Moderate to vigorous physical activity, not sedentary time, is associated with total and regional adiposity in a sample of UK adults at risk of type 2 diabetes

How sedentary time (ST) relates to total and regional adiposity and whether these associations are independent of moderate- to vigorous-intensity physical activity (MVPA) are of clinical and public health interest. We assessed the relationship between objectively measured MVPA, ST and ST breaks in adults at risk of type 2 diabetes. The sample consisted of 163 adults (37-75 years) recruited from primary care. Dual energy x-ray absorptiometry (iDXA, GE Corp) was used to estimate total and regional (appendages and trunk) fat mass as well as fat mass in the abdominal (android) and hip/thigh (gynoid) regions. The Actigraph GT3X was worn for 7 days (participants with  ⩾4 valid days included herein) and published cut-points were applied to 15 s epoch data to estimate mean MVPA, ST and breaks in ST. Multiple regression investigated associations between both ST and MVPA with total and regional adiposity without and with adjustment for known and potential confounders (including total lean mass) and for each other. MVPA was negatively and significantly associated with total (b  =  -62; p  =  0.002), and regional (p  <  0.05) adiposity before and after adjusting for confounders including ST. Although ST was positively and significantly associated with total (b  =  46.4; p  =  0.002) and regional adiposity (all p  ⩽  0.007), these relationships disappeared after adjustment for MVPA (p  >  0.05). Sedentary breaks were not significantly related to adiposity before or after adjustment. An age-by-MVPA interaction for total, android, gynoid and trunk fat revealed that MVPA did not remain significant when controlling for ST and other covariates in the adults over 65 years old. In this sample of adults at risk of type 2 diabetes, MVPA, and not ST, was associated with total and regional adiposity after adjustment for each other. However, in older adults at risk of T2D weight related benefits may be gained from reducing daily ST and increasing MVPA.

Are participant characteristics from ISCOLE study sites comparable to the rest of their country?

OBJECTIVES

The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) provides robust, multi-national information on physical activity, diet and weight status in 9-11-year-old children around the world. The purpose of this analysis was to examine the similarities and differences between participant characteristics from ISCOLE sites and data from nationally representative surveys from ISCOLE countries (Australia, Brazil, Canada, China, Colombia, Finland, Kenya, India, Portugal, South Africa, the United Kingdom and the United States).

METHODS

Distributions of characteristics were assessed within each ISCOLE country-level database, and compared with published data from national or regional surveys, where available. Variables of comparison were identified a priori and included body mass index (BMI), physical activity (accelerometer-determined steps per day) and screen time (child-report).

RESULTS

Of 12 countries, data on weight status (BMI) were available in 8 countries, data on measured physical activity (steps per day) were available in 5 countries and data on self-reported screen time were available in 9 countries. The five ISCOLE countries that were part of the Health Behaviour in School-aged Children Survey (that is, Canada, Finland, Portugal, the United Kingdom (England) and the United States) also provided comparable data on self-reported physical activity. Available country-specific data often used different measurement tools or cut-points, making direct comparisons difficult. Where possible, ISCOLE data were re-analyzed to match country-level data, but this step limited between-country comparisons.

CONCLUSIONS

From the analyses performed, the ISCOLE data do not seem to be systematically biased; however, owing to limitations in data availability, data from ISCOLE should be used with appropriate caution when planning country-level population health interventions. This work highlights the need for harmonized measurement tools around the world while accounting for culturally specific characteristics, and the need for collaboration across study centers and research groups.

A cluster randomised controlled trial to investigate the effectiveness and cost effectiveness of the 'Girls Active' intervention: a study protocol

BACKGROUND

Despite the health benefits of physical activity, data from the UK suggest that a large proportion of adolescents do not meet the recommended levels of moderate-to-vigorous physical activity (MVPA). This is particularly evident in girls, who are less active than boys across all ages and may display a faster rate of decline in physical activity throughout adolescence. The 'Girls Active' intervention has been designed by the Youth Sport Trust to target the lower participation rates observed in adolescent girls. 'Girls Active' uses peer leadership and marketing to empower girls to influence decision making in their school, develop as role models and promote physical activity to other girls. Schools are provided with training and resources to review their physical activity, sport and PE provision, culture and practices to ensure they are relevant and attractive to adolescent girls.

METHODS/DESIGN

This study is a two-arm cluster randomised controlled trial (RCT) aiming to recruit 20 secondary schools. Clusters will be randomised at the school level (stratified by school size and proportion of Black and Minority Ethnic (BME) pupils) to receive either the 'Girls Active' intervention or carry on with usual practice (1:1). The 20 secondary schools will be recruited from state secondary schools within the Midlands area. We aim to recruit 80 girls aged 11-14 years in each school. Data will be collected at three time points; baseline and seven and 14 months after baseline. Our primary aim is to investigate whether 'Girls Active' leads to higher objectively measured (GENEActiv) moderate-to-vigorous physical activity in adolescent girls at 14 months after baseline assessment compared to the control group. Secondary outcomes include other objectively measured physical activity variables, adiposity, physical activity-related psychological factors and the cost-effectiveness of the 'Girls Active' intervention. A thorough process evaluation will be conducted during the course of the intervention delivery.

DISCUSSION

The findings of this study will provide valuable information on whether this type of school-based approach to increasing physical activity in adolescent girls is both effective and cost-effective in the UK.

TRIAL REGISTRATION

ISRCTN10688342. Registered 12 January 2015.

Pattern changes in step count accumulation and peak cadence due to a physical activity intervention

OBJECTIVES

The purpose was to determine if a 12-week weight loss intervention with a physical activity (PA) component would lead to changes in steps/day, step count accumulation patterns, and peak cadence.

DESIGN

Randomized clinical trial.

METHODS

Overall, 121 overweight/obese White and African-American adults (ages 35-64yrs) were randomized to a diet education plus PA education and behavior change intervention group (DE+PA) or diet education and behavior change group (DE). The DE+PA intervention was designed to increase steps/day, and steps at moderate-to-vigorous intensity. The Actigraph GT3X+ accelerometer was used to measure steps accumulated in different cadence bands (1-19, 20-39, 40-59, 60-79, 80-99, 100-119, 120+ steps/min), and peak 1-min, 30-min and 60-min cadence. Pre- to post-intervention changes in steps/day, step count within each cadence band, and peak cadences were compared within groups using paired sample t-test and between groups after adjustment for baseline values of the same variable using ANCOVA.

RESULTS

Ninety participants had valid data (44 in the DE+PA group). Change in steps/day was not significantly different between the groups. However, participants in the DE+PA group accumulated significantly more steps at post-intervention in the 80-99, 100-119, and 120+ cadence bands, all p<0.02. The DE+PA group increased step counts accumulated within the 100-119 (463±1092 vs 56±546 step counts; p=0.01) and 120+ (390±999 vs 34±321 step counts; p=0.03) cadence bands, as well as peak 60-min cadence when compared to the DE group.

CONCLUSIONS

Non-significant changes in steps/day following a PA intervention may mask changes in steps accumulated at moderate-to-vigorous intensity cadences.

Sitting time and cardiometabolic risk in US adults: associations by sex, race, socioeconomic status and activity level

BACKGROUND

Sitting time is associated with adverse health outcomes including chronic disease and premature mortality. However, it is not known if the association of sitting time with cardiometabolic risk factors varies across sociodemographic or health factors.

METHODS

The sample included 4560 adults (≥20 years) who participated in the cross-sectional 2007-2010 US National Health and Nutrition Examination Survey. Participants self-reported typical daily sitting time. Weight, height, blood pressure, and fasting triglycerides, high-density lipoprotein-cholesterol (HDL-C), glucose and insulin were measured. Homeostatic model assessment-insulin resistance (HOMA-IR) and β cell function (HOMA-%B) were calculated. A subsample of 3727 participants underwent an oral glucose tolerance test to obtain 2 h postload glucose levels. Population-weighted linear regression analysis was used to examine the association between sitting time and each cardiometabolic risk factor, stratified by sex, race, socioeconomic status and activity level. Analyses were controlled for demographics, socioeconomic status, survey cycle, personal and family medical history, diet and physical activity.

RESULTS

Sitting time was significantly associated with adverse levels of waist circumference, body mass index, triglycerides, HDL-C, insulin, HOMA-IR, HOMA-%B and 2 h postload glucose, but not with blood pressure or glucose level. In stratified analyses, sitting time was most consistently related to cardiometabolic risk factors among low and middle socioeconomic groups and for those who reported no weekly physical activity, but there were few differences between sex or race groups.

CONCLUSIONS

Self-reported sitting time was associated with adverse cardiometabolic risk factors consistently across sex and race groups in a representative US sample, independent of other risk factors. Excessive sitting warrants a public health concern.

Activity related energy expenditure, appetite and energy intake: potential implications for weight management

The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4years; BMI 23.5kg/m(2)) and 42 female (26.9years; BMI 22.4kg/m(2)) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance.

Testing aspects of Carl Rogers's theory of creative environments: Child-rearing antecedents of creative potential in young adolescents

Longitudinal data involving 106 children and their parents were used to test preschool child-rearing implications of Carl Rogers's theory of creativity-fostering environments (Rogers, 1954). Indices were developed for each parent and for each mother-father combination that reflected the degree to which the parents' child-rearing practices and interactions with their preschool children matched the recommendations implicit in Rogers's description of a creativity-fostering environment. The three indices of Rogers-prescribed child-rearing practices each correlated positively (rs = .38 to .46) and significantly (all ps less than .001) with a composite index of creative potential in early adolescence, 7 to 11 years later. Rogers-prescribed preschool child-rearing practices also emerged as significant antecedents of adolescent creative potential in regression/path analyses that held constant the influence of sex, preschool intelligence, and preschool creative potential. Theoretical and methodological aspects of the study are discussed.

Premenstrual and menstrual mood changes in adolescent women

One hundred fifty-eight female subjects aged 15-16 years completed the Menstrual Distress Questionnaire and reported the actual date of onset of the next two menstrual periods. These female high school students and their male classmates were later given The Depression Adjective Check List and the State-Trait Anxiety Inventory twice, 2 weeks apart, in an unrelated classroom setting. This study assessed the magnitude of anxiety and depression experienced by the 29 adolescents who were tested within 4 days preceding the onset of menstruation and the 23 adolescents who were tested during the first 4 days of menstruation. Premenstrual and menstrual test scores were compared with those obtained during the intermenstrual phase of the cycle. No significant differences in mood attributable to cycle phase were found. A control group of males also showed no significant difference in mood. Adolescent women appear to be different from women over 30 who have been reported to show significantly increased state anxiety and depression during the premenstrual phase of the menstrual cycle.

Premenstrual and menstrual mood changes in adolescent women

One hundred fifty-eight female subjects aged 15-16 years completed the Menstrual Distress Questionnaire and reported the actual date of onset of the next two menstrual periods. These female high school students and their male classmates were later given The Depression Adjective Check List and the State-Trait Anxiety Inventory twice, 2 weeks apart, in an unrelated classroom setting. This study assessed the magnitude of anxiety and depression experienced by the 29 adolescents who were tested within 4 days preceding the onset of menstruation and the 23 adolescents who were tested during the first 4 days of menstruation. Premenstrual and menstrual test scores were compared with those obtained during the intermenstrual phase of the cycle. No significant differences in mood attributable to cycle phase were found. A control group of males also showed no significant difference in mood. Adolescent women appear to be different from women over 30 who have been reported to show significantly increased state anxiety and depression during the premenstrual phase of the menstrual cycle.

Effects of explicit instructions to "be creative" on the psychological meaning of divergent thinking test scores

The Alternate Uses Test was administered to 50 undergraduate males instructed to produce creative (i.e., novel and worthwhile) uses and to 55 comparable subjects simply instructed to produce as many uses as possible. All uses were rated for creativity. An index of self-assessed creative thinking ability correlated significantly more strongly (p less than .05) with the number of creative uses produced in the qualitatively-oriented condition than with the number of creative or total uses produced in the standard, quantitatively-oriented condition. The correlation between self-rated creative ability and creative uses production in the qualitatively-oriented condition remained significant (p less than .001) after indices of achievement motivation and general verbal aptitude were partialled out. The results were interpreted as demonstrating the value of coordinating informative divergent thinking test instructions with qualitative scoring criteria.