International Journal of Behavioral Nutrition and Physical Activity - Latest Articles

The potential modal shift and health benefits of implementing a public bicycle share program in Montreal, Canada

Daniel Fuller — 2013-05-24T00:00:00Z

Background: This study estimated the modal shift associated with the implementation of a public bicycle share program in Montreal, Canada. Methods: A population-based sample of adults participated in two cross sectional telephone surveys. Self-reported travel behaviors were collected at the end of the first (fall 2009) and second (fall 2010) season of implementation. The sample included 2502 (Mean age=47.8 years, 61.8% female), and 2509 (Mean age=48.9 years, 59.0% female) adult respondents in each survey. Results: The estimated modal shift associated with the implementation of the PBSP from motor vehicle use to walking, cycling, and public transportation was 6483 and 8023 trips in 2009 and 2010. This change represents 0.34% and 0.43% of all motor vehicle trips in Montreal. Conclusions: The implementation of a PBSP was associated with a shift toward active transportation. The modal shift was complex and not simply the result of a discrete shift from one mode to another. Promotion of active transportation should encourage integration of multiple active transportation modes to better reflect people's actual transportation behaviors.

Clustering of unhealthy food around German schools and its influence on dietary behavior in school children: a pilot study

Christoph Buck — 2013-05-24T00:00:00Z

Background: The availability of fast foods, sweets, and other snacks in the living environment of children is assumed to contribute to an obesogenic environment. In particular, it is hypothesized that food retailers are spatially clustered around schools and that a higher availability of unhealthy foods leads to its higher consumption in children. Studies that support these relationships have primarily been conducted in the U.S. or Australia, but rarely in European communities. We used data of FFQ and 24-HDR of the IDEFICS study, as well as geographical data from one German study region to investigate (1) the clustering of food outlets around schools and (2) the influence of junk food availability on the food intake in school children. Methods: We geocoded food outlets offering junk food (e.g. supermarkets, kiosks, and fast food restaurants). Spatial cluster analysis of food retailers around child-serving institutions was conducted using an inhomogeneous K-function to calculate global 95% confidence envelopes. Furthermore, a food retail index was implemented considering the kernel density of junk food supplies per service area, adjusted for residential density. We linked the food retail index to FFQ and 24-HDR data of 384 6- to 9-year-old school children in the study region and investigated the impact of the index on food intake, using multilevel regression models adjusted for sex, age, BMI, parent's education and income, as well as adjusting for over- and underreporting of food intake. Results: Comparing the 95% confidence envelopes to the observed K-function, we showed that food stores and fast food restaurants do not significantly cluster around schools. Apart from this result, the food retail index showed no effect on BMI (ß = 0.01, p = 0.11) or food intake variables assessed by FFQ and 24-HDR. Conclusion: In the built environment of the German study region, clustering of food retailers does not depend on the location of schools. Additionally, the results suggest that the consumption of junk food in young children is not influenced by spatial availability of unhealthy food. However, investigations should be replicated in other European communities to increase environmental variability.

Residential summer camp: a new venue for nutrition education and physical activity promotion

Alison Ventura — 2013-05-24T00:00:00Z

Background: Millions of children attend residential summer camps each year. However, few studies have examined the potential of camps for obesity prevention efforts. Research in the domain of positive youth development has shown that camp programs as short as one week have both short- and long-term positive effects on self-esteem, self-efficacy and other youth outcomes. The objective of the present study was to highlight the potential of resident camps as promising venues for the promotion of healthy eating and physical activity behaviors in the children who attend. Methods: Data for this study came from the American Camp Association 2007 Emerging Issues Survey. This survey assessed camp professionals' perspectives on a diverse array of issues, including the healthy eating and physical activity of children. Data analysis focused on responses from 247 camp professionals whose camps offered resident camp programs. Results: Descriptive and Chi-square statistics were calculated. Ninety-two percent of camp professionals reported that the healthy eating and physical activity of campers was an "important" or "very important" issue for camps. The majority of camps reported offering vegetarian options, healthy snacks and salad bars, and allergen-free options. Additionally, 86% of camp professionals indicated that they had implemented one or more strategies to address concerns related to the unhealthy eating behaviors of children, with top strategies including increasing the availability of fruits and vegetables, increasing the availability of healthy drink options, and improving the nutritional quality of menus. Fewer camp professionals (50%) indicated they had implemented strategies to increase children's physical activity levels, but many professionals indicated that their camp programs were inherently active and additional strategies to promote physical activity were not necessary. Associations were found between camp affiliation and food options available to campers. Conclusions: The majority of camp professionals believe the healthy eating and physical activity of children are important issues for camps and have implemented strategies to address these issues. An important question for future research is to examine whether these strategies are effective in promoting healthy eating and physical activity behaviors in children, as well as ways that camp programs could be improved.

Environmental and social-motivational contextual factors related to youth physical activity: systematic observations of summer day camps

Nicole Zarrett — 2013-05-20T00:00:00Z

Background: Youth risk of obesity is high during the summer months. Summer day camps can be ideal settings for preventing obesity through reducing youth summer sedentary behaviors. However, with limited research on camp settings, the mechanisms by which these programs promote children's physical activity (PA) remains largely unknown. The current study was designed to take a first step in addressing this gap in research through systematic observations of 4 summer day camps. Methods: Systematic observations of 4 summer day camps was conducted using the System for Observing Play and Leisure Activity in Youth (SOPLAY) and a social-motivational climate supplemental observation tool founded on Self-Determination Theory and previous research developed by the authors. Teams of two coders observed daily activities for four days across two-week periods at each camp. On 15 minute intervals throughout each day, camps were assessed on level of youth PA (e.g., sedentary, moderate, vigorous), five physical features (e.g., equipment), eight staff interactions (e.g., encourage PA), and six social climate components (e.g., inclusive game). Results: Across the sample, highly engaging games [F(1,329) = 17.68, p < .001], positive peer interactions [F(1,329) = 8.43, p < .01], and bullying [F(1,329) = 9.39, p < .01] were significantly related to higher PA participation rates, and clarity of rules [F(1,329) = 11.12, p < .001] was related to fewer youth participating in PA. Separate analyses for males and females indicated some sex differences with highly engaging games [F(1,329) = 23.10, p < .001] and bullying [F(1,329) = 10.00, p < .01] related to males' but not females' PA, and positive peer interactions related to only females' PA [F(1,329) = 9.58, p < .01]. Small, yet significant physical-environmental effects of temperature [F(1,328) = 1.54, p < .05] and equipment [F(1,328) = 4.34, p = .05] for girls also suggests that activities offered indoors (which was most common during high temperatures), and provision of equipment may also be important considerations for promoting girls' PA. Staff behaviors were minimally predictive of youth PA. Conclusions: This is the first study to conduct systematic observations of the physical and social resources of summer day camps and contributes to our understanding of the strengths and needs of camps to effectively promote PA in both boys and girls during the summer months when risks for obesity are high.

Examination of mid-intervention mediating effects on objectively assessed sedentary time among children in the Transform-Us! cluster-randomized controlled trial

Valerie Carson — 2013-05-20T00:00:00Z

Background: The optimal targets and strategies for effectively reducing sedentary behavior among young people are unknown. Intervention research that explores changes in mediated effects as well as in outcome behaviors is needed to help inform more effective interventions. Therefore, the purpose of this study was to examine the mid-intervention mediating effects on children's objectively assessed classroom and total weekday sedentary time in the Transform-Us! intervention. Methods: The results are based on 293 children, aged 7- to 9-years-old at baseline, from 20 schools in Melbourne, Australia. Each school was randomly allocated to one of four groups, which targeted reducing sedentary time in the school and family settings (SB; n = 74), increasing or maintaining moderate- to vigorous-intensity physical activity in the school and family settings (PA; n = 75), combined SB and PA (SB + PA; n = 80), or the current practice control (C; n = 64). Baseline and mid-intervention data (5--9 months) were collected in 2010 and analyzed in 2012. Classroom and total weekday sedentary time was objectively assessed using ActiGraph accelerometers. The hypothesized mediators including, child enjoyment, parent and teacher outcome expectancies, and child perceived access to standing opportunities in the classroom environment, were assessed by questionnaire. Results: The SB + PA group spent 13.3 min/day less in weekday sedentary time at mid-intervention compared to the control group. At mid-intervention, children in the SB group had higher enjoyment of standing in class (0.9 units; 5-unit scale) and all intervention groups had more positive perceptions of access to standing opportunities in the classroom environment (0.3-0.4 units; 3-unit scale), compared to the control group. However, none of the hypothesized mediator variables had an effect on sedentary time; thus, no mediating effects were observed. Conclusions: While beneficial intervention effects were observed on some hypothesized mediating variables and total weekday sedentary time at mid-intervention, no significant mediating effects were found. Given the dearth of existing information, future intervention research is needed that explores mediated effects. More work is also needed on the development of reliable mediator measures that are sensitive to change overtime.Trial registrationACTRN12609000715279ISRCTN83725066

Measuring parent food practices: a systematic review of existing measures and examination of instruments

Amber Vaughn — 2013-05-20T00:00:00Z

During the last decade, there has been a rapid increase in development of instruments to measure parent food practices. Because these instruments often measure different constructs, or define common constructs differently, an evaluation of these instruments is needed. A systematic review of the literature was conducted to identify existing measures of parent food practices and to assess the quality of their development. The initial search used terms capturing home environment, parenting behaviors, feeding practices and eating behaviors, and was performed in October of 2009 using PubMed/Medline, PsychInfo, Web of knowledge (ISI), and ERIC, and updated in July of 2012. A review of titles and abstracts was used to narrow results, after which full articles were retrieved and reviewed. Only articles describing development of measures of parenting food practices designed for families with children 2-12 years old were retained for the current review. For each article, two reviewers extracted data and appraised the quality of processes used for instrument development and evaluation. The initial search yielded 28,378 unique titles; review of titles and abstracts narrowed the pool to 1,352 articles; from which 57 unique instruments were identified. The review update yielded 1,772 new titles from which14 additional instruments were identified. The extraction and appraisal process found that 49% of instruments clearly identified and defined concepts to be measured, and 46% used theory to guide instrument development. Most instruments (80%) had some reliability testing, with internal consistency being the most common (79%). Test-retest or inter-rater reliability was reported for less than half the instruments. Some form of validity evidence was report for 84% of instruments. Construct validity was most commonly presented (86%), usually with analysis of associations with child diet or weight/BMI. While many measures of food parenting practices have emerged, particularly in recent years, few have demonstrated solid development methods. Substantial variation in items across different scales/constructs makes comparison between instruments extremely difficult. Future efforts should be directed toward consensus development of food parenting practices constructs and measures.

The better the story, the bigger the serving: narrative transportation increases snacking during screen time in a randomized trial

Elizabeth Lyons — 2013-05-16T00:00:00Z

Background: Watching television and playing video games increase energy intake, likely due to distraction from satiety cues. A study comparing one hour of watching TV, playing typical video games, or playing motion-controlled video games found a difference across groups in energy intake, but the reasons for this difference are not clear. As a secondary analysis, we investigated several types of distraction to determine potential psychosocial mechanisms which may account for greater energy intake observed during sedentary screen time as compared to motion-controlled video gaming. Methods: Feelings of enjoyment, engagement (mental immersion), spatial presence (the feeling of being in the game), and transportation (immersion in a narrative) were investigated in 120 young adults aged 18 – 35 (60 female). Results: Only narrative transportation was associated with total caloric intake (ρ = .205, P = .025). Transportation was also higher in the TV group than in the gaming groups (P = .002) and higher in males than in females (P = .003). Transportation mediated the relationship between motion-controlled gaming (as compared to TV watching) and square root transformed energy intake (indirect effect = −1.34, 95% confidence interval −3.57, −0.13). No other distraction-related variables were associated with intake. Conclusions: These results suggest that different forms of distraction may differentially affect eating behavior during screen time, and that narrative appears to be a particularly strong distractor. Future studies should further investigate the effects of narrative on eating behavior.

Effects of different discount levels on healthy products coupled with a healthy choice label, special offer label or both: results from a web-based supermarket experiment

Wilma Waterlander — 2013-05-16T00:00:00Z

Background: Two strategies commonly recommended to improve population diets include food labels and food taxes/subsidies. The aim of this study was to examine the effects of both strategies separately and in combination.FindingsAn experiment with a 3x3 factorial design was conducted, including: three levels of price reduction (10%; 25%; and 50%) x three labels ('special offer', 'healthy choice' and 'special offer & healthy choice') on healthy foods defined following the Choices front-of-pack nutrition label. N = 109 participants completed the experiment by conducting a typical weekly shop for their household at a three-dimensional web-based supermarket. Data were analysed using analysis of covariance.Participants receiving a 50% price discount purchased significantly more healthy foods for their household in a typical weekly shop than the 10% discount (+8.7 items; 95%CI = 3.8-13.6) and the 25% discount group (+7.7 items; 95%CI = 2.74 -- 12.6). However, the proportion of healthy foods was not significantly higher and the discounts lead to an increased amount of energy purchased. No significant effects of the labels were found. Conclusion: This study brings some relevant insights into the effects of price discounts on healthier foods coupled with different labels and shows that price effects over shadowed food labels. However, price discounts seem to have ambiguous effects; they do encourage the purchase of healthy products, but also lead to increased energy purchases. More research is needed to examine how pricing strategies can work in directing consumers towards interchanging unhealthier options for healthier alternatives.

Associations between eating meals, watching TV while eating meals and weight status among children, ages 10¿12 years in eight European countries: the ENERGY cross-sectional study

Frøydis Vik — 2013-05-15T00:00:00Z

Background: To assess the association of eating meals, and never watching TV while eating meals, with weight status among children, ages 10–12 years across Europe. Methods: 7915 children (mean age: 11.5 years) in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain and Switzerland) completed a questionnaire at school. Data on meals eaten the day before questionnaire administration and the frequency of eating meals while watching TV were collected. Height and weight of the children were objectively assessed. Multinomial and binary regression analyses were conducted to test associations of eating meals (adjusted for gender and ethnicity) and never watching TV while eating meals (adjusted for gender, ethnicity and total TV time) with overweight/obesity, and to test for country- and socio-demographic differences. Results: The proportions of children reporting eating breakfast, lunch and dinner were 85%, 96%, and 93% respectively, and 55%, 46% and 32% reported to never watch TV at breakfast, lunch and dinner respectively. The children who ate breakfast (OR = 0.6 (95% CI 0.5-0.7)) and dinner (OR = 0.4 (95% CI 0.3-0.5)), had lower odds of being overweight compared to those who did not. The children who never watched TV at lunch (OR = 0.7 (95% CI 0.7-0.8)) and dinner (OR = 0.8 (95% CI 0.7-0.9)) had lower odds of being overweight compared to those who watched TV at the respective meals. Conclusions: The odds of being overweight was lower for children who ate breakfast and dinner compared to those who did not eat the respective meals. The odds of being overweight was lower for children who reported to never watch TV at lunch and dinner compared to those who did. A focus towards meal frequency and watching TV during meals in longitudinal and interventions studies in prevention of overweight and obesity, may contribute to a better understanding of causality.

Does the availability of snack foods in supermarkets vary internationally?

Lukar Thornton — 2013-05-14T00:00:00Z

Background: Cross-country differences in dietary behaviours and obesity rates have been previously reported. Consumption of energy-dense snack foods and soft drinks are implicated as contributing to weight gain, however little is known about how the availability of these items within supermarkets varies internationally. This study assessed variations in the display of snack foods and soft drinks within a sample of supermarkets across eight countries. Methods: Within-store audits were used to evaluate and compare the availability of potato chips (crisps), chocolate, confectionery and soft drinks. Displays measured included shelf length and the proportion of checkouts and end-of-aisle displays containing these products. Audits were conducted in a convenience sample of 170 supermarkets across eight developed nations (Australia, Canada, Denmark, Netherlands, New Zealand, Sweden, United Kingdom (UK), and United States of America (US)). Results: The mean total aisle length of snack foods (adjusted for store size) was greatest in supermarkets from the UK (56.4 m) and lowest in New Zealand (21.7 m). When assessed by individual item, the greatest aisle length devoted to chips, chocolate and confectionery was found in UK supermarkets while the greatest aisle length dedicated to soft drinks was in Australian supermarkets. Only stores from the Netherlands (41%) had less than 70% of checkouts featuring displays of snack foods or soft drinks. Conclusion: Whilst between-country variations were observed, overall results indicate high levels of snack food and soft drinks displays within supermarkets across the eight countries. Exposure to snack foods is largely unavoidable within supermarkets, increasing the likelihood of purchases and particularly those made impulsively.