The association of circulating endocannabinoids with appetite regulatory substances in obese women

BackgroundsEndocannabinoids especially anadamide (AEA) and 2‑arachidonoylglycerol (2-AG) together with appetite modulators have recently been of great importance in body weight regulation and obesity incidence. The present study was carried out to investigate AEA and 2-AG levels and their association with leptin, insulin, orexin – A, and anthropometric indices in obese women.MethodsThe demographic and anthropometric data of 180 overweight/ obese women with mean age 34.2 ± 8.27 years old, and mean BMI 32.54 ± 3.73 kg/m² were evaluated. The plasma levels of anadamide and 2‑arachidonoylglycerol levels and also serum levels of leptin, insulin and orexin- A concentrations were measured. Pearson and spearmen correlation tests along with hieratical regression test were used to assess the association of endocannabinoids levels with anthropometric indices and appetite modulators.ResultsSignificant correlations were revealed between AEA and 2-AG with leptin, BMI, waist circumference (WC) and body fat percent (BF%) (P < 0.001). 2-AG levels correlated positively with mean insulin levels (P < 0.001). Neither AEA nor 2-AG correlated significantly with serum orexin - A levels. Leptin, insulin, BMI, WC, and BF% were significant independent predictors of AEA and 2-AG in the hierarchical regression model (P < .001) and explained 65% and 68% of variance in AEA and 2-AG respectively (P < 0.001).ConclusionThe findings showed that levels of AEA and 2-AG were associated with BMI, WC, BF%, and leptin and insulin levels. Also, BMI, WC, BF%, leptin and, insulin levels can have predictive value for determining AEA and 2-AG.     

Sex differences in the association between dietary restraint,insulin resistance and obesity

Background & aimsRestrained food consumption may alter metabolic function and contribute to eventual weight gain; however, sex differences in these relationships have not been assessed. The objective of this study was to examine the relationship between restrained eating and insulin resistance and the influence of body mass index and sex on this relationship in a large community sample of both men and women. We hypothesized that restrained eating would be related to insulin resistance and this relationship would be influenced by sex and body mass index.MethodsIn this cross-sectional, observational study, we studied 487 individuals from the community (men N = 222, women N = 265), who ranged from lean (body mass index 18.5–24.9 kg/m², N = 173), overweight (body mass index 25–29.9 kg/m², N = 159) to obese (body mass index > 30 kg/m², N = 155) weight categories. We assessed restrained eating using the Dutch Eating Behavior Questionnaire and obtained fasting morning plasma insulin and glucose on all subjects.ResultsIn men, but not in women, restrained eating was related to homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.0001). Furthermore, HOMA-IR was significantly higher in men who were high- versus low-restrained eaters (p = 0.0006).ConclusionsThis study is the first to report sex differences with regard to the relationship between restrained eating and insulin resistance. Our results suggest that high restrained eating is associated with insulin resistance in men but not in women.     

Objectively measured sedentary time and associations with insulin sensitivity: Importance of reallocating sedentary time to physical activity

ObjectiveThe aim of this study is to quantify associations between objectively measured sedentary time and markers of insulin sensitivity by considering allocation into light-intensity physical activity or moderate- to vigorous-intensity physical activity (MVPA).MethodsParticipants with an increased risk of impaired glucose regulation (IGR) were recruited (Leicestershire, United Kingdom, 2010–2011). Sedentary, light-intensity physical activity and MVPA time were measured using accelerometers. Fasting and 2-hour post-challenge insulin and glucose were assessed; insulin sensitivity was calculated by HOMA-IS and Matsuda-ISI. Isotemporal substitution regression models were used. Data were analysed in 2014.Results508 participants were included (average age = 65 years, female = 34%). Reallocating 30 min of sedentary time into light-intensity physical activity was associated a 5% (95% CI 1, 9%; p = 0.024) difference in Matsuda-ISI after adjustment for measured confounding variables. Reallocation into MVPA was associated with a 15% (7, 25%; p < 0.001) difference in HOMA-IS and 18% (8, 28%; p < 0.001) difference in Matsuda-ISI. Results for light-intensity physical activity were modified by IGR status with stronger associations seen in those with IGR.ConclusionsReallocating sedentary time into light-intensity physical activity or MVPA was associated with differences in insulin sensitivity, with stronger and more consistent associations seen for MVPA.     

Daily movement patterns and biological markers among adults in the United States

ObjectiveTo examine the combined effects of sedentary (SED), light (LPA) and moderate-to-vigorous physical activity (MVPA) on biological markers among a nationally representative sample of U.S. adults.MethodsData from the 2003–2006 NHANES study was used, with 5580 adults (≥ 20 years) included in the study. Participants wore an ActiGraph 7164 accelerometer with accelerometry data used to create four movement pattern groups: ≥ 150 min/week of MVPA and LPA ≥ SED; ≥ 150 min/week of MVPA and LPA < SED; < 150 min/week of MVPA but LPA ≥ SED; and < 150 min/week of MVPA and LPA < SED. Blood samples were taken to assess various biological parameters (e.g., cholesterol).Results47.2% (SE: 1.2) of Americans engaged in < 150 min/week of MVPA and had a negative LPA–SED balance. In general, participants who engaged in ≥ 150 min/week of MVPA, regardless of LPA–SED balance, had more favorable biological levels; however, there was evidence showing that even if individuals engaged in < 150 min/week of MVPA, but if their LPA exceeded SED, they had more favorable levels of triglycerides and insulin.ConclusionsPrograms are needed to increase American's engagement in MVPA, and also ensure that LPA exceeds SED behavior.     

Spatial analysis of crime incidence and adolescent physical activity

ObjectivesAdolescents do not achieve recommended levels of physical activity. Crime is believed to be a barrier to physical activity among youth, but findings are inconsistent. This study compares the spatial distribution of crime incidences and moderate-to-vigorous physical activity (MVPA) among adolescents in Massachusetts between 2011 and 2012, and examines the correlation between crime and MVPA.MethodsEighty adolescents provided objective physical activity (accelerometer) and location (Global Positioning Systems) data. Crime report data were obtained from the city police department. Data were mapped using geographic information systems, and crime and MVPA densities were calculated using kernel density estimations. Spearman's correlation tested for associations between crime and MVPA.ResultsOverall, 1694 reported crimes and 16,702 min of MVPA were included in analyses. A strong positive correlation was present between crime and adolescent MVPA (ρ = 0.72, p < 0.0001). Crime remained positively associated with MVPA in locations falling within the lowest quartile (ρ = 0.43, p < 0.0001) and highest quartile (ρ = 0.32, p < 0.0001) of crime density.ConclusionsThis study found a strong positive association between crime and adolescent MVPA, despite research suggesting the opposite relationship. This counterintuitive finding may be explained by the logic of a common destination: neighborhood spaces which are desirable destinations and promote physical activity may likewise attract crime.     

Physical activity mediates the relationship between perceived crime safety and obesity

ObjectiveThe current cross-sectional study tests whether low perceived crime safety is associated with body mass index (BMI) and obesity risk and whether less moderate-to-vigorous physical activity (MVPA) accounts for part of this relationship.MethodAdults (n = 864) from a relatively low-income and ethnically mixed neighborhood in Salt Lake City UT (2012) were assessed for perceived crime safety, objective physical activity, and BMI measures.ResultsThis neighborhood had lower perceived safety than for other published studies utilizing this safety measure. In a mediation test, lower perceived crime safety was significantly associated with higher BMI and greater risk of obesity, net of control variables. Residents with lower perceived safety had less MVPA. Lower MVPA partially explained the relationship between less safety and both elevated BMI and higher obesity risk, suggesting that perceiving less crime safety limits MVPA which, in turn, increases weight.ConclusionIn this neighborhood, with relatively low perceived safety from crime, residents' low perceived safety is related to more obesity and higher BMI; lower MVPA among residents explained part of this relationship. If residents are to become more active in their neighborhood it may be important to address perceived crime safety as part of broader efforts to enhance active living.     

Effects of aerobic,resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis

ObjectiveTo assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese.Data SearchesMEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS.Study SelectionRandomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight.Data Extraction and analysisTwo independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model.ResultsOf 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (− 3.37 μU/ml; CI 95%, − 5.16 μU/ml to − 1.57 μU/ml; I², 54%, p = 0.003) and HOMA (− 0.61; CI 95%, − 1.19 to − 0.02; I², 49%, p = 0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (− 4.52 μU/ml; CI 95%, − 7.40 to − 1.65; I², 65%, p = 0.002) and in HOMA (− 1.33; 95% confidence interval, − 2.47 to − 0.18; I², 73%, p = 0.005).ConclusionsExercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.     

Dose–response association of physical activity with HbA1c: Intensity and bout length

ObjectiveThe aims of this study were to characterize the dose–response relationship between moderate-to-vigorous intensity physical activity (MVPA), and light-intensity activity with HbA1c in adults at low, moderate, and high risks of type 2 diabetes, and to compare the relationship of short (1 to 9 min) versus long (10 + min) bouts of MVPA with HbA1c.MethodsData from 2707 participants from the 2003–2006 National Health And Nutrition Examination Survey were analyzed in 2014–2015. Type 2 diabetes risk was classified into three groups based upon age (< 40 years; ≥ 40 years) and BMI (< 30; ≥ 30). The relationship between HbA1c and accelerometer-based physical activity variables was assessed using multiple regression models.ResultsThere was a curvilinear dose–response relationship between HbA1c with total activity and MVPA in adults at moderate or high risk for type 2 diabetes: higher amounts of physical activity were associated with lower HbA1c. The association of physical activity on HbA1c was stronger at lower levels of physical activity. There was no dose–response relationship in adults at low risk for type 2 diabetes. The relationship between short bouts with HbA1c was stronger than for bouts ≥ 10 min.ConclusionsIn adults at risk for type 2 diabetes, there is a dose–response relationship between physical activity and HbA1c levels such that the relationship: (1) is curvilinear; (2) is stronger when a higher percent of total activity comes from MVPA; and (3) is more potent with short bouts of MVPA. Fractionalized physical activity of at least moderate-intensity may contribute to long-term glucose control.     

Moderate alcohol intake is associated with decreased risk of insulin resistance among individuals with vitamin D insufficiency

ObjectiveTo determine whether moderate alcohol intake modifies the association between low vitamin D levels and insulin resistance (IR), we hypothesized that moderate alcohol intake would have a modifying effect on IR in people with low vitamin D levels.MethodsThis was a cross-sectional analysis of subjects ≥20 y old without a history of diabetes, coronary heart disease, or stroke in the National Health and Nutrition Examination Survey 2001–2004. Main outcome was IR status measured by homeostasis model assessment for IR (HOMA-IR; ≥ 2.6) and fasting insulin (>12.2 μU/mL) in moderate drinkers compared with non-drinkers by vitamin D levels (deficient ≤20 ng/mL, insufficient 21–32 ng/mL, normal >32 ng/mL).ResultsTwo thousand seven hundred twenty-one subjects met the inclusion criteria, representing a weighted total of >138 million people. Of these, 34% were vitamin D deficient and 47% insufficient. In adjusted analysis, compared with moderate drinkers with normal vitamin D levels, non-drinkers had no increased risk of IR by HOMA-IR levels (odds ratio [OR] 1.18, 95% confidence interval [CI] 0.61–2.30). Vitamin D–deficient individuals had a higher risk of IR regardless of alcohol consumption (moderate drinkers OR 2.12, 95% CI 1.41–3.19; non-drinkers OR 2.22, 95% CI 1.29–3.83). However, in those with insufficient vitamin D levels, moderate alcohol intake had a modifying effect on the odds of IR, with no difference seen in moderate drinkers (OR 1.29, 95% CI 0.92–1.80) and an increased risk found in non-drinkers (OR 1.82, 95% CI 1.07–3.11). Similar results were seen with fasting insulin.ConclusionModerate alcohol consumption appears to have a modifying effect on the risk of IR in individuals with insufficient levels of vitamin D.     

Incidence and potential risk factors of obesity among Tehranian adults

AimEvaluating the incidence of obesity and its risk factors among Tehranian adults.Material & methodsIn this population-based cohort, non-obese participants, aged ≥ 20 years, were followed for development of obesity (Body Mass Index (BMI) ≥ 30). Incidence density and cumulative incidence rates of obesity were calculated for each sex. Cox proportional hazard regression was used to determine the association of potential obesity risk factors including: age, BMI, metabolic syndrome, waist circumference (WC), smoking, marital status, education, and physical activity.ResultA total of 7257 participants (3536 men) were followed for a median of 8 years. At baseline, mean age, BMI and WC were 41.3 ± 14.6 years, 25.1 ± 2.9 kg/m² (24.9 ± 3 kg/m² men and 25.2 ± 3 kg/m² women), and 84.8 ± 9.8 cm (87.06 ± 9.2 cm men and 82.6 ± 9.9 cm women) respectively. During the follow-up, 1345 participants (876 women) developed obesity contributing to cumulative incidences of 31.3% (CI: 29.9%–32.7%), 38.1% (CI: 36.2%–40.1%), and 23.4% (CI: 21.6%–25.3%) for the whole population, women, and men, respectively. Corresponding incidence density rates per 1000 person-year were 25.9 (CI: 24.5–27.3), 33.67 (CI: 31.5–36.0), and 18.0 (CI: 16.5–19.7), respectively. Highest incidence rates were observed during their 40s and 20s for women and men, respectively. Participants with metabolic syndrome, lower educational level, higher BMI and WC, were at higher risk of obesity development in both sexes.ConclusionHigh incidence of obesity was observed among Tehranian adults with higher incidence of obesity in women. Different modifiable variables may act as risk factors for obesity development which should be targeted to control the epidemic of obesity.     

Vulnerabilidad de la obesidad definida por el índice de masa corporal,perímetro abdominal y porcentaje de grasa corporal

AimTo ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]).DesignLongitudinal observational and retrospective study.SiteEleven Spanish health centers.ParticipantsMen and women with BMI ≥ 30 kg/m² (n = 1246) or general obesity (GO), with WC > 102 cm and > 88 cm, respectively (n = 2122) or abdominal obesity (AO) and with BFP > 25% and > 35%, respectively (n = 2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80 years.Main measurementsData from the PEPAF study at baseline and at 6, 12 and 24 months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women).ResultsOf 2054 participants with any type of obesity at baseline and valid data at 2 years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95% CI: 17.6-21.4) ceased to have EBF, 12.0% (95% CI: 10.4-13.7) ceased to have AO and 10.5% (95% CI: 8.5-12.7) ceased to have GO.ConclusionsObesity differs from other chronic diseases in that it can be «cured» by normalizing the amount of body fat.     

Patterns of sedentary time and cardiometabolic risk among Canadian adults

ObjectiveThe aim of this study is to examine the associations of total sedentary time and patterns of sedentary time with cardiometabolic biomarkers in a large representative sample of Canadian adults.MethodsThe study is based on 4935 adults aged 20–79 years, from the 2007/09 and 2009/11 Canadian Health Measures Survey. Total sedentary time, patterns of sedentary time (≥ 20 minute prolonged sedentary bouts, number of sedentary breaks), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Waist circumference, systolic and diastolic blood pressure, high-density lipoprotein (HDL) cholesterol, and C-reactive protein were measured. Triglycerides, low-density lipoprotein (LDL) cholesterol, insulin, and glucose were also measured in a fasting sub-sample (n = 2551).ResultsTotal sedentary time and time in ≥ 20 minute prolonged sedentary bouts were associated with higher insulin and lower diastolic blood pressure levels (P < 0.05). On average, each additional 10 breaks/day was associated with 0.83 (95%CI: 1.35, 0.31) cm lower waist circumference, 0.32 (0.62, 0.02) mm Hg lower systolic blood pressure, 0.01 (0.00, 0.02) mmol/l higher HDL-cholesterol, 3.72 (1.34, 6.13) % lower triglycerides, 0.57 (0.23, 0.92) % lower glucose, and 4.19 (1.80, 6.63) % lower insulin.ConclusionThese findings in a large representative sample of Canadian adults indicate that breaking up sedentary time may be particularly important for cardiometabolic health.     

Joint effects of objectively-measured sedentary time and physical activity on all-cause mortality

ObjectiveExamine the joint effects of objectively-measured sedentary time and moderate-to-vigorous physical activity (MVPA) on all-cause mortality.MethodsThe present study included data from the 2003–2006 National Health & Nutrition Examination Survey, with mortality follow-up data (via National Death Index) through 2011 (N = 5575 U.S. adults). Sedentary time (activity counts/min between 0 and 99) and MVPA (activity counts/min ≥ 2020) were objectively measured using the ActiGraph 7164 accelerometer.ResultsThe median age of the participants was 50 yrs; proportion of men was 50.2%; proportion of whites was 53.8%, 18.7% for blacks; median follow-up was 81 months; and 511 deaths occurred over the follow-up period. After adjusting for age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein and comorbid illness (summed score of 0–8 chronic diseases), and for a 1 min increase in MVPA and sedentary time, both MVPA (HR_adjusted = 0.98; 95% CI: 0.96–0.99; P = 0.04) and sedentary time (HR_adjusted = 1.001; 95% CI: 1.0003–1.002; P = 0.008) were independently associated with all-cause mortality. Further, MVPA was associated with all-cause mortality among those with greater (above median) sedentary time (HR_adjusted = 0.95; 95% CI: 0.93–0.97; P < .001). Sedentary time was not associated with all-cause mortality among those engaging in above median levels of MVPA (HR_adjusted = 0.998; 95% CI: 0.996–1.001; P = .32), but sedentary time was associated with increased mortality risk among those below median levels of MVPA (HR = 1.002; 95% CI: 1.001–1.003; P < 0.001).ConclusionsSedentary time and MVPA are independently associated with all-cause mortality. Above median sedentary time levels did not negate the beneficial effects of MVPA on all-cause mortality risk.     

Discipline-specific insulin sensitivity in athletes

ObjectiveWeight status and abnormal liver function are the two factors that influence whole-body insulin sensitivity. The main goal of the study was to compare insulin sensitivity in athletes (n = 757) and physically active controls (n = 670) in relation to the two factors.MethodsHomeostatic metabolic assessment for insulin resistance (HOMA-IR), weight status, and abnormal liver function (alanine aminotransferase and aspartate aminotransferase) were determined from 33 sports disciplines under morning fasted condition. This study was initiated in autumn 2006 and repeated in autumn 2007 (n = 1508) to ensure consistency of all observations.ResultsIn general, HOMA-IR and blood pressure levels in athletes were significantly greater than those in physically active controls but varied widely with sport disciplines. Rowing and short-distance track athletes had significantly lower HOMA-IR values and archery and field-throwing athletes had significantly higher values than the control group. Intriguingly, athletes from 22 sports disciplines displayed significantly greater body mass index values above control values. Multiple regression analysis showed that, for non-athlete controls, body mass index was the only factor that contributed to the variations in HOMA-IR. For athletes, body mass index and alanine aminotransferase independently contributed to the variation of HOMA-IR.ConclusionThis is the first report documenting HOMA-IR values in athletes from a broad range of sport disciplines. Weight status and abnormal liver function levels appear to be the major contributors predicting insulin sensitivity for the physically active population.     

Daily movement patterns and predicted 10-yr risk for a first atherosclerotic cardiovascular disease (ASCVD) event using the pooled cohort risk equations among US adults

ObjectiveExamine the association between movement patterns and predicted risk of a first atherosclerotic cardiovascular disease (ASCVD) event.MethodsData from the 2003–2006 National Health and Nutrition Examination Survey (NHANES) were used (40–79 yrs; N = 2421). Participants wore an ActiGraph 7164 accelerometer to create four movement pattern groups; Group 1: ≥ 150 min/wk of moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity (LIPA) ≥ sedentary behavior (SB); Group 2: ≥ 150 min/wk of MVPA and LIPA < SB; Group 3: < 150 min/wk of MVPA and LIPA ≥ SED; and Group 4: < 150 min/wk of MVPA and LIPA < SB. 10-yr risk for a first ASCVD event was estimated using the pooled cohort equations.ResultsAfter adjusting for age, gender, race–ethnicity and obesity, Group 2 (β = − 0.28; p = 0.44) was not significantly different than Group 1, but Groups 3 (β = 1.09; p = 0.01) and 4 (β = 1.44; p < 0.001) had a higher pooled risk score.ConclusionsThose in the least desirable movement pattern (Group 4) had the highest pooled risk score. Given the similar risk scores for Groups 1 and 2, future research is needed to determine if sufficient MVPA can counteract the potential consequences associated with an imbalanced LIPA:SB ratio (i.e., LIPA < SB).     

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.     

Maximizing children's physical activity using the LET US Play principles

BackgroundStaff in settings that care for children struggle to implement standards designed to promote moderate-to-vigorous physical activity (MVPA), suggesting a need for effective strategies to maximize the amount of time children spend in MVPA during scheduled PA opportunities. The purpose of this study was to compare the MVPA children accumulate during commonly played games delivered in their traditional format versus games modified according to the LET US Play principles.MethodsChildren (K–5th) participated in 1-hour PA sessions delivered on non-consecutive days (summer 2014). Using a randomized, counterbalanced design, one of the six games was played for 20 min using either traditional rules or LET US Play followed by the other strategy with a 10 min break in between. Physical activity was measured via accelerometry. Repeated-measures, mixed-effects regression models were used to estimate differences in percent of time spent sedentary and in MVPA.ResultsA total of 267 children (age 7.5 years, 43% female, 29% African American) participated in 50, 1-hour activity sessions. Games incorporating LET US Play elicited more MVPA from both boys and girls compared to the same games with traditional rules. For boys and girls, the largest MVPA difference occurred during tag games (+ 20.3%). The largest reduction in the percent of time sedentary occurred during tag games (boys − 27.7%, girls − 32.4%). Overall, the percentage of children meeting 50% time in MVPA increased in four games (+ 18.7% to + 53.1%).ConclusionLET US Play led to greater accumulation of MVPA for boys and girls, and can increase the percent of children attaining the 50% of time in MVPA standard.     

Physical activity outcomes in afterschool programs: A group randomized controlled trial

IntroductionAfterschool programs (ASPs) across the US are working towards achieving the standard of all children accumulating 30 min of moderate-to-vigorous physical activity (MVPA) during program time. This study describes the two-year impact of an intervention designed to assist ASPs meeting the 30 min/day MVPA standard.MethodsUsing a two-year delayed treatment, group randomized controlled trial, 20 ASPs serving ~ 1700 children/year (6–12 yrs) were randomized to either an immediate (n = 10, baseline-2013 and 2 yrs intervention fall-2013-to-spring-2015) or delayed group (n = 10, baseline 2013–2014 and 1 yr intervention fall-2014-to-spring-2015). The intervention, Strategies-To-Enhance-Practice (STEPs), focused on programming MVPA in the daily schedule, training of staff and leaders, and ongoing technical support/assistance. Accelerometry-derived proportion of children meeting the 30 min/day MVPA standard was measured in the spring of each year. Mixed model logistic regressions were used to examine the change in the odds of achieving the MVPA standard. Analyses were conducted in 2015. Data were collected in one southeastern US state.ResultsImmediate boys (n = 677) and delayed girls (n = 658) increased the percent achieving 30 min MVPA/day from 35.9% to 47.0% (odds ratio [OR] = 1.88, 95% CI 1.18–3.00) and 13.1% to 19.1% (OR = 1.42, 95% CI 1.03–1.96). Immediate girls (n = 613) and delayed boys (n = 687) exhibited a nonsignificant increase from 19.1% to 21.6% (OR = 1.20, 95% CI 0.84–1.72) and 29.0% to 31.3% (OR = 1.13, 95%CI 0.80–1.58).ConclusionsSTEPs can have an impact on children's MVPA and time spent sedentary, yet was unable to fully achieve the goal of all children accumulating 30 min MVPA/day. Additional efforts are need to identify strategies ASPs can use to meet this important public health standard.     

Change in general and central adiposity measures in prediction of incident dysglycemia; Tehran Lipid and Glucose Study

ObjectivesTo examine the change in general and central adiposity measures as a predictor of incident dysglycemia during a 6-year follow-up.SubjectsA total of 4029 (2333 women and 1696 men) non-dysglycemic Iranians aged ≥ 20 years, underwent standard fasting and 2-h post-challenge plasma glucose tests at baseline and follow-up.ResultsDuring follow-up, 458 new cases of dysglycemia occurred. In multivariable models including baseline values of each anthropometric measure, odds ratios (ORs) for dysglycemia incidence corresponding to a 1-SD increase in changes of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and hip circumference (HC), were 1.32, 1.56, 1.39, 1.51 and 1.39 for men and 1.59, 1.50, 1.37, 1.47, and 1.38, for women, respectively (all P < 0.05). After controlling for weight change and WC change among men and women, respectively, HC change did not remain as a predictor. Using the paired homogeneity test, there was no superiority for changes in central obesity measures compared to changes in BMI to predict dysglycemia.ConclusionThe association between HC changes and incident dysglycemia was dependent upon changes in central and general adiposity measures, where the former did not have higher predictability than the latter in prediction of dysglycemia.     

The association between physical activity and liver fat after five years of follow-up in a primary prevention multi-ethnic cohort

Objective: Excess liver fat (LF) is associated with dyslipidemia, insulin resistance and cardiovascular disease. Evidence suggests that there is an independent relationship between physical activity (PA) and LF although little is known of the role of PA intensity in reducing LF. The purpose was to evaluate whether meeting PA guidelines, the amount of PA and the intensity of PA at baseline were associated with LF after five-years.Methods: Men and women (n = 478) living in Vancouver, Canada of Aboriginal, Chinese, European or South Asian background completed baseline measurements in 2004–2005. Liver fat was assessed using CT scans at 5-year follow-up, and PA using a PA questionnaire at baseline as well as demographics and anthropometry.Results: In separate unadjusted models, meeting moderate–vigorous PA (MVPA) guidelines (p = 0.009), vigorous PA (p = 0.002) and MVPA (p = 0.017) but not moderate PA (p = 0.068) was predictive of LF at five years (p = 0.009). In multiple linear regression models, when adjusted for covariates, meeting MVPA guidelines and MVPA with LF at five years was no longer significant (p > 0.05) while vigorous PA remained significant (p = 0.021).Conclusion: Meeting PA guidelines through MVPA may not be adequate to prevent the accumulation of LF and PA guidelines may require revision. Vigorous PA should be encouraged to prevent LF accumulation.