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Lifestyle Behaviors Associated With Body Fat Percent in 9- to 11-Year-Old Children. Pediatr Exerc Sci 2021; 33:40-47. [PMID: 33771944 DOI: 10.1123/pes.2020-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine (1) associations between body fat percent (BF) and lifestyle behaviors in children aged 9-11 years and (2) the consistency of these associations over a 10-year period. METHODS In this repeat, cross-sectional study, 15,977 children aged 9-11 years completed an anthropometric assessment and the SportsLinx Lifestyle survey between 2004 and 2013. Body fat was estimated according to the sum of the triceps and subscapular skinfold measurements. Multilevel models were utilized to examine associations between BF and responses to the lifestyle survey while controlling for known covariates. RESULTS Lifestyle behaviors explained 8.6% of the total variance in body fat. Specifically, negative associations were found between BF and active transport to school ( β = -0.99 [0.19], P < .001), full-fat milk (-0.07 [0.15], P < .001), and sweetened beverage consumption (-0.40 [0.15], P = .007). Relative to the reference group of ≤8:00 PM, later bedtime was positively associated with BF: 8:00 to 8:59 PM ( β = 1.60 [0.26], P < .001); 9:00 to 10:00 PM ( β = 1.04 [0.24], P < .001); ≥10:00 PM ( β = 1.18 [0.30], P < .001). Two-way interactions revealed opposing associations between BF and the consumption of low-calorie beverages for boys ( β = 0.95 [0.25], P < .001) and girls ( β = -0.85 [0.37], P = .021). There was no significant change in these associations over a 10-year period. CONCLUSIONS In this population-level study covering a decade of data collection, lifestyle behaviors were associated with BF. Policies and interventions targeting population-level behavior change, such as active transport to school, sleep time, and consumption of full-fat milk, may offer an opportunity for improvements in BF.
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Hooson Jzh J, Hutchinson Jyh J, Warthon-Medina M, Hancock N, Greathead K, Knowles B, Vargas-Garcia E, Gibson LE, Bush LA, Margetts B, Robinson S, Ness A, Alwan NA, Wark PA, Roe M, Finglas P, Steer T, Page P, Johnson L, Roberts K, Amoutzopoulos B, Burley VJ, Greenwood DC, Cade JE. A systematic review of reviews identifying UK validated dietary assessment tools for inclusion on an interactive guided website for researchers: www.nutritools.org. Crit Rev Food Sci Nutr 2019; 60:1265-1289. [PMID: 30882230 PMCID: PMC7114915 DOI: 10.1080/10408398.2019.1566207] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Health researchers may struggle to choose suitable validated dietary assessment tools (DATs) for their target population. The aim of this review was to identify and collate information on validated UK DATs and validation studies for inclusion on a website to support researchers to choose appropriate DATs.Design: A systematic review of reviews of DATs was undertaken. DATs validated in UK populations were extracted from the studies identified. A searchable website was designed to display these data. Additionally, mean differences and limits of agreement between test and comparison methods were summarized by a method, weighting by sample size.Results: Over 900 validation results covering 5 life stages, 18 nutrients, 6 dietary assessment methods, and 9 validation method types were extracted from 63 validated DATs which were identified from 68 reviews. These were incorporated into www.nutritools.org. Limits of agreement were determined for about half of validations. Thirty four DATs were FFQs. Only 17 DATs were validated against biomarkers, and only 19 DATs were validated in infant/children/adolescents.Conclusions: The interactive www.nutritools.org website holds extensive validation data identified from this review and can be used to guide researchers to critically compare and choose a suitable DAT for their research question, leading to improvement of nutritional epidemiology research.
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Affiliation(s)
- Jozef Hooson Jzh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Jayne Hutchinson Jyh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Marisol Warthon-Medina
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.,Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Neil Hancock
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Katharine Greathead
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Bethany Knowles
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Elisa Vargas-Garcia
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lauren E Gibson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Linda A Bush
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Barrie Margetts
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andy Ness
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Nisreen A Alwan
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.,Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Petra A Wark
- Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, UK.,Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Mark Roe
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK.,EuroFIR AISBL, Brussels, Belgium
| | - Paul Finglas
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Toni Steer
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Polly Page
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katharine Roberts
- Public Health Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.,Public Health England, London, UK
| | | | - Victoria J Burley
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Faculty of Medicine and Health Division of Biostatistics, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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LeCroy MN, Stevens J. Dietary intake and habits of South Asian immigrants living in Western countries. Nutr Rev 2018; 75:391-404. [PMID: 28591786 DOI: 10.1093/nutrit/nux023] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous reviews have indicated that immigration from South Asian to Western countries leads to unhealthy changes in diet; however, these reviews have been limited by the methods used in some included studies. This critical narrative review summarizes findings from original research articles that performed appropriate statistical analyses on diet data obtained using culturally appropriate diet assessment measures. All studies quantitatively compared the diets of South Asian immigrants with those of residents of Western or South Asian countries or with those of South Asian immigrants who had varying periods of time since immigration. Most studies examined total energy and nutrient intake among adults. Total energy intake tended to decrease with increasing duration of residence and immigrant generation, and immigrants consumed less protein and monounsaturated fat compared with Westerners. However, findings for intakes of carbohydrate, total fat, saturated fat, polyunsaturated fat, and micronutrients were mixed. Studies that examine food group intake and include South Asians living in South Asia as a comparison population are needed.
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Affiliation(s)
- Madison N LeCroy
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - June Stevens
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Lloyd J, Creanor S, Logan S, Green C, Dean SG, Hillsdon M, Abraham C, Tomlinson R, Pearson V, Taylor RS, Ryan E, Price L, Streeter A, Wyatt K. Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial. THE LANCET. CHILD & ADOLESCENT HEALTH 2018; 2:35-45. [PMID: 29302609 PMCID: PMC5738974 DOI: 10.1016/s2352-4642(17)30151-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Although childhood overweight and obesity prevalence has increased substantially worldwide in the past three decades, scarce evidence exists for effective preventive strategies. We aimed to establish whether a school-based intervention for children aged 9-10 years would prevent excessive weight gain after 24 months. Methods This pragmatic cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a school-based obesity prevention intervention, was done in 32 schools in southwest England. All state-run primary and junior schools in Devon and Plymouth (UK) with enough pupils for at least one year-5 class were eligible. Schools were assigned (1:1) using a computer-generated sequence to either intervention or control, stratified by the number of year-5 classes (one vs more than one) and the proportion of children eligible for free school meals (<19% [the national average] vs ≥19%). HeLP was delivered to year-5 children (ages 9-10 years) over 1 year, and included dynamic and interactive activities such as physical activity workshops, education sessions delivered by teachers with short homework tasks, drama sessions, and setting goals to modify behaviour (with parental support and one-to-one discussions with HeLP coordinators). The primary outcome was change in body-mass index (BMI) standard deviation score (SDS) between baseline and 24 months, analysed in children with BMI data available for both timepoints. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN15811706, and the trial status is complete. Findings Between March 21, 2012, and Sept 30, 2013, 32 eligible schools with 1324 children were recruited, of which 16 schools (676 children) were randomly assigned to the HeLP intervention and 16 schools (648 children) to control. All schools that began the trial completed the intervention, and 1244 children (628 in intervention group and 616 in control group) had BMI data at both baseline and 24 months for the primary outcome analysis. Mean BMI SDS was 0·32 (SD 1·16) at baseline and 0·35 (1·25) at 24 months in the intervention group, and 0·18 (1·14) at baseline and 0·22 (1·22) at 24 months in the control group. With adjustment for school-level clustering, baseline BMI scores, sex, cohort, and number of year-5 classes and socioeconomic status of each school, the mean difference in BMI SDS score (intervention-control) at 24 months was -0·02 (95% CI -0·09 to 0·05), p=0·57. One parent reported an adverse event related to their child's eating and activity behaviours, but agreed for the child to continue trial participation after discussion with the chief investigator. Interpretation Despite a theoretically informed and extensively piloted intervention that achieved high levels of engagement, follow-up, and fidelity of delivery, we found no effect of the intervention on preventing overweight or obesity. Although schools are an ideal setting in which to deliver population-based interventions, school-based interventions might not be sufficiently intense to affect both the school and the family environment, and hence the weight status of children. Future research should focus on more upstream determinants of obesity and use whole-systems approaches. Funding UK National Institute for Health Research, Public Health Research Programme.
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Affiliation(s)
- Jenny Lloyd
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - Siobhan Creanor
- Peninsula Clinical Trials Unit and Medical Statistics, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Stuart Logan
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Colin Green
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Sarah G Dean
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Charles Abraham
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Virginia Pearson
- Public Health Devon, Devon County Council Commissioning Headquarters, Exeter, UK
| | - Rod S Taylor
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Emma Ryan
- ISCA Academy, Earl Richards Road South, Exeter, UK
| | - Lisa Price
- Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Adam Streeter
- Peninsula Clinical Trials Unit and Medical Statistics, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Katrina Wyatt
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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Lloyd J, Creanor S, Price L, Abraham C, Dean S, Green C, Hillsdon M, Pearson V, Taylor RS, Tomlinson R, Logan S, Hurst A, Ryan E, Daurge W, Wyatt K. Trial baseline characteristics of a cluster randomised controlled trial of a school-located obesity prevention programme; the Healthy Lifestyles Programme (HeLP) trial. BMC Public Health 2017; 17:291. [PMID: 28376846 PMCID: PMC5379664 DOI: 10.1186/s12889-017-4196-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/21/2017] [Indexed: 12/29/2022] Open
Abstract
Background We have developed a healthy lifestyles programme (HeLP) for primary school aged children (9–10 years), currently being evaluated in a definitive cluster randomised controlled trial. This paper descriptively presents the baseline characteristics of trial children (BMI, waist circumference, % body fat, diet and physical activity) by gender, cluster level socio-economic status, school size and time of recruitment into the trial. Methods Schools were recruited from across the South West of England and allocated 1:1 to either intervention (HeLP) or control (usual practice) stratified by the proportion of children eligible for free school meals (FSM, <19%, ≥19%) and school size (one Year 5 class, >1 Year 5 class). The primary outcome is change in body mass index standard deviation score (BMI sds) at 24 months post-randomisation. Secondary outcomes are BMI sds at 18 months, waist circumference and percentage body fat sds at 18 and 24 months, proportion of children classified as underweight, overweight and obese at 18 and 24 months, physical activity (for a sub-sample) and food intake at 18 months. Results At baseline 11.4% and 13.6% of children were categorised as overweight or obese respectively. A higher percentage of girls than boys (25.3% vs 24.8%) and children from schools in FSM category 2 (28.2% vs 23.2%) were overweight or obese. Children were consuming a mean (range) of 4.15 (0–13) energy dense snacks (EDS) and 3.23 (0–9) healthy snacks (HS) per day with children from schools in FSM category 2 consuming more EDS and negative food markers and less HS and positive food markers. Children spent an average 53.6 min per day (11.9 to 124.8) in MVPA and thirteen hours (779.3 min) per day (11 h to 15 h) doing less than ‘light’ intensity activity. Less than 5% of children achieved the Departments of Health’s recommendation of 60 min of MVPA every day. Conclusion We have excellent completeness of baseline data for all measures and have achieved compliance to accelerometry not seen before in other large scale studies. Our anthropometric baseline data is representative of local and national data for children this age and reflects the gender and socio-economic variations expected of children this age in relation to physical activity and weight status. Trial registration ISRCTN15811706 (1/05/2012).
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Affiliation(s)
- Jenny Lloyd
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Siobhan Creanor
- Peninsula Clinical Trials Unit and Biostatistics, Bioinformatics & Biomarkers Group, Plymouth University Peninsula Schools of Medicine & Dentistry (formerly Peninsula College of Medicine and Dentistry), ITTC Building, Plymouth Science Park, Plymouth, Devon, PL6 8BX, UK
| | - Lisa Price
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Charles Abraham
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sarah Dean
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Colin Green
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Melvyn Hillsdon
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Virginia Pearson
- Public Health Devon, Devon County Council, County Hall, Topsham Road, Exeter, EX2 4QL, UK
| | - Rod S Taylor
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Richard Tomlinson
- Department of Child Health Barrack Road, Royal Devon and Exeter Hospital, Royal Devon & Exeter NHS Trust, Exeter, EX2 5DW, UK
| | - Stuart Logan
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Alison Hurst
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | | | - Wendy Daurge
- St Leonard's Primary School, Exeter, Devon, EX2 4NQ, UK
| | - Katrina Wyatt
- University of Exeter Medical School, University of Exeter St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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Plaete J, De Bourdeaudhuij I, Crombez G, Steenhuyzen S, Dejaegere L, Vanhauwaert E, Verloigne M. The Reliability and Validity of Short Online Questionnaires to Measure Fruit and Vegetable Intake in Adults: The Fruit Test and Vegetable Test. PLoS One 2016; 11:e0159834. [PMID: 27441632 PMCID: PMC4956215 DOI: 10.1371/journal.pone.0159834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 07/08/2016] [Indexed: 12/22/2022] Open
Abstract
The first aim of this study was to investigate the stability of the Fruit Test and Vegetable Test over time and whether the Fruit Test and Vegetable Test are capable of measuring fruit and vegetable intake with consistency. Second, the study aimed to examine criterion (concurrent) validity of the Fruit Test and Vegetable Test by testing their agreement with 7-day food diary-derived measures of fruit and vegetable intake. In total 58 adults (31% male, mean age = 30.0±12.09y) completed the Flemish Fruit and Vegetable test by indicating the frequency of days that they ate fruit and vegetables and the number of portions during the past week. Validity was tested by using a 7-day food diary as a golden standard. Adults were asked to register their fruit and vegetable intake daily in a diary during one week. Spearman correlations were measured to compare total intake reported in the Fruit and Vegetable Test and in the 7-day diary. Agreement plots were used to illustrate absolute agreement. Test-retest reliability was evaluated by having participants completing the Fruit Test and Vegetable Test twice. The Fruit Test (ICC = 0.81) and Vegetable Test (ICC = 0.78) showed excellent and substantial reliability. The Fruit Test (ρ = 0.73) and Vegetable Test showed good validity. Agreement plots showed modest variability in differences between vegetable and fruit intake as measured by the Vegetable and Fruit Test and the 7-day food diary. Also a small underestimation of fruit intake in the Fruit test and vegetable intake in the Vegetable test against the 7-day food diary was shown. Based on the results, it is suggested to include portion size pictures and consumption of mixed vegetables to prevent underestimation. To prevent overestimation, it is concluded to add a moderate number of representative fruit and vegetable items, questions on portion size, household sizes with sufficient detail and food items highly tailored to the dietary behaviors and local food items of the population surveyed. The questionnaires can easily be adapted for the use in other diets (e.g. Asian diet), but reliability and validity should then be examined again. Also, validity remains to be tested in other population groups (i.e. low socio economic status groups, other age groups).
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Affiliation(s)
- Jolien Plaete
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | | | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Saidja Steenhuyzen
- Flemish Institute for Health Promotion and Disease Prevention (VIGeZ), Brussels, Belgium
| | - Liesbet Dejaegere
- Flemish Institute for Health Promotion and Disease Prevention (VIGeZ), Brussels, Belgium
| | - Erika Vanhauwaert
- Knowledge and Innovation Center FOOD, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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The reported intakes of sugar sweetened beverages by 10–11 year old children participating in the CHANGE! healthy eating intervention. Proc Nutr Soc 2016. [DOI: 10.1017/s0029665116001579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Nse O, Quinette L, Okechukwu O. A systematic review and appraisal of methods of developing and validating lifestyle cardiovascular disease risk factors questionnaires. Afr Health Sci 2015; 15:931-40. [PMID: 26957984 PMCID: PMC4765453 DOI: 10.4314/ahs.v15i3.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Well developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires. MATERIALS/METHODS Relevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet. RESULTS Methods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis. CONCLUSION Combination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.
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Affiliation(s)
- Odunaiya Nse
- Division of Physiotherapy, Stellenbosch University, RSA
- Department of Physiotherapy, University of Ibadan, Nigeria
| | - Louw Quinette
- Division of Physiotherapy, Stellenbosch University, RSA
| | - Ogah Okechukwu
- Department of Internal medicine, University College Hospital, Ibadan, Nigeria
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Odunaiya NA, Louw QA, Grimmers-Somers K, Ogah OS. Development, initial content validation and reliability of Nigerian composite lifestyle CVD risk factors questionnaire for adolescents. Afr Health Sci 2014; 14:600-8. [PMID: 25352878 PMCID: PMC4209641 DOI: 10.4314/ahs.v14i3.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cardiovascular disease risk (CVD) factors affect every age category including adolescents in developing nations. Prevention strategies are effective only when there are epidemiological data for the targeted populations. The collection of such data is only made easy with composite lifestyle CVD risk factors measures that are culturally sensitive and acceptable among the target populations. OBJECTIVE The objective of the study was to develop a culturally sensitive and friendly composite lifestyle CVD risk factors questionnaire for adolescents in Nigeria. METHODS A systematic review was conducted to identify existing, published questionnaires from which items could be selected. Content and face validation were conducted using an expert panel and a sub-sample of the target population. Data was analyzed qualitatively and reliability was assessed using intra-class correlation and Kappa statistic. RESULTS Based on the comments received from experts, the questions were restructured, simplified, clarified, formatted, some questions were added and expert reached a consensus. Kappa showed fair to moderate agreement in 65% of the questions and perfect agreement in one question. CONCLUSION The CVD risk factors questionnaire has acceptable content validity and reliability and should be used to assess CVD risk factors among adolescents in Nigeria.
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Affiliation(s)
- Nse A Odunaiya
- Department of Physiotherapy, University of Ibadan, Nigeria ; Department of Physiotherapy, Stellenbosch University, Republic of South Africa
| | - Quinette A Louw
- Department of Physiotherapy, Stellenbosch University, Republic of South Africa
| | - K Grimmers-Somers
- Department of Physiotherapy, Stellenbosch University, Republic of South Africa ; University of South Australia
| | - Okechukwu S Ogah
- Department of Medicine, Federal Medical center, Umuohia, Nigeria
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Boddy LM, Abayomi J, Johnson B, Hackett AF, Stratton G. Ten-year changes in positive and negative marker food, fruit, vegetables, and salad intake in 9-10 year olds: SportsLinx 2000-2001 to 2010-2011. J Hum Nutr Diet 2014; 27:236-41. [PMID: 23647239 DOI: 10.1111/jhn.12129] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To investigate changes in intakes of 'negative' and 'positive' foods, fruit, vegetables, and salad in serial cohorts of 9-10-year-old children from 2000-2001 to 2010-2011. METHODS For this serial, cross-sectional study, children in school year 5 (9-10 years of age) completed the SportsLinx Lifestyles Survey [n = 30,239 (15,336 boys and 14,903 girls)]. Changes in positive and negative food scores, and the proportion of boys and girls reportedly consuming fruit, vegetables and salad on the previous day to surveying, were investigated annually from 2000 to 2011. RESULTS The consumption of negative foods declined and positive foods increased significantly compared to baseline. Positive changes in fruit, vegetables and salad consumption were observed over time, with the most recent cohort more likely to consume fruit, vegetables and salad compared to the 2000-2001 baseline. Girls displayed more favourable positive and negative food scores and were more likely to consume fruit, salad and vegetables across several study years compared to boys. CONCLUSIONS The consumption of negative and positive foods, fruit, vegetables, and salad has improved over the last 10 years. In addition, girls appear to have better positive and negative food scores, and were more likely to consume fruit, vegetables and salad, across a number of study years or cohorts compared to boys. These encouraging findings suggest that children's food intake has improved since 2000. Furthermore, the data indicate that boys and girls may require separate or different healthy eating messages to further improve food intake.
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Affiliation(s)
- L M Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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11
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Fairclough SJ, Hackett AF, Davies IG, Gobbi R, Mackintosh KA, Warburton GL, Stratton G, van Sluijs EMF, Boddy LM. Promoting healthy weight in primary school children through physical activity and nutrition education: a pragmatic evaluation of the CHANGE! randomised intervention study. BMC Public Health 2013; 13:626. [PMID: 23819701 PMCID: PMC3733685 DOI: 10.1186/1471-2458-13-626] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 06/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This pragmatic evaluation investigated the effectiveness of the Children's Health, Activity and Nutrition: Get Educated! (CHANGE!) Project, a cluster randomised intervention to promote healthy weight using an educational focus on physical activity and healthy eating. METHODS Participants (n = 318, aged 10-11 years) from 6 Intervention and 6 Comparison schools took part in the 20 weeks intervention between November 2010 and March/April 2011. This consisted of a teacher-led curriculum, learning resources, and homework tasks. Primary outcome measures were waist circumference, body mass index (BMI), and BMI z-scores. Secondary outcomes were objectively-assessed physical activity and sedentary time, and food intake. Outcomes were assessed at baseline, at post-intervention (20 weeks), and at follow-up (30 weeks). Data were analysed using 2-level multi-level modelling (levels: school, student) and adjusted for baseline values of the outcomes and potential confounders. Differences in intervention effect by subgroup (sex, weight status, socio-economic status) were explored using statistical interaction. RESULTS Significant between-group effects were observed for waist circumference at post-intervention (β for intervention effect =-1.63 (95% CI = -2.20, -1.07) cm, p<0.001) and for BMI z-score at follow-up (β=-0.24 (95% CI = -0.48, -0.003), p=0.04). At follow-up there was also a significant intervention effect for light intensity physical activity (β=25.97 (95% CI = 8.04, 43.89) min, p=0.01). Interaction analyses revealed that the intervention was most effective for overweight/obese participants (waist circumference: β=-2.82 (95% CI = -4.06, -1.58) cm, p<0.001), girls (BMI: β=-0.39 (95% CI = -0.81, 0.03) kg/m2, p=0.07), and participants with higher family socioeconomic status (breakfast consumption: β=8.82 (95% CI = 6.47, 11.16), p=0.07). CONCLUSIONS The CHANGE! intervention positively influenced body size outcomes and light physical activity, and most effectively influenced body size outcomes among overweight and obese children and girls. The findings add support for the effectiveness of combined school-based physical activity and nutrition interventions. Additional work is required to test intervention fidelity and the sustained effectiveness of this intervention in the medium and long term. TRIAL REGISTRATION Current Controlled Trials ISRCTN03863885.
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Affiliation(s)
- Stuart J Fairclough
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62, Great Crosshall Street, Liverpool, UK.
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Wyatt KM, Lloyd JJ, Abraham C, Creanor S, Dean S, Densham E, Daurge W, Green C, Hillsdon M, Pearson V, Taylor RS, Tomlinson R, Logan S. The Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children: study protocol for a randomised controlled trial. Trials 2013; 14:95. [PMID: 23556434 PMCID: PMC3652736 DOI: 10.1186/1745-6215-14-95] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 03/11/2013] [Indexed: 02/06/2023] Open
Abstract
Background Over the last three decades there has been a substantial increase in the proportion of children who are overweight or obese. The Healthy Lifestyles Programme (HeLP) is a novel school-based intervention, using highly interactive and creative delivery methods to prevent obesity in children. Methods/Design We describe a cluster randomised controlled trial to evaluate the effectiveness and cost effectiveness of HeLP. The intervention has been developed using intervention mapping (involving extensive stakeholder involvement) and has been guided by the Information, Motivation, Behavioural Skills model. HeLP includes creating a receptive environment, drama activities, goal setting and reinforcement activities and runs over three school terms. Piloting showed that 9 to 10 year olds were the most receptive and participative. This study aims to recruit 1,300 children from 32 schools (over half of which will have ≥19% of pupils eligible for free school meals) from the southwest of England. Participating schools will be randomised to intervention or control groups with baseline measures taken prior to randomisation. The primary outcome is change in body mass index standard deviation score (BMI SDS) at 24 months post baseline. Secondary outcomes include, waist circumference and percent body fat SDS and proportion of children classified as overweight or obese at 18 and 24 months and objectively measured physical activity and food intake at 18 months. Between-group comparisons will be made using random effects regression analysis taking into account the hierarchical nature of the study design. An economic evaluation will estimate the incremental cost-effectiveness of HeLP, compared to control, from the perspective of the National Health Service (NHS)/third party payer. An in-depth process evaluation will provide insight into how HeLP works, and whether there is any differential uptake or engagement with the programme. Discussion The results of the trial will provide evidence on the effectiveness and cost effectiveness of the Healthy Lifestyles Programme in affecting the weight status of children. Trial registration ISRCTN15811706
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Affiliation(s)
- Katrina M Wyatt
- Institute of Health Services Research, University of Exeter Medical School (formerly Peninsula College of Medicine and Dentistry), Veysey Building, Salmon Pool Lane, Exeter, Devon EX2 4SG, UK.
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Price KJ, Wales J, Eiser C, Knowles J, Heller S, Freeman J, Brennan A, McPherson A, Wellington J. Does an intensive self-management structured education course improve outcomes for children and young people with type 1 diabetes? The Kids In Control OF Food (KICk-OFF) cluster-randomised controlled trial protocol. BMJ Open 2013; 3:e002429. [PMID: 23355675 PMCID: PMC3563116 DOI: 10.1136/bmjopen-2012-002429] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The Kids In Control OF Food (KICk-OFF) is a cluster-randomised controlled trial, which aims to determine the efficacy of a 5 day structured education course for 11-year-olds to 16-year-olds with type 1 diabetes (T1DM) when compared with standard care, and its cost effectiveness. Less than 15% of children and young people with T1DM in the UK meet the recommended glycaemic target. Self-management education programmes for adults with T1DM improve clinical and psychological outcomes, but none have been evaluated in the paediatric population. KICk-OFF is a 5-day structured education course for 11-year-olds to 16- year-olds with T1DM. It was developed with input from young people, parents, teachers and educationalists. METHODS AND ANALYSIS 36 paediatric diabetes centres across the UK randomised into intervention and control arms. Up to 560 participants were recruited prior to centre randomisation. KICk-OFF courses are delivered in the intervention centres, with standard care continued in the control arm. Primary outcomes are change in glycaemic control (HbA1c) and quality of life between baseline and 6 months postintervention, and the incidence of severe hypoglycaemia. Sustained change in self-management behaviour is assessed by follow-up at 12 and 24 months. Health economic analysis will be undertaken. Data will be reported according to the CONSORT statement for cluster-randomised clinical trials. All analyses will be by intention-to-treat with a two-sided p value of <0.05 being regarded as statistically significant. The study commenced in 2008. Data collection from participants is ongoing and the study will be completed in 2013. ETHICS The study has been approved by the Sheffield Research Ethics Committee. DISSEMINATION Results will be reported in peer reviewed journals and conferences. TRIAL REGISTRATION Current Controlled Trials ISRCTN37042683.
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Affiliation(s)
| | - Jerry Wales
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Christine Eiser
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Julie Knowles
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Simon Heller
- School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Jenny Freeman
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amy McPherson
- Department of Health Psychology, University of Nottingham, Nottingham, UK
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BMI status of children in the CHANGE! Project and its association with the consumption of ‘positive marker’ and ‘negative marker’ foods. Proc Nutr Soc 2013. [DOI: 10.1017/s0029665113001687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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15
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Comparison of the reported intakes of fruits and vegetables in Year 6 children: The CHANGE! Project. Proc Nutr Soc 2012. [DOI: 10.1017/s0029665112003187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol 2009; 15:230-7. [PMID: 19654490 DOI: 10.1097/rhu.0b013e3181b08f20] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study the association between baseline vitamin D status, bone mineral density (BMD), and the development of radiographic osteoarthritis (ROA) of the knee in a large population-based cohort of men and women. METHODS A sample of 1248 subjects (728 women and 520 men) was drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. At baseline, vitamin D dietary intake was determined, and BMD and 25-hydroxy vitamin D (25(OH)D) serum levels were measured. After a mean follow-up time of 6.5 years incidence and progression of knee ROA of was assessed. RESULTS The mean vitamin D intake in our study population was 64 IU/d and the mean 25(OH)D level 66 nmol/L. Vitamin D levels were associated with baseline BMD, particularly in subjects with baseline knee ROA. Progressive ROA occurred in 5.1% of the participants in the highest tertile of vitamin D intake against 12.6% in the lowest tertile, resulting in an adjusted odds ratio of 7.7 (95% CI: 1.3-43.5). Both intake and levels of 25(OH)D were not significantly related to incident ROA. However, we found a significant interaction between vitamin D intake and BMD in the association with incident knee ROA (P = 0.03): in subjects with low lumbar spine BMD at baseline we observe an increasing incidence of knee ROA with decreasing vitamin D intake and serum levels. CONCLUSIONS Low dietary vitamin D intake increases the risk of progression of knee ROA. Particularly in subjects with low baseline BMD, vitamin D status seems to influence the incidence and progression of knee ROA. Thus, improving the vitamin D status in the elderly could protect against the development and worsening of knee OA, especially in those with low BMD.
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Richards J, Hackett A, Duggan B, Ellis T, Forrest D, Grey P. An evaluation of an attempt to change the snacking habits of pre-school children using social marketing. Public Health 2009; 123 Suppl 1:e31-7. [DOI: 10.1016/j.puhe.2009.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 06/17/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
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Williamson DA, Champagne CM, Harsha D, Han H, Martin CK, Newton R, Stewart TM, Ryan DH. Louisiana (LA) Health: design and methods for a childhood obesity prevention program in rural schools. Contemp Clin Trials 2008; 29:783-95. [PMID: 18448393 PMCID: PMC2628769 DOI: 10.1016/j.cct.2008.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/12/2008] [Accepted: 03/17/2008] [Indexed: 11/26/2022]
Abstract
There is a worldwide epidemic of obesity with far-reaching consequences for the health of our nation. Prevention of obesity, especially in children, has been deemed by public health policy makers to be one of the most important objectives for our country. This prevention project, called Louisiana (LA) Health, will test whether modification of environmental and behavioral factors can prevent inappropriate weight gain in children from rural parishes of Louisiana who are enrolled in the fourth to sixth grades during Year 1. The primary aim of the LA Health project is to test the efficacy of two school-based approaches for obesity prevention: primary prevention alone and a combination of primary and secondary prevention which will be compared to a no-intervention control group using a cluster randomization research design, with 17 school clusters randomly assigned to the three treatment arms. The study will span 3 years and will provide critical tests of strategies that: 1) modify the child's environment as a primary prevention strategy and 2) provide health behavior modification via classroom instruction and internet counseling as a secondary prevention strategy. The study will also recruit a similar sample of students to measure changes in body weight relative to height, gender, and age over the same three-year period.
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Affiliation(s)
- Donald A Williamson
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA
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Hackett A, Boddy L, Boothby J, Dummer TJB, Johnson B, Stratton G. Mapping dietary habits may provide clues about the factors that determine food choice. J Hum Nutr Diet 2008; 21:428-37. [PMID: 18647211 DOI: 10.1111/j.1365-277x.2008.00894.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Food deserts are thought to be a barrier to making healthier food choices. This concept has been challenged. The interaction between the physical environment and children's food choice has received little attention. The present study used food intake data to generate hypotheses concerning the role of the physical environment in food choice. METHODS A cross-sectional analysis was conducted of the dietary habits of Year 5 (9-10-year-old) children from 90 of Liverpool's 118 primary schools. Individuals with the 'best' and 'worst' food choices were mapped and two areas associated with these extreme choices located. RESULTS One thousand five hundred and thirty-five children completed the dietary questionnaire and supplied a full and valid postcode. Two adjacent areas with relatively large numbers of children in the 'best' and 'worst' food choice groups were chosen. Both areas had very similar socio-economic profiles. The contrast in the physical environments was striking, even on visual inspection. CONCLUSIONS Food deserts as a cause of poor food choice did not stand scrutiny; the area located by the worst food choices had a plethora of shops selling food (better termed a food prairie), whereas the area located by the best food choices had no shops in evidence but did have more 'space'.
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Affiliation(s)
- A Hackett
- Centre for Tourism, Consumer and Food Studies, Liverpool John Moores University, Liverpool, UK.
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Marcotte L, Hennessy E, Dwyer J, Hyatt RR, Goldberg JP, Naumova EN, Economos CD. Validity and reliability of a calcium checklist in early
elementary-school children. Public Health Nutr 2008; 11:57-64. [PMID: 17666123 DOI: 10.1017/s1368980007000018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo create, validate and assess the reliability of a checklist to measure
calcium intake in children.DesignCalcium intakes from a checklist and parent-assisted 24-h dietary recall were
compared. Checklist reliability was assessed separately.SettingAfter-school programmes in the United States.SubjectsForty-two children (18 males, 24 females, age = 8.0 ± 0.9 years)
participated in the validation analysis and 49 children (28 males, 21
females, age = 7.5 ± 0.9 years) in the reliability analysis.ResultsNo differences in mean calcium intakes were found by method or gender. The
checklist correlated well with recall among girls (r = 0.65, P = 0.01) but not
boys (r = −0.33, P = 0.19). Agreement over time was above 80%
for most foods.ConclusionThe calcium checklist is useful for assessing calcium intake among groups of
6–10-year-old children in settings that preclude parental
assistance. More research is needed to improve accuracy among boys.
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Affiliation(s)
- Lori Marcotte
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, John Hancock Center for Physical Activity and Nutrition, Tufts University, Boston, MA 02111, USA
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The development and evaluation of a novel computer program to assess previous-day dietary and physical activity behaviours in school children: the Synchronised Nutrition and Activity Program (SNAP). Br J Nutr 2007; 99:1266-74. [PMID: 18042307 DOI: 10.1017/s0007114507862428] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Self-report recall questionnaires used to measure physical activity and dietary intake in children can be labour intensive and monotonous and tend to focus on either dietary intake or physical activity. The web-based software, Synchronised Nutrition and Activity Program (SNAP), was developed to produce a novel, simple, quick and engaging method of assessing energy balance-related behaviours at a population level, combining principles from new and existing 24 h recall methodologies, set within a user-friendly interface. Dietary intake was measured using counts for twenty-one food groups and physical activity levels were measured in min of moderate to vigorous physical activity (MVPA). A combination of the mean difference between methods, type II regression and non-parametric limits of agreement techniques were used to examine the accuracy and precision of SNAP. Method comparison analyses demonstrated a good agreement for both dietary intake and physical activity behaviours. For dietary variables, accuracy of SNAP (mean difference) was within +/- 1 count for the majority of food groups. The proportion of the sample with between-method agreement within +/- 1 count ranged from 0.40 to 0.99. For min of MVPA, there was no substantial fixed or proportional bias, and a mean difference between methods (SNAP - accelerometry) of -9 min. SNAP provides a quick, accurate, low-burden, cost-effective and engaging method of assessing energy balance behaviours at a population level. Tools such as SNAP, which exploit the popularity, privacy and engagement of the computer interface, and linkages with other datasets, could make a substantial contribution to future public health monitoring and research.
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Johnson B, Hackett AF. Trends in fruit, vegetable and salad intakes in 9-10-year-old schoolchildren living in Liverpool, 2000-2005. Public Health Nutr 2007; 10:252-5. [PMID: 17288622 DOI: 10.1017/s1368980007352506] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To report on the fruit, vegetable and salad intakes of Liverpool schoolchildren aged 9-10 years over a 5-year period (2000-2005). DESIGN Cross-sectional observational study. SETTING Between 75 and 100 Liverpool primary schools took part in each survey year. SUBJECTS Subjects consisted of five separate cohorts of 9-10-year-old children from all areas of the city. MAIN OUTCOME MEASURES Number and proportion of boys and girls who reported eating fruit, vegetables and salad on the previous day. RESULTS There was an upward trend in the reported intake of fruit between 2002 and 2005. Girls were more likely than boys to report eating fruit (P < 0.001). The trend in salad intake was positive. Between 2000 and 2005 there were significant increases in the number of boys (chi2 = 17.57, P = 0.001) and girls (chi2 = 80.56, P = 0.001) eating salad. Girls were significantly more likely to eat salad than boys in all years (chi2 = 58.75, P = 0.001). Trends in vegetable intake were similar to those for salad, with both sexes reporting yearly increases over the 5-year period. The increase in the number of boys who reported eating vegetables between 2000 and 2005 was 23.5% (chi2 = 32.9, P = 0.000). In girls there was a 44.8% increase over the same period (chi2 = 110.3, P < 0.000). CONCLUSIONS The data reveal positive trends in the fruit, vegetable and salad intakes of Liverpool schoolchildren between 2000 and 2005. Further research is needed to elucidate the specific factors that have enabled the changes to take place.
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Affiliation(s)
- B Johnson
- Department of Community Dietetics, Abercromby Health Centre, Grove Street, Liverpool, UK.
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Stone MA, Bankart J, Sinfield P, Talbot D, Farooqi A, Davies MJ, Khunti K. Dietary habits of young people attending secondary schools serving a multiethnic, inner-city community in the UK. Postgrad Med J 2007; 83:115-9. [PMID: 17308215 PMCID: PMC2805933 DOI: 10.1136/pgmj.2006.050864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood obesity is an escalating health concern with important implications, including increased risk of type 2 diabetes and cardiovascular disease. Although South Asians in the UK have an increased risk of developing these conditions, detailed studies on their lifestyles including the dietary habits of young people are scarce. METHODS As part of an action research project, a food intake questionnaire was used to survey the dietary habits of 11-15-year olds attending five inner-city schools serving a predominantly South Asian population. Food choices were considered in the overall sample and in South Asians compared with white Europeans. RESULTS 3418 (72% of registered pupils) responses were obtained. A subset of 3018 pupils could be categorised as either South Asian (86%) or white European (14%). Around one fifth of pupils started the school day without eating anything. Responses indicated high consumption of "negative" foods such as sweets, including Asian sweets (63%), but lower rates for "positive" foods such as vegetables (34%). In the full sample, 26% said they had consumed more than one can of sugar-sweetened fizzy drink and 17% reported eating more than one packet of full-fat crisps on the previous day. Poor dietary habits were indicated in both South Asian and white European pupils. CONCLUSIONS Our large-scale survey confirmed poor dietary habits in secondary school pupils from a multiethnic community. Urgent efforts are needed to find ways of encouraging healthy lifestyles, particularly in populations with a high risk of developing cardiovascular disease and type 2 diabetes.
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Affiliation(s)
- Margaret A Stone
- Department of Health Sciences (General Practice), University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
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