International Journal of Behavioral Nutrition and Physical Activity - Most viewed articles

Food Advertising and Marketing Directed at Children and Adolescents in the US

Mary Story and Simone French — 2004-02-10

In recent years, the food and beverage industry in the US has viewed children and adolescents as a major market force. As a result, children and adolescents are now the target of intense and specialized food marketing and advertising efforts. Food marketers are interested in youth as consumers because of their spending power, their purchasing influence, and as future adult consumers. Multiple techniques and channels are used to reach youth, beginning when they are toddlers, to foster brand-building and influence food product purchase behavior. These food marketing channels include television advertising, in-school marketing, product placements, kids clubs, the Internet, toys and products with brand logos, and youth-targeted promotions, such as cross-selling and tie-ins. Foods marketed to children are predominantly high in sugar and fat, and as such are inconsistent with national dietary recommendations. The purpose of this article is to examine the food advertising and marketing channels used to target children and adolescents in the US, the impact of food advertising on eating behavior, and current regulation and policies.

Joint associations of multiple leisure-time sedentary behaviours and physical activity with obesity in Australian adults

Takemi Sugiyama, Genevieve N Healy, David W Dunstan, Jo Salmon and Neville Owen — 2008-07-01

Background: Television viewing and physical inactivity are independently associated with risk of obesity. However, how the combination of multiple leisure-time sedentary behaviours (LTSB) and physical activity (LTPA) may contribute to the risk of obesity is not well understood. We examined the joint associations of multiple sedentary behaviours and physical activity with the odds of being overweight or obese. Methods: A mail survey collected the following data from adults living in Adelaide, Australia (n = 2210): self-reported height, weight, six LTSB, LTPA and sociodemographic variables. Participants were categorised into four groups according to their level of LTSB (dichotomised into low and high levels around the median) and LTPA (sufficient: ≥ 2.5 hr/wk; insufficient: < 2.5 hr/wk). Logistic regression analysis examined the odds of being overweight or obese (body mass index ≥ 25 kg/m2) by the combined categories. Results: The odds of being overweight or obese relative to the reference category (low sedentary behaviour time and sufficient physical activity) were: 1.54 (95% confidence interval [CI]: 1.20–1.98) for the combination of low sedentary behaviour time and insufficient physical activity; 1.55 (95% CI: 1.20–2.02) for the combination of high sedentary behaviour time and sufficient physical activity; and 2.26 (95% CI: 1.75–2.92) for the combination of high sedentary behaviour time and insufficient physical activity. Conclusion: Those who spent more time in sedentary behaviours (but were sufficiently physically active) and those who were insufficiently active (but spent less time in sedentary behaviour) had a similar risk of being overweight or obese. Reducing leisure-time sedentary behaviours may be as important as increasing leisure-time physical activity as a strategy to fight against obesity in adults.

Physical education, school physical activity, school sports and academic performance

François Trudeau and Roy J Shephard — 2008-02-25

Background: The purpose of this paper is to review relationships of academic performance and some of its determinants to participation in school-based physical activities, including physical education (PE), free school physical activity (PA) and school sports. Methods: Linkages between academic achievement and involvement in PE, school PA and sport programmes have been examined, based on a systematic review of currently available literature, including a comprehensive search of MEDLINE (1966 to 2007), PSYCHINFO (1974 to 2007), SCHOLAR.GOOGLE.COM, and ERIC databases. Results: Quasi-experimental data indicate that allocating up to an additional hour per day of curricular time to PA programmes does not affect the academic performance of primary school students negatively, even though the time allocated to other subjects usually shows a corresponding reduction. An additional curricular emphasis on PE may result in small absolute gains in grade point average (GPA), and such findings strongly suggest a relative increase in performance per unit of academic teaching time. Further, the overwhelmingly majority of such programmes have demonstrated an improvement in some measures of physical fitness (PF). Cross-sectional observations show a positive association between academic performance and PA, but PF does not seem to show such an association. PA has positive influences on concentration, memory and classroom behaviour. Data from quasi-experimental studies find support in mechanistic experiments on cognitive function, pointing to a positive relationship between PA and intellectual performance. Conclusion: Given competent providers, PA can be added to the school curriculum by taking time from other subjects without risk of hindering student academic achievement. On the other hand, adding time to "academic" or "curricular" subjects by taking time from physical education programmes does not enhance grades in these subjects and may be detrimental to health.

Relationships between the home environment and physical activity and dietary patterns of preschool children: a cross-sectional study

2008-05-30

ObjectiveTo assess relationships between characteristics of the home environment and preschool children's physical activity and dietary patterns. Methods: Homes of 280 preschool children were visited and information obtained by direct observation and parent interview regarding physical and nutritional characteristics of the home environment. Children's physical activity, sedentary behaviour and dietary patterns were measured using standardised parent-report questionnaires. Associations were analysed using analysis of variance and correlation. Results: Parental physical activity (p = 0.03–0.008), size of backyard (p = 0.001) and amount of outdoor play equipment (p = 0.003) were associated with more outdoor play. Fewer rules about television viewing (p < 0.001) and presence of playstation (p = 0.02) were associated with more indoor sedentary time. Higher fruit and vegetable intake was associated with restricting children's access to fruit juice (p = 0.02) and restricting high fat/sugar snacks (p = 0.009). Lower intake of non-core foods was associated with restricting children's access to fruit juice (p = 0.007), cordial/carbonated drinks (p < 0.001) and high fat/sugar snacks (p = 0.003). Lower fruit and vegetable intake was associated with reminding child to 'eat up' (p = 0.007) and offering food rewards to eat main meal (p = 0.04). Higher intake of non-core foods was associated with giving food 'treats' (p = 0.03) and offering food rewards to eat main meal (p = 0.04). The availability of food groups in the home was associated with children's intake of these foods (fruit and vegetables, p < 0.001; fat in dairy, p = <0.001; sweetened beverages, p = 0.004–<0.001; non-core foods, p = 0.01–<0.001). Conclusion: Physical attributes of the home environment and parental behaviours are associated with preschool children's physical activity, sedentary behaviour and dietary patterns. Many of these variables are modifiable and could be targeted in childhood obesity prevention and management.

Environmental determinants of active travel in youth: A review and framework for future research

Jenna R Panter, Andrew P Jones and Esther MF Van Sluijs — 2008-06-23

Background: Many youth fail to meet the recommended guidelines for physical activity. Walking and cycling, forms of active travel, have the potential to contribute significantly towards overall physical activity levels. Recent research examining the associations between physical activity and the environment has shown that environmental factors play a role in determining behaviour in children and adolescents. However, links between the environment and active travel have received less attention. Methods: Twenty four studies were identified which examined the associations between the environment (perceived or objectively measured) and active travel among youth aged 5-18 years. Findings were categorised according to the location of the environmental measure examined; attributes of the neighbourhood, destination and the route between home and destination. Results: Results from the reviewed studies indicated that youth active travel is positively associated with social interactions, facilities to assist active travel and urban form in the neighbourhood as well as shorter route length and road safety en-route. A conceptual framework is presented which highlights the associations between active travel behaviours and environmental factors, drawing upon both existing and hypothesised relationships. Conclusions: We provide a review of the available literature and present a novel theoretical framework that integrates the environment into the wider decision making process around travel choices for children and adolescents. Further work should explore associations where gaps in understanding have been identified, and account for the main moderators of behaviour so hypothesised associations can be confirmed.

Physical activity across the curriculum: year one process evaluation results

2008-07-07

Background: Physical Activity Across the Curriculum (PAAC) is a 3-year elementary school-based intervention to determine if increased amounts of moderate intensity physical activity performed in the classroom will diminish gains in body mass index (BMI). It is a cluster-randomized, controlled trial, involving 4905 children (2505 intervention, 2400 control). Methods: We collected both qualitative and quantitative process evaluation data from 24 schools (14 intervention and 10 control), which included tracking teacher training issues, challenges and barriers to effective implementation of PAAC lessons, initial and continual use of program specified activities, and potential competing factors, which might contaminate or lessen program effects. Results: Overall teacher attendance at training sessions showed exceptional reach. Teachers incorporated active lessons on most days, resulting in significantly greater student physical activity levels compared to controls (p < 0.0001). Enjoyment ratings for classroom-based lessons were also higher for intervention students. Competing factors, which might influence program results, were not carried out at intervention or control schools or were judged to be minimal. Conclusion: In the first year of the PAAC intervention, process evaluation results were instrumental in identifying successes and challenges faced by teachers when trying to modify existing academic lessons to incorporate physical activity.

Does parenting affect children's eating and weight status?

Alison K Ventura and Leann L Birch — 2008-03-17

Background: Worldwide, the prevalence of obesity among children has increased dramatically. Although the etiology of childhood obesity is multifactorial, to date, most preventive interventions have focused on school-aged children in school settings and have met with limited success. In this review, we focus on another set of influences that impact the development of children's eating and weight status: parenting and feeding styles and practices. Our review has two aims: (1) to assess the extent to which current evidence supports the hypothesis that parenting, via its effects on children's eating, is causally implicated in childhood obesity; and (2) to identify a set of promising strategies that target aspects of parenting, which can be further evaluated as possible components in childhood obesity prevention. Methods: A literature review was conducted between October 2006 and January 2007. Studies published before January 2007 that assessed the association between some combination of parenting, child eating and child weight variables were included. Results: A total of 66 articles met the inclusion criteria. The preponderance of these studies focused on the association between parenting and child eating. Although there was substantial experimental evidence for the influence of parenting practices, such as pressure, restriction, modeling and availability, on child eating, the majority of the evidence for the association between parenting and child weight, or the mediation of this association by child eating, was cross-sectional. Conclusion: To date, there is substantial causal evidence that parenting affects child eating and there is much correlational evidence that child eating and weight influence parenting. There are few studies, however, that have used appropriate meditational designs to provide causal evidence for the indirect effect of parenting on weight status via effects on child eating. A new approach is suggested for evaluating the effectiveness of intervention components and creating optimized intervention programs using a multiphase research design. Adoption of approaches such as the Multiphase Optimization Strategy (MOST) is necessary to provide the mechanistic evidence-base needed for the design and implementation of effective childhood obesity prevention programs.

International Physical Activity Questionnaire (IPAQ) and New Zealand Physical Activity Questionnaire (NZPAQ): A doubly labelled water validation

2007-12-03

Background: Accurate measurement of physical activity is a pre-requisite for monitoring population health and for evaluating effective interventions. The International Physical Activity Questionnaire (IPAQ) is used as a comparable and standardised self-report measure of habitual physical activity of populations from different countries and socio-cultural contexts. The IPAQ has been modified to produce a New Zealand physical activity questionnaire (NZPAQ). The aim of this study was to validate the IPAQ and NZPAQ against doubly labelled water (DLW). Method: Total energy expenditure (TEE) was measured over a 15-day period using DLW. Activity-related energy expenditure (AEE) was estimated by subtracting the energy expenditure from resting metabolic rate and thermic effect of feeding from TEE. The IPAQ (long form) and NZPAQ (short form) were completed at the end of each 7-day period. Activity-related energy expenditure (IPAQAEE and NZPAQAEE) was calculated from each questionnaire and compared to DLWAEE. Results: Thirty six adults aged 18 to 56 years (56% female) completed all measurements. Compared to DLWAEE, IPAQAEE and NZPAQAEE on average underestimated energy expenditure by 27% and 59%, respectively. There was good agreement between DLWAEE and both IPAQAEE and NZPAQAEE at lower levels of physical activity. However there was marked underestimation of questionnaire-derived energy expenditure at higher levels of activity. Conclusion: Both the IPAQ and NZPAQ instruments have a demonstrated systematic bias toward underestimation of physical activity-related energy expenditure at higher levels of physical activity compared to DLW. Appropriate calibration factors could be used to correct for measurement error in physical activity questionnaires and hence improve estimation of AEE.

Depression and quality of life in cancer survivors: is there a relationship with physical activity?

Nancy Humpel and Donald C Iverson — 2007-12-17

Background: Evidence is growing on the benefit of physical activity to improve well-being following a cancer diagnosis. This study examined changes in physical activity from pre to post diagnosis and explored this relationship with quality of life and depression. Methods: Participants were recruited by posters and by letter of invitation. The questionnaire was completed by 59 prostate and 32 breast cancer survivors. Results: Physical activity decreased by 72 minutes per week from pre to post diagnosis, although 20.9% reported having increased activity post diagnosis. Over 30% were considered depressed. Breast cancer participants who increased physical activity post diagnosis reported higher scores for Physical Wellbeing subscale (26 versus 21; F[1,29] = 5.19, p < .03), Emotional Wellbeing subscale (22 versus 19; F[1,30] = 4.57, p < .04) and Functional Wellbeing subscale (26 versus 19; F[1,30] = 9.03, p < .001). A greater proportion of participants taking part in no physical activity were depressed (55.6%; χ2 = 6.83, p < .04). Conclusion: Over 25% of participants identified with emotional and/or well being problems, and more than half reported insufficient physical activity to yield benefits. Future research needs to gain a better understanding of why cancer survivors decrease their physical activity following a cancer diagnosis and what is necessary for them in order to retain or increase their physical activity.

Validity and repeatability of the EPIC physical activity questionnaire: a validation study using accelerometers as an objective measure

2008-06-02

Background: A primary aim of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study is to examine the association between total physical activity levels (comprising occupational, household and recreational activity) and the incidence of cancer. We examined the validity and long-term repeatability of total physical activity measurements estimated from the past-year recall EPIC questionnaire, using accelerometers as an objective reference measure. Methods: Participants included 100 men and 82 women aged 50–65 years. Criterion validity was assessed by comparing the physical activity estimates from the EPIC questionnaire with total activity estimated from the average of three separate 7-day accelerometer periods during the same (past-year) period. Long-term repeatability of the EPIC questionnaire was assessed by comparing the responses from the baseline and 10-month administrations. Past-year EPIC estimates were also compared with the Friedenreich Lifetime Total Physical Activity Questionnaire to examine whether recent activity reflected lifetime activity. Results: Accelerometer total metabolic equivalent (MET)-hours/week were positively associated with a total physical activity index (Spearman rank correlation ρ = 0.29, 95% confidence interval (CI) 0.15, 0.42) and with non-occupational activity estimated in MET-hours/week (ρ = 0.21, 95% CI 0.07, 0.35). Stratified analyses suggested stronger correlations for non-occupational activity for participants who were male, had a lower BMI, were younger, or were not full-time workers, although the differences in correlations between groups were not statistically significant. The weighted kappa coefficient for repeatability of the total physical activity index was 0.62 (95% CI 0.53, 0.71). Spearman correlations for repeatability of components of activity were 0.65 (95% CI 0.55, 0.72) for total non-occupational, 0.58 (95% CI 0.48, 0.67) for recreational and 0.73 (95% CI 0.66, 0.79) for household activity. When past-year activity was compared to lifetime estimates of activity, there was fair agreement for non-occupational (ρ = 0.26) activity, which was greater for household activity (ρ = 0.46) than for recreational activity (ρ = 0.21). Conclusion: Our findings suggest that the EPIC questionnaire has acceptable measurement characteristics for ranking participants according to their level of total physical activity. The questionnaire should be able to identify the presence or absence of reasonably strong aetiological associations when either recent or long-term activity is the responsible factor.