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Carver A, Akram M, Barnett A, Huang WY, Gao GY, Mellecker RR, Cerin E. Family, school and individual characteristics associated with adolescents' physical activity at school in Hong Kong: the iHealt(H) study. Int J Behav Nutr Phys Act 2021; 18:14. [PMID: 33468170 PMCID: PMC7816388 DOI: 10.1186/s12966-021-01085-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents (11-18-year-olds) are at risk of physical inactivity. There is limited knowledge of physical activity (PA) levels among adolescents in the school setting in Hong Kong. We developed and tested a novel theoretical model of how household/family characteristics, school-level social and physical environmental factors and individual adolescent's characteristics impact on their school-based PA during and after school hours. METHODS Cross-sectional study participants were Hong Kong adolescents attending secondary school, paired with their parent/caregiver (n = 1299 dyads). Parents survey-reported on household/family characteristics, parental PA and rules related to PA. Adolescents survey-reported on school PA-friendly policy, PA equipment at school (combined to create PA-friendly index), social support for PA from peers, athletic ability, attitude to and enjoyment of PA. Adolescents self-reported their school-based PA during school hours (physical education; recess) and after school (sports teams/classes). Objectively-measured moderate-to-vigorous PA (MVPA) was measured using accelerometers for a sub-sample of adolescents (n = 588). Generalized additive mixed models were used to estimate how household/family-level and school-level factors, and adolescents' individual characteristics were related to adolescents' school-based PA in Hong Kong, and to identify potential mediators of these associations. RESULTS A complex network of potential pathways of influence on adolescents' school-based PA was identified. Overall, most of the significant effects were indirect ones. However, there were far fewer significant pathways between household/family characteristics and objectively-measured MVPA at school than there were for self-reported PA at school. In fact, there were no indirect pathways between these variables and MVPA at school. Gender disparities among pathways were identified. For example, school PA-friendly index was significantly associated with MVPA after school only among girls (eb = 1.06, 95%CI (1.02,1.12)). CONCLUSIONS Key points of intervention identified by our study may be in the re-design of PE classes so that adolescents spend more time being physically active during these classes, and promotion of active play during recess. Further research measuring amount, intensity and location of adolescents' PA using accelerometer and Global Positioning Systems is required in Hong Kong, as well as observational studies of PA during PE classes and in the schoolyard during recess, to guide the design of PA interventions.
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Affiliation(s)
- Alison Carver
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000 Australia
| | - Muhammad Akram
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000 Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000 Australia
| | | | | | | | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000 Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Ahmad A, Zulaily N, Shahril MR, Syed Abdullah EFH, Ahmed A. Association between socioeconomic status and obesity among 12-year-old Malaysian adolescents. PLoS One 2018; 13:e0200577. [PMID: 30044842 PMCID: PMC6059452 DOI: 10.1371/journal.pone.0200577] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 06/30/2018] [Indexed: 11/17/2022] Open
Abstract
The epidemic of obesity in developed countries is commonly associated with poor dietary habit and sedentary lifestyle. However, other determinants, including education background and family income, may contribute towards the problem especially in developing countries. This study aimed to determine the influence of socioeconomic status (SES) on obesity among 12-year-old school adolescents in Terengganu, Malaysia. Body weight and height were measured and BMI was categorised based on WHO z-score cut-off points. Information was obtained from self-reported questionnaire on parents' education background, family income and occupation. A total of 3,798 school adolescents aged 12 years (44% boys and 56% girls) were recruited. There was no significant difference in BMI status between boys and girls, or between rural and urban participants. There were significant differences between BMI categories and gender, household income and SES level within rural areas. In the urban areas, significant differences were found between BMI categories and gender, parents' occupational and educational level, household income and size, and SES level. A logistic regression model found several SES factors to be predictors of obesity in this population, namely, gender, household size, father's occupation level, household income level and SES level. Each component of SES has been significantly associated with the BMI category of school adolescents, particularly in the urban areas. This suggests the requirement of multifaceted approaches, including the role of family, society and authorities, in the effort to curtail adolescent obesity.
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Affiliation(s)
- Aryati Ahmad
- Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Nurzaime Zulaily
- Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Mohd Razif Shahril
- Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | | | - Amran Ahmed
- Institute of Engineering Mathematics, Pauh Putra Campus, Universiti Malaysia Perlis, Arau, Perlis, Malaysia
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Ferreira I, Gbatu PT, Boreham CA. Gestational Age and Cardiorespiratory Fitness in Individuals Born At Term: A Life Course Study. J Am Heart Assoc 2017; 6:e006467. [PMID: 28954725 PMCID: PMC5721855 DOI: 10.1161/jaha.117.006467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 08/04/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND In contrast to the effects of preterm birth, the extent to which shorter gestational age affects the cardiorespiratory fitness (CRF) levels of individuals who were born at term (ie, between 37 and 42 weeks) is largely unknown. The aim of this study was to examine whether life-course CRF levels varied across different gestational ages within the at-term range. METHODS AND RESULTS The association between gestational age (in weeks) obtained from Child Health Services records and CRF, estimated from field and laboratory tests and expressed by maximal oxygen uptake level through adolescence to young adulthood, was examined in 791 participants in the Northern Ireland Young Hearts Study, all singletons born at term. Longitudinal data were analyzed with generalized estimating equations, accounting for important potential confounders. Mean levels of CRF were 45.6, 43.7, and 33.0 mL/kg per minute when participants were aged 12, 15, and 22 years, respectively. After adjustment for confounders, each week increase in gestational age was associated with 0.46 mL/kg per minute (95% confidence interval, 0.14-0.79) in CRF. Compared with individuals born full term (39-40 weeks, n=533) or late term (41-42 weeks, n=148), those who were born early term (37-38 weeks, n=110) had a higher incidence of poor CRF (risk ratio, 1.57; 95% confidence interval, 1.14-2.16). The changes in CRF through adolescence to young adulthood were similar across groups, with those born early term consistently displaying the lowest CRF. CONCLUSIONS These findings suggest that early-term births within the at-term range are linked to poorer CRF through adolescence to young adulthood, and may have important clinical and public health implications for policies about (avoidable) early-term deliveries given their recent increasing trends.
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Affiliation(s)
- Isabel Ferreira
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Pei T Gbatu
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Colin A Boreham
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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Evans BC, Coon DW, Belyea MJ, Ume E. Collective Care: Multiple Caregivers and Multiple Care Recipients in Mexican American Families. J Transcult Nurs 2016; 28:398-407. [PMID: 27389911 DOI: 10.1177/1043659616657878] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Specific stressors associated with caregiving in Mexican American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. This article describes these understudied families who are poorly served by contemporary health systems because their characteristics are unknown. DESIGN Descriptive, multisite, longitudinal mixed-methods study of MA caregiving families. FINDINGS We identified three types of collective caregivers: those providing care for multiple family members simultaneously, those providing care successively to several family members, and/or those needing care themselves during their caregiving of others. DISCUSSION AND CONCLUSIONS Collective caregiving of MA elders warrants further investigation. IMPLICATIONS FOR PRACTICE Exploration of collective caregiving may provide a foundation for tailored family interventions.
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Affiliation(s)
- Bronwynne C Evans
- 1 Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA
| | - David W Coon
- 1 Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA
| | - Michael J Belyea
- 1 Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA
| | - Ebere Ume
- 2 Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Abdul Majid H, Ramli L, Ying SP, Su TT, Jalaludin MY, Abdul Mohsein NAS. Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study). PLoS One 2016; 11:e0155447. [PMID: 27187889 PMCID: PMC4871353 DOI: 10.1371/journal.pone.0155447] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 04/28/2016] [Indexed: 11/18/2022] Open
Abstract
Optimal nutrition is essential for healthy growth during adolescence. This study aims to investigate the baseline nutritional intake of Malaysian adolescents by gender, body mass index, and places of residence, both urban and rural. A cohort study was conducted consisting of 794 adolescents (aged 13-years) attending 15 public secondary schools from the Central (Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular Malaysia. Qualified dietitians conducted a 7-day historical assessment of habitual food intakes. Facilitated by flipcharts and household measurement tools, detailed information on portion sizes and meal contents were recorded. Nutritionist Pro™ Diet Analysis software was also used to analyze the dietary records.The mean age of the adolescents was 12.86 ± 0.33 y; the mean energy intake was 1659.0 ± 329.6 kcal/d. Males had significantly (P < .001) higher energy intake than females (1774.0 ± 369.8 vs 1595.2 ± 320.6 kcal/d); adolescents in rural schools consumed more energy and cholesterol (P < .001) compared to adolescents in urban schools (1706.1 ± 377.7 kcal/d and 244.1 ± 100.2 mg/d, respectively). Obese adolescents in rural schools consumed more energy and sugar (1987.6 ± 374.0 kcal/d and 48.9 ± 23.0 g/d) (p-value <0.001).The dietary intake of normal weight versus obese adolescents differs by the location of their school. Thus, the implementation of a structured and tailored intervention is recommended to help minimize this nutritional inequality.
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Affiliation(s)
- Hazreen Abdul Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Liyana Ramli
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sim Pei Ying
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Nabilla Al-Sadat Abdul Mohsein
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kim J, Shim JE, Wiley AR, Kim K, McBride BA. Is there a difference between center and home care providers' training, perceptions, and practices related to obesity prevention? Matern Child Health J 2013; 16:1559-66. [PMID: 21877239 DOI: 10.1007/s10995-011-0874-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To compare the obesity related training, practices, and perceptions of home child care providers and center care providers. A self-administered survey was collected from child care providers who attended local child care training workshops in east central Illinois from March 2009 to August 2010. Study results were based on responses from 88 home care providers and 94 center providers. The survey questions addressed child care providers' training in the prior year, their obesity prevention practices including written policies, their perceptions of influences on children's health, and factors determining food menu selection. Paired t tests and Chi-square tests were used to compare the difference by child care type. 81.9% of home care providers and 58.6% of center care providers received nutrition training, while 66.7 and 43.0% of these providers received physical activity training, respectively. Nutrition content, guidelines or state regulations, and food availability were the most important factors that influenced both types of care providers' food service menus. Both care provider types perceived they have less influence on children's food preferences, eating habits, and weight status compared to the home environment. However, home care providers perceived a smaller discrepancy between the influences of child care and home environments compared to center care providers. Compared to center providers, home care providers were more likely to have had training, be involved with health promotion activities, and rate their influence higher on children's health behaviors. Findings underscore the need for obesity prevention efforts in both types of child care settings.
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Affiliation(s)
- Juhee Kim
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 1206 South Fourth St., 213 Huff Hall, 61820, Champaign, IL, USA,
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Evans BC, Belyea MJ, Ume E. Mexican-American Males Providing Personal Care for their Mothers. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2011; 33:234-260. [PMID: 21643486 DOI: 10.1177/0739986311398615] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We know little about Mexican-American (MA) family adaptation to critical events in the informal caregiving experience but, in these days of economic and social turmoil, sons must sometimes step up to provide personal care for their aging mothers. This article compares two empirically real cases of MA males who provided such care, in lieu of a female relative. The cases are selected from a federally-funded, descriptive, longitudinal, mixed methods study of 110 MA caregivers and their care recipients. In case-oriented research, investigators can generate propositions (connected sets of statements) that reflect their findings and conclusions, and can be tested against subsequent cases: Caregiving strain and burden in MA males may have more to do with physical and emotional costs than financial ones; MA males providing personal care for their mothers adopt a matter-of-fact approach as they act "against taboo"; and this approach is a new way to fulfill family obligations.
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Affiliation(s)
- Bronwynne C Evans
- Arizona State University College of Nursing and Health Innovation, 500 N. 3rd Street, Phoenix, Arizona 85004, Office Phone 602-496-0766, Fax 602-496-0886
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Stanisławska-Sachadyn A, Mitchell LE, Woodside JV, Buckley PT, Kealey C, Young IS, Scott JM, Murray L, Boreham CA, McNulty H, Strain JJ, Whitehead AS. The reduced folate carrier (SLC19A1) c.80G>A polymorphism is associated with red cell folate concentrations among women. Ann Hum Genet 2009; 73:484-91. [PMID: 19650776 DOI: 10.1111/j.1469-1809.2009.00529.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Low folate status may be a consequence of suboptimal intake, transport or cellular utilization of folate and, together with elevated homocysteine, is a recognized risk factor or marker for several human pathologies. As folate transport across cell membranes is mediated in part by the reduced folate carrier (RFC1), variants within SLC19A1, the gene that encodes RFC1, may influence disease risk via an effect on folate and/or homocysteine levels. The present study was undertaken to assess the association between the SLC19A1 c.80G>A polymorphism and folate/homocysteine concentrations in healthy young adults from Northern Ireland. The SLC19A1 c.80G>A polymorphism was not strongly associated with either serum folate or homocysteine concentrations in either men or women. However, in women, but not in men, this polymorphism explained 5% of the variation in red blood cell (RBC) folate levels (P= 0.02). Relative to women with the SLC19A1 c.80GG genotype, women with the GA and AA genotypes had higher RBC folate concentrations. Consequently, compared to women with the SLC19A1 c.80GA and AA genotypes, women who are homozygous for the 80G allele may be at increased risk of having a child affected with a neural tube defect and of developing pathologies that have been associated with folate insufficiency, such as cardiovascular disease.
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Affiliation(s)
- Anna Stanisławska-Sachadyn
- Department of Pharmacology and Center for Pharmacogenetics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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Stanisławska-Sachadyn A, Brown KS, Mitchell LE, Woodside JV, Young IS, Scott JM, Murray L, Boreham CA, McNulty H, Strain JJ, Whitehead AS. An insertion/deletion polymorphism of the dihydrofolate reductase (DHFR) gene is associated with serum and red blood cell folate concentrations in women. Hum Genet 2008; 123:289-95. [PMID: 18247058 DOI: 10.1007/s00439-008-0475-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Accepted: 01/22/2008] [Indexed: 10/22/2022]
Abstract
A low serum folate and high homocysteine phenotype is associated with an increased risk of neural tube defects (NTDs), cardiovascular diseases and other pathologies. Thus defining both genetic and non-genetic factors that may impact folate/homocysteine metabolism will enhance our understanding of the etiologic mechanisms underlying these conditions and facilitate risk assessment. Dihydrofolate reductase catalyzes the reduction of folic acid to dihydrofolate and thereafter to tetrahydrofolate. The impact of the dihydrofolate reductase (DHFR) c.86 + 60_78 insertion/deletion (ins/del) polymorphism on folate and homocysteine concentrations was analyzed using data from healthy young adults from Northern Ireland, collected as part of visit three of the Young Hearts Project. Among men the DHFR c.86 + 60_78 polymorphism was not significantly associated with serum or red blood cell folate concentrations, or with homocysteine concentrations. Among women the DHFR c.86 + 60_78 polymorphism explained 2% of the variation in RBC folate levels and 5% of the variation in serum folate levels, but did not appear to have an independent effect on homocysteine. Relative to women with the DHFR c.86 + 60_78 ins/ins and ins/del genotypes, del/del homozygotes had increased serum and red blood cell folate concentrations and may therefore be at decreased risk of having offspring affected by NTDs and of other adverse reproductive and health outcomes attributable to low folate.
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Affiliation(s)
- Anna Stanisławska-Sachadyn
- Department of Pharmacology and Center for Pharmacogenetics, University of Pennsylvania School of Medicine, 153 Johnson Pavilion, 3620 Hamilton Walk, Philadelphia, PA, 19104-6084, USA
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Boreham C, Robson PJ, Gallagher AM, Cran GW, Savage JM, Murray LJ. Tracking of physical activity, fitness, body composition and diet from adolescence to young adulthood: The Young Hearts Project, Northern Ireland. Int J Behav Nutr Phys Act 2004; 1:14. [PMID: 15462676 PMCID: PMC524366 DOI: 10.1186/1479-5868-1-14] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Accepted: 10/05/2004] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: The assumption that lifestyles formed early in life track into adulthood has been used to justify the targeting of health promotion programmes towards children and adolescents. The aim of the current study was to use data from the Northern Ireland Young Hearts Project to ascertain the extent of tracking, between adolescence and young adulthood, of physical activity, aerobic fitness, selected anthropometric variables, and diet. METHODS: Males (n 245) and females (n 231) were assessed at age 15 y, and again in young adulthood [mean (SD) age 22 (1.6) y]. At both timepoints, height, weight and skinfold thicknesses were measured, and physical activity and diet were assessed by questionnaire and diet history method respectively. At 15y, fitness was assessed using the 20 metre shuttle run, while at young adulthood, the PWC170 cycle ergometer test was used. For each measurement made at 15y, subjects were ranked into 'low' (L1; lowest 25%), 'medium' (M1; middle 50%) or 'high' (H1; highest 25%) categories. At young adulthood, similar categories (L2, M2, H2) were created. The extent of tracking of each variable over time was calculated using 3 x 3 matrices constructed using these two sets of categories, and summarised using kappa (kappa) statistics. RESULTS: Tracking of diet and fitness was poor (kappa = 0.20) in both sexes, indicating substantial drift of subjects between the low, medium and high categories over time. The tracking of physical activity in males was fair (kappa 0.202), but was poor in females (kappa 0.021). In contrast, anthropometric variables such as weight, body mass index and sum of skinfolds tracked more strongly in females (kappa 0.540, kappa 0.307, kappa 0.357 respectively) than in males (kappa 0.337, kappa 0.199, kappa 0.216 respectively). CONCLUSIONS: The poor tracking of fitness and diet in both sexes, and physical activity in females, suggests that these aspects of adolescent lifestyle are unlikely to be predictive of behaviours in young adulthood. In contrast, the fair to moderate tracking of anthropometric variables, particularly in females, suggests that attempts to reduce the ever increasing incidence of overweight and obesity in adults, should probably begin in earlier life.
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Affiliation(s)
- Colin Boreham
- School of Applied Medical Sciences and Sports Studies, University of Ulster, Jordanstown, Northern Ireland, BT37 0QB, United Kingdom
| | - Paula J Robson
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, Northern Ireland, BT52 1SA, United Kingdom
| | - Alison M Gallagher
- Northern Ireland Centre for Food and Health (NICHE), University of Ulster, Coleraine, Northern Ireland, BT52 1SA, United Kingdom
| | - Gordon W Cran
- Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast, Northern Ireland, BT12 6BJ, United Kingdom
| | - J Maurice Savage
- Department of Child Health, Queen's University of Belfast, Belfast, Northern Ireland, BT12 6BJ, United Kingdom
| | - Liam J Murray
- Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast, Northern Ireland, BT12 6BJ, United Kingdom
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