Erin K. Howie

Alcohol Consumption and Risk of All-Cause and Cardiovascular Disease Mortality in Men

This study examined the association between consumption of alcoholic beverages and all-cause and cardiovascular disease (CVD) mortality in a cohort of men (n = 31,367). In the Cox proportional hazards model adjusted for age, year of examination, body mass index (BMI), smoking, family history of CVD, and aerobic fitness, there were no significant differences in risk of all-cause mortality across alcohol intake groups. Risk of CVD mortality was reduced 29% in quartile 1 (HR = 0.71, 95% confidence interval (CI): 0.53, 0.95) and 25% in quartile 2 (HR = 0.75, 95% CI: 0.58, 0.98). The amount of alcohol consumed to achieve this risk reduction was <6 drinks/week; less than the amount currently recommended. The addition of other potential confounders and effect modifiers including blood pressure, insulin sensitivity, lipid levels, and psychological variables did not affect the magnitude of association. Future research is needed to validate the current public health recommendations for alcohol consumption.

Acute Effects of Classroom Exercise Breaks on Executive Function and Math Performance: A Dose–Response Study

Purpose: The purpose of this study was to determine the acute dose–response relationship of classroom exercise breaks with executive function and math performance in 9- to 12-year-old children by comparing 5-min, 10-min, or 20-min classroom exercise breaks to 10 min of sedentary classroom activity. Method: This study used a within-subjects experimental design conducted in the spring of 2012. Ninety-six 4th- and 5th-grade students in 5 classrooms in South Carolina were randomized to receive each of 4 treatments: 5-min, 10-min, or 20-min exercise breaks or 10 min of a sedentary lesson led by research staff. Students completed the Trail-Making Test, an Operational Digit Recall test, and a math fluency test immediately before and after each condition. Planned linear contrasts were used to compare posttest scores between conditions using a repeated-measures mixed model, adjusted for gender, classroom, and the time-varying pretest scores. Potential effect modifiers were added as interaction terms. Results: Math scores were higher after the 10-min and 20-min exercise breaks compared with the sedentary condition (d = 0.24, p = .04, and d = 0.27, p = .02, respectively), and an interaction was observed with gender, IQ, aerobic fitness, and lower engagement in some of the conditions. There were no improvements in executive function tasks. Conclusions: A 10-min and 20-min classroom exercise break moderately improved math performance in students compared with a seated classroom lesson.

Top 10 research questions related to physical activity in preschool children.

The purpose of this article was to highlight important research needs related to physical activity in 3- to 5-year-old children. We identified research needs in 3 major categories: health effects, patterns of physical activity, and interventions and policies. The top research needs include identifying the health effects of physical activity, the effects of physical activity on the development of healthy weight, the effects of physical activity on learning and behavior, and the health implications of sedentary behavior. Research questions concerning patterns of physical activity include determining the prevalence of 3- to 5-year-olds meeting the current physical activity guidelines; the social and environmental factors that influence physical activity in home, preschool, and community settings; and how physical activity tracks into later childhood, adolescence, and adulthood. Research questions about interventions and policies include identifying the most effective strategies to promote physical activity in home, child care, and community settings and to reach diverse populations of young children, identifying effective intervention implementation and dissemination strategies, and determining the effectiveness of national, state, local, and institutional policies for increasing physical activity. In conclusion, research is needed to establish a full understanding of the health implications of physical activity in 3- to 5-year-old children, to better understand the nature of physical activity behavior in this group, and to learn how to promote physical activity in young children.

Smiles count but minutes matter: Responses to classroom exercise breaks

OBJECTIVES To determine the subjective responses of teachers and students to classroom exercise breaks, and how responses varied by duration. METHODS This mixed-methods experimental study included focus groups with teachers (N = 8) and 4(th)- and 5(th)-grade students (N = 96). Students participated in 5-, 10-, and 20-minute exercise breaks and 10 minutes of sedentary activity. In an additional exploratory analysis, video-tapes of each condition were coded and compared for positive affect. RESULTS Students and teachers discussed multiple benefits, but teachers discussed barriers to implementing regular breaks of 5-minutes or more. Students exhibited higher positive affect during each exercise condition. CONCLUSIONS Classroom exercise breaks are an enjoyable way to increase physical activity, but additional support may be needed to encourage teachers to implement breaks of 5 minutes or longer.

The impact of Curtin University's activity, food and attitudes program on physical activity, sedentary time and fruit, vegetable and junk food consumption among overweight and obese adolescents: a waitlist controlled trial.

Background To determine the effects of participation in Curtin Universitys Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents. Methods In this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records. Results During the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively). Conclusions Participating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention. Trial Registration Australia and New Zealand Clinical Trials Registry ACTRN12611001187932

Rates of attrition, non-compliance and missingness in randomized controlled trials of child physical activity interventions using accelerometers: A brief methodological review

OBJECTIVES The purpose of this brief review was to describe the missingness, from both attrition and non-compliance, during physical activity randomized controlled trials among children which have used accelerometers to measure physical activity. DESIGN Systematic review. METHODS Using a previously published search strategy, an updated search of the literature was performed in the MEDLINE database for articles published from 1996 to February 2015 identifying physical activity RCTs in children (ages 2-18) measuring physical activity using accelerometers. Rates of attrition and non-compliance were extracted from identified articles. Twenty-three independent studies provided complete attrition and non-compliance data and were included. RESULTS The mean attrition rate was 11.5% (SD 10.1%, range 0-30.9%). The mean accelerometer non-compliance rate at baseline was 22.7% (SD 16.4%, range 1.7-67.8%) and 29.6% (SD 19.4%, range 3.3-70.1%) at follow-up. The mean total study missingness was 37.4% (SD 20.2%, range 3.3-75.4%) and ranged from 3.3% to 75.4%. There was large variation in how missingness was accounted for between studies. There were no statistically significant differences in missingness between study characteristics including sample size, participant age, intervention setting, duration of follow-up, whether physical activity was the primary outcome, and weartime compliance criteria. CONCLUSIONS Missingness is common among randomized controlled trials using accelerometry in children and is currently handled inconsistently. Researchers must plan for high levels of missingness in study design and account for missingness in reporting and analyses of trial outcomes.

A crossover randomised and controlled trial of the impact of active video games on motor coordination and perceptions of physical ability in children at risk of Developmental Coordination Disorder

BACKGROUND Impaired motor development can significantly affect a childs life and may result in an increased risk of a range of physical and psychological disorders. Active video game (AVG) interventions have been demonstrated to enhance motor skills in children with Developmental Coordination Disorder (DCD); however a home-based intervention has not been assessed. OBJECTIVES The primary aim of this study was to compare the changes in motor coordination between a 16 week period of AVG use, with 16 weeks of normal activities (NAG). The secondary aim was to compare the child and parent perceptions of their physical performance between the AVG and NAG conditions. METHODS Twenty-one 9-12 year olds (10 males) were confirmed to be at risk of DCD (⩽ 16th percentile Movement Assessment Battery for Children-2nd edition (MABC-2) and ⩽ 15th percentile Developmental Coordination Disorder Questionnaire (DCDQ)) and participated in this crossover randomised and controlled trial. Data was collected at study entry, after the first 16 week condition and following the final 16 week condition, including; (1) the MABC-2, (2) three-dimensional motion analysis of single leg balance and finger-nose tasks, and (3) parent perception of physical skills. Participant perception of physical skills was collected only after the first and second conditions. RESULTS There was no significant difference between AVG and NAG for any of the primary variables including the MABC-2, balance centre-of-mass path distance and finger-nose path distance. There was no significant intervention effect for secondary measures of motor coordination; however the children perceived their motor skills to be significantly enhanced as a result of the AVG intervention in comparison to the period of no intervention. CONCLUSION A 16 week home based AVG intervention did not enhance motor skills in children with DCD, although they perceived their physical skills to be significantly improved. TRIAL REGISTRATION Australia and New Zealand Clinical trials Registry (ACTRN 12611000400965).

Organized sport trajectories from childhood to adolescence and health associations

INTRODUCTION The purpose of this study was to identify unique organized sport trajectories from early childhood to late adolescence in an Australian pregnancy cohort, the Raine Study. METHODS Participation in organized sport was assessed at ages 5, 8, 10, 14, and 17 yr. Physical activity, body composition, and self-rated physical and mental health were assessed at the age of 20 yr. Latent class analysis was used to identify patterns of sport participation. To assess the internal validity of the trajectory classes, differences in health characteristics between trajectories were analyzed using generalized linear models. RESULTS For girls, three trajectory classes were identified: consistent sport participators (47.5%), sport dropouts (34.3%), and sport nonparticipators (18.1%). For boys, three trajectory classes were identified: consistent sport participators (55.2%), sport dropouts (36.9%), and sport joiners (8.1%). For girls, there were overall differences across trajectory classes in lean body mass (P = 0.003), lean mass index (P = 0.06), and physical health (P = 0.004). For boys, there were differences across classes in physical activity (P = 0.018), percent body fat (P = 0.002), lean body mass (P < 0.001), lean mass index (P < 0.001), physical health (P = 0.06), and depression scores (P = 0.27). CONCLUSION This study identified unique, sex-specific trajectories of organized sport participation. The differences in health outcomes between trajectory classes, such as participants with consistent sport participation having more preferable health outcomes at the age of 20 yr, support the internal validity of the trajectories. Strategies are needed to identify and encourage those in the dropout trajectory to maintain their participation and those in the nonparticipator or joiner trajectories to join sport earlier. Specifically, interventions to encourage early sport participation in girls and help nonparticipating boys to join sport during adolescence may help more children receive the benefits of sport participation.

Physical activity behaviours of highly active preschoolers

What is already known about this subject Many preschool children do not participate in adequate physical activity, despite physical activity being a critical behaviour for obesity prevention. Environmental factors such as indoor and outdoor settings affect physical activity levels. Direct observation and accelerometry are valid and complementary methods for assessing physical activity.

Efficient and Effective Change Principles in Active Videogames

Active videogames have the potential to enhance population levels of physical activity but have not been successful in achieving this aim to date. This article considers a range of principles that may be important to the design of effective and efficient active videogames from diverse discipline areas, including behavioral sciences (health behavior change, motor learning, and serious games), business production (marketing and sales), and technology engineering and design (human-computer interaction/ergonomics and flow). Both direct and indirect pathways to impact on population levels of habitual physical activity are proposed, along with the concept of a game use lifecycle. Examples of current active and sedentary electronic games are used to understand how such principles may be applied. Furthermore, limitations of the current usage of theoretical principles are discussed. A suggested list of principles for best practice in active videogame design is proposed along with suggested research ideas to inform practice to enhance physical activity.