Introduction to the Active Living Research Reference List 2007

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G. Guo, K. E. North, P. Gorden-Larsen, C. M. Bulik and S. Choi. (2007). Body mass, DRD4, physical activity, sedentary behavior, and family socioeconomic status: the add health study. Obesity (Silver Spring).

OBJECTIVE: To investigate the joint role of the 48-base pair repeat polymorphism of the dopamine receptor 4 gene (DRD4) and environmental factors in body mass variation among an ethnically diverse sample of U.S. adolescents and young adults. RESEARCH METHODS AND PROCEDURES: Approximately 2600 adolescent and young adults in the National Longitudinal Study of Adolescent Health (Add Health) who provided DNA measures and measures of height and weight were included in the analysis. Mixed regression modeling was used to investigate the effects of the 7R/7R and any5R variants in the DRD4 gene simultaneously with the effects of physical activity (PA), sedentary behavior (SB), and family socioeconomic status (SES) on body mass variation. European Americans, African Americans, and Hispanic Americans were modeled separately. Results and DISCUSSION: Both the 7R/7R and any5R genotypes of the DRD4 gene were associated with age- and sex-specific BMI percentile score (BMI-P) based on the Centers for Disease Control and Prevention/National Center for Health Statistics 2000 reference curves among African Americans and only among African Americans (N = 413) 20 years old or younger. Neither genetic variants are associated with the BMI measure among white (N = 1386) and Hispanic-American (N = 331) adolescents. The presence of the 7R/7R genotype was associated with a reduction of 15.1 in BMI percentile (p = 0.005), and the presence of any5R was associated with an increase of 15.5 in BMI percentile (p = 0.003), after adjusting for PA, SB, and family SES. Neither PA nor SB as measured in Add Health is importantly associated with BMI-P, suggesting a complex relationship between body mass and PA/SB among adolescents and young adults. Family SES is negatively related to BMI-P in the European-American sample.

S. A. Ham, M. M. Yore, J. Kruger, G. W. Heath and R. Moeti. (2007). Physical activity patterns among Latinos in the United States: putting the pieces together. Preventing Chronic Disease.

INTRODUCTION: Estimates of participation in physical activity among Latinos are inconsistent across studies. To obtain better estimates and examine possible reasons for inconsistencies, we assessed 1) patterns of participation in various categories of physical activity among Latino adults, 2) changes in their activity patterns with acculturation, and 3) variations in their activity patterns by region of origin. METHODS: Using data from four national surveillance systems (the National Health and Nutrition Examination Survey, 1999-2002; the Behavioral Risk Factor Surveillance System, 2003; the National Household Travel Survey, 2001; and the National Health Interview Survey Cancer Supplement, 2000), we estimated the percentage of Latinos who participated at least once per week in leisure-time, household, occupational, or transportation-related physical activity, as well as in an active pattern of usual daily activity. We reported prevalences by acculturation measures and region of origin. RESULTS: The percentage of Latinos who participated in the various types of physical activity ranged from 28.7% for having an active level of usual daily activity (usually walking most of the day and usually carrying or lifting objects) to 42.8% for participating in leisure-time physical activity at least once per week. The percentage who participated in leisure-time and household activities increased with acculturation, whereas the percentage who participated in occupational and transportation-related activities decreased with acculturation. Participation in an active level of usual daily activity did not change significantly. The prevalence of participation in transportation-related physical activity and of an active level of usual daily activity among Latino immigrants varied by region of origin. CONCLUSION: Physical activity patterns among Latinos vary with acculturation and region of origin. To assess physical activity levels in Latino communities, researchers should measure all types of physical activity and the effects of acculturation on each type of activity.

K. Hesketh, D. Crawford, J. Salmon, M. Jackson and K. Campbell. (2007). Associations between family circumstance and weight status of Australian children. International Journal of Pediatric Obesity.

OBJECTIVE: To examine associations between weight status and multiple indicators of family circumstance in Australian elementary school children. METHODS: Data were combined from the 2001 Children's Leisure Activities Study (CLAS Study) and 2002/3 Health, Eating and Play Study (HEAP Study), involving 2520 children in Grades Prep (mean age 6 years) and 5-6 (mean age 11 years) in Melbourne, Australia. Children's body mass index (BMI) was calculated from measured height and weight. Weight status (non-overweight or overweight) was determined according to International Obesity Taskforce cut-off points and BMI was transformed to z-scores based on the 2000 US growth chart data. Parents reported family circumstance (number of parents in the home, marital status, presence of siblings, parental education, parental employment status, parental work hours [HEAP Study only]) and parental BMI. Regression analyses were conducted for the sample overall and separately for young girls, young boys, older girls and older boys. RESULTS: Children in single-parent homes, those without siblings, and those with less educated mothers and fathers tended to have higher z-BMIs (p=0.002, p=0.003, p<0.001 and p<0.001, respectively) and were more likely to be overweight (p=0.003, p<0.001, p<0.001 and p=0.02, respectively). Associations were stronger for older children. Parental employment and work hours were not consistently associated with child weight status. The multivariable models did not demonstrate a cumulative explanatory effect (R(2)=0.02), except when maternal BMI was included (R(2)=0.07). CONCLUSIONS: Individual measures of family circumstance were differentially associated with child weight status and appeared to be largely independent of other measures of family circumstance. Childhood overweight interventions may need to be tailored based on the age, gender, maternal BMI and family circumstances of the target group.

K. Hesketh, K. Ball, D. Crawford, K. Campbell and J. Salmon. (2007). Mediators of the relationship between maternal education and children's TV viewing. American Journal Of Preventive Medicine.

BACKGROUND: Maternal education is consistently found to be inversely related to children'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'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's television viewing (p<0.10)), to assess whether inclusion reduced the association between maternal education and children'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's television viewing time. CONCLUSIONS: This study suggests the strong inverse relationship between maternal education and children's television viewing is partly mediated by aspects of the family television environment.

M. Hohepa, R. Scragg, G. Schofield, G. S. Kolt and D. Schaaf. (2007). Social support for youth physical activity: Importance of siblings, parents, friends and school support across a segmented school day. International Journal of Behavioral Nutrition and Physical Activity.

ABSTRACT: BACKGROUND: Whilst evidence exists for the influence of encouragement on physical activity participation, the diversity of support sources and the type of physical activity examined previously is limited. This study examined the importance of perceived encouragement from parents, siblings/cousins, friends, and schools on participation levels across three time-specific activity opportunities that are available during a school day (after-school physical activities, lunchtime activity, and active transportation to and from school). METHODS: A cross-sectional sample of 12-18 year old high school students (n = 3,471) were recruited from low SES schools within South Auckland, New Zealand and categorised as either Junior (Years 9-11) or Senior (Years 12 & 13) students. Participants reported their physical activity levels and quantity of encouragement received from their parent(s), friend(s), sibling(s)/cousin(s), and school to be active. For each physical activity variable participants were dichotomized as being either "active" or "less active". For each social support source, participants were grouped into either receiving "high" or "low" levels of support. Binary logistic regression analyzes were conducted to calculate odd ratios and 95% confidence intervals. RESULTS: Low parental support (Juniors, OR: 0.47, 95% CI: 0.38-0.58; Seniors, OR: 0.41, 95% CI: 0.29-0.60) and low peer support (Juniors, OR: 0.61, 95% CI: 0.51-0.74; Seniors, OR: 0.49, 95% CI: 0.35-0.69) were associated with reduced odds of being regularly active after school. For lunchtime activity, low peer support (Juniors, OR: 0.39, 95% CI: 0.32-0.48; Seniors, OR: 0.41, 95% CI: 0.29-0.57) was associated with reduced odds of being categorized as active. While no variables were significantly related to active transportation among senior students, low peer support was associated with reduced odds of actively commuting for Junior students (OR: 0.78, 95% CI: 0.66-0.92). Irrespective of the activity examined, no significant difference was noted for students receiving high support from two parents than students reporting high support from their sole parent in a single parent family. CONCLUSION: The importance of encouragement from parents, siblings, friends, and schools on physical activity is dependant on the time-specific activity examined. It is clear that proximal social networks need to be considered during the development of physical activity promotion strategies.

K. Hosper, N. S. Klazinga and K. Stronks. (2007). Acculturation does not necessarily lead to increased physical activity during leisure time: a cross-sectional study among Turkish young people in the Netherlands. BMC Public Health.

BACKGROUND: Non-Western migrant populations living in Western countries are more likely to be physically inactive during leisure time than host populations. It is argued that this difference will disappear as they acculturate to the culture of the host country. We explored whether this is also true for migrants who experience contextual barriers such as having children, living in a less attractive neighbourhood, or having occupational physical activity. METHODS: Cross-sectional data were obtained from the LASER-study (2003-2004) on health related behaviours in first and second generation Turkish young people living in the Netherlands. For this study we included 485 Turkish participants aged 15-30 years, who participated in a structured interview during a home visit. Acculturation was indicated by level of 'cultural orientation towards the Dutch culture' and 'social contacts with ethnic Dutch' with persons being low oriented towards the Dutch culture and having few social contacts with ethnic Dutch as reference group. The measured barriers were 'having children', 'occupational physical activity' and 'living in a less attractive neighbourhood'. Logistic regression analyses were used to assess the associations between acculturation and physical activity during leisure time, stratified by these contextual barriers. RESULTS: Greater cultural and social integration was associated with increased physical activity during leisure time. Odds ratio's were 1.85 (CI: 1.19-2.85) for 'cultural orientation' and 1.77 (CI: 1.15-2.71) for 'social contacts with ethnic Dutch'. However, these associations were not present or less strong among people who had children, or who were living in a less attractive neighbourhood or who engaged in occupational physical activity. CONCLUSION: Physical activity during leisure time increased with greater acculturation, however, this relationship was found only among participants without children, living in a attractive neighbourhood and having no occupational activity. Interventions aimed at migrant populations should not only focus on the least integrated. Instead, effectiveness might be enhanced when interventions are sensitive to the contextual barriers that might inhibit physical activity behaviours during leisure time.

P. Hu, N. Wagle, N. Goldman, M. Weinstein and T. E. Seeman. (2007). The associations between socioeconomic status, allostatic load and measures of health in older Taiwanese persons: Taiwan social environment and biomarkers of aging study. Journal of Biosocial Science.

Data from a national representative sample of 1023 elderly and near-elderly Taiwanese were used to explore whether allostatic load is associated with health outcomes and mediates the association between socioeconomic status and health in a non-Western population. The information collected included: demographic characteristics; allostatic load scores; socioeconomic status, measured by education and income; health behaviours; health-related variables, including self-rated health, basic activities of daily living difficulties, instrumental activities of daily living difficulties, and physical activity difficulties. The adjusted prevalent odds ratios of higher allostatic load level were 1.25 (95% CI: 1.00, 1.56) for reporting one level worse in self-rated health and 1.43 (95% CI: 1.14, 1.82) for reporting one more physical activity difficulty. There were significant associations of lower education or less income with worse self-rated health and more difficulties with physical functioning. The associations between education, income and health status are not mediated by the conventional ten-point measure of allostatic load in older Taiwanese adults.

L. Kaufman and A. Karpati. (2007). Understanding the sociocultural roots of childhood obesity: food practices among Latino families of Bushwick, Brooklyn. Social Science & Medicine.

Despite prevention efforts, childhood obesity has reached epidemic proportions in the United States. This ethnographic study seeks to enhance understandings of the sociocultural dimensions of childhood obesity and inform prevention efforts. Using participant observation, interviews, and life histories, this research probes the sociocultural roots of childhood obesity by exploring the food practices and everyday lives of Latino families in Bushwick, Brooklyn, a low-income neighborhood in New York City. Mired in persistent poverty, Latino families burdened by teetering resources provide for their children using coping strategies in which everyday food practices play an important part. These practices illuminate cultural ideas about good parenting, well-being, and conceptions of the body. We argue that these practices, embedded in the neighborhood food environment, drive food choice and related activities of families, often leading to overweight and obesity in their children. They form the sociocultural roots of childhood obesity, and their implications are critically important for how public health professionals approach the relationship of food, nutrition, and obesity.

M. Kawabata and Q. Shen. (2007). Commuting inequality between cars and public transit: the case of the San Francisco Bay Area, 1990-2000. Urban Studies.

Equity in access to opportunities is increasingly recognised as an essential component of sustainable development and transport. This study presents a spatial and temporal examination of commuting inequality between cars and public transit in the San Francisco Bay Area. Results visualised in the maps show considerable inequality and temporal changes in job accessibility and commuting time between cars and public transit as well as among locations within the metropolitan area. Results from OLS and spatial regression models indicate that, in both 1990 and 2000, greater job accessibility was significantly associated with shorter commuting time for driving alone as well as for public transit, but the degree of this association was considerably greater for public transit than for driving alone. Urban and transport development that enhances mobility and accessibility for public transit relative to cars should be strongly encouraged.

K. Khunti, M. A. Stone, J. Bankart, P. K. Sinfield, D. Talbot, A. Farooqi and M. J. Davies. (2007). Physical activity and sedentary behaviours of South Asian and white European children in inner city secondary schools in the UK. Family Practice.

BACKGROUND: People of South Asian (SA) origin have an increased risk of premature coronary heart disease. In children of SA origin, there is an increased prevalence of obesity and evidence of insulin resistance. Risk factors for cardiovascular disease in children often persist into adulthood. Low levels of physical activity are likely to be linked to the rise in obesity. OBJECTIVE: To determine levels of physical activity and sedentary behaviours in secondary school pupils in the UK, including comparison of SA and white European (WE) children and those with and without a family history of cardiovascular disease. METHOD: Questionnaire survey conducted within an action research study in five inner city secondary schools serving a predominantly SA population. RESULTS: We obtained 3601 responses from 76% of eligible pupils. WE pupils were more likely to have walked to and from school compared to SAs. However, overall we identified low levels of physical activity and higher levels of inactive behaviours in both ethnic groups. Almost half (46%) of respondents spent four or more hours per day watching television or videos or playing computer games. An overall low level of active behaviour during school breaks was particularly emphasized in girls. We found no evidence of an association between physical activity levels and family history of cardiovascular disease. CONCLUSIONS: There is an urgent need for those with responsibility for young people's health, including parents, schools and community health providers, to consider and address the need for effective interventions to encourage increased physical activity levels.

R. T. Kimbro, J. Brooks-Gunn and S. McLanahan. (2007). Racial and ethnic differentials in overweight and obesity among 3-year-old children. American Journal of Public Health.

OBJECTIVES: We estimated racial/ethnic differences in overweight and obesity in a national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences. METHODS: Survey, in-home observation, and interview data were collected at birth, 1 year, and 3 years. We used logistic regression analyses and adjusted for a range of covariates in examining overweight and obesity differentials according to race/ethnicity. RESULTS: Thirty-five percent of the study children were overweight or obese. Hispanic children were twice as likely as either Black or White children to be overweight or obese. Although we controlled for a wide variety of characteristics, we were unable to explain either White-Hispanic or Black-Hispanic differences in overweight and obesity. However, birthweight, taking a bottle to bed, and mother's weight status were important predictors of children's overweight or obesity at age 3 years. CONCLUSIONS: Children's problems with overweight and obesity begin as early as age 3, and Hispanic children and those with obese mothers are especially at risk.

S. K. Kumanyika. (2007). Environmental influences on childhood obesity: Ethnic and cultural influences in context. Physiology & Behavior.

Ethnicity is associated with differences in food-related beliefs, preferences, and behaviors, and cultural influences may contribute to the higher than average risk of obesity among children and youth in U.S. ethnic minority populations. However, cultural attitudes and beliefs are not the only potential source of ethnic variation in childhood obesity prevalence and should not be studied in isolation. Demographic, socio-structural, and environmental variables must also be considered. Available evidence indicates ethnic differences along several pathways that may increase risks of obesity development during gestation, infancy, childhood and adolescence. These include above-average prevalence of obesity in adult females and of maternal diabetes during pregnancy, parental attitudes and practices that may lead to overfeeding children, above-average levels of consumption of certain high calorie foods and beverages, and inadequate physical activity. Environments with lower than average neighborhood availability of healthful foods and higher than average availability of fast food restaurants, along with exposure to ethnically targeted food marketing may contribute to reliance on high calorie foods and beverages, and these foods may be socially and culturally valued. Attitudes about and environmental contexts for physical activity are also relevant. Increasingly, it is acknowledged that individual behaviors and lifestyles, e.g. food choices or child feeding practices, are responsive to the ecological contexts in which they are practiced. Focusing attention on the fluid interactions of cultural influences with contextual factors, of recognized importance for the study of childhood undernutrition, can also lead to further understanding of how to address ethnic disparities in childhood obesity.

M. J. Lal and S. Abraham. (2007). Cultural differences of school-aged girls in the nature of disordered eating and exercise in India and Australia. Journal Of Psychosomatic Obstetrics And Gynecology.
D. D. Langevin, C. Kwiatkowski, G. McKay, J. O. Maillet, R. Touger-Decker, J. K. Smith and A. Perlman. (2007). Evaluation of diet quality and weight status of children from a low socioeconomic urban environment supports "at risk" classification. Journal Of The American Dietetic Association.

This cross-sectional study evaluated diet quality and weight status in 248 randomly selected low-income urban children, aged 7 to 13 years, who were participating in a larger study on the effectiveness of multivitamin supplementation on school performance. Food frequency questionnaires were used to determine intake of total calories and food groups, selected micronutrients, and amount and percent of calories from sweets. Results were compared to age-appropriate recommendations of the Food Guide Pyramid and to the Dietary Reference Intakes. Height, weight, and ages obtained from current-year student health records were used to calculate body mass index (calculated as kg/m(2)) percentile for age. Of 193 participants with usable food frequencies and available weight, height, sex, and age, 22% (n=43) were at risk for overweight and 36% (n=69) were overweight. More than 75% of participants failed to meet recommended servings for grains, vegetables, dairy, and fruit groups, and mean intake of each of these food groups was significantly less than recommendations (P < 0.001). Twenty-five percent or more of subjects did not meet Recommended Dietary Allowances for iron and folate. Mean intake of calcium was below the Adequate Intake for calcium and 76% of children 8 years old and. younger and 93% of children 9 years old and older did not meet the Adequate Intake for calcium. Mean calorie intake was 1,723 kcal (standard deviation +/- 924) and mean percent of calories from carbohydrate, protein, and fat was 57%, 13%, and 32%, respectively. No correlation was found between total calories, total dietary sugar, or percent of calories from sweets and body mass index. Results of this study suggest that these urban children may be "at risk," based on the high percentage who are overweight and have insufficient food group consumption and micronutrient intake.

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