International Journal of Behavioral Nutrition and Physical Activity最新文献

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.

Background: In 2015, the Position Statement on Active Outdoor Play was released in Canada, emphasizing the critical role of active outdoor play-with its risks-in fostering children's healthy development. Building on this foundation, a 10-year update of the Position Statement on Active Outdoor Play (AOP10) was initiated to broaden its scope and impact, by encompassing all age groups and extending its reach conceptually and globally. Here we explain and present the new 2025 Position Statement.

Methods: Development of the 2025 Position Statement was informed by 18 rigorous literature reviews, a series of leadership group meetings, three rounds of draft AOP10 surveys, followed by extensive communication, translation, production, and dissemination activities.

Results: The 2025 Position Statement on Active Outdoor Play states: "Active outdoor play promotes holistic health and well-being for people of all ages, communities, and environments, and for our entire planet. It is critical given the multiple global challenges we face today (e.g., social and health inequities, climate change and digital addiction). Together, as a collective of the outdoor play sector, we recommend increasing opportunities for active outdoor play in all settings where people live, learn, work, and play. To achieve this, it is important to collaborate across sectors, settings, and societies to preserve, promote, and value equitable access to active play outdoors and in nature." We also provide key evidence pertaining to the nine core themes that informed the development of the 2025 Position Statement and offer recommendations across sectors, calling for multi-sectoral, multi-level collaborations. Across all three survey rounds, responses indicated strong support for the 2025 Position Statement and its supporting content (Round 3: 93-98%). Comprehensive, proactive knowledge translation and dissemination plans were executed to maximize the reach and impact of the 2025 Position Statement.

Conclusions: The 2025 Position Statement calls for systemic changes that prioritize equitable access to active outdoor play opportunities and aims to create healthier communities. Achieved through international collaboration and consensus, the 2025 Position Statement aspires to connect, advise, inspire, and activate active outdoor play worldwide.