Accuracy of SenseWear Armband Mini-Fly for Estimating Energy Expenditure in Normal Weight, Overweight, and Obese Individuals

Obesity has become one of the greatest public health issues in America. BodyMedia promotes their SenseWear Armband physical activity monitor as a way to help with weight management. Purpose: to assess the accuracy of the SenseWear Armband Mini-Fly (SWA-MF) in adults of different BMI categories during rest, recovery, and two walking speeds. Methods: Forty-six participants were assigned to one of three BMI classifications: normal weight (n =15; 18.5-24.9 kg.m-2 [kilograms per meter squared]), overweight (n=17; 25-29.9 kg.m-2), or obese (n= 14; ≥30 kg.m-2). Height and weight were measured. Participants began the test with15 minutes of seated rest, then walked on a treadmill for 8 minutes at 50 m.min-1 [meters per minute], engaged in a seated recovery for a second 15 minute period, and then walked on a treadmill for 8 minutes at 75 m.min-1. During the test, participants wore the SWA-MF over their left triceps, and the ParvoMedics metabolic system was used to measure oxygen consumption. Calories per minute (kcal.min-1) [calories per minute] were used to quantify energy expenditure in both systems. Results: The SWA-MF error score was not affected by the participants’ BMI (p = 0.543.). The SWA-MF significantly underestimated measured energy expenditure during the resting condition by 0.21 kcal.min-1 (p \u3c 0.001) and during the recovery by 0.27 kcal.min-1 (p \u3c 0.001), but significantly overestimated measured energy expenditure during walking at 50 m.min-1 by 0.70 kcal.min-1 (p \u3c 0.001). The SWA-MF was not significantly different from measured energy expenditure during walking at 75 m.min-1 (p = 0.672) or over the duration of the total testing session (p = 0.913). Bland-Altman plots for energy expended during the total testing session showed mean biases between -0.09 and 0.09 kcal.min-1, and 95% prediction intervals between -1.16 and 1.20 kcal.min-1.Conclusion: The primary finding from this study is that the validity of the SWA-MF does not differ among BMI groups. Secondary findings support that the SWA-MF underestimates measured energy expenditure during seated resting and recovery periods and overestimates measured energy expenditure during brief periods of slow walking at 50 m.min-1

Total Energy Expenditure and Body Composition of Children with Developmental Disabilities

Background Obesity prevalence is increased in children with developmental disabilities, specifically in children with spina bifida and Down syndrome. Energy expenditure, a critical aspect of weight management, has been extensively studied in the typically developing population, but not adequately studied in children with developmental disabilities. Objective Determine energy expenditure, fat-free mass and body fat percentile and the impact of these findings on recommended caloric intake in children with spina bifida and Down syndrome. Methods/Measures This pilot study included 36 children, 18 with spina bifida, 9 with Down syndrome and 9 typically developing children. Half of the children with spina bifida were non-ambulatory. Doubly labeled water was used to measure energy expenditure and body composition. Descriptive statistics described the sample and MANOVA and ANOVA methods were used to evaluate differences between groups. Results Energy expenditure was significantly less for children with spina bifida who primarily used a wheelchair (p = .001) and children with Down syndrome (p = .041) when compared to children without a disability when adjusted for fat-free mass. However, no significant difference was detected in children with spina bifida who ambulated without assistance (p = .072). Conclusions Children with spina bifida and Down syndrome have a significantly decreased energy expenditure which directly impacts recommended caloric intake. No significant difference was detected for children with spina bifida who ambulated, although the small sample size of this pilot study may have limited these findings. Validating these results in a larger study is integral to supporting successful weight management of these children

Recruitment and reach in a school-based pediatric obesity intervention trial in rural areas

Introduction: The purpose of this study is to evaluate two recruitment strategies on schools and participant participation rates and representativeness (reach) within a pediatric obesity treatment trial tailored for families who live in rural areas. Methods: Recruitment of schools was evaluated based on their progress toward enrolling participants. Recruitment and reach of participants were evaluated using (1) participation rates and (2) representativeness of demographics and weight status of participants compared to eligible participants (who did not consent and enroll) and all students (regardless of eligibility). School recruitment, as well as participant recruitment and reach, were evaluated across recruitment methods comparing opt-in (i.e., caregivers agreed to allow their child to be screened for eligibility) vs. screen-first (i.e., all children screened for eligibility). Results: Of the 395 schools contacted, 34 schools (8.6%) expressed initial interest; of these, 27 (79%) proceeded to recruit participants, and 18 (53%) ultimately participated in the program. Of schools who initiated recruitment, 75% of schools using the opt-in method and 60% of schools using the screen-first method continued participation and were able to recruit a sufficient number of participants. The average participation rate (number of enrolled individuals divided by those who were eligible) from all 18 schools was 21.6%. This percentage was higher in schools using the screen-first method (average of 29.7%) compared to schools using the opt-in method (13.5%). Study participants were representative of the student population based on sex (female), race (White), and eligibility for free and reduced-price lunch. Study participants had higher body mass index (BMI) metrics (BMI, BMIz, and BMI%) than eligible non-participants. Conclusions: Schools using the opt-in recruitment were more likely to enroll at least 5 families and administer the intervention. However, the participation rate was higher in screen-first schools. The overall study sample was representative of the school demographics

Examining the Relationship Between Yoga Participation and Health. You Down, Dog?

The prevalence of debilitating chronic diseases, such as cardiovascular disease (CVD) and Alzheimer’s disease, are increasing in the United States. Inflammation, mitochondrial dysfunction, stress and depression are common pathologies associated with these chronic diseases. Many individuals engage in yoga because they believe it will improve their health. However, research examining the impact of yoga on markers of health associated with chronic diseases is limited and often reports conflicting results. Therefore, the purpose of this dissertation is to examine the relationship between yoga and inflammation, protein content of oxidative phosphorylation complexes, stress and depression, which may support the use of lifestyle interventions to promote health and wellbeing. The overall hypothesis of this dissertation is that yoga will be associated with improved markers of health; this will be tested through two separate studies. Study 1: Yoga and Health: A Cross Sectional Study used a cross-sectional study design to compare markers of health that are common pathologies for multiple, prevalent diseases between yoga participants and individuals who do not engage in yoga. Results support that yoga participants who engaged in yoga at least two times a week for the last six months have significantly improved perceived stress and symptoms of depression compared to non-yoga participants. Differences based on clinical cutoffs were also observed in a measure of systemic inflammation (erythrocyte sedimentation rate [ESR]). However, no differences were observed in C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), nor adiponectin. Additionally, the Complex V protein content was not different between the groups, but this may be due to the age difference of the groups rather than differences in their yoga participation. Study 2: Adherence to and Changes in Physiologic and Psychologic Health during an 8-week Yoga Intervention: A Pilot Study was conducted to evaluate the feasibility and explore the impact of an 8-week yoga intervention on perceived stress, symptoms of depression, inflammation, and protein content of oxidative phosphorylation complexes to provide insight on the relationship between yoga and the pathology of CVD. While the majority (67%) of participants adhered to the protocol, our feasibility cutoff of ≥ 85%, created a priori, was not attained. Participants who completed the study (n = 8; 89%) observed reductions in levels of perceived stress (13.9%), depression symptoms (27%) and systemic inflammation (34%), and CRP (10%). An increase of 21% was observed in adiponectin. Contrary to the hypothesis TNF-α increased by 11% and there was a minimal change in the protein content of Complex V. Overall conclusion. Collectively, the findings from both studies support that participation in yoga can improve levels of perceived stress and symptoms of depression. Further, differences based on clinical cutoffs in the cross-sectional study and exploratory analyses from the pilot study show promising findings regarding the relationship between yoga and systemic inflammation. However, this work was not able to demonstrate a clear relationship between participation in yoga and inflammatory markers of CRP, TNF-α, adiponectin, nor mitochondrial protein content. These studies are the first to directly measure changes within the mitochondria in relation to yoga participation. Additionally, results support that yoga may be recommended as a lifestyle intervention to improve mental health outcomes and, with further research, possibly be used for physiologic variables

Feasability and Applicability of Evenson Sedentary Behavior Cut Points Applied to Children with and Wihtout Intellectual and Developmental Disabilities

Aim Sedentary behavior (SB) is widely studied as it is associated with cardiometabolic health and obesity issues. However, children with Intellectual and Developmental Disabilities (IDD) have been understudied. Accelerometers are commonly used to measure SB in typically developing populations but may be inappropriate for IDD populations due to differences in body movement and physiologic responses to the activity. The use of Evenson sedentary cut-points, created based on typically developing children, has yet to be applied and/or examined in children with IDD. Purpose A descriptive cross-sectional study was conducted to (1) Assess the feasibility of applying Evenson sedentary cut-points in children with IDD (2) Describe SB over a two-week period between diagnosis groups. Methods The SB of 22 participants (8 children with Down syndrome, 6 children with spina bifida, 8 children with no chronic illness) was assessed on two separate occasions: (1) during a 7-minute sedentary protocol, and (2) over a two-week period. Results The study supports the preliminary efficacy of using Evenson cut-points for this population, with 100% of participants being within the Evenson counts per minute (0–100 cpm) during the 7-minute sedentary protocol. The total volume of SB over a two-week period was not significantly different between diagnosis groups (8.8 h, 8.6 h, and 7.1 h of SB for children with Down syndrome, spina bifida, or those with no chronic illness, respectively; p = 0.36). Conclusions Evenson sedentary cut-points can be used for children with IDD. Preliminary data suggest that children with IDD do not engage in significantly different SB than children without a chronic illness. Further study is warranted. Implications for rehabilitation Objective measures of physical activity and sedentary behavior for children with Down syndrome or spina bifida are rarely used due to potential differences in body movement (e.g., gait) during ambulation compared to typically developing peers that may influence the accuracy of cut-points. This study supports that Evenson sedentary cut-points can be used in children with Down syndrome or spina bifida to assess sedentary activity. Preliminary findings from this study demonstrate similarities in patterns of sedentary behaviors exhibited by our sample of children with Down syndrome, spina bifida, or no chronic illness

Prospective associations of neighborhood healthy food access and walkability with weight status in a regional pediatric health system

Abstract Background Most neighborhood food and activity related environment research in children has been cross-sectional. A better understanding of prospective associations between these neighborhood environment factors and children’s weight status can provide stronger evidence for informing interventions and policy. This study examined associations of baseline and changes in neighborhood healthy food access and walkability with changes in children’s weight status over 5 years. Methods Height, weight, and home address were obtained for 4,493 children (> 75% were Black or Latinx) from primary care visits within a large pediatric health system. Eligible participants were those who had measures collected during two time periods (2012–2014 [Time 1] and 2017–2019 [Time 2]). Data were integrated with census tract-level healthy food access and walkability data. Children who moved residences between the time periods were considered ‘movers’ (N = 1052; 23.4%). Mixed-effects models, accounting for nesting of children within census tracts, were conducted to model associations of baseline and changes in the neighborhood environment variables with Time 2 weight status (BMIz and overweight or obese vs. healthy weight). Models adjusted for weight status and child and neighborhood sociodemographics at baseline. Results Children living in a neighborhood with [ample] healthy food access at Time 1 had a lower BMIz at Time 2, regardless of mover status. A decrease in healthy food access was not significantly associated with children’s weight status at Time 2. Baseline walkability and improvements in walkability were associated with a lower BMIz at Time 2, regardless of mover status. Conclusions Findings provide evidence that residing in a neighborhood with healthy food access and walkability may support a healthy weight trajectory in children. Findings on changes in the neighborhood environment suggested that improved walkability in the neighborhood may support children’s healthy weight. The greater and more consistent findings among movers may be due to movers experiencing greater changes in neighborhood features than the changes that typically occur within a neighborhood over a short period of time. Future research is needed to investigate more robust environmental changes to neighborhoods

Feasibility and Acceptability of a Self-Report Activity Diary in Families of Children with and Without Special Needs

This study was conducted to examine the feasibility and acceptability of a self-report activity diary completed by parents and older children to assess the child\u27s daily activity in children with and without special needs. The study included 36 child/parent dyads stratified by child age and diagnosis. Parents (n = 36) and children ≥13 years (n = 12) were asked to report on the child\u27s daily activity using an activity diary. Feasibility was determined based on successfully returned diaries and acceptability via post-study interview. Activity diaries were submitted by 94% of the parents and 100% of the children, with 83% and 80%, respectively, successfully completed. Comments provided post-study regarding the diaries were primarily on the format and were generally negative. The activity diary was feasible to use, but not well accepted within our sample of children with and without special needs or their parents. Further research is needed to create valid physical activity assessment measures that are population specific for individuals with special needs

Accuracy of Body Mass Index in Categorizing Weight Status in Children with Intellectual and Developmental Disabilities

PURPOSE: To identify the accuracy of Body Mass Index (BMI) to categorize body weight in a sample of children with spina bifida and Down syndrome as compared to typically developing peers. METHODS: A secondary analysis of 32 children with spina bifida, Down syndrome or no chronic illness. A calculated BMI was plotted on the Centers for Disease Control and Prevention age- and sex-specific BMI growth charts to determine each child’s weight status. Percentage of body fat, obtained by labeled water, was plotted on two different body fat percentile reference curves, one derived from a whole body measure (DXA) of body fat and one by skin-fold measure. Differences in weight categories between calculated BMI and body fat percentile curves were reported. RESULTS: The calculated BMI for children with a disability had significant misclassifications as a screening tool for body fat when compared to children without a disability. Misclassifications were increased with the body fat percentile reference curve derived from skin-fold measures and for children who primarily used a wheelchair. CONCLUSION: The current recommendation to use BMI to categorize weight status is not useful for many children with disabilities. Further research to identify an alternative pragmatic strategy is necessary

Sedentary Bout Patterns and Metabolic Health in the Hispanic Community Health Study/Study of Latino Youth (SOL Youth)

Background There is limited evidence on the potential negative metabolic health impacts of prolonged and uninterrupted sedentary bouts in structurally disadvantaged youth. This study investigated associations between sedentary bout variables and metabolic health markers in the Hispanic Community Health Study/SOL Youth (Study of Latino Youth). Methods and Results SOL Youth was a population‐based cohort of 1466 youth (age range, 8–16 years; 48.5% female); 957 youth were included in the analytic sample based on complete data. Accelerometers measured moderate‐to‐vigorous physical activity (MVPA), total sedentary time, and sedentary bout patterns (daily time spent in sedentary bouts ≥30 minutes, median sedentary bout duration, and number of daily breaks from sedentary time). Clinical measures included body mass index, waist circumference, fasting glucose, glycated hemoglobin, fasting insulin, and the homeostasis model assessment of insulin resistance. After adjusting for sociodemographics, total sedentary time, and MVPA, longer median bout durations and fewer sedentary breaks were associated with a greater body mass index percentile (bbouts=0.09 and bbreaks=−0.18), waist circumference (bbouts=0.12 and bbreaks=−0.20), and fasting insulin (bbouts=0.09 and bbreaks=−0.21). Fewer breaks were also associated with a greater homeostasis model assessment of insulin resistance (b=−0.21). More time in bouts lasting ≥30 minutes was associated with a greater fasting glucose (b=0.18) and glycated hemoglobin (b=0.19). Conclusions Greater accumulation of sedentary time in prolonged and uninterrupted bouts had adverse associations with adiposity and glycemic control over and above total sedentary time and MVPA. Findings suggest interventions in Hispanic/Latino youth targeting both ends of the activity spectrum (more MVPA and less prolonged/uninterrupted sedentary patterns) may provide greater health benefits than those targeting only MVPA