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Webber BJ, Whitfield GP, Moore LV, Stowe E, Omura JD, Pejavara A, Galuska DA, Fulton JE. Physical Activity-Friendly Policies and Community Design Features in the US, 2014 and 2021. Prev Chronic Dis 2023; 20:E72. [PMID: 37590901 PMCID: PMC10457105 DOI: 10.5888/pcd20.220397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION The 2014 Community-Based Survey of Supports for Healthy Eating and Active Living documented the prevalence of US municipal policy and community design supports for physical activity. The survey was repeated in 2021. Our study examined change in the prevalence of supports from 2014 to 2021, overall and by municipality characteristic. METHODS Municipalities were sampled independently each survey year. We calculated prevalence in 2014 and 2021 and the prevalence ratio (PR) for 15 supports covering zoning codes, park policies and budgets, design standards, Complete Streets policies, and shared use agreements. We used a Bonferroni-corrected Breslow-Day test to test for interaction by municipality characteristic. RESULTS In 2014 (2,009 municipalities) compared with 2021 (1,882 municipalities), prevalence increased for several zoning codes: block sizes of walkable distances (PR = 1.46), minimum sidewalk width (PR = 1.19), pedestrian amenities along streets (PR = 1.15), continuous sidewalk coverage (PR = 1.14), and building orientation to pedestrian scale (PR = 1.08). Prevalence also increased for design standards requiring dedicated bicycle infrastructure for roadway expansion projects or street retrofits (PR = 1.19). Prevalence declined for shared use agreements (PR = 0.87). The prevalence gap widened between the most and least populous municipalities for Complete Streets policies (from a gap of 33.6 percentage points [PP] in 2014 to 54.0 PP in 2021) and for zoning codes requiring block sizes that were walkable distances (from 11.8 PP to 41.4 PP). CONCLUSION To continue progress, more communities could consider adopting physical activity-friendly policies and design features.
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Onufrak SJ, Moore LV, Pierce SL, MacGowan CA, Galuska DA. Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL). Prev Chronic Dis 2023; 20:E73. [PMID: 37590900 PMCID: PMC10457115 DOI: 10.5888/pcd20.230018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet. METHODS We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics. RESULTS In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021. CONCLUSION Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.
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Sharfman AS, Berrigan D, Galuska DA, Khan LK, Stowe EW, Reedy J. National Collaborative on Childhood Obesity Research Efforts to Advance Childhood Obesity Research: Progress and Next Steps. Am J Prev Med 2023:S0749-3797(23)00095-8. [PMID: 36935334 PMCID: PMC10363226 DOI: 10.1016/j.amepre.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/21/2023]
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Stowe EW, Moore LV, Hamner HC, Park S, Gunn JP, Juan W, Kantor MA, Galuska DA. Meeting the Healthy People 2030 Added Sugars Target. Am J Prev Med 2023:S0749-3797(23)00062-4. [PMID: 36907748 DOI: 10.1016/j.amepre.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Many Americans exceed the dietary recommendations for added sugars. Healthy People 2030 set a population target mean of 11.5% calories from added sugars for persons aged ≥2 years. This paper describes the reductions needed in population groups with varying added sugars intake to meet this target using 4 different public health approaches. METHODS Data from the 2015-2018 National Health and Nutrition Examination Survey (n=15,038) and the National Cancer Institute method were used to estimate the usual percentage calories from added sugars. Four approaches investigated lowering intake among (1) the general U.S. population, (2) people exceeding the 2020-2025 Dietary Guidelines for Americans recommendation for added sugars (≥10% calories/day), (3) high consumers of added sugars (≥15% calories/day), or (4) people exceeding the Dietary Guidelines for Americans recommendation for added sugars with 2 different reductions on the basis of added sugars intake. Added sugars intake was examined before and after reduction by sociodemographic characteristics. RESULTS To meet the Healthy People 2030 target using the 4 approaches, added sugars intake needs to decrease by an average of (1) 13.7 calories/day for the general population; (2) 22.0 calories/day for people exceeding the Dietary Guidelines for Americans recommendation; (3) 56.6 calories/day for high consumers; or (4) 13.9 and 32.3 calories/day for people consuming 10 to <15% and ≥15% calories from added sugars, respectively. Differences in added sugars intake were observed before and after reduction by race/ethnicity, age, and income. CONCLUSIONS The Healthy People 2030 added sugars target is achievable with modest reductions in added sugars intake, ranging from 14 to 57 calories/day depending on the approach.
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Paluch AE, Bajpai S, Ballin M, Bassett DR, Buford TW, Carnethon MR, Chernofsky A, Dooley EE, Ekelund U, Evenson KR, Galuska DA, Jefferis BJ, Kong L, Kraus WE, Larson MG, Lee IM, Matthews CE, Newton RL, Nordström A, Nordström P, Palta P, Patel AV, Pettee Gabriel K, Pieper CF, Pompeii L, Rees-Punia E, Spartano NL, Vasan RS, Whincup PH, Yang S, Fulton JE. Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis. Circulation 2023; 147:122-131. [PMID: 36537288 PMCID: PMC9839547 DOI: 10.1161/circulationaha.122.061288] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Taking fewer than the widely promoted "10 000 steps per day" has recently been associated with lower risk of all-cause mortality. The relationship of steps and cardiovascular disease (CVD) risk remains poorly described. A meta-analysis examining the dose-response relationship between steps per day and CVD can help inform clinical and public health guidelines. METHODS Eight prospective studies (20 152 adults [ie, ≥18 years of age]) were included with device-measured steps and participants followed for CVD events. Studies quantified steps per day and CVD events were defined as fatal and nonfatal coronary heart disease, stroke, and heart failure. Cox proportional hazards regression analyses were completed using study-specific quartiles and hazard ratios (HR) and 95% CI were meta-analyzed with inverse-variance-weighted random effects models. RESULTS The mean age of participants was 63.2±12.4 years and 52% were women. The mean follow-up was 6.2 years (123 209 person-years), with a total of 1523 CVD events (12.4 per 1000 participant-years) reported. There was a significant difference in the association of steps per day and CVD between older (ie, ≥60 years of age) and younger adults (ie, <60 years of age). For older adults, the HR for quartile 2 was 0.80 (95% CI, 0.69 to 0.93), 0.62 for quartile 3 (95% CI, 0.52 to 0.74), and 0.51 for quartile 4 (95% CI, 0.41 to 0.63) compared with the lowest quartile. For younger adults, the HR for quartile 2 was 0.79 (95% CI, 0.46 to 1.35), 0.90 for quartile 3 (95% CI, 0.64 to 1.25), and 0.95 for quartile 4 (95% CI, 0.61 to 1.48) compared with the lowest quartile. Restricted cubic splines demonstrated a nonlinear association whereby more steps were associated with decreased risk of CVD among older adults. CONCLUSIONS For older adults, taking more daily steps was associated with a progressively decreased risk of CVD. Monitoring and promoting steps per day is a simple metric for clinician-patient communication and population health to reduce the risk of CVD.
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Lee SH, Zhao L, Park S, Moore LV, Hamner HC, Galuska DA, Blanck HM. High Added Sugars Intake among US Adults: Characteristics, Eating Occasions, and Top Sources, 2015-2018. Nutrients 2023; 15:nu15020265. [PMID: 36678136 PMCID: PMC9867287 DOI: 10.3390/nu15020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
The 2020−2025 Dietary Guidelines for Americans (DGA) recommends less than 10% of total daily calories come from added sugars. However, many adults overconsume added sugars putting them at risk for poor health outcomes. We examined characteristics of high added sugars consumers among US adults (≥20 years) and described their top 10 sources of added sugars intake using National Health and Nutrition Examination Survey 2015−2018 data (n = 9647). We defined high consumers as consuming >15% of daily calories from added sugars (1.5 times higher than the DGA). We used the National Cancer Institute method to estimate usual intake of energy and percent of calories from added sugars. Top 10 sources were identified based on their percentage contribution to total added sugars intake on a given day. T-tests were used to examine differences by age, sex, race/ethnicity, education, income, marital status, and weight status. Overall, mean usual total energy intake and added sugars intake was 2068 kcal/day and 264 kcal/day, respectively, and 30% of adults were classified as high consumers. The prevalence of high added sugars consumers was significantly higher among 20−30-year-olds (29%), 31−50-year-olds (33%), and 51−70-year-olds (29%) than those aged ≥70 years (22%); non-Hispanic Black (39%) and non-Hispanic White (31%) adults than Hispanics (26%); adults with <high school (37%), high school/GED (38%), or some college (34%) than adults with college or higher (15%); adults living in lower-income households (39% for federal poverty income ratio < 130% and 35% for 130%−<350%) than high-income households (21%). The prevalence of high consumers did not differ by sex or weight status. Top sources of added sugars were sweetened beverages (42%), tea (12%), sweet bakery products (11%), and jams/syrups/sugars (7%). Our findings can inform intervention efforts to decrease added sugars intake to support health.
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O’Toole TP, Blanck HM, Flores-Ayala R, Rose K, Galuska DA, Gunn J, O’Connor A, Petersen R, Hacker K. Five Priority Public Health Actions to Reduce Chronic Disease Through Improved Nutrition and Physical Activity. Health Promot Pract 2022; 23:5S-11S. [DOI: 10.1177/15248399221120507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Paluch AE, Bajpai S, Bassett DR, Carnethon MR, Ekelund U, Evenson KR, Galuska DA, Jefferis BJ, Kraus WE, Lee IM, Matthews CE, Omura JD, Patel AV, Pieper CF, Rees-Punia E, Dallmeier D, Klenk J, Whincup PH, Dooley EE, Pettee Gabriel K, Palta P, Pompeii LA, Chernofsky A, Larson MG, Vasan RS, Spartano N, Ballin M, Nordström P, Nordström A, Anderssen SA, Hansen BH, Cochrane JA, Dwyer T, Wang J, Ferrucci L, Liu F, Schrack J, Urbanek J, Saint-Maurice PF, Yamamoto N, Yoshitake Y, Newton RL, Yang S, Shiroma EJ, Fulton JE. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. THE LANCET PUBLIC HEALTH 2022; 7:e219-e228. [PMID: 35247352 PMCID: PMC9289978 DOI: 10.1016/s2468-2667(21)00302-9] [Citation(s) in RCA: 170] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background Although 10 000 steps per day is widely promoted to have health benefits, there is little evidence to support this recommendation. We aimed to determine the association between number of steps per day and stepping rate with all-cause mortality. Methods In this meta-analysis, we identified studies investigating the effect of daily step count on all-cause mortality in adults (aged ≥18 years), via a previously published systematic review and expert knowledge of the field. We asked participating study investigators to process their participant-level data following a standardised protocol. The primary outcome was all-cause mortality collected from death certificates and country registries. We analysed the dose–response association of steps per day and stepping rate with all-cause mortality. We did Cox proportional hazards regression analyses using study-specific quartiles of steps per day and calculated hazard ratios (HRs) with inverse-variance weighted random effects models. Findings We identified 15 studies, of which seven were published and eight were unpublished, with study start dates between 1999 and 2018. The total sample included 47 471 adults, among whom there were 3013 deaths (10.1 per 1000 participant-years) over a median follow-up of 7.1 years ([IQR 4.3–9.9]; total sum of follow-up across studies was 297 837 person-years). Quartile median steps per day were 3553 for quartile 1, 5801 for quartile 2, 7842 for quartile 3, and 10 901 for quartile 4. Compared with the lowest quartile, the adjusted HR for all-cause mortality was 0.60 (95% CI 0.51–0.71) for quartile 2, 0.55 (0.49–0.62) for quartile 3, and 0.47 (0.39–0.57) for quartile 4. Restricted cubic splines showed progressively decreasing risk of mortality among adults aged 60 years and older with increasing number of steps per day until 6000–8000 steps per day and among adults younger than 60 years until 8000–10 000 steps per day. Adjusting for number of steps per day, comparing quartile 1 with quartile 4, the association between higher stepping rates and mortality was attenuated but remained significant for a peak of 30 min (HR 0.67 [95% CI 0.56–0.83]) and a peak of 60 min (0.67 [0.50–0.90]), but not significant for time (min per day) spent walking at 40 steps per min or faster (1.12 [0.96–1.32]) and 100 steps per min or faster (0.86 [0.58–1.28]). Interpretation Taking more steps per day was associated with a progressively lower risk of all-cause mortality, up to a level that varied by age. The findings from this meta-analysis can be used to inform step guidelines for public health promotion of physical activity.
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Saint-Maurice PF, Graubard BI, Troiano RP, Berrigan D, Galuska DA, Fulton JE, Matthews CE. Estimated Number of Deaths Prevented Through Increased Physical Activity Among US Adults. JAMA Intern Med 2022; 182:349-352. [PMID: 35072698 PMCID: PMC8787676 DOI: 10.1001/jamainternmed.2021.7755] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This cohort study uses National Health and Nutrition Examination Survey data to estimate the number of deaths that could be prevented through increased physical activity among US adults.
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Omura JD, Kochtitzky CS, Galuska DA, Fulton JE, Shah S, Carlson SA. Public Health Representation on Active Transportation Bodies Across US Municipalities. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E119-E126. [PMID: 32487920 PMCID: PMC10939047 DOI: 10.1097/phh.0000000000001170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Municipal bodies such as planning or zoning commissions and active transportation advisory committees can influence decisions made by local governments that support physical activity through active transportation. Public health professionals are encouraged to participate in and inform these processes. However, the extent of such collaboration among US municipalities is currently unknown. OBJECTIVE To estimate the prevalence of active transportation bodies among US municipalities and the proportion with a designated public health representative. DESIGN A cross-sectional survey administered from May through September 2014. SETTING Nationally representative sample of US municipalities with populations of 1000 or more people. PARTICIPANTS Respondents were the city or town manager, planner, or person with similar responsibilities (N = 2018). MAIN OUTCOME MEASURES The prevalence of planning or zoning commissions and active transportation advisory committees among municipalities and whether there was a designated public health representative on them. RESULTS Approximately 90.9% of US municipalities have a planning or zoning commission, whereas only 6.5% of these commissions have a designated public health representative. In contrast, while 16.5% of US municipalities have an active transportation advisory committee, 22.4% of them have a designated public health representative. These active transportation bodies are less common among municipalities that are smaller, rural, located in the South, and where population educational attainment is lower. Overall, few US municipalities have a planning or zoning commission (5.9%) or an active transportation advisory committee (3.7%) that also has a designated public health representative. CONCLUSIONS Approximately 9 in 10 US municipalities have a planning or zoning commission, whereas only 1 in 6 has an active transportation advisory committee. Public health representation on active transportation bodies across US municipalities is low. Increasing the adoption of active transportation advisory committees and ensuring a designated public health representative on active transportation bodies may help promote the development of activity-friendly communities across the United States.
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Ballard R, Arteaga SS, Berrigan D, Devlin HM, Galuska DA, Hamner HC, Kettel Khan L, Moore LV, Pannucci TE, Reedy J, Sharfman AS. Advancing Measurement to Address Childhood Obesity: Results of 3 Workshops. Am J Prev Med 2021; 61:e296-e304. [PMID: 34801209 DOI: 10.1016/j.amepre.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 01/27/2023]
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Pan L, Blanck HM, Galuska DA, Freedman DS, Lovellette G, Park S, Petersen R. Changes in High Weight-for-Length among Infants Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children during 2010-2018. Child Obes 2021; 17:408-419. [PMID: 33960827 PMCID: PMC8554792 DOI: 10.1089/chi.2021.0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Infants and young children with high weight-for-length are at increased risk for obesity in later life. This study describes prevalence of high weight-for-length and examines changes during 2010-2018 among 11,366,755 infants and young children 3-23 months of age in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods: Children's weights and lengths were measured. High weight-for-length was defined as ≥2 standard deviations above sex and age-specific median on World Health Organization growth charts. Adjusted prevalence differences (APDs) between years were calculated as 100 times marginal effects from logistic regression models. APD was statistically significant if 95% confidence interval did not include 0. Results: Adjusted prevalence of high weight-for-length decreased from 2010 to 2014, and leveled off through 2018 overall, in boys and girls, those 6-11 and 18-23 months of age, and non-Hispanic whites, non-Hispanic blacks, Hispanics, and Asians/Pacific Islanders. For 12-17 months old and American Indian/Alaska Native infants and young children, adjusted prevalence decreased from 2010 to 2014, and then increased slightly through 2018. Among 56 WIC state or territorial agencies, 33 had significant decreases between 2010 and 2018, whereas 8 had significant increases. Between 2014 and 2018, prevalence decreased significantly in 12 agencies and increased significantly in 23. Conclusions: The results indicate overall declines in prevalence of high weight-for-length from 2010 to 2018, with a prevalence stabilization since 2014. Continued surveillance is needed. Obesity prevention strategies in WIC and multiple settings are important for ensuring healthy child growth.
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Ussery EN, Whitfield GP, Fulton JE, Galuska DA, Matthews CE, Katzmarzyk PT, Carlson SA. Trends in Self-Reported Sitting Time by Physical Activity Levels Among US Adults, NHANES 2007/2008-2017/2018. J Phys Act Health 2021; 18:S74-S83. [PMID: 34465647 PMCID: PMC8477754 DOI: 10.1123/jpah.2021-0221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND High levels of sedentary behavior and physical inactivity increase the risk of premature mortality and several chronic diseases. Monitoring national trends and correlates of sedentary behavior and physical inactivity can help identify patterns of risk in the population over time. METHODS The authors used self-reported data from the National Health and Nutrition Examination Surveys (2007/2008-2017/2018) to estimate trends in US adults' mean daily sitting time, overall, and stratified by levels of leisure-time and multidomain physical activity, and in the joint prevalence of high sitting time (>8 h/d) and physical inactivity. Trends were tested using orthogonal polynomial contrasts. RESULTS Overall, mean daily sitting time increased by 19 minutes from 2007/2008 (332 min/d) to 2017/2018 (351 min/d) (Plinear < .05; Pquadratic < .05). The highest point estimate occurred in 2013/2014 (426 min/d), with a decreasing trend observed after this point (Plinear < .05). Similar trends were observed across physical activity levels and domains, with one exception: an overall linear increase was not observed among sufficiently active adults. The mean daily sitting time was lowest among highly active adults compared with less active adults when using the multidomain physical activity measure. CONCLUSIONS Sitting time among adults increased over the study period but decreased in recent years.
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Paluch AE, Bassett DR, Carnethon MR, Cuthbertson CC, Ekelund U, Evenson KR, Galuska DA, Jefferis BJ, Kraus WE, Lee IM, Matthews CE, Omura JD, Patel AV, Rees-Punia E, Pieper CF, Fulton JE. The Steps For Health Collaborative: A Description Of Baseline Steps In 11 Prospective Cohort Studies. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000761644.91917.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zhao L, Ogden CL, Yang Q, Jackson SL, Loria CM, Galuska DA, Wiltz JL, Merritt R, Cogswell ME. Association of Usual Sodium Intake with Obesity Among US Children and Adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021; 29:587-594. [PMID: 33528899 PMCID: PMC9134125 DOI: 10.1002/oby.23102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association of sodium intake with obesity in US children and adolescents. METHODS Cross-sectional data were analyzed for 9,026 children and adolescents in the National Health and Nutrition Examination Survey (NHANES) 2009-2016. Usual sodium intake was estimated from 24-hour dietary recalls using a measurement error model. Logistic regression was used to assess the association of sodium intake with overweight/obesity, obesity, and central obesity (waist to height ratio [WtHR] ≥ 0.5; waist circumferences (WC) ≥ age- and sex-specific 90th percentile). RESULTS Mean (SE) sodium intake was 3,010 (9) and 3,404 (20) mg/d for children and adolescents, respectively. The adjusted odds ratio (AOR) comparing Q4 versus Q1 (87.5th vs. 12.5th percentile of sodium intake) among children was 1.98 (95% CI: 1.19-3.28) for overweight/obesity, 2.20 (1.30-3.73) for obesity, 2.10 (1.12-3.95) for WC ≥ 90th percentile, and 1.68 (0.95-2.97) for WtHR ≥ 0.5, adjusting for demographics, energy, and sugar-sweetened beverage intake. Among adolescents, AOR was 1.81 (0.98-3.37) for overweight/obesity, 1.71 (0.82-3.56) for obesity, 1.62 (0.71-3.66) for WC ≥ 90th percentile, and 1.73 (0.85-3.50) for WtHR ≥ 0.5. CONCLUSIONS Sodium intake was positively associated with overweight/obesity, obesity, and central obesity among US children independent of energy and SSB intake, but the association did not reach significance among adolescents.
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Li R, Perrine CG, Anstey EH, Chen J, MacGowan CA, Elam-Evans LD, Galuska DA. Early Formula Supplementation Trends by Race/Ethnicity Among US Children Born From 2009 to 2015. JAMA Pediatr 2021; 175:201-204. [PMID: 32870259 PMCID: PMC7489384 DOI: 10.1001/jamapediatrics.2020.2670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This survey study uses data from the National Immunization Survey–Child to examine trends in early formula supplementation by race/ethnicity among US children born during the period from 2009 to 2015.
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Lange SJ, Moore LV, Harris DM, Merlo CL, Lee SH, Demissie Z, Galuska DA. Percentage of Adolescents Meeting Federal Fruit and Vegetable Intake Recommendations - Youth Risk Behavior Surveillance System, United States, 2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:69-74. [PMID: 33476311 PMCID: PMC7821769 DOI: 10.15585/mmwr.mm7003a1] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nelson JM, Grossniklaus DA, Galuska DA, Perrine CG. The mPINC survey: Impacting US maternity care practices. MATERNAL AND CHILD NUTRITION 2020; 17:e13092. [PMID: 33150737 PMCID: PMC7729529 DOI: 10.1111/mcn.13092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/06/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022]
Abstract
The Centers for Disease Control and Prevention administered the original Maternity Practices in Infant Nutrition and Care (mPINC) survey, a census of all US birth facilities, from 2007 to 2015 to monitor infant feeding-related maternity care practices and policies. The purpose of this paper is to describe the many uses of mPINC data. Hospitals, organizations and governments (federal, state and local) have used the mPINC survey as a tool for improving care among the populations they serve. Nationally, the mPINC survey has been used to document marked improvements in infant feeding-related maternity care. Researchers have used the mPINC data to examine a variety of questions related to maternity care practices and policies. The newly revised mPINC survey (2018) has been designed to capture changes that have occurred over the past decade in infant feeding-related US maternity care. Hospitals, organizations, governments and researchers will be able to continue using this important tool in their efforts to ensure US maternity care practices and policies are fully supportive of breastfeeding.
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Hall KS, Hyde ET, Bassett DR, Carlson SA, Carnethon MR, Ekelund U, Evenson KR, Galuska DA, Kraus WE, Lee IM, Matthews CE, Omura JD, Paluch AE, Thomas WI, Fulton JE. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. Int J Behav Nutr Phys Act 2020; 17:78. [PMID: 32563261 PMCID: PMC7305604 DOI: 10.1186/s12966-020-00978-9] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Daily step counts is an intuitive metric that has demonstrated success in motivating physical activity in adults and may hold potential for future public health physical activity recommendations. This review seeks to clarify the pattern of the associations between daily steps and subsequent all-cause mortality, cardiovascular disease (CVD) morbidity and mortality, and dysglycemia, as well as the number of daily steps needed for health outcomes. METHODS A systematic review was conducted to identify prospective studies assessing daily step count measured by pedometer or accelerometer and their associations with all-cause mortality, CVD morbidity or mortality, and dysglycemia (dysglycemia or diabetes incidence, insulin sensitivity, fasting glucose, HbA1c). The search was performed across the Medline, Embase, CINAHL, and the Cochrane Library databases from inception to August 1, 2019. Eligibility criteria included longitudinal design with health outcomes assessed at baseline and subsequent timepoints; defining steps per day as the exposure; reporting all-cause mortality, CVD morbidity or mortality, and/or dysglycemia outcomes; adults ≥18 years old; and non-patient populations. RESULTS Seventeen prospective studies involving over 30,000 adults were identified. Five studies reported on all-cause mortality (follow-up time 4-10 years), four on cardiovascular risk or events (6 months to 6 years), and eight on dysglycemia outcomes (3 months to 5 years). For each 1000 daily step count increase at baseline, risk reductions in all-cause mortality (6-36%) and CVD (5-21%) at follow-up were estimated across a subsample of included studies. There was no evidence of significant interaction by age, sex, health conditions or behaviors (e.g., alcohol use, smoking status, diet) among studies that tested for interactions. Studies examining dysglycemia outcomes report inconsistent findings, partially due to heterogeneity across studies of glycemia-related biomarker outcomes, analytic approaches, and sample characteristics. CONCLUSIONS Evidence from longitudinal data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. However, the shape of the dose-response relation is not yet clear. Data are currently lacking to identify a specific minimum threshold of daily step counts needed to obtain overall health benefit.
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Pan L, Blanck HM, Park S, Galuska DA, Freedman DS, Potter A, Petersen R. State-Specific Prevalence of Obesity Among Children Aged 2-4 Years Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children - United States, 2010-2016. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:1057-1061. [PMID: 31751324 PMCID: PMC6871901 DOI: 10.15585/mmwr.mm6846a3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lange SJ, Moore LV, Galuska DA. Data for Decision-Making: Exploring the Division of Nutrition, Physical Activity, and Obesity's Data, Trends, and Maps. Prev Chronic Dis 2019; 16:E131. [PMID: 31560645 PMCID: PMC6795071 DOI: 10.5888/pcd16.190043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Public health practitioners need quick and easy access to reliable surveillance data to monitor states' progress over time, compare benchmarks nationally or among states, and make strategic decisions about priorities and resources. Data, Trends, and Maps (DTM) at https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html is a free, online interactive database that houses and displays data on nutrition, physical activity, breastfeeding, and obesity that practitioners can use for public health action. Created in 2015 by the Centers for Disease Control and Prevention's (CDC) Division of Nutrition, Physical Activity, and Obesity, DTM was updated and relaunched in April 2017 with the capability to customize and download data sets directly; DTM also has other user-friendly features, such as visualization options. Since its relaunch, DTM has received more than 386,000 page views from approximately 110,000 unique visitors. However, the potential exists for more widespread use of DTM if more public health practitioners understood what the site offered and how others have used it in the field. Here, we explain how public health practitioners can explore the most recent state-level data on nutrition, physical activity, breastfeeding, and obesity and use this data to inform programmatic and policy efforts to prevent and control chronic diseases. We demonstrate 3 different ways practitioners can visualize data (ie, Explore by Location, Explore by Topic, and the Open Data Portal) and present 3 real-world examples to highlight DTM's utility as a public health tool.
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Pan L, Freedman DS, Park S, Galuska DA, Potter A, Blanck HM. Changes in Obesity Among US Children Aged 2 Through 4 Years Enrolled in WIC During 2010-2016. JAMA 2019; 321:2364-2366. [PMID: 31211336 PMCID: PMC7187898 DOI: 10.1001/jama.2019.5051] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Whitfield GP, Carlson SA, Ussery EN, Fulton JE, Galuska DA, Petersen R. Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults - United States, 2008-2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:513-518. [PMID: 31194722 PMCID: PMC6613551 DOI: 10.15585/mmwr.mm6823a1] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD. The Physical Activity Guidelines for Americans. JAMA 2018; 320:2020-2028. [PMID: 30418471 PMCID: PMC9582631 DOI: 10.1001/jama.2018.14854] [Citation(s) in RCA: 2877] [Impact Index Per Article: 479.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Approximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases. OBJECTIVE To summarize key guidelines in the Physical Activity Guidelines for Americans, 2nd edition (PAG). PROCESS AND EVIDENCE SYNTHESIS The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. RECOMMENDATIONS The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial. CONCLUSIONS AND RELEVANCE The Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.
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Ussery EN, Fulton JE, Galuska DA, Katzmarzyk PT, Carlson SA. Joint Prevalence of Sitting Time and Leisure-Time Physical Activity Among US Adults, 2015-2016. JAMA 2018; 320:2036-2038. [PMID: 30458482 PMCID: PMC6248166 DOI: 10.1001/jama.2018.17797] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/19/2018] [Indexed: 11/14/2022]
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