Implementing classroom physical activity breaks: Associations with student physical activity and classroom behavior

ObjectiveTo investigate the relation of classroom physical activity breaks to students' physical activity and classroom behavior.MethodsSix elementary-school districts in California implemented classroom physical activity interventions in 2013–2014. Students' (N = 1322) accelerometer-measured moderate-to-vigorous physical activity (MVPA) during school and teachers' (N = 397) reports of implementation and classroom behavior were assessed in 24 schools at two time points (both post-intervention). Mixed-effects models accounted for nested data.ResultsMinutes/day of activity breaks was positively associated with students' MVPA (βs = .07–.14; ps = .012–.016). Students in classrooms with activity breaks were more likely to obtain 30 min/day of MVPA during school (OR = 1.75; p = .002). Implementation was negatively associated with students having a lack of effort in class (β = − .17; p = .042), and student MVPA was negatively associated with students being off task or inattentive in the classroom (β = − .17; p = .042). Students provided with 3–4 physical activity opportunities (classroom breaks, recess, PE, dedicated PE teacher) had ≈ 5 more min/day of school MVPA than students with no opportunities (B = 1.53 min/opportunity; p = .002).ConclusionsImplementing classroom physical activity breaks can improve student physical activity during school and behavior in the classroom. Comprehensive school physical activity programs that include classroom-based activity are likely needed to meet the 30 min/day school physical activity guideline.     

Physical activity and cardiovascular risk factors in children: meta-analysis of randomized clinical trials

ObjectiveTo assess the effects of physical activity interventions in preventing cardiovascular risk factors in childhood through a systematic review and meta-analysis of randomized clinical trials (RCTs).MethodsA search of online databases (PubMed, EMBASE and Cochrane CENTRAL) was conducted from inception until June 2013. RCTs enrolling children 6–12 years old conducted physical activity interventions longer than 6 months, assessing their effect on body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC) and triglycerides (TG) were included. Data analysis was performed using a random-effects model.ResultsOf 23.091 articles retrieved, 11 RCTs (10.748 subjects) were included. Physical activity interventions were not associated with reductions of BMI [− 0.03 kg/m² (95%CI − 0.16, 0.13) I² 0%]. However, there was an association between the interventions and reduction of SBP [− 1.25 mmHg (95%CI − 2.47, − 0.02) I² 0%], DBP [− 1.34 mmHg (95%CI − 2.57, − 0.11) I² 43%] and TG [− 0.09 mmol/L (95%CI − 0.14, − 0.04) I² 0%], and increase of TC [0.14 mmol/L (95%CI 0.01, 0.27) I² 0%].ConclusionAs physical activity intervention programs lasting longer than 6 months are associated with reductions in blood pressure levels and triglycerides, they should be considered to be included in prevention programs for cardiovascular diseases in schoolchildren.     

Effects of exercise on sleep among young women with Generalized Anxiety Disorder

Statement of the problemGeneralized Anxiety Disorder (GAD) and disturbed sleep are prevalent, debilitating, and frequently comorbid problems for which successful treatment remains limited. Exercise can promote sleep but whether it does among GAD patients is unknown.MethodsThirty sedentary women (18−37 y) with a primary DSM-IV diagnosis of GAD were randomized to six weeks of resistance (RET) or aerobic exercise training (AET), or waitlist (WL). RET and AET involved twice-weekly sessions of either lower-body weightlifting or leg cycling matched on multiple features of exercise. Outcomes included total sleep time (TST), lights out time, awakening out of bed time, time in bed (TIB), sleep onset latency (SOL), wakefulness after sleep onset, and sleep efficiency. Hedges' d effect sizes and 95% confidence intervals were calculated for each exercise condition compared to WL. Regression examined baseline associations between anxiety and sleep and associated change.ResultsTwenty-two of 26 participants reported poor baseline sleep (Pittsburgh Sleep Quality Index > 5). RET significantly decreased weekend TIB (d = −1.79; [−2.89,−0.70]) and SOL (d = −1.30; [−2.32,−0.28]), and significantly increased weekend sleep efficiency (d = 1.30; [0.29,2.32]). AET significantly reduced weekend TIB (d = −1.13; [−2.16,−0.11]) and SOL (d = −1.08; [−2.09,−0.06]). Reduced GAD clinical severity rating was significantly associated with improved weekend sleep efficiency among RET (t₆ = −3.48, p ≤ 0.013).ConclusionsShort-term exercise training improves sleep outcomes among GAD patients, especially for RET and weekend sleep. Findings suggest improved sleep may be associated with reduced clinical severity among GAD patients.     

Self-determined motivation and physical activity in children and adolescents: A systematic review and meta-analysis

ObjectiveSelf-determination theory is used as a framework for examining the relation between motivation and physical activity. The purpose of this review was to systematically review studies that assessed the association between self-determined motivation and physical activity levels in children and adolescents.MethodWe searched electronic databases in April 2013. Included studies assessed the relation between motivation (as outlined in self-determination theory) and physical activity in children and adolescents.ResultsForty-six studies (n = 15,984 participants) met the inclusion criteria. Meta-analysis indicated that overall levels of self-determined motivation had a weak to moderate, positive associations with physical activity (ρ = .21 to .31). Autonomous forms of motivation (i.e., intrinsic motivation and identified regulation) had moderate, positive associations with physical activity (ρ = .27 to .38), whereas controlled forms of motivation (i.e., introjection and external regulation) had weak, negative associations with physical activity (ρ = − .03 to −.17). Amotivation had a weak, negative association with physical activity (ρ = − .11 to − .21).ConclusionsEvidence provides some support for self-determination theory tenets. However, there was substantial heterogeneity in most associations and many studies had methodological shortcomings.     

Empowering adolescents to be physically active: Three-year results of the Sigue la Huella intervention

ObjectiveTo examine the effects of a school-based intervention called Sigue la Huella (Follow the Footstep) on adolescents' daily moderate-to-vigorous physical activity (MVPA).MethodThis quasi-experimental, cohort study took place in four secondary schools in Huesca (Spain) during the 2009–2010, 2010–2011, and 2011–2012 academic years (students aged 12–15 years). Two schools were assigned to the experimental condition (n = 368) and two schools to the control condition (n = 314). Sigue la Huella was based on the social ecological model and self-determination theory. MVPA was measured for 7 days on 4 occasions using accelerometers. Data were analyzed with individual growth curve models.ResultsThere was a significant difference in linear growth rate of daily MVPA between the experimental and the control group, independent of study wave, type of school (public vs. private), grade level and gender (p < 0.001). Specifically, MVPA increased in the experimental group (β = 7.02, 95% confidence interval (CI) = 1.27 to 12.78, p = 0.017) and tended to decrease in the control group (β = − 5.26, 95% CI = − 11.17 to 0.65, p < 0.081). The observed increase was larger in boys than in girls (p = 0.003).ConclusionsSigue la Huella had a positive effect on adolescents' daily MVPA over three school years. Both genders benefited from the intervention, although boys to a greater extent.     

Bidirectional association between mental health and physical activity in older adults: Whitehall II prospective cohort study

ObjectiveTo investigate longitudinal and bidirectional associations between mental health and physical activity from midlife into old age.MethodsAnalysis was based on data from 6909 participants (aged 45 to 69 in 1997/99) from the Whitehall II cohort in the UK. Latent growth curve analysis examined possible bidirectional associations between the SF-36 Mental Component Summary and weekly physical activity measured at three time-points over ten years.ResultsMental health and physical activity were associated at baseline (β = 0.17, 95% CI 0.13, 0.21) and associations persisted into old age. In the latent growth curve model, both mental health and physical activity increased and their rates of change ‘moved together’ over time (β = 0.24, 95% CI 0.11, 0.37). Relatively high baseline levels of either variable were associated with slightly slower increases in the other outcome (β = − 0.02, 95% CI − 0.03, − 0.01; β = − 0.07, 95% CI − 0.11, − 0.13), which are thought to reflect regression to the mean. However, those who started high on either variable remained the most advantaged at end of follow-up.ConclusionsFrom midlife to old age, greater physical activity is associated with better mental health and vice versa. These findings suggest persistent longitudinal and bidirectional associations between physical activity and mental health.     

Weight and health-related quality of life: The moderating role of weight discrimination and internalized weight bias

ObjectivesObesity is an increasingly prevalent public health concern, with associated medical comorbidities and impairment in health-related quality of life (HRQoL). Obese women are frequently victims of weight-related discrimination. The HRQoL impairments among obese people could be related to this discrimination and to internalized weight bias.DesignWe examined the potential moderating role of discrimination (from others) and self-directed (internalized) weight-based discrimination in the association between body mass index (BMI) and HRQoL.MethodsEighty-one women (mean age = 41.1 years; mean BMI = 43.40 kg/m², 97% Caucasian) completed valid and reliable measures of weight bias internalization (weight bias internalization scale), perceived discrimination by others (everyday discrimination scale) and both physical and mental HRQoL (SF-36 Health Survey). Multiple regression analysis was used to test whether internalized weight bias or discrimination moderated the association between BMI and the summary scores for physical and mental HRQoL, controlling for age.ResultsSignificant associations were found between BMI and discrimination (r = .36, p = .002), between internalized weight bias and both mental (r = .61, p < .001) and physical HRQoL (r = .45, p < .001), and between discrimination and physical HRQoL (r = .29, p = .014). A statistically significant interaction was found between BMI and internalized weight bias (b = − .21, SE = .10, p < 0.05) in accounting for the variance in physical HRQoL.ConclusionsThe association between higher BMI and poorer physical HRQoL was found only in individuals reporting high levels of internalized weight bias. Self-discrimination among overweight individuals may be a critical factor in their physical health impairment.     

Accelerometer determined sedentary behavior and dietary quality among US adults

ObjectiveScant evidence exists pertaining to objectively measured sedentary time and dietary quality among adults. Therefore, we examined the relationships between sedentary time, physical activity, and dietary quality.MethodsCross-sectional analyses of a 4,910 US adults from two cycles (2003–2006) of the National Health and Nutrition Examination Survey. The primary independent variables were sedentary time and physical activity (continuous and categorical), while the outcomes were overall dietary quality (Healthy Eating Index (HEI) 2010), fruit and vegetable scores, and empty caloric intake (kcal).ResultsMultivariable analyses revealed that a 1 min increase in daily sedentary behavior was associated with a 0.2 kcal decrease in empty calories (− 0.18, 95% CI = − 0.34, − 0.03); however, sedentary time was not significantly related to overall dietary quality (HEI) and fruit and vegetable intake. In comparison, a 1 min increase in daily moderate-to-vigorous intensity physical activity was related to a 0.1 higher HEI score (0.08, 95% CI = 0.04, 0.11), a 0.01 higher fruit score (0.01, 95% CI = 0.01, 0.02), and conversely a 1.3 kcal decrease in empty calories (− 1.35, 95% CI = − 2.01, − 0.69). In addition, meeting physical activity guidelines was associated with a 2.8 point higher HEI score (2.82, 95% CI = 1.40, 4.25), a 0.5 point higher fruit score (0.51, 95% CI = 0.31–0.71), and 37.4 fewer empty calories (− 37.43, 95% CI = − 64.86, − 9.10).ConclusionsPhysical activity is significantly related to better overall dietary quality, while sedentary behavior is not. Findings suggest the need to promote physical activity and encourage adherence to dietary guidelines jointly, whereas sedentary behavior and overall dietary quality might need to be targeted independently.     

Evaluation of pneumococcal urinary antigen testing for respiratory tract infection investigations

ObjectiveThe pneumococcal urinary antigen test enables rapid bacteriological diagnosis in respiratory tract infections. The objective was to identify factors associated with a positive pneumococcal urinary antigen test result.Patients and methodsThis seven-year retrospective monocentric study was performed on consecutive patients presenting with respiratory tract infections reported as pneumococcal-positive. Epidemiological, biological, and radiological factors were analyzed, and severity scores were calculated.ResultsA total of 223 patients were included. Significant associations were observed between positive test results and age over 65 years (P = 0.01), positive test results and immunosuppression factors (blood disease [25% Ag+ group vs. 4% Ag− group, P = 0.001], immunosuppressive therapy [10% Ag+ group vs. 0% Ag− group, P = 0.02]). Clinically, fever (64% Ag+ group vs. 42% Ag− group, P = 0.01) and cough (46% Ag+ group vs. 19% Ag− group, P < 0.01) were associated with a positive result, as were radiological alveolar opacities (67% Ag+ group vs. 44% Ag− group, P = 0.01). High PSI score was associated with the Ag+ group (79% vs. 56% Ag− group, P = 0.001).ConclusionAge, immunosuppressive factors, typical pneumococcal symptoms, and PSI scores were associated with a positive pneumococcal urinary antigen result.     

C-reactive protein levels in the early stage of COVID-19

BackgroundCOVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity.ObjectiveWe aimed to assess the usefulness of CRP levels in the early stage of COVID-19 and to correlate them with lung lesions and severe presentation.MethodsConfirmed cases of COVID-19 were selected at the Fever Unit in two regions of Guizhou, China. On admission CRP levels were collected, and the diameter of the largest lung lesion was measured in the most severe lung lesion by lung CT scan. Differences in the diameter and CRP levels were compared in the following groups of patients: mild group, moderate group, severe group, and critical group.ResultCRP levels and the diameter of the largest lung lesion in the moderate group were higher than those in the mild group (Mann-Whitney test = −2.647, −2.171, P ˂ 0.05), those in the severe group were higher than those in the moderate group (Mann-Whitney test = 0.693, −2.177, P ˂ 0.05), and those in the critical group were higher than those in the severe group (Mann-Whitney test = −0.068, −1.549, P ˂ 0.05). The difference was statistically significant. CRP levels were positively correlated with the diameter of lung lesion and severe presentation (correlation coefficient = 0.873, 0.734, P ˂ 0.001).ConclusionIn the early stage of COVID-19 CRP levels were positively correlated with lung lesions and could reflect disease severity.     

Barreras percibidas en el desplazamiento activo al centro educativo: fiabilidad y validez de una escala

ObjectiveTo examine the reliability and validity of a scale to measure perceived barriers to active commuting to school among Spanish young people.MethodThe validity of the scale was assessed in a sample of 465 adolescents (14–18 years) using a confirmatory factor analysis and studying its association with self-reported active commuting to school. The reliability of the instrument was evaluated in a sub-sample that completed the scale twice separated by a one-week interval.ResultsThe results showed that the barriers scale had satisfactory fit indices, and two factors were determined. The first included environment- and safety-related items (α = 0.72), while the other concerned planning and psychosocial items (α = 0.64). Active commuting to school showed significant correlations with the total score of the barriers scale (rho = −0.27; p <0.001), with the environmental/safety barriers (rho = −0.22; p <0.001), as well as with the planning/psychosocial barriers (rho = −0.29; p <0.001). Test-retest ICCs for the barriers ranged from 0.68 to 0.77.ConclusionThe developed scale has acceptable validity and good reliability to assess barriers to active commuting to school among Spanish young people.     

The ‘Healthy Dads,Healthy Kids’ community randomized controlled trial: A community-based healthy lifestyle program for fathers and their children

ObjectiveTo evaluate the effectiveness of the ‘Healthy Dads, Healthy Kids (HDHK)’ program when delivered by trained facilitators in community settings.MethodA two-arm randomized controlled trial of 93 overweight/obese fathers (mean [SD] age = 40.3 [5.3] years; BMI = 32.5 [3.8] kg/m²) and their primary school-aged children (n = 132) from the Hunter Region, Australia. In 2010–2011, families were randomized to either: (i) HDHK intervention (n = 48 fathers, n = 72 children) or (ii) wait-list control group. The 7-week intervention included seven sessions and resources (booklets, pedometers). Assessments were held at baseline and 14-weeks with fathers' weight (kg) as the primary outcome. Secondary outcomes for fathers and children included waist, BMI, blood pressure, resting heart rate, physical activity (pedometry), and self-reported dietary intake and sedentary behaviors.ResultsLinear mixed models (intention-to-treat) revealed significant between-group differences for fathers' weight (P < .001, d = 0.24), with HDHK fathers losing more weight (− 3.3 kg; 95%CI, − 4.3, − 2.4) than control fathers (0.1 kg; 95%CI, − 0.9,1.0). Significant treatment effects (P < .05) were also found for fathers' waist (d = 0.41), BMI (d = 0.26), resting heart rate (d = 0.59), energy intake (d = 0.49) and physical activity (d = 0.46) and for children's physical activity (d = 0.50) and adiposity (d = 0.07).DiscussionHDHK significantly improved health outcomes and behaviors in fathers and children, providing evidence for program effectiveness when delivered in a community setting.     

Investigating links between moderate-to-vigorous physical activity and cognitive performance in elementary school students

BackgroundResearch has noted both physical and psychological benefits when children participate in physical activity. Recent studies indicate there may also be academic benefits and students may be more efficient learners after physical activity. This study investigated the influence of moderate-to-vigorous physical activity (MVPA) on four cognitive processes: planning, attention, simultaneous processing, and successive processing.MethodsParticipants were two classes of fourth-grade students in Ontario (n = 40). Using a counterbalanced design, students in the two classes completed standardized tests for each cognitive process both after no physical activity and following it (20 min MVPA within a 45 min lesson).ResultsThe results indicate that performance on the planning test significantly improved after physical activity (p < 0.001), controlling for sequence and habituation/retesting effects. No improvement was observed for attention, simultaneous processing, or successive processing.ConclusionPlanning is associated with problem solving skills and behaviour self-regulation. These skills may be improved in elementary school students immediately following physical activity.     

Comparative immunogenicity of hepatitis B vaccine with different dosages and schedules in healthy young adults in China

ObjectivesTo compare immunogenicity of hepatitis B vaccine between the standard 3-dose (20 μg) and 2-dose with higher-dosage (60 μg) regimens in healthy young adults and evaluate the safety profile.MethodsA randomized, parallel-group clinical trial was conducted among healthy young adults aged 18−25 years. Subjects were randomly assigned to three groups. One group was administered hepatitis B vaccine with the standard regimen of 0−1−6 month (20 μg) and other groups were immunized with regimens of 0−1 or 0−2 month (60 μg) respectively. Serum samples were collected at 1 month after a series vaccination and 12 months after the first-dose inoculation for anti-HBs antibody measurement with a Chemiluminescent Microparticle ImmunoAssay (CMIA).ResultsThe seroprotection rates in 20 μg (0−1−6 month), 60 μg (0−1 month) and 60 μg (0−2 month) groups were 100, 93.64 and 99.19% at month 7/2/3, and 100, 96.04 and 95.90% at month 12, respectively. There were no significant differences among three vaccine groups (p > 0.05). The geometric mean concentration (GMC) of anti-HBs was significantly higher in 20 μg (0−1−6 month) group than that in 60 μg (0−1 month) group at month 7/2 (1847.99 vs. 839.27 mIU/ml, p = 0.004), but was similar to that in 60 μg (0−2 month) group at month 7/3 (1847.99 vs. 1244.80 mIU/ml, p = 0.138). At month 12, the GMC in 20 μg (0−1−6 month) group was significantly higher than those of other groups (1456.63 vs. 256.30, 235.15 mIU/ml, respectively, p < 0.001). The total incidence of injection-site or systemic adverse reactions was <3%.ConclusionsA 2-dose with higher-dosage hepatitis B vaccine regimens are comparable to the standard 3-dose regimen in terms of immunogenicity except a relatively rapid decline in GMC levels which are associated with the longevity of protection. All formulations of hepatitis B vaccine were well tolerated.Clinicaltrials.gov identifierNCT02203357.     

Effects of clustering of multiple lifestyle-related behaviors on blood pressure in adolescents from two observational studies

BackgroudSeveral lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents.MethodsParticipants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pécs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringá/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed.ResultsThe Healthy Eating cluster was negatively associated with DBP in European girls, β = − 2.46 (− 4.62; − 0.30), and with SBP in Brazilian boys, β = − 2.79 (− 3.10; − 0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, β = 4.54 (1.29; 7.79), and in Brazilian boys, β = 4.10 (0.80; 7.40).ConclusionThe Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents.     

Insufficient sleep among elementary and middle school students is linked with elevated soda consumption and other unhealthy dietary behaviors

ObjectiveThis study examines the extent to which insufficient sleep is associated with diet quality in students taking part in the Massachusetts Childhood Obesity Research Demonstration Project.MethodsData were collected in Fall 2012 for all 4th and 7th grade children enrolled in public schools in two Massachusetts communities. During annual body mass index (BMI) screening, students completed a survey that assessed diet, physical activity, screen time, and sleep. Of the 2456 enrolled students, 1870 (76%) had complete survey data. Generalized estimating equations were used to examine associations between sleep duration and dietary outcomes (vegetables, fruits, 100% juice, juice drinks, soda, sugar-sweetened beverages and water), accounting for clustering by school. Models were adjusted for community, grade, race/ethnicity, gender, television in the bedroom, screen time, and physical activity.ResultsIn adjusted models, students who reported sleeping < 10 hours/day consumed soda more frequently (β = 0.11, 95% CI: 0.03, 0.20) and vegetables less frequently (β = − 0.09, 95% CI: − 0.18, − 0.01) compared with students who reported ≥ 10 hours/day. No significant associations were observed between sleep duration and fruits, 100% juice, juice drinks or water.ConclusionsIn this population, insufficient sleep duration was associated with more frequent soda and less frequent vegetable consumption. Longitudinal research is needed to further examine these relationships.     

Plaguicidas organofosforados y efecto neuropsicológico y motor en la Región del Maule,Chile

ObjectiveTo evaluate organophosphate pesticide exposure and neuropsychological and motor performance in agricultural and non-agricultural workers in the Maule Region in Chile.MethodAnalytic cross-sectional study in 93 exposed farm workers and 84 unexposed non-agricultural workers. A battery of four neuropsychological tests was administered together with a neuro-motor physical examination.ResultsOn the Weschler adult intelligence scale (WAIS-IV), exposed agricultural workers exhibited poorer performance than non-agricultural workers in verbal comprehension (β = −3.2; p = 0.034) and processing speed (β = −4.4; p = 0.036) and in the full scale (β = −4; p = 0.016), as well as in discrimination sensitivity (β = 1, p = 0,009), adjusted by years of schooling and/or age.ConclusionsWe suggest the development of policies and regulations for the control, sale and use of organophosphate pesticides and intervention strategies on safety measures aimed at the exposed population.     

Results of a randomized controlled trial to promote physical activity behaviours in mothers with young children

ObjectiveIncreasing levels of physical activity in mothers have long-term health benefits for the mother and family. The study aimed to evaluate the effect of a six-month, physical activity RCT for mothers of young children.MethodsWomen were recruited via playgroups and randomly assigned to intervention (n = 394) or control group (n = 322). The intervention group received a six-month multi-strategy programme delivered via playgroups in Perth, Australia. measures were mean minutes per week of moderate (M) and vigorous (V) intensity physical activity (PA), and number of days/week of muscle strength exercises.ResultsThe intervention had a significant effect on mean time for vigorous (p = 0.008), moderate (p = 0.023) and total physical activity (p = 0.001) when compared to the control group. The intervention group increased their vigorous activity by a mean of 24 min/week, moderate activity by 23 min/week and total physical activity by 72 min/week.ConclusionsA relatively minimum home based intervention was able to demonstrate modest but statistically significant improvements in physical activity in a hard to reach group. These changes if maintained over a longer period are likely to improve the health of mothers and have a positive impact on their partners and children. Australian and New Zealand Clinical Trials Registry ACTRN12609000735257.     

Greener living environment healthier people?: Exploring green space,physical activity and health in the Doetinchem Cohort Study

BackgroundEvidence is emerging that more green space in the living environment is associated with better health, partly via the pathway of physical activity.ObjectivesWe explored the cross-sectional and longitudinal associations between green space and physical activity and several health indicators in the Doetinchem Cohort Study.MethodsA random sample of men and women aged 20–59 years at baseline was measured max 5 times with 5 year-intervals in the period 1987–2012. Data of round 3–5 were used. Measurements were based on examinations (height, weight, blood pressure) or questionnaires (physical activity, perceived health, depressive symptoms, chronic conditions). The percentage of green space (mainly urban and agricultural green) around the home address (125 m and 1 km) was calculated using satellite data.ResultsMore agricultural green was associated with less time spent on bicycling (β1 km = − 0.15, 95%CL − 0.13; − 0.04) and sports (β1 km = − 0.04, 95%CL − 0.07; − 0.01) and more time spent on gardening (β1 km = 0.16, 95%CL 0.12; 0.19) and odd jobs (β1 km = 0.10, 95%CL 0.05; 0.15), and this was in the other direction for urban green. For only a few of the many health indicators a positive association with green was found, and mainly for total green within 1 km radius. Longstanding green or a transition to more green did not show more pronounced associations with health.ConclusionsFor the green space range of the Doetinchem area the findings do not strongly support the hypothesis that the percentage of green in the living environment affects health positively. The distinction by type of green may, however, be relevant for physical activity.     

The effects of a 2-year individualized and family-based lifestyle intervention on physical activity,sedentary behavior and diet in children

ObjectiveTo investigate the effects of a long-term, individualized and family-based lifestyle intervention on physical activity, sedentary behavior and diet quality in children.MethodsWe carried out a 2-year intervention study in a population sample of 506 children aged 6–8 years in Finland in 2007–2012. We allocated the participants at baseline in the intervention and control group. We assessed physical activity and sedentary behavior by questionnaires and diet by food records.ResultsTotal physical activity (+ 9 min/d in intervention group vs. − 5 min/d in control group, p = 0.001 for time*group interaction), unsupervised physical activity (+ 7 min/d vs. − 9 min/d, p < 0.001) and organized sports (+ 8 min/d vs. + 3 min/d, p = 0.001) increased in the intervention group but not in the control group. Using computer and playing video games increased less in the intervention group than in the control group (+ 9 min/d vs. + 19 min/d, p = 0.003). Consumption of vegetables (+ 12 g/d vs. − 12 g/d, p = 0.001), high-fat vegetable-oil based margarine (+ 10 g/d vs. + 3 g/d, p < 0.001) and low-fat milk (+ 69 g/d vs. + 11 g/d, p = 0.042) and intake of dietary fiber (+ 1.3 g/d vs. + 0.2 g/d, p = 0.023), vitamin C (+ 4.5 mg/d vs. − 7.2 mg/d, p = 0.042) and vitamin E (+ 1.4 mg/d vs. + 0.5 mg/d, p = 0.002) increased in the intervention group but not in the control group. Consumption of butter-based spreads increased in the control group but not in the intervention group (+ 2 g/d vs. − 1 g/d, p = 0.002).ConclusionsIndividualized and family-based lifestyle intervention increased physical activity, attenuated increase in sedentary behavior and enhanced diet quality in children.Trial registrationClinicalTrials.gov: NCT01803776.