Respirable dust and crystalline silica concentrations among workers at a brick kiln in Bhaktapur, Nepal

Exposure to respirable dust and crystalline silica (SiO2) has been linked to chronic obstructive pulmonary disease, silicosis, cancer, heart disease, and other respiratory diseases. Relatively few studies have measured respirable dust and SiO2 concentrations among workers at brick kilns in low- and middle-income countries. The purpose of this study was to measure personal breathing zone (PBZ) respirable dust and SiO2 concentrations among workers at one brick kiln in Bhaktapur, Nepal. A cross-sectional study was conducted among 49 workers in five job categories: administration, fire master, green (unfired) brick hand molder, green brick machine molder, and top loader. PBZ air samples were collected from each worker following Methods 0600 (respirable dust) and 7500 (respirable crystalline SiO2: cristobalite, quartz, tridymite) of the U.S. National Institute for Occupational Safety and Health. Eight-hour time-weighted average (TWA) respirable dust and quartz concentrations were also calculated. SiO2 percentage was measured in one bulk sample each of wet clay, the release agent used by green brick hand molders, and top coat soil at the brick kiln. The geometric mean (GM) sample and TWA respirable dust concentrations were 0.20 (95% confidence interval [CI]: 0.16, 0.27) and 0.12 (95% CI: 0.09, 0.16) mg/m3, respectively. GM sample and TWA quartz concentrations were 15.28 (95% CI: 11.11, 21.02) and 8.60 (95% CI: 5.99, 12.34) µg/m3, respectively. Job category was significantly associated with GM sample and TWA respirable dust and quartz concentrations (all p < 0.0001). Top loaders had the highest GM sample and TWA respirable dust concentrations of 1.49 and 0.99 mg/m3, respectively. Top loaders also had the highest GM sample and TWA quartz concentrations of 173.08 and 114.39 µg/m3, respectively. Quartz percentages in bulk samples were 16%-27%. Interventions including using wet methods to reduce dust generation, administrative controls, personal protective equipment, and education and training should be implemented to reduce brick kiln worker exposures to respirable dust and SiO2.

The Effects of a High-Carbohydrate versus a High-Fat Shake on Biomarkers of Metabolism and Glycemic Control When Used to Interrupt a 38-h Fast: A Randomized Crossover Study

This study aimed to determine the impact of various fast-interrupting shakes on markers of glycemic control including glucose, β-hydroxybutyrate (BHB), insulin, glucagon, GLP-1, and GIP. Twenty-seven sedentary adults (twelve female, fifteen male) with overweight or obesity completed this study. One condition consisted of a 38-h water-only fast, and the other two conditions repeated this, but the fasts were interrupted at 24 h by either a high carbohydrate/low fat (HC/LF) shake or an isovolumetric and isocaloric low carbohydrate/high fat (LC/HF) shake. The water-only fast resulted in 135.3% more BHB compared to the HC/LF condition (p < 0.01) and 69.6% more compared to the LC/HF condition (p < 0.01). The LC/HF condition exhibited a 38.8% higher BHB level than the HC/LF condition (p < 0.01). The area under the curve for glucose was 14.2% higher in the HC/LF condition than in the water condition (p < 0.01) and 6.9% higher compared to the LC/HF condition (p < 0.01), with the LC/HF condition yielding 7.8% more glucose than the water condition (p < 0.01). At the 25-h mark, insulin and glucose-dependent insulinotropic polypeptide (GIP) were significantly elevated in the HC/LF condition compared to the LC/HF condition (p < 0.01 and p = 0.02, respectively) and compared to the water condition (p < 0.01). Furthermore, insulin, GLP-1, and GIP were increased in the LC/HF condition compared to the water condition at 25 h (p < 0.01, p = 0.015, and p < 0.01, respectively). By the 38-h time point, no differences were observed among the conditions for any of the analyzed hormones. While a LC/HF shake does not mimic a fast completely, it does preserve some of the metabolic changes including elevated BHB and glucagon, and decreased glucose and insulin compared to a HC/LF shake, implying a potential for improved metabolic health.

The Effects of Potato Presentation on Vegetable Intake in School-Aged Children: A Cross-Over Study

Vegetables are an essential component of a healthy dietary pattern in children; however, their consumption is often insufficient due to lack of preference. To address this, the influence of combining vegetables (mixed peas and carrots-MPACs) with potatoes, a generally liked food, on overall vegetable consumption among children aged 7-13 years was explored. The research involved a cross-over study design with 65 participants who completed five lunchtime meal conditions, each with different combinations of MPACs and potatoes versus a control (MPACs with a wheat roll). The meals were provided in a cafeteria setting, and plate waste was used to measure vegetable consumption. Anthropometric data and other variables were also measured. Notably, self-reported hunger did not significantly differ between conditions. Meal condition was a significant predictor of MPACs (F = 5.20; p = 0.0005), with MPAC consumption highest when combined with shaped potato faces in the same bowl (+8.77 g compared to serving MPACs and shaped potato faces in separate bowls) and lowest when combined with diced potatoes in the same bowl (-2.85 g compared to serving MPACs and diced potatoes in separate bowls). The overall model for MPAC consumption was influenced by age, height z-score, body fat percentage z-score, and condition (likelihood ratio = 49.1; p < 0.0001). Age had the strongest correlation with vegetable consumption (r = 0.38), followed by male gender, height z-score (r = 0.30), and body fat z-score (r = -0.15). The results highlight the positive impact of combining potatoes with vegetables in school meals, particularly when using shaped potato faces. These findings emphasize the potential of potatoes as a valuable vegetable option in promoting healthier eating habits among children. Additionally, future research could explore the impact of different potato combinations and investigate other factors influencing meal consumption in school settings.

No significant salt or sweet taste preference or sensitivity differences following ad libitum consumption of ultra-processed and unprocessed diets: A randomized controlled pilot study

Ultra-processed food consumption has increased world-wide, yet little is known about the potential links with taste preference and sensitivity. This exploratory study aimed to (i) compare sweet and salty taste detection thresholds and preferences following consumption of ultra-processed and unprocessed diets, (ii) investigate whether sweet and salty taste sensitivity and preference were associated with taste-substrates (i.e. sodium and sugar) and ad libitum nutrient intake, and (iii) examine associations of taste detection thresholds and preferences with blood pressure (BP) and anthropometric measures following consumption of ultra-processed and unprocessed diets. In a randomized crossover study, participants (N=20) received ultra-processed or unprocessed foods for 2 weeks, followed by the alternate diet. Baseline food intake data were collected prior to admission. Taste detection thresholds and preferences were measured at the end of each diet arm. Taste-substrate/nutrient intake, body mass index (BMI), and body weight (BW) were measured daily. No significant differences were observed in participant salt and sweet detection thresholds or preferences after two weeks on ultra-processed or unprocessed diets. There was no significant association between salt and sweet taste detection thresholds, preferences, and nutrient intakes on either diet arm. A positive correlation was observed between salt taste preference and systolic BP (r=0.59; p=0.01), BW (r=0.47, p= 0.04), and BMI (r=0.50; p=0.03) following consumption of the ultra-processed diet. Thus, a two-week consumption of an ultra-processed diet does not appear to acutely impact sweet or salty taste sensitivity or preference..

Body shape perception in men and women without obesity during caloric restriction: a secondary analysis from the CALERIE study

OBJECTIVE

To examine body shape perception in 218 adults without obesity or history of eating disorders during caloric restriction (CR).

METHODS

Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) is a 2-year, randomized clinical trial using a 2:1 assignment (CR, 25% reduction in calories; Control, typical diet). For this secondary analysis, we examined perceived body shape using the Body Shape Questionnaire (BSQ). Analyses of BSQ scores are reported by group, over time, by sex, and by BMI. Data for body fat percentage, symptoms of depression, food cravings, maximal oxygen consumption, and stress were analyzed for their association with BSQ scores.

RESULTS

Compared to control, CR reduced BSQ scores. Women tended to have greater concern with body shape than men across all measurement times. There was no difference in change in BSQ scores at 12 or 24 months between those with a BMI < 25 kg/m² or ≥ 25 kg/m². Change in body fat percentage was most correlated with change in BSQ score from 0 to 12 (r = 0.39) and 0-24 months (r = 0.38). For change in BSQ score, Akaike/ Bayesian information criterion (AIC/BIC) found that the model of best fit included the following three change predictors: change in body fat percentage, depression symptoms, and food cravings. For 0-12 months, AIC/BIC = 1482.0/1505.6 and for 0-24 months AIC/BIC = 1364.8/1386.5.

CONCLUSIONS

CR is associated with reduced concern for body shape in men and women without obesity and with no history of eating disorders. Body shape perception among this sample was complex and influenced by multiple factors.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

The Effect of Wearable Activity Monitor Presence on Step Counts

Objective: In this study, we tested the effect of wearable activity monitors and tracking on physical activity over 2 weeks. Methods: Ninety young adults participated. Prior to initiation of the study, each participant was asked to download an iPhone app that tracked physical activity level (step counts) but were not told the app's purpose. Each participant was then randomly assigned to one of 3 groups (N=30/group): (1) measurement awareness, (2) measurement awareness+track/record, or (3) control. Participants in the measurement awareness and the measurement awareness+track/record groups were given a pedometer to wear for 2 weeks. Additionally, participants in the measurement awareness+track/ record group were instructed to record daily steps and submit their record after 2 weeks. Participants in the control group were not given a pedometer band nor asked track steps. Results: Neither the measurement awareness group nor the measurement awareness+track/record group were statistically different than controls during the intervention (p>.05). However, collapsing the intervention groups and comparing to the control group resulted in a 388.3 (SE=-186.9) higher daily step count during the intervention (p<.05). Conclusion: Wearable monitors modestly increases daily step count. However, the addition of recording daily step counts does not appear to provide an additional benefit in our study.

The effects of daily step goals of 10,000, 12,500, and 15,000 steps per day on neural activity to food cues: A 24-week dose-response randomized trial

INTRODUCTION

The purpose of this study was to examine the effect of different levels of sustained physical activity on neural reflections of attention allocated toward food cues in first year college women.

METHODS

Seventy-nine first-year college women (18.6 ± 0.5 years) were recruited to participate in the study. Women were randomly assigned to a daily step goal of 10,000, 12,500, or 15,000 for 24 weeks. Once during weeks 16-24, participants were shown pictures of plated meals or flowers with the neural response measured using the P300 and late positive potential (LPP) components of the scalp-recorded event-related potential. Diet was assessed using the automated 24-h recall.

RESULTS

Both the P300 and LPP amplitudes were significantly more positive to food versus flower pictures (ps < .001). There was no interaction between step group and picture condition for the P300 and LPP. However, the 12,500-step group showed a significantly elevated LPP amplitude in comparison to the other groups for both food and flowers (F(2,74) = 8.84; p < .001). The effect size for the combined results (food and flowers) was 0.56 between 10,000 and 12,500-step groups, and 0.75 between the 12,500- and 15,000-step groups. In addition, the 12,500 group reduced caloric consumption over the course of the intervention (t(1,74) = 3.35, p = .001, d_z  = 0.59).

CONCLUSION

Habitual physical activity of 10,000, 12,500, or 15,000 steps per day does not preferentially alter neural reflections toward food cues compared to flowers. There may be a nonlinear response to pleasant visual cues, with 12,500 steps per day eliciting higher LPPs than either 10,000 or 15,000.

Testing the relationship between inhibitory control and soda consumption: An event-related potential (ERP) study

The intake of sugar-sweetened beverages (SSB) may detrimentally influence health outcomes. Drinking less soda may help manage SSB consumption, as soft drinks are a top contributor to SSB intake. One cognitive factor that may influence soda consumption is inhibitory control, or the ability to withhold a dominant response in order to correctly respond to one's environment. Increased inhibitory control plays a role in decreasing consumption of high-calorie foods, and strengthening inhibitory control may help individuals manage their food intake. However, neural response to soda beverages versus traditional non-sweetened beverages, such as water, and how it relates to soda consumption is unknown. In a sample of 116 healthy individuals (M = 20.56; SD = 2.08; 47.4% female), we measured soda consumption and tested event-related potential (ERP) measures of inhibitory control, including the N2 and P3 components, during soda-specific and neutral comparison go/no-go tasks. Female participants consumed less soda on average than males, and as participants got older, they consumed less soda. Participants showed faster response times and higher accuracy on the soda-specific compared to neutral go/no-go . ERP results indicated inhibitory control was greater when individuals withheld dominant responses to soda stimuli rather than neutral stimuli. Neither N2 no-go amplitude on the soda-specific go/no-go nor P3 no-go amplitude on the soda-specific predicted measures of soda intake. Results suggest greater inhibitory control resources are required when withholding responses to soda beverages compared to neutral stimuli, but inhibitory control ERPs did not predict day-to-day soda intake.

The relationship between acute stress and neurophysiological and behavioral measures of food-related inhibitory control: An event-related potential (ERP) study

Stress influences many health-related behaviors including diet and nutrition intake, often resulting in increased calorie intake, fewer healthy eating behaviors, and poorer nutrition. Food intake is modulated by inhibitory control and has important implications for our physical, mental, and emotional health. Yet, little is known about the relationship between stress and food-related inhibitory control. We tested the influence of a short-term experimental stressor on behavioral and event-related potential (ERP; N2 and P3 components) measures of food-related inhibitory control. Ninety-seven healthy participants were randomly assigned to complete the Trier Social Stress Test (TSST) (n = 48, 27 females [52.9%]) or a neutral control condition (n = 49, 35 females [70%]) immediately followed by food-specific go/no-go and neutral go/no-go tasks while electroencephalogram (EEG) data were recorded. Stress levels were successfully manipulated, with heightened self-report and physiological measures (heart rate and systolic blood pressure) of the stress response in individuals who completed the TSST compared to control. As expected, the high calorie food-specific go/no-go task elicited larger N2 amplitude than the neutral task. N2 component amplitude was also significantly larger following the TSST relative to the control task. There were no significant between-group or task differences for P3 amplitude or behavioral measures. Findings suggest heightened N2 amplitude following psychological stress that is not specific to food or inhibition processes and may reflect heightened arousal following stress. Future research in individuals with overweight/obesity or experiencing chronic stress will further clarify the role of stress in food-related inhibitory control.

World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review

OBJECTIVE

To provide a systematic overview of world dietary sugar and sugar-sweetened beverage (SSB) intake trends in children and adolescents.

DATA SOURCES

Medline, Embase, and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched through January 2019 to identify longitudinal follow-up studies with time-trend data and repeated cross-sectional studies.

DATA EXTRACTION

Data from studies reporting ≥ 2 measurements (sugars, SSB, or sweets/candy) over ≥ 2 years and included ≥ 20 healthy, normal- or overweight children or adolescents aged 1-19 years.

DATA ANALYSIS

Data from 43 articles (n = 4 prospective cohort studies; n = 39 repeated cross-sectional studies) from 15 countries (n = 8 European countries plus Australia, Canada, China, South Korea, Mexico, Russia, and the United States) are presented narratively. According to the risk of bias in nonrandomized studies of interventions tool, 34 studies were judged to have a moderate risk of bias, and 5 to have a serious risk of bias.

CONCLUSIONS

Consumption among US children and adolescents increased substantially in the decades preceding 2000, followed by a faster and continued decline. As a whole, other international intake trends did not reveal drastic increases and decreases in SSB and dietary sugars; they tended to change only slightly across 3 decades.

Physical Activity and Insulin Resistance in 6,500 NHANES Adults: The Role of Abdominal Obesity

This cross-sectional investigation studied differences in insulin resistance across levels of physical activity in 6,500 US adults who were randomly selected as part of the National Health and Nutrition Examination Survey (NHANES). Another important objective was to determine the influence of abdominal obesity on the physical activity and insulin resistance relationship. MET-minutes were utilized to quantify total activity based on participation in 48 different physical activities. Two strategies were employed to categorize levels of physical activity: one was based on relative MET-minutes (quartiles), and the other approach was based on the US physical activity guidelines. Insulin resistance was indexed using the homeostatic model assessment (HOMA). Abdominal obesity was indexed using waist circumference. Effect modification was tested by dividing waist circumferences into sex-specific quartiles and then evaluating the relationship between physical activity and HOMA-IR within each quartile separately. Results showed that relative physical activity level was associated with HOMA-IR after controlling for demographic and demographic and lifestyle covariates (F = 11.5, P < 0.0001 and F = 6.0, P=0.0012, respectively). Adjusting for demographic and demographic and lifestyle covariates also resulted in significant relationships between guideline-based activity and HOMA-IR (F = 8.0, P < 0.0001 and F = 4.9, P=0.0017, respectively). However, statistically controlling for differences in waist circumference with the other covariates nullified the relationship between total physical activity and HOMA-IR. Effect modification testing showed that when the sample was delimited to adults with abdominal obesity (Quartile 4), relative (F = 5.6, P=0.0019) and guideline-based physical activity (F = 3.7, P=0.0098) and HOMA-IR were significantly associated. Physical activity and HOMA-IR were not related within the other three quartiles. In conclusion, it appears that differences in physical activity may play a meaningful role in insulin resistance in those with abdominal obesity, but total activity does not seem to account for differences in insulin resistance among US adults with smaller waists.

Brain reactivity to visual food stimuli after moderate-intensity exercise in children

Exercise may play a role in moderating eating behaviors. The purpose of this study was to examine the effect of an acute bout of exercise on neural responses to visual food stimuli in children ages 8-11 years. We hypothesized that acute exercise would result in reduced activity in reward areas of the brain. Using a randomized cross-over design, 26 healthy weight children completed two separate laboratory conditions (exercise; sedentary). During the exercise condition, each participant completed a 30-min bout of exercise at moderate-intensity (~ 67% HR maximum) on a motor-driven treadmill. During the sedentary session, participants sat continuously for 30 min. Neural responses to high- and low-calorie pictures of food were determined immediately following each condition using functional magnetic resonance imaging. There was a significant exercise condition*stimulus-type (high- vs. low-calorie pictures) interaction in the left hippocampus and right medial temporal lobe (p < 0.05). Main effects of exercise condition were observed in the left posterior central gyrus (reduced activation after exercise) (p < 0.05) and the right anterior insula (greater activation after exercise) (p < 0.05). The left hippocampus, right medial temporal lobe, left posterior central gyrus, and right anterior insula appear to be activated by visual food stimuli differently following an acute bout of exercise compared to a non-exercise sedentary session in 8-11 year-old children. Specifically, an acute bout of exercise results in greater activation to high-calorie and reduced activation to low-calorie pictures of food in both the left hippocampus and right medial temporal lobe. This study shows that response to external food cues can be altered by exercise and understanding this mechanism will inform the development of future interventions aimed at altering energy intake in children.

The Impact of Step Recommendations on Body Composition and Physical Activity Patterns in College Freshman Women: A Randomized Trial

PURPOSE

Transitioning from high school to college generally results in reduced physical activity and weight gain at a rate that is higher than the general population. The purpose of this study was to examine the effects of three progressively higher step recommendations over 24 weeks on changes in body weight and body composition.

METHODS

Ninety-two freshmen college women wore a multifunction pedometer for 24 weeks after being randomly assigned to a daily step level: 10,000, 12,500, or 15,000. Pedometer data were downloaded every two weeks and participants were counseled on meeting their step recommendation. Body weight and body composition were assessed at baseline and 24 weeks. Body composition was assessed by dual X-ray absorptiometry.

RESULTS

On average, women took 10,786 ± 1501, 12,650 ± 2001, and 13,762 ± 2098 steps per day for the 10,000-, 12,500-, and 15,000-step groups, respectively (F = 15.48, P < 0.0001). Participants gained 1.4 ± 2.6, 1.8 ± 2.1, and 1.4 ± 2.1 kg for the 10,000-, 12,500-, and 15,000-step groups, respectively (F = 37.74, P < 0.0001). Weight gain was not significantly different between groups (F = 0.18, P=0.8385). There was also no difference in fat weight gain (F = 0.41, P=0.7954).

DISCUSSION

A step recommendation beyond 10,000 does not prevent weight or fat gain over the first year of college. Future research should focus on either intensity of physical activity or the addition of dietary interventions to prevent weight gain during the first year of college.

Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of US Adults

The objective was to compare associations between sagittal abdominal diameter (SAD), waist circumference, and BMI to the oral glucose tolerance test (OGTT), along with fasting glucose, HbA1c, and HOMA-IR, in a nationally representative sample of 3582 US adults. The study also analyzed the effect of multiple covariates on the anthropometric and glucose metabolism associations. A cross-sectional design was used. SAD was assessed using an abdominal caliper. All other data were collected following strict NHANES protocols. The OGTT was the primary variable used to index glucose metabolism. Fasting glucose, HbA1c, and HOMA-IR were also evaluated. Results showed that mean ± SE values were as follows: SAD: 22.3 ± 0.1 cm, waist circumference: 98.0 ± 0.4 cm, BMI: 28.6 ± 0.2 kg/m2, OGTT: 113.9 ± 1.0 mg/dL, fasting glucose: 99.6 ± 0.3 mg/dL, HbA1c: 5.4 ± 0.01%, and HOMA-IR: 3.2 ± 0.1. Compared to waist circumference and BMI, SAD consistently emerged as the best predictor of glucose metabolism, before and after adjusting for the covariates, and with the sample stratified by gender, race, or age. SAD was not a better predictor of OGTT among normal-weight adults or non-Hispanic Black adults. Due to the ease of taking SAD measurements, we recommend that healthcare providers use this simple method to more precisely predict diabetes risk, especially among overweight and obese adults.

In vivo correlates between daily physical activity and intervertebral disc health

Physical activity impacts health and disease in multiple body tissues including the intervertebral discs. Fluid flow within the disc is an indicator of disc health that can be observed using diffusion weighted magnetic resonance imaging. We monitored activity levels of 26 participants, age 35-55 yrs, using Actigraph accelerometers for 4 days to evaluate vigorous-intensity activity, moderate to vigorous intensity activity, and sedentary time. Participants underwent structural and diffusion weighted magnetic resonance imaging to evaluate intervertebral disc health and fluid flow. They also underwent bone density scans, carotid artery ultrasounds, a treadmill test, and a physical exam for pain, range of motion, and instability. These measures were used to correlate MRI indicators of intervertebral disc health with participant activity levels. Participants with any vigorous-intensity physical activity compared with no vigorous-intensity activity had significantly greater L5/S1 apparent diffusion coefficient values (p = 0.002), corresponding to higher freedom of diffusive movement for cellular nutrients and metabolic waste. Sagittal T2 values in the L5/S1 were also higher (p = 0.004), corresponding to a higher water content in the discs. Higher apparent diffusion coefficients were also found in participants with more than 30 min compared with less than 30 min of daily moderate to vigorous physical activity (p = 0.03), and in participants with less than 67% awake time as sedentary time compared with more than 67% sedentary time (p = 0.03). Increased dynamic loading through physical activity and decreased static loading from sedentary time benefit intervertebral disc health. Physical activity, particularly vigorous activity, is beneficial in helping maintain intervertebral disc health. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1313-1323, 2018.

Disparity in neural and subjective responses to food images in women with obesity and normal-weight women

OBJECTIVE

Self-reports tend to differ from objective measurements of food intake, particularly in adults with obesity; however, no studies have examined how neural responses to food (an objective measure) and subjective ratings of food differ by BMI status. This study tested normal-weight women (NWW) and women with obesity (OBW) for group differences in neural indices of attention towards food pictures, subjective ratings of these pictures, and the disparity between objective and subjective measurements.

METHODS

Twenty-two NWW (21.8 ± 1.7 kg/m² ) and 22 OBW (37.0 ± 5.7 kg/m² ) viewed food and flower pictures while late positive potential amplitude, an event-related potential, was recorded. Participants rated pictures for arousal and valence.

RESULTS

Late positive potential amplitude was larger toward food than flower pictures. OBW self-reported flower pictures as more pleasant than food; NWW showed no difference for pleasantness. There were no significant main effects or interactions for arousal. Standardized scores showed that only on subjective, but not objective, measures did OBW compared with NWW disproportionately indicate food pictures as less pleasant than flowers.

CONCLUSIONS

Compared with NWW, OBW showed larger discrepancies between neural and subjective reports of attention towards food. Inaccurate self-reports of attention towards food may reduce the efficiency of health interventions.

Expanded Normal Weight Obesity and Insulin Resistance in US Adults of the National Health and Nutrition Examination Survey

This study aims to expand the evaluation of normal weight obesity (NWO) and its association with insulin resistance using an NHANES (1999-2006) sample of US adults. A cross-sectional study including 5983 men and women (50.8%) was conducted. Body fat percentage (BF%) was assessed using dual-energy X-ray absorptiometry. Expanded normal weight obesity (eNWO) categories, pairings of BMI and body fat percentage classifications, were created using standard cut-points for BMI and sex-specific median for BF%. Homeostatic model assessment-insulin resistance (HOMA-IR) levels were used to index insulin resistance. Mean ± SE values were BMI: 27.9 ± 0.2 (women) and 27.8 ± 0.1 (men); body fat percentage: 40.5 ± 0.2 (women) and 27.8 ± 0.2 (men); and HOMA-IR: 2.04 ± 0.05 (women) and 2.47 ± 0.09 (men). HOMA-IR differed systematically and in a dose-response fashion across all levels of the eNWO categories (F = 291.3, P < 0.0001). As BMI levels increased, HOMA-IR increased significantly, and within each BMI category, higher levels of body fat were associated with higher levels of HOMA-IR. Both high BMI and high BF% were strongly related to insulin resistance. Insulin resistance appears to increase incrementally according to BMI levels primarily and body fat levels secondarily. Including a precise measure of body fat with BMI adds little to the utility of BMI in the prediction of insulin resistance.

Effect of two jumping programs on hip bone mineral density in premenopausal women: a randomized controlled trial

PURPOSE

To determine the effect of two jumping programs on hip bone mineral density (BMD) in women.

DESIGN

Randomized controlled trial.

SETTING

Approximately 20 cities in the Mountain West.

SUBJECTS

Sixty premenopausal women, aged 25 to 50 years, completed the intervention.

INTERVENTION

Subjects were randomly assigned to a control group or one of two jumping groups. The Jump 10 group performed 10 jumps with 30 seconds rest between jumps, twice daily for 16 weeks, while the Jump 20 group performed the same protocol but with 20 jumps.

MEASURES

Hip BMD was measured by using dual-energy x-ray absorptiometry.

ANALYSIS

Analysis of variance and covariance.

RESULTS

At 8 weeks, unadjusted percentage change in hip BMD was significantly different among groups (F = 5.4, p = .0236). Specifically, compared with controls, the Jump 20 women had significantly greater gains in hip BMD and the Jump 10 women had marginally greater improvements. Following 16 weeks of jumping, differences between the Jump 10 and the Jump 20 groups compared with controls were significant (F = 4.2, p = .0444), especially after adjusting for the covariates (F = 7.3, p = .0092).

CONCLUSION

After 16 weeks of high-impact jump training, hip BMD can be improved in premenopausal women by jumping 10 or 20 times, twice daily, with 30 seconds of rest between each jump, compared with controls.

Reduced Sleep Acutely Influences Sedentary Behavior and Mood But Not Total Energy Intake in Normal-Weight and Obese Women

Using a crossover design, 22 normal-weight and 22 obese women completed two free-living sleep conditions: (a) Normal Sleep: night of ~8 hr time in bed; and (b) Reduced Sleep: night of < 5 hr time in bed). Outcome measures were energy intake, physical activity and sedentary time, and mood. Sleep time was 7.7 ± 0.3 and 4.8 ± 0.2 hrs during the Normal Sleep and Reduced Sleep conditions, respectively (F = 1791.94; p < 0.0001). Energy intake did not differ between groups or as a function of sleep condition (F = 2.46; p = 0.1244). Sedentary time was ~ 30 min higher after the Reduced Sleep condition (F = 4.98; p = 0.0318); other physical activity outcomes were not different by condition (p > 0.05). Total mood score, depression, anger, vigor, fatigue, and confusion were worse after Reduced Sleep (p < 0.05). Reducing sleep acutely and negatively influenced sedentary time and mood in normal-weight and obese women.

A Prospective Study of Physical Activity Intensity and Change in Adiposity in Middle-Aged Women

Purpose.

To determine the extent to which objectively measured intensity of physical activity (PA) predicts change in body fat (BF%) in women.

Design.

Prospective cohort study of PA intensity and body composition in middle-aged women.

Setting.

The study took place in a metropolitan Mountain West community.

Subjects.

Two hundred and twenty-eight women participated in two assessment periods separated by 20 months.

Measures.

Each assessment period consisted of seven consecutive days of monitoring, followed by body composition testing.

Analysis.

The general linear model using partial correlations and Mantel-Haenszel χ2 tests were performed.

Results.

At baseline and follow-up, women who participated in vigorous PA were leaner than women who participated in moderate or light PA (p < .05). Longitudinal results indicated that a greater proportion of women who decreased PA intensity over the 20 months also increased BF% (66%), compared to participants who increased or maintained PA intensity (47%) (p < .05).

Conclusions.

PA intensity seems to play a role in long-term weight maintenance. Reducing PA intensity increases the risk of BF% gain in women. Efforts to help women maintain PA intensity along with other weight management strategies may prove beneficial in preventing unwanted body fat gain in middle-aged women.

Medical cost analysis of a school district worksite wellness program

OBJECTIVE

To evaluate whether participation in a worksite wellness program differs by age and sex and is associated with frequency and average cost of medical claims.

METHODS

Healthcare cost data were available for school district employees during the academic years ending in 2009 through 2014. The wellness program was available in the later 3 years. The frequency and the average cost of medical claims were compared between the 3 years prior to and the 3 years during the wellness program.

RESULTS

Wellness program participation increased from 65.6% 2011-2012 to 79.7% 2012-2013. The increase occurred within age-groups and for males and females. The average age of program participants was significantly lower in 2011-2012 (48.2 vs. 49.4, p = 0.0099), but similar in the next 2 academic years. Participation in at least one behavior change campaign in each year was 52.1%, 53.7%, and 73.7% of all wellness program participants, respectively. Female employees were significantly more likely to complete one or more behavior change campaigns in each year of the wellness program (p < 0.0001). The percentage of employees filing at least one claim per time period was higher for those in the wellness program (p < 0.0001), but average medical claims payments were lower for those in the wellness program. After subtracting program costs, the cost savings from the wellness program was $3,612,402. The benefit-to-cost ratio was 3.6.

CONCLUSION

Participation in the wellness program resulted in lower average medical claim costs than non-participation but number of claims were higher in program participants.

Slow walking on a treadmill desk does not negatively affect executive abilities: an examination of cognitive control, conflict adaptation, response inhibition, and post-error slowing

An increasing trend in the workplace is for employees to walk on treadmills while working to attain known health benefits; however, the effect of walking on a treadmill during cognitive control and executive function tasks is not well known. We compared the cognitive control processes of conflict adaptation (i.e., congruency sequence effects—improved performance following high-conflict relative to low-conflict trials), post-error slowing (i.e., Rabbitt effect), and response inhibition during treadmill walking (1.5 mph) relative to sitting. Understanding the influence of treadmill desks on these cognitive processes may have implications for worker health and productivity. Sixty-nine individuals were randomized to either a sitting (n = 35) or treadmill-walking condition (n = 34). Groups did not differ in age or body mass index. All participants completed a computerized Eriksen flanker task and a response-inhibition go/no-go task in random order while either walking on a treadmill or seated. Response times (RTs) and accuracy were analyzed separately for each task using mixed model analysis of variance. Separate ANOVAs for RTs and accuracy showed the expected conflict adaptation effects, post-error slowing, and response inhibition effects when collapsed across sitting and treadmill groups (all Fs > 78.77, Ps < 0.001). There were no main effects or interactions as a function of group for any analyses (Fs < 0.79, Ps > 0.38), suggesting no decrements or enhancements in conflict-related control and adjustment processes or response inhibition for those walking on a treadmill versus sitting. We conclude that cognitive control performance remains relatively unaffected during slow treadmill walking relative to sitting.

Health behaviors and work-related outcomes among school employees

OBJECTIVE

To determine the association between selected health behaviors and work-related outcomes among 2398 school-based employees who voluntarily enrolled in a worksite wellness program.

METHODS

This study presents participants' baseline data collected from a personal health assessment used by Well-Steps, a third-party wellness company.

RESULTS

Employees with high levels of exercise, fruit/vegetable consumption, or restful sleep exhibited higher job-performance and job-satisfaction, and lower absenteeism (p < .05). When all 3 behaviors occurred simultaneously, there was higher job-performance (Prevalence Ratio=1.09; 95% CI=1.05-1.13), job-satisfaction (Prevalence Ratio=1.53; 95% CI=1.30-1.80), and lower absenteeism (Prevalence Ratio=1.16; 95% CI=1.08-1.325). Further, number of co-occurring health behaviors influenced other satisfaction and emotional health outcomes.

CONCLUSION

Selected healthy behaviors, individually or co-occurring, are associated with health outcomes potentially important at the worksite.

Television Viewing Time and Measured Cardiorespiratory Fitness in Adult Women

Purpose.

This study assessed the relationship between television viewing time and measured cardiorespiratory fitness and the influence of various potential confounders.

Design.

Cross-sectional.

Setting.

Intermountain West.

Subjects.

The sample was composed of 302 nonsmoking women aged 40.2 ± 3.0 years, with ∼90% Caucasian and 82% married.

Measures.

TV viewing was assessed by using a questionnaire, and cardiorespiratory fitness was measured by using a graded, maximum treadmill test. Physical activity (PA) was evaluated by using accelerometers for 7 days, and body fat percentage (BF%) was measured by using the Bod Pod.

Analysis.

Analysis of variance and partial correlation.

Results.

VO2max of Frequent (≥3 h/d) TV viewers (32.6 ± 6.4 mL/kg/min) was significantly lower than that of both Moderate (1–2 h/d) (36.2 ± 7.2 mL/kg/min) or Infrequent (<1 h/d) (36.5 ± 6.5 mL/kg/min) viewers (F= 8.0, p = .0004). The Infrequent and Moderate groups did not differ in VO2max. Age, education, body mass index, and season of assessment had no influence on the relationship when controlled statistically. Adjusting for PA (F = 4.2, p = .0157) and BF% (F = 5.0, p = .0071) weakened the relationship by 59% and 58%, respectively, but the relationships remained significant. After controlling for both PA and BF% simultaneously (F = 2.9, p = .0572), the relationship was weakened by 81% and was only borderline significant.

Conclusion.

Female Frequent TV viewers have significantly lower cardiorespiratory fitness levels than Moderate or Infrequent viewers. This association appears to be largely a function of differences in levels of PA and BF%.

Cognitive and typing outcomes measured simultaneously with slow treadmill walking or sitting: implications for treadmill desks

Purpose

This study compared cognitive (attention, learning, and memory) and typing outcomes during slow treadmill walking or sitting. Seventy-five healthy individuals were randomly assigned to a treadmill walking group (n=37; 23 female) or sitting group (n=38; 17 female).

Methods

The treadmill walking group completed a series of tests while walking at 1.5 mph. The sitting group performed the same tests while sitting at a standard desk. Tests performed by both groups included: the Rey Auditory Verbal Learning Test and a modified version of the Paced Auditory Serial Attention Test. In addition, typing performance was evaluated.

Results

Participants in the treadmill walking group performed worse on the Rey Auditory Verbal Learning Test for total learning than the sitting group; the main effect was significant (F(1,73)=4.75, p=0.03, η_p²=0.06); however, short- and long-delay recall performance did not differ between groups (p>0.05). For the Paced Auditory Serial Attention Test, total number of correct responses was lower in the treadmill walking group relative to the sitting group; the main effect was significant (F(1,73)=4.97, p=0.03, η_p²=0.06). The performance of both groups followed the same learning slope (Group x Trial interactions were not significant) for the Rey Auditory Verbal Learning Test and Paced Auditory Serial Attention Test. Individuals in the treadmill walking group performed significantly worse for all measures of typing (p<0.05).

Conclusion

Walking on a treadmill desk may result in a modest difference in total learning and typing outcomes relative to sitting, but those declines may not outweigh the benefit of the physical activity gains from walking on a treadmill.

Dietary Patterns as Predictors of Body Fat and BMI in Women: A Factor Analytic Study

Purpose.

To identify independent patterns of diet using factor analysis to determine the extent to which dietary patterns account for differences in body fat percentage (BF%) and body mass index (BMI). Also, to ascertain the extent to which the associations are influenced by age, education, menopause, energy intake, and physical activity.

Design.

Study design was cross-sectional.

Setting.

Study setting was approximately 20 cities in the Mountain West.

Subjects.

The study included 281 apparently healthy female nonsmokers.

Measures.

Diet was assessed using 7-day weighed food records, and foods were categorized using the American Diabetes and American Dietetic Associations Exchange Lists and expressed as servings per 1000 kcal. BF% was measured using the Bod Pod, and physical activity was estimated using accelerometers worn for 1 week.

Analysis.

We used factor analysis, general linear models, and partial correlations.

Results.

Three dietary patterns were identified: (1) Prudent Pattern, (2) Low-fat Milk, and (3) Meat. Higher consumption of the Prudent Pattern corresponded with significantly lower BF% (F = 8.5, p = .0038) and BMI (F = 4.4, p = .0363). The Low-fat Milk pattern was inversely related to BF% (F= 5.4, p = .0207) and BMI (F= 9.5, p = .0023). Higher intake of the Meat pattern was related to higher levels of BF% (F= 4.5, p= .0346) and BMI (F= 4.2, p = .0418).

Conclusion.

These findings support an association between dietary patterns and body composition. Dietary patterns reflect the complex interrelationships inherent in day-to-day eating and are strongly related to differences in BF% and BMI in women.

Meat Intake and Insulin Resistance in Women without Type 2 Diabetes

PURPOSE

To examine the relationship between meat intake and insulin resistance (IR) in 292 nondiabetic women.

METHODS

IR was evaluated using the homeostasis model assessment (HOMA). Diet was assessed via 7-day weighed food records. Servings of very lean meat (VLM) and regular meat (meat) were indexed using the ADA Exchange Lists Program. Physical activity was assessed using accelerometers and body fat was measured using the Bod Pod.

RESULTS

Meat intake was directly related to HOMA (F = 7.4; P = 0.007). Women with moderate or high meat intakes had significantly higher HOMA levels than their counterparts. Adjusting for body fat weakened the relationship (F = 1.0; P = 0.3201). Odds ratio results showed that the low meat quartile had 67% lower odds of being IR (75th percentile) compared to their counterparts (OR = 0.33; 95% CI = 0.16-0.71). These findings changed little after adjusting for all covariates simultaneously (OR = 0.34; 95% CI = 0.14-0.83). Conversely, VLM intake was not related to HOMA, with or without the covariates.

CONCLUSION

Moderate and high meat intakes are associated with increased insulin resistance in nondiabetic women. However, differences in body fat contribute significantly to the relationship. VLM is not predictive of IR. Prudence in the amount and type of meat consumed may be helpful in decreasing the likelihood of IR.

Dairy consumption and insulin resistance: the role of body fat, physical activity, and energy intake

The relationship between dairy consumption and insulin resistance was ascertained in 272 middle-aged, nondiabetic women using a cross-sectional design. Participants kept 7-day, weighed food records to report their diets, including dairy intake. Insulin resistance was assessed using the homeostatic model assessment (HOMA). The Bod Pod was used to measure body fat percentage, and accelerometry for 7 days was used to objectively index physical activity. Regression analysis was used to determine the extent to which mean HOMA levels differed across low, moderate, and high dairy intake categories. Results showed that women in the highest quartile of dairy consumption had significantly greater log-transformed HOMA values (0.41 ± 0.53) than those in the middle-two quartiles (0.22 ± 0.55) or the lowest quartile (0.19 ± 0.58) (F = 6.90, P = 0.0091). The association remained significant after controlling for each potential confounder individually and all covariates simultaneously. Adjusting for differences in energy intake weakened the relationship most, but the association remained significant. Of the 11 potential confounders, only protein intake differed significantly across the dairy categories, with those consuming high dairy also consuming more total protein than their counterparts. Apparently, high dairy intake is a significant predictor of insulin resistance in middle-aged, nondiabetic women.

Adherence to the 2010 Dietary Guidelines for Americans and the relationship to adiposity in young women

OBJECTIVE

To determine the relationship between adherence to the 2010 Dietary Guidelines for Americans and adiposity in young women with and without statistical adjustment for physical activity (PA).

METHODS

Participants included 324 young women (aged 17-25 years). The researchers measured dietary intake using the Dietary History Questionnaire and determined diet quality using the 2010 Healthy Eating Index (HEI-2010). BOD POD (Cosmed, Rome, Italy, 2006) and accelerometry were used to assess body fat and PA, respectively.

RESULTS

Women in the top quartile of HEI-2010 had significantly lower percent body fat than women in the lowest 3 quartiles (F = 3.36; P = .03). Controlling for objectively measured PA weakened this relationship by 20%. These young women (top quartile of HEI-2010) also had 0.37 odds (95% confidence interval, 0.16-0.85) of having body fat > 32%.

CONCLUSIONS AND IMPLICATIONS

Young women whose diets most closely meet the 2010 Dietary Guidelines for Americans have lower adiposity.

Objectively Measured Sleep Patterns in Young Adult Women and the Relationship to Adiposity

Purpose.

The purpose of this study was to examine the relationship between sleep patterns and adiposity in young adult women.

Design.

Cross-sectional.

Setting.

The study took place at two Mountain West region universities and surrounding communities.

Subjects.

Subjects were 330 young adult women (20.2 ± 1.5 years).

Measures.

Sleep and physical activity were monitored for 7 consecutive days and nights using actigraphy. Height and weight were measured directly. Adiposity was assessed using the BOD POD.

Analysis.

Regression analysis, between subjects analysis of variance, and structural equation modeling were used.

Results.

Bivariate regression analysis demonstrated that sleep efficiency was negatively related to adiposity and that the 7-day standard deviations of bedtime, wake time, and sleep duration were positively related to adiposity (p < .05). Controlling for objectively measured physical activity strengthened the relationship between sleep duration and adiposity by 84% but had a statistically negligible impact on all other relationships that were analyzed. However, multivariate structural equation modeling indicated that a model including sleep efficiency, sleep pattern inconsistency (latent variable consisting of the 7-day standard deviations of bedtime, wake time, and sleep duration), and physical activity was the best for predicting percent body fat.

Conclusion.

Inconsistent sleep patterns and poor sleep efficiency are related to adiposity. Consistent sleep patterns that include sufficient sleep may be important in modifying risk of excess body fat in young adult women.

Is the Dose-Response Relationship between Body Mass and Hip Bone Mineral Density in Women Influenced by Diet, Physical Activity, or Menopause?

Purpose.

Investigate the relationship between body mass and hip bone mineral density (BMD) and the extent to which this association is influenced by potential mediating factors.

Design.

Cross-sectional.

Setting.

Approximately 20 cities in Utah and Wyoming.

Subjects.

Subjects were 262 apparently healthy, nonsmoking females.

Measures.

Hip BMD was assessed using dual energy X-ray absorptiometry. Physical activity (PA) was measured objectively using accelerometers. Calcium and vitamin D were measured using the Block food frequency questionnaire. Menopause status and bone drug use were measured using a questionnaire.

Analysis.

General linear models and partial correlations.

Results.

With body mass divided into three categories, hip BMD differed significantly across the groups in a dose-response manner: low mass (mean ± standard deviation [SD]), .876 ± .085 g/cm2; moderate, .932 ± .109 g/cm2; and high mass, .995 ± .112 g/cm2 (F = 21.5, p < .0001). The relationship between mass and hip BMD was not affected by differences in age, height, menopause status, calcium or vitamin D intake, PA, or use of bone prescription drugs.

Conclusion.

These findings suggest that women with low body mass tend to have low hip BMD and those with high mass tend to have high BMD. Controlling for the potential mediating variables did not influence the dose-response relationship between mass and BMD. It appears that lifestyle may not influence the body mass and BMD relationship, making it a challenge for women with low mass to avoid risk of low BMD.

A 4-year prospective study of soft drink consumption and weight gain: the role of calorie intake and physical activity

PURPOSE

Examine the association between soft drink consumption and risk of weight gain over 4 years. Also, determine if the relationship between soft drink intake and weight gain is a result of differences in calorie intake or physical activity (PA), or other potential mediating factors.

DESIGN

Four-year prospective cohort.

SETTING

Approximately 20 cities in Utah and Wyoming.

SUBJECTS

One hundred seventy nonsmoking, apparently healthy women.

MEASURES

At baseline, soft drink consumption and menopause status were measured using a questionnaire; calorie intake was estimated using 7-day, weighed food records; and PA was assessed using 7-day accelerometer data. Weight was assessed using an electronic scale at baseline and follow-up.

ANALYSIS

Multiple regression and partial correlation.

RESULTS

Four-year weight gain in participants who, at baseline, consumed sugar-sweetened soft drinks (2.7 ± 5.1 kg) was greater than in participants who consumed artificially sweetened soft drinks (-.1 ± 4.4 kg) or no soft drinks (.5 ± 5.1 kg) (F = 5.4, p = .022). Adjusting for objectively measured PA had no effect on risk of weight gain. However, controlling statistically for differences in calorie intake significantly weakened the relationship between soft drink consumption and weight gain by 28%.

CONCLUSION

Consuming artificially sweetened soft drinks or no soft drinks instead of sugar-sweetened soft drinks may help to reduce risk of weight gain in women. The relationship appears to be partly a function of differences in calorie intake, but not differences in PA.

Meat intake increases risk of weight gain in women: a prospective cohort investigation

PURPOSE

Examine the extent to which meat consumption influences risk of weight gain in women during a 20-month period. Additionally, to determine the extent to which demographic, lifestyle, and dietary factors influence the meat-weight gain association.

DESIGN

Prospective cohort.

SETTING

Two metropolitan areas of the Mountain West.

SUBJECTS

Two hundred thirty-seven middle-aged women.

MEASURES

Diet was assessed by using 7-day weighed food records, and physical activity was measured by using accelerometers. Other potential confounders included age; initial body weight; energy intake; percentage of energy from fat, protein, and carbohydrate; dietary fiber intake per 1000 kcal; and time in the investigation. Two meat variables were studied: very lean meat (VLM) and other meat (Meat).

ANALYSIS

Multiple regression, partial correlation, and relative risk.

RESULTS

Each additional serving (1 ounce) of Meat consumed at baseline per 1000 kcal was associated with a 1.19-kg gain in weight over time (F = 7.3, p = .0073). Controlling for physical activity, fiber, and macronutrient intake, individually, strengthened the relationship. Servings of VLM per 1000 kcal were not predictive of weight change (F = .00, p = .9576). With all potential confounders controlled, the relative risk of gaining weight (≥5 pounds) for women with Low Meat intake was .36 (95% confidence interval = .17-.76) compared to women with High Meat intake.

CONCLUSION

Consuming meats other than those in the VLM category is associated with increased risk of weight gain over time.

Influence of weight classification on walking and jogging energy expenditure prediction in women

The purpose of this study was to determine the influence of weight classification on predicting energy expenditure (EE) in women. Twelve overweight (body mass index [BMI] = 25-29.99 kg/m(2)) and 12 normal-weight (BMI = 18.5-24.99 kg/m(2)) women walked and jogged 1,609 m at 1.34 ms(-1) and 2.23 ms(-1), respectively, while EE was assessed using indirect calorimetry and compared to several other prediction methods (American College of Sports Medicine [ACSM], 2010; Heyward, 2006; Léger & Mercier, 1984; McArdle, Katch, & Katch, 2006; Pandolf Givoni, & Goldman, 1978; van der Walt & Wyndham, 1973). More error occurred with overweight EE prediction compared to normal-weight EE prediction. The ACSM and Heyward methods for walking and the McArdle et al. method for jogging most accurately predicted EE for both groups. Weight classification influences EE prediction accuracy and, thus, is important to consider when using these prediction methods.

Improved health behaviors persist over two years for employees in a worksite wellness program

This study evaluates whether improvements in health behaviors related to a worksite wellness program persist through 2 years. The program was designed to build behavioral capability and self-efficacy by yielding immediately applicable skills and tools and segmenting the behavior change process into weekly, manageable doses. Analyses are based on 267 individuals employed from 2009 through 2011. Significant improvements were observed in the frequency and volume of exercise, and the consumption of vegetables and fruits over 12 and 24 months. Requests for health coaching significantly increased over the study period. Thus, the type of wellness program evaluated in this study produced sustainable health behaviors through 24 months, which likely will translate into future positive health outcomes and improved employee productivity.

Evaluation of a University General Education Health and Wellness Course Delivered by Lecture or Online

Purpose.

To assess a single-semester university general education (GE) health and wellness course influence on physical activity (PA) and dietary habits among university students and to compare the course delivered through lecture or online for these outcomes.

Design.

A 15-week intervention with pre-post one-group design, allowing for comparative assessments in dietary and PA habits across time by delivery method (classroom lecture vs. online).

Setting.

A large Western university.

Participants.

Participants (n = 1638, female; n = 1333, male) were 82% university freshman or sophomores.

Intervention.

Participants were required to take a GE health and wellness course either by classroom lecture or online. The lecture and online curriculum content were similar. Participation in the study was entirely voluntary and was not connected to course grade.

Measures.

PA and dietary outcomes were determined from questions used in the Behavioral Risk Factor Surveillance System survey and were assessed pre- and post-intervention. Other validated questions were used to assess fitness.

Analysis.

The general linear model was utilized to determine group x period interactions when comparing the classroom lecture vs. online course.

Results.

Students improved overall level of PA by 12%, daily minutes of moderate-intensity PA by 8%, and fitness level by 2%. Students improved fruit/vegetable consumption by 4%, bran/whole grain cereal consumption by 8%, and brown rice/whole wheat bread consumption by 11%. All improvements were statistically significant (p < .001) with percent values indicating the size of the effect. The classroom lecture course yielded stronger improvements in several PA and dietary outcomes than the online course.

Conclusions.

A single-semester university wellness course may positively influence multiple PA and dietary behaviors; however, classroom lecture may be superior to online delivery.