International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: While daily step count and stepping pace are linked to various health benefits in older adults, less is known about how the pattern of step accumulation affects physical function. For example, the same step count could be accumulated through clusters of frequent, short bouts (e.g., during house cleaning) or fewer, longer bouts (e.g., walking to and from work). This study aimed to explore whether stepping patterns, and trends in these patterns, were associated with physical function in older adults.

Methods: We analysed accelerometer data from wrist-worn GENEActiv devices, from four time points over 24 months in n = 597 older adults (age ≥65 years, 68% female) participating in the REtirement in ACTion intervention. A step counting algorithm was used to create bouts of stepping (at least 10 steps > 20 steps/minute) before counting the steps in each bout and the average cadence. Total daily steps (20-175 steps/minute), slower-paced steps (20-62 steps/minute; below the median cadence), and faster-paced walking steps (63-175 steps/minute; above the median cadence) were then calculated. We used the frequency of stepping bouts, the time between them (mean and standard deviation) and their burstiness (short bursts of stepping bouts clustered together), to examine the daily patterns of step accumulation. Linear mixed-effects models were used to assess trends in stepping variables and their association with changes in objectively measured physical function (short physical performance battery: SPPB) over the two-year period.

Results: Total, slower-paced and faster-paced daily steps declined, along with the average number of stepping bouts. The time between stepping bouts increased. All components of burstiness, but not burstiness itself, were associated with changes in physical function, even when faster and slower steps (total steps) were in the same model (fewer stepping bouts = lower SPPB, greater SD = lower SPPB). Mean time between bouts was the strongest independent predictor, whereby a 10-minute increase in time between bouts was associated with a clinically important 0.46 decline in SPPB score (p < 0.001).

Conclusions: Preventing increases in the time between stepping bouts could help preserve physical function in older adults. Future intervention trials targeting how bouts of stepping are spread throughout the day, rather than just total steps, may provide a more effective approach to promoting healthy physical functioning in older age.

Background: Although food-based dietary guidelines (FBDG) include guidelines for meat consumption, they most often do not explicitly include environmental considerations. For instance, in France, FBDG recommend consuming no more than 500 g of red meat and 150 g of processed meat per week. This study uses modeling to investigate the range of greenhouse gas emissions (GHGe) that can be achieved under FBDG compliance.

Methods: The study analyzed data collected in 2014 from 29,413 NutriNet-Santé participants to assess their adherence to the French FBDG. GHGe, cumulative energy demand (CED), and land occupation (LO) for organic and conventional foods were obtained from the DIALECTE database. First, diets adequate in nutrients, culturally acceptable, and consistent with FBDG were modeled while minimizing or maximizing GHGe. Then, the spectrum of diets between minimum and maximum GHGe was explored while minimizing total departure from the observed diet with a gradual constraint on GHGE using the same other constraints. Environmental, economic (monetary cost), nutritional, and health criteria (Health risk score denoting long-term risk for health associated with diet) were then estimated for each diet.

Results: The average observed adequacy to FBDG was low (19%, SD = 25%) and GHGe were 4.34 (SD = 2.7%) kgCO2eq/d. Under nutritional, acceptability and FBDG constraints, the GHGe range of the diets varied from 1.16 to 6.99 kgCO2eq/d, depending up to ∼ 85% on the level of meat consumption. A similar shape was observed for CED, LO, and Health Risk Score, but costs were consistently higher than in the observed diet, and exhibited a U-shape. A greater proportion of organic foods was noted in the lower-emission diet; however, this proportion was low in the meat-rich, high-emission diet. At isoenergetic diets, the diet with the lowest emissions had more vegetables, whole grains, and plant-based substitutes.

Conclusions: While French dietary guidelines contribute, on average, to mitigating climate change and promoting health, this study emphasizes levers in recommended food consumption to more efficiently reduce diets' GHGe and points to total meat as the critical issue to better account for pressure on climate change. Other environmental pressures should also be taken into account when designing dietary guidelines.

Background: This cluster-randomized trial examined the effects of active breaks (AB) and physically active lessons (PAL) on cognitive function and health indicators in elementary school children.

Methods: Six schools were randomly assigned to three groups: AB group (n = 61), PAL group (n = 77), and a control group (CTL, n = 46). First-year elementary school students participated (6.9 ± 0.6 years; 52.7% girls), and the interventions lasted eight weeks. Cognitive function was measured via reaction time and correct responses on computerized tests (Go/NoGo, DigitSpan, Mental Rotation, Visual Search, and Cueing Posner). Secondary outcomes included physical activity, quality of life, daytime sleepiness, and school perception.

Results: Significant group-by-time interactions were found in four tests: Go/NoGo (reaction time: p = 0.045), DigitSpan (correct responses: p = 0.020), Mental Rotation (reaction time: p = 0.049), and Cueing Posner (reaction time: p = 0.017). Only the PAL group presented a reduction in reaction time in inhibitory control (Go/NoGo) (change from baseline [Δ] = -106.4 ms; p < 0.001; d = 0.50), with a greater reduction than the AB group (difference-in-differences [DiD] = -107.3 ms; p = 0.019; d = 0.47). Short-term memory (Digit Span) improved only in the PAL group (Δ =  + 0.6; p < 0.001; d = 0.44), with larger gains than the CTL group (DiD =  + 0.7; p = 0.024; d = 0.54) and AB group (DiD =  + 0.7; p = 0.010; d = 0.49). Spatial reasoning (Mental Rotation) improved in both the PAL (Δ = -1967.5 ms; p < 0.001; d = 0.72) and AB groups (Δ = -1477.8 ms; p < 0.001; d = 0.54), but only the PAL group showed a greater change than the CTL group (DiD = -1394.0 ms; p = 0.012; d = 0.54). Spatial orientation (Posner Cueing) improved in all groups (PAL group: Δ = -386.6 ms; p < 0.001; d = 0.68; CTL group: Δ = -183.8 ms; p = 0.024; d = 0.29; AB group: Δ = -158.4 ms; p = 0.007; d = 0.36), with the PAL group presenting greater reductions than the CTL (DiD = -202.8 ms; p = 0.045; d = 0.33) and AB groups (DiD = -228.2 ms; p = 0.007; d = 0.45).

Conclusions: Physically active lessons enhanced various cognitive functions, while active breaks, although less impactful, also represent a beneficial strategy.

Trial registration: Brazilian Clinical Trials Registry (REBEC trial: RBR-10zxwdrh, retrospectively registered on 2025-01-09, https://ensaiosclinicos.gov.br/rg/RBR-10zxwdrh ).

Background: Excessive sodium intake exacerbates rates of hypertension. African American adults have higher rates of hypertension in part due to a higher-sodium diet. The multi-level Communication for Behavioral Impact for Sodium Reduction (COMBI-SR) community-based intervention effectively reduces sodium intake in international settings, but it has not yet been implemented and tested in the U.S. This study explored the contextual factors (barriers/facilitators) and implementation strategies for COMBI-SR in Chicago's South Side neighborhood-an area with high rates of hypertension.

Methods: Between May and November 2023, we conducted qualitative interviews with potential intervention recipients (n = 8), Research Ministry Ambassadors (n = 5) and healthcare professionals (n = 2), 1 focus group with potential intervention recipients (n = 9) and 3 focus groups with healthcare professionals (n = 10). The Consolidated Framework for Implementation Research (CFIR) 2.0 guided the development of semi-structured interview guides. Thematic analysis was performed using CFIR 2.0 constructs to identify barriers and facilitators to implementation, and the Expert Recommendations for Implementing Change (ERIC) compilation to identify implementation strategies.

Results: Key barriers included a lack of awareness of sodium content in foods, socioeconomic disparities limiting access to healthy options, and cultural dietary traditions. Facilitators included strong community partnerships, engaged faith-based organizations, and openness to integrating technology, such as a mobile app, to help monitor and reduce sodium intake. Specific strategies to support sodium reduction involved simplifying public health messages, offering low sodium cooking demonstrations, promoting healthier food options through community outreach, and providing personalized education on reading nutrition labels and managing sodium intake.

Conclusions: Successful implementation of COMBI-SR in Chicago's South Side requires addressing financial, educational, and cultural barriers while leveraging trusted community structures to promote sustainable sodium reduction. These findings will guide future efforts to implement COMBI-SR in the U.S., emphasizing culturally tailored messaging and ongoing community engagement to improve cardiovascular health.

Background: Increasing evidence positively links greenspace and physical activity (PA). However, most studies use measures of greenspace, such as satellite-based vegetation indices around the residence, which fail to capture ground-level views and day-to-day dynamic exposures, potentially misclassifying greenspace and limiting policy relevance.

Methods: We analyzed data from the US-based Nurses' Health Study 3 Mobile Health Substudy (2018-2020). Participants wore Fitbits™ and provided smartphone global positioning system (GPS) for four 7-day periods throughout the year. Street-view greenspace (%trees, %grass, %other greenspace [flowers/plants/fields]) were derived from 2019 street-view imagery using deep-learning algorithms at a 100-meter resolution and linked to 10-minute GPS observations. Average steps-per-minute for were calculated for each 10-minute period following each GPS observation. Generalized Additive Mixed Models examined associations of street-view greenspace exposure with PA, adjusting for individual and area-level covariates. We considered effect modification by region, season, neighborhood walkability and socioeconomic status (SES), temperature, and precipitation.

Results: Our sample included 335 participants (mean_age= 39.4 years, n = 304,394 observations). Mean steps-per-minute per 10-minutes were 6.9 (SD = 14.6). An IQR increase (18.7%) in street-view trees was associated with a 0.36 steps-per-minute decrease (95%CI: -0.71, -0.01). In addition, an IQR increase (10.6%) in grass exposure was associated with a 0.59 steps-per-minute decrease (95% CI: -0.79, -0.40); however, the association was non-linear and flattened out after the 75th percentile of street-view grass. Conversely, an IQR increase (1.2%) in other greenspace was associated with a 1.99 steps-per-minute increase (95%CI: 0.01, 3.97). Associations were stronger in the spring and in higher SES neighborhoods, and among residents of the Northeast.

Conclusions: In this prospective cohort, momentary street-view exposure to trees and grass was inversely associated with PA, while exposure to other greenspace was positively associated. Future research should confirm these results in other populations and explore the mechanisms through which specific greenspace components influence PA.

Background: Emerging researchers commonly navigate challenging and insecure working environments. Yet the impact on emerging behavioral nutrition and physical activity researchers is unknown. Hence, we sought to identify the contemporary challenges, needs, and opportunities for emerging behavioral nutrition and physical activity researchers.

Methods: We employed a convergent mixed methods design, using an online survey. Participants completed socio-demographic questions, and rated the impact of personal and professional challenges, development needs with descriptive elaborations, and existing and desired professional development opportunities. Data analysis included thematic analysis of open-ended responses and descriptive statistics and multiple linear regressions of quantitative data. Integration of quantitative and qualitative data was through narrative and weaving.

Results: Emerging researchers (n = 111, 57% graduate students) from over 20 countries participated. Synthesised results related to all four domains of the Researcher Development Framework. Specifically, we identified 8 themes relating to conducting research (domain 1); physical and mental health, and networking (domain 2); grant funding, and employment opportunities (domain 3); and leadership, supportive work networks, and communication with non-academic audiences (domain 4). Financial comfort was a predictor of both professional and personal development needs.

Conclusions: Our study highlights the multiple challenges emerging researchers face, with increasing demands of collective efforts to support sustainable career development. Our findings serve as a foundation for promoting an inclusive and equitable research environment for emerging researchers. Though individual-level solutions may help, greater impact is likely from systemic changes to increase job security, career progression pathways and availability of ECR-specific funding.

Background: Childhood obesity inequalities in England persist despite targeted interventions focused on promoting healthy diets and food environments. This study, part of the Family Food Experience Study-London, aimed to investigate the impact of deprivation and neighbourhood food environments on home food environments, parental feeding practices, child eating behaviours, food preferences, and child BMI.

Methods: Families (n = 728) with primary school-aged children were recruited from four socioeconomically diverse London boroughs in 2022. Data were collected through computer-assisted interviews (30.8% in-person, 69.2% telephone) on home food environment, parental feeding practices, and children's eating behaviours and food preferences. Deprivation was characterised using a composite measure of family and neighbourhood indicators of socioeconomic position. Neighbourhood food environment exposures were estimated from individualised activity spaces derived from home postcodes and reported commuting patterns. Child BMI was measured objectively. Generalised linear models examined cross-sectional associations between deprivation and neighbourhood food environment with family food-related outcomes, adjusting for school-level clustering, child sex, age and ethnicity.

Results: Greater family deprivation was significantly associated with more 'obesogenic' family food practices, child eating behaviours and child BMI. Deprivation was linked to higher food responsiveness (β = -0.12, p = 0.002), emotional overeating (β = -0.11, p < 0.001), and increased desire to drink (β = -0.26, p < 0.001). Parents in more deprived households used more emotional (β = -0.10, p < 0.05), instrumental (β = -0.11, p = 0.003) and pressuring feeding practices (β = -0.14, p < 0.001). Greater deprivation was also associated with a more obesogenic home food environment (β = -0.19, p < 0.001) and lower meal structure (β = 0.17, p < 0.001). Exposure to less healthy neighbourhood food environments around and between home and school were associated with a more obesogenic home food environment (β = -0.07, p < 0.01), but no significant associations were found with feeding practices, child eating behaviours or child BMI.

Conclusions: In this study, family deprivation, rather than neighbourhood food environments, was more strongly linked to obesogenic feeding practices, child eating behaviours and child BMI. Policies focusing on improving neighbourhood food environments will likely be most effective if combined with those addressing systemic issues related to deprivation such as welfare policies (e.g. reforms to benefit caps) or targeted subsidies for healthy food. Future research should examine the independent and accumulative impact that environment and household interventions have on childhood obesity inequalities.

Background: Wearable devices have emerged as a new technology for monitoring physical activity over time. Conventional approaches to wearable physical activity data have tended to ignore temporal changes and, instead, have typically analysed summative measures and/or snapshots (e.g., averages over a specific period). In this report, we aimed to develop a novel statistical method to analyse longitudinal physical activity data accounting for the temporal structure in the data.

Methods: This research used secondary data from the Multidimensional Individualised Physical Activity (MIPACT) randomized controlled trial. Physical activity data over the 12-week intervention for 80 participants (28 women) aged between 43 and 70 years old met the criteria for inclusion in this analysis. We modelled the temporal dynamic of each participant using a Trend Locally Stationary Wavelet model, and we introduced the Time in Reference Region of Variability (TIRRV) to assess individual changes relative to baseline.

Results: The analysis of wearable physical activity data poses an important challenge for traditional statistical methods, which often fail to account for dependency between sequential data points and varying characteristics. In this work we demonstrate the effectiveness of a Trend Locally Stationary Wavelet model (TLSW) approach in analysing hourly resolution data from a 12-week intervention, enhancing the understanding of physical activity data, and providing meaningful insights at both individual and group levels. The TLSW considers the time dependency and structure of the data, enabling detailed trend and point-wise confidence intervals analysis. In addition to trends, the newly-developed TIRRV represents a baseline-informed metric to assess the success of individuals and groups over time. The application of these methods produce robust and readily understandable insights about the effect of interventions.

Conclusions: The TLSW-based approach is a novel method for analysing physical activity collected using high-resolution wearable technology. The TLSW trends robustly characterize individual and group behaviour over extended periods of time. This novel approach enables researchers, clinicians, and patients to understand temporal changes in device-measured physical activity data in a way that was not possible previously.

Background: Children and adolescents are at increased risk of adverse health consequences linked to physical inactivity. Parental support is positively correlated with children and adolescents' physical activity (PA) levels. As a result, family-based interventions are acknowledged as an effective strategy for enhancing PA among this cohort. However, the effects of these interventions on child and adolescent PA are often inconsistent, with calls for more in-depth understanding of the contextual issues related to intervention implementation and parents' experiences of interventions. The purpose of this review was to appraise and synthesize qualitative research regarding parents' experiences of family-based PA interventions.

Methods: Seven databases (MEDLINE, PsycINFO, SportDiscus, CINAHL, Web of Science, Scopus, and ProQuest) were searched for studies published from inception to January 2024 that included qualitative evaluative data of parents' experiences of family-based PA interventions. The research quality of included studies was appraised using the Critical Appraisal Skills Programme. Qualitative data were extracted and thematically synthesized.

Results: A total of 7,770 articles were screened, of which 82 independent studies were included in the final synthesis. Three analytic themes were generated. (1) The reasons why parents enrolled in family-based interventions and the perceived benefits for parents, children, and families; (2) Parents' perspectives on intervention components, including their satisfaction, coherence, and suggestions for improvement; (3) The social and environmental factors shaping parents' intervention experiences and parental PA support. Findings show the benefits of PA, being a good role model and spending time together as motives for enrollment. Parents perceived child or adolescent's PA confidence and overall well-being and family functioning improved. Parents presented mixed views about planning, goal setting, self-monitoring, intervention materials and resources, and delivery. Child or adolescents' interest, social connections, financial constraints and availability of resources impacted parental engagement.

Conclusions: This novel and comprehensive review offers practical recommendations to guide intervention development and inform future policy and practice such as: consider using co-design methods and social network analysis; promoting the benefits of PA on family functioning during recruitment; strengthening parents PA support identities; provide opportunities for social support for families post-intervention and educate coaches to create an environment of inclusivity and enjoyment.

Trial registration: PROSPERO CRD42023421539.