International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Individual characteristics can be associated with maintaining adequate FV intake over time. Thus, we aimed to identify factors associated with maintaining changes in fruit/vegetable (FV) intake at 48 months.

Methods: Longitudinal analysis of data from a randomized trial carried out in a health promotion service, including individuals with positive changes in FV intake after intervention. FV intake was assessed at 48 months, compared to 12 months to identify whether maintenance was associated with demographics, health data, stages of change, self-efficacy, and decisional balance, using multivariate regression.

Results: We included 2,232 participants, 88.4% were women, 46.6% were maintainers at 48 months. Maintainers were older, had lower schooling and baseline FV intake, had been in the service for longer, and increased FV intake between 12 and 48 months while non-maintainers decreased it. Being older or in the service for 36 + months were associated with 1% and 30% higher odds of maintenance; higher baseline FV intake and self-efficacy were associated with 1% and 2% lower odds of maintenance.

Conclusions: Maintenance of changes in FV intake was associated with higher age, a longer time in the service, and lower baseline FV intake and self-efficacy. Health promotion services should aim for participant retention, and interventionists should pay attention to participants who might face more barriers for maintenance.

Trial registration: RBR-9h7ckx. Date of registration: August 12, 2015.

Background: Children and adolescents with intellectual and developmental disabilities (IDD) are at greater risk for obesity and poor obesogenic behaviors (e.g., physical activity, screen time, diet, sleep) than their typically developing counterparts. The Structured Days Hypothesis (SDH) suggests that in typically developing children and adolescents, obesogenic behaviors worsen during periods of reduced structure (e.g., weekend or summer vacation). However, children and adolescents with IDD have unique factors that may alter how structure (i.e., pre-planned, segmented, adult supervised, out-of-home programs) influences obesogenic behaviors. Therefore, the objective of this systematic review and meta-analysis is to examine obesogenic behaviors during periods of more and less structure among children and adolescents with IDD.

Methods: A comprehensive search of PubMed, PsycINFO, Embase, and Web of Science was performed through the end of 2024 based on the PICO framework. Studies were eligible if they included youth with IDD and measured obesogenic behaviors across contexts with differing degrees of structure. Two reviewers independently completed the screening process, extracted all relevant information, and evaluated methodological quality using the NHLBI tool. Results were synthesized using fixed- and random-effects meta-analyses and visually represented with forest plots.

Results: A total of 4,236 papers were screened with 323 full-text articles retrieved. After screening, 33 total studies were identified (physical activity = 23, sedentary behaviors = 12, sleep = 11, diet = 1). Meta-analyses indicated that the standardized mean difference of physical activity (Random = 0.27, [95%CI: 0.13-0.40], p < 0.00), and diet (0.16, [95%CI: 0.03-0.29], p = 0.02) aligned with the SDH while sleep (Random = -0.01, [95%CI: -0.16-0.14], p = 0.88), sedentary and screen time (Random = -0.01, [95%CI: -0.38-0.36], p = 0.95) did not align.

Conclusions: Periods of greater structure were associated with more favorable physical activity and diet outcomes among children and adolescents with IDD, although evidence for dietary behaviors was limited. Findings support the relevance of the SDH in this population while highlighting substantial gaps in the literature, including small study numbers and methodological heterogeneity. Future research using rigorous, longitudinal designs is needed to better understand the relationship between structure and obesogenic behaviors among children and adolescents with IDD.

Background: The increase in smart device use, including smartphones and tablets, among young children has raised concerns about its impact on health, particularly on body mass index (BMI). However, the bidirectional associations between smart device use and BMI in preschoolers remain unclear. This study examined the longitudinal associations, considering the moderating effects of mother-child interactions and child sex.

Methods: Data were obtained from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan, a cohort study conducted in Taipei, Taiwan. In total, 590 preschoolers were assessed at ages 3, 4, and 5 years. Smart device use, BMI z-scores, and mother-child interaction quality were evaluated using validated parent-reported questionnaires. The random-intercept cross-lagged panel model was used to investigate bidirectional associations, adjusting for stable confounders. Multiple-group models examined the moderating effects of mother-child interactions and child sex. Model estimates were reported as standardized coefficients.

Results: Higher BMI z-scores at age 4 years were linked to increased device use at age 5 years (β = 0.36; 95% CI, 0.05-0.67). Multiple-group models revealed that among dyads with lower mother-child interactions, higher device use at age 3 years was associated with higher BMI at age 4 years (β = 0.40; 95% CI, 0.07 to 0.72), which was subsequently linked to greater device use at age 5 years (β = 0.50; 95% CI, 0.10 to 0.90). Additionally, higher device use at age 4 years was associated with higher BMI at age 5 years (β = 0.65; 95% CI, 0.31 to 1.00). A similar bidirectional pattern was observed among boys, while no significant cross-lagged associations were found among girls. In contrast, high-quality mother-child interactions revealed higher device use at age 4 years was associated with lower BMI at age 5 years, suggesting a protective role against prolonged device use and subsequent BMI increases.

Conclusions: Our study indicates bidirectional associations between smart device use and BMI among preschoolers, emphasizing the protective role of high-quality mother-child interactions. Interventions should focus on enhancing parent-child relationships, limiting device use, and promoting active engagement. Future studies should investigate the effect of media content and children's self-regulation on these associations.