首页 > 最新文献

International Journal of Behavioral Nutrition and Physical Activity最新文献

英文 中文
24-hour movement behaviors and changes in quality of life over time among community-dwelling older adults: a compositional data analysis. 社区老年人的 24 小时运动行为和生活质量随时间的变化:组合数据分析。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-12 DOI: 10.1186/s12966-024-01681-9
Lotta Palmberg, Kristin Suorsa, Antti Löppönen, Laura Karavirta, Taina Rantanen, Timo Rantalainen

Background: Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up.

Methods: Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL.

Results: Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (βilr 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30 min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively.

Conclusions: Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age.

背景:良好的运动行为模式,包括更多的体力活动、较少的久坐行为和充足的睡眠,可促进老年人在步入老年后保持良好的生活质量(QoL)。本研究旨在调查运动行为是否能预测居住在社区的老年人在四年随访期间生活质量的未来变化:参与者为 75 岁、80 岁和 85 岁的社区老年人(n = 203),随访 4 年。参与者在基线期佩戴大腿和躯干加速度计3-7天。根据身体姿势和运动强度,对体力活动、站立和久坐行为的时间使用比例进行评估。卧床时间通过自动算法确定。在基线和随访期间进行的家庭访谈中,使用简短的《老年人生活质量问卷》(范围为 13-65,得分越高表示生活质量越高)对生活质量进行了评估。研究人员采用了构成线性回归分析法来研究基线时间使用构成是否能预测 QoL 的变化:结果:在 4 年的随访中,QoL 分数平均下降了 5%。与其他运动行为相比,较高的体力活动量与 QoL 随时间的推移而增加有关(βilr 0.94,p = 0.013),但在将基线身体功能加入模型后,这种相关性减弱。久坐行为、站立和卧床时间与 QoL 的变化无关。据估计,将30分钟的体力活动重新分配为久坐行为、站立或卧床时间会使QoL分别下降0.5(CI 95% -0.6至-0.4)、0.6(-0.7至-0.5)和0.4(-0.5至-0.3)分:理论上将体力活动重新分配为久坐行为、站立和卧床时间与老年人QoL的预期下降有关。随着年龄的增长,多参加体育锻炼,少参加被动活动,可能会提高生活质量。
{"title":"24-hour movement behaviors and changes in quality of life over time among community-dwelling older adults: a compositional data analysis.","authors":"Lotta Palmberg, Kristin Suorsa, Antti Löppönen, Laura Karavirta, Taina Rantanen, Timo Rantalainen","doi":"10.1186/s12966-024-01681-9","DOIUrl":"10.1186/s12966-024-01681-9","url":null,"abstract":"<p><strong>Background: </strong>Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up.</p><p><strong>Methods: </strong>Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL.</p><p><strong>Results: </strong>Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (β<sub>ilr</sub> 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30 min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively.</p><p><strong>Conclusions: </strong>Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"130"},"PeriodicalIF":5.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of a UK supermarket intervention to increase purchasing of fresh fruit and vegetables: process evaluation of the WRAPPED natural experiment. 实施英国超市干预措施以增加新鲜水果和蔬菜的购买量:WRAPPED 自然实验的过程评估。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-11 DOI: 10.1186/s12966-024-01679-3
Janis Baird, Preeti Dhuria, Hannah Payne, Sarah Crozier, Wendy Lawrence, Christina Vogel
<p><strong>Background: </strong>Placement interventions, characterised by greater availability and more prominent positioning of healthy food products in supermarkets and other food stores, are associated with healthier patterns of purchasing and diet. The WRAPPED intervention study is a natural experiment that aims to evaluate a supermarket placement intervention to improve fruit and vegetable sales, household purchasing and the dietary quality of women and their children. Process evaluation, alongside the evaluation of outcomes, is essential to understand how interventions are implemented, under what circumstances they are effective, and their mechanisms of impact. This study aimed to assess the implementation of the WRAPPED placement intervention.</p><p><strong>Methods: </strong>The study adopted a convergent mixed-methods design. Quantitative data extracted from study store planograms (visual representation of stores and product placement) before and after intervention implementation were used to assess the positioning of fresh fruit and vegetables in the first aisle from the front entrance (intervention dose). The availability of fresh fruit and vegetables in each study store was examined from stock-keeping unit (SKU) figures before and after intervention implementation. An intervention implementation survey (IIS) completed with store managers and senior supervisors before and 1- and 6-months post-intervention implementation enabled examination of the context across study stores. Semi-structured interviews with store managers and senior supervisors provided qualitative data about store staff experiences and perceptions of the intervention between 6-months post-intervention implementation.</p><p><strong>Results: </strong>The placement intervention was implemented with close adherence to the study protocol. There were marked differences, post-intervention implementation, in the positioning of fresh fruit and vegetables in intervention stores compared with control stores: median distance in intervention stores was 8.0 m (IQR 5.0 to 10.0) compared with 23.8 m (IQR 21.0 to 30.0) in control stores (P < 0.0001). The availability of varieties of fresh fruit and vegetables increased in intervention stores post-intervention compared with control stores: median (IQR) among intervention stores was 72 (51, 84) compared with 56.5 (50, 62) in control stores (P = 0.03). The mean change from baseline to post-implementation in number of different fruit and vegetables available in intervention stores was 15.3 (SD 16.7) (P = 0.01). IIS and interview data demonstrated little difference between intervention and store contexts over time. Reinforcing factors for intervention implementation included: head-office leadership, store staff views and attitudes and increased awareness of the importance of offering healthy food in prominent locations within stores.</p><p><strong>Conclusion: </strong>This study demonstrated that placement interventions which promote fresh f
背景:健康食品在超市和其他食品商店中更容易买到并摆放在更显眼的位置,这种摆放干预措施与更健康的购买和饮食模式有关。WRAPPED 干预研究是一项自然实验,旨在评估超市摆放干预措施,以改善水果和蔬菜销售、家庭购买以及妇女及其子女的饮食质量。在对结果进行评估的同时,过程评估对于了解干预措施的实施方式、干预措施在何种情况下有效以及干预措施的影响机制也至关重要。本研究旨在评估 WRAPPED 安置干预措施的实施情况:本研究采用了聚合混合方法设计。从干预措施实施前后的研究商店平面图(商店和产品摆放的可视化展示)中提取的定量数据被用来评估新鲜水果和蔬菜在从正门入口开始的第一个过道(干预剂量)的摆放情况。根据干预措施实施前后的库存单位(SKU)数据,对每家研究商店的新鲜水果和蔬菜供应情况进行了检查。在干预措施实施前、实施后 1 个月和 6 个月,对商店经理和高级主管进行了干预措施实施情况调查(IIS),以了解各研究商店的情况。对商店经理和高级主管进行的半结构化访谈提供了有关商店员工在干预实施后 6 个月之间的经历和对干预的看法的定性数据:结果:安置干预措施在实施过程中严格遵守了研究方案。干预措施实施后,干预商店与对照商店在新鲜水果和蔬菜的摆放位置上存在明显差异:干预商店的中位距离为 8.0 米(IQR 5.0 至 10.0),而对照商店为 23.8 米(IQR 21.0 至 30.0)(P 结论:这项研究表明,摆放干预措施促进了新鲜水果和蔬菜的摆放:这项研究表明,在折扣超市向顾客推广新鲜水果和蔬菜的投放干预措施可以有效实施。这些发现对于实施国家食品政策,改变零售环境以改善居民的购买和饮食模式具有鼓舞作用:试验注册:NCT03573973;前期结果。
{"title":"Implementation of a UK supermarket intervention to increase purchasing of fresh fruit and vegetables: process evaluation of the WRAPPED natural experiment.","authors":"Janis Baird, Preeti Dhuria, Hannah Payne, Sarah Crozier, Wendy Lawrence, Christina Vogel","doi":"10.1186/s12966-024-01679-3","DOIUrl":"10.1186/s12966-024-01679-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Placement interventions, characterised by greater availability and more prominent positioning of healthy food products in supermarkets and other food stores, are associated with healthier patterns of purchasing and diet. The WRAPPED intervention study is a natural experiment that aims to evaluate a supermarket placement intervention to improve fruit and vegetable sales, household purchasing and the dietary quality of women and their children. Process evaluation, alongside the evaluation of outcomes, is essential to understand how interventions are implemented, under what circumstances they are effective, and their mechanisms of impact. This study aimed to assess the implementation of the WRAPPED placement intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study adopted a convergent mixed-methods design. Quantitative data extracted from study store planograms (visual representation of stores and product placement) before and after intervention implementation were used to assess the positioning of fresh fruit and vegetables in the first aisle from the front entrance (intervention dose). The availability of fresh fruit and vegetables in each study store was examined from stock-keeping unit (SKU) figures before and after intervention implementation. An intervention implementation survey (IIS) completed with store managers and senior supervisors before and 1- and 6-months post-intervention implementation enabled examination of the context across study stores. Semi-structured interviews with store managers and senior supervisors provided qualitative data about store staff experiences and perceptions of the intervention between 6-months post-intervention implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The placement intervention was implemented with close adherence to the study protocol. There were marked differences, post-intervention implementation, in the positioning of fresh fruit and vegetables in intervention stores compared with control stores: median distance in intervention stores was 8.0 m (IQR 5.0 to 10.0) compared with 23.8 m (IQR 21.0 to 30.0) in control stores (P &lt; 0.0001). The availability of varieties of fresh fruit and vegetables increased in intervention stores post-intervention compared with control stores: median (IQR) among intervention stores was 72 (51, 84) compared with 56.5 (50, 62) in control stores (P = 0.03). The mean change from baseline to post-implementation in number of different fruit and vegetables available in intervention stores was 15.3 (SD 16.7) (P = 0.01). IIS and interview data demonstrated little difference between intervention and store contexts over time. Reinforcing factors for intervention implementation included: head-office leadership, store staff views and attitudes and increased awareness of the importance of offering healthy food in prominent locations within stores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrated that placement interventions which promote fresh f","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"128"},"PeriodicalIF":5.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Diurnal patterns of accelerometer-measured physical activity and sleep and risk of all-cause mortality: a follow-up of the National Health and Nutrition Examination Surveys (NHANES). 更正:加速计测量的体力活动和睡眠的昼夜模式与全因死亡风险:国家健康与营养调查(NHANES)的后续研究。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-11 DOI: 10.1186/s12966-024-01680-w
Yue Zhang, Mika Kivimäki, Rodrigo M Carrillo-Larco, Yangyang Cheng, Yaguan Zhou, Hui Wang, Changzheng Yuan, Xiaolin Xu
{"title":"Correction: Diurnal patterns of accelerometer-measured physical activity and sleep and risk of all-cause mortality: a follow-up of the National Health and Nutrition Examination Surveys (NHANES).","authors":"Yue Zhang, Mika Kivimäki, Rodrigo M Carrillo-Larco, Yangyang Cheng, Yaguan Zhou, Hui Wang, Changzheng Yuan, Xiaolin Xu","doi":"10.1186/s12966-024-01680-w","DOIUrl":"https://doi.org/10.1186/s12966-024-01680-w","url":null,"abstract":"","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"129"},"PeriodicalIF":5.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study. 投资营养干预措施以预防和减少秘鲁儿童和青少年超重和肥胖的案例:一项模型研究。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-06 DOI: 10.1186/s12966-024-01677-5
Maria Elena Ugaz, Christina L Meyer, Angela M Jackson-Morris, Daphne Wu, M Michelle Jimenez, Carlos Rojas-Davila, Carlos Orlando Zegarra Zamalloa, Elizabeth F Ludwig-Borycz, D'Arcy Williams, Jo Jewell

Background: Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.

Methods: A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.

Results: Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.

Conclusions: The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.

背景:2006 年至 2016 年间,秘鲁 5-19 岁儿童和青少年的超重和肥胖患病率从 22.7%增至 27.0%。本投资案例量化了秘鲁儿童和青少年超重和肥胖症的经济影响。它确定并量化了一系列新的或扩大的干预措施的潜在影响,这些干预措施可以加强当前国家预防和减少儿童和青少年超重和肥胖症的努力:方法:采用确定性马尔可夫队列模型,从社会成本的角度估算了通过实施干预措施预防和减少儿童和青少年超重和肥胖症而降低的死亡率和发病率,以及节约的医疗成本和提高的工资及生产力的影响。通过查阅已发表的文献,确定的干预措施包括以学校为基础的社会营销活动、纯母乳喂养推广和支持、校舍健康食品和饮料政策,以及为生活在国家贫困线以下的人群提供 20% 的水果和蔬菜补贴。在计算投资回报率(ROI)的同时,还估算了与干预措施相关的成本节约情况。对投资回报率对关键参数和假设变化的敏感性进行了分析测试:2025 年至 2092 年期间,预计秘鲁儿童和青少年超重和肥胖症造成的直接和间接医疗成本合计为 2,106 亿美元。直接医疗成本为 18 亿美元,间接成本为 2,088 亿美元。所有干预措施加在一起预计可节省 139 亿美元,人均节省 12089.8 美元。每投入 1 美元,四项干预措施的预期投资回报率分别为 39.3 美元(30 年)、64.6 美元(50 年)和 164.1 美元(66 年):结论:秘鲁儿童和青少年超重和肥胖症的流行需要广泛和扩大政策的实施范围,以实现长期降低流行率的目标。这项研究的结果表明,四项优先干预措施具有很高的投资回报率,可用于指导政策,以解决导致肥胖的各种因素之间复杂的相互作用。
{"title":"The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study.","authors":"Maria Elena Ugaz, Christina L Meyer, Angela M Jackson-Morris, Daphne Wu, M Michelle Jimenez, Carlos Rojas-Davila, Carlos Orlando Zegarra Zamalloa, Elizabeth F Ludwig-Borycz, D'Arcy Williams, Jo Jewell","doi":"10.1186/s12966-024-01677-5","DOIUrl":"10.1186/s12966-024-01677-5","url":null,"abstract":"<p><strong>Background: </strong>Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.</p><p><strong>Methods: </strong>A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.</p><p><strong>Results: </strong>Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.</p><p><strong>Conclusions: </strong>The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"127"},"PeriodicalIF":5.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the impact of the universal infant free school meal policy on the ultra-processed food content of children's lunches in England and Scotland: a natural experiment. 评估婴儿免费校餐普及政策对英格兰和苏格兰儿童午餐中超加工食品含量的影响:自然实验。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-01 DOI: 10.1186/s12966-024-01656-w
Jennie C Parnham, Kiara Chang, Fernanda Rauber, Renata B Levy, Anthony A Laverty, Jonathan Pearson-Stuttard, Martin White, Stephanie von Hinke, Christopher Millett, Eszter P Vamos

Background: The Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4-7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren.

Methods: Data from the UK National Diet and Nutrition Survey (2008-2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4-7 years, n = 835) was compared to the change in an unexposed control group (8-11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups.

Results: Before UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions.

Conclusions: This study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children's diet.

背景:2014/15 年,英格兰和苏格兰为 4-7 岁的学龄儿童推出了 "全民婴儿免费校餐"(UIFSM)政策,从而提高了校餐的摄入量。众所周知,与从家里带来的食物(盒饭)相比,英国的学校膳食更健康、工业加工更少。然而,UIFSM政策对午餐时间在学校消费的超加工食品(UPF)数量的影响尚不清楚。本研究旨在评估英国和苏格兰学童在午餐时间摄入超加工食品(UPF)的情况:方法:利用英国国家膳食与营养调查(2008-2019 年)的数据进行差异自然实验。实验结果包括学校午餐摄入量和学校午餐时间UPF平均摄入量(以克为单位的午餐总量百分比(%g)和以千卡为单位的午餐总量百分比(%Kcal))。采用线性回归法比较了干预组(4-7 岁,n = 835)与未干预对照组(8-11 岁,n = 783)在引入 "UIFSM"(英格兰为 2014 年 9 月,苏格兰为 2015 年 1 月)前后的结果变化。采用反概率加权法平衡干预组和对照组的特征:结果:在 "超级学校 "之前,干预组和对照组的学校膳食摄入量和 UPFs 消费量相似。DID模型显示,在 "UIFSM "之后,学校膳食摄入量增加了25%个百分点(pp)(95% CI 14.2,35.9),UPFs消耗量(%g)减少了6.8个百分点(95% CI -12.5,-1.0)。分析表明,这是由于微加工乳制品、蛋类和淀粉类食品的增加,以及超加工咸味零食、面包和饮料的减少。与中高收入儿童相比,最低收入儿童的差异更大(-19.3 UPF(%g);95% CI -30.4,-8.2)。使用 UPF %Kcal 进行的分析也得出了类似的结论:这项研究以之前的证据为基础,表明 "全民免费午餐 "对膳食模式产生了积极影响,减少了学校午餐时间的 UPF 消费量,对最低收入家庭的儿童影响最大。普及免费校餐可以成为长期公平改善儿童饮食的一项重要政策。
{"title":"Evaluating the impact of the universal infant free school meal policy on the ultra-processed food content of children's lunches in England and Scotland: a natural experiment.","authors":"Jennie C Parnham, Kiara Chang, Fernanda Rauber, Renata B Levy, Anthony A Laverty, Jonathan Pearson-Stuttard, Martin White, Stephanie von Hinke, Christopher Millett, Eszter P Vamos","doi":"10.1186/s12966-024-01656-w","DOIUrl":"10.1186/s12966-024-01656-w","url":null,"abstract":"<p><strong>Background: </strong>The Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4-7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren.</p><p><strong>Methods: </strong>Data from the UK National Diet and Nutrition Survey (2008-2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4-7 years, n = 835) was compared to the change in an unexposed control group (8-11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups.</p><p><strong>Results: </strong>Before UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions.</p><p><strong>Conclusions: </strong>This study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children's diet.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"124"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Secular trends and sociodemographic disparities in physical activity among adults in eleven African countries: WHO STEPS 2003-2020. 十一个非洲国家成年人体育活动的长期趋势和社会人口差异:2003-2020。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-30 DOI: 10.1186/s12966-024-01675-7
Adewale L Oyeyemi, Raphael H O Araujo, Umar A Hassan, Edward Ofori, Chad Stetcher, André O Werneck

Background: Mortality from physical inactivity-related non-communicable diseases (NCDs) is projected to surpass deaths from communicable diseases by 2030 in Africa. Monitoring physical activity (PA) is important for planning public health interventions addressing NCDS and planetary health, but there is a dearth of evidence on PA trends in Africa. This study explored the secular trends in overall and domains of PA (leisure, occupation, and transport), and examined the gender, age, and education disparities in PA trends across African countries.

Methods: We utilized data from the STEPwise approach to NCDs risk factor surveillance in eleven African countries (Algeria, Benin, Botswana, Cabo Verde, Eritrea, Eswatini, Malawi, Mali, Central Africa Republic, Sao Tome and Principe, and Zambia) with at least two surveys conducted between 2003/2010 (first-wave) and 2010/2020 (second-waves). A total of 29,282 and 40,147 adults (18-69 years) in the first and second waves, respectively, completed PA interviews using the Global Physical Activity Questionnaire. Gender, age, and education status were self-reported. Weighted individual-country PA prevalence and 95% confidence interval (95%CI) were obtained. Random-effect meta-analysis was conducted to assess pooled estimates of PA trends across countries. Gender, age, and education disparities in PA trends were also investigated.

Results: Country-specific results showed significant upward trends in total PA in eight countries. Seven countries showed significant increasing trends in some leisure-time PA (2.0% - 13.9% increase) and ≥ 150 min/week transport PA (4.0% - 24.5% increase), while five countries recorded significant increasing trends in occupational PA (6.6% - 56.9% increase). Gender, age and education disparities in meeting the WHO PA guidelines remained relatively stable over time, but disparities in leisure, transport and occupational PA increased in most countries.

Conclusions: The prevalence of overall PA among African adults has marginally increased over 17 years. There are still many adults, especially women and people with lower education, not doing well in domain specific PA. Policy and environmental interventions are needed to improve PA and to reduce gender, age, and education disparities in leisure, transport, and occupational PA in African countries.

背景:在非洲,预计到 2030 年,与缺乏体力活动相关的非传染性疾病(NCDs)造成的死亡率将超过传染性疾病造成的死亡率。监测体力活动(PA)对于规划应对非传染性疾病和地球健康的公共卫生干预措施非常重要,但有关非洲体力活动趋势的证据却很匮乏。本研究探讨了非洲国家总体体力活动和体力活动领域(休闲、职业和交通)的长期趋势,并研究了非洲国家在体力活动趋势方面的性别、年龄和教育差异:我们利用 STEPwise 方法对 11 个非洲国家(阿尔及利亚、贝宁、博茨瓦纳、佛得角、厄立特里亚、埃斯瓦提尼、马拉维、马里、中非共和国、圣多美和普林西比以及赞比亚)的非传染性疾病风险因素进行监测,这些国家在 2003/2010 年(第一波)和 2010/2020 年(第二波)之间至少进行了两次调查。在第一波和第二波调查中,分别有 29,282 名和 40,147 名成年人(18-69 岁)使用全球体育锻炼问卷完成了体育锻炼访谈。性别、年龄和教育状况均为自我报告。得出了加权的单个国家体育锻炼流行率和 95% 置信区间 (95%CI)。通过随机效应荟萃分析评估了各国 PA 趋势的集合估计值。此外,还调查了 PA 趋势中的性别、年龄和教育差异:具体国家的结果显示,8 个国家的总 PA 呈显著上升趋势。7 个国家的一些休闲时间 PA(增加 2.0% - 13.9%)和≥ 150 分钟/周的交通 PA(增加 4.0% - 24.5%)呈显著增长趋势,而 5 个国家的职业 PA(增加 6.6% - 56.9%)呈显著增长趋势。随着时间的推移,在达到世界卫生组织活动量指南要求方面的性别、年龄和教育差距保持相对稳定,但大多数国家在休闲、交通和职业活动量方面的差距有所扩大:结论:17 年来,非洲成年人的总体活动量略有增加。仍有许多成年人,尤其是妇女和教育程度较低的人,在特定领域的活动量方面表现不佳。需要采取政策和环境干预措施来改善非洲国家的活动量,并减少休闲、交通和职业活动量方面的性别、年龄和教育差异。
{"title":"Secular trends and sociodemographic disparities in physical activity among adults in eleven African countries: WHO STEPS 2003-2020.","authors":"Adewale L Oyeyemi, Raphael H O Araujo, Umar A Hassan, Edward Ofori, Chad Stetcher, André O Werneck","doi":"10.1186/s12966-024-01675-7","DOIUrl":"10.1186/s12966-024-01675-7","url":null,"abstract":"<p><strong>Background: </strong>Mortality from physical inactivity-related non-communicable diseases (NCDs) is projected to surpass deaths from communicable diseases by 2030 in Africa. Monitoring physical activity (PA) is important for planning public health interventions addressing NCDS and planetary health, but there is a dearth of evidence on PA trends in Africa. This study explored the secular trends in overall and domains of PA (leisure, occupation, and transport), and examined the gender, age, and education disparities in PA trends across African countries.</p><p><strong>Methods: </strong>We utilized data from the STEPwise approach to NCDs risk factor surveillance in eleven African countries (Algeria, Benin, Botswana, Cabo Verde, Eritrea, Eswatini, Malawi, Mali, Central Africa Republic, Sao Tome and Principe, and Zambia) with at least two surveys conducted between 2003/2010 (first-wave) and 2010/2020 (second-waves). A total of 29,282 and 40,147 adults (18-69 years) in the first and second waves, respectively, completed PA interviews using the Global Physical Activity Questionnaire. Gender, age, and education status were self-reported. Weighted individual-country PA prevalence and 95% confidence interval (95%CI) were obtained. Random-effect meta-analysis was conducted to assess pooled estimates of PA trends across countries. Gender, age, and education disparities in PA trends were also investigated.</p><p><strong>Results: </strong>Country-specific results showed significant upward trends in total PA in eight countries. Seven countries showed significant increasing trends in some leisure-time PA (2.0% - 13.9% increase) and ≥ 150 min/week transport PA (4.0% - 24.5% increase), while five countries recorded significant increasing trends in occupational PA (6.6% - 56.9% increase). Gender, age and education disparities in meeting the WHO PA guidelines remained relatively stable over time, but disparities in leisure, transport and occupational PA increased in most countries.</p><p><strong>Conclusions: </strong>The prevalence of overall PA among African adults has marginally increased over 17 years. There are still many adults, especially women and people with lower education, not doing well in domain specific PA. Policy and environmental interventions are needed to improve PA and to reduce gender, age, and education disparities in leisure, transport, and occupational PA in African countries.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"126"},"PeriodicalIF":5.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thinking about inequalities in physical activity as an emergent feature of complex systems. 将体育活动中的不平等现象视为复杂系统的一个新特征。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-29 DOI: 10.1186/s12966-024-01659-7
Sophie Marie Jones, Ana Porroche-Escudero, Katie Shearn, Ruth F Hunter, Leandro Garcia

Inequalities in physical activity are well documented, especially between socioeconomic groups. However, progress on reducing these inequalities is proving challenging. In this commentary, we argue that a complex system perspective is needed, specifically to reorient our thinking of inequalities in physical activity to be emergent features of complex systems. Operationalising this perspective involves acknowledging the multiple dynamic and non-linear interactions which take place between system parts and, over time aggregate to become macro patterns such as physical activity inequalities. We argue that this framing will enhance our understanding of the emergence of inequalities in physical activity and, therefore, provide interventions better suited to the subgroups of the population they are designed to help.

体育活动中的不平等现象有据可查,尤其是社会经济群体之间的不平等。然而,事实证明,在减少这些不平等现象方面取得进展具有挑战性。在这篇评论中,我们认为需要一种复杂系统的视角,特别是要重新定位我们的思维,将体育活动中的不平等现象视为复杂系统的新特征。要将这一观点付诸实施,就必须承认系统各部分之间存在着多种动态和非线性的相互作用,随着时间的推移,这些相互作用就会聚合成体育活动不平等等宏观模式。我们认为,这一框架将加深我们对体育锻炼不平等现象的理解,从而提供更适合人口亚群的干预措施。
{"title":"Thinking about inequalities in physical activity as an emergent feature of complex systems.","authors":"Sophie Marie Jones, Ana Porroche-Escudero, Katie Shearn, Ruth F Hunter, Leandro Garcia","doi":"10.1186/s12966-024-01659-7","DOIUrl":"10.1186/s12966-024-01659-7","url":null,"abstract":"<p><p>Inequalities in physical activity are well documented, especially between socioeconomic groups. However, progress on reducing these inequalities is proving challenging. In this commentary, we argue that a complex system perspective is needed, specifically to reorient our thinking of inequalities in physical activity to be emergent features of complex systems. Operationalising this perspective involves acknowledging the multiple dynamic and non-linear interactions which take place between system parts and, over time aggregate to become macro patterns such as physical activity inequalities. We argue that this framing will enhance our understanding of the emergence of inequalities in physical activity and, therefore, provide interventions better suited to the subgroups of the population they are designed to help.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"125"},"PeriodicalIF":5.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
National school food standards in England: a cross-sectional study to explore compliance in secondary schools and impact on pupil nutritional intake. 英格兰国家学校食品标准:一项横断面研究,旨在探讨中学遵守该标准的情况及其对学生营养摄入的影响。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-24 DOI: 10.1186/s12966-024-01672-w
Miranda Pallan, Marie Murphy, Breanna Morrison, Alice Sitch, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Emma Frew, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Irina Pokhilenko, Maisie Rowland, Vahid Ravaghi, Suzanne Spence, Peymane Adab

Background: Many countries have introduced school food standards to improve the dietary intakes of school-aged children. England has school food standards (SFS) legislation in place but little is known about how well secondary schools comply with this. We aimed to assess compliance with the SFS legislation in English secondary schools and explore the impact of the SFS on pupils' nutritional intake.

Methods: We conducted a cross-sectional study with English secondary schools from 2019 to 2022. We compared SFS compliance and pupil nutritional intake in schools mandated or not mandated to comply with the SFS legislation, and explored the association between school compliance and pupil nutritional intake. We assessed the percentage of SFS (%SFS) complied with by reviewing school food menus and observing food served in school canteens. We assessed pupil nutritional intake using a 24-hour dietary recall measure (Intake24) and estimated intakes of free sugar (primary outcome) and other nutrients/foods. We used adjusted multilevel models to compare pupil intakes in the SFS-mandated and SFS-non-mandated schools, and to explore the association between school SFS compliance and pupil intakes.

Results: 36 schools (23 not mandated and 13 mandated to comply with the SFS) and 2,273 pupils participated. The median %SFS complied with was 63.9% (interquartile range 60.0-70.0%). This was similar for SFS-non-mandated (64.5%) and SFS-mandated schools (63.3%). Compliance was highest for standards applying to lunchtime (median = 81.3%) and lowest for those applying across the whole school day (median = 41.7%). It was also lower for standards restricting high fat, sugar and energy-dense items (median = 26.1%) than for standards aiming to increase dietary variety (median = 92.3%). Pupils from SFS-mandated schools had a lower mean lunchtime intake of free sugar (g) (adjusted mean difference: -2.78g; 95% CI: -4.66g to -0.90g). There were few significant associations between %SFS complied with and pupil nutritional intake.

Conclusions: English secondary schools do not fully comply with SFS legislation regardless of whether they are mandated to comply. Schools and caterers may require monitoring and support to fully comply. There is little evidence that SFS compliance is associated with better pupil nutritional intake. Food environments outside of school also need to be considered.

Study registration: ISRCTN68757496 (17-10-2019).

背景:许多国家都引入了学校食品标准,以改善学龄儿童的膳食摄入量。英格兰已制定了学校食品标准(SFS)法规,但人们对中学遵守该法规的情况知之甚少。我们的目的是评估英国中学遵守学校食品标准法规的情况,并探讨学校食品标准对学生营养摄入的影响:我们在 2019 年至 2022 年期间对英国中学进行了一项横断面研究。我们比较了强制或非强制遵守 SFS 法规的学校的 SFS 合规性和学生营养摄入量,并探讨了学校合规性与学生营养摄入量之间的关联。我们通过审查学校食品菜单和观察学校食堂供应的食品,评估了学校遵守校餐标准的百分比(%SFS)。我们使用 24 小时膳食回忆测量法(Intake24)评估了学生的营养摄入量,并估算了游离糖(主要结果)和其他营养素/食品的摄入量。我们使用调整后的多层次模型来比较 "小学生营养餐计划 "实施学校和 "小学生营养餐计划 "未实施学校的学生摄入量,并探讨学校 "小学生营养餐计划 "实施情况与学生摄入量之间的关系:共有 36 所学校(23 所未强制实施和 13 所强制实施)和 2 273 名学生参与了研究。遵守 SFS 的百分比中位数为 63.9%(四分位间范围为 60.0-70.0%)。非强制性学校(64.5%)和强制性学校(63.3%)的情况相似。適用於午膳時間的標準達標率最高(中位數=81.3%),而適用於上課全日的標準達標率最低 (中位數=41.7%)。限制高脂肪、高糖和高能量食物的标准(中位数 = 26.1%)也低于旨在增加膳食种类的标准(中位数 = 92.3%)。实行 "学生健康标准 "学校的学生午餐时摄入的游离糖平均量(克)较低(调整后的平均差异:-2.78克;95% CI:-4.66克至-0.90克)。遵守 SFS 的百分比与学生营养摄入量之间几乎没有明显关联:英国中学无论是否被强制要求遵守 SFS 法规,都没有完全遵守。学校和膳食供应商可能需要监督和支持才能完全遵守。几乎没有证据表明,遵守 "特殊膳食标准 "与提高学生营养摄入量有关。还需要考虑校外的食品环境:ISRCTN68757496 (17-10-2019).
{"title":"National school food standards in England: a cross-sectional study to explore compliance in secondary schools and impact on pupil nutritional intake.","authors":"Miranda Pallan, Marie Murphy, Breanna Morrison, Alice Sitch, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Emma Frew, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Irina Pokhilenko, Maisie Rowland, Vahid Ravaghi, Suzanne Spence, Peymane Adab","doi":"10.1186/s12966-024-01672-w","DOIUrl":"10.1186/s12966-024-01672-w","url":null,"abstract":"<p><strong>Background: </strong>Many countries have introduced school food standards to improve the dietary intakes of school-aged children. England has school food standards (SFS) legislation in place but little is known about how well secondary schools comply with this. We aimed to assess compliance with the SFS legislation in English secondary schools and explore the impact of the SFS on pupils' nutritional intake.</p><p><strong>Methods: </strong>We conducted a cross-sectional study with English secondary schools from 2019 to 2022. We compared SFS compliance and pupil nutritional intake in schools mandated or not mandated to comply with the SFS legislation, and explored the association between school compliance and pupil nutritional intake. We assessed the percentage of SFS (%SFS) complied with by reviewing school food menus and observing food served in school canteens. We assessed pupil nutritional intake using a 24-hour dietary recall measure (Intake24) and estimated intakes of free sugar (primary outcome) and other nutrients/foods. We used adjusted multilevel models to compare pupil intakes in the SFS-mandated and SFS-non-mandated schools, and to explore the association between school SFS compliance and pupil intakes.</p><p><strong>Results: </strong>36 schools (23 not mandated and 13 mandated to comply with the SFS) and 2,273 pupils participated. The median %SFS complied with was 63.9% (interquartile range 60.0-70.0%). This was similar for SFS-non-mandated (64.5%) and SFS-mandated schools (63.3%). Compliance was highest for standards applying to lunchtime (median = 81.3%) and lowest for those applying across the whole school day (median = 41.7%). It was also lower for standards restricting high fat, sugar and energy-dense items (median = 26.1%) than for standards aiming to increase dietary variety (median = 92.3%). Pupils from SFS-mandated schools had a lower mean lunchtime intake of free sugar (g) (adjusted mean difference: -2.78g; 95% CI: -4.66g to -0.90g). There were few significant associations between %SFS complied with and pupil nutritional intake.</p><p><strong>Conclusions: </strong>English secondary schools do not fully comply with SFS legislation regardless of whether they are mandated to comply. Schools and caterers may require monitoring and support to fully comply. There is little evidence that SFS compliance is associated with better pupil nutritional intake. Food environments outside of school also need to be considered.</p><p><strong>Study registration: </strong>ISRCTN68757496 (17-10-2019).</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"123"},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women. 强心、健康社区 2.0:针对农村妇女的心血管疾病预防干预措施》的过程评估结果。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-22 DOI: 10.1186/s12966-024-01670-y
Jacob Szeszulski, Laura J Rolke, Priscilla Ayine, Regan Bailey, Margaret Demment, Galen D Eldridge, Sara C Folta, Meredith L Graham, Alexandra L MacMillan Uribe, Andrew McNeely, Miriam E Nelson, Kristin Pullyblank, Chad Rethorst, David Strogatz, Rebecca A Seguin-Fowler

Background: Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.

Methods: This process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.

Results: Average reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders' perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being "more than satisfied" with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.

Conclusions: SHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.

Clinical trials registration: www.

Clinicaltrials: gov #NCT03059472.

背景:强健心脏、健康社区 2.0(SHHC-2.0)是一项为期 24 周的心血管疾病预防计划,它能有效改善美国纽约 11 个农村城镇妇女的体育锻炼和营养行为以及临床结果。本研究对 SHHC-2.0 的实施情况进行了评估,以便为进一步推广该干预措施做好准备:这项过程评估以医学研究委员会的建议为指导,采用定量和定性的方法,让项目负责人和参与者(即 40 岁以上的女性)参与其中。定量评估包括检查注册和保留数据、参与者调查和课后完成的忠诚度检查表。描述性统计和比较性统计用于评估实施措施:计划覆盖范围、参与者出席率、提供的剂量、计划长度、感知效果、忠实度和参与者满意度。定性评估包括使用半结构化指南进行的焦点小组(13 人)和访谈(4 人);使用定向内容分析法和迭代分类法对录音和记录誊本进行演绎编码和分析。探讨了不同城镇之间以及干预组和候补对照组之间的比较:城镇内的平均覆盖率为合格人口的 7.5%(范围为 0.7-15.7%)。平均出席率为 59.8%(范围为 42.0-77.4%)。领导者提供的平均剂量占课程内容的 86.4%(范围为 73.5-95.2%)。48 节课的平均课时长度为 51.8 ± 4.8 分钟。领导者的感知效果评分平均为(4.1 ± 0.3)分(满分为 5 分)。课程内容的忠实度为 81.8%(范围为 67.4-93.2%)。参与者对整个计划(88.8%)和他们获得的健康益处(72.9%)表示 "非常满意"。定性分析显示,参与者:(1) 获得了新的知识和愉快的体验;(2) 认为自己在体育锻炼、营养和/或健康方面有所改善;(3) 在体育锻炼和健康饮食方面仍然面临一些障碍,其中与社会支持有关的障碍有所减少;(4) 对领导者和小组结构的评价较高,对研究内容的意见不一:SHHC-2.0具有广泛的影响力,在很大程度上达到了预期目标,参与者对该计划及其健康益处表示高度满意。我们的研究结果拓展了在农村社区实施心血管疾病预防计划的最佳实践。临床试验注册:www.Clinicaltrials: gov #NCT03059472。
{"title":"Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women.","authors":"Jacob Szeszulski, Laura J Rolke, Priscilla Ayine, Regan Bailey, Margaret Demment, Galen D Eldridge, Sara C Folta, Meredith L Graham, Alexandra L MacMillan Uribe, Andrew McNeely, Miriam E Nelson, Kristin Pullyblank, Chad Rethorst, David Strogatz, Rebecca A Seguin-Fowler","doi":"10.1186/s12966-024-01670-y","DOIUrl":"10.1186/s12966-024-01670-y","url":null,"abstract":"<p><strong>Background: </strong>Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.</p><p><strong>Methods: </strong>This process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.</p><p><strong>Results: </strong>Average reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders' perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being \"more than satisfied\" with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.</p><p><strong>Conclusions: </strong>SHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.</p><p><strong>Clinical trials registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov #NCT03059472.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"122"},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effectiveness and acceptability of physical activity interventions amongst older adults with lower socioeconomic status: a mixed methods systematic review. 对社会经济地位较低的老年人进行体育活动干预的有效性和可接受性:混合方法系统综述。
IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-22 DOI: 10.1186/s12966-024-01666-8
Danielle Harris, Schenelle Dayna Dlima, Ashley Gluchowski, Alex Hall, Emma Elliott, Luke Munford

Background: Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status?

Methods: This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings.

Results: Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status.

Conclusions: Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time.

Trial registration: PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .

背景:与社会经济地位较高的老年人相比,社会经济地位较低的老年人不太可能参加体育锻炼。为了给未来干预措施的制定提供信息,本综述探讨了以下问题:[i) 体育锻炼干预措施在提高社会经济地位较低的老年人的体育锻炼水平方面有多大效果;[ii] 社会经济地位较低的老年人对体育锻炼干预措施的接受程度与哪些因素有关;[iii] 为社会经济地位较低的老年人制定体育锻炼干预措施有何意义?本混合方法系统综述遵循 PRISMA 指南。检索了截至 2023 年 5 月的 MEDLINE、CENTRAL、Embase、Scopus、Web of Science、PsycINFO、CINAHL、ASSIA 和 Sports Medicine and Education Index,以确定衡量针对社会经济地位较低的老年人(年龄≥65 岁)的体育锻炼干预措施的有效性和/或经验的定量、定性和混合方法的主要研究。对国家没有限制。采用混合方法评估工具对纳入的研究进行方法学质量评估。采用基于结果的聚合综合法对结果进行综合,对定量研究结果进行叙述性综合,对定性研究结果进行主题性综合:结果:共纳入 30 项研究。结果:共纳入了 30 项研究,发现体育锻炼干预措施的效果参差不齐,对增加功利性步行(即用于交通)有积极影响,但对休闲活动没有影响;对客观测量的体育锻炼效果参差不齐,而对自我报告的总体育锻炼量或肌肉强化和柔韧性活动没有影响。参与体育锻炼干预被认为能带来很多益处,社会熟悉度对干预的可接受性很重要,当干预符合社会经济地位较低的老年人的生活方式时,干预被认为更容易被接受:针对社会经济地位较低的老年人的体育锻炼干预措施的未来发展应促进社会联系,强调体育锻炼对健康的益处,在社会经济地位较低的老年人容易到达和熟悉的地点举行干预活动,最大限度地降低参与者的成本,雇用与参与者特征相同的人来领导干预活动,并将体育锻炼与社会经济地位较低的老年人已经进行的其他活动结合起来,以便更有效地利用时间:ProCORD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .
{"title":"The effectiveness and acceptability of physical activity interventions amongst older adults with lower socioeconomic status: a mixed methods systematic review.","authors":"Danielle Harris, Schenelle Dayna Dlima, Ashley Gluchowski, Alex Hall, Emma Elliott, Luke Munford","doi":"10.1186/s12966-024-01666-8","DOIUrl":"10.1186/s12966-024-01666-8","url":null,"abstract":"<p><strong>Background: </strong>Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status?</p><p><strong>Methods: </strong>This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings.</p><p><strong>Results: </strong>Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status.</p><p><strong>Conclusions: </strong>Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"121"},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Behavioral Nutrition and Physical Activity
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1