‘You know what, I’m in the trend as well’: understanding the interplay between digital and real-life social influences on the food and activity choices of young adults

Abstract Objective: To understand young adults’ perceptions of online and real-life social influences on their food and activity choices. Design: A qualitative study involving 7 focus groups. Thematic analysis using both deductive and inductive techniques were performed. Setting: A polytechnic and a university in Singapore. Participants: A total of 46 full-time students, 19–24 years of age. Results: Participants revealed that social media meets multiple needs, contributing to its ubiquitous use and facilitating content spread between social networks. Food-related content shared on social media were mostly commercial posts, marketing foods and eateries showcasing price promotions, emphasising sensory properties of foods or creating narratives that activated trends. Subsequently, real-life social activities frequently revolve around marketed foods that were not necessarily healthy. In contrast, physical activity posts were rarely being followed up in real life. Portrayals describing a toxic gym culture could contribute to negative perceptions of peers’ physical activity posts and a disinclination towards sharing such posts. Participants expressed that close, supportive social networks in real life strongly influenced initiating and maintaining healthy lifestyles. However, in a society that highly values academic achievements, participants prioritised studying and socialising over healthy eating and physical activity. Conclusions: Overall, our findings reveal that virtual and real-life social influences have complex interactions affecting Asian young adults’ behavioural choices and should be considered when designing interventions for this group. Regulations related to the digital marketing of unhealthy food, and improving the availability, accessibility and affordability of healthier food options, particularly in the foodservice sector, would be of value to consider

Promotion of Physical Activity Using Point-of-Decision Prompts in Berlin Underground Stations

To evaluate point-of-decision prompts in the promotion of stair use in Germany, motivational posters were placed at three underground stations in Berlin. The proportion of passengers using stairs or stairways was counted before, during installation, and two weeks after removal of posters. In total, 5,467 passersby were counted. Stair use increased significantly in women, but not in men. The present pilot study thereby shows that the use of point-of-decision prompts is also feasible in Germany and it provides some evidence of effectiveness. Methodologically rigorous studies are warranted to confirm these findings

Associations between early-life screen viewing and 24 hour movement behaviours : findings from a longitudinal birth cohort study

Background Screen viewing is a sedentary behaviour reported to interfere with sleep and physical activity. However, few longitudinal studies have assessed such associations in children of preschool age (0-6 years) and none have accounted for the compositional nature of these behaviours. We aimed to investigate the associations between total and device-specific screen viewing time at age 2-3 years and accelerometer-measured 24 h movement behaviours, including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) at age 5.5 years. Methods The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is an ongoing longitudinal birth cohort study in Singapore, which began in June 2009. We recruited pregnant women during their first ultrasound scan visit at two major public maternity units in Singapore. At clinic visits done at age 2-3 years, we collected parent-reported information about children's daily total and device-specific screen viewing time (television, handheld devices, and computers). At 5.5 years, children's movement behaviours for 7 consecutive days were measured using wrist-worn accelerometers. We assessed the associations between screen viewing time and movement behaviours (sedentary behaviour, light physical activity, MVPA, and sleep) using Dirichlet regression, which accounts for the compositional nature of such behaviours. This study is active but not recruiting and is registered with ClinicalTrials.gov, NCT01174875. Findings Between June 1, 2009, and Oct 12, 2010, 1247 pregnant women enrolled and 1171 singleton births were enrolled. 987 children had parent-reported screen data at either 2 or 3 years, of whom 840 attended the clinic visit at age 5.5 years, and 577 wore an accelerometer. 552 children had at least 3 days of accelerometer data and were included in the analysis. Total screen viewing time at age 2-3 years had a significant negative association with sleep (p=0.008), light physical activity (p= 3 h screen viewing time]), and less light physical activity (384.6 vs 356.2 mins per day), and MVPA (76.2 vs 63.4 mins per day) at age 5.5 years. No significant differences in time spent sleeping were observed between the groups (539.5 vs 540.4 mins per day). Similar trends were observed for television viewing and handheld device viewing. Interpretation Longer screen viewing time in children aged 2-3 years was associated with more time spent engaged in sedentary behaviour and shorter time engaged in light physical activity and MVPA in later childhood. Our findings indicate that screen viewing might displace physical activity during early childhood, and suggest that reducing screen viewing time in early childhood might promote healthier behaviours and associated outcomes later in life. Copyright (C) 2020 Elsevier Ltd. All rights reserved.Peer reviewe

Family-focused contextual factors associated with lifestyle patterns in young children from two mother-offspring cohorts : GUSTO and EDEN

Background Integrated patterns of energy balance-related behaviours of preschool children in Asia are sparse, with few comparative analyses. Purpose Using cohorts in Singapore (GUSTO) and France (EDEN), we characterized lifestyle patterns of children and investigated their associations with family-focused contextual factors. Methods Ten behavioural variables related to child's diet, walking, outdoor play and screen time were ascertained by parental questionnaires at age 5-6 years. Using principal component analysis, sex-specific lifestyle patterns were derived independently for 630 GUSTO and 989 EDEN children. Contextual variables were organised into distal (family socio-economics, demographics), intermediate (parental health, lifestyle habits) and proximal (parent-child interaction factors) levels of influence and analysed with hierarchical linear regression. Results Three broadly similar lifestyle patterns were identified in both cohorts: "discretionary consumption and high screen time", "fruit, vegetables, and low screen time" and "high outdoor playtime and walking". The latter two patterns showed small differences between cohorts and sexes. The "discretionary consumption and high screen time" pattern was consistently similar in both cohorts; distal associated factors were lower maternal education (EDEN boys), no younger siblings (GUSTO boys) and Malay/Indian ethnicity (GUSTO), while intermediate and proximal associated factors in both cohorts and sexes were poor maternal diets during pregnancy, parents allowing high child control over food intake, snacking between meals and having television on while eating. Conclusions Three similar lifestyle patterns were observed among preschool children in Singapore and France. There were more common associated proximal factors than distal ones. Cohort specific family-focused contextual factors likely reflect differences in social and cultural settings. Findings will aid development of strategies to improve child health.Peer reviewe

Accelerometer Profile of Physical Activity and Sedentary Behavior in a Multi-Ethnic Urban Asian Population

10.1080/02701367.2020.1734520Research Quarterly for Exercise and Sport923361-36

mHealth interventions targeting movement behaviors in Asia: A scoping review

10.1111/obr.13396OBESITY REVIEWS23

Evaluation of a Population-Wide Mobile Health Physical Activity Program in 696 907 Adults in Singapore

10.1161/JAHA.121.022508JOURNAL OF THE AMERICAN HEART ASSOCIATION111

A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study

Background The purpose of this study was to examine the impact of combined cardiorespiratory fitness and waist-to-height ratio in the form of a fit-fat index on incident diabetes risk. Additionally, the independent predictive performance of cardiorespiratory fitness, waist-to-height ratio, and body mass index also were estimated and compared. Methods This was a prospective cohort study of 10,381 men who had a normal electrocardiogram and no history of major chronic disease at baseline from 1979 to 2005. Random survival forest models and traditional Cox proportional hazards models were used to predict diabetes at 5-, 10-, and 15-year incidence horizons. Results Overall, 4.8% of the participants developed diabetes. Receiver operating characteristic curve analyses for incidence risk demonstrated good discrimination using random survival forest models across fitness and fatness measures; Cox models were poor to fair. The differences between fitness and fatness measures across horizons were clinically negligible. Smoothed random survival forest estimates demonstrated the impact of each fitness and fatness measure on incident diabetes was intuitive and graded. Conclusions Although fitness and fatness measures showed a similar discriminative ability in predicting incident diabetes, unique to the study was the ability of the fit-fat index to demonstrate a better indication of incident risk when compared to fitness or fatness alone. A single index combining cardiorespiratory fitness and waist-to-height ratio may be more useful because it can indicate improvements in either or both of the measures.This article is published as sloan RA, Haaland BA, Sawada SS, Lee I-Min, Sui X, Lee DC, Ridouane Y, MüllerRiemenschneider F, Blair SN. A fit-fat index for predicting incident diabetes in apparently health men: A prospective cohort study. PLOS ONE. 2016;11(6):e0157703. 10.1371/journal.pone.0157703. Posted with permission.</p

A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study

Background: The purpose of this study was to examine the impact of combined cardiorespiratory fitness and waist-to-height ratio in the form of a fit-fat index on incident diabetes risk. Additionally, the independent predictive performance of cardiorespiratory fitness, waist-to-height ratio, and body mass index also were estimated and compared. Methods: This was a prospective cohort study of 10,381 men who had a normal electrocardiogram and no history of major chronic disease at baseline from 1979 to 2005. Random survival forest models and traditional Cox proportional hazards models were used to predict diabetes at 5-, 10-, and 15-year incidence horizons. Results: Overall, 4.8% of the participants developed diabetes. Receiver operating characteristic curve analyses for incidence risk demonstrated good discrimination using random survival forest models across fitness and fatness measures; Cox models were poor to fair. The differences between fitness and fatness measures across horizons were clinically negligible. Smoothed random survival forest estimates demonstrated the impact of each fitness and fatness measure on incident diabetes was intuitive and graded. Conclusions: Although fitness and fatness measures showed a similar discriminative ability in predicting incident diabetes, unique to the study was the ability of the fit-fat index to demonstrate a better indication of incident risk when compared to fitness or fatness alone. A single index combining cardiorespiratory fitness and waist-to-height ratio may be more useful because it can indicate improvements in either or both of the measures

Children’s perceptions of factors influencing their physical activity: a focus group study on primary school children

10.1080/17482631.2021.1980279International Journal of Qualitative Studies on Health and Well-being1611-1