The Longitudinal Association Between Objectively-Measured School-Day Physical Activity and Academic Achievement in US Elementary School Students

Background: It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement. Methods: In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics. Results: Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had β = −-0.066, β = −-0.063, β = −-0.066, and β = −-0.058 associations (p \u3c  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had β = −-0.206 and β = −-0.283 (p \u3c  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were − 1.666, − 1.638, and − 1.993 points lower respectively (p \u3c  0.001). Conlcusion: The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA – which would constitute an approximately 300% increase from current levels – results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress. Trial registration: ClinicalTrials.gov, NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT0376504

The association between long work hours and leisure-time physical activity and obesity

Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ2: 19.3; P-value: <0.01). Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ2: 13.33; P-value: <0.001; χ2: 4.42; P-value: <0.05). Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations. Keywords: Physical activity, Obesity, Occupation, Long work hour

Exploring the Impact of the New WIC Food Package on Low-Fat Milk Consumption Among WIC Recipients: A Pilot Study

OBJECTIVE: To examine if the mothers and their eldest child participating in WIC would accept the 2009 new Women, Infants, and Children (WIC) program package and drink more low-fat milk. METHODS: Mothers and their eldest child at two Atlanta WIC clinics were recruited. Data were collected at baseline (before the new WIC package), at one week and four weeks. RESULTS: The percentage of children consuming low-fat milk significantly increased: 41.3% at baseline, 58.8% at week one, and 79.5% at week four (p<.001). After four weeks, the mothers reported increased child's consumption of low-fat milk vs. whole milk (AOR = 7.36; CI: 1.44-37.52). Mothers' consumption of low-fat milk did not significantly change after introduction of the new package. CONCLUSIONS: Policy changes for WIC vouchers were implemented to encourage mothers to reduce fat calories in dairy products for them and their children. This represents a powerful, low-resource intervention to change health behaviors among low-income families

Obesity and understudied minority children: existing challenges and opportunities in epidemiology

Abstract Background Obesity is a major public health concern in the United States and should be addressed as early as possible, in childhood. Disparities exist in obesity prevalence and its associated comorbidities by racial/ethnic group, however less is known about the smaller racial/ethnic subclasses that are often aggregated and assumed to be homogeneously at risk. As the racial and ethnic composition of the US shifts towards greater diversity, it is important that epidemiologic research addresses these new challenges. Main body In this short communication, we focus on Asian American children given that subgroups are historically understudied and emerging evidence among adults suggest heterogeneous associations for both obesity and cardio-metabolic outcomes. Existing limitations in this research area include: (1) identifying the appropriate measurement of adiposity in Asian American children; (2) determining high-risk cutoffs for intervention; and (3) developing strategies to ensure study robustness. Conclusion Data disaggregation is a necessary approach to understand potentially heterogeneous associations in childhood obesity and cardio-metabolic risk, but epidemiologic investigators must address these challenges. Ultimately, successful strategies could help better identify high risk subgroups, target interventions, and effectively reduce the burden of obesity among American youth

The Association of Vaccination for Common Adult Infectious Diseases and Uptake of COVID-19 Vaccines among 5,006,851 Veterans, 20 December 2020–31 October 2021

Disparities in vaccination coverage for coronavirus disease 2019 (COVID-19) in the United States (U.S.) are consistent barriers limiting our ability to control the spread of disease, particularly those by age and race/ethnicity. This study examines the association between previous vaccination for common adult infectious diseases and vaccination for SARS-CoV-2 among a cohort of veterans in the U.S. Sociodemographic and clinical data were utilized from three databases within the Veterans Health Administration included in the electronic health record. We examined the association of previous vaccination for common adult vaccinations through six separate multivariable logistic regression analyses, one for each previous vaccine exposure, adjusting for demographic and clinical variables. We also examined the association of receiving any one of the six common adult vaccinations and vaccination against SARS-CoV-2. Adjusted models indicate higher odds of vaccination for SARS-CoV-2 among those who received each of the previous vaccinations. Significant differences were also noted by race/ethnicity and age. Veterans who recorded receiving any one of the previous vaccinations for common adult infections had significantly greater odds of receiving any vaccination against SARS-CoV-2. Understanding veterans’ previous vaccination status can assist researchers and clinicians in impacting the uptake of novel vaccines, such as vaccination against SARS-CoV-2

Obesity Is Associated with an Increase in Pharmaceutical Expenses among University Employees

Objective. To examine costs associated with obesity in an employee population and factors associated with increased costs. Methods. We used data from the Physical Activity and Life Style (PALS) study, a randomized prospective design evaluating three interventions to increase physical activity among physically inactive nonfaculty university employees (n=454). The primary exposure variable, obesity (measured by body mass index), was obtained from the in-person baseline survey. Covariates were obtained from the baseline survey and included demographic characteristics and health status. Data from the baseline survey was linked with administrative data to determine pharmaceutical, inpatient, outpatient, and total health care costs for three years. Average monthly expenditures for obese and nonobese individuals were compared using t-tests and a two-part multivariate regression model adjusted for demographic and socioeconomic characteristics and health behaviors. Results. Although in-patient and outpatient expenses were not associated with obesity, pharmaceutical expenditures were $408 or 87.2$468 versus $876) for obese individuals than for nonobese individuals, which reflected poorer health behaviors and health status of obese adults. Conclusion. Awareness of the costs associated with obesity among employees can stimulate employers to make the investment in providing employer-sponsored wellness and health improvement programs to address obesity

Anxiety and Depression and Associated Factors Among a Sample of Semi-Rural High School Students in Georgia

Background: Anxiety and depression can affect adolescents’ health and current literature lacks studies of youths living in non-urban settings. Methods: We used chi-square and t-tests on data collected from self-administered online surveys, completed by 9th-grade students (n=222) attending a large, semi-rural public high school in the state of Georgia, to assess the prevalence of symptoms of anxiety and depression and associated factors. Results: Almost half of the students self-reported anxiety (43%) or depression (55%) and students who self-reported either condition were more likely to report poorer sleep hygiene, sleepiness, race-related mistreatment, and higher stress. Conclusions: Our findings suggest that symptoms of anxiety and depression are prevalent among youths in semi-rural settings and further research is needed to understand the role of modifiable risk factors and identify effective interventions. Keywords: adolescent mental health; adolescent sleep; anxiety; depression; semi-rura