Physical activity may mitigate COVID-19 infections in people with obesity: A call to action.

In addition to the mental health benefits, moderate-intensity physical activity produces strong immune and inflammatory benefits, and most of the beneficial compounds are synthesized in, or stimulated by, active skeletal muscles. Because skeletal muscle constitutes 30% to 40% of body weight, active muscles distribute positive effects throughout the body (13). In summary, all of these documented effects emphasize that moderate-intensity activities, such as walking, could have immediate beneficial impacts on immune function, inflammatory responses, mental health, and vaccine responsiveness, all of which could reduce the severity of COVID-19 in people with obesity. Based on the relationships among physical activity, obesity, immunity, and mental health, we strongly urge health care, public health, education, workplace, and health insurance professionals and organizations to prioritize physical activity to leverage its acute benefits and immediate protection during the pandemic. Public health organizations and health plans should develop internal and public communication campaigns that emphasize the importance of physical activity for the general population and more specifically for people with obesity as a mechanism to enhance immune responsiveness and potentially mitigate the severity of future infections, physically and mentally

Using Focus Groups to Develop a Bone Health Curriculum for After-school Programs

INTRODUCTION: Childhood behaviors influence peak bone mass and osteoporosis risk in later life. The after-school environment provides an opportunity to enrich a child’s learning and experience. Our objective was to gain a better understanding of the knowledge of, attitudes and beliefs about, and barriers to achieving bone health among children, parents, and after-school program leaders from low-income, ethnically diverse communities. Findings led to the development, implementation, and evaluation of a bone health curriculum in the after-school setting. METHODS: Eight focus groups were conducted in three representative communities. Focus group participants included children aged six to eight years, parents of children aged six to eight, and after-school program staff. Transcripts and written notes from each session were reviewed and common themes were identified within each group. RESULTS: Most adults had some understanding of osteoporosis, but did not recognize that childhood behaviors had a role in developing the disease. Program leaders raised concerns about their ability to implement a health program and recommended a flexible format. Parents and program leaders recognized the importance of maintaining a fun atmosphere. CONCLUSION: It is feasible to create a curriculum for a bone health program that meets the unique needs and interests of children and program leaders in the after-school setting. Addressing the needs, interests, and common barriers of the target population is an essential first step in curriculum development

Occupational Risks and Pregnancy and Infant Health Outcomes in Florida Farmworkers

The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age

Parent-child interactions and objectively measured child physical activity: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Parents influence their children's behaviors directly through specific parenting practices and indirectly through their parenting style. Some practices such as logistical and emotional support have been shown to be positively associated with child physical activity (PA) levels, while for others (e.g. monitoring) the relationship is not clear. The objectives of this study were to determine the relationship between parent's PA-related practices, general parenting style, and children's PA level.</p> <p>Methods</p> <p>During the spring of 2007 a diverse group of 99 parent-child dyads (29% White, 49% Black, 22% Hispanic; 89% mothers) living in low-income rural areas of the US participated in a cross-sectional study. Using validated questionnaires, parents self-reported their parenting style (authoritative, authoritarian, permissive, and uninvolved) and activity-related parenting practices. Height and weight were measured for each dyad and parents reported demographic information. Child PA was measured objectively through accelerometers and expressed as absolute counts and minutes engaged in intensity-specific activity.</p> <p>Results</p> <p>Seventy-six children had valid accelerometer data. Children engaged in 113.4 ± 37.0 min. of moderate-vigorous physical activity (MVPA) per day. Children of <it>permissive </it>parents accumulated more minutes of MVPA than those of <it>uninvolved </it>parents (127.5 vs. 97.1, <it>p </it>< 0.05), while parents who provided above average levels of support had children who participated in more minutes of MVPA (114.2 vs. 98.3, <it>p </it>= 0.03). While controlling for known covariates, an <it>uninvolved </it>parenting style was the only parenting behavior associated with child physical activity. Parenting style moderated the association between two parenting practices - reinforcement and monitoring - and child physical activity. Specifically, post-hoc analyses revealed that for the <it>permissive </it>parenting style group, higher levels of parental reinforcement or monitoring were associated with higher levels of child physical activity.</p> <p>Conclusions</p> <p>This work extends the current literature by demonstrating the potential moderating role of parenting style on the relationship between activity-related parenting practices and children's objectively measured physical activity, while controlling for known covariates. Future studies in this area are warranted and, if confirmed, may help to identify the mechanism by which parents influence their child's physical activity behavior.</p

Factors related to leader implementation of a nationally disseminated community-based exercise program: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The benefits of community-based health programs are widely recognized. However, research examining factors related to community leaders' characteristics and roles in implementation is limited.</p> <p>Methods</p> <p>The purpose of this cross-sectional study was to use a social ecological framework of variables to explore and describe the relationships between socioeconomic, personal/behavioral, programmatic, leadership, and community-level social and demographic characteristics as they relate to the implementation of an evidence-based strength training program by community leaders. Eight-hundred fifty-four trained program leaders in 43 states were invited to participate in either an online or mail survey. Corresponding community-level characteristics were also collected. Programmatic details were obtained from those who implemented. Four-hundred eighty-seven program leaders responded to the survey (response rate = 57%), 78% online and 22% by mail.</p> <p>Results</p> <p>Of the 487 respondents, 270 implemented the program (55%). One or more factors from each category – professional, socioeconomic, personal/behavioral, and leadership characteristics – were significantly different between implementers and non-implementers, determined by chi square or student's <it>t</it>-tests as appropriate. Implementers reported higher levels of strength training participation, current and lifetime physical activity, perceived support, and leadership competence (all p < 0.05). Logistic regression analysis revealed a positive association between implementation and fitness credentials/certification (p = 0.003), program-specific self-efficacy (p = 0.002), and support-focused leadership (p = 0.006), and a negative association between implementation and educational attainment (p = 0.002).</p> <p>Conclusion</p> <p>Among this sample of trained leaders, several factors within the professional, socioeconomic, personal/behavioral, and leadership categories were related to whether they implemented a community-based exercise program. It may benefit future community-based physical activity program disseminations to consider these factors when selecting and training leaders.</p

Coalition-Committees as Network Interventions: Baseline Network Composition in Context of Childhood Obesity Prevention Interventions

Community coalitions can address local issues with deep, historic, and contextual understanding that enables customized implementation of evidence-based strategies. The individuals within the coalition, their partnerships, and the social context is likely an important component of unraveling the challenges of implementation so interventions reach people in need. We focus on the relevance of baseline coalition-committee network (CCN), the networks of purposely formed subcommittees within community coalitions, structure as one of the moderating, theoretical links between community coalition social networks and intervention success. We explore the baseline composition and characteristics of five CCNs at the beginning of childhood obesity prevention interventions. Using a combination of social network, multidimensional scaling, and correspondence analyses, we examine the structure and heterogeneity of five CCNs, each consisting of a core group of stakeholders in the coalition and sometimes the broader community itself. Cross-sectional analyses are used to examine the composition of coalition-committees related to network density, centralization, hierarchy, and coalition demographics and characteristics. Results indicate that CCNs are patterned in their structure and characteristics, and we discuss whether adjustments to childhood obesity prevention interventions according to baseline structure and characteristics could be advantageous for intervention implementation. Together, these findings can inform future longitudinal investigations into CCN network structure

Healthier side dishes at restaurants: an analysis of children’s perspectives, menu content, and energy impacts

BACKGROUND: Children consume restaurant-prepared foods at high rates, suggesting that interventions and policies targeting consumption of these foods have the potential to improve diet quality and attenuate excess energy intake. One approach to encouraging healthier dietary intake in restaurants is to offer fruits and vegetables (FV) as side dishes, as opposed to traditional, energy-dense accompaniments like French fries. The aims of the current study were to examine: children's views about healthier side dishes at restaurants; current side dish offerings on children's menus at leading restaurants; and potential energy reductions when substituting FV side dishes in place of French fries. METHODS: To investigate children’s attitudes, a survey was administered to a nationally representative sample of U.S. 8- to 18-year-olds (n = 1178). To examine current side dish offerings, children's menus from leading quick service (QSR; n = 10) and full service restaurant chains (FSR; n = 10) were analyzed. Energy reductions that could result from substituting commonly-offered FV side dishes for French fries were estimated using nutrition information corresponding to the children's menu items. RESULTS: Two-thirds of children reported that they would not feel negatively about receiving FV sides instead of French fries with kids' meals. Liking/taste was the most common reason that children gave to explain their attitudes about FV side dishes. Nearly all restaurants offered at least 1 FV side dish option, but at most restaurants (60% of QSR; 70% of FSR), FV sides were never served by default. Substituting FV side dishes for French fries yielded an average estimated energy reduction of at least 170 calories. CONCLUSIONS: Results highlight some healthy trends in the restaurant context, including the majority of children reporting non-negative attitudes about FV side dishes and the consistent availability of FV side dish options at leading QSR and FSR. Yet the minority of restaurants offer these FV sides by default. Promoting creative, appealing FV side dishes can result in healthier, less energy-dense meals for children. Substituting or displacing energy-dense default side dishes with such FV dishes show promise as part of continued, comprehensive efforts to increase the healthfulness of meals consumed by children in restaurant settings

Depressive Symptoms and Weight Status Among Women Recently Immigrating to the US

Objectives Depressive symptoms have been associated with obesity. Little is known about this relationship among immigrants. We examined relationships between depressive symptoms and weight status in immigrant women from three ethnic groups. Methods Participants were Brazilian, Haitian, and Latina women (n = 345) enrolled in Live Well, a community-based, randomized intervention designed to prevent weight gain in recent immigrants. Study data are from baseline when participants completed the Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale, a physical activity questionnaire, and socio-demographic questions; BMI was calculated from measured height and weight. Results Forty-four percent of participants (36 % of Brazilians, 66 % of Haitians, 30 % of Latinas) had high depressive symptoms (CES-D ≥ 16), and 38 % (26 % of Brazilians, 49 % of Haitians, 42 % of Latinas) were obese (BMI ≥ 30.0). Those reporting more depressive symptoms were more likely to be obese (Wald Chi square = 4.82, p \u3c .05). An interaction between depressive symptoms, ethnic group, and income was revealed (F(4,340) = 2.91, p \u3c .05), such that higher depressive symptoms were associated with higher BMI among Brazilians earning ≥$30,000 per year and with lower BMI among Brazilians earning \u3c$30,000. The relationship between depressive symptoms and obesity did not differ by income among Haitians or Latinas. Conclusions Depressive symptoms and obesity were highly prevalent among these recently-immigrated women. Positive relationships between these variables were consistent across ethnic and income groups, with the exception of lower-income Brazilians. While these findings suggest similar patterns and health needs across several groups of immigrants, cultural differences should be considered when addressing these health conditions

Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

BackgroundThere are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children&rsquo;s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child&rsquo;s weight.MethodsA cross-sectional analysis was conducted on a sample of school-aged children (6&ndash;11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1&ndash;6) in rural America. After measuring children&rsquo;s height and weight, we17 assessed overweight and obesity (BMI &ge; 85th percentile) associations with these behaviors: improving diet quality18 (&ge; 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (&ge; 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (&le; 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children\u27s race/ethnicity, gender, age, and government assistance.ResultsOverweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat &ge; 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.ConclusionsRural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children&rsquo;s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change