Introduction to the Active Living Research Reference List 2007


SOCIAL, CULTURAL & FAMILY ENVIRONMENT – PHYSICAL ACTIVITY, DIET & OBESITY

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SOCIAL, CULTURAL & FAMILY ENVIRONMENT – PHYSICAL ACTIVITY, DIET & OBESITY

A. M. Adachi-Mejia, M. R. Longacre, J. J. Gibson, M. L. Beach, L. T. Titus-Ernstoff and M. A. Dalton. (2007). Children with a TV in their bedroom at higher risk for being overweight. International Journal Of Obesity.

Objective: We examined having a TV in the bedroom as a risk factor for child overweight. Design: Cross-sectional study. Setting: School- and telephone-based surveys in New Hampshire and Vermont between 2002 and 2004. Participants: Two thousand three hundred and forty-three children enrolled in public schools, aged 9-12 years, and one of their parents. Main exposures: The child having a TV in the bedroom. Main outcome measures: Age- and gender-standardized child body mass index (zBMI). Overweight was defined as equal to or above the 95th percentile for zBMI. Results: Overall, 22.3% (N = 523) of the children were overweight, and almost half of all children (48.2%, N = 1130) had a TV in their bedroom. Children with a TV in their bedroom had a higher zBMI and were significantly more likely to be overweight compared to those without a TV in their bedroom (27.3 versus 17.7%, respectively; P < 0.05). After controlling for sociodemographics, physical activity, frequency of TV or movie watching and internet use, children with a TV in their bedroom who watched at least one session of TV or movies per day were more likely to be overweight compared to those without a TV in their bedroom (odds ratio 1.32, 95% confidence interval: 1.03, 1.70). Conclusions: Having a TV in the bedroom is a risk factor for child overweight, independent of reported physical activity, participation in team sports, TV or movie watching time and internet use at home. Further study is needed to fully understand the mechanism by which having a TV in the bedroom increases children's risk for overweight.

A. H. Auchincloss, A. V. Diez Roux, D. G. Brown, E. S. O'Meara and T. E. Raghunathan. (2007). Association of insulin resistance with distance to wealthy areas: the multi-ethnic study of atherosclerosis. American Journal Of Epidemiology.

Little is known about environmental determinants of type 2 diabetes. The authors hypothesized that insulin resistance is positively related to distance to a wealthy area and to local neighborhood poverty. Data were derived from The Multi-Ethnic Study of Atherosclerosis, a study of adults aged 45-84 years in six US locales, and the 2000 US Census. The homeostasis model assessment (HOMA) index was used to measure insulin resistance. Linear regression was used to estimate associations between area characteristics and insulin resistance after adjustment for age, sex, income, education, and race/ethnicity and for the potential mediators diet, physical activity, and body mass index (n = 4,821). Among persons not treated for diabetes, distance to a wealthy area was associated with HOMA independent of local poverty and person-level covariates: per 4.4-km change, the relative increase in HOMA was 13% (95% confidence interval: 7%, 19%), similar to the effect of a body mass index increase of 1.7 kg/m(2) on HOMA. This association was reduced after adjustment for physical activity, diet, and body mass index (relative increase = 9%, 95% confidence interval: 3%, 15%). Local neighborhood poverty was also positively, but more weakly associated with insulin resistance, with no association after adjustment for race/ethnicity. This study shows that proximity to resources in high-income areas is related to insulin resistance.


J. E. Barrett, R. C. Plotnikoff, K. S. Courneya and K. D. Raine. (2007). Physical activity and type 2 diabetes: exploring the role of gender and income. Diabetes Education.

PURPOSE: The purpose of this study was to explore (1) patterns in physical activity behaviors and (2) the meaning and personal significance of social cognitive theory (SCT) constructs on physical activity, across gender and income groups among people with type 2 diabetes (T2DM). METHODS: Albertans, 18 years and older (x- = 63, SD = 12.08) with T2DM (N = 1614) completed self-report measures of demographic characteristics and physical activity. Two-way, between-groups analyses of variance (ANOVAs) assessed main and interaction effects of gender and income on leisure time physical activity (LTPA). A subsample of these participants (n = 20) subsequently completed qualitative telephone interviews to provide contextual understanding of the quantitative data and to explore salient SCT influences on physical activity. RESULTS: Significant findings indicated that men participate in more LTPA than women do, and those from the highest income group participate in more LTPA than low- or middle-income groups (P <.01). Interview results suggested that walking is the most popular form of physical activity; however, gender and income groups differ in other leisure and nonleisure physical activities. Furthermore, patterns for SCT constructs related to physical activity were apparent across gender and income, most noticeably for self-efficacy and environmental and situational influences. Specifically among men, noteworthy differences existed between income groups for self-control and reinforcement strategies. CONCLUSIONS: The study highlights the need for more sensitive self-report measures and objective measures of physical activity to help distinguish whether true differences exist between certain demographic groups. Moreover, interventions that promote walking may be beneficial for people with T2DM, provided that appropriate environmental and policy changes occur to accommodate walking and other physical activity behaviors.

M. W. Beets, R. Vogel, S. Chapman, K. H. Pitetti and B. J. Cardinal. (2007). Parent's social support for children's outdoor physical activity: Do weekdays and weekends matter? Sex Roles.

In this study we examined the relationships among parental social supportive behaviors for children's weekday and weekend outdoor physical activity (OPA). Thirty-nine girls and 29 boys 8 to 11 years wore pedometers for 7 days. Sixty-five mothers and 50 fathers responded to a social support questionnaire about OPA that was comprised of four dimensions: encouragement, playing with, use of activity as family recreation, and watch. After controlling for age and sport participation, regression analyses indicated that mothers' use of activity as recreation was positively associated with girls' weekday OPA. On the weekend, fathers' play with son was positively related to OPA. The effectiveness of family-based activity interventions depends on when parents have opportunities to be present for their child's activity and gender differences in the support provided.

G. G. Bennett, K. Y. Wolin and S. A. James. (2007). Lifecourse socioeconomic position and weight change among blacks: The Pitt County study. Obesity (Silver Spring).

OBJECTIVE: The elevated prevalence of obesity among U.S. blacks has been attributed to low socioeconomic position (SEP), despite inconsistent empirical findings. It is unclear whether low SEP at various lifecourse stages differentially influences adulthood BMI and BMI change. RESEARCH METHODS AND PROCEDURES: Among 1167 black adults in the Pitt County Study, we examined independent cross-sectional and longitudinal associations between SEP, measured in childhood and adulthood, and BMI and 13-year BMI change. Low vs. high childhood SEP was measured by parental occupation and childhood household deprivation; low vs. high adulthood SEP was assessed by employment status, education, and occupation. Using childhood and adulthood SEP, four lifecourse SEP categories were created: low-low, low-high, high-low, high-high. RESULTS: We found no consistent associations between SEP and BMI or BMI change among men. Among women, we observed the expected inverse association between SEP and BMI at baseline. In multivariable-adjusted analyses, socioeconomically advantaged women demonstrated larger 13-year increases in BMI: skilled vs. unskilled parental occupation (6.1 vs. 4.8 kg/m2, p = 0.04); college-educated vs. < high school (6.2 vs. 4.5 kg/m2, p = 0.04); white-collar vs. blue-collar job (5.8 vs. 4.8 kg/m2, p = 0.05); and high-high vs. low-low lifecourse SEP (6.5 vs. 4.6 kg/m2, p = 0.02). DISCUSSION: For women in this black cohort, lower SEP predicted earlier onset of obesity; however, low SEP was less predictive of BMI increases over time. Our findings demonstrate complex patterns of association between SEP and BMI change among black women.

H. K. Blomquist and E. Bergstrom. (2007). Obesity in 4-year-old children more prevalent in girls and in municipalities with a low socioeconomic level. Acta Paediatrics.

AIM: To provide updated prevalence data of BMI and obesity in 4-year-old Swedish children, also exploring socioeconomic differences. SUBJECTS: A total of 4407 children born 1998-1999 (2231 boys and 2176 girls) in the county of Vasterbotten, Sweden. METHODS: Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI). Information about socioeconomic level of the municipalities was collected from a health survey of the adult population. RESULTS: Of the boys, 16.7% were classified as overweight and 3.1% of these as obese. Corresponding figures for girls were 22.1% and 4.5%. The P50 and P95 values for BMI were 16.2 and 18.8 for boys and 16.1 and 19.3 for girls, respectively. P50 was at the same level as in previous Swedish studies, while P95 was higher in this study. Obesity, in girls, was more prevalent in municipalities with a low socioeconomic level. CONCLUSION: Overweight and obesity in pre-school children in Sweden is more prevalent in girls than in boys, and the prevalence is as high as in school age children. A low socioeconomic level of living area seems to be related to a higher prevalence of obesity. Increased preventive efforts, both on the individual and the societal level, must be undertaken to reduce future health risks in obese children.

M. Bopp, D. Lattimore, S. Wilcox, M. Laken, L. McClorin, R. Swinton, O. Gethers and D. Bryant. (2007). Understanding physical activity participation in members of an African American church: a qualitative study. Health Education Research.

Faith-based interventions hold promise for increasing physical activity (PA) and thereby reducing health disparities. This paper examines the perceived influences on PA participation, the link between spirituality and health behaviors and the role of the church in promoting PA in African Americans. Participants (n = 44) were adult members of African American churches in South Carolina. In preparation for a faith-based intervention, eight focus groups were conducted with sedentary or underactive participants. Groups were stratified by age (<55 years versus >or=55 years), geography and gender. Four general categories were determined from the focus groups: spirituality, barriers, enablers and desired PA programs. Personal, social, community and environmental barriers and enablers were described by both men and women, with no apparent differences by age. Additionally, both men and women mentioned aerobics, walking programs, sports and classes specifically for older adults as PA programs they would like available at church. This study provides useful information for understanding the attitudes and experiences with exercise among African Americans, and provides a foundation for promoting PA through interventions with this population by incorporating spirituality, culturally specific activities and social support within the church.


K. N. Boutelle, J. A. Fulkerson, D. Neumark-Sztainer, M. Story and S. A. French. (2007). Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status. Public Health Nutrition.

OBJECTIVE: The purpose of the present study was to examine the prevalence of fast-food purchases for family meals and the associations with sociodemographic variables, dietary intake, home food environment, and weight status in adolescents and their parents. DESIGN: This study is a cross-sectional evaluation of parent interviews and adolescent surveys from Project EAT (Eating Among Teens). SUBJECTS: Subjects included 902 middle-school and high-school adolescents (53% female, 47% male) and their parents (89% female, 11% male). The adolescent population was ethnically diverse: 29% white, 24% black, 21% Asian American, 14% Hispanic and 12% other. RESULTS: Results showed that parents who reported purchasing fast food for family meals at least 3 times per week were significantly more likely than parents who reported purchasing fewer fast-food family meals to report the availability of soda pop and chips in the home. Adolescents in homes with fewer than 3 fast-food family meals per week were significantly more likely than adolescents in homes with more fast-food family meals to report having vegetables and milk served with meals at home. Fast-food purchases for family meals were positively associated with the intake of fast foods and salty snack foods for both parents and adolescents; and weight status among parents. Fast-food purchases for family meals were negatively associated with parental vegetable intake. CONCLUSIONS: Fast-food purchases may be helpful for busy families, but families need to be educated on the effects of fast food for family meals and how to choose healthier, convenient family meals.


N. H. Brodersen, A. Steptoe, D. R. Boniface and J. Wardle. (2007). Trends in physical activity and sedentary behaviour in adolescence: ethnic and socioeconomic differences. British Journal Of Sports Medicine.

Objective: To assess developmental trends in physical activity and sedentary behaviour in British adolescents in relation to sex, ethnicity and socioeconomic status (SES). Design: A 5-year longitudinal study of a diverse cohort of students aged 11 - 12 years at baseline in 1999. Setting: 36 London schools sampled using a stratified random sampling procedure. Participants: A total of 5863 students categorised as white, black or Asian, and stratified for SES using the Townsend Index. Main outcome measures: Number of days per week of vigorous activity leading to sweating and breathing hard. Hours of sedentary behaviour, including watching television and playing video games. Data were analysed using multilevel, linear, mixed models. Results: Marked reductions in physical activity and increases in sedentary behaviour were noticed between ages 11 - 12 and 15 - 16 years. Boys were more active than girls, and the decline in physical activity was greater in girls (46% reduction) than in boys (23%). Asian students were less active than whites, and this was also true of black girls but not boys. Black students were more sedentary than white students. Levels of sedentary behaviour were greater in respondents from lower SES. Most differences between ethnic and SES groups were present at age 11 years, and did not evolve over the teenage years. Conclusions: Physical activity declines and sedentary behaviour becomes more common during adolescence. Ethnic and SES differences are observed in physical activity and sedentary behaviour in British youth that anticipate adult variations in adiposity and cardiovascular disease risk. These are largely established by age 11 - 12 years, so reversing these patterns requires earlier intervention.

K. A. Brown, J. Ogden, C. Vogele and E. L. Gibson. (2007). The role of parental control practices in explaining children's diet and BMI. Appetite.

This paper aimed to investigate which parents use which types of parenting control practices to manage their children's diets and to assess the impact of these practices on children's dietary patterns and their BMI. A cross-sectional survey of 518 parents with children aged 4-7 years was carried out in 18 primary schools across the South of England. Measures included aspects of parental control practices and the child's diet. Results showed that older parents with a lower BMI and who were stay at home parents used more "snack overt control", "snack covert control" and "meal covert control" and those with more education used more covert control strategies. In contrast, male, non-white parents with younger children used more "pressure to eat". In terms of the children's diet, the results showed links between parental and child demographics and aspects of unhealthy and healthy food intake. In addition, links were also found for parental control practices. For example, eating more unhealthy snacks was related to less covert control and more pressure to eat, eating fruit and vegetables was related to higher levels of both overt and covert control over meals and less pressure to eat and being neophobic was related to less covert control over meals and more pressure to eat. The children's BMIs were unrelated to any variables measured in the study.

D. L. Burnet, A. J. Plaut, K. Ossowski, A. Ahmad, M. T. Quinn, S. Radovick, R. Gorawara-Bhat and M. H. Chin. (2008). Community and family perspectives on addressing overweight in urban, African-American youth. Journal of General Internal Medicine.

OBJECTIVE: To assess weight-related beliefs and concerns of overweight urban, African-American children, their parents, and community leaders before developing a family-based intervention to reduce childhood overweight and diabetes risk. DESIGN: We conducted 13 focus groups with overweight children and their parents and eight semistructured interviews with community leaders. PARTICIPANTS AND SETTING: Focus group participants (N = 67) from Chicago's South Side were recruited through flyers in community sites. Interview participants (N = 9) were recruited to sample perspectives from health, fitness, education, civics, and faith leaders. RESULTS: Community leaders felt awareness was higher for acute health conditions than for obesity. Parents were concerned about their children's health, but felt stressed by competing priorities and constrained by lack of knowledge, parenting skills, time, and financial resources. Parents defined overweight in functional terms, whereas children relied upon physical appearances. Children perceived negative social consequences of overweight. Parents and children expressed interest in family-based interventions to improve nutrition and physical activity and offered suggestions for making programs interesting. CONCLUSIONS: This study provides insights into the perspectives of urban, African-American overweight children, their parents, and community leaders regarding nutrition and physical activity. The specific beliefs of these respondents can become potential leverage points in interventions.

L. J. Burton and J. L. VanHeest. (2007). The importance of physical activity in closing the achievement gap. Quest.

The most significant concern within the US educational community is the academic achievement gap. Investigation of the achievement gap reveals that minority students across all levels of education are not meeting the same academic measures as their non-Hispanic White peers. In addition, a disproportionate number of minority children are identified as overweight. Physical activity has been identified as an influence on the reduction and prevention of overweight and obesity. In addition, physical activity has been recognized as beneficial to cognitive performance in children. The current review provides a stimulus to recognize the links between overweight and academic achievement in minority youth and the importance of physical activity in addressing these issues. As a nation, we cannot afford another generation of students of color and low income who are ill prepared for full citizenship. Students of every race, ethnicity, language, and income need the skills and tools to compute, critique, and create at high levels. We must agree to identify and employ initiatives that hold the greatest promise for moving all students-including students of color, poor students, rural and urban students, and second-language learners-to high levels of achievement (Gina Burkhard, CEO, Learning Points Associates).

C. Byrd-Williams, L. A. Kelly, J. N. Davis, D. Spruijt-Metz and M. I. Goran. (2007). Influence of gender, BMI and Hispanic ethnicity on physical activity in children. International Journal of Pediatric Obesity.

OBJECTIVE: The purpose of this study was to examine the association between overweight status and physical activity (PA) among gender and ethnic (Hispanic vs. non-Hispanic) sub-groups in elementary school-age children. METHODS: PA was assessed over five days using the Actigraph accelerometer in 169 fourth grade students (mean age 9.4 years; 50% female; 63% Hispanic; and 43% overweight, defined as body mass index, BMI > or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. RESULTS: In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA, p=0.01). There was a significant gender, ethnicity, and overweight interaction for total PA and MVPA (both p<0.01). MVPA and counts per minute were significantly lower in overweight non-Hispanic girls and Hispanic boys (p<0.05) and marginally lower in overweight non-Hispanic boys (p=0.10) when compared with non-overweight students, while overweight Hispanic girls were more physically active than Hispanic non-overweight girls, though the difference was non-significant (p>0.05). CONCLUSIONS: Data from the present study does not consistently support the prevailing hypothesis that overweight subjects engage in less PA. Results show overweight students engage in less PA than non-overweight students, with the exception that non-overweight Hispanic girls do not engage in more PA than their overweight peers. These results suggest the need for further investigation into the role that ethnicity and overweight status plays in PA levels, particularly among ethnic and gender sub-groups.


K. D. Campbell-Voytal, J. P. Gutai, J. Janisse, Y. Wang and J. Klein. (2007). NHANIES does not predict prevalence or pattern of obesity in a poor, urban, minority population. Diabetes.

J. A. Cassetta, B. Boden-Albala, R. R. Sciacca and E. G. V. Giardina. (2007). Association of education and Race/Ethnicity with physical activity in insured urban women. Journal Of Womens Health.

Background: Physical inactivity is a growing problem facing American women. As little as 150 minutes of moderate physical activity (PA) weekly can reduce the risk of chronic diseases, such as heart disease and stroke. We developed a survey to determine levels and predictors of PA in a diverse population of urban women with access to healthcare. Methods: From February to September 2004, women visiting an academic health center completed a self-administered PA survey. Total activity time (TAT) was calculated as the sum of all activity (walking, jogging or running, dancing, calisthenics, bicycling, aerobics, swimming) recorded over the preceding 2 weeks. Analysis of variance (ANOVA) models were used to assess the effect of different variables on TAT. Results: The survey was completed by 242 women, mean age of 43.4 years. Ninety percent were insured; 66% were non-Hispanic white, 16% were Hispanic, and 10% were African American. Seventy-six percent of women were college graduates. Only 58% of participants recorded >= 150 minutes of PA/week. TAT was related to education, with a significant difference between high school and college graduates (290 +/- 80 vs. 502 +/- 40 min [SEM], p < 0.05). Conclusions: Education was strongly associated with TAT among these insured, diverse, and well-educated women. Only 58% exercised >= 150 minutes/week, underscoring the need to target exercise programs for all women and to close the gap between women of lower and higher educational attainment.

D. M. Castellli and H. E. Erwin. (2007). A comparison of personal attributes and experiences among physically active and inactive children. Journal Of Teaching In Physical Education.
Y. M. Chao, E. M. Pisetsky, L. C. Dierker, F. A. Dohm, F. Rosselli, A. M. May and R. H. Striegel-Moore. (2007). Ethnic differences in weight control practices among U.S. adolescents from 1995 to 2005. International Journal of Eating Disorders.

OBJECTIVE: To examine trends in weight control practices from 1995 to 2005. METHOD: The Youth Risk Behavior Surveillance System biennially assesses five weight control behaviors among nationally representative samples of United States high school students. RESULTS: Across time, more females than males dieted (53.8% vs. 23.8%), used diet products (10% vs. 4.3%), purged (7.5% vs. 2.7%), exercised (66.5% vs. 46.9%), or vigorously exercised (42.8% vs. 36.8%). All weight control behaviors among males increased during the decade. Black females were less likely than Hispanic females, who were less likely than White females, to practice weight control. White males were less likely than Black males, who were less likely than Hispanic males, to practice weight control. The ethnic difference in weight control practices is consistent across time. CONCLUSION: All male adolescents are at increasing risk for developing eating disorder symptomatology, and Black females appear to continue to resist pressure to pursue thinness. (c) 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007.




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