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International Journal of Behavioral Nutrition and Physical Activity (all published Online-Articles 2007)
International Journal of Behavioral Nutrition and Physical Activity (all published Online-Articles 2007) Summary:all published single Online Articles 2007 sample in four PDFs PDF 184 Pages (20 articles) PDF 169 Pages (21 articles) PDF 176 Pages (19 articles) PDF 61 Pages ( 7 articles) open access to all articles -> ijbnpa.org The International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, international and peer-reviewed journal devoted to furthering the understanding of the behavioral aspects of diet and physical activity. Behavioral processes are believed to be at the heart of successful efforts to improve people's health through diet and physical activity. The IJBNPA is the journal of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA). The ISBNPA is an international, interdisciplinary society of researchers who focus on issues related to behavioral nutrition and physical activity. ISBNPA aims to stimulate and promote innovative research in the area of behavioral nutrition and physical activity, advocate for the interests of behavioral nutrition and physical activity in research and policy, and promote the improvement of human health on a global scale through attention to nutrition and physical activity population behaviors.What is Behavioral Nutrition and Physical Activity? The importance of physical activity and eating behaviors in promoting health is more prominently recognized than ever before. Physical activity and eating behaviors also play an important role in preventing chronic diseases, such as obesity, diabetes, cardiovascular disease, osteoporosis and some cancers. Yet population eating and physical activity behaviors do not follow recommended patterns, and imbalances remain across many population segments. Current behavioral models to do not capture the complex determinants of food and physical activity behaviors. Even less is known about the most effective ways to intervene to promote healthful eating and physical activity.How is IJBNPA responding to these challenges? The IJBNPA seeks to encourage and disseminate novel and innovative research on physical activity and eating behaviors. The IJBNPA is unique in its international focus on the behavioral aspects of nutrition and physical activity, its inclusion of multiple levels of analysis, including populations, groups and individuals, and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas. The IJBNPA strongly seeks an international perspective. In particular, papers from a variety of cultural settings are of interest to redress the current narrow focus of models and interventions that have been developed and evaluated in homogeneous settings in the western industrialized world. New ideas, new models and new methods are sought while retaining methodological rigor and high standards of scholarship. In particular, it is recognized that trans-disciplinary research among epidemiology, psychology, environmental and ecological sciences, political science, economics, and sociology has much to offer the field for theoretical and methodological innovations. Table of Contents: Research
(1) Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA, (2) Kaiser Permanente Colorado, Denver, Colorado 80231, USA, (3) Psychology Department, Arizona State University, Box 871104 Tempe, AZ 85287, USA, (4) Kaiser Permanente Colorado, Clinical Research Unit, 580 Mohawk Dr., Boulder, CO 80302, USA and (5) Preventive Medicine Research Institute, 900 Bridgeway, Sausalito, California 94965, USA * Corresponding author †Equal contributors International Journal of Behavioral Nutrition and Physical Activity 2007, 4:1 doi:10.1186/1479-5868-4-1 Abstract Background: Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. This report examines the long-term effects of a multiple-risk-factor intervention. Methods: Postmenopausal women (N = 279) with type 2 diabetes participated in the Mediterranean Lifestyle Program (MLP), a randomized, comprehensive lifestyle intervention study. The intervention targeted healthful eating, physical activity, stress management, smoking cessation, and social support. Outcomes included lifestyle behaviors (i.e., dietary intake, physical activity, stress management, smoking cessation), psychosocial variables (e.g., social support, problem solving, self-efficacy, depression, quality of life), and cost analyses at baseline, and 6, 12, and 24 months. Results: MLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception (there were too few smokers to analyze tobacco use effects), and in psychosocial measures of use of supportive resources, problem solving, self-efficacy, and quality of life. Conclusion: The MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes. Directions for future research include replication with other populations.Research
(1) Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, Québec, Canada, (2) Department of Social and Preventive Medicine, Centre de recherche CHUM, Université de Montréal, Montreal, Québec, Canada, (3) Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Québec, Canada, (4) Montreal Children's Hospital Research Institute, Montreal, Québec, Canada, (5) Department of Pediatrics, McGill University, Montreal, Québec, Canada and (6) Institut national de santé publique du Québec Montreal, Québec, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:2 doi:10.1186/1479-5868-4-2 Abstract Background: Obesity in North America is now endemic, and increased understanding of the determinants of physical inactivity is critical. This analysis identified predictors of declines in physical activity over 5 years among adults in low-income, inner-city neighbourhoods. Methods: Data on leisure time physical activity were collected in telephone interviews in 1992 and 1997 from 765 adults (47% of baseline respondents), as part of the evaluation of a community-based cardiovascular disease risk reduction program. Results: One-third of 527 participants who were physically active at baseline, were inactive in 1997. Predictors of becoming inactive included female sex (OR = 1.63 95% CI (1.09, 2.43)), older age (1.02 (1.01, 1.04)), higher BMI (1.57 (1.03, 2.40)), poor self-rated health (1.39 (1.05, 1.84)), lower self-efficacy for physical activity (1.46 (1.00, 2.14)), and not using a neighborhood facility for physical activity (1.61 (1.02, 2.14)). Conclusion: These results highlight the fact that a variety of variables play a role in determining activity level, from demographic variables such as age and sex, to psychosocial and environmental variables. In addition, these results highlight the important role that other health-related variables may play in predicting physical activity level, in particular the observed association between baseline BMI and the increased risk of becoming inactive over time. Lastly, these results demonstrate the need for multi-component interventions in low-income communities, which target a range of issues, from psychosocial factors, to features of the physical environment.Research
(1) Department of Health Behavior and Health Education and Carolina Population Center, University of North Carolina at Chapel Hill, CB#7440, Chapel Hill, NC 27599, USA, (2) Department of Public Policy and Carolina Population Center, University of North Carolina at Chapel Hill, CB#3435, Chapel Hill, NC 27599, USA and (3) Center for Behavioral and Community Health Studies, Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:3 doi:10.1186/1479-5868-4-3 Abstract Background: Physical inactivity is increasing among adolescents in the U.S., especially among girls. Despite growing evidence that parents are an important influence on adolescent health, few longitudinal studies have explored the causal relationship between parental influence and physical activity. This study examines how the relationships between parental influences and adolescent physical activity differ by gender and tests whether these relationships are mediated by adolescents' self-esteem and depression. Methods: Data are from the National Longitudinal Study of Adolescent Health. The sample includes 13,246 youth, grades 7 to 12, interviewed in 1995 and again 1 year later. Logit models were used to evaluate parental influences on achieving five or more bouts of moderate to vigorous physical activity per week [MVPA] and whether the relationship between parental influence and MVPA was mediated by adolescents' level of self-esteem and depression. Results: Family cohesion, parent-child communication and parental engagement positively predicted MVPA for both genders one year later (odds ratios and 95% confidence intervals for females, 1.09 [1.05–1.12], 1.13 [1.07–1.19], 1.25 [1.17–1.33] and males, 1.08 [1.04–1.11], 1.14 [1.07–1.23], 1.23 [1.14–1.33], respectively); however, parental monitoring did not (odds ratio and confidence intervals for females and males, 1.02 [.97–1.07]). For both females and males, self-esteem mediated the relationship between parental influence and physical activity. Depressive symptoms were only a mediator among males. Females reported higher levels of parent-child communication and lower family cohesion compared with males. There were no gender differences in levels of parental monitoring and engagement. Females had significantly lower levels of self-esteem and higher levels of depressive symptoms than males. Conclusion: Strategies to promote physical activity among adolescents should focus on increasing levels of family cohesion, parental engagement, parent-child communication and adolescent self-esteem.Research
Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:4 doi:10.1186/1479-5868-4-4 Abstract Background: Pedometers offer researchers a convenient and inexpensive tool for objective measurement of physical activity. However, many unanswered questions remain about expected values for steps/day for different populations, sources of variation in the data, and reliability of pedometer measurements. Methods: This study documented and compared mean steps/day, demographic predictors of steps/day, and pedometer reliability in two longitudinal investigations, one involving a population-based youth sample (N = 367) and the other targeting postmenopausal women with type 2 diabetes (N = 270). Individuals were asked to wear pedometers (Yamax model SW-701) at the waist for 7 days and record steps/per day. They were also asked to record daily physical activities, duration, and perceived intensity (1 = low/light, 2 = medium/moderate, 3 = high/hard) for the same 7 days. In addition, survey data regarding usual physical activity was collected. Analyses of variance (ANOVA) were conducted to determine whether there were significant differences in pedometer results according to sex, age, and body mass index. Repeated measures ANOVAs were used to examine potential differences in results among differing numbers of days. Results: Mean steps/day were 10,365 steps in the youth sample and 4,352 steps in the sample of older women. Girls took significantly fewer steps than boys, older women took fewer steps than younger women, and both youth and women with greater body mass took fewer steps than those with lower body mass. Reliability coefficients of .80 or greater were obtained with 5 or more days of data collection in the youth sample and 2 or more days in the sample of older women. Youth and older women were more active on weekdays than on weekends. Low but significant associations were found between step counts and self-report measures of physical activity in both samples. Conclusion: Mean steps/day and reliability estimates in the two samples were generally consistent with previously published studies of pedometer use. Based on these two studies, unsealed pedometers were found to offer an easy-to-use and cost-effective objective measure of physical activity in both youth and older adult populations.Research
(1) Department of Nutrition, Institue of Basic Medical Sciences, University of Oslo, Norway, (2) Department of Public Health, Erasmus University Medical Centre Rotterdam, the Netherlands, (3) Department of Biostatistics, Institue of Basic Medical Sciences, University of Oslo, Norway and (4) Department of Medical Genetics, Ullevål University Hospital, Norway * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:5 doi:10.1186/1479-5868-4-5 Abstract Background: Norwegian children consume less fruit and vegetables (FV) than recommended. In order to increase the intake, a School Fruit subscription programme is now offered to all Norwegian elementary and junior high schools. This programme has limited effect due to low participation by schools and pupils. However, recent evaluations of the programme offered for free have reported good effects in increasing FV intake. The purpose of the present study is to evaluate the long term effects of the Norwegian School Fruit programme, provided at no-cost to the pupils, three years after it was provided for free. Methods: A total of 1950 (85%) 6th and 7th grade pupils from 38 Norwegian elementary schools participated in the project. Nine schools were selected as intervention schools and participated for free in the Norwegian School Fruit programme for a school year (October 2001 until June 2002). A baseline questionnaire survey was conducted in September 2001, and follow-up surveys were conducted in May 2002 and May 2005. FV intake was assessed by a written 24-h recall (reporting FV intake at school and FV intake all day), and by four food frequency questions (reporting usual FV intake). Data were analysed by a linear mixed model for repeated measures. Results: The pupils in the free fruit group increased their FV intake compared to pupils in the control group as a result of the intervention. Some of the effect was sustained three years later. The estimated long-term effects for FV all day were 0.38 and 0.44 portion/day for boys and girls, respectively. Conclusion: The results show long-term effects of a free school fruit programme.Research
Rudd Center for Food Policy and Obesity, Yale University Department of Psychology, New Haven, CT 06520-8369, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:6 doi:10.1186/1479-5868-4-6 Abstract Background: This study evaluated an environmental intervention intended to increase consumption of the fruit serving among elementary school children participating in the National School Lunch Program (NSLP). Methods: Children's fruit consumption was measured in two schools by observation. In the intervention school, cafeteria workers provided the verbal prompt, "Would you like fruit or juice with your lunch?" as the children stood in line in front of the fruit serving options. The control school had the same fruit and 100% juice options available, but the cafeteria workers did not provide a verbal prompt to take a fruit serving. Two variables were assessed: (1) Did children leave the lunch line with a fruit serving on their trays? and (2) Did they subsequently eat the fruit serving? Results: The average percentage of children who took a fruit serving was 60% in the control school and 90% in the intervention school. In both schools, approximately 80% of children ate the fruit on their tray. As a result, nearly 70% of the children in the intervention school consumed a fruit serving at lunch, while fewer than 40% did so in the control school. Conclusion: A simple verbal prompt appears to have a significant impact on the likelihood that children will take, and subsequently consume, a fruit serving as part of their purchased school lunch. If these findings are replicated, policymakers may consider adding verbal prompts to the serving policy of the NSLP in an effort to increase fruit consumption among school children. Research
(1) School of Health and Human Performance, Central Queensland University, Rockhampton Queensland, Australia and (2) School of Nursing and Health Studies, Central Queensland University, Rockhampton Queensland, Australia * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:7 doi:10.1186/1479-5868-4-7 Abstract Background: There has been increasing interest in the ability of the internet to produce behaviour change. The focus of this study was to describe program exposure across three intervention groups from a randomised trial (RT) comparing traditional face-to-face, internet-mediated (combined internet plus face-to-face), and internet-only program delivery. Methods: Baseline and immediately post-intervention survey data, and exposure rates from participants that commenced the RT were included (n = 192). Exposure was defined as either face-to-face attendance, website usage, or a combination of both for the internet-mediated group. Characteristics of participants who were exposed to at least 75% of the program material were explored. Descriptive analysis and logistical regression were used to examine differences between groups for program exposure. Results: All groups showed decrease in program exposure over time. Differences were also observed (χ2 = 10.37, p < 0.05), between intervention groups. The internet-mediated (OR = 2.4, 95% CI 1.13–5.1) and internet-only (OR = 2.96, 95% CI 1.38–6.3) groups were more likely to have been exposed to at least 75% of the program compared to the face-to-face group. Participants with high physical activity self-efficacy were 1.82 (95% CI 1.15–2.88) times more likely to have been exposed to 75% of the program, and those allocated to the face-to-face group were less likely to have attended 75% of the face-to-face sessions if they were classified as obese (OR = 0.21 95% CI 0.04–0.96). Conclusion: These results suggest that the internet groups were as effective as the face-to-face delivery mode in engaging participants in the program material. However, different delivery methods may be more useful to different sub-populations. It is important to explore which target groups that internet-based programs are best suited, in order to increase their impact. Research
(1) Department of Nutritional Sciences, University of Toronto, 150 College Street, Toronto, Ontario, M5S 3E2, Canada, (2) School of Nutrition, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada and (3) Department of Public Health Sciences, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:8 doi:10.1186/1479-5868-4-8 Abstract Title: An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation models. Background: Socioeconomic indicators have been inversely associated with overweight and obesity, with stronger associations observed among women. The objective of the present secondary analysis was to examine the relationships among socioeconomic measures and adiposity for men and women participating in the Ontario Food Survey (OFS), and to explore lifestyle factors as potential mediators of these associations. Methods: The cross-sectional 1997/98 OFS collected anthropometric measurements, a food frequency questionnaire, data on socio-demographics (age, sex, income, and education) and physical activity from 620 women and 467 men, ages 18 to 75. Based on the 2003 Health Canada guidelines, waist circumference and BMI values were used to derive least risk, increased risk, and high risk adiposity groups. Structural equation modeling was conducted to examine increased risk and high risk adiposity in relation to education and income, with leisure time physical activity, fruit and vegetable intake, and smoking status included as potential mediators of these associations. Results: The probability of high risk adiposity was directly associated with education (β-0.19, p < 0.05) and income (β-0.22, p < 0.05) for women, but not for men. Fruit and vegetable intake was a marginally significant mediator of the relationship between education and high risk adiposity for women. Increased risk adiposity was not associated with income or education for men or women. Conclusion: The socioeconomic context of adiposity continues to differ greatly between men and women. For women only in the OFS, fruit and vegetable intake contributed to the inverse association between education and high risk adiposity; however, additional explanatory factors are yet to be determined.Research
(1) Department of Epidemiology and Community Medicine, Faculty of Medicine, Institute of Population Health, University of Ottawa, Ottawa, Canada and (2) Institute of Population Health, University of Ottawa, Ottawa, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:9 doi:10.1186/1479-5868-4-9 Abstract Background: Despite the increasing prevalence of overweight/obesity and its association to eating patterns in adolescents and adults, little is known about the relationship between problematic eating behaviours and body weight in the preschool years within the context of various social factors. This research aims to analyze the relationship between social factors, mothers' perceptions of their child's eating behaviour (picky eating and overeating), and body weight in preschool years, in a population-based cohort of preschoolers from Québec (Canada). Methods: Analyses were performed on 1498 children from the Longitudinal Study of Child Development in Québec, a representative sample of children born in 1998 in the Canadian province of Québec. Eating behaviours (picky eating and overeating) were derived from questionnaires at 2.5, 3.5, and 4.5 years of age. BMI was calculated from children's measured height and weight at 4.5 years. Children's sex and birth weight, mothers' age, immigrant status, smoking status during pregnancy, and education level, family type, annual household income and income sufficiency, the number of overweight/obese parents, children's day-care attendance, and food insufficiency were part of the analysis. Multivariate logistic regressions were used to determine odds ratios for different body weight profiles (underweight, normal weight, at risk of overweight, overweight), and one-way analysis-of-variances (ANOVA) allowed for group comparisons of means. Results: The proportion of children reported for each eating behaviour category remained quite stable across the years studied. Picky eating and overeating related to body weight among 4.5-year-old children, even when social and parental factors were accounted for in multivariate analysis. Picky eaters were twice as likely to be underweight at 4.5 years as children who were never picky eaters. Adjusted odds ratios revealed overeaters were 6 times more likely to be overweight at 4.5 years than were children who were never overeaters. Conclusion: Given the association between eating behaviours and bodyweight among 4.5-year-old children, particularly among those from less educated, lower income families and younger mothers, health professionals should target parents of children at risk of overweight/obesity and underweight with focussed messages and strategies for the management of emerging problematic eating behaviours.Research
(1) Institute of Food and Resource Economics, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 25, DK-1958 Frederiksberg C, Denmark and (2) Danish Institute of Governmental Research (AKF), Nyropsgade 37, DK-1602 København V, Denmark * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:10 doi:10.1186/1479-5868-4-10 Abstract This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn.Debate
EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:11 doi:10.1186/1479-5868-4-11 Abstract Background: On November 15–17, 2006 the World Health Organization Regional Office for Europe organised a ministerial conference on counteracting obesity in the European region. Delegations from 48 countries met in Istanbul, Turkey. Observed by relevant nongovernmental organisations and expert temporary advisors, the European ministers adopted a charter on counteracting obesity. This charter states that countries within the European region should be able to show results in slowing down and stopping the obesity epidemic within the next 4–5 years, especially among children, and that the obesity prevalence trends should be reversed before 2015. To achieve this, the charter explicitly calls for action beyond health education: changes in the physical, political, informational and social environments are needed to facilitate a healthy energy balanced lifestyle. Discussion: The fact that all member states of WHO-Europe have now explicitly agreed on an ecological approach to fighting the obesity epidemic with a timeline for visible results is important. However, the charter does not explicate specific enough and measurable objectives for improvement, nor the means needed to reach these. Summary: The fact that all WHO-Europe member states have agreed on a charter that recognizes that counteracting obesity requires a multidisciplinary and ecological approach, with a timeline for improvements, is a late but important step forward for public health policy and practice across Europe. However, more specific tangible goals should now be set, the required means should be allocated, coordinated and immediate action should be implemented, and research to identify effective strategies should be encouraged and facilitated.Research
(1) Department of Kinesiology, Kansas State University, Manhattan, KS, USA, (2) Clincal Research Unit, Kaiser Permanente Colorado, Denver, CO, USA and (3) University of Illinois at Urbana-Champaign, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:12 doi:10.1186/1479-5868-4-12 Abstract Background: Consumption of the recommended amounts of fruits and vegetables is associated with several health benefits. Currently less than 25% of the American population meets the minimum recommendation of five servings a day. In order to change this health behaviour, interventions should be based on theory and include community-wide social support. Methods: A low intensity intervention was developed in which participants (n = 86) were randomly assigned to either the fruit and vegetable intervention (FVI) or standard control condition. The intervention was integrated into an ongoing community physical activity program and study participants were drawn from the sample of community members enrolled in the program. The FVI consisted of brief social cognitive theory-based messages delivered in nine weekly newsletters designed to improve participant outcome and self-efficacy expectations related to fruit and vegetable consumption. Results: Participants in the FVI condition increased in their fruit and vegetable consumption by approximately one to one and one-third servings per day. The control condition showed no change in consumption. The effect of the intervention was enhanced when examined by the extent to which it was adopted by participants (i.e., the number of newsletters read). Those participants who read seven or more newsletters showed an increase of two servings per day. Conclusion: This intervention was effective at improving fruit and vegetable consumption among adults. Minimal interventions, such as newsletters, have the ability to reach large audiences and can be integrated into ongoing health promotion programs. As such, they have potential for a strong public health impact.Research
(1) Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway, (2) Department of Sports Medicine, Norwegian School of Sports Sciences, PO Box 4014, Ullevål Stadion, 0807 Oslo, Norway, (3) Diabetes Research Centre, Aker and Ullevål University Hospital, University of Oslo, Norway and (4) Department of Physical Performance, Norwegian School of Sports Sciences, PO Box 4014, Ullevål Stadion, 0807 Oslo, Norway * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:13 doi:10.1186/1479-5868-4-13 Abstract Background: The aim was to assess the construct validity characteristics of an adapted version of the long International Physical Activity Questionnaire (IPAQ-L) and report seasonal variations in physical activity (PA). Methods: In two multiethnic suburbs of Oslo, Norway, all men and women aged 31–67 years (N = 6140) were invited to a survey in 2000, and participants (N = 2950) were re-invited in 2003. Complete IPAQ-L forms were delivered by 2274 baseline participants. We used the first IPAQ-L version, which asks for PA in a usual week with separate answering alternatives for summer and winter. Baseline energy expenditure calculated from IPAQ-L was compared with anthropometrical and biological measurements including maximal aerobic power in a subgroup, and individual changes in PA were compared with changes in these measurements. Results: Vigorous PA within all domains, leisure-time PA (LPA), total PA, and in men occupational PA correlated with waist-to-hip ratio (rho around -0.1, p < 0.05). For vigorous PA and LPA similar correlations were found with triglycerides and high-density lipoprotein-cholesterol (rho 0.1, p < 0.05). LPA was correlated with maximal aerobic power in both sexes with rho 0.2 for total LPA and 0.4 for vigorous LPA (p < 0.01). In men, similar correlations were found for changes in total vigorous PA. The overall energy expenditure reported was 18% higher in summer than in winter. The amount of total and commuting PA in the two seasons were highly correlated with rho values of 0.9 and 0.7, respectively (p < 0.01). Conclusion: Weak, but consistent correlations with baseline biological and anthropometrical measurements were found in both sexes, but for changes in PA such a pattern was seen in men only. The total energy expenditure in summer and winter were highly correlated although the absolute volume was higher in summer than in winter. Research
(1) Faculty of Human Movement, Technical University of Lisbon, Estrada da Costa, 1495-688, Cruz-Quebrada, Portugal and (2) University Lusófona de Humanidades e Tecnologias, Campo Grande, 1749-028, Lisbon, Portugal * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:14 doi:10.1186/1479-5868-4-14 Abstract Background: This study was conceived to analyze how exercise and weight management psychosocial variables, derived from several health behavior change theories, predict weight change in a short-term intervention. The theories under analysis were the Social Cognitive Theory, the Transtheoretical Model, the Theory of Planned Behavior, and Self-Determination Theory. Methods: Subjects were 142 overweight and obese women (BMI = 30.2 ± 3.7 kg/m2; age = 38.3 ± 5.8y), participating in a 16-week University-based weight control program. Body weight and a comprehensive psychometric battery were assessed at baseline and at program's end. Results: Weight decreased significantly (-3.6 ± 3.4%, p < .001) but with great individual variability. Both exercise and weight management psychosocial variables improved during the intervention, with exercise-related variables showing the greatest effect sizes. Weight change was significantly predicted by each of the models under analysis, particularly those including self-efficacy. Bivariate and multivariate analyses results showed that change in variables related to weight management had a stronger predictive power than exercise-specific predictors and that change in weight management self-efficacy was the strongest individual correlate (p < .05). Among exercise predictors, with the exception of self-efficacy, importance/effort and intrinsic motivation towards exercise were the stronger predictors of weight reduction (p < .05). Conclusion: The present models were able to predict 20–30% of variance in short-term weight loss and changes in weight management self-efficacy accounted for a large share of the predictive power. As expected from previous studies, exercise variables were only moderately associated with short-term outcomes; they are expected to play a larger explanatory role in longer-term results.Research
(1) Norwegian School of Sport Sciences, P.O. BOX 4014, Ullevål Stadion, 0806 Oslo, Norway and (2) Aker Diabetes Research Centre, Faculty Division Aker University Hospital, 0514 Oslo, Norway * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:15 doi:10.1186/1479-5868-4-15 Abstract Background: Conducting process evaluations of health promoting interventions, and measuring the effectiveness of specific intervention components, may help in the understanding of program failure or success. The purposes of the present study were to examine adults' exposure to and involvement in specific components of a three year long pseudo-experimental community-based physical activity intervention, and to examine the relationship between such exposure and participation and changes in stages of change in physical activity and psychosocial mediators. Methods: 1497 persons in the intervention group attended the baseline survey in 2000 (50.6%) and 1204 (80.4 of baseline attendees) provided data on the outcome variables of the present study. In 2003, 1089 were still living in the area, and were re-invited to follow-up assessments. Current analyses are based on the 603 persons (mean age 49 ± 10 years) who provided baseline and follow-up data for the current purposes (56.6% follow-up rate). Process data, stages of change in physical activity, and potential psychosocial mediators of change in physical activity were assessed by questionnaires. The theory-based intervention was composed of communication, physical activity, environmental and participatory components. Data were analysed using frequency and descriptive statistics, Chi-square and t-tests, and regression analyses. Results: Exposure and participation rates in the various intervention components varied greatly (1.5–92.7%). Participation in walking groups and aerobic exercise groups, as well as having seen the "Walk the stairs"-poster were significantly and positively related to change in stages of change in physical activity (β = .12, p = .011; β = .211, p < .001; β = .105, p = .014, respectively). Additionally, having used the walk path was significantly and positively related to change in stages in women (β = .209, p = .001) but not in men (β = -.011, p = .879), and in Western people (β = .149, p = .003) but not in non-Westerners (β = -.293, p = .092). Observed significant relations were partly mediated by positive changes in psychosocial factors as social support from friends, perceived control, and physical activity identity. Conclusion: Findings revealed that particular intervention components, such as participation in physical activity groups, were more strongly related to forward transition in stages of change in physical activity than others. These findings together with results indicating that such transitions were mediated by specific psychosocial influences may improve theory and help to prioritize among specific intervention components in future programs. Short paper
(1) Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden, (2) Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden, (3) Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA, (4) Department of Biostatistics, Harvard School of Public Health, USA and 5Department of Statistics, University of Milano Bicocca, Italy * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:16 doi:10.1186/1479-5868-4-16 Abstract Information on correlates of total physical activity (PA) levels among middle-aged and elderly women is limited. This article aims to investigate whether total daily PA levels are associated with age, body mass index, smoking, drinking status, and sociodemographic factors. In a cross-sectional study of 38,988 women between the ages of 48 and 83 years residing in central Sweden, information on PA, weight, height, smoking, drinking, and sociodemographic factors was collected through a self-administered questionnaire. Total daily PA levels were measured as metabolic equivalents (MET-h/day). Odds ratios (OR) and 95% confidence intervals (CI) were estimated by ordinal logistic regression models. We observed decreasing level of total PA with increasing age (for 5-year increase: OR = 0.87; 95% CI: 0.85–0.89) and body mass index (for 5-unit, kg/m2, increase: OR = 0.81; 95% CI: 0.79–0.84). Multivariable adjusted correlates of total PA level were smoking (current vs. never: OR = 0.83; 95% CI: 0.79–0.88), drinking (current vs. never: OR = 0.88; 95% CI: 0.82–0.94), educational level (university vs. primary: OR = 0.54; 95% CI: 0.51–0.58), employment status (housewife vs. full-work: OR = 2.59; 95% CI: 2.25–2.98), and childhood environment (city vs. countryside: OR = 0.62; 95% CI: 0.59–0.65). In the present investigation, among middle-aged and elderly women, the likelihood of engaging in higher total daily PA levels decreased with age, body mass index, educational level, smoking, drinking, and growing up in urban places. Research
physically active in the garages. Conclusion: The WEM is a reliable measure of the worksite nutrition, physical activity, and weight management environment that can be used to assess changes in the work environment.Research
(1) Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, USA and (2) Office of Clinical Research, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, USA * Corresponding author †Equal contributors International Journal of Behavioral Nutrition and Physical Activity 2007, 4:18 doi:10.1186/1479-5868-4-18 Abstract Objectives: To examine high school personnel's perceptions of the school environment, its impact on obesity, and the potential impact of legislation regulating schools' food/beverage offerings. Methods: Semi-structured interviews were conducted with the principal (n = 8) and dietitian/food service manager (n = 7) at 8 schools (4 rural, 4 suburban) participating in a larger study examining the relationship between the school environment and adolescent health behavior patterns. Results: Principal themes included: 1) Obesity is a problem in general, but not at their school, 2) Schools have been unfairly targeted above more salient factors (e.g., community and home environment), 3) Attempts at change should start before high school, 4) Student health is one priority area among multiple competing demands; academic achievement is the top priority, 5) Legislation should be informed by educators and better incorporate the school's perspective. Food service themes included: 1) Obesity is not a problem at their school; school food service is not the cause, 2) Food offerings are based largely on the importance of preparing students for the real world by providing choice and the need to maintain high participation rates; both healthy and unhealthy options are available, 3) A la carte keeps lunch participation high and prices low but should be used as a supplement, not a replacement, to the main meal, 4) Vending provides school's additional revenue; vending is not part of food service and is appropriate if it does not interfere with the lunch program. Conclusion: Discrepancies exist between government/public health officials and school personnel that may inhibit collaborative efforts to address obesity through modifications to the school environment. Future policy initiatives may be enhanced by seeking the input of school personnel, providing recommendations firmly grounded in evidence-based practice, framing initiatives in terms of their potential impact on the issues of most concern to schools (e.g., academic achievement, finances/revenue), and minimizing barriers by providing schools adequate resources to carry out and evaluate the effectiveness of their efforts.Research
(1) Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, 15-21 Webster Street, Liverpool L3 2ET, UK, (2) Centre for Physical and Outdoor Education, Liverpool John Moores University, I.M. Marsh Campus, Barkhill Road, Liverpool, L17 6BD, UK, (3) The REACH Group, Liverpool John Moores University, Liverpool, UK, (4) Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands and (5) Department of Methodology and Applied Biostatistics, Institute of Health Services, Vrije University, Amsterdam, The Netherlands * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:19 doi:10.1186/1479-5868-4-19 Abstract Background: Recess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention. Methods: 150 boys and 147 girls were randomly selected from 26 elementary schools to wear uni-axial accelerometers that quantified physical activity every 5 seconds during recess. Fifteen schools located in deprived areas in one large urban city in England received funding through a national initiative to redesign the playground environment. Eleven schools served as matched socioeconomic controls. Data were collected at baseline and 6-weeks following playground intervention. Recess MVPA and VPA levels adjusted for pupil- and school-level covariates (baseline physical activity, age, gender, recess length, body mass index) were analysed using multilevel analyses. Results: Positive but non-significant intervention effects were found for MVPA and VPA when confounding variables were added to the model. Gender was a significant predictor of recess physical activity, with boys engaging in more MVPA and VPA than girls. Significant interactions for MVPA revealed that the intervention effect was stronger for younger elementary aged school children compared to older children, and the intervention effect increased as daily recess duration increased. Conclusion: The playground redesign intervention resulted in small but non-significant increases in children's recessphysical activity when school and pupil level variables were added to the analyses. Changing the playground environment produced a stronger intervention effect for younger children, and longer daily recess duration enabled children to engage in more MVPA following the intervention. This study concludes that the process of increasing recess physical activity is complex when school and pupil-level covariates are considered, though they should be taken into account when investigating the effects of playground intervention studies on children's physical activity during recess. Research
(1) HSR&D Center for Excellence, VA Health Care Medical Center, P.O. Box 130170, Ann Arbor, MI 48113-0170, USA and (2) Department of Family Medicine, University of Michigan, 1018 Fuller St. SPC: 5708, Ann Arbor, MI 48109-5708, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:20 doi:10.1186/1479-5868-4-20 Abstract Background: For high-risk individuals and their healthcare providers, finding the right balance between promoting physical activity and minimizing the risk of adverse events can be difficult. More information on the prevalence and influence of adverse events is needed to improve providers' ability to prescribe effective and safe exercise programs for their patients. Methods: This study describes the type and severity of adverse events reported by participants with cardiovascular disease or at-risk for cardiovascular disease that occurred during an unsupervised, home-based walking study. This multi-site, randomized controlled trial tested the feasibility of a diet and lifestyle activity intervention over 1.5 years. At month 13, 274 eligible participants (male veterans) were recruited who were ambulatory, BMI > 28, and reporting one or more cardiovascular disease risk factors. All participants attended five, face-to-face dietitian-delivered counseling sessions during the six-month intervention. Participants were randomized to three study arms: 1) time-based walking goals, 2) simple pedometer-based walking goals, and 3) enhanced pedometer-based walking goals with Internet-mediated feedback. Two physicians verified adverse event symptom coding. Results: Enrolled participants had an average of five medical comorbidities. During 1110 person months of observation, 87 of 274 participants reported 121 adverse events. One serious study-related adverse event (atrial fibrillation) was reported; the individual resumed study participation within three days. Non-serious, study related adverse events made up 12% of all symptoms – predominantly minor musculoskeletal events. Serious, non-study related adverse events represented 32% of all symptoms while non-serious, non-study related adverse events made up 56% of symptoms. Cardiovascular disease events represented over half of the non-study related adverse event symptoms followed by musculoskeletal complaints. Adverse events caused 50 temporary suspensions averaging 26 days in duration before physician medical clearance was obtained to resume walking. Conclusion: Men at high risk for adverse cardiovascular events can safely be advised to start a progressive walking program. Results suggest that minor to serious medical problems unrelated to exercise are a major barrier to walking adherence. Helping individuals with chronic illness return to physical activity quickly but safely after an adverse event is an important component of any physical activity intervention targeting this population. Research
(1) Faculty of Physical Education and Recreation, University of Alberta, E-424 Van Vliet Center, Edmonton, Alberta, T6G 2H9, Canada, (2) Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada, (3) Department of Obstetrics and Gynecology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada and (4) Division of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:21 doi:10.1186/1479-5868-4-21 Abstract Background: Despite evidence of the benefits of exercise in cancer survivors, exercise participation rates tend to decline after treatments. Few studies have examined the determinants of exercise in less common cancer sites. In this study, we examined medical, demographic, and social cognitive correlates of exercise in endometrial cancer survivors using the Theory of Planned Behavior (TPB). Methods: A mailed survey was completed by 354 endometrial cancer survivors (1 to 10 years postdiagnosis) residing in Alberta, Canada. The study was cross-sectional. Exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire and the TPB constructs were assessed with standard self-report scales. Multiple regression analyses were used to determine the independent associations of the TPB constructs with intention and behavior. Results: Chi-square analyses indicated that marital status (p = .003), income level (p = .013), and body mass index (BMI) (p = .020) were associated with exercise. The TPB explained 34.1% of the variance in exercise behavior with intention (β = .38, p < .001) and self-efficacy (β = .18, p = .029) being independent correlates. For intention, 38.3% of the variance was explained by the TPB with self-efficacy (β = .34, p < .001) and affective attitude (β = .30, p < .001) being the independent correlates. The TPB mediated the associations of marital status and BMI with exercise but not income level. Age and BMI moderated the associations of the TPB with intention and behavior. Conclusion: The TPB may be a useful framework for understanding exercise in endometrial cancer survivors. Exercise behavior change interventions based on the TPB should be tested in this growing population.Research
(1) Centre de recherche et d'expertise en gérontologie sociale (CREGES), CSSS Cavendish-Centre Affilié Universitaire, Montreal, Quebec, Canada, (2) Department of Kinesiology, University of Montreal; Associate Researcher, Groupe de recherche interdisciplinaire en santé (GRIS), University of Montreal, and Centre de recherche et d'expertise en gérontologie sociale(CREGES), CSSS Cavendish-Centre Affilié Universitaire, Montreal, Quebec, Canada, (3) Department of Social and Preventive Medicine, University of Montreal; Associate Researcher, Groupe de recherche interdisciplinaire en santé (GRIS), University of Montreal; Researcher, The Léa-Roback Centre on Social Inequalities of Health in Montreal, Montreal, Quebec, Canada and (4) Health Care & Outcomes Research, University Health Network & Associate Professor, Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:22 doi:10.1186/1479-5868-4-22 Abstract Background: Sustained maintenance of health behaviors is a determinant of successful symptom reduction strategies for older adults with arthritis. This study examined whether or not short-term improvements in exercise involvement were maintained 8 months following a home-based arthritis self-management intervention as well as the moderating role of individual characteristics in the maintenance of behavior change. Methods: Of the 113 housebound older adult participants at pre-intervention, 97 completed the post-intervention interview, and 80 completed the 8-month post-intervention interview. Results: Some post-intervention improvements in exercise involvement were maintained 8 months later. More specifically, weekly exercise frequency, particularly regarding walking frequency, and variety of exercise activities were still significantly greater in the experimental group than in the control group 8 months following the completion of the intervention. No moderating influences were observed for any of the individual characteristics. Conclusion: We conclude that gains in exercise involvement achieved through a self-management intervention can be maintained 8 months following the intervention.Correction
(1) Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, Québec, Canada, (2) Department of Social and Preventive Medicine, Centre de recherche CHUM, Université de Montréal, Montréal, Québec, Canada, (3) Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada, (4) Montreal Children's Hospital Research Institute, Montréal, Québec, Canada, (5) Department of Pediatrics, McGill University, Montréal, Québec, Canada and (6) Institut national de santé publique du Québec, Montreal, Québec, Canada * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:23 doi:10.1186/1479-5868-4-23 Abstract After publication it was brought to our attention that the information for one of the variables in Table 1 was incorrect (Weiss, O'Loughlin et al. International Journal of Behavioral Nutrition and Physical Activity 2007, 4:2). The variable in question is "Use of a neighborhood facility for activity". In the first column, the first row should read "yes", and the second row, "no". In the second column, the first row should read 25.8 (41) and the second row, 41.3 (152).Research
(1) Unit for Prevention and Control of Cardiovascular Disease, Ministry of Health, Victoria, Republic of Seychelles, (2) Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland, (3) National Sports Council, Ministry of Arts, Culture and Sports, Victoria, Republic of Seychelles and (4) Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Room 1578, 34th and Civic Center Blvd, Philadelphia, PA 19104, USA * Corresponding author International Journal of Behavioral Nutrition and Physical Activity 2007, 4:24 doi:10.1186/1479-5868-4-24 Abstract Background: Studies examining the relationship between physical fitness and obesity in children have had mixed results despite their interrelationship making intuitive sense. We examined the relationship between physical fitness and overweight and obesity in a large sample of adolescents in the Republic of Seychelles (Indian Ocean, African region). Methods: All students of four grades of all secondary schools performed nine physical fitness tests. These tests assessed agility, strength and endurance, and included the multistage shuttle run, a validated meas Please select one mirror to download
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