In this study, a detailed analysis of meat/poultry/fish consumption is undertaken using the 2011–12 National Nutrition and Physical Activity Survey of Australia (NNPAS), the most recent nationally representative sur- vey and the first since 1995 covering both children and adults. All meat, poultry, fish and processed meat con- sumed were examined by disaggregating all meat prod- ucts and mixed dishes into individual meat types and other food components. The aim of this study was to compare the impact of disaggregation on population meat/poultry/fish intake levels and nutrient contribu- tion, as well as an assessment of the consumption of dis- aggregated meat/poultry/fish types according to gender, age group, and socio-economic status, factors known to affect consumption [9, 12–15]. These findings will provide a more precise estimate of meat/poultry/fish consumption and help to inform evidence-based dietary advice.
12 Read more
Estimations range from 21.9 to 31.7 % within the U.S and UK [36 – 40] and from 9.4 to 15.5 % in Australia [41 – 43]. Data about meeting the combined MVPA- muscle-strengthening guidelines are even scarcer. Previous studies have shown that 18.2 to 20.6 % of U.S. adults meet both MVPA and strength training guidelines [36, 44, 45], but no such estimates exist for the Australian population. Furthermore, international studies have reported that adults from different countries sit on average between 135 and 360 min/day, whilst the prevalence rates of total sitting time above 9 h/day ranged between 2.6 and 34.9 % [46, 47]. No previous international or national studies have concurrently assessed the prevalence and correlates of MVPA, muscle-strengthening activities and sedentary behaviours, and clusters of these behaviours in a representative sample. Such data are essential to inform comprehensive interventions aimed to reduce physical inactivity and prolonged sitting, and to identify populations at the highest risk.
13 Read more
used as the measure of SEP because it was strongly associated with skipping breakfast in the univariable analysis and there were no missing data. Models for household income, remoteness index, food security, adult education and household type were not adjusted for SEP due to collinearity. For the nutrition analysis additional adjustments were also made for child, household and adult correlates that were found to be associated with skipping in the correlates analysis. Energy intake was also added to the final model for the food group analysis. We do not include energy in the models where the outcomes were percentage of energy from added sugar or discretionary food, as energy intake was used to calculate these variables. Stata SE 13.1 (2014, StataCorp, College Station, TX USA) was used for all analyses. A sensitivity analysis was conducted to examine whether day of the week was associated with skipping breakfast. Participants were classified into one of three groups, depending on the days that the 24-hour recalls referred to: two weekdays (n=959), one weekday and one weekend day (n=553), or two weekend days (n=80). The percentage of skipping breakfast was compared across the three groups using chi- squared tests.
Other national organizations and initiatives make stricter recommendations for nutrition and physical ac- tivity than those set forth in current childcare regulation. Caring for Our Children released Preventing Childhood Obesity in Early Care and Education Programs in 2012 delineating the best food and activity practices for chil- dren, endorsing CACFP guidelines for meals and snacks . For toddlers 60–90 min, and for pre-schoolers 90– 120 min of moderate to vigorous activity is recom- mended per 8 h day . Both Let’s Move Child Care and the National Association for Sport and Physical Education (NAPSE) recommend 1–2 h per day of activ- ity (60 min of structured, 60 min unstructured) [19, 20]. Let’s Move Child Care prompts providers to limit screen time, serve a fruit and vegetable at every meal, provide water at every meal and limit 100 % fruit juice to 4–6 ounces per day .
13 Read more
Physical activity (PA) is a highly modifiable health beha- vior. Regular PA prevents or ameliorates several chronic conditions or health states, including, hypertension, dys- lipidemia, overweight and obesity, cardiovascular disease, diabetes, anxiety, depression, certain cancers, and the risk of premature death [1-3]. World Health Organization (WHO) recommendations suggest that adults should accumulate at least 150 min of moderate-to-vigorous in- tensity aerobic PA (MVPA) each week . Examples of MVPA include brisk walking, jogging, climbing, lifting heavier loads, swimming, and competitive sports. Despite the proven benefits of regular MVPA [1-3], few (3%–14%) working-age women in North America are meeting cur- rent MVPA recommendations [5,6]. Not surprisingly, data from the recent Canadian Health Measures Survey (CHMS) and National Health and Nutrition Examination Survey (NHANES) revealed that 28%–31% of working-age women were classified as overweight, and 24%–36% were classified as obese [7,8]. Further, an alarming proportion of working-age women in North America (2 of every 3 women) have established risk factors for cardiovascular diseases [9,10], the leading cause of death in North America, including hypertension (estimates of 19%–32%) [11,12], dyslipidemia (estimates of 11%–25%) [13,14], and type II diabetes (estimates of 7%–11%) [15,16].
cause and effect has not been documented, one possible reason for this is that it is more difficult for heavier people to move at the same exercise intensity as those of normal weight [3,4]. It has also been suggested that excess body weight poses additional challenges in terms of tempera- ture regulation and the dissipation of body heat while exercising, as well as problems related to the buildup of sweat which may cause chafing due to movement . When people chose to become physically active, the liter- ature suggest that people begin at a low intensity level [6,7], which may contribute to an active lifestyle and be easier for obese people to perform, but expend fewer cal- ories than higher intensity activity for people of the same body size. Moreover, when previously sedentary people are prescribed an intensity that they perceive to be diffi- cult, they are less likely to continue participation . Increasing the adoption and maintenance of regular phys- ical among adults is a major challenge. In addition to per- ceived stress, King and colleagues  found that BMI > 27 kg/m 2 and low fitness levels were predictive of poor adher-
Population based assessments of school environment characteristics in Australia , the United States of America  and Canada  have mostly relied on Principal or School Administrators completion of tele- phone or paper surveys. Despite the use of such mea- sures, few have been validated . For example, the validity of the nutritional and physical activity envir- onmental characteristics of schools in Australia, as reported in large, recurrent surveys of Australian school Principals  has not been reported. Similarly, the United States National School Health Policies and Pro- grams Study (SHPPS) of school health policies and prac- tices has reported the reliability but not the validity of the questionnaires measuring school practices . An unpublished validation study of the Canadian School Health Environment Survey (SHES)  is one of the few studies that have reported the validity of school sur- vey tools. The report found high percent agreement (range 70%-100%) between direct observation and com- bined school administrator/teacher “best response” for questions related to existing physical activity facilities and healthy eating programs and promotions. Lower
rather than across the United Kingdom, wherever possible. Data from England came primarily from the Millennium Cohort Study (MCS), with additional data coming from HBSC. According to the MCS (children aged 7–8 years), boys averaged 10 739 steps per day and girls averaged 9699 steps per day. 16 This was very similar to what was seen in ISCOLE with boys averaging 10 675 steps per day and girls averaging 9435 steps per day. Self-reported data from HBSC showed that 33% of 11-year-old boys and 20% of 11-year-old girls met the physical activity guidelines, 4 whereas in ISCOLE, only 19% of boys and 11% of girls self-reported that they met the guidelines. With respect to sedentary behavior, results from the HBSC showed that 64% of 11-year-old boys and 60% of 11-year-old girls exceeded the screen time guidelines on Figure 1. Proportion of children considered overweight or obese from ISCOLE study sites and their representative countries. Dark gray bars indicate data from ISCOLE participants; white bars represent country-level data. If no white bar, then country-level data are not available. Where available, data are presented for both boys and girls. Data were analyzed as per BMI cut-points available in each country as follows. World Health Organization: Portugal, Colombia, Brazil; International Obesity Task Force: Canada, Australia; Center for Disease Control and Prevention: the United States; other: the United Kingdom (British 1990 growth reference 17 ), China (China BMI criteria, overweight ⩾ 19.4, obese ⩾ 22.2). 44 Country-level data sets included: the United Kingdom: National Child Measurement Programme; 17 Portugal: Plataforma Contra a Obesidade; 45 Canada: Canadian Health Measures Survey; 46 the United States, National Health and Nutrition Examination Survey; Colombia: Encuesta Nacional de la Situación Nutricional; Brazil: Brazilian Institute of Geography and Statistics; 25 China: China Health and Nutrition Survey; 44 Australia: Australian National Children's Nutrition and Physical Activity Survey. 35 See Additional ﬁ le 3 for additional study
NHANES is a cross-sectional observational study con- ducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention that uses a stratified, multistage probability design to obtain a nationally representative sample of the U.S. population. The survey population included randomly selected households within clusters of neighborhoods. Of the 12,761 individuals selected during the 2003–2004 survey, 10,122 individuals agreed to participate. The NHANES 2003–2004 survey included an interview, physical exa- mination and laboratory testing conducted by trained staff. Only non-pregnant adults aged 18–49 without a history of diabetes (or taking medication to treat dia- betes), cardiovascular or renal disease, stroke or emphy- sema were included in this analysis. Because participants were scheduled for either a morning blood draw after a
Blood lymphocytes were collected from participants aged $12 years and stored in liquid nitrogen as cell cultures immor- talized with Epstein–Barr virus. DNA in the form of crude cell lysates was made available for approved research projects for 7159 persons examined between 1991 and 1994. Genetic data generated from those projects from 1999 to 2006 were submit- ted to the National Center for Health Statistics and stored upon successful completion of a three-part quality-control analysis. We used data for participants genotyped at the APOE locus (dbSNP ID: rs7412 and rs429358). To maintain confidentiality of individual-level data, analysis occurred at the National Center for Health Statistics Research Data Center in Hyatts- ville, MD. Approval of the Howard University Institutional Review Board was obtained prior to the analysis.
The National Adult Nutrition Survey (NANS) is a cross- sectional study of food and nutrient intakes, lifestyle choices, level of physical activity and food choice attitudes of Irish adults aged 18 years and over . Extensive details of the survey and methodologies have been previously reported . In summary, the survey was conducted in the Republic of Ireland during 2008–2011 on a represen- tative sample of 1500 adults (740 males, 760 females). The response rate of the eligible sample was 60 %. Socio- demographic analysis and comparison of the sample to Census 2006 data as outlined in Table 1, has shown it to be representative of adults in Ireland with respect to age, gender, social class, and urban/rural location. From the sample of 1500, 1262 adults completed the food choice questionnaire, the main questionnaire used in this study. Ethical approval was granted by the University College Cork Clinical Research Ethics Committee of the Cork Teaching Hospitals and written informed consent was obtained from study participants.
10 Read more
Introduction: Leptin has been suspected to contribute to the development of osteoarthritis (OA). However, this hypothesis has not been tested in large-scale hand OA cohorts. Our study aimed to determine whether there is a cross-sectional relationship between serum leptin levels and hand OA in a population-based sample of US adults. Method: We used the Third National Health and Nutrition Examination Survey (NHANES III), a national cross- sectional population-based survey, to study the relationship between hand OA and serum leptin concentration. We applied previously established classification criteria for hand OA. Patients with rheumatoid arthritis were excluded. Potential confounders included sex, body mass index, the presence of polyarticular OA, diabetes, and total cholesterol. We estimated unadjusted mean leptin concentration by hand OA status and by all confounders. We further developed a linear regression model to assess mean leptin levels, adjusted for appropriate confounders. Results: Of 2,477 subjects in the NHANES III sample that had a hand examination and did not have rheumatoid arthritis, 1,056 (42.6%) had a leptin measurement and were included in the analysis. Subjects with and without leptin measurement had similar demographic characteristics. We did not find any significant differences in mean serum leptin levels in subjects with symptomatic hand OA (7.38 ng/ml in males (95% confidence interval (CI) = 5.31, 9.46) and 21.55 ng/ml in females (95% CI = 17.08, 26.02)), asymptomatic hand OA (6.69 ng/ml in males (95% CI = 5.19, 8.18) and 17.09 ng/ml in females (95% CI = 15.00, 19.18)), and no hand OA (8.22 ng/ml in males (95% CI = 7.47, 8.97) and 20.77 ng/ml in females (95% CI = 18.01, 23.53)) in the unadjusted analysis. In a multivariable linear regression model that included variables of hand OA status, age, race/ethnicity, and obesity status, we found no statistically significant association between serum leptin and hand OA status.
The amount of weight a woman gains during pregnancy can directly influence pregnancy outcomes and the long-term health of both mother and child. The IOM gestational weight gain guidelines were created to optimize maternal and fetal health outcomes. Weight gain below and above these guidelines are associated with many adverse health outcomes. Inadequate weight gain is associated with an increased risk of infant mortality, preterm birth, and small-for-gestational-age or intrauterine growth retardation (Institute of Medicine and National Research Council, 2009). It is worth noting that a small body of literature suggests that obese women (pre-pregnancy BMI ≥ 30 kg/m 2 ) may experience favorable pregnancy outcomes with little to no weight gain (Kiel et al., 2007; Thornton et al., 2009). While inadequate weight gain is an important public health topic that requires additional research, the majority of women gain excessive weight in pregnancy. Therefore, the emphasis of this review and dissertation will focus on excessive gestational weight gain.
255 Read more
To date, limited research has sought to develop valid nutrition and physical activity measures that are easy for practitioners to use in free-living settings like afterschool programs with limited training and at low cost . However, researchers have begun creating measures de- signed for early childcare staff [32,33]. The current study builds on this evidence base by using strong criterion measures over the course of one week to obtain a more precise estimate of nutrition and physical activity prac- tices and behaviors. It also uses repeated assessment data to determine how one day of data performs in compari- son to weekly criterion measures. While some items were significantly correlated with the criterion with one day of data, as expected the ranges of these estimates were wide. Whenever possible, researchers and program staff should use weekly averages, rather than one-day es- timates. OSNAP-OPAT is low cost and requires minimal staff time to complete. Plus, the instructions for utilizing the measure are built into the tool, rather than requiring the extra expense and time of training. Its user-friendly format can help afterschool staff take action to improve their current practices. The measure and companion tools for identifying areas for improvement and develop- ing action plans are available for free at www.osnap.org.
Stroke is a non-communicable disease caused by disruption of the blood supply to the brain which can be caused by a blockage (ischemic stroke) or rupture of a blood vessel (hemorrhagic stroke) . As a neurological disease, stroke remains one of the most devastating, which often causes death or physical and mental damage. With the epidemiological transition occurring in many countries around the world, there has been a drastic change in the prevalence of stroke prevalence . There is a difference in the incidence of stroke in developed and developing countries. Feigin, et al (2009) concluded that the incidence of strokes globally experienced inequality namely in developed countries experienced a decline of 42% while in developing countries increased by 100%. This can occur due to massive urbanization, changes in risk factors and the lack of prevention and treatment of stroke in developing countries .
activities category was not reliable for Mon- Fri or Saturday for any participant, regardless of gender; thus warranting further investigation as no significant intra- individual difference in duration of engagement were observed from baseline to post testing. There are two possible reasons for the observed low ICCs and include poor reliability in the participant reporting participation or the behaviour is not stable over time and experiences intra-individual variability. In this instance, it would appear that the reliability of reporting participation in social activities is low, especially Mon-Fri. When com- paring our reliability results to the ASAQ, the Dutch Activity Questionnaire for Adults and Adolescents (AQuAA)  and the Hong Kong CLASS validations, the results for time spent in weekly sedentary activities are comparable, with no questionnaire having acceptable reliability for all age groups. Total duration of sedentary activities (Mon-Fri, Sat & Sun) ranged from ICC = 0.57- 0.86 in the ASAQ  (11-15 y), ICC = 0.69 in Hong Kong CLASS  (9-12) years, ICC = 0.57 in AQuAA (13-15 y)  with our results having an ICC = 0.64. Caution needs to be taken when interpreting our results as 16% of the original respondents were excluded due to over-reporting sedentary participation, beyond what was considered ‘ achievable ’ during a normal school week or weekend. However, when these results were included in the analysis, the reliability coefficients were surprisingly higher, suggesting that over-reporters were consistently over-reporting their sedentary activity.
11 Read more
Resnicow & Vaughn challenged the field of behavioral nutrition and physical activity to conduct research in new ways. They challenged the predictiveness of our models, sensitivity to initial conditions, factors predisposing to change and measurement procedures. While the predictiveness of our models will reflect the sophistication of our thinking and research, and the sensitivity to initial conditions is subsumed under the sophistication of our models, research on conditions predisposing to change (e.g. epiphanies), more longitudinal designs, refined measurement procedures and testing of critical issues can only enhance the quality of our research. Improved research quality should lead to enhanced efficacy and effectiveness of our interventions, and thereby our making meaningful contributions to mitigating the chaos in our field and the crisis from the rising epidemic of obesity.
The beneficial effect of exercise on the cardiovascular system is well documented. There is a direct correlation between physical inactivity and cardiovascular mortality, and physical inactivity is an independent risk factor for the development of heart attack and stroke. Low levels of physical exercise increase the risk of cardiovascular diseases mortality (American Heart Association, 2017). Furthermore, Children who participate in physical exercise experience greater loss of body fat and increased cardiovascular fitness (Lumeng and Julie 2006). Studies have shown that academic stress in youth increases the risk of cardiovascular disease in later years; however, these risks can be greatly reduced with regular physical exercise (Ahaneku et al., 2000)
A more profound limitation of the available evidence is that identifying a relationship between, for example, urban form and walking for transport is not the same thing as showing that changing the built environment will lead to a change in behaviour . Few researchers have taken up the opportunity (or challenge) presented by 'nat- ural experiments' to investigate the effects of environmen- tal interventions on physical activity . We therefore established a longitudinal study to examine changes asso- ciated with the opening of a new urban section of the M74 motorway (freeway) currently under construction in Glas- gow, Scotland. The rationale and design for this study have been described previously . It is claimed that the new motorway, which will mostly pass through or close to densely-populated urban neighbourhoods, will contrib- ute to the regeneration of a region which includes some of the most deprived and least healthy working-class com- munities in Europe . It is also claimed that the new motorway will divert traffic from local streets, reduce traf- fic noise and bring new local employment opportunities, thereby improving characteristics of the local environ- ment held to be associated with active travel. Others claim that the new motorway will encourage car use, degrade the aesthetic quality of the surroundings and reduce the safety and attractiveness of routes for pedestrians and cyclists across the line of the motorway – all changes which may be expected to discourage active travel . The eventual aim of the M74 study will be to assess the effects of this major modification to the urban built envi- ronment and transport infrastructure on perceptions of the local environment and on population health and health-related behaviour, the primary outcome of interest being a change in the quantity of 'active travel' (walking and cycling for transport).
13 Read more
The NSAOH used a three-stage, stratified clustered de- sign, with 14,123 adults aged 15 years and older taking part in a telephone interview. Of these, 5,505 respondents were invited for, and accepted, a dental examination . The CHMS used a multi-stage stratified sampling design to interview and examine a total of 5,586 participants, including both children and adults . The NZOHS ex- amined 3,196 children and adults. The study base were participants in the previous New Zealand 2006/2007 health survey who agreed to be contacted for future sur- veys; this second survey was still found to be representa- tive . NHANES, a stratified multistage probability sample of the civilian non-institutionalized population of the US, examined 7,072 people .