Léonie Uijtdewilligen

Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies

The current review aimed to systematically identify dietary, physical activity and sedentary behaviours in preschool children (4–6 years of age) that are prospectively related to overweight or obesity later in childhood. Prospective studies published between January 1990 and June 2010 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL and Cochrane Library. Studies examining the prospective association between at least one relevant behaviour measured during preschool period (children aged 4–6 years at baseline) in relation to at least one anthropometric measurement at follow‐up (age <18 years) were included. Harvest plots were used to summarize the results and draw conclusions from the evidence.

Test-retest reliability and construct validity of the ENERGY-child questionnaire on energy balance-related behaviours and their potential determinants: the ENERGY-project.

BackgroundInsight in childrens energy balance-related behaviours (EBRBs) and their determinants is important to inform obesity prevention research. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed.ObjectiveTo examine the test-retest reliability and construct validity of the child questionnaire used in the ENERGY-project, measuring EBRBs and their potential determinants among 10-12 year old children.MethodsWe collected data among 10-12 year old children (n = 730 in the test-retest reliability study; n = 96 in the construct validity study) in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent face-to-face interview was assessed using ICC and percentage agreement.ResultsOf the 150 questionnaire items, 115 (77%) showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement ≥ 75%. Test-retest reliability was moderate for 34 items (23%) and poor for one item. Construct validity appeared to be good to excellent for 70 (47%) of the 150 items, as indicated by ICCs > .60 or percentage agreement ≥ 75%. From the other 80 items, construct validity was moderate for 39 (26%) and poor for 41 items (27%).ConclusionsOur results demonstrate that the ENERGY-child questionnaire, assessing EBRBs of the child as well as personal, family, and school-environmental determinants related to these EBRBs, has good test-retest reliability and moderate to good construct validity for the large majority of items.

Test-retest reliability and construct validity of the ENERGY-parent questionnaire on parenting practices, energy balance-related behaviours and their potential behavioural determinants: the ENERGY-project

BackgroundInsight in parental energy balance-related behaviours, their determinants and parenting practices are important to inform childhood obesity prevention. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed. The objective of the current study was to examine the test-retest reliability and construct validity of the parent questionnaire used in the ENERGY-project, assessing parental energy balance-related behaviours, their determinants, and parenting practices among parents of 10–12 year old children.FindingsWe collected data among parents (n = 316 in the test-retest reliability study; n = 109 in the construct validity study) of 10–12 year-old children in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent interview was assessed using ICC and percentage agreement.All but one item showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement ≥ 75%. Construct validity appeared to be good to excellent for 92 out of 121 items, as indicated by ICCs > .60 or percentage agreement ≥ 75%. From the other 29 items, construct validity was moderate for 24 and poor for 5 items.ConclusionsThe reliability and construct validity of the items of the ENERGY-parent questionnaire on multiple energy balance-related behaviours, their potential determinants, and parenting practices appears to be good. Based on the results of the validity study, we strongly recommend adapting parts of the ENERGY-parent questionnaire if used in future research.

Longitudinal person-related determinants of physical activity in young adults.

PURPOSE This study aimed to examine the longitudinal associations of person-related factors with physical activity (PA) behavior in young adults. METHODS We analyzed longitudinal self-reported time spent in moderate-intensity PA (MPA; 4-7 METs) and vigorous-intensity PA (VPA; >7 METs) from 499 young adults (49% male) who participated in the Amsterdam Growth and Health Longitudinal Study at the age of 21, 27, 32, and 36 yr. Sociodemographic factors (i.e., marital and employment status), physical factors (i.e., skinfolds, aerobic fitness, neuromotor fitness, back problems, and general health status), psychological factors (i.e., problem and emotion focused coping, mild health complaints, and personality), and behavioral factors (i.e., alcohol consumption, smoking, and energy intake) were assessed at each time point. We performed sex-specific univariable and multivariable generalized estimating equations. RESULTS Men and women with higher aerobic fitness were more moderately and vigorously active. Not having paid work was associated with more MPA in both men and women. Men with part-time paid work, lower scores on dominance, higher scores on hostility, and above moderate alcohol consumption (i.e., ≥140 g of alcohol per week) were more moderately active. Divorced women and those with better physical flexibility spent more time in MPA. Men having full-time paid work, with a good general health status and nonsmokers, were more vigorously active. Women being married/living together, who had better physical flexibility, lower scores on inadequacy, higher scores on dominance, and low caloric intake (around 2000 kcal·d) were more vigorously active. CONCLUSION Several sociodemographic, physical, psychological, and behavioral factors were associated with PA in Dutch young adults. Determinants were different for MPA and VPA and for men and women.

Determinants of physical activity in a cohort of young adult women. Who is at risk of inactive behaviour

OBJECTIVES To identify the biological, socio-demographic, work-related and lifestyle determinants of physical activity in young adult women. DESIGN Prospective cohort study. METHODS Self-reported data from 11,695 participants (aged 22-27 years in 2000) in the Australian Longitudinal Study on Womens Health were collected over 9 years in 2000, 2003, 2006 and 2009. Generalised Estimating Equations were used to examine univariable and multivariable associations of body mass index, country of birth, area of residence, education, marital status, number of children, occupational status, working hours, smoking, alcohol intake, and stress with physical activity status (active, ≥600 MET·min/week; or inactive, <600 MET·min/week, consistent with public health guidelines). RESULTS All variables were significantly associated with physical activity in univariable models. In the multivariable model, the lowest odds of being active (compared with the relevant reference categories) were for women who: were born in Asia (OR=0.53), had less than 12 years of education (OR=0.79), were married (OR=0.66) or in a de facto relationship (OR=0.79), had at least one child (OR ranging from 0.67 to 0.69), and were classified as non (OR=0.66) or rare drinkers (OR=0.79). CONCLUSIONS These results are among the first to confirm the biological, socio-demographic, work-related and lifestyle determinants of physical activity in women in their twenties and early thirties. These findings may be used to inform and improve the development of strategies, and to identify target groups most in need of intervention effort.

Adolescent predictors of objectively measured physical activity and sedentary behaviour at age 42: the Amsterdam Growth and Health Longitudinal Study (AGAHLS)

BackgroundThis study investigated the associations of physical characteristics and personality in adolescence with physical activity and sedentary behaviour in adulthood.FindingsPhysical characteristics (i.e. objectively measured BMI, sum of skin folds, MOPER test battery performance), and personality (i.e. self-reported inadequacy, social inadequacy, rigidity, self-sufficiency/recalcitrance, dominance, achievement motivation, facilitating anxiety, debilitating anxiety, and social desirability) were assessed in 217 adolescent boys (Mean 13.0, SD 0.6) and girls (Mean 12.9, SD 0.6). Twenty-nine years later, at the age of 42, their physical activity and sedentary behaviour were assessed by means of accelerometry. Boys who scored lower on self-sufficiency/recalcitrance and higher on facilitating anxiety spent more time sedentary in adulthood. Girls with a superior standing high jump performance, and a lower score on social desirability spent more time sedentary in adulthood. In contrast with sedentary behaviour, physical activity at age 42 year could not be predicted by physical characteristics or personality in adolescence.ConclusionsSedentary behaviour in adulthood was partly explained by physical characteristics and/or personality in adolescence. Thus, our results suggest that it may be possible to identify people who are at risk of becoming sedentary at a rather young age.

Number and appraisal of daily hassles and life events in young adulthood: the association with physical activity and screen time: a longitudinal cohort study

BackgroundYoung adults face radical life changes regarding residence, marriage, family and work that may negatively impact their health behaviours. Therefore, we investigated the associations of the number of daily hassles and life events and their subjective appraisal with physical activity and screen time in young adulthood.MethodsData came from participants of the Amsterdam Growth and Health Longitudinal Study (AGAHLS). Self-reported physical activity (min/wk) was used from wave 6 (1991; mean age 27), wave 7 (1993; mean age 29), wave 8 (1996/1997; mean age 32) and 9 (2000; mean age 36). Self-reported screen time (h/wk) was assessed in waves 8 and 9. The number and the appraisal of daily hassles and major life events were assessed with the Everyday Problem Checklist and Life Events List, respectively (including five life event domains, i.e.: health, work, home/family, personal/social relations, and finances). The final sample included 474 participants for the physical activity analyses and 475 participants for the screen time analyses. To test the longitudinal associations of daily hassles and life events with physical activity and screen time, univariable and multivariable Generalised Estimating Equations were performed. Effect modification by gender was tested.ResultsPhysical activity levels were higher in those who had experienced more daily hassles. People who reported higher subjective appraisal in the work and finances life event domains also had higher levels of physical activity, although only the subjective appraisal in the finances domain remained significant in the multivariable model. No significant associations between number and subjective appraisal of daily hassles and life events and screen time were observed.ConclusionsThe occurrence of specific life events may be more influential for people’s physical activity behaviour than their respective sum or emotional tone. Still, the assessment of daily hassles may be a relevant addition in this research field. Finally, we suggest that daily hassles and life events are less important for explaining screen time behaviour than for physical activity.

A systematic review of methods to measure family co-participation in physical activity: Family physical activity: Co-participation

The family environment is key in influencing childrens health behaviours. Encouraging family co‐participation in physical activity may therefore be an effective approach to increasing childrens physical activity levels. Yet, little is known about how to best assess family co‐participation in physical activity. This review summarizes methods to measure family co‐participation in physical activity, which was defined as joint physical activities including at least one healthy child (0–18 years) and one other family member. Methods were identified through a systematic literature search, cross‐referencing pre‐selected reviews and contacting research groups. Thirty‐seven measurement methods were included. Questionnaires were the most common method used, with the majority assessing frequency of co‐participation and few also assessing duration and type. Reliability and internal consistency of scales were often reported, but rarely specified for the item(s) relevant to co‐participation. Other methods of measuring co‐participation included diaries, event history calendars, direct observations and accelerometry combined with diary, ecological momentary assessment or global positioning systems (GPS). Whilst a large number of measurement methods of family co‐participation in physical activity exist, few are comprehensive and/or report acceptable psychometric properties. Future work should focus on reaching consensus in defining family co‐participation in physical activity, and subsequently developing reliable and valid measures.

Preventing childhood obesity in Asia: an overview of intervention programmes

The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence‐based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes.

Person‐related determinants of TV viewing and computer time in a cohort of young Dutch adults: Who sits the most?

We aimed to assess the associations of person‐related factors with leisure time television (TV) viewing and computer time among young adults. We analyzed self‐reported TV viewing (h/week) and leisure computer time (h/week) from 475 Dutch young adults (47% male) who had participated in the Amsterdam Growth and Health Longitudinal Study at the age of 32 and 36 years. Sociodemographic factors (i.e., marital and employment status), physical factors (i.e., skin folds, aerobic fitness, neuromotor fitness, back problems), psychological factors (i.e., problem‐ and emotion‐focused coping, personality), lifestyle (i.e., alcohol consumption, smoking, energy intake, physical activity), and self‐rated health (i.e., general health status, mild health complaints) were assessed. Univariable and multivariable generalized estimating equations were performed. Male gender, higher sum of skin folds, lower values of aerobic fitness, higher rigidity, higher self‐sufficiency/recalcitrance, and smoking were positively associated with TV time. Male gender, higher sum of skin folds, higher scores on self‐esteem, low energy intake, and a not so good general health status were significantly associated with higher computer time. Determinants of TV viewing and computer time were not identical, suggesting that both behaviors (a) have different at‐risk populations and (b) should be targeted differently.