Stability of physical activity across the lifespan

The contribution and interplay of implicit and explicit processes on physical activity behavior: empirical testing of the physical activity adoption and maintenance (PAAM) model

The adoption and maintenance of physical activity (PA) is an important health behavior. This paper presents the first comprehensive empirical test of the Physical Activity Adoption and Maintenance (PAAM) model, which proposes that a combination of explicit (e.g., intention) and implicit (e.g., habit,, affect) self-regulatory processes is involved in PA adoption and maintenance. Data were collected via online questionnaires in English, German, and Italian at two measurement points four weeks apart. The study included 422 participants (Mage= 25.3, SDage= 10.1; 74.2% women) from Germany, Switzerland, Italy, Canada, and the U.S. The study results largely supported the assumptions of the PAAM model, indicating that intentions and habits significantly mediate the effects of past PA on future PA. In addition, the effect of past PA on future PA was shown to be significant through a mediation chain involving affect and habit. Although the hypothesis that trait self-regulation moderates the intention-behavior relationship was not supported, a significant moderating effect of affect on the same relationship was observed. The results suggest that interventions targeting both explicit and implicit processes may be effective in promoting PA adoption and maintenance.

Lifestyle Elements for Improving Mental and Physical Health in Japanese University Students: Subjective Sleep Quality is a Common Key Factor

This study aimed to reveal the key lifestyle elements that improve physical and mental health in university students by focusing on physical activity, nutrition, and sleep. This cross-sectional study was conducted between October 2021 and December 2021. The participants were 290 first-year students (mean age, 18.63 ± .63 years; age range, 18 to 23; 198 female). The outcomes were daily step counts measured using accelerometers, dietary intake by nutrient category, sleep duration, subjective sleep quality, exercise frequency and duration by exercise type, screen time, depression level, and subjective fatigue by body part. Depression and subjective eye fatigue represent mental and physical health outcomes. Subjective sleep quality predicted depression (β = -1.22, P < .001) and eye fatigue (β = -.23, P < .01) in the path analysis. Participants with higher subjective sleep quality performed more frequent aerobic exercise (P < .01), longer session times of physical relaxation exercise (P < .05), and shorter screen time (P < .05). Subjective sleep quality could be a key factor for high mental and physical health. Furthermore, performing aerobic and relaxation exercises and reducing screen time are important for improving the subjective sleep quality.

Disparities in physical activity between sexual minority and heterosexual women: A systematic review and meta-analysis

Research examining potential differences in physical activity (PA) between sexual minority women (SMW) and heterosexual women have yielded inconsistent results.

OBJECTIVE

Therefore, the purpose of this systematic review and meta-analysis is to examine potential differences in PA between SMW and heterosexual women and to identify potential moderators that may partially explain observed differences in PA.

METHODS

All studies were peer reviewed, published in English, and included a continuous measure of PA for SMW and heterosexual women. A standardized mean difference effect size (ES) was used to compare groups, with random effects models used to estimate a mean ES and 95% CI using a 3-level meta-analysis model to adjust for the correlation between effects nested within studies.

RESULTS

The cumulative results of 24 effects gathered from 7 studies indicated there was no difference in PA between SMW (n = 1619) and heterosexual women (n = 103,295) (ES = -0.038, 95%CI -0.179 to 0.102, p = 0.576). Despite no mean differences, moderate-high heterogeneity was observed, indicating that the results were not consistent across effects (I2 = 64.8%, Q23 = 36.7, p = 0.035). The difference in PA was associated with age (β = -0.018, 95%CI -0.034 to -0.003, p = 0.022) and BMI (β = -0.145, 95%CI -0.228 to -0.061, p = 0.002), with a quadratic relationship observed for both variables.

CONCLUSIONS

Although the results of the current analysis did not indicate significant differences in PA behaviors between SMW and heterosexual women, age and BMI modify the association and are curvilinear in nature; such that smaller differences in PA were observed between SMW and heterosexual women when samples were middle-aged and overweight.

The impact of parents' physical activity goals and parental attitudes on physical activity during leisure time among children in middle childhood

Introduction

Parents' supportiveness and health-promoting habits significantly affect the intensity of children's physical activity (PA) and the involvement of parents in their engagement in PA; in this domain, both the hours devoted to PA and PA goals can be assessed. The family plays an important role in shaping the physical and social organization of the environment for children aged 4-6 years.

Methods

A total of 680 families with 5-year-old children (330 girls, 350 boys) took part in the study. Data were collected from these participants, who were recruited from preschools and primary schools in the Pomeranian region of Poland. The aim of this study was to determine whether the involvement of parents in PA mediates the influence of parental attitudes on the ways in which their children spend their leisure time.

Results

The results showed that not all parental attitudes had direct impact on children's leisure time in PA and outside PA. Other aspects parental attitude had no significant impact on offspring's free time. Among fathers, only four aspects of parental attitude (namely, acceptance-rejection, inconsistency, autonomy, and overprotectiveness) had an impact on PA goals. Mothers' goals were influenced by the strength of a larger number of aspects of attitude (namely, acceptance-rejection, autonomy, inconsistency, over-demandingness, and overprotectiveness). Similarly, the strength of mothers' and fathers' acceptance-rejection attitudes, attitudes of autonomy, and overprotectiveness had an impact on their PA goals but were not directly linked to their children's leisure-time engagement in PA.

Discussion

Not all parental attitudes have a direct impact on children's PA or non-PA leisure time. However, the goals of PA parents have been recognized influence the leisure time of children in PA and outside PA. The most statistically significant relationship for both mothers and fathers was between parental attitudes and PA goals. Parental attitudes do not play a significant role in explaining involvement in PA or lack of it in leisure time among 5-year-old children.

Longitudinal associations between physical activity and five risk factors of metabolic syndrome in middle-aged adults in Germany

BACKGROUND

We examined the longitudinal association between (change in) physical activity (PA) with new onset of five risk factors of metabolic syndrome among 657 middle-aged adults (mean age 44.1 (standard deviation (SD) 8.6) years) who were free of the respective outcome at baseline, in a longitudinal cohort study spanning over 29 years.

METHODS

Levels of habitual PA and sports-related PA were assessed by a self-reported questionnaire. Incident elevated waist circumference (WC), elevated triglycerides (TG), reduced high-density lipoprotein cholesterols (HDL), elevated blood pressure (BP), and elevated blood-glucose (BG) were assessed by physicians and by self-reported questionnaires. We calculated Cox proportional hazard ratio regressions and 95% confidence intervals.

RESULTS

Over time, participants developed (cases of incident risk factor; mean (SD) follow-up time) elevated WC (234 cases; 12.3 (8.2) years), elevated TG (292 cases; 11.1 (7.8) years), reduced HDL (139 cases; 12.4 (8.1) years), elevated BP (185 cases; 11.4 (7.5) years), or elevated BG (47 cases; 14.2 (8.5) years). For PA variables at baseline, risk reductions ranging between 37 and 42% for reduced HDL levels were detected. Furthermore, higher levels of PA (≥ 16.6 METh per week) were associated with a 49% elevated risk for incident elevated BP. Participants who increased PA levels over time, had risk reductions ranging between 38 and 57% for elevated WC, elevated TG and reduced HDL. Participants with stable high amounts of PA from baseline to follow-up had risk reductions ranging between 45 and 87% for incident reduced HDL and elevated BG.

CONCLUSIONS

PA at baseline, starting PA engagement, maintaining and increasing PA level over time are associated with favorable metabolic health outcomes.

Investigating knowledge structure and research trends in child and adolescent health literacy research through network text analysis

PURPOSE

This study aims to investigate the knowledge structure and research trends in child and adolescent health literacy research over the past 30 years by using network text analysis.

METHOD

The study was conducted in four steps: 1) collecting abstracts, 2) keyword extraction and preprocessing, 3) creation of co-occurrence matrix, and 4) text network analysis.

RESULTS

As a result of the centrality analysis, the upper-ranked core keywords were "health care," "health behavior," "prevention," "treatment," and "health promotion." In contrast to earlier times, "barrier," "caregiver," "school setting," and "QOL" have recently emerged as core keywords.

CONCLUSIONS

Over the past 30 years, child and adolescent health literacy has been importantly addressed in both clinical and public health approaches. The results of the current study provide references for future research in child and adolescent health literacy.

IMPLICATION FOR PRACTICE AND RESEARCH

This study suggests the need for additional research on school-based practices that can improve health literacy and for identifying validated and reliable multidimensional health literacy assessment instruments.

Adolescent Body Mass Index and Exposure to Peers with Overweight and Obesity: A Structural Equation Model Approach to Longitudinal Network Data

Purpose: Considerable evidence has shown that social networks influence a wide variety of health behaviors. This study investigates whether having friends with overweight/obesity in one's social network (network exposure) can predict changes in body mass index (BMI) throughout high school in a diverse urban population of students. Methods: Racially and ethnically diverse students from five high schools in Los Angeles County were surveyed at four time points throughout high school from 2010 to 2013 (N = 2091). Surveys included questions on students' social networks, demographics, and health-related information. BMI and weight categories were calculated for all students who provided height and weight information (∼50%). A latent growth curve model was used to assess the growth trajectory of BMI and the time-varying effect of network exposure to friends with overweight/obesity while controlling for demographic covariates. Results: Hispanic students had a significantly higher initial BMI compared with non-Hispanic students (p < 0.01). There was a significant positive slope for time on BMI growth (p < 0.01). Greater personal network exposure to friends with overweight/obesity was associated with a significant 0.65-point average increase in BMI (p < 0.05) at the first follow-up time point (T2) and a significant 0.62-point average increase in BMI (p < 0.01) at the last follow-up (T4) while controlling for covariates. Conclusions: Using structural equation modeling to understand the relationship between BMI and social networks, we found that increased network exposure to peers with overweight/obesity is associated with higher individual BMI, demonstrating that friendships may influence adolescents' weight status over time.

Physical activity measurement in older adults: Wearables versus self-report

Physical activity (PA) is associated with preserved age-related body and brain health. However, PA quantification can vary. Commercial-grade wearable monitors are objective, low burden tools to capture PA but are less well validated in older adults. Self-report PA questionnaires are widely accepted and more frequently used but carry inherent limitations. We aimed to compare these commonly used PA measures against one another and examine their convergent validity with a host of relevant outcomes. We also examined the factors that drive differences in PA self-reporting styles in older adults. 179 older adults completed 30-day Fitbit Flex2™ monitoring and reported PA levels via two widely used PA questionnaires: PASE and CHAMPS-METs (metabolic expenditure calories burned). Participants also completed measures of cardiometabolic (hypertension diagnosis, resting heart rate, A1C levels), cognitive (memory, processing speed, executive functioning), and brain MRI (medial temporal lobe volume) outcomes. The discrepancy between objective Fitbit monitoring and self-reported PA was evaluated using a sample-based z difference score. There were only modest relationships across all PA metrics. Fitbit step count demonstrated a stronger association with the PASE, whereas Fitbit calories burned was more strongly associated with CHAMPS-MET. Fitbit outcomes had more consistent convergence with relevant outcomes of interest (e.g., cardiometabolic and brain health indices) when compared to subjective measures; however, considerable heterogeneity within these associations was observed. A higher degree of overreporting was associated with worse memory and executive performances, as well as hypertension diagnoses. We build on prior findings that wearable, digital health indicators of PA demonstrate greater construct validity than self-report in older adults. We further show important clinical features (e.g., poorer cognitive status) of older adults that could contribute to a higher level of overreporting on self-report measures. Characterization of what PA measures truly operationalize will help elucidate relationships between most relevant facets of PA and outcomes of interest.

Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study

Background

The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms.

Methods

One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators.

Results

Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes.

Conclusions

Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01333-w.

Assessing the stress-buffering effects of social support for exercise on physical activity, sitting time, and blood lipid profiles

OBJECTIVE

This study tested the hypothesized stress-buffering effects of social support on physical activity, sitting time, and blood lipid profiles.

PARTICIPANTS

537 college students.

METHODS

College students volunteered to self-report stress, social support for exercise, physical activity and sitting time, and provided blood samples to assess lipid profiles in this cross-sectional study.

RESULTS

Lower stress was associated with higher vigorous physical activity (β = -0.1, t = -2.9, p = .004). Higher social support was associated with higher moderate (β = 0.2, t = 2.0, p = .042), vigorous (β = 0.5, t = 5.4, p < .001), and total (β = 0.1, t = 3.2, p = .001) physical activity, and lower sitting time on weekdays (β = -0.1, t = -3.3, p = .001) and weekends (β = -0.2, t = -3.6, p < .001). Social support moderated the association between stress and sitting time on weekdays.

CONCLUSIONS

Stress reduction and fostering social support may be important strategies for promoting physical activity and reducing sedentary behaviors in college students. Additional strategies are needed to buffer the deleterious effects of stress.

Dyadic Analysis of a Self-report Physical Activity Measure for Adult-Youth Dyads

Adult physical activity levels influence youth physical activity levels, but the nature of this relationship is still unknown. Most research focusing on this topic has been conducted with accelerometers, which are ideal since self-report physical activity measures can be biased. However, self-report measures for physical activity are useful to include in studies to gather information at low-cost. The purpose of this study was to further develop a self-report adult-youth dyad measure of physical activity. This study was conducted using secondary data analysis of the physical activity measures used in an intervention on behavioral nutrition (iCook 4-H). Participants were a sample of 214 adults (M = 39.0, SD = 8.0 years) and youth (M = 9.4, SD = 0.7 years) pairs. Accelerometer data was collected for a subset of youth (n = 122). There was dependency between the adult-youth physical activity data, and a dyadic confirmatory factor analysis model showed good fit to the data and achieved metric invariance, a measure to determine if the same construct was being measured in both youth and adults. Invariance was confirmed across matched versus unmatched sex pairs and some evidence of invariance with youth accelerometer data. Based on study findings, when using self-report measures of physical activity, researchers should measure both members of the adult-youth dyad to get more accurate measurements. Further validation of these findings is needed using an objective physical activity measure, like accelerometers, with all participants and more diverse samples.

Development and Validation of Chinese University Students’ Physical Activity Motivation Scale Under the Constraint of Physical Education Policies

The accurate measurement of university students’ motivation to participate in physical activity (PA) is a prerequisite to developing better physical fitness programs. However, motivation driven by government policies, i.e., physical education policies, are often excluded from many existing scales. The purpose of this study was to develop and evaluate a psychometric instrument based on self-determination theory that exclusively measures the motivation of Chinese university students to participate in PA. A total of 1,215 university students who regularly participated in PA at five universities in China constituted the final valid sample. Sample 1 (n = 311) was used to determine the underlying factor structure of the initial Chinese University Students’ Physical Activity Motivation Scale (CUSPAMS) through exploratory factor analysis (EFA). Sample 2 (n = 330) was used to test the model fit of the EFA-derived factor structure and data through confirmatory factor analysis (CFA) and to test the internal consistency of each factor and of the whole scale. Sample 3 (n = 574) was used to confirm the model stability and criterion validity. Finally, 177 individuals were randomly selected from Sample 3 to perform test–retest reliability. Preliminary evidence showed that the nine-factor CUSPAMS, consisting of 32 items, yielded good psychometric characteristics. The development of the CUSPAMS provides an opportunity to improve current theories and practices regarding the assessment of PA motivation. The CUSPAMS is recommended for examining factors that influence motives as well as the impact of motives on PA among Chinese university students.

Mid-Life Physical Activity and Late-Life Cognitive Performance among American Indians

INTRODUCTION

Research on factors associated with late-life cognitive performance in diverse racial/ethnic groups is increasingly important due to the growing size and racial diversity of the elder population.

METHODS

Using data on American Indians (AIs) from the Strong Heart Study, we measured associations between mid-life physical activity (PA), assessed by a questionnaire or pedometer, and performance on tests of general cognitive function, phonemic fluency, verbal learning and memory, and processing speed. Cognitive tests were administered 7-21 years after PA measurements. To estimate associations, we used regression models with and without inverse-probability weights to account for potential attrition bias in the cohort.

RESULTS

Questionnaire and pedometer measures of PA were positively associated with cognitive function. Participants in the top quartile of questionnaire-based PA had Modified Mini-Mental State examination scores 3.2 (95% CI: 1.5-4.9) points higher than participants in the lowest quartile. Phonemic fluency scores also trended higher for participants in the top compared to the bottom categories for both PA measures: top questionnaire quartile = 2.7 (95% CI: 0.6-4.8) points higher and top pedometry tertile = 6.7 (95% CI: 2.7-10.7) points higher. We observed no associations between PA and tests assessing verbal learning and memory, or processing speed. Weighted model results were similar, but less precise.

CONCLUSIONS

In this cohort of AIs with relatively low levels of PA, positive associations between mid-life PA and late-life cognitive performance were dose-dependent and of modest clinical significance.

Tracking of Maternal Physical Activity and Sport Participation over 11 Years: Findings from the Czech ELSPAC Study

Purpose: Tracking of physical activity (PA) and sport participation (SP) during motherhood is poorly understood. The purpose of the study was to analyze the extent of tracking of maternal PA and SP. Methods: In this investigation, data were collected from the Czech ELSPAC study subsample of 4811 and 2609 women measured postnatally (1991-1992) and after 11 years of follow-up (2002-2003), respectively. The structured questionnaire was used to assess the participation and average weekly time spent in PA, and the frequency of engaging in different sports (running, cycling, strength training, racket sports, swimming, and team sports). Tracking was calculated using generalized estimating equations (GEE) with beta coefficients (β), odds ratios (ORs), and 95% confidence intervals (95% CI). Results: Moderately high tracking coefficients were observed for cycling (β = 0.69, 95% 0.67-0.72), strength training (β = 0.59, 95% 0.56-0.63), and weekly time spent in PA (β = 0.53, 95% 0.38-0.66); meanwhile, moderate tracking coefficients were generated for swimming (β = 0.48, 95% 0.44-0.52), team sports (β = 0.44, 95% 0.39-0.48), racket sports (β = 0.44, 95% 0.39-0.48), and running (β = 0.35, 95% 0.30-0.40). Mothers who did not participate in PA at baseline were 81% more likely not to participate in it at follow-up (OR = 1.81, 95% CI 1.53-2.13). Conclusion: Cycling- and strength-related activities and weekly PA were tracked moderately-to-moderately high during motherhood. Moreover, the strong tracking of physical inactivity indicates that the detection of this risk factor before pregnancy should be advocated.

Exploring the Enjoyment of the Intergenerational Physical Activity

Intergenerational physical activity could be a pleasant method to prevent elderly sedentary behaviors. The aim of this study is to provide a basis to develop an intergenerational physical activity between preschool children and elderly people. An assessing enjoyment three questionnaire survey was administered to 140 participants (aged 67.8 ± 9.1): the global physical activity questionnaire (GPAQ) assessing the sedentariness degree; the physical activity enjoyment scale (PACES-Q) assessing enjoyment for the physical activity usually practiced; the physical activity enjoyment scale (PACES-INT) assessing the enjoyment for a hypothetical intergenerational program. Successively, the sample was divided into subgroups based on age, gender, marital status, education, employment, sports background, sedentariness level and residential location. Four multichoice questions, aiming to have guidelines in organizing an intergenerational program, were used. A total of 44.3% of the sample found the physical activity practiced pleasant, whereas 81.5% enjoyed the intergenerational program (only 7.1% expressed a negative judgment). A separated one-way ANOVA showed significant differences in PACES-INT for gender, (p = 0.009), residential location, (p < 0.001) and employment (p = 0.004). About 80% of the sample would adhere to the intergenerational programs, despite the fatigue fear and logistic or family relationship problems.

Modelling knowledge, health beliefs, and health-promoting behaviours related to cardiovascular disease prevention among Malaysian university students

Background

Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

Methods

In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

Results

The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

Conclusion

The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

Nutrition Literacy among Adolescents and Its Association with Eating Habits and BMI in Tripoli, Lebanon

(1) Background: Adolescence is a period of increased autonomy and independent decision making; it determines health behaviors that can persist into the future. Individual factors like food choices and unhealthy lifestyle have an essential role in the development and prevention of obesity among adolescents and are associated with the nutrition literacy of parents and other adults. While the association of parents' nutrition literacy with adolescent BMI has been addressed, there is still a scarcity of studies that examine the effect of adolescents' nutrition literacy on their eating habits and body mass index (BMI) status. (2) Methods: A cross-sectional study was conducted that included 189 adolescents (68 with overweight and obesity and 121 with normal weight) aged between 14-19 years from four private schools in Tripoli, Lebanon. A self-administered questionnaire that included the Nutrition Literacy Assessment Instrument (NLAI) and the Adolescent Food Habits Checklist (AFHC) was used. Anthropometrics were measured using standardized procedures. The association between nutrition literacy, food habits and BMI was assessed using a chi squared test for independence and Poisson regression analysis where suitable. (3) Results: Results indicated no association between all five components of nutrition literacy and body mass index categories. Furthermore, there was no association between the Adolescent Food Habits Checklist and overweight or obese BMI status (RR = 0.947, 95%CI: 0.629-1.426) (p = 0.796). No association was observed between nutrition literacy and food habits, except for an inverse association with macronutrients literacy. (4) Conclusions: In conclusion, the study indicated that there was no association between the components of nutrition literacy with body mass index or with food habits, except for macronutrient literacy.

Effects of small-sided recreational team handball training on mechanical muscle function, body composition and bone mineralization in untrained young adults-A randomized controlled trial

Prolonged physical inactivity in young adults may lead to deficiencies in musculoskeletal fitness, and thus a need exists to develop physical activity and exercise programmes that are effective of increasing musculoskeletal fitness. The aim of this study, therefore, was to investigate the effects of small-sided team handball training on lower limb muscle strength, postural balance and body composition in young adults. Twenty-six men and twenty-eight women were stratified for peak oxygen uptake (VO_2peak) and body fat percentage and randomly allocated to either 12 wks of small-sided recreational team handball training (THG: 14 men and 14 women, age 24.1±2.6 yrs (mean±SD), VO_2peak 39.8±5.9 ml/kg/min and body fat percentage 32.7±8.7%) or serving as non-exercising controls (CON: 12 men and 14 women, age 24.8±3.1 yrs, VO_2peak 39.7±5.0 ml/kg/min, body fat percentage 31.7±9.7%). THG trained on average 1.8 times/week for 12 wks. At 0 and 12 wks, lower limb muscle strength, rate of force development (RFD), vertical jump height and power, postural balance, body composition and muscle biopsies were assessed. No training effects were observed for maximal isokinetic or isometric knee extensor strength, maximal vertical jump height or take-off power, fibre type distribution or capillarization. Late phase (RFD) increased (+7.4%, p<0.05) and postural sway excursion length was improved after training (-9%, p<0.05) in THG with no difference from CON (p>0.05). Further, THG demonstrated a decrease in body fat percentage (-3.7%) accompanied by increases in whole-body fat free mass (FFM) (+2.2%), leg FFM (+2.5%), total bone mineral content (BMC) (+1.1%), leg BMC (+1.2%), total hip bone mineral density (+1.6%) and hip T-score (+50%) which differed from CON (all p<0.05). In conclusion, recreational small-sided team handball training appears to effectively improve rapid force capacity, postural balance, lean and fat body mass and bone health in previously untrained young adults. The study was registered at ClinicalTrials.gov (NCT04247724).

ClinicalTrials.gov ID number: NCT04247724

Successful promotion of physical activity among students of medicine through motivational interview and Web-based intervention

Background

Regular physical activity supports healthy behavior and contributes to the reduction of preventable diseases. Students in their social transition period are the ideal groups for interventions. The higher education period, associated with demanding changes and poor time management, results in a low level of physical activity. In this age, social media usually are a suitable channel of communication and multicomponent interventions are the most desirable. It has not been sufficiently investigated how effective a Web-based approach is among university students when it comes to physical activity in the long-term period. We combined a Web-based approach with motivational interviews and tested these two interventions together and separate to assess their impact on improving the physical activity of medical students 1 year after the intervention.

Methods

All 514 first-year students at the Faculty of Medicine in Belgrade were invited to fill in a baseline questionnaire. Also, they underwent measurement of weight, height and waist circumference. After that, students selected a 6 months intervention according to their preference: Intervention through social media (Facebook) (Group 1) or combined with a motivational interview (Group 2). Group 3 consisted of students without any intervention. One year after completion of the 6 months intervention period, all students were invited to a second comprehensive assessment. Analyses were performed employing a wide range of statistical testing, including direct logistic regression, to identify determinants of increased physical activity measured by an average change of Metabolic Equivalent of Task (MET). This outcome measure was defined as the difference between the values at baseline and one year after completion of the 6 months intervention period.

Results

Due to a large number of potential determinants of the change of MET, three logistic regression models considered three groups of independent variables: basic socio-demographic and anthropometric data, intervention and willingness for change, and health status with life choices. The only significant model comprised parameters related to the interventions (p < 0.001). It accurately classified 73.5% of cases. There is a highly significant overall effect for type of intervention (Wald = 19.5, df = 2, p < 0.001) with high odds for the increase of physical activity. Significant relationship between time and type of intervention also existed (F = 7.33, p < 0.001, partial η² = 0.091). The influence of both factors (time and interventions) led to a change (increase) in the dependent variable MET.

Conclusion

Our study confirmed the presence of low-level physical activity among students of medicine and showed that multicomponent interventions have significant potential for positive change. The desirable effects of the Web-based intervention are higher if an additional booster is involved, such as a motivational interview.

A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial

Background

This study aimed to describe the design and present the baseline characteristics of a web-based lifestyle intervention program, which comprises of sequentially and simultaneously delivered intervention modules targeting physical activity (PA) and fruit and vegetable consumption (FVC) in Chinese college students.

Methods

The study adopted a randomized placebo-controlled trial, using the Health Action Process Approach (HAPA) and the Compensatory Carry-Over Action Model (CCAM) as the theoretical backdrops. 556 Chinese college students participated in the 8-week web-based lifestyle intervention program. All eligible participants were randomly assigned to one of four groups: 1) the PA-first arm which received a 4-week intervention addressing PA followed by a 4-week intervention addressing FVC; 2) the FVC-first arm which received a 4-week intervention addressing FVC followed by a 4-week intervention addressing PA; 3) the PA + FVC simultaneous arm that received an 8-week intervention addressing both PA and FVC at the same time; and 4) the placebo-control arm that received 8 weeks of general health information, which is not relevant for changing actual PA and FVC behaviors. Data collection includes four time-points: at the beginning and end of the intervention, and a 3-month and 12-month follow-up after the intervention.

Results

At baseline, 41.7% of participants were male and 58.3% were female. 41.0% of the participants did not meet the standard PA-recommendations, while 69.6% did not adhere to the standard FVC-recommendations. In total, only 19.6% of participants met both PA and FVC recommendations. Baseline characteristics across the four groups had no significant differences (all P = .17–.99), indicating successful randomization.

Conclusions

The preliminary results indicate a high prevalence of unhealthy lifestyles in college students in China, which further supports the need for web-based health intervention programs. This is also the first study that examines the comparative effectiveness of simultaneously and sequentially delivered lifestyle interventions in the Chinese population. These findings may contribute to the creation of future web-based health behavior change interventions.

Trial registration

ClinicalTrails.gov: NCT03627949, 14 August, 2018.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7438-1) contains supplementary material, which is available to authorized users.

Profiles of physical activity biographies in relation to life and aging satisfaction in older adults: longitudinal findings

BACKGROUND

While there is substantial evidence on the relationship between life satisfaction and present physical activity (PA), less is known about which specific PA biographies are associated with a high quality of life and aging satisfaction. Our objective was to identify classes of PA biographies that may be associated with life and aging satisfaction.

METHODS

In this longitudinal study, PA biographies were assessed retrospectively as a baseline, followed by assessments of life and aging satisfaction at six and twelve months in 418 adults aged 60-95. Subgroups with different PA biographies were identified using latent class analysis.

RESULTS

Four distinct PA biographies emerged: increasingly active (35%; n = 147); consistently active (25%; n = 103); consistently inactive (18%; n = 75); and decreasingly active (22%; n = 94). Being consistently active was related to life satisfaction (β = .17) and consistent inactivity was associated with aging dissatisfaction (β = -.20) when accounting for current PA levels.

CONCLUSIONS

In addition to current PA, our findings emphasize the value of PA biographies for life and aging satisfaction, which could inform lifespan theories of PA and health promotion.

Factors influencing physical activity participation among older people with low activity levels

Despite the well-documented health benefits of physical activity in older adults, participation levels remain low. With rapid global population ageing, intensive efforts are needed to encourage higher levels of participation to ameliorate the negative effects of physical inactivity for older individuals and society as a whole. The aim of this qualitative study was to inform future physical activity promotion interventions by examining factors contributing to low activity levels among older people undertaking less than half the recommended level of moderate-to-vigorous physical activity (MVPA). Semi-structured interviews were conducted with 102 (65% female) community-dwelling Western Australians aged 60+ years (mean = 71.52, standard deviation = 6.26) who engaged in ⩽75 minutes of MVPA per week as measured by accelerometers. Several modifiable and unmodifiable barriers were identified, of which poor health featured most prominently. Lifetime physical inactivity, caring duties, low motivation, misperceptions of physical activity and ageing, and a lack of affordable and attractive options were the other barriers identified. The results suggest that strategies are needed to raise awareness of current physical activity guidelines, normalise engagement in MVPA throughout the lifespan, develop initiatives to motivate participation, improve the availability of affordable physical activity programmes that are attractive to this population segment, and facilitate participation among those with intensive caring responsibilities.

Describing the diurnal relationships between objectively measured mother and infant physical activity

BACKGROUND

Evidence for the importance of accumulating sufficient physical activity in the early years is mounting. This study aimed to determine the relationship between maternal and infant objectively measured physical activity, and to examine the diurnal interactions between these behaviours while accounting for potential covariates.

METHODS

Mothers and infants (n = 152 pairs; infants aged 3-24 months) were recruited from Soweto, South Africa, and physical activity was measured using a wrist worn accelerometer (Axivity AX3, Axivity Ltd., Newcastle-upon-Tyne, UK) for 3-7 days. Mothers completed sleep diaries recording night time-in-bed (used as a proxy for nocturnal sleep status) for themselves and their infant; and reported times during which their infant was in their personal care (caregiver status) for each day during the measurement period. Significant correlates of infant physical activity, as well as the interactions between mother's physical activity, day of the week, sleep status, and caregiver status, were included in panel regression analyses with infant physical activity as the outcome.

RESULTS

There was an equal distribution of boys and girls, and their age ranged from 2.6 to 24.5 months. The majority of mothers (73%) did not spend any time apart from their infant. During weekdays, the combined effect of mother's physical activity (β=0.11), the interactions between mother's physical activity and caregiver status (β=0.17), and sleep status (β= - 0.04) on infant physical activity was β=0.24; while during weekend days this association was β=0.21; and was largely moderated by the interaction between the mother being with the infant and her activity levels (β=0.23), but partly attenuated by mother's physical activity independent of other variables (β= - 0.04). For each hour of the day, for both mother and infant, peaks of physical activity were higher when the mother was not the primary caregiver.

CONCLUSIONS

Infant physical activity levels were strongly associated with their mother's activity levels particularly during the week; this relationship was stronger when mothers were more active while looking after their infant. Mothers should be encouraged to be active when looking after their children, particularly during the week, and to provide infants with as much opportunity to be active as possible.

Leisure time physical activity and future psychological distress: A thirteen year longitudinal population-based study

A number of cross-sectional studies have suggested that physical activity (PA) is negatively associated with psychological distress in adulthood. A paucity of regionally representative and longitudinal studies has considered this relationship. This study investigated the association between leisure time light and moderate-vigorous PA (MVPA) and psychological distress over 13 years in a regionally representative sample. A total of 4754 men (mean age: 47.2 years) and 5571 women from (mean age: 46.9 years) the Tromsø Study were followed for 13 years. Light PA and MVPA was captured at baseline and psychological distress was captured using the Hopkins Symptom Check List-10 scale. Ordinary least square and Poisson regression models were used, adjusting for multiple confounders to investigate the relationship between light PA/MVPA and psychological distress. In the fully-adjusted model, accounting sociodemographics, history of parental psychopathology, socioeconomic status, marital status, smoking, social support and risk factors, we found evidence that both light PA (β 0.11, 95% CI: 0.03, 0.19; p < 0.01) and MVPA (β 0.19, 95% CI: 0.12, 0.26; p < 0.001) confered protection against psychological distress at follow-up. Among men, a lower MVPA was associated with 14% (RR = 1.14, 95% CI: 1.01, 1.28) increased risk of clinically significant psychological distress; while among women, the risk was 15% (RR = 1.15, 95% CI: 1.06, 1.26; p < 0.001). In this regionally representative cohort, our study suggests that both higher levels of light PA and MVPA confer protection against future psychological distress. However, a key limitation of this study is that psychological distress at baseline was not controlled-for.

Changes in Social Integration Predict Changes in Physical Activity: A 25-Year Prospective Study

BACKGROUND

Social relationships are among the strongest predictors of health. The extent to which one is embedded in social networks, also referred to as social integration, has been associated with physical activity in short-term longitudinal and cross-sectional studies. How changes in social integration impact physical activity over longer periods of time is not well understood.

METHODS

Longitudinal data from 5 waves of the Americans' Changing Lives study were used (wave 1: n = 3617; wave 5: n = 1427). Data were modeled using latent growth curves to understand the trajectories of social integration and physical activity, separately. Latent interlocking growth curve methods were used to understand if and how changes in social integration predicted changes in physical activity.

RESULTS

Physical activity did not change over the 25-year period (P = .68). Social integration significantly decreased (P = .025). Changes in social integration predicted changes in physical activity (β = 0.12, P < .05).

CONCLUSIONS

Changes in how often adults speak to family and friends predict changes in physical activity across a 25-year period. Group- and social network-focused physical activity research, advocacy, and interventions are warranted.

A Systematic Review on Effect of Electronic Media on Diet, Exercise, and Sexual Activity among Adolescents

Context

Electronic media has become a part of day-to-day life for all, and particularly more so for children and adolescents. Exposure to electronic media may be beneficial as well as harmful.

Aim

The aim of the study is to systematically synthesize existing published and non-published empirical evidence on the effect of exposure to electronic media on diet, exercise, and sexual activity.

Methodology

Two reviewers independently searched online databases such as MEDLINE, CENTRAL, and EMBASE. We applied no language, date, or publication restrictions.

Selection Criteria

We included randomized control trials that assessed the effect of exposure of electronic media on diet, exercise, and sexual activity in participants between 5 and 19 years.

Study Selection Data Extraction

Two reviewers independently screened studies identified in electronic search and independently extracted data and assessed the risk of bias of included studies.

Data Analysis

We had planned to use the risk ratio or odds ratio for dichotomous data, and mean difference (MD) or standardized MD for continuous data. However, as included studied differed in types of intervention and reporting of outcomes, we did not undertake meta-analysis.

Main Results

All included trials were parallel randomized controlled trials except for one that was a crossover trial. Eight studies reported the effect of electronic media on diet and exercise, two on diet, two on exercise, and one on sexual activity. Quality of evidence was rated as "very low" for all outcomes due to too little information or too few data to be able to reach to any conclusions.

Conclusions

There is a little body of evidence that limits conclusions. We need to comprehend as to how to swap undesirable effects of electronic media and make it more desirable.

Registration of Systematic Review

This systematic review has been registered at PROSPERO International prospective register of systematic reviews (Registration number: PROSPERO 2018 CRD42018086935) available at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=86935.

Using Temporal Self-Regulation Theory to understand healthy and unhealthy eating intentions and behaviour

OBJECTIVES

The present research investigated whether Temporal Self-Regulation Theory (TST) can be used to help understand healthy and unhealthy eating intentions and behaviour.

DESIGN

A prospective design with two waves of data collection one week apart.

METHOD

An online survey measured the key components of TST (i.e., connectedness, timing and valence beliefs, intentions, past behaviour, habit strength, perceived environmental cues, and self-control) with respect to eating fruit and vegetables (F&V; N = 133) or unhealthy snacks (N = 125). Eating behaviour was assessed one week later.

RESULTS

The components of TST explained significant amounts of the variance in intentions and behaviour for intake of F&Vs (22% and 64%, respectively) and unhealthy snacks (18% and 35%, respectively). Beliefs about positive and negative short-term outcomes significantly predicted intentions to perform both behaviours. Intentions and past behaviour significantly predicted consumption of F&Vs, and past behaviour moderated the relationship between intention and behaviour which became stronger as past behaviour increased. Past behaviour and habit strength significantly predicted unhealthy snacking.

CONCLUSIONS

The findings suggest that TST may be a useful framework for understanding eating intentions and behaviour. However, research did not find support for all of the hypothesised relationships (e.g., self-regulatory capacity did not significantly predict eating behaviour and also failed to moderate the relationships between intentions and behaviour). Research using alternative measures of self-regulatory capacity, along with experimental manipulations of TST variables, may be needed to further understand eating intentions and behaviour.

Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial

Background

Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students.

Objective

Our objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression).

Methods

In a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015.

Results

Significant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η²) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ²₁=11.75, P=.001) and FVI (χ²₁=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F_3,492=1.23, η²=.03, P=.02).

Conclusions

This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention.

Trial Registration

Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1)

Stability of physical activity, fitness components and diet quality indices

BACKGROUND

Regular physical activity (PA), a high level of fitness and a high diet quality are positively associated with health. However, information about stability of fitness components and diet quality indices is limited. This study aimed to evaluate stability of those parameters.

METHODS

This study includes 652 adults (men=57.56 (10.28) years; women=55.90 (8.34) years at follow-up) who participated in 2002-2004 and returned for follow-up at the Policy Research Centre Leuven in 2012-2014. Minutes sport per day and Physical activity level (PAL) were calculated from the Flemish Physical Activity Computerized Questionnaire. Cardiorespiratory fitness (CRF), morphological fitness (MORF; body mass index and waist circumference) and metabolic fitness (METF) (blood cholesterol and triglycerides) were used as fitness components. Diet quality indices (Healthy Eating Index-2010 (HEI), Diet Quality Index (DQI), Mediterranean Diet Score (MDS)) were calculated from a diet record. Tracking coefficients were calculated using Pearson/Spearman correlation coefficients (rPearson) and intra-class correlation coefficients (rICC).

RESULTS

In both men (rPearson&ICC=0.51) and women (rPearson=0.62 and rICC=0.60) PAL showed good stability, while minutes sport remained stable in women (rPearson&ICC=0.57) but less in men (rPearson&ICC=0.45). Most fitness components remained stable (r⩾0.50) except some METF components in women. In general the diet quality indices and their components were unstable (r<0.50).

CONCLUSIONS

PAL and the majority of the fitness components remained stable, while diet quality was unstable over 10 years. For unstable parameters such as diet quality measurements are needed at both time points in prospective research.

The home environment and toddler physical activity: an ecological momentary assessment study

BACKGROUND

Physical activity (PA) promotion/obesity prevention in toddlerhood should include home environments.

OBJECTIVE

The aim of the study was to determine social/physical home environment factors associated with toddler PA using ecological momentary assessment (EMA, real-time data collection).

METHODS

Low-income mother-toddler dyads were recruited and given a handheld EMA device (53 random beeps followed by social/physical environment survey over 8 d). Simultaneously, PA was assessed via accelerometry (data extracted 15 min before/after response, average activity counts per minute). Linear mixed-effects models were used, adjusting for toddler age, urban/suburban residence and time of day; covariate moderating effects were examined; within-subjects and between-subjects findings were reported. PA was hypothesized to be greater when toddlers are outside (vs. inside), children are nearby (vs. alone), toddlers are interacting with their mothers (vs. not) and TV is off (vs. on).

RESULTS

The final count was 2454 EMA/PA responses for 160 toddlers (mean age 20 months, range 12-31; 55% male, 66% Black and 54% urban). Associations with PA include (within subjects) the following: outside location (212 additional counts min-1 ), children nearby (153 additional counts min-1 ) and interacting with mother (321 additional counts min-1 ), compared with alternatives. Age was moderated by outside location/PA association (within subjects), with 90 additional counts min-1 per 3-month age group outside vs. inside. No between-subjects or television/PA associations were found.

CONCLUSIONS

Home environment factors were associated with PA, including outside location, children nearby and mother interaction. EMA is a novel method, allowing identification of contextual factors associated with behaviours in natural environments.

Childhood temperament predictors of adolescent physical activity

Background

Physical inactivity is a leading cause of mortality worldwide. Many patterns of physical activity involvement are established early in life. To date, the role of easily identifiable early-life individual predictors of PA, such as childhood temperament, remains relatively unexplored. Here, we tested whether childhood temperamental activity level, high intensity pleasure, low intensity pleasure, and surgency predicted engagement in physical activity (PA) patterns 11 years later in adolescence.

Methods

Data came from a longitudinal community study (N = 206 participants, 53% females, 70% Caucasian). Parents reported their children’s temperamental characteristics using the Child Behavior Questionnaire (CBQ) when children were 4 & 5 years old. Approximately 11 years later, adolescents completed self-reports of PA using the Godin Leisure Time Exercise Questionnaire and the Youth Risk Behavior Survey. Ordered logistic regression, ordinary least squares linear regression, and Zero-inflated Poisson regression models were used to predict adolescent PA from childhood temperament. Race, socioeconomic status, and adolescent body mass index were used as covariates.

Results

Males with greater childhood temperamental activity level engaged in greater adolescent PA volume (B = .42, SE = .13) and a 1 SD difference in childhood temperamental activity level predicted 29.7% more strenuous adolescent PA per week. Males’ high intensity pleasure predicted higher adolescent PA volume (B = .28, SE = .12). Males’ surgency positively predicted more frequent PA activity (B = .47, SE = .23, OR = 1.61, 95% CI: 1.02, 2.54) and PA volume (B = .31, SE = .12). No predictions from females’ childhood temperament to later PA engagement were identified.

Conclusions

Childhood temperament may influence the formation of later PA habits, particularly in males. Boys with high temperamental activity level, high intensity pleasure, and surgency may directly seek out pastimes that involve PA. Indirectly, temperament may also influence caregivers’ perceptions of optimal activity choices for children. Understanding how temperament influences the development of PA patterns has the potential to inform efforts aimed at promoting long-term PA engagement and physical health.

Perceived neighborhood environment and physical activity among high school students from Curitiba, Brazil

OBJECTIVE

To analyze the association between perceived neighborhood environment and physical activity (PA) in high school students from Curitiba (PR), Brazil.

METHODS

A sample of 1,611 high school students from public schools was surveyed. The PA was assessed through questions, engaged for at least 20 minutes or 60 minutes. Perceptions on neighborhood environment were assessed through ten questions about neighborhood characteristics. Gender, age and number of cars in the household were self-reported and used as confounding variables. Absolute and relative frequencies were used in the sample, and associations were tested through adjusted logistic regressions for the confounding variables and stratified by gender (p < 0.05).

RESULTS

The adjusted analyses showed that the variables "interesting things" among girls (OR = 1.77; 95%CI 1.05 - 2.96) and "there are places I like" (OR = 2.18; 95%CI 1.33 - 3.58) and "I see people my age", among boys, were associated with PA of at least 20 minutes/day once a week. Additionally, among boys, "I see people my age" was associated with 60-minute (OR = 1.68; 95%CI 1.15 - 2.45). Perceiving the neighborhood environment as "very good" was associated with higher chances of taking up PA among girls (OR = 1.92; 95%CI 1.15 - 3.22) and boys (OR = 3.13; 95%CI 1.97 - 4.97).

CONCLUSION

A positive perception of the environment was associated to PA practice among boys and girls in this sample. The results suggest that some environmental characteristics which make neighborhoods more attractive could be related to PA among adolescents.

Tracking of Television Viewing Time during Adulthood: The Young Finns Study

PURPOSE

The aim of this study was to investigate the tracking of television viewing (TV) time as an indicator of sedentary behavior among adults for a period of 25 yr.

METHODS

A random sample of 1601 subjects (740 men) age 18, 21, and 24 yr participated in the Cardiovascular Risk in Young Finns Study in 1986. TV time during leisure time was measured with a single self-report question at baseline and in 2001, 2007, and 2011. Tracking of TV time was analyzed using Spearman rank correlations and simplex models. Level and change of TV time were examined using linear growth modeling.

RESULTS

The 4- and 6-yr integrated TV time stability coefficients, adjusted for measurement errors, were ≥0.60 in adulthood and quite similar for both men and women. The stability coefficients tended to decline as the time interval increased. The stability of the indirect estimation of TV time for a 25-yr period was moderately or highly significant for both genders in most age groups. Younger age, but not gender, was found to be associated with a higher initial level of TV time. Male gender and older age were found to be significantly associated with the slope of TV time.

CONCLUSION

The stability of TV time is predominantly moderate to high during adulthood and varies somewhat by age and gender.

Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up

Background

Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding.

Methods

This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945–1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (<1.5 metabolic equivalent hours/day) was first analysed for each survey. Then, the role of education was investigated for 15-year and 35-year inactivity periods in the longitudinal analyses. The co-twin control design was used to analyse the potential familial confounding of the effects. All analyses were conducted with and without multiple covariates. Odds Ratios (OR) with 95 % Confidence Intervals (CI) were calculated using logistic and conditional (fixed-effects) regression models.

Results

Each additional year of education was associated with less inactivity (OR 0.94 to 0.95, 95 % CI 0.92, 0.99) in the cross-sectional age- and sex-adjusted analyses. The associations of education with inactivity in the 15- and 35-year follow-ups showed a similar trend: OR 0.97 (95 % CI 0.93, 1.00) and OR 0.94 (95 % CI 0.91, 0.98), respectively. In all co-twin control analyses, each year of higher education was associated with a reduced likelihood of inactivity suggesting direct effect (i.e. independent from familial confounding) of education on inactivity. However, the point estimates were lower than in the individual-level analyses. Adjustment for multiple covariates did not change these associations.

Conclusions

Higher education is associated with lower odds of leisure-time physical inactivity during the three-decade follow-up. The association was found after adjusting for several confounders, including familial factors. Hence, the results point to the conclusion that education has an independent role in the development of long-term physical inactivity and tailored efforts to promote physical activity among lower educated people would be needed throughout adulthood.

Weekly Physical Activity Levels of Older Adults Regularly Using a Fitness Facility

The aim of this paper was to determine if weekly physical activity levels were greater in an independent-living older adult population that was regularly participating in structured fitness activities. Also, lifetime exercise history and sex differences were investigated in an effort to understand how they relate to current weekly step activity. Total weekly step counts, measured with a pedometer, were assessed in two older adult groups; the first consisted of members of a local senior center who regularly used the fitness facility (74.5 ± 6.0 yrs; mean ± SD) while the second group consisted of members who did not use the fitness facility (74.8 ± 6.0 yrs). Participants also completed the Lifetime Physical Activity Questionnaire (LPAQ). No significant difference was found in the total number of weekly steps between groups (p = 0.88) or sexes (p = 0.27). The LPAQ suggested a significant decline in activity with aging (p = 0.01) but no difference between groups (p = 0.54) or sexes (p = 0.80). A relationship was observed between current step activity and MET expenditure over the past year (p = 0.008, r (2) = 0.153) and from ages 35 to 50 years (p = 0.037, r (2) = 0.097). The lack of difference in weekly physical activity level between our groups suggests that independent-living older adults will seek out and perform their desired activity, in either a scheduled exercise program or other leisure-time activities. Also, the best predictor of current physical activity level in independent-living older adults was the activity performed over the past year.

High Job Demands, Job Strain, and Iso-Strain are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up

OBJECTIVE

To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations.

METHODS

Respondents (n = 11,729), given to complete a questionnaire in 2004 to 2006, were followed up approximately 5 years for sick leave spells due to mental disorders, using national registry data. Data were analyzed using logistic regression, and conditional logistic regression for twin pairs discordant for sick leave (cotwin control).

RESULTS

High job demands, job strain, and iso-strain were independent risk factors for sick leave due to mental disorders. Familial factors seem to be of importance in the associations between job support, smoking, a combination of unhealthy behaviors and sick leave.

CONCLUSIONS

Improving the psychosocial work environment may be effective in preventing sick leave due to mental disorders.

During early to mid adolescence, moderate to vigorous physical activity is associated with restoring sleep, psychological functioning, mental toughness and male gender

Numerous studies showed that regular physical activity (PA) is associated with both favourable and restorative sleep and improved psychological functioning (PF). However, there is little research on the topic covering the early to mid-adolescence period. Moreover, curiosity and exploratory behaviour (CEB) and mental toughness (MT) as a result of PA remains thus far uninvestigated, as do possible gender differences. The aim of the present study was to explore the associations between PA, subjective sleep (sS), PF, CEB, and MT during early to mid-adolescence. A total of 1361 participants (mean age = 13.37 years; range: 11-16 years; 51.2% female) took part in the study. They completed questionnaires covering PA, sS, PF, CEB, and MT. Greater PA was related to improved PF, better sS, and increased CEB and MT. Compared to male participants, females reported less PA, poorer sS, and had lower PF and MT scores. The present pattern of results suggests that during early and mid-adolescence greater PA was associated with more favourable sS and better PF, including CEB and MT, and that female participants reported lower scores in PA, sS, and PF. Accordingly, if PA has a favourable impact on sleep and psychological functioning, then data suggest that sports participation should be more tailored to increase motivation among female adolescents.

Objectively Measured Physical Activity and Health-Related Physical Fitness in Secondary School-Aged Male Students With Autism Spectrum Disorders

BACKGROUND

Recent evidence suggests that childhood obesity is increasing in children with typical development (TD) and in children with autism spectrum disorders (ASD). The associations between physical activity (PA) levels and physical fitness components have not yet been objectively examined in this population but may have clinical implications for the development of secondary health complications.

OBJECTIVE

The aims of this study were: (1) to compare PA and physical fitness between secondary school-aged male students with ASD and their peers with TD and (2) to assess possible interrelationships between PA and physical fitness levels in each group.

DESIGN

This was a cross-sectional study.

METHODS

Physical activity was recorded every 10 seconds by using accelerometry in 70 male students with (n=35) and without (n=35) ASD for up to 5 weekdays and 2 weekend days. The Brockport Physical Fitness Test was used to assess physical fitness.

RESULTS

The primary findings were: (1) participants with ASD were less physically active overall and engaged in moderate-to-vigorous PA for a lower percentage of time compared with participants with TD during weekdays; (2) participants with ASD had significantly lower scores on all physical fitness measures, except body composition; and (3) group-dependent relationships existed between physical fitness profiles and PA levels.

LIMITATIONS

The study design limits causal inference from the results.

CONCLUSION

Specific interventions for maximizing PA and physical fitness levels in secondary school-aged male students with ASD are urgently needed.

The Influence of Health Behaviors During Childhood on Adolescent Health Behaviors, Health Indicators, and Academic Outcomes Among Participants from Hawaii

BACKGROUND/PURPOSE

Health behaviors during childhood may influence adolescent health behaviors and be related to other important outcomes, but no longitudinal research has examined this in a multicultural population in Hawaii to date. This study investigated if childhood moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, and sedentary behavior influence adolescent (1) MVPA, fruit and vegetable consumption, and sedentary behavior; (2) body mass index (BMI) percentile, general health, and stress; and (3) school marks and school absenteeism.

METHODS

Three cohorts of public elementary school children (fourth to sixth graders) who participated in a state-mandated after-school program in 2004, 2005, and 2006 completed baseline (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior) and 5-year follow-up surveys (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior; BMI, general health, stress, school marks, and absenteeism; combined follow-up n = 334; 14.76 ± 0.87 years old; 55.1% female; 53% Asian, 19.8% Native Hawaiian/other Pacific Islander, 15.3% White, and 11.9% other).

RESULTS

Regressions found that childhood MVPA (mean [m] = 45.42, standard deviation [SD] = 31.2 min/day) and fruit and vegetable consumption (m = 6.96, SD = 4.54 servings/day) predicted these behaviors in adolescence (m = 47.22, SD = 27.04 min/day and m = 4.63, SD = 3.03 servings/day, respectively, p < 0.05). Childhood sedentary behavior (m = 3.85, SD = 2.85 h/day)) predicted adolescent BMI percentile (m = 60.93, SD = 28.75, p < 0.05). Childhood fruit and vegetable consumption and sedentary behavior negatively predicted adolescent marks (B average, p < 0.05).

CONCLUSIONS

Childhood health behaviors do influence adolescent health behaviors, some health outcomes, and some academic indicators in this population, especially childhood sedentary behavior, which underlines the importance of sedentary behavior interventions.

The Influence of Alcohol Consumption, Cigarette Smoking, and Physical Activity on Leukocyte Telomere Length

BACKGROUND

Telomeres protect from DNA degradation and maintain chromosomal stability. Short telomeres have been associated with an increased risk of cancer at several sites. However, there is limited knowledge about the lifestyle determinants of telomere length. We aimed to determine the effect of three factors, known to be important in cancer etiology, on relative leukocyte telomere length (rLTL): alcohol consumption, smoking, and physical activity.

METHODS

This cross-sectional study included 477 healthy volunteers ages 20 to 50 years who completed a questionnaire and provided a fasting blood sample. Multiplex quantitative real-time PCR (qPCR) was used to measure rLTL. Regression coefficients were calculated using multiple linear regression while controlling for important covariates.

RESULTS

There was no association between alcohol consumption and rLTL. Daily smokers and those in the middle and lower tertile of pack-years smoking had shorter rLTL than never daily smokers (P = 0.02). Data were suggestive of a linear trend with total physical activity (P = 0.06). Compared with the lowest quartile, the highest quartile of vigorous physical activity was associated with longer rLTL. A significant linear trend of increasing rLTL with increasing vigorous physical activity was observed (P = 0.02).

CONCLUSIONS

Cigarette smoking and vigorous physical activity have an impact on telomere length. Smoking was related to shorter telomere length while vigorous physical activity was related to longer telomeres.

IMPACT

The findings from this study suggest that lifestyle may play an important role in telomere dynamics and also suggest that engaging in healthy behaviors may mitigate the effect of harmful behaviors on telomere length.

Growth Trajectories of Health Behaviors from Adolescence through Young Adulthood

Based on nine waves of data collected during a period of 17 years (1990–2007), the present study explored different developmental trajectories of the following unhealthy behaviors: regular smoking, lack of regular exercise, lack of daily fruit intake, and drunkenness. A baseline sample of 1195 13-year-old pupils was from 22 randomly selected schools in the Hordaland County in western Norway. Latent class growth analysis revealed three developmental trajectories. The first trajectory was a conventional trajectory, comprising 36.3% of participants, who showed changes in smoking, physical exercise, fruit intake, and drunkenness consistent with the prevailing age specific norms of these behaviors in the Norwegian society at the time. The second trajectory was a passive trajectory, comprising 25.5% of participants, who reported low levels of both healthy and unhealthy behaviors during the 17-year period. The third trajectory was an unhealthy trajectory, comprising 38.2% of participants, who had high levels of unhealthy behaviors over time. Several covariates were examined, but only sex and mother’s and father’s educational levels were found to be significantly associated with the identified trajectories. While these findings need to be replicated in future studies, the identification of the different trajectories suggests the need to tailor intervention according to specific needs.

A Randomised Control Trial of the Impact of a Computer-Based Activity Programme upon the Fitness of Children with Autism

The poor levels of fitness in children with autism are prompting concern for the children's future health. This study looked to assess if a computer-based activity programme could improve fitness levels (as reflected in cardiopulmonary function) of these children, and achieve a reduction in their body mass index. In a randomised controlled trial, 50 children with autism (of which 33 were under the age of 11 years and 39 were boys) were allocated to an intervention group which encouraged them to use the Nintendo Wii and the software package "Mario and Sonics at the Olympics" in addition to their routine physical education classes. 50 children with autism (34 under the age of 11 years and 40 being boys) acted as controls. At the end of one year, analysis of the changes in scores using analysis of covariance (ANCOVA) on the Eurofit fitness tests showed that the intervention group had made statistically significant improvement on all tests other than flexibility. These improvements were also significantly better than controls. This type of intervention appears to be an effective addition to standard fitness training in order to help children with autism improve their fitness levels.

Epidemiology of lifetime fracture prevalence in England: a population study of adults aged 55 years and over

BACKGROUND

fractures remain a substantial public health problem but epidemiological studies using survey data are sparse. This study explores the association between lifetime fracture prevalence and socio-demographic factors, health behaviours and health conditions.

METHODS

fracture prevalence was calculated using a combined dataset of annual, nationally representative health surveys in England (2002-07) containing 24,725 adults aged 55 years and over. Odds of reporting any fracture was estimated separately for each gender using logistic regression.

RESULTS

fracture prevalence was higher in men than women (49 and 40%, respectively). In men, factors having a significant independent association with fracture included being a former regular smoker [odds ratios, OR: 1.18 (1.06-1.31)], having a limiting long-standing illness [OR: 1.47 (1.31-1.66)] and consuming >8 units of alcohol on the heaviest drinking day in the past week [OR: 1.65 (1.37-1.98)]. In women, significant factors included being separated/divorced [OR: 1.30 (1.10-1.55)], having a 12-item General Health Questionnaire (GHQ-12) score of 4+ [OR: 1.59 (1.27-2.00)], consuming >6 units of alcohol in the past week [OR: 2.07 (1.28-3.35)] and being obese [OR: 1.25 (1.03-1.51)].

CONCLUSION

a range of socio-demographic, health behaviour and health conditions, known to increase the risk of chronic disease and premature death, are also associated with fracture occurrence, probably involving the aetiological pathways of poor bone health and fall-related trauma.

Physical activity and onset of depression in adolescents: a prospective study in the general population cohort TRAILS

Although it has often been suggested that physical activity and depression are intertwined, only few studies have investigated whether specific aspects of physical activity predict the incidence of major depression in adolescents from the general population. Therefore the aim of this study was to investigate the effects of nature, frequency, duration and intensity of physical activity during early adolescence on the onset of a major depressive episode in early adulthood. In a population sample of adolescents (N = 1396), various aspects of physical activity were assessed at early adolescence (mean age 13.02, SD = 0.61). Major depressive episode onset was assessed using the Composite International Diagnostic Interview. A Cox regression model was performed to investigate whether physical activity characteristics and their interactions with gender predicted a major depressive episode onset up until mean age 18.5 (SD = 0.61). The individual characteristics of physical activity (nature, frequency, duration and intensity) or their interactions with gender did not predict a major depressive episode onset (p values >0.05). So far, there is no prospective evidence that physical activity protects against the development of adolescent depressive episodes in either boys or girls.

Distal and proximal factors of health behaviors and their associations with health in children and adolescents

OBJECTIVE

The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health.

METHODS

Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination.

RESULTS

Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown.

CONCLUSIONS

Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.

Childhood physical activity, sports and exercise and noncommunicable disease: a special focus on India

Establishing the relationship between childhood physical inactivity and noncommunicable disease (NCD) is difficult, since chronic disease and mortality are not direct health outcomes of physical inactivity in children. Published literature explores the relationship of physical inactivity with appearance of early childhood disease risk markers, the adverse impact of which may take some time to appear. Promoting childhood physical activity has multiple benefits including delay in evolution of risk factors contributing to adult degenerative disease. It is clear from available literature that physical inactivity or its surrogates constitute an important independent risk factor for NCD. This is likely to be underestimated not only because of measurement issues, but also because physical inactivity may act through other risk factors for NCD. To recognize and intervene on the issue of physical inactivity in children is important not only for the benefit of the child but in the context of NCD in later life. Studies on physical inactivity and its functional correlates are limited in India and this would be an important area for future research.

A theory-based online health behavior intervention for new university students: study protocol

BACKGROUND

Too few young people engage in behaviors that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. The present research developed an online intervention to target these health behaviors during the significant life transition from school to university when health beliefs and behaviors may be more open to change. This paper describes the intervention and the proposed approach to its evaluation.

METHODS/DESIGN

Potential participants (all undergraduates about to enter the University of Sheffield) will be emailed an online questionnaire two weeks before starting university. On completion of the questionnaire, respondents will be randomly assigned to receive either an online health behavior intervention (U@Uni) or a control condition. The intervention employs three behavior change techniques (self-affirmation, theory-based messages, and implementation intentions) to target four heath behaviors (alcohol consumption, physical activity, fruit and vegetable intake, and smoking). Subsequently, all participants will be emailed follow-up questionnaires approximately one and six months after starting university. The questionnaires will assess the four targeted behaviors and associated cognitions (e.g., intentions, self-efficacy) as well as socio-demographic variables, health status, Body Mass Index (BMI), health service use and recreational drug use. A sub-sample of participants will provide a sample of hair to assess changes in biochemical markers of health behavior. A health economic evaluation of the cost effectiveness of the intervention will also be conducted.

DISCUSSION

The findings will provide evidence on the effectiveness of online interventions as well as the potential for intervening during significant life transitions, such as the move from school to university. If successful, the intervention could be employed at other universities to promote healthy behaviors among new undergraduates.

TRIAL REGISTRATION

Current Controlled Trials, ISRCTN67684181.