transition

Despite broad implications for understanding human life history, energetics, and health, the impact of physical activity on childhood growth remains unclear. Particularly understudied is the effect of secular changes in physical activity on child development. We address these shortcomings using data spanning the transition from traditional to semi-developed economy among Yucatec Maya agriculturalists. Anthropometric and behavioral observation data were collected from children living in a subsistence-based rural community in 1992 and again in 2012 following the introduction of a school and mechanized technologies but minimal overt dietary change. Multiple regression analyses demonstrate dramatic twenty-year transformations in how children spent their time. This behavioral change was associated with large declines in estimated physical activity level (PAL), associated activity energy expenditure savings of several hundred kilocalories/day, and sizable increases in mean height, weight, and triceps skinfold thickness. Controlling for observed frequency of market food consumption, PAL was inversely related to child body size and subcutaneous fat stores and significantly mediated the effects of data collection year on anthropometric indices. These findings indicate that physical activity can considerably influence childhood growth, highlighting the role of energy allocation tradeoffs between physical activity and competing life tasks in shaping patterns of human ontogeny and health.

Design and Evaluation of a Computer-Based 24-Hour Physical Activity Recall (cpar24) Instrument

Background

Widespread access to the Internet and an increasing number of Internet users offers the opportunity of using Web-based recalls to collect detailed physical activity data in epidemiologic studies.

Objective

The aim of this investigation was to evaluate the validity and reliability of a computer-based 24-hour physical activity recall (cpar24) instrument with respect to the recalled 24-h period.

Methods

A random sample of 67 German residents aged 22 to 70 years was instructed to wear an ActiGraph GT3X+ accelerometer for 3 days. Accelerometer counts per min were used to classify activities as sedentary (<100 counts per min), light (100-1951 counts per min), and moderate to vigorous (≥1952 counts per min). On day 3, participants were also requested to specify the type, intensity, timing, and context of all activities performed during day 2 using the cpar24. Using metabolic equivalent of task (MET), the cpar24 activities were classified as sedentary (<1.5 MET), light (1.5-2.9 MET), and moderate to vigorous (≥3.0 MET). The cpar24 was administered twice at a 3-h interval. The Spearman correlation coefficient (r) was used as primary measure of concurrent validity and test-retest reliability.

Results

As compared with accelerometry, the cpar24 underestimated light activity by −123 min (median difference, P difference <.001) and overestimated moderate to vigorous activity by 89 min (P difference <.001). By comparison, time spent sedentary assessed by the 2 methods was similar (median difference=+7 min, P difference=.39). There was modest agreement between the cpar24 and accelerometry regarding sedentary (r=.54), light (r=.46), and moderate to vigorous (r=.50) activities. Reliability analyses revealed modest to high intraclass correlation coefficients for sedentary (r=.75), light (r=.65), and moderate to vigorous (r=.92) activities and no statistically significant differences between replicate cpar24 measurements (median difference for sedentary activities=+10 min, for light activities=−5 min, for moderate to vigorous activities=0 min, all P difference ≥.60).

Conclusion

These data show that the cpar24 is a valid and reproducible Web-based measure of physical activity in adults.

Physical activity surveillance in the European Union: reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ)

BACKGROUND

The current study examined the reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ), a novel questionnaire for the surveillance of physical activity (PA) during work, transportation, leisure time, sports, health-enhancing and muscle-strengthening activities over a typical week.

METHODS

Reliability was assessed by administering the 8-item questionnaire twice to a population-based sample of 123 participants aged 15-79 years at a 30-day interval. Concurrent (inter-method) validity was examined in 140 participants by comparisons with self-report (International Physical Activity Questionnaire-Long Form (IPAQ-LF), 7-day Physical Activity Record (PAR), and objective criterion measures (GT3X+ accelerometer, physical work capacity at 75% (PWC(75%)) from submaximal cycle ergometer test, hand grip strength).

RESULTS

The EHIS-PAQ showed acceptable reliability, with a median intraclass correlation coefficient across PA domains of 0.55 (range 0.43-0.73). Compared to the GT3X+ (counts/minutes/day), the EHIS-PAQ underestimated moderate-to-vigorous PA (median difference -11.7, p-value = 0.054). Spearman correlation coefficients (ρ) for validity were moderate-to-strong (ρ's > 0.41) for work-related PA (IPAQ = 0.64, GT3X + =0.43, grip strength = 0.48), transportation-related PA (IPAQ = 0.62, GT3X + =0.43), walking (IPAQ = 0.58), and health-enhancing PA (IPAQ = 0.58, PAR = 0.64, GT3X + =0.44, PWC(75%) = 0.48), and fair-to-poor (ρ's < 0.41) for moderate-to-vigorous aerobic recreational and muscle-strengthening PA.

CONCLUSIONS

The EHIS-PAQ showed good evidence for reliability and validity for the measurement of PA levels at work, during transportation and health-enhancing PA.

Physical activity in chronic home-living and sub-acute hospitalized stroke patients using objective and self-reported measures

BACKGROUND

Despite confirmed reduced physical activity (PA) after stroke in various stages of recovery, the type of activities stroke patients executed and the time spent at different activity levels have not been sufficiently verified with stroke-validated assessment tools.

DESIGN

Observational study.

OBJECTIVE

To determine PA of sub-acute stroke patients hospitalized in a rehabilitation centre (HOS) compared to chronic home-living stroke patients (HOM) using objective and self-reported measures during 2 weekdays and 1 weekend day.

METHODS

Fifteen HOS and 15 HOM patients wore a Sense Wear Pro 2 accelerometer (METs*minutes/24 h) and a knee-worn pedometer Yamax Digi Walker SW 200 (steps) and filled in a coded activity diary (kcal/24 h; METs*minutes/24 h) during three consecutive days.

RESULTS

In HOM significantly more steps (stepstotal HOM = 18722.6 ± 10063.6; stepstotal HOS = 7097.8 ± 5850.5) and higher energy expenditure (EE) levels (EEtotal HOM = 7759.34 ± 2243.04; EEtotal HOS = 5860.15 ± 1412.78) were measured. In this group less moderate activity (≥3-6 ≤ METs) was performed on a weekday (pday1 = 0.006; pday2 = 0.027) and in total (p = 0.037). Few therapy hours (physical, occupational and speech therapy, and psychological support) were provided in HOM compared to HOS (p < 0.001). Vigorous activities were only seen in HOM. In both groups few patients executed sport activities.

CONCLUSIONS

In HOM significantly more steps were performed and higher EE values were measured. However, participation in moderate activities and time spent on therapy were less in HOM. Evaluating PA with quantitative measures is feasible in both chronic home-living and sub-acute hospitalized patients with stroke.

Use of a Web-based physical activity record system to analyze behavior in a large population: cross-sectional study

Background

The use of Web-based physical activity systems has been proposed as an easy method for collecting physical activity data. We have developed a system that has exhibited high accuracy as assessed by the doubly labeled water method.

Objective

The purpose of this study was to collect behavioral data from a large population using our Web-based physical activity record system and assess the physical activity of the population based on these data. In this paper, we address the difference in physical activity for each urban scale.

Methods

In total, 2046 participants (aged 30-59 years; 1105 men and 941 women) participated in the study. They were asked to complete data entry before bedtime using their personal computer on 1 weekday and 1 weekend day. Their residential information was categorized as urban, urban-rural, or rural. Participant responses expressed the intensity of each activity at 15-minute increments and were recorded on a Web server. Residential areas were compared and multiple regression analysis was performed.

Results

Most participants had a metabolic equivalent (MET) ranging from 1.4 to 1.8, and the mean MET was 1.60 (SD 0.28). The median value of moderate-to-vigorous physical activity (MVPA, ≥3 MET) was 7.92 MET-hours/day. A 1-way ANCOVA showed that total physical activity differed depending on the type of residential area (F_2,2027=5.19, P=.006). The urban areas (n=950) had the lowest MET-hours/day (mean 37.8, SD, 6.0), followed by urban-rural areas (n=432; mean 38.6, SD 6.5; P=.04), and rural areas (n=664; mean 38.8, SD 7.4; P=.002). Two-way ANCOVA showed a significant interaction between sex and area of residence on the urban scale (F_2,2036=4.53, P=.01). Men in urban areas had the lowest MET-hours/day (MVPA, ≥3 MET) at mean 7.9 (SD 8.7); men in rural areas had a MET-hours/day (MVPA, ≥3 MET) of mean 10.8 (SD 12.1, P=.002). No significant difference was noted in women among the 3 residential areas. Multiple regression analysis showed that physical activity consisting of standing while working was the highest contributor to MVPA, regardless of sex.

Conclusions

We were able to compile a detailed comparison of physical activity because our Web-based physical activity record system allowed for the simultaneous evaluation of physical activity from 2046 Japanese people. We found that rural residents had greater total physical activity than urban residents and that working and transportation behaviors differed depending on region type. Multiple regression analysis showed that the behaviors affected MVPA. People are less physically active while working, and sports and active transportation might be effective ways of increasing physical activity levels.

Is a coded physical activity diary valid for assessing physical activity level and energy expenditure in stroke patients?

Objectives

to determine the concurrent validity of a physical activity diary for measuring physical activity level and total energy expenditure in hospitalized stroke patients.

Method

Sixteen stroke patients kept coded activity diaries and wore SenseWear Pro2 multi-sensor activity monitors during daytime hours for one day. A researcher observed the patients and completed a diary. Data from the patients' diaries were compared with observed and measured data to determine total activity (METs*minutes), activity level and total energy expenditure.

Results

Spearman correlations between the patients' and researchers' diaries revealed a high correlation for total METs*minutes (r_s = 0.75, p<0.01) for sedentary (r_s = 0.74,p<0.01) and moderate activities (r_s = 0.71,p<0.01) and a very high correlation (r_s = 0.92, p<0.01) for the total energy expenditure. Comparisons between the patients' diaries and activity monitor data revealed a low correlation (r_s 0.29) for total METs*minutes and energy expenditure.

Conclusion

Coded self-monitoring activity diaries appear feasible as a low-tech alternative to labor-intensive observational diaries for determining sedentary, moderate, and total physical activity and for quantifying energy expenditure in hospitalized stroke patients. Given the poor correlation with objective measurements of physical activity, however, further research is needed to validate its use against a gold-standard measure of physical activity intensity and energy expenditure.

Association between lifestyle and physical activity level in the elderly: a study using doubly labeled water and simplified physical activity record

PURPOSE

Physical activity level (PAL) is associated with all-cause mortality in the elderly. However, few studies have attempted to clarify the relationship between lifestyle and PAL in the elderly. This study aimed to examine the determinants of PAL in the elderly in terms of behavioral patterns and exercise intensity, and to validate the simplified physical activity record (sPAR).

METHODS

Thirty healthy, elderly individuals, aged 64-87 years, participated in the study. Total energy expenditure (TEEDLW), physical activity energy expenditure (PAEEDLW), and PAL (PALDLW) were calculated based on doubly labeled water (DLW) and measured basal metabolic rate. Physical activity was recorded using the sPAR.

RESULTS

PALDLW was significantly correlated with PAL estimated by sPAR (r = 0.588, P < 0.001). Good agreement was observed between TEEDLW (1,860 ± 373 kcal/day) and TEE estimated by sPAR (1,854 ± 377 kcal/day) (r = 0.825, P < 0.001). Good agreement was also observed between PAEEDLW (552 ± 242 kcal/day) and PAEE estimated by sPAR (562 ± 240 kcal/day) (r = 0.666, P < 0.001). The high PALDLW group had significantly shorter durations of 'sleeping time and rest periods' and 'daily life sedentary activities', and significantly longer durations of 'bicycling with moderate speed', 'housekeeping with standing', 'gymnastics, tai chi, stretching' and "swimming, hill climbing, fast jogging" than the low PAL group (P < 0.05).

CONCLUSIONS

The sPAR provides valid estimates of TEE and PAEE in the healthy elderly. The results suggest that engaging in housekeeping or sports activities for longer and being less sedentary may increase PALDLW in healthy elderly individuals.

Validation of Web-based physical activity measurement systems using doubly labeled water

BACKGROUND

Online or Web-based measurement systems have been proposed as convenient methods for collecting physical activity data. We developed two Web-based physical activity systems-the 24-hour Physical Activity Record Web (24hPAR WEB) and 7 days Recall Web (7daysRecall WEB).

OBJECTIVE

To examine the validity of two Web-based physical activity measurement systems using the doubly labeled water (DLW) method.

METHODS

We assessed the validity of the 24hPAR WEB and 7daysRecall WEB in 20 individuals, aged 25 to 61 years. The order of email distribution and subsequent completion of the two Web-based measurements systems was randomized. Each measurement tool was used for a week. The participants' activity energy expenditure (AEE) and total energy expenditure (TEE) were assessed over each week using the DLW method and compared with the respective energy expenditures estimated using the Web-based systems.

RESULTS

The mean AEE was 3.90 (SD 1.43) MJ estimated using the 24hPAR WEB and 3.67 (SD 1.48) MJ measured by the DLW method. The Pearson correlation for AEE between the two methods was r = .679 (P < .001). The Bland-Altman 95% limits of agreement ranged from -2.10 to 2.57 MJ between the two methods. The Pearson correlation for TEE between the two methods was r = .874 (P < .001). The mean AEE was 4.29 (SD 1.94) MJ using the 7daysRecall WEB and 3.80 (SD 1.36) MJ by the DLW method. The Pearson correlation for AEE between the two methods was r = .144 (P = .54). The Bland-Altman 95% limits of agreement ranged from -3.83 to 4.81 MJ between the two methods. The Pearson correlation for TEE between the two methods was r = .590 (P = .006). The average input times using terminal devices were 8 minutes and 10 seconds for the 24hPAR WEB and 6 minutes and 38 seconds for the 7daysRecall WEB.

CONCLUSIONS

Both Web-based systems were found to be effective methods for collecting physical activity data and are appropriate for use in epidemiological studies. Because the measurement accuracy of the 24hPAR WEB was moderate to high, it could be suitable for evaluating the effect of interventions on individuals as well as for examining physical activity behavior.

Posting point-of-purchase nutrition information in university canteens does not influence meal choice and nutrient intake

BACKGROUND

Growing concern over the relation between out-of-home eating and overweight has triggered the use of point-of-purchase (POP) nutrition information when eating out of the home. In canteens that offer various unhealthy choices, the posting of POP nutrition information has the potential to improve meal choices and dietary intakes.

OBJECTIVE

The objective of this study was to increase the proportion of consumed meals that comply with recommendations for energy, saturated fat, sodium, and vegetable content by 5%.

DESIGN

A one-group pretest-posttest design was used. A total of 224 customers of 2 university canteens completed a questionnaire used for consumer profiling and 3-d food records to assess their meal choices and nutrient intakes. The 12 best meal combinations received star ratings and descriptors for nutrients or food groups that did not comply.

RESULTS

Reported meal choices in canteens and nutrient intakes did not improve after the intervention (P > 0.05). The nutritional profile of the meal choice, obtained from a qualitative and quantitative nutritional assessment of meals, mirrored the nutritional profile of all meals offered (P > 0.05) and not that of the recommended meals offered (P < 0.001). Meal choices were not compensated for later in the day (P > 0.05). The healthiest choices were made by participants with greater objective nutrition knowledge, stronger health and weight-control motives, and a greater openness to change meal choices at baseline (P < 0.05).

CONCLUSIONS

The posting of nutrition information in university canteens did not effectively change meal choices and nutrient intakes. Despite the intervention, meal choices were largely determined by meals offered. Therefore, nutrition-information interventions in canteens may be more effective with a healthier meal supply. This trial was registered at clinicaltrials.gov as NCT01249508.

Physical activity, antioxidant status, and protein modification in adolescent athletes

Exercise may increase reactive oxygen species production, which might impair cell integrity and contractile function of muscle cells. However, little is known about the effect of regular exercise on the antioxidant status of adolescents.

PURPOSE

This study aimed to evaluate the impact of exercise on the antioxidant status and protein modifications in adolescent athletes.

METHODS

In 90 athletes and 18 controls (16 +/- 2 yr), exercise-related energy expenditure was calculated on the basis of a 7-d activity protocol. Antioxidant intake and plasma concentrations of alpha-tocopherol, carotenoids, and uric acid were analyzed. Plasma antioxidant activity was determined by Trolox equivalent (TE) antioxidant capacity and electron spin resonance spectrometry. Protein modifications were assessed with structural changes of transthyretin using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Data were analyzed by two-way ANOVA and post hoc by the Tukey-Kramer test (alpha = 0.05).

RESULTS

Antioxidant intake correlated with energy intake and was within the recommended daily allowance for vitamins C and E and beta-carotene. Plasma levels of neither nutritional antioxidants nor uric acid differed between the groups. TE antioxidant capacity was higher in athletes (men = 1.47 +/- 0.2 mmol TE per liter, women = 1.45 +/- 0.2 mmol TE per liter) compared with controls (men = 1.17 +/- 0.04 mmol TE per liter, women = 1.14 +/- 0.04 mmol TE per liter) and increased with exercise-related energy expenditure (P = 0.007). Transthyretin cysteinylation rate differed between the groups, with the highest rate of protein modifications in moderately active subjects (P = 0.007).

CONCLUSIONS

Results suggest that if the nutritional choice of athletes is well balanced, enough antioxidants are provided to meet recommended amounts. Moreover, regular exercise increases blood antioxidant capacity in young athletes, whereas chronic exercise was not shown to promote protein modifications. Thus, in young athletes who are sufficiently supplied with antioxidants, beneficial effects of exercise on antioxidant status rather than on oxidative stress may be anticipated.

Physical activity, diet, and pancreatic cancer: a population-based, case-control study in Minnesota

Although mounting evidence suggests that insulin resistance is involved in pancreatic carcinogenesis, few epidemiologic studies have comprehensively investigated the role of lifestyle factors influencing this metabolic disorder in the etiology of pancreatic cancer. We sought to examine this problem in a case-control study conducted in 1994-1998 in Minnesota. Cases (n = 186), aged 20 yr or older, were ascertained from all hospitals in the metropolitan area of the Twin Cities and the Mayo Clinic; from the latter, only cases residing in the Upper Midwest of the United States were recruited. Controls (n = 554) were randomly selected from the general population and frequency matched to cases by age (within 5 yr) and sex. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression. After adjustment for confounders, physical activity was associated with a reduced risk, but this protective effect was confined to light activity and moderate activity only (OR = 0.55, 95% CI = 0.30-0.97, P(trend) = 0.038 and OR = 0.51, 95% CI = 0.28-0.93, P(trend) = 0.07, for highest vs. lowest quartile, respectively). An increased risk was found for dietary intakes of energy and fat but was statistically significant for saturated and polyunsaturated fat only. Of note, no appreciable difference in the magnitude of the associations existed between saturated, monounsaturated, and polyunsaturated fat. Compared with individuals in the lowest quartile of fiber intake, the risk was approximately halved for those in the third (OR = 0.49, 95% CI = 0.26-0.94) and the highest quartile (OR = 0.52, 95% CI = 0.21-1.30). Our study lends support to the hypothesis that dietary and other lifestyle factors influencing insulin resistance modulate pancreatic cancer risk.

Availability of free fruits and vegetables at canteen lunch improves lunch and daily nutritional profiles: a randomised controlled trial

Canteens are known to be promising settings for activities to promote intake of fruits and vegetables, but it remains unclear to what extent distributing free fruits and vegetables can influence dietary patterns of customers. The present study evaluated the effect of providing fruits and vegetables for free in a university canteen on the daily diet of university canteen customers. Canteen customers (n 209) were randomly allocated to a fruit and vegetable group (FVG) and a control group (CG). FVG participants were given two portions of fruits and one portion of vegetables for free at lunchtime. Food and beverage intake was measured using a dietary record for 3 d and dietary quality was appraised using a comprehensive scoring system. The FVG participants ate 80 g more fruits (P < 0.01) and 108 g more vegetables (P < 0.001) on a daily basis compared with the CG participants. No differences were found for energy density, total energy, Na and energy from fat between the groups per day. A higher intake of fruits and vegetables was observed at lunch and of vegetables during the dinner and evening snacks. The FVG participants were more likely to comply with dietary recommendations for fruits and vegetables and had a better dietary profile on the study days and for the lunch consumed on those days. The results of the present study demonstrate how modifications of a canteen lunch can be instrumental to enhance the nutritional quality of lunch as well as the overall quality of the diet of the customers.

Assessment of physical activity: a critical appraisal

Assessment of physical activity in a free-living environment is important for understanding relations between physical activity and health and determining the effectiveness of interventions. Techniques include behavioral observation, questionnaires in the form of diaries, recall questionnaires and interviews, and physiological markers like heart rate, calorimetry, and motion sensors. The doubly labeled water method has become the gold standard for the validation of field methods of assessing physical activity. Then, questionnaires show a low reliability and validity but can be adequately applied as an activity-ranking instrument. The heart rate requires individual calibration to be an effective method to assess physical activity only at group level. The indicated method for the assessment of habitual physical activity in daily life is a doubly labeled water validated accelerometer. Future developments are simultaneous measurement of body acceleration and heart rate for the assessment of physical fitness. A new generation of accelerometers will provide information on body posture and activity recognition to allow objective assessment of subjects' habitual activities, options for a healthy change, and effects of the follow-up of any changes.

Validation of a 7-day physical activity diary against doubly-labelled water

BACKGROUND

The assessment of physical activity intensity and duration is essential for understanding group activity patterns.

METHODS

The present study evaluated the validity of measurement of total energy expenditure (TEE) and physical activity level (PAL) using a categorized physical activity diary. In 29 young healthy men, aged 18-27 years, with body mass index range 21-43 kg m(-2), TEE using doubly-labelled water (DLW), resting metabolic rate (RMR) by indirect calorimetry, physical activity level (PAL defined as TEE/RMR) and activity pattern, timing and level from 7-day physical activity diaries were determined.

RESULTS

TEE by DLW and estimated by activity diary were correlated (r = 0.61, p = 0.005). The mean underestimation of TEE by the activity diary compared with the DLW method was 2.50 +/- 0.72 MJ day(-1). Sedentary (lying, sitting and standing) time averaged 18 h day(-1) and was negatively correlated with PAL (r = -0.44, p = 0.018) whilst time spent in light intensity activity (5 h day(-1)) was positively correlated (r = 0.51, p = 0.005).

CONCLUSIONS

It is concluded that the categorized physical activity diary measured TEE with limited accuracy but presents an inexpensive, convenient method of discriminating individual and group physical activity patterns.

Arabinoxylan consumption decreases postprandial serum glucose, serum insulin and plasma total ghrelin response in subjects with impaired glucose tolerance

OBJECTIVE

Arabinoxylan (AX) consumption is associated with metabolic improvement during diabetes and with modulation of ghrelin, an orexigenic gut hormone. The effect of AX consumption on ghrelin secretion in disturbed metabolic states is unknown. Therefore, we investigated the postprandial responses to AX consumption of serum glucose, insulin and triglycerides and plasma total and acylated ghrelin in subjects with impaired glucose tolerance (IGT).

DESIGN

Randomized, single-blind, controlled, crossover intervention trial.

SUBJECTS

Seven female and four male adults with IGT, aged 55.5 years, and body mass index (BMI) 30.1 kg/m(2).

INTERVENTION

Subjects received either placebo or 15 g AX supplement for 6 weeks with a 6-week washout period in-between.

MAIN OUTCOME MEASUREMENTS

Postprandial responses of serum glucose, insulin and triglycerides, and plasma total and acylated ghrelin after a liquid meal challenge test (LMCT) measured at the beginning and at the end of the dietary intervention at -20, -5, 0, 15, 30, 45, 60, 90, 120, 150, 180, 210 and 240 min.

RESULTS

After LMCT, AX consumption resulted in lower postprandial responses in serum glucose, insulin and triglycerides (P<0.05). Compared to placebo, total plasma ghrelin was also reduced by 42+/-8 pg/ml (P<0.001) after AX consumption with no difference in plasma acylated ghrelin.

CONCLUSION

AX consumption improved postprandial metabolic responses after an LMCT in subjects with IGT and reduced total ghrelin response. However, acylated ghrelin responses were unchanged, suggesting that the acylated ghrelin-mediated orexigenic regulation is not improved as only total plasma ghrelin decreased.