Translational journal of the American College of Sports Medicine最新文献

Introduction/purpose: In the United States, it is recommended that schools provide at least 20 minutes of daily recess, but the optimal amount for health benefits is unknown. We examined associations between amount of recess and health indicators using National Health and Nutrition Examination Survey data (NHANES; 2013-2016).

Methods: For this cross-sectional analysis, parents/guardians of 6-11 year olds (n=738) reported recess provision which was classified as low (22.8%; approximately 10-15 min, 5 days per week), medium (54.9%; approximately 16-30 min, 5 days per week), or high (22.3%; approximately >30 min, 5 days per week). Outcomes measured included parent/guardian-reported and accelerometer-measured physical activity (PA), blood pressure, cholesterol, grip strength, bone mineral content, weight status, percent body fat, vitamin D level, and C-reactive protein level. Linear and logistic regression compared outcomes by level of recess provision accounting for the NHANES complex survey design.

Results: The odds of meeting PA guidelines according to parent/guardian reports were 1.70 and 2.05 times higher in those with medium and high (respectively) versus low recess provision. Accelerometer-measured weekday activity was highest in those with high recess provision while weekend activity was highest in those with low recess provision (Cohen's d = 0.40-0.45). There were no other significant associations.

Conclusion: At least 30 minutes of daily recess is associated with two-fold greater odds of achieving recommended PA levels according to parent/guardian reports; accelerometer data suggest this is through increased weekday activity. This finding suggests current national recess recommendations are insufficient for PA promotion. More detailed data on the frequency and duration of recess are needed to quantify optimal provision more precisely.

Context: As many as 76.7% of U.S. young adults have at least one metabolic syndrome risk factor. Often undetected, metabolic syndrome risk factors cluster with other risk factors increasing risk of future cardiometabolic disease. The prevention of metabolic syndrome risk accrual through early behavioral interventions is crucial for at-risk populations.

Objectives: This paper outlines the protocol for the Health E Start study, including the objectives, methodology, ethics, and dissemination. Additionally, we discuss the goals of the National Institutes of Health Research Enhancement Award (R15) that funded this project and how this funding will facilitate the comprehensive training of undergraduate researchers. The long-term goal of the study is to develop a theoretically driven intervention for the prevention of metabolic syndrome risk development in college students. To facilitate this goal, the aims are to identify 1) behavioral targets for the prevention of metabolic syndrome risk development and 2) the motivations behind such behaviors to develop a theoretical framework for use in intervention design.

Design: Longitudinal observational design.

Setting: Transition from living at home to independent living at colleges across the U.S.

Participants: High school seniors (n = 150) who will be transitioning to college within 3 months of graduating.

Main outcome measure: For aim 1, metabolic syndrome risk will be quantified into a risk score using a principal components analysis of traditional risk factors. Associations between changes in lifestyle behaviors and changes in the risk score will identify population-specific behavioral targets. For aim 2, changes in psychological, social, and environmental antecedents of observed behaviors will be identified.

Conclusions: Identifying the relationship between behavior change and metabolic syndrome risk, and the psychosocial and environmental predictors of observed behavior changes will facilitate the design of targeted interventions for the prevention of metabolic syndrome risk progression in the early college years.

Purpose: The importance of schools providing physical education (PE) and promoting physical activity (PA) and the benefits of PA for children are well documented. However, a majority of students do not get the nationally recommended 60 min of daily PA. Many states grant waivers, substitutions, or exemptions from PE despite national recommendations. This study examined the association between state laws allowing for the use of PE substitutions and exemptions and school-level substitution and exemption practices.

Methods: School-level PE exemption and substitution data from the 2014 School Health Policies and Practices Study were linked to state law data from the National Wellness Policy Study and the National Cancer Institute's 2013 Classification of Laws Associated with School Students. The analytic sample included 320 schools located in 42 states. Separate multivariable logistic regression models linked five types of school PE exemptions/substitutions to corresponding state laws, controlling for school characteristics.

Results: Overall, 24 of the 42 states had laws addressing PE waivers, exemptions, or substitutions. Schools had higher odds of allowing PE substitutions for school sports (adjusted odds ratio (AOR), 3.59; 95% confidence interval (CI), 1.33-9.68), other school activities (AOR, 8.52; 95% CI, 2.90-25.03), and community sports (AOR, 4.30; 95% CI, 1.43-12.96) and allowing exemptions for fitness test scores (AOR, 4.67; 95% CI, 1.49-14.62) or vocational training (AOR, 5.92; 95% CI, 1.04-33.68) if state law allowed it, compared with schools in states that did not allow such practices.

Conclusions: Given the connection between PA and beneficial outcomes for children, decision makers, school administrators, practitioners, advocates, and researchers should consider and further examine how PE waiver, exemption, and substitution policies and practices may affect students' PA and related outcomes.

Background: Physical inactivity is a major issue for African Americans that contributes to increased risk for chronic conditions including obesity, heart disease, diabetes, and cognitive decline. The purpose of this single-clinic pilot study aimed to determine if a physical activity policy would increase primary-care provider discussions of physical activity during clinic visits using the Exercise is Medicine initiative as a guide.

Methods: The study design involved data collection at three time points. Participants were recruited from a single clinic providing high quality healthcare without regard to ability to pay. Participants included 109 African American patients between the ages of 24 and 81 (39 pre-intervention, 40 at 6 weeks post-intervention, and 30 at 12-months post-intervention). The primary outcome measure was participants' answers related to whether a physical activity discussion occurred with their primary-care provider.

Results: At baseline, 13% of participants reported a physical activity discussion with their provider, this increased to 33% at 6 weeks post-intervention. However, at 12-months post-intervention, the percentage of participants who reported a physical activity discussion decreased to 23%.

Conclusion: Exercise is an underused evidence-based strategy that should be prescribed as a medicine to prevent and manage many chronic health conditions. This pilot study demonstrated the feasibility of improving provider-patient communications related to the importance of daily physical activity behaviors. Further research is needed to determine how to employ and sustain a clinic level policy that will encourage physical activity discussions at every visit.

The COVID-19 pandemic led to significant challenges in conducting physical activity and nutrition translational research. This encompassed all phases of translational research, including recruitment (e.g., lack of trust in the scientific community), assessment (university regulations restricting in-person assessments), intervention (conversion of face-to-face interventions to online formats), and retention (loss of employment, phone service, or housing among study participants). The COVID-19 pandemic has had varying impacts on research productivity as well. While some groups found the pandemic led to increases in productivity (as evidenced by increases seen in both manuscript and grant submissions), junior faculty, women (particularly caregivers), African American, Asian, and Latinx faculty, and mid-career and senior scientists all faced unique career and personal challenges during this time. This included competing demands on time that interfered with research productivity and mental and physical health stressors. Therefore, in order to ensure we retain promising scientists in the field of translational physical activity and nutrition science, it will be important to consider these challenges when it comes time to review tenure files and grant applications. Reviewers of these applications should note creativity in moving research forward, continued mentoring of students or other faculty, and plans to get back on track after a pause in their ability to conduct impactful physical activity and nutrition work.