Self-determined motivation, physical exercise and diet in obese children: A three-year follow-up study

Effects of physical activity on body mass and composition of school-age children and adolescents with overweight or obesity: Systematic review focusing on intervention characteristics

OBJECTIVE

The characteristics of physical activity (PA) interventions to improve body mass and composition in pediatric populations are unclear. This systematic review summarized the effects of PA on those outcomes in school-age children and adolescents with overweight or obesity, focusing on training components (frequency, intensity, duration, and type - FITT).

METHODS

Databases were searched for controlled trials applying exclusive PA and including children (5-12 y) or adolescents (13-17 y) with overweight/obesity.

RESULTS

Twenty-seven trials yielding 34 interventions were included. PA was recreational (children: k = 9, n = 478), systematized (children: k = 18, n = 565); or combined (children: k = 7, n = 205). Successful interventions were performed for 6- to 35 weeks (mostly 12-14 weeks), 2- to 5 d/wk (mostly 3 d/wk), during 8- to 60 min (mainly 60 min) with moderate to high intensity (60-90% maximal heart rate or 40-70% heart rate reserve). Half of the interventions applying recreational (4 out of 8), 59% of systematized (10 out of 17), and 57% of combined (4 out of 7) interventions reported improvements in body mass or composition, especially body fat. Benefits were more often reported for body composition (18 out of 34 interventions) than body mass (8 out of 34 interventions), irrespective of the age group.

CONCLUSION

Recreational and systematized PA may improve body mass, and particularly body composition in school-age children and adolescents with overweight or obesity. Successful programs were performed for at least six weeks and applied a PA amount consistent with the minimum recommended for pediatric populations (≥60 min of moderate-to-vigorous PA at least 3 d/wk).

The influence of active video game play upon physical activity and screen-based activities in sedentary children

Background

Few children meet physical activity recommendations, partly due to the prevalence of screen-based sedentary activities. Active video game (AVG) play produces light to moderate physical activity. Yet, providing children access to AVG does not increase physical activity, possibly because children who play AVG may also tend towards sedentary screen-based activities. How multiple days of AVG play influences children’s choice of other activities is not yet known.

Purpose

To examine how AVG influences children’s physical activity, sedentary screen-based activities, and other alternative activities.

Methods

Sedentary children (N = 49) played AVG 3 times/week and sedentary video games (SVG) ad libitum for 6 weeks, followed by 4 weeks of ad libitum play of both AVG and SVG. Participants wore an activity monitor for 7 days and completed a 24-hour activity recall on 4 randomly selected days at baseline, week 6, and week 10.

Results

AVG play increased during the intervention (p < 0.01). Light activity and SVG play both decreased baseline to 10 weeks (p = 0.006) and 6 to 10 weeks (p = 0.017). Non-SVG sedentary behavior increased from baseline to 10 weeks (p = 0.005) and 6 to 10 weeks (p = 0.007). Changes over time were not observed in physical activity, or recall-measured active play, social activities, other hobbies, television or computer/phone use.

Conclusion

AVG play did not change children’s objectively-measured physical activity or subjectively measured active play. SVG time was substituted with other sedentary behaviors. AVG did not increase time engaged in SVG or screen-based devices.

Physical Illiteracy and Obesity Barrier: How Physical Education Can Overpass Potential Adverse Effects? A Narrative Review

Environments lacking in stimuli together with ineffective physical education programs can lead to motor illiteracy, causing several adverse effects that could be worsened by unhealthy weight conditions (e.g., obesity). Obesity can be seen as an actual barrier for children and adolescents, especially for affective, behavioral, physical, and cognitive domains. In this context, condensing what the literature proposes could be useful in order to improve the understanding of the best intervention strategies (i.e., proper physical education programs) to manage the adverse effects of motor illiteracy in relation to the obesity barrier. The purpose of this narrative review is to improve the understanding on how physical education programs can counteract the adverse effects of physical illiteracy and obesity barrier across childhood and adolescence. Proper physical education programs should develop motor competence by fostering an individual’s awareness, self-perception, autonomous motivation, and muscular fitness on a realistic scenario (functional task difficulty related to his/her possibilities) in the attempt to counteract the adverse effects of the obesity barrier. Such programs should be designed without overlooking a proper multi teaching style approach.

Validation of the Spanish Healthy Lifestyle Questionnaire

Background/Objective: It is essential to carry out a diagnosis of people's healthy lifestyles, in order to apply strategies to improve them. The aim of the study was to validate the Healthy Lifestyles Questionnaire (CEVS-II), collecting all factors that make up the concept of a healthy lifestyle, such as a balanced diet, respect for mealtimes, tobacco consumption, rest habits, alcohol consumption, other drug use and physical activity. Method: The questionnaire was completed by 1,132 people between 18 and 89 (M = 42.43; SD = 18.69) years from different parts of Spain. Results: The seven-factor model proposed by the Confirmatory Factor Analysis, according to the goodness indices, presented an acceptable fit (SRMR = .059; CFI = .973; RMSEA = .049; 90% CI [.046, .052]; χ 2/df = 3.76), also presented good reliability indices and was endowed with concurrent validity. Conclusions: The results of the present study proved the validity and reliability of the Healthy Lifestyles Questionnaire in a Spanish population, which is an adequate instrument for the diagnosis of a healthy lifestyles in the Spanish population.

Integrating Self-determination Theory and Upper Limb Factors to Predict Physical Activity in Patients With Breast Cancer During Chemotherapy

BACKGROUND

Some empirical investigations try to describe the factors that affect the physical activity of breast cancer survivors, but these investigations rarely focus on the basic psychological needs or motivation regulation of breast cancer survivors in physical activity.

OBJECTIVE

The aim of this study was to construct structural equation modeling of the self-determination theory and upper limb factors to predict the physical activity of breast cancer patients during chemotherapy.

METHODS

A total of 236 breast cancer survivors completed measures of basic psychological needs, behavioral regulation in exercise, symptoms and dysfunction of upper limb factors, and physical activity. Path analyses structured the direct and indirect effects (via motivational orientations) of basic psychological needs and upper limb factors on physical activity.

RESULTS

A total of 216 (91.5%) participants met the standard physical activity metabolic equivalent recommended. The final model has a good degree of fit (χ2 = 809.363, df = 391, χ2/df ≤ 2.07 [1-3]; root-mean-square error of approximation, 0.067 [<0.008]). The competence (0.309) of basic psychological needs and amotivation (-0.38) of motivation regulations have the greatest effect on physical activity.

CONCLUSIONS

Competence is the most important basic psychological need of breast cancer patients during chemotherapy, and amotivation is the most important motivation regulation.

IMPLICATIONS FOR PRACTICE

Nurses need to pay more attention to the basic psychological needs and the motivation regulation in breast cancer patients during chemotherapy. Randomized controlled trials of breast cancer survivor interventions based on the self-determination theory are needed.

Multicomponent Exercise Training Combined with Nutritional Counselling Improves Physical Function, Biochemical and Anthropometric Profiles in Obese Children: A Pilot Study

Aerobics or strength exercise plus diet interventions have been shown to counteract childhood obesity. However, little is known with regard to periodized multicomponent exercise interventions combined with nutritional counselling, which might be less demanding but more enjoyable and respectful of children and adolescents’ nature. In order to analyze the impact of such a multimodal approach, 18 obese children (10.8 ± 1.6 years; 63% females; z Body Mass Index 3 ± 0.4) trained for 60 min, twice weekly and were measured for body composition, biochemical parameters and physical function. We found that 16 weeks of multimodal intervention (14 of training), based on fun-type skill-learning physical activities and physical conditioning with challenging circuits and games, together with nutritional counselling, led to an attendance > 80%, with significant overall health improvement. Body composition was enhanced (p < 0.01 for z BMI, mid-upper-arm-circumference, waist-to-height ratio, tricipital and subscapular skinfolds, body-fat % by Slaughter equation and Dual energy X-ray absorptiometry body fat% and trunk fat%), as well as metabolic profile (LDL cholesterol, gamma-glutamyl transferase , alanine aminotransferase ; p < 0.05), homeostatic model assessment of insulin resistance (HOMA-IR; p < 0.05) and inflammatory response (C-Reactive Protein; p < 0.05). Physical fitness was also improved (p < 0.01) through better cardiovascular test scores and fundamental movement patterns (Functional Movement Screen-7, FMS-4). Tailoring multimodal supervised strategies ensured attendance, active participation and enjoyment, compensating for the lack of strict caloric restrictions and the low volume and training frequency compared to the exercise prescription guidelines for obesity. Nutritional counselling reinforced exercise benefits and turned the intervention into a powerful educational strategy. Teamwork and professionals’ specificity may also be key factors.

Psychological aspects of diet: Development and validation of three measures assessing dietary goal-desire incongruence, motivation, and satisfaction with dietary behavior

OBJECTIVE

The current research created and validated three new measures of psychological mechanisms associated with dietary behavior: (i) a Dietary Goal-Desire Incongruence scale assessed the degree of conflict between ideal dietary behavior and incongruent tempting desires; (ii) a Motivation for Dietary Self-control scale measured the extent and type of motivation, according to Self-Determination Theory, which may be experienced when trying to control dietary behavior; and (iii) a Satisfaction with Dietary Behavior scale measured successful dietary goal-behavior alignment.

METHOD

A representative sample of Australian adults (N = 448, M_age = 45.7 years, SD = 16.98, 50.2% women) rated items assessing the three target constructs and also completed established scales that measure related and unrelated constructs.

RESULTS

Exploratory factor analyses indicated a 1-factor Dietary Goal-Desire Incongruence scale (6 items), 3-factor Motivation for Dietary Self-control scale (11 items), and a 1-factor Satisfaction with Dietary Behavior scale (8 items). Confirmatory factor analyses also supported the model fit of each scale's factor solution. Internal consistency as assessed by Cronbach's alpha (α) was 0.94, 0.78, and 0.94 for the three scales, respectively. A follow-up mediation analysis revealed a stage model of psychological factors related to dietary behavior (as assessed by these three scales) that build on each other. Test-retest reliability was high for each scale (r = .71-.84) and showed sound predictive validity.

CONCLUSION

The Dietary Goal-Desire Incongruence scale, Motivation for Dietary Self-control scale, and Satisfaction with Dietary Behavior scale show good psychometric properties and are brief, easy to administer measures. The utility of the scales can be explored further with other populations and in intervention studies.

The Reasons for Doing Physical Exercise Mediate the Effect of Self-Esteem on Uncontrolled Eating Amongst Nursing Personnel

BACKGROUND

Since the beginning of the 20th century, the importance of creating healthy work environments and promoting the health of workers in the healthcare sector to create Healthy and Resilient Organizations has been emphasized. In this context, self-esteem is an essential construct which influences health and healthy life styles, and, therefore, the general wellbeing of nurses. The objective of this study was to analyze the mediating role of reasons for exercising in the effect that self-esteem has on uncontrolled eating by nursing professionals.

METHODS

The sample was made up of 1094 nurses who were administered the Rosenberg General Self-Esteem Scale, the Goal Content for Exercise Questionnaire, and the Three-Factor Eating Questionnaire-R18.

RESULTS

Bivariate correlation analysis and multiple mediation analysis showed that self-esteem has direct and indirect effects on uncontrolled eating. Moreover, self-esteem determines whether one does physical exercise to improve one's image, recognition, or social affiliation-although the effects on uncontrolled eating were only significant in the case of image.

CONCLUSIONS

The results have important practical implications in the framework of Positive Occupational Health Psychology (POHP) as they emphasize self-esteem, physical exercise and eating as essential aspects of the health and wellbeing of employees in the healthcare sector, highlighting the importance of creating organizations committed to promoting the psychosocial health of their workers.

The Intention to be Physically Active in Sedentary Obese Children: A Longitudinal Study

Obese children are usually less active than their normal-weight counterparts, although the reasons for this remain unclear. The objective of the present study was to determine how a long-term program (3 years of intervention and 6 months of follow-up detraining) of physical exercise with or without a low calorie diet influenced sedentary obese children’s intention to be physically active. The participants were 27 children, ages from 8 to 11 years, who formed two groups according to the program that they followed. One group followed an exercise program (three 90-min sessions per week), and the other this same exercise program together with a hypocaloric diet. The intention to be physically active was assessed via the Measurement of Intention to be Physically Active (MIFA) questionnaire. The subjects’ scores at different times of the program (baseline, Year 3, and detraining) were compared using a repeated-measures ANOVA, and a post-hoc Tukey’s test was applied to confirm the differences. After both the intervention and detraining, both groups showed greater intention to be physically active. This suggests the suitability of long-term physical exercise to generate greater intention to be physically active and thus establish healthy life habits including increased levels of physical activity.

Effects of high-intensity interval training on physical capacities and substrate oxidation rate in obese adolescents

PURPOSE

To investigate the effects of a 3-week weight-management program entailing moderate energy restriction, nutritional education, psychological counseling and three different exercise training (a: low intensity, LI: 40 % V'O₂max; b: high intensity, HI: 70 % V'O₂max; c: high-intensity interval training, HIIT), on body composition, energy expenditure and fat oxidation rate in obese adolescents.

METHODS

Thirty obese adolescents (age: 15-17 years, BMI: 37.5 kg m^-2) participated in this study. Before starting (week 0, W0) and at the end of the weight-management program (week 3, W3), body composition was assessed by an impedancemeter; basal metabolic rate (BMR), energy expenditure and substrate oxidation rate were measured during exercise and post-exercise recovery by indirect calorimetry.

RESULTS

At W3, body mass (BM) and fat mass (FM) decreased significantly in all groups, the decreases being significantly greater in the LI than in the HI and HIIT subgroups (BM: -8.4 ± 1.5 vs -6.3 ± 1.9 vs -4.9 ± 1.3 kg and FM: -4.2 ± 1.9 vs -2.8 ± 1.2 vs -2.3 ± 1.4 kg, p < 0.05, respectively). V'O₂peak, expressed in relative values, changed significantly only in the HI and HIIT groups by 0.009 ± 0.005 and 0.007 ± 0.004 L kg FFM^-1 min^-1 (p < 0.05). Furthermore, the HI and HIIT subgroups exhibited a greater absolute rate of fat oxidation between 50 and 70 % V'O₂peak at W3. No significant changes were observed at W3 in BMR, energy expenditure during exercise and post-exercise recovery.

CONCLUSION

A 3-week weight-management program induced a greater decrease in BM and FM in the LI than in the HI and HIIT subgroups, and greater increase in V'O₂peak and fat oxidation rate in the HI and HIIT than in the LI subgroup.

Is high-intensity interval training more effective on improving cardiometabolic risk and aerobic capacity than other forms of exercise in overweight and obese youth? A meta-analysis

BACKGROUND

The scientific interest in high-intensity interval training (HIIT) has greatly increased during recent years.

OBJECTIVE

The objective of this meta-analysis was to determine the effectiveness of HIIT interventions on cardio-metabolic risk factors and aerobic capacity in overweight and obese youth, in comparison with other forms of exercise.

DATA SOURCES

A computerized search was made using seven databases.

STUDY ELIGIBILITY CRITERIA

The analysis was restricted to studies that examined the effect of HIIT interventions on cardio-metabolic and/or aerobic capacity in pediatric obesity (6-17 years old).

PARTICIPANTS AND INTERVENTIONS

Nine studies using HIIT interventions were selected (n = 274).

STUDY APPRAISAL AND SYNTHESIS METHODS

Standarized mean difference (SMD) and 95% confidence intervals were calculated. The DerSimonian-Laird approach was used.

RESULTS

HIIT interventions (4-12 week duration) produced larger decreases in systolic blood pressure (SMD = 0.39; -3.63 mmHg) and greater increases in maximum oxygen uptake (SMD = 0.59; 1.92 ml/kg/min) than other forms of exercise. Also, type of comparison exercise group and duration of study were moderators.

CONCLUSIONS

HIIT could be considered a more effective and time-efficient intervention for improving blood pressure and aerobic capacity levels in obese youth in comparison to other types of exercise. © 2016 World Obesity.

Influence of parents and physical education teachers in adolescent physical activity

The objective of this study was to analyze the influence of parents and Physical Education teachers on adolescent's extracurricular Physical Activity. Data were obtained from the Chilean System for the Assessment of Educational Quality test with a large representative sample of 23,180 students (11,927 females and 11,253 males aged 13.7 and 13.8 years respectively). The analyzed variables were the extracurricular physical activity of adolescents, parents' and physical education teachers' encouragement to do physical activity and parents' physical activity behavior. Associations between variables were analyzed using chi-squared tests. Two logistic regression models, one adjusted and the other unadjusted, were performed for each physical activity variable (vigorous, moderate, mild and total) in order to obtain odds ratios from parents' and physical education teachers' influence variables. Results showed that parents' influence is more relevant than physical education teachers' influence in order to promote physical activity in adolescents, regardless of age, sex and physical condition.