School beverage environment and children's energy expenditure associated with physical education class: an agent-based model simulation

The Influence of Martial Arts on Spine CT Image Morphological Structure Based on Optimized Ant Colony Algorithm

As the second lifeline of human body, the abnormal development of its morphological structure has a great impact on people's physical and mental health. Due to bad living habits and learning pressure, the morphological and structural development of spine in adolescents and children is abnormal to a certain extent, which can be improved by sports intervention. Therefore, this article puts forward the research on the influence of Wushu on the spinal morphological structure based on the optimization algorithm and integrates the optimization ant colony algorithm on the basis of the traditional spinal CT image segmentation method. The experimental results show that the improved CT image segmentation method based on the optimized ant colony algorithm can solve the sensitive problem of the number of clusters, improve the segmentation efficiency and quality, and provide more accurate data for the subsequent comparative experiments. At the same time, the comparative test results show that Wuqinxi Wushu can better improve the abnormal dry tilt angle, abnormal kyphosis angle, and body balance angle of teenagers, improve the activity of teenagers' spine, and help teenagers enhance the overall health of spine.

Applications of Complex Systems Models to Improve Retail Food Environments for Population Health: A Scoping Review

Retail food environments (RFEs) are complex systems with important implications for population health. Studying the complexity within RFEs comes with challenges. Complex systems models are computational tools that can help. We performed a systematic scoping review of studies that used complex systems models to study RFEs for population health. We examined the purpose for using the model, RFE features represented, extent to which the complex systems approach was maximized, and quality and transparency of methods employed. The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines were followed. Studies using agent-based modeling, system dynamics, discrete event simulations, networks, hybrid, or microsimulation models were identified from 7 multidisciplinary databases. Fifty-six studies met the inclusion criteria, including 23 microsimulation, 13 agent-based, 10 hybrid, 4 system dynamics, 4 network, and 2 discrete event simulation models. Most studies (n = 45) used models for experimental purposes and evaluated effects of simulated RFE policies and interventions. RFE characteristics simulated in models were diverse, and included the features (e.g., prices) customers encounter when shopping (n = 55), the settings (e.g., restaurants, supermarkets) where customers purchase food and beverages (n = 30), and the actors (e.g., store managers, suppliers) who make decisions that influence RFEs (n = 25). All models incorporated characteristics of complexity (e.g., feedbacks, conceptual representation of multiple levels), but these were captured to varying degrees across model types. The quality of methods was adequate overall; however, few studies engaged stakeholders (n = 10) or provided sufficient transparency to verify the model (n = 12). Complex systems models are increasingly utilized to study RFEs and their contributions to public health. Opportunities to advance the use of these approaches remain, and areas to improve future research are discussed. This comprehensive review provides the first marker of the utility of leveraging these approaches to address RFEs for population health.

Association between Mobile Phone Addiction Index and Sugar-Sweetened Food Intake in Medical College Students Stratified by Sex from Shanghai, China

This study’s objective was to depict sugar-sweetened food (SSF) consumption in medical college students stratified by sex from Shanghai, China, and to explore the association between the Mobile Phone Addiction Index (MPAI) and SSF intake. The data were obtained from 1121 medical college students from the Fudan University, Shanghai, China, who took an online questionnaire investigation in December 2020. Data included demographics, the MPAI, the Nutrition Literacy Assessment Questionnaire (NLAQ), total and food expenditure per month, the International Physical Activity Questionnaire (IPAQ), and a food frequency questionnaire (carbonated beverages (CB), other sugar-based beverages (OSBB), sugar/chocolate). We evaluated the association between the MPAI and three types of SSF intake according to multivariate logistic regression analysis stratified by sex. The mean CB, OSBB, and sugar/chocolate intakes were, respectively, 65.66 mL/d, 74.20 mL/d, and 4.96 g/d in men and 30.42 mL/d, 71.48 mL/d, and 4.99 g/d in women. The MPAI was positively associated with SSF intake, regardless of sex. In men, the CB and OSBB odds ratios (ORs) were, respectively, 1.023 (95% CI: 1.004–1.042), 1.019 (95% CI: 1.001–1.038); and in women, the CB, OSBB, and sugar/chocolate ORs were, respectively, 1.026 (95% CI: 1.013–1.039), 1.020 (95% CI: 1.007–1.033), and 1.019 (95% CI: 1.006–1.032). Age, NLAQ, total expenditure, food expenditure, and total physical activity also were related to SSF intake. Age and the application capacity of the NLAQ were negatively associated with SSF intake, whereas comprehension capacity of the NLAQ, total and food expenditure, and total physical activity were positively associated with SSF intake. This study confirmed that SSF intake is widespread among medical college students from Shanghai, China, even if they have relatively high nutrition health literacy. From a public health perspective, it is necessary to reduce SSF intake in medical college students by decreasing the MPAI, controlling the total and food expenditure per month in high-consumption areas, and improving the application ability of the NLAQ. Further studies are needed to explore the MPAI and other potential factors that may influence SSF intake of college students by expanding the sample size of college students throughout China, and the causal association between them.

Like me, like you - relative importance of peers and siblings on children's fast food consumption and screen time but not sports club participation depends on age

Background

Lifestyle interventions to prevent paediatric obesity often target family and peer settings; their success is likely to depend on the influence that peers and families exert on children’s lifestyle behaviors at different developmental stages.

Objective

First, to determine whether children’s lifestyle behavior more closely resembles their peers’ or siblings’ behaviors. Secondly, to investigate longitudinally whether children’s behavioral change is predicted by that of their peers or their siblings as they grow older.

Methods

The European prospective IDEFICS/I.Family cohort (baseline survey: 2007/2008, first follow-up: 2009/2010, and second follow-up: 2013/2014) aims at investigating risk factors for overweight and related behaviors during childhood and adolescence. The present investigation includes 2694 observations of children and their siblings aged 2 to 18 years. Peers were defined as same-sex, same-age children in the same community and identified from the full cohort. The longitudinal analysis (mean follow-up time: 3.7 years) includes 525 sibling pairs. Children’s lifestyle behaviors including fast food consumption (frequency/week), screen time (hours/week) and sports club participation (hours/week) were assessed by questionnaire. Data were analyzed using multilevel linear models.

Results

Children’s lifestyle behavior was associated with the respective behavior of their peers and sibling for all 3 behaviors. For fast food consumption, the peer resemblance was more than 6-fold higher than the sibling resemblance and the peer resemblance surpassed the sibling resemblance by the age of 9–10 years. The similarities with peers for fast food consumption and screen time steadily increased, while the similarities with siblings steadily decreased with increasing age of the children (P_interaction < 0.001). In contrast, the relative importance of peers and siblings on sports club duration did not vary by the age of the children. Longitudinal results showed that children’s changes in fast food consumption were more strongly associated with those in their peer group than their sibling, in particular if the age gap between siblings was large.

Conclusion

In conclusion, our results support the implementation of multi-setting interventions for improving lifestyle behaviors in children. Our findings might also guide future intervention studies in the choice of timing and setting in which interventions are likely to be most effective. From the ages of 9–10 years onwards, family- or home-based interventions targeting children’s fast food intake and screen time behavior may become less effective than school- or community-based interventions aimed at peer groups.

NASA Mission X Program for Healthy Eating and Active Living among Taiwanese Elementary School Students

PURPOSE

This study assessed the effects of an intervention program adapted from the NASA Mission X (MX) program on children's Healthy Eating Active Living (HEAL) knowledge and behaviors and anthropometry.

METHODS

This clustered randomized control trial recruited 8 elementary schools in remote rural areas of Northern Taiwan. The intervention was the 8-week MX program. All the 3rd and 4th graders were invited to the study (n = 245). Children's weight, height, HEAL knowledge and behaviors were measured pre- and post-intervention.

RESULTS

The intervention group had significantly more improvements than control group in physical activity knowledge score (+0.91 vs. +0.25, p = 0.002), diet knowledge score (+0.62 vs. +0.17, p = 0.044), and score of interests in NASA and space exploration (+0.34 vs. -0.07, p < 0.0001). BMI increased from 18.4 to 18.6 (p < 0.05) for the control group but did not change for the intervention group. The changes in BMI between groups did not differ significantly.

CONCLUSION AND PRACTICE IMPLICATIONS

This randomized controlled trial showed that the NASA MX program was feasible and acceptable among children in Taiwan, and improved children's HEAL knowledge. (ClinicalTrials.gov registration: NCT03355131).

A systematic review of system dynamics and agent-based obesity models: Evaluating obesity as part of the global syndemic

The problem of obesity has recently been reframed as part of the global syndemic-the co-occurring, interacting pandemics of obesity, undernutrition, and climate change that are driven by common underlying societal drivers. System science modeling approaches may help clarify how these shared drivers operate and the best ways to address them. The objective of this paper was to determine to what extent existing agent-based and system dynamics computational models of obesity provide insights into the shared drivers of the global syndemic. Peer-reviewed studies published until July 2018 were identified from Scopus, Web of Science, and PubMed databases. Thirty-eight studies representing 30 computational models were included. They show a growing use of system dynamics and agent-based modeling in the past decade. They most often examined mechanisms and interventions in the areas of social network-based influences on obesity, physiology and disease state mechanics, and the role of food and physical activity environments. Usefulness for identifying common drivers of the global syndemic was mixed; most models represented Western settings and focused on obesity determinants close to the person (eg, social circles, school settings, and neighborhood environments), with a relative paucity in models at mesolevel and macrolevel and in developing country contexts.

Complex Systems Approaches to Diet: A Systematic Review

CONTEXT

Complex systems approaches can help to elucidate mechanisms that shape population-level patterns in diet and inform policy approaches. This study reports results of a structured review of key design elements and methods used by existing complex systems models of diet.

EVIDENCE ACQUISITION

The authors conducted systematic searches of the PubMed, Web of Science, and LILACS databases between May and September 2018 to identify peer-reviewed manuscripts that used agent-based models or system dynamics models to explore diet. Searches occurred between November 2017 and May 2018. The authors extracted relevant data regarding each study's diet and nutrition outcomes; use of data for parameterization, calibration, and validation; results; and generated insights. The literature search adhered to PRISMA guidelines.

EVIDENCE SYNTHESIS

Twenty-two agent-based model studies and five system dynamics model studies met the inclusion criteria. Mechanistic studies explored neighborhood- (e.g., residential segregation), interpersonal- (e.g., social influence) and individual-level (e.g., heuristics that guide food purchasing decisions) mechanisms that influence diet. Policy-oriented studies examined policies related to food pricing, the food environment, advertising, nutrition labels, and social norms. Most studies used empirical data to inform values of key parameters; studies varied in their approaches to calibration and validation.

CONCLUSIONS

Opportunities remain to advance the state of the science of complex systems approaches to diet and nutrition. These include using models to better understand mechanisms driving population-level diet, increasing use of models for policy decision support, and leveraging the wide availability of epidemiologic and policy evaluation data to improve model validation.

Associations between muscle mass, physical activity and dietary behaviour in adolescents

BACKGROUND AND OBJECTIVES

Investigations in older individuals suggest that adequate nutrition and physical activity are particularly important to skeletal muscle health; however, data in adolescents are scant and equivocal. The objective was to determine the associations among diet, physical activity and skeletal muscle mass in adolescents.

METHODS

We assessed diet with four to seven 24-h recalls and physical activity by accelerometry in 640 adolescents. Using total body measures of fat-free soft tissue mass and fat mass assessed by dual-energy X-ray absorptiometry, the skeletal muscle mass index (SMMI) was derived by adjusting fat-free soft tissue mass for fat mass in addition to height.

RESULTS

Skeletal muscle mass index (SMMI) was negatively associated with consumption of sugar-sweetened beverages (standardized beta coefficient [β] = -0.10, P = 0.001) and saturated fats (β = -0.28, P < 0.001). SMMI was positively associated with physical activity (moderate + vigorous) (β = 0.20, P < 0.001). In further analysis, we observed a significant interaction between physical activity and sugar-sweetened beverage intake on SMMI (P = 0.002).

CONCLUSION

Our study in adolescence suggests that physical activity and consumption of both sugar-sweetened beverages and saturated fats are associated with skeletal muscle mass. More importantly, our findings suggest that sugar-sweetened beverage intake may attenuate the beneficial effects of physical activity on skeletal muscle mass.

Nutrition and physical activity related school environment/policy factors and child obesity in China: a nationally representative study of 8573 students in 110 middle schools

BACKGROUND

Obesity is a serious threat to global health. School is a key setting for obesity intervention. Research on school risk factors for child obesity is limited in developing countries.

OBJECTIVES

To examine regional variations in obesity and school environments/policies and their associations among students in China.

METHODS

Analyses were based on the first nationally representative sample of 8573 9^th graders in 110 middle schools from 28 regions across China. Multilevel models tested associations between school factors and child self-reported weight outcomes and by school urbanicity setting (urban, rural).

RESULTS

Overweight/obesity rate is higher among boys and in urban areas. Schools in rural areas, or less developed regions, promote longer on-campus life, as is indicated by the presence of school cafeterias, night study sessions and longer class hours. Multilevel models show that (i) school cafeterias (OR = 2.53, 95% CI = 1.35-4.75) and internet bars close to school (OR = 1.63, 95% CI = 1.15-2.30) are associated with increased overweight/obesity risk in rural areas, especially for boys; (ii) school night study sessions are associated with lower overweight/obesity risk (OR = 0.69, 95% CI = 0.50-0.96) in rural areas.

CONCLUSIONS

China has large regional disparities in school environment/policies related to nutrition and physical activity. Some school factors are associated with students' weight status, which vary across gender and areas. Future school-based interventions should attend to diverse regional contexts.