Linda H. Eck

The accuracy of self-reports of physical activity.

This investigation determined the accuracy of self-reports of physical activity compared to observations obtained surreptitiously. Subjects were 44 adults engaged in 1 h of their preferred physical activity while actual activity levels were surreptitiously obtained and compared to immediate self-reported estimates of physical activity. Results indicated that subjects were moderately accurate in recalling their physical activity levels (R = 0.62) but underestimated sedentary activities and overestimated aerobic activities by over 300%. Males overestimated their activity relative to females, and obese subjects underestimated their activity levels compared to normal-weight subjects. Finally, a number of two-way interactions that moderated the accuracy of those subjects engaging in high chronic levels of physical activity were observed.

Effects of obesity, social interactions, and physical environment on physical activity in preschoolers.

Examined demographic, environmental, and parent-child interactional correlates of physical activity in a group of 222 preschoolers. Activity levels were assessed with a system that quantified directly observed physical activity in the natural environment. Using regression-modeling procedures, results revealed a significant relationship between (a) childs relative weight, parental weight status, and percentage of time spent outdoors (environment) and (b) childrens activity levels. Parental obesity was associated with lower levels of physical activity in children, childhood relative weight was associated with slightly higher levels of physical activity, and more outdoor activity was associated with higher activity levels. Parental participation in childrens activities also significantly interacted with levels of parental obesity in predicting activity levels. Those children with a 50% risk for obesity (as defined by both, one, or neither parent being overweight) had small changes in activity across levels of parent-child interaction, whereas those at higher risk for obesity responded with increased activity as parent-child interactions increased. Results are discussed, and the implications of these findings for future intervention efforts are examined.

Who Underreports Dietary Intake in a Dietary Recall? Evidence from the Second National Health and Nutrition Examination Survey.

The present study sought to identify the presence and degree of apparent underreporting of dietary intake in 11,663 participants in the Second National Health and Nutrition Examination Survey (NHANES II). Self-reported dietary intake was compared with estimated basal metabolic rate. Underreporting was based on cutoff limits that identified plausible levels of energy expenditure for adult individuals. Results indicated that up to 31% of adults in this sample may have underreported dietary intake. Those individuals at greatest risk of underreporting were less well educated and heavier. The Sex x Race interaction indicated that for both ethnic categories, women were more likely to underreport than men, but the difference between men and women was greater among Caucasian participants. It is concluded that such factors as reduced energy needs, deliberate falsification, and measurement error inherent in dietary assessment contribute to apparent underreporting, and this occurs in a large percentage of dietary data.

Are weight concerns predictive of smoking cessation ? A prospective analysis

Participants in an 8-session, community based smoking cessation intervention rated whether they would stay quit if they experienced weight gain. The majority reported that they would not relapse to smoking, even after a 20-lb, (9.07-kg) weight gain. Those who were weight concerned were more likely to be female, to weight less and be normal or underweight, and to report chronic dieting. This group was also significantly less likely to be abstinent posttreatment, and at the 1-, 6- and 12-month follow-ups. Individuals presenting for formal smoking cessation interventions may be less weight concerned than the general population of smokers. However, weight-concerned smokers who do present for treatment are less likely to quit smoking. Implications for recruitment and intervention are discussed.

How much weight gain occurs following smoking cessation ? A comparison of weight gain using both continuous and point prevalence abstinence

Estimates of postcessation weight gain vary widely. This study determined the magnitude of weight gain in a cohort using both point prevalence and continuous abstinence criteria for cessation. Participants were 196 volunteers who participated in a smoking cessation program and who either continuously smoked (n = 118), were continuously abstinent (n = 51), or who were point prevalent abstinent (n = 27) (i.e., quit at the 1-year follow-up visit but not at others). Continuously abstinent participants gained over 13 lbs. (5.90 kg) at 1 year, significantly more than continuously smoking (M = 2.4 lb.) and point prevalent abstinent participants (M = 6.7 lbs., or 3.04 kg). Individual growth curve analysis confirmed that weight gain and the rate of weight gain (pounds per month) were greater among continuously smoking participants and that these effects were independent of gender, baseline weight, smoking and dieting history, age, and education. Results suggest that studies using point prevalence abstinence to estimate postcessation weight gain may be underestimating postcessation weight gain.

Relationship between psychosocial functioning and body fat in preschool children: A longitudinal investigation.

This study examined whether preschool children differed on measures of psychosocial functioning both cross-sectionally and longitudinally. One hundred and thirty-two children who varied in levels of body fat participated in the study along with their natural parents. Results indicated that the children did not differ in levels of self-esteem and family functioning as a function of their body fat. Prospectively, physical self-esteem weakly (but significantly) correlated with body fat at 1 and 2 years, and fathers perception of family functioning predicted body fat at 1 year only. Results suggested that childhood obesity may not develop as a result of psychosocial factors.

A prospective study of the reliability and convergent validity of three physical activity measures in a field research trial

This investigation sought to determine the test-retest reliability and convergent validity of three commonly used physical activity measures. The Stanford Physical Activity Recall, the Caltrac Activity Monitor, and a daily physical activity log were administered to 45 subjects over a 3-week period. The results indicated high levels of test-retest reliability for the Stanford and the daily log; low test-retest reliability was obtained for the Caltrac. Convergent validity was also high between the Stanford and daily log but was low for both of these measures with the Caltrac. These results suggest that the Stanford Physical Activity Recall may be the self-report measure of choice for large studies due to its high reliability and convergent validity with a more time-consuming daily log, as well as its cost- and time-efficiency. Based on the results, it is recommended that the Caltrac activity sensors not be used for field studies of physical activity until the logistical problems of their use in clinical trials are solved.

A Model for Making Outcomes Research Standard Practice in Clinical Dietetics

In todays rapidly changing health care environment, it is imperative that dietitians demonstrate the importance of their role as health care providers by initiating and participating in outcomes research. Patient care should be based on empirical studies, and clinical dietitians should participate in or be at the helm of such investigations. Nutrition research is usually accomplished and reported by persons with MD or PhD degrees who do not have clinical training in nutrition and does not often address situations encountered by dietitians in clinical settings. This article examines the extent to which clinical dietitians are conducting and reporting outcomes research, their attitudes about such research, and how they think they could best acquire the skills needed to incorporate outcomes research into their practice. Results indicate that clinical dietitians are not writing a substantial percentage of articles and that reports of outcomes research are not commonly included in clinical nutrition journals. Clinical dietitians appear to value the inclusion of research in clinical practice, but they are not spending a great amount of time doing research. Dietitians report being comfortable about participating in research but not about designing, conducting, and reporting research. Results from several surveys were used to develop a model for integrating research in clinical practice. This model includes the research process as a basis for clinical practice. A model for collaborative efforts between clinical and academic dietitians is also proposed and emphasizes the responsibility of academic dietetics training programs in the integration of research and clinical practice.

Precision and estimated accuracy of two short-term food frequency questionnaires compared with recalls and records☆

Two widely used food frequency questionnaires (Block FFQ, Willett FFQ) were modified to reflect intake over the past 7 days and compared to intake information gathered from diet records and 24-hr recalls covering the same 7-day period. The Block FFQ and the Willett FFQ were also gathered at the beginning of the assessment period to reflect the 7-day period of time before records and recalls were gathered. Fifty-six subjects were assigned to either recording diet for 3 days, recording diet for 6 days, or providing three 24-hr recalls. Results indicate similar levels of within-method test-retest reliabilities for 3-day RECORDS and 6-day RECORDS, and within the two Block FFQs and within the two Willett FFQs from each subject, while lower reliabilities were seen in 24-hr RECALLS. When the FFQs were compared to the 6-day RECORDS with between-method agreement coefficients, there was a moderate level of agreement, with most values between 0.5 and 0.8 for both FFQs. Significant differences between mean levels of nutrients estimated by the three methods indicated differences only in the estimates of carbohydrate and vitamin A. The use of FFQs to gather short-term intake information is discussed.

The relationship between a history of depression and adherence to a multicomponent smoking-cessation program☆

The purpose of this study was to determine whether a history of depression in female smokers (age 18-65) who did not self-report any current depression was associated with adherence to a multisession, multicomponent smoking-cessation program. Participants in a 13-week cognitive-behavioral group program plus random assignment to nicotine gum, appetite suppressant gum, or placebo chewing gum were grouped by depressive-history and compared on attendance, average expired carbon monoxide after planned cessation, and number of pieces of gum chewed. No significant differences between the depressive history (yes/no) subgroups were found on any of the three measures of adherence. The power to detect a significant difference (alpha = 0.05) was calculated to be 0.89. Group cognitive-behavioral treatment appears to be the basis of an effective smoking-cessation program for women with a history of depression who are not currently depressed.