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White JW, Finnegan OL, Tindall N, Nelakuditi S, Brown DE, Pate RR, Welk GJ, de Zambotti M, Ghosal R, Wang Y, Burkart S, Adams EL, Chandrashekhar M, Armstrong B, Beets MW, Weaver RG. Comparison of raw accelerometry data from ActiGraph, Apple Watch, Garmin, and Fitbit using a mechanical shaker table. PLoS One 2024; 19:e0286898. [PMID: 38551940 PMCID: PMC10980217 DOI: 10.1371/journal.pone.0286898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/12/2024] [Indexed: 04/01/2024] Open
Abstract
The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. Pearson product moment, Lin's concordance correlation coefficient (CCC), absolute error, mean bias, and equivalence testing were calculated to assess the validity between the raw estimates from the devices and the reference metric. Estimates from Apple, ActiGraph, Garmin, and Fitbit were reliable, with ICCs = 0.99, 0.97, 0.88, and 0.88, respectively. Estimates from ActiGraph, Apple, and Fitbit devices exhibited excellent concordance with the reference CCCs = 0.88, 0.83, and 0.85, respectively, while estimates from Garmin exhibited moderate concordance CCC = 0.59 based on the mean aggregation method. ActiGraph, Apple, and Fitbit produced similar absolute errors = 16.9mg, 21.6mg, and 22.0mg, respectively, while Garmin produced higher absolute error = 32.5mg compared to the reference. ActiGraph produced the lowest mean bias 0.0mg (95%CI = -40.0, 41.0). Equivalence testing revealed raw accelerometry data from all devices were not statistically significantly within the equivalence bounds of the shaker speed. Findings from this study provide evidence that raw accelerometry data from Apple, Garmin, and Fitbit devices can be used to reliably estimate movement; however, no estimates were statistically significantly equivalent to the reference. Future studies could explore device-agnostic and harmonization methods for estimating physical activity using the raw accelerometry signals from the consumer wearables studied herein.
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Affiliation(s)
- James W. White
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Olivia L. Finnegan
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Nick Tindall
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Srihari Nelakuditi
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States of America
| | - David E. Brown
- Division of Pediatric Pulmonology, Pediatric Sleep Medicine, Prisma Health Richland Hospital, Columbia, SC, United States of America
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Gregory J. Welk
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
| | | | - Rahul Ghosal
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States of America
| | - Yuan Wang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States of America
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Elizabeth L. Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Mvs Chandrashekhar
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States of America
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - Michael W. Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
| | - R. Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States of America
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Boudreaux BD, Kennedy AB, Pate RR. Remembering Steven N Blair for making physical activity count every step of the way. Br J Sports Med 2024; 58:351-352. [PMID: 38272649 DOI: 10.1136/bjsports-2024-108086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Benjamin D Boudreaux
- Center for Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ann Blair Kennedy
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Pate RR, Dowda M, Dishman RK, Saunders RP, Cordan KL, Shull ER, Bucko AG, Colabianchi N. Determinants of Change in Physical Activity in Children During the Transition from Elementary to High School. Med Sci Sports Exerc 2024:00005768-990000000-00481. [PMID: 38451739 DOI: 10.1249/mss.0000000000003422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school. METHODS Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th through 11th grades in 2010 - 2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age. RESULTS As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years. CONCLUSIONS Interventions should target multiple domains of influences that may vary by age.
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Affiliation(s)
- Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Rod K Dishman
- Department of Kinesiology, College of Education, The University of Georgia, Athens, GA
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Kerry L Cordan
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Emily R Shull
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Agnes G Bucko
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Natalie Colabianchi
- School of Kinesiology and Institute for Social Research, University of Michigan, Ann Arbor, MI
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Olejua P, McLain AC, Inak N, Dowda M, Pate RR. Clustering Patterns of 24-Hour Physical Activity in Children 6-36 Months Old. Pediatr Exerc Sci 2024:1-8. [PMID: 38307017 DOI: 10.1123/pes.2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE To determine 24-hour physical activity (PA) clusters in children 6-36 months of age, factors associated with the clusters, and their agreement across time. METHOD A longitudinal study followed 150 infants from South Carolina up to 36 months of age. Measures included 24-hour PA and demographic data. Functional clustering was used to obtain the clusters. The association between cluster membership and infant/parent characteristics was examined by Kruskal-Wallis and chi-squared tests. Concordance was measured with the kappa coefficient and percent agreement. RESULTS At each follow-up, 3 clusters were optimal, identified as late activity (cluster 1), high activity (cluster 2), and medium activity (cluster 3). The defining feature of the late activity cluster was that their physical activity (PA) activity was shifted to later in the day versus children in clusters 2 and 3. At 6 months, the clusters were associated with race (<0.001), crawling (0.043), other children in the household (0.043), and mother's education (0.004); at 12 months with race (0.029), childcare (<0.001), and education (<0.001); and at 36 months with other children in the household (0.019). Clusters showed moderate agreement (kappa = .41 [.25 to .57], agreement = 61% [49% to 72%]) between 6 and 12 months and, at 36 months, showed no agreement with either 6 or 12 months. CONCLUSION Twenty-four-hour PA can be clustered into medium, high, and late PA. Further research is needed into the consequences of late sleeping in children at this age. Clusters are associated with household and childcare factors, and cluster membership is dynamic across time.
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Affiliation(s)
- Peter Olejua
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Nabila Inak
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
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Dowda M, Saunders RP, Dishman RK, Pate RR. Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status. Int J Obes (Lond) 2024; 48:240-246. [PMID: 37932409 DOI: 10.1038/s41366-023-01405-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity rates have increased in recent years. The effectiveness of future public health interventions to reduce childhood obesity will be enhanced by a better understanding of behavioral factors that influence adiposity in children as they transition from childhood to adolescence. The purpose of this study was to examine whether initial weight status modifies the longitudinal associations of physical activity, sedentary behavior, and diet quality with changes in adiposity over time. SUBJECTS/METHODS A total of 658 children (45% boys) were stratified into 3 groups based on 5th grade BMI percentiles ( < 85th, 85-95th, > 95th) and followed from 5th grade to 6th and/or 7th grade. Study variables, including fat-mass-index (FMI), moderate-to-vigorous physical activity (MVPA), diet quality, and sedentary behavior, were measured at 5th, 6th, and/or 7th grades. Separate growth curve models were conducted within each weight status group to examine the associations between MVPA, sedentary behavior, diet quality and adiposity, operationalized as FMI. All models controlled for sex, maturity offset, race, and parent education. RESULTS Of the 658 children, 53% were classified with normal weight at baseline, 18% with overweight, and 29% with obesity. Associations between MVPA, sedentary behavior, diet quality and FMI varied within each weight status group. MVPA was negatively associated with adiposity (FMI) for all weight status groups. Diet quality and sedentary behavior were associated with adiposity only in children with obesity at baseline; neither diet quality nor sedentary behavior was associated with FMI for those with overweight. CONCLUSIONS MVPA was negatively associated with adiposity (FMI) in all weight status groups, suggesting that MVPA may protect against higher adiposity. Sedentary behavior and diet quality were associated with adiposity only in children with obesity at baseline; neither sedentary behavior nor diet quality was associated with FMI for children with overweight.
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Affiliation(s)
- Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
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Pate RR, Zaltz DA, Neelon B, Liu T, Bucko A, Benjamin-Neelon SE. Policies, Practices, and Environmental Characteristics Among Family Child Care Homes in South Carolina. Child Obes 2024. [PMID: 38197857 DOI: 10.1089/chi.2023.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background: Child care program requirements have adopted nutrition and physical activity standards to address childhood obesity, but few studies have examined the effects of these standards in family child care homes (FCCHs). Methods: In a cross-sectional study (2017-2019), the Childcare Home Eating and Exercise study examined self-reported provider characteristics and observed policies and practices related to physical activity and nutrition in FCCHs in South Carolina. Two-sample t-tests were used to compare observed nutrition and physical activity policy, practice, and environment scores in child care homes that participated in versus did not participate in the state's ABC Quality program, which is designed to improve child care and includes policies and practices intended to increase physical activity levels and improve diet quality. Results: Environment and Policy Assessment and Observation results for nutrition and physical activity were 7.5 out of 21 and 11.8 out of 30, respectively, indicating much room for improvement in nutrition and physical activity policies, practices, and environment in South Carolina FCCHs. The study found one difference between FCCHs that did and did not participate in the ABC Quality program; non-ABC homes provided more time for physical activity. Conclusions: Future research should develop ways to strengthen the guidelines and improve the implementation of obesity prevention standards in FCCHs.
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Affiliation(s)
- Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniel A Zaltz
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Tiange Liu
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Agnes Bucko
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Reid LA, Geraci M, Mendoza JA, Merchant AT, Reboussin BA, Pate RR, Dolan LM, Sauder KA, Lustigova E, Kim G, Liese AD. Household Food Insecurity Is Associated With Physical Activity in Youth and Young Adults With Diabetes: A Cross-Sectional Study. J Phys Act Health 2024; 21:77-84. [PMID: 37922896 DOI: 10.1123/jpah.2022-0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/13/2023] [Accepted: 09/16/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Physical activity (PA) is essential for optimal diabetes management. Household food insecurity (HFI) may negatively affect diabetes management behaviors. The purpose of this study was to cross-sectionally examine the association between HFI and PA in youth and young adults (YYA) with type 1 (N = 1998) and type 2 (N = 391) diabetes from the SEARCH for Diabetes in Youth Study. METHODS HFI was measured with the US Household Food Security Survey Module. PA was measured with the International Physical Activity Questionnaire Short Form. Walking, moderate-intensity PA (excluding walking), vigorous-intensity PA, moderate- to vigorous-intensity PA, and total PA were estimated as minutes per week, while time spent sitting was assessed in minutes per day. All were modeled with median regression. Meeting PA guidelines or not was modeled using logistic regression. RESULTS YYA with type 1 diabetes who experienced HFI spent more time walking than those who were food secure. YYA with type 2 diabetes who experienced HFI spent more time sitting than those who were food secure. CONCLUSIONS Future research should examine walking for leisure versus other domains of walking in relation to HFI and use objective PA measures to corroborate associations between HFI and PA in YYA with diabetes.
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Affiliation(s)
- Lauren A Reid
- South College, Atlanta, GA, USA
- University of South Carolina, Columbia, SC, USA
| | - Marco Geraci
- University of South Carolina, Columbia, SC, USA
- Sapienza University of Rome, Rome, Italy
| | - Jason A Mendoza
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | | | | | | | | | | | - Eva Lustigova
- Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Grace Kim
- University of Washington School of Medicine, Seattle, WA, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Katzmarzyk PT, Jakicic JM, Pate RR, Piercy KL, Whitsel LP. Amplifying Support for Physical Activity: The National Strategy on Hunger, Nutrition, and Health. Am J Prev Med 2023; 65:1187-1191. [PMID: 37467867 PMCID: PMC10792114 DOI: 10.1016/j.amepre.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana.
| | - John M Jakicic
- Division of Physical Activity & Weight Management, Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Katrina L Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, Maryland
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Kohl HW, DiPietro L, Lee IM, Ding D, Hallal PC, Morrow JR, Pate RR. Remembering Steven N. Blair. J Phys Act Health 2023; 20:993. [PMID: 37857385 DOI: 10.1123/jpah.2023-0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Harold W Kohl
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, Houston, TX,USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX,USA
| | - Loretta DiPietro
- Milken Institute School of Public Health, The George Washington University, Washington, DC,USA
| | - I-Min Lee
- Harvard T.H. Chan School of Public Health, Boston, MA,USA
| | - Ding Ding
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW,Australia
- The Charles Perkins Center, The University of Sydney, Camperdown, NSW,Australia
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana-Champaign, IL,USA
| | - James R Morrow
- Regents Professor Emeritus, University of North Texas, Denton, TX,USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC,USA
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Zaltz DA, Pate RR, Liu T, McIver KL, Neelon B, Benjamin-Neelon SE. Young Children's Dietary Quality in Family Child Care and in Their Own Home. J Acad Nutr Diet 2023; 123:1197-1206. [PMID: 37479379 PMCID: PMC10851279 DOI: 10.1016/j.jand.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 09/29/2022] [Accepted: 10/25/2022] [Indexed: 07/23/2023]
Abstract
BACKGROUND Some evidence suggests that children may have higher quality dietary intake in early care and education settings, compared with their respective homes, but no studies have explored these differences among children in less formal family child care. OBJECTIVE The purpose of this study was to compare dietary quality via the Healthy Eating Index 2015 among children in family child care and in their own home. DESIGN This was a cross-sectional analysis of baseline dietary intake data from the Childcare Home Eating and Exercise Research study, a natural experiment, using directly observed dietary data in child care and 24-hour recall data in homes among children in South Carolina. PARTICIPANTS/SETTING Participants were 123 children in 52 family child-care homes between 2018 and 2019. MAIN OUTCOME MEASURE The main outcome was total and component Healthy Eating Index 2015 scores. STATISTICAL ANALYSIS The analysis was a hierarchical linear regression of children nested within family child care homes adjusting for child, provider, facility, and parent characteristics, including sex, age, race, ethnicity, and income, with parameters and SEs estimated via bootstrap sampling. RESULTS Children had a mean ± SD Healthy Eating Index 2015 score of 60.3 ± 12.1 in family child-care homes and 54.3 ± 12.9 in their own home (P < 0.001). In adjusted analysis and after accounting for clustering of children in family child care homes, total HEI-2015 scores were lower at home than in care (β = -5.18 ± 1.47; 95% CI -8.05 to -2.30; P = 0.003). CONCLUSIONS Children had healthier dietary intake in family child-care homes vs their respective homes.
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Affiliation(s)
- Daniel A Zaltz
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
| | - Tiange Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kerry L McIver
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Bucko AG, Armstrong B, McIver KL, McLain AC, Pate RR. Longitudinal associations between sleep and weight status in infants and toddlers. Pediatr Obes 2023; 18:e13056. [PMID: 37246280 PMCID: PMC10524641 DOI: 10.1111/ijpo.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/02/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The limited research assessing relationships between sleep duration and weight status in infants and toddlers relies primarily on parent-reported sleep and cross-sectional studies. OBJECTIVES Examine whether average sleep duration and changes in sleep duration among 6-24-month-old children were associated with weight-for-length z-scores, and whether these associations varied by race/ethnicity, socioeconomic status and sex. METHODS Data were collected when children were approximately 6, 12, 18 and 24 months old (N = 116). Sleep duration was measured using actigraphy. Weight-for-length z-scores were calculated using children's height and weight. Physical activity was assessed using accelerometry. Diet was assessed using a feeding frequency questionnaire. Demographic characteristics included sex, race/ethnicity and socioeconomic status. Separate associations of between- and within-person changes in sleep duration were estimated with weight-for-length z-score treated as the outcome variable in linear mixed model analyses. Additional models were assessed that included interactions between sleep and demographic characteristics. RESULTS At time points where children slept longer at night compared to their own average, their weight-for-length z-score was lower. This relationship was attenuated by physical activity levels. CONCLUSIONS Increasing sleep duration can improve weight status outcomes in very young children who have low physical activity levels.
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Affiliation(s)
- Agnes G Bucko
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Kerry L McIver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina First Steps to School Readiness, Columbia, SC
| | - Alexander C. McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Shull ER, McIver K, McLain AC, Monsma E, Pate RR. Factors Associated with Children's Physical Activity During Youth Soccer Practices. Res Q Exerc Sport 2023:1-7. [PMID: 37466911 DOI: 10.1080/02701367.2023.2225563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/11/2023] [Indexed: 07/20/2023]
Abstract
Purpose: To identify practice and social contextual factors that associate with physical activity (PA) levels of children during their participation in a youth soccer program. Methods: Twenty-seven youth soccer teams serving children ages 6-11 years participated. Research staff directly observed and recorded PA intensity and practice and social contextual factors using momentary time-sampling procedures. Each team was observed for 1 practice, during which approximately 6 children were each observed for twenty 30-s observation blocks (10-s observation, 20-s recording). In total, children were observed for 3,102 intervals. Multilevel logistic regression analyses were conducted to describe associations between PA intensity and practice and social contexts. Interaction terms were introduced into the models to determine if the associations differed across girls-only, boys-only, and coed teams. Results: A total of 158 children were observed across the 27 teams. Children were more likely to engage in moderate or vigorous PA while performing fitness (Odds Ratio [OR], 9.9, 95% CI = 5.34-18.04), game (OR, 4.0, 95% CI = 2.88-5.66), warm-up (OR, 2.8, 95% CI = 1.85-4.11), and drill (OR, 1.9, 95% CI = 1.41-2.67) activities compared to tactic/instructional activities. The associations between PA intensity levels and practice and social contexts did not differ across girls-only, boys-only, and coed teams. Conclusions: Fitness activities and full-team game play were associated with higher PA intensity levels during children's participation in youth soccer practices. Youth sport practice protocols can be modified to increase children's physical activity.
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Eichner-Seitz N, Pate RR, Paul IM. Physical activity in infancy and early childhood: a narrative review of interventions for prevention of obesity and associated health outcomes. Front Endocrinol (Lausanne) 2023; 14:1155925. [PMID: 37293499 PMCID: PMC10244791 DOI: 10.3389/fendo.2023.1155925] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
In the context of the childhood obesity epidemic, this narrative review aims to explore opportunities to promote physical activity (PA) between birth and age 5 years as well as the health outcomes associated with PA in early childhood. Although early childhood is an ideal time to promote healthy habits, guidelines for PA have often ignored early childhood given the limited evidence for children <5 years old. Herein we discuss and highlight infant, toddler and preschool age interventions to promote PA and prevent obesity both in the short and long-term. We describe novel and modified interventions to promote improved early childhood health outcomes, encompassing cardiorespiratory, muscle, and bone strengthening components necessary for short-term motor development and long-term health. We call for new research aimed at developing and testing innovative early childhood interventions that may be performed in home or childcare settings, monitored by parents or caregivers.
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Affiliation(s)
- Natalie Eichner-Seitz
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Ian M. Paul
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
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14
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Kohl HW, Johnson AM, Dooley EE, Towner B, Pate RR, Heischmidt K, Elliott EM. An Assessment of State-Level Planning for Physical Activity Promotion in the United States. J Phys Act Health 2023:1-6. [PMID: 37185452 DOI: 10.1123/jpah.2022-0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/06/2023] [Accepted: 03/01/2023] [Indexed: 05/17/2023]
Abstract
The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan.
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Affiliation(s)
- Harold W Kohl
- School of Public Health, University of Texas Health Science Center at Houston, Austin, TX,USA
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX,USA
| | - Ashleigh M Johnson
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA,USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL,USA
| | - Brooke Towner
- Department of Recreation Management and Physical Education, Appalachian State University, Boone, NC,USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC,USA
| | | | - Eloise M Elliott
- College of Applied Human Sciences, West Virginia University, Morgantown, WV,USA
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15
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Taverno Ross SE, Saunders RP, Dowda M, Pate RR. Longitudinal changes in domains of physical activity during the transition from elementary school to high school in the U.S. J Sci Med Sport 2023; 26:261-266. [PMID: 37156695 PMCID: PMC10330139 DOI: 10.1016/j.jsams.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/23/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To describe patterns of age-related change in self-reported physical activity domains within a heterogeneous sample of boys and girls in the U.S. transitioning from elementary to high school. DESIGN Prospective cohort study. METHODS Participants included n = 644 children recruited in 5th grade (10.5 ± 0.5 years old, 45 % female) who completed the Physical Activity Choices survey at least twice over 5 time points (5th, 6th, 7th, 9th and 11th grade). Participants' self-reported physical activities were categorized into organized and non-organized activities, and a comprehensive variable was created as the product of the total number of physical activities reported in the past 5 days, the number of days spent in each activity, and the total time spent in each activity. Descriptive statistics and growth curve models (controlling for covariates) for the total sample and by sex were examined for total, organized, and non-organized physical activities from ages 10 to 17. RESULTS There was a significant age by gender interaction (p < 0.05) for time spent in non-organized physical activities. Specifically, both sexes had similar patterns of decline before age 13, while boys increased after age 13 and girls declined and then maintained. In contrast, boys and girls declined in organized physical activities from ages 10 to 17 (p < 0.001). CONCLUSIONS We observed stark differences in the age-related change between organized and non-organized physical activities and marked differences in the patterns of non-organized physical activities between boys and girls. Future research should examine physical activity interventions that consider age-, sex-, and domain-specific physical activity options for youth.
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Affiliation(s)
| | - Ruth P Saunders
- University of South Carolina, Columbia, South Carolina, United States of America
| | - Marsha Dowda
- University of South Carolina, Columbia, South Carolina, United States of America
| | - Russell R Pate
- University of South Carolina, Columbia, South Carolina, United States of America
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16
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Clennin MN, Shull ER, Dowda M, Pate RR. Longitudinal Associations of Cardiorespiratory Fitness and Poverty With Academic Performance Among Youth. J Sch Health 2023; 93:115-122. [PMID: 36208133 DOI: 10.1111/josh.13251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/10/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) plays a significant role in health and academic performance in youth. The purpose of this study was to examine the longitudinal relationship between CRF and academic performance from fifth to eighth grade among a large, diverse, and state-wide cohort of students, and to determine the extent to which the relationship between change in CRF and academic performance is moderated by poverty status. METHODS CRF and academic performance data were obtained for a retrospective state-wide cohort of 11,013 students with baseline (fifth grade, school year 2015-2016) and follow-up (eighth grade, school year 2018-2019) data. Analysis of covariance was used to examine the association between changes in CRF over a 3-year follow-up period and eighth grade academic performance. RESULTS After adjusting for covariates, change in CRF and poverty status were positively and significantly associated with eighth grade academic performance. Poverty status did not significantly moderate the association between changes in CRF and academic performance. CONCLUSIONS Schools should prioritize evidence-based policies and programs that optimize students' access to high quantity and quality physical activity throughout the school day. Such efforts can improve and maintain student CRF and thus academic performance outcomes.
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Affiliation(s)
- Morgan N Clennin
- Institute of Health Research, Kaiser Permanente Colorado, Aurora, CO
| | | | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC
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17
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Bucko AG, Dowda M, Pate RR. Factors Related to High-School Students’ Odds of Having Overweight or Obesity. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221147885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study used data the Youth Risk Behavior Surveillance System ( N = 7,088) to examine factors associated with the odds of overweight/obesity. Overweight/obese was defined as a body mass index ≥85th percentile, based on age- and sex-specific growth charts. Participants were categorized into meeting/not meeting guidelines for: sleep, moderate-to-vigorous PA (MVPA), muscle strengthening PA, screen time, breakfast eating, fruit and vegetable consumption, and soda and milk consumption. Logistic regression analyses determined whether meeting guidelines for each health behavior was associated with the odds of students having overweight/obesity in the total group and stratified by sex. Meeting MVPA guidelines was the only behavior associated with having a lower odds of overweight/obesity in both sexes. For females, meeting recommendations for breakfast eating and strength training were also associated with lower odds of having overweight/obesity, whereas for boys, getting the recommended amount of sleep was associated with having lower odds of overweight/obesity. Interventions to reduce the prevalence of overweight/obesity in youth should be implemented inside and outside of the school environment and should include components addressing physical activity, diet, and sleep. Such interventions should address barriers to healthy behaviors that are unique to adolescents already affected by overweight/obesity.
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Affiliation(s)
- Agnes G. Bucko
- College of Health and Human Services, University of North Carolina at Charlotte, NC, USA
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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18
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Lau EY, Ashe MC, Ross SET, Pate RR. Editorial: Sustainability of physical activity interventions and public health. Front Public Health 2022; 10:1115411. [PMID: 36620299 PMCID: PMC9815762 DOI: 10.3389/fpubh.2022.1115411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Erica Y. Lau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada,*Correspondence: Erica Y. Lau ✉
| | - Maureen C. Ashe
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
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19
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Johnson SB, Tamura R, McIver KL, Pate RR, Driscoll KA, Melin J, Larsson HE, Haller MJ, Yang J. The association of physical activity to oral glucose tolerance test outcomes in multiple autoantibody positive children: The TEDDY Study. Pediatr Diabetes 2022; 23:1017-1026. [PMID: 35702057 PMCID: PMC9588568 DOI: 10.1111/pedi.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/21/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the association of physical activity (PA), measured by accelerometry, to hemoglobin AIC (HbA1c) and oral glucose tolerance test (OGTT) outcomes in children who were multiple persistent confirmed autoantibody positive for type 1 diabetes (T1D). METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) multinational study followed children from birth. Children ≥3 years of age who were multiple persistent confirmed autoantibody positive were monitored by OGTTs every 6 months. TEDDY children's PA was measured by accelerometry beginning at 5 years of age. We examined the relationship between moderate plus vigorous (mod + vig) PA, HbA1c, and OGTT in 209 multiple autoantibody children who had both OGTT and PA measurements. RESULTS Mod + vig PA was associated with both glucose and C-peptide measures (fasting, 120-min, and AUC); higher mod + vig PA was associated with a better OGTT response primarily in children with longer duration of multiple autoantibody positivity. Mod + vig PA also interacted with child age; lower mod + vig PA was associated with a greater increase in C-peptide response across age. Mod + vig PA was not related to fasting insulin, HOMA-IR or HbA1c. CONCLUSIONS The OGTT is the gold standard for diabetes diagnosis and is used to monitor those at high risk for T1D. We found higher levels of mod + vig PA were associated with better OGTT outcomes in children ≥5 years of age who have been multiple autoantibody positive for longer periods of time. Physical activity should be the focus of future efforts to better understand the determinants of disease progression in high-risk children.
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Affiliation(s)
- Suzanne Bennett Johnson
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine Tallahassee, FL USA
| | - Roy Tamura
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Kerry L. McIver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Kimberly A. Driscoll
- Department of Clinical and Health Psychology, School of Public Health and Health Professions, University of Florida, Gainesville, FL USA
| | - Jessica Melin
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Helena Elding Larsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Paediatrics, Skane University Hospital, Malmo, Sweden
| | - Michael J. Haller
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL USA
| | - Jimin Yang
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - TEDDY Study Group
- Additional member of the TEDDY Study Group and their affiliations are available online in the electronic supplemental materials
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20
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Zhu X, Liu J, Sevoyan M, Pate RR. Acculturation and leisure-time physical activity among Asian American adults in the United States. Ethn Health 2022; 27:1900-1914. [PMID: 34538159 DOI: 10.1080/13557858.2021.1979193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
ABSTRACTObjectives: To examine the association between acculturation and leisure-time physical activity among Asian Americans.Design: Data came from the 2011-2016 National Health and Nutrition Examination Survey, restricting to non-Hispanic Asian adults aged 20 years and older (n = 1989). Acculturation was assessed by language preference at home, birth locations, and length of residency in the United States (US). Self-reported physical activity was used to estimate leisure-time moderate-to-vigorous physical activity (MVPA) in MET-minutes/week and meeting the World Health Organization's physical activity guidelines. Multiple linear and logistic regression models were used to model MVPA as continuous and categorical variables, respectively.Results: A quarter of Asian Americans spoke only English and 47.8% spoke only non-English at home; 13.0% were born in the US. Asians who spoke only English (adjusted prevalence ratio [aPR]:1.5) and Asians who spoke both English and non-English at home (aPR: 1.4) had greater proportions of meeting physical activity guidelines compared to those who spoke only non-English at home. The US-born Asians had higher a proportion of meeting the physical activity guidelines (aPR:1.4) and performed 547.6 more MET-minutes of MVPA each week than foreign-born Asians; they also had a higher proportion of meeting the physical activity guidelines than foreign-born Asians who stayed in US for ≤10 years (aPR:1.5). Length of time staying in the US was associated with a higher proportion of meeting physical activity guidelines. Among foreign-born Asian Americans, higher acculturation measures were also positively associated with meeting physical activity guidelines.Conclusions: Acculturation was positively associated with physical activity levels among Asian Americans. More acculturated Asian Americans such as those who spoke more English at home and US-born Asians, performed more MVPA than less acculturated Asian Americans. Interventions are needed to promote physical activity among non-English speaking Asian immigrants and recent immigrants.
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Affiliation(s)
- Xuanxuan Zhu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Maria Sevoyan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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21
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Pate RR, Dishman RK, Dowda M, McIver KL, Pfeiffer KA, Porter DE, Saunders RP, Ward DS. A Summary of One Research Team's Contributions to Understanding Physical Activity Behavior in Children and Youth. Int J Environ Res Public Health 2022; 19:14136. [PMID: 36361011 PMCID: PMC9655861 DOI: 10.3390/ijerph192114136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Schools are well-positioned to provide physical activity opportunities to help youth achieve the recommended 60 or more daily minutes of moderate-to-vigorous physical activity. The Children's Physical Activity Research Group (CPARG) at the University of South Carolina has focused on understanding physical activity in school-aged youth for 30+ years. The purpose of this article was to critically review (CPARG) contributions to the field in school settings and school-age youth. We reviewed 127 published CPARG articles from six research projects conducted between 1993-2019. The review was guided by questions in five categories: measurement of physical activity and its determinants, characteristics of physical activity behavior, correlates/determinants of physical activity, physical activity interventions, and race/ethnicity and physical activity. Results were summarized by question and synthesized across categories. CPARG contributions included assessing physical activity levels, patterns, forms, and contexts; identifying and measuring physical activity correlates/determinants; and conducting school-based physical activity interventions. Identifying multiple domains of physical activity determinants enables researchers and practitioners to select/design age-appropriate, valid, and reliable instruments to assess determinants. Focusing on determinants enables them to create effective physical activity interventions, environments, programs, and policies in schools. These efforts must address race/ethnicity differences, ensuring that measurement instruments and intervention strategies are culturally appropriate.
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Affiliation(s)
- Russell R. Pate
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Rod K. Dishman
- Department of Kinesiology, The University of Georgia Ramsey Student Center, 330 River Road, Athens, GA 30602, USA
| | - Marsha Dowda
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Kerry L. McIver
- Public Health Research Center, Department of Exercise Science, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Karin A. Pfeiffer
- Department of Kinesiology, Michigan State University, 308 West Circle Drive, 27R Intramural Rec Sports-Circle, East Lansing, MI 48824, USA
| | - Dwayne E. Porter
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, 915 Green Street, Suite 518, Columbia, SC 29208, USA
| | - Ruth P. Saunders
- Public Health Research Center, Department of Health Promotion, Education, and Behavior, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC 29208, USA
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB # 7461, Chapel Hill, NC 27599, USA
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22
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Brown A, Wilson DK, Sweeney AM, van Horn ML, Zarrett N, Pate RR. Buffering effects of protective factors on light and moderate-to-vigorous physical activity among african american women. J Behav Med 2022:10.1007/s10865-022-00360-z. [PMID: 36260160 PMCID: PMC10113398 DOI: 10.1007/s10865-022-00360-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/22/2022] [Indexed: 10/24/2022]
Abstract
Physical activity (PA) plays an integral role in reducing risk for the leading causes of death and has also been shown to buffer stress. Based on the stress-buffering hypothesis, the present study examined whether protective factors (self-efficacy and informal social control) buffered the effects of perceived stress on PA over time. Secondary data analyses of female African American caregivers (N = 143) were conducted using data from the Families Improving Together (FIT) trial. Validated measures of stressors and protective factors were assessed at baseline. Light PA and moderate-to-vigorous PA were assessed using seven-day accelerometry estimates over sixteen weeks. Multilevel growth modeling was used to assess whether protective factors moderated the effects of perceived stress on PA outcomes across 16 weeks. There was a significant two-way interaction between informal social control and time (B = 0.40, SE = 0.17, p = .019) such that higher informal social control was positively associated with MVPA over time. There was a marginal three-way interaction (B = -18.90, SE = 10.31, p = .067) such that stress was associated with greater LPA at baseline under conditions of high but not low self-efficacy. This study provides preliminary support that social factors may be important for maintaining MVPA regardless of stress levels, while cognitive resources may be more important to target for influencing LPA engagement under conditions of high stress.
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Affiliation(s)
- Asia Brown
- Department of Psychology, University of South Carolina, Columbia, SC, USA.
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - M Lee van Horn
- Department of Educational Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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23
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Shull ER, Dowda M, McIver KL, McLain AC, Benjamin-Neelon SE, Ulrich B, Pate RR. Behavioral, Environmental, and Demographic Factors Associated with Objectively Measured Physical Activity in Infants. Child Obes 2022; 18:466-475. [PMID: 35143345 PMCID: PMC9529315 DOI: 10.1089/chi.2021.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: To describe objectively measured physical activity (PA) in infants, and to identify demographic, behavioral, and environmental factors associated with infants' PA. Methods: Participants were 6-7-month-old infants and their mothers (N = 143 dyads) from two Southeastern US counties. Infant measures included PA assessed by accelerometers at ankle and waist sites, motor developmental status (i.e., stationary and locomotion), and anthropometric characteristics (i.e., height and weight). Mothers provided information on home environment, child care settings, and family demographic factors. PA levels were compared across demographic subgroups. Correlation coefficients described associations between PA and continuous variables, including motor developmental status and anthropometric characteristics. Multiple linear regression analyses examined factors found to be independently associated with PA. Results: Infants' PA counts were greater at the ankle (77,700 counts/hr) vs. the waist site (32,500 counts/hr). In univariate analyses, a diverse set of environmental, behavioral, and infant-level demographic factors were found to be significantly associated with PA at the ankle site. Multivariate analyses indicated that more advanced motor development status (B = 666.3 ± 329.8, p < 0.05), attendance at home child care settings (B = -13,724.4 ± 5083.9, p < 0.05), greater exposure to tummy time (B = 213.5 ± 79.9, p < 0.05), and white racial/ethnic composition (B = -19,953.4 ± 5888.5, p < 0.01) were independently, associated with infants' PA. Conclusions: In 6-7-month-old infants, objectively measured PA was found to be associated with motor developmental status and physical and social environmental factors, including both demographic moderators and factors that are influenced by parents and caregivers. Longitudinal studies are needed to determine if these relationships persist or change as infants develop.
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Affiliation(s)
- Emily R. Shull
- Department of Exercise Science and Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Marsha Dowda
- Department of Exercise Science and Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kerry L. McIver
- Department of Exercise Science and Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Alexander C. McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Beverly Ulrich
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Russell R. Pate
- Department of Exercise Science and Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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24
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Kelley GA, Kelley KS, Pate RR. Exercise and Cardiovascular Disease Risk Factors in Children and Adolescents With Obesity: A Systematic Review With Meta-Analysis of Randomized Controlled Trials. Am J Lifestyle Med 2022; 16:485-510. [PMID: 35860364 PMCID: PMC9290181 DOI: 10.1177/1559827620988839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine the effects of exercise on cardiovascular disease (CVD) risk factors in children and adolescents with obesity. Randomized controlled trials (RCTs) of exercise ≥4 weeks in children and adolescents with obesity were included if one or more CVD risk factors were included as an outcome. Studies were retrieved by searching 7 electronic databases, cross-referencing, and expert review. Data were pooled using the inverse-variance heterogeneity (IVhet) model and strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Thirty-nine studies representing 1548 participants (847 exercise, 701 control) met the inclusion criteria. Aerobic exercise improved 10 of 12 (83.3%) outcomes (P < .05 for all) while combined aerobic and strength training improved 5 of 8 (62.5%) outcomes (P < .05 for all). The strength of evidence ranged from "very low" to "moderate." It was concluded that aerobic exercise, as well as combined aerobic and strength training, is associated with improvements in multiple CVD risk factors among children and adolescents with obesity. However, the generally low strength of evidence suggests a need for future well-designed and conducted RCTs on the effects of exercise, especially strength training, in children and adolescents with obesity.
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Affiliation(s)
- George A. Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Kristi S. Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Russell R. Pate
- Children’s Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Pate RR, Saunders RP, Taverno Ross SE, Dowda M. Patterns of age-related change in physical activity during the transition from elementary to high school. Prev Med Rep 2022; 26:101712. [PMID: 35145840 PMCID: PMC8819127 DOI: 10.1016/j.pmedr.2022.101712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/06/2022] [Accepted: 01/23/2022] [Indexed: 11/29/2022] Open
Abstract
This study was designed: 1) to describe patterns of age-related change in total and moderate-to-vigorous physical activity (MVPA) in children as they transitioned from elementary school to high school, and 2) to determine if those patterns differed across demographic sub-groups formed on the basis of gender, race/ethnicity, parent education (socioeconomic status), and urbanicity. A cohort of children (analysis sample, N = 951) was comprised of students drawn from two public school districts in South Carolina. Physical activity was measured by accelerometry on at least two and up to five occasions between 2010 and 2017. Growth curve analyses were performed to describe the pattern of age-related change in the physical activity variables for the full sample and for demographic sub-groups. A relatively steep age-related decline in total physical activity was observed in children before age 14, with a slower rate after that age. Physical activity was lower in girls than boys, and the age-related rate of decline was steeper in girls. Physical activity patterns did not differ across race/ethnicity groups, but children of parents with less education were more active than children of parents with more education. Children living in rural areas participated in less MVPA than children living in urban settings, and this difference increased with increasing age. These findings indicate that children experience a particularly steep decrease in physical activity as they transition from elementary to middle school, and this trend is particularly prominent in girls, children living in rural areas, and children of parents with college education.
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Affiliation(s)
- Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Corresponding author at: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly St., Columbia, SC 29208, USA.
| | - Ruth P. Saunders
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, USA
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Pate RR, Dowda M, Dishman RK, Gorab J, Bucko A, Saunders RP. Longitudinal association of biological maturation with physical activity behaviors in girls transitioning from 5th to 7th grade. Am J Hum Biol 2022; 34:e23737. [PMID: 35213763 PMCID: PMC9253076 DOI: 10.1002/ajhb.23737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction This longitudinal study determined if social cognitive variables influence physical activity in girls stratified on the basis of maturity status. Methods Participants attended South Carolina public schools (Mage in 5th grade = 11.1 years) and included a cohort of 529 girls who provided physical activity data in the 5th grade and in 6th and/or 7th grade. The measure of maturity status was age at peak height velocity (APHV) estimated from maturity offset when the children were in the 5th grade. The Earlier Maturity (EM) group included girls whose APHV was one standard deviation or more below the mean APHV for the full sample. All other girls were placed in the Later Maturity (LM) group. Physical activity was assessed at each time point via accelerometry. Social‐cognitive variables were assessed at each time point by a questionnaire measuring self‐efficacy, enjoyment, competence, appearance, fitness, and social motives for physical activity. Growth curves for the total, Earlier Maturing, and Later Maturing groups assessed relationships between physical activity over time and time‐varying social cognitive variables. Results Physical activity was lower in the Earlier Maturing group and was positively associated with self‐efficacy and enjoyment motivation in the total group. These relationships were observed in the 5th grade and maintained through 7th grade. In the Later Maturing group, we observed positive relationships between physical activity and self‐efficacy, enjoyment and competence motivation. Conclusions Strategies to increase confidence, skills, and enjoyment of physical activity may only be effective for promoting activity among later maturing girls.
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Affiliation(s)
- Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Rod K Dishman
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Joseph Gorab
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Agnes Bucko
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
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Lane-Cordova AD, Jerome GJ, Paluch AE, Bustamante EE, LaMonte MJ, Pate RR, Weaver RG, Webber-Ritchey KJ, Gibbs BB. Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association. Circulation 2021; 145:e117-e128. [PMID: 34847691 DOI: 10.1161/cir.0000000000001035] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase-specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health-promoting behaviors.
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Bucko AG, Dowda M, Frongillo EA, Torres ME, Pate RR. Nighttime sleep and physical activity in 6-7 month-old infants. Infant Behav Dev 2021; 65:101628. [PMID: 34392076 PMCID: PMC8627435 DOI: 10.1016/j.infbeh.2021.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
This study examined associations between objectively-measured nighttime sleep duration and physical activity in a sample of 6-7 month-old infants (N=93). The study also investigated relationships between infant sleep and demographic and environmental characteristics. Cross-sectional relationships were assessed using linear regression analyses. Nighttime sleep duration was positively associated with physical activity levels. Nighttime sleep duration was greater when infants had a consistent bedtime, slept in a separate room, were male, and had mothers who reported having a college education or greater. These findings can inform the development of interventions that aim to improve infant sleep.
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Affiliation(s)
- Agnes G Bucko
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Weaver RG, Hunt E, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, Pate RR, Maydeu-Olivares A, Saelens B, Youngstedt SD, Dugger R, Parker H, von Klinggraeff L, Jones A, Burkhart S, Ressor-Oyer L. Impact of a year-round school calendar on children's BMI and fitness: Final outcomes from a natural experiment. Pediatr Obes 2021; 16:e12789. [PMID: 33763967 PMCID: PMC8440426 DOI: 10.1111/ijpo.12789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Structure may mitigate children's accelerated summer BMI gain and cardiorespiratory-fitness (CRF) loss. OBJECTIVES Examine BMI and CRF change during school and summer for year-round and traditional calendar school children. METHODS Three schools (N = 2279, 1 year-round) participated in this natural experiment. Children's BMI z-score (zBMI) and CRF (PACER laps) were measured from 2017 to 2019 each May/August. Mixed effects regression estimated monthly zBMI and CRF change during school/summer. Secondary analyses examined differences by weight status and race. Spline regression models estimated zBMI and CRF growth from kindergarten-sixth grade. RESULTS Compared to traditional school, children attending a year-round school gained more zBMI (difference = 0.015; 95CI = 0.002, 0.028) during school, and less zBMI (difference = -0.029; 95CI = -0.041, -0.018), and more CRF (difference = 0.834; 95CI = 0.575, 1.093) monthly during summer. Differences by weight status and race were observed during summer and school. Growth models demonstrated that the magnitude of overall zBMI and CRF change from kindergarten-sixth grade was similar for year-round or traditional school children. CONCLUSIONS Contrary to traditional school children zBMI increased during the traditional 9-month school calendar and zBMI decreased during the traditional summer vacation for year-round school children. Structured summer programming may mitigate accelerated summer BMI gain and CRF loss especially for overweight or obese, and/or Black children.
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Affiliation(s)
- Robert Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Ethan Hunt
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Michael W. Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, Florida
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | | | - Brian Saelens
- Center for Child Health Behavior and Development, Seattle Children’s Hospital, Seattle, Washington
| | - Shawn D. Youngstedt
- Department of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | | | - Alexis Jones
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Sarah Burkhart
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Layton Ressor-Oyer
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Weaver RG, Hunt ET, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, Pate RR, Youngstedt SD, Dugger R, Parker H, von Klinggraeff L, Jones A, Burkart S, Ressor-Oyer L. COVID-19 Leads to Accelerated Increases in Children's BMI z-Score Gain: An Interrupted Time-Series Study. Am J Prev Med 2021; 61:e161-e169. [PMID: 34148734 PMCID: PMC8443301 DOI: 10.1016/j.amepre.2021.04.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may have negatively impacted children's weight status owing to the closure of schools, increased food insecurity and reliance on ultraprocessed foods, and reduced opportunities for outdoor activity. METHODS In this interrupted time-series study, height and weight were collected from children (n=1,770 children, mean age=8.7 years, 55.3% male, 64.6% Black) and were transformed into BMI z-score in each August/September from 2017 to 2020. Mixed-effects linear regression estimated yearly BMI z-score change before the COVID-19 pandemic year (i.e., 2017-2019) and during the COVID-19 pandemic year (i.e., 2019-2020). Subgroup analyses by sex, race (i.e., Black, White, other race), weight status (overweight or obese and normal weight), and grade (i.e., lower=kindergarten-2nd grade and upper=3rd-6th grade) were conducted. RESULTS Before the COVID-19 pandemic, children's yearly BMI z-score change was +0.03 (95% CI= -0.10, 0.15). Change during the COVID-19 pandemic was +0.34 (95% CI=0.21, 0.47), an acceleration in BMI z-score change of +0.31 (95% CI=0.19, 0.44). For girls and boys, BMI z-score change accelerated by +0.33 (95% CI=0.16, 0.50) and +0.29 (95% CI=0.12, 0.46), respectively, during the pandemic year. Acceleration in BMI z-score change during the pandemic year was observed for children who were Black (+0.41, 95% CI=0.21, 0.61) and White (+0.22, 95% CI=0.06, 0.39). For children classified as normal weight, BMI z-score change accelerated by +0.58 (95% CI=0.40, 0.76). Yearly BMI z-score change accelerated for lower elementary/primary (+0.23, 95% CI=0.08, 0.37) and upper elementary/primary (+0.42, 95% CI=0.42, 0.63) children. CONCLUSIONS If similar BMI z-score accelerations occurred for children across the world, public health interventions to address this rapid unhealthy BMI gain will be urgently needed.
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Affiliation(s)
- R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Ethan T Hunt
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Keith Brazendale
- Department of Health Sciences, UCF College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Shawn D Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Roddrick Dugger
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Layton Ressor-Oyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Taverno Ross SE, Smith Tapia I, Saunders RP, Documet PI, Pate RR. Implementation Monitoring of a Promotora-Led, Home-Based Obesity Prevention Pilot Study With Latino Preschool Children and Their Mothers. Int Q Community Health Educ 2021; 41:411-418. [PMID: 33143559 DOI: 10.1177/0272684x20970375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Latino preschool children have higher rates of obesity than children from other racial/ethnic backgrounds. Few effective, culturally-tailored obesity prevention interventions exist that have focused on Latino preschool children, and even fewer have published results of the process evaluation. The purpose of this paper was to monitor reach, fidelity, and completeness of implementation to determine whether ANDALE, a promising promotora-led, home-based pilot study to prevent obesity in Latino preschool children, was implemented as planned. METHODS Guided by a logic model, we assessed reach, implementation fidelity and completeness through descriptive analyses of multiple data sources. Reach was assessed through attendance records. Fidelity was assessed via observation checklist and completeness was assessed via survey with both parents and promotoras in a subsample of 12 families. RESULTS Promotoras recruited participants primarily through their own social networks and delivered the intervention to 50 families (mother-child dyads); the majority were of Mexican-origin, low-acculturation, dual-parent households. Nearly all (98%) families completed the whole 10-week intervention. Results demonstrated completeness and fidelity of implementation were acceptable in a subsample of 12 families. In sum, 75% of families in the subsample met the criteria (≥75%) for overall implementation of essential program elements (i.e., reach, completeness, and fidelity). CONCLUSION Evidence suggests that ANDALE was delivered with high levels of completeness and fidelity in this sample of Latino families with preschool-aged children. These results support implementation of ANDALE in a large, randomized trial.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Human Developmen, Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | | | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, United States
| | - Patricia I Documet
- Department of Behavioral and Community Health Sciences, Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Russell R Pate
- Department of Exercise Science, Physical Activity Research Group, University of South Carolina, Columbia, South Carolina, United States
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Armstrong B, Beets MW, Starrett A, Brazendale K, Turner-McGrievy G, Saelens BE, Pate RR, Youngstedt SD, Maydeu-Olivares A, Weaver RG. Dynamics of sleep, sedentary behavior, and moderate-to-vigorous physical activity on school versus nonschool days. Sleep 2021; 44:5902294. [PMID: 32893864 DOI: 10.1093/sleep/zsaa174] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
STUDY OBJECTIVES Studies examining time-use activity behaviors (sleep, sedentary behavior, and physical activity) on school days compared with nonschool days have examined these behaviors independently, ignoring their interrelated nature, limiting our ability to optimize the health benefits of these behaviors. This study examines the associations of school-day (vs. nonschool day) with time-use activity behaviors. METHODS Time series data (6,642 days) from Fitbits (Charge-2) were collected (n = 196, 53% female, 5-10 years). We used a variable-centered dynamic structural equation modeling approach to estimate day-to-day associations of time-use activity behaviors on school days for each child. We then used person-centered cluster analyses to group individuals based on these estimates. RESULTS Within-participant analysis showed that on school days (vs. nonschool days), children (1) slept less (β = -0.17, 95% CI = -0.21, -0.13), (2) were less sedentary (β = -0.05, 95% CI = -0.09, -0.02), and (3) had comparable moderate-to-vigorous physical activity (MVPA; β = -0.05, 95% CI = -0.11, 0.00). Between-participant analysis showed that, on school days, children with higher sleep carryover experienced greater decreases in sleep (β = 0.44, 95% CI = 0.08, 0.71), children with higher body mass index z-score decreased sedentary behavior more (β = -0.41, 95% CI = -0.64, -0.13), and children with lower MVPA increased MVPA more (β = -0.41, 95% CI -0.64, -0.13). Cluster analysis demonstrated four distinct patterns of connections between time-use activity behaviors and school (High Activity, Sleep Resilient, High Sedentary, and Dysregulated Sleep). CONCLUSIONS Using a combination of person-centered and more traditional variable-centered approaches, we identified patterns of interrelated behaviors that differed on school, and nonschool days. Findings can inform targeted intervention strategies tailored to children's specific behavior patterns.
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Affiliation(s)
- Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Angela Starrett
- College of Education, University of South Carolina, Columbia, SC
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL
| | | | - Brian E Saelens
- Seattle Children's Hospital, Center for Child Health Behavior and Development, Seattle, WA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Shawn D Youngstedt
- Department of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | | | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC
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Dowda M, Dishman RK, Saunders RP, Pate RR. Associations between three measures of physical activity and selected influences on physical activity in youth transitioning from elementary to middle school. Sports Medicine and Health Science 2021; 3:21-27. [PMID: 35782676 PMCID: PMC9219254 DOI: 10.1016/j.smhs.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/16/2022] Open
Abstract
Measurement of physical activity is challenging, and objective and subjective methods can be used. The purposes of this study were to apply structural equation modeling in: 1) examining the associations between three distinct measures of physical activity and three factors that are often found to be correlated to physical activity in children, and 2) examining the associations of the combination of three measures with the same correlates in a cohort of youth followed from 5th to 7th grade. A total of 409 children (45% boys) had complete physical activity data derived from accelerometers, self-report by youth, and proxy-report by parents. The potential correlates of physical activity included self-efficacy, physical activity support, and facilities for physical activity. Structural equation models were used to assess the relationship between physical activity and the correlates. The structural equation models examining associations between individual measures of physical activity and selected correlates showed that parent-reported and child self-reported physical activity were associated with parental support for physical activity and self-efficacy. Objectively measured physical activity was associated only with facilities for physical activity. A structural equation model showed that a composite expression of physical activity, based on the inclusion of all three individual measures, was associated with all three correlates of physical activity. In conclusion, combining measures of physical activity from different sources may improve the identification of correlates of physical activity. This information could be used to plan more effective physical activity interventions in children and youth.
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Kelley GA, Kelley KS, Pate RR. How Many US Children and Adolescents with Overweight and Obesity Could Improve Their Percent Body Fat by Exercising?: Meta-Analytic Based Estimates. Child Obes 2021; 17:144-150. [PMID: 33544030 DOI: 10.1089/chi.2020.0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Provide national estimates of the number of US children and adolescents with overweight and obesity who could improve their percent body fat by exercising. Methods: Data were derived from (1) a previous meta-analysis, (2) 2015-2016 prevalence data from the National Health and Nutrition Examination Survey (NHANES), and (3) 2017 US Census population data. Multiplicative calculations were based on (1) number-needed-to treat data from a previous meta-analysis of the number of children with overweight and obesity who could reduce their percent body fat by participating in either aerobic, strength, or combined aerobic and strength training, (2) 2015-2016 NHANES data on the prevalence of children and adolescents with overweight or obesity, and (3) 2017 US Census population data on children and adolescents 2-19 years of age. Results: For both children and adolescents with overweight or obesity, the number who could improve their percent body fat was estimated at 4,388,273 [95% confidence interval (CI) 3,831,523-4,845,023] for either aerobic or strength exercise and 6,507,410 (95% CI 5,744,285-7,267,534) for combined aerobic and strength exercise. Conclusions: A large number of US children and adolescents with overweight and obesity could improve their percent body fat by exercising.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Brazendale K, Beets MW, Armstrong B, Weaver RG, Hunt ET, Pate RR, Brusseau TA, Bohnert AM, Olds T, Tassitano RM, Tenorio MCM, Garcia J, Andersen LB, Davey R, Hallal PC, Jago R, Kolle E, Kriemler S, Kristensen PL, Kwon S, Puder JJ, Salmon J, Sardinha LB, van Sluijs EMF. Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis. Int J Behav Nutr Phys Act 2021; 18:28. [PMID: 33568183 PMCID: PMC7877033 DOI: 10.1186/s12966-021-01095-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/29/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.
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Affiliation(s)
- Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, 4364 Scorpius Street, Orlando, FL, 32816, USA.
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ethan T Hunt
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Timothy A Brusseau
- Department of Health & Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Amy M Bohnert
- Department of Psychology, Loyola University Chicago, College of Arts and Sciences, Chicago, IL, USA
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Rafael M Tassitano
- Department of Physical Education, Federal Rural University of Pernambuco, Recife, PE, Brazil
| | - Maria Cecilia M Tenorio
- Department of Physical Education, Federal Rural University of Pernambuco, Recife, PE, Brazil
| | - Jeanette Garcia
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, 4364 Scorpius Street, Orlando, FL, 32816, USA
| | - Lars B Andersen
- Department of Teacher Education and Sport, Western Norwegian University of Applied Sciences, Sogndal, Norway
| | - Rachel Davey
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Pedro C Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Elin Kolle
- Norwegian School of Sport Sciences, Oslo, Norway
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | | | - Soyang Kwon
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Jardena J Puder
- Service of Obstetrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, ZDeakin University, Geelong, Australia
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Movement, Universidade de Lisboa, Lisbon, Portugal
| | - Esther M F van Sluijs
- MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
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Kelley GA, Kelley KS, Pate RR. Inter-individual differences in body mass index were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity. Pediatr Obes 2021; 16:e12692. [PMID: 32657544 DOI: 10.1111/ijpo.12692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise has been recommended as an important intervention for reducing adiposity in children and adolescents with overweight and obesity. OBJECTIVE Determine whether inter-individual differences exist in relation to exercise-induced changes in adiposity among children and adolescents with overweight and obesity. METHODS Meta-analysis of randomized controlled aerobic exercise trials and body mass index (BMI) in kg · m-2 . Change outcome standard deviations were pooled using the inverse-variance heterogeneity model. RESULTS Twenty-eight studies (1185 participants) were included. Inter-individual differences in BMI were -0.1 (95% compatibility interval, -0.7 to 0.7). The 95% prediction interval for inter-individual responses in a future study was -2.9 to 2.9. The probability of a clinically meaningful difference in variability was 29% (possibly clinically important) in favour of controls vs exercisers. CONCLUSIONS Inter-individual differences for BMI in kg · m-2 were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity.
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Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Weaver RG, Armstrong B, Hunt E, Beets MW, Brazendale K, Dugger R, Turner-McGrievy G, Pate RR, Maydeu-Olivares A, Saelens B, Youngstedt SD. The impact of summer vacation on children's obesogenic behaviors and body mass index: a natural experiment. Int J Behav Nutr Phys Act 2020; 17:153. [PMID: 33243252 PMCID: PMC7690133 DOI: 10.1186/s12966-020-01052-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children's BMI gain accelerates during summer. The Structured Days Hypothesis posits that the lack of the school day during summer vacation negatively impacts children's obesogenic behaviors (i.e., physical activity, screen time, diet, sleep). This natural experiment examined the impact of summer vacation on children's obesogenic behaviors and body mass index (BMI). METHODS Elementary-aged children (n = 285, 5-12 years, 48.7% male, 57.4% African American) attending a year-round (n = 97) and two match-paired traditional schools (n = 188) in the United States participated in this study. Rather than taking a long break from school during the summer like traditional schools, year-round schools take shorter and more frequent breaks from school. This difference in school calendars allowed for obesogenic behaviors to be collected during three conditions: Condition 1) all children attend school, Condition 2) year-round children attend school while traditional children were on summer vacation, and Condition 3) summer vacation for all children. Changes in BMI z-score were collected for the corresponding school years and summers. Multi-level mixed effects regressions estimated obesogenic behaviors and monthly zBMI changes. It was hypothesized that children would experience unhealthy changes in obesogenic behaviors when entering summer vacation because the absence of the school day (i.e., Condition 1 vs. 2 for traditional school children and 2 vs. 3 for year-round school children). RESULTS From Condition 1 to 2 traditional school children experienced greater unhealthy changes in daily minutes sedentary (∆ = 24.2, 95CI = 10.2, 38.2), screen time minutes (∆ = 33.7, 95CI = 17.2, 50.3), sleep midpoint time (∆ = 73:43, 95CI = 65:33, 81:53), and sleep efficiency percentage (-∆ = 0.7, 95CI = -1.1, - 0.3) when compared to year-round school children. Alternatively, from Condition 2 to 3 year-round school children experienced greater unhealthy changes in daily minutes sedentary (∆ = 54.5, 95CI = 38.0, 70.9), light physical activity minutes (∆ = - 42.2, 95CI = -56.2, - 28.3) MVPA minutes (∆ = - 11.4, 95CI = -3.7, - 19.1), screen time minutes (∆ = 46.5, 95CI = 30.0, 63.0), and sleep midpoint time (∆ = 95:54, 95CI = 85:26, 106:22) when compared to traditional school children. Monthly zBMI gain accelerated during summer for traditional (∆ = 0.033 95CI = 0.019, 0.047) but not year-round school children (∆ = 0.004, 95CI = -0.014, 0.023). CONCLUSIONS This study suggests that the lack of the school day during summer vacation negatively impacts sedentary behaviors, sleep timing, and screen time. Changes in sedentary behaviors, screen time, and sleep midpoint may contribute to accelerated summer BMI gain. Providing structured programming during summer vacation may positively impact these behaviors, and in turn, mitigate accelerated summer BMI gain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03397940 . Registered January 12th 2018.
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Affiliation(s)
- R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA.
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Ethan Hunt
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - R Dugger
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | | | - Brian Saelens
- Seattle Children's Hospital, Center for Child Health Behavior and Development, Seattle, Washington, USA
| | - Shawn D Youngstedt
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ, USA
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Neff RA, Zaltz DA, Hecht AA, Pate RR, Neelon B, O’Neill JR, Benjamin-Neelon SE. Preschool Healthy Food Policy Did Not Increase Percent of Food Wasted: Evidence from the Carolinas. Nutrients 2020; 12:E3024. [PMID: 33023143 PMCID: PMC7600022 DOI: 10.3390/nu12103024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/10/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022] Open
Abstract
This research evaluates the effects of a South Carolina (SC) policy, which changed the nutrition standards for foods served in early care and education (ECE) settings, on wasted food. A two-group pre-test/post-test evaluation was performed in ECE centers serving children age 3-5 from households with lower incomes in SC (n = 102 children from 34 centers, intervention) and North Carolina (NC; n = 99 children from 30 centers, comparison). Direct observation was performed to assess the quantity and kcal of food served and quantity and percent of food discarded, by food group and nutrient, enabling assessment of waste in the absence of intervention. Mixed-effects linear models were fit to estimate, by state, differences in change from baseline to post-implementation at the center level. Covariates were selected a priori, including center enrollment, racial composition, director educational attainment, years in operation, for-profit status, and Child and Adult Care Food Program (CACFP) participation. Waste of food was high across states and time points. The policy was not associated with a change in percent of food discarded in SC compared to NC in adjusted analyses.
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Affiliation(s)
- Roni A. Neff
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Daniel A. Zaltz
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA; (D.A.Z.); (S.E.B.-N.)
| | - Amelie A. Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Brian Neelon
- Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, 35 Cannon St, Charleston, SC 29415, USA;
| | - Jennifer R. O’Neill
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA; (D.A.Z.); (S.E.B.-N.)
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Taverno Ross SE, Militello G, Dowda M, Pate RR. Changes in Diet Quality in Youth Living in South Carolina From Fifth to 11th Grade. J Nutr Educ Behav 2020; 52:928-934. [PMID: 32334976 PMCID: PMC7554150 DOI: 10.1016/j.jneb.2020.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To examine diet quality levels and changes in a diverse sample of youth from fifth to 11th grade, and interactions by race/ethnicity and socioeconomic status. DESIGN Transitions and Activity Changes in Kids prospective cohort study. SETTING Elementary, middle, and high schools in South Carolina. PARTICIPANTS A sample of 260 fifth-graders (106 boys and 154 girls) with complete data at baseline and at least 1 time point each in middle school and in high school. MAIN OUTCOME MEASURE Dietary intake assessed with the Block Food Screener for Kids (last week). Diet quality was assessed using energy-adjusted intakes of 5 food groups. ANALYSIS Descriptive statistics and growth curve models for the total group and by gender for diet quality from fifth to 11th grade (P < 0.05). RESULTS Both boys and girls had low levels of diet quality, which continued to decline through 11th grade. Significant main effects by race and poverty as well as a race by poverty interaction were observed. CONCLUSIONS AND IMPLICATIONS Programs and policies that support healthy dietary patterns in children transitioning from elementary to middle and high school are needed. Specific efforts that focus on nutrition disparities in children from low-income and minority backgrounds are warranted.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
| | - Geena Militello
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC
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Schenkelberg MA, Brown WH, McIver KL, Pate RR. An observation system to assess physical activity of children with developmental disabilities and delays in preschool. Disabil Health J 2020; 14:101008. [PMID: 33023842 DOI: 10.1016/j.dhjo.2020.101008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/19/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Physical activity (PA) behaviors during preschool settings can influence the health and development of children with developmental disabilities (DD). There is a need for a direct observation system that simultaneously assesses PA and preschool environmental contexts. OBJECTIVE The purpose of this study was to develop an observation instrument for measuring PA and related contextual factors of preschoolers with DD, and to establish content validity and reliability. METHODS Content validity was established through consultation with experts, informal observations in inclusive and special education preschools, and literature reviews. Categories and codes were identified and modified from existing observational systems for young children. Reliability was assessed in a convenience sample of preschool children with DD using a cross-sectional design. Data were collected using a momentary time sampling system (5-sec observe, 25-sec record) following a focal child. Inter-rater reliability was assessed during 20% of the observation sessions. RESULTS The instrument development process resulted in ten coding categories that accounted for PA levels, types, and social and physical environmental contexts relevant to preschoolers with disabilities. Observers completed 137.5 observation sessions, yielding 5498 30-s observation intervals. Interval-by-interval percent agreement was excellent (91%-100%) and kappa values were high (0.82-0.99). CONCLUSIONS The instrument was found to be a reliable measure of PA of preschoolers with DD and provided important contextual information about PA behaviors in early childhood special education settings. Additionally, it allowed for the simultaneous measurement of specific types and contexts of PA behaviors of preschoolers with DD and will be useful for describing PA and informing future interventions.
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Affiliation(s)
- Michaela A Schenkelberg
- University of South Carolina, Department of Exercise Science, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA; University of Nebraska at Omaha, School of Health and Kinesiology, 6001 Dodge Street, H&K 207, Omaha, NE, 68182, USA.
| | - William H Brown
- University of South Carolina, College of Education, 820 Main Street, Columbia, SC, 29208, USA.
| | - Kerry L McIver
- University of South Carolina, Department of Exercise Science, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Russell R Pate
- University of South Carolina, Department of Exercise Science, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
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Clennin M, Brown A, Lian M, Dowda M, Colabianchi N, Pate RR. Neighborhood Socioeconomic Deprivation Associated with Fat Mass and Weight Status in Youth. Int J Environ Res Public Health 2020; 17:ijerph17176421. [PMID: 32899280 PMCID: PMC7503851 DOI: 10.3390/ijerph17176421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: Few studies have examined the relationship between neighborhood socioeconomic deprivation (SED) and weight-related outcomes in youth, controlling for weight-related behaviors. Hence, the purpose of this study was to examine the association between neighborhood SED, weight status, and fat mass in a diverse sample of youth, before and after controlling for physical activity and diet. (2) Methods: The sample included 828 youth from the Transitions and Activity Changes in Kids study. Neighborhood SED was expressed as an index score at the census tract of residence. Height, weight, and body composition were measured and used to calculate fat mass index (FMI) and weight status. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (min/h) were measured via accelerometry. Diet quality was assessed via the Block Food Screener for Kids. Multilevel regression models were employed to examine these relationships. (3) Results: Neighborhood SED was significantly associated with FMI and weight status before and after controlling for MVPA, sedentary behavior, and diet. Notably, youth residing in the most deprived neighborhoods had significantly higher FMI and were 30% more likely to be overweight/obese (OR = 1.30; 95% CI = 1.03-1.65). (4) Conclusions: Greater neighborhood SED was consistently and significantly associated with higher fat mass index and increased likelihood of overweight/obesity among youth.
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Affiliation(s)
- Morgan Clennin
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO 80014, USA
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (M.D.); (R.R.P.)
- Correspondence:
| | - Asia Brown
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA;
| | - Min Lian
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (M.D.); (R.R.P.)
| | - Natalie Colabianchi
- School of Kinesiology & Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (M.D.); (R.R.P.)
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Saunders RP, Schenkelberg MA, Moyer C, Howie EK, Brown WH, Pate RR. The translation of an evidence-based preschool physical activity intervention from in-person to online delivery of professional development to preschool teachers. Transl Behav Med 2020; 9:1186-1196. [PMID: 31116392 DOI: 10.1093/tbm/ibz076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Study of Health and Activity in Preschool Environments (SHAPES) aimed to increase preschoolers' physical activity by engaging preschool teachers in professional development designed to modify instructional practices. SHAPES originated as a randomized controlled trial, tested in 16 preschools and disseminated to 4 control schools, and was shown to be effective in increasing preschool children's physical activity (Phase I, 2008-2012). This article describes the steps taken to translate an evidence-based physical activity intervention, SHAPES, from in-person delivery to online delivery of professional development to preschool teachers. In Phase II (2013-2016), professional development delivery was modified from an in-person to an online program for preschool teachers. Teacher implementation completeness and fidelity were examined in 10 pilot preschools and then replicated in 30 preschools. Large-scale dissemination of SHAPES began in Phase III (2017-2019), reaching 818 teachers from 228 unique centers after 2 years. The final SHAPES program consisted of six online modules, an accompanying guidebook, over 90 activities, self-assessment techniques, a video library, and an electronic community forum. The SHAPES core elements, defined in Phase I, were retained throughout all three phases. The Phase II change to online delivery was characterized by high levels of implementation completeness and fidelity. Results of Phase III statewide dissemination revealed comparable implementation completeness and fidelity. An intervention shown to be effective in a randomized controlled trial can be translated into an online professional development program and disseminated on a large scale in a timely manner.
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Affiliation(s)
- Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Public Health Research Center, University of South Carolina, Suite, Columbia, SC, USA
| | - Michaela A Schenkelberg
- Department of Health Promotion, University of Nebraska Medical Center, Maurer Center for Public Health, Nebraska Medical Center, Omaha, NE, USA.,Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
| | - Christina Moyer
- Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
| | - Erin K Howie
- Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - William H Brown
- Educational Studies, Wardlaw College, University of South Carolina, Columbia, USA
| | - Russell R Pate
- Department of Exercise Science, Public Health Research Center, University of South Carolina, Columbia, SC, USA
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Pate RR, Clennin M, Shull ER, Reed JA, Dowda M. Poverty Status Moderates the Relationship between Cardiorespiratory Fitness and Academic Achievement. J Sch Health 2020; 90:630-640. [PMID: 32542762 DOI: 10.1111/josh.12913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 03/05/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The purpose of the study was to examine the associations among cardiorespiratory fitness (CRF), weight status and academic achievement in youth, and to determine if these relationships are moderated by poverty status. METHODS The sample included 5th (N = 27,791) and 8th grade (N = 16,047) South Carolina students. Academic achievement was assessed using a state-wide assessment and classified into 2 categories (ie, does not meet/approaches standards vs meets/exceeds standards). CRF was assessed and expressed as Healthy Fitness Zone (HFZ) or Needs Improvement/Needs-Improvement-Health Risk. Students' demographics and poverty status were reported. Multilevel logistic regression analyses were used to examine the association between CRF, weight status and academic achievement. Interaction terms were introduced into the final models. Analyses were performed separately by grade level and academic subject. RESULTS The CRF was significantly associated with the odds of meeting/exceeding academic standards after controlling for covariates and adjusting for weight status. The relationship between CRF and academic achievement varied significantly by poverty status. After adjustment for CRF, weight status was not significantly associated with academic achievement. CONCLUSIONS The odds of achieving academic standards were significantly higher among students achieving CRF HFZ regardless of poverty status. CRF may partially mitigate the adverse effect of poverty on academic achievement.
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Affiliation(s)
- Russell R Pate
- Professor, , Department of Exercise Science, University of South Carolina, Arnold School of Public Health, 921 Assembly St., Suite 212, Columbia, SC 29208
| | - Morgan Clennin
- Postdoctoral Research Fellow, , Kaiser Permanente of Colorado, Institute of Health Research, 2550 S. Parker Rd., Ste 200, Aurora, CO 80014
| | - Emily R Shull
- PhD Candidate, , Department of Exercise Science, University of South Carolina, Arnold School of Public Health, 921 Assembly St., Suite 212, Columbia, SC 29208
| | - Julian A Reed
- Professor, , Department of Health Sciences, Furman University, 3300 Poinsett Hwy, Greenville, SC 29613
| | - Marsha Dowda
- Biostatistician, , Department of Exercise Science, University of South Carolina, Arnold School of Public Health, 921 Assembly St., Suite 212, Columbia, South Carolina 29208
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Reid LA, Geraci M, Mendoza JA, Reboussin BA, Pate RR, Sauder KA, Dolan LM, Kim G, Lawrence JM, Liese AD. Association Of Household Food Security And Physical Activity Among Youth And Young Adults With Diabetes. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680552.16270.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kelley GA, Kelley KS, Pate RR. Are There Inter-Individual Differences in Fat Mass and Percent Body Fat as a Result of Aerobic Exercise Training in Overweight and Obese Children and Adolescents? A Meta-Analytic Perspective. Child Obes 2020; 16:301-306. [PMID: 32486838 DOI: 10.1089/chi.2020.0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Determine whether inter-individual response differences exist with respect to changes in fat mass and percent body fat as a result of aerobic exercise training in overweight and obese children and adolescents. Methods: Using the meta-analytic approach, randomized controlled trials that examined the effects of aerobic exercise training on fat mass and percent body fat in overweight and obese children and adolescents were included. Change outcome standard deviations for fat mass and percent body fat were used to calculate true inter-individual differences from each study. The inverse variance heterogeneity model was used to pool results. Results: Pooled changes for inter-individual response differences in fat mass (16 studies, 575 participants) were 0.9 kg (95% confidence interval [CI], -1.4 to 1.8 kg) while tau ([Formula: see text]) was 2.9. For percent body fat, inter-individual differences (27 studies, 1035 participants) were 0.6% (95% CI, -0.6% to 1.0%, [Formula: see text] = 0.7). The 95% prediction interval for true inter-individual responses in a future study was -4.9 to 5.5 kg for fat mass and -0.7% to 1.7% for percent body fat. The percent chance, that is, probability, of a clinically meaningful difference in variability was 47% for fat mass and 26% for percent body fat, both of which were considered as only possibly clinically important. Conclusions: There is a lack of convincing evidence to suggest that true inter-individual response differences exist with respect to aerobic exercise training and changes in fat mass and percent body fat in overweight and obese children and adolescents.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Department of Exercise Science, Children's Physical Activity Research Group, University of South Carolina, Columbia, SC, USA
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McDonald SM, Yeo S, Liu J, Wilcox S, Sui X, Pate RR. Association between change in maternal physical activity during pregnancy and infant size, in a sample overweight or obese women. Women Health 2020; 60:929-938. [PMID: 32588785 DOI: 10.1080/03630242.2020.1779904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Physical activity (PA) naturally declines during pregnancy and its effects on infant size are unclear, especially in overweight or obese pregnancies, a low-active subpopulation that tends deliver heavier infants. The objective of this study was to evaluate changes in prenatal PA and infant birthweight in a group of overweight or obese pregnant women. We employed a prospective analysis using data from a randomized controlled exercise trial (2001 to 2006) in sedentary, overweight or obese pregnant women in Michigan. Women with complete data on peak oxygen consumption, daily PA (via pedometers) and birthweight were included in the analyses. Change in PA was estimated via repeated measures analyses, and then its influence on infant birthweight was assessed via linear regression. Eighty-nine pregnant women were included and considered low-active (6,579.91 ± 2379.17 steps/day). PA declined from months 4 to 8 (-399.73 ± 371.38 steps∙day-1∙month-1). Analyses showed that the decline in PA (β = -0.28 g, 95%CI: -0.70, 0.25 g, p = .35) was not associated with birthweight. The findings of this study demonstrated that the decline in maternal PA during mid- to late-pregnancy, in overweight or obese women, was unrelated to infant birthweight. Future investigations should employ rigorous measurements of PA and infant anthropometry in this subpopulation.
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Affiliation(s)
- Samantha M McDonald
- School of Dental Medicine, East Carolina University , Greenville, North Carolina, USA
| | - SeonAe Yeo
- College of Nursing, University of North Carolina , Chapel Hill, North Carolina, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, University of South Carolina , Columbia, South Carolina, USA
| | - Sara Wilcox
- University of South Carolina , Columbia, SC, USA
| | - Xuemei Sui
- University of South Carolina , Columbia, SC, USA
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Pate RR, Frongillo EA, Cordan K, Dowda M, McLain AC, Torres ME, Brown WH, Bucko A, Shull ER. Linking Activity, Nutrition, and Child Health (LAUNCH): protocol for a longitudinal cohort study of children as they develop from infancy to preschool age. BMC Public Health 2020; 20:931. [PMID: 32539852 PMCID: PMC7296728 DOI: 10.1186/s12889-020-09023-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity is known to provide important health benefits in children ages 3 years and above, but little is known about the effects of physical activity on health in very young children under age 3. LAUNCH (Linking Activity, Nutrition, and Child Health) is a study designed to expand the body of knowledge on development of physical activity behavior and associations between physical activity and other health characteristics as children transition from infancy to preschool age. METHODS Physical activity and sedentary behavior will be measured objectively in young children over a period of 30 months. Each child will complete a measurement protocol at 6, 12, 18, 24, 30 and 36 months of age. The following factors will be measured at each time point: physical activity, sedentary behavior, anthropometric characteristics, and motor developmental status. Objectively-measured sleep behavior will be included as an optional component of the protocol. Parents will provide information on demographic factors, parenting behaviors, home and childcare characteristics, and the child's dietary and sleep behaviors. DISCUSSION LAUNCH will employ a longitudinal study design and objective measures of physical activity, sedentary behavior and sleep in examining developmental trends for those characteristics in children between the ages of 6 and 36 months. Associations among physical activity, sedentary behavior, sleep, and weight status will be examined. Findings will inform public health guidance and intervention strategies for very young children.
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Affiliation(s)
- Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, 558, Columbia, SC, 29208, USA
| | - Kerry Cordan
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Green Street, Columbia, SC, 29208, USA
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Green Street, Columbia, SC, 29208, USA
| | - William H Brown
- Department of Educational Studies, College of Education, University of South Carolina, 820 Main Street, Columbia, SC, 29208, USA
| | - Agnes Bucko
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Emily R Shull
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
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Zaltz DA, Hecht AA, Neff RA, Pate RR, Neelon B, O’Neill JR, Benjamin-Neelon SE. Healthy Eating Policy Improves Children's Diet Quality in Early Care and Education in South Carolina. Nutrients 2020; 12:E1753. [PMID: 32545400 PMCID: PMC7353374 DOI: 10.3390/nu12061753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022] Open
Abstract
Policies to promote healthy foods in early care and education (ECE) in the United States exist, but few have been prospectively evaluated. In South Carolina, a statewide program serving low-income children in ECE enacted new policies promoting healthy foods. We conducted an evaluation to measure changes in dietary intake among children in ECE exposed and not exposed to the new policy. Using direct observation, we assessed dietary intake in 112 children from 34 ECE centers in South Carolina and 90 children from 30 ECE centers in North Carolina (a state with no policy). We calculated Healthy Eating Index-2015 (HEI) scores to measure diet quality consumed before and after the policy was enacted. We fit mixed-effects linear models to estimate differences in HEI scores by state from baseline to post-policy, adjusting for child race, number of children enrolled, director education, center years in operation, participation in the Child and Adult Care Food Program (CACFP), and center profit status. The policy increased HEI scores for whole fruits, total fruits, and lean proteins, but decreased scores for dairy. Thus, the policy was associated with some enhancements in dietary intake, but additional support may help improve other components of diet.
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Affiliation(s)
- Daniel A. Zaltz
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Amelie A. Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Roni A. Neff
- Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health 111 Market Pl, Suite 840, Baltimore, MD 21202, USA;
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Brian Neelon
- Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Charleston, SC 29415, USA;
| | - Jennifer R. O’Neill
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
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Zaltz DA, Hecht AA, Pate RR, Neelon B, O'Neill JR, Benjamin-Neelon SE. Participation in the Child and Adult Care Food Program is associated with fewer barriers to serving healthier foods in early care and education. BMC Public Health 2020; 20:856. [PMID: 32503568 PMCID: PMC7275407 DOI: 10.1186/s12889-020-08712-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/15/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Early care and education (ECE) is an important setting for influencing young children's dietary intake. There are several factors associated with barriers to healthy eating in ECE, and recent evidence suggests that participation in the Child and Adult Care Food Program (CACFP), the primary national food assistance program in ECE, may be associated with fewer barriers to serving healthier foods. However, no prior studies have examined differences between CACFP participants and non-participants across a large, multi-state sample. This is the first study to examine the association between CACFP participation and barriers to serving healthier foods in ECE using a random sample of directors from two regions across the country. METHODS We conducted a cross-sectional survey among a random sample of child care center directors from four states (Massachusetts, North Carolina, Rhode Island, and South Carolina). We conducted logistic and Poisson regression to calculate the odds and incidence rate ratios of reporting 1) no barriers, 2) specific barriers (e.g., cost), and 3) the total number of barriers, by CACFP status, adjusting for covariates of interest. RESULTS We received 713 surveys (36% response rate). About half (55%) of centers participated in CACFP. The most prevalent reported barriers to serving healthier foods were cost (42%) and children's food preferences (19%). Directors from CACFP centers were twice as likely to report no barriers, compared to directors from non-CACFP centers (OR 2.03; 95% CI [1.36, 3.04]; p < 0.01). Directors from CACFP centers were less likely to report cost as a barrier (OR = 0.46; 95% [CI 0.31, 0.67]; p < 0.001), and reported fewer barriers overall (IRR = 0.77; 95% CI [0.64, 0.92]; p < 0.01), compared to directors from non-CACFP centers. CONCLUSIONS CACFP directors reported fewer barriers to serving healthier foods in child care centers. Still, cost and children's food preferences are persistent barriers to serving healthier foods in ECE. Future research should evaluate characteristics of CACFP participation that may alleviate these barriers, and whether barriers emerge or persist following 2017 rule changes to CACFP nutrition standards.
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Affiliation(s)
- Daniel A Zaltz
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - Amelie A Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC, 29208, USA
| | - Brian Neelon
- Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Charleston, SC, 29425, USA
| | - Jennifer R O'Neill
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC, 29208, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
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McIver KL, Pate RR, Dowda M, Johnson SB, Yang J, Butterworth M, Liu X. Cross-Country Comparisons of Physical Activity and Sedentary Behavior among 5-Year-Old Children. Int J Pediatr 2020; 2020:7912894. [PMID: 32565835 PMCID: PMC7290875 DOI: 10.1155/2020/7912894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/03/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Previous studies have observed that physical activity (PA) levels tend to be lower in the U.S. population than in many other countries. Within the U.S., PA levels in children are lower in the South than in other regions. Cross-country and interregional differences in PA have not been studied in young children. METHODS In an ongoing study of children at genetic risk for Type 1 diabetes, PA was measured by accelerometry in samples of 5-year-old children (n = 2008) from Finland (n = 370), Germany (n = 85), Sweden (n = 706), and the U.S. (n = 847). The U.S. sample was drawn from centers in Washington State, Colorado, and Georgia/Florida. Children wore accelerometers for 7 days, and the data were reduced to daily minutes of light-, moderate- (MPA), vigorous- (VPA), and moderate-to-vigorous- (MVPA) intensity PA and sedentary behavior. Multiple regression was used to compare children across countries and across regions in the U.S, adjusting for wear time, body mass index, and demographic characteristics. RESULTS After adjusting for previously mentioned factors, MVPA and MPA were lower in U.S. children than those in Finland and Sweden. Estimates of physical activity were higher in Finland than in other countries, although not all comparisons were significantly different. U.S children spent significantly more time in sedentary behavior than children in Finland (p < 0.0001). Within the U.S., children's PA was consistently lowest in Georgia/Florida and highest in Washington. CONCLUSIONS Cross-country differences in PA, previously reported for adults and adolescents, are evident in 5-year-old children. In general, PA levels are lower in U.S. children than their European counterparts, and within the U.S., are lower in Georgia/Florida and Colorado than in Washington. Future studies should be designed to identify the factors that explain these differences.
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Affiliation(s)
- Kerry L. McIver
- University of South Carolina, Arnold School of Public Health, Department of Exercise Science, 921 Assembly Street, Columbia, SC 29208, USA
| | - Russell R. Pate
- University of South Carolina, Arnold School of Public Health, Department of Exercise Science, 921 Assembly Street, Columbia, SC 29208, USA
| | - Marsha Dowda
- University of South Carolina, Arnold School of Public Health, Department of Exercise Science, 921 Assembly Street, Columbia, SC 29208, USA
| | - Suzanne Bennett Johnson
- Florida State University, College of Medicine, Department of Behavioral Sciences and Social Medicine, Tallahassee, FL 32306, USA
| | - Jimin Yang
- University of South Florida, Health Informatics Institute, Tampa, FL 33620, USA
| | - Martha Butterworth
- University of South Florida, Health Informatics Institute, Tampa, FL 33620, USA
| | - Xiang Liu
- University of South Florida, Health Informatics Institute, Tampa, FL 33620, USA
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