People, places...and other people? Integrating understanding of intrapersonal, social and environmental determinants of physical activity

&ldquo;People or places: what should be the target?&rdquo; was the provocative title of a keynote session at the fifth Australian National Physical Activity Conference held in Melbourne in 2005. This paper will argue that in fact there need not be major conflict between these views, and that couching recent debate about physical activity promotion as a polarised choice between these presents a false dichotomy. To illustrate this, the paper will consider several problems with singular approaches to understanding and promoting physical activity, and will then describe emerging empirical evidence on the nexus between people and places. To balance an increasing emphasis in the scientific literature on physical environmental determinants of physical activity, the role of intrapersonal and social factors will also be revisited. It is concluded that growing evidence supporting the multiple domains of influence on physical activity justifies calls for multi-disciplinary and multi-sectoral partnerships and approaches to the promotion of active lifestyles.<br /

Epiphanies, velcro balls and McDonaldization: highlights from the 5(th )Meeting of the International Society for Behavioral Nutrition and Physical Activity

This commentary provides an overview and selected highlights from the scientific program of the 5th Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity

Body image importance and body dissatisfaction among Indigenous Australian adolescents

Despite their elevated risk of health problems and a propensity to be more overweight or underweight relative to the other members of the Australian population, there has been no previous investigation of body image concerns among Indigenous Australians. In this study we investigated the level of body image importance and body image dissatisfaction among 19 rural Indigenous adolescents (7 males, 12 females) and 28 urban Indigenous adolescents (15 males and 13 females). Our hypotheses that there would be gender differences in body image importance and body image satisfaction were not generally supported. However, males placed more importance on muscle size and strength than females, and rural participants placed more importance on weight than urban participants. Comparison to existing data obtained from Caucasian adolescents suggested that Indigenous youth may be less concerned and dissatisfied with body weight and shape. These results are discussed in relation to findings from studies of non-Indigenous adolescents, and Indigenous health issues. The limitations of the current study and the need for further studies are also discussed

Socio-economic factors in obesity: a case of slim chance in a fat world?

The global obesity pandemic has been well-documented and widely discussed by the public, the media, health officials, the food industry and academic researchers. While the problem is widely recognised, the potential solutions are far less clear. There is only limited evidence to guide decisions as to how best to manage obesity in individuals and in populations. While widely viewed as a clinical and public health problem in developed countries, it is now clear that many developing countries also have to grapple with this problem or face the crippling healthcare costs resulting from obesity-related morbidity. There is also abundant evidence that obesity is socio-economically distributed. In developed countries persons of lower socio-economic position are more likely to be affected, while in developing countries, it is often those of higher socio-economic position who are overweight or obese. The aim of this paper is to briefly review the evidence that links socio-economic position and obesity, to discuss what is known about underlying mechanisms, and to consider the role of social, physical, policy and cultural environments in explaining the relationships between socio-economic position and obesity. We introduce the concept of &lsquo;resilience&rsquo; as a potential theoretical construct to guide research efforts aimed at understanding how some socio-economically disadvantaged individuals manage to avoid obesity. We conclude by considering an agenda to guide future research and programs focused on understanding and reducing obesity among those of low socio-economic position.<br /

Behavioural determinants of the obesity epidemic

Obesity is a serious and growing public health problem affecting developed and developing countries. It is generally agreed that the causes of the current obesity epidemic are not genetic in origin, but are the result of changes in the environments in which we live. While acknowledging the importance of environmental factors, the central role of behaviour in the obesity epidemic cannot be ignored. It is our eating, physical activity and sedentary behaviours that form the interface between our biology and the environments to which we are exposed. However, a lack of understanding of the specific behaviours that are important in the aetiology of obesity poses a major constraint to preventing obesity. A better understanding of the behaviours that contribute to weight gain and obesity is critical in order to plan and implement effective obesity prevention initiatives.Theory-driven investigations of eating, physical activity and sedentary behaviours, their determinants, and their role in weight gain and obesity among different population groups are urgent research priorities. Without an understanding of the key behaviours that contribute to weight gain, and the influences on these behaviours, it will remain difficult to identify where to intervene in the environment and be confident that action will prevent obesity.<br /

Behavior and weight correlates of weight-control efforts in Australian women living in disadvantage : the READI study

BackgroundWith increasing obesity rates worldwide, more and more people are actively attempting to lose weight or avoid weight gain, but relatively little is known about what specific behaviors comprise these efforts and which, if any, are associated with better weight control over time.MethodsThis paper reports relationships between body weight, weight-control efforts and related behaviors over a three-year period in 1,634 Australian women. The women were purposefully recruited from 80 disadvantaged neighborhoods in Victoria, Australia. Weight loss efforts were categorized as trying to lose weight, trying to prevent weight gain and no weight-control efforts. Behavioral correlates examined included different kinds of physical activity and consumption of a number of specific foods types.Results and discussionSelf-reported body weight at baseline was higher in women trying to lose weight. Frequency of consumption of low energy density foods was positively associated with reported weight-control efforts, as was frequency of reported total and leisure-time physical activity. Longitudinal associations between changes in weight-control efforts and changes in behaviors were consistent with the cross-sectional findings. At three-year follow up, however, weight-control efforts were not associated with change in body weight. More detailed analyses of specific food choices suggested that part of the explanation of no effect of reported weight-control efforts and weight over time might be that people are not as well-informed as they should be about the energy density of some common foods. In particular, those reporting engagement in weight-control efforts reported reducing consumption of carbohydrate-containing foods such as bread and potatoes more than is justified by their energy content, while they reported increasing consumption of some high energy density foods (e.g., cheese and nuts).ConclusionIt is tentatively concluded that women living in disadvantaged neighborhoods understand messages about weight-control (more activity and foods with lower fat and lower energy density) but that some foods eaten more by women engaged in weight control may reduce the effectiveness of these efforts.<br /

What help do young women want in their efforts to control their weight? Implications for program development

The aim of this study was to examine women\u27s views on the usefulness of various types of information and practical sessions on weight control, their preferences for program delivery, and likelihood of participation. Cross-sectional survey of 462 women aged 18&ndash;33 years randomly selected from the community was conducted. We examined the perceived usefulness of various types of information and practical classes on weight control; preferred mode of delivery; willingness to participate. Among the women 82% were interested in trying to lose or control weight. Information on weight control was considered to be more useful than practical sessions. Information about meal planning, cooking and low-fat recipes and how to manage stress was considered most useful. Fifty-eight per cent of women reported they would prefer to participate in an individual face-to-face program delivered by a health professional. Thirty-one per cent of women reported it was very likely that they would participate in a program if it included the sort of things they considered useful and was offered in the way they preferred; a further 35% felt it \u27likely\u27. It appears that health professional-delivered, individual, information-based programs appear most popular among this target group. Tailoring the content and delivery mode of weight management programs to young women\u27s preferences may enhance program participation.<br /

Socioeconomic status and weight change in adults: a review

In developed countries, obesity is inversely associated with socioeconomic status (SES) among women, and less consistently among men; whereas, in developing countries, the association is direct. However, the relationship of SES to weight change over time is unknown. This relationship was the focus of the present literature review. It was hypothesized that, compared with persons of higher SES, persons of low SES would show greater weight gain or risk of weight gain over time. A search of electronic databases identified 34 relevant articles from developed countries reporting on studies that assessed the relationship of various measures of SES with weight change over time in adults (there were too few papers from developing countries (n=1) to include). Results of the methodologically strongest studies (those which obtained objectively measured adiposity data and used a follow-up period of 4 years or more) showed that, among non-black samples, there were relatively consistent inverse associations between occupation and weight gain for men and women. When SES was assessed using education, evidence was slightly less consistent, but still provided some support for the hypothesized relationship. However, when income was used as the indicator of SES, findings were inconsistent, although there were fewer studies available. There was little support for a relationship between SES and weight gain for black samples. In the context of the worldwide epidemic of obesity, these findings suggest that in developed countries, weight gain prevention efforts might best be focused on those who are most socioeconomically disadvantaged, particularly those in lower status occupations.<br /

Mediators of the relationship between maternal education and children\u27s TV viewing

Background: Maternal education is consistently found to be inversely related to children&rsquo;s television viewing and is associated with aspects of the family television environment. This study investigates whether family television environment mediates the relationship between maternal education and children&rsquo;s television viewing.Methods: Parents of 1484 children reported maternal education, time their child spends watching television, and 21 aspects of the family television environment (potential mediators) during 2002 and 2003. Separate regression analyses were conducted in 2006 for each potential mediator that met two initial conditions for mediation (associated with both maternal education and children&rsquo;s television viewing (p&lt;0.10)), to assess whether inclusion reduced the association between maternal education and children&rsquo;s television viewing. Multivariable regression assessed the combined impact of all mediators.Results: Twelve of 21 potential mediators met the initial conditions for mediation. Inclusion of each resulted in decreased &beta; values (3.2% to 15.2%) for the association between maternal education and television viewing. Number and placement of televisions in the home appeared to have the greatest mediating effect, followed by frequency of eating dinner in front of the television with the child and rules about television viewing during mealtimes. Together, the 12 mediators accounted for more than one-third of the association between maternal education and children&rsquo;s television viewing time.Conclusions: This study suggests the strong inverse relationship between maternal education and children&rsquo;s television viewing is partly mediated by aspects of the family television environment.<br /