International Journal of Behavioral Nutrition and Physical Activity最新文献

The term behavioral nutrition was introduced at the conception of the International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) twenty-one years ago but it was not formally defined. This commentary describes and contrasts behavioral nutrition against other branches of nutrition sciences such as clinical nutrition and nutritional epidemiology. Examples of how IJBNPA has contributed to the development of behavioral nutrition is provided before concluding with some suggestions for further development. We hope that this will lead to more relevant and innovative submissions of behavioral nutrition research to IJBNPA.

Background: Children living with disability have poorer health outcomes than their typically developing peers. They are less physically active and at increased risk of chronic disease. Teacher-led, whole-of-school physical activity interventions are promising levers for population-level change, but are seldom tested among children with disability. We aimed to evaluate the effect of a blended teacher-professional learning program (online and in-person) on fundamental movement skills (FMS) and physical activity among children with intellectual disability.

Methods: In this cluster randomized clinical trial, we randomized 20 government-funded primary schools, including 238 consenting students (Grades 2-5; aged 8-11 years at baseline). Ten schools received the blended teacher-professional learning intervention and 10 were assigned as waitlist controls. The professional learning was designed to support teachers as they implemented a whole-of-school intervention designed to enhance FMS and increase physical activity levels. The school-based intervention was mostly online learning, followed by lesson observations and site visits from project staff. Blinded assessors measured FMS competency using the Test of Gross Motor Development-3. Secondary outcomes were self-concept, enjoyment, wellbeing, 300-yard run time, and accelerometer-measured physical activity.

Results: We found no significant group-by-time effects for the primary outcome (FMS competency: b = 1.07 [95% CI -3.70, 5.84], p =.658) or any secondary outcomes.

Conclusions: A school-based intervention did not improve FMS competency or physical activity in children with intellectual disability. Results may be attenuated by the COVID-19 pandemic. Alternatively, low intensity teacher-professional learning interventions may not be enough to improve FMS or physical activity among children with intellectual disability.

Trial registration: Australian New Zealand Clinical Trials Registry registration number: ACTRN12620000405910, registered: 25/03/2020.

Background: There is currently limited evidence on the long-term effectiveness of referral programs from healthcare to community sectors to help people with long-term conditions (LTCs) maintain physical activity. This study aimed to (i) identify the support needs of people with LTCs in maintaining physical activity following physical activity referral schemes (PARS); (ii) understand healthcare professionals' experiences of referring and delivering on PARS, and; (iii) begin co-designing a pathway integrating healthcare, leisure and community to maintain physical activity for LTCs.

Methods: A qualitative design involved (i) stakeholder mapping, ii) interviews with people with LTCs (n = 15) and healthcare professionals (n = 9), and; (iii) workshops with participants with LTCs (n = 6) and multi-sectoral professionals (n = 15). Workshops involved multi-sectoral professionals responsible for designing, delivering, referring and/or commissioning PARS across health, leisure and community sectors. Interviews and workshops were thematically analyzed, with themes mapped to the Capability, Opportunity, Motivation-Behavior (COM-B) model.

Results: Participants with LTCs recognized that although PARS increased their psychological and physical capabilities, aging and symptoms impacted their day-to-day capabilities and motivation. Professional feedback and monitoring, complemented by peer support, were essential in mitigating this and maintaining physical activity behaviors. Healthcare professionals were challenged by the time taken to identify community-based opportunities, navigating referrals, and lacked sufficient feedback on client progress, but felt group activities, enjoyment and social support were integral. Workshops highlighted the need for an integrated pathway from medical intervention to community-based support, to improve physical activity maintenance for LTCs. Better partnership working between multi-sectoral agencies was prioritized to increase scheme accessibility, including simple, standardized referrals. Using behavior change techniques to personalize support was also valued, including 'healthy conversations' training for healthcare professionals.

Conclusions: Healthcare, leisure, and community sectors should collaborate to create accessible local activities that promote social support, feedback and monitoring, and public partnership. Healthcare professionals should consider individual capabilities, foster motivation during and after PARS, and facilitate networks for resources and knowledge sharing.

Background: There are numerous psychosocial and health benefits linked to physical activity; however, 80% of children and youth are not meeting the recommended guidelines. Genetics, socio-economic status and familial factors impact childhood movement behaviors. In particular, active families support well developed and resilient offspring. As the family unit is optimally placed during a critical time in development, it is pertinent to explore the relationship between family functioning and child and youth physical activity.

Purpose: To synthesize and analyze the literature to determine the associations between general domains of family functioning (general family functioning, cohesion, communication, conflict, organization, family problem-solving ability, household chaos, and affective environment) and child and youth (children: aged five to 12, youth: aged 13 to 17) physical activity.

Methods: Literature searches across six databases were performed.

Inclusion: Studies that performed and presented a statistical analysis between direct measurements of child and youth physical activity and general domains of family functioning.

Exclusion: Indirect measurements of family functioning (e.g., support and encouragement). The summary median effect sizes (Pearson r) and interquartile range [IQR] were calculated between child or youth physical activity and each family functioning domain.

Results: Search results k = 12,999. Included articles k = 43. Child physical activity had a small median effect size and indeterminate association with general family functioning (r = 0.09; [IQR]: -0.06 to 0.09) and cohesion (r = 0.06; [IQR]: 0.05 to 0.22). Youth physical activity presented with small median effect sizes and significant positive associations with the domains of general family functioning (r = 0.04; [IQR]: 0.02 to 0.06), cohesion (r = 0.09; [IQR]: 0.07 to 0.14), communication (r = 0.17; [IQR]: 0.09 to 0.40), and a negative association with the domain of conflict (r = -0.09; [IQR]: -0.21 to 0.02). Family problem-solving ability, organization, household chaos, and affective environment were understudied across both age groups.

Conclusions: A small effect size in the domains of cohesion, communication, and conflict highlights the association between child and youth physical activity and family functioning. These findings provide a new avenue for researchers, programmers, and policy writers to target to support child and youth physical activity.

Trial registration: This review is registered with The National Institute for Health and Care Research at The International Prospective Register of Systematic Reviews (PROSPERO). PROSPERO ID number is CRD42023454220.

Background: Adolescence is associated with declining physical activity (PA) levels, and potential prevailing changes into young adulthood are indicated, but less explored. This study investigates longitudinal changes in PA from adolescence to young adulthood among males and females in a North Norwegian cohort.

Methods: In the population-based Fit Futures Study, PA was assessed with both questionnaires (Saltin-Grimby Physical Activity Level Scale) and accelerometers (ActiGraph) at ages ~ 16 (n_self-report=936; n_{accelerometer}=674), ~ 18 (n_self-report=808; n_{accelerometer}=507), and ~ 27 (n_self-report=648; n_{accelerometer}=466). We used mixed effects models to analyze longitudinal changes in accelerometer-measured PA and sedentary time, alongside mixed effects multinomial logistic regression for changes in self-reported leisure time PA.

Results: We observed a significant non-linear U-shaped trend in accelerometer-measured moderate-to-vigorous PA (MVPA) over time (p < 0.001), with an initial decline in minutes per day from age 16 (mean ± SD: 70.7 ± 25.2) to age 18 (62.3 ± 23.8), followed by an increase to age 27 (67.5 ± 30.4). At age 16, males exhibited higher MVPA than females. By age 18 and 27, MVPA levels were similar between sexes. Accelerometer-measured sedentary time decreased linearly across all three surveys (p = 0.002). We observed distributional shifts in self-reported leisure time PA over time: vigorously- and highly active proportions declined, while the moderately active proportion increased, and the proportion of sedentary participants remained stable (~ 20%). Compared to vigorously active, the odds of reporting sedentary (OR: 1.07, 95% CI: 1.03 to 1.11), moderately active (OR: 1.11, 95% CI: 1.07 to 1.15), and highly active (OR: 1.07, 95% CI: 1.03 to 1.11) increased with each year from age 16 (all p ≤ 0.001). Compared to moderately active, the odds of reporting other categories decreased over time (ORs: 0.92 to 0.96, all p ≤ 0.001).

Conclusions: We observed non-linear changes in accelerometer-measured MVPA, indicating a U-shaped trend with a decline from 16 to 18 years, followed by an increase to age 27. Self-reported leisure time PA levels declined from adolescence to young adulthood, with decreasing proportions highly and vigorously active, while the proportion moderately active increased and the proportion of sedentary was unchanged. These results indicate that from adolescence to young adulthood, not all PA changes lead exclusively to increased sedentariness.

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.