International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Engaging in no moderate-to-vigorous physical activity (MVPA) has been recognized as an important indicator in physical activity (PA) surveillance, as any engagement in MVPA confers health benefits compared to none. Studying the prevalence of no MVPA can provide valuable insights into physical inactivity patterns and inform public health intervention efforts. While some cross-sectional studies have examined this issue, no research has analysed year-to-year trends. Therefore, the aim of this study was to assess trends of no MVPA among adolescents and key subgroups using a nationally representative US sample.

Methods: Data from 2005 to 2021 cycles of the Youth Risk Behavior Surveillance System were used, with 115,926 US adolescents aged 14-17 years included (female: unweighted sample size = 58,582, 50.5%; weighted%=49.4%). Participants self-reported their demographic (sex, age, race/ethnicity, body mass index) and behavioural information (days of ≥ 60 min of MVPA over the past week, and recreational screen time). No MVPA was operationalized as reporting 0 days of ≥ 60 min of MVPA. Trend analysis was performed to assess temporal variations from 2005 to 2021 using a series of binary logistic regression models after controlling for demographic and screen time related variables.

Results: Declining trends in no MVPA were observed among adolescents from 2005 (weighted: 24.3%) to 2021 (weighted: 15.5%). After stratifying by sex, age, race/ethnicity, body mass index and recreational screen time, similar downward trends were shown across all adolescent subgroups consistently (p for trend < 0.001). Girls, older adolescents, those who identified as non-White, adolescents with excess weight, and those engaging in more than 2 h of recreational screen time per day tended to report no MVPA at higher rates (all p < 0.001) compared to their counterparts.

Conclusions: No MVPA has declined among the US adolescents, especially after 2009. Notably, sociodemographic disparities were observed in no MVPA among different population subgroups. PA promotion strategies targeting girls and older adolescents should be prioritized to further reduce the prevalence of no MVPA.

Background: Population surveys indicate that a large proportion of children worldwide do not meet the recommended 60 min of moderate-to-vigorous physical activity (PA) daily. This study aimed to assess the impact of the Great Live and Move Challenge (GLMC), a theory of planned behavior (TPB)-based intervention, on PA and TPB variables in French primary school children over two school years. Secondary objectives included assessing whether TPB variables mediated the GLMC's impact on PA and whether the GLMC impacted the strength of the link between TPB variables.

Methods: A cluster-randomized controlled trial was conducted over 16 months. One hundred primary schools were randomized into an intervention or control group. A total of 2723 children aged 7-11 years (mean age: 9.1; 49.7% boys) were included (n intervention = 1420, n control = 1303). The GLMC, based on TPB, comprised a motivational phase (targeting attitudes, subjective norms, and perceived behavioral control) and a volitional phase (notably focusing on the intentions-PA link). The intervention involved teachers, parents, and community stakeholders. The primary outcome was the change in the proportion of children meeting PA guidelines after 16 months. Secondary outcomes included changes in mean daily PA and TPB variables. Assessments occurred at baseline, 4, 12, and 16 months. Data were analyzed using mixed models and path analyses.

Results: The "time × group" interaction indicated that, compared with the control group, the intervention group had a significantly higher proportion of children meeting international PA guidelines after 16 months (OR = 3.38, 95% CI = 2.50 to 4.56, P < 0.001). TPB variables did not significantly mediate the impact of the GLMC on mean daily PA at 16 months. The path coefficient between intentions and mean daily PA was significantly higher in the intervention group than in the control group at 4 (CR = 2.45; β = 0.22 vs. 0.13) and 16 months (CR = 2.87; β = 0.24 vs. 0.14).

Conclusions: The GLMC increased the proportion of children meeting PA guidelines over 16 months, and may help bridge the intentions-PA gap. The absence of mediation by TPB variables highlights the need to investigate other psychosocial mechanisms to better understand how the GLMC promotes PA in children.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN) Registry: 61,116,221 (retrospectively registered).

Background: Physical inactivity remains a global concern. Understanding population-level physical activity (PA) trends is essential for evidence-based policy-making.

Methods: Repeated cross-sectional analysis was conducted using the five waves (2011-2020) of data from the China Health and Retirement Longitudinal Study. PA was assessed by the International Physical Activity Questionnaire. PA sources (job demands, entertainment, exercise, and others) were assessed since 2013. Age- and sex-standardized prevalence was calculated. Log-binomial regression was performed to explore associated factors.

Results: Among Chinese adults ≥ 45 years, weekly exercise participation nearly doubled from 22.6% (2013) to 43.9% (2020). Job-related PA declined but remained the major source of moderate-to-vigorous PA. Insufficient PA prevalence demonstrated slight fluctuations, bottoming at 19.6% in 2018 between 2011 (23.9%) and 2020 (22.2%), with significant reductions in adults ≥ 75 years (-12.7%), females (-5.8%), urban residents (-5.5%), hypertension (-4.1%) or diabetes (-9.7%) groups. By 2020, insufficient PA was more prevalent among adults ≥ 75 years (41%, PR: 2.06, 95% CI: 1.65 to 2.57), individuals with low socioeconomic status (SES) (PR: 1.41, 95% CI: 1.26 to 1.59), rural residents (PR: 1.13, 95% CI: 1.01 to 1.26), and individuals with dyslipidemia (PR:1.12, 95% CI: 1.00 to 1.24).

Conclusion: Our study provides national updated evidence showing exercise participation doubled among middle and older Chinese, yet insufficient PA remained stable over the past decade, which is likely attributable to reductions in job-related PA. In the context of rapid lifestyle and societal changes, future policies and intervention programs need to co-target exercise and varied PA domains and prioritize high-risk populations, including advanced age seniors, rural residents, and low SES groups, to alleviate inequities.

Background: Given the therapeutic potential of Approach-Avoidance interventions (AAIs) in the alcohol domain, research has increasingly applied them to the food domain. In AAIs, harmful stimuli are avoided while healthy ones are approached, for example by respectively moving a phone away from or towards oneself.

Methods: We administered a phone-based AAI six times over two weeks to 156 participants in a pre-registered randomized-controlled trial to reduce intake of six "decrease-foods" and increase intake of six "increase-foods", selected according to each participant's individual dietary goals. The control group received a placebo task in which all stimuli were equally often approached and avoided. Food craving and intake were the outcomes, measured daily during the training period, four days before and after, and once during a follow-up one month after training. Per-food approach bias was recorded before and after training, and at follow-up.

Results: Compared to placebo, active training reduced the level of decrease-food craving (b = -0.19; 95% HDI [-0.31, -0.05]) without affecting how often craving occurred. Restrained eaters (b = -0.19; 95% HDI [-0.36, -0.03]) and those with low past dietary success (b = 0.13; 95% HDI [0.03, 0.24]) showed the strongest craving strength reduction. Active training also reduced approach bias for decrease-foods, albeit with weaker evidence (b = -38.10; 89% HDI [-73.82, -0.39]). We found no intervention effects on increase-foods on any outcome. There were no interpretable training effects for food intake and no changes were maintained at follow-up.

Conclusions: A multisession mobile AAI reduced craving intensity for foods that participants wanted to eat less of in the 4 days after the end of the intervention period with reductions bouncing back at 4-week follow-up. It remains to future research how this can be sustained long-term and effectively translated into reduced food intake.

Trial registration: This study was registered in the German Clinical Trials Register, ID DRKS00030780.

Purpose: Physical activity is beneficial across the lifespan, but most Americans do not meet physical activity guidelines. Multiple sources exist that identify opportunities to address gaps in physical activity research knowledge and implementation. Several of these opportunities have important considerations for populations experiencing health inequities. The goal of this study was to identify, synthesize, and categorize opportunities for research (i.e., systematic investigations to develop generalizable knowledge) into a conceptual framework to advance physical activity research in a cohesive and efficient manner.

Methods: The National Collaborative on Childhood Obesity Research convened subject matter experts to conduct five qualitative document analysis steps: (1) identify sources published by United States government, intergovernmental, or national non-profit organizations related to physical activity, (2) review sources to extract research opportunities, (3) code the opportunities by variables (translational research phase, social ecological level, setting, and priority population) determined by the expert group, (4) synthesize data on similar opportunities, and (5) review crosstabulation data to examine coding patterns and develop a framework.

Results: Opportunities (n = 385) were extracted from sources (n = 11) and combined into condensed opportunity statements (n = 87). Most called for effectiveness research (n = 44, 51%) or dissemination and implementation science research (n = 14, 16%). 38% were related to policy, systems, and environmental interventions (n = 33), and 70% mentioned community settings (n = 61). Additionally, 76% did not include health equity considerations (n = 66), and 75% mentioned no specific population or populations across the lifespan (n = 65). The resultant Physical Activity Research Opportunities (PARO) framework details opportunities by translational research phase (methods/measures development, etiology, efficacy, effectiveness, dissemination and implementation, and surveillance) and social ecological level (individual or interpersonal, policy/systems/environmental, and crosscutting), including health equity considerations.

Conclusions: The resultant PARO framework highlights gaps in current evidence and reveals opportunities for physical activity funders, researchers, policymakers, and practitioners to strategically advance their work. There are prospects for designing efficacy and effectiveness trials with an eye toward dissemination and implementation, developing strategies for improving dissemination and implementation, and using community- and practitioner-engaged approaches across translational research phases to advance health equity. Health equity can also be addressed by tailoring interventions, enhancing reach to priority populations, and improving social determinants of health.

Background: Hypertension remains a major public health challenge in China. Leisure-time physical activity (LTPA) is critical for hypertension control. Yet its social network determinants, particularly key role models, are understudied in China's familial-centric cultural context.

Methods: This sequential mixed-methods study integrated quantitative surveys with qualitative interviews among hypertensive patients in Yichang, China. A total of 2639 patients were selected from 18 primary healthcare institutions using multi-stage random sampling method. Totally, 10,550 social relationships were nominated. Quantitative data on LTPA was measured by the International Physical Activity Questionnaire Long Form, and social network characteristics (size, density, LTPA aggregation, LTPA heterogeneity, and LTPA status of specific members) was gathered through the name generator method. Generalized additive mixed models assessed nonlinear associations between social network characteristics and LTPA levels (individual-level, n = 2639); mixed-effects logistic regression analyzed member-patient LTPA linkages (relationship-level, n = 10,550). Qualitative data (n = 37) via interviews underwent grounded theory coding to contextualize mechanisms.

Results: Among participants, 70.56% engaged in light intensity LTPA (L-LTPA), whereas 34.82% achieved ≥ 150 minutes/week moderate-to-vigorous intensity LTPA (MV-LTPA). Nonlinear thresholds were identified: smaller networks (≤ 4 members) with higher kinship density (≥ 65%) significantly increased MV-LTPA adherence (P < 0.001). Network-level LTPA aggregation demonstrated linearly positive with MV-LTPA (P < 0.001) but triphasic associations (i.e., increase then decrease to steady) with L-LTPA (P = 0.006). Critically, having a physically active spouse was the strongest predictor of MV-LTPA adherence (OR = 1.967, 95% CI: 1.571-2.463, P < 0.001). Qualitative themes revealed that kinship networks fostered LTPA through shared norms and social support.

Conclusions: Social networks represent modifiable factors that influence LTPA behaviors. Integrating network-driven strategies into hypertension management and prioritizing spouses as "exercise advocates" could promote LTPA for middle-aged and elderly hypertensive patients in China. This study advances cross-cultural behavioral theory and offers actionable solutions for pragmatic solutions for global hypertension management in aging populations under similar social context.

Objective: This study reviewed (1) the effects of physical enrichment of (pre-)school playgrounds on children's and adolescents' movement behaviours and their cognitive, psychological, and social development, and (2) how enrichment characteristics influenced these outcomes.

Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. We searched 7 databases (SPORTDiscus, CINAHL, MEDLINE, APA PsycINFO, Cochrane Library, Web of Science, and Scopus) and two reviewers independently screened studies for eligibility. Effect sizes of interventions were calculated using standardized mean differences (Hedges' g) and tested using random-effects models. Meta-regression was used to explore heterogeneous findings. Narrative syntheses were conducted when meta-analysis was not possible.

Results: Twenty-eight studies and 19,753 participants were included. Three studies had low risk of bias, 11 studies had high risk of bias, while 14 studies had some concerns. The meta-analyses for movement behaviours showed significant increases in vigorous physical activity (VPA, n = 7 studies, g = 0.17, 95% Confidence Interval (CI): 0.06, 0.27), moderate-to-vigorous physical activity (MVPA, n = 17, g = 0.17, CI: 0.03, 0.30), and steps per minute (n = 3, g = 0.81, CI: 0.03, 1.59) for enrichment interventions relative to control conditions. The results for MVPA had large heterogeneity and were only significant short-term. Line markings alone or in combination with physical structures (e.g., climbing walls) increased MVPA, while involving end-users decreased MVPA. Line markings alone or in combination with physical structures or equipment increased VPA. There was no effect of enrichment for sedentary behaviour, low or moderate intensity physical activity. The results for cognitive (attention restoration and executive functioning), psychological (wellbeing and quality of life), and social (interactions, orientations, and bullying) development were mixed.

Conclusion: Our findings show that studies on physical enrichment had low methodological quality and findings had high heterogeneity. Line markings in isolation or combined with other enrichment strategies might increase levels of VPA and MVPA in children and adolescents. Evidence on cognitive, psychological and social development is inconclusive due to few and weak studies for these outcomes. We provide future directions for research and practice by drawing from the environmental enrichment paradigm.

Trial registration: PROSPERO registration number CRD42022364392.