One- and two-year predictors of decline in physical activity among inner-city schoolchildren

BACKGROUND: Alarming secular declines in physical activity (PA) have been observed among youth over the last decade. A better understanding of the predictors of these declines is crucial to identifying those children most at risk and to developing interventions that target youth before the onset of decline. This report identifies 1- and 2-year predictors of decline in PA among fourth- and fifth-grade students from inner-city neighborhoods in Montreal, Canada. METHODS: Data for this study were collected in classroom questionnaires each May/June from 1993 to 1997. Analyses for this paper were completed in 2001. The cohort included active (at least one PA per day) children with baseline and 1-year (n =1873) or 2-year (n =509) follow-up data. RESULTS: In boys, 1-year predictors of decline to an inactive status identified in generalized estimating equations analysis included moderate (vs high) baseline PA (odds ratio [OR]=1.66, 95% confidence interval [CI]=0.91-3.05); low PA self-efficacy (OR=1.67, 95% CI=1.03-2.71); born outside Canada (OR=2.13; 95% CI=1.31-3.46); Asian origin (OR=1.81; 95% CI=1.03-3.16) and no participation in school teams (OR=1.81, 95% CI=0.93-3.55). In girls, these 1-year predictors included moderate PA (OR=1.91, 95% CI=1.10-3.32); low PA self-efficacy (OR=1.70, 95% CI=1.15-2.49); watching four or more TV programs per day (OR=1.40, 95% CI=0.97-2.02); mother unemployed (OR=1.54, 95% CI=1.07-2.23); and grade five (vs grade four) (OR=1.35, 95% CI=0.94-1.93). Two-year predictors in boys included moderate baseline PA (OR=2.52, 95% CI=0.84-7.50), and born outside Canada (OR=1.96, 95% CI=0.91-4.20). In girls, these 2-year predictors included moderate baseline PA (OR=2.75, 95% CI=1.01-7.49); no participation in school teams (OR=2.14, 95% CI=0.92-5.00); watching four or more TV programs per day (OR=1.93, 95% CI=0.99-3.74); and born outside Canada (OR=1.85, 95% CI=0.96-3.55). CONCLUSIONS: Reduced TV viewing among girls and increased participation in school sports teams in boys and girls may prevent declines in PA among pre-adolescents from inner-city neighborhoods.     

Young children’s screen habits are associated with consumption of sweetened beverages independently of parental norms

Objectives

This study investigated the associations between children’s screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child’s screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms.

Methods

In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children’s (n = 1,733) lifestyle and diets.

Results

Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1–1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1–3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2–1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3–2.1). TV viewing time and commercial exposure contributed to the associations independently of each other.

Conclusions

The results strengthen the assumption that it is possible to influence children’s dietary habits through their TV habits.     

Television viewing and abdominal obesity in young adults: is the association mediated by food and beverage consumption during viewing time or reduced leisure-time physical activity?

BACKGROUND: The behavioral pathways through which television (TV) viewing leads to increased adiposity in adults are unclear. OBJECTIVE: We wanted to determine whether the association between TV viewing and abdominal obesity in young adults is mediated by food and beverage consumption during TV viewing time or by a reduction in overall leisure-time physical activity (LTPA). DESIGN: This study involved a cross-sectional analysis of data from 2001 Australian adults aged 26-36 y. Waist circumference (WC) was measured at study clinics, and TV viewing time, frequency of food and beverage consumption during TV viewing, LTPA, and demographic characteristics were self-reported. RESULTS: Women watching TV > 3 h/d had a higher prevalence of severe abdominal obesity (WC: > or = 88 cm) compared with women watching < or = 1 h/d [prevalence ratio (PR): 1.89; 95% CI: 1.32, 2.71]. Moderate abdominal obesity (WC: 94-101.9 cm) was more prevalent in men watching TV > 3 h/d than in men watching < or = 1 h/d (PR: 2.16; 95% CI: 1.37, 3.41). Adjustment for LTPA made little difference, but adjustment for food and beverage consumption during TV viewing attenuated the associations (PR: 1.48; 95% CI: 1.01, 2.17 for women; PR: 1.73; 95% CI: 1.06, 2.83 for men). CONCLUSIONS: The association between TV viewing and WC in young adults may be partially explained by food and beverage consumption during TV viewing but was not explained by a reduction in overall LTPA. Other behaviors likely contribute to the association between TV viewing and obesity.     

An observational study on socio-economic and ethnic differences in indicators of sedentary behavior and physical activity in preschool children

Objective

We studied associations between social disadvantage and indicators of sedentary behavior and physical activity at preschool age.

Methods

Data from 4688 children enrolled in a birth cohort in Rotterdam, the Netherlands, between 2002 and 2006 were analyzed. Indicators of sedentary behavior (watching television ≥ 2 h/day and sitting in a buggy ≥ 0.5 h/day) and physical inactivity (playing outside < 3 h/day) were measured by a parent-reported questionnaire at age 3. Adjustments were made for social circumstances and indicators of health behaviors. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CI).

Results

Children with low-educated mothers (OR: 3.27, 95% CI 2.12-5.05) and non-Dutch children (OR_nonWestern: 2.67, 95% CI 2.04-3.49, OR_Western: 2.09, 95% CI 1.42-3.0) were more likely to watch television for at least 2 h/day. Similar results were seen for sitting in a buggy for at least 0.5 h/day. Non western children were more likely to play outside for less than 3 h/day (OR: 1.95, 95% CI: 1.39-2.73) than native Dutch children, while no differences were seen for other western children or children from mothers with a low educational level.

Conclusions

Socio-economic status and ethnicity are already associated with indicators of sedentary lifestyles at preschool age.     

Physical activity inversely associated with the presence of depression among urban adolescents in regional China

Background  

An inverse relationship between physical activity (PA) and depression among adolescents has been reported in developed communities without consideration of sedentary behaviors (SB, including sitting for course study, viewing TV, and sleeping). We explored the association between recreational PA time (hr/wk) and depression after adjustment with SB and other possible confounders among Chinese adolescents.     

Occupational noise exposure,psychosocial working conditions and the risk of tinnitus

Purpose

The purpose of this study was to evaluate the influence of occupational noise (current and cumulative doses) and psychosocial work factors (psychological demands and decision latitude) on tinnitus occurrence among workers, using objective and non-self-reported exposure measures to prevent reporting bias.

Methods

In a cross-sectional study, we analyzed data from a Danish survey from 2009 to 2010 that included 534 workers from children day care units and 10 manufacturing trades. Associations between risk factors (current noise exposure, cumulative noise exposure and psychosocial working conditions) and tinnitus were analyzed with logistic regression.

Results

We found no statistically significant associations between either current [OR 0.95 (95% CI 0.89; 1.01)] or cumulative [OR 0.93 (95% CI 0.81; 1.06)] occupational noise exposure and tinnitus. Likewise, results for psychosocial working conditions showed no statistically significant association between work place decision latitude [OR 1.06 (95% CI 0.94; 1.13)] or psychological demands [OR 1.07 (95% CI 0.90; 1.26)] and tinnitus.

Conclusions

Our results suggest that current Danish occupational noise levels (in combination with relevant noise protection) are not associated with tinnitus. Also, results indicated that the psychosocial working conditions we observed in this cohort of mainly industrial workers were not associated with tinnitus. Therefore, psychosocial working conditions comparable to those observed in this study are probably not relevant to take into account in the evaluation of workers presenting with tinnitus.

     

Behavioral and Psychosocial Risk Factors Associated with First and Recurrent Cystitis in Indian Women: A Case-control Study

Background:

The risk factors for urinary tract infections (UTIs) from developed countries are not applicable to women from developing world.

Objective:

To analyze the behavioral practices and psychosocial aspects pertinent to women in our region and assess their association with acute first time or recurrent UTI.

Materials and Methods:

Sexually active premenopausal women with their first (145) and recurrent (77) cystitis with Escherichia coli as cases and women with no prior history of UTI as healthy controls (257) were enrolled at a tertiary care hospital in India, between June 2011 and February 2013. Questionnaire-based data was collected from each participant through a structured face-to-face interview.

Results:

Using univariate and multivariate regression models, independent risk factors for the first episode of cystitis when compared with healthy controls were (presented in odds ratios [ORs] with its 95% confidence interval [CI]): Anal sex (OR = 3.68, 95% CI = 1.59-8.52), time interval between last sexual intercourse and current episode of UTI was <5 days (OR = 2.27, 95% CI = 1.22-4.23), use of cloth during menstrual cycle (OR = 2.36, 95% CI = 1.31-4.26), >250 ml of tea consumption per day (OR = 4.73, 95% CI = 2.67-8.38), presence of vaginal infection (OR = 3.23, 95% CI = 1.85-5.62) and wiping back to front (OR = 2.52, 95% CI = 1.45-4.38). Along with the latter three, history of UTI in a first-degree female relative (OR = 10.88, 95% CI = 2.41-49.07), constipation (OR = 4.85, 95% CI = 1.97-11.92) and stress incontinence (OR = 2.45, 95% CI = 1.18-5.06) were additional independent risk factors for recurrent cystitis in comparison to healthy controls.

Conclusion:

Most of the risk factors for initial infection are potentially modifiable but sufficient to also pose risk for recurrence. Many of the findings reflect the cultural and ethnic practices in our country.     

Infancy and childhood growth and physical activity in adolescence: prospective birth cohort study from Brazil

Background

A poor understanding of the specific lifestyle behaviors that result in weight loss has hindered the development of effective interventions. The aim of this paper was to identify potential behavioral mediators of weight loss in the Healthy Dads, Healthy Kids (HDHK) intervention for overweight fathers.

Findings

The three-month intervention was evaluated in a randomized controlled trial and conducted in Newcastle, New South Wales, Australia. Baseline, three month (immediate post-intervention) and six month assessments were conducted. Recruitment and follow-up occurred between October 2008 and May 2009. The study sample included 53 overweight/obese men [mean ( SD) age=40.6( 97.1) years; body mass index (BMI)=33.2 (3.9) kgm^-2] and their primary school-aged children [n=71, 54% boys; age=8.2 (2.0) years] who were randomized to HDHK program or a wait-list control group. Physical activity (PA) was assessed using pedometers and dietary behaviors were measured using a validated food frequency questionnaire. The intervention resulted in significant weight loss (5.131.27kg, P<0.0001) and increased PA among fathers (2769750 steps/day, P<0.001) and their children (1486521 steps/day, P<0.01). Fathers PA mediated weight loss in the intervention (AB=2.31, 95% CI=4.63 to 0.67) and was responsible for 47% of the intervention effect. Changes in dietary behaviors were not statistically significant.

Conclusions

PA was an important mediator of weight loss in the HDHK intervention. Encouraging overweight fathers to be more active with their children appears to be a promising strategy for obesity treatment in men.     

Gestational Age and Child Development at Age Five in a Population‐Based Cohort of Australian Aboriginal and Non‐Aboriginal Children

Background

Preterm birth and developmental vulnerability are more common in Australian Aboriginal compared with non‐Aboriginal children. We quantified how gestational age relates to developmental vulnerability in both populations.

Methods

Perinatal datasets were linked to the Australian Early Development Census (AEDC), which collects data on five domains, including physical, social, emotional, language/cognitive, and general knowledge/communication development. We quantified the risk of developmental vulnerability on ≥1 domains at age 5, according to gestational age and Aboriginality, for 97 989 children born in New South Wales, Australia, who started school in 2009 or 2012.

Results

Seven thousand and seventy‐nine children (7%) were Aboriginal. Compared with non‐Aboriginal children, Aboriginal children were more likely to be preterm (5% vs. 9%), and developmentally vulnerable on ≥1 domains (20% vs. 36%). Overall, the proportion of developmentally vulnerable children decreased with increasing gestational age, from 44% at ≤27 weeks to 20% at 40 weeks. Aboriginal children had higher risks than non‐Aboriginal children across the gestational age range, peaking among early term children (risk difference [RD] 19.0, 95% confidence interval [CI] 16.3, 21.7; relative risk [RR] 1.91, 95% CI 1.77, 2.06). The relation of gestational age to developmental outcomes was the same in Aboriginal and non‐Aboriginal children, and adjustment for socio‐economic disadvantage attenuated the risk differences and risk ratios across the gestational age range.

Conclusions

Although the relation of gestational age to developmental vulnerability was similar in Aboriginal and non‐Aboriginal children, Aboriginal children had a higher risk of developmental vulnerability at all gestational ages, which was largely accounted for by socio‐economic disadvantage.     

Variability and seasonality of active transportation in USA: evidence from the 2001 NHTS

Background

Tracking studies determine the stability and predictability of specific phenomena. This study examined tracking of TV viewing (TV) and video game use (VG) from middle childhood through early adolescence after adjusting for moderate and vigorous physical activity (MVPA), percentage of body fat (% BF), and maturity.

Methods

TV viewing and VG use were measured at ages 5, 8, 11, and 13 (n = 434) via parental- and self-report. MVPA was measured using the Actigraph, % BF using dual-energy x-ray absorptiometry, and maturity via Mirwald predictive equations. Generalized Estimating Equations (GEE) were used to assess stability and logistic regression was used to predict children "at risk" for maintaining sedentary behaviors. Additional models examined tracking only in overfat children (boys ≥ 25% BF; girls ≥ 32% BF). Data were collected from 1998 to 2007 and analyzed in 2010.

Results

The adjusted stability coefficients (GEE) for TV viewing were 0.35 (95% CI = 0.26, 0.44) for boys, 0.32 (0.23, 0.40) for girls, and 0.45 (0.27, 0.64) for overfat. For VG use, the adjusted stability coefficients were 0.14 (0.05, 0.24) for boys, 0.24 (0.10, 0.38) for girls, and 0.29 (0.08, 0.50) for overfat. The adjusted odds ratios (OR) for TV viewing were 3.2 (2.0, 5.2) for boys, 2.9 (1.9, 4.6) for girls, and 6.2 (2.2, 17.2) for overfat. For VG use, the OR were 1.8 (1.1, 3.1) for boys, 3.5 (2.1, 5.8) for girls, and 1.9 (0.6, 6.1) for overfat.

Conclusions

TV viewing and VG use are moderately stable throughout childhood and predictive of later behavior. TV viewing appears to be more stable in younger children than VG use and more predictive of later behavior. Since habitual patterns of sedentarism in young children tend to continue to adolescence, early intervention strategies, particularly to reduce TV viewing, are warranted.     

Substanzkonsum und Gewaltwiderfahrnisse Jugendlicher

Background

Teen dating violence is discussed as a potential risk factor for harmful behaviour. For prevention strategies it is interesting to see the extent to which evidence can be found in epidemiological studies.

Methods

We searched the databases CINAHL, EMBASE, PsycINFO, Cochrane Library, Web of Science as well as in the free web for longitudinal studies which examined substance consumption as a result of teen dating violence.

Results

Seven studies fulfilled the inclusion criteria. Each one study described teen dating violence to increase marijuana consumption among girls (odds ratio [OR] 2.1, 95% confidence interval [95% CI] 1.22–3.70) and boys (OR 1.34, 95% CI 1.03–1.74), two studies with mixed sex population in boys (class 8: b = 0.55, p < 0.01; class 12: b = 1.14, p < 0.001) and in both sexes (ERR = 1.21, 95% CI 0.96–1.52; ERR = 1.30, 95% CI 0.81–2.11). Four studies observed increased consumption of tobacco in mixed sex group populations (B = 0.31, SE = 0.14, p < 0.03), in girls (OR 2.28, 95% CI 1.39–3.74; OR 1.53, 95% CI 1.13–2.06; OR 2.15, 95% CI 1.07–4.35) or boys (OR 3.04, 95% CI 1.16–7.95), whereas alcohol consumption was measured in 2 studies: in girls (OR 1.44, 95% CI 1.03–1.74) and in mixed sex study populations (B = 0.25, SE = 0.14; p < 0.5). Two studies described an increased substance dependence in girls (ß = 0.16; CI 0.06–0.26) and in mixed sex study population (OR = 10.61; p < 0.011).

Conclusion

The low effect dimensions, limitations caused by the study design and the lack of consideration of confounders presuppose that such interpersonal violence cannot be considered as a risk factor.

     

Mortalité au cours du choc septique de l’enfant secondaire à une infection communautaire : à propos de 70 cas

Goal

This study had for aim to determine the mortality rate and the factors affecting mortality among 70 children admitted for septic shock secondary to a community acquired infection.

Patients and methods

A retrospective analysis was made of patients admitted between January 1998 and August 2005, in a pediatric ICU for septic shock secondary to a community-acquired infection. Neonates under 7 days of age were excluded from the study.

Results

Seventy cases were included and 32 (45.7 %) of them died. Their average age was 3.8 ± 4.2 years and their PRISM during the first 24 hours was 19.2 ± 8.4. Sixty-nine children (98.6 %) presented with multivisceral failure and 60 (85.7 %) with more than two deficient organs. The average time between the observation of first hemodynamic disorders and admission to ICU was 9.4 ± 11.3 hours. Three independent mortality risk factors were identified: failure of more than two organs on admission (OR, 4.4; 95 % CI [2.1–9.4]), an infusion volume superior to 20 ml/kg on the second day of resuscitation (OR, 3.4; 95 CI  % [1.1–10.3]), and the use of more than two vasoactive drugs (OR, 3.3; 95 CI  % [1.2–9]).     

The economic benefits of reducing physical inactivity: an Australian example

Background

Time spent watching television affects multiple aspects of child and adolescent health. Although a diverse range of factors have been found to be associated with young people's television viewing, parents and the home environment are particularly influential. However, little is known about whether parents, particularly those who are concerned about their child's television viewing habits, translate their concern into action by providing supportive home environments (e.g. rules restricting screen-time behaviours, limited access to screen-based media). The aim of this study was to examine associations between parental concerns for child television viewing and child television viewing and the home sedentary environment.

Methods

Parents of children aged 5-6 years ('younger' children, n = 430) and 10-12 years ('older children', n = 640) reported usual duration of their child's television (TV) viewing, their concerns regarding the amount of time their child spends watching TV, and on aspects of the home environment. Regression analyses examined associations between parental concern and child TV viewing, and between parental concern and aspects of the home environment. Analyses were stratified by age group.

Results

Children of concerned parents watched more TV than those whose parents were not concerned (B = 9.63, 95% CI = 1.58-17.68, p = 0.02 and B = 15.82, 95% CI = 8.85-22.80, p < 0.01, for younger and older children respectively). Parental concern was positively associated with younger children eating dinner in front of the television, and with parental restriction of sedentary behaviours and offering sedentary activities (i.e. TV viewing or computer use) as a reward for good behaviour among older and young children. Furthermore, parents of older children who were concerned had fewer televisions in the home and a lower count of sedentary equipment in the home.

Conclusions

Children of concerned parents watched more TV than those whose parents who were not concerned. Parents appear to recognise excessive television viewing in their children and these parents appear to engage in conflicting parental approaches despite these concerns. Interventions targeting concerned parents may be an innovative way of reaching children most in need of strategies to reduce their television viewing and harnessing this parental concern may offer considerable opportunity to change the family and home environment.     

Pregnancy Intendedness,Maternal Psychosocial Factors and Preterm Birth

Objectives: This study examined associations between reported pregnancy intendedness and several maternal psychosocial factors in relation to preterm birth (<37 weeks' completed gestation). Methods: Women were recruited into a prospective cohort study between the 24th and 29th weeks of pregnancy in central North Carolina from 1996 to 2000. Prior to delivery, participants responded to questions about pregnancy intendedness, life events impacts, depressive symptoms, and coping style. Results: Women who reported not intending their pregnancy had increased odds of reporting low, medium and high levels of perceived stress during pregnancy (OR = 1.4 [95% CI: 1.1, 1.9], OR = 2.2 [95% CI: 1.7, 2.8], and OR = 3.4 [95% CI: 2.6, 4.5], respectively, relative to very low), medium and high levels of depressive symptoms (OR = 2.2 [95% CI: 1.8, 2.9] and OR = 3.1 [95% CI: 2.4, 3.9], respectively), and medium and high levels of several coping styles. Reporting not intending the pregnancy was not associated with increased risk of preterm birth (Risk Ratio [RR] = 1.0, 95% CI: 0.8, 1.1), but reporting the highest quartile of perceived stress (RR = 1.6, 95% CI: 1.1, 2.3) and the highest tertile of distancing coping style (compared with lowest quartile) was associated with preterm birth (RR = 1.4, 95% CI: 1.1, 1.9). Interactions between pregnancy intendedness and the psychosocial variables perceived stress, depression or coping style did not modify the psychosocial variable's associations with preterm birth. Conclusions: Pregnancy intendedness remains an important concept in the reproductive health literature integrally tied to indicators of maternal mental health, but not necessarily to pregnancy outcomes.     

Physical Activity and Health Service Utilization Among Older People

BackgroundRising health care use among older people presents a challenge to medical care. Physical activity (PA) is beneficial; however, it is unknown if initiating PA among the very old reduces health service use. We examined the effects of changing PA levels on emergency room (ER) visits and hospitalization at ages 78 and 85.MethodsA representative sample (born 1920–1921) from the Jerusalem Longitudinal Cohort Study (1990–2010) were assessed at ages 78 and 85 for self-reported PA; ER visits and hospitalization; and social, functional, and medical domains.ResultsWe examined 896 and 1173 subjects at ages 78 and 85, respectively. ER usage at ages 78 and 85 respectively was lower among active subjects (15.8% vs 37.4%, P < .0001; 30.6% vs 50.8%, P < .0001), as was hospitalization (10.5% vs 16.7%, P < .05; 22.1% vs 37.8%, P < .0001). We adjusted for gender, education, loneliness, functional dependence, cognitive impairment, depression, diabetes, heart disease, hypertension, neoplasm, renal disease, self-rated health, body mass index, and smoking. PA at age 78 was associated with a reduced likelihood of ER visits (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.27–0.89), but not hospitalization (OR 1.14, 95% CI 0.54–2.42); at age 85 with a reduced likelihood for ER visits (OR 0.72, 95% CI 0.52–0.99) and hospitalization (OR 0.68, 95% CI 0.48–0.98). Compared with subjects consistently active at ages 78 and 85, initiating PA between ages 78 and 85 resulted in similar lower likelihood of ER visits (OR 0.6, 95% CI 0.23–1.56) and hospitalization (OR 1.20, 95% CI 0.48–3.02); stopping PA and never being active between 78 and 85 were respectively associated with increased ER visits (OR 1.72, 95% CI 1.02–2.88; OR 2.18, 95% CI 1.04–4.57) and hospitalization (OR 1.85, 95% CI 1.06–3.23; OR 2.01, 95% CI 0.92–4.4).ConclusionsAmong the oldest old, not only continuing but also becoming physically active is associated with reduced health service use. Initiating PA among the very old should be encouraged.     

Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors

BACKGROUND: The prevalence of pediatric obesity in North America is increasing. Native American children are at especially high risk. OBJECTIVES: The objective was to evaluate the prevalence of pediatric overweight and associated behavioral factors in a Native Canadian community with high rates of adult obesity and type 2 diabetes mellitus. DESIGN: Height and weight were measured in 445 children and adolescents aged 2-19 y. Fitness level, television viewing, body image concepts, and dietary intake were assessed in 242 subjects aged 10-19 y. Overweight was defined as a body mass index > or =85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Multiple logistic regression was used to examine factors associated with overweight, with adjustment for age and sex. RESULTS: The overall prevalence of overweight in subjects aged 2-19 y was significantly higher than NHANES III reference data [boys: 27. 7% (95% CI: 21.8, 34.5); girls: 33.7% (95% CI: 27.9, 40.1)]. In the subset aged 10-19 y, > or =5 h television viewing/d was associated with a significantly higher risk of overweight than was < or =2 h/d [odds ratio (OR) = 2.52; 95% CI: 1.06, 5.98]. Subjects in the third and fourth quartiles of fitness had a substantially lower risk of overweight than did those in the first quartile [third quartile compared with first quartile: OR = 0.24 (95% CI: 0.09, 0.66); fourth quartile compared with first quartile: OR = 0.13 (95% CI: 0.03, 0. 48)]. Fiber consumption on the previous day was associated with a decreased risk of overweight (OR = 0.69; 95% CI: 0.47, 0.99 for each 0.77 g/MJ increase in fiber intake). CONCLUSIONS: Pediatric overweight is a harbinger of future diabetes risk and indicates a need for programs targeting primary prevention of obesity in children and adolescents.     

Preschool Enrollment is Associated with Lower Odds of Childhood Obesity Among WIC Participants in LA County

The prevalence of obesity among children in the United States has increased rapidly during the past few decades. Research into social and behavioral determinants of obesity could lead to innovative strategies for prevention. The objective of the present study was to examine the association between childhood obesity and preschool enrollment and number of hours in child care among low-income preschool-aged children who were participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We conducted a case–control study including 556 3- to 4-year-old children who were either obese (BMI > 95th percentile of reference standard) or normal-weight (BMI 25–75th percentile). The population was largely (96%) Hispanic, an ethnic group that has one of the highest rates of overweight and obesity in adults and children in the US. In multiple logistic regression analysis, controlling for a variety of psychosocial and cognitive home environment variables, key demographics and maternal variables, the odds ratio of being obese was 0.61 for children who attended preschool more than 4 days a week (95% CI: 0.41–0.90). Watching television or videos for an hour or more on a typical day (odds ratio 1.71 (95% CI 1.07–2.75)), and higher maternal BMI (odds ratio 1.08 (95% CI 1.05–1.11)) were independently related to odds of obesity. The impact of preschool attendance and TV viewing are potentially instructive in terms of preventive interventions for children at this age.     

Correlates of objectively assessed physical activity and sedentary time in children: a cross-sectional study (The European Youth Heart Study)

Background  

Identifying leisure time activities performed before and after school that influence time in physical activity (PA) and/or time spent sedentary can provide useful information when designing interventions aimed to promote an active lifestyle in young people. The purpose of this study was to examine associations between mode of transportation to school, outdoor play after school, participation in exercise in clubs, and TV viewing with objectively assessed PA and sedentary behaviour in children.     

Sedentary Behavior,Physical Activity,and All-Cause Mortality: Dose-Response and Intensity Weighted Time-Use Meta-analysis

ObjectivesPrevious studies have placed those with excessive sedentary behavior at increased risk of all-cause mortality. There is evidence of interdependency of sedentary behavior with physical activity, and its elucidation will have implications for guidelines and practice. This study investigated if sedentary behavior–related mortality risk can be offset by moderate- to vigorous-intensity physical activity (MVPA) considered in a time-use fashion.DesignPubMed was searched (from its inception till May 2018) for studies or meta-analyses that used data harmonized for MVPA. Of the 17 data-custodians located, 7 provided data on sitting time or TV viewing time, or both. A dose-response meta-analysis modeling log relative risks of all-cause mortality against uncompensated sedentary behavior metabolic equivalent hours (USMh) was run using the robust error meta-regression method. (Registration: CRD42017062439)SettingIndividual subject data held by data custodians on this topic.ParticipantsGeneral adults.MeasurementsSedentary time, MVPA.ResultsFive harmonized cohorts of sitting time (258,688 participants) and 4 of TV viewing time (156,593 participants) demonstrated that sedentary behavior was significantly associated with mortality, but this risk was attenuated with increasing energy expenditure through MVPA modeled in a time-use fashion. The average increment in mortality per USMh spent on sitting was 1% [relative risk (RR) 1.01, 95% confidence interval (CI) 1.00, 1.02; P = .01] and that per USMh spent on TV viewing was 7% (RR 1.07, 95% CI 1.04, 1.10; P < .001). The thresholds for risk started at 7 USMh for sitting and 3 USMh for TV viewing.Conclusions/ImplicationsOur findings suggest that overall daily sitting time energy expenditure of 7 MET-hours (or TV viewing of 3 MET-hours) in excess of that expended on MVPA is independently related to all-cause mortality. These findings support the view that sitting is strongly influenced by consideration of concurrent MVPA in its impact on adverse health consequences and that the USMh is a more practical metric of sedentary behavior.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.