A high-sugar/low-fiber meal compared with a low-sugar/high-fiber meal leads to higher leptin and physical activity levels in overweight Latina females

Acute effects of high-sugar/low-fiber meals vs low-sugar/high-fiber meals on hormones and behavior were studied in 10 overweight Latina females, age 11 to 12 years, using a crossover design. In this exploratory pilot study, participants arrived fasted at an observation laboratory on two occasions and randomly received either a high-sugar/low-fiber meal or a low-sugar/high-fiber meal at each visit. Glucose, insulin, and leptin were assayed from serum drawn at 0, 15, 30, 60, 90, and 120 minutes. Ad libitum snacks were provided at 120 minutes. Physical activity was measured using an observational system that provides data on time spent lying down, sitting, standing, walking, and in vigorous activity. Data were collected between March 2005 and July 2006. In the high-sugar/low-fiber condition, glucose and leptin levels decreased more slowly, glucose levels were higher at 60 minutes (111.2 mg/dL vs 95.4 mg/dL, P=0.03), and leptin levels were higher at 90 minutes (49.3 ng/mL vs 46.7 ng/mL, P=0.017) than in the low-sugar/high-fiber condition. Meals did not affect insulin or ad libitum dietary intake. Sitting, standing, lying down, and vigorous activity differed by condition, but not walking. Participants were significantly more active in the first 30 to 60 minutes after the high-sugar/low-fiber meal, but after 60 minutes there was a trend for activity to be lower after the high-sugar/low-fiber meal vs the low-sugar/high-fiber meal. High-sugar meals sustain glucose and leptin levels longer, which may play an important role in modulating levels of physical activity in this group at high risk for obesity-related disease.

School Physical Education: The Pill Not Taken

Physical education programs in schools have the potential to promote healthy, active lifestyles by providing children with some of their recommended physical activity, increasing their physical fitness levels, and teaching them generalizable movement and behavioral skills. If “exercise is medicine,” physical education is the pill not taken. Numerous barriers, including limited curriculum time allocations, low subject status, and inadequate resources hinder physical education from playing a major role in providing and promoting physical activity. This article profiles physical education as it relates to physical activity, describes its current status from both historical and contextual standpoints, and concludes with recommendations for improving it.

School design and physical activity among middle school girls

Building design and grounds might contribute to physical activity, and youth spend much of their daylight hours at school. We examined the associations among school building footprints, the size of school grounds, and in-school physical activity of 1566 sixth-grade girls from medium to large middle schools enrolled in the Trial of Activity for Adolescent Girls (TAAG). The school building footprint and the number of active outdoor amenities were associated with physical activity among adolescent girls. On average, the school footprint size accounted for 4% of all light physical activity and 16% of all MET-weight moderate-to-vigorous physical activity (MW-MVPA) during school hours. Active outdoor amenities accounted for 29% of all MW-MVPA during school. School design appears to be associated with physical activity, but it is likely that programming (eg, physical education, intramurals, club sports), social factors, and school siting are more important determinants of total physical activity.

Physical activity levels of children in special schools

OBJECTIVE

Children's physical activity (PA) has been studied extensively, but little information is available on those with disabilities. We sought to examine the PA of children with disabilities during physical education (PE) and recess while simultaneously documenting environmental conditions.

METHOD

Five schools designed for students with four types of special needs (physical disability, mild intellectual disability, hearing impairment, and visual impairment) participated. We used the System for Observing Fitness Instruction Time (SOFIT) to code the PA of children in grades 4 to 6 during both PE and recess and to document teacher behavior and lesson context in PE. Observations were conducted during 2 school days over a 2-week period.

RESULTS

Children accrued little moderate-to-vigorous physical activity (MVPA) during PE (7.8 min) and recess (8.9 min). Activity levels varied across disability types, with differences attributed to lesson context and teacher behavior. Children with physical disabilities were the least active during both PE and recess.

CONCLUSIONS

Children with disabilities accrue little PA at school. Increased PE frequency and lesson intensity, more PA opportunities during non-structured school time, and collaborations with home and community agencies are needed to reach PA recommendations.

Commercial venues as supports for physical activity in adolescent girls

OBJECTIVE

The purposes of this study were to describe the types and availability of commercial facilities for physical activity (PA) in six diverse geographic areas (Washington DC and Maryland; South Carolina; Minnesota; Louisiana; Arizona; and California) and to assess the relationship between those facilities and the non-school PA of adolescent girls.

METHODS

A total of 1556 6th grade girls participating in the Trial of Activity for Adolescent Girls (TAAG) wore accelerometers for 7 days providing 6 days of complete data, completed questionnaires in 2003 and had their residential addresses geocoded. Nearby commercial facilities available to provide PA (i.e. dance studios, youth organizations) within a 1-mile radius of participants' residences were identified and geocoded. The association between the presence of any commercial PA facility and girls' PA was determined using a multi-level design and controlling for demographic characteristics and other potential confounders. Analyses were conducted in 2005-2006.

RESULTS

Sixty-eight percent of the girls had at least one commercial PA facility near their homes. Availability and types of commercial PA facilities differed by where participants lived. Girls who lived near one or more commercial PA facilities had higher non-school MET-weighted moderate-to-vigorous PA than girls who had none near their homes.

CONCLUSIONS

The findings suggest that commercial PA facilities are important contributors to the accumulation of PA among adolescent girls.

Contribution of public parks to physical activity

OBJECTIVES

Parks provide places for people to experience nature, engage in physical activity, and relax. We studied how residents in low-income, minority communities use public, urban neighborhood parks and how parks contribute to physical activity.

METHODS

In 8 public parks, we used direct observation to document the number, gender, race/ethnicity, age group, and activity level of park users 4 times per day, 7 days per week. We also interviewed 713 park users and 605 area residents living within 2 miles of each park.

RESULTS

On average, over 2000 individuals were counted in each park, and about two thirds were sedentary when observed. More males than females used the parks, and males were twice as likely to be vigorously active. Interviewees identified the park as the most common place they exercised. Both park use and exercise levels of individuals were predicted by proximity of their residence to the park.

CONCLUSIONS

Public parks are critical resources for physical activity in minority communities. Because residential proximity is strongly associated with physical activity and park use, the number and location of parks are currently insufficient to serve local populations well.

Girls' activity levels and lesson contexts in middle school PE: TAAG baseline

PURPOSE

To assess girls' physical activity (PA) in middle school physical education (PE) as it relates to field site, lesson context and location, teacher gender, and class composition.

METHODS

We observed girls' PA levels, lesson contexts, and activity promotion by teachers in 431 lessons in 36 schools from six field sites participating in the Trial of Activity for Adolescent Girls. Interobserver reliabilities exceeded 90% for all three categories. Data were analyzed using mixed-model ANOVA with controls for clustering effects by field site and school.

RESULTS

Mean lesson length was 37.3 (+/-9.4) min. Time (13.9+/-7.0 min) and proportion of lessons (37.9+/-18.5%) spent in moderate to vigorous PA (MVPA), and time (4.8+/-4.2 min) and proportion of lessons (13.1+/-11.7%) in vigorous PA (VPA) differed by field site (P<0.004). Lesson time for instructional contexts differed by field site, with overall proportions as follows: game play (27.3%), management (26.1%), fitness activities (19.7%), skill drills (12.1%), knowledge (10.6%), and free play (4.4%). Coed classes were 7.9 min longer than girls-only classes (P=0.03). Although 27 s shorter, outdoor lessons were more intense (MVPA%=45.7 vs 33.7% of lesson, P<0.001) and provided 4.0 more MVPA minutes (P<0.001). MVPA, VPA, and lesson contexts did not differ by teacher gender. There was little direct promotion of PA by teachers during lessons.

CONCLUSIONS

Substantial variation in the conduct of PE exists. Proportion of lesson time girls spent accruing MVPA (i.e., 37.9%) fell short of the Healthy People 2010 objective of 50%. Numerous possibilities exist for improving girls' PA in PE.

Public parks and physical activity among adolescent girls

OBJECTIVES

Physical activity may be constrained or facilitated by local environments. The availability of neighborhood facilities for physical activity may be particularly relevant for youth, who are unable to drive and whose activity is often limited to the immediate distance they are able to walk or bicycle. Several studies have shown that proximity to recreational facilities and parks is one of the most important predictors of physical activity. Because the United States already has an extensive infrastructure of parks, with 70% of adults indicating that they live within walking distance of a park or playground, parks may be a potential venue for increasing physical activity. This might be particularly important for adolescent girls, whose physical activity levels decline substantially as they go through puberty. The goal of this study was to examine the association between park proximity, park type, and park features and physical activity in adolescent girls.

PATIENTS AND METHODS

This was a cross-sectional study using baseline data from the Trial of Activity for Adolescent Girls. It included 1556 grade 6 girls who were randomly selected from 6 middle schools in each of the following 6 field site areas: Washington, DC, and Baltimore, Maryland; Columbia, South Carolina; Minneapolis, Minnesota; New Orleans, Louisiana; Tucson, Arizona; and San Diego, California. Girls wore accelerometers for 6 days to measure metabolic equivalent-weighted moderate-to-vigorous physical activity, a measure accounting for the volume and intensity of activity. Metabolic equivalent-weighted moderate-to-vigorous physical activity was calculated for the hours outside of school time using 2 different cutpoints, activity levels > or = 3.0 metabolic equivalents and > or = 4.6 metabolic equivalents, the latter indicating activity at the intensity of a brisk walk or higher. We mapped all of the parks within 1 mile of each girl's home. Trained staff used a checklist to document the presence of facilities and amenities at each park, including passive amenities, such as drinking fountains, restrooms, and areas with shade, as well as active amenities like basketball courts, multipurpose fields, playgrounds, and tennis courts.

RESULTS

Mean nonschool metabolic equivalent-weighted moderate/vigorous physical activity, using the 4.6 metabolic equivalent cutoff, was 611.1 minutes (range: 49.7-4718.6 metabolic equivalent minutes per 6 days) and 1704.8 metabolic equivalent minutes per 6 days (range: 276.2-5792.6 metabolic equivalent minutes per 6 days) when using the 3.0 metabolic equivalent cutpoint. Many girls had multiple parks within a 1-mile radius of their homes: 57% had > or = 1 type of park, the majority being neighborhood or community parks; 42% had between 1 and 3 parks, 37% had > or = 4 parks, and 14% had > or = 8 parks. The type, number, and specific parks features were associated with girls' nonschool metabolic equivalent-weighted moderate/vigorous physical activity. At the 4.6 metabolic equivalent cutpoint, higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity were associated with both neighborhood and community parks (22 metabolic equivalent minutes) and miniparks (40 metabolic equivalent minutes). Each park, regardless of type, in the half-mile around each girl's home was associated with an increase in nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 2.8% or 17.2 nonschool minutes of metabolic equivalent-weighted moderate/vigorous physical activity per 6 days. Beyond a half-mile, each park increased nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 1.1% or 6.7 metabolic equivalent minutes per 6 days. For the average girl with 3.5 parks within a 1-mile radius of home, the presence of parks accounted for 36.5 extra nonschool metabolic equivalent minutes per 6 days, approximately 6% of total nonschool metabolic equivalent-weighted moderate/vigorous physical activity. Using the 3.0 metabolic equivalent cutpoint, this sums to an additional 68 metabolic equivalent minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity over 6 days, or 4% of the total. The most common amenities in the parks were playgrounds, multipurpose fields, and picnic areas. Slightly more than one third of girls lived within a half-mile of a park with a basketball court, and > 20% had access to walking paths and tennis courts in their local park. Higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity per 6 days were associated with walking paths (13 metabolic equivalent minutes), running tracks (82 metabolic equivalent minutes), playgrounds (28 metabolic equivalent minutes), and basketball courts (30 metabolic equivalent minutes). Parks with streetlights and floodlights were also associated with an increase of 18 and 22 minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity, respectively. With the 3.0 metabolic equivalent cutoff for metabolic equivalent-weighted moderate/vigorous physical activity, additional nonschool metabolic equivalent minutes more than doubled when girls had miniparks (92 metabolic equivalent minutes), natural resource areas (36 metabolic equivalent minutes), walking paths (59 metabolic equivalent minutes), and running tracks (208 metabolic equivalent minutes) within a half-mile of their homes. Skateboard areas and special-use parks were negatively associated with nonschool metabolic equivalent-weighted moderate/vigorous physical activity in adolescent girls.

CONCLUSIONS

Adolescent girls who live near more parks, particularly near those with amenities that are conducive to walking and with active features, engage in more nonschool metabolic equivalent-weighted moderate/vigorous physical activity than those with fewer parks. Whether this is because of actual use of the parks or neighborhood choice could not be determined. Although the magnitude of the association between parks and additional minutes of metabolic equivalent-weighted moderate/vigorous physical activity was small for an individual, amounting to an average of 4%-6% of a girl's total nonschool metabolic equivalent-weighted moderate/vigorous physical activity, it is likely to have a large population-level association. Because of the potential population level impact, the use of parks to promote physical activity should be further studied.

Active transportation to school over 2 years in relation to weight status and physical activity

OBJECTIVE

To prospectively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth.

RESEARCH METHODS AND PROCEDURES

A cohort of students from seven elementary schools was measured four times--in the fall and spring of fourth grade (N = 1083) and fifth grade (N = 924). Participants were classified as active (walking, biking, or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting) or non-active commuters to school. Accelerometers were used to measure physical activity. Height, weight, and skinfolds were objectively assessed.

RESULTS

Boys who actively commuted to school had lower BMI (p < 0.01) and skinfolds (p < 0.05) than non-active commuters to school in the fourth grade. Active commuting to school over 2 years was not associated with BMI change or overweight status.

DISCUSSION

Walking and cycling to school may contribute to preventing excessive weight gain, or leaner children may walk or cycle to school.

Data to action: using formative research to develop intervention programs to increase physical activity in adolescent girls

Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls' stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed.

System for Observing Play and Recreation in Communities (SOPARC): Reliability and Feasibility Measures

BACKGROUND: New tools are needed to examine physical activity and the contexts in which it occurs. Community parks contribute to physical activity, but measuring activity and associated variables in them is challenging because area contexts change and the numbers and characteristics of users are highly variable. METHODS: We developed SOPARC (System for Observing Play and Recreation in Communities) and tested its use by observing 16,244 individuals in 165 park areas. Reliabilities included 472 simultaneous measures by independent observers. RESULTS: Correlations between observers on number of area participants was 0.99 for female and male park users. Reliabilities (i.e., percent agreement) for age (89%, females; 85%, males), race/ethnic (80%, females; 82%, males), and activity level (80%, females; 88%, males) groupings met acceptable criteria. Reliabilities for area contexts (i.e., usable, accessible, supervised, organized, equipped) exceeded 94%. CONCLUSIONS: SOPARC is a reliable and feasible instrument for assessing physical activity and associated contextual data in community settings.

Using school-level interviews to develop a Multisite PE intervention program

The Trial of Activity for Adolescent Girls (TAAG) is a randomized, multicenter field trial in middle schools that aims to reduce the decline of physical activity in adolescent girls. To inform the development of the TAAG intervention, two phases of formative research are conducted to gain information on school structure and environment and on the conduct of physical education classes. Principals and designated staff at 64 eligible middle schools were interviewed using the School Survey during Phase 1. The following year (Phase 2), physical education department heads of the 36 schools selected into TAAG were interviewed. Responses were examined to design a standardized, multicomponent physical activity intervention for six regions of the United States. This article describes the contribution of formative research to the development of the physical education intervention component and summarizes the alignment of current school policies and practices with national and state standards.

Evaluating the sustainability of SPARK physical education: a case study of translating research into practice

Dissemination and sustainability of evidence-based physical education programs (PE) has been studied rarely. The sustainability of a health-related PE program (SPARK) was independently evaluated in 111 elementary schools in 7 states. Surveys were mailed to schools that had received SPARK curriculum books, training and follow-up (response rate = 47%). Up to 80% of schools that adopted SPARK PE reported sustained use up to 4 years later. Schools using SPARK had more frequent PE classes. Sustained use was related to support from the principal, not previously having a standard PE program, having adequate equipment, and teachers being physically active. Program sustainability was similar in advantaged and disadvantaged schools. Evidence-based PE programs can be sustained up to 4 years.

Viability of parks and recreation centers as sites for youth physical activity promotion

This descriptive study explored the potential for public parks and recreation centers as intervention sites for promoting physical activity among youth. Directors (55% women) of 44 recreation centers in San Diego County completed a survey of their centers' physical activity programming for youths ages 3 to 17 years (response rate = 60%). On an average weekday, 373 (SD = 782) youths participated in physical activity at a center. More boys attended than girls (p <.05). Some centers sponsored after-school programs at elementary (41%) and middle (11%) schools but not at high schools (0%). Primary barriers to providing physical activity programs were inadequate staffing (54%), funding (39%), and facilities (32%). Girls and low-income youth were identified as the most difficult populations to reach. Directors reported considerable interest in collaborating on interventions to improve youth activity programs. Public parks and recreation centers are understudied settings with the potential for substantial involvement in efforts to promote youth physical activity.

Evaluation of a Two-Year Middle-School Physical Education Intervention: M-SPAN

PURPOSE

School physical education (PE) is highly recommended as a means of promoting physical activity, and randomized studies of health-related PE interventions in middle schools have not been reported. We developed, implemented, and assessed an intervention to increase physical activity during middle-school PE classes.

METHODS

Twenty-four middle schools (approximately 25,000 students, 45% nonwhite) in Southern California participated in a randomized trial. Schools were assigned to intervention (N = 12) or control (N = 12) conditions, and school was the unit of analysis. A major component of the intervention was a 2-yr PE program, which consisted of curricular materials, staff development, and on-site follow-up. Control schools continued usual programs. Student activity and lesson context were observed in 1849 PE lessons using a validated instrument during baseline and intervention years 1 and 2.

RESULTS

The intervention significantly (P = 0.02) improved student moderate to vigorous physical activity (MVPA) in PE, by approximately 3 min per lesson. Effects were cumulative; by year 2 intervention schools increased MVPA by 18%. Effect sizes were greater for boys (d = 0.98; large) than girls (d = 0.68; medium).

CONCLUSIONS

A standardized program increased MVPA in middle schools without requiring an increase in frequency or duration of PE lessons. Program components were well received by teachers and have the potential for generalization to other schools. Additional strategies may be needed for girls.

Maintenance of effects of the CATCH physical education program: results from the CATCH-ON study

Long-term maintenance effects of physical education (PE) curriculum and staff development programs have not been studied. The authors assessed the sustainability of the Child and Adolescent Trial for Cardiovascular Health (CATCH) PE intervention using direct observations of 1,904 PE lessons in former intervention and control schools in four U.S. states 5-years postintervention. Student physical activity levels, lesson contexts, and level of CATCH PE training of teachers were analyzed. Student energy expenditure levels and proportion of PE time in moderate-to-vigorous physical activity in intervention schools were maintained 5 years later, but vigorous activity declined sharply. Meanwhile, postintervention gains in former control schools, influenced by delayed program implementation and secular trends, resulted in a convergence of activity levels in intervention and control schools. Use of CATCH PE curricula was associated with increased levels of teacher training and school support for PE in both former intervention and control schools.

Long-term implementation of the CATCH physical education program

To test the effectiveness of the Child and Adolescent Trial for Cardiovascular Health (CATCH) program, a randomized trial was conducted in 96 elementary schools in four regions of the United States. Results from the original trial indicated a significant positive effect on the delivery of physical education (PE). All 56 former intervention schools (FI), 20 randomly selected former control schools (FC), and 12 newly selected unexposed control schools (UC) were assessed 5 years postintervention. Results indicate a strong secular trend of increasing moderate to vigorous physical activity (MVPA) in PE classes among both FC and UC schools. The FI schools surpassed the Healthy People 2010 goal for MVPA during PE lesson time (i.e., 50%), whereas the FC and UC schools came close to it. Barriers to implementing CATCH PE included insufficient training and lower importance of PE compared to other academic areas and indicate the need for in-service training.

Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools

BACKGROUND

Our objective was to evaluate the effects of environmental, policy, and social marketing interventions on physical activity and fat intake of middle school students on campus.

DESIGN

Twenty-four middle schools were randomly assigned to intervention or control conditions. Baseline measures were collected in spring 1997, and interventions were conducted during the 1997-1998 and 1998-1999 school years SETTING/PARTICIPATION: The schools had mean enrollments of 1109, with 44.5% nonwhite students. Over 2 years, physical activity interventions were designed to increase physical activity in physical education classes and throughout the school day. Nutrition interventions were designed to provide and market low-fat foods at all school food sources, including cafeteria breakfasts and lunches, a la carte sources, school stores, and bag lunches. School staff and students were engaged in policy change efforts, but there was no classroom health education.

MAIN OUTCOMES MEASURES

Primary outcomes were measured by direct observation and existing records.

RESULTS

Randomized regression models (N =24 schools) revealed a significant intervention effect for physical activity for the total group (p <0.009) and boys (p <0.001), but not girls (p <0.40). The intervention was not effective for total fat (p <0.91) or saturated fat (p <0.79). Survey data indicated that the interventions reduced reported body mass index for boys (p <0.05).

CONCLUSIONS

Environmental and policy interventions were effective in increasing physical activity at school among boys but not girls. The interventions were not effective in reducing fat intake at school. School environmental and policy interventions have the potential to improve health behavior of the student population, but barriers to full implementation need to be better understood and overcome.

Assessment of a pilot video's effect on physical activity and heart health for young children

This article assessed the effects of a video, "Dynamotion," on children's knowledge, self-efficacy, and attitude about physical activity and heart health. A quasi-experimental design was used; 12 classrooms (grades K-2) were assigned to intervention (N = 116) or comparison (N = 92) groups. Students completed a 9-item pre- and posttest; only the intervention group was exposed to the video, during which qualitative assessments were made. Repeated measures analyses were used to detect changes. Overall, the intervention group had greater gains in knowledge and self-efficacy than did the comparison group (p < 0.001), and they seemed to enjoy the video. The results suggest that exposure to a short, interactive, educational video may promote health among young children.

Childhood movement skills: predictors of physical activity in Anglo American and Mexican American adolescents?

We assessed the relationship between young children's movement skills and their physical activity in early adolescence. Balance, agility, eye-hand coordination, and skinfold thicknesses in 207 Mexican American and Anglo American children (104 boys, 103 girls) were measured at ages 4, 5, and 6 years. Habitual physical activity was assessed at the age of 12 years by two interviewer-administered 7-day recalls. Ethnic differences in movement skills were not found. Young girls were better at jumping and balancing, and young boys were better at catching. Tracking of skills was low, and children's early childhood skills were not related to their physical activity 6 years later. Further studies involving additional movement skills and other populations are recommended to determine if enhanced movement skills in children promote subsequent physical activity.

Factors influencing the performance of volunteers who provide physical activity in middle schools

Increasing physical activity among youth represents a national health goal, and using volunteer activity providers at schools offers one possible solution. This paper describes results from a program to recruit volunteer physical activity providers in middle schools. Twenty-one volunteers provided 850 physical activity hours at seven schools, including 575 activity sessions and 7,186 student contacts. Volunteers who received incentives offered more minutes of activity, conducted more activity sessions, reached a greater number of students, and logged more student-minutes of physical activity than those who received none. Male volunteers provided more activity minutes than female volunteers, but females were marginally more successful in engaging female students. Results can help guide schools to more effectively increase student physical activity throughout the school day.

Changes and tracking of physical activity across seven years in Mexican-American and European-American mothers

Longitudinal changes in physical activity among 129 Mexican-American (mean age 30.8; SD = 5.6) and 97 European-American (mean age 31.2; SD = 5.4) women were studied. Two physical activity recall interviews were administered at baseline and 7 years later. At baseline, European-American women reported more vigorous leisure activity (p < .005) than Mexican-Americans, and Mexican-Americans reported more moderate work activity (p < .02) than European-Americans. Virtually all components of physical activity increased significantly over the 7 years. Pearson tracking correlations for total energy expenditure were about r = 0.30. The finding that both groups increased physical activity overtime was unexpected and was unrelated to a reduction in the number of preschool children in the homes over time.

Physical activity assessment options within the context of the Canadian Physical Activity, Fitness, and Lifestyle Appraisal

The Canadian Physical Activity, Fitness, and Lifestyle Appraisal (CPAFLA) is a standardized battery of tests that is commonly used to assess asymptomatic individuals. This paper reviews evidence concerning the reliability, validity, and utility of the procedure currently used to assess habitual physical activity in the CPAFLA and surveys available physical activity assessment options. Special considerations related to age, gender, ethnicity, seasonal variations, and within-week variance are discussed. The potential assessment options are discussed with consideration given to the logistical and pragmatic constraints inherent in the CPAFLA. New technologies for future assessment of physical activity are briefly presented and recommendations for future research forwarded.

Effects of the CATCH physical education intervention: teacher type and lesson location

BACKGROUND

Substantial differences exist in how and where physical education (PE) is conducted in elementary schools throughout the United States. Few effectiveness studies of large-scale interventions to improve PE have been reported.

DESIGN

Multicenter randomized trial.

SETTING/ PARTICIPANTS

The Child and Adolescent Trial for Cardiovascular Health (CATCH) was implemented in PE classes in 96 schools (56 intervention, 40 control) in four study centers: California, Louisiana, Minnesota, and Texas.

INTERVENTION

The 2.5-year PE intervention consisted of professional development sessions, curricula, and follow-up consultations.

MAIN OUTCOME MEASURES

Intervention effects on student physical activity and lesson context in PE were examined by teacher type (PE specialists and classroom teachers) and lesson location (indoors and outdoors).

RESULTS

Differential effects by teacher type and lesson location were evidenced for both physical activity and lesson context. Observations of 2016 lessons showed that intervention schools provided more moderate-to-vigorous physical activity (p=0.002) and vigorous physical activity (p=0.02) than controls. Classroom teachers improved physical activity relatively more than PE specialists, but PE specialists still provided longer lessons and more physical activity. Classroom teachers increased lesson length (p=0.02) and time for physical fitness (p=0.03).

CONCLUSIONS

The intervention improved PE of both specialists' and classroom teachers' lessons. States and districts should ensure that the most qualified staff teaches PE. Interventions need to be tailored to meet local needs and conditions, including teacher type and location of lessons.

Parental provision of transportation for adolescent physical activity

BACKGROUND

Physical activity (PA) is important to adolescents' health. Parent transportation to activity locations is a practical strategy for increasing youth PA that has rarely been examined.

DESIGN

Cross-sectional surveys of students and parents.

SETTING/PARTICIPANTS

Ethnically diverse students (N=1678; 712 boys, 966 girls; M age=13.0 years) from 24 middle schools (grades six to eight) and their parents completed surveys (response rate=72%).

MAIN OUTCOME MEASURES

Frequency of parents transporting adolescents to PA locations was studied in relation to adolescents' reported participation in PA during the previous week and their involvement in sports and activity lessons during the past year.

RESULTS

Parents transported adolescents to PA locations 2.13 times per week, with boys being transported more often than girls (p=0.03). Ethnic/racial differences in frequency of transport were evidenced (p=0.002). Parent transportation for PA significantly contributed to girls' total PA (p=0.001) and their participation in sports/activity lessons (p=0.001). Transportation contributed marginally (p=0.06) to boys' total PA, but significantly to their participation in sports/activity lessons (p=0.001).

CONCLUSIONS

Parent provision of transportation to activity locations is associated with out-of-school PA in a diverse adolescent population. This variable should be targeted for intervention.

The association of school environments with youth physical activity

OBJECTIVES

This study assessed the association of school environmental characteristics with student physical activity on campus.

METHODS

Physical activity areas (n = 137) at 24 public middle schools were assessed for area type, size, and improvements (e.g., basketball courts). Student physical activity and the presence of equipment and supervision were directly observed before school, after lunch, and after school.

RESULTS

Environmental characteristics explained 42% of the variance in the proportion of girls who were physically active and 59% of the variance for boys.

CONCLUSIONS

School environments with high levels of supervision and improvements stimulated girls and boys to be more physically active.

Student activity levels, lesson context, and teacher behavior during middle school physical education

There is little research on students' engagement in physical activity in middle school physical education (PE). We observed student activity, lesson context, and teacher behavior in 430 PE lessons taught by 126 teachers in 24 schools. Variables were analyzed by mixed-model nested analyses of covariance. Boys were more active than girls overall and during skill drills, game play, and free play. Student activity varied by lesson context, with fitness activities producing the most activity. Class size was negatively associated with student activity. Daily PE contributed a weekly total of 25 min of vigorous activity and 83 min of moderate-to-vigorous activity--much less than national objectives. Results suggest that numerous opportunities exist for increasing student physical activity during middle school PE.

Physical activity behavior change: issues in adoption and maintenance

The many benefits of participation in regular moderate- or vigorous-intensity physical activity are well established, yet more than 60% of the population is sedentary or insufficiently active. Published studies have revealed that behavior modification and cognitive-behavior modification can be successfully used to assist patients, healthy adults, and youth in the adoption of physically active lifestyles. However, few studies with adults and youth have examined the maintenance of physical activity behavior beyond 6 months of adoption of this behavior. Maintenance of physical activity is critically important because ongoing participation in the behavior is necessary to sustain health benefits. Knowledge of effective intervention strategies for long-term maintenance of physical activity is at an early stage. The authors provide a summary of what is known about the maintenance of physical activity behavior in adults and youth and how physical activity behavior relates to other health behaviors such as smoking, as well as recommendations for research on physical activity behavior change and maintenance.

Leisure-time physical activity in school environments: an observational study using SOPLAY

BACKGROUND

Schools provide settings for physical activity (PA), but objective tools for measuring PA are lacking. We assessed an instrument to directly observe group PA and measured the leisure-time PA of adolescents throughout the school day.

METHODS

Leisure-time PA was studied by direct observation in 24 middle schools in Southern California using SOPLAY (System for Observing Play and Leisure Activity in Youth). SOPLAY uses momentary time sampling to record the activity of each individual as sedentary, walking, or very active.

RESULTS

The largest proportion of students visited activity areas at lunch time (19.5%), followed by before (4. 1%) and after school (2.1%). More boys than girls visited activity areas before school (33.4 vs 7.7) and at lunch time (148.8 vs 36.7). Boys in areas engaged in more moderate to vigorous PA than girls before school (59.6 vs 40%) and at lunch time (67.7 vs 51.7%).

CONCLUSIONS

Few students use opportunities to be physically active during lesiure time at school. Policies and environmental manipulations (e.g., supervision, equipment, structured programs) are needed to attract more adolescents, especially girls, to existing activity areas. The feasibility of SOPLAY for measuring group PA was established.

Correlations among physical activity and eating behaviors in 4- to 7-year-old Anglo- and Mexican-American children

Physical activity and dietary behaviors are often correlated in adults and adolescents. This association was examined in 351 Anglo- and Mexican-American children between the ages of 4 and 7 years. Behaviors were assessed by structured observations and interviews at home and school. Observed physical activity was significantly correlated with energy intake (r = .43), but was unrelated to the percentage of calories from total fat or saturated fat. Thus, interventions with young children to improve dietary behavior or physical activity should not be expected to automatically lead to changes in the other.

Effects of health-related physical education on academic achievement: project SPARK

The effects of a 2-year health-related school physical education program on standardized academic achievement scores was assessed in 759 children who completed Metropolitan Achievement Tests before and after the program. Schools were randomly assigned to condition: (a) Specialists taught the Sports, Play, and Active Recreation for Kids curriculum; (b) classroom teachers were trained to implement the curriculum; and (c) controls continued their usual programs. The Trained Teacher condition was superior to Control on Language, Reading, and Basic Battery. The Specialist condition was superior to Control on Reading, but inferior on Language. Despite devoting twice as many minutes per week to physical education as Controls, the health-related physical education program did not interfere with academic achievement. Health-related physical education may have favorable effects on students' academic achievement.

Predictors of change in children's physical activity over 20 months. Variations by gender and level of adiposity

BACKGROUND

Physical activity declines during childhood and determinants of this decline are poorly understood. The purpose of this prospective study was to examine modifiable psychological and social correlates of physical activity change over 20 months.

SUBJECTS

370 girls and 362 boys in public schools, studied through the 4th and 5th grades.

MEASURES

A physical activity index was computed from child reports, parent reports, and objective activity monitoring. Predictor variables were assessed by child and parent surveys.

RESULTS

In multiple regressions, after adjustments for demographic variables, psychological variables explained 4% of the variance in boys' physical activity change, parent variables explained 8%, and interactions with skinfolds explained 3%, for a total of 15% (unadjusted). Regarding change in girls' physical activity, psychological variables explained 3%, parent variables explained 1.5%, and interactions with skinfold explained 1.5%, for a total of 6% explained variance (unadjusted). There were differences in predictors among children with high and low levels of body fat.

CONCLUSIONS

Children's preferences for physical activity and frequency of parents transporting children to activity locations explained significant proportions of variance for girls and boys. The results support a dynamic model of the determinants of children's physical activity, but most of the variance was left unexplained.

Effects of physical activity interventions in youth. Review and synthesis

INTRODUCTION

Physical inactivity has been identified as an important public health concern for youth. School and community settings can be important infrastructures for promoting physical activity (PA). This paper reviews studies of physical activity in school and community settings among preschool through college-aged persons to determine characteristics and effects of interventions. Studies in progress are included.

METHODS

Studies from 1980 to 1997 testing physical activity interventions in schools and community settings were identified by computerized search methods and reference lists of published reviews. Studies needed to have used a quantitative assessment of PA, used a comparison or control group, included participants who were preschool through college age, and be conducted in the United States or foreign school or community settings. Significance of effects was examined overall and for various types of interventions.

RESULTS

Twenty-two school-based studies were reviewed, 14 completed and 8 in progress. Three studies were in countries other than the United States. The 8 studies in progress were all in the United States. Only 7 community studies were reviewed, all in the United States. Four studies were in progress. Several community studies involved a high percentage of African-American or Hispanic youth and their families. Studies showing the best results used randomized designs, valid and reliable measurements, and more extensive interventions. Some follow-up results showed PA was sustained after interventions ended.

CONCLUSIONS

The collection of school and community studies is limited for several age groups with none below third grade and only three at college age. There are few community studies. The most is known about upper-elementary-age-students, including the first multicenter randomized trial to report significant results for increasing moderate to vigorous physical activity (MVPA) in physical education (PE) and increase vigorous PA outside of school. A number of older study designs were weak and assessments less than optimal, but studies in progress are stronger. Special attention is needed for girls, middle schools, and community settings for all youth. More objective assessments are needed for measuring PA outside of school and in younger children, since they cannot provide reliable self-report.

Determinants of dietary intake in a sample of white and Mexican-American children

OBJECTIVE

To assess the influence of several potential psychosocial determinants on children's eating behavior.

PARTICIPANTS

Three hundred fifty-one Mexican-American and non-Hispanic white children (mean age = 4.4 years old at baseline) participated in the San Diego Study of Children's Activity and Nutrition for up to 2.5 years.

METHODS

Child's eating behavior was described by 3 dependent variables: total energy, percentage energy from fat, and sodium intake per 1,000 kcal. Dietary information was collected 4 days a year using a 24-hour food intake record, which was a combination of direct observation and interviews with food preparers. The 35 predictor variables from child, parental, demographic, and environmental domains were collected by behavioral observation, interviewer-administered questionnaires, and physical measurements.

STATISTICAL ANALYSES

Bivariate and regression analyses via mixed linear models were performed.

RESULTS

Variables from the children's domain (such as skinfold thickness and weight) had the strongest associations with energy intake; parental variables (such as fat avoidance behavior and prompts to increase children's food intake) were associated with child's percentage energy from fat and sodium intake. In regression analyses, parsimonious subsets of variables accounted for 46% of variance in energy intake (3 variables), 40% of the variance in percentage of energy from fat (4 variables), and 44% of variance in sodium intake per 1,000 kcal energy (1 variable) in between-subject variance components.

CONCLUSIONS

Fat and sodium intake of children may be improved by improving parents' nutrition habits and by having parents encourage children to eat a healthful diet. Few modifiable correlates of children's energy intake were identified.

Children's television viewing, body fat, and physical fitness

PURPOSE

The study examines the relationship between children's television (TV) viewing and physical fitness.

DESIGN

Cross-sectional data from questionnaires and objective measures were analyzed.

SETTING

Data were collected during the fall of 1990 from public elementary school students in a suburban California city.

SUBJECTS

Approximately 98% of eligible students participated. Of these, 10% were dropped due to missing data, yielding a final sample of 284 girls and 304 boys.

MEASURES

Children reported their amount of TV viewing on a typical summer day; parents reported their child's TV viewing on a typical weekday during the school year. Cardiovascular fitness was the 1-mile run/walk. Body fat was both the child's body mass index (BMI) and skinfolds. Additional measures included muscular strength/endurance and flexibility.

RESULTS

Mile run/walk times were associated with both parental (eta 2 = .051 and .031 for boys and girls, respectively) and child reports (eta 2 = .020 and .028) of the child's amount of TV viewing. Parental reports, but not child reports, of the child's TV viewing were related to BMI (eta 2 = .041 and .058) and skinfolds (eta 2 = .050 and .029). Neither measure of children's TV viewing was related to muscular strength/endurance or flexibility.

CONCLUSIONS

Children's TV viewing seems to be weakly and inconsistently related to various components of physical fitness. However, given the tracking of cardiovascular disease risk factors from childhood into adulthood and the high proportion of children who watch television, these relationships are worthy of further study.

Tracking of health-related fitness components in youth ages 9 to 12

PURPOSE

The purpose of this study was to examine the tracking of multiple health-related fitness components in children from fourth to sixth grade.

METHODS

A battery of fitness tests was used to measure 414 children (213 boys, 201 girls, mean = 9.48 yr, +/- 0.41) from three elementary schools in Southern California. Children were assessed during the fall and spring of each grade. Baseline scores were correlated (Spearman) with each subsequent time point.

RESULTS

For boys 3-yr correlations of body mass index (BMI) (0.89), skinfold thickness (0.80), sit-and-reach test (0.67), and the pull-up test (0.66) indicated high levels of tracking. Mile run (0.56), sit-up test (0.46), and waist-to-hip ratio (0.30) tracked moderately. For girls BMI (0.83), sum of skinfolds (0.75), sit-and-reach test (0.72), and the pull-up test (0.63) tracked highly, while mile run (0.42), sit-up test (0.47), and waist-to-hip ratio (0.42) tracked moderately.

CONCLUSIONS

Results suggest that relative rankings of BMI, skinfold thickness, and sit-and-reach test performance are more likely to track during early adolescence. Measures of cardiovascular fitness, muscular strength, and endurance and fat distribution may be less likely to track into adolescence, possibly because they are more influenced by changes in physical activity or because tracking may be reduced by measurement error.

Direct home observations of the prompting of physical activity in sedentary and active Mexican- and Anglo-American children

Social interactions are important correlates of physical activity in children. Previous studies used global measures; the present study examined the influence of specific social interactions on immediate physical activity in children with data obtained from the Behaviors of Eating and Activity for Child Health: Evaluation System (BEACHES). The study examined parental and peer prompting of physical activity at home among 178 Mexican-American and 113 Anglo-American children at age 4 years and again at age 6.5 years. Most activity prompts came from adults interacting with children when they were sedentary. A reduction in the frequency of prompts from baseline to follow-up occurred in the prompter group (adult or child peer), gender, ethnicity, and preprompted activity level categories. Children's responses to these prompts showed that as they aged, they seemed to rely less on the interpersonal (especially adult) aspects of their environment for cues to be more active.

Long-term effects of a physical education curriculum and staff development program: SPARK

This 4-year study, conducted in seven elementary schools assigned to three conditions--Physical Education Specialists (PES), Trained Classroom Teachers (TT), and Controls (CO)--had two parts. The first investigated effects of a health-related physical education program on quantity and quality of lessons. Specialists produced the best outcomes, and TT were significantly better than nontrained peers. Part Two assessed maintenance effects approximately 1.5 years after intervention termination. Withdrawal of specialists significantly reduced the quantity and quality of physical education. TT maintained PES frequency but with a loss in lesson quality and a decline in student activity to 88% of intervention levels. Results support employing specialists and demonstrate the need for extensive professional development for classroom teachers responsible for physical education.

Physical activity levels and prompts in young children at recess: a two-year study of a bi-ethnic sample

We investigated physical activity and encouragement for activity in a bi-ethnic cohort during recess. Activity and associated interactions of 287 children were recorded at preschool and again 2.2 years later. Children expended nearly twice as much energy at preschool recess than at elementary recess. Activity levels declined as recess time elapsed. At preschool, European-American children engaged in more moderate to vigorous activity than Mexican-Americans. As participants moved to elementary school, teachers' prompts to be active decreased and prompts from peers increased. Boys and girls received similar amounts of activity prompts at preschool, but prompts to boys increased over time. The findings suggest that school environments could be altered to promote healthful physical activity among young children.