International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Assessing adolescents' dietary intakes in relation to Canada's Food Guide 2019 (CFG-2019) recommendations on healthy food choices is a critical component to public health surveillance efforts. The study aimed to develop a brief self-administered screener to assess food intake based on CFG-2019 food choices recommendations among English- and French-speaking adolescents aged 10-17 years living in Canada.

Methods: The development and assessment of the content validity of the tool was undertaken in collaboration with Health Canada advisors and informed by external content experts, including nutrition researchers and practitioners. Following a rapid review of screeners used among children aged 6-17 years, an initial draft was developed, and content validity was assessed by an expert panel with expertise in public health nutrition and questionnaire validation (English n = 13, French n = 7). Two rounds of cognitive interviews were then conducted with adolescents (English n = 15, French n = 14) to assess comprehension and further refine the screener items. Cognitive testing using a direct probing approach was conducted iteratively in two phases to assess understanding of questions and incorporate feedback from adolescents to improve the clarity and wording of the items at each phase.

Results: Following the expert panel and iterative discussions with Health Canada advisors, four items were removed from the initial 14-item screener as these items were deemed not sufficiently reflective of the CFG recommendations and one item asking about water intake was tested. Cognitive testing revealed that the items were well understood overall, and feedback at each interview round enabled additional refinements to improve comprehension. The resulting screener includes 10 items designed to rapidly assess food intake based on CFG-2019 recommendations on healthy food choices for adolescents aged 10 to 17 years.

Conclusions: The Canadian Food Intake Screener for Adolescents/Questionnaire court canadien sur les apports alimentaires des adolescents is designed to rapidly assess dietary intake over the past week among children aged 10 to 17 years. Before it can be used for research and population-level nutrition surveillance, further research is needed to develop a scoring system and evaluate the screener's construct validity and reliability.

Background: Young adults (18-25) face significant risk for weight gain and transitioning to a higher body mass index category when compared to other adult groups. As active internet users, they encounter food-related content across digital platforms, yet little is known about their behavioural and cognitive responses to this compound exposure.

Methods: This pre-registered mixed-methods systematic review features primary studies about participants aged 18 to 25 exposed to digital food communication and assessed for behavioural or cognitive responses towards food and nutrition. We evaluate consumption and food purchase as behavioural responses; intentions to consume and/or purchase, and attitudes towards food and nutrition as cognitive responses. We searched PubMed, PsycINFO, Global Index Medicus, and Business Source Ultimate for studies published from database inception to August 1, 2024. Quality appraisals were conducted using a modified version of the Newcastle-Ottawa Quality Assessment Form, the ROB1 Tool for randomised trials, the JBI Quasi-Experiment Checklist for quasi-experiments and the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies. We used a three-pronged method for analysis. Meta-analyses combined findings from randomised trials for behavioural and cognitive responses, while observational studies were summarised narratively. The thematic synthesis approach informed our qualitative synthesis of young adults' narratives of their responses after exposure to digital food communication. Finally, a cross-study matrix synthesised analytical qualitative themes and quantitative findings.

Results: Of the 6132 studies identified, 45 are included in the systematic review, representing 8,914 young adults in 16 countries. Meta-analyses on behavioural and cognitive responses demonstrate statistical significance with effect sizes of 0.34 (95% CI: 0.18-0.50) and 0.19 (95% CI: 0.10-0.28), respectively. Observational studies confirmed the findings of the meta-analyses. Difficulty deciphering what represents good nutrition, critical distinctions when engaging with content viewed as helpful versus misleading and balancing intentions versus actual behaviours were barriers to the effectiveness of digital food communication. Using a cross-study synthesis matrix, we developed ten recommendations to improve digital dietary interventions and their assessed implementation by experimental studies in the review.

Conclusions: Our results illustrate the need to approach digital food communication as a digital determinant of dietary health for young adults, shaping behaviours and cognition.

Background: Monitoring and improving physical activity levels is essential for promoting healthy aging. The objective of this study was to create age-specific normative values for the Physical Activity Scale for the Elderly (PASE) among community-dwelling women and men aged 45-85 years old.

Methods: 36,701 participants (47% female) aged 45-85 years old, free of any mobility limitation or activities of daily living disability from the Canadian Longitudinal Study on Aging (CLSA) were included. Best fitting models were identified using Generalized Akaike Information Criteria values and cross-validation. Seasonal differences for males and females were also explored.

Results: Separate models for males and females are presented, providing a range of percentile values (5-95%) in charts and tables. Total PASE scores were highest in 45-year-olds and decreased with age. Seasonal differences were not substantial or consistent at the population level.

Conclusions: The age- and sex- specific normative values provided can improve the interpretability of PASE scores among middle-aged and older adults. In addition to PA guideline cut-offs, normative values provide further information for monitoring physical activity by allowing for more personalized observations that account for healthy variation.

Background: Adults in rural Australia are at elevated risk of cardiovascular disease (CVD). To date, no intervention trials have evaluated the impact of dietitian delivered nutrition therapy using telehealth exclusively in patients recruited in the primary care setting. The primary aim was to assess effectiveness of telehealth delivered Medical Nutrition Therapy (MNT) on change in dietary intake energy, reported as percent energy derived from nutrient-dense (core) foods. Secondary aims included assessment of the intervention effects on percentage weight loss, quality of life, health literacy and patient engagement in their health (patient activation).

Methods: This was a secondary data analysis of a pragmatic cluster Randomised Controlled Trial (RCT). Adults from rural areas within the New England North West and Upper Hunter regions of New South Wales, Australia, were identified by their general practitioner (GP) following a Heart Health Check, as being at moderate-to-high risk of CVD and invited to participate. General practices were randomised into intervention or usual care groups. Intervention participants received five personalised telehealth MNT consultations over 6 months. Usual care received stand-alone personalised nutrition reports. All participants were managed by their GP and followed up after 12 months. Primary and secondary outcomes were analysed using Bayesian linear mixed models. Models included fixed categorical effects for time, group, group-by-time interaction, age, and sex, with additional predetermined adjustment for variables determined by the literature.

Results: Mean baseline to 12-month increase in percentage of energy from core foods was 7.0% (9.4 SD) for the intervention group and 1.3% (9.6 SD) for usual care group, with an estimated adjusted difference in mean change of 5.9% (95%CI 0.5-11.2). Significant improvements in quality of life (0.04, 95%CI 0.01-0.07) and patient activation were also observed (6.44, 95%CI 0.99-11.83) favouring the intervention group.

Conclusion: A personalised telehealth MNT intervention delivered by dietitians significantly improved percentage energy from nutrient-dense foods amongst rural adults at an elevated risk of CVD. Future research is required to support implementation of telehealth MNT into general practice in rural Australia.

Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12621001495819).

Background: Despite the well-researched general effect of physical activity on mental health, less is known about specific effects, such as qualitative and contextual aspects of physical activity. Thus, this review aimed to systematically synthesise evidence on the effects and experiences of different types of leisure-time physical activity (LTPA; e.g., running, fitness, yoga) on distinct positive mental health (PMH) outcomes among adolescents.

Methods: We searched in seven databases (MEDLINE, Embase, PsycINFO, Cochrane, SPORTDiscus, CINAHL, and Web of Science) without language restrictions for records from January 2009 to 16 June 2025. Inclusion criteria were defined according to the PICOS framework: population (adolescents from non-clinical studies); intervention (specific LTPA type); comparisons (with and without comparator); outcomes (measures or experiences of PMH); study designs (longitudinal quantitative and qualitative studies). We appraised included studies using the mixed-methods appraisal tool.

Results: 44 articles from initial 8,149 records were included. Following a convergent segregated approach, the meta-analyses for synthesising the quantitative studies showed different effects depending on the LTPA type. Additionally, the effects depend on the PMH outcome in focus. We identified four facilitators to promote PMH outcomes from the synthesis of qualitative studies: social facilitators for all types of LTPA and various configurations of other facilitators (mastery-related, setting-related, affective-related) for specific LTPA types. The mixed-methods synthesis shows the interplay between LTPA and PMH outcomes depending on the LTPA type.

Conclusions: The effects of LTPA on PMH in adolescents depend on the LTPA type and PMH outcome in focus. Perceived facilitators highlight possible explanations for the effects found. By investigating specific LTPA types and different PMH outcomes, ecologically valid implications for specific contexts to foster adolescent mental health may be derived. The limited number of studies per LTPA type, PMH aspect, and study design emphasises the need for more research to derive more specific and robust implications for tailored mental health promotion.

With great interest, I read the article by Lien et al. "Twenty years of behavioural nutrition - A reflection on the road less travelled". This commentary reflects the long-standing absence of a formal definition for "behavioral nutrition" (BN) and its implications for scientific and clinical communities. It highlights the Brazilian experience in conceptualizing BN as a scientifically grounded approach to modifying eating behaviors through a biopsychosociocultural perspective, moving beyond the outdated prescriptive role of the dietitian. The commentary also reviews the historical use of BN in publications, noting inconsistencies, conceptual conflation with "eating behavior," and limited clarity on what constitutes a BN intervention. A clearer, theory-driven definition and expanded discourse on behavioral approaches and models are essential to advancing the field.

Background: This report details the effect of LIFE-Mom's multicomponent lifestyle interventions on physical activity (PA) and inactivity time across pregnancy (2nd and 3rd trimesters) and their effect on gestational weight gain (GWG) and maternal/neonatal outcomes, a pre-specified secondary analysis.

Methods: Pregnant people with BMI ≥ 25 kg/m² were randomized to lifestyle interventions with dietary and PA counseling or standard care. PA and inactivity time measured by accelerometry and metabolic and inflammatory biomarkers measured in fasting blood are reported in 522 pregnant people at baseline and end of pregnancy. Generalized linear models with and without covariates were used to evaluate group differences (intervention vs. control) and, separately, time differences (total sample with both groups combined).

Results: Although there were statistically significant differences in vigorous activity between the intervention and control group (p = .024), there were no clinically meaningful differences in PA. In the combined sample, moderate to vigorous PA (MVPA) significantly decreased across pregnancy (mean ± SD: 72.9 ± 29.1 min/day vs 63.9 ± 28.1 min/day; p < 0.0001), and inactivity time increased [617.5 min/day (573.5, 659.6) vs 630.4 min/day (56.7, 679.9); p < 0.0001]. Increased inactivity time was associated with a less favorable maternal milieu (biomarker Z-scores) for pro-inflammatory (0.2 ± 0.1; p = 0.003) and cardiometabolic markers (0.1 ± 0.07; p = 0.030).

Conclusions: Physical activity declined over the course of pregnancy, though the intervention group experienced a smaller reduction in activity levels. Our results linked increased inactivity time to maternal metabolic dysregulation and inflammation. Further research is needed to determine if intensive interventions reducing inactivity can improve maternal health and weight outcomes in pregnant people with overweight and obesity.

Trial registration: NCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, and NCT01812694.