Why combine diet and physical activity in the same international research society?

Research in diet and physical activity in the U.S. started in very different traditions, with behavioral science input being uneven in their development. Investigators and policy makers in Europe have recognized the complementarity of diet and physical activity and incorporated them both under the label Public Health Nutrition. Joining these disciplines internationally offers the opportunity to benefit all, since the problems addressed are human, not specific to any one country. In regard to why combine diet and physical activity, at the biological level, there is reason to believe that diet and physical activity working in concert can remodel physiological structures and processes toward healthful ends. The diet and physical activity behaviors themselves vary in characteristics and are similar in others. The behavioral science components of these two disciplines face similar problems, and can learn from the advances made by the other, in the areas of measurement, correlates and intervention. By working together, knowledge will be enhanced from uncovering complementary and interactive relationships between diet and physical activity, and in relation to disease risks, that may result in designing more effective and efficient interventions and policies. Since the behavioral sciences are at a disadvantage in comparison to the biological sciences in terms of scientific advances and thereby capturing the popular imagination for solutions to health problems, we must redouble our efforts to enhance funding for behavioral research in regard to diet and physical activity and to make the research advances necessary to prevent the medicalizing of essentially social and behavioral problems. Nutrition and physical activity should most effectively do this together

The effectiveness of asking behaviors among 9-11 year-old children in increasing home availability and children's intake of fruit and vegetables : results from the Squire's Quest II self-regulation game intervention

Background: Home environment has an important influence on children's fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire's Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children's FV intake. This study's aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)? Methods: This is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n = 100 child-parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n = 400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used. Results: Baseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake. Conclusions: Children influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research

Active video games for youth : a systematic review

Background: A population level increase in physical activity (PA) is critical to reduce obesity in youth. Video games are highly popular and active video games (AVGs) have the potential to play a role in promoting youth PA. Method: Studies on AVG play energy expenditure (EE) and maintenance of play in youth were systematically identified in the published literature and assessed for quality and informational value. Results: Nine studies measuring AVG play EE were identified. The meta-analytic estimates of average METs across these studies were 3.1 (95% CI: 2.6, 3.6) to 3.2 (95% CI: 2.7, 3.7). No games elicited an average EE above the 6 MET threshold for vigorous EE. Observed differences between studies were likely due to the different types of games used, rather than age or gender. Four studies related to maintenance of play were identified. Most studies reported AVG use declined over time. Studies were of low-to-medium quality. Conclusion: AVGs are capable of generating EE in youth to attain PA guidelines. Few studies have assessed sustainability of AVG play, which appears to diminish after a short period of time for most players. Better-quality future research must address how AVG play could be maintained over longer periods of time

Is participatory design associated with the effectiveness of serious digital games for healthy lifestyle promotion? : a meta-analysis

Background: Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (ie, users are asked for input and feedback) or codesigner (ie, users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective: This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion. Methods: Four databases were searched for peer-reviewed papers in English that were published or in press before October 2014, using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results: A total of 58 games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075, 95% CI 0.017 to 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P<.05) than when users were only involved as testers (g=0.520, 95% CI 0.150 to 0.890, P<.01). Games developed with PD (g=0.171, 95% CI 0.061 to 0.281, P<.01) were also related to lower game effectiveness on self-efficacy (Q=7.83, P<.05) than when users were not involved in game design (g=0.384, 95% CI 0.283 to 0.485, P<.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (ie, informant or codesigner), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (beta=.215, 95% CI .075 to .356, P<.01) and, more specifically, as an informant (beta=.235, 95% CI .079 to .329, P<.01). Involving users as informants in PD to create game levels was also related to higher game effectiveness (Q=7.02, P<.01). Codesign was related to higher effectiveness when used to create the game challenge (Q=11.23, P<.01), but to lower game effectiveness when used to create characters (Q=4.36, P<.05) and the game world (Q=3.99, P<.05). Conclusions: The findings do not support higher effectiveness of games developed with PD. However, significant differences existed among PD games. More support was found for informant roles than for codesign roles. When PD was applied to game dynamics, levels, and game challenge, this was associated with higher effectiveness than when it was applied to game aesthetics. Since user involvement may have an important influence on reach, adoption, and implementation of the intervention, further research and design efforts are needed to enhance effectiveness of serious games developed with PD

Distance to food stores & adolescent male fruit and vegetable consumption: mediation effects

<p>Abstract</p> <p>Background</p> <p>The physical environments in which adolescents reside and their access to food stores may influence their consumption of fruit and vegetables. This association could either be direct or mediated via psychosocial variables or home availability of fruit and vegetables. A greater understanding of these associations would aide the design of new interventions. The purpose of this study was to examine associations between distance to food stores and restaurants and fruit and vegetable consumption and the possible mediating role of psychosocial variables and home availability.</p> <p>Methods</p> <p>Fruit and vegetable consumption of 204 Boy Scouts was assessed by a food frequency questionnaire in 2003. Participant addresses were geo-coded and distance to different types of food stores and restaurants calculated. Fruit and vegetable preferences, home availability and self-efficacy were measured. Regression models were run with backward deletion of non-significant environmental and psychosocial variables. Mediation tests were performed.</p> <p>Results</p> <p>Residing further away from a small food store (SFS) (convenience store and drug store) was associated with increased fruit and juice and low fat vegetable consumption. Residing closer to a fast food restaurant was associated with increased high fat vegetable and fruit and juice consumption. Vegetable preferences partially mediated (26%) the relationship between low fat vegetable consumption and distance to the nearest SFS.</p> <p>Conclusion</p> <p>Distance to SFS and fast food restaurants were associated with fruit and vegetable consumption among male adolescents. Vegetable preferences partially mediated the distance to low fat vegetable relationship. More research is needed to elucidate how environmental variables impact children's dietary intake.</p

Achieving fruit, juice, and vegetable recipe preparation goals influences consumption by 4th grade students

<p>Abstract</p> <p>Background</p> <p>Including children in food preparation activities has long been recommended as a method to encourage children's consumption, but has not been evaluated. Goal setting is also a common component of behavior change programs. This study assessed the impact of attaining goals to prepare fruit-juice or vegetable recipes on student fruit and vegetable consumption as part of a 10-week fruit and vegetable intervention for fourth grade students.</p> <p>Methods</p> <p>At six of the 10 sessions, students (n = 671) selected a fruit-juice or vegetable recipe to prepare at home before the next session. Students returned parent-signed notes reporting their child's goal attainment. Baseline and post consumption were assessed with up to four days of dietary recalls. Analyses included regression models predicting post consumption from the number of fruit-juice or vegetable recipe preparation goals attained, controlling for baseline consumption.</p> <p>Results</p> <p>In general, girls and Hispanic students achieved the most recipe preparation goals. For students with highest baseline fruit-juice consumption, post fruit-juice consumption was higher by about 1.0 serving for those achieving 2 or 3 fruit-juice recipe preparation goals. Post vegetable consumption was highest for students reporting the highest baseline vegetable consumption and who achieved two or three vegetable recipe preparation goals. In general, recipe goal setting was a useful procedure primarily for those with high baseline consumption.</p> <p>Conclusion</p> <p>This is one of the first reports demonstrating that home recipe preparation was correlated with dietary change among children.</p

Associations among sleep, body mass index, waist circumference and risk of type 2 Diabetes among US childbearing age women : national health and nutrition examination survey

Background. Women of childbearing age (18 to 44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity and risk of type 2 diabetes among childbearing age women in the National Health and Nutrition Examination Survey (NHANES). Methods. Data were from NHANES, 2005-2008. The study population consisted of 18 to 44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC and 2-hour OGTT. Results. Total sample consisted of 2388 childbearing age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality were significantly associated with 2-hour OGTT in any of the models. Conclusions. Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC or risk of type 2 diabetes in US childbearing age women. Additional studies, especially longitudinal ones using objective measures of sleep are needed to confirm the present findings

Intergenerational effects of health issues among women of childbearing age : a review of the recent literature

Purpose of review. This review summarizes the latest scientific evidence, primarily from systematic reviews/meta-analyses and large cohort studies, on the impact of health issues among women of childbearing age and their effect on their offspring during pregnancy and from birth to adulthood. Recent findings. Women of childbearing age with overweight/obesity, diabetes and hypertension prior to pregnancy are at increased risk for adverse outcomes during pregnancy, such as excessive gestational weight gain, gestational diabetes mellitus and hypertensive disorders of pregnancy. These adverse outcomes could complicate delivery and put their offspring at risk of developing overweight/obesity, diabetes and hypertension (i.e., intergenerational transmission of health issues). Summary. Interventions should target women of childbearing age, especially those who wish to conceive, in order to possibly stop the transmission of women’s health issues to the offspring and favor a healthy pregnancy from the start. This could be one of the best strategies to promote both maternal and child health

Effects of goal setting on dietary and physical activity changes in the Boy Scout badge projects.

Background: This study evaluates the relationship of goal setting to low-fat vegetable (LV) and fruit/100% juice (FJ) consumption and physical activity (PA) change. Methods: A total of 473 10- to 14-year-old Boy Scouts from Houston took part in a 9-week intervention. A two-group (LV and FJ or PA) intervention design was used with each group serving as the control for the other. Internet-based activities included goal setting at home. Food frequencies measured dietary intake. Results: Goals attained were not related to LV intake or PA. Immediate posttest FJ consumption increased about 0.7 servings as home FJ availability increased, but social desirability of response appeared to confound reports of FJ intake at posttest 6 months assessment. Conclusions: Goals attained were not related to LV intake or PA but was related to FJ intake, but only when home FJ availability was high and the relationship was confounded by social desirability of response. Further research is needed with higher quality measures of dietary intake to clarify these relationships

Relating Use of Effective Responsive, Structure, and Non-Directive Control Vegetable Parenting Practices to Subscales from the Model of Goal Directed Behavior

Parents may positively influence children’s vegetable consumption through effective vegetable parenting practices (VPP). Research has demonstrated three dimensions of effective VPP: Effective Responsiveness, Structure, and Non-Directive Control, but there is limited research investigating each separately. This study presents the modeling of Effective Responsive, Structure, and Non-Directive Control VPP using constructs from the Model of Goal Directed Vegetable Parenting Practices (MGDVPP). Parents (n=307) completed a survey on demographics, MGDVPP constructs, and effective VPP. Block regression modeling tested three models: one for each dimension of effective VPP as the dependent variable. Independent variables included validated subscales representing MGDVPP constructs: Intention, Desire, Perceived Barriers, Autonomy, Relatedness, Self-Efficacy, Habit, Anticipated Emotions, Perceived Behavioral Control, Attitudes, and Norms. Participants were racially diverse, and a majority was female, of higher socioeconomic status, and with a male child. Effective Responsive VPP was positively related to a Habit subscale. Effective Structure VPP was positively related to a Barrier, two Habit, and an Attitude subscales. Effective Non-Directive Control VPP was positively related to being a high school or GED graduate, having younger children, a Habit, and two Intentions subscales, and negatively related to an Intentions and a Perceived Behavioral Control subscales. The adjusted R2 for the Effective Responsive, Structure, and Non-Directive Control VPP models were 0.432, 0.310, and 0.515, respectively. This was the first study to relate constructs from a theoretical model to effective VPP dimensions. Research is needed to longitudinally assess the MGDVPP and test its utility in vegetable-related interventions