The Association of Television Viewing with Snacking Behavior and Body Weight of Young Adults

A longitudinal exploration of self-reported TV behaviours as a surrogate for sedentary behaviour in older adults with an intellectual disability from the intellectual disability supplement to the Irish longitudinal study on aging (IDS-TILDA) study

This study presents the findings of an investigation into the self-reported TV habits of adults with an intellectual disability, where time watching TV was used as a proxy for sedentary behaviour (SB). Risk factors identified for the general and intellectual disability populations and standard covariates of age, sex, level of intellectual disability, living circumstances and BMI were explored to determine their viability as contributors to increased TV viewing and SB. Missing data was imputed using Multiple Imputation Chained Equation (MICE). Multinomial logistic regression and Chi-squared Automatic Interaction Detector Analysis (CHAID) analyses of risk factors for increased TV viewing were explored and compared. The Systems of Sedentary Behaviour (SOS) framework was used to structure results. Novel risk factors for increased TV viewing were identified.

Living Alone: Associations with Diet and Health in the Spanish Young Adult Population

Eating together as a family has important health benefits, as the diet is more balanced and of a higher quality. Eating together is also a factor in the prevention of diet-related diseases. The promotion of family and shared meals is currently a public health strategy. The aim of this research was to study the eating habits of the Spanish young adult population and their impact on health. An observational, descriptive, cross-sectional study was carried out using surveys. A questionnaire was designed and validated to explore a set of variables related to food and health. The dissemination was carried out through social networks by means of an online form, using non-probabilistic snowball sampling to obtain a sample of 17,969 subjects aged between 18 and 45 years. We found statistically significant differences between people living in a family home compared to people living outside a family home in the healthy eating index for the Spanish population, fish consumption, and fried food consumption. This suggests that the nutrition of people living in a family home is healthier, although their BMI is higher. People living together have a statistically higher healthy eating index value than people living alone; consume fast food, fried food, and ultra-processed food less frequently; and eat fish more often. On the other hand, people who live in a family home or are accompanied are more likely to have a sedentary lifestyle and are less physically active. It was concluded that people living alone have a worse healthy eating index than those living with company, which seems to indicate that nutritional interventions should pay attention to people living alone as a variable to be taken into account in future analyses.

Impact of COVID-19 on a worksite weight loss program for employees with overweight and obesity

Objective

The COVID-19 pandemic has been shown to be negatively associated with physical activity engagement, adherence to healthy diet, and weight management among people with obesity. The current study examined COVID-19-related changes in weight, physical activity (PA), and diet among employees with obesity or overweight who participated in Vibrant Lives (VL), a worksite weight loss program.

Methods

School district employees participated in the 6-month VL weight loss program and were categorized into non-COVID-era participants and COVID-era participants. Participants completed questionnaires about PA and dietary intake at baseline and follow-up. COVID-era participants reported the effects of pandemic on their behaviors. Changes in weight, PA, and diet were compared between groups using multilevel linear mixed models and logistic regression models.

Results

A total of 266 participants (non-COVID, n=173; COVID, n=93) were included. Significant weight loss (non-COVID, -2.3 kg vs. COVID, -1.3 kg) and increases in moderate-to-vigorous PA minutes (non-COVID, 48.7 min vs. COVID, 61.5 min) were observed associated with the program, but no significant differences in changes between the groups were found. Compared to non-COVID participants, COVID participants decreased fast food consumption (P=.008) and increased sugar-sweetened beverage intake (P=.016). Higher frequency of snacking and overeating were reported as barriers to a healthy diet.

Conclusion

The COVID-19 pandemic was negatively associated with healthful dietary behaviors. The information obtained from participants regarding the reasons for their pandemic-related changes in diet may help identify strategies to encourage healthier behaviors and weight management among people who have been negatively affected by the COVID-19 pandemic.This article is protected by copyright. All rights reserved.

Are Students Paid to Market Sugar-Sweetened Beverages to Peers? A Review of University Pouring Rights Contracts

Background: Many university students regularly consume sugar-sweetened beverages (SSBs), which are associated with obesity and related chronic diseases. Moreover, students are strongly influenced by both their peers and product marketing. Our exploratory study examined pouring rights contracts between universities and beverage companies, focusing on provisions establishing campus/brand ambassador positions and marketing/merchandising manager positions whose jobs are to market SSBs on campus. Methods: For this cross-sectional study conducted in late 2020, two independent coders reviewed 131 pouring rights contracts between Coca-Cola or Pepsi and 124 unique public universities with 20,000 or more students enrolled. Contracts were active in 2018 or 2019. Results: Twenty-six contracts (20%) contained provisions specifically establishing either campus/brand ambassador positions (n = 16), marketing/merchandising manager positions (n = 7), both (n = 1), or unclear language related to these positions (n = 2). Thirteen contracts (10%) required that the position be filled by a current student. The objectives for both types of positions included increasing revenue and driving beverage sales. When stated in the contracts (n = 5), the payments allocated for these positions ranged between $5,000 and $10,000 per year. Conclusions: Given the association between SSBs and obesity and other related health outcomes, combined with the influence that peers and product marketing may have on adolescents' and young adults' attitudes toward consumption of these beverages, universities should be more transparent when these provisions are included in their pouring rights contracts and should carefully consider whether it is appropriate for these contracts to include funding for students to market SSBs.

The energy density of meals and snacks consumed by young Australian adults (18-30 years old) are influenced by preparation location but not screen use nor social interactions: findings from the MYMeals wearable camera study

The present study examined the association of contextual factors (social and food preparation location) with the energy density of meals and snacks consumed in a sample of young Australian adults (18-30 years old) identified using wearable camera technology. Over three consecutive days, a subsample of young adults wore a wearable camera that captured images in 30 s intervals. Eating episodes from 133 participants were annotated for preparation location and social context (covering social interaction and screen use). Over the same period, participants completed daily 24 h recalls. The nutritional composition of meals and snacks was calculated by matching the items identified in the camera to the 24 h recall using time and date stamps. Self-reported data (weight and height) was used to calculate body mass index and (residential postcode) to assign socio-economic status. The association of context and demographic factors with energy density was determined using a mixed linear regression model employing the bootstrap method with bias-corrected and accelerated. In total, 1817 eating episodes were included in the analysis (n 8 preparation unclear and n 15 food components could not be identified excluded). Food prepared within the home was 1⋅1 kJ/g less energy-dense than other preparation locations. Lunches (CI -1⋅7 to -0⋅3) and dinners (CI -1⋅6 to -0⋅5) were both 1⋅0 kJ/g lower in energy density than breakfasts. Snacks were 3⋅5 kJ/g (CI 2⋅8-4⋅1) more energy-dense than breakfasts. Food prepared outside the home and food consumption during snacking appear to be adversely contributing to energy-dense food intake.

Sedentary behavior and cardiovascular disease risk: An evolutionary perspective

A ubiquitous aspect of contemporary societies is sedentary behavior (SB), defined as low intensity activities in a seated, reclined, or supine posture. Leading public health agencies, including the World Health Organization, have recognized the strong association between SB and poor health outcomes, particularly cardiovascular disease. However, while public health agencies have begun to advocate for “reductions” in SB, the current US guidelines are typically vague and non-specific. There is good reasoning behind this non-committal advocacy—there is limited mechanistic and clinical evidence to support policy development. To guide SB policy development, it is important to first consider the origins and evolution of SB, including the following: 1) is SB really a novel/contemporary behavior? i.e., how has this behavior evolved? 2) how did our ancestors sit and in what contexts? 3) how does SB interact with 24-hour activity behaviors, including physical activity and sleep? 4) what other historical and contemporary facets of life interact with SB? and 5) in what context do these behaviors occur and how might they provide different evolutionarily novel stressors? This perspective article will synthesize the available evidence that addresses these questions and stimulate discussion pertaining to the lessons that we can learn from an historical and evolutionary perspective. Last, it will outline the gaps in current SB interruption literature that are hindering development of feasible SB reduction policy.

Fright but not fight‐or‐flight: Violent video games elevated stress markers, but did not impact muscle function, memory recall or food intake, in a randomized trial in healthy young men

Objectives

Regular video game playing has been linked with obesity, but the underlying mechanisms remain unclear. Drawing on evolutionary life history theory, we hypothesized that playing violent video games, through activating the stress response, might increase the immediate demand for fuel by muscle and brain tissue, resulting in elevated appetite and food consumption.

Methods

We randomized 71 young adult men to play video games, involving either violent content or nonviolent puzzle‐solving, for 1 h. Over this period, we measured stress markers (blood pressure [BP], heart rate, visual‐analogue scale [VAS] self‐ratings), muscle function (handgrip strength) and cognitive function (memory recall test). Appetite was assessed by VAS, and by food intake using a test‐meal after the intervention. Linear mixed‐effects models were fitted to assess group effects and group:time effects.

Results

During the intervention, the violent video game group showed elevated systolic BP (∆ = 4.7 mm Hg, 95% CI 1.0, 8.4) and reported feeling more alert but less calm or happy. They showed no difference in grip strength or memory recall. They reported lower feelings of “fullness” but consumed similar food‐energy during the test‐meal.

Conclusions

Although playing a video game with violent content elevated physiological and perceived stress markers compared with a nonviolent game, this was not associated with markers of altered fuel distribution toward two tissues (muscle and brain) that contribute to the “fight‐or‐flight” response. Rather than more energy being allocated to the brain overall, energy may have been reallocated within the brain. This may explain why there was no compensatory increase in energy intake in the violent video game group.

Choice Hygiene for "Consumer Neuroscientists"? Ethical Considerations and Proposals for Future Endeavours

Is the use of psychological and neuroscientific methods for neuromarketing research always aligned with the principles of ethical research practice? Some neuromarketing endeavours have passed from informing consumers about available options, to helping to market as many products to consumers as possible. Needs are being engineered, using knowledge about the human brain to increase consumption further, regardless of individual, societal and environmental needs and capacities. In principle, the ground ethical principle of any scientist is to further individual, societal and environmental health and well-being with their work. If their findings can be used for the opposite, this must be part of the scientist's considerations before engaging in such research and to make sure that the risks for misuse are minimised. Against this backdrop, we provide a series of real-life examples and a non-exhaustive literature review, to discuss in what way some practices in the neuromarketing domain may violate the Helsinki Declaration of Experimentation with Human Subjects. This declaration was set out to regulate biomedical research, but has since its inception been applied internationally also to behavioural and social research. We illustrate, point by point, how these ground ethical principles should be applied also to the neuromarketing domain. Indisputably, the growth in consumption is required due to current prevalent economical models. Thus, in the final part of the paper, we discuss how alternative models may be promotable to a larger public, aided by more ethical marketing endeavours, based on neuroscientific discoveries about the human brain. We propose this as a philosophical question, a point of discussion for the future, to make neuromarketing as a discipline, fit for the future, respecting the ethical implications of this research.

The degree of consistency of applying parental dietary and sedentary behavior rules as indicators for overweight in children: a cross-sectional study

BACKGROUND

Review studies increasingly emphasize the importance of the role of parenting in interventions for preventing overweight in children. The aim of this study was to examine typologies regarding how consistently parents apply energy-balance related behavior rules, and the association between these typologies and socio-demographic characteristics, energy balance-related behaviors among school age children, and the prevalence of being overweight.

METHODS

For this cross-sectional study, we had access to a database managed by a Municipal Health Service Department in the Netherlands. In total, 4,865 parents with children 4-12 years of age participated in this survey and completed a standardized questionnaire. Parents classified their consistency of applying rules as "strict", "indulgent", or "no rules". Typologies were identified using latent class analyses. We used regression analyses to examine how the typologies differed with respect to the covariates socio-demographic characteristics, children's energy balance-related behaviors, and weight status.

RESULTS

We identified four stable, distinct parental typologies with respect to applying dietary and sedentary behavior rules. Overall, we found that parents who apply "overall strict EBRB rules" had the highest level of education and that their children practiced healthier behaviors compared to the children of parents in the other three classes. In addition, we found that parents who apply "indulgent dietary rules and no sedentary rules" had the lowest level of education and the highest percentage of non-Caucasians; in addition, their children 8-12 years of age had the highest likelihood of being overweight compared to children of parents with "no dietary rules".

CONCLUSIONS

Parents' consistency in applying rules regarding dietary and sedentary behaviors was associated with parents' level of education and ethnic background, as well as with children's dietary and sedentary behaviors and their likelihood of becoming overweight. Our results may contribute to helping make healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight, as well as the importance of encouraging parents to apply strict dietary and sedentary behavior rules. These results can serve as a starting point for developing effective strategies to prevent overweight among children.

Trends in television viewing and overweight /obesity among Nepalese women: Findings from 2006, 2011 and 2016 Nepal Demographic and Health Surveys

BACKGROUND AND AIMS

Associations between overweight/obesity and television (TV) viewing have been identified in high-income countries, but little evidence is available from low- and middle-income countries. This study examined the trends and correlates of television viewing and overweight/obesity among Nepalese women between 2006 and 2016.

METHODS AND RESULTS

We analysed the data from 22,161 women aged 15-49 years who took part in Nepal Demographic Health Surveys 2006 (n = 10,115), 2011 (n = 5,881) or 2016 (n = 6,165). Trained staff collected data on TV viewing and sociodemographic attributes from a face-to-face survey while height and weight were measured objectively to determine body mass index. Around 38% of the study participants watched TV at least once a week in 2006, which increased to 49% in 2011 and 46% in 2016. The prevalence of overweight and obesity increased from 8% in 2006 to 14.6% in 2011 and 19.8% in 2016. Compared to those who did not watch TV at all, those watching it at least once a week were at 1.54 (95% CI: 1.02-2.33), 1.79 (95% CI: 1.23-2.60) and 1.46 (95% CI: 1.13-1.88) times higher odds of being overweight/obese in 2006, 2011 and 2016 respectively.

CONCLUSION

The prevalence of TV viewing rose among women in Nepal between 2006 and 2016 and was associated with overweight/obesity, which also increased dramatically over this period. Future studies examining the use of multiple screen devices, daily usage duration and content viewed are recommended to understand better the health impacts of transitions to more sedentary living in Nepal and similar settings.

Measuring university students' beliefs toward healthy snack selection

Objectives: Understanding university students' beliefs toward selecting healthy snacks is important in developing effective programs targeting healthy eating behaviors. The purpose of this research was to assess students' beliefs toward healthy snack selection and consumption. Participants: In November 2017, a convenience sample of 779 undergraduate students living on campus completed an online survey. Methods: A survey was developed to measure students' beliefs about eating healthy snacks. Paired t-tests were used to compare differences in beliefs and their importance. Independent t-tests were used to compare differences in belief responses by gender. Results: Students believed that healthy snacks were good for health and assisting with weight management. However, time management, motivation, preparation needs, and poor taste were reported as barriers to selection and consumption of healthy snacks. Conclusions: Increasing students' awareness of available food preparation facilities, developing food preparation skills, and motivation for consumption of healthy-good tasting snacks may increase healthier snacking.

Snacking behavior differs between evening and morning chronotype individuals but no differences are observed in overall energy intake, diet quality, or food cravings

There is a growing body of literature that links chronotype to certain undesirable eating behaviors. However, the relationship between chronotype and dietary intake is poorly characterized among adults in the United States (U.S.). This cross-sectional study examined the associations among chronotype, snacking habits, dietary intake and quality, and food cravings. One-hundred adults living in the U.S. completed the study. Based on the Horne-Östberg Morningness-Eveningness Questionnaire score, an individual was categorized as having either a morning (M)-type, intermediate (I)-type, or evening (E)-type chronotype. Snack intake was assessed using a previously published specialized food frequency questionnaire. Sugar-sweetened beverage (SSB) intake was assessed using the updated version of the Beverage Intake Questionnaire-15. Alcohol misuse was measured using the Alcohol Use Disorders Identification Test-Consumption. Diet quality was obtained using the Diet History Questionnaire III. The validated General Food Cravings Questionnaire-Trait measured participants' food cravings. E-type individuals reported consuming snacks more often over the course of a week than M-types (p = .002) but not I-types. In terms of timing of snacking, E-type individuals consumed more snacks after dinner than M-types (p < .001). E-type individuals consumed more energy-dense snacks (p = .005), especially candies (p = .005), than M-types. However, there were no significant differences in healthy snack frequency, diet quality, energy and macronutrient intake, SSB consumption, alcohol misuse, or food cravings among chronotypes (p > .05, for all). In conclusion, E-type individuals consumed snacks more frequently and later than M-types; however, chronotype was not associated with an individual's energy intake, diet quality, and food cravings, which suggests that chronotype is negligibly associated with weight gain-related behaviors in this population.

Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise

A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).

Technological Devices and Their Effect on Preschool Children's Eating Habits in Communities of Mixed Socioeconomic Status in Istanbul; a Pilot Cross-Sectional Study

The use of technological devices is increasing in all age groups, especially in preschool-aged children. However, there is a limiting number of studies investigating the relationship between the use of technological devices, eating behavior, and weight status in preschool children. The aim of this study was (1) to describe total usage of technological devices, (2) to evaluate level of exclusive use of such devices by children, (3) to investigate children’s eating behaviors and diet in relation to screen time and type. A cross-sectional study was conducted with 104 children aged 2–5 years in Küçükçekmece and Bakırköy, Istanbul. Data collection consisted of a validated parental questionnaire on demographics and the child’s use of technology and eating behavior, while associations in children were examined using logistic regression analysis. The analysis of the obtained data uncovered a strong association between children’s TV and tablet/smart phone use and the foods consumed by children when using these devices (p = 0.0001; p = 0.012). Also, there was a significant association between children’s eating habits and TV, and tablet/smart phone durations of use (p = 0.015; p = 0.025), but not with computer duration of use (p > 0.05). Obesity and associated health problems can arise as results of suboptimal eating behavior, such as the ones observed in our study, which are also intensified with an increased duration of use of technological devices. The attitude of families towards prudent use of technological equipment is of great importance in impacting present and future health.

Effect of COVID-19 Pandemic-Induced Dietary and Lifestyle Changes and Their Associations with Perceived Health Status and Self-Reported Body Weight Changes in India: A Cross-Sectional Survey

Home confinement during the COVID-19 pandemic is accompanied by dramatic changes in lifestyle and dietary behaviors that can significantly influence health. We conducted an online cross-sectional survey to assess COVID-19 pandemic-induced dietary and lifestyle changes and their association with perceived health status and self-reported body weight changes among 1000 Indian adults in early 2021. Positive improvements in dietary habits, e.g., eating more nutritious (85% of participants) and home-cooked food (89%) and an increase in overall nutrition intake (79%), were observed. Sixty-five percent of participants self-reported increased oat consumption to support immunity. There were some negative changes, e.g., more binge eating (69%), eating more in between meals (67%), and increasing meal portion size (72%). Two-thirds of participants reported no change in lifestyles, whereas 21 and 23% reported an increase, and 13 and 10% reported a decrease in physical activity and sleep, respectively. Overall, 64 and 65% of participants reported an improvement in perceived health and an increase in body weight during the COVID-19 period compared to pre-COVID-19, respectively. The top motivations for improving dietary habits included improving physical and mental health and building immunity. In conclusion, the overall perceived health was improved and there was an increase in self-reported body weight in most participants during COVID-19. Diet emerged as the most crucial determinant for these changes.

Lifestyle correlates of dietary patterns among young adults: evidence from an Australian birth cohort

OBJECTIVE

Previous studies of sociodemographic and lifestyle correlates of dietary patterns among young adults have primarily focused on physical activity and smoking, with inconclusive results. This study aims to examine the associations between a broader range of lifestyles of young adults and their patterns of food consumption.

DESIGN

Cross-sectional.

SETTING

Brisbane, Australia.

PARTICIPANTS

The data set are from a long running birth cohort study which commenced in 1981. Details of dietary intake and sociodemographic and lifestyle factors were from the 21-year follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) birth cohort. The effective cohort (n 2665, 57 % women) is of young adult offspring. Usual dietary intake was assessed using a Food Frequency Questionnaire (FFQ). Data on sociodemographic and lifestyle variables were obtained from self-reports.

RESULTS

Western and prudent dietary patterns were identified for the combined cohort of women and men using principal components analysis. Multivariable linear regression models were used to examine the associations between lifestyle variables and dietary patterns adjusting for potential confounders. Results from multivariable adjusted models showed that physical activity, watching TV and smoking were strongly associated with each dietary pattern; alcohol consumption and BMI showed weaker associations (P < 0·05 for all).

CONCLUSIONS

Our study describes a clustering of unhealthy lifestyles in young adults. Young adults with unhealthy lifestyles less often adhere to a healthy prudent dietary pattern and more often an unhealthy Western pattern. Dietary preferences are enmeshed in a lifestyle matrix which includes physical activity, sedentary activity, smoking and alcohol consumption of young adults.

Consuming media, consuming food: investigating concurrent TV viewing and eating using a 7-d time use diary survey

OBJECTIVE

One explanation for the relationship between TV viewing and obesity is that people may (over)eat while watching TV. The current study investigated associations between TV viewing and the time spent on (concurrent) eating in a naturalistic setting among a general population sample.

DESIGN

Preregistered secondary data analyses were performed of a diary survey in which respondents reported their time use in 10-min blocks for 7 d.

SETTING

Concurrent TV viewing and eating was operationalised as all blocks in which TV viewing and eating occurred simultaneously. Furthermore, the TV content respondents watched was coded as food-related (i.e. culinary content) or non-food related.

PARTICIPANTS

The sample composed of 2292 adults (58·9 % female) in the Netherlands, aged ≥ 20 years, from all educational levels (18·1 % low, 29·8 % middle and 51·4 % high).

RESULTS

More than half of the respondents (51·3 %) reported concurrent TV viewing and eating at least once during the 7-d diary period. The average eating occasion was longer in duration while watching TV (v. without media use), and the total time spent on eating was longer on days of concurrent TV viewing and eating (v. days of eating without media use). The percentage of TV viewing time spent on concurrent eating did not differ between food-related and non-food-related TV content.

CONCLUSIONS

Eating while watching TV was related to an increased time spent on eating. Even though energy intake was not assessed, these findings from a naturalistic setting provide further evidence that concurrent TV viewing and eating may contribute to overeating.

Dietary practices of adult Egyptians before and during the COVID-19 lockdown

Aim

The aim of this study was to describe dietary practices of adult Egyptians, estimate changes in their body mass index (BMI), and identify possible determinants of such changes before and during the COVID-19 lockdown.

Subject and methods

A cross-sectional web-based survey was conducted during the nationwide COVID-19 partial lockdown. Data were obtained from 430 Egyptian adults regarding their personal and socio-demographic characteristics, routine daily physical activities, dietary patterns, practices related to food purchase and food handling, and weight and BMI before and during the lockdown using an online web-based questionnaire.

Results

The number of daily meals and daily snacks significantly increased during the lockdown. Moreover, the consumption of all types of snacks increased, except for chocolate and sweets, whose consumption decreased. Eating of fast food decreased, whereas the number of individuals practicing indoor physical activities increased during the lockdown. During the lockdown, no significant changes in the mean BMI were observed. The mean weekly consumption of starch, meat, milk, fat, and free foods decreased, whereas the mean weekly consumption of fruits and vegetables increased. Food handling practices improved during the lockdown. Based on the results of the linear regression analysis, age, the number of daily meals, practicing of physical activities during lockdown, and mean weekly consumption of meat were the independent predictors of BMI during the lockdown.

Conclusion

During the lockdown, no significant changes in the BMI of adult Egyptians were observed, whereas dietary practices and food handling practices changed.

Quarantine during COVID-19 outbreak: Adherence to the Mediterranean diet among the Cypriot population

OBJECTIVE

The aim of this study was to analyze adherence to the Mediterranean diet among the adult general population of Cyprus during the COVID-19 confinement.

METHODS

This was an Internet-based, cross-sectional study that collected information about socioeconomic and demographic characteristics, adherence to the Mediterranean diet and other dietary details, physical activity levels, and smoking habits using a self-administered questionnaire. The survey was conducted between April 6 and June 20, 2020, 1 to 2.5 mo after the initiation of the social confinement measures.

RESULTS

There were 1485 Cypriot adults who participated in the study. The median Mediterranean diet score was 21 (q1 = 19, q3 = 24) with men, married individuals, residents of rural regions, and physically active participants being more adherent to the Mediterranean diet compared with women; unmarried, divorced, or widowed; residents of urban regions; and physically inactive participants, respectively (P < 0.05). Multinomial logistic regression showed that being ≥45 y of age and physically active was positively associated with the Mediterranean diet score, whereas being unmarried, divorced, or widowed and a current smoker was negatively associated with the Mediterranean diet score (P < 0.05).

CONCLUSIONS

Adherence to the Mediterranean diet during the confinement imposed due to the COVID-19 pandemic among the Cypriot adult population was associated with male sex, age >45 y, being married, being physically active, and being resident of rural regions. The importance of better understanding of nutritional behavior during COVID-19 lockdowns is emphasized so public health authorities can plan future lockdown policies on nutritional recommendations, should a new pandemic occur.

How is television time linked to cardiometabolic health in adults? A critical systematic review of the evidence for an effect of watching television on eating, movement, affect and sleep

OBJECTIVE

To improve our understanding of how television (TV) time is linked to cardiometabolic health among adults by systematically and critically evaluating the evidence that watching TV is associated with increased food consumption, lack of movement or negative affect or affects subsequent sleep.

DESIGN

Systematic review.

DATA SOURCES

Web of Science and PubMed.

ELIGIBILITY CRITERIA

Studies that provided quantitative evidence on short-term associations of watching TV with dietary intake, characteristics of sitting, affect and sleep among samples of healthy adults (≥18 years old).

DATA EXTRACTION AND SYNTHESIS

Study quality was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tools; studies deemed to be of low quality were excluded from the review. Due to heterogeneity of study designs and measurements, the findings were synthesised using narrative summary accompanied by custom plots.

RESULTS

We identified 31 studies that met the inclusion criteria. Most of the associations reported by the studies included in this review were weak or inconsistent. There was no strong evidence to suggest that food consumption is higher while watching TV than in other contexts or that TV is a particularly 'sedentary' behaviour. Affect was less likely to be positive while watching TV than in other contexts but was not more likely to be negative. Two small studies suggest that TV may impact sleep via suppressing melatonin and delaying bedtime.

CONCLUSION

There is currently no strong evidence to suggest that TV might impact cardiometabolic health via increasing food consumption, being linked with prolonged/inactive sitting, affect or subsequent sleep. Additional research is required to understand how TV fits within everyday lives and relates to eating, sitting, affect and sleep to improve our understanding of how it might impact cardiometabolic health.

Managing Obesity in Lockdown: Survey of Health Behaviors and Telemedicine

Since the outbreak of COVID-19, billions of people have gone into lockdown, facing pandemic related challenges that engender weight gain, especially in the obese. We report the results of an online survey, conducted during Israel’s first quarantine, of 279 adults treated in hospital-based obesity clinics with counseling, medications, surgery, endoscopic procedures, or any combination of these for weight loss. In this study, we assessed the association between changes in dietary and lifestyle habits and body weight, and the benefits of receiving weight management care remotely through telemedicine during lockdown. Compared to patients not receiving obesity care via telemedicine, patients receiving this care were more likely to lose weight (OR, 2.79; p = 0.042) and also to increase participation in exercise (OR, 2.4; p = 0.022). While 40% of respondents reported consuming more sweet or salty processed snacks and 33% reported less vegetables and fruits, 65% reported more homemade foods. At the same time, 40% of respondents reported a reduction in exercise and 52% reported a decline in mood. Alterations in these eating patterns, as well as in exercise habits and mood, were significantly associated with weight changes. This study highlights that lockdown affects health behaviors associated with weight change, and advocates for the use of telemedicine to provide ongoing obesity care during future quarantines in order to promote weight loss and prevent weight gain.

Increased Screen Time Is Associated With Alcohol Desire and Sweetened Foods Consumption During the COVID-19 Pandemic

Background: Elevated screen time has been associated with addictive behaviors, such as alcohol and sugar intake and smoking. Considering the substantial increase in screen time caused by social isolation policies, this study aimed to analyze the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults. Methods: A sample of 1,897 adults with a mean age of 37.9 (13.3) years was assessed by an online survey, being composed by 58% of women. Participants were asked whether screen time in television, cell phone, and computer increased during the pandemic, as well as how much time is spent in each device. Closed questions assessed the frequency of alcohol and sweetened food consumption, smoking, and an increased desire to drink and smoke during the pandemic. Educational level, age, sex, feeling of stress, anxiety, depression, and use of a screen device for physical activity were covariates. Binary logistic regression models considered adjustment for covariates and for mutual habits. Results: Increased television time was associated with increased desire to drink (OR = 1.46, 95% CI: 1.12; 1.89) and increased sweetened food consumption (OR = 1.53, 95% CI: 1.18; 1.99), while an increase in computer use was negatively associated with consumption of alcohol (OR = 0.68, 95% CI: 0.53; 0.86) and sweetened foods (OR = 0.78, 95% CI: 0.62; 0.98). Increased cell phone time was associated with increased sweetened food consumption during the pandemic (OR = 1.78, 95% CI: 1.18; 2.67). Participants with increased time in the three devices were less likely to consume sweetened foods for ≥5 days per week (OR = 0.63, 95% CI: 0.39; 0.99) but were twice as likely to have sweetened food consumption increased during pandemic (OR = 2.04, 95% CI: 1.07; 3.88). Conclusion: Increased screen time was differently associated with consumption and desire for alcohol and sweets according to screen devices. Increased time in television and cell phones need to be considered for further investigations of behavioral impairments caused by the pandemic.

On computing critical factors based healthy behavior index for behavior assessment

OBJECTIVE

Ubiquitous computing has supported personalized health through a vast variety of wellness and healthcare self-quantification applications over the last decade. These applications provide insights for daily life activities but unable to portray the comprehensive impact of personal habits on human health. Therefore, in order to facilitate the individuals, we have correlated the lifestyle habits in an appropriate proportion to determine the overall impact of influenced behavior on the well-being of humans.

MATERIALS AND METHODS

To study the combined impact of personal behaviors, we have proposed a methodology to derive the comprehensive Healthy Behavior Index (HBI) consisting of two major processes: (1) Behaviors' Weight-age Identification (BWI), and (2) Healthy Behavior Quantification and Index (HBQI) modeling. The BWI process identifies the high ranked contributing behaviors through life-expectancy based weight-age, whereas HBQI derives a mathematical model based on quantification and indexing of behavior using wellness guidelines.

RESULTS

The contributing behaviors are identified through text mining technique and verified by seven experts with a Kappa agreement level of 0.379. A real-world user-centric statistical evaluation is applied through User Experience Questionnaire (UEQ) method to evaluate the impact of HBI service. This HBI service is developed for the Mining Minds, a wellness management application. This study involves 103 registered participants (curious about the chronic disease) for a Korean wellness management organization. They used the HBI service over 12 weeks, the results for which were evaluated through UEQ and user feedback. The service reliability for the Cronbach's alpha coefficient greater than 0.7 was achieved using HBI service whereas the stimulation coefficient of the value 0.86 revealed significant effect. We observed an overall novelty of the value 0.88 showing the potential interest of participants.

CONCLUSIONS

The comprehensive HBI has demonstrated positive user experience concerning the stimulation for adapting the healthy behaviors. The HBI service is designed independently to work as a service, so any other wellness management service-enabled platform can consume it to evaluate the healthy behavior index of the person for recommendation generation, behavior indication, and behavior adaptation.

Changes in Dietary Behaviours during the COVID-19 Outbreak Confinement in the Spanish COVIDiet Study

The aim of this study was to evaluate whether dietary behaviours of the Spanish adult population were changed during the COVID-19 outbreak confinement. For that purpose, an online questionnaire, based on 44 items including socio-demographic data, Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, processed foods intake, changes in their usual food choices and weight gain was distributed using social media and snowball sampling. A total of 7514 participants (37% aged below 35 years, 70.6% female, 77.9% university-level education or higher) from all the Spanish territory completed the questionnaire. Results outlined healthier dietary behaviours during the confinement when compared to previous habits. Overall, the MEDAS score (ranging from 0 to 14, whereby higher a scoring reflects greater adherence to the MedDiet) increased significantly from 6.53 ± 2 to 7.34 ± 1.93 during the confinement. Multivariate logistic regression models, adjusted for age, gender, region and other variables, showed a statistically significant higher likelihood of changing the adherence to the MedDiet (towards an increase in adherence) in those persons who decreased the intake of fried foods, snacks, fast foods, red meat, pastries or sweet beverages, but increased MedDiet-related foods such as olive oil, vegetables, fruits or legumes during the confinement. COVID-19 confinement in Spain has led to the adoption of healthier dietary habits/behaviours in the studied population, as reflected by a higher adherence to the MedDiet. This improvement, if sustained in the long-term, could have a positive impact on the prevention of chronic diseases and COVID-19-related complications.

Time Spent Sitting as an Independent Risk Factor for Cardiovascular Disease

Sedentary behavior is highly prevalent despite growing evidence of adverse effects on the cardiovascular and metabolic system that are independent of the level of recreational physical activity (PA). We present results for the association between sitting time and cardiovascular disease (CVD) from selected cohort and cross-sectional studies published in or after the year 2010 according to the domains where sitting time is accumulated during the day. These include TV viewing, occupational sitting, and sitting during transportation as well as overall sitting. The outcomes considered in this review are total CVD, coronary heart disease, and stroke as well as CVD risk factors-namely, hypertension, hypercholesterolemia, and type 2 diabetes and their associated biomarkers. Finally, several current issues with regard to studying the effects of sitting time on CVD are discussed, including how sedentary behavior is assessed, isotemporal substitution modeling, examination of joint associations for sitting and PA, and benefits of breaks in sitting time. Overall, the scientific evidence supports public health recommendations that encourage adults to limit their sedentary time in order to improve their cardiovascular health.

The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis

Background

The use of computers/TV has become increasingly common worldwide after entering the twenty-first century and depression represents a growing public health burden. Understanding the association between screen time-based sedentary behavior (ST-SB) and the risk of depression is important to the development of prevention and intervention strategies.

Methods

We searched the electronic databases of Medline, Embase and the Cochrane Library. The odds ratio (OR) with corresponding 95% confidence intervals (CIs) was adopted as the pooled measurement. Subgroup analyses were investigated by stratified meta-analyses based on age, gender and reference group (reference category of screen time, e.g. 2 h/day, 4 h/day).

Results

There were 12 cross-sectional studies and 7 longitudinal studies met the inclusion criteria. Overall, the pooled OR was 1.28 with high heterogeneity (I² = 89%). Compared to those who reported less SB, persons reporting more SB had a significantly higher risk of depression. When the gender was stratified, the pooled OR was 1.18 in female groups while no significant association was observed in males. Among the 19 studies, 5 studies used a reference group with ST = 2 h/days (pooled OR = 1.46), 9 studies used ≥4 h as a reference group (pooled OR = 1.38), 2 studies used 1 h as a reference group (pooled OR = 1.07) and for the remaining 3 studies, hours of ST were calculated as a continuous variable (pooled OR = 1.04).

Conclusions

ST-SB is associated with depression risk and the effects vary in different populations. In addition, valid objective measures of SB should be developed in future studies.

The effects of meal-timing on self-rated hunger and dietary inflammatory potential among a sample of college students

College is an important time for young adults to establish healthy eating habits since students are at risk for gaining weight during the college years. An emerging area of research is examining the effect of meal-timing, which involves the timing of food intake throughout the day, in an effort to improve satiety and bodyweight. The purpose of this study was to examine the use of meal-timing among a sample of college students and to assess what aspects from an intervention could help them to adhere to meal-timing long term. Participants were randomly assigned to either a daytime group (≤30% total kcals after 5 pm) or a nighttime group (≥50% total kcals after 5 pm). After completing the intervention, almost half of participants (49%) reported they could adhere to meal-timing long-term. Having more resources that support meal-timing are needed to help students potentially achieve a healthy weight and prevent chronic diseases.

Association between bedtime and the prevalence of newly diagnosed non-alcoholic fatty liver disease in adults

BACKGROUND & AIMS

Emerging evidence supported that circadian clocks played an important role in the development and progression of non-alcoholic fatty liver disease (NAFLD). Bedtime is a strong regulator of circadian rhythms, implying that it may contribute to the onset of NAFLD. However, few studies have examined the association between bedtime and NAFLD. The purpose of the study was to determine whether late bedtime is associated with newly diagnosed NAFLD in an adult population.

METHODS

This population-based study was performed in 22 807 participants in Tianjin, China. Bedtime was obtained from a self-administered questionnaire, and NAFLD was diagnosed by abdominal ultrasonography. Odds ratios of NAFLD for bedtime categories were estimated with multiple logistic regression models.

RESULTS

The prevalence of newly diagnosed NAFLD was 18.8% in the present study. After adjustment for the potential confounders, compared with the reference group (bedtime ≤22:00), the odds ratios (95% confidence intervals) of NAFLD were 1.18 (1.05-1.32) and 1.42 (1.21-1.68) for bedtime from 22:00 to 24:00 and ≥24:00, respectively.

CONCLUSION

Late bedtime was slightly but significantly associated with an increased prevalence of newly diagnosed NAFLD, independently of confounding factors. It is suggested that early bedtime may be beneficial in preventing NAFLD.

Correlates of sedentary behaviour in university students: A systematic review

High levels of sedentary behaviour are associated with negative health-related outcomes. However, there is limited evidence on the variables influencing sedentary behaviour in university students. The aim of this systematic review was to identify the intrapersonal, interpersonal, environmental, and time correlates of sedentary behaviour in university students. Records from 12 electronic databases were screened by two independent reviewers. Inclusion criteria included: (i) peer-reviewed articles written in English, Spanish, or French; (ii) studies including undergraduate or postgraduate university students; (iii) studies reporting on the association between sedentary behaviour and at least one variable. The protocol is registered in PROSPERO (CRD42017074198). A total of 126 studies published between 1994 and 2017 met the inclusion criteria. The primary measure of sedentary behaviour was self-reported screen time (61%), followed by total sitting time (28%). Most studies were cross-sectional (86%). After excluding high risk of bias studies (58%), only three intrapersonal variables were sufficiently investigated (≥4) to determine an association with sedentary behaviour: physical activity (negative association with sitting time), obesity markers (indeterminate associations with TV viewing), and gender - female (null associations with total sitting time and screen time). Overall, most of the reported correlates of sedentary behaviour were intrapersonal, non-modifiable factors. Further research on modifiable correlates covering all socio-ecologic levels is required to inform future intervention development. In addition, longitudinal studies are needed to enable the identification of determinants. Improvements in designing and reporting future studies are recommended to help strengthen the available evidence and facilitate future reviewing efforts.

Disentangling the relationship between sedentariness and obesity: Activity intensity, but not sitting posture, is associated with adiposity in women

BACKGROUND

The relationship between free-living sedentary behaviour (SB) and obesity is unclear. Studies may arrive at disparate conclusions because of inconsistencies and limitations when defining and measuring free-living SB. The aim of this cross-sectional study was to examine whether the relationship between SB and adiposity differed depending on the way SB was operationally defined and objectively measured.

METHODS

Sixty-three female participants aged 37.1 years (SD = 13.6) with a body mass index (BMI) of 29.6 kg/m² (SD = 4.7) had their body composition measured (BodPod, Concord, CA) then were continuously monitored for 5-7 days with the SenseWear Armband (SWA; sleep and activity intensity) and the activPAL (AP; posture). Data from both activity monitors were analysed separately and integrated resulting in a third measure of SB (activity intensity and posture; SED^INT). SB outputs were compared according to week or weekend day averages then correlated against body composition parameters after adjusting for moderate-to-vigorous physical activity (MVPA).

RESULTS

SED^SWA resulted in the most sedentary time 11.74 h/day (SD = 1.60), followed by SED^AP 10.16 h/day (SD = 1.75) and SED^INT 9.10 h/day (SD = 1.67). There was a significant positive association between SED^SWA and body mass [r(61) = 0.29, p = .02], BMI [r (61) = 0.33, p = .009] and fat mass [r(61) = 0.32, p = .01]. SED^AP and SED^INT were not associated with any of the indices of adiposity. Correlations between SB and adiposity were non-significant when controlling for MVPA.

CONCLUSIONS

The relationship between SB and adiposity differed depending on how SB was operationally defined and measured, and was dependent on MVPA. The definition of SB based on a sitting posture (SED^AP) was not strongly related to body fat, whereas the accumulation of any behaviour (sitting or standing) with an intensity of <1.5 METs (SED^SWA) (offset by the presence of MVPA) was positively associated with indices of adiposity. These data suggest that the postural element of SB (sitting) is not sufficient for the accumulation of adiposity, rather activities requiring low EE (<1.5 METs) and the absence of MVPA, regardless of posture, are associated with higher fat mass.

Real-World Usage of Educational Media Does Not Promote Parent-Child Cognitive Stimulation Activities

OBJECTIVE

To determine whether educational media as actually used by low-income families promote parent-child cognitive stimulation activities.

METHODS

We performed secondary analysis of the control group of a longitudinal cohort of mother-infant dyads enrolled postpartum in an urban public hospital. Educational media exposure (via a 24-hour recall diary) and parent-child activities that may promote cognitive stimulation in the home (using StimQ) were assessed at 6, 14, 24, and 36 months.

RESULTS

Data from 149 mother-child dyads, 93.3% Latino, were analyzed. Mean (standard deviation) educational media exposure at 6, 14, 24, and 36 months was, respectively, 25 (40), 42 (58), 39 (49), and 39 (50) minutes per day. In multilevel model analyses, prior educational media exposure had small positive relationship with subsequent total StimQ scores (β = 0.11, P = .03) but was nonsignificant (β = 0.08, P = .09) after adjusting for confounders (child: age, gender, birth order, noneducational media exposure, language; mother: age, ethnicity, marital status, country of origin, language, depressive symptoms). Educational media did predict small increases in verbal interactions and toy provision (adjusted models, respectively: β = 0.13, P = .02; β = 0.11; P = .03). In contrast, more consistent relationships were seen for models of the relationship between prior StimQ (total, verbal interactions and teaching; adjusted models, respectively: β = 0.20, P = .002; β = 0.15, P = .006; β = 0.20, P = .001) and predicted subsequent educational media.

CONCLUSIONS

Educational media as used by this sample of low-income families does not promote cognitive stimulation activities important for early child development or activities such as reading and teaching.

Sedentary Behavior Is Associated With Low Leisure-Time Physical Activity and High Body Fatness in Older Brazilian Adults

Sedentary behavior (SB) has emerged as a new health risk factor, including risk of premature death. This study examined the association between SB and measures of physical activity and body fatness in older Brazilian adults. Self-report measures of SB (ie, sitting time [ST]), leisure-time physical activity (LTPA), and body fatness (body mass index [BMI]) were collected from 355 older adults aged 60 years and older by trained interviewers. Statistical procedures were conducted using SPSS software with significance set at P < .05. Overall, the median ST was 3 hours per day. Mean values of LTPA and BMI for the entire sample were 90.0 (197.4) min/week and 26.5 (4.9) kg/m², respectively. Partial correlations controlling for age revealed that ST was negatively associated with LTPA (pr = -.15 [-.25; -.04]; P = .006) and positively associated with BMI (pr = .25 [.14; .35]; P < .001). Age, BMI, and LTPA emerged as independent predictors of ST, explaining a small but significant variance in ST (R ² = .12; P = .02). Furthermore, t test revealed a significant difference in LTPA and BMI between groups of different amounts of sitting. The findings suggest that prolonged ST may have a negative impact on LTPA and BMI in older Brazilian adults.

Factors Associated With Changes in Fruit Intake During Young Adulthood: A Classification and Regression Tree Analysis of Longitudinal Data

OBJECTIVE

To examine whether distinct participant groupings for changes in fruit intake (FI) levels between ages 23 and 31 years are identifiable based on both time-varying and time-invariant sociodemographic and behavioral variables.

METHODS

Data were derived from the National Longitudinal Survey of Youth-1997, US. Change in FI frequency constituted the dependent variable. For 21 variables, changes and averages in 2007-2011 were calculated. Classification and regression tree analysis was conducted using Generalized, Unbiased, Interaction Detection, and Estimation software.

RESULTS

Analysis isolated 5 variables (changes in smoking, drinking alcohol, and television viewing, plus 5-year mean of income-to-poverty ratio and computer use) and associated cutoff values to identify 7 groups of participants with differing degrees of FI change.

CONCLUSIONS AND IMPLICATIONS

Multiple groupings existed within upper social strata; a majority maintained healthy behaviors whereas some adopted substance use stress-coping mechanisms. Some low-income individuals demonstrated a capacity to adopt healthy behaviors. Dietary interventions could identify behavioral clustering, with emphasis on drinking, smoking, and screen time.

Mealtime habits and risk of developing the metabolic syndrome or insulin resistance among Mexican adults

Meals are an important source of food intake, contributing to body weight and health status. Previous studies have examined the relationship between isolated mealtime behaviours and the metabolic syndrome (MetS). The aim of this study was to examine the influence over time of ten interrelated mealtime habits on the risk of developing the MetS and insulin resistance (IR) among Mexican adults. We conducted a prospective cohort study with a sample of 956 health workers. The Mealtime Habits Quality (MHQ) scale is based on four mealtime situations (availability of time to eat, distractions while eating, environmental and social context of eating, and familiar or cultural eating habits), which were used to assess the participants' MHQ at the baseline (2004-2006) and follow-up (2010-2012) evaluations. The MetS was assessed using criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). IR was defined using the homoeostasis model assessment. Crude and adjusted relative risks were calculated to estimate the relationship between MHQ and the risk of developing the MetS or IR. Participants classified in the lower MHQ category had an 8·8 (95 % CI 3·1, 25) and 11·1 (95 % CI 3·4, 36·1) times greater risk of developing the MetS (using the NCEP-ATP III and IDF criteria, respectively), and an 11·2 times (95 % CI 3·9, 31·5) greater likelihood of developing IR, compared with those in the higher MHQ group. This prospective study reveals that individuals who engaged in more undesirable than recommended mealtime behaviours had a >10-fold risk of developing the MetS or IR.

Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study

Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.

What Is a Snack, Why Do We Snack, and How Can We Choose Better Snacks? A Review of the Definitions of Snacking, Motivations to Snack, Contributions to Dietary Intake, and Recommendations for Improvement

Around the world, adults consume energy outside of traditional meals such as breakfast, lunch, and dinner. However, because there is no consistent definition of a "snack," it is unclear whether those extra eating occasions represent additional meals or snacks. The manner in which an eating occasion is labeled (e.g., as a meal or a snack) may influence other food choices an individual makes on the same day and satiety after consumption. Therefore, a clear distinction between "meals" and "snacks" is important. This review aims to assess the definition of extra eating occasions, to understand why eating is initiated at these occasions, and to determine what food choices are common at these eating occasions in order to identify areas for dietary intervention and improvement. Part I of this review discusses how snacking is defined and the social, environmental, and individual influences on the desire to snack and choice of snack. The section concludes with a brief discussion of the associations of snacking with cardiometabolic health markers, especially lipid profiles and weight. Part II addresses popular snack choices, overall snacking frequencies, and the demographic characteristics of frequent snackers in several different countries. This review concludes with a recommendation for nutrition policymakers to encourage specific health-promoting snacks that address nutrient insufficiencies and excesses.

Effects of reducing sedentary time on glucose metabolism in immigrant Pakistani men

Purpose

This study aimed to examine the association between changes in objectively measured overall physical activity (PA) and changes in fasting and postprandial plasma insulin, C-peptide, and glucose concentrations in type 2 diabetes-prone immigrant Pakistani men living in Norway and to examine whether this association is explained by changes in moderate and vigorous PA (MVPA) or changes in sedentary time.

Methods

The current study is a secondary cohort analysis on data collected from the Physical Activity and Minority Health study, a randomized controlled trial aimed at increasing the PA level, and not sedentary time per se, in a group of sedentary immigrant Pakistani men (n = 150). For the present analyses, the two groups were merged and a cohort analysis was performed. Overall PA (counts per minute) and its subcomponents, sedentary time and MVPA, were measured with accelerometry. Outcome variables were measured after a 2-h standardized glucose tolerance test.

Results

Change in overall PA was significantly associated with postprandial log-transformed plasma insulin (β = −0.002; 95% confidence interval (CI), −0.003 to 0.000; P = 0.008), C-peptide (β = −2.7; 95% CI, −4.9 to −0.5; P = 0.01), and glucose concentration (β = −0.006; 95% CI, −0.01 to −0.002; P = 0.002). Change in sedentary time was significantly and beneficially associated with changes in postprandial log-transformed plasma insulin (β = 0.002; 95% CI, 0.001–0.003; P = 0.001), C-peptide (β = 3.7; 95% CI, 1.5–6.0; P = 0.001), and glucose concentration (β = 0.006; 95% CI, 0.002–0.1; P = 0.002), independent of changes in MVPA, waist circumference, and other confounders.

Conclusions

Increasing overall PA by reducing sedentary time seems as important as increasing time spent at MVPA in relation to postprandial plasma insulin and glucose levels in diabetes-prone immigrant men.

Is the relationship between sedentary behaviour and cardiometabolic health in adolescents independent of dietary intake? A systematic review

Screen time, but not overall sedentary behaviour, is consistently related to cardiometabolic health in adolescents. Because of the associations screen time has with dietary intake, diet may be an important factor in the screen time and health relationship; however, evidence has not previously been synthesized. Thus, the aim of this systematic review was to explore whether the associations between various sedentary behaviours and cardiometabolic risk markers are independent of dietary intake in adolescents. Online databases and personal libraries were searched for peer-reviewed original research articles published in English before March 2014. Included studies assessed associations between sedentary behaviour and cardiometabolic markers in 12- to 18-year-olds and adjusted for dietary intake. Twenty-five studies met the inclusion criteria. From the 21 studies examining sedentary behaviour and adiposity, the majority found significant positive associations between television viewing, screen time and self-reported overall sedentary behaviour with markers of adiposity, independent of dietary intake. No significant associations between screen time with blood pressure and cholesterol were reported. Sedentary behaviour appears to be associated with adiposity in adolescents, irrespective of dietary intake. However, the variability of dietary variables between studies suggests further work is needed to understand the role of dietary intake when examining these associations in youth.

Internet and video game use in relation to overweight in young adults

PURPOSE

To examine the relationship between interactive media use (Internet and video games) and overweight risk in young adults.

DESIGN

Prospective cohort study.

SETTING

France (TEMPO study).

SUBJECTS

Community sample of 674 young adults aged 22 to 35 in 2009 (response rate to the original mail out: 44.3%).

MEASURES

Data were collected through mail-based questionnaires from study participants in 1999 (juvenile overweight, juvenile TV use) and 2009 (overweight, Internet and video game use, regular physical activity), and from their parents who participated in the GAZEL study from 1989 to 2009 (parental overweight).

ANALYSIS

Logistic regression.

RESULTS

Participants who engaged in regular video game use (>1 time/wk) were more likely to be overweight than those who did not (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.42-3.42). Adjusting for sex, regular athletic activity, juvenile overweight, juvenile TV use, and parental overweight, the OR associated with video game use decreased but remained statistically significant (OR 1.94, 95% CI 1.15-3.28). We found no significant association between Internet use and overweight.

CONCLUSION

Video game use may be a relevant target for interventions aiming to decrease the burden of overweight and associated consequences in young adults.

Longitudinal association between television watching and computer use and risk markers in diabetes in the SEARCH for Diabetes in Youth Study

BACKGROUND

The study provides evidence of the longitudinal association between screen time with hemoglobin A1c (HbA1c) and cardiovascular risk markers among youth with type 1 diabetes (T1D) and type 2 diabetes (T2D).

OBJECTIVE

To examine the longitudinal relationship of screen time with HbA1c and serum lipids among youth with diabetes.

SUBJECTS

Youth with T1D and T2D.

METHODS

We followed up 1049 youth (≥10 yr old) with recently diagnosed T1D and T2D participating in the SEARCH for Diabetes in Youth Study.

RESULTS

Increased television watching on weekdays and during the week over time was associated with larger increases in HbA1c among youth with T1D and T2D (p-value <0.05). Among youth with T1D, significant longitudinal associations were observed between television watching and TG (p-value <0.05) (week days and whole week), and low-density lipoprotein cholesterol (LDL-c, p-value <0.05) (whole week). For example, for youth who watched 1 h of television per weekday at the outset and 3 h per weekday 5 yr later, the longitudinal model predicted greater absolute increases in HbA1c (2.19% for T1D and 2.16% for T2D); whereas for youth who watched television 3 h per weekday at the outset and 1 h per weekday 5 yr later, the model predicted lesser absolute increases in HbA1c (2.08% for T1D and 1.06% for T2D).

CONCLUSIONS

Youth with T2D who increased their television watching over time vs. those who decreased it had larger increases in HbA1c over 5 yr. Youth with T1D who increased their television watching over time had increases in LDL-c, TG, and to a lesser extent HbA1c.

Lifestyle factors associated with childhood obesity: a cross-sectional study in Shanghai, China

Background

Limited research has been conducted to investigate factors associated with overweight and obesity of children in China, where obesity has been increasing. This study investigated associations of lifestyle factors with overweight or obesity among Chinese primary school-aged children.

Methods

A cross-sectional survey was conducted with 2400 children aged 6–12 from 11 primary schools. Children completed a self-administered questionnaire assisted by their parents at home. The survey included questions on self-reported height and weight, screen time, physical activity, modes of travel to/from school, and dietary habits. Multilevel models were conducted to examine factors associated with overweight or obesity.

Results

15.6% of children were overweight and 11.2% were obese; nearly 80% of children spent ≤2 hrs./day either on physical activities or screen time. Compared with those spent >3 hrs./day on screen time, children who spent ≤2 hrs./day or between 2-3 hrs./day were significantly less likely to be obese after adjusting for other variables (AOR = 0.34, 95% CI: 0.20-0.60, P < 0.01; or AOR = 0.41, 95% CI: 0.20-0.84, P = 0.02 respectively). Children spent ≤2 hrs./day on screen time were less likely to become overweight or obesity, compared with >3 hrs./day (AOR = 0.62, 95% CI: 0.38-0.99, P < 0.05).

Conclusions

Screen time is independently associated with childhood obesity, and needs be focused for obesity prevention in school-aged children in China.

The SNAPSHOT study protocol: SNAcking, Physical activity, Self-regulation, and Heart rate Over Time

Background

The cognitive processes responsible for effortful behavioural regulation are known as the executive functions, and are implicated in several factors associated with behaviour control, including focussing on tasks, resisting temptations, planning future actions, and inhibiting prepotent responses. Similar to muscles, the executive functions become fatigued following intensive use (e.g. stressful situations, when tired or busy, and when regulating behaviour such as quitting smoking). Therefore, an individual may be more susceptible to engaging in unhealthy behaviours when their executive functions are depleted. In the present study we investigate associations between the executive functions, snack food consumption, and sedentary behaviour in real time. We hypothesise that individuals may be more susceptible to unhealthy snacking and sedentary behaviours during periods when their executive functions are depleted. We test this hypothesis using real-time objective within-person measurements.

Methods/Design

A sample of approximately 50 Scottish adults from varied socio-economic, working, and cultural backgrounds will participate in the three phases of the SNAcking, Physical activity, Self-regulation, and Heart rate Over Time (SNAPSHOT) study. Phase one will require participants to complete home-based questionnaires concerned with diet, eating behaviour, and physical activity (≈1.5 hours to complete). Phase two will constitute a 2-3 hour psychological laboratory testing session during which trait-level executive function, general intelligence, and diet and physical activity intentions, past behaviour, and automaticity will be measured. The final phase will involve a 7-day ambulatory protocol during which objective repeated assessments of executive function, snacking behaviour, physical activity, mood, heart rate, perceived energy level, current context and location will be measured during participants’ daily routines. Multi-level regression analysis, accounting for observations nested within participants, will be used to investigate associations between fluctuations in the executive functions and health behaviours.

Discussion

Data from the SNAPSHOT study will provide ecologically valid information to help better understand the temporal associations between self-regulatory resources (executive functions) and deleterious health behaviours such as snacking and sedentary behaviour. If we can identify particular periods of the day or locations where self-regulatory resources become depleted and produce suboptimal health behaviour, then interventions can be designed and targeted accordingly.