The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial

Background  

Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours (poor diet, low physical activity and high sedentary behaviour) from their inception. These factors include the rapidly increasing prevalence of fatness throughout childhood, the instigation of obesity-promoting behaviours in infancy, and the tracking of these behaviours from childhood through to adolescence and adulthood. The Infant Feeding Activity and Nutrition Trial (INFANT) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents. The intervention, conducted with parents over the infant's first 18 months of life, will use existing social networks (first-time parent's groups) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours, and reduced sedentary behaviours in infancy.     

Evidence for factors associated with diet and physical activity in African and Caribbean countries

ObjectiveTo identify and describe summarized evidence on factors associated with diet and physical activity in low- and middle-income countries in Africa and the Caribbean by performing a scoping review of reviews.MethodsWe searched the Medline®, LILACS, Scopus, Global Health and Web of Science databases for reviews of factors associated with diet or physical activity published between 1998 and 2019. At least 25% of studies in reviews had to come from African or Caribbean countries. Factors were categorized using Dahlgren and Whitehead’s social model of health. There was no quality appraisal.FindingsWe identified 25 reviews: 13 on diet, four on physical activity and eight on both. Eighteen articles were quantitative systematic reviews. In 12 reviews, 25–50% of studies were from Africa or the Caribbean. Only three included evidence from the Caribbean. Together, the 25 reviews included primary evidence published between 1926 and 2018. Little of the summarized evidence concerned associations between international health or political factors and diet or associations between any factor and physical activity across all categories of the social model of health.ConclusionThe scoping review found a wide range of factors reported to be associated with diet and physical activity in Africa and the Caribbean, but summarized evidence that could help inform policies encouraging behaviours linked to healthy diets and physical activity in these regions were lacking. Further reviews are needed to inform policy where the evidence exists, and to establish whether additional primary research is needed.     

Correction to: Objective understanding of the Nutri-score front-of-pack label by European consumers and its effect on food choices: an online experimental study

There is increasing concern about the time people spend in sedentary behaviour, including screen time, leisure and occupational sitting. The number of both primary research studies (published trials) and reviews has been growing rapidly in this research area. A summary of the highest level of evidence that provides a broader quantitative synthesis of diverse types of interventions is needed. This research is to articulate the evidence of efficacy of sedentary behaviour interventions to inform interventions to reduce sitting time. The umbrella review, therefore, synthesised systematic reviews that conducted meta-analyses of interventions aiming at reducing sedentary behaviour outcomes across all age group and settings. A systematic search was conducted on six databases (MEDLINE Complete, PsycINFO, CINAHL, Global Health via EBSCOhost platform, EMBASE, and Cochrane Central Register of Systematic Reviews). Included articles were systematic reviews with meta-analysis of interventions aiming at reducing sedentary behaviour (screen time, sitting time or sedentary time) in the general population across all age group. Seventeen reviews met the inclusion criteria (7 in children and adolescent, 10 in adults). All reviews of sedentary behaviour interventions in children and adolescents investigated intervention effectiveness in reducing screen time. Six out of 11 meta-analyses (reported in 7 reviews) showed small but significant changes in viewing time. All reviews of sedentary behaviour interventions in office workplaces indicated substantial reduction in occupational sitting time (range: 39.6 to 100 min per 8-h workday). Sub-group analyses reported a trend favouring environmental change components such as sit-stand desks, active permissive workstations etc. Meta-analyses indicated that sedentary behaviour interventions were superior to physical activity alone interventions or combined physical activity and sedentary behaviour interventions in reducing sitting time. The current systematic reviews and meta-analyses supported sedentary behaviour interventions for reducing occupational sitting time in particular, with small changes seen in screen time in children and adolescents. Future research should explore approaches to maintaining behaviour change beyond the intervention period and investigate the potential of sedentary behaviour reduction interventions in older age groups in non-occupational settings.     

Paths to child social adjustment: parenting quality and children's processing of social information

BaCKGROUND: The purpose of this research was to examine the manner in which multiple influences on child social adjustment operated together to predict differential outcomes for young children. Specifically, this study was designed to (i) examine the role of social cognitive and emotional factors in parents' observed and self-reported behaviour towards their children, and (ii) investigate the impact of parenting and children's social information processing (SIP) patterns on children's subsequent social adjustment in the school setting. METHODS: A model of children's peer social adjustment was evaluated using a group of 166 children, over-sampled for history of physical child abuse. Assessment of constructs was multi-method, including parent and child self-reports as well as teacher reports of child adjustment and observations of parent-child and child-peer interactions. RESULTS: Using structural equation modelling, support was found for our theoretical model. Specifically, parents' negative child-related beliefs and clinical elevations in emotional distress were predictors of harsh, insensitive parenting, which in turn predicted children's SIP operations and social maladjustment 6 months later. However, children's SIP did not significantly predict their social adjustment above and beyond the impact of parenting. CONCLUSIONS: Results indicated that the quality of parenting that children received was more central to subsequent adjustment in peer interactions than were children's SIP operations. Furthermore, the quality of parenting children experienced was closely linked to parents' beliefs about their children and parents' mental health status. Directions for future research and potential implications for clinical practice are discussed.     

Sedentary behaviour, physical activity and weight problems in adolescents in Wales

OBJECTIVE: We studied the prevalence and stability of overweight and obesity in a cohort of adolescents, and the effects of sedentary behaviour and physical activity on changes in body mass. The study also examined the extent to which physical activity mediated the relationship between sedentary behaviour and body mass. DESIGN: Four-year cohort study. METHODS: The study was part of the Health Behaviour of School-aged Children Study that took place in Wales between 1994 and 1998. Body height and weight measurements and self-report data on sedentary behaviour, physical activity and psychosocial adjustment were collected from 355 adolescents on two occasions 4 years apart. The mean age of the sample at baseline was 12.30 (SD=6.30) years. RESULTS: Weight conditions (underweight, overweight and obesity) and body mass were moderately stable over the interval. Regression analyses showed that sedentary behaviour at Time 1 predicted body mass at Time 2, while physical activity predicted a change in body mass over time. The influence of sedentary behaviour on body mass was not found to be mediated by physical activity. However, weight problems in Year 7 coincided with getting bullied, bullying others, and feeling left out of things. Obesity was also related to snacking and skipping breakfast. CONCLUSIONS: Sedentary behaviour and physical activity in early adolescence both influenced body mass in late adolescence. Results indicated that promoting healthy diets and physical activities may have long-term health benefits for young people.     

Health-related lifestyle in adolescence--origin of social class differences in health?

Survey data collected by mail, representing Finnish 16 year olds (N = 2977; response rate 83%), were used to identify which particular aspects of lifestyle are typical of adolescents who select various educational tracks and, thus, have different probabilities of ending up in low or high social positions. The dependent variable, educational track, was formed by classifying the respondents into five successive categories predicting their social position in adulthood. Lifestyle is measured by health behaviours, leisure-time activities and social relations. The probability of belonging to educational tracks with good social prospects in adulthood was high among adolescents who placed much emphasis on health-enhancing behaviours (not smoking, physical exercise, low milk-fat diet, dental hygiene, use of seatbelts, etc.), who did not spend much time watching TV or listening to music and who attended church or other religious meetings weekly. Health-related lifestyle, at the age of 16, is oriented towards the social group the individual is likely to belong to as an adult. The study provides evidence for a strong association between health-related lifestyle and educational track in adolescence.     

Association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents

ABSTRACT: BACKGROUND: Many different factors influenced food habits and physical activity patterns of adolescents in a complex interactive way. The aim of this study was to assess association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents. METHODS: A cross-sectional survey (n = 1961; 12--17 years old) was carried out. Physical activity was assessed using the International Physical Activity Questionnaire for adolescents (IPAQ-A). Sedentary behaviour was defined as <300 min/week of moderate and vigorous physical activity. Anthropometric measurements, body image, socio-economic and lifestyle determinants, food consumption, and adherence to the Mediterranean diet were assessed. RESULTS: The prevalence of sedentary behaviour was 37.1% (22.0% boys, 50.8% girls). Active boys consumed frequently breakfast cereals and fresh fruit; active girls yogurt, cheese, breakfast cereals, and fresh fruit; and sedentary girls high fat foods and soft drinks. Sedentary behaviour of girls was directly associated to age, and time spent on media screen and homework, and inversely related to adherence to Mediterranean diet, and body composition. Sedentary behaviour of boys was inversely related to adherence to the Mediterranean diet, and the desire to remain the same weight. CONCLUSIONS: The prevalence of sedentary behaviour among Balearic Islands adolescents is high, mainly among girls. Age, sex, parental educational and profession levels, body size dissatisfaction, and poor quality diet are important factors of physical activity practice among adolescents.     

Where Do Online Games Fit into the Health Behaviour Ecology of Emerging Adults: A Scoping Review

Online video games are a common pastime for emerging adults (EAs). EAs are an age group that is of interest in health communication because habits formed during this life stage can cause or prevent disease later in life. Guided by three research questions, this scoping review identifies the current state of research into socio-ecological influences on physical activity and diet behaviours of EAs. The review also examines the role that online video games play within this behavioural ecology. In total, 112 articles were found that focused on behavioural ecological influences for physical activity and diet behaviour among EAs. Seven of these articles focused on the impact of online video games, although only in conjunction with their influence on physical activity, identifying a gap in understanding the influence of online games on diet. Results show that online video games are currently under-researched in terms of impacts on physical activity and diet despite the prevalence of the use of these games within the EA cohort.     

Adolescent screen-viewing behaviour is associated with consumption of sugar-sweetened beverages: the role of habit strength and perceived parental norms

The association between adolescent screen-viewing behaviour (i.e., television viewing and computer use) and the consumption of sugar-sweetened beverages was studied in a Dutch sample of adolescents (N=383) using self-administered questionnaires. In particular, the previously understudied role of habit and perceived parental norms in the execution of these behaviours was investigated. Results showed that screen-viewing behaviour was associated with consumption of sugar-sweetened beverages (r=.32). Habit strength of both behaviours correlated with a large effect size (r=.50). The interaction between both behaviours was underlined by the finding that consumption of sugar-sweetened beverages was explained by perceived parental norms regarding screen-viewing behaviour (beta=.12; adjusted for the behaviour and perceived parental norm regarding sugar-sweetened beverage consumption). Consequences of the identified role of habit and parental norms in the interplay between sedentary behaviour and consumption of sugar-sweetened beverages among adolescents are discussed.     

Ambient air pollution and movement behaviours: A scoping review

This scoping review summarizes the literature about how ambient (outdoor) air pollution impacts movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), or beliefs about movement behaviours. Of 6552 potential documents, 58 documents and 218 findings were included in the final synthesis. Most studies were from the United States and China, involved cross-sectional designs, and included mixed age groups. Overall, unfavourable changes/associations (i.e., decreased/lower physical activity, increased/higher sedentary-related behaviour, and decreased/lower sleep duration and quality) or no change/association in movement behaviours in relation to ambient air pollution were identified. Our findings suggest that more attention should be given to understanding the impact of ambient air pollution on movement behaviours in general and in diverse countries and vulnerable populations such as children or older adults.     

Sitzendes Verhalten als Risikofaktor im Kindes- und Jugendalter

Background

Sedentary behaviour is already very common in daily life of children and adolescents. An increasing number of studies within the public health context have examined issues around this topic and findings indicate that sedentarism and physical activity are independent behaviours.

Objective and methods

The objective of the current paper is to systematically introduce in terms of a behavioural epidemiology framework into the topic of sedentary behaviour in children and adolescents. The six phases of the framework are described based on a narrative compilation of currently available international reviews and original studies.

Findings and conclusions

From both a conceptual and a public health lens it is recommendable to consider sedentary behaviour as a meaningful indicator of interventions. However, sedentary behaviour is independent of the level of physical activity associated with physical and psychological health. In addition studies showed that it is possible to reduce sitting time through specific interventions. A lot of issues around sedentary behaviour have not been fully understood and researches are especially faced with challenges in terms of measurement and study design. To foster the reduction of sitting time it is necessary to understand the determinants of this behaviour and to examine the interaction and the effectiveness of intervention to reduce sitting time in addition to the promotion of physical activity.     

Physical activity interventions in the prevention and treatment of paediatric obesity: systematic review and critical appraisal

Interventions for prevention and treatment of childhood obesity typically target increases in physical activity and, more recently, reductions in physical inactivity (sedentary behaviour such as television viewing). However, the evidence base for such strategies is extremely limited. The main aim of the present review was to update the systematic review and critical appraisal of evidence in the light of the recent rapid expansion of research in this area. Randomised controlled trials (RCT) that targeted activity or inactivity, that followed up children or adolescents for at least 1 year and that included an objective weight-related outcome measure were included. Trials were appraised using previously published criteria (Harbour & Miller, 2001), and literature search strategies described previously (Reilly et al. 2002) were updated to May 2002. A total of four new RCT, two new systematic reviews and one meta-analysis were identified. The evidence base has increased markedly since the completion of earlier reviews, although high-quality evidence is still lacking. The evidence on childhood obesity prevention is not encouraging, although promising targets for prevention are now clear, notably reduction in sedentary behaviour. There is stronger evidence that targeting activity and/or inactivity might be effective in paediatric obesity treatment, but doubts as to the generalisability of existing interventions, and the clinical relevance of the interventions is unclear. Further research in settings outside the USA is urgently needed, and two ongoing RCT in Scotland are summarised.     

Assessing the impact of road traffic on cycling for leisure and cycling to work

Background

This study investigated the associations of physical characteristics and personality in adolescence with physical activity and sedentary behaviour in adulthood.

Findings

Physical characteristics (i.e. objectively measured BMI, sum of skin folds, MOPER test battery performance), and personality (i.e. self-reported inadequacy, social inadequacy, rigidity, self-sufficiency/recalcitrance, dominance, achievement motivation, facilitating anxiety, debilitating anxiety, and social desirability) were assessed in 217 adolescent boys (Mean 13.0, SD 0.6) and girls (Mean 12.9, SD 0.6). Twenty-nine years later, at the age of 42, their physical activity and sedentary behaviour were assessed by means of accelerometry. Boys who scored lower on self-sufficiency/recalcitrance and higher on facilitating anxiety spent more time sedentary in adulthood. Girls with a superior standing high jump performance, and a lower score on social desirability spent more time sedentary in adulthood. In contrast with sedentary behaviour, physical activity at age 42 year could not be predicted by physical characteristics or personality in adolescence.

Conclusions

Sedentary behaviour in adulthood was partly explained by physical characteristics and/or personality in adolescence. Thus, our results suggest that it may be possible to identify people who are at risk of becoming sedentary at a rather young age.     

Relative contributions of health behaviours versus social factors on perceived and objective weight status in Canadian adolescents

ObjectivesPublic health interventions for adolescent “obesity prevention” have focused predominantly on individualistic health behaviours (e.g., diet and physical activity) at the expense of recognizing body weight diversity and the array of social factors (e.g., stigma and discrimination of marginalized identities) that may be linked to weight status. Research is needed to examine the extent to which individualistic health behaviours versus social factors contribute to weight status in adolescents. As such, the aim of this study was to investigate the relative contribution of individualistic health behaviours versus social factors to objective and perceptual indices of weight status.MethodsCross-sectional survey data were collected as part of the Toronto Public Health Student Survey and comprised students 12 to 19 years of age (N = 5515). Measures included perceived and objective weight status, social and demographic factors (e.g., gender, sexual orientation, school connectedness), and health behaviours (e.g., physical activity, nutritious consumption).ResultsFindings from latent variable regression models partially supported hypotheses, whereby social factors (i.e., age, sex, socio-economic access, sexual minority status) contribute similar amounts of variance, or relatively more variance in weight indices, compared to health behaviours (e.g., physical activity, nutritious consumption).ConclusionContrary to traditional views of adolescent weight status, physical activity (i.e., school-based, individual, active transport) and nutritious consumption (i.e., fruits, vegetables, milk) were not associated with weight status, when considering social factors. These findings challenge the utility of public health approaches that target individualistic behaviours as critical risk factors in “obesity prevention” efforts in adolescence.     

Understanding determinants of nutrition, physical activity and quality of life among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL) study

ABSTRACT: BACKGROUND: Nutrition and physical activity are major determinants of health and quality of life; however, there exists little research focusing on determinants of these behaviours in older adults. This is important, since just as these behaviours vary according to subpopulation, it is likely that the determinants also vary. An understanding of the modifiable determinants of nutrition and physical activity behaviours among older adults to take into account the specific life-stage context is required in order to develop effective interventions to promote health and well-being and prevent chronic disease and improve quality of life. METHODS: The aim of this work is to identify how intrapersonal, social and environmental factors influence nutrition and physical activity behaviours among older adults living in urban and rural areas. This study is a cohort study of adults aged 55-65 years across urban and rural Victoria, Australia. Participants completed questionnaires at baseline in 2010 and will complete follow-up questionnaires in 2012 and 2014. Self-report questionnaires will be used to assess outcomes such as food intake, physical activity and sedentary behaviours, anthropometry and quality of life. Explanatory variables include socioeconomic position, and measures of the three levels of influence on older adults' nutrition and physical activity behaviours (intrapersonal, social and perceived environmental influences). DISCUSSION: Obesity and its determinant behaviours, physical inactivity and poor diet are major public health concerns and are significant determinants of the quality of life among the ageing population. There is a critical need for a better understanding of the determinants of nutrition and physical activity in this important target group. This research will provide evidence for the development of effective policies and programs to promote and support increased physical activity and healthy eating behaviours among older adults.     

Parent- and child-reported parenting. Associations with child weight-related outcomes

The present study aimed to investigate associations of both parent-reported and child-perceived parenting styles and parent-reported parenting practices with child weight and weight-related behaviours. Participants were 175 children (56% female) aged between 7 and 11, and their primary caregivers (91% female), recruited through South Australian primary schools. Children completed measures of parenting style, attitude toward fruit, vegetables, and non-core food, and attraction to physical activity. Parents completed measures of parenting style and domain-specific parenting practices (feeding and activity-related practices) and reported on child dietary intake, physical activity, and sedentary behaviour. Objective height and weight measurements were taken from children, from which body mass index (BMI) was calculated. Child-reported parenting style and parent-reported parenting practices were uniquely associated with child weight-related outcomes, but styles and practices did not interact in their association with child outcomes. Child-reported parenting style was associated with child food and activity attitudes, whereas parent-reported parenting style was not associated with child outcomes. The findings of the present study generally support the recommendation of a parenting style high in demandingness and responsiveness for supporting healthy child weight-related behaviours, along with appropriate domain-specific practices. The child's perspective should be incorporated into research involving child outcomes wherever possible.     

Parenting style and adolescent fruit consumption

The importance of the social environment for dietary behaviour has been highlighted in the past decade. A type of environmental influence that has received increasing research attention in recent years is the influence that parents can have on their children's dietary behaviour through food-related parenting practices. Much of the work done so far, however, has reported inconsistent findings and poorly understood mechanisms of influence. The present study aimed to explore the possible environmental influence of general parenting style on adolescent food choice patterns. Data were collected at schools (N=643; mean age 16.5 years), using self-administered questionnaires on parenting style, fruit intake behaviour and fruit-specific cognitions. Consistent and theoretically predictable differences were found between adolescents who described their parents as authoritative, authoritarian, indulgent or neglectful. Fruit consumption and fruit-specific cognitions were most favourable among adolescents who were being raised with an authoritative parenting style. Children of parents with indulgent parenting styles consumed more fruit than adolescents from authoritarian or neglectful homes. Consequences of these results for the interpretation of earlier studies on the influence of parenting practices are discussed, and a research model is proposed for future studies of parental influences on adolescent dietary behaviours.     

Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL

Background  

Identification of non-modifiable correlates of physical activity and sedentary behaviour in youth contributes to the development of effective targeted intervention strategies. The purpose of this research was to examine the relationships between family circumstances (e.g. socio-economic status, single vs. dual parent household, presence/absence of siblings) and leisure-time physical activity and sedentary behaviours in adolescents.     

Psychological-health correlates of physical activity and sedentary behaviour during the COVID pandemic

BackgroundWhile physical inactivity is associated with adverse psychological outcomes, less is known about the psychological outcomes associated with sedentary behaviour, and specifically, its mentally active and passive forms. The COVID-19 pandemic represents a unique opportunity to study associations between these variables in light of widespread stay-at-home mandates and restrictions on outdoor exercise/social activities. Using a cross-sectional dataset acquired during the COVID-19 pandemic in Australia, we examined whether physical activity and sedentary behaviour were associated with subjective quality of life (sQoL) and subjective cognitive dysfunction, and whether these associations were mediated by depressive symptoms.Methods658 participants (males = 169, females = 489) self-reported data on physical activity and sedentary behaviour in an online survey during May 2020–May 2021. Data on physical activity and sedentary behaviour (both mentally active and passive types) was compared according to whether it was collected during or out of a lockdown period. Regression models were used to test associations of physical activity and sedentary behaviour with sQoL and subjective cognitive dysfunction, and whether these associations were mediated by depression severity.ResultsPhysical activity was beneficially associated with sQoL, whereas sedentary behaviour (both total hours and the reduction of mentally active/increase in mentally passive behaviour) was detrimentally associated with sQoL. These associations were mediated by depression severity. Physical activity and sedentary behaviour were also indirectly associated with subjective cognitive dysfunction by virtue of their associations with depression severity.ConclusionsThere are important differences in the psychological correlates of mentally passive and active sedentary behaviours. Our findings suggest that health promotion strategies should focus on not only increasing physical activity but also reducing passive sedentary behaviours as a means of maintaining good psychological health.