An evaluation of UK secondary data sources for the study of childhood obesity, physical activity and diet

Background This study assesses the potential of secondary datasets for measuring recent and future trends in childhood obesity, physical activity and diet in the UK, at national, regional and sub‐regional levels, and in relation to inequalities. Methods Relevant datasets were identified using online searches; they were excluded if they had low sample sizes, were assembled prior to 1990 or on only one occasion, were not potentially accessible, or were limited to a specific population. Remaining datasets were assessed according to content, sampling frame and size, timing and ability to be used to assess inequalities and regional trends. Results A total of 96 datasets were identified, but only 11 had the potential to be used to assess trends. Eight of these contained data on physical activity, 8 on diet and 3 on obesity. The period over which trends might be assessed varied from 2 years to over 10, with over half of the datasets expected to continue data collection into the future. Most had the potential to be used to assess inequalities and also regional and sub‐regional level trends, albeit with relatively small sample sizes. There were some limitations to the datasets, such as non‐objective measures of diet and physical activity and, in some, low response rates, which would require further consideration when utilizing individual datasets. Conclusions Awareness of the potential of secondary datasets for monitoring trends in childhood obesity should be raised, alongside the financial and intellectual capacity to enhance and exploit them.     

The influence of diet and physical activity therapy on the body's composition of medium obesity women and men

In 56 women and 15 men the efficiency of two weeks diet and physical activity therapy was evaluated. The following parameters before and after the therapy were measured: BM, BMI, LBM, WHR and the fat mass (FATkg and FAT%). The subjects were divided into four groups depending on sex: (group of men and group of women), and value of BMI (group of persons with BMI lower than 27 and group of persons with BMI higher than 27). Both, body mass, content of fat and BMI decreased in all groups after two weeks of therapy.     

Identification of contrastive and comparable school neighborhoods for childhood obesity and physical activity research

   

The neighborhood social and physical environments are considered significant factors contributing to children's inactive lifestyles, poor eating habits, and high levels of childhood obesity. Understanding of neighborhood environmental profiles is needed to facilitate community-based research and the development and implementation of community prevention and intervention programs. We sought to identify contrastive and comparable districts for childhood obesity and physical activity research studies.     

Pathways to obesity: identifying local, modifiable determinants of physical activity and diet

Many studies document small area inequalities in morbidity and mortality and show associations between area deprivation and health. However, few studies unpack the "black box" of area deprivation to show which specific local social and physical environmental characteristics impact upon health, and might be amenable to modification. We theorised a model of the potential causal pathways to obesity and employed path analysis using a rich data set from national studies in England and Scotland to test the model empirically. Significant associations between obesity and neighbourhood disorder and access to local high street facilities (local shops, financial services and health-related stores found in a typical small UK town) were found. There was a tendency for lower levels of obesity in areas with more swimming pools and supermarkets. In turn, policing levels, physical dereliction and recorded violent crime were associated with neighbourhood disorder. The analysis identifies several factors that are associated with (and are probably determinants of) obesity and which are outside the standard remit of the healthcare sector. They highlight the role that public and private sector organisations have in promoting the nation's health. Public health professionals should seek to work alongside or within these organisations to capitalise on opportunities to improve health.     

Predictors of physical activity stage of change among adults with physical disabilities

PURPOSE: To use the Transtheoretical Model (TTM) constructs to examine the most important physical activity stage of change predictors for mostly inactive adults with physical disabilities. METHODS: A cross-sectional survey completed on the Internet. One hundred fifty-one individuals with physical disabilities (50% response rate) completed the survey questionnaires. Self-report standardized measures were used. RESULTS: A direct discriminant function analysis revealed that the most important stage of change predictors were the behavioral (r2 = .88) and cognitive (r2 = .50) processes of change, followed by self-efficacy (r2 = .33) and decisional balance (r2 = .13). The most accurate stages in prediction were the contemplation (76.3%), preparation (58.3%), and precontemplation (40%) stages, whereas the least accurate stages were the action (0.0%) and maintenance (8.3%) stages. CONCLUSION: Health promoters and educators may use strategies from the TTM to develop theory-driven physical activity motivational programs for the posited populace. Considering the cross-sectional design, study replication is warranted.     

利用学校环境对肥胖儿童进行集体干预效果分析

【目的】探讨利用学校环境对儿童青少年单纯性肥胖症的防治方法。【方法】采用“12周连续膳食与运动干预法”，根据在校小学生的特点，通过实施有利于控制肥胖的学校健康促进策略，于2001年10～12月对肥胖儿童开展集体干预活动。同时，对肥胖儿童饮食和运动行为给予个体指导。【结果】参与干预活动的90名肥胖儿童中有86．67％的体重得到了有效控制，与此同时，肥胖儿童身高、臀围、腹围、肺活量、总胆固醇等生理、生化指标也发生了明显改善。【结论】利用学校环境采用连续的饮食运动的集体干预和个体指导相结合的方法是控制儿童肥胖症的有效途径。     

Reliability of moderate-intensity and vigorous physical activity stage of change measures for young adults

BACKGROUND: The purpose of this study was to examine the reliability of stage of change (SOC) measures for moderate-intensity and vigorous physical activity in two separate samples of young adults. Staging measures have focused on vigorous exercise, but current public health guidelines emphasize moderate-intensity activity. METHOD: For college students in the USA (n=105) and in Australia (n=123), SOC was assessed separately on two occasions for moderate-intensity activity and for vigorous activity. Test-retest repeatability was determined, using Cohen's kappa coefficient. RESULTS: In both samples, the reliability scores for the moderate-intensity physical activity staging measure were lower than the scores for the vigorous exercise staging measure. Weighted kappa values for the moderate-intensity staging measure were in the "fair to good" range for both studies (0.50 and 0.45); for the vigorous staging measure kappa values were "excellent" and "fair to good" (0.76 and 0.72). CONCLUSIONS: There is a need to standardize and improve methods for staging moderate-intensity activity, given that such measures are used in public health interventions targeting HEPA (health-enhancing physical activity).     

Parents' perceptions of neighborhood safety and children's physical activity

OBJECTIVE: The obesity epidemic disproportionately affects minority and poor children. Negative perceptions of neighborhood safety in poor communities may affect overweight by inhibiting children's physical activity. This study investigates the degree to which parents in a poor inner city vs. a middle-class suburban community limit their children's outdoor activity because of neighborhood safety concerns. METHOD: Parents of children aged 5-10 years from an inner city family practice in a poor community and from a suburban pediatric practice in a middle-class community completed a 20-item questionnaire. Parents estimated the amount of their child's activity in various situations and indicated their level of anxiety concerning gangs, child aggression, crime, traffic, and personal safety in their neighborhood. RESULTS: Inner city children (n = 204) engaged in less physical activity than suburban children (N = 103) (P < 0.001). Inner city parents expressed much greater anxiety about neighborhood safety than suburban parents (P < 0.0001). In the inner city population, children's physical activity levels were negatively correlated with parental anxiety about neighborhood safety (r = -0.18, P < 0.05). CONCLUSIONS: Inner city parents have high levels of anxiety about neighborhood safety. While these concerns may not entirely explain the discrepancy in activity levels between inner city and suburban children, a safe environment is crucial to increasing opportunities for physical activity.     

Relative influence of diet and physical activity on body composition in urban Chinese adults

BACKGROUND: The relative influence of diet and physical activity on body fatness remains uncertain. OBJECTIVE: The objective of the study was to investigate associations of dietary variables and physical activity with body fatness in urban Chinese adults. DESIGN: We conducted a cross-sectional study in 130 weight-stable men and women aged 35-49 y. Subjects were selected from upper and lower tertiles of dietary fat and physical activity on the basis of screening questionnaires. Dietary intake was assessed by weighed food intake, physical activity level (PAL) was calculated as the ratio of predicted total energy expenditure (TEE) to predicted resting energy expenditure, and body composition was measured with the use of (2)H(2)O. Reported energy intake and predicted TEE were validated against TEE determined with the use of (2)H(2)(18)O (n = 73). RESULTS: Body fatness was positively associated with dietary variety (ie, variety of ingredients) (partial r = 0.186, P = 0.039) and frequency of consuming restaurant foods (partial r = 0.237, P = 0.001) and negatively associated with PAL (partial r = -0.307, P = 0.001) in a multiple regression analysis that controlled for sex and confounders. The combined variance accounted for by dietary variety and restaurant food consumption (9.1%) was equivalent to that for PAL (9.4%). Neither dietary fat nor energy density predicted body fatness, but dietary energy density predicted within-subject day-to-day variation in reported energy intake (P < 0.001). CONCLUSIONS: Dietary variety, frequency of restaurant food consumption, and PAL significantly predicted body fatness in urban Chinese adults, but dietary fat did not. These findings support previous studies in US adults and suggest that dietary variables other than fat have an important influence on adult body composition.     

Self-determination and stage of readiness to change physical activity behaviour in schizophrenia

PurposeThe present study examined whether reasons for physical activity, as formulated by the self-determination theory, differed across the stages identified by the transtheoretical model of behaviour change.MethodsA total of 129 persons with schizophrenia completed the Behavioural Regulation in Exercise Questionnaire-2 and the Patient-centred Assessment and Counselling for Exercise questionnaire. Multivariate and discriminant analyses were applied to determine whether reasons for physical activity differed between men and women and across the stages of change.ResultsDiscriminant analyses indicated that persons with schizophrenia at the early stages of change are less autonomous in the regulation of their physical activity behaviour than those at the later stages. Multivariate analyses showed a difference in amotivation, external regulation, and autonomous regulation, but not introjected regulation across the different stages of change.ConclusionsOur results suggest that autonomous motivation may have an important role to play in the adoption and maintenance of health promoting behaviours in persons with schizophrenia.     

Physical activity and childhood obesity.

The most variable component of energy expenditure is activity. Fidgeting, an undetectable type of low-grade activity, may account for more expenditure than once thought. Television viewing, which is considered a major source of inactivity, and parents' activity patterns are both directly related to childhood obesity. Physical activity, preferably routine or life-style activities, used in the context of a mixed program involving diet can have a significant impact on childhood obesity.     

Depression severity, diet quality, and physical activity in women with obesity and depression

Major depressive disorder (MDD) is prevalent in clinical weight-loss settings and predicts poor weight-loss outcomes. It is unknown whether the severity of depressive symptoms among those with MDD is associated with diet quality or physical activity levels. This knowledge is important for improving weight-loss treatment for these patients. It was hypothesized that more severe depression is associated with poorer diet quality and lower physical activity levels among individuals with obesity and MDD. Participants were 161 women with current MDD and obesity enrolled in the baseline phase of a weight-loss trial between 2007 and 2010. Depression severity was measured with the Beck Depression Inventory II. The Alternate Healthy Eating Index was applied to data from three 24-hour diet recalls to capture overall diet quality. Daily metabolic equivalents expended per day were calculated from three 24-hour physical activity recalls. Greater depression severity was associated with poorer overall diet quality (estimate=-0.26, standard error 0.11; P=0.02), but not with physical activity (estimate=0.07, standard error 0.05; P=0.18), in linear regression models controlling for income, education, depression-related appetite change, binge eating disorder, and other potential confounds. Associations with diet quality were primarily driven by greater intake of sugar (r=0.20; P<0.01), saturated fat (r=0.21; P<0.01), and sodium (r=0.22; P<0.01). More severe depression was associated with poorer overall diet quality, but not physical activity, among treatment-seeking women with MDD and obesity. Future studies should identify mechanisms linking depression to diet quality and determine whether diet quality improves with depression treatment.     

The relationship of stage of change for smoking cessation to stage of change for fruit and vegetable consumption and physical activity in a health plan population

PURPOSE: The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. DESIGN: The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). SETTING: This study was conducted at a mixed-model health plan with approximately 1 million adult members. SUBJECTS: Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. MEASURES: The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. RESULTS: Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (chi2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (chi2 = 89. 7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. CONCLUSIONS: This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.     

Parents' beliefs about appropriate infant size,growth and feeding behaviour: implications for the prevention of childhood obesity

Background  

A number of risk factors are associated with the development of childhood obesity which can be identified during infancy. These include infant feeding practices, parental response to infant temperament and parental perception of infant growth and appetite. Parental beliefs and understanding are crucial determinants of infant feeding behaviour; therefore any intervention would need to take account of their views. This study aimed to explore UK parents' beliefs concerning their infant's size, growth and feeding behaviour and parental receptiveness to early intervention aimed at reducing the risk of childhood obesity.     

Influence of home/school environments on children's obesity,diet, and physical activity: the SUECO study protocol

ObjectiveThe SUECO study examines the relationship between urban obesogenic environments and health outcomes among school-age children in the city of Madrid, Spain. We will study how features of the urban environment (related to the food- and the physical activity environment) associate with children's anthropometrics, eating habits, and physical activity levels.MethodWe describe the study protocol of this multilevel study in a representative sample of school-age children in the city of Madrid (2017; n = 5,961 children ages 3-12). Main outcome variables include anthropometrics (body mass index, waist circumference, and body fat), healthy and unhealthy consumption measures, and physical activity measures. The primary explanatory variables are grouped into food environment (e.g., unhealthy food retailers’ density) and physical activity environment (e.g., walkability, physical activity opportunities) variable categories. Multilevel models will be used to calculate the associations between each indicator and obesity and physical inactivity.