Active lifestyles related to excellent self-rated health and quality of life: cross sectional findings from 194,545 participants in The 45 and Up Study

Background: Physical activity and sitting time independently contribute to chronic disease risk, though little work has focused on aspirational health outcomes. The purpose of this study was to examine associations between physical activity, sitting time, and excellent overall health (ExH) and quality of life (ExQoL) in Australian adults. Methods: The 45 and Up Study is a large Australian prospective cohort study (n = 267,153). Present analyses are from 194,545 participants (48% male; mean age = 61.6 ± 10.7 yrs) with complete baseline questionnaire data on exposures, outcomes, and potential confounders (age, income, education, smoking, marital status, weight status, sex, residential remoteness and economic advantage, functional limitation and chronic disease). The Active Australia survey was used to assess walking, moderate, and vigorous physical activity. Sitting time was determined by asking participants to indicate number of hours per day usually spent sitting. Participants reported overall health and quality of life, using a five-point scale (excellent—poor). Binary logistic regression models were used to analyze associations, controlling for potential confounders. Results: Approximately 16.5% of participants reported ExH, and 25.7% reported ExQoL. In fully adjusted models, physical activity was positively associated with ExH (AOR = adjusted odds ratio for most versus least active = 2.22, 95% CI = 2.20, 2.47; P[subscript trend] < 0.001) and ExQoL (AOR for most versus least active = 2.30, 95% CI = 2.12, 2.49; P[subscript trend]  < 0.001). In fully adjusted models, sitting time was inversely associated with ExH (AOR for least versus most sitting group = 1.13, 95% CI = 1.09, 1.18; P[subscript trend]  < 0.001) and ExQoL (AOR for least versus most sitting group = 1.13, 95% CI = 1.10, 1.17; P[subscript trend]  < 0.001). In fully adjusted models, interactions between physical activity and sitting time were not significant for ExH (P = 0.118) or ExQoL (P = 0.296). Conclusions: Physical activity and sitting time are independently associated with excellent health and quality of life in this large diverse sample of Australian middle-aged and older adults. These findings bolster evidence informing health promotion efforts to increase PA and decrease sitting time toward the achievement of better population health and the pursuit of successful aging

Household dietary diversity and child stunting in East Java, Indonesia

Background and Objectives: More than one-quarter of under-five children in the developing world are stunted, and those with poor nutrient intake are at risk of irreversible cognitive impairment. The purpose of this study was to determine the relationship between dietary diversity and child stunting in an Indonesian context. Methods and Study Design: Dietary diversity was assessed using a maternal-reported checklist of 12 food groups, summed as a Household Dietary Diversity Score. Stunting was defined as ≤-2.0 height-for-age z-score by WHO-Anthro 2005. Trained interviewers administered the household dietary diversity questionnaire to 768 households with children aged <5 years in East Java, Indonesia. Logistic regression models were constructed to test the association be-tween dietary diversity and child stunting. Results: The prevalence of child stunting was 39.4%, and the percent-age of households consuming food groups high in protein and calcium, like dairy products (41%), and meat/poultry, (65%) was lower compared with other food groups. The unadjusted model revealed that higher die-tary diversity scores were associated with lower likelihood of child stunting (OR=0.89; 95% CI=0.80–0.98). This relationship remained significant after adjustment for family size, maternal literacy, food expenditure, breastfeed-ing, energy, and protein intake (OR=0.89; 95% CI=0.80–0.99). Conclusions: The dietary diversity score was moderate, with consumption of dairy products and meat/poultry lowest among 12 food groups. Hence, population interventions should focus on promoting food groups currently lacking in maternal and child diet, including those rich in growth-promoting nutrients like dairy, meat/poultry. These results, from an Indonesian context, confirm the widely observed protective relationship between dietary diversity and child stuntin

The potential link between sugar-sweetened beverage consumption and post-exercise airway narrowing across puberty: a longitudinal cohort study

Citation: Emerson, S. R., Rosenkranz, S. K., Rosenkranz, R. R., Kurti, S. P., & Harms, C. A. (2016). The potential link between sugar-sweetened beverage consumption and post-exercise airway narrowing across puberty: a longitudinal cohort study. Public Health Nutrition, 19(13), 2435-2440. doi:10.1017/s1368980015003109Objective The prevalence of asthma is rising, presenting serious public health challenges. Recent data suggest that sugar-sweetened beverage (SSB) consumption plays a role in asthma aetiology. The purpose of the present study was to determine whether SSB consumption is linked to post-exercise airway narrowing (predictor of asthma development) across puberty. Design Participants completed pulmonary function tests, physical activity and dietary habit questionnaires, and an exercise test to exhaustion. Setting Community in Manhattan, Kansas, USA. Subjects We recruited ten boys and ten girls from an original cohort of forty participants tested in our laboratory approximately 5 years prior. Participants were aged 97 (sd 09) years at baseline and 147 (sd 09) years at follow-up. Results Pre-puberty, boys consumed 68 (sd 48) servings/week and girls consumed 69 (sd 37) servings/week, while post-puberty boys consumed 115 (sd 53) servings/week and girls consumed 77 (sd 43) servings/week. Using Pearson correlation, SSB consumption was not significantly related to post-exercise airway narrowing at pre-puberty (r=-035, P=0130). In linear regression analyses, SSB consumption was significantly related to post-exercise airway narrowing post-puberty before (standardized =-060, P=0005) but not after (standardized =-033, P=0211) adjustment for confounders. Change in SSB consumption from pre- to post-puberty was significantly associated with post-exercise airway narrowing post-puberty (r=-061, P=0010) and change in post-exercise airway narrowing from pre- to post-puberty (r=-045, P=0048) when assessed via Pearson correlations. Conclusions These findings suggest a possible link between SSB consumption and asthma development during maturation. Reduced SSB intake may be a possible public health avenue for blunting rising asthma prevalence

Does dietary intake change during an intervention to reduce sedentary behavior and cardiovascular disease risk? A randomized comparative effectiveness trial

Citation: Casey, K., Mailey, E. L., Rosenkranz, R. R., Swank, A., Ablah, E., & Rosenkranz, S. K. (2018). Does dietary intake change during an intervention to reduce sedentary behavior and cardiovascular disease risk? A randomized comparative effectiveness trial. BMC Nutrition, 4(1). https://doi.org/10.1186/s40795-018-0223-1Background: Evidence from physical activity interventions suggests that women, in particular, may overcompensate for exercise energy expenditure by increasing caloric intake. Sedentary behavior and poor dietary quality are independent risk factors for many major chronic diseases, including cardiovascular disease (CVD). The primary purpose of this study was to determine whether insufficiently active women, accumulating less than 60 min per week of moderate-to-vigorous physical activity, alter caloric intake or dietary quality when participating in an 8-week intervention to reduce sedentary behavior and CVD risk. A secondary aim was to determine whether the two treatment groups differed from one another in dietary intake while participating in the intervention. Methods: Insufficiently active women (n = 49) working full-time sedentary jobs were randomized to one of two treatment groups to reduce sedentary behavior during the workweek: short-break (1–2 min breaks from sitting every half hour, SB), or long-break (15 min breaks from sitting twice daily, LB). Three-day food records were collected at baseline, week 4 and week 8. Dietary quality was assessed using the Alternative Healthy Eating Index 2010 (AHEI-2010). Risk factors for CVD were assessed at baseline and week 8. Results: For all participants, average caloric intake decreased significantly from baseline to week 8 by approximately 12% (Δ = − 216.0 kcals, p = 0.003). Average caloric intake decreased significantly over time for the SB group (Δ = − 369.6 kcals, p = 0.004), but not the LB group (Δ = − 179.5 kcals, p = 0.17). There was no significant difference between SB and LB groups with regard to calories from baseline to week 8 (F = 0.51, p = 0.48). Total AHEI-2010 scores did not decrease significantly for all participants (Δ = − 4.0, p = 0.14), SB (Δ = − 5.2, p = 0.16), or LB groups (Δ = − 4.5, p = 0.67). Conclusions: Following an 8-week intervention to reduce sedentary time, insufficiently active women decreased caloric intake over time, however there were no differences between SB and LB groups. In all participants, dietary quality was not altered over time. Future studies should explore sedentary reduction interventions compared to physical activity interventions as a means to create negative energy balance, as frequent sedentary breaks may be effective for improving health outcomes in women. Trial registration: ClinicalTrials.gov registration number NCT02609438, retrospectively registered November 20, 2015

Physical activity and physical function in older adults: the 45 and up study

OBJECTIVES: To determine the strength of the relationship between physical activity and physical function in older adults. DESIGN: Cross-sectional. SETTING: The 45 and Up Study baseline questionnaire, New South Wales, Australia. PARTICIPANTS: Ninety-one thousand three hundred seventy-five Australian men and women aged 65 and older from the 45 and Up Study. MEASUREMENTS: Physical activity engagement (Active Australia Survey), physical function (Medical Outcomes Study Physical Functioning), psychological distress (Kessler- 10), and self-reported age, smoking history, education, height, and weight were all measured. RESULTS: Higher levels of physical activity were associated with better physical function in older adults (correlation coefficient = 0.166, P < .001). Participants engaging in higher levels of physical activity had progressively lower likelihoods of functional limitation (middle tertile: odds ratio (OR) = 0.39, 95% confidence interval (CI) = 0.38– 0.41; highest tertile: OR = 0.28, 95% CI = 0.27–0.29). This relationship remained significant, but weakened slightly, when adjusted for age, sex, body mass index, smoking history, psychological distress, and educational attainment (middle tertile: adjusted OR (AOR) = 0.48, 95% CI = 0.46–0.50; highest tertile: AOR = 0.36, 95% CI = 0.34–0.37). CONCLUSION: There is a significant, positive relationship between physical activity and physical function in older adults, with older adults who are more physically active being less likely to experience functional limitation than their more-sedentary counterparts. Level of engagement in physical activity is an important predictor of physical function in older adults

Household Air Pollution Exposure and Influence of Lifestyle on Respiratory Health and Lung Function in Belizean Adults and Children: A Field Study

Citation: Kurti, S. P., Kurti, A. N., Emerson, S. R., Rosenkranz, R. R., Smith, J. R., Harms, C. A., & Rosenkranz, S. K. (2016). Household Air Pollution Exposure and Influence of Lifestyle on Respiratory Health and Lung Function in Belizean Adults and Children: A Field Study. International Journal of Environmental Research and Public Health, 13(7), 12. doi:10.3390/ijerph13070643Household air pollution (HAP) contributes to the global burden of disease. Our primary purpose was to determine whether HAP exposure was associated with reduced lung function and respiratory and non-respiratory symptoms in Belizean adults and children. Our secondary purpose was to investigate whether lifestyle (physical activity (PA) and fruit and vegetable consumption (FV)) is associated with reported symptoms. Belizean adults (n = 67, 19 Male) and children (n = 23, 6 Male) from San Ignacio Belize and surrounding areas participated in this cross-sectional study. Data collection took place at free walk-in clinics. Investigators performed initial screenings and administered questionnaires on (1) sources of HAP exposure; (2) reported respiratory and non-respiratory symptoms and (3) validated lifestyle questionnaires. Participants then performed pulmonary function tests (PFTs) and exhaled breath carbon monoxide (CO). There were no significant associations between HAP exposure and pulmonary function in adults. Increased exhaled CO was associated with a significantly lower forced expiratory volume in 1-s divided by forced vital capacity (FEV1/FVC) in children. Exposed adults experienced headaches, burning eyes, wheezing and phlegm production more frequently than unexposed adults. Adults who met PA guidelines were less likely to experience tightness and pressure in the chest compared to those not meeting guidelines. In conclusion, adults exposed to HAP experienced greater respiratory and non-respiratory symptoms, which may be attenuated by lifestyle modifications

Increasing girls’ physical activity during an organised youth sport basketball program: a randomised controlled trial protocol

Background: Participation in organised youth sports (OYS) has been recommended as an opportunity to increase young peoples’ moderate-to-vigorous physical activity (MVPA) levels. Participants, however, spend a considerable proportion of time during OYS inactive. The purpose of this study, therefore, was to investigate whether coaches who attended coach education sessions (where education on increasing MVPA and decreasing inactivity during training was delivered) can increase players’ MVPA during training sessions over a 5-day basketball program compared to coaches who did not receive coach education sessions. Methods/design: A convenience sample of 80 female players and 8 coaches were recruited into the UWS School Holiday Basketball Program in Greater Western Sydney, Australia. A two-arm, parallel-group randomised controlled trial was employed to investigate whether coaches who attended 2 coach education sessions (compared with a no-treatment control) can increase their players’ MVPA during training sessions over a 5-day basketball program. Objectively measured physical activity, directly observed lesson context and leader behaviour, player motivation, players’ perceived autonomy support, and coaching information (regarding training session planning, estimations on player physical activity and lesson context during training, perceived ability to modify training sessions, perceived importance of physical activity during training, intention to increase physical activity/reduce inactivity, and likelihood of increasing physical activity/reducing inactivity) were assessed at baseline (day 1) and at follow-up (day 5). Linear mixed models will be used to analyse between arm differences in changes from baseline to follow-up on all outcomes. Discussion: The current trial protocol describes, to our knowledge, the first trial conducted in an OYS context to investigate the efficacy of an intervention, relative to a control, in increasing MVPA. This study’s findings will provide evidence to inform strategies targeting coaches to increase MVPA in OYS, which could have major public health implications, given the high proportion of children and adolescents who participate in OYS globally

Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls

Citation: Cull, B. J., Rosenkranz, S. K., Dzewaltowski, D. A., Teeman, C. S., Knutson, C. K., & Rosenkranz, R. R. (2016). Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls. Pilot and Feasibility Studies, 2(1), 26. https://doi.org/10.1186/s40814-016-0066-yChildhood obesity is a major public health problem, with one third of America’s children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants

The effectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial

Citation: Mahmudiono, T., Nindya, T. S., Andrias, D. R., Megatsari, H., & Rosenkranz, R. R. (2016). The effectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial. Bmc Public Health, 16, 11. doi:10.1186/s12889-016-3155-1Background: Nutrition transition in developing countries were induced by rapid changes in food patterns and nutrient intake when populations adopt modern lifestyles during economic and social development, urbanization and acculturation. Consequently, these countries suffer from the double burden of malnutrition, consisting of unresolved undernutrition and the rise of overweight/obesity. The prevalence of the double burden of malnutrition tends to be highest for moderate levels (third quintile) of socioeconomic status. Evidence suggests that modifiable factors such as intra-household food distribution and dietary diversity are associated with the double burden of malnutrition, given household food security. This article describes the study protocol of a behaviorally based nutrition education intervention for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition. Methods: NEO-MOM is a randomized controlled trial with a three-month behavioral intervention for households involving pairs of 72 stunted children aged 2-5 years old and overweight/obese mothers (SCOWT) in urban Indonesia. The SCOWT pairs were randomly assigned to either an intervention group or to a comparison group that received usual care plus printed educational materials. The intervention consisted of six classroom sessions on nutrition education and home visits performed by trained community health workers using a motivational interviewing approach. The primary outcomes of this study are the prevalence of double burden of malnutrition as measured in SCOWT, child's height-for-age z-score (HAZ) and maternal body mass index (BMI). Discussion: Because previous studies are mainly observational in nature, this study advances understanding of the double burden of malnutrition through a fully powered randomized controlled trial. The intervention assists participants in self-administered goal setting to improve diet and child feeding behaviors by improving self-efficacy. Maternal self-efficacy may be enhanced through vicarious and active mastery of experiences gained during six sessions of nutrition education and verbal persuasion during home visits

Does self-determined motivation interact with environmental contexts to influence moderate-to-vigorous physical activity during a girls' youth sport camp?

Objective: To explore whether basketball player's self-determined motivation interacts with environmental contexts and coach training to influence percentage time in moderate-to-vigorous physical activity (%MVPA). Methods: A secondary analysis of data from 76 girls (mean ± SD, 10.5 ± 1.0 years) was conducted. Players were classified as high self-determined motivation (HSDM) or low self-determined motivation (LSDM) and randomised to trained (intervention) or untrained (control) coaches. Training included 2 workshops on strategies for activity-promoting practices. Girls were exposed to environmental contexts (practices and games) led by a trained/untrained coach (depending on arm) and one without coaches (free time) daily. Girls wore accelerometers each day. Using mixed random-effects models, the influence of motivation, context and training on %MVPA was analysed. Results: Trained coaches' practices were associated with the greatest %MVPA with no difference between HSDM and LSDM players (38.28 ± 1.77%; 37.64 ± 1.80%; p = 0.66). HSDM players had significantly greater %MVPA versus LSDM players during untrained coaches' practices (23.58 ± 1.77%; 20.51 ± 1.78%; p = 0.03). During games with trained coaches, HSDM players had greater %MVPA compared to LSDM players (23.79 ± 1.76%; 18.56 ± 1.74%; p < 0.001). No between-group difference in %MVPA during free time was found (12.85 ± 0.82%; 13.39 ± 0.84%; p = 0.64). Conclusion: The impact of individual differences in self-determined motivation on %MVPA during practices was attenuated when coaches were trained to implement activity-promoting practices