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

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

Physical activity 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.     

Developmental trajectories of physical activity during elementary school physical education

ObjectivePhysical education (PE) during school provides an opportunity for children to be physically active. Few empirical studies have investigated developmental trajectories and determinants of objective moderate to vigorous physical activity (MVPA) during PE classes. The purpose of this study was to examine the developmental trajectories and determinants of MVPA during PE lessons in young children (8–12 years of age) in primary schools.MethodsStudents in grades 5–7 (n = 1202; 51.2% girls) were recruited from 17 elementary schools from the Geneva canton in 2012–2013. The percentage of time spent in accelerometer-assessed MVPA during regular PE lessons was used as a dependent variable.ResultsLinear mixed-model analyses revealed (a) that boys had a higher percentage of MVPA than girls, but none of the children reached the recommended activity levels (i.e., 50% of the PE class time spent in MVPA), (b) a linear decrease in the percentage of MVPA with age, (c) that higher perceived competence predicted a higher percentage of MVPA, and (d) that higher perceived competence reduced the negative linear effect of age among boys, but not among girls.ConclusionThe percentage of PE time spent in MVPA did not reach recommendations made by Centers for Disease Control and Prevention and decreased from 8 to 12 years old both for boys and girls. Perceived competence appears crucial to reduce MVPA decline for boys, but not for girls.     

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.     

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).     

Establishing school day pedometer step count cut-points using ROC curves in low-income children

Previous research has not established pedometer step count cut-points that discriminate children that meet school day physical activity recommendations using a tri-axial ActiGraph accelerometer criterion. The purpose of this study was to determine step count cut-points that associate with 30 min of school day moderate-to-vigorous physical activity (MVPA) in school-aged children. Participants included 1053 school-aged children (mean age = 8.4 ± 1.8 years) recruited from three low-income schools from the state of Utah in the U.S. Physical activity was assessed using Yamax DigiWalker CW600 pedometers and ActiGraph wGT3X-BT triaxial accelerometers that were concurrently worn during school hours. Data were collected at each school during the 2014–2015 school year. Receiver operating characteristic (ROC) curves were used to determine pedometer step count cut-points that associated with at least 30 min of MVPA during school hours. Cut-points were determined using the maximum Youden's J statistic (J max). For the total sample, the area-under-the-curve (AUC) was 0.77 (p < 0.001) with a pedometer cut-point of 5505 steps (J max = 0.46, Sensitivity = 63%, Specificity = 84%; Accuracy = 76%). Step counts showed greater diagnostic ability in girls (AUC = 0.81, p < 0.001; Cut-point = 5306 steps; Accuracy = 78.8%) compared to boys (AUC = 0.72, p < 0.01; Cut-point = 5786 steps; Accuracy = 71.4%). Pedometer step counts showed good diagnostic ability in girls and fair diagnostic ability in boys for discriminating children that met at least 30 min of MVPA during school hours.     

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.     

The association between discrepant weight perceptions and objectively measured physical activity

BackgroundSome individuals perceive themselves as being normal weight, despite having an excess body fat percentage (e.g., underestimate weight). Conversely, other individuals perceive themselves as being overweight, despite having a normal body fat percentage (e.g., overestimate weight). When perceived and actual weight statuses are incongruent, individuals possess a discrepant weight perception. The association between discrepant weight perceptions and engagement in moderate-to-vigorous physical activity (MVPA) has not been thoroughly investigated, which was this study's purpose.MethodsFor this cross-sectional study, data from the 2003–2006 National Health and Nutrition Examination Survey were utilized (N = 5462 adults). MVPA was assessed via accelerometry. Based on measured body mass index and whether participants considered themselves as overweight, underweight, or about the right weight, we classified individuals as accurate perception, overestimate weight (discrepant), or underestimate weight (discrepant). A negative binomial logistical regression was used to assess the association between discrepant weight perception (independent variable) and engagement in MVPA (outcome variable).ResultsFemales who said that they are normal weight, but were in fact overweight based on body mass index, engaged in 13% less MVPA (rate ratio = .87, 95% confidence interval: .769–.999, P = .05). Also, older adults (> 60 yrs) who said that they are normal weight, but were overweight based on body mass index, engaged in 23% less MVPA (rate ratio = .77, 95% confidence interval: .616–.965, P = .025).ConclusionDiscrepant weight perceptions were associated with less objectively measured MVPA. Interventions should take weight perceptions into consideration when designing and evaluating intervention impact.     

Does being a “SunSmart School” influence hat-wearing compliance? An ecological study of hat-wearing rates at Australian primary schools in a region of high sun exposure

BackgroundChildhood sun exposure is an important risk factor for skin cancer. Anecdotal evidence suggests that hats are under-utilized by Australian primary school students.MethodsThe proportion of students and adult role-models wearing hats was observed at 36 primary schools (63.9% SunSmart schools [SSS]) in Townsville (latitude 19.3°S; high to extreme maximum daily UV-index year round), Queensland, Australia, from 2009 to 2011.ResultsOverall, 52.2% of 28,775 students and 47.9% of 2954 adults were observed wearing a hat. Hat use (all styles) among SSS and non-SunSmart school (NSSS) students was similar before (24.2% vs 20.5%; p = 0.701), after (25.4% vs 21.7%; p = 0.775) and during school-hours (93.0% vs 89.2%; p = 0.649) except SSS students wore gold-standard (broad-brim/bucket/legionnaire) hats during school play-breaks more often in the warmer months (October–March) than NSSS students (54.7% vs 37.4%; p = 0.02). Although the proportion of adults who wore hats (all styles) was similar at SSS and NSSS (48.2% vs 46.8%; p = 0.974), fewer adults at SSS wore them before school (3.7% vs 10.2%; p = 0.035).ConclusionsSunSmart status is not consistently associated with better hat-wearing behavior. The protective nature of hats and the proportion of school students and adult role-models wearing them could be improved, possibly by offering incentives to schools that promote sun-safety.     

Risk factors for overweight and obesity in French adolescents: Physical activity,sedentary behavior and parental characteristics

ObjectiveWe determined the prevalence by age and sex and associated factors of overweight and obesity in French adolescents.MethodsWe conducted a cross-sectional study of 2385 adolescents aged 11–18 y (1213 boys and 1172 girls) from middle and high schools in the Aquitaine region (southwest France) in 2004–2005. Weight and height were measured, and adolescents filled in a questionnaire about their characteristics and those of their parents. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task force.ResultsPrevalence of overweight (obesity included) was greater in boys and younger children. The odds ratio (OR) for an adolescent being overweight increased with parents' being overweight (at least one parent overweight, OR 1.97, 1.48–2.62, P < 0.0001), low paternal socioeconomic status (OR 1.78, 1.22–2.60, P < 0.01) and sedentary behavior (22 h/wk, OR 1.33, 1.02–1.74, P < 0.05), and decreased with physical activity of parents (at least one parent active, OR 0.67, 0.51–0.89, P = 0.01).ConclusionOur data support the hypothesis that parental overweight and low socioeconomic status and adolescents' sedentary behavior are strong risk factors for adolescent overweight and obesity, and that parents active lifestyle is associated with a lower risk of overweight in their adolescents.     

The effect of a school-centered multicomponent intervention on daily physical activity and sedentary behavior in primary school children: The Active Living study

The aim of the current study was to examine the effectiveness of a school-centered multicomponent PA intervention, called ‘Active Living’, on children's daily PA levels.A quasi-experimental design was used including 9 intervention schools and 9 matched control schools located in the Netherlands. The baseline measurement took place between March–June 2013, and follow-up measurements were conducted 12 months afterwards. Accelerometer (ActiGraph, GT3X +) data of 520 children aged 8–11 years were collected and supplemented with demographics and weather conditions data. Implementation magnitude of the interventions was measured by keeping logbooks on the number of implemented physical environmental interventions (PEIs) and social environmental interventions (SEIs). Multilevel multivariate linear regression analyses were used to study changes in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) between baseline and follow-up. Finally, effect sizes (ESs) were calculated using Cohen's d.No pooled effects on PA and SB were found between children exposed and not exposed to Active Living after 12 months. However, children attending Active Living schools that implemented larger numbers of both PEIs and SEIs engaged in 15 more minutes of LPA per weekday at follow-up than children in the control condition (ES = 0.41; p < .05). Moreover, children attending these schools spent less time in SB at follow-up (ES = 0.33), although this effect was non-significant. No significant effects were found on MVPA.A school-centered multicomponent PA intervention holds the potential to activate children, but a comprehensive set of intervention elements with a sufficient magnitude is necessary to achieve at least moderate effect sizes.     

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.     

Smoking and mortality among persons aged 75–94

ObjectivesExamine the effect of current level of smoking and lifetime tobacco consumption on mortality in persons 75–94 years of age.MethodsData were from a representative sample of older Jewish persons in Israel, which included 1,200 self-respondent participants aged 75–94 (Mean = 83.1, SD = 5.3) from the Cross-Sectional and Longitudinal Aging Study (CALAS). Data collection took place during 1989–1992. Mortality data on 95.1% of the sample at 20-year follow up were recorded from the Israeli National Population Registry.ResultsThe following variables adversely affected mortality for the whole sample: Smoking 11–20 cigarettes daily (HR = 1.276, p < .05), smoking over 20 cigarettes daily (HR = 1.328, p < .05), total tobacco consumption (HR = 1.002, p < .01), and heavy lifetime tobacco consumption (HR = 1.270, p < .01). Results were similar for persons aged 75–84, but the effect of smoking seems to decrease or disappear for ages 85 and above.ConclusionThis is the first report of all-cause mortality risk in both genders of a representative population aged 75 and over. Increased mortality risk is related to high daily quantity of current smoking, and to cumulative amount of lifetime smoking. The effect of smoking may disappear for ages 85 and above, and should be studied in larger oldest–old samples.     

Physically active vs. sedentary academic lessons: A dose response study for elementary student time on task

BackgroundPhysically active academic lessons are an effective intervention to reduce sedentary time and increase student physical activity. They have also been shown to enhance task engagement, as indicated by observations of attention and behavior control, time on task (TOT). However, it is not clear if the improved TOT stems from the physical activity or if it is the result of an enjoyable break from traditional instruction. If it is due to physical activity, what dose of intensity is required for the effect? This study was designed to test these questions.MethodsParticipants were 320 children (7–9 years) recruited from school districts in Central Texas in 2012. They were assigned by classroom (n = 20) to one of four conditions: 1) sedentary, standard lesson (n = 72); 2) sedentary academic game (n = 87); 3) low to moderate intensity PA (LMPA), academic game (n = 81); and 4) moderate to vigorous intensity PA (MVPA), academic game (n = 76). Measures included PA via accelerometer and TOT.ResultsMixed-method RMANOVA indicated TOT decreased following the standard lesson (p < 0.001), showed no change following the sedentary academic game (p = 0.68), and increased following the LMPA (p < 0.01) and MVPA (p < 0.001) academic games.ConclusionsWhile the sedentary, academic game prevented the reduction in TOT observed in the standard lesson, PA resulted in increased TOT. Future research should be designed to examine the potential academic benefits of the change in TOT.     

Symptoms of specific anxiety disorders may relate differentially to different physical activity modalities in young adults

BackgroundAnxiety symptoms may be a barrier to physical activity (PA) such that persons who experience anxiety engage in less PA. The purpose of this study was to assess if symptoms of panic disorder, social phobia, generalized anxiety disorder (GAD) or agoraphobia are associated with frequency, intensity or type of PA in young adults.MethodsData on lifetime anxiety symptoms and current PA levels were collected in self-report questionnaires in 2007–2008 from 880 persons aged 18–24 years participating in the Nicotine Dependence in Teens (NDIT) study. The associations between anxiety symptom subtypes and different PA modalities were investigated in five multivariable logistic regression models, one for each of five PA indicators (i.e., meeting moderate-to vigorous PA (MVPA) guidelines, meeting strength training guidelines, meeting both MVPA and strength training guidelines, participating in team sports, frequent walking) as outcomes.Results37%, 47%, 40% and 21% of participants reported lifetime symptoms of panic disorder, social phobia, GAD, and agoraphobia, respectively. In multivariable logistic regression, participants who endorsed lifetime GAD symptoms were statistically significantly less likely to meet MVPA guidelines (OR 0.5, 95% CI 0.4–0.8, p < 0.05), and MVPA and strength training guidelines (OR 0.7, 95% CI 0.5–1.0, p < 0.05). Those with agoraphobia symptoms were more likely to walk frequently [OR (95% CI) = 1.6 (1.1, 2.3)].ConclusionPA interventions may need to be tailored to people who have experienced specific anxiety symptoms to maximize adherence to PA recommendations, and increase the potential for health benefits from PA participation.     

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.     

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.     

Evaluation of policies to promote physical activity in afterschool programs: Are we meeting current benchmarks?

BackgroundPolicies now recommend afterschool programs (ASP, 3–6 pm) provide children a minimum amount of physical activity daily. We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity (PA).MethodsAccelerometer-derived physical activity (light and moderate-to-vigorous, MVPA) of 253 children (5–13 years) was compared to policies that recommend varying amounts of PA children should achieve during an ASP.ResultsThe proportion of children achieving a policy ranged from 0.0% (California 60 min MVPA and North Carolina 20% of daily program time devoted to MVPA), 1.2% (California 30 min MVPA), to 48.2% (National Afterschool Association 30 min light plus MVPA). Random effects logistic models indicated boys (odds ratio [OR] range 2.0 to 6.27) and children from a minority background (Black/Hispanic, OR range 1.87 to 3.98) were more likely to achieve a recommended level of physical activity, in comparison to girls and White children. Neither age nor BMI were related to achieving a policy.ConclusionsThe PA of children attending ASP falls below policy recommended levels; however, these policies were developed in absence of data on expected PA levels during ASPs. Thus, concerted effort towards building a stronger ASP evidence-base for policy refinement is required.     

Dog walking among adolescents: Correlates and contribution to physical activity

PurposeTo assess the association of dog walking with adolescents' moderate-to-vigorous physical activity (MVPA) and body mass index (BMI), and identify correlates of dog walking.Methods/designParticipants were 12–17 year-olds (n = 925) from the Baltimore, MD and Seattle, WA regions. Differences in accelerometer-assessed minutes/day of MVPA and self-reported BMI (percentile) were compared among adolescents (1) without a dog (n = 441) and those with a dog who (2) did (≥ 1 days/week, n = 300) or (3) did not (n = 184) walk it. Correlates of (1) dog walking (any vs. none) among adolescents with dogs (n = 484), and (2) days/week of dog walking among dog walkers (n = 300) were investigated. Potential correlates included: demographic, psychosocial, home environment, perceived neighborhood environment, and objective neighborhood environment factors.Results52% of adolescents lived in a household with a dog, and 62% of those reported dog walking ≥ 1 day/week. Dog walkers had 4–5 more minutes/day of MVPA than non-dog-walkers and non-dog-owners. BMI was not associated with dog walking or ownership. Among households with dogs, adolescents who lived in objectively walkable neighborhoods were 12% more likely to walk their dog than those in less walkable neighborhoods. Among dog walkers, having a multi-family home, college-educated parent, lower perceived traffic safety, higher street connectivity and less mixed use were related to more days/week of dog walking.ConclusionsDog walkers had 7–8% more minutes/day of MVPA than non-dog walkers, and correlates of dog walking were found at multiple levels of influence. Results suggest multilevel interventions that include both environmental and psychosocial components to increase dog walking should be evaluated.     

The effects of objectively measured sedentary behavior on all-cause mortality in a national sample of adults with diabetes

BackgroundDiabetes is a highly prevalent chronic disease that has been increasing globally and is the seventh leading cause of death in the United States. Sedentary behavior is associated with increased risk of diabetes and is unfavorably related to all-cause mortality, but there are limited studies examining the sedentary–mortality relationship among those with diabetes, which was the purpose of this study.MethodsUsing data from the 2003–2006 NHANES, 712 adult participants with evidence of diabetes had complete data on the study variables. A multivariable Cox proportional hazard model was used to examine the association between objectively measured sedentary behavior and all-cause mortality among this diabetic sample.ResultsResults showed that for every 60 min/day increase in sedentary behavior, independent of moderate-to-vigorous physical activity (MVPA) and other covariates, adults with diabetes had a 13% increased risk of all-cause mortality (HR_adjusted = 1.13; 95% CI = 1.03–1.24; P = 0.01). However, after adjusting for total physical activity (light and MVPA), sedentary behavior was no longer associated with mortality risk (HR_adjusted = 1.04; 95% CI = 0.92–1.16; P = 0.46).ConclusionAmong those with diabetes, sedentary behavior may not have increased mortality risk independent of total physical activity behavior.