Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia—A multi-centre study

Background: We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. Methods: This analysis on rural South Asian children aged 5–14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores). Results: The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2. 4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education (OR = 2.1; 95 % CI: 1.1, 4.1). In multivariate analyses, sedentary activity ≤ 2 h/day was associated with lower BMI-z-scores (β = −0.3; 95 % CI: −0.5, −0.08) and lower waist-z-scores (β = −1.1; 95 % CI: −2.2, −0.07). Conclusion: Only one quarter of children in these rural areas achieved RPAL in active travel, leisure and sedentary activity. Improved understanding of RPAL in rural South Asian children is important due to rapid socio-economic transition

Socioeconomic inequalities in smoking and drinking in adolescence:social network dynamics

BackgroundNetwork-based interventions have the potential to prevent socioeconomic inequalities in health behaviors but require a good understanding of the underlying social network mechanisms. We investigated whether (1) adolescents selected friends with a similar socioeconomic status (SES), (2) smoking and alcohol consumption spread in networks, and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.MethodsWe applied Stochastic Actor Oriented Models to the complete social network data (“Wired into Each Other” data) of 253 adolescents in eight Hungarian secondary school classes over three waves between 2010 and 2013. SES was measured based on entitlement to an income-tested regular child protection benefit.ResultsHigh SES adolescents were most likely to form friendships with peers from their own SES group (odds ratio [OR] = 1.1, 95% Confidence Interval [CI] = 1.0-1.1). Adolescents adjusted their smoking behavior (OR = 24.0, 95% CI 1.3-454.9) but not their alcohol consumption (OR = 1.6, 95% CI 0.6-4.4) to emulate the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 1.0, 95% CI 0.9-1.1), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.2, 95% CI 1.0-1.3), but this association was not significantly different according to SES.ConclusionsSocioeconomic inequalities in health behaviors were driven by preferences to form friendships within their own SES group and the spread of smoking and alcohol consumption in the network. These inequalities were not amplified by SES differences in encouraging smoking or drinking.Main messages: In three waves of observations in a Hungarian adolescent cohort, the study found social network effects for inequalities in smoking and alcohol consumption

Socioeconomic inequalities in smoking and drinking in adolescence:social network dynamics

BackgroundNetwork-based interventions have the potential to prevent socioeconomic inequalities in health behaviors but require a good understanding of the underlying social network mechanisms. We investigated whether (1) adolescents selected friends with a similar socioeconomic status (SES), (2) smoking and alcohol consumption spread in networks, and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.MethodsWe applied Stochastic Actor Oriented Models to the complete social network data (“Wired into Each Other” data) of 253 adolescents in eight Hungarian secondary school classes over three waves between 2010 and 2013. SES was measured based on entitlement to an income-tested regular child protection benefit.ResultsHigh SES adolescents were most likely to form friendships with peers from their own SES group (odds ratio [OR] = 1.1, 95% Confidence Interval [CI] = 1.0-1.1). Adolescents adjusted their smoking behavior (OR = 24.0, 95% CI 1.3-454.9) but not their alcohol consumption (OR = 1.6, 95% CI 0.6-4.4) to emulate the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 1.0, 95% CI 0.9-1.1), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.2, 95% CI 1.0-1.3), but this association was not significantly different according to SES.ConclusionsSocioeconomic inequalities in health behaviors were driven by preferences to form friendships within their own SES group and the spread of smoking and alcohol consumption in the network. These inequalities were not amplified by SES differences in encouraging smoking or drinking.Main messages: In three waves of observations in a Hungarian adolescent cohort, the study found social network effects for inequalities in smoking and alcohol consumption

Is the Healthy Start scheme associated with increased food expenditure in low-income families with young children in the United Kingdom?

Introduction: Healthy Start is a food assistance programme in the United Kingdom (UK) which aims to provide a nutritional safety-net and enable low-income families on welfare benefits to access a healthier diet through the provision of food vouchers. Healthy Start was launched in 2006 but remains under-evaluated. This study aims to determine whether participation in the Healthy Start scheme is associated with differences in food expenditure in a nationally representative sample of households in the UK. Methods: Cross-sectional analyses of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n=4,869). Multivariable quantile regression compared the expenditure and quantity of fruit and vegetables (FV), infant formula and total food purchases. Four exposure groups were defined based on eligibility, participation and income (Healthy Start Participating, Eligible Non-participating, Nearly Eligible low-income and Ineligible high-income households). Results: Of 876 eligible households, 54% participated in Healthy Start. No significant differences were found in FV or total food purchases between participating and eligible non-participating households, but infant formula purchases were lower in Healthy Start participating households. Ineligible higher-income households had higher purchases of FV. Conclusion: This study did not find evidence of an association between Healthy Start participation and FV expenditure. Moreover, inequalities in FV purchasing persist in the UK. Higher participation and increased voucher value may be needed to improve programme performance and counteract the harmful effects of poverty on diet

Using alternatives to the car and risk of all-cause, cardiovascular and cancer mortality

Abstract: Objective: To investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes and morbidity and mortality Methods: We conducted a prospective study using 358799 participants aged 37-73 from UK Biobank. Commute and non-commute travel were assessed at baseline in 2006-2010. We classified participants according to whether they relied exclusively on the car, or used alternative modes of transport that were more active at least some of the time. Main outcome measures were incident CVD and cancer, and CVD, cancer and all-cause mortality. We excluded events in the first two years and conducted analyses separately for those who regularly commuted and those who did not. Results: In maximally-adjusted models, regular commuters with more active patterns of travel on the commute had a lower risk of incident (HR 0.89, 95% CI 0.79 to 1.00) and fatal CVD (HR 0.70, 95% CI 0.51 to 0.95). Those regular commuters who also had more active patterns of non-commute travel had an even lower risk of fatal CVD (HR 0.57, 95% CI 0.39 to 0.85). Among those who were not regular commuters, more active patterns of travel were associated with a lower risk of all-cause mortality (HR 0.92, 95% CI 0.86 to 0.99). Conclusions: More active patterns of travel are associated with a reduced risk of incident and fatal CVD and all-cause mortality in adults. This is an important message for clinicians advising people about how to be physically active and reduce their risk of disease.JP, DO, SB and SS are supported by the Medical Research Council (Unit Programme Nos MC_UU_12015/1, MC_UU_12015/3 and MC_UU_12015/6) and KW is also supported by the British Heart Foundation (Intermediate Basic Science Research Fellowship grant No FS/12/58/29709). AAL is funded by the NIHR (RP 014-04-032), and the Public Health Policy Evaluation Unit are grateful for the support of the NIHR School of Public Health Research. This research was conducted using the UK Biobank resource (application No 20684). The work was also supported under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence at the University of Cambridge, for which funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the United Kingdom Clinical Research Collaboration, is gratefully acknowledged

Synchrophasor-Based Islanding Detection for Distributed Generation Systems Using Systematic Principal Component Analysis Approaches

Systematic principal component analysis (PCA) methods are presented in this paper for reliable islanding detection for power systems with significant penetration of distributed generations (DGs), where synchrophasors, recorded by phasor measurement units, are used for system monitoring. Existing islanding detection methods, such as rate-of-change-of-frequency and vector shift are fast for processing local information; however, with the growth in installed capacity of DGs, they suffer from several drawbacks. Incumbent genset islanding detection cannot distinguish a system-wide disturbance from an islanding event, leading to maloperation. The problem is even more significant when the grid does not have sufficient inertia to limit frequency divergences in the system fault/stress due to the high penetration of DGs. To tackle such problems, this paper introduces PCA methods for islanding detection. A simple control chart is established for intuitive visualization of the transients. A recursive PCA scheme is proposed as a reliable extension of the PCA method to reduce the false alarms for time-varying process. To further reduce the computational burden, the approximate linear dependence condition errors are calculated to update the associated PCA model. The proposed PCA and RPCA methods are verified by detecting abnormal transients occurring in the U.K. utility network

Socio-economic inequalities in smoking and drinking in adolescence:Assessment of social network dynamics

AIMS: We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.DESIGN: This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves.SETTING: Eight Hungarian secondary schools with socio-economically diverse classes took part.PARTICIPANTS: This study comprised 232 adolescents aged between 14 and 15 years in the first wave.MEASUREMENTS: Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit.FINDINGS: Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES.CONCLUSIONS: Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.</p

Associations between active travel and adiposity in rural India and Bangladesh: a cross-sectional study.

BACKGROUND: Data on use and health benefits of active travel in rural low- and middle- income country settings are sparse. We aimed to examine correlates of active travel, and its association with adiposity, in rural India and Bangladesh. METHODS: Cross sectional study of 2,122 adults (≥18 years) sampled in 2011-13 from two rural sites in India (Goa and Chennai) and one in Bangladesh (Matlab). Logistic regression was used to examine whether ≥150 min/week of active travel was associated with socio-demographic indices, smoking, oil/butter consumption, and additional physical activity. Adjusting for these same factors, associations between active travel and BMI, waist circumference and waist-to-hip ratio were examined using linear and logistic regression. RESULTS: Forty-six percent of the sample achieved recommended levels of physical activity (≥150 min/week) through active travel alone (range: 33.1 % in Matlab to 54.8 % in Goa). This was more frequent among smokers (adjusted odds ratio 1.36, 95 % confidence interval 1.07-1.72; p = 0.011) and those that spent ≥150 min/week in work-based physical activity (OR 1.71, 1.35-2.16; p < 0.001), but less frequent among females than males (OR 0.25, 0.20-0.31; p < 0.001). In fully adjusted analyses, ≥150 min/week of active travel was associated with lower BMI (adjusted coefficient -0.39 kg/m(2), -0.77 to -0.02; p = 0.037) and a lower likelihood of high waist circumference (OR 0.77, 0.63-0.96; p = 0.018) and high waist-to-hip ratio (OR 0.72, 0.58-0.89; p = 0.002). CONCLUSIONS: Use of active travel for ≥150 min/week was associated with being male, smoking, and higher levels of work-based physical activity. It was associated with lower BMI, and lower risk of a high waist circumference or high waist-to-hip ratio. Promotion of active travel is an important component of strategies to address the growing prevalence of overweight in rural low- and middle- income country settings