Benedicte Deforche

Relationship between the physical environment and physical activity in older adults: A systematic review

Previous reviews on children, adolescents and adults have reported consistent relationships between several physical environmental characteristics and physical activity (PA). This systematic review aims to provide a comprehensive overview of the literature concerning the relationship between the physical environment and PA in older adults. A systematic literature search resulted in the inclusion of 31 articles. Results were inconsistent but most of the studied environmental characteristics were reported not to be related to PA. More studies in different contexts utilizing longitudinal designs, standardized, reliable and validated PA and environmental measurements and investigating possible moderating effects are definitely warranted.

Neighborhood SES and walkability are related to physical activity behavior in Belgian adults.

OBJECTIVE To investigate whether neighborhood walkability (higher residential density, land use mix, street connectivity) is positively associated with physical activity in Belgian adults and whether this association is moderated by neighborhood SES. METHODS The Belgian Environmental Physical Activity Study (BEPAS) was conducted in Ghent, Belgium. Data were collected between May 2007 and September 2008. Twenty-four neighborhoods were selected, stratified on GIS-based walkability and neighborhood SES. In total, 1200 adults (aged 20-65 years; 50 per neighborhood) completed the International Physical Activity Questionnaire and wore an accelerometer for seven days. After omitting participants with missing accelerometer data, the final sample consisted of 1166 adults. RESULTS Living in a high-walkable neighborhood was associated with more accelerometer-based minutes of moderate-to-vigorous physical activity (38.6 vs. 31.8 min/day, p<0.001), transportational walking and cycling, recreational walking, and less motorized transport (all p<0.05). Low neighborhood SES was related to more cycling for transport and less motorized transport (all p<0.05). No interactions between walkability and neighborhood SES were found. CONCLUSIONS The BEPAS results generally confirmed the findings from Australia and the US showing that, in Europe, walkability is also positively related to physical activity. As neighborhood SES was not a significant moderator, walkability appears beneficial for all economic strata.

Relationship between the physical environment and different domains of physical activity in European adults: a systematic review

BackgroundIn the past decade, various reviews described the relationship between the physical environment and different physical activity (PA) domains. Yet, the majority of the current review evidence relies on North American/Australian studies, while only a small proportion of findings refer to European studies. Given some clear environmental differences across continents, this raises questions about the applicability of those results in European settings. This systematic review aimed at summarizing Europe-specific evidence on the relationship between the physical environment and different PA domains in adults.MethodsSeventy eligible papers were identified through systematic searches across six electronic databases. Included papers were observational studies assessing the relationship between several aspects of the physical environment and PA in European adults (18-65y). Summary scores were calculated to express the strength of the relationship between each environmental factor and different PA domains.ResultsConvincing evidence on positive relationships with several PA domains was found for following environmental factors: walkability, access to shops/services/work and the composite factor environmental quality. Convincing evidence considering urbanization degree showed contradictory results, dependent on the observed PA domain. Transportation PA was more frequently related to the physical environment than recreational PA. Possible evidence for a positive relationship with transportation PA emerged for walking/cycling facilities, while a negative relationship was found for hilliness. Some environmental factors, such as access to recreational facilities, aesthetics, traffic- and crime-related safety were unrelated to different PA domains in Europe.ConclusionsGenerally, findings from this review of European studies are in accordance with results from North American/Australian reviews and may contribute to a generalization of the relationship between the physical environment and PA. Nevertheless, the lack of associations found regarding access to recreational facilities, aesthetics and different forms of safety are likely to be Europe-specific findings and need to be considered when appropriate interventions are developed. More research assessing domain-specific relationships with several understudied environmental attributes (e.g., residential density) is needed.

Environmental and psychosocial correlates of physical activity in Portuguese and Belgian adults.

Objectives: To investigate differences in reported physical activity levels and in perceived environmental and psychosocial correlates of activity between Portuguese and Belgian adults; and to analyse the relative contribution of environmental and psychosocial variables in explaining physical activity within different contexts in Portugal and Belgium. Design: Cross-sectional study. Setting: One city in Portugal (Oeiras) and one in Belgium (Ghent). Subjects: In total 526 participants, 247 from Portugal and 279 from Belgium, completed the long International Physical Activity Questionnaire and a validated questionnaire on environmental and psychosocial correlates. Results: For the sum of all activities of at least moderate intensity, a significantly higher mean level of activity was found in Belgian adults (P , 0.001). However, comparable percentages of the Belgian (38%) and Portuguese (42%) samples did not meet the recommendation of 30 min per day. The variance explained by environmental factors was lower (1% to 8%) than by psychosocial factors (maximum 42%). Regression analyses showed activity-specific relations with environmental variables which were analogous in both countries. Walking/cycling for transportation and walking for recreation were related to social support from family and/or friends and to walkability and walking facilities in the neighbourhood. Recreational physical activity was mainly determined by social support, self-efficacy, and perceived benefits and barriers. Conclusions: Activity campaigns addressing psychosocial determinants are needed to encourage leisure-time activity, while a combination of neighbourhood design changes and encouragement of social support in walking is warranted to increase walking in different contexts.

The contribution of psychosocial and home environmental factors in explaining eating behaviours in adolescents

Objective:The present study aimed at investigating the influence of food availability, rules and television viewing habits on eating behaviours in adolescents.Design:Cross-sectional study.Setting:Four randomly selected middle schools.Subjects:A sample of 534 seventh and eighth graders.Interventions:Validated questionnaires were used to measure the family environment and fat, soft drink and fruit consumption. Hierarchical regression analyses on fat, soft drink and fruit consumption, with demographic and psychosocial variables entered as the first and environmental factors as the second block were conducted in boys and girls.Results:Boys with more unhealthy products available at home consumed more fat (P⩽0.001, 95% CI: 8.2–29.4) and more soft drinks (P⩽0.01, 95% CI: 0.2–1.4). Boys who reported better television viewing habits ate more fruit (P⩽0.001, 95% CI: −1.7 to −0.5). Girls who reported better television viewing habits consumed less fat (P⩽0.01, 95% CI: 1.4–9.0) and more fruit (P⩽0.05, 95% CI: −1.0 to −0.1). Girls who reported higher availability of healthy products at home (P⩽0.05, 95% CI: 0.3–3.1) and more food rules (P⩽0.001, 95% CI: −1.8 to −0.5), consumed more fruit. Environmental factors were poor predictors of soft drink consumption among girls.Conclusion:Availability of (un)healthy food products, family food rules and TV viewing habits were related to one or more eating behaviours in boys or girls. Although home environmental factors can play an important role in influencing adolescents’ eating behaviours, these factors were generally less predictive than demographic and psychosocial variables.Sponsorship:Ghent University and Policy Research Centre Sport, Physical Activity and Health funded by the Flemish Government.

Gross motor coordination in relation to weight status and age in 5- to 12-year-old boys and girls: a cross-sectional study.

OBJECTIVE The purpose of this study was to investigate differences in gross motor coordination in healthy-weight, overweight, and obese children of different ages. METHODS Using a cross-sectional design, data were collected in 954 Flemish primary school children (500 girls, 454 boys) stratified in consecutive age groups (5-7 years, 8-9 years, 10-12 years). Weight status (healthy-weight, overweight, obese) was defined according to the International Obesity Task Force body mass index (BMI) cut-off points for children. Gross motor coordination was assessed by means of the Körperkoordinationstest für Kinder (KTK). RESULTS Childhood overweight and particularly obesity were found to result in poorer KTK performances (p < 0.001), with the most apparent effect of BMI on items requiring physical properties next to dynamic body coordination. Expressed as an age-related Motor Quotient (MQ), overall KTK performance was featured by a BMI × AGE interaction (p < 0.01). Healthy-weight children displayed similar MQs across age groups (p = 0.999). Overweight and obese children in the 10-12-year-old group showed significantly poorer motor coordination performance compared with the corresponding 5-7-year-old group (p < 0.01). Less than 20% of the healthy-weight participants was identified as being motor impaired, while that proportion increased to 43.3% and up to 70.8% in children with overweight and obesity, respectively. CONCLUSION Results indicate that BMI-related differences in gross motor coordination were more pronounced as children belonged to an older age group. Although this outcome needs to be confirmed in future longitudinal research, it emphasizes the need of an early focus on motor skill improvement to encourage overweight and obese children to be physically active.

A longitudinal analysis of gross motor coordination in overweight and obese children versus normal-weight peers

Background:The relationship of childhood overweight (OW) and obesity (OB) with motor skill and coordination is gaining due attention; however, longitudinal evidence is currently lacking.Objective:The dual purpose of this study was (1) to investigate the short-term evolution in the level of gross motor coordination according to childrens weight status, and (2) to identify those factors predicting their gross motor coordination performance over a 2-year interval.Subjects:Participants were 50 children with OW, including 8 with OB (aged 6–10 years at baseline, with 52% boys), and 50 with normal-weight (NW) matched for gender and age.Measurements:Anthropometrics (body height, body weight, body mass index (BMI), %body fat) and level of gross motor coordination (Körperkoordinationstest für Kinder, KTK) were assessed in 2007 (baseline) and 2 years later in 2009 (follow-up). At baseline, participants completed a survey based on the Flemish Physical Activity Questionnaire (FPAQ) to obtain socio-demographic information and to determine physical activity levels in diverse domains.Results:The evolution in the level of gross motor coordination over time was strongly related to childrens weight status. Participants in the NW group showed more progress than their OW/OB peers, who demonstrated significantly poorer performances. Accordingly, between-group differences in KTK outcomes (that is, raw item scores and total motor quotient) became more evident over time. Multiple linear regression analysis further indicated that, in addition to BMI per se (negative predictor), participation in organized sports within a sports club (positive predictor) determines gross motor coordination performance(s) 2 years later.Conclusion:Our results provide conclusive evidence for an increasingly widening gap of OW/OB childrens gross motor coordination relative to NW peers across developmental time in the absence of targeted initiatives. Special attention is thus needed for OW/OB children, especially for those not practicing sports in a club environment, in terms of motor skill improvement to promote regular participation in physical activity.

Neighbourhood Walkability and its Particular Importance for Adults With a Preference for Passive Transport

In this study, differences in physical activity between adults living in high versus low walkable neighbourhoods were examined. In Sint-Niklaas, Belgium, neighbourhood walkability was defined by geographical map data and observations. One high walkable and one low walkable neighbourhood were selected. A sample of 120 adults between 20 and 65 years old, agreed to participate in the study and wore a pedometer for seven days. Self-reported physical activity and psychosocial data were collected. Results showed that residents of the high walkable neighbourhood took more steps/day and walked more for transport in their neighbourhood. Further analyses showed that living in a high walkable neighbourhood was associated with taking more steps, especially in adults with a preference for passive transport and/or a low intention to walk or cycle. In a health promotion context, these results are very promising.

Determinants of eating behaviour in university students: a qualitative study using focus group discussions

BackgroundCollege or university is a critical period regarding unhealthy changes in eating behaviours in students. Therefore, the purpose of this study was to explore which factors influence Belgian (European) university students’ eating behaviour, using a qualitative research design. Furthermore, we aimed to collect ideas and recommendations in order to facilitate the development of effective and tailored intervention programs aiming to improve healthy eating behaviours in university students.MethodsUsing a semi-structured question guide, five focus group discussions have been conducted consisting of 14 male and 21 female university students from a variety of study disciplines, with a mean age of 20.6 ± 1.7 yrs. Using Nvivo9, an inductive thematic approach was used for data analysis.ResultsAfter the transition from secondary school to university, when independency increases, students are continuously challenged to make healthful food choices. Students reported to be influenced by individual factors (e.g. taste preferences, self-discipline, time and convenience), their social networks (e.g. (lack of) parental control, friends and peers), physical environment (e.g. availability and accessibility, appeal and prices of food products), and macro environment (e.g. media and advertising). Furthermore, the relationships between determinants and university students’ eating behaviour seemed to be moderated by university characteristics, such as residency, student societies, university lifestyle and exams. Recommendations for university administrators and researchers include providing information and advice to enhance healthy food choices and preparation (e.g. via social media), enhancing self-discipline and self-control, developing time management skills, enhancing social support, and modifying the subjective as well as the objective campus food environment by e.g. making healthy foods price-beneficial and by providing vending machines with more healthy products.ConclusionsThis is the first European study examining perceived determinants of eating behaviour in university students and collecting ideas and recommendations for healthy eating interventions in a university specific setting. University characteristics (residency, exams, etc.) influence the relationships between individual as well as social environmental determinants and university students’ eating behaviour, and should therefore be taken into account when designing effective and tailored multilevel intervention programs aiming to improve healthy eating behaviours in university students.

Correlates of energy balance-related behaviours in preschool children: a systematic review.

Childhood overweight is a multifactorial health problem influenced by several factors. The interaction of behaviours such as physical activity, sedentary behaviour and eating behaviour determines whether or not a positive energy balance or weight gain is experienced. Knowing the correlates of these behaviours in 4‐ to 6‐year‐old children is of major interest for intervention development. According to the systematic literature search, attending a rural preschool was positively associated with physical activity. Gender, age and socioeconomic status were not associated with physical activity, while an indeterminate result was found for ethnicity. Gender and ethnicity were not associated with sedentary behaviour and indeterminate results were found for age and socioeconomic status. Preschoolers were more physically active as well as sedentary on weekdays. Watching television was associated with a higher consumption of snacks and sweet beverages. Strategies aiming to influence energy balance‐related behaviours in preschoolers should target both boys and girls and all ethnic groups from low as well as high social status. During the week, there should be a focus on decreasing sedentary behaviour and in the weekend on increasing physical activity. Focusing on television viewing and the consumption of snacks and sweet beverages could/should also be a strategy.