40 research outputs found
Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural KenyaâThe Kenya-LINX project
BackgroundLike many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya.MethodChildren (n = 539) aged 11.1 Âą 0.8 years (52% female) were recruited from 8 urban and 8 rural private and public schools in Kenya. Physical activity (PA) and sleep duration were estimated using 24-h raw data from wrist-worn accelerometers. Screen time (ST) and potential correlates were self- reported. Multi-level logistic regression was applied to identify correlates of adherence to combined and individual movement guidelines.ResultsCompliance with the combined movement guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children. Seventy-six percent of rural children met the individual PA guidelines compared to 60% urban children while more rural children also met sleep guidelines (27% vs 14%). The odds of meeting the combined movement guidelines reduced with age (OR = 0.55, 95% CI = 0.35â0.87, p = 0.01), was greater among those who could swim (OR = 3.27, 95% CI = 1.09â9.83, p = 0.04), and among those who did not engage in ST before school (OR = 4.40, 95% CI = 1.81â10.68, p<0.01). The odds of meeting PA guidelines increased with the number of weekly physical education sessions provided at school (OR = 2.1, 95% CI = 1.36â3.21, p<0.01) and was greater among children who spent their lunch break walking (OR = 2.52, 95% CI = 1.15â5.55, p = 0.02) or running relative to those who spent it sitting (OR = 2.33, 95% CI = 1.27â4.27, p = 0.01).ConclusionsPrevalence of meeting movement guidelines among Kenyan children is low and of greatest concern in urban areas. Several correlates were identified, particularly influential were features of the school day, School is thus a significant setting to promote a healthy balance between sleep, sedentary time, and PA
Combining diaries and accelerometers to explain change in physical activity during a lifestyle intervention for adults with pre-diabetes: A PREVIEW sub-study
Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in device-based PA between clusters in a lifestyle intervention, the PREVIEW diabetes prevention study. In total, 232 participants with overweight and prediabetes (147 women; 55.9 Âą 9.5yrs; BMI âĽ25 kg¡m-2; impaired fasting glucose and/or impaired glucose tolerance) were clustered using a partitioning around medoids algorithm based on self-reported daily activities before a lifestyle intervention and their changes after 6 and 12 months. Device-assessed PA levels (PAL), sedentary time (SED), light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed using ActiSleep+ accelerometers and compared between clusters using (multivariate) analyses of covariance. At baseline, the self-reported âwalking and houseworkâ cluster had significantly higher PAL, MVPA and LPA, and less SED than the âinactiveâ cluster. LPA was higher only among the âcyclingâ cluster. There was no difference in the device-based measures between the âsocial-sportsâ and âinactiveâ clusters. Looking at the changes after 6 months, the âincreased walkingâ cluster showed the greatest increase in PAL while the âincreased cyclingâ cluster accumulated the highest amount of LPA. The âincreased houseworkâ and âincreased supervised sportsâ reported least favourable changes in device-based PA. After 12 months, there was only minor change in activities between the âincreased walking and cyclingâ, âno changeâ and âincreased supervised sportsâ clusters, with no significant differences in device-based measures. Combining self-report and device-based measures provides better insights into the behaviours that change during an intervention. Walking and cycling may be suitable activities to increase PA in adults with prediabetes
Homes became the âeverything spaceâ during COVID-19: impact of changes to the home environment on childrenâs physical activity and sitting
BackgroundDuring the 2020 UK COVID-19 lockdown restrictions, children spent almost all of their time at home, which had a significant influence on their physical activity (PA) and sedentary behaviour. This study aimed to: 1) determine changes to the social and physical environment at home and childrenâs home-based sitting, PA, standing and sitting breaks as a result of the COVID-19 restrictions; and 2) examine associations between changes at home and childrenâs movement behaviours.MethodsOne hundred and two children had their PA and sitting, standing and sitting breaks at home objectively measured pre-COVID-19 and during the first COVID-19 lockdown (June-July 2020). Childrenâs parents (nâ=â101) completed an audit of their home physical environment and a survey on the home social environment at both time points. Changes in the home physical and social environment and behavioural outcomes were assessed using Wilcoxon signed ranked tests, paired t-tests, or chi-square. Repeated linear regression analyses examined associations between changes in homes and changes in the home-based behavioural outcomes.ResultsDuring COVID-19, households increased the amount of seated furniture and electronic media equipment at home. The number of books and PA equipment decreased and fewer parents enforced a screen-time rule. Childrenâs preference for physical activities and socialising at home decreased. Time at home and sitting at home increased during COVID-19, whilst PA, standing and sitting breaks decreased. Both MVPA and TPA were positively associated with child preference for PA, and negatively associated with attending school. Sitting was negatively associated with child preference for PA and child preference for socialising at home. Media equipment was negatively associated with sitting breaks, whilst PA equipment was positively associated with standing.ConclusionThe COVID-19 restrictions forced children to spend almost all their time at home. Childrenâs PA, standing, and sitting breaks at home declined during the restrictions, while sitting increased. Mostly negative changes occurred in homes, some of which impacted childrenâs behaviours at home. To avoid the changes persisting post-lockdown, interventions are needed to reset and promote childrenâs PA and discourage prolonged sitting time
Understanding (in) formal health and wellbeing networks within higher education: a mixed-method social network perspective
Motor Competence between Children with and without Additional Learning Needs: A Cross-Sectional Population-Level Study
The aim of this study was to examine associations in motor competence between children with additional learning needs (ALN) and typically developing children. This cross-sectional study involved a nationally representative cohort of 4555 children (48.98% boys; 11.35 Âą 0.65 years) from sixty-five schools across Wales (UK). Demographic data were collected from schools, and children were assessed using the Dragon Challenge assessment of motor competence, which consists of nine tasks completed in a timed circuit. A multi-nominal multi-level model with random intercept was fitted to explore the proficiency between children with ALN and those without. In all nine motor competence tasks, typically developing children demonstrated higher levels of proficiency than their peers with ALN, with these associations evident after accounting for age, sex, ethnicity, and socioeconomic status. This study highlights motor competence inequalities at a population level and emphasises the need for policymakers, practitioners, and researchers to prioritise motor competence development, particularly for children with ALN
Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-APREVIEWrandomized clinical trial
Background Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. Objectives The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. Methods Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI >= 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. Results 126 adolescents were included in this study (13.6 +/- 2.2 years, BMI z-score 3.04 +/- 0.66, HOMA-IR 3.48 +/- 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. Conclusions The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.Peer reviewe
Objectively Measured Physical Activity and Sedentary Time Are Associated With Cardiometabolic Risk Factors in Adults With Prediabetes: The PREVIEW Study
OBJECTIVE The aim of the present cross-sectional study was to examine the association among physical activity (PA), sedentary time (ST), and cardiometabolic risk in adults with prediabetes.RESEARCH DESIGN AND METHODS Participants (n = 2,326; 25â70 years old, 67% female) from eight countries, with a BMI >25 kg â
mâ2 and impaired fasting glucose (5.6â6.9 mmol â
Lâ1) or impaired glucose tolerance (7.8â11.0 mmol â
Lâ1 at 2 h), participated. Seven-day accelerometry objectively assessed PA levels and ST.RESULTS Multiple linear regression revealed that moderate-to-vigorous PA (MVPA) was negatively associated with HOMA of insulin resistance (HOMA-IR) (standardized β = â0.078 [95% CI â0.128, â0.027]), waist circumference (WC) (β = â0.177 [â0.122, â0.134]), fasting insulin (β = â0.115 [â0.158, â0.072]), 2-h glucose (β = â0.069 [â0.112, â0.025]), triglycerides (β = â0.091 [â0.138, â0.044]), and CRP (β = â0.086 [â0.127, â0.045]). ST was positively associated with HOMA-IR (β = 0.175 [0.114, 0.236]), WC (β = 0.215 [0.026, 0.131]), fasting insulin (β = 0.155 [0.092, 0.219]), triglycerides (β = 0.106 [0.052, 0.16]), CRP (β = 0.106 [0.39, 0.172]), systolic blood pressure (BP) (β = 0.078 [0.026, 0.131]), and diastolic BP (β = 0.106 [0.39, â0.172]). Associations reported between total PA (counts â
minâ1) and all risk factors were comparable or stronger than for MVPA: HOMA-IR (β = â0.151 [â0.194, â0.107]), WC (β = â0.179 [â0.224, â0.134]), fasting insulin (β = â0.139 [â0.183, â0.096]), 2-h glucose (β = â0.088 [â0.131, â0.045]), triglycerides (β = â0.117 [â0.162, â0.071]), and CRP (β = â0.104 [â0.146, â0.062]).CONCLUSIONS In adults with prediabetes, objectively measured PA and ST were associated with cardiometabolic risk markers. Total PA was at least as strongly associated with cardiometabolic risk markers as MVPA, which may imply that the accumulation of total PA over the day is as important as achieving the intensity of MVPA
Higher Protein Intake Is Not Associated with Decreased Kidney Function in Pre-Diabetic Older Adults Following a One-Year InterventionâA Preview Sub-Study
Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic men and women, aged 55 years and older. Analyses were based on baseline and one-year data in a sub-group of 310 participants included in the PREVIEW project (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World). Protein intake was estimated from four-day dietary records and 24-hour urinary urea excretion. We used linear regression to assess the association between protein intake after one year of intervention and kidney function markers: creatinine clearance, estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio (ACR), urinary urea/creatinine ratio (UCR), serum creatinine, and serum urea before and after adjustments for potential confounders. A higher protein intake was associated with a significant increase in UCR (p = 0.03) and serum urea (p = 0.05) after one year. There were no associations between increased protein intake and creatinine clearance, eGFR, ACR, or serum creatinine. We found no indication of impaired kidney function after one year with a higher protein intake in pre-diabetic older adults.Peer reviewe
Perceived stress as a predictor of eating behavior during the 3-year PREVIEW lifestyle intervention
Peer reviewe
PREVIEW (Prevention of Diabetes Through Lifestyle Intervention and Population Studies in Europe and Around the World) study in children aged 10 to 17 years: Design, methods and baseline results
Insulin resistance (IR) in adolescence is associated with type 2 diabetes mellitus [T2DM]. The PREVIEW (Prevention of Diabetes Through Lifestyle Intervention and Population Studies in Europe and Around the World) study assessed the effectiveness of a high-protein, low-glycaemic-index diet and a moderate-protein, moderate-glycaemic-index diet to decrease IR in insulin-resistant children who were overweight or obese. Inclusion criteria were age 10 to 17âyears, homeostatic model assessment of IR (HOMA-IR) âĽ2.0 and overweight/obesity. In 126 children (meanâÂąâSD age 13.6 Âą 2.2 years, body mass index [BMI] z-score 3.04âÂą 0.66, HOMA-IR 3.48âÂą 2.28) anthropometrics, fat mass percentage (FM%), metabolic characteristics, physical activity, food intake and sleep were measured. Baseline characteristics did not differ between the groups. IR was higher in pubertal children with morbid obesity than in prepubertal children with morbid obesity (5.41âÂą 1.86 vs 3.23âÂą 1.86; P =â.007) and prepubertal and pubertal children with overweight/obesity (vs 3.61âÂą 1.60, P =â.004, and vs 3.40âÂą 1.50, P <â.001, respectively). IR was associated with sex, Tanner stage, BMI z-score and FM%. Fasting glucose concentrations were negatively associated with Baecke sport score (r =ââ0.223, P =â.025) and positively with daytime sleepiness (r = 0.280, P =â.016) independent of sex, Tanner stage, BMI z-score and FM%. In conclusion, IR was most severe in pubertal children with morbid obesity. The associations between fasting glucose concentration and Baecke sport score and sleepiness suggest these might be possible targets for diabetes prevention