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Jennifer R. O’Neill, Karin A. Pfeiffer, Marsha Dowda and Russell R. Pate

Background:

Little is known about the relationship between children’s physical activity (PA) in preschool (in-school) and outside of preschool (out-of-school). This study described this relationship.

Methods:

Participants were 341 children (4.6 ± 0.3 years) in 16 preschools. Accelerometers measured moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) in-school and out-of-school. In the full sample, Pearson correlation was used to describe associations between in-school and out-of-school PA. In addition, children were categorized as meeting or not meeting a PA guideline during school. MVPA and TPA were compared between the 2 groups and in-school and out-of-school using 2-way repeated-measures analysis of variance.

Results:

In the full sample, in-school and out-of-school PA were positively correlated for MVPA (r = .13, P = .02) and TPA (r = .15, P = .01). Children who met the guideline in-school remained comparably active out-of-school. However, those who did not meet the guideline were more active out-of-school than in-school. The groups were active at comparable levels while out-of-school. Identical patterns were seen for MVPA and TPA.

Conclusions:

Children’s in-school PA was positively associated with out-of-school PA. Children who did not meet the guideline in-school were more active out-of-school than in-school, suggesting preschool and classroom factors may reduce some children’s PA in-school.

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Rebecca A. Schlaff, Claudia Holzman, Lanay M. Mudd, Karin A. Pfeiffer and James M. Pivarnik

Background:

Little is known about how leisure-time physical activity (LTPA) influences gestational weight gain (GWG) among body mass index (BMI) categories. The purpose of this study was to examine the relationship between pregnancy LTPA and the proportion of normal, overweight, and obese women who meet GWG recommendations.

Methods:

Participants included 449 subcohort women from the Pregnancy Outcomes and Community Health (POUCH) study. LTPA was collapsed into 3 categories [(None, < 7.5 kcal/kg/wk (low), ≥ 7.5 kcal/kg/wk (recommended)]. GWG was categorized according to IOM recommendations (low, recommended, or excess). Chi-square and logistic regression analyses were used to evaluate relationships among LTPA, BMI, and GWG.

Results:

Overweight women were more likely to have high GWG vs. normal weight women (OR = 2.3, 95% CI 1.3–4.0). Obese women were more likely to experience low GWG (OR = 7.3, 95% CI 3.6–15.1; vs. normal and overweight women) or excess GWG (OR = 3.5, 95% CI 1.9–6.5; vs. normal weight women). LTPA did not vary by prepregnancy BMI category (P = .55) and was not related to GWG in any prepregnancy BMI category (P = .78).

Conclusions:

Regardless of prepregnancy BMI, LTPA did not affect a woman’s GWG according to IOM recommendations. Results may be due to LTPA not differing among BMI categories.

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Ryan McGrath, Chantal A. Vella, Philip W. Scruggs, Mark D. Peterson, Christopher J. Williams and David R. Paul

Background: This investigation sought to determine how accelerometer wear (1) biased estimates of sedentary behavior (SB) and physical activity (PA), (2) affected misclassifications for meeting the Physical Activity Guidelines for Americans, and (3) impacted the results of regression models examining the association between moderate to vigorous physical activity (MVPA) and a clinically relevant health outcome. Methods: A total of 100 participants [age: 20.6 (7.9) y] wore an ActiGraph GT3X+ accelerometer for 15.9 (1.6) hours per day (reference dataset) on the hip. The BOD POD was used to determine body fat percentage. A data removal technique was applied to the reference dataset to create individual datasets with wear time ranging from 15 to 10 hours per day for SB and each intensity of PA. Results: Underestimations of SB and each intensity of PA increased as accelerometer wear time decreased by up to 167.2 minutes per day. These underestimations resulted in Physical Activity Guidelines for Americans misclassification rates of up to 42.9%. The regression models for the association between MVPA and body fat percentage demonstrated changes in the estimates for each wear-time adherence level when compared to the model using the reference MVPA data. Conclusions: Increasing accelerometer wear improves daily estimates of SB and PA, thereby also improving the precision of statistical inferences that are made from accelerometer data.

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Edgard Melo Keene von Koenig Soares, Guilherme E. Molina, Daniel Saint Martin, João Luís A. E. Sadat P. Leitão, Keila E. Fontana, Luiz F. Junqueira Jr., Timóteo Leandro de Araújo, Sandra Mahecha Matsudo, Victor K. Matsudo and Luiz Guilherme Grossi Porto

Background: The World Health Organization recommends 150 minutes of moderate to vigorous physical activity (PA) throughout the week. However, the weekly frequency of PA and how to combine moderate and vigorous PA to define who reaches the recommended PA are controversial. PA level might be highly different based on the recommendation and/or the criteria employed. Methods: Demographic data and PA level evaluated by International Physical Activity Questionnaire from 3 random and representative samples from 1 state, 1 city, and 1 local organization in Brazil were analyzed (n = 2961). Nine criteria from different recommendations were used to define PA level. Prevalence estimates and 95% confidence intervals of sufficient PA were calculated for each criterion and compared with the referent (World Health Organization guideline). Total agreement, sensitivity, and specificity were also calculated with 95% confidence interval. Results: When a weekly frequency of PA was required, the prevalence of sufficient PA decreased by 11% (P < .05). For all criteria, doubling the vigorous PA minutes was similar to simply adding them to moderate PA. These findings are consistent regardless of sex, age, and educational level. Conclusion: Prevalence estimates and agreement between different PA recommendations were significantly affected when a minimum frequency was required but did not change when vigorous PA minutes were doubled.

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Stacey L. Tannenbaum, Laura A. McClure, Taghrid Asfar, Recinda L. Sherman, William G. LeBlanc and David J. Lee

Background:

Cancer survivors who engage in physical activity (PA) have improved quality of life, reduced fatigue, and lower mortality rates. We compare the percentage of cancer survivors meeting PA recommendations for US states, stratified by age and gender, to identify the need for PA education and intervention among cancer survivors.

Methods:

Pooled data from the 1997–2010 National Health Interview Survey were used to determine and rank age-adjusted PA by state. American Cancer Society guidelines (≥150 min/wk of PA) were used to compare prevalence by state, stratified by age group (< 65 and ≥65) and gender.

Results:

Thirty-three percent of cancer survivors met PA recommendations. The highest age-adjusted compliance to PA recommendations was in Vermont (59.9%, 95% confidence interval [CI], 40.8–76.3) and the lowest was in Louisiana (14.8%, 95% CI, 9.6–22.1) and Mississippi (15.5%, 95% CI, 10.4–22.3). The lowest percentages meeting recommendations were in Arkansas for males (8.6%, 95% CI, 7.0–10.6), Louisiana for females (12.5%, 95% CI, 6.8–21.9), Louisiana for survivors < 65 (15.6%, 95% CI, 10.5–22.6), and West Virginia for those ≥65 years (12.7%, 95% CI, 7.6–20.6).

Conclusions:

Meeting PA recommendations by cancer survivors varies markedly by state of residence. Future efforts should target states with low percentages, tailoring interventions to the special needs of this high-risk population. The importance of PA should be incorporated within cancer survivorship care plans.

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Lubna Abdul Razak, Tara Clinton-McHarg, Jannah Jones, Sze Lin Yoong, Alice Grady, Meghan Finch, Kirsty Seward, Edouard Tursan d’Espaignet, Rimante Ronto, Ben Elton and Luke Wolfenden

Background: Identifying factors influencing the implementation of evidence-based environmental recommendations to promote physical activity in childcare services is required to develop effective implementation strategies. This systematic review aimed to: (1) identify barriers and facilitators reported by center-based childcare services impacting the implementation of environmental recommendations to increase physical activity among children, (2) synthesize these factors according to the 14 domains of the “Theoretical Domains Framework,” and (3) report any associations between service or provider characteristics and the reported implementation of such recommendations. Methods: Electronic searches were conducted in 6 scientific databases (eg, MEDLINE) and Google Scholar to identify studies reporting data from childcare staff or other stakeholders responsible for childcare operations. Included studies were based on childcare settings and published in English. From 2164 identified citations, 19 articles met the inclusion criteria (11 qualitative, 4 quantitative, and 4 mixed methods). Results: Across all articles, the majority of factors impacting implementation fell into the “environmental context and resources” domain (eg, time, equipment, and space; n = 19) and the “social influences” domain (eg, support from parents, colleagues, supervisors; n = 11). Conclusion: The current review provides guidance to improve the implementation of environmental recommendations in childcare services by addressing environmental, resource, and social barriers.

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Danielle Arigo, Paul Rohde, Heather Shaw and Eric Stice

Background:

Moderate-to-vigorous physical activity (MVPA) is critical for maintaining a healthy weight, although little is known about psychological barriers to maintaining MVPA in at-risk groups. Identifying characteristics associated with poor MVPA maintenance in obesity prevention programs could improve participant outcomes.

Methods:

Toward this end, we examined predictors of MVPA in an obesity prevention trial for college students at risk for weight gain (n = 333; 72% female, mean BMI = 23.4 kg/m2). Participants engaged in 1 of 3 weight control interventions and in 4 assessments over 12-month follow-up (ie, measured height/weight, self-reports of psychosocial characteristics, 4 days of accelerometer wear).

Results:

Multilevel modeling analyses showed that across conditions, participants decreased total MVPA minutes per week over 12 months (B = –5.48, P < .01). Baseline self-report scores for both impulsiveness and cognitive dissonance regarding engaging in unhealthy behaviors negatively predicted MVPA over time. Participants higher (vs. lower) in baseline impulsiveness (B = –6.89, P = .03) and dissonance (B = –4.10, P = .04) began the study with more MVPA minutes, but showed sharper declines over time.

Conclusions:

Targeted MVPA-focused intervention for students who show elevated impulsiveness and cognitive dissonance may improve both MVPA and weight control outcomes for these individuals.

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Elroy J. Aguiar, Zachary R. Gould, Scott W. Ducharme, Chris C. Moore, Aston K. McCullough and Catrine Tudor-Locke

Background: A walking cadence of ≥100 steps/min corresponds to minimally moderate intensity, absolutely defined as ≥3 metabolic equivalents (METs). This threshold has primarily been calibrated during treadmill walking. There is a need to determine the classification accuracy of this cadence threshold to predict intensity during overground walking. Methods: In this laboratory-based cross-sectional investigation, participants (N = 75, 49.3% women, age 21–40 y) performed a single 5-minute overground (hallway) walking trial at a self-selected preferred pace. Steps accumulated during each trial were hand tallied and converted to cadence (steps/min). Oxygen uptake was measured using indirect calorimetry and converted to METs. The classification accuracy (sensitivity, specificity, overall accuracy, and positive predictive value) of ≥100 steps/min to predict ≥3 METs was calculated. Results: A cadence threshold of ≥100 steps/min yielded an overall accuracy (combined sensitivity and specificity) of 73.3% for predicting minimally moderate intensity. Moreover, for individuals walking at a cadence ≥100 steps/min, the probability (positive predictive value) of achieving minimally moderate intensity was 80.3%. Conclusions: Although primarily developed using treadmill-based protocols, a cadence threshold of ≥100 steps/min for young adults appears to be a valid heuristic value (evidence-based, rounded, practical) associated with minimally moderate intensity during overground walking performed at a self-selected preferred pace.

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Adilson Marques, João Martins, Hugo Sarmento, Leonardo Rocha and Francisco Carreiro da Costa

Background:

Knowledge is required for people to make health decisions. It can be conjectured that knowledge of physical activity recommended levels can be a step to behavior change. This study examined the knowledge of physical activity guidelines of adolescents who were completing the secondary school.

Methods:

A survey was conducted with 2718 students (1613 girls), aged 16 to 18 years (Mean = 17.2 ± 0.2 years). Gender and age were self-reported and socioeconomic status was calculated based on parental occupation. Students were asked about frequency, duration, and intensity of physical activity to achieve the recommended level. Chi-square was applied to the results.

Results:

16.2% reported that physical activity should be practiced daily. For the duration component of the recommendation, 43.5% identified correctly that the minimum recommended is 60 min/day. The intensity component was correctly answered by 62.7%. Considering all the components of the recommendation, only 3.6% of the students were able to identify correctly the physical activity recommendation, with no differences between genders or among socioeconomic status.

Conclusions:

These results highlight the need for an effective communication strategy for disseminating the message to ensure that young people are aware of, and understand the physical activity guidelines.

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Rona Macniven, Victoria Pye, Dafna Merom, Andrew Milat, Claire Monger, Adrian Bauman and Hidde van der Ploeg

Background:

Physical activity interventions targeting older adults are optimized if barriers and enablers are better understood. This study identified barriers and enablers of physical activity and examined whether these were associated with meeting physical activity recommendations.

Methods:

2225 adults aged 65 years and above who perceived themselves to be insufficiently active but would like to be more physically active self-reported their barriers and enablers to physical activity in the 2009 New South Wales Falls Prevention Survey. Binary logistic regression analyses examined associations between barriers and enablers and meeting the physical activity recommendation.

Results:

After adjusting for gender, age, BMI, and education, people who listed ill health (52%; OR = 0.56, 95% CI 0.45 to 0.70) as a barrier or who listed people to exercise with (4%; OR = 0.49, 95% CI 0.27 to 0.88) as an enabler had significantly lower odds of meeting recommendations. Those citing too expensive (3%) as a barrier (OR = 2.07, 95% CI 1.11 to 3.87) or who listed nothing will help (29%; OR = 1.40, 95% CI 1.10 to 1.77) and making time to be active (9%; OR = 1.78, 95% CI 1.23 to 2.58) as enablers had significantly higher odds of meeting physical activity recommendations.

Conclusions:

These findings give insights into older adults’ perceptions of factors that influence their physical activity, which could assist physical activity program planning in this population.